Medical research archives最新文献

{"title":"Achieving Chronic Care Equity by Leveraging the Telehealth Ecosystem (ACCTIVATE): A Multilevel Randomized Controlled Trial Protocol.","authors":"Adenike Omomukuyo, Andy Ramirez, Aliyah Davis, Alexandra Velasquez, Adriana L Najmabadi, Marianna Kong, Rachel Willard-Grace, William Brown, Andrew Broderick, Karla Suomala, Charles E McCulloch, Nora Franco, Urmimala Sarkar, Courtney Lyles W, Amber S Tran, Anjana E Sharma, Delphine S Tuot","doi":"10.18103/mra.v12i11.6087","DOIUrl":"10.18103/mra.v12i11.6087","url":null,"abstract":"<p><strong>Background: </strong>Racial/ethnic and socioeconomic disparities in diabetes and hypertension outcomes persist in the United States (U.S.), and worsened during the COVID-19 pandemic. This was in part due to suboptimal implementation of telehealth in U.S. safety-net settings alongside the pre-existing \"digital divide\" - structural determinants that limit access to digital tools by marginalized communities. To improve health equity, it is critical that health systems in the U.S. integrate principles of digital and health literacy for more equitable chronic disease care.</p><p><strong>Methods: </strong>We are conducting a 2x2 factorial randomized controlled trial, in partnership with a Community Advisory Board, assessing a multi-level intervention addressing barriers that affect the equitable use of telehealth amongst low-income patients in San Francisco County. Patient-level support is provided through the evidence-based strategies of health coaching and digital navigation (\"digital coaching\"); clinic-level support includes equity dashboards, patient advisory councils, and practice facilitation. We are randomizing 600 low-income, racially/ethnically diverse English and Spanish-speaking patients with uncontrolled diabetes to receive digital coaching (n=200) vs. usual care (n=400) for 3 months; and 11 public health primary care clinics to clinic support vs. usual care for 24 months. We aim to evaluate the impact of patient and clinic level interventions to determine individual effectiveness and potential synergistic impact on clinical and process measures related to diabetes and telehealth outcomes.</p><p><strong>Results: </strong>The study's primary clinical outcome is change in patient-level Hemoglobin A1C (A1c); the primary process outcome is patient portal usage. Secondary clinical outcomes include changes in patient-level systolic blood pressure (SBP) and microalbuminuria (UACR), and changes in clinic-level A1c, SBP, and UACR. Secondary process outcomes assess patient-level changes in digital literacy, medication adherence, patient activation, and visit show rates, and clinic-level measures of telehealth adoption.</p><p><strong>Discussion: </strong>The ACCTiVATE trial tests a multi-level intervention developed through a stakeholder-engaged research approach and user-centered design to be feasible and acceptable for impacted communities. If efficacious, ACCTiVATE may provide a scalable model to improve chronic health outcomes and telehealth equity among marginalized racial/ethnic populations experiencing structural and interpersonal access barriers.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT06598436. Registered 15 September 2024.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831590","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":"Cultural Effects on the Performance of Older Haitian Immigrants on Timed Cognitive Tests.","authors":"Marie Adonis-Rizzo, Ruth M Tappen, Monica Rosselli, David Newman, Joshua Conniff, Jinwoo Jang, KwangSoo Yang, Borko Furht","doi":"10.18103/mra.v12i11.5868","DOIUrl":"10.18103/mra.v12i11.5868","url":null,"abstract":"<p><strong>Background: </strong>Ignoring the cultural factors that can affect performance on cognitive tests may result in use of tests that have not been validated for that group. One example is testing of Haitian Creole speaking adults who are increasingly affected by Alzheimer's disease and related dementias, for whom few tests have been validated.</p><p><strong>Aims: </strong>Our purpose is to describe differences in timed test performance between Haitian Creole and English-speaking participants and explore factors that may account for any differences in results found.</p><p><strong>Methods: </strong>Data was obtained from an ongoing longitudinal driving and cognition study \"In Vehicle Sensors to Detect Cognitive Change in Older Drivers.\" Two groups consisting of 12 Creole speaking and 12 English speaking older adults were matched by age and gender. Test scores were selected from the battery of tests administered in the parent study. The measures were translated by two bilingual Creole-English researchers. Group performance on five timed cognitive tests commonly used in research was compared.