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Pham LA, Clark PJ, Macdonald GA, Thomas JA, Dalais C, Fonda A, Kendall BJ, Thrift AP. Colorectal cancer screening participation in First Nations populations worldwide: a systematic review and data synthesis. EClinicalMedicine 2024; 73:102666. [PMID: 38828132 PMCID: PMC11139771 DOI: 10.1016/j.eclinm.2024.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 06/05/2024] Open
Abstract
Background First Nations populations have poorer colorectal cancer (CRC) survival compared to non-First Nations populations. Whilst First Nations populations across the world are distinct, shared experiences of discrimination and oppression contribute to persistent health inequities. CRC screening improves survival, however screening rates in First Nations populations are poorly described. This study seeks to define participation rates in CRC screening in First Nations populations worldwide. Methods A systematic literature search was conducted of PubMed, Embase, Cochrane Library, CINAHL, MEDLINE, grey literature, national registries and ClinicalTrials.gov. All sources were searched from their inception date to 18 February 2024. Studies were included if they reported CRC screening rates in adult (≥18 years) First Nations populations. We aimed to undertake a meta-analysis if there were sufficient data. Quality of papers were assessed using the Joanna Briggs Institute (JBI) appraisal tool. The study was registered with PROSPERO, CRD42020210181. Findings The literature search identified 1723 potentially eligible published studies. After review, 57 studies were included, 50 from the United States (US), with the remaining studies from Australia, Aotearoa New Zealand (NZ), Canada, Dominica and Guatemala. Additionally, eleven non-indexed reports from national programs in Australia and NZ were included. There were insufficient data to undertake meta-analysis, therefore a systematic review and narrative synthesis were conducted. CRC screening definitions varied, and included stool-based screening, sigmoidoscopy and colonoscopy. US First Nations screening rates ranged between 4.0 and 79.2%, Australia reported 10.6-35.2%, NZ 18.4-49%, Canada 22.4-53.4%, Guatemala 2.2% and Dominica 4.2%. Fifty-five studies were assessed as moderate or high quality and two as low quality. Interpretation Our findings suggested that there is wide variation in CRC screening participation rates across First Nations populations. Screening data are lacking in direct comparator groups and longitudinal outcomes. Disaggregation of screening data are required to better understand and address First Nations CRC outcome inequities. Funding None.
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Affiliation(s)
- Lily A. Pham
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Paul J. Clark
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Graeme A. Macdonald
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - James A. Thomas
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Christine Dalais
- University of Queensland Library, The University of Queensland, Brisbane, Australia
| | - Annie Fonda
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Brisbane, Australia
| | - Bradley J. Kendall
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Aaron P. Thrift
- Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, United States
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, United States
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Willingham ML, Sy A, Taafaki M, Bodnar R, Diaz TP, Somera LP, Porte CL, Ceria-Ulep CD, Pingul A, Bissell J, Cassel KD. Utilizing Filipino key informants to guide community outreach for cancer prevention in Hawai'i. Public Health Nurs 2023; 40:836-843. [PMID: 37530122 PMCID: PMC11115969 DOI: 10.1111/phn.13234] [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: 01/06/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE/DESIGN The University of Hawai'i Cancer Center works with academic and community partners to examine health disparities and inequities that persist among Pacific Island Populations through the Pacific Island Partnership for Cancer Health Equity (PIPCHE). The Partnership's Community Outreach Core (COC) assists and promotes cancer research and helps to ensure the integration of historically excluded community perspectives by utilizing community-engaged and culturally-grounded approaches to reduce cancer burdens. However, cancer health disparities among Filipinos demonstrate a need for cancer-control initiatives within this community. SAMPLE/MEASUREMENTS COC staff conducted five semi-structured key informant interviews with Filipino nurse and healthcare leaders in Hawai'i to establishpartnerships with the community, as well as provide community-driven guidance for future cancer prevention and control efforts. RESULTS The informants provided recommendations for COC community engagement, relationship building, and future areas of directed cancer focus. The interviews also initiated relationship-building and community collaborations for directed cancer education and resources within Filipino communities. CONCLUSION The themes uncovered from the interviews provided guidance on how to begin addressing cancer concerns, and led to the informants' subsequent membership in our Outreach Advisory Council to engage in future collaboration with the Filipino community and a framework for future community-engaged cancer prevention efforts.
