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Fuertes-Bucheli JF, Buenaventura-Alegría DP, Rivas-Mina AM, Pacheco-López R. Congenital Syphilis Prevention Challenges, Pacific Coast of Colombia, 2018-2022. Emerg Infect Dis 2024; 30:890-899. [PMID: 38666579 PMCID: PMC11060441 DOI: 10.3201/eid3005.231273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
High incidences of congenital syphilis have been reported in areas along the Pacific coast of Colombia. In this retrospective study, conducted during 2018-2022 at a public hospital in Buenaventura, Colombia, we analyzed data from 3,378 pregnant women. The opportunity to prevent congenital syphilis was missed in 53.1% of mothers because of the lack of syphilis screening. Characteristics of higher maternal social vulnerability and late access to prenatal care decreased the probability of having >1 syphilis screening test, thereby increasing the probability of having newborns with congenital syphilis. In addition, the opportunity to prevent congenital syphilis was missed in 41.5% of patients with syphilis because of the lack of treatment, which also increased the probability of having newborns with congenital syphilis. We demonstrate the urgent need to improve screening and treatment capabilities for maternal syphilis, particularly among pregnant women who are more socially vulnerable.
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Tunstall AM, O'Brien SC, Monaghan DM, Burakoff A, Marquardt RK. Lessons Learned from Cross-Systems Approach to COVID-19 Pandemic Response in Juvenile Justice System, Colorado, USA. Emerg Infect Dis 2024; 30:S13-S16. [PMID: 38561629 PMCID: PMC10986830 DOI: 10.3201/eid3013.230782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The global COVID-19 pandemic illustrates the importance of a close partnership between public health and juvenile justice systems when responding to communicable diseases. Many setting-specific obstacles must be navigated to respond effectively to limit disease transmission and negative health outcomes while maintaining necessary services for youth in confinement facilities. The response requires multidisciplinary expertise and collaboration to address unique considerations. Public health mitigation strategies must balance the risk for disease against the negative effects of restrictions. Key aspects of the COVID-19 response in the juvenile justice system of Colorado, USA, involved establishing robust communication and data reporting infrastructures, building a multidisciplinary response team, adapting existing infection prevention guidelines, and focusing on a whole-person health approach to infection prevention. We examine lessons learned and offer recommendations on pandemic emergency response planning and managing a statewide public health emergency in youth confinement settings that ensure ongoing readiness.
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Acuff K, Wu JH, Varkhedi V, Baxter SL. Social determinants of health and health disparities in glaucoma: A review. Clin Exp Ophthalmol 2024; 52:276-293. [PMID: 38385607 PMCID: PMC11038416 DOI: 10.1111/ceo.14367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
Social determinants of health and barriers to care can significantly impact patients' access to glaucoma care and treatment, resulting in disparities within disease presentation, progression, management, and treatment outcomes. The widespread adoption of electronic health record systems has allowed researchers and clinicians to further explore these relationships, identifying factors such as race, ethnicity, and socioeconomic status to be risk factors for more severe disease and lower treatment adherence. These disparities highlight potential targets for interventions to combat these disparities and improve overall patient outcomes. This article provides a summary of the available data on health disparities within glaucoma disease presentation, progression, management, treatment, and outcomes and discusses interventions to improve care delivery and outcomes among patients with glaucoma.
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Affiliation(s)
- Kaela Acuff
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Jo-Hsuan Wu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Varsha Varkhedi
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
| | - Sally L. Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
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Greene A, Iloabuchi VC, Stoos E, Butterfield RJ, Zhang N, Mangold AR, Leachman S, Costello CM. Increase in melanoma knowledge in Latino patients after a targeted digital educational program. JAAD Int 2024; 14:61-63. [PMID: 38274397 PMCID: PMC10809116 DOI: 10.1016/j.jdin.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Affiliation(s)
- Adina Greene
- University of Arizona College of Medicine, Phoenix, Arizona
- Department of Dermatology, Mayo Clinic, Scottsdale, Arizona
| | | | - Elizabeth Stoos
- Department of Dermatology and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | | | - Nan Zhang
- Department of Quantitative Health Sciences, Scottsdale, Arizona
| | | | - Sancy Leachman
- Department of Dermatology and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
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Bogner MS, Faulks D. Understanding oral health from the point of view of adults with disabilities and/or complex medical conditions: A scoping review. Spec Care Dentist 2024; 44:280-299. [PMID: 37248195 DOI: 10.1111/scd.12882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
AIM This study aimed to review the qualitative scientific literature investigating experience of the mouth and oral health amongst adults with disabilities and/or complex health conditions. METHODS A scoping review methodology was applied in accordance with the methodological framework of Arksey & O'Malley and the PRISMA-SCR checklist. Electronic searching was performed using the databases Pubmed, Embase, and PsychInfo. RESULTS Thirty articles were included in the final selection. The populations included in the selected studies were very varied in terms of health conditions and disabilities. Three major themes relating to the experience and understanding of the mouth, oral health, and function were highlighted in the review: the representation of oral health, the influence of oral health on the participant's life, and the influence of the socio-environmental context on oral health. No study explicitly described the functional, social, and psychological roles of the mouth in a comprehensive manner. CONCLUSIONS Perception of the mouth and oral health differs depending on the individual and their health condition. Oral health is described as dependent on the socio-environmental context, however, outside of the experience of dental care services, this context is not investigated in the literature. This scoping review demonstrated that exhaustive understanding of the dimensions of the mouth and oral health has not been explored in published research for this population.
