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Bourne DA, Henry M, Brisbin A, Davenport D, Shetty S, Baratz M. Diversity in Hand Surgery Leadership: The Impact of Mentorship and Bias. Hand (N Y) 2024:15589447241235341. [PMID: 38622827 DOI: 10.1177/15589447241235341] [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] [Indexed: 04/17/2024]
Abstract
BACKGROUND Diversity in leadership drives innovation. However, underrepresented minorities may face barriers. The aim of this study is to understand the impact of gender and race on the experience of leaders in hand surgery. METHODS An anonymous survey was sent to leaders in hand surgery who attained the position of national society president, head of a division/department, or hand fellowship director. The survey assessed demographic information, grit, mentorship, and bias. RESULTS One hundred twenty-one leaders responded for a response rate of 60.5%. Men represented 81.0% and women 19.0%. Most respondents were white (87.6%) with 7% Asian and 6% any other race. Ninety-one percent of female respondents lived in a dual career household, compared with 53.7% of male respondents (odds ratio [OR] 0.15, P = .017). Female respondents had significantly higher grit compared with male respondents (4.3 vs 4.0, P = .050). Male respondents were more likely to have a male mentor/sponsor than women (95% vs 76%, respectively, P = .001). White respondents were more likely to have a white mentor/sponsor than nonwhite respondents (91% vs 61%, respectively, P = .009). Ninety-five percent of women reported experiencing bias compared with 27% of men (P < .001). Specifically, women reported bias in salary, promotion, nomination, sponsorship, networking, and clinical resources. Nonwhite respondents were significantly more likely to experience bias in promotion (P = .006). CONCLUSIONS Women and racial minorities face bias and barriers to leadership within hand surgery.
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Affiliation(s)
| | - Miriam Henry
- Division of Plastic Surgery, University of Kentucky, Lexington, USA
| | - Alyssa Brisbin
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel Davenport
- Division of Plastic Surgery, University of Kentucky, Lexington, USA
| | - Sameer Shetty
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark Baratz
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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Fernandez JM, Mata EM, Plampton K, Whitley MJ, Sutton AV, Wysong A. Melanoma characteristics and overall survival predictors in American Indians and Alaska Natives: An analysis of the national cancer database from 2004 to 2018. J Am Acad Dermatol 2024; 90:836-837. [PMID: 38043590 DOI: 10.1016/j.jaad.2023.11.045] [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: 07/27/2023] [Revised: 11/12/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Jennifer M Fernandez
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Elizabeth M Mata
- Department of Medicine, University of Arizona, College of Medicine - Tucson, Tucson, Arizona
| | - Katherine Plampton
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska; University of Minnesota Medical School, Minneapolis, Minnesota
| | - Melodi Javid Whitley
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina
| | - Adam V Sutton
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska.
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3
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Rosenqvist J, Slama S, Haavisto A. Generalizability of the Swedish WISC-V to the Finland-Swedish minority - the FinSwed study. Child Neuropsychol 2024:1-27. [PMID: 38526303 DOI: 10.1080/09297049.2024.2331277] [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: 04/28/2023] [Accepted: 03/11/2024] [Indexed: 03/26/2024]
Abstract
International guidelines highlight the importance of using appropriate and culturally fair test materials when conducting clinical psychological assessments. In the present study, the generalizability of the Swedish WISC-V with Scandinavian normative data was explored in 6-16-year-old Swedish-speaking children in Finland (N = 134), as no local test versions or norms are available for this minority. First, metric measurement invariance was established, i.e., the constructs measured were equivalent between the standardization data and the present sample. Second, the performance of this minority group on the Swedish WISC-V was compared to the Scandinavian normative mean. The findings showed that the Finland-Swedish children performed overall higher than the normative mean on the Swedish WISC-V, with an FSIQ of 103. The performance was significantly higher also in the indexes VSI, FRI, and WMI as well as in several subtests. However, in the subtest Vocabulary, the Finland-Swedish children achieved significantly lower scores than the Scandinavian mean. Further analyses showed significant associations between cognitive performance and age as well as parental education. For the VCI and the FSIQ, performance increased significantly with age, despite the use of age-standardized scaled scores. The general high performance was suggested to relate to the overall high educational level of the Finland-Swedes as well as to other cultural and test-related factors. The results have implications for clinicians conducting assessments with this minority, but also highlight the importance of establishing test fairness by validating tests when used in different cultural groups.
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Affiliation(s)
- Johanna Rosenqvist
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Susanna Slama
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu Haavisto
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
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4
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Wang YY, Rohanachandra Y, Dahanayake D. Editorial: Mental health of children and adolescents of minority groups. Front Psychiatry 2024; 15:1391368. [PMID: 38559396 PMCID: PMC10979419 DOI: 10.3389/fpsyt.2024.1391368] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Yuan Yuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yasodha Rohanachandra
- Child and Youth Mental Health Services, Latrobe Regional Health, Traralgon, VIC, Australia
| | - Dulangi Dahanayake
- Child and Youth Mental Health Service, Darling Downs Hospital and Health Service, Toowoomba, QLD, Australia
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Perales-Puchalt J, Peltzer J, Fracachan-Cabrera M, Perez GA, Ramírez M, Greiner KA, Burns JM. Authors' Response to Peer Reviews of "Impact of the COVID-19 Pandemic on Latino Families With Alzheimer Disease and Related Dementias: Qualitative Interviews With Family Caregivers and Primary Care Providers". JMIRx Med 2024; 5:e56439. [PMID: 38509604 PMCID: PMC11004510 DOI: 10.2196/56439] [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] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States
| | - Jill Peltzer
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Monica Fracachan-Cabrera
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - G Adriana Perez
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Mariana Ramírez
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - K Allen Greiner
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jeffrey Murray Burns
- Department of Neurology, University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States
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Perales-Puchalt J, Peltzer J, Fracachan-Cabrera M, Perez GA, Ramírez M, Greiner KA, Burns JM. Impact of the COVID-19 Pandemic on Latino Families With Alzheimer Disease and Related Dementias: Qualitative Interviews With Family Caregivers and Primary Care Providers. JMIRx Med 2024; 5:e42211. [PMID: 38488740 PMCID: PMC11004515 DOI: 10.2196/42211] [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] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/11/2023] [Accepted: 01/13/2024] [Indexed: 03/19/2024]
Abstract
Background Latino individuals experience disparities in the care of Alzheimer disease and related dementias (ADRD) and have disproportionately high COVID-19 infection and death outcomes. Objective We aimed to gain an in-depth understanding of the impact of the COVID-19 pandemic among Latino families with ADRD in the United States. Methods This was a qualitative study of 21 informal caregivers of Latino individuals with ADRD and 23 primary care providers who serve Latino patients. We recruited participants nationwide using convenience and snowball sampling methods and conducted remote interviews in English and Spanish. We organized the transcripts for qualitative review to identify codes and themes, using a pragmatic approach, a qualitative description methodology, and thematic analysis methods. Results Qualitative analysis of transcripts revealed eight themes, including (1) the pandemic influenced mental and emotional health; (2) the pandemic impacted physical domains of health; (3) caregivers and care recipients lost access to engaging activities during the confinement; (4) the pandemic impacted Latino caregivers' working situation; (5) the pandemic impacted health care and community care systems; (6) health care and community care systems took measures to reduce the impact of the pandemic; (7) Latino families experienced barriers to remote communication during the pandemic; and (8) caregiver social support was critical for reducing social isolation and its sequalae. Conclusions Latino families with ADRD experienced similar but also unique impacts compared to those reported in the general population. Unique impacts may result from Latino individuals' underserved status in the United States, commonly held cultural values, and their intersectionality with ADRD-related disability. Family caregiver social support was crucial during this time of adversity. These findings suggest the need for more equitable access, culturally appropriate and trustworthy content and delivery of health care and community services, as well as stronger financial and social supports for family caregivers.
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Affiliation(s)
- Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States
| | - Jill Peltzer
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Monica Fracachan-Cabrera
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - G Adriana Perez
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Mariana Ramírez
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - K Allen Greiner
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jeffrey Murray Burns
- Department of Neurology, University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States
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Bounoua N, Sadeh N, Payne YA, Hitchens BK. Structural barriers explain the link between negative community re-entry experiences and motives for illegal behavior in street-identified Black men and women. Am J Community Psychol 2024; 73:280-293. [PMID: 37846126 PMCID: PMC10947981 DOI: 10.1002/ajcp.12713] [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] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 08/07/2023] [Accepted: 09/04/2023] [Indexed: 10/18/2023]
Abstract
This study examines how the re-entry process is related to structural barriers in the community and to motives for engaging in illegal behavior-two key risk factors for recidivism. We analyzed survey data collected on perceptions of community re-entry, employment opportunities, neighborhood violence, and illegal behavior motives from 379 formerly incarcerated and street-identified Black-American community members residing in Wilmington, Delaware (Mage = 32.3/8.9 years old; 77.0% men; 100% Black) by employing Street Participatory Action Research (Street PAR) methodology. We found that negative perceptions of re-entry correlated positively with (i) hardship caused by structural barriers in the community, specifically blocked employment opportunities and neighborhood violence, and (ii) motives for engaging in illegal behavior. Notably, the link between negative perceptions of re-entry and motives for illegal behavior became significantly weaker when the influence of structural barriers on these individual-level factors was included in a multivariate model. Results suggest negative views of the re-entry process reflect the resource-scarce and stressful environments people are living in, and structural barriers can account for the relationship between negative re-entry experiences and why individuals are motivated to engage in illegal behavior. Findings underscore the importance of improving the economic conditions of communities with high numbers of returning citizens.
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Affiliation(s)
- Nadia Bounoua
- University of Delaware, Department of Psychological and Brain Sciences
| | - Naomi Sadeh
- University of Delaware, Department of Psychological and Brain Sciences
| | - Yasser A. Payne
- University of Delaware, Department of Sociology and Criminal Justice
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8
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Greif C, Gibson RS, Kimball AB, Holcomb ZE, Porter ML. Evaluating minority representation across health care settings in hidradenitis suppurativa and psoriasis. Int J Womens Dermatol 2024; 10:e129. [PMID: 38240009 PMCID: PMC10796135 DOI: 10.1097/jw9.0000000000000129] [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: 03/26/2023] [Accepted: 11/11/2023] [Indexed: 01/22/2024] Open
Abstract
Background Females and minorities have been underrepresented in clinical research despite legislative efforts, including in hidradenitis suppurativa (HS) and psoriasis (PsO) clinical trials. Objective To identify differences in demographic breakdowns of HS and PsO patients between health care settings to uncover any causative health disparities. Methods This study reports racial, ethnic, and sex of HS and PsO patient populations across the emergency department (ED), inpatient, clinical trial, and registry settings. In addition, 95% confidence intervals are used as proxies of statistical significance to compare demographics between settings. Results Female, Hispanic, and Black patients were underrepresented in HS clinical trials compared to their population prevalence (female: 63.7% vs 73.5%; Hispanic: 3.8% vs 12.0%; Black: 9.1% vs 20.3%). Female and Black patients were underrepresented in PsO trials compared to their population prevalence (female: 33.0% vs 54.8%; Black: 2.2% vs 5.7%). Black patients were overrepresented in the inpatient and ED settings in HS (inpatient vs ED vs population prevalence: 49.9% vs 49.9% vs 20.3%) and in the inpatient setting in PsO (inpatient vs population prevalence: 19.8% vs 5.7%). Limitations The main limitation is the reliability and generalizability of the published studies used to compare demographics across settings. Conclusion Underrepresentation of females and minorities in HS and PsO clinical trials is consistent with published literature. Overrepresentation of Black patients in acute care settings is likely multifactorial.
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Affiliation(s)
- Charlotte Greif
- Preliminary Internal Medicine Program, Internal Medicine Department, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Ruby S. Gibson
- Tulane Dermatology Program, Dermatology Department, Tulane University School of Medicine, New Orleans, Louisiana
| | - Alexa B. Kimball
- Dermatology Department, Harvard Medical School, Clinical Laboratory for Epidemiology and Applied Research in Skin, Boston, Massachusetts
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Zachary E. Holcomb
- Department of Medicine, Carilion Clinic, Section of Dermatology, Roanoke, Virginia
- Dermatology Department, Virginia Tech-Carilion School of Medicine, Roanoke, Virginia
| | - Martina L. Porter
- Dermatology Department, Harvard Medical School, Clinical Laboratory for Epidemiology and Applied Research in Skin, Boston, Massachusetts
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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9
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Fernandez JM, Plampton K, Behbahani S, Sutton AV, Whitley MJ, Wysong A. Racial Differences in Anatomic Sites of Distant Metastatic Melanoma: A Retrospective Cohort Study of 10,120 Cases. J Cutan Med Surg 2024; 28:190-191. [PMID: 38263788 DOI: 10.1177/12034754231223457] [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: 01/25/2024]
Affiliation(s)
- Jennifer M Fernandez
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Katherine Plampton
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sara Behbahani
- Department of Dermatology and Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Adam V Sutton
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Melodi J Whitley
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Dermatology, Duke University School of Medicine, Durham, NC, USA
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
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Da'as R, Slobodin O. "God Did Not Create Us This Way": An Investigation into the Experiences of School Counselors Working with Arab-Muslim LGBTQ Youth. J Homosex 2024:1-25. [PMID: 38421282 DOI: 10.1080/00918369.2024.2321239] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Schools play a key role in supporting, protecting, and advocating for LGBTQ students. However, educational programs worldwide tend to exclude and marginalize LGBTQ issues, especially when it comes to ethnic and racial minorities. In the current study, we examined Arab school counselors' experiences of working with Arab-Muslim LGBTQ youth. After 100 counselors declined to participate, the study included semi-structured interviews with 60 female counselors in Arab-Muslim schools in Israel. Data were analyzed using interpretive phenomenological analysis. Four main themes emerged: religious considerations, causal explanations of LGBTQ orientation, working practices, and supportive resources. Our findings point to the unique challenges facing Arab school counselors who are torn between their professional values and traditional norms. Among the strategies counselors used for managing this tension were separating LGBTQ orientation from LGBTQ adolescents, passive listening while avoiding proactive inquiry, and referring to LBGTQ orientation as a transient phase. Our findings emphasize the need to develop culturally relevant programs that address LGBTQ orientation for students, teachers, and families.
