Health Equity最新文献

{"title":"Compassionate Curiosity: Mitigating the Effects of Bias Through Motivational Interviewing.","authors":"Paul J Hershberger, Dean A Bricker, Angie Castle, Timothy N Crawford, Stacy R Flowers, Alexandria L Goff, Katharine Conway","doi":"10.1089/heq.2024.0054","DOIUrl":"10.1089/heq.2024.0054","url":null,"abstract":"<p><p>There is strong evidence that the implicit biases of health care professionals affect the treatment of patients, and that minority and other marginalized patients are disproportionately harmed. Assumptions made about patient knowledge or lack thereof function as judgments that are prone to bias, which then affect the education and advice imposed upon patients. We review how the motivational interviewing (MI) approach to patient engagement includes components of evidence-based bias-mitigating strategies, such as understanding circumstances from the patient's point of view, and therefore we propose that the MI approach can reduce the impact of bias in patient care.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"351-354"},"PeriodicalIF":2.6,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621141","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":"Family-Centered Care Experiences in Elderly with Chronic Diseases in Communities: Qualitative Study of Patients, Families, Nurses, and Volunteers.","authors":"Ah Yusuf, Jenny Marlindawani Purba, Dewi Eka Putri, Ronal Surya Aditya, Abdullah Saleh Alruwaili, Daifallah M AlRazeeni","doi":"10.1089/heq.2024.0009","DOIUrl":"10.1089/heq.2024.0009","url":null,"abstract":"<p><strong>Introduction: </strong>The family, at community, must be an important part of elderly care. However, most of the elderly experience a decrease in psychological well-being and quality of life. This is not in accordance with the concept of the family-centered care (FCC) model and can endanger the continuity of the elderly with chronic illnesses.</p><p><strong>Objective: </strong>The aim of this study was to explore experience of FCC among patients with chronic illness, nurses, families, and volunteers.</p><p><strong>Methods: </strong>This study examines the contextual-based FCC model qualitatively. In-depth interviews and focus group discussions were conducted by 12 elderly people, 3 nurses, 10 family members, and 3 volunteers. In total, 36 people, where several were FGD participants, were also interviewed in depth. Data were analyzed using thematic analysis, with codes organized into larger themes.</p><p><strong>Result: </strong>In total, 36 interviews and FGDs were conducted. The concept of information interaction, the phenomenon of emotional interaction, the practical interaction, and various factors that can either facilitate or impede interaction, were considered the four significant themes.</p><p><strong>Conclusion: </strong>FCC acceptance is found in interactions between parents, nurses, family, and volunteers who are not optimistic. Lack of communication and collaboration was noted between community nurses and volunteers. Offer a new perspective on developing and implementing interventions that facilitate positive interactions, reduce family burdens, provide high-quality treatment for parents with chronic diseases, and improve the quality of care for those with advanced chronic conditions.</p><p><strong>Recommendation: </strong>These insights provide a fresh perspective on how to develop and implement effective interventions in this context. It is recommended that future research should employ multiple methodologies to investigate FCC across diverse health practices for the elderly population.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"338-350"},"PeriodicalIF":2.6,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621143","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":"Navigating Homelessness Assistance While Pregnant: A Rapid Qualitative Research-to-Policy Collaboration in Washington, DC.","authors":"Christina X Marea, C Anneta Arno, Kelly Sweeney McShane, Andrew Lozano, Makeda Vanderpuije, Kelley N Robinson, Karen Trister Grace, Noelene Jeffers","doi":"10.1089/heq.2023.0235","DOIUrl":"10.1089/heq.2023.0235","url":null,"abstract":"<p><strong>Background: </strong>Homelessness during pregnancy contributes to adverse pregnancy and infant outcomes from birth through early childhood. Washington, DC, a microcosm of structural inequities in the United States, has persistent racial disparities in perinatal outcomes and housing insecurity.</p><p><strong>Methods: </strong>Grounded in a reproductive justice framework, we explored the lived experience of navigating homelessness assistance while pregnant to inform recommendations for a collaborative policy and practice change effort. We conducted 20 individual interviews with DC residents who experienced homelessness during pregnancy. We analyzed the data using thematic analysis and an action-oriented approach.