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Devine KA, Ohman-Strickland P, Barnett M, Donovan KA, Thompson LMA, Manne SL, Kearney J, Levonyan-Radloff K, Diaz D, Dugad S, Sahler OJZ. Protocol of a Multisite Randomized Controlled Trial of Bright IDEAS-Young Adults: Problem-Solving Skills Training to Reduce Distress among Young Adults with Cancer. Contemp Clin Trials 2024; 145:107656. [PMID: 39111386 DOI: 10.1016/j.cct.2024.107656] [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: 04/12/2024] [Revised: 07/29/2024] [Accepted: 08/03/2024] [Indexed: 08/11/2024]
Abstract
BACKGROUND Young adults with cancer diagnosed between the ages of 18 to 39 are recognized as a vulnerable group with unique emotional, social, and practical needs that put them at risk of poor psychosocial outcomes and impaired health-related quality of life (HRQOL). This study describes the protocol of a randomized controlled trial to evaluate the efficacy of Bright IDEAS-Young Adults (Bright IDEAS-YA), a problem-solving skills training intervention, on psychosocial outcomes of young adults newly diagnosed with cancer. METHODS Bright IDEAS-YA is a two-arm, parallel, randomized controlled trial. Young adults are eligible if they are 18-39 years of age, within four months of a first cancer diagnosis, and receiving systemic therapy with life expectancy of at least six months. Participants are randomized 1:1 to Bright IDEAS-YA or enhanced usual care. Survey measures are completed at enrollment and 3, 6, 12, and 24 months. The primary endpoint will be the estimated change from baseline to 6 months in symptoms of depression, anxiety, and psychosocial HRQOL. The other time points are secondary endpoints. Mediators and moderators will be examined. CONCLUSIONS This randomized trial will determine the efficacy of Bright IDEAS-YA on psychosocial outcomes for young adults newly diagnosed with cancer. Analyses will also examine mechanisms of action and potentially identify subgroups for whom the intervention is particularly useful. TRIAL REGISTRATION clinicaltrials.gov #NCT04585269.
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Affiliation(s)
| | | | - Marie Barnett
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Kristine A Donovan
- Moffitt Cancer Center, Tampa, FL 33612, USA; Mayo Clinic, Rochester, MN 55905, USA
| | | | | | - Julia Kearney
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | | | - Diana Diaz
- Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Sanjana Dugad
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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2
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Ashton RE, Faghy MA, Roscoe CMP, Aning J. Inclusivity in prostate cancer and exercise research: a systematic review. Support Care Cancer 2024; 32:616. [PMID: 39198292 PMCID: PMC11358357 DOI: 10.1007/s00520-024-08793-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 08/07/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Prostate cancer (PCa) is the most prevalent type of cancer in men in the UK. Exercise has been shown to improve the health and quality of life of PCa patients. Exercise should be easily accessible to men with PCa regardless of socioeconomic group or ethnicity. There is a need to better understand whether the current evidence base for exercise interventions is representative and inclusive of racial and ethnic minority men with PCa. METHODS A systematic review of the literature was conducted according to PRISMA guidelines and prospectively registered via Prospero (ID: CRD42022384373). The MEDLINE Ovid, Cochrane Library and PubMed databases were searched from inception to December 2022. The search strategy keywords and MeSH terms used included the following: (1) exercise, (2) training, (3) prostate cancer, (4) ethnic and (5) diversity. RESULTS A total of 778 records were retrieved from database searches, of which 15 records were duplicates. A further 649 were eliminated following the screening of titles and abstracts. After full-text screening of 186 articles, 28 manuscripts were included for review. CONCLUSION This systematic review highlights that there is high heterogeneity in the reporting of participants' ethnicity and there are low numbers of ethnic minority men included in PCa and exercise studies in the UK. Further work is required to understand why representation is lacking within PCa exercise trials in the UK and strategies are needed to achieve representation from all ethnic groups. IMPLICATIONS FOR CANCER SURVIVORS Improved representation and reporting of ethnicity in exercise trials is vital to ensure the results are applicable to all patients.
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Affiliation(s)
- Ruth E Ashton
- Research Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK.
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK.
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Mark A Faghy
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Clare M P Roscoe
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Jonathan Aning
- Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury-On-Trym, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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3
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Morie KP, Gilstad-Hayden K, Martino S, Lazar CM, Rosen MI. Sensitivity, specificity, and discordance with self-report of nail sample testing for alcohol and cannabis. Drug Alcohol Depend 2024; 261:111358. [PMID: 38943713 DOI: 10.1016/j.drugalcdep.2024.111358] [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] [Received: 03/03/2024] [Revised: 05/27/2024] [Accepted: 06/02/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Nails accumulate the alcohol metabolite, ethyl glucuronide (ETG), and the cannabis metabolite, carboxy- delta-9-THC over 3-6 months. Few studies have examined nail toxicology testing's sensitivity and specificity and the agreement between nail testing and self-reported alcohol and marijuana use. METHODS In an ongoing clinical trial, 1101 veterans completed initial telephone questionnaires and were then asked to mail nail clippings for substance use analysis. We examined sensitivity and specificity of ETG and carboxy- delta-9-THC in nails compared to self-report of alcohol use patterns (the AUDIT-C) and substance-related harms (alcohol and THC subscales of the ASSIST). We then examined factors associated with discordance between nails and self-report. RESULTS Almost two-thirds (707/1101) of respondents mailed in nail clippings. Those with returned nails were disproportionately married, white race, older, and less depressed. At a threshold of 8pg/mg, sensitivity was only.50 to detect risky alcohol use and.49 to detect alcohol-related issues. Sensitivity for marijuana issues was only.61. Specificity was greater than.77 for all measures. Factors associated with positive nails/negative self-report (i.e. false positives) for risky alcohol use on the Audit-C included more pain and being unmarried; false positive nails for alcohol-related issues on the ASSIST were associated with being unmarried and non-Hispanic ethnicity. False positive nails for THC-related issues on the ASSIST were associated with being African American, Hispanic, and having had legal issues. CONCLUSIONS At standard cut-offs, nail measures had low sensitivity and higher specificity. The groups who disproportionately submit positive nails/negative self-report could have substance use patterns not adequately captured by self-report, inaccurate self-report due to social pressures, or distinct drug metabolism.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA.
| | - Kathryn Gilstad-Hayden
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Steve Martino
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Christina M Lazar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Marc I Rosen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
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4
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Kenny M, Raos R, Ahmad F, Gonzalez A. Assessing Health Equity in Partnership with Children's Mental Health Organizations: Considerations Before the Implementation of Parenting Programs. Health Equity 2024; 8:419-425. [PMID: 39015219 PMCID: PMC11250835 DOI: 10.1089/heq.2023.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 07/18/2024] Open
Abstract
Objectives Understanding and addressing how an individual's social, political, economic, and cultural context affects their ability to achieve optimal health is essential to designing and implementing interventions. Before evaluating two parenting programs, in partnership with four children's mental health organizations, we used the Health Equity Impact Assessment tool (HEIA) to identify groups that may experience unintended health impacts, as well as generated mitigation strategies to address these impacts. Methods HEIA activities included a review of the published literature, a review of organizational documents, key informant interviews with staff (n = 12) and other related community service providers (n = 7), and a geographic information systems analysis. All sources of evidence were considered and analyzed using reflective thematic analysis. Summary reports were shared with all partners. Results A range of groups were identified as at risk of experiencing unintended health impacts, including caregivers who are racialized, immigrants, Indigenous, living with mental health issues or addictions, dealing with intellectual challenges and/or low literacy levels, survivors of childhood trauma, single parent families, or families experiencing financial difficulties. Unintended health impacts were sorted into 6 main themes which fell under the overarching themes of accessibility of the programs and cultural appropriateness. Mitigation strategies as well as innovative strategies already being applied by participating organizations are discussed. Conclusion Although this HEIA focused on parenting programs, the findings address equity issues applicable to the provision of a wide spectrum of children's mental health services.
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Affiliation(s)
- Meghan Kenny
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
| | - Rob Raos
- Geographic Information Systems Analyst, McMaster University, Hamilton, Canada
| | - Fatima Ahmad
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Offord Centre for Child Studies, Hamilton, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Offord Centre for Child Studies, Hamilton, Canada
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Lewins A, Morant N, Akther-Robertson J, Crellin NE, Stansfeld JL, Smith R, Moncrieff J. A qualitative exploration of family members' perspectives on reducing and discontinuing antipsychotic medication. J Ment Health 2024; 33:333-340. [PMID: 35521675 DOI: 10.1080/09638237.2022.2069710] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 02/24/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Antipsychotics are routinely prescribed to people diagnosed with schizophrenia or psychosis on a long-term basis. Considerable literature explores service users' opinions and experiences of antipsychotics, but studies investigating family members' views are lacking. AIMS To explore family members' perspectives on antipsychotics, particularly their views on long-term use, reduction and discontinuation of antipsychotics. METHODS Semi-structured interviews were conducted with 11 family members of people experiencing psychosis. Participants were recruited through community support groups and mental health teams. Interviews were analysed thematically. RESULTS The majority of family members valued antipsychotic medication primarily in supporting what they saw as a fragile stability in the person they cared for. Their views of medication were ambivalent, combining concerns about adverse effects with a belief in the importance of medication due to fears of relapse. They described a need for constant vigilance in relation to medication to ensure it was taken consistently, and often found changes, particularly reduction in medication difficult to contemplate. CONCLUSIONS Findings highlight that family members' attitudes to medication sometimes conflict with those of the people they care for, impacting on their health and the caring relationship. Family members may need more support and could be usefully involved in medication decision-making.