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Affiliation(s)
- Marie-Sophie Bogner
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Denise Faulks
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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Hippalgaonkar N, Nguyen RHT, Cohn EB, Horowitz J, Waite AW, Mersha T, Sandoval C, Khan S, Salum K, Thomas P, Murphy AM, Brent B, Coleman L, Khosla P, Hoskins KF, Henderson V, Carnahan LR. Are We the Problem? A Call to Action for Addressing Institutional Challenges to Engaging Community Partners in Research. Int J Environ Res Public Health 2024; 21:236. [PMID: 38397725 PMCID: PMC10888328 DOI: 10.3390/ijerph21020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Community-engaged research (CEnR) is a potent tool for addressing health inequities and fostering equitable relationships among communities, researchers, and institutions. CEnR involves collaboration throughout the research process, demonstrating improvements in study recruitment and retention, intervention efficacy, program sustainability, capacity building among partners, and enhanced cultural relevance. Despite the increasing demand for CEnR, institutional policies, particularly human participation protection training (HPP), lag behind, creating institutional barriers to community partnerships. Here, we highlight challenges encountered in our ongoing study, Fostering Opportunities in Research through Messaging and Education (FOR ME), focused on promoting shared decision-making around clinical trial participation among Black women diagnosed with breast cancer. Grounded in CEnR methods, FOR ME has a partnership with a community-based organization (CBO) that addresses the needs of Black women with breast cancer. Our CBO partner attempted to obtain HPP training, which was administratively burdensome and time-consuming. As CEnR becomes more prevalent, academic and research institutions, along with researchers, are faced with a call to action to become more responsive to community partner needs. Accordingly, we present a guide to HPP training for community partners, addressing institutional barriers to community partner participation in research. This guide outlines multiple HPP training pathways for community partners, aiming to minimize institutional barriers and enhance their engagement in research with academic partners.
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Affiliation(s)
- Neha Hippalgaonkar
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
| | - Ryan Huu-Tuan Nguyen
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Eliza Brumer Cohn
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | - Joseph Horowitz
- Department of Medicine and Pediatrics, University of Illinois College of Medicine, Chicago, IL 60612, USA;
| | - Ana Williams Waite
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Tigist Mersha
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Christen Sandoval
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Sarah Khan
- Sinai Chicago, Chicago, IL 60612, USA; (S.K.); (P.K.)
| | - Kauthar Salum
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | | | - Anne Marie Murphy
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Beulah Brent
- Sisters Working It Out, Chicago, IL 60612, USA; (B.B.); (L.C.)
| | - Lolita Coleman
- Sisters Working It Out, Chicago, IL 60612, USA; (B.B.); (L.C.)
| | | | - Kent F. Hoskins
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Vida Henderson
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | - Leslie R. Carnahan
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
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Robinson L, Matamoros C. Applied patient-level palliative care interventions designed to meet the needs of sexual and gender minorities: A scoping review and qualitative content analysis of how to support sexual and gender minorities at end of life. Palliat Med 2024; 38:69-84. [PMID: 38062858 PMCID: PMC10798012 DOI: 10.1177/02692163231214123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND Sexual and gender minorities experience considerable health disparities across the life span. End of life presents unique challenges for this population, further exacerbating existing disparities. AIM We aimed to identify applied patient-level palliative care interventions for sexual and gender minorities and describe how said interventions met the needs of these populations at end of life. DESIGN We conducted a scoping review in keeping with the updated Arksey and O'Malley Framework. All included reports were analyzed qualitatively to describe the intervention and summarize thematically how it met the needs of sexual and gender minorities at end of life. DATA SOURCES We conducted searches in MEDLINE, EMBASE, PsychInfo, and CINAHL from 1946 to June 10, 2023. Reports were eligible for inclusion if they described a palliative care intervention delivered to sexual and gender minorities, and if the palliative care intervention responded to at least one specific need of the sexual and gender minority population(s) in question. RESULTS We included and summarized 27 reports. We identified three overarching themes describing how palliative care interventions responded to the needs of sexual and gender minorities at end of life. CONCLUSIONS This review responds to a need to improve palliative care delivery for sexual and gender minorities. Recommendations derived from these interventions, including how to center and advocate for sexual and gender minorities at end of life, can be applied by any interdisciplinary palliative care provider.
