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Gilbert KL, Baker EA, Bain K, Flood J, Wolbers J. Say Something, Do Something: Evaluating a Forum Theater Production to Activate Youth Violence Prevention Strategies in Schools. Int J Environ Res Public Health 2023; 21:39. [PMID: 38248504 PMCID: PMC10815014 DOI: 10.3390/ijerph21010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 09/18/2023] [Accepted: 11/08/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Youth violence that takes place within school settings exposes youth to serious social, mental and physical consequences that affect education performance, and life opportunities. Previous work shows positive youth development frameworks can promote social-emotional learning by enhancing empathy and building problem-solving and conflict management skills. Theater-based interventions have been shown to enhance social emotional development by privileging youth voices, and building youth capacities and strengths. The current manuscript presents the evaluation of an arts-based and public health framework conducted to assess the development, implementation and impact of a forum theater production, Say Something, Do Something (SSDS) in St. Louis, Missouri. METHODS An iterative mixed methods approach was used, starting with observations of productions. Using convenience sampling, we then conducted post interviews of the theater team (n = 8) and school personnel (n = 10). RESULTS Respondents highlighted that as a result of engagement of school personnel in program development, the language and scenarios presented were relevant to students. Data indicated that SSDS increased student knowledge and changed attitudes, developed student conflict management and problem-solving skills, and improved interpersonal behavior. SSDS also raised awareness of the importance of, and created the foundation for, additional system and policy changes in the schools. CONCLUSION AND IMPLICATIONS Forum theater is an approach that can enhance socio-emotional learning and conflict management among youth. Collaborative initiatives between public health and the arts are poised to uniquely engage community partners, animate interventions, and impact critical public health issues including youth violence prevention.
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Affiliation(s)
- Keon L. Gilbert
- The Brookings Institution, Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, USA
| | - Elizabeth A. Baker
- The Brookings Institution, Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, USA
| | - Karen Bain
- Metro Theater Company, St. Louis, MO 63103, USA
| | - Julia Flood
- Metro Theater Company, St. Louis, MO 63103, USA
| | - John Wolbers
- Prison Performing Arts, St. Louis, MO 63103, USA
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Gilbert KL, Shaw M, Siddiqi A, Goodman MS. Achieving the Health Equity Agenda Through Transformative Community-Engaged Strategies. Prev Chronic Dis 2023; 20:E99. [PMID: 37943729 PMCID: PMC10684278 DOI: 10.5888/pcd20.230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Affiliation(s)
- Keon L Gilbert
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, St. Louis, MO 63104
- Brookings Institution, Washington, DC
| | - Mary Shaw
- Jackson State University, Department of Behavioral & Environmental Health, College of Health Sciences, Jackson, Mississippi
| | - Arjumand Siddiqi
- University of Toronto, Dalla Lana School of Public Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melody S Goodman
- New York University, School of Global Public Health, New York, New York
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Bennet W, Gilbert KL, Roe KM. An Invitation to Imagine: Conclusion of the HPP Series "What Is Anti-Racism in Health Promotion Practice?". Health Promot Pract 2023; 24:1246-1248. [PMID: 37712559 DOI: 10.1177/15248399231195047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Throughout Volume 24 (2023) of Health Promotion Practice, we presented responses to our Call for content addressing the question, "What is Anti-Racism in Health Promotion Practice?" With Editorial Board colleagues, Aditi Srivastav Bussells and Carlos Rodríguez-Diaz, we (Keon L. Gilbert and Kathleen M. Roe) sought frameworks for action and practical examples that would catalyze, support, and (re)invigorate the field in response to the urgent need to eliminate racism as a cause of inequalities in health. This conversation with artist Wriply Bennett concludes the series. We invite scholars and practitioners to review all 17 contributions to the series and to continue to ask - and address - the question 'What is anti-racism in our practice, scholarship, and lives?"
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Abstract
The 10 articles in the Preventing Chronic Disease (PCD) special collection on health equity highlight that a commitment to self-reflection, cultural humility, and lifelong learning are foundations of health equity science and that the field is interdependent with the perspectives and context of communities.Three themes - place, perspective, and partnership - emerged from the PCD special collection. The articles embody the principles outlined in the Healthy People definition of health equity and CDC's CORE Health Equity Science and Intervention Strategy. They highlight the critical role that context, qualitative methods, and community-based participatory research play in efforts to achieve health equity. However, the science of achieving health equity is rooted in antiracism principles; the "inner work" of learning, unlearning, relearning, and co-learning; and the efforts to equip communities to act, research, and intervene for themselves. Without these added critical structural lenses, health equity science will continue to fail to achieve its goal.
