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Iluno AC, Tatterton MJ, Haith-Cooper M. Meta-synthesis of ethnic minority families' experiences of children's palliative care across developed countries. Palliat Support Care 2024:1-14. [PMID: 38654706 DOI: 10.1017/s1478951524000609] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Meeting the needs of people accessing healthcare from ethnic minority (EM) groups is of great importance. An insight into their experience is needed to improve healthcare providers' ability to align their support with the perspectives and needs of families. This review provides insight into how families from EM backgrounds experience children's palliative care (CPC) by answering the question, "What are the experiences of EM families of children's palliative care across developed countries?" METHODS A systematic search of articles from 6 databases (Scopus, Medline, Web of Science, APA PsycINFO, CINAHL, and Global Health) with no limit to the date of publication. The search was conducted twice, first in June 2022 and again in December 2022. The extracted data were analyzed using thematic synthesis. RESULTS Eight studies explored the experiences of families of EM in different high-income countries. Four themes were identified: unmet needs leading to communication gaps, accessibility of hospital services and resources, the attitude of healthcare workers, and the need for survival as an immigrant. SIGNIFICANCE OF RESULTS Overall, the study shows EM families rely heavily on healthcare professionals' cultural competence in delivering palliative care for their children. There is an interplay between EM families' culture, spiritual ties, communication, and social needs from this review. Understanding how to bridge the communication gap and how families use their culture, faith, and spirituality to manage their pain, and grief and improve their quality of life would be extremely beneficial for healthcare practitioners in increasing their support to EM families accessing CPC.
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Affiliation(s)
- Adaobi C Iluno
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Michael J Tatterton
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Bluebell Wood Children's Hospice, Sheffield, United Kingdom
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de Leeuw AE, Ester WA, Bolhuis K, Hoek HW, Jansen PW. Maternal Migration, Prenatal Stress and Child Autistic Traits: Insights From a Population-Based Cohort Study. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00183-7. [PMID: 38599371 DOI: 10.1016/j.jaac.2024.04.004] [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: 04/13/2023] [Revised: 02/02/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE There is emerging evidence for an increased prevalence of autism in children of mothers with a migration background. To date, the mechanisms underlying this relationship are poorly understood. We investigated whether prenatal stress exposure mediates the association between maternal migration and child autistic traits, assessing first- and second-generation migrant mothers in the Netherlands and their children. METHOD The study was embedded in the prospective population-based Generation R cohort. Of the 4,727 participants, 1,773 mothers (38%) had a migration background. Prenatal stress was assessed using questionnaires related to stressful life events, family functioning, self-esteem, long-lasting difficulties, symptoms of psychopathology, social support, and perceived discrimination. Autistic traits were measured at age 6 years with the parent-reported Social Responsiveness Scale exclusively. Longitudinal multiple mediation analyses were performed. Analyses were stratified by migration origin (Europe and outside Europe) because of differences in migration characteristics. RESULTS Maternal migration background was associated with more experienced stress and with higher child autistic trait scores (Europe: mean = 0.42, SD = 0.25; outside Europe: mean = 0.50, SD = 0.24) compared to no migration background (Netherlands: mean = 0.38, SD = 0.23; both p < .01). Prenatal stress, especially perceived discrimination and maternal psychopathology, accounted for up to half of the total effect of maternal migration, which remained after adjusting for sociodemographic factors (Bindirect = 0.035, 95% CI = 0.027, 0.043, Btotal = 0.074). CONCLUSION Stress during pregnancy mediated the association between maternal migration status and child autistic traits. Future research should focus on early interventions to assess whether reducing prenatal stress exposure among women with a migration background can result in lower offspring autistic traits. DIVERSITY & INCLUSION STATEMENT We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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Affiliation(s)
- Anne E de Leeuw
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Wietske A Ester
- Leiden University Medical Center, Curium, Oegstgeest, the Netherlands; Sarr Autism Rotterdam, Youz, Parnassia Group, Rotterdam, the Netherlands
| | - Koen Bolhuis
- Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Columbia University, Mailman School of Public Health, New York
| | - Pauline W Jansen
- Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands; Erasmus University Rotterdam, the Netherlands.
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Iudici M, Rueda Sanchez JC, Girard-Guyonvarc'h C, Puéchal X. Race, Ethnicity, Sex, Gender, Socioeconomic Status, and Representativeness of Race and Ethnicity in ANCA Vasculitis Randomized Trials. Clin J Am Soc Nephrol 2024; 19:514-516. [PMID: 38150245 PMCID: PMC11020421 DOI: 10.2215/cjn.0000000000000415] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/20/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Michele Iudici
- Division of Rheumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | | | | | - Xavier Puéchal
- National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) Centre, Université Paris Cité, Paris, France
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Wang C, Niu Y. Knowledge and awareness of early gastrointestinal cancer screening in Sunan Yugur Autonomous County in Gansu, China. J Int Med Res 2024; 52:3000605241233935. [PMID: 38483133 PMCID: PMC10943729 DOI: 10.1177/03000605241233935] [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] [Received: 10/04/2023] [Accepted: 01/29/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE We aimed to assess the level of knowledge and awareness regarding the need for screening of early gastrointestinal cancer among residents of Sunan Yugur Autonomous County in China. METHODS In this cross-sectional study, we conducted a survey among permanent residents of Sunan Yugur Autonomous County from January 2020 to January 2023 using a questionnaire to obtain data on knowledge regarding early gastrointestinal cancer screening. RESULTS The survey included 12,000 residents. Among participants, 62.30% (7476/12,000) were aware of the need for early gastrointestinal cancer screening. Awareness about the need for early gastrointestinal cancer screening differed significantly based on participants' sex, age, level of education, area of residence, and ethnicity. CONCLUSION The level of awareness regarding the need for early gastrointestinal cancer screening was relatively low in our study population. The government and medical institutions should provide information and promote early gastrointestinal cancer screening in the region to improve the health status and quality of life among the Yugur people.
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Affiliation(s)
- Caihong Wang
- Nursing Department, Hexi University Affiliated Zhangye People’s Hospital, Zhangye, Gansu, China
| | - Yumei Niu
- Nursing Department, Hexi University Affiliated Zhangye People’s Hospital, Zhangye, Gansu, China
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Vy HMT, Coca SG, Sawant A, Sakhuja A, Gutierrez OM, Cooper R, Loos RJ, Horowitz CR, Do R, Nadkarni GN. Genome-Wide Polygenic Risk Score for CKD in Individuals with APOL1 High-Risk Genotypes. Clin J Am Soc Nephrol 2024; 19:374-376. [PMID: 37962879 PMCID: PMC10937008 DOI: 10.2215/cjn.0000000000000379] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Ha My T. Vy
- Icahn School of Medicine, New York City, New York
| | | | | | | | | | - Richard Cooper
- Loyola University School of Public Health, Chicago, Illinois
| | | | | | - Ron Do
- Icahn School of Medicine, New York City, New York
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Lai AHY, Lam JKH, Yao H, Tsui E, Leung C. Effects of students' perception of teachers' ethnic-racial socialization on students' ethnic identity and mental health in rural China's schools. Front Psychol 2024; 14:1275367. [PMID: 38425347 PMCID: PMC10903739 DOI: 10.3389/fpsyg.2023.1275367] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024] Open
Abstract
Introduction Using students in the Liangshan Yi autonomous prefectures of southwestern China (n = 585; 13-15 years old), we examined (i) the effects of students' perception of their teachers' ethnic-racial socialization on their ethnic identity and mental health outcomes of depressive and stress symptoms; (ii) the effects of students' ethnic identity on their depressive and stress symptoms; (iii) the differential associations among these factors in Yi ethnic minority versus Han cultural majority students. Methods We conducted a cross-sectional survey and used multistage sampling to collect the information. Chinese-validated standardized measures were used: the Patient Health Questionaires-9, Children's Revised Impact of Event Scale-8, Multigroup Ethnic Identity Measure, Cultural Socialization Scale, and Teachers' Attitude on Adoption of Cultural Diversity Scale. Multigroup confirmatory factor analysis and multigroup structural equation modeling were employed. Results Comparing the findings in Yi and Han students, their perception of teachers' ethnic-racial socialization had dissimilar effects on their ethnic identity and mental health outcomes. Three key findings comparing the differences between Yi and Han students were as follows: (i) students' perception of their teachers' multicultural socialization practices positively affected the ethnic identity of both Yi and Han young people; however, their perception of their teachers' socializing them to their own cultures did not exert any effect; (ii) students' perception of teachers' multicultural socialization practices had different mental health effects on Yi versus Han students; and (iii) ethnic identity affected the mental health of Yi ethnic minority students only. Conclusion The findings underscore the importance of teachers' multicultural socialization in the ethnic identity development of both Yi ethnic minority and Han majority students. Ethnic identity serves as a linking variable bridging perceived teachers' multicultural socialization practices and mental health in Yi ethnic minority students but not among the Han cultural majority youths. Research, practice, and policy implications relevant to the global context are also discussed.
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Affiliation(s)
| | - Jason K. H. Lam
- Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Hong Yao
- Minzu University of China, Beijing, China
| | - Elaine Tsui
- School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Cynthia Leung
- Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Pang RCC, Ho MSH, Wong PWC. A Review of the Literature on the Multiple Forms of Stigmatization of Caregivers of Children with Autism Among Ethnic Minority Groups. J Racial Ethn Health Disparities 2024; 11:545-559. [PMID: 36877377 DOI: 10.1007/s40615-023-01540-6] [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] [Received: 03/03/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/07/2023]
Abstract
Multiple forms of stigmatization are experienced by caregivers of children with autism among ethnic minority (EM) groups in various countries. Such forms of stigmatization can lead to delayed assessment and services for mental health among children and caregivers. This review identified the research literature on the types of stigmatization experienced by caregivers of children with autism with an EM background. A total of 19 studies published after 2010 (i.e., 12 from the USA, 2 from the UK, 1 from Canada, and 1 from New Zealand) of caregivers of 20 ethnicities were identified and reviewed, and their reporting qualities systematically also assessed. Four main themes: (1) self-stigma, (2) social stigma, (3) stigma towards EM parents of children on the autism spectrum, and (4) service utilization stigma, and nine sub-themes were identified. The discrimination experienced by caregivers were extracted, synthesized, and further discussed. While the reporting quality of the studies included is good, the depth of the understanding of this under-researched yet important phenomenon is very limited. The multiple forms of stigmatization experiences are complex, and it may be difficult to disentangle whether the causes of stigmatization were autism and/or EM related, and the types of stigmatization can vary enormously among different ethnic groups in different societies. More quantitative studies are needed to quantify the impacts of multiple forms of stigmatization on families of children with autism in EM groups so that more socially inclusive support for caregivers with an EM background in host countries can be developed.
