Health Equity最新文献

{"title":"Assessing the Impact of a Culturally Congruent Perinatal Home-Visiting Program on Gestational Age at Delivery for Black Women.","authors":"Erin Snowden, Deborah F Perry, Rabiyah Amina, Bryan Shaw, Aza Nedhari","doi":"10.1089/heq.2024.0076","DOIUrl":"10.1089/heq.2024.0076","url":null,"abstract":"<p><strong>Purpose: </strong>There is a Black maternal health crisis in America, with significant racial disparities in birth outcomes for Black women in Washington, DC. Programs designed to reduce these inequities must intentionally address the role of systemic racism and the ongoing legacy of oppression that is endemic to traditional perinatal care services. This article describes the findings from the quantitative analysis of an innovative perinatal program (Mothers Rising) designed by and for Black women in the Washington, DC, metropolitan area that was part of a larger mixed methods study.</p><p><strong>Methods: </strong>Using data provided by a Medicaid managed care organization that insured program participants and women who did not receive Mothers Rising, program participants (<i>n</i> = 102) were matched with a group of Black women who did not receive the program (<i>n</i> = 102) using propensity scores matching. Perinatal outcomes were extracted from electronic health records from the managed care dataset, including birth weight and gestational age.</p><p><strong>Results: </strong>Statistical analyses of the differences in birth outcomes between program participants and their matched peers demonstrated small but statistically significant differences in gestational age, favoring the Mothers Rising group.</p><p><strong>Conclusions: </strong>This study adds to the evidence base for the effectiveness of culturally tailored interventions to successfully address persistent racial disparities in Black women's perinatal health outcomes that result from persistent racism. Hyperlocal, community-developed home-visiting programs, such as Mothers Rising, should be funded to sustain impact and optimize maternal health outcomes.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"599-607"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693657","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":"Black Women's Experiences Along the HIV Care Continuum in the United States: A Scoping Review.","authors":"Jacqueline P Thomas, Will Ballew, Miu Ha Kwong","doi":"10.1089/heq.2024.0020","DOIUrl":"10.1089/heq.2024.0020","url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of HIV among Black women is higher than the prevalence among other ethnic groups. Although antiretroviral therapy reduces HIV transmission and mortality, Black women still face health disparities when it comes to receiving health care. The purpose of this scoping review is to synthesize research regarding health disparities and health inequities faced by Black women living with HIV (BWLH).</p><p><strong>Methods: </strong>We searched three scholarly databases, PsychNet, MEDLINE, and CINAHL, and 18 peer-reviewed complete studies that met the inclusion criteria.</p><p><strong>Results: </strong>Several themes emerged from the literature, including discrimination, poverty, mental and physical health, health care, and social support. Each theme had a role in the progression of BWLH along the HIV care continuum.</p><p><strong>Conclusion: </strong>Black women continue to be disproportionately affected by HIV, which involves active engagement in HIV care to sustain viral suppression to prevent the spread of the virus. Factors continue to exist that contribute to health disparities and inequities, such as discrimination, internal and enacted HIV-related stigma, and poverty. Thematic findings in this review indicate that patient-centered care and support systems can positively impact BWLH experiences along the HIV continuum.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"608-617"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693662","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":"Reply to: [Letter to the Editor].","authors":"Justin M List, David Au, William C Yarbrough, Ernest Moy","doi":"10.1089/heq.2024.0049","DOIUrl":"10.1089/heq.2024.0049","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"636-638"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693751","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":"Overcoming Research Mistrust in African American Communities by Engaging Community Members as Research Team Members: Challenges and Opportunities.","authors":"Melissa Ryan, Travaé Hardaway Griffith, Grace Okoro, Tiffany Osborne, Lori Brand Bateman, Janet M Turan, Raegan W Durant, Lece Webb, Mona N Fouad, Gabriela R Oates","doi":"10.1089/heq.2024.0050","DOIUrl":"10.1089/heq.2024.0050","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to understand factors surrounding COVID-19 testing in vulnerable urban and rural African American communities in Alabama, which are characterized by mistrust in medical research.</p><p><strong>Methods: </strong>To address widespread mistrust, we trained lay community members as research coordinators (Community Engagement Coordinators-CECs) and employed them for study recruitment and data collection. We then explored their experiences through group discussions and individual interviews.