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Affiliation(s)
- Lilian Robinson
- Temmy Latner Centre for Palliative Care, Sinai Health System, Scarborough Health Network, Toronto, ON, Canada
| | - Cam Matamoros
- Scarborough Health Network, Scarborough Center for Healthy Communities, Department of Family and Community Medicine, Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
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Pichardo CM, Ezeani A, Pichardo MS, Agurs‐Collins T, Powell‐Wiley TM, Ryan B, Minas TZ, Bailey‐Whyte M, Tang W, Dorsey TH, Wooten W, Loffredo CA, Ambs S. Association of neighborhood gentrification with prostate cancer and immune markers in African American and European American men. Cancer Med 2023; 13:e6828. [PMID: 38151903 PMCID: PMC10807554 DOI: 10.1002/cam4.6828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Prior studies showed that neighborhood deprivation increases the risk of lethal prostate cancer. However, the role of neighborhood gentrification in prostate cancer development and outcome remains poorly understood. We examined the relationships of gentrification with prostate cancer and serum proteome-defined inflammation and immune function in a diverse cohort. METHODS The case-control study included 769 cases [405 African American (AA), 364 European American (EA) men] and 1023 controls (479 AA and 544 EA), with 219 all-cause and 59 prostate cancer-specific deaths among cases. Geocodes were linked to a neighborhood gentrification index (NGI) derived from US Census data. Cox and logistic regression, and MANOVA, were used to determine associations between NGI, as continuous or quintiles (Q), and outcomes. RESULTS Adjusting for individual socioeconomic status (SES), continuous NGI was positively associated with prostate cancer among all men (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14). AA and low-income men experienced the highest odds of prostate cancer when residing in tracts with moderate gentrification, whereas EA men experienced reduced odds of regional/metastatic cancer with increased gentrification in SES-adjusted analyses. Continuous NGI also associated with mortality among men presenting with localized disease and low-income men in SES-adjusted Cox regression analyses. NGI was not associated with serum proteome-defined chemotaxis, inflammation, and tumor immunity suppression. CONCLUSIONS Findings show that neighborhood gentrification associates with prostate cancer and mortality in this diverse population albeit associations were heterogenous within subgroups. The observations suggest that changing neighborhood socioeconomic environments may affect prostate cancer risk and outcome, likely through multifactorial mechanisms.
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Affiliation(s)
| | - Adaora Ezeani
- Division of Cancer Control and Population Sciences, NCINIHRockvilleMarylandUSA
| | - Margaret S. Pichardo
- Department of Surgery, Hospital of the University of PennsylvaniaPenn MedicinePhiladelphiaPennsylvaniaUSA
| | - Tanya Agurs‐Collins
- Division of Cancer Control and Population Sciences, NCINIHRockvilleMarylandUSA
| | - Tiffany M. Powell‐Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute (NHLBI)National Institutes of HealthBethesdaMarylandUSA
- Intramural Research Program, National Institute on Minority Health and Health Disparities (NIMHD)National Institutes of HealthBethesdaMarylandUSA
| | - Brid Ryan
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - Tsion Zewdu Minas
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - Maeve Bailey‐Whyte
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
- School of MedicineUniversity of LimerickLimerickIreland
| | - Wei Tang
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
- Data Science & Artificial Intelligence, R&DAstraZenecaGaithersburgMarylandUSA
| | - Tiffany H. Dorsey
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - William Wooten
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center Biostatistics Shared ServiceBaltimoreMarylandUSA
| | - Christopher A. Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer CenterGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
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Gee GC, Chien J, Sharif MZ, Penaia C, Tran E. East is east … or is it? Racialization of Asian, Middle Eastern, and Pacific Islander persons. Epidemiol Rev 2023; 45:93-104. [PMID: 37312559 DOI: 10.1093/epirev/mxad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/28/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023] Open
Abstract
The conventional use of racial categories in health research naturalizes "race" in problematic ways that ignore how racial categories function in service of a White-dominated racial hierarchy. In many respects, racial labels are based on geographic designations. For instance, "Asians" are from Asia. Yet, this is not always a tenable proposition. For example, Afghanistan resides in South Asia, and shares a border with China and Pakistan. Yet, people from Afghanistan are not considered Asian, but Middle Eastern, by the US Census. Furthermore, people on the west side of the Island of New Guinea are considered Asian, whereas those on the eastern side are considered Pacific Islander. In this article, we discuss the complexity of the racial labels related to people originating from Oceania and Asia, and, more specifically, those groups commonly referred to as Pacific Islander, Middle Eastern, and Asian. We begin with considerations of the aggregation fallacy. Just as the ecological fallacy refers to erroneous inferences about individuals from group data, the aggregation fallacy refers to erroneous inferences about subgroups (eg, Hmong) from group data (ie, all Asian Americans), and how these inferences can contribute to stereotypes such as the "model minority." We also examine how group averages can be influenced merely by the composition of the subgroups, and how these, in turn, can be influenced by social policies. We provide a historical overview of some of the issues facing Pacific Islander, Middle Eastern, and Asian communities, and conclude with directions for future research.