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Affiliation(s)
- Raneen Da'as
- School of Education, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ortal Slobodin
- School of Education, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Mahmood B, Adu P, McKee G, Bharmal A, Wilton J, Janjua NZ. Ethnic Disparities in COVID-19 Vaccine Mistrust and Receipt in British Columbia, Canada: Population Survey. JMIR Public Health Surveill 2024; 10:e48466. [PMID: 38363596 PMCID: PMC10896316 DOI: 10.2196/48466] [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: 04/25/2023] [Revised: 09/16/2023] [Accepted: 12/15/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Racialized populations in the United States, Canada, and the United Kingdom have been disproportionately affected by COVID-19. Higher vaccine hesitancy has been reported among racial and ethnic minorities in some of these countries. In the United Kingdom, for example, higher vaccine hesitancy has been observed among the South Asian population and Black compared with the White population, and this has been attributed to lack of trust in government due to historical and ongoing racism and discrimination. OBJECTIVE This study aimed to assess vaccine receipt by ethnicity and its relationship with mistrust among ethnic groups in British Columbia (BC), Canada. METHODS We included adults ≥18 years of age who participated in the BC COVID-19 Population Mixing Patterns Survey (BC-Mix) from March 8, 2021, to August 8, 2022. The survey included questions about vaccine receipt and beliefs based on a behavioral framework. Multivariable logistic regression was used to assess the association between mistrust in vaccines and vaccine receipt among ethnic groups. RESULTS The analysis included 25,640 adults. Overall, 76.7% (22,010/28,696) of respondents reported having received at least 1 dose of COVID-19 vaccines (Chinese=86.1%, South Asian=79.6%, White=75.5%, and other ethnicity=73.2%). Overall, 13.7% (3513/25,640) of respondents reported mistrust of COVID-19 vaccines (Chinese=7.1%, South Asian=8.2%, White=15.4%, and other ethnicity=15.2%). In the multivariable model (adjusting for age, sex, ethnicity, educational attainment, and household size), mistrust was associated with a 93% reduced odds of vaccine receipt (adjusted odds ratio 0.07, 95% CI 0.06-0.08). In the models stratified by ethnicity, mistrust was associated with 81%, 92%, 94%, and 95% reduced odds of vaccine receipt among South Asian, Chinese, White, and other ethnicities, respectively. Indecision, whether to trust the vaccine or not, was significantly associated with a 70% and 78% reduced odds of vaccine receipt among those who identified as White and of other ethnic groups, respectively. CONCLUSIONS Vaccine receipt among those who identified as South Asian and Chinese in BC was higher than that among the White population. Vaccine mistrust was associated with a lower odds of vaccine receipt in all ethnicities, but it had a lower effect on vaccine receipt among the South Asian and Chinese populations. Future research needs to focus on sources of mistrust to better understand its potential influence on vaccine receipt among visible minorities in Canada.
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Affiliation(s)
- Bushra Mahmood
- Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Prince Adu
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, United States
| | - Geoffrey McKee
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Aamir Bharmal
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - James Wilton
- British Columbia Center for Disease Control, Vancouver, BC, Canada
| | - Naveed Zafar Janjua
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
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Liu J, Lou Y, Cheung ESL. Beyond Dichotomy and Stability: ICT Use Among Asian American Older Adults During the COVID-19 Pandemic. J Appl Gerontol 2024; 43:170-181. [PMID: 37807902 DOI: 10.1177/07334648231204781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
This study examined the effect of the COVID-19 pandemic on information and communications technology (ICT) use and the typology of ICT users among older Chinese and Korean Americans. Survey data were collected from 513 Chinese and Korean older adults in New York City. We measured ICT use for social contact, grocery shopping, health care, and COVID-19 information seeking. In the study sample, ICT use for online shopping with others, contact with doctors, and telehealth significantly increased during the pandemic. Three groups of ICT users were identified: limited, users, expanding users, and active users. Older Chinese Americans and those with better English proficiency were more likely to be expanding and active ICT users. The patterns and heterogeneity of ICT use among older Asian Americans are multifaceted and dynamic beyond dichotomy and stability. The findings of this study offer helpful guidance for future development of ICT-based interventions for older Asian Americans.
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Affiliation(s)
- Jinyu Liu
- Diana R. Garland School of Social Work, Baylor University, Waco, TX, USA
| | - Yifan Lou
- Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA
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13
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Chang PS, Cohee A, Poe C, Kim J, Yergler A, Lu Y. A Content Analysis of African Americans' Experience of Engaging in Qigong Exercise Intervention in a Community Setting. J Integr Complement Med 2024; 30:146-156. [PMID: 37585619 PMCID: PMC10886424 DOI: 10.1089/jicm.2023.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Introduction: Although an increasing number of African Americans 50 years of age and older practice qigong, a mind-body exercise, to manage their health conditions, little is known about their perceptions and experiences of engaging in and learning qigong exercise. This study aimed to explore the subjective perceptions of the health benefits, engagement, adherence, and learning of qigong exercise in African Americans 45-85 years of age as a foundation for promoting this approach for African Americans' physical and psychological health. Methods: Fifteen African Americans were enrolled in a 1-h qigong exercise program twice a week for 8 weeks (a total of 16 sessions) in the activity center of a local church. Participants were interviewed after the intervention to explore their perceptions of learning and practicing qigong exercise. Interviews were conducted in person, audio recorded, transcribed verbatim, and analyzed using content analysis. Results: Five themes emerged: (1) Perceived benefits of practicing qigong, (2) helpful strategies for qigong learning, (3) facilitators for home qigong practice, (4) motivators for qigong exercise adherence, and (5) recommending qigong to others. qigong exercise was perceived to be effective for balance, flexibility, muscle strength, sleep quality, emotion regulation, and stress management. Nearly 75% of participants reported home qigong practice at least twice a week. Conclusions: Middle-age and older African Americans' responses provide insights on health benefits associated with practicing qigong exercise, adherence, home practice, and learning, which may serve as the first step to promoting the use of qigong exercise in this population and may be adopted to similar exercise interventions with minority older adults in the future.
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Affiliation(s)
- Pei-Shiun Chang
- Department of Community and Health Policy, School of Nursing, Indiana University Bloomington, Bloomington, IN, USA
| | | | - Christina Poe
- Department of Community and Health Policy, School of Nursing, Indiana University Bloomington, Bloomington, IN, USA
| | - Junhyoung Kim
- Department of Health & Wellness Design, School of Public Health, Indiana University Bloomington, Bloomington, IN, USA
| | - Abby Yergler
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Yvonne Lu
- Department of Nursing Science, School of Nursing, Indiana University, Indianapolis, IN, USA
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Shlomovitz O, Atias-Varon D, Yagel D, Barel O, Shasha-Lavsky H, Skorecki K, Eliyahu A, Bathish Y, Frajewicki V, Kushnir D, Zaid R, Paperna T, Ofir A, Tchirkov M, Hassan K, Kruzel E, Khazim K, Geron R, Weisman I, Hanut A, Nakhoul F, Kenig-Kozlovsky Y, Refael G, Antebi A, Storch S, Leiba M, Kagan M, Shukrun R, Rechavi G, Dekel B, Ben Moshe Y, Weiss K, Assady S, Vivante A. Genetic Markers Among the Israeli Druze Minority Population With End-Stage Kidney Disease. Am J Kidney Dis 2024; 83:183-195. [PMID: 37717846 DOI: 10.1053/j.ajkd.2023.06.006] [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: 12/31/2022] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 09/19/2023]
Abstract
RATIONALE & OBJECTIVE Genetic etiologies have been identified among approximately 10% of adults with chronic kidney disease (CKD). However, data are lacking regarding the prevalence of monogenic etiologies especially among members of minority groups. This study characterized the genetic markers among members of an Israeli minority group with end-stage kidney disease (ESKD). STUDY DESIGN A national-multicenter cross-sectional study of Israeli Druze patients (an Arabic-speaking Near-Eastern transnational population isolate) who are receiving maintenance dialysis for ESKD. All study participants underwent exome sequencing. SETTING & PARTICIPANTS We recruited 94 adults with ESKD, comprising 97% of the total 97 Druze individuals throughout Israel being treated with dialysis during the study period. PREDICTORS Demographics and clinical characteristics of kidney disease. OUTCOME Genetic markers. ANALYTICAL APPROACH Whole-exome sequencing and the relationship of markers to clinical phenotypes. RESULTS We identified genetic etiologies in 17 of 94 participants (18%). None had a previous molecular diagnosis. A novel, population-specific, WDR19 homozygous pathogenic variant (p.Cys293Tyr) was the most common genetic finding. Other monogenic etiologies included PKD1, PKD2, type IV collagen mutations, and monogenic forms of noncommunicable diseases. The pre-exome clinical diagnosis corresponded to the final molecular diagnosis in fewer than half of the participants. LIMITATIONS This study was limited to Druze individuals, so its generalizability may be limited. CONCLUSIONS Exome sequencing identified a genetic diagnosis in approximately 18% of Druze individuals with ESKD. These results support conducting genetic analyses in minority populations with high rates of CKD and for whom phenotypic disease specificity may be low. PLAIN-LANGUAGE SUMMARY Chronic kidney disease (CKD) affects many people worldwide and has multiple genetic causes. However, there is limited information on the prevalence of genetic etiologies, especially among minority populations. Our national-multicenter study focused on Israeli Druze patients. Using exome-sequencing, we identified previously undetected genetic causes in nearly 20% of patients, including a new and population-specific WDR19 homozygous pathogenic variant. This mutation has not been previously described; it is extremely rare globally but is common among the Druze, which highlights the importance of studying minority populations with high rates of CKD. Our findings provide insights into the genetic basis of end-stage kidney disease in the Israeli Druze, expand the WDR19 phenotypic spectrum, and emphasize the potential value of genetic testing in such populations.
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Affiliation(s)
- Omer Shlomovitz
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Danit Atias-Varon
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Dina Yagel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ortal Barel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel
| | - Hadas Shasha-Lavsky
- Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel; Department of Pediatric Nephrology, Galilee Medical Center, Nahariya, Israel
| | - Karl Skorecki
- Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel
| | - Aviva Eliyahu
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Victor Frajewicki
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Daniel Kushnir
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Rinat Zaid
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Tamar Paperna
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Ayala Ofir
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Marina Tchirkov
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Kamal Hassan
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Etty Kruzel
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Khaled Khazim
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Ronit Geron
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Irit Weisman
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Anaam Hanut
- Division of Nephrology and Hypertension Baruch Padeh Medical Center Poriya, Tiberias, Israel
| | - Farid Nakhoul
- Division of Nephrology and Hypertension Baruch Padeh Medical Center Poriya, Tiberias, Israel
| | - Yael Kenig-Kozlovsky
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Gery Refael
- Nephrology Unit, Mayanei HaYeshua Medical Center, Bnei Brak, Israel
| | - Alon Antebi
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Shimon Storch
- Nephrology and Hypertension Unit, Bnai-Zion Medical Center, Haifa, Israel
| | | | - Maayan Kagan
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Rachel Shukrun
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Gidi Rechavi
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel; Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel
| | - Benjamin Dekel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; Pediatric Stem Cell Research Institute, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Division of Pediatric Nephrology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yishay Ben Moshe
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Karin Weiss
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Suheir Assady
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Asaf Vivante
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; Division of Pediatric Nephrology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
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Abo-Rass F, Abu-Kaf S, Nakash O, Braun-Lewensohn O. Mental health literacy as a barrier and facilitator for service use: Qualitative inquiry among Palestinian Bedouins in Israel. Int J Soc Psychiatry 2024:207640231223433. [PMID: 38279598 DOI: 10.1177/00207640231223433] [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] [Indexed: 01/28/2024]
Abstract
BACKGROUND Mental health literacy (MHL) has been related to health behaviors and outcomes. However, studies examining MHL as a barrier and facilitator to service use are limited, especially among minority groups. AIMS This study examined MHL as a barrier and facilitator to mental health service use among the Palestinian Bedouin minority in Israel. METHODS Twenty-five Bedouins (15 women) from southern Israel participated in semi-structured, in-depth interviews. The participants were recruited by publishing an ad on social media about the study, then through a snowball technique. The data were analyzed thematically using ATLAS.ti.9, and the intercoder reliability was 92%. RESULTS We identified four major themes in the interviews: (1) MHL as a barrier to service use, due to lack of knowledge about professionals in the field, mental health services, or reasons and risk factors for mental health problems; (2) traditional attitudes that acted as barriers to service use, including a preference for informal treatment, a lack of faith in mental health treatment, aversion to discussing private feelings, and the perception that mental health is a luxury; (3) MHL as a facilitator to service use by enabling accurate identification of mental distress and suggesting practical avenues for seeking help; and (4) ways to improve MHL that should be culturally sensitive and under the government agencies' responsibility. CONCLUSIONS Interventions aimed at increasing the use of mental health services among Bedouins and reducing racial/ethnic disparities should increase knowledge in culturally adapted ways, especially regarding professionals and services, and change negative attitudes such as mental health treatment as ineffective or bonus.