</p><p><strong>Results: </strong>Ten CECs (8 in Jefferson, 2 in Dallas County; 8 female, 2 male) completed 5 h of instructor-led training followed by virtual Collaborative Institutional Training Initiative (CITI) Human Subjects Training. In 11 weeks, CECs recruited 318 study participants and administered 303 surveys. After survey data collection was completed, CECs recruited survey respondents for participation in focus groups, enrolling 53 individuals. CECs continued their study engagement by reviewing developed study products.</p><p><strong>Conclusions: </strong>Engaging CECs as research personnel facilitated successful completion of planned enrollment with minimal missing data. Investing in communities by training and employing community members as study personnel can help overcome research mistrust and promote support for research and public health interventions.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"639-647"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693388","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":"Patient Caregiver Perspectives on Accessing Language Interpretation in a Pediatric Emergency Department.","authors":"Emily A Hartford, Nicholas Dimenstein, Dwight Barry, K Casey Lion","doi":"10.1089/heq.2024.0010","DOIUrl":"10.1089/heq.2024.0010","url":null,"abstract":"<p><p>Patients and caregivers with a language for care other than English (LOE) are at risk for inequitable care in the pediatric emergency department (ED). Professional interpretation (PI) improves outcomes, but there can be complexity in determining optimal language for care and interpretation need. Our goal was to learn more about the perspectives from caregivers who speak different languages regarding interpretation with a survey near ED discharge. Caregivers of patients with LOE, identified during ED check-in, were approached by research staff using PI near ED discharge. A survey was completed via interpreter or bilingual research staff prior to discharge or by phone within 48 h. Answers were entered into REDCap and analyzed descriptively. A total of 154 participants were approached; 49 completed a survey between April and November 2021. A variety of languages were spoken in the sample (<i>n</i> = 15) and represented the ED population. Twenty percent of caregivers with LOE also reported good comprehension in English. Families indicated a desire for interpretation at various stages of the ED encounter, reported different interpretation needs among family members, and indicated interest in family-initiated interpreter access. Determining optimal language for care and provision of PI during ED encounters can be complex. In this study, we report caregiver perspectives on the use of PI. Most participants wanted PI at all stages of the ED visit and were interested in accessing it themselves. Future directions are to pilot family-initiated access to PI to tailor its use to the needs of patients and families.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"648-653"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693435","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":"Heterosexist Discrimination and Substance Use in Young Adult Sexual Minority Men: Examining the Moderating Role of Mindfulness.","authors":"Dale Dagar Maglalang, Lance Keene, Fatima A Mabrouk, Jasmine Agostino, Arryn A Guy, Shufang Sun","doi":"10.1089/heq.2024.0015","DOIUrl":"10.1089/heq.2024.0015","url":null,"abstract":"<p><strong>Purpose: </strong>Young sexual minority adults experience high rates of heterosexist discrimination. The use of substances has been documented as a form of coping with discrimination. While mindfulness has been used to address experiences of discrimination and the use of substances, respectively, few studies have explored whether mindfulness can lower the negative effects of discrimination on substance use. The purpose of this study is to examine the association between heterosexist discrimination and substance use in young adult sexual minority men (YASMM), and if dispositional mindfulness can moderate this relationship.</p><p><strong>Methods: </strong>Logistic regression analysis was used to examine the association of heterosexist discrimination and cigarette, e-cigarette, and hazardous drinking in a sample of YASMM (18-35 years old; <i>n</i> = 325) from a national survey. A two-way interaction analysis was also implemented to evaluate if dispositional mindfulness moderated this relationship.</p><p><strong>Results: </strong>Heterosexist discrimination was associated with increased odds of cigarette use (adjusted odds ratio [aOR] = 1.06; 95% confidence interval [CI]: 1.03, 1.08) and e-cigarette use (aOR = 1.03; 95% CI: 1.01, 1.05). Higher scores of dispositional mindfulness moderated the relationship between heterosexist discrimination and hazardous drinking, indicating a weakening effect with higher scores of dispositional mindfulness.</p><p><strong>Conclusion: </strong>Mindfulness may decrease the negative effects of heterosexist discrimination on hazardous drinking among YASMM.Health Equity Implications: Researchers and practitioners should consider incorporating mindfulness as a component to their intervention to help YASMM deal with stressors engendered by discrimination, which may prevent hazardous drinking as a coping mechanism at a younger age.