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Mills-Reyes E, Devlin KN, Olmedo P. Abdominal Ultrasonography Used for Abdominal Pain in the Rural Outpatient Setting of South Texas: Impact on Patient Outcomes. Cureus 2024; 16:e64462. [PMID: 39135831 PMCID: PMC11318497 DOI: 10.7759/cureus.64462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction Abdominal ultrasonography is a key diagnostic tool used in complaints of abdominal pain. The rationale for this study is to examine abdominal ultrasonography's impact on the conclusion of care of abdominal pain in a predominantly Hispanic/Latino patient population. Materials and methods A chart review of 350 patients with a new diagnosis of abdominal pain from a rural family practice clinic in Texas was performed. These patients' charts were reviewed for a new diagnosis of abdominal pain, medications prescribed for abdominal pain, whether abdominal ultrasonography was completed, and the number of visits regarding their complaint. The last visit for their abdominal pain was denoted as the conclusion of care of abdominal pain within the clinic. The primary analyses were logistic regressions with conclusion of pain care or number of visits as the outcome and abdominal ultrasound completion as the primary predictor. Results The sample size was 216 of the 350. Patients were excluded due to age under 18 and if the patient's pain was not coded as epigastric, generalized, or right upper quadrant pain. The patient age range was 18-88 years, and they were all of Hispanic/Latino origin. Abdominal ultrasound was completed on 59 of the patients, and 65 patients experienced conclusion of primary care for abdominal pain. Regarding the number of visits for abdominal pain, 69% had one visit, 25% had two visits, and 6% had three or more visits. Patients who had abdominal ultrasounds were more likely to have multiple visits (typically just two visits) but had markedly higher conclusions of care for abdominal pain. These relationships remained when adjusting for demographic and medical covariates such as age, abdominal pain (all types), and medical treatments used. Conclusion In the outpatient rural care of Hispanic/Latino patients residing in the Rio Grande Valley, patients who had a new complaint of abdominal pain were more likely to have conclusion of primary care for abdominal pain, with only a slight increase in primary care healthcare consumption, if abdominal ultrasonography was completed for abdominal pain.
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Affiliation(s)
| | | | - Pablo Olmedo
- Family Medicine, Sagrado Corazon Family Clinic, Mission, USA
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Merk K, Arpey NC, Gonzalez AM, Valdez KE, Cohen-Rosenblum A, Edelstein AI, Suleiman LI. Racial and Ethnic Minorities Underrepresented in Pain Management Guidelines for Total Joint Arthroplasty: A Meta-analysis. Clin Orthop Relat Res 2024; 482:00003086-990000000-01533. [PMID: 38497759 PMCID: PMC11343556 DOI: 10.1097/corr.0000000000003026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/07/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Total joint arthroplasty aims to improve quality of life and functional outcomes for all patients, primarily by reducing their pain. This goal requires clinical practice guidelines (CPGs) that equitably represent and enroll patients from all racial/ethnic groups. To our knowledge, there has been no formal evaluation of the racial/ethnic composition of the patient population in the studies that informed the leading CPGs on the topic of pain management after arthroplasty surgery. QUESTIONS/PURPOSES Using papers included in the 2021 Anesthesia and Analgesia in Total Joint Arthroplasty Clinical Practice Guidelines and comparing them with US National census data, we asked: (1) What is the representation of racial/ethnic groups in randomized controlled trials compared with their representation in the US national population? (2) Is there a relationship between the reporting of racial/ethnic groups and year of data collection/publication, location of study, funding source, or guideline section? METHODS Participant demographic data (study year published, study