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Affiliation(s)
- Fareeda Abo-Rass
- School for Social Work, Smith College, Northampton, Massachusetts, USA
| | - Sarah Abu-Kaf
- Conflict Management and Resolution Program, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, Massachusetts, USA
| | - Orna Braun-Lewensohn
- Conflict Management and Resolution Program, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Nazir N, Kevern P. Understanding and Awareness of Dementia in the Pakistani-Origin Community of Stoke-on-Trent, UK: A Scenario-Based Interview Study. Healthcare (Basel) 2024; 12:251. [PMID: 38275532 PMCID: PMC10815018 DOI: 10.3390/healthcare12020251] [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: 11/13/2023] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
The aim of this project was to explore the understanding and awareness of dementia in the Pakistani-origin community in a deprived urban region of the UK. The study was unique in accessing and interviewing Pothwari speakers, some of whom could not read or understand spoken English. Data generated from an earlier study were used to construct five scenarios, which were used as the basis for face-to-face semi-structured interviews with 11 male and female participants from the Pakistani-origin community spanning two generations. Braun and Clarke's six phases of thematic analysis were used to analyse the data to answer the research questions. Themes constructed from these interviews indicated a lack of awareness and understanding of dementia, a range of attitudes and assumptions, reluctance to seek external support, and a significant role for the cultural background in shaping the individuals' responses. The study found that poor understanding, cultural differences, and language issues presented barriers to accessing services in the British Pakistani community, particularly among those who had been born in Pakistan and/or spoke Pothwari in preference to English. Services and information may need to be offered by Pothwari speakers in order to reach this neglected sector of the population.
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Affiliation(s)
- Nargis Nazir
- School of Health, Sciences and Wellbeing, Staffordshire University, Stoke-on-Trent ST4 2DE, UK
| | - Peter Kevern
- School of Health, Sciences and Wellbeing, Staffordshire University, Stoke-on-Trent ST4 2DE, UK
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Zeng D, Chen Z, Yang Y, Li J, Tian B, Mo L. Genotype analysis of 55,281 cases of thalassemia in northern Guangxi. Am J Transl Res 2024; 16:51-62. [PMID: 38322564 PMCID: PMC10839378] [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: 11/19/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To understand the genotype and distribution of thalassemia in northern Guangxi. METHODS The study subjects were 55,281 individuals who came to the Affiliated Hospital of Guilin Medical University for genetic diagnosis of thalassemia from January 2012 to August 2023. All of their household registration was in the precincts of Guibei District and its affiliated counties. Red blood cell parameters and hemoglobin analysis were used for thalassemia screening. Gap-PCR, PCR-reverse dot blot hybridization (PCR-RDB), and multicolor melting curve analysis (MMCA) were used to identify common thalassemia genes. Multiplex ligation-dependent probe amplification (MLPA), Sanger sequencing, and third-generation single-molecule real-time (SMRT) sequencing were employed to identify rare thalassemia genes. RESULTS Among the 55,281 samples, 16,442 (29.74%) were diagnosed with thalassemia. The detection rates of α, β, and α combined β-thalassemia were 18.57%, 9.99% and 1.18%, respectively. Among ethnical groups, allele mutation frequency of thalassemia was the highest in Zhuang (44.97%), followed by Yao (40.11%), Dong (31.33%), Han (29.85%), Miao (24.31%), and Hui (20.6%). A total of 11,659 alleles (21.09%) of 8 types of α-thalassemia were identified in 55,281 samples, primarily --SEA (53.9%), followed by -α3.7 (21.3%), including rare alleles: --THAI (0.45%) and HKαα (0.38%). A total of 6367 (11.52%) and 14 types of β-thalassemia alleles were identified, mainly CD41-42 (50.12%), followed by CD17 (22.22%), including rare alleles: βCD37 (0.16%) and Gγ+ (Aγδβ)0/βN (0.05%). A total of 31 genotypes were detected in 10,264 cases of α-thalassemia, and the main types were --SEA/αα (53.23%), -α3.7/αα (19.15%), and -α4.2/αα (7.21%). A total of 34 genotypes were detected in 5525 cases of β-thalassemia, and the main types were βCD41-42/βN (50.53%), βCD17/βN (21.77%), and βIVS-II-654/βN (12.16%). A total of 78 gene types were detected in 653 cases of α- and β-thalassemia, and the main types were --SEA/αα, βCD41-42/βN (18.68%) and -α3.7/αα, βCD41-42/βN (13.02%). There were 580 cases (5.65%) of HbH disease (α0/α+), and 4 cases of Hemoglobin Bart's Hydrops Foetus syndrome (--SEA/--SEA). In addition, there were 92 cases (1.67%) of intermedia or severe types of β-thalassemia (β0/β0, β0/β+, β+/β+), including 23 cases of combined α-thalassemia. Among the samples screened negative for thalassemia, 3.7% of them were found to carry thalassemia genes, and 91.35% of the genotypes were αWSα/αα, -α3.7/αα, and -α4.2/αα. In addition, 40.26% of αWSα/αα, 22.89% of -α3.7/αα, and 18.51% of -α4.2/αα had no hematological phenotype. CONCLUSION The population in northern Guangxi exhibited rich ethnic diversity, with high allelic carrying rates among the Zhuang, Yao and Dong ethnic groups. Thalassemia gene mutations are diverse, encompassing a variety of gene types, with α thalassemia predominating, notably the --SEA/αα gene type. The prevalence of intermedia or severe types of thalassemia is not low, but there are still some carriers of thalassemia in people who are initially tested negative.
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Affiliation(s)
- Dan Zeng
- Ruikang Clinical Medical College of Guangxi University of Traditional Chinese MedicineNanning 530011, Guangxi, PR China
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
- Precision Joint Testing Center, Guangxi Zhuang Autonomous Region People’s HospitalNanning 530021, Guangxi, PR China
| | - Zhizhong Chen
- Ruikang Clinical Medical College of Guangxi University of Traditional Chinese MedicineNanning 530011, Guangxi, PR China
- Precision Joint Testing Center, Guangxi Zhuang Autonomous Region People’s HospitalNanning 530021, Guangxi, PR China
| | - Yifeng Yang
- Department of Laboratory, Guilin People’s HospitalGuilin 541002, Guangxi, PR China
| | - Jun Li
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
| | - Baodong Tian
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
| | - Limin Mo
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
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Hasan-Aslih S, Idan O, Willer R, Halperin E. Disadvantaged group members are prouder of their group when using the language of the dominant group compared to their native language. Proc Natl Acad Sci U S A 2024; 121:e2307736120. [PMID: 38147544 PMCID: PMC10769828 DOI: 10.1073/pnas.2307736120] [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: 05/11/2023] [Accepted: 10/12/2023] [Indexed: 12/28/2023] Open
Abstract
In ethnically and linguistically diverse societies, disadvantaged groups often face pressures to acquire and speak the advantaged group's language to achieve social inclusion and economic mobility. This work investigates how using the advantaged group's language affects disadvantaged group members' in-group pride and collective self-esteem, relative to using their native language. Across six experimental studies involving Palestinian citizens of Israel (total N = 1,348), we test two competing hypotheses: Disadvantaged group members may experience greater in-group pride when using a) their native language, due to its emotional significance (the nativity hypothesis), or b) the language of the advantaged group, due to activation of habituated compensatory responses to dominance relations (the identity enhancement hypothesis). We found that respondents reported significantly higher in-group pride when responding to a Hebrew survey when compared to performing the same activity in Arabic (Studies 1a and 1b), regardless of whether the researchers administering the survey were identified as Jewish or Arab (Studies 2a and 2b). Study 3 replicated this effect while employing the "bogus pipeline" technique, suggesting the pride expression was authentic, not merely driven by social desirability. Finally, Study 4 (pre-registered) examined additional measures of positive regard for the in-group, finding that participants described their group more positively in an attribute selection task, and reported greater collective self-esteem, when surveyed in Hebrew, rather than in Arabic. Taken together, these findings suggest that language use influences disadvantaged group members' perceptions and feelings concerning their group when those languages are associated with relative position in an intergroup hierarchy.
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Affiliation(s)
| | - Orly Idan
- Baruch Ivcher School of Psychology, Reichman University (IDC Herzliya),Herzliya4610101, Israel
| | - Robb Willer
- Department of Sociology, Stanford University, Stanford, CA94305
| | - Eran Halperin
- Department of Psychology, Hebrew University,Jerusalem9190501, Israel
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Deboever N, Correa AM, Feldman H, Mathur U, Hofstetter WL, Mehran RJ, Rice DC, Roth JA, Sepesi B, Swisher SG, Walsh GL, Vaporciyan AA, Antonoff MB, Rajaram R. Disparities in early-stage lung cancer outcomes at minority-serving hospitals compared with nonminority serving hospitals. J Thorac Cardiovasc Surg 2024; 167:329-337.e4. [PMID: 37116780 DOI: 10.1016/j.jtcvs.2023.04.025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/05/2023] [Accepted: 04/17/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVES Disparities in cancer care are omnipresent and originate from a multilevel set of barriers. Our objectives were to describe the likelihood of undergoing surgery for early-stage non-small cell lung cancer at minority-serving hospitals (MSHs), and evaluate the association of race/ethnicity with resection based on MSH status. METHODS A retrospective study using the National Cancer Database (2008-2016) was conducted including patients with clinical stage I non-small cell lung cancer. MSHs were defined as hospitals in the top decile of providing care to Hispanic or African American patients. The primary outcome evaluated was receipt of definitive surgery at MSHs vs non-MSHs. Outcomes related to race/ethnicity stratified by hospital type were also investigated. RESULTS A total of 142,580 patients were identified from 1192 hospitals (120 MSHs and 1072 non-MSHs). Most patients (85% [n = 121,240]) were non-Hispanic White, followed by African American (9% [n = 12,772]), and Hispanic (3%, [n= 3749]). MSHs cared for 7.4% (n = 10,491) of the patients included. In adjusted analyses, patients treated at MSHs were resected less often than those at non-MSHs (odds ratio, 0.87; 95% CI, 0.76-1.00; P = .0495). African American patients were less likely to receive surgery in the overall analysis (P < .01), and at MSHs specifically (P < .01), compared with non-Hispanic White patients. Hispanic patients had similar rates of resection in the overall analysis (P = .11); however, at MSHs, they underwent surgery more often compared with non-Hispanic White patients (P = .02). Resected patients at MSHs had similar overall survival (median, 91.7 months; 95% CI, 86.6-96.8 months) compared with those resected at non-MSHs (median, 85.7 months; 95% CI, 84.5-86.8 months). CONCLUSIONS Patients with early-stage non-small cell lung cancer underwent resection less often at MSHs compared with non-MSHs. Disparities related to underutilization of surgery for African American patients continue to persist, regardless of hospital type.
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Affiliation(s)
- Nathaniel Deboever
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Arlene M Correa
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Hope Feldman
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Urvashi Mathur
- University of Texas Rio Grande Valley Medical School, Edinburg, Tex
| | - Wayne L Hofstetter
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Reza J Mehran
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - David C Rice
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Jack A Roth
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Boris Sepesi
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Stephen G Swisher
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Garrett L Walsh
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Ara A Vaporciyan
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Ravi Rajaram
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
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Mózes N, Takács J, Ungvari Z, Feith HJ. Screening attendance disparities among Hungarian-speaking Roma and non-Roma women in central and eastern European countries. Front Public Health 2023; 11:1292598. [PMID: 38186708 PMCID: PMC10771837 DOI: 10.3389/fpubh.2023.1292598] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
The Roma populations in Central and Eastern Europe are two to three times more likely to have unmet health needs compared to non-Roma residents. The aim of the present study was to investigate the disparity in screening attendance between Hungarian-speaking Roma (R) and non-Roma (nR) women in Hungary (HU-R:322; nR:294), Romania (RO-R:258; nR:183), and Slovakia (SK-R:146; nR:163), while also identifying the factors that influence attendance at any kind of screening tests in both populations. In order to examine these factors, a multiple binary logistic regression was conducted. The findings revealed significant associations between attendance at any kind of screening tests and certain factors among different groups. Among Hungarian Roma women, it was found that having a chronic disease and smoking were linked to attendance at any kind of screening tests (p = 0.009). Specifically, having a chronic disease increased the odds of attendance (OR = 1.71 [1.01, 2.90]), while smoking decreased the odds (OR = 0.57[0.365, 0.91]). In Romania, the study found that not having health insurance decreased the odds of attendance among Roma women (OR = 0.50 [0.27, 0.91]), whereas having a chronic disease increased the odds (OR = 2.87 [1.44, 5.72]) (p = 0.006). Among non-Roma women in Romania, physical inactivity was associated with a decreased likelihood of attendance at any kind of screening tests (OR = 0.48 [0.25, 0.95]). Among Slovakian Roma women, not having health insurance (OR = 0.09[0.02, 0.36]) and smoking (OR = 0.25[0.11, 0.61]) were found to decrease the odds of attendance (p < 0.001). On the other hand, non-Roma women in Slovakia with chronic diseases were more likely to attend at any kind of screening tests (OR = 2.52[1.12, 5.66]). Our research emphasizes the impact of lacking health insurance on screening attendance, particularly among the Roma population. It also highlights the significance of health-related behaviours such as smoking and physical inactivity in relation to missed screening tests, which in turn contribute to the development of non-communicable diseases. Therefore, promoting targeted screening programs for the Roma community is crucial to ensure their access to screening tests, especially in cases of chronic illnesses.
