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Britez Ferrante E, Blady S, Sheu D, Maitra MR, Drakes J, Lieberman A, Mussell A, Bair EF, Hearn CM, Thorbecke L, Zhu J, Kohn R. Operationalizing Equity, Inclusion, and Access in Research Practice at a Large Academic Institution. J Gen Intern Med 2024; 39:1037-1047. [PMID: 38302812 DOI: 10.1007/s11606-023-08539-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/15/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Healthcare advances are hindered by underrepresentation in prospective research; sociodemographic, data, and measurement infidelity in retrospective research; and a paucity of guidelines surrounding equitable research practices. OBJECTIVE The Joint Research Practices Working Group was created in 2021 to develop and disseminate guidelines for the conduct of inclusive and equitable research. METHODS Volunteer faculty and staff from two research centers at the University of Pennsylvania initiated a multi-pronged approach to guideline development, including literature searches, center-level feedback, and mutual learning with local experts. RESULTS We developed guidelines for (1) participant payment and incentives; (2) language interpretation and translation; (3) plain language in research communications; (4) readability of study materials; and (5) inclusive language for scientific communications. Key recommendations include (1) offer cash payments and multiple payment options to participants when required actions are completed; (2) identify top languages of your target population, map points of contact, and determine available interpretation and translation resources; (3) assess reading levels of materials and simplify language, targeting 6th- to 8th-grade reading levels; (4) improve readability through text formatting and style, symbols, and visuals; and (5) use specific, humanizing terms as adjectives rather than nouns. CONCLUSIONS Diversity, inclusion, and access are critical values for research conduct that promotes justice and equity. These values can be operationalized through organizational commitment that combines bottom-up and top-down approaches and through partnerships across organizations that promote mutual learning and synergy. While our guidelines represent best practices at one time, we recognize that practices evolve and need to be evaluated continuously for accuracy and relevance. Our intention is to bring awareness to these critical topics and form a foundation for important conversations surrounding equitable and inclusive research practices.
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Affiliation(s)
- Emma Britez Ferrante
- Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, USA
| | - Shira Blady
- Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, USA
| | - Dorothy Sheu
- Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, USA
| | - Medha Romee Maitra
- Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, USA
- University of Georgia, Athens, GA, USA
| | - Josiah Drakes
- Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, USA
- Xavier University of Louisiana, New Orleans, LA, USA
| | - Adina Lieberman
- Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, USA
| | - Adam Mussell
- Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth F Bair
- Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Caleb M Hearn
- Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Leo Thorbecke
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, USA
- Center for Digital Health, Penn Medicine Center for Health Care Innovation, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jingsan Zhu
- Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel Kohn
- Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, PA, USA.
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
- Leonard Davis Institute of Health Economics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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Matthias MS, Daggy JK, Perkins AJ, Adams J, Bair MJ, Burgess DJ, Eliacin J, Flores P, Myers LJ, Menen T, Procento P, Rand KL, Salyers MP, Shanahan ML, Hirsh AT. Communication and activation in pain to enhance relationships and treat pain with equity (COOPERATE): a randomized clinical trial. Pain 2024; 165:365-375. [PMID: 37733487 DOI: 10.1097/j.pain.0000000000003021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/23/2023] [Indexed: 09/23/2023]
Abstract
ABSTRACT Racialized disparities in chronic pain care are well-documented and persist despite national priorities focused on health equity. Similar disparities have been observed in patient activation (ie, having the knowledge, confidence, and skills to manage one's health). As such, interventions targeting patient activation represent a novel approach to addressing and reducing disparities in pain care. Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity is a randomized controlled trial of a 6-session telephone-delivered intervention to increase patient activation for Black patients with chronic pain. Two hundred fifty Black patients from a Midwestern Veterans Affairs medical center were randomized to the intervention or attention control. The primary outcome was patient activation; secondary outcomes included communication self-efficacy, pain, and psychological functioning. Outcomes were assessed at baseline and at 3 (primary endpoint), 6, and 9 months (sustained effects). Analyses used an intent-to-treat approach. Compared with baseline, patient activation increased 4.6 points at 3 months (versus +0.13 in control group, 95% CI: 0.48, 7.34; P = 0.03). These improvements in the intervention group were sustained, with +7 from baseline at 6 months and +5.77 at 9 months, and remained statistically significant from the control group. Communication self-efficacy increased significantly relative to the control group from baseline to 3 months. Pain intensity and interference improved at 3 months, but differences were not significant after adjusting for multiple comparisons. Most other secondary outcomes improved, but group differences were not statistically significant after controlling for multiple comparisons. Results suggest that increasing patient activation is a potentially fruitful path toward improving pain management and achieving health equity.
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Affiliation(s)
- Marianne S Matthias
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States
- Regenstrief Institute, Indianapolis, IN, United States
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Joanne K Daggy
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Anthony J Perkins
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jasma Adams
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States
| | - Matthew J Bair
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States
- Regenstrief Institute, Indianapolis, IN, United States
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Diana J Burgess
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN, United States
| | - Johanne Eliacin
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States
- Regenstrief Institute, Indianapolis, IN, United States
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States
| | - Perla Flores
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States
| | - Laura J Myers
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States
- Regenstrief Institute, Indianapolis, IN, United States
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Tetla Menen
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States
| | - Philip Procento
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States
| | - Michelle P Salyers
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States
| | - Mackenzie L Shanahan
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States
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Coleman KJ, Rossom RC, Braciszewski JM, Padilla A, Li X, Waters HC, Penfold RB, Simon GE, Nau CL. Beyond clinical outcomes: Case control study of the role of race in disruptive life events for people with serious mental illness. Gen Hosp Psychiatry 2023; 85:80-86. [PMID: 37844540 DOI: 10.1016/j.genhosppsych.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE To understand how race and serious mental illness (SMI) interact for disruptive life events defined as financial (bankruptcy and judgement filings), and non-financial (arrests). METHODS Patients were adults with schizophrenia (SCZ; N = 16,159) or bipolar I disorder (BPI; N = 30,008) matched 1:1 to patients without SMI (non-SMI) from health systems in Michigan and Southern California during 1/1/2007 through 12/31/2018. The main exposure was self-reported race, and the outcome was disruptive life events aggregated by Transunion. We hypothesized that Black patients with SCZ or BPI would be the most likely to experience a disruptive life event when compared to Black patients without SMI, and all White or Asian patients regardless of mental illness. RESULTS Black patients with SCZ had the least likelihood (37% lower) and Asian patients with BPI had the greatest likelihood (2.25 times higher) of experiencing a financial disruptive life event among all patients in the study. There was no interaction of race with either SCZ or BPI for experiencing an arrest. The findings did not support our hypotheses for patients with SCZ and partially supported them for patients with BPI. CONCLUSIONS Clinical initiatives to assess social determinants of health should consider a focus on Asian patients with BPI.