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Affiliation(s)
- Derek M Griffith
- Racial Justice Institute, Center for Men's Health Equity, Georgetown University, Washington, DC
- Georgetown University, 300 Reservoir Rd NW, Washington, DC 20057
| | - Dawn Satterfield
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Keon L Gilbert
- Brookings Institution, Washington, DC
- Department of Behavioral Science and Health Education, Institute for Healing Justice and Equity, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
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Helton JJ, Asher BlackDeer A, Banks KH, Pousson M, Gilbert KL. Racial Discrimination of Adolescents With Special Healthcare Needs. J Adolesc Health 2023:S1054-139X(23)00148-9. [PMID: 37140518 DOI: 10.1016/j.jadohealth.2023.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/01/2023] [Accepted: 02/26/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE Examine racial discrimination of adolescents of color by type of special healthcare need (SHCN). METHODS Pooled cross-sectional data of youth over 10 years of age from 2018 to 2020 National Surveys of Children's Health were used (n = 48,220). Rates of discrimination by SHCN diagnoses within racial and ethnic groups were examined. RESULTS Adolescents of color with SHCNs were almost twice as likely to experience racial discrimination as peers of color without SHCNs. Asian youth with SHCNs were over 3.5 times likely to experience racial discrimination as peers without. Youth with depression experienced highest rates of racial discrimination. Compared to peers without, Black youth with asthma or a genetic disorder, and Hispanic youth with autism or intellectual disabilities, experienced higher rates of racial discrimination. DISCUSSION SHCN status heightens racial discrimination for adolescents of color. However, this risk was not uniform by racial or ethnic group for every SHCN type.
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Affiliation(s)
- Jesse J Helton
- College of Public Health and Social Justice, School of Social Work, Saint Louis University, St. Louis, Missouri.
| | - Autumn Asher BlackDeer
- Brown School of Social Work, Buder Center for American Indian Studies, Washington University, St. Louis, Missouri
| | - Kira H Banks
- Department of Psychology, Institute for Healing and Justice and Equity, Saint Louis University, St. Louis, Missouri
| | - Mark Pousson
- School of Education, Saint Louis University, St. Louis, Missouri
| | - Keon L Gilbert
- College of Public Health and Social Justice, Institute for Healing and Justice and Equity, Saint Louis University, St. Louis, Missouri
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Gilbert KL, Roe KM. From Health Disparities to an Agenda for Anti-Racism in Health Promotion. Health Promot Pract 2023; 24:197-200. [PMID: 36707926 DOI: 10.1177/15248399221148135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Abstract
This review aims to delineate the role of structural racism in the formation and accumulation of social capital and to describe how social capital is leveraged and used differently between Black and White people as a response to the conditions created by structural racism. We draw on critical race theory in public health praxis and restorative justice concepts to reimagine a race-conscious social capital agenda. We document how American capitalism has injured Black people and Black communities' unique construction of forms of social capital to combat systemic oppression. The article proposes an agenda that includes communal restoration that recognizes forms of social capital appreciated and deployed by Black people in the United States that can advance health equity and eliminate health disparities. Developing a race-conscious social capital framing that is inclusive of and guided by Black community members and academics is critical to the implementation of solutions that achieve racial and health equity and socioeconomic mobility.
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Affiliation(s)
- Keon L Gilbert
- Department of Behavioral Health Science and Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA; ,
- Governance Studies, The Brookings Institution, Washington, DC
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA;
| | - Lorraine T Dean
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA;
| | - Jerell DeCaille
- Department of Behavioral Health Science and Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA; ,
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA;
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Gilbert KL, Chang RS. (Im)Balancing Acts: Criminalization and De-Criminalization of Social and Public Health Problems. J Law Med Ethics 2022; 50:703-710. [PMID: 36883401 DOI: 10.1017/jme.2023.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Racially disparate policing, prosecution, and punishment harm individuals, families, and communities. These practices must be understood within the context of the development of the criminal legal system as a means of racialized social control. This context permits a critical examination of the way criminalization has been and is still deployed to subject poor and racialized communities to systemic injustices. This commentary frames a call for interventions to integrate a health justice approach to ensure that they advance racial and health equity to promote the well-being of individuals, families, and communities.