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Affiliation(s)
- Noémi Mózes
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Doctoral School of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Johanna Takács
- Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration, and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Helga Judit Feith
- Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
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Rei KM, Reddy V, Brazdzionis J, Siddiqi J. Determinants and Disparities of Neurosurgery Patients Refusing Inpatient Palliative Care After Provider Recommendation. Cureus 2023; 15:e49925. [PMID: 38179361 PMCID: PMC10765216 DOI: 10.7759/cureus.49925] [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: 08/12/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Background Disparities have been found in the utilization of palliative care (PC). However, a limitation of existing research is that it co-mingles factors affecting whether a patient is offered PC with factors affecting whether a patient accepts/refuses PC. Our objective is to identify the determinants and disparities of neurosurgery patients accepting/refusing inpatient PC after a provider recommends an inpatient PC consult. Methodology In this single-center retrospective cohort study, the last 750 consecutive neurosurgery patient medical records were screened. Inclusion criteria were as follows: (1) the patient was seen by the neurosurgery service during their hospitalization and (2) the patient had a documented inpatient PC consult ordered or the patient had at least one progress note documenting PC in the plan of care. Excluded were patients not seen by the neurosurgery service during the hospitalization in which the PC consult order or plan was documented. Analysis was performed using multivariate logistic regression with backward stepwise variable selection. Candidate variables included age, gender, race, ethnicity, language, marital status, insurance type, surrogate decision-maker (SDM) relationship to patient, advanced directive, Charlson Comorbidity Index (CCI), ambulation, activities of daily living (ADL) dependence, primary diagnosis category, Glasgow Coma Scale (GCS) at the time of admission, GCS at the time of PC consult, GCS at the time of discharge, duration of hospitalization, and hospitalization mortality. Results Of the last 750 neurosurgery patients, this study included 144 patients (33.3% female; mean age 57.53±19.89 years). Among these patients, 109 patients (75.7%) accepted PC and 35 patients (24.3%) refused PC. Univariate analysis showed that patients refusing PC tended to be older (p=0.003) and have a shorter duration of hospitalization (p=0.023). Chi-squared analysis found associations between PC acceptance/refusal and preferred language (p=0.026), religion (p<0.001), and SDM relationship to patient (p=0.004). Multivariate logistic regression found that predictors of PC refusal were older age (OR=0.965, p=0.049), non-English (OR=0.219, p=0.004), adult child SDM (OR=0.246, p=0.023), and other relative/friend SDM (OR=0.208, p=0.011). Religious patients were more likely to accept PC (OR=7.132, p<0.001). Race and ethnicity factors were not found to be significant predictors of PC refusal: Black (p=0.649), other race (p=0.189), and Hispanic (p=0.525). Conclusion Nearly one-quarter of neurosurgery patients offered PC refused this care. Predictors of PC refusal were older age, non-English, adult child SDM, and other relative/friend SDM. Religious patients were more likely to accept PC. Race and ethnicity were not found to be significant predictors of accepting/refusing PC, which may suggest these previously identified disparities stem from minority patients being offered less PC. Additional research is needed to replicate these findings among different patient populations. Because PC is compatible with life-prolonging therapies and aims to provide additional emotional and spiritual support to the patient and family, the finding that nearly one-quarter of patients refused PC may demonstrate a pervasive misconception and need for patient education.
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Affiliation(s)
- Kyle M Rei
- Neurosurgery, California University of Science and Medicine, Colton, USA
| | - Vedhika Reddy
- Neurosurgery, California University of Science and Medicine, Colton, USA
| | - James Brazdzionis
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
| | - Javed Siddiqi
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
- Neurosurgery, Arrowhead Regional Medical Center, Colton, USA
- Neurosurgery, California University of Science and Medicine, Colton, USA
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22
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Struble LM, Potempa K, Lichtenberg PA, Croff RL, Ellis A, Dodge HH. Including Socially Isolated Black, Older Old Adults (Aged 80 and Above) with and without Mild Cognitive Impairment in a Clinical Trial: Recruitment Strategies and Perspectives. J Multidiscip Healthc 2023; 16:3663-3673. [PMID: 38046050 PMCID: PMC10693244 DOI: 10.2147/jmdh.s427946] [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: 07/22/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023] Open
Abstract
Objective This study describes strategies for the recruitment of socially isolated older old Black individuals to participate in the "Internet-based conversational engagement clinical trial (I-CONECT)" (Clinical Trial.gov: NCT02871921) and lessons learned in this critical population segment. Methods Best practice strategies to recruit the target population included mass mailings, advertisements, and direct community outreach, including the collaboration with a community group created to reach Black individuals interested in research participation. We also made protocol changes to measure recruitment criteria for older old Black adults more accurately and to increase their participation. Results Descriptive data related to the challenges and successes in recruiting Black participants compared to the White participants is presented. The primary site contacted 17,523 primarily White potential participants and enrolled/randomized 145 White and 2 Asian/mixed race participants (0.8%). The Midwest site contacted 12,141 Black potential participants and enrolled/randomized 39 (0.3%) participants. Discussion While best practices were employed, several factors complicated recruitment, including the need to adjust recruitment criteria, navigate regional regulations, and respect diverse community preferences. Conclusion Older old African Americans are reachable and willing to participate in research when considering their beliefs and practices, influenced by their community and experience.
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Affiliation(s)
- Laura M Struble
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Kathleen Potempa
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Peter A Lichtenberg
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Raina L Croff
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Alexis Ellis
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Hiroko H Dodge
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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23
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Obeid S, Mashiach-Eizenberg M, Gur A, Lavy I. Examining Ethnic Disparities in Digital Healthcare Services Utilization: Insights from Israel. J Multidiscip Healthc 2023; 16:3533-3544. [PMID: 38024120 PMCID: PMC10661913 DOI: 10.2147/jmdh.s429121] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The purpose of this study was to examine ethnic disparities in the utilization of digital healthcare services (DHS) in Israel and explore the characteristics and factors influencing DHS use among the Arab minority and Jewish majority populations. Methods A cross-sectional correlational design was employed to collect data from 606 Israeli participants, 445 Jews, and 161 Arabs. Participants completed a digital questionnaire that assessed DHS utilization, digital health literacy, attitudes towards DHS, and demographic variables. Results The findings reveal significant disparities in DHS utilization and attitudes between these ethnic groups, with Jewish participants demonstrating higher rates of utilization and positive attitudes toward DHS. The study also explores the predictive role of digital health literacy and attitudes in DHS use while considering ethnicity as a potential moderator. Significant predicting factors related to DHS utilization among Jews include positive attitudes and high health literacy. Among the Arabs, only attitudes towards DHS significantly predict the extent of DHS use. Digital health literacy affects the extent of use through attitudes at the two groups of the moderator significantly, but it is stronger among the Arab group. Conclusion To improve healthcare outcomes and reduce disparities, efforts should focus on ensuring equitable access to DHS for the Arab minority population. Targeted interventions, including digital literacy education, removing technology access barriers, offering services in Arabic, and collaborating with community organizations, can help bridge the gap and promote equal utilization of DHS.
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Affiliation(s)
- Samira Obeid
- Department of Nursing, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
- Public Health Research Department, North District, the Ministry of Health, Nof Hagalil, Israel
| | - Michal Mashiach-Eizenberg
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Amit Gur
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Ilana Lavy
- Department of Information Systems, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
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24
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Foresi BD, Pellot K, Quadri SS, Muzyka L, White S, Uzoukwu C, Pannullo SC. Assessing the state of LGBTQ+ diversity and inclusion in neurosurgery. Neurosurg Focus 2023; 55:E10. [PMID: 37913532 DOI: 10.3171/2023.8.focus23285] [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: 04/28/2023] [Accepted: 08/24/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The aim of this study was to assess the diversity of neurosurgeons in terms of lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) gender and sexual minority status using the Graduation Questionnaire (GQ) as the single nationalized source of LGBTQ+ identification. Additionally, inclusivity was assessed through interviews by residents and attendings in the field. METHODS First, a PRISMA literature review was conducted and independently reviewed by two authors on studies involving LGBTQ+ representation in neurosurgery from PubMed, Web of Science, and Google Scholar. Then, aggregate responses of 16,901 participants' sexual and gender identities from the GQ administered between 2016 and 2022 were compiled. To statistically analyze the response frequencies, the authors performed a chi-square analysis. Finally, interviews were conducted with individuals who identify as LGBTQ+ and are currently neurosurgical residents or attendings. Direct invitations were extended to participate in interviews, and all participants gave informed consent prior to the interview. Interviews were conducted using standardized questions and were video recorded. RESULTS Two studies were identified by literature review that referenced the LGBTQ+ community in neurosurgery. A GQ chi-square analysis comparing neurosurgical with nonneurosurgical LGBTQ+ identification proved statistically insignificant (p = 0.65). More broad analysis of majority sexual and gender identification (heterosexual and cisgendered) compared with the total gender and sexual minority group also proved statistically insignificant (p = 0.32) in response frequency. Five interviews, including 4 residents and 1 attending, provided several overarching themes including self-identification as an invisible minority, self-limiting behavior to ensure inclusion, and LGBTQ+ status as a direct departure from the stereotypical neurosurgeon. CONCLUSIONS Results from the GQ analysis indicate that neurosurgery is achieving LGBTQ+ diversity of its incoming members comparable to that of other fields in medicine. However, qualitative data from the interviews and a lack of specific literature indicate that despite obtaining diversity, inclusion of LGBTQ+ neurosurgeons and trainees is lacking.
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Affiliation(s)
| | | | - Saif S Quadri
- 3Kansas City University School of Osteopathic Medicine, Kansas City, Missouri
| | - Logan Muzyka
- 4Dell Medical School at The University of Texas at Austin, Texas
| | - Sarah White
- 5Campbell University School of Osteopathic Medicine, Lillington, North Carolina; and
| | | | - Susan C Pannullo
- 6Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, New York
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25
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Radu I, Scheermesser M, Spiess MR, Schulze C, Händler-Schuster D, Pehlke-Milde J. Digital Health for Migrants, Ethnic and Cultural Minorities and the Role of Participatory Development: A Scoping Review. Int J Environ Res Public Health 2023; 20:6962. [PMID: 37887700 PMCID: PMC10606156 DOI: 10.3390/ijerph20206962] [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: 07/06/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Abstract
Digital health interventions (DHIs) are increasingly used to address the health of migrants and ethnic minorities, some of whom have reduced access to health services and worse health outcomes than majority populations. This study aims to give an overview of digital health interventions developed for ethnic or cultural minority and migrant populations, the health problems they address, their effectiveness at the individual level and the degree of participation of target populations during development. We used the methodological approach of the scoping review outlined by Tricco. We found a total of 2248 studies, of which 57 were included, mostly using mobile health technologies, followed by websites, informational videos, text messages and telehealth. Most interventions focused on illness self-management, mental health and wellbeing, followed by pregnancy and overall lifestyle habits. About half did not involve the target population in development and only a minority involved them consistently. The studies we found indicate that the increased involvement of the target population in the development of digital health tools leads to a greater acceptance of their use.
