1
|
Saksena Y. Breaking the bamboo ceiling and de-bunking the model minority myth. J Dent Educ 2024; 88 Suppl 1:678-684. [PMID: 38758068 DOI: 10.1002/jdd.13510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/12/2024] [Accepted: 03/03/2024] [Indexed: 05/18/2024]
Abstract
Leadership roles must incorporate representation from all involved individuals for the resulting decision-making process to reflect the interests and expertise of a diverse organization. Many resources have rightly focused on developing historically underrepresented racial and ethnic (HURE) leaders. Though numbers of Black and Hispanic dental school deans have increased, more work is needed for these and other HURE groups such as American Indians. Asians are not classified as HURE. As an aggregated group they have robust presence in the dental workforce in North America, the United Kingdom and Australia. The assumption is they are fine, so the group is ignored. Previous research indicates Asians are almost invisible in leadership roles in dentistry, and while the "Glass Ceiling" phenomenon for women persists, Asian women face even greater obstacles to leadership. This paper explores cultural factors contributing to the "Bamboo Ceiling", such as Confucian values emphasizing collectivism and deference to authority. It examines challenges faced by Asian women at the intersection of gender and race. The impact of the "Model Minority Myth" compounds these challenges, leading to overlooking diverse needs. The importance of dispelling these harmful myths is underscored. This paper provides strategies to combat them, urging proactive efforts from minorities and management. By shedding light on the "Bamboo Ceiling" and the "Model Minority Myth", this paper aims to reassess existing norms, current policies and procedures pertaining to equitable representation and leadership opportunities for Asian women in academic dentistry, community oral health, research, and in dental corporations.
Collapse
Affiliation(s)
- Yun Saksena
- Department of Adult Restorative Dentistry, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| |
Collapse
|
2
|
Ullah N, Martin S, Poduval S. A Snapshot of COVID-19 Vaccine Discourse Related to Ethnic Minority Communities in the United Kingdom Between January and April 2022: Mixed Methods Analysis. JMIR Form Res 2024; 8:e51152. [PMID: 38530334 DOI: 10.2196/51152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Existing literature highlights the role of social media as a key source of information for the public during the COVID-19 pandemic and its influence on vaccination attempts. Yet there is little research exploring its role in the public discourse specifically among ethnic minority communities, who have the highest rates of vaccine hesitancy (delay or refusal of vaccination despite availability of services). OBJECTIVE This study aims to understand the discourse related to minority communities on social media platforms Twitter and YouTube. METHODS Social media data from the United Kingdom was extracted from Twitter and YouTube using the software Netlytics and YouTube Data Tools to provide a "snapshot" of the discourse between January and April 2022. A mixed method approach was used where qualitative data were contextualized into codes. Network analysis was applied to provide insight into the most frequent and weighted keywords and topics of conversations. RESULTS A total of 260 tweets and 156 comments from 4 YouTube videos were included in our analysis. Our data suggests that the most popular topics of conversation during the period sampled were related to communication strategies adopted during the booster vaccine rollout. These were noted to be divisive in nature and linked to wider conversations around racism and historical mistrust toward institutions. CONCLUSIONS Our study suggests a shift in narrative from concerns about the COVID-19 vaccine itself, toward the strategies used in vaccination implementation, in particular the targeting of ethnic minority groups through vaccination campaigns. The implications for public health communication during crisis management in a pandemic context include acknowledging wider experiences of discrimination when addressing ethnic minority communities.
Collapse
Affiliation(s)
- Nazifa Ullah
- Research Department of Primary Care & Population Health, University College London, London, United Kingdom
| | - Sam Martin
- Vaccines and Society Unit, Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
| | - Shoba Poduval
- Institute of Health Informatics, University College London, London, United Kingdom
| |
Collapse
|
3
|
Wang YY, Rohanachandra Y, Dahanayake D. Editorial: Mental health of children and adolescents of minority groups. Front Psychiatry 2024; 15:1391368. [PMID: 38559396 PMCID: PMC10979419 DOI: 10.3389/fpsyt.2024.1391368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Yuan Yuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yasodha Rohanachandra
- Child and Youth Mental Health Services, Latrobe Regional Health, Traralgon, VIC, Australia
| | - Dulangi Dahanayake
- Child and Youth Mental Health Service, Darling Downs Hospital and Health Service, Toowoomba, QLD, Australia
| |
Collapse
|
4
|
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
| | | |
Collapse
|
5
|
Nilsson SF, Wimberley T, Speyer H, Hjorthøj C, Fazel S, Nordentoft M, Laursen TM. The bidirectional association between psychiatric disorders and sheltered homelessness. Psychol Med 2024; 54:742-752. [PMID: 37679023 DOI: 10.1017/s0033291723002428] [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: 09/09/2023]
Abstract
BACKGROUND Psychiatric disorders and homelessness are related, but temporal associations are unclear. We aimed to explore the overlap between hospital-based psychiatric disorders and sheltered homelessness. METHODS This population-based cohort study was conducted using the Danish registers e.g., the Danish Homeless Register and the Danish National Patient Register. The study cohort included all individuals aged 15 years or older, living in Denmark at least one day during 2002-2021 (born 1984-2006). First psychiatric diagnosis was used to define psychiatric disorder and first homeless shelter contact to define homelessness. Adjusted incidence rate ratios (IRRs) and cumulative incidences were estimated. RESULTS Among 1 530 325 individuals accounting for 16 787 562 person-years at risk aged 15-38 years, 11 433 (0.8%) had at least one homeless shelter contact. Among 1 406 410 individuals accounting for 14 131 060 person-years at risk, 210 730 had at least one psychiatric disorder. People with any psychiatric disorder had increased risk of sheltered homelessness relative to individuals with no psychiatric disorder [IRR 9.2, 95% confidence interval (CI) 8.8-9.6]. Ten years after first psychiatric disorder, 3.0% (95% CI 2.9-3.1) had at least one homeless shelter contact. Individuals experiencing homelessness had increased risk of any psychiatric disorder compared to individuals with no homeless shelter contact (IRR 7.0, 95% CI 6.7-7.4). Ten years after first homeless shelter contact, 47.1% (45.3-48.0) had received a hospital-based psychiatric diagnosis. CONCLUSION Strong bidirectional associations between psychiatric disorders and homelessness were identified. Health and social care professionals should be aware of and address these high risks of accumulated psychiatric and social problems.
Collapse
Affiliation(s)
- Sandra Feodor Nilsson
- Copenhagen Research Center for Mental Health - CORE, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Theresa Wimberley
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- iPSYCH - The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Aarhus, Denmark
| | - Helene Speyer
- Copenhagen Research Center for Mental Health - CORE, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, UK and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- iPSYCH - The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Aarhus, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Munk Laursen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| |
Collapse
|
6
|
Ciaffoni S, Rubini M, Moscatelli S. Turning ingroup wounds into bonds: perceptions of gender inequalities predict attitudes toward other minorities. Front Psychol 2024; 14:1327262. [PMID: 38259557 PMCID: PMC10800884 DOI: 10.3389/fpsyg.2023.1327262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Despite significant strides in reducing gender disparities over the past decades, women still face disparities in several domains. While extensive research has explored the various consequences of gender inequalities for women, this study (N = 493 participants) delves into a less-explored dimension, investigating whether and how perceiving gender inequalities is associated with attitudes toward minorities. Drawing on relative deprivation theory and intra-minority solidarity research, we examined the relationship between women's perceptions of gender inequalities-spanning workplace inequality, domestic inequality, sexual harassment, and social expectations-and attitudes toward gays and lesbians, transgender women, and immigrants. We also explored whether indignation, arising from recognizing unjust circumstances, mediated these relationships, and the moderating role of perceived friends' support for gender equality. The results of the path analyses unveiled a nuanced relationship. While women who were more aware of gender inequalities exhibited more positive attitudes toward gays and lesbians and transgender women, no such relationship was observed regarding immigrants. Indignation and perceived friends' support for gender equality were key factors in fostering positive intergroup attitudes. Regarding their moderating role, perceived social norms only influenced the relationship between indignation and attitudes toward gays and lesbians. These findings shed light on the intricate interplay between gender inequalities and minority group attitudes. Recognizing the multifaceted nature of gender inequality and its emotional impact can catalyze promoting coalitional attitudes and collective action among disadvantaged groups. The study also underscores the potential of close groups' norms in promoting positive intergroup attitudes, warranting further exploration.
Collapse
|
7
|
Dawson K, Burke L, Flack, Jr WF, O’Higgins S, McIvor C, MacNeela P. Patterns of Sexual Harassment: An Intersectional Approach to Reported Victimization in a Campus Climate Survey of Students at Irish Higher Education Institutions. Violence Against Women 2024; 30:323-344. [PMID: 37788357 PMCID: PMC10666493 DOI: 10.1177/10778012231203619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
This study explores how identifying with multiple minority groups relates to sexual harassment victimization (SHV) among students in higher education institutions in Ireland (n = 6,002). Results show that gender nonconforming and female students were more likely than males to experience SHV. Bisexual or queer and gay or lesbian students were more likely than their heterosexual peers to experience SHV. Students with a physical or cognitive disability were more likely to experience SHV than those who reported no disability, and white students were more likely than minority ethnic groups to experience SHV. When controlling for sexual orientation, gender, and disability status, students who identified as both gay and lesbian and reported a cognitive disability were 8.5 times more likely to experience SHV. Victims of SHV reported having lower scores on perceived institutional support items than those who had not experienced SHV.
Collapse
|
8
|
Marzbanrad A, Niaghi F, Tiwana S, Siddiqi J, Ding J, Tanvir I, Khosa F. Advancing Diversity in Microbiology: A 55-Year Retrospective Analysis. Cureus 2024; 16:e52528. [PMID: 38371065 PMCID: PMC10874303 DOI: 10.7759/cureus.52528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Background For over 50 years, affirmative action helped advance equity, diversity and inclusion (EDI) in educational institutions in the United States (U.S.). However, the recent U.S. Supreme Court decision to end affirmative action in college admissions threatens the progress toward EDI. Objective This study aimed to assess the progress in promoting gender and racial diversity within the discipline of microbiology over a 55-year period. We sought to analyze the representation of women and minority groups in faculty ranks, tenure positions, and leadership to identify disparities and trends and determine who will likely be impacted most with the end of affirmative action. Materials and methods This longitudinal retrospective study utilized publicly available and non-identifiable Association of American Medical Colleges (AAMC) data on full-time microbiology faculty from 1967 to 2021. Faculty members were categorized based on academic ranks and tenure status, while gender and racial data were also considered. Results The analysis revealed a consistent dominance of white faculty, with over 60% representation across all academic ranks throughout the study period. The Asian and female faculty representation decreased in senior academic ranks. We observed a positive trend in the annual increase of women in faculty positions, academic ranks, chairs, and tenure positions. Furthermore, Asian faculty demonstrated the most robust surge in representation. However, disparities persisted for black, Hispanic, and Native American faculty members, reflecting broader challenges in their representation. Discussion Although efforts to enhance diversity within microbiology have yielded positive results, underrepresented minority groups still face obstacles in attaining leadership positions and senior academic ranks. The diminishing proportion of women at higher academic ranks raises concerns about potential attrition or lack of promotion opportunities. The end of affirmative action poses a risk of perpetuating this trend, leading to a decline in diversity among microbiology faculty.