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Affiliation(s)
- Amy Lewins
- Population Policy and Practice, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, United Kingdom of Great Britain and Northern Ireland
| | - Nicola Morant
- Division of Psychiatry, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Johura Akther-Robertson
- Division of Psychiatry, University College London, London, United Kingdom of Great Britain and Northern Ireland
- NELFT Research & Development Department, North East London NHS Foundation Trust Maggie Lilley Suite, Goodmayes Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Nadia E Crellin
- Division of Psychiatry, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Jacki L Stansfeld
- Division of Psychiatry, University College London, London, United Kingdom of Great Britain and Northern Ireland
- NELFT Research & Development Department, North East London NHS Foundation Trust Maggie Lilley Suite, Goodmayes Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Ruth Smith
- Independent consultant, Brighton, United Kingdom of Great Britain and Northern Ireland
| | - Joanna Moncrieff
- Division of Psychiatry, University College London, London, United Kingdom of Great Britain and Northern Ireland
- Havering Community Recovery Team, Harold Wood, United Kingdom of Great Britain and Northern Ireland
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Onwumere J, Gentle A, Obanubi R, Davis A, Karuga M, Ali R, Cardi V. Amplifying the voices of Black racial minorities in mental health research through public involvement and engagement: The importance of advisory roles. Health Expect 2024; 27:e13892. [PMID: 37986702 PMCID: PMC10726207 DOI: 10.1111/hex.13892] [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] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/13/2023] [Accepted: 10/05/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Ensuring adequate representation and the active, meaningful and visible involvement of groups likely to be most impacted by research findings and/or the lack of research inquiry are increasingly acknowledged. This is particularly relevant for Black racially minoritised groups who are less visible as research participants and in patient and public involvement and engagement (PPIE) roles. Our viewpoint article sought to discuss reflections and insights on their involvement experience, with particular attention to perceived barriers and enablers to PPIE involvement. METHODS Qualitative data were collected as part of facilitated group discussions from nine Black racially minoritised experts-by-experience involved in a PPIE advisory group. Data were subjected to thematic analysis to identify key themes. RESULTS Five main themes were identified that reflected factors linked to practicalities: role unfamiliarity, benefits for the larger community, acknowledgement of previous harm and mental health stigma. CONCLUSION Given the existence and importance of the direct links between research and service and treatment innovations in health and social care, ensuring that those from underrepresented Black racial communities are meaningfully and equitably supported to have roles in advising and influencing research programmes should be prioritised and an ongoing consideration for different stakeholders, including research funders, researchers, healthcare providers and community leaders/representatives. PATIENT OR PUBLIC CONTRIBUTION This viewpoint article is a collaboration between lived experience stakeholders and researchers, comprising conceiving the original idea for the paper, its conceptualisation and data generation and the coproduction including editing of the manuscript.
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Affiliation(s)
- Juliana Onwumere
- Department of Psychology, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
- NIHR Biomedical Research Centre for Mental Health South London and Maudsley NHSLondonUK
| | | | | | | | | | - Rubbia Ali
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | | | - Valentina Cardi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of General PsychologyUniversity of PadovaPaduaItaly
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7
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Sulaiman-Hill R, Porter R, Schluter P, Beaglehole B, Dean S, Tanveer S, Boden J, Bell C. Research following trauma in minority ethnic and faith communities: lessons from a study of the psychosocial sequelae of the Christchurch mosque terror attacks. BJPsych Open 2024; 10:e27. [PMID: 38205604 PMCID: PMC10790214 DOI: 10.1192/bjo.2023.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024] Open
Abstract
Recruiting participants for research from highly traumatised ethnic and faith communities requires a participatory and trauma-informed approach that considers logistic barriers, as well as trauma-related and culture-specific issues. Active community engagement through every stage of the project and employing community members in research roles can help build trust, identify and mitigate concerns early, prevent re-traumatization, and ensure that findings will be of value to the community. Some of these research challenges are discussed in the context of the Christchurch mosque terror attacks. These insights may be helpful for researchers and clinicians working in similarly challenging environments.
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Affiliation(s)
| | - Richard Porter
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Philip Schluter
- Te Kaupeka Oranga – Faculty of Health, Te Whare Wānanga o Waitaha – University of Canterbury, New Zealand; and Primary Care Clinical Unit, School of Clinical Medicine, The University of Queensland, Australia
| | - Ben Beaglehole
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Shaystah Dean
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Sandila Tanveer
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
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Smarr MM, Avakian M, Lopez AR, Onyango B, Amolegbe S, Boyles A, Fenton SE, Harmon QE, Jirles B, Lasko D, Moody R, Schelp J, Sutherland V, Thomas L, Williams CJ, Dixon D. Broadening the Environmental Lens to Include Social and Structural Determinants of Women's Health Disparities. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:15002. [PMID: 38227347 PMCID: PMC10790815 DOI: 10.1289/ehp12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Due to the physical, metabolic, and hormonal changes before, during, and after pregnancy, women-defined here as people assigned female at birth-are particularly susceptible to environmental insults. Racism, a driving force of social determinants of health, exacerbates this susceptibility by affecting exposure to both chemical and nonchemical stressors to create women's health disparities. OBJECTIVES To better understand and address social and structural determinants of women's health disparities, the National Institute of Environmental Health Sciences (NIEHS) hosted a workshop focused on the environmental impacts on women's health disparities and reproductive health in April 2022. This commentary summarizes foundational research and unique insights shared by workshop participants, who emphasized the need to broaden the definition of the environment to include upstream social and structural determinants of health. We also summarize current challenges and recommendations, as discussed by workshop participants, to address women's environmental and reproductive health disparities. DISCUSSION The challenges related to women's health equity, as identified by workshop attendees, included developing research approaches to better capture the social and structural environment in both human and animal studies, integrating environmental health principles into clinical care, and implementing more inclusive publishing and funding approaches. Workshop participants discussed recommendations in each of these areas that encourage interdisciplinary collaboration among researchers, clinicians, funders, publishers, and community members. https://doi.org/10.1289/EHP12996.
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Affiliation(s)
- Melissa M. Smarr
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | | | | | | | - Sara Amolegbe
- Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Abee Boyles
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Suzanne E. Fenton
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Quaker E. Harmon
- Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Bill Jirles
- Office of the Director, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Denise Lasko
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Rosemary Moody
- Division of Extramural Research, National Institute on Drug Abuse, Bethesda, Maryland, USA
| | - John Schelp
- Office of the Director, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Vicki Sutherland
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Laura Thomas
- Division of Translational Research, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Carmen J. Williams
- Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Darlene Dixon
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
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Hale ME, George AM, Caughy MO, Suveg C. Resting respiratory sinus arrythmia and cognitive reappraisal moderate the link between political climate stress and anxiety symptoms in Latina and Black mothers. ANXIETY, STRESS, AND COPING 2024; 37:100-113. [PMID: 37075162 DOI: 10.1080/10615806.2023.2199207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 03/29/2023] [Indexed: 04/21/2023]
Abstract
Guided by the Family Stress Model for minority families, the present study examined the potential buffering effect of resting respiratory sinus arrythmia (RRSA), cognitive reappraisal, and mindfulness on the association between political climate stress (PCS) and anxiety symptoms in a sample of Latina and Black mothers. Participants were 100 mothers living in the southeastern United States. Mothers reported on PCS, cognitive reappraisal, mindfulness, and symptoms of anxiety. RRSA were measured during a resting task. Moderation analyses tested the influence of these three factors (RRSA, cognitive reappraisal, mindfulness) on the relation between PCS and anxiety. Results showed that the relation between PCS and anxiety symptoms was strongest at low levels of RRSA and cognitive reappraisal. At high levels of these two factors, there was no association between PCS and anxiety symptoms. Mothers with high levels of RRSA and cognitive reappraisal may be able to interact with and evaluate environmental stimuli in such a way that allows for adaptive adjustment, buffering against the negative impact of PCS. RRSA and cognitive reappraisal may be important targets of interventions designed to address the rising rates of anxiety symptoms in Latina and Black mothers.
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Affiliation(s)
- Molly E Hale
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Andrea M George
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Margaret O Caughy
- Department of Human Development and Family Sciences, University of Georgia, Athens, GA, USA
| | - Cynthia Suveg
- Department of Psychology, University of Georgia, Athens, GA, USA
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Kotera Y, Adam H, Kirkman A, Aledeh M, Brooks-Ucheaga M, Todowede O, Rennick-Egglestone S, Jackson JE. Positive Mental Health of Migrants in the UK during COVID-19: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7046. [PMID: 37998277 PMCID: PMC10671421 DOI: 10.3390/ijerph20227046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/27/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023]
Abstract
COVID-19 impacted the mental health of many people in the UK. The negative impact was especially substantial among vulnerable population groups, including migrants. While research has focused on the negative aspects of mental health during the pandemic, the positive mental health of migrants in the UK during COVID-19 remained to be evaluated. This review aimed to identify literature that focused on positive mental health, and thematically synthesise the findings to understand what positive mental health approaches were employed to support specific outcomes during the pandemic for them to survive in this difficult time. Medline, Embase, and PsycINFO were searched using terms including "mental health", "migrants", and "COVID-19". The Critical Appraisal Skills Programme checklist was used to assess the quality of the included studies. There were only two studies examining the positive mental health of UK migrants during this period. They describe approaches such as religious beliefs, passion for and acknowledgement of their job, learning new things, being physically active, social media, and social activities, producing outcomes such as inner peace, confidence, well-being, and a sense of belonging. The quality of the included studies was high. More research about positive mental health in migrants in the UK during the pandemic is needed.
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Affiliation(s)
- Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham NG7 2TU, UK; (Y.K.); (O.T.); (S.R.-E.)
- Center for Infectious Disease Education and Research, Osaka University, Osaka 565-0871, Japan
| | - Habib Adam
- Institut für Religionswissenschaft, University of Vienna, 1010 Vienna, Austria;
| | - Ann Kirkman
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK; (A.K.); (M.B.-U.); (J.E.J.)
| | - Muhammad Aledeh
- Department of Psychiatry, Wiener Gesundheitsverbund, Klinik Donaustadt, Langobardenstraße 122, 1220 Vienna, Austria
| | - Michelle Brooks-Ucheaga
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK; (A.K.); (M.B.-U.); (J.E.J.)
| | - Olamide Todowede
- School of Health Sciences, University of Nottingham, Nottingham NG7 2TU, UK; (Y.K.); (O.T.); (S.R.-E.)
| | - Stefan Rennick-Egglestone
- School of Health Sciences, University of Nottingham, Nottingham NG7 2TU, UK; (Y.K.); (O.T.); (S.R.-E.)
| | - Jessica Eve Jackson
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK; (A.K.); (M.B.-U.); (J.E.J.)
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11
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Sam N, Hill J, Hamer O. Recruiting adults of ethnic minorities into clinical trials: a synthesis of strategies. BRITISH JOURNAL OF CARDIAC NURSING 2023; 18:2023.0032. [PMID: 38808261 PMCID: PMC7616012 DOI: 10.12968/bjca.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
There is a long history of BAME under-representation in medical research. Underrepresentation of minority ethnic groups have been assessed by several studies, showing that black and minority ethnic groups were less likely to participate and engage in medical research when compared to white British groups (in relation to education, occupation, health, belief, and attitudes to medical research).There may be several strategies that improve inclusivity, including translation of participant information, culturally specific recruitment, and adaptations to the invitation process. However, with a dearth of literature in the area, there is now a need to contextualise these strategies in relation to renal research.