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Affiliation(s)
- Irina Radu
- Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
| | - Mandy Scheermesser
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
| | - Martina Rebekka Spiess
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland; (M.R.S.); (C.S.)
| | - Christina Schulze
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland; (M.R.S.); (C.S.)
| | - Daniela Händler-Schuster
- Institute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
- UMIT TIROL Institute for Nursing Science, Private University of Health Sciences and Health Technology, 6060 Hall in Tirol, Austria
- School of Nursing, Midwifery, and Health Practice, Faculty of Health, Victoria University of Wellington, Wellington 6012, New Zealand
| | - Jessica Pehlke-Milde
- Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
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Bashkin O, Suisa A, Levi S. Higher Education in Public Health as a Tool to Reduce Disparities: Findings from an Exploratory Study among the Bedouin Community in Israel. Eur J Investig Health Psychol Educ 2023; 13:2082-2094. [PMID: 37887148 PMCID: PMC10606249 DOI: 10.3390/ejihpe13100147] [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: 08/11/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
The Bedouin community is a minority disadvantaged population in Israel that suffers from a variety of health and socioeconomic disparities and limited access to higher education. The current study aimed to examine perceptions, successes, and challenges experienced by Bedouin students during their studies and to assess an internship program developed on the principles of a community-based participatory research approach to public health. In-depth interviews were conducted with 34 Bedouin students studying in the public health academic track between January and April 2023. Grounded Theory was used to analyze the data. Three main themes emerged from the analysis: (1) facilitators for the decision to pursue higher education in public health, (2) challenges and coping strategies, and (3) experiences of success. The internship program included eleven Bedouin students who conducted six community intervention projects covering a range of topics with different target Bedouin populations. Higher education is crucial for empowering minorities, producing leadership, and reducing socioeconomic and health gaps. The field internship enabled the necessary alignment between academia and public health practice. It is important to further reflect on the integration of minority groups in public health studies and its role in decreasing health inequity.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Avia Suisa
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Sharon Levi
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
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27
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Ali-Saleh O, Khatib M, Hadid S, Dahamsheh K, Basis F. Factors Related to the Compliance of Arab Parents in Israel to the Vaccination of Children and Adolescents against COVID-19. Vaccines (Basel) 2023; 11:1540. [PMID: 37896945 PMCID: PMC10610611 DOI: 10.3390/vaccines11101540] [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: 08/21/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
The Arab minority consists of 20% of the Israeli population. Most of the Arab minority live in rural villages, mostly in closed communities, with specific psycho-social and sociodemographic characteristics. Previous studies showed different attitudes to COVID-19 vaccination among Arab adults. OBJECTIVES To examine the influence of factors on the willingness of parents to vaccinate their young and adolescent children and if there is a difference between parents' attitudes to both groups. METHODS AND MATERIALS The survey examined correlations between variables and attitudes toward the vaccine and the pandemic and was disseminated anonymously to parents of children between the ages of 5 and 18 in the Arab population of Israel through social media networks, using the snowball method. Statistical analyses included the Pearson correlation, MANCOVA, and logistic regression tests. RESULTS In total, 361 Arab Israeli parents participated. As mentioned above, 130 parents had both children and adolescents. Overall, 48 parents (36.9%) chose not to vaccinate both their children and adolescents, 52 parents (40.0%) chose to vaccinate only their adolescents, only 1 parent (0.8%) chose to vaccinate only the child, and 29 parents (22.3%) vaccinated both their children and adolescents. Significant correlations were found among a higher age of parents and socioeconomic status, attitudes toward COVID vaccination, subjective norms, perceived severity of the disease, perceived benefits of vaccination, and trust in formal sources. DISCUSSION There is a difference between parents' decision to be vaccinated and their willingness to vaccinate their children. There is a difference between their decision to vaccinate their adolescents and their young children. Different factors positively or negatively influenced parents' decisions. Addressing these factors by authorities may increase compliance of Arab minorities with instructions in the future.
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Affiliation(s)
- Ola Ali-Saleh
- The Max Stern Yezreel Valley College, Emek Yezrael 1930600, Israel;
| | - Mohammad Khatib
- The Galilee Society, Zefat Academic College, University of Haifa, Zefat 13206, Israel;
- Zefat Academic College, Safed 1320611, Israel
| | - Salam Hadid
- Nazareth Academic School of Nursing, Nazareth 16100, Israel; (S.H.); (K.D.)
| | - Kamal Dahamsheh
- Nazareth Academic School of Nursing, Nazareth 16100, Israel; (S.H.); (K.D.)
| | - Fuad Basis
- Rambam Health Care Campus, Haifa 3109601, Israel
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28
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Krasuska M, Davidson EM, Beune E, Jenum AK, Gill JM, Stronks K, van Valkengoed IG, Diaz E, Sheikh A. A Culturally Adapted Diet and Physical Activity Text Message Intervention to Prevent Type 2 Diabetes Mellitus for Women of Pakistani Origin Living in Scotland: Formative Study. JMIR Form Res 2023; 7:e33810. [PMID: 37713245 PMCID: PMC10541642 DOI: 10.2196/33810] [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: 09/24/2021] [Revised: 12/20/2022] [Accepted: 01/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Individuals of South Asian origin are at an increased risk of developing type 2 diabetes mellitus (T2DM) compared with other ethnic minority groups. Therefore, there is a need to develop interventions to address, and reduce, this heightened risk. OBJECTIVE We undertook formative work to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. METHODS We used a stepwise approach that was informed by the Six Steps in Quality Intervention Development framework, which consisted of gathering evidence through literature review and focus groups (step 1), developing a program theory for the intervention (step 2), and finally developing the content of the text messages and an accompanying delivery plan (step 3). RESULTS In step 1, we reviewed 12 articles and identified 3 key themes describing factors impacting on diet and physical activity in the context of T2DM prevention: knowledge on ways to prevent T2DM through diet and physical activity; cultural, social, and gender norms; and perceived level of control and sense of inevitability over developing T2DM. The key themes that emerged from the 3 focus groups with a total of 25 women were the need for interventions to provide "friendly encouragement," "companionship," and a "focus on the individual" and also for the text messages to "set achievable goals" and include "information on cooking healthy meals." We combined the findings of the focus groups and literature review to create 13 guiding principles for culturally adapting the text messages. In step 2, we developed a program theory, which specified the main determinants of change that our text messages should aim to enhance: knowledge and skills, sense of control, goal setting and planning behavior, peer support, and norms and beliefs guiding behavior. In step 3, we used both the intervention program theory and guiding principles to develop a set of 73 text messages aimed at supporting a healthy diet and 65 text messages supporting increasing physical activity. CONCLUSIONS We present a theory-based approach to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. This study outlines an approach that may also be applicable to the development of interventions for other ethnic minority populations in diverse settings. There is now a need to build on this formative work and undertake a feasibility trial of a text message-based diet and physical activity intervention to prevent T2DM for women of Pakistani origin living in Scotland.
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Affiliation(s)
- Marta Krasuska
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma M Davidson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Erik Beune
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jason Mr Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Irene Gm van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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Epps K, Goel R, Mehran R, Kandzari D, Damluji A, Tehrani B, Sherwood M, Truesdell A, Davis S, Wang JC, Lopez M, Singh S, Underwood P, Allocco D, Batchelor W. Influence of Race/Ethnicity and Sex on Coronary Stent Outcomes in Diabetic Patients. J Soc Cardiovasc Angiogr Interv 2023; 2:101053. [PMID: 38469035 PMCID: PMC10927016 DOI: 10.1016/j.jscai.2023.101053] [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] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Background How diabetes mellitus (DM), race/ethnicity, and sex impact ischemic events following coronary artery stent procedures is unknown. Methods Using the PLATINUM Diversity and PROMUS Element Plus Post-Approval Pooled Study (N = 4184), we examined the impact of race/ethnicity, sex, and DM on coronary stent outcomes. Primary outcome was 1-year major adverse cardiac events (MACE) (MACE composite: death, myocardial infarction [MI], and target vessel revascularization). Results The study sample included 1437 diabetic patients (501 White men, 470 White women, 246 minority men, 220 minority women) and 2641 patients without medically treated DM (561 minority, 1090 women). Mean age (years) ranged from 61 in minority men to 65 in White women. Diabetic patients had a higher prevalence of atherosclerotic risk factors and comorbidities. Diabetic minority women (DMW; 70% Black, 27% Hispanic) had similar atherosclerotic risk factors to other diabetics, but experienced higher 1-year MACE (14.4% vs 7.5%, P <.01) and MI (4.3% vs 1.6%, P <.01) rates compared with patients without medically treated DM. No other diabetic cohort (White men, White women, minority men) showed an increased risk of MACE vs patients without medically treated DM. The incremental risk of MACE in DMW was associated with insulin use and persisted after risk adjustment (adjusted odds ratio 1.6 vs patients without medically treated DM; 95% CI, 1.0-2.5). Independent predictors of 1-year MACE included insulin use, hyperlipidemia, renal disease, and prior MI. Conclusions DMW face the highest risk of ischemic events following coronary stenting, driven, in part, by insulin use. Aggressive secondary prevention and strict glycemic control are imperative in this cohort, and further research is warranted to elucidate the biologic mechanisms underpinning these observations. Clinical Trial Registration NCT02240810 (http://clinicaltrials.gov/).
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Affiliation(s)
- Kelly Epps
- Inova Heart and Vascular Institute, Falls Church, Virginia
| | | | | | | | | | - Behnam Tehrani
- Inova Heart and Vascular Institute, Falls Church, Virginia
| | | | | | | | - John C. Wang
- MedStar Union Memorial Hospital, Baltimore, Maryland
| | - Mario Lopez
- Charlotte Heart and Vascular Institute, Port Charlotte, Florida
| | | | - Paul Underwood
- Boston Scientific Corporation, Marlborough, Massachusetts
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Brisola EB, Reis G, Costa M, Bellamy C. Brazilian immigrants in the United States and mental health: An integrative review. Int J Soc Psychiatry 2023; 69:1303-1311. [PMID: 36924461 DOI: 10.1177/00207640231159800] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Brazilian immigrants are becoming a more visible minority and, although different from other Latinos (in a linguistic, cultural, historical, and ethnic sense), are usually either counted as Latinos, not included in the Latino samples or simply overlooked in research studies. It is essential to understand the stress and pressures they undergo and appreciate their singular perspective and culturally-infused experiences to meet their needs and improve their mental healthcare and quality of life in the United States. AIM The aim of this review is to understand and describe the experience of Brazilian immigrants in the U.S., related to mental health, assessing what studies have addressed and what is still needing to be researched. METHOD We carried out an integrative review of peer-reviewed articles published between 2011 and 2022 using PychInfo, PubMed, and Proquest, addressing mental health of Brazilian immigrants in the United States. RESULTS A total of 10 articles were included revealing the interest of a variety of fields and uncovering three themes: (1) mental healthcare needs (especially warmth and understanding of culture), (2) common sources of support and stress in the community and work, and (3) Socioeconomic aspects related to their mental health, including discrimination, work-life balance, neighborhood cohesion, and acculturation. CONCLUSIONS Results may be useful to practitioners, researchers, and policy makers, who should be attentive to client's familiarity with the English language, their sources of support, spirituality, specific Brazilian traits, their feeling of 'being invisible', life in community, and their previous experiences with healthcare in Brazil.
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Affiliation(s)
- Elizabeth Bv Brisola
- School of Behavior and Social Sciences, St. Edward's University, Austin, TX, USA
| | - Graziela Reis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Mark Costa
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Chyrell Bellamy
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Mercen JL, Curran KM, Belmar MT, Sanchez J, Hasan I, Kalra S, Raina PM, Patel S, Arrechavaleta D, Lee V, Anderson P. Social Determinants of Health Impacting Access to Renal Dialysis for Racial/Ethnic Minorities. Cureus 2023; 15:e45826. [PMID: 37876398 PMCID: PMC10593311 DOI: 10.7759/cureus.45826] [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: 07/07/2023] [Accepted: 09/22/2023] [Indexed: 10/26/2023] Open
Abstract
Although widespread, the burden of disease presented by chronic kidney disease (CKD) is not equally distributed among all demographics. Examining the social determinants of health (SDOH) that relate to barriers to renal dialysis care in CKD can help to prevent future disparities. There has not been a study addressing the social factors that create barriers to care for ethnic minority patients with CKD. The aim of this scoping review is to address the SDOH that affects access to renal dialysis for ethnic minority patients in the United States. This study was based on the protocol published by the Joanna Briggs Institute. A total of 349 studies were identified from PubMed, EBSCOhost, and Embase. Each article was screened against population, concept, and context criteria in order to be considered for inclusion. The population was determined to be adults of all genders from underrepresented minority populations. The selected concept was SDOH. The context of this study was the United States population. From the articles selected by the search criteria, neighborhood of residence, mental health care access, glomerular filtration rate (GFR) methodology, socioeconomic status (SES), language barriers, immigration status, and military rank were identified as SDOH affecting access to renal dialysis care. While this study identified four social determinants, more research is needed for the investigation of other possible SDOH contributing to disparities related to CKD and access to renal dialysis care.
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Affiliation(s)
- Joseph L Mercen
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Kiely M Curran
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale , USA
| | - Markeeta T Belmar
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater , USA
| | - Jaron Sanchez
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Ibrahim Hasan
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Sahib Kalra
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Parth M Raina
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Sahil Patel
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Dania Arrechavaleta
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Vincent Lee
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Paula Anderson
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
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Constantino JN, Abbacchi AM, May BK, Klaiman C, Zhang Y, Lowe JK, Marrus N, Klin A, Geschwind DH. Prospects for Leveling the Playing Field for Black Children With Autism. J Am Acad Child Adolesc Psychiatry 2023; 62:949-952. [PMID: 37196781 PMCID: PMC10948275 DOI: 10.1016/j.jaac.2023.05.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/04/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023]
Abstract
Among the many race-based health disparities that have persistently plagued the US population,1 the disproportionate burden of adverse neurodevelopmental outcomes to Black children affected by autism spectrum disorder (ASD) is particularly devastating given its major lifelong consequences. Recently, in 3 successive reports from the Autism and Developmental Disabilities Monitoring (ADDM) program of the US Centers for Disease Control and Prevention (CDC) (birth cohort years 2014, 2016, and 2018), we and our collaborators reported that although the prevalence of community-diagnosed ASD had equalized for Black and non-Hispanic White (NHW) children in the United States, there has persisted a pronounced racial disparity in the proportion of ASD-affected children with comorbid intellectual disability (ID), on the order of 50% for Black children with ASD vs 20% for White children with ASD.2 Here, we provide data to support the following: much earlier diagnosis is possible; early diagnosis alone is not likely to close the ID comorbidity disparity; and judicious efforts over care as usual are necessary to ensure that Black children have access to timely implementation of developmental therapy, for which we observed promising associations with improved cognitive and adaptive outcomes in our sample.