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Moore JX, Gilbert KL, Lively KL, Laurent C, Chawla R, Li C, Johnson R, Petcu R, Mehra M, Spooner A, Kolhe R, Ledford CJW. Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States. Vaccines (Basel) 2021; 9:vaccines9080879. [PMID: 34452004 PMCID: PMC8402307 DOI: 10.3390/vaccines9080879] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022] Open
Abstract
In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97-5.26-91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99-27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.
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Affiliation(s)
- Justin Xavier Moore
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
- Cancer Prevention, Control, & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
- Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Correspondence: ; Tel.: +1-706-721-4621
| | - Keon L. Gilbert
- Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO 63103, USA;
| | - Katie L. Lively
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Christian Laurent
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Rishab Chawla
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Cynthia Li
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ryan Johnson
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Robert Petcu
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Mehul Mehra
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Antron Spooner
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA 30912, USA; (K.L.L.); (C.L.); (R.C.); (C.L.); (R.J.); (R.P.); (M.M.); (A.S.)
| | - Ravindra Kolhe
- Department of Pathology, Section of Anatomic Pathology, Augusta University, Augusta, GA 30912, USA;
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Gilbert KL. Keon Gilbert Comments. Am J Public Health 2020; 110:457-458. [DOI: 10.2105/ajph.2020.305590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Johnson O, St Vil C, Gilbert KL, Goodman M, Johnson CA. How neighborhoods matter in fatal interactions between police and men of color. Soc Sci Med 2018; 220:226-235. [PMID: 30472515 DOI: 10.1016/j.socscimed.2018.11.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/11/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
Abstract
This article addresses the concern that death by legal intervention is a health outcome disproportionately experienced by boys and men of color, and predicated on the quality of the locations in which encounters with law enforcement occur. Using a more comprehensive cross-verified sample of police homicides from online databases and a nationally representative sample of law enforcement agencies, this study examines whether neighborhood social disorganization, minority threat, and defense of inequality theories help explain the odds that males of color will have a fatal interaction with police (FIP). There are several noteworthy results. First, in support of the defense of inequality thesis, we found that income inequality within the area in which a FIP occurred is related to increased relative odds of fatal injury for males of color and Hispanic males. Second, consistent with the minority threat thesis, we found low levels of racial segregation dramatically reduced the odds of a FIP for Black males while higher levels of segregation increased the odds for Hispanic males. Third, Hispanic males were over 2.6 times as likely as others to be killed by officers from agencies with relatively higher percentages of Hispanic officers. We conclude the study with a discussion of its implications for research and policy.
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Affiliation(s)
- Odis Johnson
- Departments of Sociology and Education, Faculty Scholar, Institute of Public Health, Washington University in St. Louis, 138 Seigle Hall, One Brookings Drive, St. Louis, MO, 63130, USA.
| | | | - Keon L Gilbert
- Department of Behavioral Sciences and Health Education, St. Louis University, USA
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Ray R, Sewell AA, Gilbert KL, Roberts JD. Missed Opportunity? Leveraging Mobile Technology to Reduce Racial Health Disparities. J Health Polit Policy Law 2017; 42:901-924. [PMID: 28663182 DOI: 10.1215/03616878-3940477] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Blacks and Latinos are less likely than whites to access health insurance and utilize health care. One way to overcome some of these racial barriers to health equity may be through advances in technology that allow people to access and utilize health care in innovative ways. Yet, little research has focused on whether the racial gap that exists for health care utilization also exists for accessing health information online and through mobile technologies. Using data from the Health Information National Trends Survey (HINTS), we examine racial differences in obtaining health information online via mobile devices. We find that blacks and Latinos are more likely to trust online newspapers to get health information than whites. Minorities who have access to a mobile device are more likely to rely on the Internet for health information in a time of strong need. Federally insured individuals who are connected to mobile devices have the highest probability of reliance on the Internet as a go-to source of health information. We conclude by discussing the importance of mobile technologies for health policy, particularly related to developing health literacy, improving health outcomes, and contributing to reducing health disparities by race and health insurance status.