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Affiliation(s)
- Gilbert C Gee
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Jessie Chien
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Mienah Z Sharif
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, United States
- Center for the Study of Racism, Social Justice and Health, University of California at Los Angeles, Los Angeles, CA 90025, United States
| | - Corina Penaia
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Emma Tran
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
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McCloskey K, Henao D, Gregory C, Corsig L, Plummer D. Breastfeeding Disparities During the COVID-19 Pandemic: Race/Ethnicity, Age, Education, and Insurance Payor. J Hum Lact 2023; 39:615-624. [PMID: 37515445 DOI: 10.1177/08903344231187907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND There are well-documented disparities in rates of continued breastfeeding. Existing research regarding breastfeeding during COVID-19 has raised concerns that the pandemic may have exacerbated these disparities. RESEARCH AIMS The aim of this research was first to quantify disparities in any breastfeeding associated with the maternal factors of race/ethnicity, age, insurance payor, and zip code rates of education in North Carolina. Second, we aimed to investigate any changes in these disparities before and during the COVID-19 pandemic. METHOD This was an observational study, with a retrospective, longitudinal design. Participants included infants who were born in one of eight medical centers across North Carolina from either September 1, 2019 to October 31, 2019 (pre-COVID: n = 1,104) or from April 1, 2020 to May 31, 2020, (during COVID: n = 1,157), and whose caregivers reported whether they were breastfeeding at either a 3-month or 6-month postnatal follow-up (N = 2,261). Mixed effects logistic models, including random effects of zip code, assessed predictors associated with probability of breastfeeding cessation at 3- and 6-month child well-check. RESULTS Overall, younger maternal age, being non-Hispanic Black, not having commercial insurance, and residing in a zip code with lower rates of higher education, were all independently associated with earlier breastfeeding cessation across both cohorts. Disparities did not significantly change during the COVID-19 pandemic. CONCLUSION We did not find support for the hypothesis that the COVID-19 pandemic might have exacerbated breastfeeding disparities. Nevertheless, there is a continued need to eliminate existing disparities.
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Affiliation(s)
- Kiran McCloskey
- Office of Health Equity, Novant Health, Winston-Salem, NC, USA
| | - David Henao
- Office of Health Equity, Novant Health, Winston-Salem, NC, USA
| | - Chere Gregory
- Office of Health Equity, Novant Health, Winston-Salem, NC, USA
| | - Laura Corsig
- Department for Lactation Services, Novant Health, Charlotte, NC, USA
| | - Dianne Plummer
- Women and Children's Institute, Novant Health, Winston-Salem, NC, USA
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MacPherson M. Immigrant, Refugee, and Indigenous Canadians' Experiences With Virtual Health Care Services: Rapid Review. JMIR Hum Factors 2023; 10:e47288. [PMID: 37812489 PMCID: PMC10594134 DOI: 10.2196/47288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/28/2023] [Accepted: 08/04/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND The remote, dispersed, and multicultural population of Canada presents unique challenges for health care services. Currently, virtual care solutions are being offered as an innovative solution to improve access to care. OBJECTIVE Given the inequities in health care access faced by immigrant, refugee, and Indigenous Canadians, this review aimed to summarize information obtained from original research regarding these people's experiences with virtual care services in Canada. METHODS We conducted a rapid review following published recommendations. MEDLINE and CINAHL were searched for studies relating to virtual care and Canadian immigrants, refugees, or Indigenous peoples. Peer-reviewed articles of any type were included so long as they included information on the experiences of virtual care service delivery in Canada among the abovementioned groups. RESULTS This review demonstrates an extreme paucity of evidence examining the experiences of immigrant, refugee, and Indigenous groups with virtual care in Canada. Of the 694 publications screened, 8 were included in this review. A total of 2 studies focused on immigrants and refugees in Canada, with the remaining studies focusing on Indigenous communities. Results demonstrate that virtual care is generally accepted within these communities; however, cultural appropriateness or safety and inequitable access to wireless services in certain communities were among the most cited barriers. CONCLUSIONS Little evidence exists outlining immigrants', refugees', and Indigenous peoples' perspectives on the landscape of virtual care in Canada. The development of virtual care programming should take into consideration the barriers, facilitators, and recommendations outlined in this review to improve equitable access. Further, developers should consult with local community members to ensure the appropriateness of services for immigrant, refugee, and Indigenous communities in Canada.
