Health Equity最新文献

{"title":"The Importance of Recruitment of Low-Income Pregnant Persons in Interdisciplinary Research to Understand the Impact of Social and Environmental Determinants: Lessons Learned About Implementation and Recruitment.","authors":"Erika Marquez, Amanda Haboush-Deloye, Elizabeth Lawrence, Selam Ayele, Courtney Coughenour, Nora Doyle, Wynona Dizon, Lizbeth Perez Rodriguez, Chloe Bombara","doi":"10.1089/heq.2024.0112","DOIUrl":"10.1089/heq.2024.0112","url":null,"abstract":"<p><strong>Background: </strong>Prior research indicates that enrolling underrepresented populations in clinical research is challenging. Although research has identified some barriers to participation and strategies to overcome them, studies have made little progress in being inclusive and representative. There remains a great need for including racial/ethnic minorities, low-income families, and pregnant women in research. The purpose of this article is to describe the implementation of enrollment strategies used in our study to understand the feasibility of building a maternal cohort and better understand the relationship between environmental and social impacts on maternal exposure and child outcomes.</p><p><strong>Methods: </strong>Working across multiple academic units, our team implemented equity-focused team science strategies to recruit diverse populations into a research study. The phases included development, conceptualization, implementation, and translation.</p><p><strong>Results: </strong>Our interdisciplinary team study used intentionality and commitment to deploy effective strategies including clearly defining the problem, selecting the correct team members to leverage expertise, clearly defining the study, establishing roles and responsibilities, representation, and clear and constant communication. A total of 100 pregnant women enrolled in our study using a team science interdisciplinary model.</p><p><strong>Discussion: </strong>Building interdisciplinary teams can help us understand complex problems, increase innovation, and develop effective solutions in policy and practice. More specifically, interdisciplinary teams can advance our ability to recruit diverse populations into research. Future studies should consider how to harness the strengths of the different research team members to achieve more inclusive participation.</p><p><strong>Health equity implications: </strong>This work has the potential to improve representation in research findings, enhance understanding of health disparities, and promote inclusive research practices.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"175-182"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training Doctoral Students to Advance Health Equity Through Policy Leadership: An Overview of the Health Policy Research Scholars Program.","authors":"Keshia M Pollack Porter, Attia Goheer, Jessica Harrington, Shannon Frattaroli","doi":"10.1089/heq.2024.0159","DOIUrl":"10.1089/heq.2024.0159","url":null,"abstract":"<p><p>Health Policy Research Scholars (HPRS) is an innovative, equity-focused leadership program for doctoral students from marginalized backgrounds and identities. HPRS trains scholars from various disciplines to apply their research while engaging in policy to advance health equity. The HPRS logic model illustrates that training will lead to short-term changes including increased knowledge and skills; an interdisciplinary mindset; and increased sense of belonging, confidence, and self-awareness to advance health equity in the longterm. This article provides an overview of HPRS, including the logic model, curriculum, and implications for training doctoral students to become health equity leaders.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"170-174"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should I Buy Groceries or Get a Diagnostic Scan?","authors":"Brad Isaacson, Emma Greally","doi":"10.1089/heq.2024.0111","DOIUrl":"10.1089/heq.2024.0111","url":null,"abstract":"<p><p>The economic burden of medical care is shared (often disproportionately) between patients, health care systems, and payers. Diagnostic scans in particular provide valuable information for providers; however, imaging is often performed in high-cost settings. Independent Diagnostic Testing Facilities have emerged as viable options for patients, but care is often fragmented and may lack sufficient quality standards. To change health care, bold steps are needed to maximize value-based care, enhance access, and ensure affordability for communities. If this fails to occur, for many more years, we will unfortunately hear \"should I buy groceries or get a diagnostic scan?\".