type, guideline section, year of data collection, study site, study funding, study size, gender, age, and race/ethnicity) were collected from articles cited by this guideline. Studies were included if they were full text, were primary research articles conducted primarily within the United States, and if they reported racial and ethnic characteristics of the participants. The exclusion criteria included duplicate articles, articles that included the same participant population (only the latest dated article was included), and the following article types: systematic reviews, nonsystematic reviews, terminology reports, professional guidelines, expert opinions, population-based studies, surgical trials, retrospective cohort observational studies, prospective cohort observational studies, cost-effectiveness studies, and meta-analyses. Eighty-two percent (223 of 271) of articles met inclusion criteria. Our original literature search yielded 27 papers reporting the race/ethnicity of participants, including 24 US-based studies and three studies conducted in other countries; only US-based studies were utilized as the focus of this study. We defined race/ethnicity reporting as the listing of participants' race or ethnicity in the body, tables, figures, or supplemental data of a study. National census information from 2000 to 2019 was then used to generate a representation quotient (RQ), which compared the representation of racial/ethnic groups within study populations to their respective demographic representation in the national population. An RQ value greater than 1 indicates an overrepresented group and an RQ value less than 1 indicates an underrepresented group, relative to the US population. Primary outcome measures of RQ value versus time of publication for each racial/ethnic group were evaluated with linear regression analysis, and race reporting and manuscript parameters were analyzed with chi-square analyses. RESULTS Two US-based studies reported race and ethnicity independently. Among the 24 US-based studies reporting race/ethnicity, the overall RQ was 0.70 for Black participants, 0.09 for Hispanic participants, 0.1 for American Indian/Alaska Natives, 0 for Native Hawaiian/Pacific Islanders, 0.08 for Asian participants, and 1.37 for White participants, meaning White participants were overrepresented by 37%, Black participants were underrepresented by 30%, Hispanic participants were underrepresented by 91%, Asian participants were underrepresented by 92%, American Indian/Alaska Natives were 90% underrepresented, and Native Hawaiian Pacific Islanders were virtually not represented compared with the US national population. On chi-square analysis, there were differences between race/ethnicity reporting among studies with academic, industry, and dual-supported funding sources (χ2 = 7.449; p = 0.02). Differences were also found between race/ethnicity reporting among US-based and non-US-based studies (χ2 = 36.506; p < 0.001), with 93% (25 of 27) of US-based studies reporting race as opposed to only 7% (2 of 27) of non-US-based studies. Finally, there was no relationship between race/ethnicity reporting and the year of data collection or guideline section referenced. CONCLUSION The 2021 Anesthesia and Analgesia in Total Joint Arthroplasty Clinical Practice Guidelines provide evidence-based recommendations that reflect the current standards in orthopaedic surgery, but the studies upon which they are based overwhelmingly underenroll and underreport racial/ethnic minorities relative to their proportions in the US population. As these factors impact analgesic administration, their continued neglect may perpetuate inequities in outcomes after TJA. CLINICAL RELEVANCE Our study demonstrates that all non-White racial/ethnic groups were underrepresented relative to their proportion of the US population in the 2021 Anesthesia and Analgesia in Total Joint Arthroplasty Clinical Practice Guidelines, underscoring a weakness in the orthopaedic surgery evidence base and questioning the overall external validity and generalizability of these combined CPGs. An effort should be made to equitably enroll and report outcomes for all racial/ethnic groups in any updated CPGs.