Collapse
Affiliation(s)
| | - Farhad Niaghi
- Emergency Radiology, University of British Columbia, Vancouver, CAN
| | - Sabeen Tiwana
- Dentistry, University of British Columbia, Vancouver, CAN
| | - Javed Siddiqi
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
- Neurosurgery, Arrowhead Regional Medical Center, Colton, USA
- Neurosurgery, California University of Science and Medicine, Colton, USA
| | - Jeffrey Ding
- Medicine, University of British Columbia, Vancouver, CAN
| | - Imrana Tanvir
- Pathology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Faisal Khosa
- Radiology, Vancouver General Hospital, Vancouver, CAN
| |
Collapse
|
9
|
Alick CL, Braxton D, Skinner H, Alexander R, Ammerman AS, Keyserling TC, Samuel-Hodge CD. Rural African American Women With Severe Obesity: A Cross-Sectional Analysis of Lifestyle Behaviors and Psychosocial Characteristics. Am J Health Promot 2023; 37:1060-1069. [PMID: 37505193 PMCID: PMC10631280 DOI: 10.1177/08901171231190597] [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] [Indexed: 07/29/2023]
Abstract
PURPOSE To examine differences in lifestyle behavioral and psychosocial factors between rural African American women with Class 3 obesity and those with overweight, and Class 1-2 obesity. DESIGN Cross-sectional study. SETTING Rural Southeastern United States. SUBJECTS Participants included 289 African American women with a mean age of 56 years, 66% with a high school education or less, and a mean body mass index (BMI) of 38.6 kg/m2; 35% (n = 102) were classified with Class 3 obesity. MEASURES We objectively measured height, weight, and physical activity steps/day. Self-reported dietary and physical activity behaviors, general health-related quality of life, mental health, and social support were measured with validated surveys. ANALYSIS Chi-Square analysis for categorical variables and analysis of variance (ANOVA) - via multiple linear regression - for continuous variables. RESULTS There were no significant demographic differences between BMI groups, except for age, where women with Class 3 obesity were on average younger (51 vs 58 y, P < .001). Although dietary behaviors did not differ significantly between groups, we observed significant group differences in self-reported and objective measures of physical activity. The age-adjusted difference in means for self-reported total physical activity minutes/wk. was 91 minutes, with women categorized with Class 3 obesity reporting significantly fewer weekly minutes than those with overweight/Class 1-2 obesity (64.3 vs 156.4 min/wk. respectively, P < .01). Among psychosocial variables, only in the physical component scores of health-related quality of life did we find significant group differences - lower physical well-being among women with Class 3 obesity compared to those with overweight/Class 1-2 obesity (P = .02). CONCLUSION For African American women with Class 3 obesity living in rural setting, these findings suggest behavioral weight loss interventions may need to target physical activity strategies that address physical, psychosocial, and environmental barriers.
Collapse
Affiliation(s)
- Candice L. Alick
- Center for Health Promotion & Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Danielle Braxton
- Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Harlyn Skinner
- Department of Biological Science, Center for Human Health and the Environment, North Carolina State University, Chapel Hill, NC, USA
| | - Ramine Alexander
- Department of Family and Consumer Sciences, Food and Nutritional Sciences, North Carolina Agricultural & Technical State University, Greensboro, NC, USA
| | - Alice S. Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C. Keyserling
- Internal Medicine, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Carmen D. Samuel-Hodge
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
10
|
Hawks-Ladds N, Labagnara K, Meeks W, North A, Small A. Factors Influencing Medical Students' Pursuit of Urology: Results From the AUA Census (2019-2021). Urol Pract 2023:101097UPJ0000000000000466. [PMID: 37902216 DOI: 10.1097/upj.0000000000000466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/20/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Growing interest in urology among medical students highlights the need to understand factors influencing their specialty choice in today's context. We also investigate COVID-19's impact on these factors and any disparities among female and underrepresented in medicine (URiM) students. METHODS From 2019 to 2021, the AUA Annual Census survey included medical student-focused questions on demographics, career interests, and decision factors. Responses were analyzed. RESULTS One hundred ninety-two medical students participated. Thirty-six (24%) identified as female and 19 (13%) as URiM. Common reasons students would choose urology included surgical procedures (93%) and "good lifestyle" among surgical careers (85%), with no differences across gender or URiM status. Compared to pre-COVID (2019), during COVID (2020-2021), a greater proportion of students cited cutting-edge technology (90.1% vs 73.1%, P = .008) and surgical procedures (98.6% vs 87.2%, P = .008) as reasons to choose urology. Reasons for not choosing urology included competitiveness (48%) and poor lifestyle (26%). Female and URiM students expressed concern related to the combined "male dominated/gender discrimination/lack of diversity" aspect (female 33% vs male 3%, P < .001; URiM 25% vs non-URiM 7%, P = .04). CONCLUSIONS The AUA Census survey highlights factors influencing medical students' decisions regarding urology. Interest in procedural and technological aspects grew during COVID. Students expressed concern over the field's competitiveness and poor lifestyle, while also acknowledging that urology offers a favorable lifestyle compared to other surgical careers. Female and URiM students expressed ongoing concerns over the combined aspect of gender discrimination and/or the lack of existing diversity in the field.
Collapse
Affiliation(s)
| | | | - William Meeks
- American Urological Association, Linthicum, Maryland
| | - Amanda North
- Department of Urology, Montefiore Medical Center, Bronx, New York
| | - Alexander Small
- Department of Urology, Montefiore Medical Center, Bronx, New York
| |
Collapse
|
11
|
Gundersen AB, van der Linden S, Piksa M, Morzy M, Piasecki J, Ryguła R, Gwiaździński P, Noworyta K, Kunst JR. The role of perceived minority-group status in the conspiracy beliefs of factual majority groups. R Soc Open Sci 2023; 10:221036. [PMID: 37859838 PMCID: PMC10582598 DOI: 10.1098/rsos.221036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
Research suggests that minority-group members sometimes are more susceptible to misinformation. Two complementary studies examined the influence of perceived minority status on susceptibility to misinformation and conspiracy beliefs. In study 1 (n = 2140), the perception of belonging to a minority group, rather than factually belonging to it, was most consistently related with an increased susceptibility to COVID-19 misinformation across national samples from the USA, the UK, Germany and Poland. Specifically, perceiving that one belongs to a gender minority group particularly predicted susceptibility to misinformation when participants factually did not belong to it. In pre-registered study 2 (n = 1823), an experiment aiming to manipulate the minority perceptions of men failed to influence conspiracy beliefs in the predicted direction. However, pre-registered correlational analyses showed that men who view themselves as a gender minority were more prone to gender conspiracy beliefs and exhibited a heightened conspiracy mentality. This effect was correlationally mediated by increased feelings of system identity threat, collective narcissism, group relative deprivation and actively open-minded thinking. Especially, the perception of being a minority in terms of power and influence (as compared to numerically) was linked to these outcomes. We discuss limitations and practical implications for countering misinformation.
Collapse
Affiliation(s)
| | | | - Michał Piksa
- Department of Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Krakow, Poland
| | - Mikołaj Morzy
- Institute of Computing Science, Poznan University of Technology, Poznan, Poland
| | - Jan Piasecki
- Department of Philosophy and Bioethics, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Ryguła
- Department of Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Krakow, Poland
| | - Paweł Gwiaździński
- Department of Philosophy and Bioethics, Jagiellonian University Medical College, Kraków, Poland
- Department of Philosophy and Sociology, Pedagogical University of Krakow, Kraków, Poland
| | - Karolina Noworyta
- Department of Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Krakow, Poland
| | - Jonas R. Kunst
- Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway
| |
Collapse
|
12
|
Bonilla E, Fogel J, Hubley R, Anand R, Liu PC. Survey of COVID-19 Vaccine Attitudes in Predominately Minority Pregnant Women. South Med J 2023; 116:677-682. [PMID: 37536694 PMCID: PMC10417252 DOI: 10.14423/smj.0000000000001587] [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] [Accepted: 02/01/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Despite recommendations for coronavirus disease (COVID-19) vaccination during pregnancy, some pregnant women are concerned about COVID-19 vaccines and decline to be vaccinated. This study focuses on attitudes in a sample of mostly minority pregnant Hispanic and Black women that may influence vaccine hesitancy. METHODS This was a cross-sectional survey of 400 pregnant women. Participants were provided with a one-page information sheet on pregnancy health, COVID-19 health, and COVID-19 vaccines. They were then asked to complete a survey on attitudes about these topics. RESULTS We found that attitudes for knowing about the health topics were in the range from agree to strongly agree, whereas attitudes for knowing about topics pertaining to COVID-19 messenger RNA (mRNA) vaccines were in a lower-level range from neutral to agree. Negative vaccine attitudes were significantly associated with decreased agreement for knowing about health attitudes, but not significantly associated with COVID-19 mRNA vaccine attitudes. CONCLUSIONS COVID-19 vaccine mRNA technology was a lesser understood topic than attitudes for knowing about other health topics. This finding suggests the need for physician intervention and that further education about COVID-19 vaccine mRNA technology may influence patient attitudes toward acceptance of the COVID-19 mRNA vaccine in pregnancy.
Collapse
Affiliation(s)
- Engelbert Bonilla
- From the Department of Obstetrics & Gynecology, Nassau University Medical Center, East Meadow, New York
| | - Joshua Fogel
- From the Department of Obstetrics & Gynecology, Nassau University Medical Center, East Meadow, New York
- Department of Business Management, Brooklyn College of the City University of New York, Brooklyn
| | - Robert Hubley
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury
| | - Rahul Anand
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury
| | - Paul C. Liu
- From the Department of Obstetrics & Gynecology, Nassau University Medical Center, East Meadow, New York
| |
Collapse
|
13
|
Simon SS, Brucki SMD, Fonseca LM, Becker J, Cappi C, Marques AH, Heyn PC, Gonçalves PD, Martins SS, Busatto G, Bertola L, Suemoto CK, Nitrini R, Caramelli P, Yassuda MS, Miotto EC, Grinberg LT, Arce Renteria M, Alegria M, Stern Y, Rivera‐Mindt M. The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States. Alzheimers Dement (N Y) 2023; 9:e12425. [PMID: 37744309 PMCID: PMC10517444 DOI: 10.1002/trc2.12425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/26/2023]
Abstract
Introduction The Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group-specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities.It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population. Methods We reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles. Results This perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S-residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials. Conclusions The recommendation and research efforts proposed should help to pave the way for the development of community-engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally-informed intervention to the U.S.-residing Brazilian communities. HIGHLIGHTS The Brazilian population in the United States is growing but is underrepresented in U.S. health research.Approximately 71% of Brazilian immigrants in the United States are undocumented, with an increased risk for health inequities.Mental health is reported as a central health priority by Brazilian immigrants in the United States.There is a lack of research on Alzheimer's disease and other dementias (ADRD) in Brazilian immigrants in the United States.Epidemiological research is needed to map the prevalence/incidence of mental health conditions and ADRD risk factors among Brazilian immigrants in the United States.
Collapse
Affiliation(s)
- Sharon Sanz Simon
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | | | - Luciana Mascarenhas Fonseca
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Department of Community and Behavioral HealthElson S. Floyd College of MedicineWashington State UniversitySpokaneWashingtonUSA
| | - Jacqueline Becker
- Division of General Internal MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Carolina Cappi
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Seaver Autism Center for Research and TreatmentIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of PsychiatryClinics HospitalUniversity of São PauloSchool of MedicineSão PauloSão PauloBrazil
| | - Andrea Horvath Marques
- Elliott School International AffairsThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Patricia C. Heyn
- Center for Optimal AgingDepartment of Physical TherapyMarymount UniversityArlingtonVirginiaUSA
| | - Priscila Dib Gonçalves
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
| | - Silvia S. Martins
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
| | - Geraldo Busatto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Laiss Bertola
- Department of PsychiatryEscola Paulista de Medicina, Universidade Federal de São PauloSão PauloBrazil
| | - Claudia Kimie Suemoto
- Division of GeriatricsDepartment of Clinical MedicineUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Ricardo Nitrini
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research GroupFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMinas GeraisBrazil
| | - Monica Sanches Yassuda
- Department of NeurologyUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Gerontology, School of Arts, Sciences, and HumanitiesUniversity of São PauloSão PauloSão PauloBrazil
| | - Eliane Correa Miotto
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Lea Tenenholz Grinberg
- Memory and Aging CenterDepartment of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- LIM‐22Department of PathologyUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Miguel Arce Renteria
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Margarita Alegria
- Disparities Research UnitDepartment of MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Yaakov Stern
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Monica Rivera‐Mindt
- Department of PsychologyFordham UniversityNew YorkNew YorkUSA
- Department of NeurologyIcahn School of MedicineNew YorkNew YorkUSA
| |
Collapse
|
14
|
de Silva D, Roberts R, Nayar V, Rutt G, Gregory S, Khan A. Tackling differential attainment in specialist GP training in England and Scotland. Educ Prim Care 2023; 34:199-203. [PMID: 37643423 DOI: 10.1080/14739879.2023.2243453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/29/2023] [Indexed: 08/31/2023]
Abstract
In this article NHS England and NHS Education for Scotland describe practical ways we are tackling differences in the attainment of people training as general practitioners (GPs).Trainees from minority ethnic groups and international medical graduates are less likely than others to qualify as GPs. It is difficult to change systemic inequalities, but over the past five years we have made practical changes to GP speciality training. Educators recognise there is an issue and are trying to tackle it.For example, people who had not successfully qualified had an opportunity to return to GP training. When we provided individualised targeted support, the proportion who completed training significantly increased (76%).This was a catalyst for reviewing unconscious bias in GP training. We implemented a national programme to tackle differential attainment and system-level bias. Educators now work with all GP trainees to identify their individual needs. Supervisors are trained to recognise bias and provide targeted support. There is mental health support and regular reviews to see whether trainees are ready to sit exams. Trainee representatives are championing the learner voice in national committees. Exams are being altered to reduce unconscious bias. We are monitoring attainment over time.The key message is that differential attainment should not be in the 'too hard basket'. The narrative is changing from 'can't do' to 'must do', supported by appropriate leadership, promotion and resourcing. There is much more to do, but we are making changes, evaluating and applying our learning. We have moved from talking to taking action.
