1
|
Heaton A. An incomplete picture: A scoping review of how scholars account for race and ethnicity in family homelessness research. JOURNAL OF COMMUNITY PSYCHOLOGY 2024. [PMID: 39233470 DOI: 10.1002/jcop.23148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/05/2024] [Accepted: 08/23/2024] [Indexed: 09/06/2024]
Abstract
Families of color in the United States experience homelessness at a disproportionately higher rate than White families; however, little is known about how scholars account for race and ethnicity in family homelessness research. This scoping review analyzes how researchers examine race and ethnicity in conceptual frameworks, methods, and analysis. Following PRISMA-ScR reporting standards, I searched PubMed, PsycINFO, Scopus, and ERIC for quantitative studies including a housing outcome for homeless service-involved families. I used Covidence to screen for inclusion and extract data, and QuADS to evaluate study quality. Fourteen studies met inclusion criteria. Researchers' articles lacked theory and the context of racism, lacked detail on how race and ethnicity were conceptualized and operationalized, and most (71%) did not disaggregate results. Without putting data within the context of systemic racism and disaggregating outcomes, research will produce incomplete knowledge on family homelessness, leading to ineffective interventions for families of color.
Collapse
Affiliation(s)
- Abigail Heaton
- School of Social Work, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
2
|
Vazquez SR, Yates NY, Beavers CJ, Triller DM, McFarland MM. Differences in quality of anticoagulation care delivery according to ethnoracial group in the United States: A scoping review. J Thromb Thrombolysis 2024; 57:1076-1091. [PMID: 38733515 PMCID: PMC11315726 DOI: 10.1007/s11239-024-02991-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/13/2024]
Abstract
Anticoagulation therapy is standard for conditions like atrial fibrillation, venous thromboembolism, and valvular heart disease, yet it is unclear if there are ethnoracial disparities in its quality and delivery in the United States. For this scoping review, electronic databases were searched for publications between January 1, 2011 - March 30, 2022. Eligible studies included all study designs, any setting within the United States, patients prescribed anticoagulation for any indication, outcomes reported for ≥ 2 distinct ethnoracial groups. The following four research questions were explored: Do ethnoracial differences exist in 1) access to guideline-based anticoagulation therapy, 2) quality of anticoagulation therapy management, 3) clinical outcomes related to anticoagulation care, 4) humanistic/educational outcomes related to anticoagulation therapy. A total of 5374 studies were screened, 570 studies received full-text review, and 96 studies were analyzed. The largest mapped focus was patients' access to guideline-based anticoagulation therapy (88/96 articles, 91.7%). Seventy-eight articles made statistical outcomes comparisons among ethnoracial groups. Across all four research questions, 79 articles demonstrated favorable outcomes for White patients compared to non-White patients, 38 articles showed no difference between White and non-White groups, and 8 favored non-White groups (the total exceeds the 78 articles with statistical outcomes as many articles reported multiple outcomes). Disparities disadvantaging non-White patients were most pronounced in access to guideline-based anticoagulation therapy (43/66 articles analyzed) and quality of anticoagulation management (19/21 articles analyzed). Although treatment guidelines do not differentiate anticoagulant therapy by ethnoracial group, this scoping review found consistently favorable outcomes for White patients over non-White patients in the domains of access to anticoagulation therapy for guideline-based indications and quality of anticoagulation therapy management. No differences among groups were noted in clinical outcomes, and very few studies assessed humanistic or educational outcomes.
Collapse
Affiliation(s)
- Sara R Vazquez
- University of Utah Health Thrombosis Service, 6056 Fashion Square Drive, Suite 1200, Murray, UT, 84107, USA.
| | - Naomi Y Yates
- Kaiser Permanente Clinical Pharmacy Services, 200 Crescent Center Pkwy, Tucker, GA, 30084, USA
| | - Craig J Beavers
- Anticoagulation Forum, Inc, 17 Lincoln Street, Suite 2B, Newton, MA, 02461, USA
- University of Kentucky College of Pharmacy, 789 S Limestone, Lexington, KY, 40508, USA
| | - Darren M Triller
- Anticoagulation Forum, Inc, 17 Lincoln Street, Suite 2B, Newton, MA, 02461, USA
| | - Mary M McFarland
- University of Utah Spencer S. Eccles Health Sciences Library, 10 N 1900 E, Salt Lake City, UT, 84112, USA
| |
Collapse
|
3
|
Millager RA, Feldman JI, Williams ZJ, Shibata K, Martinez-Torres KA, Bryan KM, Pruett DG, Mitchell JT, Markfeld JE, Merritt B, Daniels DE, Jones RM, Woynaroski T. Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of American Speech-Language-Hearing Association Publications in 2020. PERSPECTIVES OF THE ASHA SPECIAL INTEREST GROUPS 2024; 9:836-852. [PMID: 38912383 PMCID: PMC11192539 DOI: 10.1044/2024_persp-23-00204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Purpose One manifestation of systemic inequities in communication sciences and disorders (CSD) is the chronic underreporting and underrepresentation of sex, gender, race, and ethnicity in research. The present study characterized recent demographic reporting practices and representation of participants across CSD research. Methods We systematically reviewed and extracted key reporting and participant data from empirical studies conducted in the United States (US) with human participants published in the year 2020 in journals by the American Speech-Language-Hearing Association (ASHA; k = 407 articles comprising a total n = 80,058 research participants, search completed November 2021). Sex, gender, race, and ethnicity were operationalized per National Institutes of Health guidelines (National Institutes of Health, 2015a, 2015b). Results Sex or gender was reported in 85.5% of included studies; race was reported in 33.7%; and ethnicity was reported in 13.8%. Sex and gender were clearly differentiated in 3.4% of relevant studies. Where reported, median proportions for race and ethnicity were significantly different from the US population, with underrepresentation noted for all non-White racial groups and Hispanic participants. Moreover, 64.7% of studies that reported sex or gender and 67.2% of studies that reported race or ethnicity did not consider these respective variables in analyses or discussion. Conclusion At present, research published in ASHA journals frequently fails to report key demographic data summarizing the characteristics of participants. Moreover, apparent gaps in representation of minoritized racial and ethnic groups threaten the external validity of CSD research and broader health care equity endeavors in the US. Although our study is limited to a single year and publisher, our results point to several steps for readers that may bring greater accountability, consistency, and diversity to the discipline.