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Affiliation(s)
| | - Nicholas C. Arpey
- Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA
| | - Alba M. Gonzalez
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katia E. Valdez
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anna Cohen-Rosenblum
- Department of Orthopaedic Surgery, Louisiana State University, New Orleans, LA, USA
| | - Adam I. Edelstein
- Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA
| | - Linda I. Suleiman
- Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA
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Porterfield L, Santiago Delgado Z, Patel PG, Goodman ML, Campbell KM, Vaughan EM. Preparing Community Health Workers to Empower Latino(a)s With Diabetes: A Real-World Implementation Study. Sci Diabetes Self Manag Care 2024; 50:56-64. [PMID: 38243754 PMCID: PMC10851650 DOI: 10.1177/26350106231220012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
PURPOSE The purpose of the study was to evaluate the delivery of diabetes self-management education (DSME) to Latino(a) adults by community health workers (CHWs). METHODS Investigators developed an evidence-based, bilingual (Spanish/English) diabetes education curriculum and trained 10 CHWs on its content. CHWs then implemented the curriculum in 6-month diabetes group visit programs for low-income Latino(a)s with type 2 diabetes in nonacademic 501(c)3 community clinics. Investigators evaluated efficacy of the training through successful implementation, measured by participant group visit acceptance and attendance. RESULTS Participants (n = 70) reported high levels of program satisfaction (3.8/4.0), improvement in quality of life (9.7/10), meeting of individual needs (3.8/4.0), and acceptability (9.7/10.0). Content analyses revealed that 87.1% of participants would not change the program or wanted to extend it. Participant attendance was 81.6%. CONCLUSIONS Investigators demonstrated the ability to develop a training that nonmedical personnel (CHWs) successfully implemented in a real-world study. This study provides a curricular framework for CHW-led education that may serve as a template to extend to other diseases and populations.
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Affiliation(s)
- Laura Porterfield
- Department of Family Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas
- Sealy Institute for Vaccine Sciences, UTMB, Galveston, Texas
| | | | | | | | - Kendall M. Campbell
- Department of Family Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas
| | - Elizabeth M. Vaughan
- Department of Internal Medicine, UTMB, Galveston, Texas
- Department of Medicine, Baylor College of Medicine, Houston, Texas
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Mariner Gonzalez A, Reyes SG, Ho AA, Brown O, Franklin P, Suleiman LI. Underrepresentation of Non-White Participants in the American Academy of Orthopaedic Surgeons Guidelines for Surgical Management of Knee Osteoarthritis. J Arthroplasty 2024; 39:520-526. [PMID: 37572721 PMCID: PMC11210326 DOI: 10.1016/j.arth.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND The aim of this study was to examine the racial and ethnic representation in studies included in the 2015 American Academy of Orthopaedic Surgeons Surgical Management of the Knee Evidence-Based Clinical Practice Guideline relative to their representation of the United States (US). METHODS The demographic characteristics reported in articles included in the 2015 American Academy of Orthopaedic Surgeons Surgical Management of the Knee Evidence-Based Clinical Practice Guideline were analyzed. The primary outcome of interest was the representation quotient, which is the ratio of the proportion of a racial/ethnic group in the guideline studies relative to their proportion in the US. There were 211 studies included, of which 15 (7%) reported race. There were 35 studies based in the US and 7 of the US-based studies reported race. RESULTS No US-based studies reported race and ethnicity separately, no studies reported American Indian/Alaska Native participants and no US-based studies reported Asian participants. The representation quotient of US-based studies was 0.66 for Black participants, 0.33 for Hispanic participants, and 1.30 for White participants, which indicates a relative over-representation of White participants compared to national proportions. CONCLUSION This study illustrated that the evidence base for the surgical management of knee osteoarthritis has been constructed from studies which fail to consider race and ethnicity. Of those US-based studies which do report race or ethnicity, study cohorts do not reflect the US population. These results illustrate a disparity in clinical orthopedic surgical evidence and highlight the need for improved research recruitment strategies.
