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Sadarangani TR, Salcedo V, Chodosh J, Kwon S, Trinh-Shevrin C, Yi S. Redefining the Care Continuum to Create a Pipeline to Dementia Care for Minority Populations. J Prim Care Community Health 2020; 11:2150132720921680. [PMID: 32476553 PMCID: PMC7265073 DOI: 10.1177/2150132720921680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Multiple studies show that racial and ethnic minorities with low socioeconomic status are diagnosed with Alzheimer’s disease and Alzheimer’s disease–related dementias (AD/ADRD) in more advanced disease stages, receive fewer formal services, and have worse health outcomes. For primary care providers confronting this challenge, community-based organizations can be key partners in supporting earlier identification of AD/ADRD and earlier entry into treatment, especially for minority groups. The New York University Center for the Study of Asian American Health, set out to culturally adapt and translate The Kickstart-Assess-Evaluate-Refer (KAER) framework created by the Gerontological Society of America to support earlier detection of dementia in Asian American communities and assist in this community-clinical coordinated care. We found that CBOs play a vital role in dementia care, and are often the first point of contact for concerns around cognitive impairment in ethnically diverse communities. A major strength of these centers is that they provide culturally appropriate group education that focuses on whole group quality of life, rather than singling out any individual. They also offer holistic family-centered care and staff have a deep understanding of cultural and social issues that affect care, including family dynamics. For primary care providers confronting the challenge of delivering evidence-based dementia care in the context of the busy primary care settings, community-based organizations can be key partners in supporting earlier identification of AD/ADRD and earlier entry into treatment, especially for minority groups.
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Affiliation(s)
| | - Vanessa Salcedo
- Grossman School of Medicine, New York University, New York, NY
| | - Joshua Chodosh
- Grossman School of Medicine, New York University, New York, NY.,VA New York Harbor Healthcare System, New York, NY, USA
| | - Simona Kwon
- Grossman School of Medicine, New York University, New York, NY
| | | | - Stella Yi
- Grossman School of Medicine, New York University, New York, NY
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Adams IKR, Okoli CTC, Krok-Schoen JL, Hartel L, Keita AD, Figueroa W, Polanin JR, McElfish PA, Kanesiro MH. Physical Activity Among Native Hawaiians and Pacific Islanders: A Systematic Review and Meta-Analysis. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:245-258. [PMID: 30527674 DOI: 10.1016/j.jneb.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/17/2018] [Accepted: 09/19/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To examine the proportion of Native Hawaiian and Pacific Islander (NHPI) meeting recommended physical activity guidelines for Americans (PAG) and determine differences in physical activity (PA) by sex and between NHPI and Asians when data are disaggregated. DESIGN Systematic review and meta-analysis. SETTING Articles identified in CINAHL, The Cochrane Library, Embase, PsychINFO, PubMed, Scopus, SocINDEX, SPORTDiscus, and Web of Science. PARTICIPANTS NHPI children and adults, and Asian adults. INTERVENTIONS Proportion of NHPI meeting PAG and differences in PA involvement by sex and by ethnicity. METHODS Summary reporting for articles, and meta-analysis using random-effects and inverse-various weighted models. CONCLUSIONS AND IMPLICATIONS Just over one-third of NHPI children met the PAG (mean = 38.6%, 95% CI [32.43-45.08]), with more males (42.8%) than females (34.7%) meeting the guidelines (t = 6.74, df = 1, P = .02). Less than half met the PAG for combination (mean = 48.7%, 95% CI [34.69-62.97]), moderate (mean = 47.1%, 95% CI [33.62-61.07]), and about one-third met the PAG for vigorous PA (mean = 33.4%, 95% CI [24.55-43.62]). There were no significant differences between Asians and NHPI in PA. Policy, systems, and environmental changes as well as culturally appropriate interventions are needed to increase physical activity among NHPI.