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Gilbert KL. Engaging the Disengaged Community: Opportunities, Strategies and Lessons Learned Working with African American Males. Narrat Inq Bioeth 2017; 7:E4-E7. [PMID: 28713122 DOI: 10.1353/nib.2017.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Imm KR, Williams F, Housten AJ, Colditz GA, Drake BF, Gilbert KL, Yang L. African American prostate cancer survivorship: Exploring the role of social support in quality of life after radical prostatectomy. J Psychosoc Oncol 2017; 35:409-423. [PMID: 28398149 PMCID: PMC5683844 DOI: 10.1080/07347332.2017.1294641] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Purpose: The aim of this study was to explore the African American prostate cancer survivorship experience following radical prostatectomy and factors contributing to quality of life during survival. Design: African American men who were part of a larger prostate cancer cohort were invited to participate in a focus group. Eighteen open-ended questions were designed by the study team and an experienced moderator to elicit participants' survivorship experiences. Results: Twelve men consented to participate in the study. Emergent themes included views of prostate cancer in the African American community, perceptions of normalcy, emotional side effects following radical prostatectomy, and social support involvement and impact during recovery. Conclusions: Previous findings suggest that African American men may experience more distress than Caucasian men when facing typical prostate cancer side effects. Traditional masculine role norms and negative perceptions of “disease disclosure” in the African American community could be contributing to the distress reported by some in this study. Strengthening social support systems by promoting more prosocial coping and help-seeking behaviors early in the survivorship journey may help bypass the detrimental health effects associated with masculine role identification, resulting in improved quality of life throughout the lengthy survival period anticipated for these men.
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Affiliation(s)
- Kellie R Imm
- a Division of Public Health Sciences, Department of Surgery , Washington University School of Medicine , Saint Louis , MO , USA
| | - Faustine Williams
- a Division of Public Health Sciences, Department of Surgery , Washington University School of Medicine , Saint Louis , MO , USA.,b Department of Health Services Management and Policy , East Tennessee State University , Johnson City , TN , USA
| | - Ashley J Housten
- a Division of Public Health Sciences, Department of Surgery , Washington University School of Medicine , Saint Louis , MO , USA.,c Division of Cancer Prevention & Population Sciences, Department of Health Services Research , University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Graham A Colditz
- a Division of Public Health Sciences, Department of Surgery , Washington University School of Medicine , Saint Louis , MO , USA.,d Alvin J. Siteman Cancer Center , Saint Louis , MO , USA
| | - Bettina F Drake
- a Division of Public Health Sciences, Department of Surgery , Washington University School of Medicine , Saint Louis , MO , USA.,d Alvin J. Siteman Cancer Center , Saint Louis , MO , USA
| | - Keon L Gilbert
- e Department of Behavioral Science and Health Education , Saint Louis University , Saint Louis , MO , USA
| | - Lin Yang
- a Division of Public Health Sciences, Department of Surgery , Washington University School of Medicine , Saint Louis , MO , USA.,f Department of Epidemiology, Center for Public Health , Medical University of Vienna , Vienna , Austria
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Gilbert KL, Ray R, Siddiqi A, Shetty S, Baker EA, Elder K, Griffith DM. Visible and Invisible Trends in Black Men's Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health. Annu Rev Public Health 2017; 37:295-311. [PMID: 26989830 DOI: 10.1146/annurev-publhealth-032315-021556] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Over the past two decades, there has been growing interest in improving black men's health and the health disparities affecting them. Yet, the health of black men consistently ranks lowest across nearly all groups in the United States. Evidence on the health and social causes of morbidity and mortality among black men has been narrowly concentrated on public health problems (e.g., violence, prostate cancer, and HIV/AIDS) and determinants of health (e.g., education and male gender socialization). This limited focus omits age-specific leading causes of death and other social determinants of health, such as discrimination, segregation, access to health care, employment, and income. This review discusses the leading causes of death for black men and the associated risk factors, as well as identifies gaps in the literature and presents a racialized and gendered framework to guide efforts to address the persistent inequities in health affecting black men.