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Discepolo K, Melvin P, Ghazarians M, Tennermann N, Ward VL. Socioeconomic and Clinical Demography of Dental Missed Care Opportunities. JDR Clin Trans Res 2023; 8:356-366. [PMID: 35722931 DOI: 10.1177/23800844221104790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Missed care opportunities (MCOs) contribute to poor health outcomes, and pediatric dental patients are particularly vulnerable; identifying associated patient characteristics will help inform development of targeted interventional programs. OBJECTIVE To assess socioeconomic and demographic disparities associated with MCOs among children in an urban pediatric hospital's dental clinic. MCOs lead to a lack of continuous care and increased emergent needs, so understanding MCOs is required to achieve equitable pediatric dental health. METHODS A retrospective 2-y (2019-2020) cohort of MCOs in children 1 to 17 y old, with scheduled dental visits. MCOs were defined as appointments not attended or canceled and not rescheduled prior to initial scheduled visit. Multivariable mixed-effects logistic regression models with patient-level clustering assessed the associations of demographics, neighborhood-level socioeconomic factors (using social vulnerability index [SVI]), and clinic characteristics with MCOs. RESULTS Of 30,095 visits, 30.9% were MCOs. Multivariable logistic regression estimated increased likelihood of MCOs in Black/non-Hispanic (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.09-1.32) and Hispanic (OR, 1.18; 95% CI, 1.06-1.31) patients, patients with public insurance (OR, 1.25; 95% CI, 1.15-1.36) or no insurance (OR, 1.46; 95% CI, 1.15-1.85), patients with complex chronic conditions (OR, 1.11; 95% CI, 1.03-1.19), visits scheduled during the COVID-19 pandemic (OR, 9.48; 95% CI, 8.89-10.11), appointments with wait days over 21 d (OR, 4.07; 95% CI, 3.49-4.74), and children from neighborhoods of high social vulnerability (75th percentile SVI) (OR, 1.08; 95% CI, 1.01-1.16). CONCLUSIONS Children with highest dental MCOs were from neighborhoods with high SVI, had public insurance, and were from marginalized populations. MCOs contribute to inequities in overall health; hence, interventions that address barriers related to characteristics associated with pediatric dental MCOs are needed. KNOWLEDGE TRANSFER STATEMENT Missed care opportunities contribute to poor health outcomes; identifying associated patient characteristics will help inform development of targeted interventional programs. Providing these findings to stakeholders will better impart understanding access barriers and drive research and program development. Dissemination of this information in the form of altering appointment practices will better accommodate specific patient population needs.
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Affiliation(s)
- K Discepolo
- Department of Dentistry, Boston Children's Hospital, Boston, MA, USA
| | - P Melvin
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
| | - M Ghazarians
- Department of Dentistry, Boston Children's Hospital, Boston, MA, USA
| | - N Tennermann
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
| | - V L Ward
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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13
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Britton GB, Huang L, Villarreal AE, Levey A, Philippakis A, Hu C, Yang CC, Mushi D, Oviedo DC, Rangel G, Ho JS, Thompson L, Khemakhem M, Ross M, Carreira MB, Kim N, Joung P, Albastaki O, Kuo PC, Low S, Paddick S, Kuan Y, Au R. Digital phenotyping: An equal opportunity approach to reducing disparities in Alzheimer's disease and related dementia research. Alzheimers Dement (Amst) 2023; 15:e12495. [PMID: 38034851 PMCID: PMC10687344 DOI: 10.1002/dad2.12495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/12/2023] [Accepted: 09/25/2023] [Indexed: 12/02/2023]
Abstract
A rapidly aging world population is fueling a concomitant increase in Alzheimer's disease (AD) and related dementias (ADRD). Scientific inquiry, however, has largely focused on White populations in Australia, the European Union, and North America. As such, there is an incomplete understanding of AD in other populations. In this perspective, we describe research efforts and challenges of cohort studies from three regions of the world: Central America, East Africa, and East Asia. These cohorts are engaging with the Davos Alzheimer's Collaborative (DAC), a global partnership that brings together cohorts from around the world to advance understanding of AD. Each cohort is poised to leverage the widespread use of mobile devices to integrate digital phenotyping into current methodologies and mitigate the lack of representativeness in AD research of racial and ethnic minorities across the globe. In addition to methods that these three cohorts are already using, DAC has developed a digital phenotyping protocol that can collect ADRD-related data remotely via smartphone and/or in clinic via a tablet to generate a common data elements digital dataset that can be harmonized with additional clinical and molecular data being collected at each cohort site and when combined across cohorts and made accessible can provide a global data resource that is more racially/ethnically represented of the world population.