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Affiliation(s)
- Nirmala Sam
- Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK
| | - James Hill
- University of Central Lancashire, Preston, UK
- National Institute for Health and Care Research Applied Research Collaboration − Northwest Coast, UK
| | - Oliver Hamer
- University of Central Lancashire, Preston, UK
- National Institute for Health and Care Research Applied Research Collaboration − Northwest Coast, UK
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12
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Assessing targeted invitation and response modes to improve survey participation in a diverse New York City panel: Healthy NYC. PLoS One 2023; 18:e0280911. [PMID: 36701347 PMCID: PMC9879422 DOI: 10.1371/journal.pone.0280911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Healthy NYC is an innovative survey panel created by the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) that offers a cost-effective mechanism for collecting priority and timely health information. Between November 2020 and June 2021, invitations for six different surveys were sent to Healthy NYC panelists by postal mail, email, and text messages. Panelists had the option to complete surveys online or via paper survey. METHODS We analyzed whether panelists varied by sociodemographic characteristics based on the contact mode they provided and the type of invitation that led to their response using logistic regression models. Poisson regression models were used to determine whether the number of invitations received before participating in a survey was associated with sociodemographic characteristics. RESULTS Younger age and higher education were positively associated with providing an email or text contact. Furthermore, age, race, and income were significant predictors for invitation modes that led to a survey response. Black panelists had 72% greater odds (OR 1.72 95% CI: 1.11-2.68) of responding to a mail invite and 33% lesser odds (OR 0.67, 95% CI: 0.54-0.83) of responding to an email invite compared with White panelists. Additionally, in five of the six surveys, more than half of the respondents completed surveys after two invites. Email invitations garnered the highest participation rates. CONCLUSIONS We recommend using targeted invitation modes as an additional strategy to improve participation in panels. For lower-income panelists who do not provide an email address, it may be reasonable to offer additional response options that do not require internet access. Our study's findings provide insight into how panels can tailor outreach to panelists, especially among underrepresented groups, in the most economical and efficient ways.
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Vujcich D, Brown G, Durham J, Gu Z, Hartley L, Lobo R, Mao L, Moro P, Pillay V, Mullens AB, Oudih E, Roberts M, Wilshin C, Reid A. Strategies for Recruiting Migrants to Participate in a Sexual Health Survey: Methods, Results, and Lessons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12213. [PMID: 36231514 PMCID: PMC9564521 DOI: 10.3390/ijerph191912213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
In this article, we describe the approaches taken to recruit adult migrants living in Australia for a sexual health and blood-borne virus survey (paper and online) and present data detailing the outcomes of these approaches. The purpose was to offer guidance to redress the under-representation of migrants in public health research. Methods of recruitment included directly contacting people in individual/organizational networks, social media posts/advertising, promotion on websites, and face-to-face recruitment at public events/venues. Search query strings were used to provide information about an online referral source, and project officers kept records of activities and outcomes. Descriptive statistical analyses were used to determine respondent demographic characteristics, proportions recruited to complete the paper and online surveys, and sources of referral. Logistic regression analyses were run to predict online participation according to demographic characteristics. The total sample comprised 1454 African and Asian migrants, with 59% identifying as female. Most respondents (72%) were recruited to complete the paper version of the survey. Face-to-face invitations resulted in the highest number of completions. Facebook advertising did not recruit large numbers of respondents. Same-sex attraction and age (40-49 years) were statistically significant predictors of online completion. We encourage more researchers to build the evidence base on ways to produce research that reflects the needs and perspectives of minority populations who often bear the greatest burden of disease.
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Affiliation(s)
- Daniel Vujcich
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Graham Brown
- Centre for Social Impact, UNSW, Sydney, NSW 2052, Australia
| | - Jo Durham
- Centre for Healthcare Transformation, Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, West End, QLD 4101, Australia
| | - Lisa Hartley
- Centre for Human Rights Education, Curtin University, Bentley, WA 6102, Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW, Sydney, NSW 2052, Australia
| | - Piergiorgio Moro
- Multicultural Health Support Service, Centre for Culture, Ethnicity and Health, Richmond, VIC 3121, Australia
| | - Vivienne Pillay
- Ethnic Communities Council of WA, North Perth, WA 6006, Australia
| | - Amy B. Mullens
- Centre for Health Research, School of Psychology & Wellbeing, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Enaam Oudih
- Relationships Australia South Australia, Hindmarsh, SA 5007, Australia
| | - Meagan Roberts
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Caitlin Wilshin
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Alison Reid
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
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14
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Reinosa Segovia FA, Benuto LT. A Systematic Review of Ethnoracial Participation in Randomized Clinical Trials of Behavioral Activation. Behav Ther 2022; 53:927-943. [PMID: 35987549 DOI: 10.1016/j.beth.2022.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/18/2022] [Accepted: 03/25/2022] [Indexed: 11/27/2022]
Abstract
As of the last available NIH report, people of color (POC) constituted 28.1% of enrollment across all U.S. domestic clinical trials. The literature on prevalence rates of depression among POC is mixed. While the prevalence rates of depression may vary across POC, it remains unknown to what degree POC have been included in outcome clinical trials of depression since NIH's mandates for inclusion of minorities in clinical outcome research. Following PRISMA guidelines, the present review identified randomized controlled trials of behavioral activation from 1989 to 2021 using the following search engines: PsycINFO, EMBASE, and Cochrane Central Register of Controlled Trials. We reviewed 5,247 articles and included 28 articles that met full inclusion criteria (n = 5,169 participants). Across studies included in this review, 70% were non-Latinx White, 14.1% were African American, 8.9% were Latinx, 0.5% were Asian, 2.9% were other, and 3.7% were unknown. Results indicated an increase in representation of ethnoracial inclusion rates across time and that recruitment method was not associated with adequate inclusion of POC. However, the university setting was associated with inadequate representation of POC.
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15
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Harrison D, Wilson R, Graham A, Brown K, Hesselgreaves H, Ciesielska M. Making every contact count with seldom-heard groups? A qualitative evaluation of voluntary and community sector (VCS) implementation of a public health behaviour change programme in England. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3193-e3206. [PMID: 35218264 PMCID: PMC9544506 DOI: 10.1111/hsc.13764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/19/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Making Every Contact Count (MECC) is a national, long-term public health strategy in England. It supports public-facing workers to use opportunities during routine contacts to enable healthy lifestyle changes. This paper reports the findings from an external evaluation of voluntary and community sector (VCS) delivery of MECC in the North East of England, which focused on engaging under-represented client groups. The study aimed to (a) Establish if (and how) MECC had impacted the workforce, including changes to staff knowledge, confidence and behaviour; (b) Identify benefits, challenges and unintended consequences; and (c) Explore outcomes for service users. A multi-stage qualitative design focused on understanding both process and outcomes. The study utilised three data collection methods, including a journey mapping workshop (n = 20), semi-structured interviews with delivery leads, VCS workers and volunteers who had accessed MECC training (n = 11), and focus group discussions with clients (n = 22). The findings illustrated positive early outcomes, including improvements in self-reported staff knowledge and confidence as well as emerging examples of organisational culture shift and individual behaviour change. Alongside this, the data provided a rich picture of barriers and challenges which are examined at different levels-national programme, local programme, VCS sector, partner organisation, worker and client. The research highlights clear successes of the VCS delivery model. However, it is presented as a 'double-edged sword,' in light of associated challenges such as sector-level funding uncertainty and accessibility of MECC resources to diverse client groups. The discussion considers issues related to the measurement and attribution of behaviour change outcomes for brief interventions, as well as fidelity, legacy and long-term sustainability challenges. The recommendations call for system-level analysis and comparison of different MECC implementation models, to improve our understanding of challenges, opportunities and programme reach for behaviour change intervention programmes-particularly in relation to seldom-heard client groups.
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Affiliation(s)
- Deborah Harrison
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
| | - Rob Wilson
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
| | - Andy Graham
- Public Health ConsultantLocal GovernmentNorth East EnglandUK
| | - Kristina Brown
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
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16
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MacDermod C, Pettie MA, Carrino EA, Garcia SC, Padalecki S, Finch JE, Sanzari C, Kennedy HL, Pawar PS, Mcgough MM, Iwashita A, Takgbajouah M, Coan D, Szakasits L, Goode RW, Wu Y, Reyes‐Rodríguez ML, Vacuán EMTC, Kennedy MA, Cleland L, Jordan J, Maguire S, Guintivano JD, Giusti‐Rodríguez P, Baker JH, Thornton LM, Bulik CM. Recommendations to encourage participation of individuals from diverse backgrounds in psychiatric genetic studies. Am J Med Genet B Neuropsychiatr Genet 2022; 189:163-173. [PMID: 35785430 PMCID: PMC9542122 DOI: 10.1002/ajmg.b.32906] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/04/2022] [Accepted: 06/14/2022] [Indexed: 11/21/2022]
Abstract
We present innovative research practices in psychiatric genetic studies to ensure representation of individuals from diverse ancestry, sex assigned at birth, gender identity, age, body shape and size, and socioeconomic backgrounds. Due to histories of inappropriate and harmful practices against marginalized groups in both psychiatry and genetics, people of certain identities may be hesitant to participate in research studies. Yet their participation is essential to ensure diverse representation, as it is incorrect to assume that the same genetic and environmental factors influence the risk for various psychiatric disorders across all demographic groups. We present approaches developed as part of the Eating Disorders Genetics Initiative (EDGI), a study that required tailored approaches to recruit diverse populations across many countries. Considerations include research priorities and design, recruitment and study branding, transparency, and community investment and ownership. Ensuring representation in participants is costly and funders need to provide adequate support to achieve diversity in recruitment in prime awards, not just as supplemental afterthoughts. The need for diverse samples in genetic studies is critical to minimize the risk of perpetuating health disparities in psychiatry and other health research. Although the EDGI strategies were designed specifically to attract and enroll individuals with eating disorders, our approach is broadly applicable across psychiatry and other fields.
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Affiliation(s)
- Casey MacDermod
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Michaela A. Pettie
- Department of Pathology and Biomedical ScienceUniversity of OtagoChristchurchNew Zealand
| | - Emily A. Carrino
- Department of Psychology and NeuroscienceUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Susana Cruz Garcia
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyUniversity at Albany, State University of New YorkAlbanyNew YorkUSA
| | - Sophie Padalecki
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Elon UniversityElonNorth CarolinaUSA
| | - Jody E. Finch
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Christina Sanzari
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyUniversity at Albany, State University of New YorkAlbanyNew YorkUSA
| | - Hannah L. Kennedy
- Department of Psychological MedicineUniversity of OtagoChristchurchNew Zealand
| | - Pratiksha S. Pawar
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Dr. D. Y. Patil Biotechnology & Bioinformatics InstituteDr. D. Y. Patil VidyapeethPuneIndia
| | | | - Ava Iwashita
- Crystal Springs Uplands SchoolHillsboroughCaliforniaUSA
| | - Mary Takgbajouah
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyDePaul UniversityChicagoIllinoisUSA
| | - Danielle Coan
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Social WorkNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Lindsey Szakasits
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychiatryCampbell UniversityBules CreekNorth CarolinaUSA
| | - Rachel W. Goode
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Ya‐Ke Wu
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,School of NursingUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | - Eva María Trujillo Chi Vacuán
- Comenzar de Nuevo Eating Disorders Treatment and Research CenterMonterreyMexico,Department of PediatricsSchool of Medicine and Health Sciences Tec SaludMonterreyMexico
| | - Martin A. Kennedy
- Department of Pathology and Biomedical ScienceUniversity of OtagoChristchurchNew Zealand
| | - Lana Cleland
- Department of Psychological MedicineUniversity of OtagoChristchurchNew Zealand
| | - Jennifer Jordan
- Department of Psychological MedicineUniversity of OtagoChristchurchNew Zealand
| | - Sarah Maguire
- Inside Out Institute for Eating DisordersSydneyAustralia,Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
| | - Jerry D. Guintivano
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | - Jessica H. Baker
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
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17
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Baiden D, Evans M. Recruitment Strategies to Engage Newcomer Mothers of African Descent in Maternal Mental Health Research in Canada. J Transcult Nurs 2022; 33:467-474. [PMID: 35466798 PMCID: PMC9240378 DOI: 10.1177/10436596221090268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Newcomer mothers of African descent are at risk for maternal mental
stress because of inadequate social support, newcomer status,
and stress of motherhood. Limited participation of newcomer
African mothers in mental health research contributes to a
knowledge gap in this area further impacting culturally
competent health services. This article reports recruitment
strategies to better engage African newcomer women in maternal
mental health research. Methods: In-depth discussion of recruitment strategies, used in a
qualitative descriptive study conducted with Black African
newcomer mothers in Canada. Results: Ten African newcomer mothers were successfully recruited using
recruitment strategies such as engagement with religious
organizations, snowballing, and the use of social media. Discussion: Cultural beliefs on motherhood, resilience, and mental illness may
account for hesitancy to engage in maternal mental health
research. Recruitment strategies could help overcome the
challenges and potentially diversify maternal mental health
research in Canada through the engagement of African newcomer
mothers.