Collapse
Affiliation(s)
- Ryan A. Millager
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Jacob I. Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
- Frist Center for Autism and Innovation, Vanderbilt University
| | - Zachary J. Williams
- Department of Hearing and Speech Sciences, Vanderbilt University
- Frist Center for Autism and Innovation, Vanderbilt University
- Vanderbilt Brain Institute, Vanderbilt University
- Medical Scientist Training Program, Vanderbilt University School of Medicine
| | - Kiiya Shibata
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Keysha A. Martinez-Torres
- Department of Hearing and Speech Sciences, Vanderbilt University
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
| | | | - Dillon G. Pruett
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Jade T. Mitchell
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Jennifer E. Markfeld
- Department of Hearing and Speech Sciences, Vanderbilt University
- Frist Center for Autism and Innovation, Vanderbilt University
| | - Brandon Merritt
- Department of Speech, Language, and Hearing Sciences, The University of Texas at El Paso
| | - Derek E. Daniels
- Department of Communication Sciences and Disorders, Wayne State University
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center
| | - Tiffany Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
- Frist Center for Autism and Innovation, Vanderbilt University
- Vanderbilt Brain Institute, Vanderbilt University
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa
| |
Collapse
|
4
|
Hamm RF, Srinivas SK, Mccoy J, Morales KH, Levine LD. Standardized Cesarean Risk Counseling with Induction: Impact on Racial Disparities in Birth Satisfaction. Am J Perinatol 2023; 40:1834-1840. [PMID: 34784614 PMCID: PMC9119147 DOI: 10.1055/s-0041-1739468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Our prior work demonstrated decreased birth satisfaction for Black women undergoing labor induction. We aimed to determine if implementation of standardized counseling around calculated cesarean risk during labor induction could reduce racial disparities in birth satisfaction. STUDY DESIGN We implemented use of a validated calculator that provides an individual cesarean risk score for women undergoing induction into routine care. This prospective cohort study compared satisfaction surveys for 6 months prior to implementation (preperiod: January 2018-June 2018) to 1 year after (postperiod: July 2018-June 2019). Women with full-term (≥37 weeks) singleton gestations with intact membranes and an unfavorable cervix undergoing induction were included. In the postperiod, providers counseled patients on individual cesarean risk at the beginning of induction using standardized scripts. This information was incorporated into care at patient-provider discretion. The validated 10-question Birth Satisfaction Scale-Revised (BSS-R) subdivided into three domains was administered throughout the study. Patients were determined to be "satisfied" or "unsatisfied" if total BSS-R score was above or below the median, respectively. In multivariable analysis, interaction terms evaluated the differential impact of the calculator on birth satisfaction by race (Black vs. non-Black women). RESULTS A total of 1,008 of 1,236 (81.6%) eligible women completed the BSS-R (preperiod: 330 [79.7%] versus postperiod: 678 [82.5%], p = 0.23), 63.8% of whom self-identified as Black. In the preperiod, Black women were 50% less likely to be satisfied than non-Black women, even when controlling for differences in parity (Black: 39.0% satisfied vs. non-Black: 53.9%, adjusted odds ratio [aOR] = 0.49, 95% confidence interval [CI]: 0.30-0.79). In the postperiod, there was no difference in satisfaction by race (Black: 43.7% satisfied vs. non-Black: 44.0%, aOR = 0.97. 95% CI: 0.71-1.33). Therefore, disparities in birth satisfaction were no longer present at postimplementation (interaction p = 0.03). CONCLUSION Implementation of standardized counseling with a validated calculator to predict cesarean risk after labor induction is associated with a decrease in racial disparities in birth satisfaction. KEY POINTS · Preintervention, Black women were less likely to have above-median birth satisfaction.. · We implemented standardized counseling around cesarean risk with labor induction.. · Implementation was associated with reduced racial disparities in birth satisfaction scores..
Collapse
Affiliation(s)
- Rebecca F Hamm
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sindhu K Srinivas
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jennifer Mccoy
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Knashawn H Morales
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lisa D Levine
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| |
Collapse
|
5
|
Berger JT, Ribeiro Miller D. Clarity on Race, Racism, and Ethnocentrism in the Medical Literature. J Pain Symptom Manage 2023; 66:e449-e450. [PMID: 37352943 DOI: 10.1016/j.jpainsymman.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Affiliation(s)
- Jeffrey T Berger
- NYU Long Island School of Medicine and NYU Langone Health, Mineola, New York, USA.
| | - Dana Ribeiro Miller
- NYU Long Island School of Medicine and NYU Langone Health, Mineola, New York, USA
| |
Collapse
|
6
|
Judge SM, Jackson KJ. The COVID-19 pandemic and male sex workers who have sex with men: associations between age and race and advertising for work in 2019-2021. CULTURE, HEALTH & SEXUALITY 2023; 25:728-743. [PMID: 35819828 DOI: 10.1080/13691058.2022.2092653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 06/17/2022] [Indexed: 06/02/2023]
Abstract
Despite government-mandated restrictions on business and social activities worldwide, some sex workers continued to see clients in person throughout the COVID-19 pandemic. To better understand this behaviour, we compiled publicly available data from Internet advertisements posted on a popular website before and during the pandemic by male sex workers providing services to men. We first collected data in March 2019 from 172 advertisements - the complete number available at that time - posted by male sex workers advertising services in the Atlanta region. We then assessed whether these same sex workers continued to advertise their availability at three subsequent points during the COVID-19 pandemic: April 2020, January 2021 and February 2021. We also determined whether age and race were associated with advertising presence at each time point. While advertising rates declined among sex workers in all race categories (Black, White and 'other'), results from our mixed effects logistic regression model show that the odds of older male sex workers continuing to advertise were greater than the odds for their younger counterparts. Further, the predicted probability of continued advertising was highest for White male sex workers. Our findings provide additional insights into male sex work during a global pandemic.
Collapse
Affiliation(s)
- Shana M Judge
- Duddon Evidence to Policy Research, Albuquerque, NM, USA
| | | |
Collapse
|
7
|
|
8
|
Cené CW, Viswanathan M, Fichtenberg CM, Sathe NA, Kennedy SM, Gottlieb LM, Cartier Y, Peek ME. Racial Health Equity and Social Needs Interventions: A Review of a Scoping Review. JAMA Netw Open 2023; 6:e2250654. [PMID: 36656582 PMCID: PMC9857687 DOI: 10.1001/jamanetworkopen.2022.50654] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE Social needs interventions aim to improve health outcomes and mitigate inequities by addressing health-related social needs, such as lack of transportation or food insecurity. However, it is not clear whether these studies are reducing racial or ethnic inequities. OBJECTIVE To understand how studies of interventions addressing social needs among multiracial or multiethnic populations conceptualize and analyze differential intervention outcomes by race or ethnicity. EVIDENCE REVIEW Sources included a scoping review of systematic searches of PubMed and the Cochrane Library from January 1, 1995, through November 29, 2021, expert suggestions, and hand searches of key citations. Eligible studies evaluated interventions addressing social needs; reported behavioral, health, or utilization outcomes or harms; and were conducted in multiracial or multiethnic populations. Two reviewers independently assessed titles, abstracts, and full text for inclusion. The team developed a framework to assess whether the study was "conceptually thoughtful" for understanding root causes of racial health inequities (ie, noted that race or ethnicity are markers of exposure to racism) and whether analyses were "analytically informative" for advancing racial health equity research (ie, examined differential intervention impacts by race or ethnicity). FINDINGS Of 152 studies conducted in multiracial or multiethnic populations, 44 studies included race or ethnicity in their analyses; of these, only 4 (9%) were conceptually thoughtful. Twenty-one studies (14%) were analytically informative. Seven of 21 analytically informative studies reported differences in outcomes by race or ethnicity, whereas 14 found no differences. Among the 7 that found differential outcomes, 4 found the interventions were associated with improved outcomes for minoritized racial or ethnic populations or reduced inequities between minoritized and White populations. No studies were powered to detect differences. CONCLUSIONS AND RELEVANCE In this review of a scoping review, studies of social needs interventions in multiracial or multiethnic populations were rarely conceptually thoughtful for understanding root causes of racial health inequities and infrequently conducted informative analyses on intervention effectiveness by race or ethnicity. Future work should use a theoretically sound conceptualization of how race (as a proxy for racism) affects social drivers of health and use this understanding to ensure social needs interventions benefit minoritized racial and ethnic groups facing social and structural barriers to health.