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Affiliation(s)
- Karen J Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA.
| | | | | | - Ariadna Padilla
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Xia Li
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Heidi C Waters
- Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA
| | - Robert B Penfold
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Gregory E Simon
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Claudia L Nau
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
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Jones EJ, Marsland AL, Kraynak TE, Votruba-Drzal E, Gianaros PJ. Subjective Social Status and Longitudinal Changes in Systemic Inflammation. Ann Behav Med 2023; 57:951-964. [PMID: 37549189 PMCID: PMC10578390 DOI: 10.1093/abm/kaad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status. PURPOSE We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex. METHODS Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race. RESULTS Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (β = -0.06), hopelessness (β = -0.06), and depressive symptoms (β = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (β = -0.06), but was slightly attenuated after adjusting for hopelessness (β = -0.06) and depressive symptoms (β = -0.06). There were no associations for CRP or moderation by race or sex. CONCLUSIONS Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.
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Affiliation(s)
- Emily J Jones
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Thomas E Kraynak
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Sawin G, Klasson CL, Kaplan S, Larson Sawin J, Brown A, Thadaney Israni S, Schonberg J, Gregory A. Scoping Review of Restorative Justice in Academics and Medicine: A Powerful Tool for Justice Equity Diversity and Inclusion. Health Equity 2023; 7:663-675. [PMID: 37786530 PMCID: PMC10541936 DOI: 10.1089/heq.2023.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 10/04/2023] Open
Abstract
Purpose Restorative Justice (RJ) as a practice and mindset is growing within academic medicine and health care. The authors aim to categorize the extent to which RJ training and practices have been researched, explored, and applied within health care, medicine, and academic contexts. Methods In July 2021, the authors conducted a scoping literature review, searching four databases for peer-reviewed articles and book chapters discussing RJ. Authors also used bibliography searches and personal knowledge to add relevant work. Reviewers independently screened article titles and abstracts, assessing the full texts of potentially eligible articles with inclusion and exclusion criteria. From each included article, authors extracted the publication year, first author's country of origin, specific screening criteria met, and the depth with which it discussed RJ. Results From 599 articles screened, 39 articles, and books were included (published 2001-2021). Twenty-five (64%) articles discussed RJ theory with few describing application practices with substantial depth. Ten (26%) articles only referenced the term "restorative justice" and seven (18%) discussed legal applications in health care. Fifty-four percent were from outside the United States. Articles tended to describe RJ uses to address harm and often missed the opportunity to explore RJ's capacity to proactively build community and culture that helps prevent harm. Conclusions RJ in health care is a rapidly expanding field that offers a framework capable of building stronger communities, authentically preventing and responding to harm, inviting radical inclusion of diverse participants to build shared understanding and culture, and ameliorate some of the most toxic and unproductive hierarchical practices in academics and medicine. Most literature calls to RJ for help to respond to harm, although there are very few well-designed and evaluated implementations. Investment in RJ practices holds significant promise to steer our historically hierarchical, "othering" and imperfect systems to align with values of justice (vs. punishment), equity, diversity, and inclusion.
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Affiliation(s)
- Gregory Sawin
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Samantha Kaplan
- Duke University Medical Center Library and Archives, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jennifer Larson Sawin
- Independent Researcher and Restorative Justice Consultant, Durham, North Carolina, USA
| | - Ann Brown
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sonoo Thadaney Israni
- Stanford University School of Medicine, Stanford, California, USA
- Rx for RJ Initiative, University of San Diego, San Diego, California, USA
| | - Jessica Schonberg
- Office for Faculty, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ada Gregory
- Kenan Institute for Ethics, Duke University, Durham, North Carolina, USA
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Hampton-Anderson JN, Novacek DM, Zhen-Duan J, Latimer S, Perry T, Renard D. Redefining the Role of Public Health Professionals Serving Black Youths Seeking Mental Health Care: Implications for Training and Mentoring. Am J Public Health 2023; 113:S140-S148. [PMID: 37339410 PMCID: PMC10282850 DOI: 10.2105/ajph.2022.307194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 06/22/2023]
Abstract
Attrition rates for Black youths in mental health treatment settings are high, and the extant literature suggests this may be because treatment is not meeting their unique needs. Public health professionals, defined here as all individuals who work to increase the well-being of youths, can play a major role in changing these outcomes. The purpose of this article is to suggest a broader scope of practice, or a redefined role, for public health professionals who work with Black youths seeking outpatient mental health care and to explicate ways in which training and mentoring can help accomplish this goal. Bolstered by a socioecological conceptual model, we suggest 3 standards of practice that we believe must be satisfied to meet the requirement for this redefined public health professional role: using a sociocultural framework, exercising flexibility in one's assigned role, and understanding and incorporating culturally specific strengths and protective factors into care. (Am J Public Health. 2023;113(S2):S140-S148. https://doi.org/10.2105/AJPH.2022.307194).
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Affiliation(s)
- Joya N Hampton-Anderson
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Derek M Novacek
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Jenny Zhen-Duan
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Saundra Latimer
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Tyler Perry
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Destini Renard
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
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Gianaros PJ, Miller PL, Manuck SB, Kuan DCH, Rosso AL, Votruba-Drzal EE, Marsland AL. Beyond Neighborhood Disadvantage: Local Resources, Green Space, Pollution, and Crime as Residential Community Correlates of Cardiovascular Risk and Brain Morphology in Midlife Adults. Psychosom Med 2023; 85:378-388. [PMID: 37053093 PMCID: PMC10239348 DOI: 10.1097/psy.0000000000001199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Residing in communities characterized by socioeconomic disadvantage confers risk of cardiometabolic diseases. Residing in disadvantaged communities may also confer the risk of neurodegenerative brain changes via cardiometabolic pathways. This study tested whether features of communities-apart from conventional socioeconomic characteristics-relate not only to cardiometabolic risk but also to relative tissue reductions in the cerebral cortex and hippocampus. METHODS Participants were 699 adults aged 30 to 54 years (340 women; 22.5% non-White) whose addresses were geocoded to compute community indicators of socioeconomic disadvantage, as well as air and toxic chemical pollutant exposures, homicide rates, concentration of employment opportunities, land use (green space), and availability of supermarkets and local resources. Participants also underwent assessments of cortical and hippocampal volumes and cardiometabolic risk factors (adiposity, blood pressure, fasting glucose, and lipids). RESULTS Multilevel structural equation modeling demonstrated that cardiometabolic risk was associated with community disadvantage ( β = 0.10, 95% confidence interval [CI] = 0.01 to 0.18), as well as chemical pollution ( β = 0.11, 95% CI = 0.02 to 0.19), homicide rates ( β = 0.10, 95% CI = 0.01 to 0.18), employment opportunities ( β = -0.16, 95% CI = -0.27 to -0.04), and green space ( β = -0.12, 95% CI = -0.20 to -0.04). Moreover, cardiometabolic risk indirectly mediated the associations of several of these community features and brain tissue volumes. Some associations were nonlinear, and none were explained by participants' individual-level socioeconomic characteristics. CONCLUSIONS Features of communities other than conventional indicators of socioeconomic disadvantage may represent nonredundant correlates of cardiometabolic risk and brain tissue morphology in midlife.