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18
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Ahmed A, Vandrevala T, Hendy J, Kelly C, Ala A. An examination of how to engage migrants in the research process: building trust through an 'insider' perspective. ETHNICITY & HEALTH 2022; 27:463-482. [PMID: 31722534 DOI: 10.1080/13557858.2019.1685651] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
Introduction: Ensuring all members of society can equally participate in research and the provision of services is a challenging goal. Increased migration has been mirrored by media narratives of social threat, leaving many migrants feeling differentiated and distrustful of mainstream society.Objectives: We explore how migrant and ethnic minority populations can be given the opportunity to participate in the research process. In this work, we iteratively and jointly developed a range of engagement strategies that adopt an 'insider' approach; seeking to eliminate feelings of differentiation and 'otherness' by establishing mutual trust.Design: Recruitment activities were carried out with 8 focus groups of first-generation South Asian migrants (the largest ethnic minority group in England). Our analysis was grounded in the broad principles of action research with reflective evaluation of our recruitment process using field observations and relevant focus group data; asking whether we tackled barriers to engagement.Results: Our findings show that 'otherness' can be reduced by establishing a trustworthy researcher-community relationship, but also that this relationship is complex, and needs to acknowledge residual mistrust. Alongside, researchers need to enable opportunities for empowered interaction, with flexible strategies to negotiate potential power divides.Conclusions: We can successfully create opportunities for engagement but there is no 'one size fits all'. Engagement requires tailored approaches that embrace flexibility, and position both engagement and non-engagement as positive and empowered choices.
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Affiliation(s)
- Ayesha Ahmed
- Brunel Business School, Brunel University London, London, UK
| | - T Vandrevala
- Department of Psychology, School of Social and Behavioural Sciences, Kingston University, Kingston-Upon-Thames, UK
| | - J Hendy
- Brunel Business School, Brunel University London, London, UK
| | - C Kelly
- Department of Gastroenterology and Hepatology, The Royal Surrey County Hospital NHS Foundation Trust Guildford, Guildford, UK
| | - A Ala
- Department of Gastroenterology and Hepatology, The Royal Surrey County Hospital NHS Foundation Trust Guildford, Guildford, UK
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Institute of Liver Studies, King's College Hospital London, London, UK
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19
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Farooqi A, Jutlla K, Raghavan R, Wilson A, Uddin MS, Akroyd C, Patel N, Campbell-Morris PP, Farooqi AT. Developing a toolkit for increasing the participation of black, Asian and minority ethnic communities in health and social care research. BMC Med Res Methodol 2022; 22:17. [PMID: 35026996 PMCID: PMC8758375 DOI: 10.1186/s12874-021-01489-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/03/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND It is recognised that Black, Asian and Minority Ethnic (BAME) populations are generally underrepresented in research studies. The key objective of this work was to develop an evidence based, practical toolkit to help researchers maximise recruitment of BAME groups in research. METHODS Development of the toolkit was an iterative process overseen by an expert steering group. Key steps included a detailed literature review, feedback from focus groups (including researchers and BAME community members) and further workshops and communication with participants to review the draft and final versions. RESULTS Poor recruitment of BAME populations in research is due to complex reasons, these include factors such as inadequate attention to recruitment strategies and planning, poor engagement with communities and individuals due to issues such as cultural competency of researchers, historical poor experience of participating in research, and lack of links with community networks. Other factors include language issues, relevant expertise in research team and a lack of adequate resources that might be required in recruitment of BAME populations. CONCLUSIONS A toolkit was developed with key sections providing guidance on planning research and ensuring adequate engagement of communities and individuals. Together with sections suggesting how the research team can address training needs and adopt best practice. Researchers highlighted the issue of funding and how best to address BAME recruitment in grant applications, so a section on preparing a grant application was also included. The final toolkit document is practical, and includes examples of best practice and 'top tips' for researchers.
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Affiliation(s)
| | - Karan Jutlla
- Institute of Health, University of Wolverhampton, Gorway Road, Walsall, Wolverhampton, WS1 3BD, UK.
| | | | | | | | - Carol Akroyd
- East Midlands Centre for BME Health, Leicester, UK
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20
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Characteristics of Asian-American Breast Cancer Survivors Retained in a 3-Month Technology-Based Intervention. Cancer Nurs 2022; 45:E766-E774. [PMID: 34661563 PMCID: PMC9001739 DOI: 10.1097/ncc.0000000000001025] [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: 01/03/2023]
Abstract
BACKGROUND Technology-based intervention programs are known to be effective in approaching socially excluded groups or racial/ethnic minorities, including this specific population. However, the retention of participants in technology-based intervention studies is far more complicated and challenging compared with conventional studies targeting racial/ethnic minorities. OBJECTIVE This study aimed to identify the complex characteristics of the groups within Asian American breast cancer survivors who were successfully retained in a 3-month technology-based intervention study. METHODS This secondary analysis of the data from a larger ongoing intervention study included 155 Asian American breast cancer survivors. Major variables were measured using multiple instruments including the questions on characteristics of the participants, the Personal Resource Questionnaire, perceived isolation, Memorial Symptom Assessment Scale-Short Form, Cancer Behavior Inventory, 34-item Supportive Care Needs Survey Short Form, and Functional Assessment of Cancer Therapy Scale-Breast Cancer. Data analyses were done through χ2 tests, t tests, and decision tree analyses. RESULTS The retention rates differed by subethnicity (P = .025), immigration age (P < .001), and stage of breast cancer (P = .003). The decision tree indicated four groups with the highest probability of retention: (a) those who were diagnosed with stage II, III, or IV breast cancer, (b) those who immigrated to the United States after turning 31 years old, and (c) those who had high perceived barriers. CONCLUSION This study provides directions for future retention strategies for technology-based interventions among Asian American breast cancer survivors. IMPLICATIONS FOR PRACTICE Participants' characteristics need to be considered in developing retain strategies for technology-based interventions among Asian American breast cancer survivors.
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21
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Kokorelias KM, Nelson MLA, Tang T, Steele Gray C, Ellen M, Plett D, Jarach CM, Xin Nie J, Thavorn K, Singh H. Who is Included in Digital Health Technologies to Support Hospital to Home Transitions for Older Adults?: Secondary analysis of a rapid review and equity-informed recommendations (Preprint). JMIR Aging 2021; 5:e35925. [PMID: 35475971 PMCID: PMC9096639 DOI: 10.2196/35925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Kristina Marie Kokorelias
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Sinai Health System/University Health Network, Toronto, ON, Canada
| | - Michelle LA Nelson
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, Toronto, ON, Canada
| | - Terence Tang
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carolyn Steele Gray
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Moriah Ellen
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Eilat, Israel
| | - Donna Plett
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Carlotta Micaela Jarach
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Hardeep Singh
- March of Dimes Canada, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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22
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Stice E, Onipede ZA, Shaw H, Rohde P, Gau JM. Effectiveness of the Body Project eating disorder prevention program for different racial and ethnic groups and an evaluation of the potential benefits of ethnic matching. J Consult Clin Psychol 2021; 89:1007-1019. [PMID: 35025541 PMCID: PMC9422777 DOI: 10.1037/ccp0000697] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Provide an adequately powered tests of whether a group-delivered dissonance-based eating disorder prevention program (Body Project) is similarly effective for different racial and ethnic groups and evaluate whether an improved match between minority participant race/ethnicity and fellow group members is associated with larger effects. METHOD Study 1 examined data from 539 young women from seven high schools and four universities and Study 2 examined data from 1,195 young women and men from 50 universities who completed the Body Project, focusing on pretest-to-posttest reductions in outcomes. RESULTS In Study 1, reductions in thin-ideal internalization, body dissatisfaction, dieting, negative affect, and eating disorder symptoms did not significantly differ for White versus Asian, Black, and Native Americans, though we did not have power to contrast racial and ethnic minority groups. In Study 2, only one intervention effect was weaker for a minority group relative to Whites (Black vs. White participants showed smaller reductions in thin-ideal internalization), but there was evidence that intervention effects were significantly larger for Hispanic versus White and Black participants, and to a lesser extent for Hispanic versus Asian and Native Americans; these differences were partially driven by differences in pretest risk across ethnic groups. Ethnic/racial matching was not associated with larger effects. CONCLUSIONS Results suggest that the Body Project produced relatively similar effects for racial/ethnic minority groups relative to White participants, that the effects were sometimes larger for Asian and Hispanic participants, and that recruiting Black participants at higher risk may contribute to larger effects for this racial group. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Eric Stice
- Department of Psychiatry, Stanford University
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23
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Perspectives on barriers and facilitators to mental health support after a traumatic birth among a sample of primarily White and privately insured patients. Gen Hosp Psychiatry 2021; 73:46-53. [PMID: 34583284 PMCID: PMC8629868 DOI: 10.1016/j.genhosppsych.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To elicit the perspectives of individuals with a traumatic birth experience on barriers and facilitators to receiving mental health support in the postpartum period. METHODS Individuals who experienced a traumatic birth within the last three years (n = 32) completed semi-structured phone interviews about their birth and postpartum experience. The Post-traumatic Stress Disorder Checklist for DSM-V (PCL-5), Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder scale (GAD-7) were administered. Qualitative data was analyzed using a modified grounded theory by three independent coders. RESULTS Among participants, 34.4% screened positive for PTSD, 18.8% for depression, and 34.4% for anxiety. Participants described multi-level barriers that prevented clinicians from recognizing and supporting patients' postpartum mental health needs; those involved lack of communication, education, and resources. Recommendations from participants included that 1) obstetric professionals should acknowledge birth-related trauma experienced by any individual, 2) providers of multiple disciplines need to be integrated into postpartum care, and 3) mental health support may be needed before the ambulatory postpartum visit. CONCLUSIONS There are multi-level barriers towards detecting and responding to individuals' mental health needs after a traumatic birth. Obstetric professionals need to use a trauma-informed approach and proactively assess mental health throughout the postpartum period.