Collapse
Affiliation(s)
- Crystal W. Cené
- Department of Medicine, University of California, San Diego Health, San Diego
- School of Medicine, University of California, San Diego
| | - Meera Viswanathan
- RTI International–University of North Carolina at Chapel Hill Evidence-based Practice Center, RTI International, Research Triangle Park
| | - Caroline M. Fichtenberg
- University of California, San Francisco Social Intervention Research and Evaluation Network, San Francisco
- School of Medicine, Department of Family and Community Medicine, Center for Health and Community, University of California, San Francisco
| | - Nila A. Sathe
- RTI International–University of North Carolina at Chapel Hill Evidence-based Practice Center, RTI International, Research Triangle Park
| | - Sara M. Kennedy
- RTI International–University of North Carolina at Chapel Hill Evidence-based Practice Center, RTI International, Research Triangle Park
| | - Laura M. Gottlieb
- School of Medicine, Department of Family and Community Medicine, Center for Health and Community, University of California, San Francisco
| | - Yuri Cartier
- University of California, San Francisco Social Intervention Research and Evaluation Network, San Francisco
| | - Monica E. Peek
- Section of General Internal Medicine, MacLean Center for Clinical Medical Ethics, Center for the Study of Race, Politics and Culture, The University of Chicago, Chicago, Illinois
| |
Collapse
|
9
|
Okah E, Glover L, Donahue KE, Corbie-Smith G, Dave G. Physicians' Perceptions of Race and Engagement in Race-Based Clinical Practice: a Mixed-Methods Systematic Review and Narrative Synthesis. J Gen Intern Med 2022; 37:3989-3998. [PMID: 35867305 PMCID: PMC9640482 DOI: 10.1007/s11606-022-07737-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Using race-a socially assigned identity that does not adequately capture human genetic variation-to guide clinical care can result in poor outcomes for racially minoritized patients. This study assessed (1) how physicians conceptualize and use race in their clinical care (race-based care) and (2) physician characteristics associated with race-based care. METHODS PubMed, CINAHL, EMBASE, and Scopus databases were searched. Qualitative, quantitative, and mixed-methods studies written in peer-reviewed, English-language journal articles evaluating US physicians' perceptions of race and physician factors associated with race-based care were included. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Qualitative studies were evaluated using thematic analysis, and quantitative findings were summarized and combined with qualitative findings in a narrative synthesis. RESULTS A total of 1149 articles were identified; 9 (4 qualitative, 5 quantitative) studies met inclusion criteria. Five themes emerged: (1) the belief in race as biological; (2) the use of race to contextualize patients' health; (3) the use of race to counsel patients and determine care; (4) justifications for race-based practice (evidence-based, personal experience, addresses disparities, provides personalized care, increases compliance); and (5) concerns with race-based practice (poorly characterizes patients, normalizes disparities, patient distrust, clinician discomfort, legitimized biological race). In quantitative studies, older age was positively associated with race-based care. DISCUSSION Physicians had varied perceptions of race, but many believed race was biological. Concern and support for race-based practice were related to beliefs regarding the evidence for using race in care and the appropriateness of race as a variable in medical research. Older physicians were more likely to use race, which could be due to increased exposure to race-based medical literature, in addition to generational differences in conceptualizations of race. Additional research on the evolution of physicians' perceptions of race, and the role of medical literature in shaping these perceptions, is needed.
Collapse
Affiliation(s)
- Ebiere Okah
- Department of Family Medicine, School of Medicine, University of North Carolina, NC, , Chapel Hill, USA.
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, NC, , Chapel Hill, USA.
| | - LáShauntá Glover
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, NC, , Chapel Hill, USA
| | - Katrina E Donahue
- Department of Family Medicine, School of Medicine, University of North Carolina, NC, , Chapel Hill, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, NC, , Chapel Hill, USA
| | - Giselle Corbie-Smith
- Department of Medicine, School of Medicine, University of North Carolina, NC, , Chapel Hill, USA
- Department of Social Medicine, School of Medicine, University of North Carolina, NC, , Chapel Hill, USA
- Center for Health Equity Research, School of Medicine, University of North Carolina, Chapel Hill,, NC, USA
| | - Gaurav Dave
- Department of Medicine, School of Medicine, University of North Carolina, NC, , Chapel Hill, USA
- Department of Social Medicine, School of Medicine, University of North Carolina, NC, , Chapel Hill, USA
- Center for Health Equity Research, School of Medicine, University of North Carolina, Chapel Hill,, NC, USA
| |
Collapse
|
10
|
Greene AS, Shen X, Noble S, Horien C, Hahn CA, Arora J, Tokoglu F, Spann MN, Carrión CI, Barron DS, Sanacora G, Srihari VH, Woods SW, Scheinost D, Constable RT. Brain-phenotype models fail for individuals who defy sample stereotypes. Nature 2022; 609:109-118. [PMID: 36002572 PMCID: PMC9433326 DOI: 10.1038/s41586-022-05118-w] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 07/15/2022] [Indexed: 01/19/2023]
Abstract
Individual differences in brain functional organization track a range of traits, symptoms and behaviours1-12. So far, work modelling linear brain-phenotype relationships has assumed that a single such relationship generalizes across all individuals, but models do not work equally well in all participants13,14. A better understanding of in whom models fail and why is crucial to revealing robust, useful and unbiased brain-phenotype relationships. To this end, here we related brain activity to phenotype using predictive models-trained and tested on independent data to ensure generalizability15-and examined model failure. We applied this data-driven approach to a range of neurocognitive measures in a new, clinically and demographically heterogeneous dataset, with the results replicated in two independent, publicly available datasets16,17. Across all three datasets, we find that models reflect not unitary cognitive constructs, but rather neurocognitive scores intertwined with sociodemographic and clinical covariates; that is, models reflect stereotypical profiles, and fail when applied to individuals who defy them. Model failure is reliable, phenotype specific and generalizable across datasets. Together, these results highlight the pitfalls of a one-size-fits-all modelling approach and the effect of biased phenotypic measures18-20 on the interpretation and utility of resulting brain-phenotype models. We present a framework to address these issues so that such models may reveal the neural circuits that underlie specific phenotypes and ultimately identify individualized neural targets for clinical intervention.
Collapse
Affiliation(s)
- Abigail S Greene
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA.
- MD-PhD program, Yale School of Medicine, New Haven, CT, USA.
| | - Xilin Shen
- Depatment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Stephanie Noble
- Depatment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Corey Horien
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA
- MD-PhD program, Yale School of Medicine, New Haven, CT, USA
| | - C Alice Hahn
- Depatment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Jagriti Arora
- Depatment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Fuyuze Tokoglu
- Depatment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Marisa N Spann
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Carmen I Carrión
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Daniel S Barron
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerard Sanacora
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Vinod H Srihari
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Scott W Woods
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA
- Depatment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, CT, USA
- Department of Statistics and Data Science, Yale University, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA.
- Depatment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, CT, USA.