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Affiliation(s)
| | - Anna M Abbacchi
- Washington University School of Medicine, St. Louis, Missouri
| | - Brandon K May
- Washington University School of Medicine, St. Louis, Missouri
| | - Cheryl Klaiman
- Marcus Autism Center, School of Medicine, Emory University, Atlanta, Georgia
| | - Yi Zhang
- Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer K Lowe
- David Geffen School of Medicine, University of California, Los Angeles, California
| | - Natasha Marrus
- Washington University School of Medicine, St. Louis, Missouri
| | - Ami Klin
- Marcus Autism Center, School of Medicine, Emory University, Atlanta, Georgia
| | - Daniel H Geschwind
- David Geffen School of Medicine, University of California, Los Angeles, California
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Opara I, Gabriel C, Duran-Becerra B, Bond K, Hill AV, Hussett-Richardson S, Alves C, Kershaw T. Sexual Health and Drug Use Prevention for Black Girls (The Dreamer Girls Project): Protocol for an Intervention Development. JMIR Res Protoc 2023; 12:e45007. [PMID: 37556188 PMCID: PMC10448282 DOI: 10.2196/45007] [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: 12/12/2022] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Substance use among adolescent girls is associated with numerous risk characteristics, including engaging in sexual risk behaviors, which can lead to HIV and sexually transmitted infection (STI) diagnoses. This is an important phenomenon to target as there is a significant race-gendered paradox that occurs when Black girls use and misuse drugs. When misuse occurs among this group, they are more likely to face harsher consequences and worse health outcomes than boys and other ethnic-minority girls. Therefore, there is a need to understand the risk and protective factors of drug use and sexual risk behaviors among Black girls and develop a robust intervention that can cater for this group. OBJECTIVE We propose the development of a strengths-based prevention education intervention for Black girls between the ages of 13 and 18 years to promote protective factors. METHODS A sequential, mixed methods study will be conducted, and we will use the first 3 steps of the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework to begin the development of the intervention. Three aims will be described in this protocol. First, aim 1 is to explore sociocultural risk and protective factors among Black girls between the ages 13 and 18 years in drug use and HIV/STI prevention using focus group methodology and surveys. We will conduct at least 10 focus groups to include up to 75 Black girls or until we reach saturation. Our target sample size for the quantitative portion of the study will be 200 participants. Aim 2 will focus on deciding upon an intervention based on findings from aim 1 and forming a youth advisory board to guide intervention development. Aim 3 will be to conduct a pretest of the intervention with the youth advisory board to determine if the intervention is feasible and will be accepted by Black girls. RESULTS The study is part of a 2-year research pilot study award from the National Institutes of Mental Health. Data collection for this study began in October 2021. For aim 1, data collection is 95% complete. We expect to complete all data collection for aim 1 on or before May 30, 2023. Study activities for aim 2 are occurring simultaneously as data are being collected and analyzed and will be completed in the summer of 2023. Study activities for aim 3 will begin in the fall of 2023. CONCLUSIONS This study will be one of the few interventions that address both sexual health and drug use together and cater to Black girls. We anticipate that the intervention will be beneficial for Black girls across the nation to work on building culturally appropriate prevention education and building peer social supports, resulting in reduction or delayed substance use and improved sexual health. TRIAL REGISTRATION ClinicalTrials.gov NCT05014074; https://clinicaltrials.gov/ct2/show/NCT05014074. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45007.
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Affiliation(s)
- Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Cora Gabriel
- Yale School of Public Health, New Haven, CT, United States
| | | | - Keosha Bond
- City University of New York School of Medicine, New York, NY, United States
| | - Ashley V Hill
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Courtnae Alves
- Columbia University School of Public Health, New York, NY, United States
| | - Trace Kershaw
- Yale School of Public Health, New Haven, CT, United States
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Le D, Almaw RD, Rinaldi D, Ivanochko NK, Harris S, Benjamin A, Maly MR. Barriers and strategies for recruiting participants who identify as racial minorities in musculoskeletal health research: a scoping review. Front Public Health 2023; 11:1211520. [PMID: 37601207 PMCID: PMC10433765 DOI: 10.3389/fpubh.2023.1211520] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/20/2023] [Indexed: 08/22/2023] Open
Abstract
Objective Visible minorities are disproportionately affected by musculoskeletal disorders (MSD) and other diseases; yet are largely underrepresented in health research. The purpose of this scoping review was to identify barriers and strategies associated with increasing recruitment of visible minorities in MSD research. Methods Electronic databases (MEDLINE, EMBASE, CINAHL, and PsycInfo) were searched. Search strategies used terms related to the concepts of 'race/ethnicity', 'participation', 'research' and 'musculoskeletal'. All research designs were included. Two reviewers independently screened titles and abstracts, completed full-text reviews, and extracted data. Papers that did not focus on musculoskeletal research, include racial minorities, or focus on participation in research were excluded. Study characteristics (study location, design and methods; sample characteristics (size, age, sex and race); MSD of interest) as well as barriers and strategies to increasing participation of visible minorities in MSD research were extracted from each article and summarized in a table format. Results Of the 4,282 articles identified, 28 met inclusion criteria and were included. The majority were conducted in the United States (27 articles). Of the included studies, the groups of visible minorities represented were Black (25 articles), Hispanic (14 articles), Asian (6 articles), Indigenous (3 articles), Middle Eastern (1 article), and Multiracial (1 article). The most commonly cited barriers to research participation were mistrust, logistical barriers (e.g., transportation, inaccessible study location, financial constraints), and lack of awareness or understanding of research. Strategies for increasing diversity were ensuring benefit of participants, recruiting through sites serving the community of interest, and addressing logistical barriers. Conclusion Understanding the importance of diversity in MSD research, collaborating with communities of visible minorities, and addressing logistical barriers may be effective in reducing barriers to the participation of visible minorities in health research. This review presents strategies to aid researchers in increasing inclusion in MSD-related research.
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Affiliation(s)
- Denise Le
- Department of Biology, University of Waterloo, Waterloo, ON, Canada
| | - Rachel D. Almaw
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Daniel Rinaldi
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Natasha K. Ivanochko
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sheereen Harris
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Ashley Benjamin
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada
| | - Monica R. Maly
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Stegman MM, Lucarelli-Baldwin E, Ural SH. Disparities in high risk prenatal care adherence along racial and ethnic lines. Front Glob Womens Health 2023; 4:1151362. [PMID: 37560034 PMCID: PMC10407102 DOI: 10.3389/fgwh.2023.1151362] [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: 01/26/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
The term "high-risk pregnancy" describes a pregnancy at increased risk for complications due to various maternal or fetal medical, surgical, and/or anatomic issues. In order to best protect the pregnant patient and the fetus, frequent prenatal visits and monitoring are often recommended. Unfortunately, some patients are unable to attend these appointments for various reasons. Moreover, it has been documented that patients from ethnically and racially diverse backgrounds are more likely to miss medical appointments than are Caucasian patients. For instance, a case-control study retrospectively identified the race/ethnicity of patients who no-showed for mammography visits in 2018. Women who no-showed were more likely to be African American than patients who kept their appointments, with an odds ratio of 2.64 (4). Several other studies from several other primary care and specialty disciplines have shown similar results. However, the current research on high-risk obstetric no-shows has focused primarily on why patients miss their appointments rather than which patients are missing appointments. This is an area of opportunity for further research. Given disparities in health outcomes among underrepresented racial/ethnic groups and the importance of prenatal care, especially in high-risk populations, targeted attempts to increase patient participation in prenatal care may improve maternal and infant morbidity/mortality in these populations.
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Affiliation(s)
- Molly M Stegman
- College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Elizabeth Lucarelli-Baldwin
- Department of Obstetrics and Gynecology, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | - Serdar H Ural
- Department of Obstetrics and Gynecology, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
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Torres TS, Silva MST, Coutinho C, Hoagland B, Jalil EM, Cardoso SW, Moreira J, Magalhaes MA, Luz PM, Veloso VG, Grinsztejn B. Evaluation of Mpox Knowledge, Stigma, and Willingness to Vaccinate for Mpox: Cross-Sectional Web-Based Survey Among Sexual and Gender Minorities. JMIR Public Health Surveill 2023; 9:e46489. [PMID: 37459174 PMCID: PMC10411424 DOI: 10.2196/46489] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The 2022 multicountry mpox outbreak positioned the condition as a public health emergency of international concern. By May 2023, Brazil ranked second globally in the cumulative number of mpox cases and deaths. The higher incidence of mpox among gay and other men who have sex with men in the current mpox outbreak deepens the stigma and discrimination against sexual and gender minorities (SGM). This might worsen the structural barriers impacting access to health services, which ultimately leads to undertesting and underreporting of cases. There are no data available on mpox knowledge and stigma in Latin America. OBJECTIVE We aimed to evaluate mpox knowledge, stigma, and willingness to vaccinate for mpox among SGM, and to describe sociodemographic and behavioral characteristics according to self-reported mpox diagnosis. METHODS A cross-sectional, internet-based survey was conducted in a convenience sample of adults (aged >18 years) living in Brazil recruited through advertisements on dating apps, social media, referral institutions for infectious diseases websites, and mass media (October-November 2022). We compared participants' characteristics according to self-reported mpox diagnosis using chi-square test or Fisher exact test for qualitative variables and Kruskal-Wallis test for quantitative variables. RESULTS We enrolled 6236 participants: 5685 (91.2%) were cisgender men; 6032 (96.7%) were gay, bisexual, or pansexual; 3877 (62.2%) were White; 4902 (78.7%) had tertiary education; and 4070 (65.2%) reported low or middle income. Most participants (n=5258, 84.4%) agreed or strongly agreed that "LGBTQIA+ individuals are being discriminated and stigmatized due to mpox." Mpox awareness was 96.9% (n=6044), and 5008 (95.1%) were willing to get vaccinated for mpox. Overall, 324 (5.2%) reported an mpox diagnosis. Among these, 318 (98.1%) reported lesions, 178 (56%) local pain, and 316 (99.4%) sought health care. Among participants not reporting a diagnosis, 288 (4.9%) had a suspicious lesion, but only 158 (54.9%) of these had sought health care. Compared to participants with no diagnosis, those reporting an mpox diagnosis were younger (P<.001), reported more sex partners (P<.001), and changes in sexual behavior after mpox onset (P=.002). Moreover, participants diagnosed with mpox reported more frequently being tested for HIV in the prior 3 months (P<.001), living with HIV (P<.001), currently using HIV pre-exposure prophylaxis (P<.001), and previous sexually transmitted infection diagnosis (P<.001). CONCLUSIONS Our results point to high mpox knowledge and willingness to vaccinate among SGM in Brazil. Participants self-reporting mpox diagnosis more frequently reported to be living with HIV, STI diagnosis, and current pre-exposure prophylaxis use, highlighting the importance of an mpox assessment that includes comprehensive sexual health screenings. Efforts to decrease stigma related to mpox among SGM are necessary to avoid mpox underdiagnosis.
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Affiliation(s)
- Thiago Silva Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Carolina Coutinho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Brenda Hoagland
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Emilia Moreira Jalil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandra Wagner Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Monica Avelar Magalhaes
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (ICICT-Fiocruz), Rio de Janeiro, Brazil
| | - Paula Mendes Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Valdilea G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Abdul Latip SNB, Chen SE, Im YR, Zielinska AP, Pawa N. Systematic review of randomised controlled trials on interventions aimed at promoting colorectal cancer screening amongst ethnic minorities. Ethn Health 2023; 28:661-695. [PMID: 36352539 DOI: 10.1080/13557858.2022.2139815] [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] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 10/16/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Significant disparities exist between different ethnic groups when it comes to participation in colorectal cancer (CRC) screening programmes. A variety of interventions have been proposed to improve participation rates of ethnic minorities for CRC screening. This systematic review aims to appraise the evidence available from published randomised controlled trials (RCTs) and to identify effective interventions aimed at promoting CRC screening amongst underserved ethnic minorities. DESIGN We searched EmBASE, Medline, PsychInfo, Scopus and CINAHL for RCTs that analysed interventions to promote CRC screening in all ethnic minorities. CRC screening was measured as documented or self-reported screening rates. The protocol of this study was registered prospectively on PROSPERO with the registration number CRD42020216384. RESULTS We identified 42 relevant RCT articles, out of 1805 articles highlighted by the initial search. All except one were conducted in the US. The most frequently studied ethnic groups were African-Americans (33%), East Asians (30%), and Hispanics/Latinos (23%). In total, 7/42 (16%) RCTs had multiple arms. Interventions mainly intended to educate (52%), provide patient navigation services (21%), or provide a combination of these interventions (19%). We demonstrate that combination methods are most effective. CONCLUSION Many RCTs, mostly in the US, have trialed interventions aimed to increase CRC screening uptake amongst ethnic minorities to varying success. We conclude that using a combination of methods with patient navigation, education, and cultural tailoring is most effective at increasing CRC screening uptake amongst ethnic minorities. This highlights that multiple factors may hinder CRC screening and finding a one-size-fits-all solution that can be reliably implemented among different cultures and countries may be complex.
