Health Equity最新文献

{"title":"Opportunities to Retrofit, Reform, and Reimagine Systematic Reviews for Racial Equity.","authors":"Darchelle V Excellent, Bonnie Jones-Hepler, Amelia N Gibson, Megan von Isenburg, Kristin P Tully, Debra H Brandon","doi":"10.1089/heq.2023.0150","DOIUrl":"10.1089/heq.2023.0150","url":null,"abstract":"<p><p>Systematic reviews are used for synthesizing and summarizing published research on any given topic and population of interest. These reviews can expand knowledge within a content area but are limited by place and time values, which can perpetuate bias and systemic racism. This article reports a student's experience with conducting a systematic review on breastfeeding experiences among black birthing parents. We explore the systematic racism perpetuated by the current systematic review search process. We then use McLemore's \"Retrofit, Reform, and Reimagine\" framework for health equity to propose ways to increase transparency and racial equity through the systematic review process and academic mentoring.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"554-557"},"PeriodicalIF":2.6,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693736","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":"Establishing a Health Equity Office: The Importance of Recentering Equity.","authors":"Aswita Tan-McGrory, Amita Bey, John D Cowden, Hans B Kersten, Arie Nettles, W Cody Reynolds, Valerie L Ward, Lenny Lopez","doi":"10.1089/heq.2024.0004","DOIUrl":"10.1089/heq.2024.0004","url":null,"abstract":"<p><strong>Objectives: </strong>The Pediatric Health Equity Collaborative (PHEC) set out to describe the best practices for establishing a health equity-focused office within a clinical setting.</p><p><strong>Study design: </strong>Survey and in-depth interviews of the members of the PHEC comprised pediatric care delivery systems in the United States and Canada.</p><p><strong>Methods: </strong>Human-centered design methods were utilized in an iterative fashion to develop and agree on survey and interview domains. The final seven domains were as follows: (1) history of the office, (2) general description of the office, (3) position of the office in the organization, (4) budget and finance, (5) stakeholders, (6) community engagement, and (7) measuring outcomes. Interviews were analyzed using an applied thematic approach to inductively identify themes until saturation was achieved.</p><p><strong>Results: </strong>PHEC participants articulated several key implementation factors in the development of a health equity office. First, the history of the office is important and has the potential to determine the office's scope of work and sphere of influence. Second, a health equity office can provide crosscutting organizational direction, stability, and execution of equity efforts, reducing the effects of siloing. Third, high-level leadership buy-in provides time and financial resources. Finally, a health equity office should be centrally involved in the collection, analysis, and reporting of equity-focused metrics.</p><p><strong>Conclusions: </strong>A health equity-focused office can play an integral and sustaining role in representing and focusing equity efforts across an organization, measuring processes and outcomes, and helping to develop the equity mission and vision.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"538-553"},"PeriodicalIF":2.6,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693681","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":"Identity, Acculturation, and E-Cigarette Use among Bicultural Hispanic Youth and Young Adults.","authors":"Emily C Sanders, Sarah Evans, Alex Budenz, N Yvette Frias, Sarah Byrnes, Everly Macario","doi":"10.1089/heq.2024.0013","DOIUrl":"10.1089/heq.2024.0013","url":null,"abstract":"<p><strong>Introduction: </strong>Research suggests Hispanic/Latino/a/x/e (hereafter Hispanic) youth/young adult (YYA) tobacco use may vary by acculturation level, but few studies have explored e-cigarette use by acculturation or how bicultural identity may affect tobacco susceptibility. This study examined acculturation's role in U.S. Hispanic YYA e-cigarette use to better understand risk and protective factors.</p><p><strong>Methods: </strong>We conducted 20 virtual focus groups in English/Spanish with Hispanic 13-24-year-olds (December 2021-January 2022). We coded transcripts in their original language (intercoder reliability kappa 0.89) and conducted thematic analysis segmented by age cohort, e-cigarette use, and acculturation level.</p><p><strong>Results: </strong>More acculturated participants had greater knowledge/familiarity with tobacco/nicotine compared with less acculturated participants. Bicultural participants more commonly mentioned curiosity and direct peer pressure as e-cigarette use drivers. While bicultural participants noted the negative impacts of e-cigarette use on family relationships, this was not a use deterrent. Less acculturated participants were most concerned with stigma, negative family impacts, and broader Hispanic community disapproval.