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Affiliation(s)
| | - Mimi S H Ho
- Department of Special Education and Counselling, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, Hong Kong
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Oldham M, Dinu L, Loebenberg G, Field M, Hickman M, Michie S, Brown J, Garnett C. Methodological Insights on Recruitment and Retention From a Remote Randomized Controlled Trial Examining the Effectiveness of an Alcohol Reduction App: Descriptive Analysis Study. JMIR Form Res 2024; 8:e51839. [PMID: 38180802 PMCID: PMC10799283 DOI: 10.2196/51839] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Randomized controlled trials (RCTs) with no in-person contact (ie, remote) between researchers and participants offer savings in terms of cost and time but present unique challenges. OBJECTIVE The goal of this study is to examine the differences between different forms of remote recruitment (eg, National Health Service [NHS] website, social media, and radio advertising) in the proportion of participants recruited, demographic diversity, follow-up rates, and cost. We also examine the cost per participant of sequential methods of follow-up (emails, phone calls, postal surveys, and postcards). Finally, our experience with broader issues around study advertising and participant deception is discussed. METHODS We conducted a descriptive analysis of 5602 increasing-and-higher-risk drinkers (Alcohol Use Disorders Identification Test score ≥8), taking part in a 2-arm, parallel group, remote RCT with a 1:1 allocation, comparing the intervention (Drink Less app) with usual digital care (NHS alcohol advice web page). Participants were recruited between July 2020 and March 2022 and compensated with gift vouchers of up to £36 (a currency exchange rate of £1=US $1.26988 is applicable) for completing follow-up surveys, with 4 stages of follow-up: email reminders, phone calls, postal survey, and postcard. RESULTS The three main recruitment methods were advertisements on (1) social media (2483/5602, 44.32%), (2) the NHS website (1961/5602, 35.01%), and (3) radio and newspapers (745/5602, 13.3%), with the remaining methods of recruitment accounting 7.37% (413/5602) of the sample. The overall recruitment cost per participant varied from £0 to £11.01. Costs were greater when recruiting participants who were men (£0-£28.85), from an ethnic minority group (£0-£303.81), and more disadvantaged (£0-£49.12). Targeted approaches were useful for recruiting more men but less useful in achieving diversity in ethnicity and socioeconomic status. Follow-up at 6 months was 79.58% (4458/5602). Of those who responded, 92.4% (4119/4458) responded by email. Each additional stage of follow-up resulted in an additional 2-3 percentage points of the overall sample being followed up, although phone calls, postal surveys, and postcards were more resource intensive than email reminders. CONCLUSIONS For remote RCTs, researchers could benefit from using a range of recruitment methods and cost-targeted approaches to achieve demographic diversity. Automated emails with substantial financial incentives for prompt completion can achieve good follow-up rates, and sequential, offline follow-up options, such as phone calls and postal surveys, can further increase follow-up rates but are comparatively expensive. We also make broader recommendations focused on striking the right balance when designing remote RCTs. Careful planning, ongoing maintenance, and dynamic decision-making are required throughout a trial to balance the competing demands of participation among those eligible, deceptive participation among those who are not eligible, and ensuring no postrandomization bias is introduced by data-checking protocols.
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Affiliation(s)
- Melissa Oldham
- University College London, London, London, United Kingdom
| | - Larisa Dinu
- University College London, London, London, United Kingdom
| | | | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Jamie Brown
- University College London, London, London, United Kingdom
| | - Claire Garnett
- University College London, London, London, United Kingdom
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Duveau C, Wets C, Delaruelle K, Demoulin S, Dauvrin M, Lepièce B, Ceuterick M, De Maesschalck S, Bracke P, Lorant V. Individual, interpersonal, and organisational factors associated with discrimination in medical decisions affecting people with a migration background with mental health problems: the case of general practice. Ethn Health 2024; 29:126-145. [PMID: 37936401 DOI: 10.1080/13557858.2023.2279476] [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: 03/23/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES Although people with a migration background (MB) have more unmet mental health needs than the general population, patients with a MB are still underrepresented in mental health care services. Provider bias towards these patients has been evidenced repeatedly but its driving factors remain elusive. We assessed the moderating effect of the individual (e.g. age and ethnicity), interpersonal (e.g. healthcare provider trust), and organisational (e.g. perceived workload) factors on general practitioners (GPs) differential decision-making regarding diagnosis, treatment, and referral for a depressed patient with or without a MB. DESIGN An experimental study was carried out in which GPs were shown one of two video vignettes featuring adult male depressed patients, one with a MB and the other without. Belgian GPs (n = 797, response rate was 13%) had to decide on their diagnosis, treatment, and referral. Analysis of variance and logistic regression were used to analyse the effect of a MB, adding interaction terms for the explanatory variables. RESULTS Overall, we found that there were ethnic differences in GPs' decisions regarding diagnosis and treatment recommendations. GPs perceived the symptoms of the patient with a MB as less severe (F = 7.68, p < 0.01) and demonstrated a reduced likelihood to prescribe a combination of medical and non-medical treatments (F = 11.55, p < 0.001). Those differences increased in accordance with the GP's age and perceived workload; at an interpersonal level, we found that differences increased when the GP thought the patient was exaggerating his distress. CONCLUSION This paper showed that lower levels of trust among GPs' towards their migrant patients and high GP workloads contribute to an increased ethnic bias in medical decision-making. This may perpetuate ethnic inequalities in mental health care. Future researchers should develop an intervention to decrease the ethnic inequities in mental health care by addressing GPs' trust in their migrant and ethnic minority patients.
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Affiliation(s)
- Camille Duveau
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
| | - Camille Wets
- Health and Demographic Research, Ghent University, Ghent, Belgium
| | | | - Stéphanie Demoulin
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Marie Dauvrin
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
- Belgian Health Care Knowledge Centre, KCE, Brussels, Belgium
| | - Brice Lepièce
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
| | | | | | - Piet Bracke
- Health and Demographic Research, Ghent University, Ghent, Belgium
| | - Vincent Lorant
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
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Zhang X, Jaswal A, Quint J. Experience in Accessing Healthcare in Ethnic Minority Patients with Chronic Respiratory Diseases: A Qualitative Meta-Synthesis. Healthcare (Basel) 2023; 11:3170. [PMID: 38132060 PMCID: PMC10743025 DOI: 10.3390/healthcare11243170] [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] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Access to healthcare is part of every individual's human rights; however, many studies have illustrated that ethnic minority patients seem to be confronted with barriers when using healthcare services. Understanding how healthcare utilities are accessed from the perspective of patients and why healthcare disparities occur with patients from a minority background has the potential to improve health equality and care quality. This qualitative systematic review aims to gain insights into the experiences of people with chronic respiratory diseases (CRDs) from a minority background and explore factors contributing to their experiences in accessing healthcare to inform related health policy makers and healthcare providers. METHODS This systematic review complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, where the Joanna Briggs Institute meta-aggregative instrument facilitated the qualitative synthesis. The study protocol was registered with PROSPERO (CRD42022346055). PubMed, Scopus, Web of Science, and CINAHL were the databases explored. RESULTS From the papers selected, 47 findings were derived from 10 included studies, and four synthesised findings were generated: (1) the relationship between patients and healthcare professionals affects the usage of healthcare services; (2) patients' perceptions and cultural beliefs affect their compliance with disease management; (3) personal behaviours affect the usage of healthcare services; and (4) health resource inequalities have an impact on accessing healthcare services. CONCLUSIONS This systematic review demonstrates that ethnic minorities with CRDs face inequalities when engaging in healthcare. The relationship between patients and clinicians impacting the use of healthcare is the most pivotal discovery, where not speaking the same language and being of a different race alongside the accompanying criticism and faith in facilities are key contributors to this effect. In addition, the thinking patterns of these marginalised groups may reflect their cultural upbringing and diminish their engagement with therapies. This paper has uncovered ways to attenuate inequalities amongst ethnic minorities in engaging with healthcare providers and provides insight into building effective equity-promoting interventions in healthcare systems. To overcome these disparities, coaching doctors to communicate better with minority cohorts could help such patients to be more comfortable in connecting with medical facilities.
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Affiliation(s)
| | | | - Jennifer Quint
- School of Public Health, Imperial College London, London W12 0BZ, UK; (X.Z.); (A.J.)
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Carpenter SM, Greer ZM, Newman R, Murphy SA, Shetty V, Nahum-Shani I. Developing Message Strategies to Engage Racial and Ethnic Minority Groups in Digital Oral Self-Care Interventions: Participatory Co-Design Approach. JMIR Form Res 2023; 7:e49179. [PMID: 38079204 PMCID: PMC10750234 DOI: 10.2196/49179] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/22/2023] [Revised: 08/01/2023] [Accepted: 08/25/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND The prevention of oral health diseases is a key public health issue and a major challenge for racial and ethnic minority groups, who often face barriers in accessing dental care. Daily toothbrushing is an important self-care behavior necessary for sustaining good oral health, yet engagement in regular brushing remains a challenge. Identifying strategies to promote engagement in regular oral self-care behaviors among populations at risk of poor oral health is critical. OBJECTIVE The formative research described here focused on creating messages for a digital oral self-care intervention targeting a racially and ethnically diverse population. Theoretically grounded strategies (reciprocity, reciprocity-by-proxy, and curiosity) were used to promote engagement in 3 aspects: oral self-care behaviors, an oral care smartphone app, and digital messages. A web-based participatory co-design approach was used to develop messages that are resource efficient, appealing, and novel; this approach involved dental experts, individuals from the general population, and individuals from the target population-dental patients from predominantly low-income racial and ethnic minority groups. Given that many individuals from racially and ethnically diverse populations face anonymity and confidentiality concerns when participating in research, we used an approach to message development that aimed to mitigate these concerns. METHODS Messages were initially developed with feedback from dental experts and Amazon Mechanical Turk workers. Dental patients were then recruited for 2 facilitator-mediated group webinar sessions held over Zoom (Zoom Video Communications; session 1: n=13; session 2: n=7), in which they provided both quantitative ratings and qualitative feedback on the messages. Participants interacted with the facilitator through Zoom polls and a chat window that was anonymous to other participants. Participants did not directly interact with each other, and the facilitator mediated sessions by verbally asking for message feedback and sharing key suggestions with the group for additional feedback. This approach plausibly enhanced participant anonymity and confidentiality during the sessions. RESULTS Participants rated messages highly in terms of liking (overall rating: mean 2.63, SD 0.58; reciprocity: mean 2.65, SD 0.52; reciprocity-by-proxy: mean 2.58, SD 0.53; curiosity involving interactive oral health questions and answers: mean 2.45, SD 0.69; curiosity involving tailored brushing feedback: mean 2.77, SD 0.48) on a scale ranging from 1 (do not like it) to 3 (like it). Qualitative feedback indicated that the participants preferred messages that were straightforward, enthusiastic, conversational, relatable, and authentic. CONCLUSIONS This formative research has the potential to guide the design of messages for future digital health behavioral interventions targeting individuals from diverse racial and ethnic populations. Insights emphasize the importance of identifying key stimuli and tasks that require engagement, gathering multiple perspectives during message development, and using new approaches for collecting both quantitative and qualitative data while mitigating anonymity and confidentiality concerns.
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Affiliation(s)
- Stephanie M Carpenter
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Zara M Greer
- Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Rebecca Newman
- Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susan A Murphy
- Department of Statistics, Harvard University, Cambridge, MA, United States
- Department of Computer Science, Harvard University, Cambridge, MA, United States
| | - Vivek Shetty
- Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
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Filakovska Bobakova D, Plavnicka J, Urbancikova I, Edelstein M, Jansen D, Dankulincova Veselska Z. Barriers to HPV vaccination in marginalized Roma communities in Slovakia. Front Public Health 2023; 11:1239963. [PMID: 38115851 PMCID: PMC10728715 DOI: 10.3389/fpubh.2023.1239963] [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] [Received: 06/14/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Limited access to healthcare services leads to lower vaccination rates in marginalized Roma communities (MRCs). This study aimed to explore health system barriers to HPV vaccination faced by people from MRCs from multiple perspectives. Methods The qualitative study was conducted in Slovakia in 2021/22 with 43 community members and health professionals. Data were analyzed using a combination of content analysis and consensual qualitative research. Results A substantial barrier to vaccination is limited coverage of vaccination expenses for certain age categories by health insurance. Moreover, Slovakia faces a significant shortage of healthcare personnel, leading to work overload and a lack of capacity and motivation to address HPV vaccination. Impaired relationships between health care providers and people from MRCs lead to the avoidance of healthcare services, which contributes to insufficient delivery of information and a lack of awareness regarding HPV-related diseases and vaccination. Conclusion Strengthening the capacities of health care providers, expanding the age group covered by health insurance and providing tailored information to people from MRCs are necessary prerequisites to increase the availability of HPV vaccination and enable people to make informed decisions about HPV vaccination.