Collapse
Affiliation(s)
- Debra de Silva
- Department of primary care, The Evidence Centre, London, UK
| | | | - Vijay Nayar
- Department of primary care, NHS England, London, UK
| | - Graham Rutt
- Department of primary care, NHS England, London, UK
| | | | - Amjad Khan
- Department of primary care, NHS Education for Scotland, Edinburgh, UK
| |
Collapse
|
15
|
Grimes T, Marcilly R, Bonnici West L, Cordina M. Medication-Related Outcomes and Health Equity: Evidence for Pharmaceutical Care. Pharmacy (Basel) 2023; 11:pharmacy11020060. [PMID: 36961038 PMCID: PMC10037618 DOI: 10.3390/pharmacy11020060] [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: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
Marginalised people experience diminished access to pharmaceutical care and worse medication-related outcomes than the general population. Health equity is a global priority. This article explores the key evidence of health inequity and medication use, structures the causes and contributory factors and suggests opportunities that can be taken to advance the pharmaceutical care agenda so as to achieve health equity. The causes of, and contributors to, this inequity are multi-fold, with patient- and person-related factors being the most commonly reported. Limited evidence is available to identify risk factors related to other aspects of a personal medication use system, such as technology, tasks, tools and the internal and the external environments. Multiple opportunities exist to enhance equity in medication-related outcomes through pharmaceutical care research and practice. To optimise the effects and the sustainable implementation of these opportunities, it is important to (1) ensure the meaningful inclusion and engagement of members of marginalised groups, (2) use a person-centred approach and (3) apply a systems-based approach to address all of the necessary components of a system that interact and form a network as work processes that produce system outcomes.
Collapse
Affiliation(s)
- Tamasine Grimes
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, D02PN40 Dublin, Ireland
| | - Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France
- Inserm, CIC-IT 1403, F-59000 Lille, France
| | - Lorna Bonnici West
- Applied Research and Innovation Centre, Malta College of Arts, Science and Technology, PLA9032 Paola, Malta
| | - Maria Cordina
- Department of Clinical Pharmacology & Therapeutics, WHO Collaborating Centre for Health Professionals Education and Research, Faculty of Medicine and Surgery, University of Malta, 2080 Msida, Malta
| |
Collapse
|
16
|
Nugent SM, Golden SE, Chapa J, Tuepker A, Slatore CG, Vranas KC. "You're Socially Distant and Trying Not to Be Emotionally Distant." Physicians' Perspectives of Communication and Therapeutic Relationships in the ICU During the COVID-19 Pandemic: A Qualitative Study. Crit Care Explor 2023; 5:e0854. [PMID: 36817963 DOI: 10.1097/CCE.0000000000000854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
To: 1) characterize how COVID-19-related policies influence patient-clinician communication and relationships in the ICU, with attention to race and ethnicity as factors and 2) identify interventions that may facilitate patient-clinician communication. DESIGN We conducted a qualitative study between September 2020 and February 2021 that explored facilitators and barriers to patient-clinician communication and the formation of therapeutic relationships. We used thematic analysis to develop findings describing patient-communication and therapeutic relationships within the ICU early in the COVID-19 pandemic. SETTING We purposively selected hospital dyads from regions in the United States that experienced early and/or large surges of patients hospitalized with COVID-19. SUBJECTS We recruited a national sample of ICU physicians from Veteran Affairs (VA) Health Care Systems and their associated academic affiliate hospitals. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Twenty-four intensivists from seven VA hospitals and six academic-affiliate hospitals participated. Intensivists noted the disproportionate impact of the pandemic on among people holding minoritized racial and ethnic identities, describing how language barriers and restrictive visitation policies exacerbated institutional mistrust and compromised physicians' ability to develop therapeutic relationships. We also identified several perceived influences on patient-clinician communication and the establishment of therapeutic relationships. Barriers included physicians' fear of becoming infected with COVID-19 and use of personal protective equipment, which created obstacles to effective physical and verbal interactions. Facilitators included the presence of on-site interpreters, use of web-based technology to interact with family members outside the ICU, and designation of a care team member or specialist service to provide routine updates to families. CONCLUSIONS The COVID-19 pandemic has threatened patient-clinician communication and the development of therapeutic relationships in the ICU, particularly among people holding minoritized racial and ethnic identities and their families. We identified several facilitators to improve patient-clinician communication as perceived by intensivists that may help improve trust and foster therapeutic alliances.
Collapse
|
17
|
Gershfeld-Litvin A, Halabi S, Bellizzi KM. Stigma related to breast cancer among women and men: The case of the Druze minority in Israel. J Health Psychol 2023; 28:189-199. [PMID: 35894170 PMCID: PMC9936445 DOI: 10.1177/13591053221115619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The objective of this study was to explore stigma related to breast cancer among Druze women and men and identify factors associated with low screening rates among Druze women. A sample of 270 Druze women and men completed an online questionnaire adapted to detect breast cancer stigma and internalized breast cancer stigma. Independent samples t-test results showed higher scores for men compared to women, at a significant level, on four of the Breast Cancer Stigma scales: awkwardness, avoidance, policy opposition, and personal responsibility. Independent samples t-test results also showed higher scores for men compared to women, at a significant level, on two of the Internalized Breast Cancer Stigma scales: stereotype endorsement and discrimination experience. These results suggest a need for psychoeducation about breast cancer screening for minority groups such as the Druze, with male partners of women who are diagnosed with breast cancer being the main target recipients.
Collapse
Affiliation(s)
- Avital Gershfeld-Litvin
- The Academic College of Tel Aviv-Yaffo, Israel,Avital Gershfeld-Litvin, School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Rabenu Yeruham 2, Yaffo 6818211, Israel.
| | | | | |
Collapse
|
18
|
Schofield P, Das-Munshi J, Webb RT, Horsdal HT, Pedersen CB, Agerbo E. Lack of fit with the neighbourhood social environment as a risk factor for psychosis - a national cohort study. Psychol Med 2023; 53:866-874. [PMID: 34140057 PMCID: PMC9975998 DOI: 10.1017/s0033291721002233] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Many studies report an ethnic density effect whereby psychosis incidence among ethnic minority groups is higher in low co-ethnic density areas. It is unclear whether an equivalent density effect applies with other types of socioeconomic disadvantages. METHODS We followed a population cohort of 2 million native Danes comprising all those born on 1st January 1965, or later, living in Denmark on their 15th birthday. Socioeconomic disadvantage, based on parents' circumstances at age 15 (low income, manual occupation, single parent and unemployed), was measured alongside neighbourhood prevalence of these indices. RESULTS Each indicator was associated with a higher incidence of non-affective psychosis which remained the same, or was slightly reduced, if neighbourhood levels of disadvantage were lower. For example, for individuals from a low-income background there was no difference in incidence for those living in areas where a low-income was least common [incidence rate ratio (IRR) 1.01; 95% confidence interval (CI) 0.93-1.10 v. those in the quintile where a low income was most common. Typically, differences associated with area-level disadvantage were the same whether or not cohort members had a disadvantaged background; for instance, for those from a manual occupation background, incidence was lower in the quintile where this was least v. most common (IRR 0.83; 95% CI 0.71-0.97), as it was for those from a non-manual background (IRR 0.77; 95% CI 0.67-0.87). CONCLUSION We found little evidence for group density effects in contrast to previous ethnic density studies. Further research is needed with equivalent investigations in other countries to see if similar patterns are observed.
Collapse
Affiliation(s)
- Peter Schofield
- School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Jayati Das-Munshi
- ESRC Centre for Society and Mental Health, King's College London, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London & Maudsley NHS Foundation Trust, London, UK
| | - Roger T. Webb
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Centre, Manchester, UK
| | | | - Carsten B. Pedersen
- National Centre for Register-Based Research (NCCR), Aarhus University, Aarhus, Denmark
- CIRRAU – Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- National Centre for Register-Based Research (NCCR), Aarhus University, Aarhus, Denmark
- CIRRAU – Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| |
Collapse
|
19
|
Escobar-Domingo MJ, Bustos VP, Fanning JE, Foppiani J, Kim E, Hernandez-Alvarez A, Lin SJ, Singhal D, Lee BT. Underreporting and Underrepresentation of Racial and Ethnic Minority Patients in Lymphedema Clinical Trials: A Systematic Review. Lymphology 2023; 56:41-60. [PMID: 38621383] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The generalizability of findings from Clinical Trials (CTs) investigating lymphedema treatment modalities requires an accurate representation of the target population. This study aims to evaluate racial and ethnic reporting and representation in lymphedema CTs. A comprehensive systematic literature search was conducted during May 2023 using multiple databases, following the PRISMA guidelines. All CTs published from 2018 to 2023 were included. A total of 84 articles were included in this review, from which 6,546 participants were included in the analysis. Seventy-four (88.1%) articles addressed secondary lymphedema, of which 60 (81.1%) were related to breast cancer. Only 12 (13%) of CTs reported at some extend race or ethnicity. Of these, five (41.6%) reported race and two (16.6%) reported ethnicity according to FDA guidelines. White race had the highest pooled prevalence (80%; 95% CI 72-86%; I2=90%), followed by Black (7%; 95% CI 2- 15%; I2= 94.3%) and Asian (4%; 95% CI 1-8%; I2= 89.9%). In studies reporting ethnicity, participants were predominantly non-Hispanic (92.1%; 95% CI 90 - 94%). There is an underreporting and underrepresentation of racial and ethnic minorities among lymphedema CTs, limiting their generalizability. It is imperative to future development of strategies to enhance diversity in the study sample.
Collapse
Affiliation(s)
- M J Escobar-Domingo
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - V P Bustos
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - J E Fanning
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - J Foppiani
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - E Kim
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - A Hernandez-Alvarez
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - S J Lin
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - D Singhal
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - B T Lee
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
20
|
Murthy D, Lee J, Dashtian H, Kong G. Influence of User Profile Attributes on e-Cigarette-Related Searches on YouTube: Machine Learning Clustering and Classification. JMIR Infodemiology 2023; 3:e42218. [PMID: 37124246 PMCID: PMC10139687 DOI: 10.2196/42218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/30/2022] [Accepted: 02/06/2023] [Indexed: 05/02/2023]
Abstract
Background The proliferation of e-cigarette content on YouTube is concerning because of its possible effect on youth use behaviors. YouTube has a personalized search and recommendation algorithm that derives attributes from a user's profile, such as age and sex. However, little is known about whether e-cigarette content is shown differently based on user characteristics. Objective The aim of this study was to understand the influence of age and sex attributes of user profiles on e-cigarette-related YouTube search results. Methods We created 16 fictitious YouTube profiles with ages of 16 and 24 years, sex (female and male), and ethnicity/race to search for 18 e-cigarette-related search terms. We used unsupervised (k-means clustering and classification) and supervised (graph convolutional network) machine learning and network analysis to characterize the variation in the search results of each profile. We further examined whether user attributes may play a role in e-cigarette-related content exposure by using networks and degree centrality. Results We analyzed 4201 nonduplicate videos. Our k-means clustering suggested that the videos could be clustered into 3 categories. The graph convolutional network achieved high accuracy (0.72). Videos were classified based on content into 4 categories: product review (49.3%), health information (15.1%), instruction (26.9%), and other (8.5%). Underage users were exposed mostly to instructional videos (37.5%), with some indication that more female 16-year-old profiles were exposed to this content, while young adult age groups (24 years) were exposed mostly to product review videos (39.2%). Conclusions Our results indicate that demographic attributes factor into YouTube's algorithmic systems in the context of e-cigarette-related queries on YouTube. Specifically, differences in the age and sex attributes of user profiles do result in variance in both the videos presented in YouTube search results as well as in the types of these videos. We find that underage profiles were exposed to e-cigarette content despite YouTube's age-restriction policy that ostensibly prohibits certain e-cigarette content. Greater enforcement of policies to restrict youth access to e-cigarette content is needed.