</p><p><strong>Discussion: </strong>This study suggests that differences related to Hispanic identity and the acculturative process may increase or decrease e-cigarette use risk. Bicultural YYA, who represent more than half of U.S. Hispanic YYA, toggle between Hispanic roots and mainstream U.S. culture, which can lead to unique stressors that may increase susceptibility to e-cigarettes.</p><p><strong>Health equity implications: </strong>Public health efforts must recognize the heterogeneity of the Hispanic population and the role acculturation plays in e-cigarette use. A nuanced understanding can inform the design of targeted and effective public health strategies to reduce disparities in e-cigarette risk and use.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"527-537"},"PeriodicalIF":2.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693648","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":"Equity Across Religious Identity: Assessing Student Attitudes and Experiences with the Medical School Religious Holiday Policy.","authors":"Sarah Battiston, Emily Otiso, Dustyn Levenson, Haniyeh Zamani, Ijeoma Nnodim Opara","doi":"10.1089/heq.2024.0066","DOIUrl":"10.1089/heq.2024.0066","url":null,"abstract":"<p><strong>Background: </strong>Wayne State University School of Medicine (WSUSOM) is the largest single-campus medical school located in a diverse community. WSUSOM's religious holiday policy guarantees time off for observance of one religious holiday. For all other religious holidays, students must request for time off. The current policy lacks specific guidelines to ensure equity across religious identities when granting time off. Religious and spiritual practice can enhance wellness. Therefore, assessing the equity of the current policy is crucial to ensuring equitable access to wellness.</p><p><strong>Objective: </strong>This project aims to assess students' attitudes and experiences with the current religious holiday policy at WSUSOM and compare experiences across religious identities.</p><p><strong>Methods: </strong>A 17-question Qualtrics survey was emailed to all WSUSOM students. Survey questions included demographics, experiences with the current policy, and Likert scales to assess attitudes. Data was analyzed holistically and assessed for variation among religious identities using chi-squared analysis.</p><p><strong>Results: </strong>Analysis included 156 surveys: 27.5% of students reported difficulties getting their religious holiday off, and 9.8% were denied a religious holiday, Muslims being the most impacted (<i>p</i> < 0.01). Muslim identifying students (75%) reported the highest incidence of completing additional work to receive an absence; 35.6% of students agreed that the current policy caused mental distress and majority of those being Muslim students (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>The current policy has caused difficulty for many students and has disproportionately impacted students from minority religions (especially Islam), exposing the need for a new policy.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"519-526"},"PeriodicalIF":2.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693679","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":"The Continued Significance of Obstetric Violence: A Response to Chervenak, McLeod-Sordjan, Pollet et al.","authors":"Dána-Ain Davis, Monica J Casper, Evelynn Hammonds, Wendy Post","doi":"10.1089/heq.2024.0093","DOIUrl":"10.1089/heq.2024.0093","url":null,"abstract":"<p><p>This guest editorial offers a critical response to Chervenak, McLeod-Sordjan, Pollet et al.'s clinical opinion dismissing obstetric violence as both emotionally charged and damaging to provider-patient relationships. We assert that obstetric violence remains a significant and useful framework to name and challenge racist, misogynist, and harmful medical practices. We note that such harmful practices are embedded in systems and cannot be addressed merely by individual physicians or shifts in the provider-patient relationship. Throughout, we situate the term obstetric violence in historical and legal context and demonstrate its continuing relevance to contemporary reproductive health care.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"513-518"},"PeriodicalIF":2.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693752","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":"An Examination of Responses to COVID-19 Contact-Tracing Efforts in Black/African American and Hispanic/Latinx Communities of Los Angeles.","authors":"Sharon Cobb, Katrina Schrode, Hafifa Siddiq, Shanika Boyce, Kelly D Taylor, Roberto Vargas, Nina Harawa","doi":"10.1089/heq.2023.0243","DOIUrl":"10.1089/heq.2023.0243","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the experiences and perceptions of COVID-19 contact-tracing efforts among cases tested in under-resourced and predominately Latino and Black communities of South Los Angeles, California.