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Affiliation(s)
- Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia
| | - Jana Plavnicka
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Ingrid Urbancikova
- Department of Epidemiology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | | | - Danielle Jansen
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
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Wesson DE. Racial and Ethnic Diversity is a Tool for Eliminating Unequal Racial and Ethnic Kidney Health. J Am Soc Nephrol 2023; 34:1938-1940. [PMID: 37876239 PMCID: PMC10703080 DOI: 10.1681/asn.0000000000000254] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Affiliation(s)
- Donald E Wesson
- Dell Medical School, The University of Texas at Austin, Austin, TX
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Hassan H, Williams F, Cordwell J, Mann J. Ethnic minority fathers' experiences of the Neonatal Care Unit: barriers to accessing psychological support. J Reprod Infant Psychol 2023:1-13. [PMID: 38018095 DOI: 10.1080/02646838.2023.2287079] [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] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/19/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The Neonatal Care Unit is a challenging environment for parents. Previous literature documents the need for increased and more specialised understanding of support for fathers. There remains a dearth of literature on the experiences of ethnic minority fathers in particular, who may be less likely to access psychological support available. METHOD This project aimed to understand the barriers ethnic minority fathers face when accessing psychology support at a Neonatal Care Unit in England. Seven fathers from ethnic minority backgrounds participated in semi-structured interviews after their babies were discharged. RESULTS Data were analysed using a Reflexive Thematic Analysis approach. Three main themes were identified: 'Psychology is a Threat', 'It's Not Really Talked About in our Culture', and 'A Space for Mum, Not Me'. These themes are discussed in reference to the extant literature, and recommendations are provided to improve access to support in this neonatal unit. CONCLUSIONS There is a need to recognise interacting influences of gender and cultural norms in supporting these fathers, including understanding the role of psychology, consideration of stigma, and knowing families in relation to their cultural context.
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Affiliation(s)
- Hibah Hassan
- The Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Fin Williams
- The Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Jacinta Cordwell
- Children's Psychological Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Joanna Mann
- Children's Psychological Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
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15
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Sharma E, Puthussery S, Tseng PC, Harden A, Li L. Development, acceptability and feasibility of a community-based intervention to increase timely initiation of antenatal care in an area of high ethnic diversity and low socio-economic status in the UK. Midwifery 2023; 126:103812. [PMID: 37690314 DOI: 10.1016/j.midw.2023.103812] [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] [Received: 03/30/2023] [Revised: 08/17/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Antenatal care plays an important role in preventing adverse maternal and new-born outcomes. Women from ethnic minority backgrounds and of low socio-economic status are at greater risk of initiating antenatal care later than the recommended 10 weeks. There is a paucity of research exploring the development and evaluation of community-based interventions to increase the timely initiation of antenatal care. OBJECTIVE To develop and evaluate the acceptability and feasibility of a co-produced community-based intervention to increase uptake of antenatal care in an area with high ethnic diversity and low socio-economic status. DESIGN The intervention was developed using co-production workshops and conversations with 20 local service users and 14 stakeholders, underpinned by the theory of Diffusion of Innovation. The intervention was evaluated, on the domains of acceptability, adoption, appropriateness, and feasibility. Questionnaires (n=36), interviews (n=10), and focus groups (n=13) were conducted among those who received the intervention. Observations (n=13) of intervention sessions were conducted to assess intervention fidelity. Quantitative and qualitative data were analysed using SPSS and NVivo software respectively. RESULTS Over 91% of respondents positively ranked the intervention. Qualitative findings with respect to 'acceptability' included four subthemes: how the intervention was communicated, the characteristics of the person delivering the intervention and their knowledge, and the reassurance offered by the intervention. The 'adoption' theme included three sub-themes: being informed helps women to engage with antenatal care, the intervention provides information for future use, and onwards conveyance of the intervention information. The 'appropriateness' theme included three sub-themes: existing gap in information, nature of information given as part of the intervention, and talking about pregnancy in public. The 'feasibility' theme included two sub-themes: value of delivering the intervention in areas of high footfall and relational aspect of receiving the intervention. Observations showed intervention fidelity of 100%. CONCLUSION The community-based intervention, coproduced with women and maternity care stakeholders, was positively evaluated, and offered an innovative and promising approach to engage and educate women about the timely initiation of antenatal care in an ethnically diverse and socio-economically deprived community.
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Affiliation(s)
- Esther Sharma
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square Rm B201, Luton, Bedfordshire LU1 3JU.
| | - Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square Rm B201, Luton, Bedfordshire LU1 3JU.
| | - Pei-Ching Tseng
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square Rm B201, Luton, Bedfordshire LU1 3JU.
| | - Angela Harden
- School of Health Sciences, Division of Health Services Research and Management, City, University of London, Northampton Square London EC1V 0HB.
| | - Leah Li
- Population, Policy & Practice Department, Great Ormond Street Institute of Child Health, University College London, Guildford Street, London WC1N 1EH.
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Moore JB, Smith SC, Russell LP, Serdoz ES, Dilts NA, Alexander AA, Reboussin DM, Bagwell BM, Spainhour MH, Reeves-Daniel AM, Wesley-Farrington DJ, Ma L, Freedman BI. Creation of a Single Institutional Review Board for Collaborative Research in Nephrology: The APOLLO Experience. Clin J Am Soc Nephrol 2023; 18:1362-1365. [PMID: 37163584 PMCID: PMC10578633 DOI: 10.2215/cjn.0000000000000197] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Affiliation(s)
- J. Brian Moore
- Institutional Review Board and Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - S. Carrie Smith
- Department of Internal Medicine, Section on Gerontology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Laurie P. Russell
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Emily S. Serdoz
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Natalie A. Dilts
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Amir A. Alexander
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - David M. Reboussin
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Benjamin M. Bagwell
- Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Mitzie H. Spainhour
- Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Amber M. Reeves-Daniel
- Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Deborah J. Wesley-Farrington
- Institutional Review Board and Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Lijun Ma
- Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Barry I. Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Dickerson J, Bridges S, Willan K, Kelly B, Moss RH, Lister J, Netkitsing C, Atkinson AL, Bird PK, Uphoff EP, Mason D, Newsham A, Waiblinger D, Razaq R, Ahern S, Bryant M, Blower SL, Pickett KE, McEachan RM, Wright J. Born in Bradford's Better Start (BiBBS) interventional birth cohort study: Interim cohort profile. Wellcome Open Res 2023; 7:244. [PMID: 37830108 PMCID: PMC10565418 DOI: 10.12688/wellcomeopenres.18394.2] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Background: The Born in Bradford's Better Start (BiBBS) interventional birth cohort study was designed as an innovative cohort platform for efficient evaluation of early life interventions delivered through the Better Start Bradford programme. There are a growing number of interventional cohorts being implemented internationally. This paper provides an interim analysis of BiBBS in order to share learning about the feasibility and value of this method. Methods: Recruitment began in January 2016 and will complete in December 2023 with a target sample of 5,000 pregnancies. An interim analysis was completed for all pregnancies recruited between January 2016 and November 2019 with an expected due date between 1 st April 2016 and 8 th March 2020. Descriptive statistics were completed on the data. Results: Of 4,823 eligible pregnancies, 2,626 (54%) pregnancies were recruited, resulting in 2,392 mothers and 2,501 children. The sample are representative of the pregnant population (61% Pakistani heritage; 12% White British; 8% other South Asian and 6% Central and Eastern European ethnicity). The majority of participants (84%) live in the lowest decile of the Index of Multiple Deprivation, and many live in vulnerable circumstances. A high proportion (85%) of BiBBS families have engaged in one or more of the Better Start Bradford interventions. Levels of participation varied by the characteristics of the interventions, such as the requirement for active participation and the length of commitment to a programme. Conclusions: We have demonstrated the feasibility of recruiting an interventional cohort that includes seldom heard families from ethnic minority and deprived backgrounds. The high level of uptake of interventions is encouraging for the goal of evaluating the process and outcomes of multiple early life interventions using the innovative interventional cohort approach. BiBBS covers a period before, during and after the coronavirus disease 2019 (COVID-19) pandemic which adds scientific value to the cohort.
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Affiliation(s)
- Josie Dickerson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sally Bridges
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Kathryn Willan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Brian Kelly
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rachael H. Moss
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Jennie Lister
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Chandani Netkitsing
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Amy L. Atkinson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Philippa K. Bird
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Dan Mason
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Alex Newsham
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Dagmar Waiblinger
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rifat Razaq
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sara Ahern
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Maria Bryant
- Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | | | | | - Rosemary M. McEachan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - John Wright
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
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18
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Newman B, Chin M, Robinson L, Chauhan A, Manias E, Wilson C, Harrison R. Improving Medication Safety in Cancer Services for Ethnic Minority Consumers: Protocol for a Pilot Feasibility and Acceptability Study of a Co-Designed Consumer Engagement Intervention. JMIR Res Protoc 2023; 12:e49902. [PMID: 37721784 PMCID: PMC10546273 DOI: 10.2196/49902] [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] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND People from ethnic minorities are often exposed to unsafe care contributing to poorer health care outcomes. Medication safety is a high-risk area requiring intervention to improve care outcomes. Using an adapted, experience-based co-design process with cancer service staff and patients from ethnic minorities, a medication communication tool was created: Making it Meaningful (MiM). OBJECTIVE We aim to test whether the MiM tool is feasible and acceptable for use with ethnic minority consumers in cancer services in Australia. METHODS A single site, controlled before and after this pilot study, will be used. Patients from Mandarin- and Russian-speaking backgrounds are eligible for inclusion. In total, 40 patients from these cultural backgrounds will be recruited and stratified by language to the intervention and control groups, with 20 participants in the intervention and 20 in the control group. Further, 4 health practitioners will be recruited and trained to use the MiM. Clinicians providing care for patients in the intervention will use the MiM during their usual appointment while providing medication communication using standard care processes for the control group. Telephone surveys will be conducted with participants at 3 time points, T1 before the intervention, T2 1 week post intervention, and T3 1 month post intervention, to assess knowledge and self-efficacy in medication management, perceived usability, and acceptability of the MiM. Qualitative interviews with clinicians who have used the MiM will be conducted 1 month postintervention to explore their perceptions of MiM feasibility and acceptability. RESULTS Ethical approval for this research has been provided by the South Eastern Sydney Area Health Human Research Ethics Committee (HRECXXX). Bilingual field-workers, 1 Mandarin-speaking and 1 Russian-speaking, are contacting eligible patients to enroll. It is anticipated that recruitment will be completed by October 2023, with data collection completed by December 2023. CONCLUSIONS Using experience-based co-design, we identified communication about medication, particularly between appointments, as a key issue impacting the safety of care for patients from ethnic minorities accessing cancer services. Increasing consumer engagement in medication management was identified as a strategy to reduce medication safety problems in cancer care; the MiM strategy was developed to address this issue. It is anticipated that by using the MiM, patient knowledge about prescribed medications and confidence in medication management will increase. Evidence from the pilot study will be used to inform a full-scale trial of the MiM tool with a range of ethnic minority communities accessing cancer services. A full-scale trial will seek to determine whether the MiM intervention is effective in knowledge and confidence about medication management, but also whether this improves patient outcomes in cancer care. TRIAL REGISTRATION Australian New Zealand Clinical Trials ACTRN12622001260718p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384658&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49902.