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.
| |
Collapse
|
11
|
Prakash Y, Ward LM, Jaleel Z, Ilavarasan V, Liang JJ, Prakash M, Levi JR. The Use of Race and Socioeconomic Status Variables in Published Otolaryngologic Research. Ann Otol Rhinol Laryngol 2022:34894221111323. [PMID: 35861198 DOI: 10.1177/00034894221111323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To characterize the use of race and socioeconomic status (SES) variables in clinical otolarynogologic research. METHODS Databases were queried for all articles published in 2016 issues of 5 major otolaryngologic journals. One thousand, one hundred and forty of 1593 articles abstracted met inclusion criteria for analysis. RESULTS In total, 244 (21.4%) studies specified race as a variable. The subspecialty of Head and Neck cancer specified race at statistically higher rates compared to other subspecialties (P = .002). Two hundred nine (34.0%) domestic studies specified race compared to 35 (6.7%) international studies. Of the 244 studies that specified race, 79 (32.4%) defined race using racial and ethnic categories interchangeably. Two hundred twenty-four (91.8%) studies reported data by race, 145 (59.4%) analyzed the data, and 112 (45.9%) discussed race-based results.In total, 94 (8.2%) studies specified SES. All subspecialties specified SES at statistically similar rates. Seventy (11.4%) domestic studies specified SES compared to 24 (4.6%) international studies. Of the 94 studies that specified SES, 42 (44.7%) defined SES using insurance status, 35 (37.2%) used education, and 32 (34.0%) used income. Seventy-eight (83.0%) studies reported data by SES, 71 (75.5%) analyzed the data, and 68 (72.3%) discussed SES-based results. CONCLUSION In clinical otolaryngologic research, the study of race and SES is limited. To improve quality of research and patient care for all patients, investigators should clearly justify their use of race and SES variables, carefully select their measures of race and SES (if the use of these variables is justified), and study race/SES-based data beyond just a superficial level.
Collapse
Affiliation(s)
- Yash Prakash
- Boston University School of Medicine, Boston, MA, USA
| | - Libby M Ward
- Boston University School of Medicine, Boston, MA, USA
| | - Zaroug Jaleel
- Department of Otolaryngology/Head and Neck Surgery, University of Washington Medical Center, Seattle, WA, USA
| | | | - Jennifer J Liang
- Department of Otolaryngology/Head and Neck Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | | | - Jessica R Levi
- Department of Otolaryngology/Head and Neck Surgery, Boston Medical Center, Boston, MA, USA
| |
Collapse
|
12
|
Jivens M, Okafor I, Beverly EA. Osteopathic medical students' understanding of race-based medicine. J Osteopath Med 2022; 122:277-287. [PMID: 35470644 DOI: 10.1515/jom-2021-0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT Race is a social construct, not a biological or genetic construct, utilized to categorize people based on observable traits, behaviors, and geographic location. Findings from the Human Genome Project demonstrated that humans share 99.9% of their DNA; despite this evidence, race is frequently utilized as a risk factor for diagnosis and prescribing practices. Diagnosing and treating people based on race is known as race-based medicine. Race-based medicine perpetuates biases and diverts attention and resources from the social determinants of health that cause racial health inequities. Minimal research has examined medical students' understanding of race-based medicine. OBJECTIVES The purpose of this study was to assess osteopathic medical students' knowledge, beliefs, and experiences with race-based medicine. METHODS We conducted a descriptive, cross-sectional survey study to assess osteopathic medical students' knowledge, beliefs, and experiences with race-based medicine. An electronic, anonymous survey was distributed to all osteopathic medical students enrolled at a medical school in the Midwest with three campuses during the 2019-2020 academic year. Participants completed a brief demographic questionnaire and the Race-Based Medicine Questionnaire. Descriptive and inferential statistics were conducted utilizing SPSS statistical software version 28.0, and statistical significance was defined as a p<0.05. Open-ended questions were analyzed utilizing content and thematic analyses. RESULTS A total of 438 of the 995 osteopathic medical students consented to participate in the study, for a response rate of 44.0%. Among those participants, 221 (52.0%) reported that they had heard of the term "race-based medicine." Familiarity with the term differed by racial background (χ [2] = 24.598, p<0.001), with Black or African American participants indicating greater familiarity with the term compared to all other races. Of the participants familiar with race-based medicine, 79 (44.4%) provided the correct definition for the term; this finding did not differ by any sociodemographic variable. Part of the way through the questionnaire, all participants were provided the correct definition of "race-based medicine" and asked if they thought medical schools should teach race-based medicine. The majority of participants (n=231, 61.4%) supported the teaching of race-based medicine. Qualitative findings elaborated on participants' support or opposition for teaching race-based medicine in medical school. Those in support explained the importance of teaching historical perspectives of race-based medicine as well as race as a data point in epidemiology and its presence on board examinations, whereas those in opposition believed it contradicted osteopathic principles and practice. CONCLUSIONS Findings showed half of the participants were familiar with race-based medicine, and among those, less than half knew the definition of the term. Highlighting osteopathic philosophy and its focus on the whole person may be one approach to educating osteopathic medical students about race-based medicine.
Collapse
Affiliation(s)
- Morgan Jivens
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ifeoma Okafor
- Department of Family Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Elizabeth A Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA
| |
Collapse
|
13
|
Let’s “Talk” about the police: The role of race and police legitimacy attitudes in the legal socialization of youth. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02709-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Affiliation(s)
- Brittany E. Bryant
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC 29425 USA
| | - Ayana Jordan
- Yale University School of Medicine, New Haven, CT 06511 USA
| | - Uraina S. Clark
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
- Center for Scientific Diversity, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| |
Collapse
|
15
|
Academic, Leadership, and Demographic Characteristics of Orthopaedic Sports Medicine Division Chiefs in the United States. J Am Acad Orthop Surg Glob Res Rev 2022; 6:01979360-202201000-00009. [PMID: 35007236 PMCID: PMC8751768 DOI: 10.5435/jaaosglobal-d-21-00139] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022]
Abstract
Introduction: Division chiefs (DCs) play an integral role within the department, making critical decisions and helping shape the future of both the division and the department. This study aimed to investigate the demographic characteristics and scholarly work of DCs in academic orthopaedic sports medicine division in the United States. Methods: Orthopaedic residency programs at academic centers were identified using the Association of American Medical Colleges' Electronic Residency Application Service. DCs were identified using the program's respective websites where data points such as sex, race/ethnicity, fellowship training institution, time since graduating fellowship, academic rank, number of degrees, and additional leadership titles were collected. Scopus database was used to determine h-indices. Results: From the 191 programs identified, 100 had a DC for the sports medicine subspecialty division, and 66 programs offered a sports medicine fellowship. Most DCs (96%) were men. The racial/ethnic demographics of the DCs were mostly White (86%), followed by Asian (11%), African American (1%), Hispanic/Latino (1%), and mixed ethnicity (1%). On average, the DCs were 19.6 years past their fellowship completion. The average h-index was 21.2. Many (48%) had an academic rank of professor, 28% associate professor, and 12% assistant professor. Four held additional graduate degrees. The fellowship programs that trained the most DCs were Hospital for Special Surgery (11), Kerlan Jobe Orthopaedic Clinic (8), University of Pittsburgh (7), American Sports Medicine Institution (5), Cleveland Clinic (5), Cincinnati Sports Medicine (4), Massachusetts General Hospital (4), and Steadman Hawkins Clinic (4). Discussion: DCs in academic orthopaedic surgery plays a crucial role in the department and is a topic that is understudied. A lack of diversity exists among DCs in academic Sports Medicine in orthopaedics. The position is held predominately by White men with a rank of either full or associate professor and extensive leadership experience. More efforts are needed to increase the diversity of sports medicine leadership within academic orthopaedic programs in the United States.