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"578-587"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693693","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":"Examining Black Birthing People's Experiences with Racism, Discrimination, and Contextualized Stress and Their Perspectives on Racial Concordance with Prenatal Providers.","authors":"E Nicole Teal, Aryana Daye, Sarah C Haight, M Kathryn Menard, Karen Sheffield-Abdullah","doi":"10.1089/heq.2023.0266","DOIUrl":"10.1089/heq.2023.0266","url":null,"abstract":"<p><strong>Introduction: </strong>We examine Black birthing people's experiences with racism, discrimination, and contextualized stress and whether those experiences are associated with preference for racially concordant prenatal care providers.</p><p><strong>Methods: </strong>This cross-sectional study is the quantitative component of a larger, mixed-methods study. Data were from initial (August-October 2021) and follow-up (December 2022-January 2023) surveys among self-identified Black and/or African American birthing people who delivered a baby at a university system between 2019 and 2021 and were at least 18 years old. Respondents were 3-32 months postdelivery at the initial survey, which collected data on demographics and the Perceived Racism (ranges 0-430), Perceived Discrimination (ranges 0-36), and Jackson, Hogue, Phillips Contextualized Stress Measure (ranges 0-355) scales. The follow-up survey assessed views on racial and gender concordance and continuity with prenatal providers. Pearson correlation coefficients assessed relationships between scale scores and agreement that racial concordance is important and preferable. Poisson regression assessed whether a top quartile score on scales was related to importance of and preference for racial concordance with providers.</p><p><strong>Results: </strong>Participants (<i>n</i> = 200) scored medians of 99.5 on the racism scale, 33 on the discrimination scale, and 177 on the contextualized stress scale. Of follow-up survey participants (<i>n</i> = 69), 78.3% agreed they would choose a racially concordant prenatal provider if possible (<i>n</i> = 54) and 42.0% agreed that racial concordance with their provider was important (<i>n</i> = 29). Scoring higher on discrimination and contextualized stress scales was positively correlated with agreeing that racial concordance was important. Regression analyses showed no significant associations between scale scores and agreeing that racial concordance with one's prenatal provider is important or preferable.</p><p><strong>Conclusion: </strong>Black birthing people experience high levels of racism, discrimination, and contextualized stress. The overwhelming majority would choose racial concordance with their prenatal provider if possible.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"588-598"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693684","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":"\"They Need to Know the Science, but We also Need to Listen\": Perspectives of Black Rural Postpartum Mothers' Health Care Providers And Support Persons.","authors":"Natalie Hernandez-Green, Morgan V Davis, Kaitlyn Hernandez-Spalding, Merna S Beshara, Oluyemi Farinu, Kennedy Lewis, Sherilyn Francis, LeThenia Joy Baker, Sherrell Byrd, Andrea Parker, Rasheeta Chandler","doi":"10.1089/heq.2024.0051","DOIUrl":"10.1089/heq.2024.0051","url":null,"abstract":"<p><strong>Background: </strong>In the United States, Black women are three times more likely to be affected by maternal mortality than White women. People who live in rural areas also face an increased risk. The objective of this study was to explore the perspectives of Black postpartum women's support persons and health care providers, and the impact of race and rurality on their roles, to inform the development of a mobile health (mHealth) application focused on postpartum transitional care for rural Black women.</p><p><strong>Methods: </strong>Utilizing a semistructured designed discussion guide, we conducted four focus groups between July 2021 and October 2021. We asked support persons and health care providers to share their opinions about (1) postpartum needs, (2) the current hospital discharge process, (3) gender discrimination and experiences of racism and classism, and (4) suggestions for mobile application development.</p><p><strong>Results: </strong>Ten health care providers and seven support persons participated in the focus groups. A total of 57.1% of support persons identified themselves as a family member of the mother. In addition, 60% of health care providers indicated they practiced in a rural area at the time. Identified themes included race and rurality, emotional health, participants' roles in relation to mothers' needs, and the importance of technology for accessing information and resources.