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Affiliation(s)
- Siti Nadiah Binte Abdul Latip
- Department of Colorectal Surgery, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Isleworth, UK
| | | | - Yu Ri Im
- Department of Colorectal Surgery, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Isleworth, UK
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Agata P Zielinska
- Department of Colorectal Surgery, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Isleworth, UK
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Nikhil Pawa
- Department of Colorectal Surgery, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Isleworth, UK
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Shukla M, Crew A, Wu A, Riddleston L, Hutchinson T, Kumari V, Hughes LD, Lau JYF. Self-Reported Worries in Young People During the COVID-19 Pandemic. Cognit Ther Res 2023; 47:1-12. [PMID: 37363750 PMCID: PMC10238236 DOI: 10.1007/s10608-023-10396-3] [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] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
Purpose COVID-19 pandemic has had long-standing consequences for all aspects of life. Although young people appear less susceptible to severe forms of physical illness due to the coronavirus, they have not escaped unscathed from its' psychological impacts. The present study measured the content of worries in young people residing in the UK during the pandemic and how it varied with sociodemographic factors. Methods Between May and December 2020, UK-residing participants aged 12-25 years completed an online survey that presented participants with free-text fields to describe their top three worries over the last two weeks, in addition to demographic and other information. Cross-sectional data from 2560 participants (Males = 767; Female = 1793) was analyzed. Results Irrespective of sociodemographic, a majority of the participants reported worries related to academics, followed by social relationships, own physical health, social and work routines, and physical health of others. Significantly more females reported concerns about academics, finances, physical health, social and work routines, social relationships, mental health and emotions, and physical health of others. Expectedly, more older (18-25 years) than younger (12-17 years) participants reported concerns about career-prospects and finances, while more younger than older ones were worried about academics (98.41% vs. 80.90%). With respect to financial worries, a higher percentage of BAME (Black, Asian and Minority Ethnic) communities in the UK reported such worries. Ethnicity significantly predicted more worries about social relationships among White than BAME participants. Significant differences also existed across different SES groups regarding endorsement of a particular category of worry. Conclusion These findings highlight the need for tailored interventions depending on the major concerns for young people of different ages, sexes, ethnicities, and SES. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-023-10396-3.
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Affiliation(s)
- Meenakshi Shukla
- Department of Psychology, University of Allahabad, Prayagraj, 211002 India
| | - Amelia Crew
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Alison Wu
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Laura Riddleston
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Taryn Hutchinson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Veena Kumari
- Centre for Cognitive Neuroscience, Brunel University London, Uxbridge, UK
| | - Lyndsay D. Hughes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jennifer Y. F. Lau
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Youth Resilience Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Li X, Roy S, Damonte J, Park HY, Hoogland AI, Jamison K, Komrokji KR, Yeo CD, Kim Y, Dhillon J, Gudenkauf LM, Oswald LB, Jim HS, Yamoah K, Pow-Sang JM, Kanetsky PA, Gwede CK, Park JY, Gonzalez BD. Recruiting African American Prostate Cancer Survivors for a Population-based Biobank Study. Cancer Epidemiol Biomarkers Prev 2023; 32:768-775. [PMID: 36958853 PMCID: PMC10308568 DOI: 10.1158/1055-9965.epi-22-1157] [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: 11/01/2022] [Revised: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Prostate cancer affects African American men disproportionately compared with men of other racial/ethnic groups. To identify biological bases for this health disparity, we sought to create a state-wide biobank of African American prostate cancer survivors in Florida. METHODS African American men diagnosed with prostate cancer between 2013 and 2017 and living in Florida at diagnosis were identified through the State of Florida's cancer registry. Individuals were approached via mail and telephone, assessed for eligibility, and asked for informed consent. χ2 and t tests were conducted to identify differences between eligible and reachable individuals (i.e., had valid contact information) versus consented participants. RESULTS Of the 5,960 eligible and reachable individuals, 3,904 were eligible and contacted at least once, and 578 consented [overall consent rate = 10% (578/5,960); adjusted consent rate = 15% (578/3,904)]. Statistically significant (Ps < 0.05) but small differences in demographic and clinical variables were observed. Consented participants were less likely to be older than 64 (35% vs. 41%) and less likely to have received radiotherapy (36% vs. 41%) and hormone therapy (16% vs. 21%), but more likely to have regional prostate cancer (13% vs. 11%) and have undergone surgery (44% vs. 39%). Consented participants did not differ from reachable individuals on other demographic and clinical factors (Ps > 0.05). CONCLUSIONS Recruiting African American prostate cancer survivors to biobanking research through a cancer registry is feasible. However, the consent rate was low, and existing challenges limit consent and participation. IMPACT Strategies for overcoming barriers to informed consent and increasing participation in biospecimen research are needed to address cancer disparities.
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Affiliation(s)
- Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Siddhartha Roy
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
| | - Jennifer Damonte
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Hyun Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Kala Jamison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Khaled R. Komrokji
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Chang Dong Yeo
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | | | - Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Kosj Yamoah
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL
| | - Julio M. Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | | | - Clement K. Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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Zengeni M, Briggs NN. The Prevalence of COVID-19 Vaccine Hesitancy Among the Black Asian Ethnic Minority in New South Wales, Australia. Cureus 2023; 15:e40626. [PMID: 37350977 PMCID: PMC10284598 DOI: 10.7759/cureus.40626] [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] [Accepted: 06/18/2023] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION Vaccination provides a cost-effective approach to controlling the COVID-19 pandemic. The success of vaccination depends on global preparedness and acceptance of the new vaccines, and this is threatened by vaccine hesitancy worldwide. This study aimed to measure the prevalence of COVID-19 vaccine hesitancy, attitudes, and contributing factors in the Black Asian Ethnic Minority (BAME) of New South Wales (NSW), Australia. Aim: This study aimed to measure the prevalence of COVID-19 vaccine hesitancy and identify contributing factors leading to vaccine hesitancy in the Black Asian and Ethnic Minority (BAME) in NSW. METHOD A cross-sectional study was conducted among the BAME community in NSW; over 12 weeks, from January 3rd, 2022, to March 28th, 2022. The study used the pre-existing previously known 5Cs model (confidence, constraints, complacency, calculation, and collective responsibility) to assess reasons for hesitancy. The questionnaire was distributed in English using social media platforms: Facebook and WhatsApp. RESULTS The study received 101 respondents over 18 years from all states in Australia from BAME communities, males and females, with different educational levels, employment sectors, marital statuses, co-existing chronic medical conditions, previous COVID-19 infection status, and COVID-19 vaccine received. Of these, 56 respondents were from NSW. Our findings revealed a high prevalence of COVID-19 vaccine hesitancy among the BAME community in NSW, with 72.8% of respondents demonstrating hesitancy/reluctance due to various attitudes identified by the 5Cs model. Despite this high hesitancy, 98.2% of the participants had received at least one to three vaccine doses. CONCLUSION Even in populations with high vaccine uptake, it is still essential to address vaccine hesitancy and provide ongoing education about the importance of vaccination, particularly as new variants of COVID-19 continue to emerge and the need for booster shots may arise. This can help ensure continued protection against the virus and prevent future outbreaks.
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Affiliation(s)
- Mercy Zengeni
- Medicine, Oceania University of Medicine, Brisbane, AUS
| | - Naomi N Briggs
- Emergency Medicine, Sunshine Coast University Hospital, Sunshine Coast, AUS
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Meador JE, James W, Branson J, Bennett J, Matthews K. COVID-19 pandemic and the social determinants of health. Front Epidemiol 2023; 3:1139371. [PMID: 38516332 PMCID: PMC10956357 DOI: 10.3389/fepid.2023.1139371] [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] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/19/2023] [Indexed: 03/23/2024]
Abstract
Hesitancy to receive a COVID-19 vaccination across sub-groups within the US population contributed to higher illness rates and deaths. Specifically, minority groups and those living in rural and remote areas are more vaccine-hesitant populations known to suffer from higher disparities in health. Identifying successful and replicable approaches to promoting vaccination within these subpopulations is critical to ensuring vaccination rates can be maximized in these vulnerable groups. In this paper, we present findings from the Mississippi Recognizing Important Vaccine & Education Resources (RIVERs) project, a multi-state effort to spread accurate information related to COVID-19 vaccinations using a variety of community and media-based methods as well as provide vaccinations. Vaccination rates for Black people in Mississippi exceeded those of White people, likely due to the concerted effort of regional health and community organizations. Propensity score matching is performed to test intervention styles using spatial and temporal data related to approximately 7,000 events across Mississippi and parts of Tennessee and publicly available data on vaccination rates and socio-economic data. We demonstrate that vaccination rates within the vulnerable groups may be closely related to misinformation being spread through local social networks and that interventions carried out by local leaders with high levels of local social capital are best at quashing misinformation at the local level. We recommend that policymakers consider the importance of local efforts as an effective tool in increasing vaccination rates in future pandemics.
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Affiliation(s)
| | - Wesley James
- Center for Community Research and Evaluation, University of Memphis, Memphis, TN, United States
| | - Joseph Branson
- Center for Community Research and Evaluation, University of Memphis, Memphis, TN, United States
| | - Jonathan Bennett
- Center for Community Research and Evaluation, University of Memphis, Memphis, TN, United States
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Lee SJC, Lee J, Zhu H, Chen PM, Wahid U, Hamann HA, Bhalla S, Cardenas RC, Natchimuthu VS, Johnson DH, Santini NO, Patel HR, Gerber DE. Assessing Barriers and Facilitators to Lung Cancer Screening: Initial Findings from a Patient Navigation Intervention. Popul Health Manag 2023. [PMID: 37219548 DOI: 10.1089/pop.2023.0053] [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] [Indexed: 05/24/2023] Open
Abstract
Low-dose computed tomography-based lung cancer screening represents a complex clinical undertaking that could require multiple referrals, appointments, and time-intensive procedures. These steps may pose difficulties and raise concerns among patients, particularly minority, under-, and uninsured populations. The authors implemented patient navigation to identify and address these challenges. They conducted a pragmatic randomized controlled trial of telephone-based navigation for lung cancer screening in an integrated, urban safety-net health care system. Following standardized protocols, bilingual (Spanish and English) navigators educated, motivated, and empowered patients to traverse the health system. Navigators made systematic contact with patients, recording standardized call characteristics in a study-specific database. Call type, duration, and content were recorded. Univariable and multivariable multinomial logistic regression was performed to investigate associations between call characteristics and reported barriers. Among 225 patients (mean age 63 years, 46% female, 70% racial/ethnic minority) assigned navigation, a total of 559 barriers to screening were identified during 806 telephone calls. The most common barrier categories were personal (46%), provider (30%), and practical (17%). System (6%) and psychosocial (1%) barriers were described by English-speaking patients, but not by Spanish-speaking patients. Over the course of the lung cancer screening process, provider-related barriers decreased 80% (P = 0.008). The authors conclude that patients undergoing lung cancer screening frequently report personal and health care provider-related barriers to successful participation. Barrier types may differ among patient populations and over the course of the screening process. Further understanding of these concerns may increase screening uptake and adherence. Clinical Trial Registration number: (NCT02758054).
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Affiliation(s)
- Simon J Craddock Lee
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jessica Lee
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Hong Zhu
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Patricia M Chen
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Urooj Wahid
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Heidi A Hamann
- Departments of Psychology and Family and Community Medicine, University of Arizona, Tucson, Arizona, USA
| | - Sheena Bhalla
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Rodrigo Catalan Cardenas
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - David H Johnson
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Noel O Santini
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
- Parkland Health, Dallas, Texas, USA
| | - Himani R Patel
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
| | - David E Gerber
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA
- Parkland Health, Dallas, Texas, USA
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Williams C, Shang D. Telehealth Usage Among Low-Income Racial and Ethnic Minority Populations During the COVID-19 Pandemic: Retrospective Observational Study. J Med Internet Res 2023; 25:e43604. [PMID: 37171848 PMCID: PMC10185335 DOI: 10.2196/43604] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 10/18/2022] [Revised: 03/07/2023] [Accepted: 04/30/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Despite considerable efforts to encourage telehealth use during the COVID-19 pandemic, we witnessed a potential widening of health inequities that may continue to plague the US health care system unless we mitigate modifiable risk factors. OBJECTIVE This study aimed to examine the hypothesis that there are systemic differences in telehealth usage among people who live at or below 200% of the federal poverty level. Factors that we consider are age, gender, race, ethnicity, education, employment status, household size, and income. METHODS A retrospective observational study was performed using the COVID-19 Research Database to analyze factors contributing to telehealth inequities. The study period ranged from March 2020 to April 2021. The Office Ally database provided US claims data from 100 million unique patients and 3.4 billion claims. The Analytics IQ PeopleCore Consumer database is nationally representative of 242.5 million US adults aged 19 years and older. We analyzed medical claims to investigate the influence of demographic and socioeconomic factors on telehealth usage among the low-income racial and ethnic minority populations. We conducted a multiple logistic regression analysis to determine the odds of patients in diverse groups using telehealth during the study period. RESULTS Among 2,850,831 unique patients, nearly 60% of them were female, 75% of them had a high school education or less, 49% of them were unemployed, and 62% of them identified as non-Hispanic White. Our results suggest that 9.84% of the patients had ≥1 telehealth claims during the study period. Asian (odds ratio [OR] 1.569, 95% CI 1.528-1.611, P<.001) and Hispanic (OR 1.612, 95% CI 1.596-1.628, P<.001) patients were more likely to use telehealth than non-Hispanic White and -Black patients. Patients who were employed full-time were 15% (OR 1.148, 95% CI 1.133-1.164, P<.001) more likely to use telehealth than unemployed patients. Patients who identified as male were 12% (OR 0.875, 95% CI 0.867-0.883, P<.001) less likely to use telehealth than those who identified as female. Patients with high school education or less were 5% (OR 0.953, 95% CI 0.944-0.962, P<.001) less likely to use telehealth than those with a bachelor's degree or higher. Patients in the 18-44-year age group were 32% (OR 1.324, 95% CI 1.304-1.345, P<.001) more likely to use telehealth than those in the ≥65-year age group. CONCLUSIONS Factors that impact telehealth usage include age, gender, race, education, employment status, and income. While low-income racial and ethnic minority communities are at greater risk for health inequities among this group, Hispanic communities are more likely to use telehealth, and non-Hispanic Black patients continue to demonstrate telehealth inequity. Gender, age, and household income contribute to health inequities across gradients of poverty. Strategies to improve health use should consider characteristics of subgroups, as people do not experience poverty equally.