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Affiliation(s)
- Keon L Gilbert
- Department of Behavioral Sciences and Health Education and
| | - Rashawn Ray
- Department of Sociology, University of Maryland at College Park, College Park, Maryland 20742
| | - Arjumand Siddiqi
- Division of Epidemiology and.,Division of Social and Behavioral Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 27599
| | - Shivan Shetty
- Department of Behavioral Sciences and Health Education and
| | | | - Keith Elder
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri 63104;
| | - Derek M Griffith
- Center for Medicine, Health, and Society and.,Institute for Research on Men's Health, Vanderbilt University, Nashville, Tennessee 37240
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Williams F, Imm KR, Colditz GA, Housten AJ, Yang L, Gilbert KL, Drake BF. Physician role in physical activity for African-American males undergoing radical prostatectomy for prostate cancer. Support Care Cancer 2016; 25:1151-1158. [PMID: 27999951 PMCID: PMC5321695 DOI: 10.1007/s00520-016-3505-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 11/21/2016] [Indexed: 12/31/2022]
Abstract
Purpose Physical activity is recognized as a complementary therapy to improve physical and physiological functions among prostate cancer survivors. Little is known about communication between health providers and African-American prostate cancer patients, a high risk population, regarding the health benefits of regular physical activity on their prognosis and recovery. This study explores African-American prostate cancer survivors’ experiences with physical activity prescription from their physicians. Methods Three focus group interviews were conducted with 12 African-American prostate cancer survivors in May 2014 in St. Louis, MO. Participants’ ages ranged from 49 to 79 years, had completed radical prostatectomy, and their time out of surgery varied from 7 to 31 months. Results Emerged themes included physician role on prescribing physical activity, patients’ perceived barriers to engaging in physical activity, perception of normalcy following surgery, and specific resources survivors’ sought during treatment. Of the 12 men who participated, 8 men (67%) expressed that their physicians did not recommend physical activity for them. Although some participants revealed they were aware of the importance of sustained physical activity on their prognosis and recovery, some expressed concerns that urinary dysfunction, incontinence, and family commitments prevented them from engaging in active lifestyles. Conclusions Transitioning from post radical prostatectomy treatment to normal life was an important concern to survivors. These findings highlight the importance of physical activity communication and prescription for prostate cancer patients. Electronic supplementary material The online version of this article (doi:10.1007/s00520-016-3505-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Faustine Williams
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, P O Box 70264, Johnson City, TN, 37614, USA.
| | - Kellie R Imm
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, St. Louis, MO, USA
| | - Ashley J Housten
- Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1st Floor, 1090, Vienna, Austria
| | - Keon L Gilbert
- Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO, USA
| | - Bettina F Drake
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, St. Louis, MO, USA
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Goodman MS, Gilbert KL, Hudson D, Milam L, Colditz GA. Descriptive Analysis of the 2014 Race-Based Healthcare Disparities Measurement Literature. J Racial Ethn Health Disparities 2016; 4:10.1007/s40615-016-0281-5. [PMID: 27571958 PMCID: PMC5332523 DOI: 10.1007/s40615-016-0281-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 08/12/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
Abstract
IMPORTANCE There are more than 500 articles in the 2014 race-based healthcare disparities literature across a broad array of diseases and outcomes. However, unlike many other forms of research (e.g., clinical trials and systematic reviews), there are no required reporting guidelines when submitting results of disparities studies to journals. OBJECTIVE This study describes the race-based healthcare disparities measurement literature in terms of study design, journal characteristics, generation of health disparities research, type of disparity measure used, and adherence to disparities measurement guidelines. METHODS We searched three databases of peer-reviewed literature, PubMed, Ovid Medline, and JSTOR, for English language articles published in 2014 on racial/ethnic healthcare disparities. Studies must have quantitatively measured the difference in health outcomes between two racial/ethnic groups in order to be included. Our final sample included 266 studies from 167 medical and public health journals. FINDINGS Only 7 % (n = 19) of articles reported both an absolute and relative measure of disparity; the majority of studies (64 %, n = 171) reported only a relative measure of effect. Most studies were published in clinical journals (74 %, n = 198), used secondary data (86 %, n = 229), and calculated black-white disparities (82 %, n = 218). The most common condition studied was cancer (25 %, n = 67), followed by a surgical procedure (18 %, n = 48). On average, articles in the sample only met 61 % of the applicable guidelines on reporting of disparities. CONCLUSIONS AND RELEVANCE To be able to synthesize findings in the racial disparities literature (meta-analysis), there is a need for the use of consistent methods for quantifying disparities and reporting in the literature. A more consistent battery of measures and consistent reporting across studies may help speed our understanding of the origins and development of solutions to address healthcare disparities. Despite guidelines for best practices in reporting disparities, there is a lack of adherence in the current literature.