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Affiliation(s)
- Bronwyn Newman
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | - Melvin Chin
- South Eastern Sydney Local Health District, Randwick, Australia
| | - Louisa Robinson
- South Eastern Sydney Local Health District, Randwick, Australia
| | - Ashfaq Chauhan
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | - Elizabeth Manias
- Australia School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Reema Harrison
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
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19
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Nair D. Centering Symptom Burden in Patient-Oriented Clinical Trials in Kidney Disease. Kidney360 2023; 4:e1196-e1198. [PMID: 37768808 PMCID: PMC10549999 DOI: 10.34067/kid.0000000000000256] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Affiliation(s)
- Devika Nair
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt Center for Health Services Research, Nashville, Tennessee; and Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee
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20
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Richardson N, McDonnell K, Carroll P, O’Donnell S. Using an Intersectional Approach to Explore the Lived Mental Health Experiences of Traveller Men Affected by Suicide in Ireland. Am J Mens Health 2023; 17:15579883231189063. [PMID: 37688409 PMCID: PMC10493055 DOI: 10.1177/15579883231189063] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 09/10/2023] Open
Abstract
Rates of suicide are seven times higher among Traveller men, an Indigenous ethnic minority group in Ireland, compared with non-Traveller men. Several factors are implicated, including racism, social exclusion, discrimination, inadequate accommodation, unemployment, and lower educational attainment. Systemic and cultural barriers inhibit Traveller men from seeking support. This study addresses a gap in the literature by exploring the lived mental health experiences of Traveller men affected by suicide. Semi-structured interviews (n = 13; aged 19-50) were conducted with Traveller men affected by suicide. Interviews were recorded and transcribed verbatim. Thematic content analysis was used to analyze the data, which yielded three broad themes. Theme 1, "key determinants of Traveller men's mental health," describes the impact on Traveller men of issues relating to accommodation/homelessness, education, and unemployment, as well as frequent exposure to prejudice, discrimination, and racism. Theme 2, "contemporary Traveller masculinities," considers how Traveller masculinities were shaped by a patrilineal tradition and by historical/ongoing tensions related to their ethnicity. Theme 3, "navigating support seeking and coping with distress," encapsulates both resistant and proactive approaches used by participants to manage their mental health. The intersection of structural inequalities, internalized racism, Traveller masculinities, and strong historical associations between stigma and mental health/suicide within the Traveller community lies at the heart of the heavy burden of suicide carried by Traveller men. Findings provide a deeper understanding of the sources of distress and pathways to resilience/recovery among Traveller men affected by suicide and can inform the development of more gender- and culturally appropriate suicide prevention interventions.
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Affiliation(s)
| | | | - Paula Carroll
- South East Technological University, Carlow, Ireland
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Özen-Dursun B, Panagioti M, Alharbi R, Giles S, Husain N. A qualitative study on lived experience of self-harm in South Asians in the UK: From reasons to recovery. Clin Psychol Psychother 2023; 30:1179-1189. [PMID: 37337356 DOI: 10.1002/cpp.2875] [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] [Received: 02/07/2023] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Self-harm rates and clinical presentations differ by ethnicity. South Asian women are at risk of self-harm. Previous research suggested investigating individuals' experiences with self-harm with qualitative studies in developing self-harm prevention strategies. This research aims to explore self-harm experiences among South Asians in the United Kingdom. DESIGN Qualitative study. METHODS Participants were recruited via third-sector organizations and online platforms. Semi-structured interviews were conducted with 11 South Asian individuals with a history of self-harm living in the United Kingdom. The data were analysed based on a reflective thematic analysis approach. RESULTS Results revealed four main themes: (1) reasons for self-harm; (2) recovery journey; (3) culture and mental health; and (4) the transition to suicidal thoughts and behaviours. Reasons for self-harm included negative life circumstances, social life difficulties, challenges faced during COVID-19 and mental health problems. Participants described their recovery journey by acknowledging the role of professional help, self-care, psychoeducation and personal growth, improving social relationships, and faith and spirituality. Cultural factors included generational differences and stigma. Culturally adapted psychological interventions were perceived as promising. The reported transition from self-harm to suicidal behaviours was linked to experiencing major stressful life events and the use of severe methods of self-harm. CONCLUSIONS The findings suggest that socio-cultural factors impact mental health and recovery processes among South Asians. Mental health services should consider improving culturally sensitive clinical practices in responding to self-harm among South Asian communities.
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Affiliation(s)
- Büşra Özen-Dursun
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Maria Panagioti
- Division of Population Health, Health Services Research and Primary Care, National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health and Care Research School for Primary Care Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Reem Alharbi
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Sally Giles
- Division of Population Health, Health Services Research and Primary Care, National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Nusrat Husain
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Mersey Care NHS Foundation Trust, Prescot, UK
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Atwal A, Sriram V, McKay EA. Mentoring for Black and Minoritized Allied Health Professionals in Health and Social Care: A Scoping Review. J Multidiscip Healthc 2023; 16:2251-2259. [PMID: 37581204 PMCID: PMC10423563 DOI: 10.2147/jmdh.s413085] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/30/2023] [Indexed: 08/16/2023] Open
Abstract
Introduction Diversity, equality and belonging are important aspects within Allied Health Professional (AHP) groups. Mentoring is considered as a solution to improve career progression. To date, there is no consensus on what good mentoring looks like and whether current models are fit for purpose for Black and Minoritised Ethnicity AHPs. Methods Scoping review to understand mentoring among Black and Minoritised Ethnicity (BME) AHPs through searches in four electronic databases using pre-defined criteria. Results From 1440 studies screened, 2 studies were included in this review that researched mentoring for BME AHPs in a health and/or social care setting. Themes that emerged from the literature were related to access and amount of mentoring for BME AHPs, psychosocial mentoring may influence cross-race mentorship outcomes and organisational issues related to workforce pressures and management support. There is uncertainty around the importance of same race relationships in mentoring but there is some evidence that within cross-race mentoring this could influence outcomes. Conclusion It is unknown if mentoring enables career success in BME AHPs. There is emerging evidence on the importance of psychosocial mentoring within cross-race relationships. Careful reflection and further research is needed on how current mentoring models work and ensure fair access to mentorship and support for BME AHPs.
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Affiliation(s)
- Anita Atwal
- London South Banking University, School of Allied and Community Health, London, UK
| | - Vimal Sriram
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Collaborative Learning and Capacity Building Theme, NIHR Applied Research Collaboration in Northwest London, London, UK
| | - Elizabeth A McKay
- Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK
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Myers V, Saban M, Valinsky L, Luxenburg O, Wilf-Miron R. Timely childhood vaccination in Israel: a national retrospective study of ethnic and socioeconomic disparities. Health Promot Int 2023; 38:daab172. [PMID: 34741615 DOI: 10.1093/heapro/daab172] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/15/2022] Open
Abstract
A large proportion of children do not receive vaccines within the recommended timeframe. This study examined ethnic and socioeconomic differences in age-appropriate immunization of children in Israel, where immunization is freely available. Percent of children receiving MMR/V at 12-13 months, and four doses of DTP/IPV/Hib by 18 months were obtained from the National Programme for Quality Measures between 2015 and 2018. Ethnic group (Jewish vs Arab) (defined by proxy by the neighbourhood in which the clinic was located), neighbourhood socioeconomic status and peripherality were obtained. Rates of MMR vaccination were 61% in the Jewish and 82% in the Arab population; for DPT/IPV/Hib 75% in the Jewish, compared to 92% in the Arab population. These patterns were stable over time. Lowest rates occurred in the most peripheral areas for Arab children, and in urban areas for Jewish children. Differences between ethnic groups were significant at higher SES levels. Greater adherence to the vaccination schedule occurred in the Arab minority in contrast to studies showing lower vaccination in ethnic minorities elsewhere. Lower immunization rates among rural Arab children suggest a need for improved access to clinics. Efforts should be directed towards lower SES groups, while emphasizing the importance of timely vaccination in wealthier groups in order to achieve herd immunity.
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Affiliation(s)
- Vicki Myers
- Gertner Institute of Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | - Mor Saban
- Gertner Institute of Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | | | | | - Rachel Wilf-Miron
- Gertner Institute of Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
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Islam F. How has the Olympic legacy transformed the heart of East London? Understanding socio-economic exclusions and disproportionate COVID-19 impact on minoritised communities through a rights-based perspective. Front Sports Act Living 2023; 5:1170466. [PMID: 37547817 PMCID: PMC10402273 DOI: 10.3389/fspor.2023.1170466] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
This research paper explores the experience of British-Bangladeshi and Black African Caribbean communities living in the areas surrounding London's Olympic Park, in terms of how they are appropriating the legacy-led socio-spatial changes, applying Lefebvre's right to the city perspective. Highlighting the top-down legacy-led regeneration process, the empirical evidence suggests that the games-led regeneration is contributing to an unjust trade-off between pre-existing minoritised ethnic residents and wealthier gentrifiers, ignoring the real needs of the socially and economically disadvantaged ethnic minority communities in East London. The findings provide a further understanding of factors such as housing and health-related inequalities and sub-standard living conditions, which may have contributed to the disproportionate impact of COVID-19 on the Bangladeshi and African Caribbean people living in East London boroughs. Given the scale of the pandemic, the paper argues that a greater understanding of the socio-structural problems and barriers arising out of poverty and deprivation is needed in order to formulate appropriate policy interventions to reduce disproportionate social, economic and health-related impacts on some minoritised communities, which could be achieved through residents' active participation and appropriation at different stages of the legacy-led regeneration process.
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Sun P, Zhu L, Ma L, Li C, Wang Z, Zhang R, Ye S, Wang Y. Blood Service in a Region of China's Qinghai-Tibetan Plateau. Healthcare (Basel) 2023; 11:1944. [PMID: 37444778 DOI: 10.3390/healthcare11131944] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/02/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Objectives: The purpose of this paper is to describe blood services in the Aba Tibetan and Qiang Regions, (hereinafter referred to as Aba Prefecture), a region of China's Qinghai-Tibetan Plateau, the third largest area of Tibet and the main inhabited area of the Qiang people. Design: We present a comprehensive investigation into blood donations, donors, screening and supply in the 13 counties of Aba Prefecture based on data from 2013 to 2018. Geography and population were also used to analyze the differences in blood services among different regions. Participants: The number of blood donors totaled 19,047. Results: Over the past 6 years, blood donations have increased by 29 and clinical blood usage by 45%. The blood donation rate was 3.4‱ and per capita blood use was 1.04 mL, both of which were significantly lower than the national average, and blood donation decreased with altitude. It should be noted that the donation rate of the Tibetan and Qiang peoples is much lower than that of the Han population. Moreover, the rejection rate of blood in laboratory testing was found to be higher than the national average, especially in counties located at higher altitudes. Conclusions: Blood donations and usage increased every year in Aba Prefecture, but blood shortage is still an important issue. In addition, the prevalence of transfusion-transmitted diseases is relatively high, which may be linked to lower-education and unfavorable geographical and medical conditions.
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Affiliation(s)
- Pan Sun
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
| | - Liyuan Zhu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
| | - Li Ma
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
| | - Changqing Li
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
| | - Zongkui Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
| | - Rong Zhang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
| | - Shengliang Ye
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
- Blood Center of Aba Tibetan and Qiang Autonomous Prefecture, Barkam 624000, China
| | - Ya Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China
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MacLellan J, Dixon S, Bi S, Toye F, McNiven A. Perimenopause and/or menopause help-seeking among women from ethnic minorities: a qualitative study of primary care practitioners' experiences. Br J Gen Pract 2023; 73:e511-e518. [PMID: 37130614 PMCID: PMC10170522 DOI: 10.3399/bjgp.2022.0569] [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] [Received: 11/15/2022] [Accepted: 01/20/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Each woman's experience of the perimenopause and/or menopause is individual and unique. Research shows women from ethnic minorities often have different experiences from their White peers, and these are not being considered in conversations about the menopause. Women from ethnic minorities already face barriers to help-seeking in primary care, and clinicians have expressed challenges in cross cultural communication including the risk that women from ethnic minorities' perimenopause and/or menopause health needs are not being met. AIM To explore primary care practitioners' experiences of perimenopause and/or menopause help-seeking among women from ethnic minorities. DESIGN AND SETTING A qualitative study of 46 primary care practitioners from 35 practices across 5 regions of England, with patient and public involvement (PPI) consultations with 14 women from three ethnic minority groups. METHOD Primary care practitioners were surveyed using an exploratory approach. Online and telephone interviews were conducted and the data were analysed thematically. The findings were presented to three groups of women from ethnic minorities to inform interpretation of the data. RESULTS Practitioners described a lack of awareness of perimenopause and/or menopause among many women from ethnic minorities, which they felt impacted their help-seeking and communication of symptoms. Cultural expressions of embodied experiences could offer challenges to practitioners to 'join the dots' and interpret experiences through a holistic menopause care lens. Feedback from the women from ethnic minorities provided context to practitioner findings through examples from their individual experiences. CONCLUSION There is a need for increased awareness and trustworthy information resources to help women from ethnic minorities prepare for the menopause, and clinicians to recognise their experiences and offer support. This could improve women's immediate quality of life and potentially reduce future disease risk.