</p><p><strong>Methods: </strong>Study involved a cross-sectional survey with 1,713 adults. Recruitment occurred between June and November 2021 with eligible individuals who had previously received a COVID-19 diagnosis through designated testing sites. The LA County Department of Public Health operated a culturally responsive program for contact tracing that included provision of education and service referrals to newly diagnosed cases through much of the pandemic.</p><p><strong>Results: </strong>Participants were majority female (63%), Hispanic/Latino/a/x (64%), ages 18-40 (69%), and surveyed in English (77%). Overall contact-tracing experiences were rated positively, regardless of demographics (average means of 3.1-3.2/4.0). Those surveyed in Spanish were more likely to endorse positive statements if their contact tracer also spoke Spanish. Although over 75% of participants shared a range of the different information types requested, 49-52% endorsed concerns about data security and uses of the solicited information.</p><p><strong>Conclusions: </strong>Despite eliciting some concerns, contact-tracing efforts were generally positively received.</p><p><strong>Policy implications: </strong>Investments in contact tracing in similar communities should consider language-concordant contact tracers, community-based health worker training in trust building, and addressing social and health needs.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"493-504"},"PeriodicalIF":2.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693654","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":"MCO Perspectives on Medicaid Policy: Racial Equity in Pregnancy and Child Health.","authors":"Christine McClure, Cynthia Salter, Dara D Méndez, Evan S Cole, Sarah A Sanders, Sydney Sharp, Marquita Smalls, Linda Adodoadji, Adena Bowden, Marian Jarlenski","doi":"10.1089/heq.2024.0025","DOIUrl":"10.1089/heq.2024.0025","url":null,"abstract":"<p><strong>Introduction: </strong>In 2020 and 2021, Pennsylvania implemented the Equity Incentive Program and the Maternity Care Bundled Payment program, two unique pay-for-performance (P4P) programs that provide financial incentives for managed care organizations (MCOs) that make improvements in utilization and quality metrics for Black women and children. The current study addresses gaps in the research about MCO perceptions regarding the ability of financial policy incentives to improve racial health inequities.</p><p><strong>Methods: </strong>Qualitative, semi-structured group interviews with representatives (<i>n</i> = 30) from the six Medicaid MCOs in Pennsylvania were completed in the summer of 2022. Data were thematically coded, using a preestablished codebook.</p><p><strong>Results: </strong>Interviews with representatives from six Pennsylvania MCOs generated four distinct but interconnected themes: (1) data optimism, (2) pursuing uniform care, (3) diffusion of responsibility, and (4) missing pieces of the puzzle.</p><p><strong>Discussion: </strong>Perspectives of MCO representatives indicate the need for MCO involvement in Medicaid policymaking. Interviews revealed MCO representatives' perceptions that warrant further research: (1) the expectation for providers to change care delivery based solely on data, (2) racial health equity in pregnancy and child health can be accomplished by providing uniform care, and (3) the limited responsibility MCOs believe they have in addressing racial health inequities.</p><p><strong>Racial health implications: </strong>Little is known about MCOs' general understanding of and reactions to P4P models and implementation, particularly models aimed at addressing racial inequities. Findings from this study can assist Medicaid agencies in understanding how MCOs interpret and implement equity-based policy to ensure intended populations are benefiting from the planned outcomes.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"505-512"},"PeriodicalIF":2.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693650","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":"Getting Ours? \"Girlbossing\" and the Ethics of Nurse Reimbursement Models.","authors":"Danisha Jenkins, Jennifer Cohen, Rae Walker, Patrick McMurray, Jess Dillard Wright","doi":"10.1089/heq.2024.0059","DOIUrl":"10.1089/heq.2024.0059","url":null,"abstract":"<p><strong>Introduction: </strong>This article politicizes a reimbursement model proposed by some professional nursing associations that aim to better align the price of nursing labor (nurses' pay) to the value of nursing and make nurses' contributions more visible.