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Affiliation(s)
- Ingrid K Richards Adams
- College of Food, Agricultural, and Environmental Sciences, Department of Extension, Ohio State University Columbus, OH; Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, OH.
| | - Chizimuzo T C Okoli
- Tobacco Treatment and Prevention Division, Tobacco Policy Research Program, University of Kentucky College of Nursing, Lexington, KY
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, OH
| | - Lynda Hartel
- Health Sciences Library, Ohio State University, Columbus, OH
| | - Akilah Dulin Keita
- Institute for Community Health Promotion, Department of Behavioral and Social Sciences, Brown University, Providence, RI
| | | | | | - Pearl Anna McElfish
- Office of Community Health and Research, Center for Pacific Islander Health, University of Arkansas for Medical Sciences, Fayetteville, AR
| | - Marcela H Kanesiro
- Universidade Federal de Alfenas-UNIFAL-MG, Alfenas, Minas Gerais, Brazil
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Siriwardhana C, Lim E, Aggarwal L, Davis J, Hixon A, Chen JJ. Racial/Ethnic and County-level Disparity in Inpatient Utilization among Hawai'i Medicaid Population. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2018; 77:103-113. [PMID: 29761028 PMCID: PMC5945927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We investigated racial/ethnic and county-level disparities in inpatient utilization for 15 clinical conditions among Hawaii's Medicaid population. The study was conducted using inpatient claims data from more than 200,000 Hawai'i Medicaid beneficiaries, reported in the year 2010. The analysis was performed by stratifying the Medicaid population into three age groups: children and adolescent group (1-20 years), adult group (21-64 years), and elderly group (65 years and above). Among the differences found, Asians had a low probability of inpatient admissions compared to Whites for many disease categories, while Native Hawaiian/Pacific Islanders had higher probabilities than Whites, across all age groups. Pediatric and adult groups from Hawai'i County (Big Island) had lower probabilities for inpatient admissions compared to Honolulu County (O'ahu) for most disease conditions, but higher probabilities were observed for several conditions in the elderly group. Notably, the elderly population residing on Kaua'i County (Kaua'i and Ni'ihau islands) had substantially increased odds of hospital admissions for several disease conditions, compared to Honolulu.
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Affiliation(s)
- Chathura Siriwardhana
- Department of Complementary and Integrative Medicine, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (CS, EL, JD, JJC)
- Department of Family Medicine & Community Health, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (LA, AH)
| | - Eunjung Lim
- Department of Complementary and Integrative Medicine, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (CS, EL, JD, JJC)
- Department of Family Medicine & Community Health, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (LA, AH)
| | - Lovedhi Aggarwal
- Department of Complementary and Integrative Medicine, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (CS, EL, JD, JJC)
- Department of Family Medicine & Community Health, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (LA, AH)
| | - James Davis
- Department of Complementary and Integrative Medicine, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (CS, EL, JD, JJC)
- Department of Family Medicine & Community Health, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (LA, AH)
| | - Allen Hixon
- Department of Complementary and Integrative Medicine, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (CS, EL, JD, JJC)
- Department of Family Medicine & Community Health, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (LA, AH)
| | - John J Chen
- Department of Complementary and Integrative Medicine, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (CS, EL, JD, JJC)
- Department of Family Medicine & Community Health, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI (LA, AH)
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Oropeza S, Sadile MG, Phung CN, Cabiles M, Spackman S, Abuan M, Seligman F, Araneta MR. STRIVE, San Diego! Methodology of a Community-Based Participatory Intervention to Enhance Healthy Dining at Asian and Pacific Islander Restaurants. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:297-306.e1. [PMID: 29254761 DOI: 10.1016/j.jneb.2017.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/25/2017] [Accepted: 09/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations have elevated prevalence of dietary-related chronic conditions; however, culturally relevant dietary interventions are lacking. This article describes the methodology for a community-based participatory intervention. Strategies to Reach and Implement the Vision of Health Equity, San Diego! aims to increase access to healthy food in AANHPI restaurants, grocery stores, and farmers' markets. DESIGN Time series quasi-experimental study design. Dietitians, health promotion specialists, and community partners collaborated with restaurant owners and chefs to develop culturally tailored approaches without compromising traditional flavors. SETTING AANHPI restaurants in San Diego County, CA. PARTICIPANTS Twenty restaurants and 600 diners are anticipated and will be sampled at 3 intervals for a total of 1,800 diners. INTERVENTION We describe the community-based interventions within restaurants, including (1) analyzing and modifying selected recipes to create and promote healthier dishes; (2) providing nutrition labels on selected food items; (3) marketing healthy menu items through food tastings, signage, and social media promotion; and (4) offering low-sodium soy sauce and other condiments. MAIN OUTCOME MEASURES Temporal changes in availability of healthful options, and the frequency of healthy dining choices. ANALYSIS Program evaluation consists of assessment of the nutritional environment in 20 participating restaurants and surveys of customers' opinions and behaviors at baseline and at 3 and 12 months postintervention. Fifteen restaurants have been recruited to date.