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Affiliation(s)
- Gabrielle B. Britton
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
- Universidad Santa María La Antigua, Vía Ricardo J. AlfaroPanamá CityPanama
| | - Li‐Kai Huang
- Taipei Medical University Shuang‐Ho HospitalTaipeiTaiwan
| | - Alcibiades E. Villarreal
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
| | - Allan Levey
- Emory University School of MedicineAtlantaGeorgiaUSA
| | - Anthony Philippakis
- Broad Institute at Massachusetts Institute of Technology and Harvard UniversityCambridgeMassachusettsUSA
| | - Chaur‐Jong Hu
- Taipei Medical University Shuang‐Ho HospitalTaipeiTaiwan
| | | | - Declare Mushi
- Kilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Diana C. Oviedo
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
- Universidad Santa María La Antigua, Vía Ricardo J. AlfaroPanamá CityPanama
| | - Giselle Rangel
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
| | - Jor Sam Ho
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
| | - Louisa Thompson
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | | | - Makayla Ross
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
| | - María B. Carreira
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
| | - Nicole Kim
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
| | - Philip Joung
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
| | | | - Po Chih Kuo
- National Tsing Hua University, East DistrictHsinChuTaiwan
| | - Spencer Low
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
- Boston University Chobanian and Avedisian School of MedicineBostonMassachusettsUSA
- Boston University Alzheimer's Disease CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | | | - Yi‐Chun Kuan
- Taipei Medical University Shuang‐Ho HospitalTaipeiTaiwan
| | - Rhoda Au
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
- Boston University Chobanian and Avedisian School of MedicineBostonMassachusettsUSA
- Boston University Alzheimer's Disease CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- The Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine, Boston University School of Public HealthFraminghamMassachusettsUSA
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14
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Padamsee TJ, Stover DG, Tarver WL, Washington CM, Baltic RD, DeGraffinreid CR, Whiting CRB, Rumano R, Lee CN, Nolan T, Oppong B, Obeng-Gyasi S, Toland AE, Bernardo B, Hampel H, Paskett ED. Turning the Page on Breast Cancer in Ohio: Lessons learned from implementing a multilevel intervention to reduce breast cancer mortality among Black women. Cancer 2023; 129:3114-3127. [PMID: 37691524 PMCID: PMC10881116 DOI: 10.1002/cncr.34845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/14/2023] [Accepted: 04/11/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Turning the Page on Breast Cancer (TPBC) uses a multilevel approach to reduce breast cancer (BC) mortality among Black women. TPBC intervenes by (1) improving health care facilities' ability to conduct effective BC screening, follow-up, and treatment; (2) involving community-based organizations; and (3) providing education and personal risk information through a culturally relevant website. Ohio has among the worst BC mortality rates in the United States for Black women. TPBC is in its third year of providing targeted interventions in 12 Ohio counties with particularly high BC rates among Black women. METHODS TPBC enrolls health care facilities, collects organizational and patient data, and conducts key informant interviews to inform the provision of appropriate evidence-based interventions. TPBC engages Black communities through community-based organizations and social media advertising. The TPBC website offers BC information, connects Black women to community BC resources, and provides access to a risk-assessment tool. RESULTS TPBC has provided tailored information packets, evidence-based interventions, and systematic support for improving the tracking and follow-up of breast health care among patients in 10 clinical partnerships. The project has provided education at community events monthly since mid-2021. The TPBC website (http://endbreastcancerohio.org) is promoted through social media (primarily Facebook) and community events to reach Black women aged 25-70 years. To date, 4108 unique users have visited the website, of whom 15.9% completed the risk assessment. CONCLUSIONS Novel strategies are needed to address persistent disparities in BC outcomes among Black women. TPBC demonstrates the potential effectiveness of multiple methods of community-based, clinic-based, and web-based engagement. PLAIN LANGUAGE SUMMARY Turning the Page on Breast Cancer (TPBC) aims to reduce breast cancer mortality among Black women in Ohio by conducting multilevel, community-engaged interventions in 12 counties. Women are provided risk information and education at virtual and in-person community events and through a community-friendly website that was launched in November 2020. Almost 4000 women have visited the website, which offers community-targeted information, urges screening for individuals at elevated risk, and offers access to patient navigation services; 655 users have used a breast cancer risk-assessment tool on the site. Community-based organizations conduct educational efforts. TPBC partners with health care facilities, which are taught to improve their ability to conduct effective breast cancer screening, follow-up, and treatment. So far, TPBC has provided educational information, evidence-based intervention lists, tailored information packets, and ongoing quarterly support to partners in 10 counties. Evaluation will focus on aggregated data for screening and genetic testing referral at the clinic level.