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Affiliation(s)
| | - Angela Sy
- John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, Hawai’i
| | - Munirih Taafaki
- John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, Hawai’i
| | - Reyna Bodnar
- University of Hawai’i Cancer Center, Honolulu, Hawai’i
| | | | | | | | | | | | - Jeny Bissell
- State of Hawaiʻi Dept. of Health, Maui District Health Office, Maui, Hawai’i
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Leon Guerrero RT, Mummert AG, Rios DC, Mian NC, Cruz TP, Siriwardhana C, Yanagihara R. Perceived Barriers and Benefits of COVID-19 Testing among Pacific Islanders on Guam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6302. [PMID: 37444149 PMCID: PMC10341953 DOI: 10.3390/ijerph20136302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
Pacific Islanders residing in the U.S. Affiliated Pacific Islands have had among the highest COVID-19-associated morbidity and mortality rates in the U.S. To reduce this disparity, we conducted a study to increase the reach and uptake of COVID-19 testing in Guam. Participants, who completed a pre-survey on demographics, health status, history of COVID-19 testing and vaccination, access to COVID-19 testing, sources of COVID-19 information, and knowledge and attitudes towards COVID-19 test results and transmission, were invited to attend an online educational session about COVID-19 testing and transmission and to complete a post-survey. There were significant positive changes between pre- and post-survey in knowledge and perceptions about COVID-19 testing and transmission, but changes were not necessarily due to exposure to the educational session. Compared to CHamoru participants (n = 380), Other Micronesians (n = 90) were significantly less knowledgeable about COVID-19 transmission and testing, were significantly more likely to not want to know if they had COVID-19, were more likely to believe if they did have COVID-19 there was not much that could be done for them, and that they would have difficulty in getting the needed healthcare. This study is another example of disparities in health knowledge and perceptions of certain Pacific Islander groups.
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Affiliation(s)
| | - Angelina G. Mummert
- Office of Research & Sponsored Programs, University of Guam, Mangilao, GU 96923, USA
| | - Dareon C. Rios
- Office of Research & Sponsored Programs, University of Guam, Mangilao, GU 96923, USA
| | - Niza C. Mian
- Office of Research & Sponsored Programs, University of Guam, Mangilao, GU 96923, USA
| | - Teofila P. Cruz
- Office of Research & Sponsored Programs, University of Guam, Mangilao, GU 96923, USA
| | - Chathura Siriwardhana
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Richard Yanagihara
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
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Cancer Disparities among Pacific Islanders: A Review of Sociocultural Determinants of Health in the Micronesian Region. Cancers (Basel) 2023; 15:cancers15051392. [PMID: 36900185 PMCID: PMC10000177 DOI: 10.3390/cancers15051392] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/13/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
It is well appreciated that the social determinants of health are intimately related with health outcomes. However, there is a paucity of literature that explores these themes comprehensively for the indigenous people within Micronesia. Certain Micronesia-specific factors, such as transitions from traditional diets, the consumption of betel nut, and exposure to radiation from the nuclear bomb testing in the Marshall Islands, have predisposed certain Micronesian populations to an increased risk of developing a variety of malignancies. Furthermore, severe weather events and rising sea levels attributed to climate change threaten to compromise cancer care resources and displace entire Micronesian populations. The consequences of these risks are expected to increase the strain on the already challenged, disjointed, and burdened healthcare infrastructure in Micronesia, likely leading to more expenses in off-island referrals. A general shortage of Pacific Islander physicians within the workforce reduces the number of patients that can be seen, as well as the quality of culturally competent care that is delivered. In this narrative review, we comprehensively underscore the health disparities and cancer inequities faced by the underserved communities within Micronesia.
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Moon PK, Chakoma T, Ma Y, Megwalu UC. Thyroid Cancer Incidence, Clinical Presentation, and Survival Among Native Hawaiian and Other Pacific Islanders. Otolaryngol Head Neck Surg 2022:1945998221118538. [PMID: 35943808 DOI: 10.1177/01945998221118538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the incidence, clinical presentation, and survival in Native Hawaiian and other Pacific Islander (NHPI) patients with well-differentiated thyroid cancer. STUDY DESIGN This population-based incidence analysis and retrospective cohort study utilized data from the Surveillance, Epidemiology, and End Results database. SETTING Incidence analysis included patients diagnosed between 1990 and 2014, while the cohort to study clinical presentation and survival comprised patients diagnosed between 2004 and 2015. METHODS Incidence rates and trends were compared among NHPI, Asian, and non-Hispanic White (NHW) populations. Clinical presentation was assessed via multivariable logistic regression. Survival was assessed per Cox regression. RESULTS Recent incidence trends (2009-2014) show that the rate of increase remained consistent among NHPI patients (annual percentage change, 3.67%; 95% CI, 2.66%-4.69%), while it slowed in the NHW population and plateaued among Asians as compared with previous years. NHPI patients were more likely to present with distant metastasis than NHW patients (odds ratio, 3.37; 95% CI, 1.97-5.36) and Asian patients (odds ratio, 1.82; 95% CI, 1.05-2.97). NHPI race was also associated with advanced T stage and nodal metastasis as compared with the NHW race. Survival outcomes were similar among NHPI, NHW, and Asian patients. CONCLUSION Well-differentiated thyroid cancer incidence has increased at a higher rate for the NHPI population as opposed to the NHW and Asian populations in recent years. NHPI patients are more likely to present with advanced disease when compared with NHW and Asian patients. These results highlight the importance of disaggregating the often-combined Asian/Pacific Islander group in epidemiologic studies.