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Affiliation(s)
- Peter J Gianaros
- From the Department of Psychology (Gianaros, Manuck, Votruba-Drza, Marsland) and Learning and Research Development Center (Miller, Votruba-Drza), University of Pittsburgh, Pittsburgh, Pennsylvania; Corning Incorporated (Kuan), Corning, New York; and Department of Epidemiology (Rosso), University of Pittsburgh, Pittsburgh, Pennsylvania
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Volpe VV, Hope EC, Mosley DV, Javidi H, Sosoo EE, Benson GP. How We Get Free: Graduate Training as an Opportunity for Equitable Participation and Liberation. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:428-444. [PMID: 36037403 DOI: 10.1177/17456916221096086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this conceptual article, we assert that psychology should be transformed to adopt the explicit goal of working toward the liberation of people oppressed by society rather than striving for mere equality. To achieve such a transformation, it is necessary to reenvision graduate training in psychology. Graduate training in psychology is an important vehicle by which psychologists can become prepared to use research and practice to eradicate inequities in society. Therefore, we propose six pillars for liberation-focused graduate training in psychology: critical unlearning/unknowing, cooperative modes of production, prioritizing indigenous knowledge, embedded interdependence, systems-level action, and prioritizing members of oppressed groups. Although this conceptualization may engender resistance, we argue that there are many potential pathways by which graduate training may use liberation psychology to work equitably with oppressed groups to seek justice.
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Affiliation(s)
| | - Elan C Hope
- Department of Psychology, North Carolina State University
| | | | - Hannah Javidi
- Department of Psychology, North Carolina State University
| | - Effua E Sosoo
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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Nagendra A, Orleans-Pobee M, Vincent C, Padgett J, Merritt C, Crosby C, Welch K, Roberts SO, Penn DL. The representation of authors of color in schizophrenia research articles published in high-impact psychiatric journals. Schizophr Res 2023; 253:75-78. [PMID: 36216712 DOI: 10.1016/j.schres.2022.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/06/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We evaluate how often scholars of color publish papers on schizophrenia in high-impact psychiatric journals, and whether they are more likely than white authors to prioritize race/ethnicity as a primary variable of interest in analyses. METHODS Prior work categorized the types of ethnoracial analyses reported in 474 papers about schizophrenia published in high-impact psychiatric journals between 2014 and 2016. In this study, the photographs of the first and last author for each paper were coded as "person of color" (POC) or "white". Additionally, each author was asked to self-report their race and ethnicity. The percentage of papers published by white versus POC authors was calculated. Chi-square analyses tested the hypotheses that (a) white scholars are more likely than POC scholars to conduct any sort of racial analysis; (b) POC scholars are more likely to conduct primary analyses by race/ethnicity; and (c) white scholars are more likely to analyze race/ethnicity as extraneous variables. RESULTS Eighteen percent of papers were published by POC first authors, and 17% were published by POC last authors. There were minimal differences in the types of analyses conducted by POC and white authors. Self-reported race/ethnicity showed that Asian scholars were the most highly represented within POC authors (9% of respondents), but only 3% of authors identified as Hispanic/Latinx and none identified as Black or Indigenous American. CONCLUSIONS People of color are underrepresented as authors in US-based schizophrenia research published in high-impact journals. Culturally-informed mentorship as well as prioritization of race/ethnicity in funding structures are important to increase representation of POC authors.
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Affiliation(s)
- A Nagendra
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - M Orleans-Pobee
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - C Vincent
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Padgett
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - C Merritt
- Department of Psychology, Center for Comparative Studies in Race and Ethnicity, Stanford University, USA
| | - C Crosby
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K Welch
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S O Roberts
- Department of Psychology, Center for Comparative Studies in Race and Ethnicity, Stanford University, USA
| | - D L Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Australian Catholic University, School of Behavioural and Health Sciences, Melbourne, VIC, Australia
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10
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Sadeh N, Bounoua N. Race moderates the impact of intolerance of uncertainty on mental health symptoms in Black and White community adults. J Anxiety Disord 2023; 93:102657. [PMID: 36455413 PMCID: PMC9839518 DOI: 10.1016/j.janxdis.2022.102657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/20/2022] [Accepted: 11/22/2022] [Indexed: 11/24/2022]
Abstract
Racism increases the amount of uncertainty in daily life, which may differentially affect the mental health of individuals from racial minority groups who score high on trait intolerance of uncertainty (IU), or the tendency to experience uncertainty as highly aversive. We examined associations between trait IU and current symptoms of common mental disorders in community samples of Black (N = 125) and White (N = 125) adults ages 18-55 who were matched on age, gender, and educational attainment. Given that data were collected between 2017 and 2021, we also examined pandemic exposure as a moderator of these associations. No mean differences emerged between Black and White adults on trait IU measured with the Intolerance of Uncertainty Scale-12 or on current psychiatric symptoms assessed with the Structured Clinical Interview for DSM-5. Trait IU was more strongly associated with current psychiatric symptoms in Black than White adults, a racial difference that dissipated following pandemic exposure. Present results extend prior work by suggesting the dispositional tendency to find uncertainty aversive is a stronger predictor of mental health symptoms in Black than White adults outside the context of pandemic-related stress. Implications of these findings for understanding the impact of racial- and pandemic-related environmental uncertainty on mental health is discussed.
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Affiliation(s)
- Naomi Sadeh
- University of Delaware, Department of Psychological and Brain Sciences, USA.
| | - Nadia Bounoua
- University of Delaware, Department of Psychological and Brain Sciences, USA
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11
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Boyd RC, Castro FG, Finigan-Carr N, Okamoto SK, Barlow A, Kim BKE, Lambert S, Lloyd J, Zhang X, Barksdale CL, Crowley DM, Maldonado-Molina M, Obasi EM, Kenney A. Strategic Directions in Preventive Intervention Research to Advance Health Equity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 24:577-596. [PMID: 36469162 PMCID: PMC9734404 DOI: 10.1007/s11121-022-01462-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 12/09/2022]
Abstract
As commissioned by the Society for Prevention Research, this paper describes and illustrates strategic approaches for reducing health inequities and advancing health equity when adopting an equity-focused approach for applying prevention science evidence-based theory, methodologies, and practices. We introduce an ecosystemic framework as a guide for analyzing, designing, and planning innovative equity-focused evidence-based preventive interventions designed to attain intended health equity outcomes. To advance this process, we introduce a health equity statement for conducting integrative analyses of ecosystemic framework pathways, by describing the role of social determinants, mechanisms, and interventions as factors directly linked to specific health equity outcomes. As background, we present health equity constructs, theories, and research evidence which can inform the design and development of equity-focused intervention approaches. We also describe multi-level interventions that when coordinated can produce synergistic intervention effects across macro, meso, and micro ecological levels. Under this approach, we encourage prevention and implementation scientists to apply and extend these strategic directions in future research to increase our evidence-based knowledge and theory building. A general goal is to apply prevention science knowledge to design, widely disseminate, and implement culturally grounded interventions that incrementally attain specific HE outcomes and an intended HE goal. We conclude with recommendations for conducting equity-focused prevention science research, interventions, and training.