</p><p><strong>Results: </strong>Our analysis resulted in three main recommendation areas for policy and practice change: (1) timely and meaningful access to safe and stable housing in pregnancy; (2) care coordination for services and referrals that support physical, mental, and social well-being; and (3) access to a living wage and affordable housing.</p><p><strong>Discussion: </strong>Access to stable housing is critical to ensure that pregnant and parenting people can have and raise children in a safe and sustainable environment-key tenets of reproductive justice. Housing support must be meaningfully accessible, including service delivery that accommodates the complex social histories and competing demands that accompany housing insecurity.</p><p><strong>Health equity implications: </strong>This study informed the development of strategic recommendations, catalyzed a new model for multisector collaboration, and influenced a system-wide practice change to expand access to robust housing supports for pregnant people. Policy and practice change require sustained leveraging of political will to promote economic justice and ensure that residents can achieve safe, sustainable, and affordable housing.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"325-337"},"PeriodicalIF":2.6,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627948","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":"Bridging the Health Equity Gap: An Update from the U.S. Food and Drug Administration Office of Minority Health and Health Equity.","authors":"Richardae Araojo, Christine Lee, Milena Lolic","doi":"10.1089/heq.2023.0233","DOIUrl":"10.1089/heq.2023.0233","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"235-237"},"PeriodicalIF":2.7,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337091","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":"Student Health Services at Historically Black Colleges and Universities and Predominantly Black Institutions in the United States.","authors":"Susan D Mueller, Melissa A Sutherland, M Katherine Hutchinson, Bing Si, Yu Ding, Somatra L Connolly","doi":"10.1089/heq.2023.0219","DOIUrl":"10.1089/heq.2023.0219","url":null,"abstract":"<p><strong>Introduction: </strong>Student health services are associated with improved health outcomes and academic success, particularly among under-resourced college populations. This study compared student health services at Historically Black Colleges and Universities (HBCUs) and Predominantly Black Institutions (PBIs) and identified factors associated with the availability of comprehensive health services (CHS).</p><p><strong>Methods: </strong>We conducted a secondary analysis of 2022 data from the Integrated Postsecondary Education Data System (IPEDS), the Minority Serving Institutions (MSIs) Directory, and the websites of HBCUs and PBIs (<i>n</i>=167). Bivariate and multivariate logistic regression analyses were undertaken to identify institutional variables associated with providing CHS. Institutional variables included college type (public vs. private), MSI category (HBCU vs. PBI), undergraduate enrollment, location, and proportion of Pell grant recipients.</p><p><strong>Results: </strong>Approximately 13% of HBCUs and 26% of PBIs offered no student health services; 65% of HBCUs and 39% of PBIs offered on-campus CHS with prescribing providers. Four-year HBCUs were five times more likely than 4-year PBIs to have CHS (<i>p</i>=0.014). Institutions with more Pell Grant recipients were less likely to offer CHS.</p><p><strong>Conclusions: </strong>Access to health care is an important social determinant of health, academic persistence, and achievement for college students. HBCUs were significantly more likely than PBIs to offer CHS. HBCUs are more likely than PBIs to have resources from federal funding, donors, and endowments that may support the development of student health centers and services. Increased funding for PBI health centers could improve access and promote health equity among the most vulnerable student populations.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"226-234"},"PeriodicalIF":2.7,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337092","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 Importance of Community-Based and Community-Partnered COVID-19 Testing for Reducing Disparities Among African American Populations.","authors":"Chavon Hamilton-Burgess, Jannette Berkley-Patton, Jenifer Allsworth, Carole Bowe Thompson, Frank E Thompson, Tacia Burgin, Eric D Williams, Kathryn P Derose","doi":"10.1089/heq.2022.0185","DOIUrl":"10.1089/heq.2022.0185","url":null,"abstract":"<p><strong>Background: </strong>Health inequalities in African American communities have been further exacerbated by COVID-19. Public health departments and other safety-net providers across the United States have partnered with community-based organizations to address barriers to COVID-19 testing in disproportionately impacted communities. This narrative review summarizes lessons learned from published examples of these community-based COVID-19 testing efforts.