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Affiliation(s)
- Peter K Moon
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Tatenda Chakoma
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Yifei Ma
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Uchechukwu C Megwalu
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
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Moon PK, Ma Y, Megwalu UC. Head and Neck Cancer Stage at Presentation and Survival Outcomes Among Native Hawaiian and Other Pacific Islander Patients Compared With Asian and White Patients. JAMA Otolaryngol Head Neck Surg 2022; 148:636-645. [PMID: 35616952 PMCID: PMC9136676 DOI: 10.1001/jamaoto.2022.1086] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Research studies often group Native Hawaiian and Other Pacific Islander individuals together with Asian individuals despite being consistently identified as having worse health outcomes and higher rates of comorbidities and mortality. Native Hawaiian and Other Pacific Islander individuals also have high incidence rates of oral cavity and pharyngeal cancer compared with the general population; however, disparities in clinical presentation and survival outcomes of head and neck cancer squamous cell carcinoma (HNSCC) among this population have not been investigated nor compared with those of other races. Objective To determine the association of race with cancer stage at diagnosis and survival outcomes among Native Hawaiian and Other Pacific Islander patients with HNSCC compared with Asian and non-Hispanic White patients. Design, Setting, and Participants This was a retrospective population-based cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) 18 database. Asian, Native Hawaiian or Other Pacific Islander, and non-Hispanic White adult patients diagnosed in 1988 through 2015 with HNSCC of the oral cavity, oropharynx, nasopharynx, larynx, and hypopharynx were included; any patient whose record was missing data on disease or demographic information was excluded. Main Outcomes and Measures Cancer stage at presentation was compared among Asian, Native Hawaiian and Other Pacific Islander, and non-Hispanic White patients using a multivariable logistic regression model. Survival outcomes were compared among these racial groups using Cox regression models. Data analyses were performed from July 1, 2021, to March 20, 2022. Results The total study population comprised 76 473 patients: 4894 Asian (mean [SD] age at presentation, 60.7 [14.6] years), 469 Native Hawaiian and Other Pacific Islander (57.8 [12.3] years), and 71 110 non-Hispanic White (62.2 [12.1] years) individuals. Native Hawaiian and Other Pacific Islander patients were more likely to present with advanced-stage HNSCC (odds ratio [OR], 1.38; 95% CI, 1.12 -1.72) compared with non-Hispanic White patients. Asian patients presented with similar stage disease (OR, 1.04; 95% CI, 0.97-1.11) compared with non-Hispanic White patients. Native Hawaiian and Other Pacific Islander patients had worse disease-specific survival (HR, 1.18; 95% CI, 1.02-1.36) compared with non-Hispanic White patients after adjusting for clinical and demographic factors. In contrast, Asian patients had improved disease-specific survival (HR, 0.93; 95% CI, 0.88-0.98) compared with non-Hispanic White patients. Conclusions and Relevance This retrospective population-based cohort study suggests that Native Hawaiian and Other Pacific Islander race was associated with more advanced HNSCC, and worse disease-specific survival compared with non-Hispanic White race, while Asian race was associated with improved survival. This study highlights the importance of disaggregating Asian from Pacific Islander data when assessing health disparities, and the need for culturally sensitive interventions to promote earlier detection of head and neck cancer and improved survival among the Native Hawaiian and Other Pacific Islander population.