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Affiliation(s)
- Rhonda C Boyd
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | - Allison Barlow
- John Hopkins Center for American Indian Health, Baltimore, MD, USA
| | | | | | - Jacqueline Lloyd
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, USA
| | - Xinzhi Zhang
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Crystal L Barksdale
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Anne Kenney
- John Hopkins Center for American Indian Health, Baltimore, MD, USA
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12
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Intersectional stigma subgroup differences in unhealthy drinking and disordered marijuana use among Black and Latino cisgender sexual minority young men. Drug Alcohol Depend 2022; 241:109652. [PMID: 36332595 PMCID: PMC10082566 DOI: 10.1016/j.drugalcdep.2022.109652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated associations of intersectional stigma subgroups with alcohol and marijuana use among Black and Latino sexual minority young men. Subgroups included Minimal Stigma (low to no stigma), Select Social Stigma (occasional stigma in social relationships), Multiform Heterosexism (internalized and interpersonal heterosexism from family/friends), Multiform Racism (racism across diverse contexts), Compound Stigma (frequent, ubiquitous racism and heterosexism). METHODS Cohort of Black and Latino cisgender sexual minority young men (n = 414; baseline ages 16-25) surveyed semiannually 2016-2019. Generalized estimating equations integrated with latent class analysis modeled linear and quadratic age effects and association of stigma subgroups with past 6-month alcohol use, marijuana use, unhealthy drinking, and marijuana use disorder symptoms. RESULTS All past 6-month substance use peaked between ages 21-23 years old. Across all ages and relative to Minimal Stigma, odds of drinking were higher in every subgroup and highest in Compound Stigma (OR=2.72, 95% CI 1.17-6.35); unhealthy drinking was higher in every subgroup and highest in Multiform Heterosexism (β = 3.31, 95% CI 1.92-3.89); marijuana use disorder symptoms were higher in most subgroups and highest in Compound Stigma (β = 1.30, 95% CI 0.76-1.85). Marijuana use odds did not differ among groups. CONCLUSION By examining intersectional stigma subgroups, we identified subgroups for whom substance use was elevated during a development period when use tends to be highest. Young men experiencing stigma patterns characterized primarily by heterosexism or heterosexism together with racism may be especially at risk for developing unhealthy drinking behaviors and marijuana use disorder symptoms.
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13
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Volpe VV, Smith NA, Skinner OD, Lozada FT, Hope EC, Del Toro J. Centering the Heterogeneity of Black Adolescents' Experiences: Guidance for Within-Group Designs among African Diasporic Communities. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:1298-1311. [PMID: 35334122 PMCID: PMC9509491 DOI: 10.1111/jora.12742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/05/2021] [Accepted: 02/16/2022] [Indexed: 06/09/2023]
Abstract
Despite notable improvements in theory and methods that center the lived experiences of Black adolescents, White supremacy endures in developmental science. In this article, we focus on one methodological manifestation of White supremacy-sampling decisions that assume Black adolescents are a homogeneous group. We examine overlooked concerns about within-group designs with Black adolescents, such as the erasure of some African diasporic communities in the United States. We first describe the homogeneity assumption and join other scholars in advocating for within-group designs. We next describe challenges with current approaches to within-group designs. We then provide recommendations for antiracist research that makes informed within-group design sampling decisions. We conclude by describing the implications of these strategies for researchers and developmental science.
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14
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Elliott T, Floyd James K, Coleman KJ, Skrine Jeffers K, Nau CL, Choi K. Cross-sectional Comparison of Disparities by Race Using White vs Hispanic as Reference Among Children and Youths With Developmental Disabilities Referred for Speech Therapy. JAMA Netw Open 2022; 5:e2234453. [PMID: 36194413 PMCID: PMC9533182 DOI: 10.1001/jamanetworkopen.2022.34453] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IMPORTANCE Health care research on racial disparities among children and youths has historically used the White race as a reference category with which other racial and ethnic groups are compared, which may inadvertently set up Whiteness as a standard for health. OBJECTIVE To compare 2 interpretations of an analysis of racial disparities in speech therapy receipt among children and youths with developmental disabilities: a traditional, White-referenced analysis and a Hispanic majority-referenced analysis. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used multiple logistic regression to analyze speech therapy referrals for children, adolescents, and transition age youths in an integrated health care system in Southern California from 2017 to 2020. Eligible participants were children and youths up to age 26 years with 1 or more diagnosed intellectual or developmental disability (eg, autism spectrum disorder, speech or language delay, developmental delay, Down syndrome, and others). EXPOSURES Child or youth race and ethnicity as reported by parents or caregivers (Asian, Black and African American, Hispanic and Latinx, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, White, multiple, and other). MAIN OUTCOMES AND MEASURES Receipt of speech therapy within 1 year of referral. RESULTS A total 66 402 referrals were included; 65 833 referrals (99.1%) were for children under age 17 years, 47 323 (71.3%) were for boys, and 39 959 (60.2%) were commercially insured. A majority of participants were identified as Hispanic (36 705 [55.3%]); 6167 (9.3%) were identified as Asian, 4810 (7.2%) as Black, and 14 951 (22.5%) as White. In the traditional racial disparities model where the reference category was White, referrals of children and youths who identified as Hispanic, Black, Pacific Islander, and other had lower odds of actual receipt of speech therapy compared with referrals for White children and youths (Hispanic: OR, 0.79; 95% CI, 0.75-0.83; Black: OR, 0.72; 95% CI, 0.66-0.78; Pacific Islander: OR, 0.74; 95% CI, 0.57-0.98). When using the majority race group (Hispanic) as the reference category, referrals for children and youths who identified as White (OR, 1.26; 95% CI, 1.20-1.30), Asian (OR, 1.21; 95% CI, 1.12-1.30), and multiracial (OR, 1.35; 95% CI, 1.08-1.71) had higher odds of resulting in actual service receipt in comparison with referrals for Hispanic children and youths. CONCLUSIONS AND RELEVANCE The cross-sectional study demonstrates the value of decentering Whiteness in interpreting racial disparities research and considering racial differences against multiple referents. Racial disparities researchers should consider investigating multiple between-group differences instead of exclusively using White as the default reference category.
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Affiliation(s)
- Thomas Elliott
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Kortney Floyd James
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Karen J. Coleman
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
- Southern California Permanente Medical Group, Kaiser Permanente Southern California, Pasadena
| | | | - Claudia L. Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Kristen Choi
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
- School of Nursing, University of California, Los Angeles
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles
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15
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King RU, Este DC, Yohani S, Duhaney P, McFarlane C, Liu JKK. Actions needed to promote health equity and the mental health of Canada's Black refugees. ETHNICITY & HEALTH 2022; 27:1518-1536. [PMID: 34392754 DOI: 10.1080/13557858.2021.1955092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The overall goal was to synthesize knowledge on actions that need to be taken to promote health equity and the mental health of Black refugees in Canada. DESIGN Group concept mapping systems were applied to generate and organize action-oriented statements related to the different social determinants of health. A total of 174 participants from the cities of Calgary and Edmonton with experience working with Black Canadians participated in four focus groups: (a) 2 focus groups that engaged 123 participants in brainstorming 84 statements guided by the following focus prompt: 'A specific action that would improve the mental health equity of Black refugees living in Canada is … ' and (b) 2 focus groups of 51 participants who sorted the generated statements and rated them by order of 'importance' and 'ideas seen in action.' Data was further computed and analysed by the research team and a select advisory group from the participants. RESULTS A 10-cluster map generated included the following clusters: (1) promoting cultural identity, (2) promoting ways of knowing, (3) addressing discrimination and racism, (4) addressing the criminalization of Black Canadians, (5) investing in employment for equity, (6) promoting equity in housing, (7) facilitating self-determination, (8) improving (public) services, (9) promoting appropriate and culturally relevant mental health services, and (10) working with and addressing faith and belief related issues. Clusters 4 and 9 ranked as the most important clusters in promoting health equity and the mental health of Black Canadians. CONCLUSIONS Addressing the criminalization of Black Canadians through a range of rehumanizing interventions at institutional levels will provide a platform from which they can participate and engage others in developing appropriate and culturally relevant mental health services.