Collapse
|
16
|
Dobias ML, Sugarman MB, Mullarkey MC, Schleider JL. Predicting Mental Health Treatment Access Among Adolescents With Elevated Depressive Symptoms: Machine Learning Approaches. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:88-103. [PMID: 34213666 DOI: 10.1007/s10488-021-01146-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/26/2022]
Abstract
A large proportion of adolescents experiencing depression never access treatment. To increase access to effective mental health care, it is critical to understand factors associated with increased versus decreased odds of adolescent treatment access. This study used individual depression symptoms and sociodemographic variables to predict whether and where adolescents with depression accessed mental health treatments. We performed a pre-registered, secondary analysis of data from the 2017 National Survey of Drug Use and Health (NSDUH), a nationally representative sample of non-institutionalized civilians in the United States. Using four cross-validated random forest models, we predicted whether adolescents with elevated past-year depressive symptoms (N = 1,671; ages 12-17 years) accessed specific mental health treatments in the previous 12 months ("yes/no" for inpatient, outpatient, school, any). 53.38% of adolescents with elevated depressive symptoms accessed treatment of any kind. Even with depressive symptoms and sociodemographic factors included as predictors, pre-registered random forests explained < 0.00% of pseudo out-of-sample deviance in adolescent access to inpatient, outpatient, school, or overall treatments. Exploratory elastic net models explained 0.80-2.50% of pseudo out-of-sample deviance in adolescent treatment access across all four treatment types. Neither individual depressive symptoms nor any socioeconomic variables meaningfully predicted specific or overall mental health treatment access in adolescents with elevated past-year symptoms. This study highlights substantial limitations in our capacity to predict whether and where adolescents access mental health treatment and underscores the broader need for more accessible, scalable adolescent depression treatments.
Collapse
Affiliation(s)
- Mallory L Dobias
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
| | - Michael B Sugarman
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Michael C Mullarkey
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
| |
Collapse
|
17
|
Mekonnen ZK, Oehlert JW, Eskenazi B, Shaw GM, Balmes JR, Padula AM. The relationship between air pollutants and maternal socioeconomic factors on preterm birth in California urban counties. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:503-513. [PMID: 33859340 PMCID: PMC8134052 DOI: 10.1038/s41370-021-00323-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Preterm birth is the leading cause of perinatal morbidity and mortality in the U.S. and disparities among racial and ethnic groups persist. While etiologies of preterm birth have not been fully elucidated, it is probable that environmental and social factors play a role. OBJECTIVE We hypothesized that there is an interactive association between exposure to fine particulate matter (PM2.5) or ozone (O3) and neighborhood socioeconomic factors that increase the risk of preterm birth. METHODS We conducted a retrospective study using geocoded birth certificate data between 2007 and 2011, daily ambient air quality data on PM2.5 and O3, and American Community Survey (2007-2011 5-year estimates) data to assess census tract-level socioeconomic factors in California urban counties. RESULTS Our study found a small positive association between maternal exposures to PM2.5 and O3 and preterm birth that varied by gestational exposure period. In mixed-effects models, we found an increase in the risk of preterm birth for a one-unit change in PM2.5 averaged across the entire pregnancy (AOR = 1.02, 95% CI: 1.01, 1.02) and O3 during 3-months pre-pregnancy (AOR = 1.03, 95% CI: 1.02, 1.04). Interaction between census tract-level factors and air pollutants showed an increase in the risk of preterm birth among mothers living in higher socioeconomic areas, though, a fixed cohort bias sensitivity analysis showed these associations were not significant. SIGNIFICANCE These findings substantiate previous studies that showed associations between air pollution and preterm birth, even as pollution levels have decreased. This study has important implications for policy decisions and may help inform research on potential mechanisms of preterm birth.
Collapse
Affiliation(s)
- Zesemayat K Mekonnen
- University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, USA
| | - John W Oehlert
- Department of Pediatrics, Division of Neonatology, Stanford University, Stanford, CA, USA
| | - Brenda Eskenazi
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Gary M Shaw
- Department of Pediatrics, Division of Neonatology, Stanford University, Stanford, CA, USA
| | - John R Balmes
- University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, USA
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Amy M Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| |
Collapse
|
18
|
Bredella MA, Singhal V, Hazhir Karzar N, Animashaun A, Bose A, Stanford FC, Carmine B, Misra M. Racial differences in lumbar marrow adipose tissue and volumetric bone mineral density in adolescents and young adults with obesity. Bone Rep 2020; 13:100726. [PMID: 33392365 PMCID: PMC7772680 DOI: 10.1016/j.bonr.2020.100726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Areal bone mineral density (BMD) of the lumbar spine by DXA is greater in Black compared to White adolescents. Bone strength is determined not only by BMD but also its microenvironment, and marrow adipose tissue (MAT) has been shown to be an important determinant of skeletal integrity, independent of BMD. Racial differences in volumetric BMD (vBMD) and MAT in adolescents and young adults with obesity are unknown. OBJECTIVE To assess racial differences in lumbar vBMD and MAT in Black and White adolescents and young adults with obesity and to assess body composition determinants of bone parameters. We hypothesized that Blacks will have higher vBMD and lower MAT of the lumbar spine compared to Whites. METHODS The study group comprised 77 adolescents/young adults, 25 Black and 52 White, (mean age 18.2 ± 2.5 years, range 13 to 24 years) with moderate to severe obesity (mean body mass index (BMI) 46.2 ± 7.3 kg/m2, range 35.5 to 69.7 kg/m2). Groups were similar in age, BMI, and sex distribution (p > 0.84). Subjects underwent QCT of the lumbar spine (L1-L2) for assessment of vBMD with the use of a calibration phantom and 1H-MRS/MRI for quantification of lumbar MAT content (L1-L2) and abdominal fat and thigh muscle mass. Groups were compared by Student's t-test or Wilcoxon test. Correlation analysis was performed to assess associations between bone parameters and body composition. RESULTS Black adolescents/young adults with obesity had higher vBMD compared to Whites (p < 0.0001), while there was no significant difference in lumbar MAT (p = 0.64). There were also no significant differences in body composition measures between groups (p ≥ 0.28). An inverse association between MAT and vBMD was observed in Whites (r = -0.47, P = 0.001) but not in Blacks (p = 0.6). There were no significant associations between body composition measures and bone parameters (p > 0.1). CONCLUSION There are racial differences in lumbar vBMD in adolescents and young adults with moderate to severe obesity, with Blacks having higher vBMD than Whites, while there were no differences in MAT content. The known inverse association between BMD and MAT was only observed in Whites but not in Blacks, suggesting possible racial differences in stem cell differentiation into the bone and fat lineages.