Collapse
Affiliation(s)
- Dhiraj Murthy
- Computational Media Lab, School of Journalism and Media Moody College of Communication The University of Texas at Austin Austin, TX United States
| | - Juhan Lee
- Department of Psychiatry Yale School of Medicine New Haven, CT United States
| | - Hassan Dashtian
- Computational Media Lab, School of Journalism and Media Moody College of Communication The University of Texas at Austin Austin, TX United States
| | - Grace Kong
- Department of Psychiatry Yale School of Medicine New Haven, CT United States
| |
Collapse
|
21
|
Staccini P, Lau AY. Consuming Health Information and Vulnerable Populations: Factors of Engagement and Ongoing Usage. Yearb Med Inform 2022; 31:173-180. [PMID: 36463876 PMCID: PMC9719752 DOI: 10.1055/s-0042-1742549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To summarise the state of the art during the year 2021 in consumer health informatics and education, with a special emphasis on "Inclusive Digital Health: Addressing Equity, Literacy, and Bias for Resilient Health Systems". METHODS We conducted a systematic search of articles published in PubMed using a predefined set of queries. In order to build queries, we have used a common understanding of digital inclusion. Leaving no one behind in the digital age requires not only reaching the most vulnerable populations, but also those people and population groups that are not digitally literate. It implies appropriate access, digital skills, and usability and navigability aspects in the development of technological solutions. Thus, we identified 126 potential articles for review. These articles were screened according to topic relevance and 13 were selected for consideration of best paper candidates, which were then presented to a panel of international experts for full paper review and scoring. The top five papers were discussed in a consensus meeting. Four papers received the highest score from the expert panel, and these papers were selected to be representative papers on consumer informatics for exploring inclusive digital health in the year 2021. RESULTS Bibliometrics analysis conducted on words found in abstracts of the candidate papers revealed five clusters of articles, where the clustering outcomes explained 93.58% of the dispersion. The first cluster analysed the use of mobile apps to improve quality of communications between racial subgroups (e.g., Black patients and their family members) and healthcare professionals, and reduce racial disparities in core palliative care outcomes. The second cluster revealed studies reporting health literacy and experience of patients with specific diseases or impairments (e.g., type 2 diabetes, asthma and deaf people). The third focused assessing the effectiveness of interactive social media interventions on changing health behaviors, health outcomes and health equity in the adult population. The fourth targeted people with limited health literacy, as well as potentially disadvantaged or marginalized groups (people with cerebrovascular or cancer problems, students with mental problems, African American Young adults), and explored how social media may help reduce health disparities and improve health outcomes. The last explored health literacy levels among groups who experience difficulties with health service engagement and retention (patients with cancer or lay consumers of online disease information). CONCLUSIONS Although the query was built to address consumer inclusiveness and digital health, without specifying any health status or disease, COVID-19 was the topic in a lot of retrieved papers. Beyond the classic health issues targeted by social media (e.g., influencing health behaviors, from smoking and diet adherence to preventative screening and exercise habits), the pandemic has exposed many situations of vulnerability and health inequality. There is universal agreement on the necessity of a healthcare policy that addresses issues of gender, age, sexual orientation, and different cultures to ensure health equity for all, regardless of age or resources available. The place of digital health is studied both as a solution and a possible factor of accentuating healthcare disparities, inequalities, and exclusions. Healthcare providers should implement a digital health literacy plan to make sure health information technology is an option for everyone. Public health policies and health promotion strategies must focus on strengthening and adapting the digital health literacy in known vulnerable subgroups (ethnic and racial minorities, sexual and gender minorities, children and adolescents, elderly people, students population, impaired people, patients with cancer and chronic diseases) increasing citizen technology engagement and guaranteeing equity in access to information and in the skills to manage, discriminate, and apply information to health.
Collapse
Affiliation(s)
- Pascal Staccini
- URE RETINES, Faculté de Médecine, Université Côte d'Azur, France,Correspondence to: Pascal Staccini URE RETINES, Faculté de Médecine28 av de Valombrose, NiceFrance
| | - Annie Y.S. Lau
- Center for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Australia
| |
Collapse
|
22
|
Rivera‐González AC, Roby DH, Stimpson JP, Bustamante AV, Purtle J, Bellamy SL, Ortega AN. The impact of Medicaid funding structures on inequities in health care access for Latinos in New York, Florida, and Puerto Rico. Health Serv Res 2022; 57 Suppl 2:172-182. [PMID: 35861151 PMCID: PMC9660415 DOI: 10.1111/1475-6773.14036] [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] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To study the impact of Medicaid funding structures before and after the implementation of the Affordable Care Act (ACA) on health care access for Latinos in New York (Medicaid expansion), Florida (Medicaid non-expansion), and Puerto Rico (Medicaid block grant). DATA SOURCES Pooled state-level data for New York, Florida, and Puerto Rico from the 2011-2019 Behavioral Risk Factor Surveillance System and data from the 2011-2019 American Community Survey and Puerto Rico Community Survey. STUDY DESIGN Cross-sectional study using probit with predicted margins to separately compare four health care access measures among Latinos in New York, Florida, and Puerto Rico (having health insurance coverage, having a personal doctor, delayed care due to cost, and having a routine checkup). We also used difference-in-differences to measure the probability percent change of having any health insurance and any public health insurance before (2011-2013) and after (2014-2019) the ACA implementation among citizen Latinos in low-income households. DATA COLLECTION The sample consisted of Latinos aged 18-64 residing in New York, Florida, and Puerto Rico from 2011 to 2019. PRINCIPAL FINDINGS Latinos in Florida had the lowest probability of having health care access across all four measures and all time periods compared with those in New York and Puerto Rico. While Latinos in Puerto Rico had greater overall health care access compared with Latinos in both states, health care access in Puerto Rico did not change over time. Among citizen Latinos in low-income households, New York had the greatest post-ACA probability of having any health insurance and any public health insurance, with a growing disparity with Puerto Rico (9.7% any [1.6 SE], 5.2% public [1.8 SE]). CONCLUSIONS Limited Medicaid eligibility (non-expansion of Florida's Medicaid program) and capped Medicaid funds (Puerto Rico's Medicaid block grant) contributed to reduced health care access over time, particularly for citizen Latinos in low-income households.
Collapse
Affiliation(s)
| | - Dylan H. Roby
- Health, Society, and BehaviorUniversity of California Irvine Public HealthIrvineCaliforniaUSA
| | - Jim P. Stimpson
- Health Management and PolicyDrexel University Dornsife School of Public HealthPhiladelphiaPennsylvaniaUSA
| | - Arturo Vargas Bustamante
- Health Policy and ManagementUniversity of California Los Angeles Jonathan and Karin Fielding School of Public HealthLos AngelesCaliforniaUSA
| | - Jonathan Purtle
- Public Health Policy and ManagementNew York University School of Global Public HealthNew YorkNew YorkUSA
| | - Scarlett L. Bellamy
- Epidemiology and BiostatisticsDornsife School of Public Health, Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Alexander N. Ortega
- Health Management and PolicyDrexel University Dornsife School of Public HealthPhiladelphiaPennsylvaniaUSA
| |
Collapse
|
23
|
Muacevic A, Adler JR, Kraft D, Mathur A, Ramamurti P, Tabaie S. Racial Disparities in Outcomes Following Open Treatment of Pediatric Femoral Shaft Fractures. Cureus 2022; 14:e33149. [PMID: 36601175 PMCID: PMC9803589 DOI: 10.7759/cureus.33149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/01/2023] Open
Abstract
Introduction Femoral shaft fractures are a common pediatric injury that can require non-operative or operative management. Several studies have shown that race impacts pain management and a number of emergency department visits in the pediatric femur fracture population. This study aimed to investigate any association between pediatric patient race and number of comorbidities, 30-day postoperative outcomes, and length of stay following open surgical treatment of femoral shaft fractures. Methods Pediatric patients who underwent open treatment of femoral shaft fracture were identified in the National Surgical Quality Improvement Program-Pediatric database from 2012-2019. Patients were categorized into two cohorts: White and underrepresented minority (URM). URM groups included Black or African American, Hispanic, Native American or Alaskan, and Native Hawaiian or Pacific Islander. Demographics, comorbidities, and postoperative complications were compared using bivariate and multivariable regression analyses. Results Of the 5,284 pediatric patients who underwent open treatment of femoral shaft fracture, 3,650 (69.1%) were White, and 1,634 (30.9%) were URM. Compared to White patients, URM patients were more likely to have a higher American Society of Anesthesiologists score (p=0.012), more likely to have pulmonary comorbidities (p=0.005), require preoperative blood transfusion (p=0.006), and have an increased risk of prolonged hospital stay (OR 2.36; p=0.007). Conclusion Pediatric URM patients undergoing open treatment of femoral shaft fractures have an increased risk of extended hospital stay postoperatively compared to White patients. As the racial and ethnic constitution of the pediatric population changes, understanding racial and ethnic health disparities will be crucial to providing equitable care to all patients.
Collapse
|
24
|
Abstract
This paper raises health equity concerns about the use of passports for domestic and international travel to certify COVID-19 vaccination. Part I argues that for international travel, health equity objections undercut arguments defending vaccine passports, which are based on tholding people responsible, protecting global health, safeguarding individual liberty and continuing current practice. Part II entertains a proposal for a scaled down vaccine passport for domestic use in countries where vaccines are widely and equitably available. It raises health equity concerns related to racial profiling and fairness to people who are vaccine cautious. Part III sets forth a proposal for a flexible pass that certifies people who have been vaccinated, tested, previously infected or granted a conscientious objection. It sets ethical guidelines for the timing and use of flexible passes that promote equity, public health education, antidiscrimination, privacy and flexibility.
Collapse
Affiliation(s)
- Nancy S Jecker
- Department of Bioethics & Humanities, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Philosophy, University of Johannesburg, Auckland Park, Gauteng, South Africa
| |
Collapse
|
25
|
Guan Y, Pathak S, Ballard D, Veluswamy JK, McCullough LE, McBride CM, Gornick MC. Testing a deliberative democracy method with citizens of African ancestry to weigh pros and cons of targeted screening for hereditary breast and ovarian cancer risk. Front Public Health 2022; 10:984926. [PMID: 36424974 PMCID: PMC9679525 DOI: 10.3389/fpubh.2022.984926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/14/2022] [Indexed: 11/09/2022] Open
Abstract
Background Democratic deliberation (DD), a strategy to foster co-learning among researchers and communities, could be applied to gain informed public input on health policies relating to genomic translation. Purpose We evaluated the quality of DD for gaining informed community perspectives regarding targeting communities of African Ancestry (AAn) for Hereditary Breast and Ovarian Cancer (HBOC) screening in Georgia. Methods We audiotaped a 2.5 day conference conducted via zoom in March 2021 to examine indicators of deliberation quality based on three principles: (1) inclusivity (diverse viewpoints based on participants' demographics, cancer history, and civic engagement), (2) consideration of factual information (balanced and unbiased expert testimonies, participant perceived helpfulness), and (3) deliberation (speaking opportunities, adoption of a societal perspective on the issue, reasoned justification of ideas, and participant satisfaction). Results We recruited 24 participants who reflected the diversity of views and life experiences of citizens of AAn living in Georgia. The expert testimony development process we undertook for creating balanced factual information was endorsed by experts' feedback. Deliberation process evaluation showed that while participation varied (average number of statements = 24, range: 3-62), all participants contributed. Participants were able to apply expert information and take a societal perspective to deliberate on the pros and cons of targeting individuals of AAn for HBOC screening in Georgia. Conclusions The rigorous process of public engagement using deliberative democracy approach can successfully engage a citizenry with diverse and well-informed views, do so in a relatively short time frame and yield perspectives based on high quality discussion.