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Massett HA, Mitchell AK, Alley L, Simoneau E, Burke P, Han SH, Gallop-Goodman G, McGowan M. Facilitators, Challenges, and Messaging Strategies for Hispanic/Latino Populations Participating in Alzheimer's Disease and Related Dementias Clinical Research: A Literature Review. J Alzheimers Dis 2021; 82:107-127. [PMID: 33998537 DOI: 10.3233/jad-201463] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) disproportionally affect Hispanic and Latino populations, yet Hispanics/Latinos are substantially underrepresented in AD/ADRD clinical research. Diverse inclusion in trials is an ethical and scientific imperative, as underrepresentation reduces the ability to generalize study findings and treatments across populations most affected by a disease. This paper presents findings from a narrative literature review (N = 210) of the current landscape of Hispanic/Latino participation in clinical research, including the challenges, facilitators, and communication channels to conduct culturally appropriate outreach efforts to increase awareness and participation of Hispanics/Latinos in AD/ADRD clinical research studies. Many challenges identified were systemic in nature: lack of culturally relevant resources; staffing that does not represent participants' cultures/language; eligibility criteria that disproportionately excludes Hispanics/Latinos; and too few studies available in Hispanic/Latino communities. The paper also details facilitators and messaging strategies to improve engagement and interest among Hispanics/Latinos in AD/ADRD research, starting with approaches that recognize and address the heterogeneity of the Hispanic/Latino ethnicity, and then, tailor outreach activities and programs to address their diverse needs and circumstances. The needs identified in this article represent longstanding failures to improve engagement and interest among Hispanics/Latinos in AD/ADRD research; we discuss how the field can move forward learning from the experiences of the COVID-19 pandemic.
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Affiliation(s)
- Holly A Massett
- Division of Extramural Activities, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | - Sae H Han
- Kelly Government, Kelly Services, Inc., Rockville, MD, USA
| | - Gerda Gallop-Goodman
- Office of Communications and Public Liaison, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Melissa McGowan
- Office of Communications and Public Liaison, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
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Freudenthal R, Marston L, Stansfeld JL, Priebe S, Moncrieff J. How do participants in clinical trials compare with other patients with schizophrenia? Contemp Clin Trials Commun 2021; 22:100803. [PMID: 34195470 PMCID: PMC8233122 DOI: 10.1016/j.conctc.2021.100803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 01/31/2023] Open
Abstract
We aimed to explore the clinical relevance of a multicentre, pragmatic randomised trial of antipsychotic reduction in people diagnosed with schizophrenia or psychosis The sample recruited for the antipsychotic reduction study (n = 69 people) was compared with the population of patients with an eligible diagnosis undergoing treatment in the same service (n = 3067 people), using routinely-collected, anonymised data. The trial sample was found to resemble the wider population in terms of the number of past admissions, the likelihood of having been subject to legal detention and the level of risk the patient was perceived to pose to themselves or others. There was a lower proportion of people from minority ethnic backgrounds in the trial sample. The results provide some reassurance that trial recruits were similar to the wider population in terms of the severity of their condition and did not comprise a highly select sample of people with milder problems. The different ethnic composition of the research sample is consistent with other research.
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Affiliation(s)
| | - Louise Marston
- Research Department of Primary Care and Population Health, University College London, London, UK.,Priment Clinical Trials Unit, University College London, London, UK
| | - Jacki L Stansfeld
- Division of Psychiatry, University College London, London, UK.,Research & Development Department, Goodmayes Hospital, North East London NHS Foundation Trust, Essex, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Joanna Moncrieff
- Division of Psychiatry, University College London, London, UK.,Research & Development Department, Goodmayes Hospital, North East London NHS Foundation Trust, Essex, UK
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Lim C, Hernandez M, Gaona L, Barrio C. Recruitment of Asian Americans with Schizophrenia Spectrum Disorder for Research Participation: Barriers, Strategies, and Outcomes. Community Ment Health J 2021; 57:490-501. [PMID: 32588227 DOI: 10.1007/s10597-020-00670-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 06/19/2020] [Indexed: 11/28/2022]
Abstract
Difficulty reaching Asian Americans with schizophrenia spectrum disorder has prompted mental health researchers to exclude this subpopulation from the sampling frame or enroll a comparatively smaller sample compared to other races and ethnicities with similar diagnoses. Understanding potential influences on research participation may facilitate efforts to increase the representation of this vulnerable yet underrepresented population in research. We detailed our experiences recruiting Asian Americans with schizophrenia spectrum disorder for participation in an observational study that evaluated their clinical outcomes. We applied the matching model of recruitment by identifying recruitment barriers encountered by or arising from the target group and researchers at the macro (community mental health center and academic institution), mediator (gatekeepers and research team), and micro (participant and interviewer) levels and then implementing a multilevel approach to overcoming identified obstacles. Our yearlong recruitment efforts yielded a diverse community sample (n = 75) recruited from six urban community mental health centers. Barriers to involving Asian Americans with schizophrenia spectrum disorder in research are complex and associated with being a member of a heterogeneous racial and ethnic minority group and having a serious psychiatric condition. Engaging Asian Americans with schizophrenia spectrum disorder in research is feasible if researchers devote time and resources to address barriers confronting the target group and challenges researchers encounter.
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Affiliation(s)
- Caroline Lim
- Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3 Level 4, 3 Arts Link, Singapore, 117570, Singapore.
| | - Mercedes Hernandez
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, USA
| | - Lizbeth Gaona
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.,College of Behavioral and Social Sciences, Calfornia Baptist University, Riverside, USA
| | - Concepción Barrio
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
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Issues in Recruiting and Retaining Asian American Breast Cancer Survivors in a Technology-Based Intervention Study. Cancer Nurs 2020; 43:E22-E29. [PMID: 30346330 DOI: 10.1097/ncc.0000000000000657] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Difficulties in recruiting and retaining Asian Americans in traditional research have been well documented. Despite an increasing number of technology-based cancer studies among racial/ethnic minorities, little is still known about potential issues in recruiting and retaining racial/ethnic minority cancer survivors for technology-based intervention research. OBJECTIVE This discussion article aims to examine issues in recruiting and retaining a group of racial/ethnic minorities-Asian American breast cancer survivors-for a technology-based intervention study. METHODS The parent study is an ongoing large-scale, national-scope, technology-based intervention study among a target number of 330 Asian American breast cancer survivors. During the recruitment and retention process, research diaries were written by research team members, and the written records of weekly research team meetings were kept. The written records were analyzed using a content analysis. Then, the themes were used to support the discussion points made in the article. RESULTS There existed subethnic differences in research participation; it was easier to recruit Chinese participants compared with other subethnic groups. The use of culturally matched research team members and multiple languages was essential. Gatekeepers were also elemental for recruitment and retention. Various motivation strategies were needed to retain the participants. Each subethnic group used different communication apps. Finally, trust building was essential to retain the participants in the intervention. CONCLUSIONS Researchers need to consider these practical issues in future technology-based intervention research. IMPLICATIONS FOR PRACTICE These issues need to be considered in future program/intervention development and implementation among racial/ethnic minority cancer survivors.
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Ragavan MI, Cowden JD. Bilingual and Bicultural Research Teams: Unpacking the Complexities. Health Equity 2020; 4:243-246. [PMID: 32587936 PMCID: PMC7310226 DOI: 10.1089/heq.2019.0111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
Researchers often describe use of “bilingual/bicultural” research teams, especially for research being conducted with marginalized communities. In this perspectives article, we argue that while increasing the diversity of research teams is imperative, using the term “bilingual/bicultural” without further explanation is problematic. We first review the nuances of the terms bilingual and bicultural individually. Next, we describe how the terms bilingual and bicultural cannot be conflated. Finally, we provide recommendations for researchers, journals, and funding agencies.
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Affiliation(s)
- Maya I Ragavan
- Division of General Academic Pediatrics, University of Pittsburgh/Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John D Cowden
- Division of General Academic Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
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Newmark J, Gebara MA, Aizenstein H, Karp JF. Engaging in Late-Life Mental Health Research: a Narrative Review of Challenges to Participation. ACTA ACUST UNITED AC 2020; 7:317-336. [PMID: 32837830 PMCID: PMC7242610 DOI: 10.1007/s40501-020-00217-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose of review This narrative review seeks to ascertain the challenges older patients face with participation in mental health clinical research studies and suggests creative strategies to minimize these obstacles. Recent findings Challenges to older adults’ engagement in mental health research include practical, institutional, and collaboration-related barriers applicable to all clinical trials as well as more personal, cultural, and age-related patient barriers specific to geriatric mental health research. Universal research challenges include (1) institutional barriers of lack of funding and researchers, inter-researcher conflict, and sampling bias; (2) collaboration-related barriers involving miscommunication and clinician concerns; and (3) practical patient barriers such as scheduling issues, financial constraints, and transportation difficulties. Challenges unique to geriatric mental health research include (1) personal barriers such as no perceived need for treatment, prior negative experience, and mistrust of mental health research; (2) cultural barriers involving stigma and lack of bilingual or culturally matched staff; and (3) chronic medical issues and concerns about capacity. Summary Proposed solutions to these barriers include increased programmatic focus on and funding of geriatric psychiatry research grants, meeting with clinical staff to clarify study protocols and eligibility criteria, and offering transportation for participants. To minimize stigma and mistrust of psychiatric research, studies should devise community outreach efforts, employ culturally competent bilingual staff, and provide patient and family education about the study and general information about promoting mental health.
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Affiliation(s)
- Jordyn Newmark
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Bellefield Towers 726, Pittsburgh, PA 15213 USA
| | - Marie Anne Gebara
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Bellefield Towers 726, Pittsburgh, PA 15213 USA
| | - Howard Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Bellefield Towers 726, Pittsburgh, PA 15213 USA
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Bellefield Towers 726, Pittsburgh, PA 15213 USA.,Center for Interventions to Enhance Community Health, University of Pittsburgh, Pittsburgh, USA
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Waheed W, Mirza N, Waheed MW, Blakemore A, Kenning C, Masood Y, Matthews F, Bower P. Recruitment and methodological issues in conducting dementia research in British ethnic minorities: A qualitative systematic review. Int J Methods Psychiatr Res 2020; 29:e1806. [PMID: 31808215 PMCID: PMC7051842 DOI: 10.1002/mpr.1806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 07/11/2019] [Accepted: 08/16/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Identifying existing recruitment and methodological issues within dementia research conducted in UK studies that included ethnic minorities. METHODS We searched for and included any publication detailing dementia research in the UK that included any ethnic minority. The search results and all titles and abstracts were screened according to the inclusion criteria followed by screening of the full texts. We extracted data regarding the recruitment and methodological issues faced by the researchers. This data was combined and listed, and related issues were grouped into overarching themes and subthemes. RESULTS Of 52 publications suitable for analysis, 33 provided data collated into six themes: attitudes and beliefs about dementia in ethnic minority communities, recruitment process, data collection issues, practical issues, researcher characteristics, and lack of published research and normative data. These themes allowed us to identify three areas responsible for addressing these recruitment and methodological issues: community and patient education, health services, and researchers' training. CONCLUSIONS This is the first review identifying recruitment and methodological issues within UK dementia research that included ethnic minorities. We now have a compilation of reported existing issues and a framework of areas responsible for addressing them and devising solutions.