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Affiliation(s)
- Melody S Goodman
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA.
| | - Keon L Gilbert
- Department of Behavioral Science & Health Education, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Darrell Hudson
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Laurel Milam
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
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18
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Gilbert KL, Ray R. Why Police Kill Black Males with Impunity: Applying Public Health Critical Race Praxis (PHCRP) to Address the Determinants of Policing Behaviors and "Justifiable" Homicides in the USA. J Urban Health 2016; 93 Suppl 1:122-40. [PMID: 26661386 PMCID: PMC4824696 DOI: 10.1007/s11524-015-0005-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Widespread awareness of the recent deaths of several black males at the hands of police has revealed an unaddressed public health challenge-determining the root causes of excessive use of force by police applied to black males that may result in "justifiable homicides." The criminalization of black males has a long history in the USA, which has resulted in an increase in policing behaviors by legal authorities and created inequitable life chances for black males. Currently, the discipline of public health has not applied an intersectional approach that investigates the intersection of race and gender to understanding police behaviors that lead to "justifiable homicides" for black males. This article applies the core tenets and processes of Public Health Critical Race Praxis (PHCRP) to develop a framework that can improve research and interventions to address the disparities observed in recent trend analyses of "justifiable homicides." Accordingly, we use PHCRP to offer an alternative framework on the social, legal, and health implications of violence-related incidents. We aim to move the literature in this area forward to help scholars, policymakers, and activists build the capacity of communities to address the excessive use of force by police to reduce mortality rates from "justifiable homicides."
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Affiliation(s)
- Keon L Gilbert
- College for Public Health & Social Justice, Saint Louis University, Salus Center, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA.
| | - Rashawn Ray
- University of Maryland, College Park, MD, USA
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19
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Gilbert KL, Elder K, Lyons S, Kaphingst K, Blanchard M, Goodman M. Racial Composition Over the Life Course: Examining Separate and Unequal Environments and the Risk for Heart Disease for African American Men. Ethn Dis 2015; 25:295-304. [PMID: 26673460 DOI: 10.18865/ed.25.3.295] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Studies have demonstrated the effects of segregated social and physical environments on the development of chronic diseases for African Americans. Studies have not delineated the effects of segregated environments specifically on the health of African American men over their lifetime. This study examines the relationship between life course measures of racial composition of social environments and diagnosis of hypertension among African American men. DESIGN We analyzed cross-sectional data from a convenience sample of African American men seeking health care services in an outpatient primary care clinic serving a medically underserved patient population (N=118). Multivariable logistic regression analyses were used to examine associations between racial composition of multiple environments across the life course (eg, junior high school, high school, neighborhood growing up, current neighborhood, place of employment, place of worship) and hypertension diagnosis. RESULTS The majority (86%) of participants were not currently in the workforce (retired, unemployed, or disabled) and more than half (54%) reported an annual household income of <$9,999; median age was 53. Results suggest that African American men who grew up in mostly Black neighborhoods (OR=4.3; P=.008), and worked in mostly Black environments (OR=3.1; P=.041) were more likely to be diagnosed with hypertension than those who did not. CONCLUSION We found associations between mostly Black residential and workplace settings and hypertension diagnoses among African American men. Findings suggest exposure to segregated environments during childhood and later adulthood may impact hypertension risk among African American men over the life course.
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Affiliation(s)
- Keon L Gilbert
- 1. Department of Behavioral Science and Health Education at Saint Louis University, College for Public Health and Social Justice
| | - Keith Elder
- 2. Department of Health Management and Policy at Saint Louis University, College for Public Health and Social Justice
| | - Sarah Lyons
- 3. Washington University School of Medicine Division of Public Health Sciences
| | - Kimberly Kaphingst
- 5. University of Utah, Department of Communication, Huntsman Cancer Institute
| | - Melvin Blanchard
- 4. Department of Internal Medicine/Primary Care at Washington University School of Medicine
| | - Melody Goodman
- 3. Washington University School of Medicine Division of Public Health Sciences
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20
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Elder K, Meret-Hanke L, Dean C, Wiltshire J, Gilbert KL, Wang J, Shacham E, Barnidge E, Baker E, Wray R, Rice S, Johns M, Moore T. How Do African American Men Rate Their Health Care? An Analysis of the Consumer Assessment of Health Plans 2003-2006. Am J Mens Health 2014; 9:178-85. [DOI: 10.1177/1557988314532824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
African American (AA) men remain one of the most disconnected groups from health care. This study examines the association between AA men’s rating of health care and rating of their personal physician. The sample included 12,074 AA men aged 18 years or older from the 2003 to 2006 waves of the Consumer Assessment of Healthcare Providers and Systems Adult Commercial Health Plan Survey. Multilevel models were used to obtain adjusted means rating of health care systems and personal physician, and the relationship of ratings with the rating of personal physician. The adjusted means were 80 (on a 100-point scale) for most health ratings and composite health care scores: personal physician (83.9), specialist (83.66), health care (82.34), getting needed care (89.57), physician communication (83.17), medical staff courtesy (86.58), and customer service helpfulness (88.37). Physician communication was the strongest predictor for physician rating. AA men’s health is understudied, and additional research is warranted to improve how they interface with the health care system.