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Affiliation(s)
- Alba Mariner Gonzalez
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Samuel G Reyes
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alisha A Ho
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Oluwateniola Brown
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Patricia Franklin
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medicine (Rheumatology), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Linda I Suleiman
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Malika N, Roberts LR, Casiano CA, Montgomery S. A Health Profile of African Immigrant Men in the United States. J Migr Health 2023; 8:100202. [PMID: 37664414 PMCID: PMC10470375 DOI: 10.1016/j.jmh.2023.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/04/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023] Open
Abstract
African immigrants (AI) are the fastest growing group of immigrants to the U.S. however, their health and health practices remains poorly characterized. Thus, this study aimed to describe the health profile of this under-described U.S. population. In order to contextualize their health profiles, we compared AI (n=95) to other U.S. Black populations, namely African Americans (AA, n=271) and Caribbean American (CA, n=203) immigrants. We used cross-sectional survey data from a prostate cancer health study with 569 Black adult male participants, ages 21 years or older. Demographic characteristics were compared using Chi-square tests and prevalence ratios, and prevalence odds ratios (POR) were estimated for AIs compared to AA and CA immigrants using a log-binomial regression model. Results revealed that AI exhibited significantly lower prevalence of asthma and diabetes, when compared to AA and CA immigrants. Furthermore, AI reported lower consumption of alcohol than AA (POR, 0.43, 95%CI 0.24, 0.75) and lower smoking prevalence than AA (POR, 0.19, 95%CI 0.05, 0.70) and CA immigrants (POR, 0.21, 95%CI 0.05, 0.76). Additionally, AI reported significantly lower medical mistrust than CA (POR, 0.51, 95%CI 0.26, 0.95), significantly low financial strain than CAs immigrants (POR, 1.66, 95%CI 1.00, 2.75) and significantly higher levels of religious coping than both AA (POR, 2.43, 95%CI 1.43, 4.12) and CA immigrant men (POR, 1.78, 95%CI 1.03, 3.08). This study further supports emerging evidence that Blacks in the U.S. are not a monolithic group and that it is necessary to assess the Black subgroups separately. In addition, as one of the fastest growing immigrant populations, it is critical for future research to understand African immigrant's health needs and its correlates.
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Affiliation(s)
- Nipher Malika
- RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA
| | - Lisa R. Roberts
- Loma Linda University School of Nursing, 11262 Campus Street, West Hall, Loma Linda, CA 92350 USA
| | - Carlos A. Casiano
- Center for Health Disparities and Molecular Medicine, Departments of Basic Sciences and Medicine, Loma Linda University School of Medicine, Mortensen Hall, 11085 Campus Street, Loma Linda, CA 92350 USA
| | - Susanne Montgomery
- Loma Linda University, School of Behavioral Health, 11065 Campus St., Loma Linda, CA 92350 USA
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Castellanos-Fernandez MI, Pal SC, Arrese M, Arab JP, George J, Méndez-Sánchez N. Nonalcoholic Fatty Liver Disease in Latin America and Australia. Clin Liver Dis 2023; 27:301-315. [PMID: 37024209 DOI: 10.1016/j.cld.2023.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
The epidemiologic and demographical features of nonalcoholic fatty liver disease (NAFLD) vary significantly across countries and continents. In this review, we analyze current data regarding prevalence of NAFLD in Latin America and Caribbean and Australia and review some peculiarities found in these regions. We stress the need of greater awareness of NAFLD and the development of cost-effective risk stratification strategies and clinical care pathways of the disease. Finally, we highlight the need of effective public health policies to control the main risk factors for NAFLD.