Collapse
Affiliation(s)
- Yue Guan
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States,*Correspondence: Yue Guan
| | - Sarita Pathak
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Denise Ballard
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States,Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | | | - Lauren E. McCullough
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Colleen M. McBride
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Michele C. Gornick
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| |
Collapse
|
26
|
Dorling JL, Martin CK, Yu Q, Cao W, Höchsmann C, Apolzan JW, Newton RL, Denstel KD, Mire EF, Katzmarzyk PT. Mediators of weight change in underserved patients with obesity: exploratory analyses from the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) cluster-randomized trial. Am J Clin Nutr 2022; 116:1112-1122. [PMID: 35762659 PMCID: PMC9535544 DOI: 10.1093/ajcn/nqac179] [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: 03/15/2022] [Revised: 05/26/2022] [Accepted: 06/21/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Intensive lifestyle interventions (ILIs) stimulate weight loss in underserved patients with obesity, but the mediators of weight change are unknown. OBJECTIVES We aimed to identify the mediators of weight change during an ILI compared with usual care (UC) in underserved patients with obesity. METHODS The PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) trial randomly assigned 18 clinics (n = 803) to either an ILI or UC for 24 mo. The ILI group received an intensive lifestyle program; the UC group had routine care. Body weight was measured; further, eating behaviors (restraint, disinhibition), dietary intake (percentage fat intake, fruit and vegetable intake), physical activity, and weight- and health-related quality of life constructs were measured through questionnaires. Mediation analyses assessed whether questionnaire variables explained between-group variations in weight change during 2 periods: baseline to month 12 (n = 779) and month 12 to month 24 (n = 767). RESULTS The ILI induced greater weight loss at month 12 compared with UC (between-group difference: -7.19 kg; 95% CI: -8.43, -6.07 kg). Improvements in disinhibition (-0.33 kg; 95% CI: -0.55, -0.10 kg), percentage fat intake (-0.25 kg; 95% CI: -0.50, -0.01 kg), physical activity (-0.26 kg; 95% CI: -0.41, -0.09 kg), and subjective fatigue (-0.28 kg; 95% CI: -0.46, -0.10 kg) at month 6 during the ILI partially explained this between-group difference. Greater weight loss occurred in the ILI at month 24, yet the ILI group gained 2.24 kg (95% CI: 1.32, 3.26 kg) compared with UC from month 12 to month 24. Change in fruit and vegetable intake (0.13 kg; 95% CI: 0.05, 0.21 kg) partially explained this response, and no variables attenuated the weight regain of the ILI group. CONCLUSIONS In an underserved sample, weight change induced by an ILI compared with UC was mediated by several psychological and behavioral variables. These findings could help refine weight management regimens in underserved patients with obesity.This trial was registered at clinicaltrials.gov as NCT02561221.
Collapse
Affiliation(s)
- James L Dorling
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Qingzhao Yu
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Wentao Cao
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Christoph Höchsmann
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - John W Apolzan
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Kara D Denstel
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Emily F Mire
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | |
Collapse
|
27
|
Rahman J, Cheung G, Lyndon MP, Lawrence M, Ma'u E, Chen Y, Ramalho R. Prioritising a culturally safe e-Mental Health research agenda in Aotearoa New Zealand: A sector survey report. Australas Psychiatry 2022; 30:619-623. [PMID: 35592907 DOI: 10.1177/10398562221101794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To collect mental health and addiction service providers' opinions about priorities for an e-Mental Health (eMH) research agenda focused on delivering culturally safe eMH in Aotearoa New Zealand. METHOD Service providers were recruited to participate in an anonymous online survey, which asked participants to rate the importance of potential research domains and items on a continuous scale from 1 to 10. The mean values of each item were normalised to develop a priority index. RESULTS 48 participants rated at least one of the listed research items. The highest-rated items were (i) identifying strategies to improve access; co-developing eMH with the community (ii) a set of competencies required for delivering culturally safe care, (iii) a set of meaningful clinical outcomes that can be achieved via eMH, (iv) guidelines for the delivery of eMH services and (v) investigating the extent to which eMH could meet the mental health needs of these communities. 'Standards and guidelines' was the domain with the highest priority index. CONCLUSIONS Mental health and addiction service providers in Aotearoa New Zealand prioritised an eMH research agenda that is focused on pro-equity outcomes and incorporating the voices and experiences of the communities they seek to serve.
Collapse
Affiliation(s)
- Juma Rahman
- Department of Social and Community Health, School of Population Health, 56382University of Auckland, Auckland, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, School of Medicine, 56382University of Auckland, Auckland, New Zealand
| | - Mataroria P Lyndon
- Centre for Medical and Health Sciences Education, School of Medicine, 56382University of Auckland, Auckland, New Zealand
| | - Mark Lawrence
- Department of Psychological Medicine, School of Medicine, 56382University of Auckland, Auckland, New Zealand
| | - Etuini Ma'u
- Department of Psychological Medicine, School of Medicine, 56382University of Auckland, Auckland, New Zealand
| | - Yan Chen
- Centre for Medical and Health Sciences Education, School of Medicine, 56382University of Auckland, Auckland, New Zealand
| | - Rodrigo Ramalho
- Department of Social and Community Health, School of Population Health, 56382University of Auckland, Auckland, New Zealand
| |
Collapse
|
28
|
Holmen SJ, Petersen TS, Ryberg J. Leveling (down) the playing field: performance diminishments and fairness in sport. J Med Ethics 2022:jme-2022-108497. [PMID: 36038200 DOI: 10.1136/jme-2022-108497] [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] [Received: 06/24/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
The 2018 eligibility regulation for female competitors with differences of sexual development (DSD) issued by World Athletics requires competitors with DSD with blood testosterone levels at or above 5 nmol/L and sufficient androgen sensitivity to be excluded from competition in certain events unless they reduce the level of testosterone in their blood. This paper formalises and then critically assesses the fairness-based argument offered in support of this regulation by the federation. It argues that it is unclear how the biological advantage singled out by the regulation as an appropriate target for diminishment, is relevantly different from other biological advantages that athletes may enjoy, and specifically that Sigmund Loland's recent attempt to drive a wedge between heightened levels of blood testosterone and other biological advantages fails. The paper also suggests that even if heightened blood testosterone levels do differ relevantly from other types of biological advantage, the regulation is further challenged by studies indicating that athletes with blood testosterone at the high end of the normal range have a competitive advantage over athletes with blood testosterone levels at the low end of it. Finally, the paper contends that the premises of the fairness-based argument do not unequivocally support the conclusion that DSD athletes with heightened levels of testosterone should diminish those levels, since, just as powerfully, they support allowing athletes with normal levels of testosterone to use performance-enhancing drugs in the name of fairness.
Collapse
Affiliation(s)
- Sebastian Jon Holmen
- Philosophy and Science Studies, Department of Communication and Arts, Roskilde University, Roskilde, Denmark
| | - Thomas Søbirk Petersen
- Philosophy and Science Studies, Department of Communication and Arts, Roskilde University, Roskilde, Denmark
| | - Jesper Ryberg
- Philosophy and Science Studies, Department of Communication and Arts, Roskilde University, Roskilde, Denmark
| |
Collapse
|
29
|
Jimenez MP, Gutierrez TB, Soria-Contreras DC, Abdel Magid HS, Kaufman JS, Committee of the Society for Epidemiologic Research OBOTDAI. Increasing Representation of Epidemiologists From Around the World in the Society for Epidemiologic Research: The Case of Mexico. Am J Epidemiol 2022; 191:1842-1846. [PMID: 35896787 PMCID: PMC9767647 DOI: 10.1093/aje/kwac127] [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: 02/11/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 02/01/2023] Open
Abstract
Mexico has a population of 129 million and is considered one of the most unequal countries in the world, suffering from widespread health disparities. There is a pressing need to strengthen epidemiologic capacity in Mexico, to help solve the complex health problems the country faces and to reduce health inequities. However, the representation of Mexican epidemiologists in the largest epidemiologic society in North America is low, despite the short distance to the United States. In this commentary, we discuss the barriers to higher representation of Mexican epidemiologists within the Society for Epidemiologic Research (SER), including language barriers, costs, and regional necessities. We also discuss opportunities to expand Mexican SER representation and collaboration. Overall, we hope that this is a call towards expanding SER global participation and starting a conversation on a common agenda for epidemiologic research.
Collapse
Affiliation(s)
- Marcia P Jimenez
- Correspondence to Dr. Marcia P. Jimenez, Department of Epidemiology, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118 (e-mail: )
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
Description Microaggressions are pervasive throughout society, including in healthcare and academic institutions. They are often unconscious but accumulate over time, and they negatively impact the recipients' productivity and achievement by creating a sense of inadequacy as well as a lack of belonging. We outline several evidence-based strategies and teaching frameworks that institutions and training programs can adopt to reduce the prevalence and impact of microaggressions against trainees from historically marginalized groups, and that can promote psychological safety for everyone.
Collapse
Affiliation(s)
- Tracy MacIntosh
- University of Central Florida College of Medicine, Orlando, FL
- HCA Florida Osceola Hospital, Kissimmee, FL
| | | | - Anuja S. Mehta
- University of Central Florida College of Medicine, Orlando, FL
- Nemours Children’s Hospital, Orlando, FL
| |
Collapse
|
31
|
Tong L, Tong T, Noji A, Kitaike T, Wang X. Nurses' experiences of providing transcultural nursing care to minority patients in Yunnan province: A descriptive qualitative study. Nurs Health Sci 2022; 24:661-669. [PMID: 35633139 DOI: 10.1111/nhs.12959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/29/2021] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
Abstract
Cultural competency is essential for providing transcultural nursing care. This qualitative study explores nurses' experiences of providing transcultural nursing care to patients from ethnic minority in Yunnan province, China, with the aim of supplementing and enriching previous quantitative research. Yunnan is home to 25 ethnic minorities with the highest proportion (33.1%) of people from ethnic minorities in China. A descriptive qualitative method was used to describe the experiences of 12 nurses. Data were collected in October 2020 through semistructured interviews and analyzed using conventional content analysis methods. Three themes were generated, including limitations of resources to provide transcultural nursing care, challenges in providing transcultural nursing care, and concerns about the quality of nursing care. The results suggest that there is scope for improving cultural competence of nurses in Yunnan through education that would enable them to provide high-quality transcultural nursing care. Training topics could include transcultural knowledge, cultural sensitivity, minority languages, and immersive multicultural experiences. Other suggested improvements include a resource room for transcultural care, the accommodation of religious and dietary needs, and dedicated staff who lead transcultural care in hospitals.
Collapse
Affiliation(s)
- Ling Tong
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Tong Tong
- Faculty of Nursing, ChiangMai University, ChiangMai, Thailand
| | - Ariko Noji
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | | | - Xingli Wang
- The Second Department of Medical Oncology, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| |
Collapse
|
32
|
Castellini G, Pellegrino A, Tarchi L, Calabrese M, Boddi M, Ricca V, Costanzo G, Modesti PA. Body-Size Perception among First-Generation Chinese Migrants in Italy. Int J Environ Res Public Health 2022; 19:6063. [PMID: 35627600 PMCID: PMC9141417 DOI: 10.3390/ijerph19106063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 02/04/2023]
Abstract
Body-size perception is an important factor in motivating people to lose weight. Study aim was to explore the perception of body image among first-generation Chinese migrants living in Italy. A sample of 1258 Chinese first-generation immigrants and of 285 native Italians living in Prato, Italy, underwent blood pressure measurements, blood tests (with measurement of glucose, cholesterol, and triglycerides), and anthropometric measurements. Body-size perception was investigated with Pulvers’ figure rating scale using logistic or linear multivariable regression adjusted for age, gender, BMI, education and years spent in Italy. Chinese migrants had lower BMI and discrepancy score (preferred minus current body size) than Italians (p < 0.05 for both). After a logistic regression analysis, the discrepancy score remained lower in the Chinese than in the Italian cohort independently from BMI and other confounders (OR 0.68; 95%CI 0.50 to 0.92). In the Chinese cohort, female gender, BMI and years spent in Italy were positive determinants of discrepancy score (desire to be thinner), while age showed negative impact (p < 0.05 for all). Overweight is an important risk factor for diabetes, a very prevalent condition among first-generation Chinese migrants. The present study offers useful information and suggests the need for prevention programs specifically addressed to men.
Collapse
Affiliation(s)
- Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (G.C.); (L.T.); (V.R.)
| | - Alessio Pellegrino
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy; (M.B.); (P.A.M.)
| | - Livio Tarchi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (G.C.); (L.T.); (V.R.)
| | - Maria Calabrese
- Diabetology Unit, Ospedale Misericordia e Dolce, 59100 Prato, Italy;
| | - Maria Boddi
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy; (M.B.); (P.A.M.)