</p><p><strong>Results: </strong>The English-speaking group's mean scores were significantly higher than the Creole speaking group on the MoCA and the timed Animal category fluency, letter P fluency, Stroop Color Test, and Trail Making Test A and B. The most significant effects were noted in Letter P fluency, Trail Making Test A and B and Animal category fluency where the differences had large effect sizes. However, the Creole speaking group had higher mean scores than the English-Speaking group on the Stroop Color Word Test, although the difference was not statistically significant. It was not feasible to match education levels due to the differences in years of education across the groups. These results highlight the significant role of culture and linguistic context in cognitive task performance.</p><p><strong>Conclusions: </strong>The results suggest performance in cognitive testing among non-English speaking groups may be impacted by cultural factors related to time perception and the testing approach employed, leading to misinterpretation and misdiagnosis. Future studies should explore the fairness of various cognitive testing approaches with Haitian older adults and other societies with cultures and educational approaches different from those of Western cultures.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019086","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":"Augmenting the Hospital Score with social risk factors to improve prediction for 30-day readmission following acute myocardial infarction.","authors":"Iben Ricket, Michael E Matheny, Ruth M Reeves, Rashmee U Shah, Christine A Goodrich, Glenn Gobbel, Meagan E Stabler, Amy M Perkins, Freneka Minter, Chad Dorn, Bruce E Bray, Lee Christensen, Ramkiran Gouripeddi, John Higgins, Wendy W Chapman, Todd MacKenzie, Jeremiah R Brown","doi":"10.18103/mra.v12i11.6089","DOIUrl":"https://doi.org/10.18103/mra.v12i11.6089","url":null,"abstract":"<p><strong>Background: </strong>Hospital Score is a well-known and validated tool for predicting readmission risk among diverse patient populations. Integrating social risk factors using natural language processing with the Hospital Score may improve its ability to predict 30-day readmissions following an acute myocardial infarction.</p><p><strong>Methods: </strong>A retrospective cohort included patients hospitalized at Vanderbilt University Medical Center between January 1, 2007, and December 31, 2016, with a primary index diagnosis of acute myocardial infarction, who were discharged alive. To supplement ascertainment of 30-day readmissions, data were linked to Center for Medicare & Medicaid Services (CMS) administrative data. Clinical notes from the cohort were extracted, and a natural language processing model was deployed, counting mentions of eight social risk factors. A logistic regression prediction model was run using the Hospital Score composite, its component variables, and the natural language processing-derived social risk factors. ROC comparison analysis was performed.</p><p><strong>Results: </strong>The cohort included 6,165 unique patients, where 4,137 (67.1%) were male, 1,020 (16.5%) were Black or other people of color, the average age was 67 years (SD: 13), and the 30-day hospital readmission rate was 15.1% (N=934). The final test-set AUROCs were between 0.635 and 0.669. The model containing the Hospital Score component variables and the natural language processing-derived social risk factors obtained the highest AUROC.</p><p><strong>Discussion: </strong>Social risk factors extracted using natural language processing improved model performance when added to the Hospital Score composite. Clinicians and health systems should consider incorporating social risk factors when using the Hospital Score composite to evaluate risk for readmission among patients hospitalized for acute myocardial infarction.