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Affiliation(s)
- Jennifer MacLellan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Sharon Dixon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Sultana Bi
- The Lister Surgery, Westbourne Green Community Health Centre, Bradford
| | - Francine Toye
- Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust, UK
| | - Abigail McNiven
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
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Gadegbeku CA. Mirror, Mirror on the Wall: Do Kidney RCT Populations Represent the People We Treat? J Am Soc Nephrol 2023; 34:1127-1128. [PMID: 37218033 PMCID: PMC10356169 DOI: 10.1681/asn.0000000000000151] [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: 05/24/2023] Open
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Do KH, Pham CTM, Do TC, Hoang TT, Hoang TA, Nguyen CV, Bui GV, Ngo LL, Van Nguyen T, Le QV. Clinical features and outcome of retinoblastoma at the Vietnam National Cancer Hospital. Pediatr Blood Cancer 2023:e30526. [PMID: 37355858 DOI: 10.1002/pbc.30526] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/23/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To characterize the clinical features, treatment, and outcome of children diagnosed with retinoblastoma (RB) at Vietnam National Cancer Hospital. METHODS The study enrolled all RB patients newly diagnosed at Vietnam National Cancer Hospital from January 2018 to December 2022. The primary endpoint was overall survival (OS) and the eye salvage rate. RESULTS In total, 139 patients were enrolled, 51.8% patients were male. Median age was 18.9 months. Most patients presented with leukocoria (63.3%), followed by strabismus (14.4%), and 43.9% had bilateral disease. Of 200 eyes, 129 (64.5%) were classified as group E. Extraocular extension was noted in 10 of 139 patients (7.2%). About one-third of the patients lived more than 300 kilometers (km) away from these hospitals, and 17.3% of the patients belonged to minority groups, both of which were dominated by group E and extraocular or high-risk eyes at the time of consultation. Primary enucleation was done for 57 eyes (28.5%), and 51 of 61 patients (83.6%) received eye salvage therapy in bilateral RB group. At study closure, 127 children were alive at the last follow-up, 12 cases were confirmed dead. The 5-year OS and progression-free survival (PFS) rates were 90.3% and 85.9%, respectively. In particular, ethnic minority, distance to hospital more than 150 km, and extraocular disease were significantly associated with higher mortality among children with RB treated in Vietnam National Cancer Hospital. CONCLUSIONS There is a need to support for screening RB with early symptoms in grassroots medical facilities and raise awareness among patients' families through health education programs. Besides, caring and supporting treatment for patients from the ethnic minority and who live far from hospitals are also extremely necessary.
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Affiliation(s)
- Kien Hung Do
- Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Department of Pediatric Oncology, Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Department of Medical Oncology 1, Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
| | | | - Thanh C Do
- Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Department of Pediatric Oncology, Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
| | - Trang T Hoang
- Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Department of Pediatric Oncology, Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
| | | | - Chu V Nguyen
- Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Department of Pathology, Vietnam National Eye Hospital, Hanoi, Vietnam
| | - Giang V Bui
- Department of Diagnostic Imaging and Nuclear Medicine, Vimmec Times City International Hospital, Hanoi, Vietnam
| | - Lam L Ngo
- Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Diagnostic and Interventional Radiology Centre, Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
| | - Tai Van Nguyen
- Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Department of Medical Oncology 1, Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
| | - Quang V Le
- Vietnam National Cancer Hospital - K Hospital, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
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Beuthin O, Bhui K, Yu LM, Shahid S, Almidani L, Bilalaga MM, Hussein R, Harba A, Nasser Y. Culturally Adapting a Digital Intervention to Reduce Suicidal Ideation for Syrian Asylum Seekers and Refugees in the United Kingdom: Protocol for a Qualitative Study. JMIR Res Protoc 2023; 12:e47627. [PMID: 37347522 DOI: 10.2196/47627] [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] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The conflict in Syria has produced the largest forced displacement crisis since the Second World War. As a result, Syrians have experienced various stressors across the migratory process, putting them at an increased risk of developing mental health issues, including, crucially, suicidal ideation (SI). Despite their high rates of SI across Europe, there remain various barriers to accessing treatment. One way to increase access is the use of culturally adapted digital interventions, which have already shown potential for other minority populations. To culturally adapt the intervention, further research is needed to better understand Syrian asylum seekers' and refugees' cultural conceptualizations, coping strategies, and help-seeking behavior for SI. To do so, this study will use a unique cultural adaptation framework to intervene at points of lived experience with the migratory process where Syrian culture and signs of psychopathology converge. Likewise, co-design events will be used to adapt points of experience with the intervention where Syrian culture and the intervention conflict. As the first cultural adaption of a digital SI intervention for Syrian asylum seekers and refugees, this study will hopefully encourage further development of culturally sensitive interventions for the largest refugee population in the United Kingdom and the world. OBJECTIVE The objective of the study is to increase access to mental health treatment for Syrian asylum seekers and refugees in the United Kingdom by culturally adapting a digital intervention to reduce SI. METHODS The study will use experience-based co-design, an action research method, to culturally adapt a digital intervention to reduce SI for Syrian asylum seekers and refugees in the United Kingdom. This will involve conducting 20-30 interviews to understand their lived experiences with the migratory process, cultural conceptualizations of mental health and SI, coping strategies, mental health help-seeking behavior, and perceptions of digital mental health interventions. In addition, 3 co-design events with 6 participants in each will be held to collaboratively adapt the intervention. Touchpoints and themes extracted from each phase will be prioritized by a community panel before adapting the intervention. RESULTS The study began in November 2022 and will continue until the last co-design event in August 2023. The results of the study will then be published by December 2023. CONCLUSIONS Access to treatment for some of the most severe mental health issues is still limited for Syrian asylum seekers and refugees in the United Kingdom. Cultural adaptations of digital interventions developed for general populations have the potential to increase access to treatment for this population. Specifically, adapting the intervention for Syrian asylum seekers' and refugees' experiences with SI in relation to their lived experience with the migratory process may enable greater recruitment and adherence for users of various cultural and ethnic subgroups and levels of SI. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47627.
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Affiliation(s)
- Oliver Beuthin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Kamaldeep Bhui
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Ly-Mee Yu
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Sadiya Shahid
- Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, United Kingdom
| | - Louay Almidani
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | | | - Alnarjes Harba
- Centre for Global Health, St George's, University of London, London, United Kingdom
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Quayle G, Jones B, Atkins J, Shannon C, Smith R, Tabor D, Bałabuch Z, Cox C, Horsell S, John M, McGrail White T, Vickers S, Whittinger S, Bannister N, Raleigh V, Mateen B, Drummond R. Qualitative interviews to understand methods and systems used to collect ethnicity information in health administrative data sources in England. Wellcome Open Res 2023; 8:265. [PMID: 37766853 PMCID: PMC10521056 DOI: 10.12688/wellcomeopenres.19262.1] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 09/29/2023] Open
Abstract
Background: This article is one of a series aiming to inform analytical methods to improve comparability of estimates of ethnic health disparities based on different sources. This article explores the quality of ethnicity data and identifies potential sources of bias when ethnicity information is collected in three key NHS data sources. Future research can build on these findings to explore analytical methods to mitigate biases. Methods: Thematic analysis of semi-structured qualitative interviews to explore potential sources of error and bias in the process of collecting ethnicity information across three NHS data sources: General Practice Extraction Service (GPES) Data for Pandemic Planning and Research (GDPPR), Hospital Episode Statistics (HES) and Improving Access to Psychological Therapies (IAPT). The study included feedback from 22 experts working on different aspects of health admin data collection for England (including staff from NHS Digital, IT system suppliers and relevant healthcare service providers). Results: Potential sources of error and bias were identified across data collection, data processing and quality assurance processes. Similar issues were identified for all three sources. Our analysis revealed three main themes which can result in bias and inaccuracies in ethnicity data recorded: data infrastructure challenges, human challenges, and institutional challenges. Conclusions: Findings highlighted that analysts using health admin data should be aware of the main sources of potential error and bias in health admin data, and be mindful that the main sources of error identified are more likely to affect the ethnicity data for ethnic minority groups. Where possible, analysts should describe and seek to account for this bias in their research.
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Affiliation(s)
- Gemma Quayle
- Office for National Statistics, Newport, NP10 8XG, UK
| | - Bethan Jones
- Office for National Statistics, Newport, NP10 8XG, UK
| | | | | | - Roxanne Smith
- Office for National Statistics, Newport, NP10 8XG, UK
| | - David Tabor
- Office for National Statistics, Newport, NP10 8XG, UK
| | | | - Courtney Cox
- Office for National Statistics, Newport, NP10 8XG, UK
| | - Sarah Horsell
- Office for National Statistics, Newport, NP10 8XG, UK
| | - Marie John
- Office for National Statistics, Newport, NP10 8XG, UK
| | | | | | | | | | - Veena Raleigh
- The King's Fund, London, England, W1G 0AN, UK
- Nuffield Trust, London, England, UK
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Pascal E, Holman AC, Miluț FM. Emotional relevance and prejudice: testing the differentiated effect of incidental disgust on prejudice towards ethnic minorities. Front Psychol 2023; 14:1177263. [PMID: 37397321 PMCID: PMC10311252 DOI: 10.3389/fpsyg.2023.1177263] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Negative emotions such as disgust or anger influence the evaluation of minorities and amplify prejudice, stereotypes, and discrimination behaviors towards them. However, new discoveries suggest that these spillover effects might be more specific in the sense that the bias might occur only if the emotions are specific to the affect that is generally evoked by that particular minority, i.e. anger increases prejudice towards anger-relevant groups, and disgust towards disgust-relevant groups. Our study aimed to examine, the specificity of the spillover effects, namely the importance of emotion's relevance to the prejudice towards out-groups. To test this hypothesis, we investigated the influence of incidental disgust on the evaluation of two minorities, one that is usually associated with disgust (the Roma minority) and one usually associated with anger (the Hungarian minority). We used a 2 × 2 between-subjects experimental design where we manipulated the emotion experienced by the participants (disgust versus neutral) and the target they evaluated (Romani or Hungarian minority). We tested the effects of these manipulations on three aspects of prejudice toward the target group: cognitive, affective, and behavioral. The results support the specificity of the spillover effect, by showing that incidental disgust increased prejudice only towards the disgust-relevant target, namely the Roma minority, and that the intensity of this emotion experienced by the participants mediates this effect. Moreover, incidental disgust increased not only the negative emotions associated with the Romani (i.e., the affective component) but also the negative cognitions associated with them and the desire to maintain an increased social distance (i.e., behavioral prejudice). These findings highlight the importance of emotions' relevance in bias toward minorities and provide a starting point for future anti-discrimination interventions.