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Affiliation(s)
| | | | - Sophie Yohani
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Patrina Duhaney
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Christine McFarlane
- Master of Christian Studies (MCS) Candidate, Christian Studies, Ambrose University, Calgary, Canada
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16
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Practical Approaches for Promoting Health Equity in Communities. Matern Child Health J 2022; 26:82-87. [PMID: 35920955 PMCID: PMC9482601 DOI: 10.1007/s10995-022-03456-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 12/04/2022]
Abstract
The Maternal and Child Health workforce, public health practitioners, researchers, and other groups need clear, practical guidance on how to promote health equity in the communities they serve. The National Maternal and Child Health Workforce Development Center’s Health Equity Team synthesized eight approaches for promoting health equity that drew on their experience working with public health practitioners and communities. The approaches are to: Expand the understanding of the drivers of health and work across sectors; Take a systems approach; Reflect on your own organization; Follow the lead of communities who experience injustices; Work with community members, decision-makers, and other stakeholders to prioritize action; Foster agency within individuals and collective action within groups; Identify and collect data to show where health inequities currently exist to inform equitable investment of resources; and Be accountable to outcomes that reflect real improvements in people’s lives. The fields of maternal and child health and public health more broadly is already engaged in the complex work of promoting equity and social justice, and in doing so, should refine, challenge, add to, and build upon these approaches.
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17
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Matthias MS, Adams J, Burgess DJ, Daggy J, Eliacin J, Flores P, Hirsh AT, Myers LJ, Perkins AJ, Menen T, Procento P, Rand KL, Salyers MP, Shanahan ML, Bair MJ. Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE): Rationale, study design, methods, and sample characteristics. Contemp Clin Trials 2022; 118:106790. [PMID: 35568376 DOI: 10.1016/j.cct.2022.106790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chronic pain is associated with profound negative effects, and racial disparities are well-documented in chronic pain treatment. In addition, Black patients report poorer communication with providers and exhibit lower levels of patient activation (self-management self-efficacy) than White patients. Although the causes of healthcare disparities are complex and require intervention at multiple levels, empowering patients is one critical path to achieving health equity. The current study is a coaching intervention focused on increasing patient activation and building communication skills for Black patients with chronic pain. METHODS In this randomized controlled trial, 250 Black patients with chronic pain were randomized to either the coaching intervention or an attention control arm. Intervention patients attended 6 telephone-delivered individual coaching sessions over 12 weeks. Coaching focused on clarifying and prioritizing goals and on communication skills, such as agenda setting. The primary outcome is patient activation. Secondary outcomes include communication self-efficacy, pain intensity and interference, and psychological functioning. DISCUSSION Having the knowledge and confidence to participate in one's pain care, coupled with the skills needed to effectively communicate with providers, is essential to optimize chronic pain care. This is particularly important for Black patients who often experience lower quality pain care. Interventions such as COOPERATE hold promise for helping patients to acquire the requisite tools to take greater control of their chronic pain care. TRIAL REGISTRATION clinicaltrials.gov, # NCT03562793.
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Affiliation(s)
- Marianne S Matthias
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States of America; Regenstrief Institute, Indianapolis, IN, United States of America; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States of America.
| | - Jasma Adams
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States of America
| | - Diana J Burgess
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN, United States of America; Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Joanne Daggy
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Johanne Eliacin
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States of America; Regenstrief Institute, Indianapolis, IN, United States of America; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Perla Flores
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States of America
| | - Laura J Myers
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States of America; Regenstrief Institute, Indianapolis, IN, United States of America; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Anthony J Perkins
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Tetla Menen
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States of America
| | - Philip Procento
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States of America
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States of America
| | - Michelle P Salyers
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States of America
| | - Mackenzie L Shanahan
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States of America
| | - Matthew J Bair
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States of America; Regenstrief Institute, Indianapolis, IN, United States of America; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States of America
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18
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Mathur VA, Trost Z, Ezenwa MO, Sturgeon JA, Hood AM. Mechanisms of injustice: what we (do not) know about racialized disparities in pain. Pain 2022; 163:999-1005. [PMID: 34724680 PMCID: PMC9056583 DOI: 10.1097/j.pain.0000000000002528] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/29/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Vani A. Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Zina Trost
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States
| | - Miriam O. Ezenwa
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, United States
| | - John A. Sturgeon
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
| | - Anna M. Hood
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
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19
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Hood AM, Booker SQ, Morais CA, Goodin BR, Letzen JE, Campbell LC, Merriwether EN, Aroke EN, Campbell CM, Mathur VA, Janevic MR. Confronting Racism in All Forms of Pain Research: A Shared Commitment for Engagement, Diversity, and Dissemination. THE JOURNAL OF PAIN 2022; 23:913-928. [PMID: 35288029 PMCID: PMC9415432 DOI: 10.1016/j.jpain.2022.01.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 01/25/2023]
Abstract
This third paper in the "Confronting Racism in All Forms of Pain Research" series discusses adopting an antiracism framework across all pain research disciplines and highlights the significant benefits of doing so. We build upon the previous call to action and the proposed reframing of study designs articulated in the other papers in the series and seek to confront and eradicate racism through a shared commitment to change current research practices. Specifically, we emphasize the systematic disadvantage created by racialization (ie, the Eurocentric social and political process of ascribing racialized identities to a relationship, social practice, or group) and discuss how engaging communities in partnership can increase the participation of racialized groups in research studies and enrich the knowledge gained. Alongside this critical work, we indicate why diversifying the research environment (ie, research teams, labs, departments, and culture) enriches our scientific discovery and promotes recruitment and retention of participants from racialized groups. Finally, we recommend changes in reporting and dissemination practices so that we do not stigmatize or reproduce oppressive forms of power for racialized groups. Although this shift may be challenging in some cases, the increase in equity, generalizability, and credibility of the data produced will expand our knowledge and reflect the pain experiences of all communities more accurately. PERSPECTIVE: In this third paper in our series, we advocate for a shared commitment toward an antiracism framework in pain research. We identify community partnerships, diversification of research environments, and changes to our dissemination practices as areas where oppressive forms of power can be reduced.