Collapse
Affiliation(s)
- Miriam A. Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Vibha Singhal
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- MGH Weight Center, Boston, MA, United States of America
| | - Nazanin Hazhir Karzar
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Abisayo Animashaun
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Amita Bose
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Fatima Cody Stanford
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- MGH Weight Center, Boston, MA, United States of America
| | - Brian Carmine
- Department of Surgery, Boston University Medical Center, Boston, MA, United States of America
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| |
Collapse
|
19
|
Lumpkins CY, Philp A, Nelson KL, Miller LM, Greiner KA. A road map for the future: An exploration of attitudes, perceptions, and beliefs among African Americans to tailor health promotion of cancer-related genetic counseling and testing. J Genet Couns 2020; 29:518-529. [PMID: 32291871 DOI: 10.1002/jgc4.1277] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 01/30/2023]
Abstract
African Americans (AA), the second largest racial/ethnic minority group in the United States (US), carry the largest mortality burden of cancer compared with other racial/ethnic groups (Cancer Facts & Figures for African Americans, 2019-2021, American Cancer Society).One solution to address this disparity is through cancer-related genetic counseling and testing (CGT). Although CGT is utilized among the general population, it remains underutilized among AA populations. Community-engaged and community-driven health promotion programs within faith-based organizations (FBOs) have been successfully implemented and delivered among AA populations (Israel et al., American Journal of Public Health, 100, 2010, 2094). FBOs are well positioned for cancer-related health promotion and equipped as conduits of health education and information distribution for cancer prevention. In the present pilot study, a community-based participatory approach (CBPR) was used to collect exploratory data on attitudes, perceptions, and beliefs toward CGT and uptake among an AA sample in the Midwest. Focus groups were conducted in two churches where respondents (N=34) answered a pre-focus group survey prior to a discussion. Respondents were largely unaware of CGT and thought of testing as primarily for ancestral discovery and not for an inheritable disease. Themes identified through qualitative analysis included emotional experiences with cancer; perception of cancer risk; different pictures of genetic testing; other things to worry about; trust in the healthcare system/faith in God and the healthcare system; and ideas and insights regarding promotion of CGT. These primary themes showed participants' perceptions of CGT were shaped by their experiences with cancer, faith, faith communities/FBOs, and cost and access to CGT. Overall, participants within these organizations had positive perceptions about the church as a conduit of genetic testing information but had mixed opinions about the rationale for completing CGT. These findings have implications for genetic counselors, medical providers, and health promotion personnel as to how AA faith populations view CGT and the utility of FBOs as promoters of CGT information.
Collapse
Affiliation(s)
- Crystal Y Lumpkins
- Department of Family Medicine and Community Health, University of Kansas Medical Center, School of Medicine, Kansas City, Kansas
| | - Alisdair Philp
- Department of Internal Medicine, University of Kansas Medical Center, School of Medicine, Kansas City, Kansas
| | - Katherine L Nelson
- Department of Internal Medicine, University of Kansas Medical Center, School of Medicine, Kansas City, Kansas
| | - Lynn M Miller
- Faith Works Connecting for a Healthy Community Advisory Board, Kansas City, Kansas
| | - Keith Allen Greiner
- Department of Family Medicine and Community Health, University of Kansas Medical Center, School of Medicine, Kansas City, Kansas
| |
Collapse
|
20
|
Cowden JD, Flores G, Chow T, Rodriguez P, Chamblee T, Mackey M, Lyren A, Gutzeit MF. Variability in Collection and Use of Race/Ethnicity and Language Data in 93 Pediatric Hospitals. J Racial Ethn Health Disparities 2020; 7:928-936. [DOI: 10.1007/s40615-020-00716-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/15/2020] [Accepted: 02/02/2020] [Indexed: 11/30/2022]
|
21
|
Sanchez TH, Rai M, Zlotorzynska M, Jones J, Sullivan PS. Birth Cohort and Racial/Ethnic Differences in the Age of First Oral and Anal Sex Among U.S. Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:275-286. [PMID: 31664555 PMCID: PMC7018607 DOI: 10.1007/s10508-019-01508-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/21/2019] [Accepted: 06/27/2019] [Indexed: 05/28/2023]
Abstract
Earlier age of first sex has potential direct and indirect health effects later in life. Though there are multiple nationwide general population studies on ages of first sex, there is no such nationwide study of first male-male oral or anal sex among men who have sex with men (MSM). This may be important for understanding racial/ethnic disparities in HIV and sexually transmitted infection acquisition among young racial/ethnic minority MSM. Our study examined the birth cohort and racial/ethnic differences in ages of first male-male oral and anal sex using a diverse 2015 U.S. nationwide sample of 10,217 sexually active MSM. The mean age of first male-male oral sex was 18.0 years. Compared with older birth cohorts, those MSM born 1990-2000 were more likely to have younger age of first male-male oral sex. Compared to white MSM, Hispanic MSM and non-Hispanic black MSM were more likely to have younger age of first male-male oral sex with a man. The mean age of first male-male anal sex was 20.3 years. Compared with older birth cohorts, those MSM born 1990-2000 were more likely to have younger age of first male-male anal sex. Compared to white MSM, MSM of all other racial/ethnic groups were more likely to have younger age of first male-male anal sex. These findings emphasize the need for comprehensive and MSM-inclusive sexual health education for young teens and online sexual health resources for young gay, bisexual, queer, and other MSM.
Collapse
Affiliation(s)
- Travis H Sanchez
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | - Mona Rai
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Maria Zlotorzynska
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Jeb Jones
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Patrick S Sullivan
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| |
Collapse
|
22
|
Rose M, Aronow L, Breen S, Tully C, Hilliard ME, Butler AM, Streisand R. Considering Culture: A Review of Pediatric Behavioral Intervention Research in Type 1 Diabetes. Curr Diab Rep 2018; 18:16. [PMID: 29473103 DOI: 10.1007/s11892-018-0987-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW Type 1 diabetes (T1D) incidence in youth is growing across all racial/ethnic backgrounds, with the most marked increase in African-American youth under 5. Underrepresented racial/ethnic minorities are at an increased risk for health complications. This review focuses on the reported disparities, demographics of samples in behavioral interventions, and study design considerations. RECENT FINDINGS Recruitment data from two ongoing behavioral intervention trials for young children with T1D are presented to compare enrolled/non-enrolled individuals and to discuss culturally appropriate study design considerations. Data were compared to the demographics of children (ages 1-6) with T1D in the clinic populations from the recruitment sites. Enrolling a representative sample and designing culturally appropriate behavioral interventions are important for generalizability, yet there is a gap between the individuals participating in T1D research and those who are most negatively affected by T1D. Suggestions are offered for ways to expand inclusion of diverse samples in behavioral intervention research in T1D.
Collapse
Affiliation(s)
- Meredith Rose
- Children's National Medical Center, 111 MI Ave NW, Washington, DC, 20010, USA
| | - Laura Aronow
- Children's National Medical Center, 111 MI Ave NW, Washington, DC, 20010, USA
| | - Sarah Breen
- Children's National Medical Center, 111 MI Ave NW, Washington, DC, 20010, USA
| | - Carrie Tully
- Children's National Medical Center, 111 MI Ave NW, Washington, DC, 20010, USA
- The George Washington University School of Medicine, 2300 I St NW, Washington, DC, 20052, USA
| | - Marisa E Hilliard
- Baylor College of Medicine and Texas Children's Hospital, 1102 Bates Avenue, Suite 940, Houston, TX, 77030, USA
| | - Ashley M Butler
- Baylor College of Medicine and Texas Children's Hospital, 1102 Bates Avenue, Suite 940, Houston, TX, 77030, USA
| | - Randi Streisand
- Children's National Medical Center, 111 MI Ave NW, Washington, DC, 20010, USA.