</p><p><strong>Methods: </strong>We searched online databases for peer-reviewed articles on community-based COVID-19 testing interventions in the United States aimed at increasing COVID-19 testing among African American populations. We abstracted information about each example and synthesized the primary lessons learned and key aspects that contributed to their success.</p><p><strong>Results: </strong>Seven examples of community-based COVID-19 testing aimed at increasing testing among African Americans and other underserved populations were identified and described, across various U.S. locations and involving multiple types of partners (1) St. Paul, MN (faith, health centers, Mayo Clinic); (2) Chicago, IL (university hospital and health centers); (3) NC (health centers, Community Advisory Board); (4) Baltimore, MD (hospitals, community clinic, mobile clinic); (5) Marion County, FL (health department and community partners); (6) New Orleans, LA (health department and health system); and (7) New York City, NY health and hospital system, mobile clinic).</p><p><strong>Discussion: </strong>Several key aspects of the COVID-19 testing models included the following: (1) close proximity of the testing site to affected communities and availability of walk-up and drive-through testing options; (2) partnerships between safety-net providers and broad community networks, which facilitated outreach and trust; (3) increased resources for safety-net providers; and (4) the use of data to identify areas of need and track impact. The merging of resources and relationships among well-equipped, safety-net providers and other health care institutions and culture-rich, community-centered organizations, to jointly address structural and systemic inequities, is key to cultivating health equity in the distribution of COVID-19 testing and other essential public health services.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"147-156"},"PeriodicalIF":2.6,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176888","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":"Advancing Transportation Equity and Safety Through Autonomous Vehicles.","authors":"Johnathon P Ehsani, Jeffrey P Michael, Takeru Igusa, Joshua Mueller, Chia-Hsiu Chang, Gayane Yenokyan","doi":"10.1089/heq.2023.0107","DOIUrl":"https://doi.org/10.1089/heq.2023.0107","url":null,"abstract":"<p><p>Motor vehicle crashes are a leading cause of death in the United States, and disproportionately impact communities of color. Replacing human control with automated vehicles (AVs) holds the potential to reduce crashes and save lives. The benefits of AVs, including automated shuttles, buses, or cars could extend beyond safety to include improvements in congestion, reductions in emissions, and increased access to mobility, particularly for vulnerable populations. However, AVs have not attained the level of public trust that has been expected, given their potential to save lives and increase access to mobility. Public opinion surveys have highlighted safety and security concerns as reasons for this lack of confidence. In this study, we present the findings of an experiment we conducted to actively shift mindsets on AVs toward advancing health equity. We demonstrate through a nationally representative sample of 2265 U.S. adults that the public support for AVs can be improved by expanding their scope of application to include advancing social benefit. The survey began with questions on respondent's support for AVs based on <i>a priori</i> knowledge and beliefs. Consistent with prior surveys, baseline support (strong support and some degree of support) was low at 26.4% (95% confidence interval 24.0-29.0). After introducing information about how AVs could be used to provide mobility for older adults, those with limited income, or the vision-impaired, respondents were asked to reassess their support for AVs. Support significantly increased to include the majority of respondents. By prioritizing the deployment of AVs to serve individuals and communities in greatest need of mobility, AVs would not only demonstrate compelling social value by reducing disparities but would also gain widespread public support among the U.S. public.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"143-146"},"PeriodicalIF":2.7,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176886","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":"Change Is Slow: Acquisition of Disability-Accessible Medical Diagnostic Equipment in Primary Care Offices over Time.","authors":"Nancy R Mudrick, Julia Blackwell, Mary Lou Breslin, Xiafei Wang","doi":"10.1089/heq.2023.0155","DOIUrl":"https://doi.org/10.1089/heq.2023.0155","url":null,"abstract":"<p><strong>Introduction: </strong>The lack of disability-accessible medical diagnostic equipment (MDE) in primary care impedes the receipt of quality medical care by people with mobility impairments. Cross-sectional surveys and observational studies have found <40% of medical offices have disability-accessible examination tables or weight scales. Although government agencies and advocates recommend primary care acquisition of the accessible MDE, the rate of acquisition is unknown.