</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"183-185"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What <i>Health Equity</i> Journal Stands For.","authors":"Monica R McLemore","doi":"10.1089/heq.2025.0031","DOIUrl":"10.1089/heq.2025.0031","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"142-143"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Vision to Action: National Bleeding Disorders Foundation's Roadmap for Achieving Health Equity, Diversity, and Inclusion.","authors":"Keri L Norris, Marissa Melton, Karina Lopez, Dawn Rotellini, Leonard A Valentino","doi":"10.1089/heq.2024.0146","DOIUrl":"10.1089/heq.2024.0146","url":null,"abstract":"<p><strong>Background: </strong>The National Bleeding Disorders Foundation (NBDF) consistently hears from lived experience experts about daily challenges preventing them from leading their best life and thriving physically, mentally, and emotionally. Dedicated to enabling people and families impacted by inheritable blood and bleeding disorders (BDs) to thrive, NBDF recognized that the impact of social determinants, disparities, and inequities of health must be addressed explicitly to achieve their mission.</p><p><strong>Methods: </strong>NBDF developed a health equity, diversity, and inclusion strategic direction for the coming decade in the context of collaboration with regional, national, and international partners. Drawing upon limited available data, extensive community consultation, and a thorough landscape scan, NBDF identified specific social determinants of health preventing health equity in the inheritable BDs community.</p><p><strong>Results: </strong>NBDF developed a model detailing the engaging, empowering, and elevating work individual, community, organizational, and institutional stakeholders must undertake to dismantle health equity barriers. Overarching priorities and strategies were established, providing leadership, and support was offered in the form of tools, resources, and expertise.</p><p><strong>Conclusion: </strong>Designed to be tailored to needs and capacities, this approach may be applied by other rare disorder communities to develop and operationalize their own health, equity, diversity, and inclusion strategic direction to advance social justice.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"144-160"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Assessment and Inference in Race-Based Clinical Algorithms: A Narrative Review and Health Policy Analysis Focused on Living Kidney Donation.","authors":"Sienna E Schaeffer, Carolina Gonzalez Bravo, Christopher D Ahlers, Alaina N Elliott-Wherry, Hannah Zadeh, Precious-Junia de-Winton Cummings, Kimberly C Dukes, Nasrien E Ibrahim, DeShauna Jones, Patrick T Zamba, Aloha D Wilks, Martha L Carvour","doi":"10.1089/heq.2024.0170","DOIUrl":"10.1089/heq.2024.0170","url":null,"abstract":"<p><strong>Background: </strong>Minoritized racial and ethnic groups in the United States face long-standing disparities in a variety of health outcomes, owing to inequitable distribution of social and structural determinants of health along racial and ethnic lines. Although the existence of such disparities has long been a topic of scientific inquiry, there has been a dearth of investigations regarding their underlying mechanisms and potential remedies. This presents a challenge to those creating evidence-based and equity-focused health policy.</p><p><strong>Methods: </strong>We conducted an evidence-based, equity-focused narrative review about living kidney donor eligibility using salient literature about donor eligibility and racial and ethnic disparities in kidney transplantation and donation in the United States. We sought to examine the rigor and reproducibility of the evidence base regarding race- and ethnicity-based living kidney donation policies.</p><p><strong>Results: </strong>Our review identified several threats to scientific validity in the evidence base, including ambiguity in the operationalization of race and ethnicity variables, instances of type III error and racial essentialist biases, and causal inferences made using underpowered or scientifically unsubstantial subgroup analyses. We also identified structural barriers to the interpretation of this evidence to advance health equity, including barriers to the practices of clinical equipoise and shared medical decision-making.</p><p><strong>Conclusions: </strong>Threats to scientific validity and inferential errors in the evidence base about health inequities may forestall progress toward equity. We provide recommendations for addressing such barriers using standards applied in other clinical and research domains.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"161-169"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee.","authors":"L Lauren Brown, Almariana J Acuña, Amna Osman, Lloyda B Williamson, Carolyn M Audet, Megan L Wilkins, Jessica M Sales, Samantha V Hill, Jill Foster, April C Pettit, Latrice C Pichon","doi":"10.1089/heq.2023.0251","DOIUrl":"10.1089/heq.2023.0251","url":null,"abstract":"<p><strong>Background: </strong>Compared with the general public, people with HIV (PWH) experience more psychological trauma and higher rates of post-traumatic stress disorder (PTSD), yet limited research explores how PWH may uniquely experience trauma. The primary goal of this study was to investigate trauma exposure typologies and sequelae among PWH to inform trauma screening and interventions.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with a convenience sample of 20 PWH with PTSD, receiving services from an urban, Tennessee-based HIV Service Organization. Interview guides were conducted to gain a rich understanding of exposure types from the Life Events Checklist-5 (LEC-5), explore potential social determinants of trauma, and uncover effects of chronic trauma or traumata. Thematic content analysis was used to examine typologies and effects.