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Affiliation(s)
| | - Shreya C Pal
- Faculty of Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City, Mexico; Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Marco Arrese
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada; Alimentiv, London, Ontario, Canada
| | - Jacob George
- Storr Liver Centre, The Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, New South Wales, Australia
| | - Nahum Méndez-Sánchez
- Faculty of Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City, Mexico; Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
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7
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Ganoza LF, Alvidrez J, Liggins CA. Assessing National Institutes of Health Prevention Research on Leading Causes of Death Focused on Racial or Ethnic Minority Populations, Fiscal Years 2016-2020. Ethn Dis 2023; 33:44-50. [PMID: 38846263 PMCID: PMC11152156 DOI: 10.18865/1718] [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] [Indexed: 06/09/2024] Open
Abstract
Objective To characterize the National Institutes of Health (NIH) prevention research portfolio on leading causes of death focused on racial or ethnic minority populations. Research Design Longitudinal analysis of NIH-funded prevention research projects from FY2016-FY2020. Measures Project characteristics including type of prevention, study design, budget, minority health focus, and causes of death addressed. Results Minority health projects comprised 27.0% of prevention projects and 33.1% of funding across all leading causes of death. Homicide (42.9%), diabetes (36.3%), and stroke (35.5%) had the highest proportion of minority health projects and suicide (20.2%), Alzheimer disease (18.8%), and pneumonia or influenza (8.3%) the lowest. Most minority health projects focused on identifying risk factors or on primary prevention efforts (80.3%). Most projects had an observational design (80.0%), and this predominance was observed for each cause of death. There was a significant correlation between the proportion of minority health projects for cause of death and the ratio of minorities versus non-minorities mortality rate. Conclusions Only about one-fourth of NIH-funded prevention research on leading causes of death focused on racial or ethnic minorities, who currently comprise about 40% of the US population. Only a small fraction of minority health prevention projects included an intervention design, suggesting a limited contribution to the evidence base on effective interventions to address racial or ethnic mortality disparities. Also, we identified that the number of projects increase where mortality rate disparities are higher. This portfolio analysis provides a useful baseline to assess future progress in building the minority health prevention research portfolio, a critical component to promoting health equity in population health.
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Affiliation(s)
- Luis F. Ganoza
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
| | - Jennifer Alvidrez
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
| | - Charlene A. Liggins
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
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Teruel Camargo J, Taylor MK, Gajewski BJ, Carlson SE, Sullivan DK, Gibbs HD. Higher Diet Quality in Latina Women during Pregnancy May Be Associated with Sociodemographic Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113895. [PMID: 36360774 PMCID: PMC9657950 DOI: 10.3390/ijerph192113895] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 06/12/2023]
Abstract
Acculturation contributes to low diet quality and can foster health inequities for Latina women during pregnancy. Conversely, nutrition literacy (NL) increases diet quality and could promote health equity. This study assessed the associations between the diet quality, acculturation, and NL of Latina women (n = 99) participating in the Assessment of Docosahexaenoic Acid On Reducing Early Preterm Birth (ADORE) study. Acculturation and nutrition literacy factored together tended to modify diet quality, but this was not statistically significant. Diet quality was associated with acculturation, age, and nativity. Most (76.8%) demonstrated low nutrition literacy. Women who were bicultural and were born in Latin American countries other than Mexico had lower diet quality scores than women who had lower acculturation and were born in Mexico. Women who were 35 years or older had better diet quality than those who were younger. Future studies are needed to explore diet quality differences for pregnant Latina women with high nutrition literacy and high acculturation, as well as for women from the Caribbean, Central and South American countries living in the US, to promote nutrition and maternal health for Latina women.
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Affiliation(s)
- Juliana Teruel Camargo
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Department of Urology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Matthew K. Taylor
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Byron J. Gajewski
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Susan E. Carlson
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Debra K. Sullivan
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Heather D. Gibbs
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Martínez AD, Ruelas-Thompson L. Acceptability, feasibility, and ethics of saliva collection in community-based research with Mexican-origin mixed-status families during high immigration enforcement. BMC Public Health 2022; 22:1685. [PMID: 36064334 PMCID: PMC9446519 DOI: 10.1186/s12889-022-13903-5] [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] [Received: 04/20/2021] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background There are concerns about the representation of vulnerable and underrepresented racial-ethnic minorities in biomedical and public health research, particularly when the research requires the collection of biospecimens. The current paper reports on the acceptability, feasibility, and ethics of saliva collection in a study examining the relationship between chronic stressors among mostly mixed-status, Latinx families (N = 30) during high immigration enforcement. Methods Data for this study included anthropometric measures and salivary biospecimens from each family member (N = 110) and a household survey. Data for this analysis are from ethnographic field notes, which were analyzed using a bricolage of critical ethnography and case study analysis techniques. Results We discuss the feasibility, aversions, acceptability, and ethical implications of integrating salivary biomarkers with Mexican-origin mixed-status families living in an area with restrictive immigration enforcement policies. We present the recruitment and data collection strategies used by the research team to gain participants’ trust, retain families, and maintain confidentiality. Conclusion We recommend that researchers who obtain biospecimens from Latinx, Mexican-origin, and/or immigrant populations answer the participants’ questions honestly and without fear that they will not understand the science to obtain voluntary assent and consent. We recommend that researchers be knowledgeable of the sociopolitical context that the Latinx, immigrant, and in particular, mixed-status families inhabit so that they are prepared to provide informational resources. Finally, we think it is imperative that the study team in the field be bilingual, multicultural Latinx persons who identify with the community.