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Affiliation(s)
| | | | | | | | | | | | | | - Maria Rosario Araneta
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA.
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Briggs AM, Jordan JE, Jennings M, Speerin R, Bragge P, Chua J, Woolf AD, Slater H. Supporting the Evaluation and Implementation of Musculoskeletal Models of Care: A Globally Informed Framework for Judging Readiness and Success. Arthritis Care Res (Hoboken) 2017; 69:567-577. [PMID: 27273891 DOI: 10.1002/acr.22948] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/16/2016] [Accepted: 05/31/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To develop a globally informed framework to evaluate readiness for implementation and success after implementation of musculoskeletal models of care (MOCs). METHODS Three phases were undertaken: 1) a qualitative study with 27 Australian subject matter experts (SMEs) to develop a draft framework; 2) an eDelphi study with an international panel of 93 SMEs across 30 nations to evaluate face validity, and refine and establish consensus on the framework components; and 3) translation of the framework into a user-focused resource and evaluation of its acceptability with the eDelphi panel. RESULTS A comprehensive evaluation framework was developed for judging the readiness and success of musculoskeletal MOCs. The framework consists of 9 domains, with each domain containing a number of themes underpinned by detailed elements. In the first Delphi round, scores of "partly agree" or "completely agree" with the draft framework ranged 96.7%-100%. In the second round, "essential" scores ranged 58.6%-98.9%, resulting in 14 of 34 themes being classified as essential. SMEs strongly agreed or agreed that the final framework was useful (98.8%), usable (95.1%), credible (100%) and appealing (93.9%). Overall, 96.3% strongly supported or supported the final structure of the framework as it was presented, while 100%, 96.3%, and 100% strongly supported or supported the content within the readiness, initiating implementation, and success streams, respectively. CONCLUSION An empirically derived framework to evaluate the readiness and success of musculoskeletal MOCs was strongly supported by an international panel of SMEs. The framework provides an important internationally applicable benchmark for the development, implementation, and evaluation of musculoskeletal MOCs.
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Affiliation(s)
| | | | - Matthew Jennings
- New South Wales Agency for Clinical Innovation, Chatswood, New South Wales, Australia, and Liverpool Hospital, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Robyn Speerin
- New South Wales Agency for Clinical Innovation, Chatswood, New South Wales, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
| | - Jason Chua
- Department of Health, Government of Western Australia, Perth, Western Australia, Australia, and Centre for Musculoskeletal Outcomes Research, Dunedin School of Medicine, University of Otago, Dunedin Hospital, Dunedin, New Zealand
| | | | - Helen Slater
- Curtin University, Perth, Western Australia, Australia
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Kwon SC, Rideout C, Patel S, Arista P, Tepporn E, Lipman J, Kunkel S, Le DQ, Chin KK, Trinh-Shevrin C. Improving Access to Healthy Foods for Asian Americans, Native Hawaiians, and Pacific Islanders: Lessons Learned from the STRIVE Program. J Health Care Poor Underserved 2016; 26:116-36. [PMID: 25981093 DOI: 10.1353/hpu.2015.0063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) experience a large burden from certain chronic disease-related risk factors. The STRIVE Program funded four AANHPI community-based organizations (CBOs) to implement culturally adapted community gardens and farmers' markets to increase access to healthy foods. Key CBO informant interviews were conducted to understand processes and lessons learned.
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Patel S, Kwon S, Arista P, Tepporn E, Chung M, Ko Chin K, Rideout C, Islam N, Trinh-Shevrin C. Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders. Am J Public Health 2015; 105 Suppl 3:S455-8. [PMID: 25905839 DOI: 10.2105/ajph.2015.302637] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.
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Affiliation(s)
- Shilpa Patel
- Shilpa Patel, Simona Kwon, Catlin Rideout, Nadia Islam, and Chau Trinh-Shevrin are with the Center for the Study of Asian American Health, Department of Population Health, NYU School of Medicine, New York, NY. Pedro Arista, Ed Tepporn, Marianne Chung, and Kathy Ko Chin are with the Asian & Pacific Islander American Health Forum, San Francisco, CA
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