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Affiliation(s)
- Peter Kim Moon
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Yifei Ma
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Uchechukwu C. Megwalu
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
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DelNero PF, Buller ID, Jones RR, Tatalovich Z, Vanderpool RC, Ciolino HP, Croyle RT. A National Map of NCI-Designated Cancer Center Catchment Areas on the 50th Anniversary of the Cancer Centers Program. Cancer Epidemiol Biomarkers Prev 2022; 31:965-971. [PMID: 35101903 PMCID: PMC9074106 DOI: 10.1158/1055-9965.epi-21-1230] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In 1971, the National Cancer Act created a process to recognize the leadership, facilities, and research efforts at cancer centers throughout the United States. Toward this goal, each NCI-designated cancer center defines and describes a catchment area to which they tailor specific scientific and community engagement activities. METHODS The geographically defined catchment areas of 63 NCI-designated comprehensive and clinical cancer centers are collated and presented visually. In addition, the NCI-designated cancer center catchment areas are geographically linked with publicly available data sources to aggregate sociodemographic and epidemiologic characteristics across the NCI Cancer Centers Program. RESULTS The national map portrays the size, shape, and locations for 63 catchment areas of the 71 NCI-designated cancer centers. The findings illustrate the geographic extent of the NCI Cancer Centers Program during the 50th anniversary of the National Cancer Act. CONCLUSIONS NCI-designated cancer centers occupy a prominent role in the cancer control ecosystem and continue to perform research to address the burden of cancer among their local communities. The strength of the NCI Cancer Centers Program is partly defined by the scope, quality, and impact of community outreach and engagement activities in the catchment areas. IMPACT The collation and geographic presentation of the distinct, but complementary, NCI-designated cancer center catchment areas are intended to support future research and community outreach activities among NCI-designated cancer centers. See related commentary by Vadaparampil and Tiro, p. 952.
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Affiliation(s)
- Peter F. DelNero
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, 20850, USA
- Implementation Science, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
| | - Ian D. Buller
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, 20850, USA
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850, USA
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850, USA
| | - Zaria Tatalovich
- Statistical Research & Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
| | - Robin C. Vanderpool
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
| | - Henry P. Ciolino
- Office of Cancer Centers, National Cancer Institute, Rockville, MD, 20850, USA
| | - Robert T. Croyle
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
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Nguyen-Truong CKY, Davis A, Vuong VMN, Nguyen KQV, Truong AM, Leung J. Perceptions, Beliefs, and Experiences of Asians and Micronesian Islanders on Family Health History Genetic Cancer Screening Community Outreach. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1341-1353. [PMID: 34495435 PMCID: PMC8425315 DOI: 10.1007/s13187-021-02085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
Cancer carries stigma, taboos, and shame including, for diverse communities, who can have difficulty understanding and communicating about family health history genetic cancer screening (GCS). The Oregon Health Authority ScreenWise Program reached out to our academic-community research team to explore Asians and Micronesian Islanders (MI) perceptions on public health education outreach on GCS due to having previously only worked with the Latinx community. The purpose of the qualitative description pilot study was to elicit perceptions, beliefs, experiences, and recommendations from Asian and MI community leaders and community members regarding family health history GCS outreach in communities. Twenty Asians (Chinese and Vietnamese) and Micronesian Islanders (Chuukese and Marshallese) were recruited from the US Pacific Northwest. Nineteen participants are immigrants with an average 21.4 and 18.5 years having lived in the USA, respectively. Individual in-depth interviews were conducted using a semi-structured, open-ended interview guide and analyzed using conventional content analysis. Three main transcultural themes were identified: (1) degree of knowing and understanding cancer screening versus family health history GCS, (2) needing culturally relevant outreach messaging on family health history GCS, and (3) communication and decision-making regarding discussing with family and health care providers about cancer screening and GCS. Culturally relevant messaging rather than generic messaging is needed for inclusive outreach. Healthcare providers are encouraged to assess a client's family health history routinely because Asian and MI clients may not understand the information requested, may be hesitant to offer, or unable to provide information about their personal or family history of cancer.
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Affiliation(s)
| | - Andra Davis
- School of Nursing, University of Portland, Portland, OR, USA
| | | | | | | | - Jacqueline Leung
- Micronesian Islander Community, Salem, OR, USA
- Health Human Performance, and Athletics with an emphasis in Public Health, Linfield University, Salem, OR, USA
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Echeverria S, Onukwugha E. Early Stage Investigators: Emerging Research Supporting Health Equity. Ethn Dis 2020; 30:517-518. [PMID: 32989350 PMCID: PMC7518525 DOI: 10.18865/ed.30.4.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Ethn Dis. 2020;30(4):517-518; doi:10.18865/ed.30.4.517
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Affiliation(s)
- Sandra Echeverria
- Department of Public Health Education, University of North Carolina at Greensboro, NC
| | - Eberechukwu Onukwugha
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
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