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Affiliation(s)
- Anna M Hood
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
| | - Staja Q Booker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Calia A Morais
- Department of Community Dentistry and Behavioral Sciences, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Burel R Goodin
- Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Janelle E Letzen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa C Campbell
- Department of Psychology, East Carolina University, Greenville, North Carolina
| | - Ericka N Merriwether
- Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York, New York; Department of Medicine, NYU Grossman School of Medicine, New York University, New York, New York
| | - Edwin N Aroke
- School of Nursing, Nurse Anesthesia Program, Department of Acute, Chronic, and Continuing Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Mary R Janevic
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
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20
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Mercier CM, Abbott DM, Ternes MS. Coping Matters: An Examination of Coping among Black Americans During COVID-19. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000211069598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using a critical race theory framework and a convergent mixed-method design, this study examined the relationship between coping with stress and psychological distress among Black U.S. Americans ( N = 155) during the COVID-19 pandemic in the context of race-based stressors (e.g., anti-Black racism). Path analysis revealed mixed support for hypotheses; avoidant coping was positively related to all measured facets of psychological distress, whereas socially supported coping was associated with none. Self-sufficient coping was negatively associated with only depressive symptoms. Qualitative analysis revealed four salient themes: (a) Race and the COVID-19 Pandemic, (b) Complex Pandemic Related Changes to Life, (c) Emotional Responses to the Pandemic, and (d) Coping with the COVID Pandemic. These themes suggested the pandemic disrupted participants’ ability to engage in, or effectively use, typically adaptive coping strategies and distress was exacerbated by fears for the safety of other Black U.S. Americans. Implications for training, practice, research, and advocacy are discussed.
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Affiliation(s)
- Caitlin M. Mercier
- Department of Psychology and Behavioral Sciences, Louisiana Tech University, Ruston, LA, USA
| | - Dena M. Abbott
- Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Michael S. Ternes
- Department of Psychology and Behavioral Sciences, Louisiana Tech University, Ruston, LA, USA
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21
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Stoll N, Yalipende Y, Arday J, Smithies D, Byrom NC, Lempp H, Hatch SL. Protocol for black student well-being study: a multi-site qualitative study on the mental health and well-being experiences of black UK university students. BMJ Open 2022; 12:e051818. [PMID: 35140150 PMCID: PMC8830255 DOI: 10.1136/bmjopen-2021-051818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION There is an increasing concern about the mental health and mental well-being of university students in the UK. Black university students who report a mental health condition are less likely to complete their course, achieve a first-class or upper second-class degree and progress to further education. This study will document black university students' accounts of their mental health experiences and perceptions of key turning points of biographical changes to their mental health as they move through the university life cycle. METHODS AND ANALYSIS This is a qualitative study. Data will be collected through a biographical narrative interpretive method. Interviews will enable the researcher to study systematically how participants make sense of themselves and account for the complexities of their life experiences, from their own perspectives and language. An interpretative phenomenological approach will be used to offer insights into what black students studying at UK universities report affects their mental health and well-being. Data collection for this study commenced in October 2020. Data collection and analyses will be completed by January 2022. ETHICS AND DISSEMINATION Full ethical approval for the current study was obtained from King's College London Psychiatry, Nursing and Midwifery Research Ethics Subcommittee (Rec Ref: 20489, Project Ref: HR-19/20-20489, 2 October 2020). From the study findings, we aim to contribute to the evidence base, make recommendations for interventions and encourage further study into black student mental health.
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Affiliation(s)
- Nkasi Stoll
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Centre For Society and Mental Health, King's College London, London, UK
| | - Yannick Yalipende
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Jason Arday
- Department of Sociology and Social Policy, University of Durham, Durham, UK
| | | | - Nicola C Byrom
- Department of Psychology, King's College London, London, UK
| | - Heidi Lempp
- Inflammation Biology, King's College London, London, UK
| | - Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Centre For Society and Mental Health, King's College London, London, UK
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Layland EK, Maggs JL, Kipke MD, Bray BC. Intersecting racism and homonegativism among sexual minority men of color: Latent class analysis of multidimensional stigma with subgroup differences in health and sociostructural burdens. Soc Sci Med 2022; 293:114602. [PMID: 34933242 PMCID: PMC9020748 DOI: 10.1016/j.socscimed.2021.114602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 10/04/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
RATIONALE Applying an intersectional framework to quantitative public health research among Black and Latino sexual minority men requires analysis that considers interlocking, multidimensional systems of racist and homonegative oppression that fundamentally subvert health. In this study, person-centered methods reflected the complexity of intersecting stigma and how subgroups experience that intersection differently. METHODS Data were from a cohort of 435 Black and Latino sexual minority young men (mean age = 22.3 years) in the Healthy Young Men's Cohort Study in Los Angeles, United States. Participants provided data semiannually on five occasions spanning 24 months from 2016 to 2019. The marginal approach to longitudinal latent class analysis was used to identify latent classes indicated by multidimensional experiences of racism (e.g., police harassment, workplace discrimination, sexual objectification) and homonegativism (e.g., violence, family rejection, identity concealment) during the transition to adulthood. Associations between sociostructural burdens (e.g., socioeconomic status, food insecurity, unstable housing) and class incidents were investigated. Prevalence of mental health care needs, chronic health conditions, and overall self-reported health were compared among classes. RESULTS Five latent classes were identified: Minimal Stigma (26% of person records), Select Social Stigma (22%), Homonegativism (17%), Multiform Racism (24%), and Compound Stigma (11%). Sociostructural burdens were generally associated with 1.69-3.75 times higher odds of Select Social Stigma, Homonegativism, Multiform Racism, and Compound Stigma class incidents relative to Minimal Stigma. The Compound Stigma class had the greatest sociostructural burden, highest mental health care needs, and highest odds of sleep and gastrointestinal disorders, but classes did not differ in overall self-reported health. CONCLUSION These results exemplify how sociostructural burdens are interconnected with intersectional stigma experiences that together erode the health of Black and Latino sexual minority young men.
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Affiliation(s)
- Eric K Layland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 220 E. 23rd Street, Suite 405, New York, NY, 10010, USA; Department of Human Development and Family Studies, The Pennsylvania State University, 208 Health and Human Development Building, University Park, PA, 16803, USA.
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, The Pennsylvania State University, 208 Health and Human Development Building, University Park, PA, 16803, USA.
| | - Michele D Kipke
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA, 90027, USA; Departments of Pediatrics and Preventive Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA, 90027, USA.
| | - Bethany C Bray
- Center for Dissemination and Implementation Science, University of Illinois at Chicago, 818 S Wolcott Ave., Chicago, IL, 60612, USA.