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191660","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":"Characteristics associated with social anxiety in adults with developmental stuttering: A review.","authors":"K R Bauerly","doi":"10.18103/mra.v12i10.5876","DOIUrl":"10.18103/mra.v12i10.5876","url":null,"abstract":"<p><p>People who stutter are at a greater risk for developing symptoms of social anxiety, with up to 22-60% of adults who stutter meeting the criteria for a clinical diagnosis. Negative attitudes and feelings about speaking and stuttering are reported to emerge as early as the preschool years and are suspected to be due to exposure to negative listener reactions, stereotyping and social isolation. Repeated negative experiences lead to feelings of fear, embarrassment and loss of control during speaking which over time, leads to the development of more severe difficulties with speaking and an overall apprehension to speak as they perceive themselves as an incompetent communicator. The present review aims to summarize risk factors, particularly temperament and environmental factors, that are reported to play a role in the emergence and maintenance of social anxiety in people who stutter. Another aim of this review is to summarize the features of social anxiety reported in adults who stutter, some of which, are similar to high socially anxious fluent speakers (e.g., avoidant strategies) while others are specific to stuttering (e.g., muscle tension). The clinical implications of these findings and recommendations for future research are also discussed.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803891","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":"Air Pollution as an Environmental Risk Factor for Alzheimer's Disease and Related Dementias.","authors":"Heui Hye Park, Matthew J Armstrong, Fredric A Gorin, Pamela J Lein","doi":"10.18103/mra.v12i10.5825","DOIUrl":"10.18103/mra.v12i10.5825","url":null,"abstract":"<p><p>Alzheimer's disease and related dementias are a leading cause of morbidity in our aging populations. Although influenced by genetic factors, fewer than 5% of Alzheimer's disease and related dementia cases are due solely to genetic causes. There is growing scientific consensus that these dementias arise from complex gene by environment interactions. The 2020 Lancet Commission on dementia prevention, intervention, and care identified 12 modifiable risk factors of dementia, including lifestyle, educational background, comorbidities, and environmental exposures to environmental contaminants. In this review, we summarize the current understanding and data gaps regarding the role(s) of environmental pollutants in the etiology of Alzheimer's disease and related dementias with a focus on air pollution. In addition to summarizing findings from epidemiological and experimental animal studies that link airborne exposures to environmental contaminants to increased risk and/or severity of Alzheimer's disease and related dementias, we discuss currently hypothesized mechanism(s) underlying these associations, including peripheral inflammation, neuroinflammation and epigenetic changes. Key data gaps in this rapidly expanding investigative field and approaches for addressing these gaps are also addressed.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019078","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":"Hybrid care model: Combining telemedicine and office visits for diabetes management in older adults with type 1 diabetes.","authors":"Elena Toschi, Atif Adam, Nana Frimpong, Rebecca Hurlbert, Christine Slyne, Lori Laffel, Medha Munshi","doi":"10.18103/mra.v12i9.5728","DOIUrl":"10.18103/mra.v12i9.5728","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the use of hybrid (telehealth and in-person) care on visitation and glycaemia in older adults with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>In this retrospective study, we examined clinical characteristics, number of visits (telehealth and in-person) and continuous glucose monitoring (CGM) metrics for older adults (≥65 years) with T1D from electronic health records during the pre-COVID-19 pandemic (March 1, 2019-March 1, 2020; in-person) and pandemic (September 1, 2020-August 31, 2021; hybrid) periods. Main outcomes were the number of visits and changes in glycaemic control (HbA1c), and in a sub-group of older adults using CGM, changes in CGM metrics between in-person and hybrid care.</p><p><strong>Results: </strong>We analysed data of 661 older adults with T1D (age 72±5 years). The hybrid care resulted in an increased number of annual diabetes visits (6.3 vs 4.2 visits/person) without change in glycaemic control (HbA1c 7.4% vs 7.2%) compared with in-person care alone. In the sub-group of 299 older adults with T1D using CGM, hybrid care compared with in-person care resulted in an improvement of time-in-range (70-180 mg/dL) (68% to 71%; p<0.001) without increasing hypoglycaemia (<70 mg/dL).</p><p><strong>Conclusion: </strong>Compared with in-person only visits, hybrid care maintained visit frequency and preserved glycaemic control measured as HbA1c. In a sub-group of older adults with T1D using CGM, time-in-range improved while time in hypoglycaemia did not change. These data suggest that a hybrid care model is efficacious in maintaining visitation and glycaemic control, and, as demonstrated in a sub-group of older adults with T1D using CGM, safe with respect to time in hypoglycaemia.