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Affiliation(s)
- Keith Elder
- Saint Louis University, Saint Louis, MO, USA
| | | | - Caress Dean
- Saint Louis University, Saint Louis, MO, USA
| | | | | | - Jing Wang
- Saint Louis University, Saint Louis, MO, USA
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21
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Abstract
Social capital refers to various levels of social relationships formed through social networks. Measurement differences have lead to imprecise measurement. A meta-analysis of eligible studies assessing the bivariate association between social capital and self-reported health and all-cause mortality was performed. Thirty-nine studies met inclusion criteria, showing social capital increased odds of good health by 27 percent (95% confidence intervals [CI] =21%, 34%). Social capital variables, reciprocity increased odds of good health by 39 percent (95% CI = 21%, 60%) and trust by 32 percent (95% CI =19%, 46%). Future research suggests operationalizing measures by assessing differences by race/ethnicity, gender and socioeconomic status.
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22
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Elder K, Ramamonjiarivelo Z, Wiltshire J, Piper C, Horn WS, Gilbert KL, Hullett S, Allison J. Trust, medication adherence, and hypertension control in Southern African American men. Am J Public Health 2012; 102:2242-5. [PMID: 22698017 DOI: 10.2105/ajph.2012.300777] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We examined the relationship between trust in the medical system, medication adherence, and hypertension control in Southern African American men. The sample included 235 African American men aged 18 years and older with hypertension. African American men with higher general trust in the medical system were more likely to report better medication adherence (odds ratio [OR] = 1.06), and those with higher self-efficacy were more likely to report better medication adherence and hypertension control (OR = 1.08 and OR = 1.06, respectively).
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Affiliation(s)
- Keith Elder
- Department of Health Management and Policy, School of Public Health, St. Louis University, St. Louis, MO 63104, USA.
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23
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Gilbert KL, Quinn SC, Ford AF, Thomas SB. The urban context: a place to eliminate health disparities and build organizational capacity. J Prev Interv Community 2011; 39:77-92. [PMID: 21271434 DOI: 10.1080/10852352.2011.530168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study seeks to examine the process of building the capacity to address health disparities in several urban African American neighborhoods. An inter-organizational network consisting of a research university, community members, community organizations, media partners, and foundations was formed to develop a community-based intervention designed to provide health promotion and disease prevention strategies for type 2 diabetes and hypertension. In-depth qualitative interviews (n = 18) with foundation executives and project directors, civic organization leadership, community leaders, county epidemiologist, and university partners were conducted. Our study contextualizes a process to build a public health partnership using cultural, community, organizational, and societal factors necessary to address health disparities. Results showed 5 important factors to build organizational capacity: leadership, institutional commitment, trust, credibility, and inter-organizational networks. These factors reflected other important organizational and community capacity indicators such as: community context, organizational policies, practices and structures, and the establishment of new commitments and partnerships important to comprehensively address urban health disparities. Understanding these factors to address African American health disparities will provide lessons learned for health educators, researchers, practitioners, foundations, and communities interested in building and sustaining capacity efforts through the design, implementation, and maintenance of a community-based health promotion intervention.
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Affiliation(s)
- Keon L Gilbert
- School of Public Health, Saint Louis University, St. Louis, Missouri 63104, USA.
