Journal of the National Medical Association最新文献

{"title":"Insights on Medical Education","authors":"Marie L. Borum MD, EdD, MPH, MACP, FACG, AGAF, FRCP","doi":"10.1016/j.jnma.2025.06.001","DOIUrl":"10.1016/j.jnma.2025.06.001","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Page 87"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydrus stent removal for delayed cystoid macular edema: Two cases","authors":"Daniel Laroche , Alissa Belzie , Idaima Calderon","doi":"10.1016/j.jnma.2024.12.001","DOIUrl":"10.1016/j.jnma.2024.12.001","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Pages 88-93"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underrepresented in medicine resident physician distribution by race, gender, and specialty trends from 2013–2019","authors":"Joshua Ellis ,&nbsp;Alden Landry ,&nbsp;Leeanne Fagan ,&nbsp;Payton Cabrera ,&nbsp;Andrew Marshall ,&nbsp;Ryan Burke ,&nbsp;Nicole Dubosh","doi":"10.1016/j.jnma.2025.03.003","DOIUrl":"10.1016/j.jnma.2025.03.003","url":null,"abstract":"<div><div>Importance: While significant racial disparities in the physician workforce have existed for decades, recent attention on this mismatch and the current sociopolitical climate have led to an increase in recruitment efforts of Underrepresented in Medicine (URiM) physicians by residency programs. The effect of these efforts on URiM distribution across residency programs has not yet been comprehensively studied. Objective: To describe the distribution of URiM residents across the top 20 most populous medical and surgical specialties by race and gender as well as trends observed from 2013 to 2019. Design: Multicenter, retrospective cross sectional analysis Setting: US residency programs Participants: All first-year residents matching in the 20 most populous specialties as documented in the Association of American Medical Colleges (AAMC) Data Resource Books during the study period. Main Outcomes: The primary outcome of this study was to describe the percentages of URiM resident physicians in the US by race and gender, as defined by the AAMC during the study period. Secondary outcomes include an analysis of URiM race and gender distribution as well as URiM distribution in competitive vs noncompetitive specialties, surgical vs nonsurgical specialties, and primary care specialties. Results: From 2013-2019, there were 228,645 entries by 211,356 first-year residents to the top 20 most populous specialties. In total, 15.2% of entries were URiM residents. Forty-six percent of applicants identified as female. All but two specialties studied had an increase in URiM representation. No specialty had greater than 4% increase in URiM representation. In 2019, there were differences in specialty representation when individual race and gender categories within URiM were considered. The URiM percentages were as follows in specialty subtypes: surgical (16%) vs nonsurgical (16.4%) and competitive (12.3%) vs noncompetitive (18.2%). The top 3 specialities with the highest percentage of URiM residents were primary care specialties. Conclusion: Despite the increase in recruitment efforts for URiM applicants at the residency level, there was only a slight change in total URiM distribution by specialty over the study time period. Individual race categories and gender had an impact on the distribution of residents in the most recent year</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Pages 123-131"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of patient and clinician demographics and concordance with medicaid sterilization consent form validity","authors":"Lisa Jackson-Moore ,&nbsp;Kim Malloy ,&nbsp;Gene Urrutia ,&nbsp;Kristen A. Berg ,&nbsp;Emily S. Miller ,&nbsp;Margaret Boozer ,&nbsp;Tania Serna ,&nbsp;Jennifer L. Bailit ,&nbsp;Suzanna Larkin ,&nbsp;Kavita Shah Arora","doi":"10.1016/j.jnma.2025.04.003","DOIUrl":"10.1016/j.jnma.2025.04.003","url":null,"abstract":"<div><h3>Objective(s)</h3><div>To evaluate the association between patient demographics, clinician demographics, and concordance of patient-clinician demographics and Medicaid sterilization consent form validity, defined as the waiting period having elapsed.</div></div><div><h3>Study Design</h3><div>Secondary analysis of a large, multi-center retrospective cohort study. This analysis included patients with Medicaid insurance desiring postpartum permanent contraception across three study sites. Our primary outcome was Medicaid sterilization consent form validity. Patient demographics were abstracted from the electronic medical record. Clinician demographics were obtained both through self- and peer-report. Descriptive, random effects modeling, and multivariable logistic regression analyses were utilized.</div></div><div><h3>Results</h3><div>Of the 1644 patients delivered by 124 clinicians in our cohort, 840 (51 %) had a valid Medicaid sterilization consent form. Descriptively, patients who were Black, unmarried, and not college educated were more likely to have valid forms (<em>p</em> &lt; 0.001). The religious affiliation of the clinician (<em>p</em> &lt; 0.001), but no other clinician characteristics, was associated with form validity. In multivariable models, patients who were of a different racial identity than their clinicians were more likely to have a valid form (aOR 1.32, 95 % confidence interval (CI) 1.05–1.66).</div></div><div><h3>Conclusion(s)</h3><div>While unable to determine the causes of our findings, the differential proportion of Medicaid sterilization consent form validity based on patient characteristics is concerning. Differences in form validity based on patient-clinician racial and ethnic concordance is deserving of further study.