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019091","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":"Psychometric Evaluation of Screens for Common Mental Disorders, Severe Mental Disorders, Substance Use Disorders, and Suicide Risk in Mozambican Healthcare.","authors":"Kathryn L Lovero, Melissa A Stockton, M Claire Greene, Cale Basaraba, Saida Khan, Dirceu Mabunda, Flavio Mandlate, Lidia Gouveia, Wilza Fumo, Melanie M Wall, Cristiane S Duarte, Maria A Oquendo, Milton L Wainberg","doi":"10.18103/mra.v12i8.5294","DOIUrl":"https://doi.org/10.18103/mra.v12i8.5294","url":null,"abstract":"<p><p>Globally, mental and substance use disorders are a leading cause of disease burden. In low- and middle-income countries, where there is an extreme shortage of trained mental health specialists, validated, brief screening tools for mental and substance use disorders are required for non-specialists to efficiently identify patients in need of mental health care. Mozambique, one of the poorest countries in the world, has fewer than two mental health specialists for every 100,000 people. In the present study, we evaluated a comprehensive set of seven measures for depression, anxiety, somatization, alcohol use disorder, substance use disorder, psychosis and mania, and suicide risk among N=911 Mozambican adults in general healthcare settings. All instruments demonstrated acceptable internal consistency (α > 0.75). Compared to diagnoses made by the Mini International Neuropsychiatric Interview, all measures showed good criterion validity (AUC > 0.75), except the Psychosis Screening Questionnaire, which showed low sensitivity (0.58) for psychotic disorder. No substantial differences were observed in internal consistency when stratifying by gender, age, education level, primary language, facility-type, and patient status; criterion validity showed some variability when stratified by sub-population, particularly for education, primary language, and whether the participant was seeking care that day. Exploratory factor analyses indicated that the measures best differentiate categories of diagnoses (common mental disorder, severe mental disorders, substance use disorders, and suicide risk) rather than individual diagnoses, suggesting the utility of a transdiagnostic approach. Our findings support the use of these measures in Mozambique to identify common mental disorders, substance use disorders, and suicide risk, but indicate further research is needed to develop an adequate screen for severe mental disorders. Given the limited mental health specialists in this and other LMIC settings, these brief measures can support non-specialist provision of mental health services and promote closure of the treatment gap.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305016","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":"Identification of a Novel <i>SCN5A</i> gene variant in a young female with atrioventricular canal defect in the absence of classical Brugada syndrome phenotype.","authors":"Ritwick Mondal, Rahul Manna, Emili Banerjee, Julián Benito-León, Shramana Deb","doi":"10.18103/mra.v12i7.5527","DOIUrl":"10.18103/mra.v12i7.5527","url":null,"abstract":"<p><strong>Background: </strong>Brugada syndrome is generally considered a cardiac channelopathy disorder characterized by syncope or sudden cardiac death. The sodium voltage-gated channel alpha subunit 5 (<i>SCN5A</i>) gene is the most commonly mutated gene associated with Brugada syndrome. Recent discoveries of new variants of this gene, along with current guidance of family screening, have identified several asymptomatic carriers with potentially causative mutations.</p><p><strong>Case presentation: </strong>We present the case of a 25-year-old female patient without any family history of Brugada syndrome nor related congenital cardiovascular disorders, with an extensive atrioventricular canal defect, who tested positive for a novel heterozygous variant NM_198056.3: c.3169G>C (p. Asp1057 His) in the <i>SCN5A</i> gene. She had no history of syncope or aborted sudden cardiac death except for recurrent chest infections since her early childhood. Intriguingly, she did not show a type I Brugada electrocardiogram pattern.</p><p><strong>Conclusions: </strong>This report provides a novel heterozygous variant NM_198056.3: c.3169G>C (p. Asp1057 His) in the <i>SCN5A</i> gene, which may have a potential detrimental effect.