- The George Washington University School of Medicine, 2300 I St NW, Washington, DC, 20052, USA.
| |
Collapse
|
23
|
Meagher KM, McGowan ML, Settersten RA, Fishman JR, Juengst ET. Precisely Where Are We Going? Charting the New Terrain of Precision Prevention. Annu Rev Genomics Hum Genet 2017; 18:369-387. [PMID: 28441061 PMCID: PMC6203331 DOI: 10.1146/annurev-genom-091416-035222] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In addition to genetic data, precision medicine research gathers information about three factors that modulate gene expression: lifestyles, environments, and communities. The relevant research tools-epidemiology, environmental assessment, and socioeconomic analysis-are those of public health sciences rather than molecular biology. Because these methods are designed to support inferences and interventions addressing population health, the aspirations of this research are expanding from individualized treatment toward precision prevention in public health. The purpose of this review is to explore the emerging goals and challenges of such a shift to help ensure that the genomics community and public policy makers understand the ethical issues at stake in embracing and pursuing precision prevention. Two emerging goals bear special attention in this regard: (a) public health risk reduction strategies, such as screening, and (b) the application of genomic variation studies to understand and reduce health disparities among population groups.
Collapse
Affiliation(s)
- Karen M Meagher
- Center for Genomics and Society, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599;
| | - Michelle L McGowan
- Ethics Center, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229;
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45229
- Department of Women's, Gender, and Sexuality Studies, University of Cincinnati, Cincinnati, Ohio 45221
| | - Richard A Settersten
- Human Development and Family Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon 97331;
| | - Jennifer R Fishman
- Biomedical Ethics Unit, Department of Social Studies of Medicine, McGill University, Montreal, Quebec H3A 1X1, Canada;
| | - Eric T Juengst
- Center for Bioethics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599;
| |
Collapse
|
24
|
Juengst E, McGowan ML, Fishman JR, Settersten RA. From "Personalized" to "Precision" Medicine: The Ethical and Social Implications of Rhetorical Reform in Genomic Medicine. Hastings Cent Rep 2016; 46:21-33. [PMID: 27649826 PMCID: PMC5153661 DOI: 10.1002/hast.614] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Since the late 1980s, the human genetics and genomics research community has been promising to usher in a "new paradigm for health care"-one that uses molecular profiling to identify human genetic variants implicated in multifactorial health risks. After the completion of the Human Genome Project in 2003, a wide range of stakeholders became committed to this "paradigm shift," creating a confluence of investment, advocacy, and enthusiasm that bears all the marks of a "scientific/intellectual social movement" within biomedicine. Proponents of this movement usually offer four ways in which their approach to medical diagnosis and health care improves upon current practices, arguing that it is more "personalized," "predictive," "preventive," and "participatory" than the medical status quo. Initially, it was personalization that seemed to best sum up the movement's appeal. By 2012, however, powerful opinion leaders were abandoning "personalized medicine" in favor of a new label: "precision medicine." The new label received a decisive seal of approval when, in January 2015, President Obama unveiled plans for a national "precision medicine initiative" to promote the development and use of genomic tools in health care.
Collapse
|
25
|
Leff HS, Chow C, Wieman DA, Ostrow L, Cortés DE, Harris T. Measurement of Perceived and Technical Quality of Care for Depression in Racially and Ethnically Diverse Groups. J Immigr Minor Health 2016; 18:810-818. [PMID: 26748509 DOI: 10.1007/s10903-015-0286-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Measurement of patient satisfaction is now considered essential for providing patient centered care and is an important tool for addressing health care disparities. However, little is known about how ethnically and racially diverse (ERD) groups differ in how they perceive quality, and widely used instruments for measuring perceived quality give little attention to cultural elements of care. This study examined the relationship between the culturally determined beliefs and expectations of four ERD groups (African Americans, Latinos, Portuguese-speakers, and Haitians, total N = 160) and the technical quality of treatment for depression provided in four "culturally-specific" primary care clinics. Using data from the Experiences of Care and Health Outcomes survey, chart reviews and focus groups, the study addressed a set of questions related to the psychometric properties of perceived care measures and the technical quality of care. The groups differed in preferred cultural elements except all preferred inclusion of religion. They did not differ in overall perceived quality. Technical quality was higher for Portuguese and Haitians than for African Americans and Latinos. Implications of group differences for measuring quality are discussed.
Collapse
Affiliation(s)
- H Stephen Leff
- Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA
| | - Clifton Chow
- Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA
| | - Dow A Wieman
- Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA. .,Human Services Research Institute (HSRI), 2336 Massachusetts Avenue, Cambridge, MA, 02140, USA.
| | - Laysha Ostrow
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dharma E Cortés
- Mauricio Gastón Institute for Latino Community Development and Public Policy, University of Massachusetts Boston, Boston, MA, USA
| | - Treniece Harris
- Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA
| |
Collapse
|
26
|
Racial and ethnic disparities in personal capital during pregnancy: findings from the 2007 Los Angeles Mommy and Baby (LAMB) study. Matern Child Health J 2014; 18:209-222. [PMID: 23504131 DOI: 10.1007/s10995-013-1256-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objectives of this study were to determine if racial and ethnic differences in personal capital during pregnancy exist and to estimate the extent to which any identified racial and ethnic differences in personal capital are related to differences in maternal sociodemographic and acculturation characteristics. Data are from the 2007 Los Angeles Mommy and Baby study (n = 3,716). Personal capital comprised internal resources (self-esteem and mastery) and social resources (partner, social network, and neighborhood support) during pregnancy. The relationships between race/ethnicity and personal capital were assessed using multivariable generalized linear models, examining the impact of sociodemographic and acculturation factors on these relationships. Significant racial and ethnic disparities in personal capital during pregnancy exist. However, socioeconomic status (i.e., income and education) and marital status completely explained Black-White disparities and Hispanic-White disparities in personal capital, whereas acculturation factors, especially nativity and language spoken at home, partially mediated the disparities in personal capital between Asian/Pacific Islander women and White women. Findings suggest that the risks associated with low socioeconomic status, single motherhood, and low acculturation, rather than race or ethnicity, contribute to low personal capital for many pregnant women. As personal capital during pregnancy may influence subsequent maternal and child health outcomes, the development of interventions should consider addressing sociodemographic and acculturation factors in order to reduce racial and ethnic disparities in personal capital and ultimately in poor maternal and child health outcomes.
Collapse
|
27
|
Kanakamedala P, Haga SB. Characterization of clinical study populations by race and ethnicity in biomedical literature. Ethn Dis 2012; 22:96-101. [PMID: 22774316 PMCID: PMC3412405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE The importance of race and ethnicity in biomedical research has long been a subject of debate, recently heightened by data revealed by the completion of the sequencing of the human genome and the mapping of human genetic variation. We aimed to determine whether and how the reporting of race has changed over the last three decades and how the practice may differ given study location, where the journal of publication is based, and decade of publication. DESIGN We analyzed a sample of studies published in the Journal of the American Medical Association, The Lancet, and the Canadian Medical Association Journal from 1980 to 2009. MAIN OUTCOME MEASURES The number of articles that reported race by journal and decade and the descriptors used. RESULTS Of 1867 articles analyzed, 17.30% reported race. The reporting of race and number of populations reported increased over time for all three journals. In addition, the diversity of race/ethnicity descriptors increased, with increased use of race/ethnicity combinations and nationality of research subjects. CONCLUSION Though it has increased over the past few decades, the reporting of race/ethnicity of study populations is relatively low, ambiguous and inconsistent, likely influenced by the uncertain relevance of these variables to the study's outcomes, study location, researcher views, and the policies of journals and funding agencies. Thus, due to the inconsistent and ambiguous practice of reporting race/ethnicity, comparison of study outcomes can result in misleading conclusions. Improvements in standardization of terms and new approaches to characterize research participants related to race/ethnicity are imperative.