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Pages 148-154"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing health attitudes and information engagement among African American men using an online health education intervention","authors":"Shawnta L. Lloyd ,&nbsp;Kelvin L. Williams ,&nbsp;Allison Caban-Holt ,&nbsp;Suzanne Craft ,&nbsp;Laura D. Baker ,&nbsp;Goldie S. Byrd","doi":"10.1016/j.jnma.2025.04.002","DOIUrl":"10.1016/j.jnma.2025.04.002","url":null,"abstract":"<div><h3>Background and objectives</h3><div>In this article, we describe the results of a 6-month follow-up assessment among African American (AA) men who participated in the Black Men’s Health Forum, a 6-week online health education intervention.</div></div><div><h3>Methods</h3><div>A pre-post survey design was used to capture attitudes and behaviors before and 6-months after the intervention. The 6-month follow-up used the health conscious scale, Health Information Orientation Scale (HIOS), and the Short Multidimensional Inventory Lifestyle Evaluation (SMILE) to assess changes in attitudes toward health, health information seeking, and health behaviors. In addition, the influence of accountability partners among AA male participants of the forum was examined.</div></div><div><h3>Results</h3><div>A sample of 24 AA men [61.7 years of age (range: 34.1 to 75.9 years of age)] completed the follow-up. Participants became more self-aware of their health (5.6 to 6.2, <em>p = </em>0.0093), more motivated to improve health (5.8 to 6.5, <em>p = </em>0.0181), and took more personal responsibility for their health (5.6 to 6.4, <em>p = </em>0.0099). Results from the HIOS revealed that health information engagement increased among participants (2.7 to 3.1, <em>p = </em>0.0168).</div></div><div><h3>Conclusions</h3><div>AA men’s attitudes towards health and information engagement were successfully improved through an online health education intervention. In addition, we leveraged family and friends in the lives of men to serve as a support system for men in the study to help improve health behaviors.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Pages 140-147"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical awareness approach to cluster hiring for academic inclusion","authors":"Sierra Carter ,&nbsp;Emmanuella Asabor ,&nbsp;Grace Packard ,&nbsp;Margaux Kenwood ,&nbsp;Ayana Jordan ,&nbsp;Rachel A. Ross","doi":"10.1016/j.jnma.2025.02.001","DOIUrl":"10.1016/j.jnma.2025.02.001","url":null,"abstract":"<div><div>Minoritized groups experience interpersonal, structural, and systemic marginalization that is also perpetuated within academic institutions. This marginalization produces barriers that exclude racial/ethnic minoritized groups within academic medicine from career opportunities and advancement. Racial/ethnic minoritized faculty are often expected to take on additional labor to serve the diversity needs of the program and/or institution that are often unrecognized or undervalued in the tenure or promotion process or detract from additional responsibilities. The unique needs resulting from multiple intersecting identities must be considered when planning initiatives to support minoritized groups in academia. This is detrimental to medicine as it limits innovation, perpetuates health disparities, and prevents the recruitment of scholars/physicians that are representative of the diversity within the U.S. population. Cluster hiring is a newer initiative adopted by many institutions; recently supported by funding from the National Institutes of Health (NIH) to improve diversity and inclusion of racial/ethnic minoritized groups. Here we discuss the elements of the cluster hire process and how they might be particularly relevant to intersectional inclusion and structural change of academic institutions, while also highlighting potential limitations to broad adoption. We conclude with recommendations for the potential need for integration of more culturally informed cluster hiring practices that can be made at the departmental, institutional and national level to positively impact the hiring, retention and advancement of faculty from marginalized populations.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Pages 98-106"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing African American representation in plastic surgery","authors":"Joshua E. Lewis ,&nbsp;Wei-Chen Lee","doi":"10.1016/j.jnma.2025.01.009","DOIUrl":"10.1016/j.jnma.2025.01.009","url":null,"abstract":"<div><div>Plastic surgery is a specialty crucial for addressing the needs of diverse patient, yet it faces significant underrepresentation of African Americans, especially in academic leadership. This imbalance persists throughout medical education, training, and professional advancement. Dr. Arthur L. Garnes, the first board-certified African American plastic surgeon, overcame profound challenges, inspiring subsequent generations. Notable figures like Dr. Camille Cash and Dr. Steven Williams further exemplify resilience in the face of barriers. Mentorship emerges as pivotal, fostering diversity and inclusion within plastic surgery. Initiatives promoting mentorship, financial support, and recruitment are essential to rectifying disparities, ensuring equitable representation, and improving access to care for minority patients.