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Affiliation(s)
- Airín Denise Martínez
- School of Public Health and Health Sciences, Department of Health Promotion and Policy, University of Massachusetts-Amherst, 715 N. Pleasant Street, Arnold House 333, 01003, Amherst, MB, USA.
| | - Lillian Ruelas-Thompson
- College of Liberal Arts & Sciences, ASU Advance,, Knowledge Exchange for Resilience, Arizona State University, Box 5302, Tempe, AZ, 85281, USA
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Patterson JT, Koob GF, Anderson RI. Understanding Hyperkatifeia to Inform Treatment for Alcohol Use Disorder: An Assessment of the National Institute on Alcohol Abuse and Alcoholism Research Portfolio. Biol Psychiatry 2022; 91:e53-e59. [PMID: 35469669 DOI: 10.1016/j.biopsych.2022.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/27/2022] [Accepted: 02/10/2022] [Indexed: 11/02/2022]
Affiliation(s)
| | - George F Koob
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Rachel I Anderson
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
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11
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Martínez AD, Mercado E, Barbieri M, Kim SY, Granger DA. The Importance of Biobehavioral Research to Examine the Physiological Effects of Racial and Ethnic Discrimination in the Latinx Population. Front Public Health 2022; 9:762735. [PMID: 35083188 PMCID: PMC8784784 DOI: 10.3389/fpubh.2021.762735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022] Open
Abstract
A growing body of research is documenting how racial and ethnic populations embody social inequalities throughout the life course. Some scholars recommend the integration of biospecimens representing the hypothalamic-pituitary-adrenal axis, neurological and endocrinological processes, and inflammation to capture the embodiment of inequality. However, in comparison to other racial and ethnic groups, there has been little research examining how Hispanic/Latinx persons embody racial and ethnic discrimination, much less resulting from institutional and structural racism. We provide a rationale for expanding biobehavioral research examining the physiological consequences of racism among Latinx persons. We identify gaps and make recommendations for a future research agenda in which biobehavioral research can expand knowledge about chronic disease inequities among Latinx populations and inform behavioral and institutional interventions. We end by cautioning readers to approach the recommendations in this article as a call to expand the embodiment of racism research to include the diverse Latinx population as the United States addresses racial inequity.