</p><p><strong>Methods: </strong>Using the concept of \"missing care,\" the critique reveals how professionalization directs attention to individual-level interactions between care seekers and practitioners while obscuring from view the harm inflicted by social institutions and structures constitutive of a capitalist political economy and the related carceral state.</p><p><strong>Results: </strong>Direct reimbursement models render practitioners complicit in the harms perpetrated and perpetuated by the health care industrial complex while professionalization processes are deployed to reduce cognitive dissonance (and moral injury) produced by combining harm with nursing's normative principles.</p><p><strong>Discussion: </strong>We describe and trace the complementary capitalist imperatives of extraction-based profit maximization and efficiency through the health care industrial complex to demonstrate how formative those imperatives are of the health care system, care-seekers' outcomes, nurses' experiences, nonconsensual modes of data collection, and surveillance.</p><p><strong>Conclusion: </strong>The naturalization of racial capitalism and the precarity and violence it entails foreclose the creation of ethical alternatives that prioritize well-being instead of the pursuit of profit that could bring the provision of and payment for care closer to the normative principles held by practitioners.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"480-492"},"PeriodicalIF":2.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976867","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":"\"She's a Family Member\": How Community Health Workers Impact Perinatal Mothers' Stress Through Social-Emotional Support and Connections to Programs and Resources.","authors":"Justin Rex, Nichole Fifer, Karen D Johnson-Webb, Maddi Menich, Alyissa Horn, Carly Salamone, Holly T Renzhofer Pappada, Camelia Arsene, Crystal Martin, Malcolm Cunningham","doi":"10.1089/heq.2024.0038","DOIUrl":"10.1089/heq.2024.0038","url":null,"abstract":"<p><strong>Introduction: </strong>This study examines whether being a client in the Northwest Ohio Pathways HUB program reduces stress and improves mental wellbeing for perinatal mothers. The HUB works to improve health by connecting mothers to community health workers (CHWs) who assess mothers' risk factors and connect them to evidence-based care pathways to reduce known risks associated with adverse birth outcomes.</p><p><strong>Methods: </strong>A one-time survey of 119 mothers in the program and monthly semi-structured interviews with 41 mothers, totaling 220 interviews.</p><p><strong>Results: </strong>Almost all mothers reported significantly reduced stress after joining the program. The majority also reported an improved sense of safety, security, and hope. Interviews show additional moderate reductions in stress over time while being a program client. Interviews also indicate that mothers' relationship with their CHW is key to these improvements: CHW provide social-emotional support, access to tangible goods, and help navigating social service bureaucracies.</p><p><strong>Discussion: </strong>The results support the broader literature on the health benefits of community health workers and address identified gaps within the literature, which has infrequently studied CHWs in the perinatal context.</p><p><strong>Conclusion: </strong>CHWs may be one way to address racial inequity in birth outcomes linked to infant mortality, given research on the links between inequitable exposure to stressors, the impacts of racism-induced stress, and preterm and low birth weight babies. Further, the findings indicate the need to better support CHWs, and the programs that utilize them, with increased funding, insurance reimbursement, and certification.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"469-479"},"PeriodicalIF":2.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141622137","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":"Diversifying Doulas Initiative: Improving Maternal Health Outcomes in People of Color Through Doula Care.","authors":"Sharee Livingston, Cherise Hamblin, Crista Johnson, LaShekia Chatman, Kayla Bolden","doi":"10.1089/heq.2023.0082","DOIUrl":"10.1089/heq.2023.0082","url":null,"abstract":"<p><p>The Diversifying Doulas Initiative (DDI) aims to improve maternal health outcomes in Black and Brown people through doula care in Lancaster County. DDI trained 28 Black and Brown doulas and provided fully subsidized doula care to over 200 patients of color giving birth in Lancaster County. The perinatal workforce comprises community birth workers, doulas, midwives, nurses, students, and physicians. By diversifying the perinatal workforce and increasing access to doulas, patients of color benefit from a proven intervention.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"455-460"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621142","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}