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Saini P, Porcellato L, Hunt A, Timpson H, Harrison R, Bigland C, Levy C, Brett CE, Forshaw MJ, Hope VD. Impact of the government's restrictions and guidance in relation to "social distancing" on the lives of ethnic minority populations: A mixed methods study. Health Sci Rep 2023; 6:e1356. [PMID: 37347094 PMCID: PMC10279946 DOI: 10.1002/hsr2.1356] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
Background and Aims The impacts of the COVID-19 pandemic have not been equal, with a disproportionate impact among ethnic minority communities. Structural inequalities in social determinants of health such as housing and employment have contributed to COVID-19's impact on deprived communities, including many ethnic minority communities. To compare (1) how the UK government's "social distancing" restrictions and guidance were perceived and implemented by ethnic minority populations compared to white populations, (2) the impact of restrictions and guidance upon these groups. Methods An explanatory sequential mixed methods study incorporated a quantitative survey and qualitative semi-structured interviews to explore individual perceptions and experiences of COVID-19 and the national restrictions. Survey participants (n = 1587) were recruited from North West England; 60 (4%) participants were from ethnic minority communities. Forty-nine interviews were conducted; 19 (39%) participants were from ethnic minority communities. Interviews were transcribed verbatim and analysed using a thematic approach. Data collection was between April and August 2020. Results Significant differences in demographics and household overcrowding were observed between white vs ethnic minority survey respondents, who were also significantly less confident in their knowledge of COVID-19, less likely to be high-risk drinkers, and marginally more likely to have experienced job loss and/or reduced household income. There were no group differences in wellbeing, perceptions, or nonfinancial impacts. Two inter-related themes included: (1) government guidance, incorporating people's knowledge and understanding of the guidance and their confusion/frustration over messaging; (2) the impacts of restrictions on keyworkers, home-schooling, working from home and changes in lifestyle/wellbeing. Conclusions Further research is needed on the long-term impacts of COVID-19 on ethnic minority communities. If policy responses to COVID-19 are to benefit ethnic minority communities, there is a need for future studies to consider fundamental societal issues, such as the role of housing and economic disadvantage.
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Affiliation(s)
- Pooja Saini
- School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Lorna Porcellato
- Public Health InstituteLiverpool John Moores UniversityLiverpoolUK
| | - Anna Hunt
- School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Hannah Timpson
- Public Health InstituteLiverpool John Moores UniversityLiverpoolUK
| | - Rebecca Harrison
- Public Health InstituteLiverpool John Moores UniversityLiverpoolUK
| | | | - Conan Levy
- Public Health InstituteLiverpool John Moores UniversityLiverpoolUK
| | | | - Mark J. Forshaw
- School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Vivian D. Hope
- Public Health InstituteLiverpool John Moores UniversityLiverpoolUK
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Smith SM, Kheri A, Ariyo K, Gilbert S, Salla A, Lingiah T, Taylor C, Edge D. The Patient and Carer Race Equality Framework: a model to reduce mental health inequity in England and Wales. Front Psychiatry 2023; 14:1053502. [PMID: 37215650 PMCID: PMC10196047 DOI: 10.3389/fpsyt.2023.1053502] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
The Patient and Carer Race Equality Framework (PCREF) is an Organisational Competence Framework (OCF), recommended by the Independent Review of the Mental Health Act as a means to improve mental health access, experience and outcomes for people from ethnic minority backgrounds, particularly Black people. This is a practical framework that should be co-produced with and tailored to the needs of service users, based on quality improvement and place-based approaches. We aim to use the PCREF to address the longstanding epistemic justices experienced by people with mental health problems, particularly those from minoritised ethnic groups. We will outline the work that led to the proposal, the research on racial inequalities in mental health in the UK, and how the PCREF will build on previous interventions to address these. By taking these into account, the PCREF should support a high minimum standard of mental health care for all.
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Affiliation(s)
- Shubulade Mary Smith
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Amna Kheri
- UCL Medical School, University College London, London, United Kingdom
| | - Kevin Ariyo
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Steve Gilbert
- Steve Gilbert Consulting, Birmingham, United Kingdom
| | - Anthony Salla
- Oxytocin Learning Community Interest Company, Oxfordshire, United Kingdom
| | - Tony Lingiah
- Kingston Hospital, Kingston upon Thames, United Kingdom
| | - Clare Taylor
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, United Kingdom
| | - Dawn Edge
- Division of Psychology and Mental Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Trust, Manchester, United Kingdom
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Apers H, Van Praag L, Nöstlinger C, Agyemang C. Interventions to improve the mental health or mental well-being of migrants and ethnic minority groups in Europe: A scoping review. Glob Ment Health (Camb) 2023; 10:e23. [PMID: 37854435 PMCID: PMC10579672 DOI: 10.1017/gmh.2023.15] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 10/20/2023] Open
Abstract
In Europe, migrants and ethnic minority groups are at greater risk for mental disorders compared to the general population. However, little is known about which interventions improve their mental health and well-being and about their underlying mechanisms that reduce existing mental health inequities. To fill this gap, the aim of this scoping review was to synthesise the available evidence on health promotion, prevention, and non-medical treatment interventions targeting migrants and ethnic minority populations. By mapping and synthesising the findings, including facilitators and barriers for intervention uptake, this scoping review provides valuable insights for developing future interventions. We used the PICo strategy and PRISMA guidelines to select peer-reviewed articles assessing studies on interventions. In total, we included 27 studies and synthesised the results based on the type of intervention, intervention mechanisms and outcomes, and barriers and facilitators to intervention uptake. We found that the selected studies implemented tailored interventions to reach these specific populations who are at risk due to structural inequities such as discrimination and racism, stigma associated with mental health, language barriers, and problems in accessing health care. The majority of interventions showed a positive effect on participants' mental health, indicating the importance of using a tailored approach. We identified three main successful mechanisms for intervention development and implementation: a sound theory-base, systematic adaption to make interventions culturally sensitive and participatory approaches. Moreover, this review indicates the need to holistically address social determinants of health through intersectoral programming to promote and improve mental health among migrants and ethnic minority populations. We identified current shortcomings and knowledge gaps within this field: rigorous intervention studies were scarce, there was a large diversity regarding migrant population groups and few studies evaluated the interventions' (cost-)effectiveness.
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Affiliation(s)
- Hanne Apers
- Centre for Migration and Intercultural Studies/Centre for Population, Family and Health, University of Antwerp, Antwerp, Belgium
| | - Lore Van Praag
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Christiana Nöstlinger
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Kisely S, McMahon L, Siskind D. Benefits following community treatment orders have an inverse relationship with rates of use: meta-analysis and meta-regression. BJPsych Open 2023; 9:e68. [PMID: 37056174 PMCID: PMC10134313 DOI: 10.1192/bjo.2023.28] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Community treatment order (CTO) use in Australia and New Zealand ranges from less than 40 per 100 000 population in Western Australia and Canterbury to over 100 per 100 000 in Victoria, South Australia and Waitemata. Recent publications on CTO use now permit a meta-regression to investigate whether differences in CTO use by jurisdiction affect either the possible predictors or outcomes of CTOs. AIMS To assess whether factors associated with CTO placement or subsequent outcomes vary by rates of use. METHOD A systematic search of PubMed/Medline, Embase, CINAHL, the Cochrane Central Register of Controlled Trials and PsycINFO for any Australian or New Zealand study comparing CTO cases with controls receiving voluntary psychiatric treatment. This study was prospectively registered with PROSPERO (protocol registration number: CRD42022351500). RESULTS There were 35 articles from 16 studies identified in the search, plus unpublished data from a further study. Of these, 29 publications were included in meta-analyses. Two were from New Zealand. People who were male, single and not engaged in work, study or home duties were significantly more likely to be on CTOs. In addition, those from migrant backgrounds were 47% more likely to be on an order. On meta-regression, cases in jurisdictions with higher CTO rates had higher proportions of females or individuals with diagnoses other than non-affective psychoses. High-use jurisdictions were also less likely to show reductions in readmission rates or bed-days. CONCLUSIONS There are marked differences in the possible predictors and outcomes of CTO placement between high- and low-use jurisdictions in Australia and New Zealand. These findings may have implications elsewhere and indicate that better-targeted CTO placement might improve outcomes.
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Affiliation(s)
- Steve Kisely
- The University of Queensland School of Medicine, Queensland, Australia; Metro South Health Service, Woolloongabba, Queensland, Australia; Griffith Criminology Institute, Griffith University, Queensland, Australia; and Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Laura McMahon
- The University of Queensland School of Medicine, Queensland, Australia
| | - Dan Siskind
- The University of Queensland School of Medicine, Queensland, Australia; and Metro South Health Service, Woolloongabba, Queensland, Australia
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Conneely M, Packer KC, Bicknell S, Janković J, Sihre HK, McCabe R, Copello A, Bains K, Priebe S, Spruce A, Jovanović N. Exploring Black and South Asian women's experiences of help-seeking and engagement in perinatal mental health services in the UK. Front Psychiatry 2023; 14:1119998. [PMID: 37077277 PMCID: PMC10109459 DOI: 10.3389/fpsyt.2023.1119998] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/06/2023] [Indexed: 04/21/2023] Open
Abstract
Background and aims In the United Kingdom (UK), Black and South Asian women are less likely than White British women to access support from perinatal mental health services, despite experiencing similar, or higher, levels of distress. This inequality needs to be understood and remedied. The aim of this study was to answer two questions: how do Black and South Asian women experience (1) access to perinatal mental health services and (2) care received from perinatal mental health services? Method Semi-structured interviews were conducted with Black and South Asian women (n = 37), including four women who were interviewed with an interpreter. Interviews were recorded and transcribed line-by-line. Data were analyzed using framework analysis, by an ethnically diverse multidisciplinary team of clinicians, researchers and people with lived experience of perinatal mental illness. Results Participants described a complex interplay of factors that impacted on seeking, and receiving help, and benefiting from services. Four themes emerged that captured the highly varied experiences of individuals: (1) Self-identity, social expectations and different attributions of distress deter help-seeking; (2) Hidden and disorganized services impede getting support; (3) The role of curiosity, kindness and flexibility in making women feel heard, accepted and supported by clinicians; (4) A shared cultural background may support or hinder trust and rapport. Conclusion Women described a wide range of experiences and a complex interplay of factors impacting access to, and experience of, services. Women described services as giving them strength and also leaving them disappointed and confused about where to get help. The main barriers to access were attributions related to mental distress, stigma, mistrust and lack of visibility of services, and organizational gaps in the referral process. These findings describe that many women feel heard, and supported by services, reporting that services provide a high quality of care that was inclusive of diverse experiences and understandings of mental health problems. Transparency around what PMHS are, and what support is available would improve the accessibility of PMHS.
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Affiliation(s)
- Maev Conneely
- Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- East London NHS Foundation Trust, London, United Kingdom
| | - Katy C. Packer
- Camden and Islington NHS Foundation Trust, London, United Kingdom
- North East London NHS Foundation Trust, London, United Kingdom
| | - Sarah Bicknell
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
| | - Jelena Janković
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Harpreet Kaur Sihre
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Rosemarie McCabe
- School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Alex Copello
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Kiren Bains
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- East London NHS Foundation Trust, London, United Kingdom
| | - Amy Spruce
- Action on Postpartum Psychosis, London, United Kingdom
| | - Nikolina Jovanović
- Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- East London NHS Foundation Trust, London, United Kingdom
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Pokharel B, Yelland J, Hooker L, Taft A. A Systematic Review of Culturally Competent Family Violence Responses to Women in Primary Care. Trauma Violence Abuse 2023; 24:928-945. [PMID: 34629009 PMCID: PMC10009494 DOI: 10.1177/15248380211046968] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Existing culturally competent models of care and guidelines are directing the responses of healthcare providers to culturally diverse populations. However, there is a lack of research into how or if these models and guidelines can be translated into the primary care context of family violence. This systematic review aimed to synthesise published evidence to explore the components of culturally competent primary care response for women experiencing family violence. We define family violence as any form of abuse perpetrated against a woman either by her intimate partner or the partner's family member. We included English language peer-reviewed articles and grey literature items that explored interactions between culturally diverse women experiencing family violence and their primary care clinicians. We refer women of migrant and refugee backgrounds, Indigenous women and women of ethnic minorities collectively as culturally diverse women. We searched eight electronic databases and websites of Australia-based relevant organisations. Following a critical interpretive synthesis of 28 eligible peer-reviewed articles and 16 grey literature items, we generated 11 components of culturally competent family violence related primary care. In the discussion section, we interpreted our findings using an ecological framework to develop a model of care that provides insights into how components at the primary care practice level should coordinate with components at the primary care provider level to enable efficient support to these women experiencing family violence. The review findings are applicable beyond the family violence primary care context.
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Affiliation(s)
- Bijaya Pokharel
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
- Bijaya Pokharel, Judith Lumley Centre,
School of Nursing and Midwifery, La Trobe University, Plenty Rd &, Kingsbury
Dr, Bundoora VIC 3086, Australia.