Collapse
Affiliation(s)
| | - Susanne B. Haga
- Sanford School of Public Policy, Duke University (P.K. and S.B.H.)
| |
Collapse
|
28
|
Breland HL, Ellis C. Is Reporting Race and Ethnicity Essential to Occupational Therapy Evidence? Am J Occup Ther 2012; 66:115-9. [DOI: 10.5014/ajot.2012.002246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hazel L. Breland
- Hazel L. Breland, PhD, OTR/L, is Assistant Professor, Division of Occupational Therapy, Department of Health Professions, College of Health Professions, Medical University of South Carolina, 151B Rutledge Avenue, MSC 962, Charleston, SC 29425-9620;
| | - Charles Ellis
- Charles Ellis, Jr., PhD, CCC-SLP, is Associate Professor, Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston
| |
Collapse
|
29
|
Cruz-Flores S, Rabinstein A, Biller J, Elkind MSV, Griffith P, Gorelick PB, Howard G, Leira EC, Morgenstern LB, Ovbiagele B, Peterson E, Rosamond W, Trimble B, Valderrama AL. Racial-ethnic disparities in stroke care: the American experience: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011; 42:2091-116. [PMID: 21617147 DOI: 10.1161/str.0b013e3182213e24] [Citation(s) in RCA: 351] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Our goal is to describe the effect of race and ethnicity on stroke epidemiology, personal beliefs, access to care, response to treatment, and participation in clinical research. In addition, we seek to determine the state of knowledge on the main factors that may explain disparities in stroke care, with the goal of identifying gaps in knowledge to guide future research. The intended audience includes physicians, nurses, other healthcare professionals, and policy makers. METHODS Members of the writing group were appointed by the American Heart Association Stroke Council Scientific Statement Oversight Committee and represent different areas of expertise in relation to racial-ethnic disparities in stroke care. The writing group reviewed the relevant literature, with an emphasis on reports published since 1972. The statement was approved by the writing group; the statement underwent peer review, then was approved by the American Heart Association Science Advisory and Coordinating Committee. RESULTS There are limitations in the definitions of racial and ethnic categories currently in use. For the purpose of this statement, we used the racial categories defined by the US federal government: white, black or African American, Asian, American Indian/Alaskan Native, and Native Hawaiian/other Pacific Islander. There are 2 ethnic categories: people of Hispanic/Latino origin or not of Hispanic/Latino origin. There are differences in the distribution of the burden of risk factors, stroke incidence and prevalence, and stroke mortality among different racial and ethnic groups. In addition, there are disparities in stroke care between minority groups compared with whites. These disparities include lack of awareness of stroke symptoms and signs and lack of knowledge about the need for urgent treatment and the causal role of risk factors. There are also differences in attitudes, beliefs, and compliance among minorities compared with whites. Differences in socioeconomic status and insurance coverage, mistrust of the healthcare system, the relatively limited number of providers who are members of minority groups, and system limitations may contribute to disparities in access to or quality of care, which in turn might result in different rates of stroke morbidity and mortality. Cultural and language barriers probably also contribute to some of these disparities. Minorities use emergency medical services systems less, are often delayed in arriving at the emergency department, have longer waiting times in the emergency department, and are less likely to receive thrombolysis for acute ischemic stroke. Although unmeasured factors may play a role in these delays, the presence of bias in the delivery of care cannot be excluded. Minorities have equal access to rehabilitation services, although they experience longer stays and have poorer functional status than whites. Minorities are inadequately treated with both primary and secondary stroke prevention strategies compared with whites. Sparse data exist on racial-ethnic disparities in access to surgical care after intracerebral hemorrhage and subarachnoid hemorrhage. Participation of minorities in clinical research is limited. Barriers to participation in clinical research include beliefs, lack of trust, and limited awareness. Race is a contentious topic in biomedical research because race is not proven to be a surrogate for genetic constitution. CONCLUSIONS There are limitations in the current definitions of race and ethnicity. Nevertheless, racial and ethnic disparities in stroke exist and include differences in the biological determinants of disease and disparities throughout the continuum of care, including access to and quality of care. Access to and participation in research is also limited among minority groups. Acknowledging the presence of disparities and understanding the factors that contribute to them are necessary first steps. More research is required to understand these differences and find solutions.
Collapse
|
30
|
Knerr S, Wayman D, Bonham VL. Inclusion of racial and ethnic minorities in genetic research: advance the spirit by changing the rules? THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2011; 39:502-12. [PMID: 21871045 PMCID: PMC4082969 DOI: 10.1111/j.1748-720x.2011.00617.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Genetic research aimed at understanding human health and disease is grounded in the study of genetic variation. The inclusion of research subjects with diverse ancestral backgrounds is essential for genetic and genomic research that fully explores human diversity. Large-scale cohort studies and biobanks in Europe and the United States often do not include the breadth of ethnic and racial diversity observed in their countries' citizens. This article explores the findings of a qualitative study of U.S. scientists' understanding and views of the NIH Policy and Guidelines on the Inclusion of Minorities as Subjects in Clinical Research. The findings suggest that the policy restricts how scientists use racial and ethnic categories to define and report their study populations and does little to motivate their efforts to increase the inclusion of non-European ancestral populations in genetic and genomic research.
Collapse
Affiliation(s)
- Sarah Knerr
- Department of Health Services, University of Washington School of Public Health, WA, USA
| | | | | |
Collapse
|
31
|
Ellis C. Does race/ethnicity really matter in adult neurogenics? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2009; 18:310-314. [PMID: 19332522 DOI: 10.1044/1058-0360(2009/08-0039)] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Recent evidence suggests that race/ethnicity is a variable that is critical to outcomes in neurological disorders. The purpose of this article was to examine the proportion of studies published in the American Journal of Speech-Language Pathology (AJSLP) and the Journal of Speech, Language, and Hearing Research (JSLHR) that were designed to examine neurologically based disorders of communication in adults and that reported the race/ethnicity of the participants. METHOD A review of articles in AJSLP and JSLHR from 1997 through 2007 was completed to determine what proportion of articles in the area of adult neurogenic communication disorders reported the race/ethnicity of the participants. RESULTS Between 1997 and 2007, less than 15% of the 116 articles published in the 2 journals reported the race/ethnicity of the participants. The review of studies indicates that the reporting of the race/ethnicity of participants in studies of adult neurogenic communication disorders remains inconsistent. CONCLUSIONS Because few studies report race/ethnicity or consider how race/ethnicity has the potential to confound the results and conclusions drawn, the generalization of the reported findings may be limited. Reporting race/ethnicity is likely critical to the external validity of studies in adult neurogenic communication disorders and when available can enhance the relevance of the findings reported.
Collapse
Affiliation(s)
- Charles Ellis
- Medical University of South Carolina, College of Health Professions, Department of Health Professions, Charleston, SC 29425, USA.
| |
Collapse
|
32
|
Shoo BA. The change we need: Revisiting race and skin phototype classification. J Am Acad Dermatol 2009; 61:151. [DOI: 10.1016/j.jaad.2009.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 01/07/2009] [Accepted: 01/11/2009] [Indexed: 10/20/2022]
|