Social and Behavioral Sciences Commons^™

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel Rickles, Silvia Dominguez, Hortensia Amaro

Journal of Health Disparities Research and Practice

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans’ perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006.

Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Colorectal Cancer Screening Behaviors Among American Indians In The Midwest, Christine M. Daley, Niaman Nazir, K. A. Greiner, Aimee S. James, Won S. Choi

Journal of Health Disparities Research and Practice

Colorectal cancer is the second most diagnosed cancer among American Indians and is also the second leading cause of cancer death. We used a community-based participatory approach to conduct a mixed methods study to examine colorectal cancer screening behaviors. Here we report on the screening behaviors of our focus group participants (n=153). There were significant gender differences in the colorectal cancer screening rates for FOBT and colonoscopy. Although over 80% of participants reported having health insurance, only 35% of males over 50 years old and 57% of females reported ever having a colonoscopy. More research is needed to identify the …

Social Capital And Violence Across Racial And Ethnic Samples Of Adolescents, Darlene R. Haff, Kevin M. Fitzpatrick, H. H. Floyd

Journal of Health Disparities Research and Practice

Using a national sample of adolescents, results of this study demonstrate the important role family and school social capital plays in protecting both White and selected non- White students against violent outcomes. For example, parent-child relationship was associated with reduced violence for Black and White adolescents but not for Hispanics. School affiliation was significant in models for Hispanic and White adolescents but not in models for Black students. Sports participation was associated with greater violence among Hispanics and Whites, but not Blacks. Interestingly, club participation was significant for Whites, but, like sports, it was associated with greater violence. Parental monitoring …

Not Always Black And White: Racial Bias For Birth Disparities From Excluding Hispanic Identification, Barbara L. Wilson, Cristi Coursen, Matthew Butler

Journal of Health Disparities Research and Practice

Despite gains in prenatal care (PNC) usage and birth outcomes for minority women during the past few decades, observed disparities between non-Hispanic Whites, Blacks, and Hispanics persist. Using the National Center for Health Statistics’ (NCHS) natality files from 1981 through 1998, Alexander, Kogan, & Nabukera (2002) examined live births of U.S. residents by trimester in which PNC was initiated and the appropriateness of that care based on the Adequacy of Prenatal Care Utilization Index (APNCU) (Kotelchuck, 1994). They found racial disparities between White and Black women in both the trimester of PNC initiation and the number of PNC visits made. …

A Su Salud En Acción: Replicating A Model To Increase Utilization Of Cancer Screening Among Low Income Latinas, Amelie G. Ramirez Drph, Patricia Chalela, Lucina Suarez, Kipling J. Gallion

Journal of Health Disparities Research and Practice

Latinas suffer longstanding disparities in breast cancer survival and cervical cancer incidence and mortality compared to non-Hispanic white women. This study assessed the feasibility of replicating the theory-based A Su Salud En Acción communication model to impact cancer screening behaviors in two at-need Nevada clinics. The intervention significantly increased the number of mammograms and Pap smears among Latinas. Mammograms and Pap smear rates increased by 58.7‰ and 51.8‰ respectively in the pilot site (95% CI 40.1-49.1 and 47.1-56.5 respectively) and by 33.7‰ and 7.5‰ respectively (95% CI 15.6-51.9 and 4.3-10.6) in the replication site, among women ages 50-64.

This study …

Participant Recruitment Of African American College Students At An Historically Black College And University (Hbcu): Challenges And Strategies For Health-Related Research, Cecile N. Yancu, Anna K. Lee, Daphne D. Witherspoon, Correll D. Mcrae

Journal of Health Disparities Research and Practice

Lack of research participation among African Americans is problematic for population relevant health disparity research. The purpose of this paper is to identify and describe challenges and strategies in recruitment of African American college students for health related research being conducted at a small Historically Black College or University (HBCU). Upon completion of a recruitment and retention literature review, study investigators constructed and tested a culturally-specific, direct-appeal protocol to recruit participants. Major barriers to recruitment of African American college students included discrete sources of distrust, lack of understanding of the research process, and logistical concerns. Implementation of a culturally-specific, direct …

Self-Stigma, Stress, And Smoking Among African American And American Indian Female Smokers: An Exploratory Qualitative Study, Diana Burgess, Rachel Widome, Michelle Van Ryn, Sean Phelan, Steven Fu

Journal of Health Disparities Research and Practice

Research suggests that negative emotions and difficulty coping with stressful events might impede women’s ability to quit smoking. This study uses qualitative methods to explore interrelationships between smoking behavior and negative emotions among a sample of racial/ethnic minority female smokers with the aims of theory-building and hypothesis generation. Data were derived from a larger study involving sixteen focus groups with current and former smokers from ethnic minority communities. The present study consisted of three focus groups of female African American and American Indian smokers (N = 16). Data was analyzed following standard methods for in vivo coding of qualitative data. …

Asthma Management: An Ecosocial Framework For Disparity Research, Robin A. Evans-Agnew

Journal of Health Disparities Research and Practice

Background: Asthma management disparities (AMD) between African and White Americans are significant and alarming. Various determinants have been suggested by research frameworks that affect the unfair distribution of resources for asthma management to groups who are more or less advantaged socially. Ecosocial models organize determinants into individual/family, healthcare, community, and sociocultural levels. Multilevel interventions can affect AMD through simultaneous actions on different levels and pathways between determinants.

Objective: Provide a comprehensive summary of the known determinants of AMD.

Method: Peer reviewed research frameworks of AMD from 1998-2009 were retrieved from PubMed/ Web of Science databases using (“Socioeconomic Factors”[Mesh] OR (“Healthcare …

Breast Cancer Screening Practices Among American Indians And Alaska Natives In The Midwest, Christine M. Daley, Melissa Filippi, Aimee S. James, Sarah Brokenleg, Stacy Braiuca, K. A. Greiner, Won S. Choi

Journal of Health Disparities Research and Practice

American Indian and Alaska Native (AI/AN) women currently have some of the highest mortality rates from breast cancer for any racial/ethnic group in the United States and some of the lowest screening rates. However, current data are not available for regional differences in screening, which can result in dramatically different stage at diagnosis and mortality. We conducted surveys with 120 focus group participants in a needs assessment of mammography among AI/AN in the greater Kansas City metropolitan area and parts of Northeast Kansas. We found that among women under age 40, for whom recommended screenings include only annual clinical breast …

Race And Hepatitis C Management Within The Veterans Administration, Joahd Toure, Joshua Metlay, Sandford Schwartz, Knashawn Morales, David Kaplan, Peter Groeneveld

Journal of Health Disparities Research and Practice

Objective: To examine black-white differences in hepatitis C treatment within the Veterans Administration (VA) and determine whether racial variation in specialty consultation explains differences in hepatitis C treatment between blacks and whites.

Methods: We performed a retrospective cohort study of 1040 veterans meeting VA eligibility criteria for hepatitis C treatment. We used multiple imputation to handle missing race data. Specialty consultation was determined from the VA outpatient medical dataset and hepatitis C treatment was determined from the VA decision support system. Conditional logistic regression was used to examine the association between race and hepatitis C treatment as well as race …