,
| | - Jane Yelland
- Murdoch Children’s Research
Institute, Parkville, VIC,
Australia
| | - Leesa Hooker
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
| | - Angela Taft
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
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Bullock JL, Hall YN. Social Determinants of Health and Estimation of Kidney Function. Clin J Am Soc Nephrol 2023; 18:424-426. [PMID: 37026747 PMCID: PMC10103306 DOI: 10.2215/cjn.0000000000000131] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- Justin L. Bullock
- Division of Nephrology, Kidney Research Institute, University of Washington, Seattle, Washington
| | - Yoshio N. Hall
- Division of Nephrology, Kidney Research Institute, University of Washington, Seattle, Washington
- Nephrology Section, VA Puget Sound Health Care System, Seattle, Washington
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Allam I, Gresham M, Phillipson L, Brodaty H, Low LF. Beliefs around help-Seeking and Support for Dementia in the Australian Arabic Speaking Community. Dementia (London) 2023:14713012231166170. [PMID: 36990452 DOI: 10.1177/14713012231166170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/31/2023]
Abstract
BACKGROUND The number of people with dementia in multicultural Australia is rapidly increasing. Despite its culturally diverse population, there is limited research about how people from ethnic minority groups understand and approach help-seeking and support for dementia. The aim of this study is to understand the perceptions of dementia symptoms, help-seeking and support in the Australian Arabic-speaking community. METHODS This study used a cross-sectional qualitative research design. Individual, semi-structured interviews using projective stimulus techniques were used. Participants were three Arabic-speaking people aged over 70 who were experiencing cognitive changes or dementia symptoms, six carers, and five health or social care practitioners experienced in working with Arab-Australians. Phone or video chat interviews were conducted in either Arabic or English. Interviews were audiotaped, translated when needed, transcribed verbatim and inductive thematic analysis was undertaken. FINDINGS Seven themes were identified. Participants described dementia as relating to symptoms of confusion and memory loss. Carers and older people believe that when older people are experiencing these cognitive symptoms, they must be cared for primarily by ensuring their happiness and comfort. Barriers to help-seeking and support included a lack of help-seeking due to cultural norms of family orientated care, families are unsure of where to seek help and fear of community judgement. Two ways to facilitate help-seeking and support were to build trust through culturally appropriate support and to educate the community. CONCLUSION Family, trust and community were identified as central pillars of the Australian-Arabic-speaking community. There is a need to increase dementia literacy in this community particularly around help-seeking and decreasing stigma. Education should be promoted by trusted community members and religious leaders. As the first point of professional contact, general practitioners need to be upskilled to support Arabic-speaking Australians around dementia.
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Affiliation(s)
- Issra Allam
- 522555The University of Sydney Faculty of Medicine and Health, Sydney, NSW, AU
| | - Meredith Gresham
- Centre for Healthy Brain Ageing, 98994University of New South Wales Faculty of Medicine, Sydney, NSW, AU
| | - Lyn Phillipson
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, AU
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales Faculty of Medicine, Sydney, NSW, AU
| | - Lee-Fay Low
- The University of Sydney Faculty of Medicine and Health, Sydney, NSW, AU
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Phan V, Kloos B. Examining civic engagement in ethnic minority youth populations: A literature review and concept analysis. Am J Community Psychol 2023; 71:54-78. [PMID: 36609782 DOI: 10.1002/ajcp.12643] [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: 01/31/2022] [Revised: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 05/07/2023]
Abstract
Racial reckoning is defined as the subjugation of Black, Indigenous, and people of Color (BIPOC) to racial hierarchies and subordinate groups that influence multiple well-being outcomes throughout the developmental lifespan and across generations. With the two pandemics of racial reckoning and COVID-19 amidst a growing controversial political landscape, topics around civic engagement have been brought to the forefront of community conversation. Discussions surrounding civic engagement must go beyond addressing issues of public concern and examine the vehicle in which civic engagement may be delivered. This is becoming increasingly important as civic engagement is one of the main avenues of social change through individual and collective action, particularly regarding racial reckoning and healthcare disparities highlighted by COVID-19. The paper focuses on civic engagement among ethnic minority youth and young adults. An integrated model of civic engagement was created based off what was learned through this review. This proposed model of civic engagement is meant to be the first step to addressing the gap in civic engagement literature for ethnic minority youth. Weaknesses and future considerations regarding the model will also be discussed, as well as any implications for ethnic minority youth and young adults.
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Affiliation(s)
- Van Phan
- University of South Carolina, Columbia, South Carolina, USA
| | - Bret Kloos
- University of South Carolina, Columbia, South Carolina, USA
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41
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Bang SH, Huang YC, Kuo HJ, Cho ES, García AA. Health status and Healthcare Access of Southeast Asian refugees in the United States: An integrative review. Public Health Nurs 2023; 40:324-337. [PMID: 36662767 DOI: 10.1111/phn.13167] [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] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/15/2022] [Accepted: 12/11/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Since 2010, more than 527,000 refugees have resettled in the United States (US), most from Asia, fleeing war, violence, and persecution. However, there is little research that integrates findings about health among Southeast Asian refugees (SEAR). DESIGN We conducted an integrative review of studies that examined health status, risk factors, and barriers to healthcare access among SEAR in the US. We synthesized findings of studies published from 1980, when the Refugee Act was enacted, to 2022 using five databases. We reviewed 20 articles and data were extracted into a table for synthesis. RESULTS Participants were from Cambodia, Vietnam, Laos, Burma and the Thailand-Myanmar border. Hypertension (12%-64%), hypercholesterolemia (37%-39%), diabetes (0.6%-27%), heart disease (7%), bone and muscle problems (23%-50%), and chronic pain (8%-51%) were most common physical health problems; and PTSD (45%-86%) and depression (20%-80%) were the most common mental health problems. Trauma, resettlement stress, lack of community or religious engagement were associated with mental health problems. Language differences, transportation, and lack of health insurance were the most significant obstacles to receiving healthcare. CONCLUSION SEAR experienced worse physical and mental health than the general US population. Different patterns of disease were identified depending on gender, time settled in the US, and ethnic group. Qualitative and longitudinal studies will elucidate refugees' experience and should guide interventions.
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Affiliation(s)
- So Hyeon Bang
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA
| | - Ya-Ching Huang
- School of Nursing, Texas A&M University, College Station, Texas, USA
| | - Hsuan-Ju Kuo
- School of Nursing, College of Medicine, National Taiwan University, Taiwan
| | - Emma S Cho
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA
| | - Alexandra A García
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA
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Sauter A, Herbert-Maul A, Abu-Omar K, Thiel A, Ziemainz H, Frahsa A, Linder S, Herrmann-Johns A. Corrigendum: "For me, it's just a piece of freedom"-Increased empowerment through physical activity promotion among socially disadvantaged women. Front Public Health 2023. [PMID: 36866096 PMCID: PMC9972080 DOI: 10.3389/fpubh.2023.1146584] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.867626.].
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Affiliation(s)
- Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany,*Correspondence: Alexandra Sauter ✉
| | - Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Heiko Ziemainz
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Stephanie Linder
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
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Aisbitt GM, Nolte T, Fonagy P. Editorial Perspective: The digital divide - inequalities in remote therapy for children and adolescents. Child Adolesc Ment Health 2023; 28:105-107. [PMID: 35179284 DOI: 10.1111/camh.12545] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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] [Accepted: 01/21/2022] [Indexed: 01/18/2023]
Abstract
COVID-19 has triggered a shift towards remote delivery of therapy and, despite a number of benefits, it risks discriminating against young people already marginalised due to adverse early life experiences, poverty or ethnicity. This editorial perspective considers challenges for remote therapy, focusing on: the financial burden of telehealth; the necessity of safety to speak; and, how telehealth may exacerbate difficulties in therapeutic alliance formation by interfering with epistemic trust and mentalising. As well as compounding the inaccessibility for children who are subject to abuse, the implicit assumptions behind telehealth risk disproportionately excluding from therapy those from a low socioeconomic status, and who are from ethnic minorities. Suggestions are made for how these challenges may be addressed. It is argued that service design and delivery should seek to proceed with the practicalities and principles of engagement in mind and use this as an opportunity to improve parity of access, rather than risk further entrenching inequalities.
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Affiliation(s)
- Georgina M Aisbitt
- Newham Personality Disorder Service, East London NHS Foundation Trust, London, UK
| | - Tobias Nolte
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, UCL, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, UK
- Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
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Baz SA, Fang C, Carpentieri JD, Sheard L. 'I don't know what to do or where to go'. Experiences of accessing healthcare support from the perspectives of people living with Long Covid and healthcare professionals: A qualitative study in Bradford, UK. Health Expect 2023; 26:542-554. [PMID: 36512382 PMCID: PMC10124541 DOI: 10.1111/hex.13687] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 08/02/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In October 2022, it was estimated 2.3 million people in the United Kingdom have self-reported Long Covid (LC). Many people have reported not receiving adequate healthcare support. There is a lack of research which provides an in-depth exploration of the barriers faced by people with LC in accessing healthcare support. It is important to understand these barriers to provide better support, care and advice for those experiencing LC. OBJECTIVE To understand the barriers faced in accessing primary, secondary and specialist healthcare support for people with LC. DESIGN AND PARTICIPATION 40 interviews were conducted with people living with LC in Bradford alongside 12 interviews with healthcare professionals (HCPs) providing LC support in Bradford healthcare settings. Interviews were analysed using reflexive thematic analysis. RESULTS People living with LC had a large degree of difficulty in accessing healthcare services for LC support. We categorized the healthcare access experiences of participants into five main types: (1) being unable to access primary care, (2) accessing primary care but receiving (perceived) inadequate support, (3) extreme persistence, (4) alternatives to mainstream health care and (5) positive experiences. There was a severe lack of access to specialist LC services. Ethnic minority participants faced a further barrier of mistrust and fear of services deterring them from accessing support. HCPs discussed systemic barriers to delivering services. Experiences were embedded in macrostructural issues further exacerbated by the pandemic. CONCLUSION To better support people with LC, the barriers faced in accessing healthcare support must be addressed. Of significance, improvements to general practitioner access are required; especially as GPs are the first line of support for people living with LC. PATIENT AND PUBLIC INVOLVEMENT A patient and public involvement group is engaged at regular intervals in the project.
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Affiliation(s)
- Sarah A Baz
- Department of Health Sciences, University of York, York, UK
| | - Chao Fang
- Institute of Education, University College London, London, UK
| | - J D Carpentieri
- Institute of Education, University College London, London, UK
| | - Laura Sheard
- Department of Health Sciences, University of York, York, UK
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Urizar GG, Murillo J, Miller K. Factors Associated with Prenatal Health Behaviors among Low-Income, Ethnic Minority Women. Int J Environ Res Public Health 2023; 20:1695. [PMID: 36767060 PMCID: PMC9914291 DOI: 10.3390/ijerph20031695] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
Less than one-third of pregnant women in the U.S. meet prenatal nutrition, exercise, and stress management health behavior guidelines. Low rates of these prenatal health behaviors have been especially observed among low-income, ethnic minority women, placing them and their infants at a disproportionally higher risk for health complications. Yet, few studies have identified factors associated with these prenatal health behaviors in this population. This study examined whether certain demographic (e.g., ethnicity) and psychosocial characteristics (i.e., coping, stress, pregnancy-specific stress, and depression) were associated with prenatal nutrition (i.e., high-fat food and fruit and vegetable intake), exercise, and stress management health behaviors in 100 low-income, pregnant women (39% African American, 30% foreign-born Latinas, 15% U.S.-born Latinas, 10% non-Hispanic white, and 6% Asian American/Pacific Islander) in southern California using an embedded, mixed-methods, cross-sectional design. Results demonstrated that ethnic minority women who experienced more stress and used more maladaptive coping strategies (e.g., avoidance) were particularly at risk of consuming more high-fat foods and engaging in less exercise and stress management during pregnancy. Qualitative responses revealed women's experiences with these prenatal health behaviors. These findings highlight the need for interventions and collaborative care models that target psychosocial factors in order to optimize prenatal health behaviors and health outcomes among ethnic minority women.