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (G.C.); (L.T.); (V.R.)
| | | | - Pietro Amedeo Modesti
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy; (M.B.); (P.A.M.)
| |
Collapse
|
33
|
Henderson KH, Helmkamp LJ, Steiner JF, Havranek EP, Vupputuri SX, Hanratty R, Blair IV, Maertens JA, Dickinson M, Daugherty SL. Relationship Between Social Vulnerability Indicators and Trial Participant Attrition: Findings From the HYVALUE Trial. Circ Cardiovasc Qual Outcomes 2022; 15:e007709. [PMID: 35418247 PMCID: PMC9117483 DOI: 10.1161/circoutcomes.120.007709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Social vulnerability indicators are associated with health care inequities and may similarly impede ongoing participation in research studies. We evaluated the association of social vulnerability indicators and research participant attrition in a trial focused on reducing health disparities. METHODS Self-identified White or Black adults enrolled in the HYVALUE trial (Hypertension and VALUEs), a randomized trial testing a values-affirmation intervention on medication adherence, from February 2017 to September 2019 were included. The self-reported measures of social vulnerability indicators included: (1) Black race; (2) female gender; (3) no health insurance; (4) unemployment; (5) a high school diploma or less; and (6) financial-resource strain. Full attrition was defined as not completing at least one 3- or 6-month follow-up study visit. Log-binomial regression models adjusted for age, gender, race, medical comorbidities, and the other social vulnerability indicators to estimate the relative risk of each social vulnerability indicator with study attrition. RESULTS Among 825 participants, the mean age was 63.3 years (±11.7 years), 60% were women, 54% were Black, and 97% reported at least one social vulnerability. Overall, 21% participants had full attrition after study enrollment. After adjustment for all other social vulnerabilities, only financial-resource strain remained consistently associated with full attrition (relative risk, 1.71 [95% CI, 1.28-2.29]). In a secondary analysis of partial attrition (completed only one follow-up visit), financial-resource strain (relative risk, 1.40 [95% CI, 1.09-1.81]) and being uninsured (relative risk, 1.54 [95% CI, 1.01-2.34]) were associated with partial attrition. CONCLUSIONS In a trial aimed at reducing disparities in medication adherence, participants who reported financial-resource strain had a higher risk of participant attrition independent of race or gender. Our findings suggest that efforts to retain diverse populations in clinical trials should extend beyond race and gender to consider other social vulnerability indicators. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT03028597.
Collapse
Affiliation(s)
- Kamal H Henderson
- Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO (K.H.H.).,Division of Cardiology (K.H.H., E.P.H., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - Laura J Helmkamp
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - John F Steiner
- Kaiser Permanente Colorado, Institute for Health Research, Denver, CO (J.F.S.)
| | - Edward P Havranek
- Division of Cardiology (K.H.H., E.P.H., S.L.D.), University of Colorado School of Medicine, Aurora, CO.,Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO.,Department of Medicine, Denver Health and Hospital Authority, CO (E.P.H., R.H.)
| | - Suma X Vupputuri
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, MD (S.X.V.)
| | - Rebecca Hanratty
- Department of Medicine, Denver Health and Hospital Authority, CO (E.P.H., R.H.)
| | - Irene V Blair
- Department of Psychology and Neuroscience, University of Colorado Boulder (I.V.B.)
| | - Julie A Maertens
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - Miriam Dickinson
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - Stacie L Daugherty
- Division of Cardiology (K.H.H., E.P.H., S.L.D.), University of Colorado School of Medicine, Aurora, CO.,Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| |
Collapse
|
34
|
Rosenblum M, Jacoby-Senghor DS, Brown ND. Detecting Prejudice From Egalitarianism: Why Black Americans Don't Trust White Egalitarians' Claims. Psychol Sci 2022; 33:889-905. [PMID: 35482995 DOI: 10.1177/09567976211054090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although White Americans increasingly express egalitarian views, how they express egalitarianism may reveal inegalitarian tendencies and sow mistrust with Black Americans. In the present experiments, Black perceivers inferred likability and trustworthiness and accurately inferred underlying racial attitudes and motivations from White writers' declarations that they are nonprejudiced and egalitarian (Experiments 1 and 2). White writers believed that their egalitarianism seemed more inoffensive and indicative of allyship than was perceived by Black Americans (Experiment 1a). Linguistic analysis revealed that, when inferring racial attitudes and motivations, Black perceivers accurately attended to language emphasizing humanization, support for equal opportunity, personal responsibility, and the idea that equality already exists (Experiment 1b). We found causal evidence that these linguistic cues informed Black Americans' perceptions of White egalitarians (Experiment 2). Suggesting societal costs of these perceptions, White egalitarians' underlying racial beliefs negatively predicted Black participants' actual trust and cooperation in an economic game (Experiment 3). Our experiments (N = 1,335 adults) showed that White Americans' insistence that they are egalitarian itself perpetuates mistrust with Black Americans.
Collapse
Affiliation(s)
- Michael Rosenblum
- Department of Management and Organizations, Stern School of Business, New York University
| | | | - N Derek Brown
- Haas School of Business, University of California, Berkeley
| |
Collapse
|
35
|
Ramos-Rincon JM, Cobos-Palacios L, López-Sampalo A, Ricci M, Rubio-Rivas M, Martos-Pérez F, Lalueza-Blanco A, Moragón-Ledesma S, Fonseca-Aizpuru EM, García-García GM, Beato-Perez JL, Josa-Laorden C, Arnalich-Fernández F, Molinos-Castro S, Torres-Peña JD, Artero A, Vargas-Núñez JA, Mendez-Bailon M, Loureiro-Amigo J, Hernández-Garrido MS, Peris-García J, López-Reboiro ML, Barón-Franco B, Casas-Rojo JM, Gómez-Huelgas R. Ethnicity and Clinical Outcomes in Patients Hospitalized for COVID-19 in Spain: Results from the Multicenter SEMI-COVID-19 Registry. J Clin Med 2022; 11:1949. [PMID: 35407557 PMCID: PMC8999367 DOI: 10.3390/jcm11071949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5−58.9) to 57.1 (44.1−67.1) vs. 71.5 (59.5−81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10−0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17−1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26−2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21−1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often.
Collapse
Affiliation(s)
| | - Lidia Cobos-Palacios
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Almudena López-Sampalo
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Michele Ricci
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | | | | | - Sergio Moragón-Ledesma
- Internal Medicine Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | | | | | - Jose-Luis Beato-Perez
- Internal Medicine Department, Albacete University Hospital Complex, 02006 Albacete, Spain;
| | | | | | - Sonia Molinos-Castro
- Internal Medicine Department, Santiago de Compostela Clinic Hospital, 15706 Santiago de Compostela, Spain;
| | - José-David Torres-Peña
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain;
- Spain CIBER Fisiopatologia de la Obesidad y la Nutricion, Carlos III Health Institute, 28029 Madrid, Spain
| | - Arturo Artero
- Internal Medicine Department, Doctor Peset University Hospital, 46017 Valencia, Spain;
| | - Juan-Antonio Vargas-Núñez
- Internal Medicine Department, Puerta de Hierro University Hospital, Instituto de Investigación Sanitaria Puerta de Hierro—Segovia de Arana, 28222 Madrid, Spain;
| | | | - Jose Loureiro-Amigo
- Internal Medicine Department, Moisès Broggi Hospital, 08970 Sant Joan Despí, Spain;
| | | | - Jorge Peris-García
- Internal Medicine Department, de Sant Joan d’Alacant University Clínic Hospital, 03550 Alicante, Spain;
| | | | - Bosco Barón-Franco
- Internal Medicine Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | - Jose-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, 28981 Madrid, Spain;
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
- Spain CIBER Fisiopatologia de la Obesidad y la Nutricion, Carlos III Health Institute, 28029 Madrid, Spain
| | | |
Collapse
|
36
|
Poole T, Jura M, Taylor G, Gates P, Mertz E. Slipping through the cracks: Just how underrepresented are minorities within the dental specialties? J Public Health Dent 2022; 82 Suppl 1:53-62. [PMID: 35726471 PMCID: PMC9545059 DOI: 10.1111/jphd.12520] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 12/04/2022]
Abstract
Objective There is a lack of diversity in the dental workforce. Efforts to enhance underrepresented minority (URM) recruitment and retention within dental school exist, but little effort has been made to track URM providers through education and practice. This study assesses the status of workforce diversity in the dental specialties and the predictors of URM dentist specialization. Methods The primary data used were a 2012 national sample survey of Hispanic/Latino (H/L), Black, or American Indian/Alaska Native (AI/AN) dentists in the US, supplemented by publicly available workforce data. Descriptive and multivariate statistical analyses were performed to describe the demographic composition of URM clinical general and specialist dentists and analyze changes in proportions of URMs specializing among age cohorts, differences in specific type of specialization, and racial concordance between specialists and their patients. Results The pathway continues to winnow with fewer URM dentists in specialty practice. Among all URM clinical dentists being first in his/her family to obtain a college degree, having a strong desire to work in his/her own cultural community or joining a loan repayment program due to debt load independently predicted lower odds of specialization. Alternatively, being initially foreign trained as a dentist and valuing professional training were independently predictive of higher odds of specialization. Conclusion The lack of diversity within the dental specialties is a critical flaw in our education and care delivery systems demanding clear actions toward improving the pathway into residency programs for URM students.
Collapse
Affiliation(s)
| | - Matthew Jura
- Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
| | - George Taylor
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
| | - Paul Gates
- Academy for Advancing Leadership, Atlanta, Georgia, USA
| | - Elizabeth Mertz
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA.,Healthforce Center, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
37
|
Bennett G, Bardon LA, Gibney ER. A Comparison of Dietary Patterns and Factors Influencing Food Choice among Ethnic Groups Living in One Locality: A Systematic Review. Nutrients 2022; 14:nu14050941. [PMID: 35267916 PMCID: PMC8912306 DOI: 10.3390/nu14050941] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/16/2022] [Accepted: 02/20/2022] [Indexed: 01/23/2023] Open
Abstract
Globally, the number of minority ethnic groups in high-income countries is increasing. However, despite this demographic change, most national food consumption surveys are not representative of ethnically diverse populations. In consequence, many ethnic minorities' dietary intakes are underreported, meaning that accurate analysis of food intake and nutrient status among these groups is not possible. This systematic review aims to address these gaps and understand differences in dietary intakes and influencers of dietary habits of ethnic groups worldwide. A systematic search was conducted through three databases (Pubmed, Web of Science and Scopus) and manual searches, generating n = 56,647 results. A final search of these databases was completed on 13 September 2021, resulting in a total of 49 studies being included in this review. Overall, food group intakes-particularly fruit, vegetable and fish intake-and diet quality scores were seen to differ between ethnicities. Overall Black/African American groups were reported to be among the poorest consumers of fruit and vegetables, whilst Asian groups achieved high diet quality scores due to higher fish intakes and lower fat intakes compared to other groups. Limited data investigated how nutrient intakes, dietary and meal patterns compared between groups, meaning that not all aspects of dietary intake could be compared. Socioeconomic status and food availability appeared to be associated with food choice of ethnic groups, however, confounding factors should be considered more closely. Future work should focus on comparing nutrient intakes and meal patterns between ethnicities and investigate potential targeted interventions which may support adherence to food-based dietary guidelines by all ethnic groups.
Collapse
Affiliation(s)
- Grace Bennett
- Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (G.B.); (L.A.B.)
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Laura A. Bardon
- Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (G.B.); (L.A.B.)
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Eileen R. Gibney
- Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (G.B.); (L.A.B.)