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Affiliation(s)
- Waquas Waheed
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | - Nadine Mirza
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | | | - Amy Blakemore
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | - Cassandra Kenning
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | - Yumna Masood
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | - Fiona Matthews
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Peter Bower
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
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eHealth and mHealth Interventions for Ethnic Minority and Historically Underserved Populations in Developed Countries: an Umbrella Review. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42413-019-00055-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AbstractHealth disparities among historically disadvantaged populations can undermine the effectiveness of eHealth and mHealth interventions and limit their acceptability among diverse community members. The twin aims of this umbrella review of systematic reviews (SRs) are to summarise the evidence on the characteristics and effectiveness of eHealth and mHealth interventions among underserved populations in developed counties and provide recommendations to community organizers, policy makers and researchers. Comprehensive searches were conducted in bibliographic databases, Google Scholar and references lists for SRs published in English between 2000 and 2019. SRs were selected following a protocol registered with PROSPERO. Two independent reviewers were involved in the selection appraisal process, quality assessment and data extraction process. Six SRs met the inclusion criteria for this umbrella review. The six SRs concerned interventions delivered by computer programmes, cell-phones or other electronic devices. The studies in the SRs reported improvements to physiological well-being, health knowledge and self-management, as well as improvements in psychosocial outcomes. This umbrella review concludes with recommendations for community organizers, policy makers and researches for the formation of guidelines, inclusion of target community members in the development of eHealth interventions and directions for future research.
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Buscemi J, Buitrago D, Iacobelli F, Penedo F, Maciel C, Guitleman J, Balakrishnan A, Corden M, Adler RF, Bouchard LC, Perez-Tamayo A, Yanez BR. Feasibility of a Smartphone-based pilot intervention for Hispanic breast cancer survivors: a brief report. Transl Behav Med 2019; 9:638-645. [PMID: 29986120 PMCID: PMC7184867 DOI: 10.1093/tbm/iby058] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/28/2018] [Accepted: 05/22/2018] [Indexed: 11/13/2022] Open
Abstract
Hispanic breast cancer survivors (BCS) are at high risk for experiencing poor health-related quality of life (HRQoL) after completion of active breast cancer treatment. Therefore, there is a need to develop culturally tailored interventions for Hispanic BCS. To date, there have been limited interventions that have demonstrated that increasing cancer-related knowledge, self-efficacy in communication, and self-management skills can improve HRQoL among Hispanic BCS. These interventions have been delivered in person or by phone, which may be burdensome for Hispanic BCS. To facilitate intervention delivery, we developed My Guide, a Smartphone application aimed at improving HRQoL among Hispanic BCS. The purpose of the current study is to describe the feasibility results of a 4-week pilot trial testing My Guide among Hispanic BCS. Twenty-five women enrolled in the study (75% recruitment rate) and 22 women were retained (91.6% retention rate). Mean time spent using My Guide across the 4 weeks was 9.25 hr, and mean score on the satisfaction survey was 65.91 (range 42-70), in which higher scores reflect greater satisfaction. Participants' scores on the Breast Cancer Knowledge Questionnaire significantly improved from study baseline (M = 9.50, SD = 2.92) to the postintervention assessment (M = 11.14, SD = 2.66), d = 0.59. Participants' HRQoL scores improved over the course of 4 weeks, but these improvements were not statistically significant. Overall, My Guide was feasible and acceptable. Future studies will assess the preliminary efficacy of My Guide in improving HRQoL in a larger, randomized trial of Hispanic BCS.
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Affiliation(s)
- Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Diana Buitrago
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Francisco Iacobelli
- Department of Computer Science, Northeastern Illinois University, DeKalb, IL, USA
| | - Frank Penedo
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Crystal Maciel
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | | | - Aparna Balakrishnan
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Marya Corden
- Department of Preventive Medicine Northwestern University, Evanston, IL, USA
| | - Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, DeKalb, IL, USA
| | - Laura C Bouchard
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | | | - Betina R Yanez
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
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Sathish T, Aziz Z, Absetz P, Thankappan KR, Tapp RJ, Balachandran S, Shetty SS, Oldenburg B. Participant recruitment into a community-based diabetes prevention trial in India: Learnings from the Kerala Diabetes Prevention Program. Contemp Clin Trials Commun 2019; 15:100382. [PMID: 31193921 PMCID: PMC6545388 DOI: 10.1016/j.conctc.2019.100382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/05/2019] [Accepted: 05/15/2019] [Indexed: 11/16/2022] Open
Abstract
Background Data on participant recruitment into diabetes prevention trials are limited in low- and middle-income countries (LMICs). We aimed to provide a detailed analysis of participant recruitment into a community-based diabetes prevention trial in India. Methods The Kerala Diabetes Prevention Program was conducted in 60 polling areas (electoral divisions) of the Neyyatinkara taluk (subdistrict) in Trivandrum district, Kerala state. Individuals (age 30–60 years) were screened with the Indian Diabetes Risk Score (IDRS) at their homes followed by an oral glucose tolerance test (OGTT) at community-based clinics. Individuals at high-risk of developing diabetes (IDRS score ≥60 and without diabetes on the OGTT) were recruited. Results A total of 1007 participants (47.2% women) were recruited over nine months. Pilot testing, personal contact and telephone reminders from community volunteers, and gender matching of staff were effective recruitment strategies. The major recruitment challenges were: (1) during home visits, one-third of potential participants could not be contacted, as they were away for work; and (2) men participated less frequently in the OGTT screening than women (75.2% vs. 84.2%). For non-participation, lack of time (42.0%) was most commonly cited followed by ‘I am already feeling healthy’ (30.0%), personal reasons (24.0%) and ‘no benefit to me or my family’ (4.0%). An average of 17 h were spent to recruit one participant with a cost of US$23. The initial stage of screening and recruitment demanded higher time and costs. Conclusions This study provides valuable information for future researchers planning to implement community-based diabetes prevention trials in India or other LMICs. Trial registration Australia and New Zealand Clinical Trials Registry: ACTRN12611000262909.
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Affiliation(s)
- Thirunavukkarasu Sathish
- Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie St, Carlton, VIC, 3053, Australia
| | - Zahra Aziz
- Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie St, Carlton, VIC, 3053, Australia
| | - Pilvikki Absetz
- Department of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Kavumpurathu Raman Thankappan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, Kerala, India
| | - Robyn Jennifer Tapp
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London, SW17 ORE, United Kingdom
| | - Sajitha Balachandran
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, Kerala, India
| | - Suman Surendra Shetty
- Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie St, Carlton, VIC, 3053, Australia
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie St, Carlton, VIC, 3053, Australia.,WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, The University of Melbourne, Carlton, VIC, 3053, Australia
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Prendeville P, Kinsella W. The Role of Grandparents in Supporting Families of Children with Autism Spectrum Disorders: A Family Systems Approach. J Autism Dev Disord 2019; 49:738-749. [PMID: 30229360 DOI: 10.1007/s10803-018-3753-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A family systems approach is required to identify the needs of families of children with autism. This paper explores how grandparents support children with autism and their parents using a family systems perspective. A thematic analysis of eighteen semi-structured interviews was conducted with participants from nine families, capturing experiences of both parents' and grandparents'. Themes identified were family recalibrating; strengthening the family system; and current needs and future concerns of grandparents. The views of families indicated the overwhelming need to acknowledge the grandparental role in supporting families that strengthen the family system by supporting the needs of a child with autism. Findings revealed that grandfathers have a calming role in these families where children have significant behavioural difficulties.
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Affiliation(s)
- P Prendeville
- Enable Ireland Children's Services, Lavanagh House, Cork, Ireland. .,School of Education, University College Dublin, Dublin, Ireland.
| | - W Kinsella
- School of Education, University College Dublin, Dublin, Ireland
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Rodgers RF, Donovan E, Cousineau TM, McGowan K, Yates K, Cook E, Lowy AS, Franko DL. Ethnic and racial diversity in eating disorder prevention trials. Eat Disord 2019; 27:168-182. [PMID: 31084423 DOI: 10.1080/10640266.2019.1591824] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Recruiting diverse samples for prevention trials is challenging, but essential. This paper provides baseline data for four racial/ethnic groups from a randomized controlled trial of a mobile-based prevention intervention and systematically reviews recruitment trends in diversity across technology-based prevention studies. Female emerging adults completed measures of appearance esteem, body image flexibility, appearance comparison, and self-compassion. White participants reported lower body esteem and body image flexibility, and higher appearance comparison compared to Black and Asian participants. Latina participants evidenced higher appearance comparison compared to Black participants. The literature review revealed that while rates of diversity in previous trials vary, the majority of the participants were White. Efforts are needed to increase diversity in prevention trials.
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Affiliation(s)
- Rachel F Rodgers
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA.,b Department of Psychiatric Emergency & Acute Care , Lapeyronie Hospital, CHRU Montpellier , Montpellier , France
| | | | | | | | - Kayla Yates
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
| | - Elizabeth Cook
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
| | - Alice S Lowy
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
| | - Debra L Franko
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
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36
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Haack LM, Araujo EJ. The Collaborative Life Skills Program in Spanish (CLS-S): Pilot Investigation of Intervention Process, Outcomes, and Qualitative Feedback. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2019; 4:18-41. [PMID: 31938725 PMCID: PMC6959204 DOI: 10.1080/23794925.2018.1560236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Lauren M. Haack
- University of California, San Francisco (UCSF), 401 Parnassus
Avenue 855, San Francisco, CA 94143, Fax: 415-476-7170,
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Masood Y, Bower P, Waheed MW, Brown G, Waheed W. Synthesis of researcher reported strategies to recruit adults of ethnic minorities to clinical trials in the United Kingdom: A systematic review. Contemp Clin Trials 2019; 78:1-10. [PMID: 30634035 DOI: 10.1016/j.cct.2019.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/04/2018] [Accepted: 01/04/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND People from ethnic minorities are reported to have higher rates of physical illness (diabetes and ischemic heart disease) and mental disorders. Disparities relate not just to diagnosis, but also to care pathways and treatment outcomes. Despite this, they are underrepresented in clinical research. This reduces the generalisability of research findings across multi ethnic populations and hinders the development of accessible services. Researchers often face difficulties in recruiting ethnic minority participants to clinical research due to low levels of cultural competence and limited resources. There are few published trials focusing on ethnic minorities in the UK and we need to understand what recruitment strategies have already been implemented and recommended when recruiting ethnic participants. This will help researchers in applying these lessons to future clinical trials. METHOD To identify strategies for recruiting ethnic minorities to clinical trials in the UK a systematic review of published randomised controlled trials (RCT) exclusively targeting ethnic minorities was conducted. Multiple databases were searched by combining the terms "ethnic minorities", "randomised controlled trials" and "United Kingdom". Data was extracted on recruitment strategies described by each RCT and then themes were created. RESULTS Twenty-one included RCT's identified various strategies to recruit ethnic communities to clinical trials. These have been described under three overarching themes; adaptation of screening and outcome measures, culturally specific recruitment training and recruitment processes. CONCLUSION The review highlighted that researchers employed limited strategies to enhance the recruitment level. The full extent of the use of strategies was not described well in the publications. There is a need for wider training and support for the trialist to enhance and build up recruitment skills to facilitate the recruitment of ethnic minorities to clinical trials.