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Wilson DT, O'Connor MF. From Grief to Grievance: Combined Axes of Personal and Collective Grief Among Black Americans. Front Psychiatry 2022; 13:850994. [PMID: 35573332 PMCID: PMC9095947 DOI: 10.3389/fpsyt.2022.850994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
In the current article, we argue that the current conceptualization of grief as "the acute pain that accompanies the loss of a loved one" is too narrow in scope. Specifically, our current conceptualization of grief fails to account for the various ways in which grief is manifested amongst Black Americans. Throughout the article, we explore how the history of the racialization of Black people in America has resulted in a unique experience of loss, grief, and bereavement which previous research has largely failed to elucidate. Additionally, we explore how grief catalyzes political and social action. The article also proposes a novel theoretical conceptualization of personal and collective grief to deepen our conceptualization of grief amongst Black Americans. Finally, we posit that we must also consider how to further research on this collective grief to increase our understanding of it and to account for similar phenomena that may exist in communities who've had similar experiences (e.g., Indigenous peoples in the Americas and Dalits in India).
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Affiliation(s)
- Da'Mere T Wilson
- Department of Psychology, University of Arizona, Tucson, AZ, United States
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24
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State- and Provider-Level Racism and Health Care in the U.S. Am J Prev Med 2021; 61:338-347. [PMID: 34419231 DOI: 10.1016/j.amepre.2021.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/24/2021] [Accepted: 03/02/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION This study examines the associations between state-level and provider sources of racism and healthcare access and quality for non-Hispanic Black and White individuals. METHODS Data from 2 sources were integrated: (1) data from the Association of American Medical Colleges' Consumer Survey of Health Care Access (2014-2019), which included measures of self-reported healthcare access, healthcare quality, and provider racial discrimination and (2) administrative data compiled to index state-level racism. State-level racism composite scores were calculated from federal sources (U.S. Census, Department of Labor, Department of Justice). The data set comprised 21,030 adults (n=2,110 Black, n=18,920 White) who needed care within the past year. Participants were recruited from a national panel, and the survey employed age-insurance quotas. Logistic and linear regressions were conducted in 2020, adjusting for demographic, geographic, and health-related covariates. RESULTS Among White individuals, more state-level racism was associated with 5% higher odds of being able to get care and 6% higher odds of sufficient time with provider. Among Black individuals, more state-level racism was associated with 8% lower odds of being able to get care. Provider racial discrimination was also associated with 80% lower odds of provider explaining care, 77% lower odds of provider answering questions, and 68% lower odds of sufficient time with provider. CONCLUSIONS State-level racism may engender benefits to healthcare access and quality for White individuals and may decrease access for Black individuals. Disparities may be driven by both White advantage and Black disadvantage. State-level policies may be the actionable levers of healthcare inequities with implications for preventive medicine.
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Layland EK, Ram N, Caldwell LL, Smith EA, Wegner L. Leisure Boredom, Timing of Sexual Debut, and Co-Occurring Behaviors among South African Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2383-2394. [PMID: 34401994 PMCID: PMC8911384 DOI: 10.1007/s10508-021-02014-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/01/2020] [Accepted: 04/16/2021] [Indexed: 06/13/2023]
Abstract
Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an underexplored correlate of sexual behavior that is associated with many adolescent health outcomes. We investigated if and how individual differences in leisure boredom may be associated with timing of sexual debut, and whether individuals engage in safe or risky behaviors at debut. Survival analysis, logistic regression, and Poisson regression were applied to eight-wave longitudinal data obtained from 3,088 South African adolescents (baseline Mage = 13.9 years) to examine associations between leisure boredom and cumulative hazard of sexual debut across adolescence, odds of co-occurring sexual behaviors, and incidence rate of co-occurring sexual risk behaviors at debut. Higher levels of leisure boredom were associated with elevated hazard cumulatively across adolescence. Higher levels of leisure boredom were also associated with lower odds of safe sex and higher odds of substance use during sex and transactional sex at sexual debut, but not casual sex or condom non-use at sexual debut. Although odds of singular risk behaviors were lower for girls than for boys, the association between leisure boredom and the number of risk behaviors at sexual debut was stronger for girls than boys. Higher trait leisure boredom was associated with elevated hazard of sexual debut, greater likelihood that risky behaviors accompanied sexual debut, and greater number of co-occurring risky behaviors at sexual debut. Results support leisure boredom as a potential target for preventing sexual risk behavior among South African adolescents.
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Affiliation(s)
- Eric K Layland
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Nilam Ram
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA
| | - Linda L Caldwell
- Department of Recreation, Park and Tourism Management, The Pennsylvania State University, University Park, PA, USA
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Edward A Smith
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
- Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Lisa Wegner
- Department of Occupational Therapy, University of Western Cape, Cape Town, South Africa
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Cipollina R, Sanchez DT. Identity cues influence sexual minorities' anticipated treatment and disclosure intentions in healthcare settings: Exploring a multiple pathway model. J Health Psychol 2021; 27:1569-1582. [PMID: 33678046 DOI: 10.1177/1359105321995984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The present work experimentally examines how identity cues that signal minority inclusion contribute to sexual minorities' (SM) healthcare visit expectations. We find that minority representation cues reduced SM's (N = 188) expectations of a healthcare provider's bias and increased perceived provider cultural competency which was, in turn, associated with lower anticipated identity-based devaluation and greater sexual orientation disclosure comfort. Providers' diversity-valuing statements had mixed effects highlighting the importance of more concrete indicators of inclusion in this context. This work suggests that a lack of identity safety cues in healthcare settings may contribute to disparate health outcomes for sexual minority populations.
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Koffer RE, Thurston RC, Bromberger JT, Matthews KA. Racial/Ethnic Differences in Women's Life Event Exposure Across Midlife. J Gerontol B Psychol Sci Soc Sci 2021; 77:272-283. [PMID: 33560407 PMCID: PMC8824596 DOI: 10.1093/geronb/gbab024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Stressful life events are associated with poorer physical, cognitive, and mental health. Examining life events trends across midlife illustrates normative experiences of stress in a critical life period for intervention and disease prevention. Further, there is a critical need for research with racially/ethnically diverse samples to identify differences in life event exposure, as they may relate to later health disparities. METHOD Annual life event reports were analyzed from 3,066 White, Black, Hispanic, Chinese, and Japanese women in the Study of Women's Health Across the Nation. Across ages 43-65, longitudinal trajectories were fit to annual number of life events and 9 subcategories of life events (i.e., work problems, economic problems, partner unemployment, illness/accident of loved one, caregiving, bereavement, relationship problems, family legal/police problems, and violent events that happened to the self or family). Racial/ethnic differences were examined, controlling for education. RESULTS Number of annual life events declined with age and plateaued in later midlife. This pattern was largely consistent across types of life events, though family health and bereavement-related life events increased in later midlife. Compared to White women, Black women experienced more life events, while Chinese, Hispanic, and Japanese women experienced fewer life events. Racial/ethnic differences were amplified in specific subtypes of life events. DISCUSSION Racial/ethnic differences in exposure to life events across midlife may contribute to racial/ethnic health disparities in later life.