</p><p><strong>Conclusion: </strong>When describing their personal experiences, participants emphasized the importance of mHealth technology for helping Black postpartum mothers access health information. Insight from support persons and health care providers highlighted the challenges Black rural mothers face during the postpartum period and how our mobile application can be best utilized to address their needs.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"568-577"},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693633","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":"Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study.","authors":"Yelba Castellon-Lopez, O Kenrik Duru, Norman Turk, Gerardo Moreno, Keith C Norris, Amanda Vu, Rintu P Saju, Chi-Hong Tseng, Kia Skrine-Jeffers, Carol M Mangione, Dominick Frosch, Tannaz Moin","doi":"10.1089/heq.2023.0186","DOIUrl":"10.1089/heq.2023.0186","url":null,"abstract":"<p><strong>Background: </strong>To achieve health equity, interventions should yield similar effectiveness across all patient subgroups. However, the adoption of diabetes prevention strategies and successful weight loss in \"real-world\" Diabetes Prevention Program (DPP) translational studies have varied by race and ethnicity. We examined racial and ethnic differences in diabetes prevention outcomes among study participants from the Prediabetes Informed Decisions and Education (PRIDE) Study.</p><p><strong>Methods: </strong>In a retrospective analysis of data from the PRIDE cluster randomized trial across a large health system, we examined (1) percent weight change and (2) uptake of DPP and/or metformin among overweight/obese participants with prediabetes 12 months after participating in a pharmacist-led shared decision-making (SDM) intervention. We stratified the outcomes by race and ethnicity using a generalized linear mixed-effects model.</p><p><strong>Results: </strong>The study participants (<i>n</i> = 515) had an average age of 56 years (standard deviation [SD] = 11.0), hemoglobin A1c of 6.0% (SD = 0.20), and body mass index of 30.3 (SD = 5.2). Black/African American and Latino study participants lost significantly less weight at the 12-month follow-up compared with White/Caucasian participants (-1.0% and -1.2%, respectively, vs. -3.3%, <i>p</i> < 0.01 for both comparisons). There was no significant difference in the adoption of diabetes prevention strategies between racial and ethnic groups after completing an educational SDM intervention.</p><p><strong>Conclusion: </strong>To better promote health equity, future studies should investigate the potential causal factors for these differences in weight loss, such as variations in socioeconomic status, physical activity, cultural influences, and neighborhood characteristics.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"659-666"},"PeriodicalIF":2.6,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701729","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":"Overcoming Health Inequities: Spatial Analysis of Seroprevalence and Vaccination Against COVID-19 in Chile.","authors":"Muriel Ramírez-Santana, Juan Correa, Loreto Núñez Franz, Mauricio Apablaza, Paola Rubilar, Cecilia Vial, Lina Jimena Cortes, Juan Hormazábal, Luis Canales, Pablo Vial, Ximena Aguilera","doi":"10.1089/heq.2023.0204","DOIUrl":"10.1089/heq.2023.0204","url":null,"abstract":"<p><strong>Background: </strong>In unequal economies, the spread of the first waves of the COVID-19 was usually associated with low socioeconomic status of individuals and their families. Chile exemplified this. By mid-2020, Chile had one of the highest SARS-CoV-2 infection rates in the world predominantly in poorer areas. A year later, the country launched a universal vaccination campaign based on the national strategy of immunization established in 1975. By 2022, Chile presented one of the highest COVID-19 vaccination coverages globally, reaching 94.3% of the population with the primary scheme by the end of 2022.</p><p><strong>Objective: </strong>This study analyzes the spatial distribution of SARS-CoV-2 seroprevalence at the beginning of the pandemic (2020) compared with the seroprevalence after 2 years of ongoing epidemic and COVID-19 vaccination campaigns (2022).</p><p><strong>Methods: </strong>Two population-based random samples of individuals aged 7 years and older from two Chilean cities were studied. Utilizing an enzyme-linked immunosorbent assay test, IgG antibodies were measured in serum of 1061 participants in 2020, and 853 in 2022.</p><p><strong>Results: </strong>Using the Global Moran's Index, the seroprevalence distribution pattern for the year 2020 showed clustering in the two cities. Conversely, seroprevalence and vaccinations were homogeneously distributed in 2022. These results show the success of the vaccination campaign in Chile, not only in coverage but also because it widely reached all individuals.</p><p><strong>Conclusions: </strong>The uptake of this preventive measure is high, regardless of the social and economic factors, achieving broad population immunity. The extensive deployment of the primary health care network contributed to reducing health inequities and promoting to universal health access.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"558-567"},"PeriodicalIF":2.6,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693671","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}