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Affiliation(s)
- Airín D. Martínez
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst, MA, United States
| | - Evelyn Mercado
- Department of Psychological and Brain Sciences, College of Natural Sciences, University of Massachusetts-Amherst, Amherst, MA, United States
| | - Marielena Barbieri
- Department of Psychological and Brain Sciences, College of Natural Sciences, University of Massachusetts-Amherst, Amherst, MA, United States
| | - Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas-Austin, Austin, TX, United States
| | - Douglas A. Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- The Johns Hopkins University Bloomberg School of Public Health, School of Nursing, School of Medicine, Baltimore, MD, United States
- Saliva Bioscience Laboratory, University of Nebraska-Lincoln, Lincoln, NE, United States
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Obra JK, Lin B, Đoàn LN, Palaniappan L, Srinivasan M. Achieving Equity in Asian American Healthcare: Critical Issues and Solutions. JOURNAL OF ASIAN HEALTH 2021; 1:e202103. [PMID: 37872960 PMCID: PMC10593109 DOI: 10.59448/jah.v1i1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Equity is a fundamental goal of the US health care system. Asians comprise 6% of the US population, and 60% of the world's population. Less than 1% of National Institutes of Health funding is directed toward Asian health. Asian health outcomes are often worse than non-Hispanic Whites (NHWS) in America. Increasing federal and foundation resources and funding toward Asian health research could illuminate these risks and develop precision interventions to reduce known health disparities. When disaggregated by race/ethnicity, Asian health risks are even more apparent. Here, we discuss critical health outcome differences between the six major Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) comprising 80% of the US Asian population, highlighting demographic, pharmacologic, disease prevalence, and mortality outcomes. We then outline seven critical issues contributing to Asian American health disparities, including aggregated Asian health data, undersampling, invalid extrapolations, underrepresentation in clinical trials, lack of funding and awareness of disparities, and the model minority myth. Building on the successes of national public health initiatives, we propose nine leverage points to improve Asian American health including the following: obtaining disaggregated Asian health data, improved Asian health research (oversampling Asians, improving clinical trial participation, and increasing research funding), stakeholder collaboration (national and with Asian nations), community engagement, providing culturally precise health care, and expansion of the Asian American research ecosystem. Achieving health equity takes deliberate practice and does not occur by accident. By addressing critical issues that perpetuate Asian health disparities, we grow closer to understanding how to effectively improve Asian health and build a nationally unified mindset toward action that emphasizes equitable care for all.
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Affiliation(s)
- Jed Keenan Obra
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Neurobiology, Physiology, and Behavior, University of California Davis; Davis, CA
| | - Bryant Lin
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Medicine, Stanford University School of Medicine; Palo Alto, CA
| | - Lan N. Đoàn
- Department of Population Health, NYU Grossman School of Medicine; New York, NY
| | - Latha Palaniappan
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Medicine, Stanford University School of Medicine; Palo Alto, CA
| | - Malathi Srinivasan
- Stanford Center for Asian Research and Education, Stanford University School of Medicine; Palo Alto, CA
- Department of Medicine, Stanford University School of Medicine; Palo Alto, CA
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Vorkoper S, Arteaga SS, Berrigan D, Bialy K, Bremer AA, Cotton P, Czajkowski S, Neilson E, Osganian SK, Pratt CA, Price LSN, Tabor DC, Walker JR, Williams MJ, Anand N. Childhood obesity prevention across borders: A National Institutes of Health commentary. Obes Rev 2021; 22 Suppl 3:e13243. [PMID: 33739585 PMCID: PMC8365634 DOI: 10.1111/obr.13243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/30/2022]
Abstract
In response to the increasing rates of childhood obesity, the United States and countries across Latin America have invested in research that tests innovative strategies and interventions. Despite this, progress has been slow, uneven, and sporadic, calling for increased knowledge exchange and research collaboration that accelerate the adaptation and implementation of promising childhood obesity interventions. To share research results, challenges, and proven intervention strategies among Latin American and US researchers, particularly those working with Latino and Latin American populations, the National Institutes of Health (NIH) convened researchers from the United States and Latin America to highlight synergies between research conducted in Latin America and among Latino populations in the United States with the goal of catalyzing new relationships and identifying common research questions and strategies. This article highlights the NIH's research and priorities in childhood obesity prevention as well as areas for future direction, including overarching NIH plans and NIH institutes, centers, and offices investments in specific areas related to childhood obesity prevention in Latin America and/or among Latino populations in the United States.
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Affiliation(s)
- Susan Vorkoper
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - S Sonia Arteaga
- Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - David Berrigan
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kevin Bialy
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew A Bremer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul Cotton
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Susan Czajkowski
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Elizabeth Neilson
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, USA
| | - Stavroula K Osganian
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Charlotte A Pratt
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Le Shawndra N Price
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Derrick C Tabor
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Jenelle R Walker
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Makeda J Williams
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Nalini Anand
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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