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Pages 94-97"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating racism in medical education: Problems, definitions, principles and practical steps","authors":"Joshua E. Lewis ,&nbsp;Lornee C. Pride ,&nbsp;Maame A. Effirim ,&nbsp;Adedamola Ashade ,&nbsp;Raven Hollis ,&nbsp;Kafayat Oyejide ,&nbsp;Wei-Chen Lee","doi":"10.1016/j.jnma.2025.02.002","DOIUrl":"10.1016/j.jnma.2025.02.002","url":null,"abstract":"<div><div>Racism remains a significant issue in the medical field, profoundly affecting minority medical students. These students face unique challenges — including microaggressions, implicit biases, systemic barriers, and overt discrimination — impacting their education, mental health, career trajectories, and ability to provide compassionate care. Despite some progress, structural obstacles and underrepresentation persist, highlighting the need for systemic changes. This viewpoint paper explores definitions, principles, and practical steps for fostering antiracist cultures within medical education. It emphasizes the importance of developing self-advocacy, building support networks, and practicing continuous learning for minority students, while advocating for institutional strategies such as creating inclusive spaces, mentorship programs, curriculum reform, and financial support. By combining personal resilience with unwavering institutional support, medical education can move towards true equity and inclusion, ensuring that all students can thrive and contribute to a more equitable healthcare system.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 2","pages":"Pages 107-114"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in concerns and experiences with police-involved shootings among Colorado adults","authors":"Anna H. Abrams ,&nbsp;Rachel L. Johnson ,&nbsp;Ashley Brooks-Russell ,&nbsp;Marian E. Betz ,&nbsp;Erin Wright-Kelly","doi":"10.1016/j.jnma.2025.01.005","DOIUrl":"10.1016/j.jnma.2025.01.005","url":null,"abstract":"<div><h3>Objective</h3><div>To assess prevalence of concern and experiences with police-involved shootings among Colorado adults and differential impact on sociodemographic groups.</div></div><div><h3>Methods</h3><div>We analyzed a biennial state-representative online survey of Colorado adults, administered April-May 2023. Participants included the Ipsos KnowledgePanel of Colorado adults and additional opt-in respondents (<em>n</em> = 1,520). Main outcomes were self-reported concern about and personal experience with a police-involved shooting.</div></div><div><h3>Results</h3><div>Overall, 43.3 % of Colorado adults were concerned about a police-involved shooting occurring in their community and 26.1 % were concerned about a police-involved shooting occurring to themselves or their family. Black and Hispanic adults had significantly higher rates of concern compared to White and non-Hispanic adults, respectively. Of all Colorado adults, 4.4 % reported personal experiences with police-involved shootings; Hispanic adults report significantly higher rates to non-Hispanics (<em>p</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>Results highlight pervasive levels of concern with police-involved shootings, with highest rates of both concern and personal experiences among Black and Hispanic adults. These findings underscore the need for comprehensive and reliable data to understand police-involved shootings and concerns about police-involved violence among diverse populations and the impact on communities’ health.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 36-41"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity engagement among Black African-born immigrant women in the United States: Results from the 2011 to 2018 National Health Interview Surveys","authors":"Bose Maposa ,&nbsp;Emily Hill Guseman ,&nbsp;Dawn Graham ,&nbsp;Zelalem T. Haile","doi":"10.1016/j.jnma.2025.01.008","DOIUrl":"10.1016/j.jnma.2025.01.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Black women in the US, including Black African immigrant women, have the lowest rates of physical activity (PA). This study aimed to identify sociodemographic, anthropometric, and health characteristics associated with PA engagement among African-born Black women immigrants.</div></div><div><h3>Methods</h3><div>The sample consisted of 736 Black African-born women respondents the 2011–2018 National Health Interview Surveys. The outcomes of interest were aerobic activity, strengthening activity, and combined aerobic and strengthening activity. Independent variables of interest included sociodemographic characteristics, health behaviors, and anthropometrics. Descriptive statistics and multivariable adjusted logistic regression analyses were performed.</div></div><div><h3>Results and Discussion</h3><div>Of the 736 women, 43.1 % were sufficiently active in aerobic activities and 17.4 % met the strengthening activity guidelines. Overall, only 15.7 % of the participants met the guidelines for total PA (aerobic and strength), while 55 % did not meet any guidelines. Participants who consumed alcohol were more likely to be sufficiently active in aerobic activity compared to those who abstained (AOR = 3.54, 95 % CI [2.43,5.16]). Factors negatively associated with sufficient aerobic activity were smoking (AOR = 0.42, 95 % CI [0.19,0.92] and having obesity (AOR = 0.50, 95 % CI [0.33,0.75]). The odds of meeting strengthening activity guidelines were greater among those with high school education (AOR = 2.94, 95 % CI [1.20, 7.20]) and more than high school (AOR = 2.54, 95 % CI [1.09,5.95]) than among those with less than high school education, Additionally, being in the US 15 years or more (AOR = 2.15, 95 % CI [1.18–3.91]). and a current drinker (AOR = 2.14, 95 % CI [1.22–3.75]) was positively associated with meeting strength guidelines.</div></div><div><h3>Implications</h3><div>Findings provide missing information about Black African immigrant women's participation in PA and suggest that more research is needed to understand how African immigrant women make decisions about PA. The findings join calls to disaggregate data and health related research on Africans.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 61-73"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}