</p><p><strong>Methods: </strong>Using panel data, the research examined if primary care offices audited for disability accessibility increased accessible examination table and scale presence between the first and second audit. Data for 2006-2009 (Time 1 [T1]) and 2013-2016 (Time 2 [T2]) came from 1293 primary care practices associated with Medicaid managed care organizations. Permutations of presence or absence of a height-adjustable examination table and accessible weight scale were analyzed to assess rate of change across time periods.</p><p><strong>Results: </strong>More practices had disability-accessible examination tables or weight scales at the second observation, although total presence was low (12.9%, 7.9%). Practices added equipment between time periods; however, ∼60% of practices with accessible MDE at T1 no longer had it available at T2.</p><p><strong>Discussion: </strong>The acquisition rate of accessible MDE was low, despite prior auditing. Studying change in accessible MDE presence in primary care offices requires attention to equipment acquisition and its retention.</p><p><strong>Health equity implications: </strong>Stronger federal enforcement of Medicaid and Americans with Disabilities Act (ADA) access requirements, with regular standardized auditing of medical office accessibility, may be required to produce a more equitable health care experience for disabled people.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"157-163"},"PeriodicalIF":2.7,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176887","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":"My Health in My Hands: Improving Medication Abortion Knowledge and Closing Disparities with a Community-Led Media Intervention.","authors":"Hayley V McMahon, Leslie Serrano, Teja Vyavahare, Indya Hairston, Sequoia Ayala, Zainab Jah, Tiffany Hailstorks, Dázon D Diallo, Elizabeth A Mosley","doi":"10.1089/heq.2023.0210","DOIUrl":"10.1089/heq.2023.0210","url":null,"abstract":"<p><strong>Purpose: </strong>Inaccurate beliefs about medication abortion (MA) are common. This study evaluated pilot data from a community-led media intervention designed to increase MA knowledge among Black and Latinx women in Georgia.</p><p><strong>Methods: </strong>Participants (<i>N</i>=855) viewed the intervention video and completed pre-post surveys. Data were analyzed using linear and logistic regression.</p><p><strong>Results: </strong>Knowledge scores significantly increased from 3.88/5.00 to 4.47/5.00. Participants who were Native American, Asian and Pacific Islander, multiracial, Black, <20 years old, and living in Georgia scored below the sample mean at baseline; however, nearly all disparities disappeared after intervention exposure.</p><p><strong>Conclusions: </strong>This intervention effectively increased MA knowledge and narrowed racial/ethnic, age-based, and geographic disparities.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"138-142"},"PeriodicalIF":2.7,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022817","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":"Geospatial Analysis of the Proportion of Persons Defined as Underrepresented in Medicine for Each Medical School and Their Surrounding Core-Based Statistical Area.","authors":"Zoel A Quiñónez, Angel Benitez-Melo, Laura M Diaz, Michael Lennig, Danton Char, Charlotte Smith","doi":"10.1089/heq.2023.0221","DOIUrl":"10.1089/heq.2023.0221","url":null,"abstract":"<p><strong>Background: </strong>The current approach to increasing diversity in medical education fails to consider local community demographics when determining medical school matriculation.</p><p><strong>Purpose: </strong>We propose that medical schools better reflect their surrounding community, both because racially/ethnically concordant physicians have been shown to provide better care and to repair the historical and current racist impacts of these institutions that have criminalized, displaced, and excluded local Black and Brown communities.</p><p><strong>Methods and results: </strong>In this study, we used geospatial analysis to determine that medical school enrollments generally fail to reflect their surrounding community, represented as their core-based statistical area, within which the individual medical schools reside.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"132-137"},"PeriodicalIF":2.7,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022806","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}