</p><p><strong>Results: </strong>Exposure typologies appeared as social determinants of trauma, including molestation as the most common followed by racial trauma, community violence, incarceration, addiction, interpersonal violence, poverty cycles, and stigma. Standard PTSD symptoms were reported in addition to emerging effects of complexity, synergism, and resilience. Complex effects spanned socioecological contexts and included sequelae of affective dysregulation, negative self-concept/self-organization, and disturbances in relationships.</p><p><strong>Conclusion: </strong>Many typologies were not well accounted for in the LEC-5, underscoring the potential to miss exposure types and thus treatment indication. Similarly, effects expanded beyond standard PTSD symptoms, suggesting that nuanced treatment needs may also be overlooked. Findings are consistent with literature indicating the need for updated trauma screening and assessment measures to most comprehensively and accurately direct treatment needs.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"131-141"},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Equity and <i>BRCA1/2</i> Testing.","authors":"Steven Sorscher","doi":"10.1089/heq.2024.0167","DOIUrl":"10.1089/heq.2024.0167","url":null,"abstract":"<p><p>Although most cancers are sporadic, a significant proportion are related to inherited cancer-causing genes called pathogenic germline variants (PGVs). There are recommended measures for prevention and earlier diagnosis of cancers in patients identified as <i>BRCA1</i> and <i>BRCA2</i> PGV carriers, which are the most common cancer-predisposing PGVs. For example, published guidelines recommend that patients with <i>BRCA1/2</i> PGVs undergo bilateral oophorectomies to prevent ovarian cancer and regular magnetic resonance imaging to screen for breast cancer. Also, those same measures are recommended for family members identified by cascade testing as <i>BRCA1/2</i> carriers. Here, reports of the significant disparities between groups in which patients diagnosed with breast cancer are offered and undergo testing for <i>BRCA1/2</i> PGVs are reviewed. Expanding the current standard of care guidelines for <i>BRCA1/2</i> testing to all patients diagnosed with breast cancer and enacting the Cancer Moonshot 2.0 Initiative measures that should mitigate these disparities are discussed as well.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"127-130"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/heq.2024.80057.revack","DOIUrl":"https://doi.org/10.1089/heq.2024.80057.revack","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"125-126"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Strict Isolation Precautions on Families with a Language Other than English.","authors":"Polina Frolova Gregory, Sanyukta Desai, Corrie E McDaniel, Austin DeChalus, Emily Bowen, Michael Dinh, Jessica Gagen, Dwight Barry, Abena Knight, Matthew Test, Arti D Desai, Mersine A Bryan","doi":"10.1089/heq.2024.0117","DOIUrl":"10.1089/heq.2024.0117","url":null,"abstract":"<p><strong>Introduction: </strong>Children with a language for care other than English (LOE) are at risk for inequitable care. We examined the association of isolation precautions in the care of hospitalized children with LOE through the frequency of professional interpreter use and timing of in-person consultation.</p><p><strong>Methods: </strong>Retrospective cohort study of children in a strict isolation unit (SIU) between 2/2020 and 12/2021. Negative binomial regression was used to assess both differences in interpretation rates between SIU and non-SIU, and within 72-h/in-person consultation rates within the SIU between English-speaking and LOE encounters.</p><p><strong>Results: </strong>We identified 487 encounters in the SIU; 126 (26%) involved patients with LOE. The median interpretations per day were 4.5 (Interquartile Range [IQR]: 2.0-6.7). Among patients with LOE, there was an observed difference in median interpretations per day in the SIU (3.9, IQR: 1.7-6.4) versus encounters in non-SIU acute care units (5.0, IQR: 1.2-8.2). However, this difference was not statistically significant (Incidence Rate Ratio [IRR]: 0.89; 95% confidence interval [CI]: 0.70-1.13). Sub-specialty consultations were requested for 410 (84%) encounters within the SIU; 282 (69%) were completed in person within 72 h. A small difference between the percentage of completed consultations for encounters with LOE (<i>n</i> = 61, 64%) and English-speaking patients' encounters (<i>n</i> = 221, 70%) was noted, which again was not statistically significant (IRR: 0.93; 95% CI: 0.71-1.21).</p><p><strong>Conclusion: </strong>Despite the increased barriers of strict isolation, we exceeded institutional standards for interpretations per day and had similar rates of interpretation for encounters with LOE admitted to medical units regardless of isolation status.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"100-105"},"PeriodicalIF":2.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}