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24
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Thadani VM, Siegel AH, Lewis P, Siegel AM, Gilbert KL, Darcey TM, Roberts DW, Williamson PD. SPECT in neocortical epilepsies. Adv Neurol 2001; 84:425-33. [PMID: 11091885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- V M Thadani
- Section of Neurology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA
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25
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Lewis PJ, Siegel A, Siegel AM, Studholme C, Sojkova J, Roberts DW, Thadani VM, Gilbert KL, Darcey TM, Williamson PD. Does performing image registration and subtraction in ictal brain SPECT help localize neocortical seizures? J Nucl Med 2000; 41:1619-26. [PMID: 11037989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
UNLABELLED Ictal brain SPECT (IS) findings in neocortical epilepsy (patients without mesiotemporal sclerosis) can be subtle. This study is aimed at assessing how the seizure focus identification was improved by the inclusion of individual IS and interictal brain SPECT (ITS)-MRI image registration as well as performing IS - ITS image subtraction. METHODS The study involved the posthoc analysis of 64 IS scans using 99mTc-ethyl cysteinate dimer that were obtained in 38 patients without mesiotemporal sclerosis but with or without other abnormalities on MRI. Radiotracer injection occurred during video-electroencephalographic (EEG) monitoring. Patients were injected 2-80 s (median time, 13 s) after clinical or EEG seizure onset. All patients had sufficient follow-up to correlate findings with the SPECT results. All patients had ITS and MRI, including a coronal volume sequence used for registration. Image registration (IS and ITS to MRI) was performed using automated software. After normalization, IS - ITS subtraction was performed. The IS, ITS, and subtraction studies were read by 2 experienced observers who were unaware of the clinical data and who assessed the presence and localization of an identifiable seizure focus before and after image registration and subtraction. Correlation was made with video-EEG (surface and invasive) and clinical and surgical follow-up. RESULTS Probable or definite foci were identified in 38 (59%) studies in 33 (87%) patients. In 52% of the studies, the image registration aided localization, and in 58% the subtraction images contributed additional information. In 9%, the subtraction images confused the interpretation. In follow-up after surgery, intracranial EEG or video-EEG monitoring (or both) has confirmed close or reasonable localization in 28 (74%) patients. In 6 (16%) patients, SPECT indicated false seizure localization. CONCLUSION Image registration and image subtraction improve the localization of neocortical seizure foci using IS, but close correlation with the original images is required. False localizations occur in a minority of patients.
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Affiliation(s)
- P J Lewis
- Department of Radiology, Dartmouth-Hitchcock Medical Center; Lebanon, New Hampshire 03766, USA
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Abstract
Convulsive or generalized tonic clonic status epilepticus (SE) is a neurological emergency that can lead to transient or permanent brain damage or even death. An algorithm was designed to aid nursing and medical staff members in decision making about the type of SE and pharmacological intervention needed to stop prolonged or repetitive seizures. Fifteen registered nurses at a northern New England medical center's epilepsy unit participated in educational sessions on classification of seizures and status epilepticus prior to use of the algorithm. A pretest-posttest design with an investigator-developed tool was used to measure SE knowledge before and after educational intervention. There was a significant improvement in scores on the posttest of the classification of status epilepticus (Z = -2.93, p = .003). Twenty-nine medical records of patients who had experienced SE between February 1992 and December 1997 were reviewed. Nineteen patients experienced SE before the algorithm was implemented, and 10 patients experienced SE after the algorithm was implemented. A total of 16 patients experienced generalized convulsive SE with 12 episodes occurring before and 4 episodes after algorithm implementation. The mean time taken to stop the episode of SE after pharmacologic treatment began was compared in both groups using a t-test. The mean difference between the groups was 235 minutes (t = 2.57, p = .026). The findings of this project demonstrate that combining a treatment algorithm with education of staff members on its use has benefits in the practice setting of an inpatient comprehensive epilepsy program. Episodes of SE are more accurately classified and successful treatment of the episodes occurs earlier.
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Affiliation(s)
- K L Gilbert
- Dartmouth Epilepsy Program, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA
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27
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Palfrey JS, Levy JC, Gilbert KL. Use of primary care facilities by patients attending specialty clinics. Pediatrics 1980; 65:567-72. [PMID: 7360546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The health care patterns of 158 children attending a medical specialty clinic at least twice a year were studied. The families were interviewed about (1) use of a primary care source, (2) continued contact with the referring physician, and (3) perceived health needs. For almost one third of the children, no source of primary care was reported. This group contained a higher percentage of older children and children from the urban center than did the group as a whole. No differences were attributable to insurance coverage. Of patients referred by a primary care provider, 62% were still in contact with that provider, whereas only 20% referred from another hospital-based program were still in touch with that program. Of the children attending specialty clinics 60% had other perceived health needs. Thirty-eight percent of the families reported health problems that they had never discussed with any medical provider. This study indicates that a large proportion of children with frequent attendance at specialty clinics perceive the hospital as the source of all their care. Health planners and providers need to take this patient perception into account as they design and manage programs for chronically ill children.
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