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Population-based assessment of health, healthcare utilisation, and specific needs of Syrian migrants in Germany: what is the best sampling method? BMC Med Res Methodol 2019; 19:5. [PMID: 30616507 PMCID: PMC6323854 DOI: 10.1186/s12874-018-0652-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 12/26/2018] [Indexed: 02/06/2023] Open
Abstract
Background Studies elucidating health-related information and special needs of Syrian migrants living in Germany are urgently required. However, data is scarce and finding appropriate sampling strategies to obtain representative results is challenging. In order to increase survey response in hard-to-reach populations, new methods were developed. One of them is respondent-driven sampling (RDS), a network sampling technique. We aimed to assess if respondent-driven sampling is a better approach to recruit Syrian migrants for health research than classical random sampling via the population registry. Methods A cross-sectional study was conducted in Munich between April and June 2017 inviting adults (18+ years) born in Syria to answer an online questionnaire asking for sociodemographic and health-related information. Recruitment of participants was done using a) random sampling via the population registry (PR) and b) RDS. The two study populations recruited via respondent-driven sampling and the population registry were compared to a sample drawn from the population registry with respect to gender and citizenship. In addition, the two study populations were compared to each other regarding self-reported health status, healthcare utilisation, lifestyle factors, social network size, and acculturation. Results Of 374 persons randomly drawn from the population registry, 49 individuals answered the questionnaire completely (response: 13.1%) while via RDS 195 participants were recruited by 16 seeds. More persons possessed German citizenship in the total sample (20.5, 95% CI: 16.6 to 24.8%) and in the PR study population (28.6, 95% CI: 16.6 to 43.3%) than in the study population (0.5, 95% CI: 0.1 to 1.5%). Participants recruited via the population registry were older, smoked less, reported more often to hold a university degree, and indicated a higher prevalence of chronic diseases, more frequent healthcare utilisation, higher scores of acculturation as well as a larger social network compared to the study population obtained via RDS. Conclusions Response was very low in the PR sample. The number of participants recruited via RDS was larger and led to a study population with substantially different characteristics. Our study thus indicates that RDS is a useful way to gain access to specific subgroups that are hard to reach via traditional random sampling. Electronic supplementary material The online version of this article (10.1186/s12874-018-0652-1) contains supplementary material, which is available to authorized users.
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Smith A, Vidal GA, Pritchard E, Blue R, Martin MY, Rice LJ, Brown G, Starlard-Davenport A. Sistas Taking a Stand for Breast Cancer Research (STAR) Study: A Community-Based Participatory Genetic Research Study to Enhance Participation and Breast Cancer Equity among African American Women in Memphis, TN. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122899. [PMID: 30567326 PMCID: PMC6313663 DOI: 10.3390/ijerph15122899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 01/14/2023]
Abstract
African American women are substantially underrepresented in breast cancer genetic research studies and clinical trials, yet they are more likely to die from breast cancer. Lack of trust in the medical community is a major barrier preventing the successful recruitment of African Americans into research studies. When considering the city of Memphis, TN, where the percentage of African Americans is significantly higher than the national average and it has a high rate of breast cancer mortality inequities among African American women, we evaluated the feasibility of utilizing a community-based participatory (CBPR) approach for recruiting African American women into a breast cancer genetic study, called the Sistas Taking A Stand for Breast Cancer Research (STAR) study. From June 2016 and December 2017, African American women age 18 and above were recruited to provide a 2 mL saliva specimen and complete a health questionnaire. A total of 364 African American women provided a saliva sample and completed the health questionnaire. Greater than 85% agreed to be contacted for future studies. Educational workshops on the importance of participating in cancer genetic research studies, followed by question and answer sessions, were most successful in recruitment. Overall, the participants expressed a strong interest and a willingness to participate in the STAR study. Our findings highlight the importance of implementing a CBPR approach that provides an educational component detailing the importance of participating in cancer genetic research studies and that includes prominent community advocates to build trust within the community.
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Affiliation(s)
- Alana Smith
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Gregory A Vidal
- Department of Medicine, The University of Tennessee West Cancer Center, Memphis, TN 38163, USA.
- Division of Hematology and Oncology, Department of Medicine, University of Tennessee Health Science Center, 7945 Wolf River Boulevard, Memphis, TN 38138, USA.
| | - Elizabeth Pritchard
- Department of Medicine, The University of Tennessee West Cancer Center, Memphis, TN 38163, USA.
| | - Ryan Blue
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Michelle Y Martin
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - LaShanta J Rice
- School of Health Sciences, Online Learning, Stratford University, 3201 Jermantown Road, Ste 500, Fairfax, VA 22030, USA.
| | - Gwendolynn Brown
- Carin and Sharin Breast Cancer Support Group, Memphis, TN 38613, USA.
| | - Athena Starlard-Davenport
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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Lemetyinen H, Onwumere J, Drake RJ, Abel K, Haigh C, Moulton G, Edge D. Co-production and evaluation of an e-learning resource to improve African-Caribbean families' knowledge about schizophrenia and engagement with services: a pilot randomised controlled trial protocol. Pilot Feasibility Stud 2018; 4:174. [PMID: 30479829 PMCID: PMC6245541 DOI: 10.1186/s40814-018-0368-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 11/07/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND A higher proportion of African-Caribbean people in the UK are diagnosed with schizophrenia spectrum disorders than other ethnic groups. High levels of shame and stigma at individual and community levels contribute to delayed access to care, potentially increasing the duration of untreated psychosis and so worsening outcomes. Inferior access, more coercive care, and worse outcomes have created a 'circle of fear' of mental health services within African-Caribbean communities. This further discourages early engagement with statutory services and increases the burden of care for families living with schizophrenia.Providing tailored and relevant information about psychosis (psychoeducation) has the potential for improving outcomes for patients and families. However, there are no culturally appropriate psychoeducation programmes for African-Caribbeans in the UK. We aim to determine whether an e-learning resource, co-produced with African-Caribbean stakeholders to improve knowledge about psychoses, would be culturally acceptable and accessible to members of this population. METHODS A pilot randomised controlled trial of the feasibility of co-producing and testing a novel e-learning resource to improve knowledge about and attitudes towards schizophrenia in African-Caribbean families. We will seek to recruit 40 participants, aged ≥ 16 years, either to receive the intervention or as controls. They will self-refer or be referred via inpatient and wellbeing services, family and carers' forums, statutory community mental health teams, and voluntary sector/non-governmental agencies (NGOs). Participants will complete the Ca-KAP, ASMI, and SF-12. Acceptability will be explored qualitatively via focus groups and individual semi-structured interviews. DISCUSSION The proposed trial will demonstrate the feasibility of conducting a fully powered RCT to evaluate the efficacy of an e-learning resource about schizophrenia with African-Caribbean families. Qualitative work will explore the intervention's accessibility and barriers/facilitators to participation, including attitudes to randomisation. These data will facilitate further refinement of the intervention. TRIAL REGISTRATION ISRCTN11394005, retrospectively registered 20/03/2018.
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Affiliation(s)
- Henna Lemetyinen
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Juliana Onwumere
- King’s College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX UK
| | - Richard James Drake
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester, UK
| | - Kathryn Abel
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester, UK
| | - Carol Haigh
- Manchester Metropolitan University, Brook Building, Bonsall Street, Manchester, UK
| | - Georgina Moulton
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Dawn Edge
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
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Mercer L, Evans LJ, Turton R, Beck A. Psychological Therapy in Secondary Mental Health Care: Access and Outcomes by Ethnic Group. J Racial Ethn Health Disparities 2018; 6:419-426. [PMID: 30430460 DOI: 10.1007/s40615-018-00539-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/05/2018] [Accepted: 10/29/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To explore the differences in access to, and outcomes of, psychological therapy for different ethnic groups across a South London Mental Health Trust. METHOD This study used Trust data to explore the proportions of ethnic groups accessing psychological therapy as a proportion of all patients supported by the Trust, as well as their outcomes within broad diagnostic clusters. RESULTS Compared to proportions in the local population, there were significantly more White/White British patients and significantly fewer patients from 'other ethnic groups' in the Trust (p < .05). There was also significantly greater proportion of Black/Black British patients with schizophrenia diagnoses compared to the proportion of Black/Black British people in the local population (p < .001). Of those accessing psychological therapy, there were significantly more White/White British and 'other ethnic group' patients and significantly fewer Black/Black British patients (p < .05). For schizophrenia diagnoses, significantly fewer Black/Black British and 'other ethnic group' patients were accessing psychological therapy (p < .05); however for behavioural and emotional disorders, there were significantly higher proportions of 'other ethnic group' and White/White British patients. Outcomes varied by diagnosis; Black/Black British patients experienced significantly higher distress scores at the beginning of therapy for depression and neurotic diagnoses (p < .05), with the latter persisting at the end of treatment. CONCLUSIONS Across the Trust, there were significant differences in the proportion of ethnic groups in accessing psychological therapy, as well as in outcomes. More research is needed to understand the factors that may underlie these disparities.
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Affiliation(s)
- Louise Mercer
- South London and Maudsley NHS Foundation Trust, London, England, UK
- Department of Psychology and Psychotherapy, Maudsley Hospital, Denmark Hill, London, UK
| | - Lauren Jayne Evans
- South London and Maudsley NHS Foundation Trust, London, England, UK
- Department of Psychology and Psychotherapy, Maudsley Hospital, Denmark Hill, London, UK
| | - Robert Turton
- South London and Maudsley NHS Foundation Trust, London, England, UK.