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Affiliation(s)
- Tasleem J. Padamsee
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Daniel G. Stover
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Willi L. Tarver
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | - Ryan D. Baltic
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
| | | | | | - Ruvarashe Rumano
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Clara N. Lee
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Timiya Nolan
- The Ohio State University College of Nursing, Columbus, Ohio, USA
| | - Bridget Oppong
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Samilia Obeng-Gyasi
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Amanda E. Toland
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | - Heather Hampel
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, California, USA
| | - Electra D. Paskett
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
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15
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Orlando CM, Pérez CA, Agyei P, Elsehety M, Singh SK, Thomas J, Alaina O, Lincoln JA. Social determinants of health and disparate disability accumulation in a cohort of Black, Hispanic, and White patients with multiple sclerosis. Mult Scler 2023; 29:1304-1315. [PMID: 37435828 PMCID: PMC10503235 DOI: 10.1177/13524585231185046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Black and Hispanic patients with multiple sclerosis (MS) have been shown to accumulate greater multiple sclerosis-associated disability (MSAD) than White patients. Disparities in social determinants of health (SDOH) among these groups have also been reported. OBJECTIVE To determine the extent to which associations of race and ethnicity with MSAD may be attributable to differences in SDOH. METHODS Retrospective chart analysis of patients at an academic MS center grouped by self-identified Black (n = 95), Hispanic (n = 93), and White (n = 98) race/ethnicity. Individual patient addresses were geocoded and matched with neighborhood-level area deprivation index (ADI) and social vulnerability index (SVI). RESULTS Average Expanded Disability Status Scale (EDSS) scores at last-recorded evaluations of White patients (1.7 ± 2.0) were significantly lower than Black (2.8 ± 2.4, p = 0.001) and Hispanic (2.6 ± 2.6, p = 0.020) patients. Neither Black race nor Hispanic ethnicity was significantly associated with EDSS in multivariable linear regression models that included individual-level SDOH indicators and either ADI or SVI. CONCLUSION Black race and Hispanic ethnicity are not significantly associated with EDSS in models that include individual and neighborhood-level SDOH indicators. Further research should elucidate mechanisms by which structural inequities affect MS disease course.
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Affiliation(s)
- Christopher M Orlando
- Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Carlos A Pérez
- Maxine Mesinger Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Paunel Agyei
- Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Sonia Kaur Singh
- Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Joseph Thomas
- Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Omar Alaina
- Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - John A Lincoln
- Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
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16
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Heck JL, Jones EJ, Goforth Parker J. Establishment of a Community Advisory Board to Address Postpartum Depression Among Indigenous Women. J Obstet Gynecol Neonatal Nurs 2023; 52:320-327. [PMID: 37290490 DOI: 10.1016/j.jogn.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
In this article, we describe the process of establishing an academically and tribally supported community advisory board (CAB) to guide and inform community-engaged research about postpartum depression (PPD) among Indigenous women. Using a community-based participatory research framework, we created a CAB with stakeholders from the Chickasaw Nation because they are well situated to inform a research agenda about PPD in Indigenous women. We developed CAB roles, goals, and responsibilities; established processes for compensation and recognition; identified and recruited potential members; and conducted meetings to build rapport, brainstorm, receive feedback, and invite discussion of topics related to PPD that have been deemed important by the tribe (October 2021 through June 2022). The CAB defined specific roles, goals, and responsibilities for the academic-community partnership, including assumptions, expectations, and confidentiality. We used a standing agenda item to recognize member achievements. Members of the CAB represented many tribal departments and professional disciplines. We use a CAB framework to evaluate our process and to provide recommendations for future research and policymaking.
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17
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Vlassak E, Bessems K, Gubbels J. The Experiences of Midwives in Caring for Vulnerable Pregnant Women in The Netherlands: A Qualitative Cross-Sectional Study. Healthcare (Basel) 2022; 11. [PMID: 36611593 DOI: 10.3390/healthcare11010130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/03/2023] Open
Abstract
Vulnerable pregnant women have an increased risk for preterm birth and perinatal mortality. This study identifies the perspectives, perceived barriers, and perceived facilitators of midwives toward current care for vulnerable pregnant women in the Netherlands. Knowing those perspectives, barriers, and facilitators could help increase quality of care, thereby reducing the risks of preterm birth and perinatal mortality. Midwives working in primary care practices throughout the Netherlands were interviewed. Semi-structured interviews were conducted remotely through a video conference program, audio recorded, transcribed verbatim, and coded based on the theoretical domains framework and concepts derived from the interviews, using NVivo-12. All midwives provided psychosocial care for vulnerable pregnant women, expected positive consequences for those women resulting from that care, considered it their task to identify and refer vulnerable women, and intended to improve the situation for mother and child. The main barriers perceived by midwives were too many organizations being involved, inadequate communication between care providers, lack of time to care for vulnerable women, insufficient financing to provide adequate care, and uncooperative clients. The main facilitators were having care coordinators, treatment guidelines, vulnerability detection tools, their own knowledge about local psychosocial organizations, good communication skills, cooperative clients, consultation with colleagues, and good communication between care providers. The findings suggest that midwives are highly motivated to care for vulnerable women and perceive a multitude of facilitators. However, they also perceive various barriers for providing optimal care. A national guideline on how to care for vulnerable women, local overviews of involved organizations, and proactive midwives who ensure connections between the psychosocial and medical domain could help to overcome these barriers, and therefore, maximize effectiveness of the care for vulnerable pregnant women.