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- Correspondence:
| |
Collapse
|
38
|
Nielsen TR, Nielsen DS, Waldemar G. Feasibility of a culturally tailored dementia information program for minority ethnic communities in Denmark. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5656. [PMID: 34762345 PMCID: PMC9298896 DOI: 10.1002/gps.5656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/07/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Proactive efforts that take language and cultural barriers into consideration may be needed to raise awareness of dementia and improve access to services in minority ethnic communities. The aim of this study was to assess the feasibility of a culturally tailored dementia information program and the immediate effects on participants' intention to seek help for memory problems, their knowledge and beliefs about dementia, and their knowledge about options for support. METHODS A novel dementia information program, consisting of one 2-h session, was developed through a collaborative research process with primary care dementia coordinators and multicultural link workers as co-researchers. It provides basic knowledge about dementia to minority ethnic communities and can be delivered in a community setting by non-specialists. RESULTS Six information program sessions were conducted with a total of 110 participants; 65 Turkish, 19 Pakistani, 20 Arabic-speaking, and 6 with another minority ethnic heritage. The program had a significant effect on participants' immediate knowledge and beliefs about dementia as measured with a quiz (z = -2.02, p = 0.04, d = 0.90). In a post-program focus group meeting, facilitating multicultural link workers reported satisfaction with facilitator training, adopted recruitment strategies, and content and delivery of the information sessions and provided feedback on improving the program. CONCLUSIONS The results provide support for the feasibility of the culturally tailored dementia information program. The program has the potential to improve knowledge and beliefs about dementia and options for formal support in minority ethnic communities and seems easily implemented in existing services, and at a low cost.
Collapse
Affiliation(s)
- T. Rune Nielsen
- Danish Dementia Research Centre, Department of Neurology, Neuroscience Centre, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Dorthe S. Nielsen
- Migrant Health ClinicOdense University HospitalOdenseDenmark,Centre for Global HealthUniversity of Southern DenmarkOdenseDenmark,Department of Geriatric MedicineOdense University HospitalOdenseDenmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Neuroscience Centre, RigshospitaletUniversity of CopenhagenCopenhagenDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| |
Collapse
|
39
|
Bybee S, Cloyes K, Ellington L, Baucom B, Supiano K, Mooney K. Bots and nots: Safeguarding online survey research with underrepresented and diverse populations. Psychol Sex 2022; 13:901-911. [PMID: 36439051 PMCID: PMC9697945 DOI: 10.1080/19419899.2021.1936617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The COVID-19 pandemic has intensified the use of online recruitment and data collection for reaching historically underrepresented minorities (URMs) and other diverse groups. Preventing and detecting responses from automated accounts "bots" and those who misrepresent themselves is one challenge in utilizing online approaches. Through internet-mediated methods, interested LGBTQ+ and non-LGBTQ+ couples facing advanced cancer completed an interest form via REDCap®. Eligible participants received a direct link to electronic consent and surveys in REDCap®. Once responses to the interest form (N = 619) were received, the study PI: 1) assessed participants' entries and non-response survey data (time of completion, rate of recruitment, etc.), 2) temporarily postponed recruitment, 3) sent eligibility questionnaires, consent documents, and validated surveys to N= 10 couples and scrutinized these data for suspicious patterns or indications of untrustworthy data, 4) responded to potential participants via email, and 5) implemented additional strategies for detecting and preventing untrustworthy survey responses. Investigators must consider multi-step eligibility screening processes to detect and prevent the collection of untrustworthy data. Investigators' reliance on internet-mediated approaches for conducting research with diverse, hard-to-reach populations increases the importance of addressing threats to data validity. Ultimately, safeguarding internet-mediated research supports research accessibility and inclusion for URMs while also protecting participant data integrity.
Collapse
Affiliation(s)
- Sara Bybee
- University of Utah, College of Nursing, 10 S 2000 E, Salt Lake City, UT, 84112
| | | | | | | | | | | |
Collapse
|
40
|
Trevizo-Nimeri C, Webber-Ritchey KJ, Aquino E, Simonovich SD. Barriers to Dialysis Home Therapy Utilization: A Systematic Review. Nephrol Nurs J 2022; 49:29-27. [PMID: 35225493] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Barriers to the utilization of home therapy among patients with chronic kidney disease (CKD) impact progression to kidney failure and access to treatment options. The impact of health disparities on home therapy utilization receiving kidney replacement therapy requires investigation. A systematic review utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was conducted to examine health disparity barriers to home therapy utilization among patients with kidney failure. Twelve articles published from 2010-2020 identified relationships between health disparities and home dialysis utilization among adults receiving kidney replacement therapy. Findings included association between the utilization of home therapy and the barriers of race/ethnicity (n = 5), economic barriers (n = 4), and insurance type (n = 3). Implications of findings are provided.
Collapse
Affiliation(s)
- Cristina Trevizo-Nimeri
- Graduate Student, is School of Nursing, College of Science & Health, DePaul University, Chicago, IL
| | - Kashica J Webber-Ritchey
- Assistant Professor, School of Nursing, College of Science & Health, DePaul University, Chicago, IL
| | - Elizabeth Aquino
- Associate Professor, School of Nursing, College of Science & Health, DePaul University, Chicago, IL
| | - Shannon D Simonovich
- Assistant Professor, School of Nursing, College of Science & Health, DePaul University, Chicago, IL
| |
Collapse
|
41
|
Zoellner JM, You W, Hill JL, Brock DJP, Yuhas M, Price B, Wilson J, Montague DR, Estabrooks PA. Comparing two different family-based childhood obesity treatment programmes in a medically underserved region: Effectiveness, engagement and implementation outcomes from a randomized controlled trial. Pediatr Obes 2022; 17:e12840. [PMID: 34396714 DOI: 10.1111/ijpo.12840] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Access to evidence- and family-based childhood obesity (FBCO) treatment interventions is a challenge, especially in underserved regions where childhood obesity disparities persist. OBJECTIVE Compare two 6-month FBCO treatment interventions, iChoose (high intensity, parent-child dyads) and Family Connections (low intensity, parents only), in one underserved US region. METHODS This unblinded, RCT reports on effectiveness and implementation outcomes. Eligibility included children ages 5-12 with BMI ≥85th percentile. Analyses included descriptive statistics and intention-to-treat Heckman treatment effect models. RESULTS Enrolled children (n = 139, mean age 10.1 ± 1.7 years, 30% with overweight, 70% with obesity, 45% black, 63% Medicaid) were randomly assigned to iChoose (n = 70) or Family Connections (n = 69). Retention rates were 63% for iChoose and 84% for Family Connection. Among children, 6-month BMI z-score changes were not statistically significant within iChoose [BMI z-score 0.03 (95% CI = -0.13, 0.19)] or Family Connections [BMI z-score 0.00 (95% CI = -0.16, 0.16)]. Likewise, parents' BMI changes were not statistically significant. No adverse events were reported. Both programmes were delivered with high fidelity (77%-100%). Engagement in core components was 25%-36% for iChoose and 52%-61% for Family Connections. Implementation costs per child with improved BMI z-score were $2841 for iChoose and $955 for Family Connections. CONCLUSIONS Neither intervention yielded significant improvements in child BMI z-score or parent BMI, yet both were delivered with high fidelity. Relative to iChoose, descriptive data indicated higher retention, better engagement, and lower costs for Family Connections-suggesting that a lower intensity and parent-focused programme may better fit the intended audience's context.
Collapse
Affiliation(s)
- Jamie M Zoellner
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Wen You
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Jennie L Hill
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Donna-Jean P Brock
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Maryam Yuhas
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Bryan Price
- Community Outreach and Education, UVA Cancer Center, Danville, Virginia, USA
| | - Jonathon Wilson
- Parks and Recreation, City of Danville, Danville, Virginia, USA
| | | | - Paul A Estabrooks
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, Nebraska, USA
| |
Collapse
|
42
|
Wagner AL, Wileden L, Shanks TR, Goold SD, Morenoff JD, Gorin SNS. Mediators of Racial Differences in COVID-19 Vaccine Acceptance and Uptake: A Cohort Study in Detroit, MI. Vaccines (Basel) 2021; 10:36. [PMID: 35062697 PMCID: PMC8778664 DOI: 10.3390/vaccines10010036] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/02/2022] Open
Abstract
Despite their disparate rates of infection and mortality, many communities of color report high levels of vaccine hesitancy. This paper describes racial differences in COVID-19 vaccine uptake in Detroit, and assesses, using a mediation model, how individuals' personal experiences with COVID-19 and trust in authorities mediate racial disparities in vaccination acceptance. The Detroit Metro Area Communities Study (DMACS) is a panel survey of a representative sample of Detroit residents. There were 1012 respondents in the October 2020 wave, of which 856 (83%) were followed up in June 2021. We model the impact of race and ethnicity on vaccination uptake using multivariable logistic regression, and report mediation through direct experiences with COVID as well as trust in government and in healthcare providers. Within Detroit, only 58% of Non-Hispanic (NH) Black residents were vaccinated, compared to 82% of Non-Hispanic white Detroiters, 50% of Hispanic Detroiters, and 52% of other racial/ethnic groups. Trust in healthcare providers and experiences with friends and family dying from COVID-19 varied significantly by race/ethnicity. The mediation analysis reveals that 23% of the differences in vaccine uptake by race could be eliminated if NH Black Detroiters were to have levels of trust in healthcare providers similar to those among NH white Detroiters. Our analyses suggest that efforts to improve relationships among healthcare providers and NH Black communities in Detroit are critical to overcoming local COVID-19 vaccine hesitancy. Increased study of and intervention in these communities is critical to building trust and managing widespread health crises.
Collapse
Affiliation(s)
- Abram L. Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Lydia Wileden
- Department of Sociology, Gerald R. Ford School of Public Policy, Institute for Social Research, University of Michigan, Ann Arbor, MI 48109, USA; (L.W.); (J.D.M.)
| | - Trina R. Shanks
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Susan Door Goold
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI 48109, USA;
| | - Jeffrey D. Morenoff
- Department of Sociology, Gerald R. Ford School of Public Policy, Institute for Social Research, University of Michigan, Ann Arbor, MI 48109, USA; (L.W.); (J.D.M.)
| | | |
Collapse
|
43
|
Shorey S, Ng ED, Downe S. Cultural competence and experiences of maternity health care providers on care for migrant women: A qualitative meta-synthesis. Birth 2021; 48:458-469. [PMID: 34363236 DOI: 10.1111/birt.12581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The United Nations Sustainable Development Goals 2030 aim to reduce health care inequity and maternal and infant mortality rates amongst marginalized populations. To provide adequate and culturally relevant maternity care for minority ethnic groups, it is imperative to examine health care providers' views on care for migrant women. We reviewed published accounts of views and experiences of maternity health care providers providing maternity care for migrant women as a way of exploring their cultural competency. METHOD A qualitative meta-synthesis was conducted. Systematic searches were conducted in five electronic databases from inception dates through February 2021. Qualitative data were analyzed using a framework thematic analysis based on Campinha-Bacote's five-component cultural competency model. FINDINGS Eleven studies were included. Findings were presented according to Campinha-Bacote's model: cultural awareness, cultural knowledge (personal responsibility, familial role and cultural influence, the influence of social and system factors, conflicting maternity care expectations), cultural encounter (language and communication), and cultural desire (establishing trust and going the extra mile, resources to boost culturally competent care). DISCUSSION Our findings can inform the design of high-quality behavioral change, health care management, sociological, and other relevant studies, along with reviews of what matters to service users about cultural responsiveness. Our data also suggest that health system constraints can exacerbate the lack of cultural competency. Improving the quality of care for migrant communities will necessitate a joint effort between health care organizations, health care providers, policymakers, and researchers in developing and implementing more culturally relevant maternity care policies and management interventions.
Collapse
Affiliation(s)
- Shefaly Shorey
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Esperanza Debby Ng
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Soo Downe
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| |
Collapse
|
44
|
Abstract
BACKGROUND An 'ethnic' or 'group' density effect in psychosis has been observed, whereby the risk of psychosis in minority group individuals is inversely related to neighbourhood-level proportions of others belonging to the same group. However, there is conflicting evidence over whether this effect differs between minority groups and limited investigation into other moderators. AIMS To conduct a comprehensive systematic review and meta-analysis of the group density effect in psychosis and examine moderators. METHOD Four databases were systematically searched. A narrative review was conducted and a three-level meta-analysis was performed. The potential moderating effect of crudely and specifically defined minority groups was assessed. Country, time, area size and whether studies used clinical or non-clinical outcomes were also tested as moderators. RESULTS Thirty-two studies were included in the narrative review and ten in the meta-analysis. A 10 percentage-point decrease in own-group density was associated with a 20% increase in psychosis risk (OR = 1.20, 95% CI 1.09-1.32, P < 0.001). This was moderated by crudely defined minority groups (F6,68 = 6.86, P < 0.001), with the strongest associations observed in Black populations, followed by a White Other sample. Greater heterogeneity was observed when specific minority groups were assessed (F25,49 = 7.26, P < 0.001). CONCLUSIONS This is the first review to provide meta-analytic evidence that the risk of psychosis posed by lower own-group density varies across minority groups, with the strongest associations observed in Black individuals. Heterogeneity in effect sizes may reflect distinctive social experiences of specific minority groups. Potential mechanisms are discussed, along with the implications of findings and suggestions for future research.