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Affiliation(s)
- Guido G. Urizar
- Department of Psychology, California State University, 1250 Bellflower Blvd, Long Beach, CA 90840-0901, USA
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Song L, Yu X, Su B, Geng WK, Lan G, Zhang X. HIV Prevalence and Risk Factors Among Young Men Who Have Sex With Men in Southwest China: Cross-sectional Questionnaire Study. JMIR Form Res 2023; 7:e37344. [PMID: 36630166 PMCID: PMC9893886 DOI: 10.2196/37344] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/06/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Previous studies showed an increase in HIV prevalence among young men who have sex with men aged 25 years or younger in China. OBJECTIVE This study aimed to assess HIV prevalence and associated factors among young men who have sex with men in the Guangxi Zhuang Autonomous Region. METHODS This study was conducted in 4 cities (Guilin, Liuzhou, Beihai, and Nanning) in the Guangxi Zhuang Autonomous Region between June 2014 and May 2016. Participants were reached through web-based and site recruitment approaches. Laboratory tests were performed to detect HIV and syphilis infections. A self-administered questionnaire was used to collect data from 632 eligible young men who have sex with men. RESULTS The prevalence of HIV and syphilis was 9.3% (59/632) and 11.4% (72/632), respectively. Multivariable logistic analysis showed that ethnic minority (adjusted odds ratio [AOR] for Han Chinese vs other minorities 0.28, 95% CI 0.11-0.71, P=.007), receptive sexual positioning in the past 6 months (AOR 2.94, 95% CI 1.32-6.53, P=.008), current syphilis infection (AOR for individuals without vs those with infection 0.38, 95% CI 0.19-0.75, P=.005), inconsistent condom use in the past 6 months (AOR 1.91, 95% CI 1.06-3.45, P=.03), and psychotropic drug use before last anal intercourse (AOR 16.70, 95% CI 2.34-119.18, P=.005) were independently associated with HIV infection. CONCLUSIONS There is an urgent need to scale up HIV and syphilis interventions in young men who have sex with men. Some subgroups might need specific attention for HIV prevention, including ethnic minority men, individuals with a history of sexually transmitted infections, and individuals who have been engaging in receptive anal sex.
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Affiliation(s)
- Liping Song
- School of Public Health, Guilin Medical University, Guilin, China
| | - Xiangyuan Yu
- School of Public Health, Guilin Medical University, Guilin, China
| | - Bing Su
- Department of Clinical Psychology, Qingdao Mental Health Center, Qingdao, China
| | - Wen Kui Geng
- Guangxi Zhuang Autonomous Region Health and Family Planning Commission, Nanning, China
| | - Guanghua Lan
- Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Xiangjun Zhang
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States
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Safi A, Khawaja I, Collins P, Myers T. A Cross-Sectional Study Exploring the Physical Activity Levels of Afghans and Other South Asian Youth in the UK. Int J Environ Res Public Health 2023; 20:1087. [PMID: 36673843 PMCID: PMC9858935 DOI: 10.3390/ijerph20021087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/24/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/01/2023]
Abstract
Introduction: Participating in regular physical activity (PA) has numerous benefits, such as reducing obesity, chronic degenerative conditions, and depression. Despite many health-related benefits, physical inactivity is increasing in young people worldwide, especially in ethnic minority groups, such as British South Asians (BSAs). The aim of this study was to explore the PA levels of BSAs, specifically focusing on youth from Afghan, Pakistani, Bangladeshi, and Indian groups. Methods: A total of 191 (Afghans N = 44; Bangladeshi N = 39; Indian N = 56, Pakistani N = 52) youth from the West Midlands (UK) participated in this study (mean age 15.4 ± 0.5). The International Physical Activity Questionnaire—Short Form was used to measure PA levels. Data were modelled using a Bayesian approach to determine differences in PA levels. Results: The results indicated that 88.5% Afghans, 80% Bangladeshi, 78.6% Indians and 63% Pakistani reported engaging in <30 min of PA per day. Additionally, boys were more active than girls across all ethnic groups. Discussion: This study highlighted an alarmingly low proportion of young people from each BSA ethnic group meeting the PA guidelines. To the authors’ knowledge, this is the first study to explore and compare PA levels of the young British Afghan population, thus contributing novel findings to the area of BSA PA. Conclusion: Overall, the vast majority of BSA young people failed to meet the recommended PA guidelines of 60 min per day. Future research could utilise objective methods, such as Global Positioning System, pedometers and accelerometery to track and monitor PA levels, and could adopt an ecological approach to explore determinants of PA within each ethnic and gender group.
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Affiliation(s)
- Ayazullah Safi
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, London W1W 6UW, UK
| | - Irfan Khawaja
- Department of Sport and Exercise, School of Health Sciences, Birmingham City University, Birmingham B15 3TN, UK
| | - Peter Collins
- Faculty of Education Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
| | - Tony Myers
- Department of Social Science, Sport and Business, Newman University, Birmingham B32 3NT, UK
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Van Dyne A, Washington N, Villodas M, Cronan T. Racial and Ethnic Disparities in Weight Loss Behaviors Among US College Students. Psychol Res Behav Manag 2023; 16:857-873. [PMID: 36960414 PMCID: PMC10028297 DOI: 10.2147/prbm.s395357] [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] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Purpose Weight loss behaviors are prevalent among college students and are associated with adverse physical and psychological outcomes, such as an elevated risk of developing an eating disorder. While cross-ethnic differences have been reported, no consistent pattern has emerged. The purpose of this study was to examine racial and ethnic differences in weight loss behaviors among female and male college students. Patients and Methods The American College Health Association-National College Health Assessment (ACHA-NCHA) II-C survey data from the collection periods from 2015 to 2019 was used. A total of 426,425 students participated in the survey. Most participants were White (60%) and female (68.5%). Information on students' age, body mass index (BMI), and self-rated health was also collected. Logistic regression analyses were performed to determine cross-ethnic differences in weight loss methods among female and male students. Results Students' weight loss behaviors were assessed and included dieting, exercising, vomiting or taking laxatives, and the use of diet pills in the past 30 days. More than half of the participants attempted to lose weight through exercise (53.5%), and 40.3% of students dieted to lose weight in the past month. Purging and the use of diet pills were endorsed by 2.9% and 2.8% of the participants, respectively. With few exceptions, male students from racial and ethnic minority backgrounds were more likely to engage in extreme weight control practices (ie, vomiting or taking laxatives, taking diet pills) than White male students, while female students from racial and ethnic minority backgrounds were less likely to use diet and exercise as weight loss methods than White female students. For all outcomes, Biracial/Multiracial and Hispanic/Latino male students were more likely to attempt weight loss than White male students. Biracial/Multiracial female students more frequently endorsed extreme weight control behaviors than White female students. Conclusion The results of the present study add to the growing body of literature on the relationship between race and ethnicity and weight loss behaviors. The findings indicate the need for tailored educational and intervention programs on college campuses.
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Affiliation(s)
- Angelina Van Dyne
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Nicole Washington
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Miguel Villodas
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Terry Cronan
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Correspondence: Terry Cronan, Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA, Tel +1619 594-6915, Fax +1619 594-1247, Email
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Asim S, Nichini E, Goggins WB, Dong D, Yeoh EK. Maternity care experience of Pakistani ethnic minority women in Hong Kong. Front Public Health 2023; 11:1009214. [PMID: 36935720 PMCID: PMC10014597 DOI: 10.3389/fpubh.2023.1009214] [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] [Received: 08/01/2022] [Accepted: 02/07/2023] [Indexed: 03/06/2023] Open
Abstract
Background Persistent inequalities in maternity care experience and outcomes exist globally for ethnic minority (EM) and migrant women. Despite the fact that this is an important research area, no prior study has been done in Hong Kong (HK) to examine maternity care experience of EM women. Objectives To investigate maternity care experience of Pakistani EM women (both local born and immigrants) during pregnancy, birth and after birth in hospital in HK. An evaluation of their satisfaction and factors predicting satisfaction with care during the three phases of maternity care was included in the study. Methods A cross sectional survey was conducted among Pakistani EM women who had given birth in HK in last 3 years, using a structured questionnaire by a bilingual interviewer, from April to May 2020. Counts and percentages were used to describe all categorical variables. Association between predictor variables and overall satisfaction was assessed by bivariate analysis and multiple logistic regression. Results One hundred and twenty questionnaires were completed. Almost 60 percent of the women were very satisfied with the overall care. More than half of the women described the care they received as kind, respectful and well communicated. After adjusting for age and parity, HK born Pakistani women expressed relatively less satisfaction with care, especially during pregnancy and labor and birth, as compared with Pakistan born women. Women with conversational or fluent English-speaking ability also felt comparatively less satisfied particularly from intrapartum and postnatal care in hospital. Education level had a negative association with satisfaction with care during pregnancy. Conclusions Maternity care providers should take into account the diversity of EM women population in HK. Our findings suggest that effective communication and care that can meet individual needs, expectations, and values is imperative to improve experience and quality of maternity care for EM women in HK.
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Affiliation(s)
- Saba Asim
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Elena Nichini
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - William Bernard Goggins
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Hong Kong, Hong Kong SAR, China
- *Correspondence: Dong Dong
| | - Eng-King Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Hong Kong, Hong Kong SAR, China
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Vo T, Canty L. Global mental health experiences of single mothers: A mixed methods research synthesis. J Adv Nurs 2023; 79:68-82. [PMID: 36226874 DOI: 10.1111/jan.15461] [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] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/09/2022] [Accepted: 10/01/2022] [Indexed: 12/15/2022]
Abstract
AIM The aim of this research is to synthesize findings from primary studies (quantitative and qualitative) that investigated the global mental health experiences of single mothers to provide a deeper understanding to better care and respond to the support needs of single mothers. DESIGN Hayvaert et al.'s mixed methods research synthesis approach. DATA SOURCES The search process in the following databases, CINAHL, PsycINFO, and Scopus resulted in eight high-quality studies (5 qualitative and 3 quantitative) published between June 2016 and July 2021. REVIEW METHODS Descriptive statistics and instrument scores were provided in summary form. Themes were analysed using Krippendorff's content analysis. A joint display was provided to reveal a complementary relationship between two different data sets. RESULTS A total of 348 single mothers participated. Amongst the pooled sample, women identified as: Japanese (n = 174), Israeli (n = 147), Black African (n = 18), African American (n = 9), Native American (n = 5), Burundian-Australian (n = 8), UK British (n = 12), Asian (n = 3), South Korean (n = 7), Indian (n = 2), Malaysian (n = 44), Hispanic/Latina (n = 1) and Eastern European (n = 3). Four themes were identified: (1) Learning to let go of the past, (2) It takes a whole village: Importance of social support, (3) Seeking a self-reliant life: Challenges with balancing career & childcare and (4) Finding strength within: Personal growth. Only one intervention utilizing creative group counselling was found to significantly decrease depression (p = .008), anxiety (p = .005), and stress (p = .012) whilst increasing self-compassion (p = .013). CONCLUSION It is important for clinicians who care for single mothers, particularly if they recently immigrated, are multiparous, and an ethnic minority to encourage engagement in peer-initiated counselling and obtain mental health care as necessary. IMPACT This study identified and addressed the mental health issues that single mothers face worldwide. This is also the first mixed methods research synthesis to report single mothers' ethnicity in nursing and midwifery literature. Thus, findings from this mixed methods research synthesis can help nurses worldwide build culturally-concordant programs in their respective community organizations and partners (e.g. community health centres, mother-child enrichment clubs), inform health policies, and promote safer spaces for many single mothers, particularly for those who will immigrate to the Global North (i.e. UK, US, Canada) and become an ethnic minority.
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Affiliation(s)
- Timothea Vo
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| | - Lucinda Canty
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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