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18
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McLeod CD, Heaton LJ, Chung‐Bridges K, Raskin SE. Refining the process: Safety net dental professionals' experiences with teledentistry implementation during the first year of COVID-19. J Public Health Dent 2022:10.1111/jphd.12547. [PMID: 36257777 PMCID: PMC9874645 DOI: 10.1111/jphd.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/06/2022] [Accepted: 08/09/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Teledentistry helped dentistry adapt to pandemic-era challenges; little is known about dental professionals' teledentistry experiences during this time. This analysis sought to understand professionals' pandemic teledentistry experiences and expectations for the modality's future. METHODS We conducted virtual individual interviews (n = 21) via Zoom to understand how federally qualified health centers (FQHCs) delivered oral care during the first year of the pandemic, including but not limited to the use of teledentistry. We independently coded each transcript, then identified themes and sub-themes. RESULTS We identified three major themes: (1) Logistical and equity considerations shaped teledentistry's adoption; (2) Team-based factors influenced implementation; and (3) Teledentistry's future is as-yet undetermined. CONCLUSIONS Experiences with teledentistry during the first year of COVID-19 varied substantially. Future directions should be more deliberate to counter the urgency of pandemic-style implementation and must address appropriate use, reimbursement guidance, patient and provider challenges, and customizability to each clinic's context.
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Affiliation(s)
| | - Lisa J. Heaton
- Analytics and Evaluation, CareQuestInstitute for Oral HealthBostonMassachusettsUSA
| | | | - Sarah E. Raskin
- L. Douglas Wilder School of Government and Public Affairs and iCubed Initiative Oral Health CoreVirginia Commonwealth UniversityRichmondVirginiaUSA
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19
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Montiel Ishino FA, Rowan CE, Villalobos K, Rajbhandari-Thapa J, Williams F. A Time-Varying Effect Model (TVEM) of the Complex Association of Tobacco Use and Smoke Exposure on Mean Telomere Length: Differences between Racial and Ethnic Groups Assessed in the National Health and Nutrition Examination Survey. Int J Environ Res Public Health 2022; 19:11069. [PMID: 36078786 PMCID: PMC9518386 DOI: 10.3390/ijerph191711069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Telomere length is affected by lifestyle and environmental factors and varies between racial and ethnic groups; however, studies are limited, with mixed findings. This study examined the effects of tobacco use and smoke exposure on mean telomere length to identify critical age periods by race/ethnicity. We used time-varying effect modeling on the National Health and Nutrition Examination Survey for continuous years 1999-2002 to observe the effects of active tobacco use and environmental tobacco smoke-measured through serum cotinine-and mean telomere length for adults 19 to 85 and older (N = 7826). Models were run for Mexican American, other Hispanic, non-Hispanic White, non-Hispanic Black, and other/multi-race categories to allow for time-varying group differences, and controlled for biological sex, socioeconomic status, education, and ever-smoker status. Serum cotinine was found to have an increasing effect on telomere length from age 37 to approximately age 74 among Mexican Americans. Among other/multi-race individuals serum cotinine was found to have a decreasing effect at approximately age 42, and among Blacks, it had an overall decreasing effect from age 61 to 78. Findings reveal a further need to focus additional support and resources to intervene regarding disparate health effects from tobacco use and environmental smoke exposure for already vulnerable groups at particular ages.
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Affiliation(s)
- Francisco Alejandro Montiel Ishino
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
| | - Claire E. Rowan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Kevin Villalobos
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
| | - Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
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MacIntosh T, Gracious BL, Brooks JR, Donini G. Health Equity in Medicine. HCA Healthc J Med 2022; 3:77-79. [PMID: 37424608 PMCID: PMC10324834 DOI: 10.36518/2689-0216.1516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Description Healthcare disparities exist when, due to racial, ethnic, or gender identity differences linked to social, economic or environmental factors, certain populations lack equitable access to quality healthcare and insurance coverage. Such disparities across history carry profound future implications that we have only begun to contemplate as a profession. This special issue of the HCA Healthcare Journal of Medicine examines the critical issue of health equity in medicine and how the medical community can advance health equity through inclusive behavior and interactions in clinical and educational settings, and our communities.
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Affiliation(s)
- Tracy MacIntosh
- University of Central Florida College of Medicine, Orlando, FL
- HCA Florida Osceola Hospital, Osceola, FL
| | | | | | - Graig Donini
- HCA Healthcare Graduate Medical Education, Brentwood, TN
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