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Affiliation(s)
- R E Koffer
- Department of Psychiatry, University of Pittsburgh, Pennsylvania, USA,Address correspondence to: R. E. Koffer, PhD, Department of Psychiatry, University of Pittsburgh, 201 N. Craig Street, Suite 200, Pittsburgh, PA 15213, USA. E-mail:
| | - R C Thurston
- Department of Psychiatry, University of Pittsburgh, Pennsylvania, USA
| | - J T Bromberger
- Department of Psychiatry, University of Pittsburgh, Pennsylvania, USA
| | - K A Matthews
- Department of Psychiatry, University of Pittsburgh, Pennsylvania, USA
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Layland EK, Exten C, Mallory AB, Williams ND, Fish JN. Suicide Attempt Rates and Associations with Discrimination Are Greatest in Early Adulthood for Sexual Minority Adults Across Diverse Racial and Ethnic Groups. LGBT Health 2020; 7:439-447. [PMID: 33290152 PMCID: PMC7757577 DOI: 10.1089/lgbt.2020.0142] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The study purpose was to investigate differences in past 5-year suicide attempts among racially/ethnically diverse sexual minority (SM) and heterosexual adults across the life course and examine the association of discrimination with past 5-year suicide attempts among SM adults. Methods: Using nationally representative data collected from 2012 to 2013, we assessed differences in age-varying prevalence of past 5-year suicide attempts among Black, Hispanic, and White SM and heterosexual adults (ages 18-60). We tested whether the association between discrimination and suicide attempts differed by race/ethnicity among SM adults. All secondary data analyses were approved by the Institutional Review Boards of The Pennsylvania State University and University of Maryland. Results: Compared with heterosexual adults of any race/ethnicity, SM adults exhibited elevated suicide attempt rates until the late twenties when prevalence for Black and Hispanic SM adults declined. Disparities persisted into the mid-40s for White SM adults. Among SM adults of all races/ethnicities, the relationship between SM discrimination and suicide attempts was strongest between ages 18 and 25. For SM adults reporting SM discrimination, odds of suicide attempts were 3.6 times higher for White SM adults and 4.5 times higher for Black and Hispanic SM adults, relative to same-race/ethnicity SM adults who did not report SM discrimination. The effect of SM discrimination was robust among Black and Hispanic SM young adults even when accounting for racial/ethnic discrimination. Conclusions: SM adults of all racial/ethnic groups demonstrated disparities when contrasted with heterosexual adults of any race/ethnicity, although ages characterized by heightened prevalence rates of suicide attempts differed by race/ethnicity. Early adulthood is a critical period for intervention seeking to disrupt the association between SM discrimination and suicide attempts.
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Affiliation(s)
- Eric K. Layland
- The Methodology Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Cara Exten
- College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Allen B. Mallory
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Natasha D. Williams
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
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Inagaki TK. Health neuroscience 2.0: integration with social, cognitive and affective neuroscience. Soc Cogn Affect Neurosci 2020; 15:1017-1023. [PMID: 32888307 PMCID: PMC7657452 DOI: 10.1093/scan/nsaa123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tristen K Inagaki
- Department of Psychology, San Diego State University, San Diego, USA
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30
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Purcell JB, Orihuela CA, Elliott MN, Tortolero Emery S, Schuster MA, Mrug S. Examining Sex and Racial/Ethnic Differences in Co-use of Alcohol, Cannabis, and Cigarettes in a Community Sample of Adolescents. Subst Use Misuse 2020; 56:101-110. [PMID: 33164639 DOI: 10.1080/10826084.2020.1843056] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Although adolescents often co-use alcohol, cigarettes, and cannabis, little is known about sex and racial/ethnic differences in the co-use of these substances. Therefore, this investigation examined sex and racial/ethnic differences in alcohol, cigarette, and cannabis co-use in a large and ethnically diverse group. Methods: Participants were drawn from a large, multi-site study of adolescents from three regions in the United States (N = 4,129; Mage=16.10 years, SD = 0.59; 51% female, 49% male; 37% Black, 37% Hispanic, 25% White). Participants were categorized into eight mutually exclusive groups based on their self-reported use of alcohol, cannabis, and cigarettes in the last 30 days. Results: Unadjusted multinomial logistic regression revealed that males were more likely than females to use cannabis-only and to co-use all three substances. Additionally, Black and Hispanic adolescents were more likely to use cannabis-only, while White adolescents were more likely than Black and Hispanic adolescents to co-use alcohol and cigarettes. After adjusting for other sociodemographic variables (age, household income, parental education, and parent marital status), males were more likely to use cannabis-only than females; White youth were more likely than Hispanic youth to use cigarettes only and co-use cigarettes and alcohol. White youth were more likely than Black youth to co-use alcohol and cigarettes and co-use all three substances. Discussion: These results indicate sex and racial/ethnic differences in substance co-use that were not explained by socioeconomic factors. Results of this work suggest potential strategies for targeted prevention efforts and underscore the importance of continued efforts to better understand patterns of alcohol and substance co-use.
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Affiliation(s)
| | | | | | | | - Mark A Schuster
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Sylvie Mrug
- University of Alabama at Birmingham, Birmingham, Alabama, USA
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Adams RD, Tyson CA. "There is a Balm in Gilead": Black Social Workers' Spiritual Counterstory on the COVID-19 Crisis. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:523-532. [PMID: 32970547 DOI: 10.1080/19371918.2020.1806169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The authors assert that art-based inquiry can serve as a powerful medium for understanding the connection between faith and resilience as perceived and understood by older African-Americans adults disproportionately affected by the COVID-19 pandemic. Utilizing the CRT method of counterstorytelling as our conduit to elucidate our culturally situated responses to the COVID-19 pandemic. We seek to explore the connections between faith and resilience in social work practice during this public health crisis. Drawing from our shared experiences as two Black social workers we discuss the role spirituality plays in mitigating loneliness and stress among socially isolated older African-American adults (i.e., social distancing). Finally, with physical contact limited (i.e., social distancing) because of COVID-19, implications and recommendations for using spiritual-based practices with older African-American adults and families are discussed.
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Affiliation(s)
- Raymond D Adams
- College of Liberal and Performing Arts, Southern Arkansas University , Magnolia, Arkansas, USA
- Department of Behavioral and Social Sciences, Southern Arkansas University , Magnolia, Arkansas, USA
| | - Cynthia A Tyson
- College of Education and Human Ecology, Ohio State University , Columbus, Ohio, USA
- Department of Teaching and Learning, Ohio State University , Columbus, Ohio, USA
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Cooley E, Brown-Iannuzzi JL, Lei RF, Philbrook LE, Cipolli W, McKee SE. Investigating the Health Consequences for White Americans Who Believe White Americans Are Wealthy. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2020. [DOI: 10.1177/1948550620905219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Poor White Americans report feeling “worse off” than poor Black Americans despite the persistent negative effects of racism on Black Americans. Additionally, some health issues are rising among White but not Black Americans. Across two representative samples, we test whether White = wealthy stereotypes lead White Americans to feel relatively worse off than their racial group and whether these perceptions have health consequences. Across both samples, White Americans perceived their own status to be significantly lower than the status of the majority of White Americans. In contrast, Black Americans perceived their own status to be significantly higher than the majority of Black Americans. Critically, status comparisons between the self and one’s racial group predicted the experience of fewer positive emotions among White, but not Black, Americans, which mediated reduced mental and physical health. We conclude that race/class stereotypes may shape how poverty subjectively feels.
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