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Affiliation(s)
- Cynthia Williams
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, United States
| | - Di Shang
- Department of Management, University of North Florida, Jacksonville, FL, United States
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Dorsey C, Arora VM, Carter K. Fixing Flexner: Disrupting and Rebuilding Academic Medicine for Women of Color to Lead. J Med Internet Res 2023; 25:e47773. [PMID: 37163317 DOI: 10.2196/47773] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
In an effort to address the lack of compositional diversity seen in academic leadership, our generation has an opportunity to rebuild academic medicine in a way that welcomes, values, and supports the development and success of women of color.
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Affiliation(s)
- Chelsea Dorsey
- Department of Surgery, University of Chicago Medicine, Chicago, IL, United States
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Vineet M Arora
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
- Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
| | - Keme Carter
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
- Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
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Henson C, Chapman F, Shepherd G, Carlson B, Rambaldini B, Gwynne K. How Older Indigenous Women Living in High-Income Countries Use Digital Health Technology: Systematic Review. J Med Internet Res 2023; 25:e41984. [PMID: 37071466 PMCID: PMC10155089 DOI: 10.2196/41984] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/21/2022] [Accepted: 03/15/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Research associated with digital health technologies similar to the technologies themselves has proliferated in the last 2 decades. There are calls for these technologies to provide cost-effective health care for underserved populations. However, the research community has also underserved many of these populations. Older Indigenous women are one such segment of the population. OBJECTIVE Our objective is to systematically review the literature to consolidate and document what we know about how older Indigenous women living in high-income countries use digital health technology to enhance their health. METHODS We analyzed the peer-reviewed literature by systematically searching 8 databases in March 2022. We included studies published between January 2006 and March 2022 with original data specific to older Indigenous women from high-income countries that reported on the effectiveness, acceptability, and usability of some user-focused digital health technology. We incorporated 2 measures of quality for each study. We also conducted a thematic analysis and a lived experience analysis, which examined each paper from the perspectives of older Indigenous women. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in this study. RESULTS Three papers met the inclusion criteria. The key findings were that older Indigenous women do not see themselves reflected in mainstream health messaging or other digital health offerings. They prefer an approach that considers their uniqueness and diversity. We also identified 2 significant gaps in the literature. First, research reporting on older Indigenous women from high-income countries' experiences with digital health technology is minimal. Second, the limited research related to older Indigenous women has not consistently engaged Indigenous people in the research process or governance. CONCLUSIONS Older Indigenous women want digital health technologies to respond to their needs and preferences. Research is needed to understand their requirements and preferences to ensure equity as we move toward greater adoption of digital health technology. Engaging older Indigenous women throughout the research is essential to ensuring that digital health products and services are safe, usable, effective, and acceptable for older Indigenous women.
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Affiliation(s)
- Connie Henson
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Djurali Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Sydney, Australia
| | - Felicity Chapman
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Gina Shepherd
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Bronwyn Carlson
- Centre for Global Indigenous Futures, Macquarie University, Sydney, Australia
- Department of Indigenous Studies, Faculty of Arts, Macquarie University, Sydney, Australia
| | - Boe Rambaldini
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Djurali Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Sydney, Australia
| | - Kylie Gwynne
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Djurali Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Sydney, Australia
- Centre for Global Indigenous Futures, Macquarie University, Sydney, Australia
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Hong YA, Shen K, Han HR, Ta Park V, Bagchi P, Lu HK, Chen H, Wang JHY. A WeChat-based Intervention, Wellness Enhancement for Caregivers (WECARE), for Chinese American Dementia Caregivers: Pilot Assessment of Feasibility, Acceptability, and Preliminary Efficacy. JMIR Aging 2023; 6:e42972. [PMID: 37018042 PMCID: PMC10131589 DOI: 10.2196/42972] [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: 09/26/2022] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Chinese American family caregivers of persons with dementia experience high rates of psychosocial distress and adverse health outcomes. Due to their immigrant and minority status, they face substantial obstacles to care and support, including stigma and misperception of dementia, limited knowledge and use of welfare and services, and poor social support. Few interventions have been developed or tested for this vulnerable population. OBJECTIVE This study aims to pilot-test the Wellness Enhancement for Caregivers (WECARE) intervention, a culturally tailored program delivered via WeChat, a social media app highly popular in the Chinese population. The 7-week WECARE was designed specifically for Chinese American dementia caregivers to improve their caregiving skills, reduce stress, and enhance psychosocial well-being. Feasibility, acceptability, and preliminary efficacy of the WECARE were assessed in this pilot. METHODS A total of 24 Chinese American family caregivers of persons with dementia were recruited for a pre-post 1-arm trial of the WECARE. By subscribing to the WECARE official account, participants received interactive multimedia programs on their WeChat account multiple times a week for 7 weeks. A backend database automatically delivered program components and tracked user activities. Three online group meetings were organized to facilitate social networking. Participants completed a baseline and a follow-up survey. Feasibility was assessed by the follow-up rate and curriculum completion rate; acceptability was assessed by user satisfaction and perceived usefulness of the program; and efficacy was assessed with pre-post differences in 2 primary outcomes of depressive symptoms and caregiving burden. RESULTS The intervention was completed by 23 participants with a retention rate of 96%. Most of them (n=20, 83%) were older than 50 years and the majority (n=17, 71%) were female. The backend database revealed that the mean curriculum completion rate was 67%. Participants also reported high rates of user satisfaction and perceived usefulness of the intervention and high ratings of weekly programs. The intervention led to significant improvement in participants' psychosocial health outcomes; their depressive symptoms reduced from 5.74 to 3.35 with an effect size of -0.89 and caregiving burden decreased from 25.78 to 21.96 with an effect size of -0.48. CONCLUSIONS This pilot study suggests that WeChat-based WECARE intervention was feasible and acceptable; it also demonstrated initial efficacy in improving psychosocial well-being in Chinese American dementia caregivers. Further research with a control group is needed to assess its efficacy and effectiveness. The study highlights the need for more culturally appropriate mobile health interventions for Chinese American family caregivers of persons with dementia.
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Affiliation(s)
- Y Alicia Hong
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, VA, United States
| | - Kang Shen
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, VA, United States
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Van Ta Park
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Pramita Bagchi
- Department of Statistics, George Mason University, Fairfax, VA, United States
| | - Huixing Kate Lu
- Chinese Culture and Community Service Center, Inc, Gaithersburg, MD, United States
| | - Hsiaoyin Chen
- Chinese Culture and Community Service Center, Inc, Gaithersburg, MD, United States
| | - Judy Huei-Yu Wang
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
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Dahak S, Fernandez JM, Rosman IS. Funded dermatology visiting elective rotations for medical students who are underrepresented in medicine: A cross-sectional analysis. J Am Acad Dermatol 2023; 88:941-943. [PMID: 36396000 DOI: 10.1016/j.jaad.2022.11.018] [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: 09/21/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Sabrina Dahak
- University of Arizona College of Medicine - Phoenix, Phoenix, Arizona
| | - Jennifer M Fernandez
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Ilana S Rosman
- Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri.
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48
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Zvolensky MJ, Shepherd JM, Clausen BK, Kabel KE, Kauffman BY, Garey L, McGrew SJ, Vujanovic AA. Anxiety Sensitivity Among Trauma-Exposed Non-Hispanic Black Adults: Relations to Posttraumatic Stress. J Nerv Ment Dis 2023; 211:273-280. [PMID: 36252272 PMCID: PMC10049966 DOI: 10.1097/nmd.0000000000001609] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The non-Hispanic Black population experiences trauma-related disparities. One potentially important individual difference construct for posttraumatic stress is anxiety sensitivity. There is limited work on anxiety sensitivity among non-Hispanic Black persons, and no research has focused on this construct in terms of posttraumatic stress among this population. This study sought to build on this limited knowledge by exploring whether this construct was uniquely associated with more severe posttraumatic stress among this population. Participants included non-Hispanic Black trauma-exposed adults ( N = 121; Mage = 21.79 years). Results indicated that anxiety sensitivity was related to more severe overall posttraumatic stress and greater severity of each posttraumatic stress symptom cluster; all effects were evident after adjusting for the variance accounted for by age, sex, education, subjective social status, neuroticism, and number of traumatic event types experienced (lifetime). The study provides the first empirical evidence that, among a trauma-exposed non-Hispanic Black sample of adults, anxiety sensitivity is related to more severe posttraumatic stress symptoms. This intraindividual difference factor could be a focus of intervention programming for this trauma disparity population.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | | | - Bryce K. Clausen
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Shelby J. McGrew
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
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Young K, Collis RW, Sheinbein D, Shope C, Suresh T, Tam I, Snyder A, Cotton C, Hunt R, Goldenberg A, Goldminz A, Lugo-Somolinos A, Grisham E, Martin KL, Sandhu M, Eichenfield D, Sprague J, Kleinman E, Sum K, Chen JK, Teng J, Aquino MR, Plante J, Franca K, Onate A, Udrizar P, Liszewski W, Yu J. Retrospective review of pediatric patch testing results in skin of color. J Am Acad Dermatol 2023; 88:953-954. [PMID: 36427663 DOI: 10.1016/j.jaad.2022.11.031] [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: 05/16/2022] [Revised: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022]
Affiliation(s)
| | - Reid W Collis
- Washington University School of Medicine, St. Louis, Missouri
| | - David Sheinbein
- Washington University School of Medicine, St. Louis, Missouri
| | - Chelsea Shope
- Medical University of South Carolina, Charleston, South Carolina
| | - Tara Suresh
- Washington University School of Medicine, St. Louis, Missouri
| | - Idy Tam
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Alan Snyder
- Medical University of South Carolina, Charleston, South Carolina
| | - Colleen Cotton
- Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina
| | - Raegan Hunt
- Department of Dermatology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Alina Goldenberg
- Dermatologist Medical Group of North County, San Diego, California
| | - Ari Goldminz
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Chestnut Hill, Massachusetts
| | - Aida Lugo-Somolinos
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eric Grisham
- University of Missouri School of Medicine, Columbia, Missouri; Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Kari L Martin
- Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri
| | - Mandeep Sandhu
- University of Missouri School of Medicine, Columbia, Missouri
| | - Dawn Eichenfield
- Department of Dermatology, University of California San Diego School of Medicine, La Jolla, California; Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California
| | - Jessica Sprague
- Department of Dermatology, University of California San Diego School of Medicine, La Jolla, California; Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California
| | - Elana Kleinman
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California
| | - Katie Sum
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Jennifer K Chen
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Joyce Teng
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Marcella R Aquino
- Department of Pediatrics, Division of Allergy and Immunology, Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - John Plante
- Medical University of South Carolina, Charleston, South Carolina
| | - Katlein Franca
- Dr Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alejandra Onate
- Department of Dermatology, Feinberg School of Medicine Northwestern University, Chicago, Illinois
| | - Patricia Udrizar
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Walter Liszewski
- Department of Dermatology, Feinberg School of Medicine Northwestern University, Chicago, Illinois
| | - JiaDe Yu
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
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Meedsen P, Sathirapanya C. Developing and Implementing an Action Plan among the "Orang Asali" Minority in Southernmost Thailand for Equitable Accessibility to Public Health Care and Public Services Following the United Nations Sustainable Development Goals. Int J Environ Res Public Health 2023; 20:5018. [PMID: 36981928 PMCID: PMC10049293 DOI: 10.3390/ijerph20065018] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Ending social inequality by 2030 is a goal of the United Nations' endorsed sustainable development agenda. Minority or marginalized people are susceptible to social inequality. This action research qualitatively evaluated the requirements for and barriers to full access to public services of the Orang Asali (OA), a minority people living in the Narathiwas province in southernmost Thailand. With the cooperation of the staff of the Southern Border Provinces Administrative Center (SBPAC), we interviewed the OA, local governmental officers and Thai community leaders regarding the OA's living conditions and health status. Then, an action plan was developed and implemented to raise their living standards with minimal disruption to their traditional cultural beliefs and lifestyle. For systematic follow-ups, a Thai nationality registration process was carried out before the assistance was provided. Living conditions and livelihood opportunities, health care and education were the main targets of the action plan. Universal health coverage (UHC), according to Thai health policy, was applied to OA for holistic health care. The OA were satisfied with the assistance provided to them. While filling the gap of social inequality for the OA is urgent, a balance between the modern and traditional living styles should be carefully considered.
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Affiliation(s)
- Praves Meedsen
- Institute for Development of Civil Officials in Southern Border Provinces, Southern Border Provinces Administrative Center, Meung, Yala 95000, Thailand
| | - Chutarat Sathirapanya
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
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