- Department of Psychology and Psychotherapy, Maudsley Hospital, Denmark Hill, London, UK.
| | - Alison Beck
- South London and Maudsley NHS Foundation Trust, London, England, UK
- Department of Psychology and Psychotherapy, Maudsley Hospital, Denmark Hill, London, UK
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Pickard K, Reyes N, Reaven J. Examining the inclusion of diverse participants in cognitive behavior therapy research for youth with autism spectrum disorder and anxiety. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1057-1064. [PMID: 30160515 DOI: 10.1177/1362361318795678] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Results of randomized controlled trials have demonstrated significant reductions in anxiety symptoms following cognitive behavior therapy participation. Although promising, the extent to which previous research has included families from low socioeconomic status or racially/ethnically diverse backgrounds is unknown. Aims of this study are as follows: (1) What is the race, ethnicity, and educational attainment of youth with autism spectrum disorder and their families who have participated in research examining the efficacy of cognitive behavior therapy for anxiety? and (2) How do the demographics of these participants compare to that of the United States census? A total of 14 studies were reviewed that included 473 participants. Chi-square analyses indicated that there are significant differences between the race/ethnicity of youth with autism spectrum disorder participating in cognitive behavior therapy research for anxiety and that of youth in the United States. Standard residuals indicated significant overrepresentation of White youth and significant underrepresentation of Black and Latino youth in cognitive behavior therapy research (all p-values <0.001). Similarly, there were significant differences in the educational attainment of caregivers participating in cognitive behavior therapy research, with a significant underrepresentation of caregivers from low socioeconomic status backgrounds ( p < 0.001). These findings have implications for the development of cognitive behavior therapy interventions for youth with autism spectrum disorder and anxiety that are both rigorous and inclusive.
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Affiliation(s)
| | - Nuri Reyes
- University of Colorado, Anschutz Medical Campus, USA
| | - Judy Reaven
- University of Colorado, Anschutz Medical Campus, USA
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Page-Reeves J, Regino L, McGrew HC, Tellez M, Pedigo B, Overby A, Cunningham A, Tigert S, Burge M. Collaboration and Outside-the-Box Thinking to Overcome Training-Related Challenges for Including Patient Stakeholders as Data Collectors in a Patient-Engaged Research Project. J Patient Exp 2018; 5:88-91. [PMID: 29978023 PMCID: PMC6022949 DOI: 10.1177/2374373517729506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Including patient stakeholders as active members of the research team is essential to a patient-engaged research design. To hire community-based research staff for a study comparing the effectiveness of diabetes self-management programs for Latinos, we had to provide phlebotomy training which was not allowed under the fiscal guidelines of our funders. By collaborating with partners at the Clinical and Translational Science Center, we were not only able to find a creative solution and provide phlebotomy training to our research staff but the process of creating the training also contributed to improved infrastructure for patient-engaged research at our institution.
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Affiliation(s)
- Janet Page-Reeves
- Office for Community Health, Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Lidia Regino
- Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Hannah Cole McGrew
- Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Maria Tellez
- One Hope Centro de Vida Health Center, East Central Ministries, Albuquerque, NM, USA
| | - Blanca Pedigo
- One Hope Centro de Vida Health Center, East Central Ministries, Albuquerque, NM, USA
| | - Amy Overby
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Abigail Cunningham
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Susan Tigert
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Mark Burge
- Department of Endocrinology, Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
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Multidimensional Family Therapy as a community-based alternative to residential treatment for adolescents with substance use and co-occurring mental health disorders. J Subst Abuse Treat 2018; 90:47-56. [DOI: 10.1016/j.jsat.2018.04.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/27/2018] [Accepted: 04/23/2018] [Indexed: 11/17/2022]
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Winter SS, Page-Reeves JM, Page KA, Haozous E, Solares A, Nicole Cordova C, Larson RS. Inclusion of special populations in clinical research: important considerations and guidelines. J Clin Transl Res 2018; 4:56-69. [PMID: 30873495 PMCID: PMC6410628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Trials that involve human participants call for experiments or observations that are performed in a clinical research setting. Currently, there are over 16,000 clinical trials open in the United States. Despite continuing efforts to include "special populations" in clinical trials, there are gaps in participation for people who are either minors or elderly adults, are from historically under-represented minorities, or live in rural communities. The inclusion of these special populations in clinical trials research is essential for conclusions that benefit all populations. Data suggest that study partic-ipation rates for special populations have fallen to levels that could endanger the successful performance of some types of research. This is particularly concerning in the 21st century, where demographic trends in the United States continue to shift towards an older and Hispanic population with fewer rural dwellers. Trends in New Mexico and other minority-majority states mirror many of these shifts. RELEVANCE FOR PATIENTS In this review, we highlight improvement strategies for enhanced clinical trial participation by members of special populations. Key drivers for disparate clinical trials participation and outcomes often include differences in genetics, physiology, and perceptions of mistrust towards researchers. To overcome these barriers, we focus on best practices in recruitment strategies from the perspectives of the participants, the researchers and the institutions that support clinical trials.
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Affiliation(s)
- Stuart S. Winter
- 1Children's Minnesota Research Institute, Minneapolis, MN, United States
| | - Janet M. Page-Reeves
- 2Department of Family and Community Medicine, University of New Mexico, Albuquerque, United States
| | - Kimberly A. Page
- 3Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico, Albuquerque, United States
| | - Emily Haozous
- 4UNM College of Nursing, University of New Mexico, Albuquerque, United States
| | - Angelica Solares
- 5University of New Mexico School of Law, University of New Mexico, Albuquerque, United States
| | - Carla Nicole Cordova
- 6UNM Clinical and Translational Science Center, University of New Mexico, Albuquerque, United States
| | - Richard S. Larson
- 6UNM Clinical and Translational Science Center, University of New Mexico, Albuquerque, United States
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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.
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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.
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Reyes AT, Constantino RE, Arenas RA, Bombard JN, Acupan AR. Exploring Challenges in Conducting E-Mental Health Research Among Asian American Women. Asian Pac Isl Nurs J 2018; 3:139-153. [PMID: 31037262 PMCID: PMC6484146 DOI: 10.31372/20180304.1016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In this discussion paper, we explore the challenges of conducting e-mental health intervention research among Asian American women and propose a model for addressing these barriers. Based on an extensive literature review, we identify two main types of barriers to conducting e-mental health intervention research among Asian American women: recruitment barriers and adherence barriers. Recruitment barriers are further subcategorized into those related to (1) stigmatized cultural beliefs about mental illness and mental health services; (2) lack of awareness about mental health services; and (3) language barrier. As to adherence barriers, the two identified subtypes concern (1) acuity and severity of mental health condition; and (2) lack of time. In order to enhance recruitment and adherence in e-mental health intervention research among the studied population, we formulate the following three main research strategies, namely: (1) considering the cultural and social contexts of Asian American women in the development of e-mental health interventions; (2) determining appropriate program length; and (3) conducting feasibility studies to test e-mental health interventions. We suggest that nurse researchers integrate our proposed model in conducting e-mental health interventions among Asian American women. Our proposed model also implies that nurses play an important role in encouraging Asian American women's acceptance of and adherence to e-mental health interventions. In order to overcome the obstacles to conducting e-mental health research among Asian American women, we recommend that nurses familiarize themselves with credible, relevant, and evidence-based e-mental health resources and integrate online mental health services and information within their nursing practice.
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Ethnic disparities in the dietary requirement for vitamin D during pregnancy: considerations for nutrition policy and research. Proc Nutr Soc 2017; 77:164-173. [PMID: 29182508 DOI: 10.1017/s0029665117004116] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Despite the inverse association between skin colour and efficiency of cutaneous vitamin D synthesis, in addition to the widely accepted racial disparity in vitamin D status, populations of ethnic minority are understudied in terms of setting target serum 25-hydroxyvitamin D concentrations and corresponding dietary requirements for vitamin D. In minority groups, prevention of vitamin D deficiency on a population basis is challenging due to the lack of clarity surrounding the metabolism and transport of vitamin D. Authoritative agencies have been unable to define pregnancy-specific dietary recommendations for vitamin D, owing to an absence of sufficient evidence to confirm whether nutritional requirements for vitamin D are altered during pregnancy. While the question of setting race- and pregnancy-specific dietary reference values for vitamin D has not been addressed to date, endemic vitamin D deficiency has been reported among gravidae worldwide, specifically among ethnic minorities and white women resident at high latitude. In light of the increased risk of nutritional rickets among infants of ethnic minority, coupled with growing evidence for potential non-skeletal roles of vitamin D in perinatal health, determination of the dietary vitamin D requirement that will prevent deficiency during pregnancy is a research priority. However, systematic approaches to establishing dietary requirements are limited by the quality of the available evidence and the under-representation of minority groups in clinical research. This review considers the evidence for racial differences in vitamin D status and response to vitamin D supplementation, with particular application to pregnancy-specific requirements among ethnic minorities resident at high latitudes.
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Peteet BJ. Psychosocial risks of prescription drug misuse among U.S. racial/ethnic minorities: A systematic review. J Ethn Subst Abuse 2017; 18:476-508. [PMID: 29173117 DOI: 10.1080/15332640.2017.1381662] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Prescription drug misuse (PDM) is the leading cause of accidental death in the U.S. One in five Americans report at least one lifetime incident of PDM. PDM has been studied extensively, yet there is limited inclusion of racial/ethnic minorities due to purportedly lower rates of PDM. However, health disparate groups often face more detrimental consequences of substance abuse including behavioral, social, and medical/mental health (e.g., injury, HIV/AIDS, incarceration, educational attainment, and comorbidity). Failing to characterize risk factors for and consequences of PDM in racial/ethnic minorities may mask the disproportionate negative impact of this epidemic. This systematic review of three research indexes revealed 28 peer-reviewed studies published on PDM in racial/ethnic minority adults. Results indicated a high prevalence of PDM among veterans, bisexual and gay young adults, and substance abusers compared to the general population. Demographic correlates of PDM included younger age, male gender, less educated, unmarried, and those with health/emotional issues. Rates of PDM in demographically vulnerable populations suggest that broadening inclusiveness in PDM research, interventions, and clinical practice is imperative.
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Nielsen DS, Minet L, Zeraig L, Rasmussen DN, Sodemann M. “Caught in a Generation Gap”: A Generation Perspective on Refugees Getting Old in Denmark—A Qualitative Study. J Transcult Nurs 2017; 29:265-273. [DOI: 10.1177/1043659617718064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: Older non-Western migrants in Europe are a vulnerable population, due to old age and multiple disadvantages related to language barriers and different understandings of care, health, and disease. Our aim was to gain a better understanding and insight into the care needs of families with refugee background Method: The study was designed as a qualitative exploration using semistructured individual interviews and family group interviews. Results: The results illustrate how vulnerability can “transmit” from one family member to another. Discrepancies between the older person’s expectations and needs and society’s expectations trap family members in ethical and moral dilemmas. This divides and stresses the family and results in difficult decision making, increased stress, and vulnerability. Conclusion and Implication: Migration and displacement can lead to ambivalent feelings among younger relatives regarding their role in caring for older relatives. Health professionals need to address and acknowledge this to be able to provide culturally congruent health care.
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Affiliation(s)
- Dorthe S. Nielsen
- Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
- University College Lillebaelt, Odense, Denmark
| | - Lisbeth Minet
- Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
- University College Lillebaelt, Odense, Denmark
| | | | - Dlama Nggida Rasmussen
- Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Morten Sodemann
- Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
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