Collapse
Affiliation(s)
- Sophie J. Baker
- School of Psychology, Bangor University, UK,Correspondence: Sophie J. Baker.
| | - Mike Jackson
- North Wales Clinical Psychology Programme, School of Psychology, Bangor University; and Betsi Cadwaladr University Health Board, Bangor, UK
| | - Hannah Jongsma
- Centre for Transcultural Psychiatry Veldzicht, Balkbrug; and Department of Psychiatry, University of Groningen; and University Medical Centre Groningen, The Netherlands
| | | |
Collapse
|
45
|
Suolang D, Chen BJ, Wang NY, Gottesman RF, Faigle R. Geographic and Regional Variability in Racial and Ethnic Disparities in Stroke Thrombolysis in the United States. Stroke 2021; 52:e782-e787. [PMID: 34670410 DOI: 10.1161/strokeaha.121.035220] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND PURPOSE Intravenous thrombolysis (IVT) after ischemic stroke is underutilized in racially/ethnically minoritized groups. We aimed to determine the regional and geographic variability in racial/ethnic IVT disparities in the United States. METHODS Acute ischemic stroke admissions between 2012 and 2018 were identified in the National Inpatient Sample. Multivariable logistic regression was used to test the association between IVT and race/ethnicity, stratified by geographic region and controlling for demographic, clinical, and hospital characteristics. RESULTS Of the 545 509 included cases, 47 031 (8.6%) received IVT. Racially/ethnically minoritized groups had significantly lower adjusted odds of IVT compared with White people in the South Atlantic region (odds ratio [OR], 0.86 [95% CI, 0.82-0.91]), the East North Central region (OR, 0.91 [95% CI, 0.85-0.97]) and the Pacific region (OR, 0.90 [95% CI, 0.85-0.96]). In the South Atlantic region, IVT use in racial/ethnic minority groups was below the national average of all racial/ethnic minority patients (P=0.002). Compared with White patients, Black patients had lower odds of IVT in the Middle Atlantic region (OR, 0.84 [95% CI, 0.78-0.91]), the South Atlantic region (OR, 0.78 [95% CI, 0.74-0.82]), and the East North Central region (OR, 0.86 [95% CI, 0.79-0.93]). In the South Atlantic region, this difference was below the national average for Black people (P<0.001). Hispanic patients had significantly lower use of IVT only in the Pacific region (OR, 0.92 [95% CI, 0.85-0.99]), while Asian/Pacific Islander patients had lower odds of IVT in the Mountain (OR, 0.76 [95% CI, 0.59-0.98]) and Pacific region (OR, 0.89 [95% CI, 0.82-0.97]). CONCLUSIONS Racial/ethnic disparities in IVT use in the United States vary by region. Geographic hotspots of lower IVT use in racially/ethnically minoritized groups are the South Atlantic region, driven predominantly by lower use of IVT in Black patients, and the East North Central and Pacific regions.
Collapse
Affiliation(s)
- Deji Suolang
- Departments of Neurology (D.S., B.J.C., R.F.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Bridget J Chen
- Departments of Neurology (D.S., B.J.C., R.F.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nae-Yuh Wang
- Medicine (N.-Y.W.), Johns Hopkins University School of Medicine, Baltimore, MD.,Biostatistics (N.-Y.W.), Johns Hopkins University School of Medicine, Baltimore, MD.,Epidemiology (N.-Y.W.), Johns Hopkins University School of Medicine, Baltimore, MD.,Johns Hopkins Center for Health Equity, Baltimore, MD (N.-Y.W., R.F.)
| | - Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke, Intramural Research Program, National Institutes of Health, Bethesda, MD (R.F.G.)
| | - Roland Faigle
- Departments of Neurology (D.S., B.J.C., R.F.), Johns Hopkins University School of Medicine, Baltimore, MD.,Johns Hopkins Center for Health Equity, Baltimore, MD (N.-Y.W., R.F.)
| |
Collapse
|
46
|
Walton GM, Okonofua JA, Remington Cunningham K, Hurst D, Pinedo A, Weitz E, Ospina JP, Tate H, Eberhardt JL. Lifting the Bar: A Relationship-Orienting Intervention Reduces Recidivism Among Children Reentering School From Juvenile Detention. Psychol Sci 2021; 32:1747-1767. [PMID: 34606384 DOI: 10.1177/09567976211013801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
When children return to school from juvenile detention, they face a severe stigma. We developed a procedure to orient educators and students toward each other as positive relationship partners during this period. In Study 1, through a structured exercise, students reentering school powerfully articulated to an educator of their choosing their prosocial hopes for school as well as challenges they faced. In a preliminary field trial (N = 47), presenting this self-introduction to this educator in a one-page letter via a third-party requesting the educator's help reduced recidivism to juvenile detention through the next semester from 69% to 29%. In Study 2 (preregistered), the letter led experienced teachers (N = 349) to express greater commitment to, anticipate more success for, and feel more love and respect for a student beginning their reentry into school, potentially initiating a better trajectory. The results suggest how relationship-orienting procedures may sideline bias and make school more supportive for students facing stigma.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Hattie Tate
- Juvenile Justice Center, Oakland Unified School District
| | | |
Collapse
|
47
|
Nielsen TR, Nielsen DS, Waldemar G. A personalized dementia care intervention for family carers from minority ethnic groups in Denmark: A pilot study. Dementia (London) 2021; 21:477-488. [PMID: 34605285 PMCID: PMC8811331 DOI: 10.1177/14713012211046597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is a growing number of people with dementia in minority ethnic groups in Denmark. Support for the increasing number of family carers from minority ethnic groups is crucial, as caring for a relative with dementia may negatively affect the carer's health and quality of life. The aim of this study was to determine the feasibility of a personalized intervention for family carers from minority ethnic groups. The intervention was a modified version of a culturally sensitive case-management program developed in Australia which had been shown to improve carers' sense of competence in managing dementia and their mental well-being. METHODS A small pilot trial was used to examine the feasibility and preliminary efficacy of the intervention. Feasibility indicators included data on recruitment, retention, adherence, and fidelity. Acceptability and suitability of the intervention was explored in post-intervention interviews with family carers, and baseline and follow-up scores for outcome measures were examined. RESULTS Ten (30%) of 33 eligible family carers consented to participate in the study, but three were lost to follow-up and seven (70%) family carers completed the trial. Intervention fidelity, acceptance, and satisfaction were high. Results for outcome measures indicated that the intervention may improve family carers' sense of competence by helping them cope better with challenges relating to caring and managing dementia and improved their satisfaction with primary care services. CONCLUSIONS The results suggest that the intervention is feasible and worth exploring for family carers of people with dementia from minority ethnic groups in Denmark.
Collapse
Affiliation(s)
- T Rune Nielsen
- Danish Dementia Research Centre, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark
| | - Dorthe S Nielsen
- Migrant Health Clinic, Odense University Hospital, Odense, Denmark.,Centre for Global Health, 6174University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Copenhagen University Hospital, 53146Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
48
|
Stephens J, Tan A, Miller H, Perkins A. Associations between lifestyle factors and body mass index in African-American community college students. J Am Coll Health 2021; 69:704-709. [PMID: 32672496 DOI: 10.1080/07448481.2019.1706530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 06/11/2023]
Abstract
The goal was to examine associations between body mass index (BMI) and lifestyle factors in African American community college students. Methods: Young adults, 18-25, who identified as African American were eligible to participate from 3/17 to 11/17. BMI, body image, discrimination, social roles, emotional and informational support, nutrition knowledge, and physical activity were assessed. Results: Data from 323 students were analyzed. The mean age was 20.1 ± 2.0 years. There were no significant differences between individuals with BMI ≥ 25 and BMI < 25 on social role satisfaction, discrimination, and emotional or informational support. Overweight/obese individuals rated themselves higher on body image than normal weight individuals. The association between ideal body image and BMI sustained after adjusting for various factors. Conclusions: This is a unique population and they have unique needs in weight loss interventions. The strong relationship between body image and BMI suggests that incorporating body image into intervention design may assist in weight loss.
Collapse
Affiliation(s)
- Janna Stephens
- College of Nursing, Ohio State University, Columbus, Ohio, USA
| | - Alai Tan
- College of Nursing, Ohio State University, Columbus, Ohio, USA
| | - Hailey Miller
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Antoinette Perkins
- Sports and Exercise Sciences, Columbus State Community College, Columbus, Ohio, USA
| |
Collapse
|
49
|
Abstract
INTRODUCTION The World Health Organization states that suicide is the second leading cause of death among youngs, and racism has been proven to have detrimental effects on both physical and mental health. These two plagues represent a public health priority, especially for susceptible minorities. METHOD This systematic review analyzed 23 studies from multiple database searches, to understand the relationship between racism and suicidality in young minority groups. RESULTS The review demonstrated the correlation between racism and suicidality with the consequent development of mental disorders. There is strong evidence that the main suicide risk factor is acculturation, interpreted as the assimilation of the dominant culture with the loss of values from one's cultural background. DISCUSSION Health care professionals should not underestimate the risk of suicidality associated with racism. Prevention is crucial and it should be implemented from a young age, in schools, through a joint intervention with children and their families, aiming toward integration without acculturation.
Collapse
Affiliation(s)
- Giorgia Rudes
- IRCCS Burlo Garofolo Pediatric Institute, Trieste, Italy
| | - Claudia Fantuzzi
- School of Nursing, University of Trieste, Italy.,Azienda Sanitaria Universitaria Integrata, Trieste, Italy
| |
Collapse
|
50
|
Feldman JM, Becker J, Arora A, DeLeon J, Torres-Hernandez T, Greenfield N, Wiviott A, Jariwala S, Shim C, Federman AD, Wisnivesky JP. Depressive Symptoms and Overperception of Airflow Obstruction in Older Adults With Asthma. Psychosom Med 2021; 83:787-794. [PMID: 33938504 PMCID: PMC8419010 DOI: 10.1097/psy.0000000000000951] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Older adults are at increased risk for depression and poor asthma outcomes. We examined whether depressive symptoms are associated with overperception of airflow obstruction and a pattern of worse asthma control, but not pulmonary function. METHODS We recruited a cohort of adults with asthma 60 years and older in East Harlem and the Bronx, New York. Baseline measures included the Geriatric Depression Scale, Asthma Control Questionnaire, and Mini Asthma Quality of Life Questionnaire. Spirometry was conducted at baseline to assess pulmonary function. Perception of airflow obstruction was assessed for 6 weeks following baseline by participants entering estimates of peak expiratory flow (PEF) into a programmable peak flow meter followed by PEF blows. Participants were blinded to actual PEF values. The percentage of time that participants were in the overperception zone was calculated as an average. RESULTS Among the 334 participants (51% Hispanic, 25% Black), depressive symptoms were associated with overperception of airflow obstruction (β = 0.14, p = .029), worse self-reported asthma control (β = 0.17, p = .003), and lower asthma-related quality of life (β = -0.33, p < .001), but not with lung function (β = -0.01, p = .82). Overperception was also associated with worse self-reported asthma control (β = 0.14, p = .021), but not lung function (β = -0.05, p = .41). CONCLUSIONS Depressive symptoms were associated with greater perceived impairment from asthma, but not pulmonary function. Overperception of asthma symptoms may play a key role in the relationship between depression and asthma outcomes in older adults.
Collapse
Affiliation(s)
- Jonathan M Feldman
- From the Ferkauf Graduate School of Psychology (Feldman, Greenfield, Wiviott), Yeshiva University; Division of Academic General Pediatrics, Department of Pediatrics (Feldman, DeLeon, Torres-Hernandez), Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx; Division of General Internal Medicine (Becker, Arora, Federman, Wisnivesky), Icahn School of Medicine at Mount Sinai, New York; Division of Allergy/Immunology, Department of Medicine (Jariwala), Albert Einstein College of Medicine/Montefiore Medical Center; Division of Pulmonary Medicine, Department of Medicine (Shim), Jacobi Medical Center/Albert Einstein College of Medicine, Bronx; and Division of Pulmonary, Critical Care and Sleep Medicine (Wisnivesky), Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|