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524005","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":"Design and testing of Hepatitis Delta Ribozymes for suppression of Chikungunya virus infection in cell cultures.","authors":"Mark E Fraser, Cheryl Kucharski, Zoe Loh, Erin Hanahoe, Malcolm J Fraser","doi":"10.18103/mra.v12i8.5762","DOIUrl":"https://doi.org/10.18103/mra.v12i8.5762","url":null,"abstract":"<p><p>Chikungunya virus is an emerging pathogen with widespread distribution in regions of Africa, India, and Asia that threatens to spread into temperate climates following the introduction of its major vector, <i>Aedes albopictus</i>. Recent cases have been documented in Europe, the Caribbean, and the Americas. Chikungunya virus causes a disease frequently misdiagnosed as Dengue fever, with potentially life-threatening symptoms that can result in long term debilitating arthritis. There have been ongoing investigations of possible therapeutic interventions for both acute and chronic symptoms, but to date none have proven effective in reducing the severity or lasting effects of this disease. Recently, a promising vaccine candidate has received accelerated approval, indicating the importance of remedies to this emerging worldwide health threat. Nonetheless, therapeutic interventions for Chikungunya and other mosquito borne virus diseases are urgently needed yet remain elusive. The increasing risk of spread from endemic regions via human travel and commerce, coupled with the absence of a vaccine or approved therapeutic, puts a significant proportion of the world population at risk for this disease. In this report we explore the possibility of using Specific On/oFf Adapter Hepatitis Delta Virus Ribozymes as antivirals in cells infected with Chikungunya virus. The results we obtained suggest there could be some role in using these ribozyme molecules as antiviral therapies for not only Chikungunya virus, but potentially other viruses as well.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335384","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":"Medical Mistrust on Prostate Cancer Screening: A mixed method study among African Americans, Caribbean immigrants and African immigrants.","authors":"Malika Nipher, Roberts Lisa, Alemi Qais, Casiano Carlos A, Montgomery Susanne","doi":"10.18103/mra.v12i8.5727","DOIUrl":"10.18103/mra.v12i8.5727","url":null,"abstract":"<p><strong>Objectives: </strong>The contribution of medical mistrust to healthcare utilization delays has been gaining increasing attention. However, few studies have examined these associations among subgroups of Black men (African Americans, Caribbean, and African immigrants) in relation to prostate cancer (PCa). This study addresses this gap by assessing how medical mistrust affects PCa screening behavior and to further understand perceptions of medical mistrust among subgroups of Black men.</p><p><strong>Methods: </strong>This research employs a mixed-methods approach comprising two distinct phases. In Phase 1, a cross-sectional examination was conducted to evaluate the influence of medical mistrust toward healthcare organizations on prostate cancer screening among 498 Black men. In Phase 2, a qualitative investigation was undertaken to delve into the nuances of medical mistrust through six focus groups (n=51) and ten key informant interviews (n=10). Logistic regression and grounded theory methods were employed for data analysis.</p><p><strong>Results: </strong>Quantitative findings unveiled disparities in mistrust among subgroups, with Caribbean immigrants exhibiting higher levels of medical mistrust. Nevertheless, individuals with a family history of PCa showed elevated likelihoods of undergoing screening, despite mistrust. Qualitative results revealed 1) differences in reasons for medical mistrust among Black subgroups, 2) cultural perceptions which influence medical mistrust and medical care seeking, 3) lack of education in relation to PCa that contributes to medical mistrust, 4) negative past experiences and poor provider communication contribute, and 5) when PCa directly affected one's life, either personally or within the family, there was a recognized importance placed on monitoring one's risk despite mistrust.</p><p><strong>Conclusion: </strong>While medical mistrust may not significantly deter healthcare utilization among individuals with a family history or diagnosis of PCa, it underscores the variability of medical mistrust and its underlying reasons among different Black subgroups.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402480","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}