Journal of the National Medical Association最新文献

{"title":"Development of the American Medical Association's Health Equity in Organized Medicine Survey.","authors":"Fernando De Maio, Blair Aikens, Emily C Cleveland Manchanda, Jennifer Brown, William Jordan, Aletha Maybank","doi":"10.1016/j.jnma.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.05.003","url":null,"abstract":"<p><p>Many efforts to embed equity into systems and policies have been launched across the health care ecosystem in the past five years, including in medical and professional societies. There are many examples of equity-focused initiatives in organized medicine, often announced or celebrated at national meetings and conventions of specific organizations. Yet until now, we have not had a systematic view, with standardized questions and data, of equity efforts across state/territorial medical associations and specialty societies. This paper explores methodologic and strategic lessons learned from the first two waves of the American Medical Association's Health Equity in Organized Medicine Survey. There is potential to use these data to motivate additional initiatives and evaluate the longer-term impact of equity efforts.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From conference to career: Tracing medical pathways of Stanford university's minority medical alliance (SUMMA) premedical conference alumni.","authors":"Aneysis D Gonzalez-Suarez, Emily Moya, Felipe D Perez, Mark Gutierrez, Reena P Thomas","doi":"10.1016/j.jnma.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.05.001","url":null,"abstract":"<p><p>Despite the growing diversity of the U.S. population, racial and ethnic minorities remain underrepresented in healthcare professions, perpetuating health disparities. This study evaluates the effectiveness of the Stanford University's Minority Medical Alliance (SUMMA) Premedical Conference in addressing these challenges. We conducted a survey of 238 former conference attendees from 2018 to 2023 to assess the conference's impact on their educational and career trajectories in medicine. The survey examined demographic variables, post-graduate intentions, and perceptions of the conference's impact using a 5-point Likert scale. 85% of survey respondents identified as first-generation medical students, with significant representation from Hispanic/Latino (30.67%), Black/African-American (20.17%), and Asian (21.43%) backgrounds. 44% applied to medical school post-conference, and 74% aspired to or were enrolled in medical school. Chi-square tests revealed that 43.75% of Black/African-American and 37.67% of Hispanic/Latino respondents applied to medical school, compared to 28.57% of Asian respondents (χ²=10.72, p=0.030), and that 56.25% of economically disadvantaged students applied to medical school compared to 30.91% of those not disadvantaged (χ²=16.99, p=0.001). Logistic regression highlighted that first-generation and economically-disadvantaged students had higher odds of applying to medical school (OR=4.84, p=0.005; OR=9.94, p<0.001). Likert scale responses showed that 81.9% of respondents agreed that the conference increased their confidence in navigating medical school applications and 68.2% agreed that it increased their confidence in seeking advisors. By sharing the effectiveness of the SUMMA conference in supporting minority students, we provide a learning opportunity by which other institutions may engage their communities to increase diversity in healthcare education.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing peer educators to increase genetic testing for prostate cancer among black males: results of a randomized controlled trial.","authors":"A E Leader, J Blanding Godbolt, N Crumpler, L Gross, R Hartman, S W Keith, V N Giri","doi":"10.1016/j.jnma.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.05.005","url":null,"abstract":"<p><strong>Background: </strong>Black males have low rates of genetic testing for prostate cancer (PCa). Peer-based strategies have not been tested for PCa genetic testing. We aimed to evaluate the impact of a peer-based educational intervention about PCa genetic testing for Black males in a community setting.</p><p><strong>Methods: </strong>Black males, ages 35 to 69, were randomized to either a group-based discussion led by a peer educator who explained PCA and the risks and benefits of genetic testing or standard informational materials with no interaction with a peer educator. Participants completed baseline and endpoint surveys and were connected to free PCA genetic testing if interested.</p><p><strong>Results: </strong>One hundred and thirty (n=130) Black males enrolled in the study. There were increases in knowledge (9.5% increase, intervention arm; 8.1% increase, control arm; p=0.98) and decreases in decisional conflict (-0.4 change, intervention arm; -0.4 change, control arm; p=0.95) in both study arms. Males in the intervention arm had increased intentions to seek PCA genetic counseling while males in the control arm tended to have decreased intentions (p=0.06).</p><p><strong>Conclusion: </strong>While educational materials may be sufficient to impart knowledge about PCA, more complex decisions like genetic testing may benefit from the support of individuals with similar lived experiences.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-level factors associated with low dose computed tomography lung cancer screening in the United States.","authors":"Tung-Sung Tseng, Chien-Ching Li, Hui-Yi Lin, Kelsey N Witmeier, Chaoyi Zeng, Yu-Wen Chiu, Michael D Celestin, Edward J Trapido","doi":"10.1016/j.jnma.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.05.002","url":null,"abstract":"<p><p>Low-dose computed tomography (LDCT) screening is recommended for high-risk smokers to decrease lung cancer-related mortality and increase prognosis. In the U.S., the uptake of LDCT screening among eligible smokers is suboptimal. The impacts of social-environmental and individual factors on LDCT screening uptake using nationally representative dataset recommendations are understudied. The current study investigated multi-level factors associated with LDCT screening using national data.</p><p><strong>Methods: </strong>The 2017-2021 Behavioral Risk Factor Surveillance System (BRFSS) data, social determinants of health (SDOH) and other state-level variables (Medicaid expansion status and the number of screening facilities using American Lung Association (ALA) 's State of Lung Cancer) were applied. Our study outcome variance was LDCT screening among study participants who met the U.S. Preventive Services Task Force guidelines for lung cancer screening. The final study sample consisted of 15640 respondents from 29 states. All analyses were weighted to account for the complex sampling design applied in BRFSS.</p><p><strong>Results: </strong>The overall utilization rate of LDCT screening is only 18.4%. The LDCT screening rate varied by state (6.2 -31.1%). LDCT screen rates were not significantly associated with the number of lung cancer screening facilities (r=0.02, p=0.909) but were positively associated with the number of lung cancer screening facilities per 10,000 smokers (r=0.67, p<0.001). Among the respondents, individuals who were employed, never married, reported good health status, did not have primary care physicians, economic concerns like low income, did not have routine checkups, and did not have certain chronic conditions (i.e. cancer, asthma, COPD) had a lower utilization rate of LDCT screening compared with their counterpart.</p><p><strong>Conclusion: </strong>The use of LDCT screening among eligible smokers remains low. Enhancing access to care for high-risk individuals, promoting services to diverse racial and socioeconomic groups, and expanding Medicaid coverage to incorporate annual LDCT screening can be used to guide future lung cancer screening programs.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of patient and clinician demographics and concordance with medicaid sterilization consent form validity.","authors":"Lisa Jackson-Moore, Kim Malloy, Gene Urrutia, Kristen A Berg, Emily S Miller, Margaret Boozer, Tania Serna, Jennifer L Bailit, Suzanna Larkin, Kavita Shah Arora","doi":"10.1016/j.jnma.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.04.003","url":null,"abstract":"<p><strong>Objective(s): </strong>To evaluate the association between patient demographics, clinician demographics, and concordance of patient-clinician demographics and Medicaid sterilization consent form validity, defined as the waiting period having elapsed.</p><p><strong>Study design: </strong>Secondary analysis of a large, multi-center retrospective cohort study. This analysis included patients with Medicaid insurance desiring postpartum permanent contraception across three study sites. Our primary outcome was Medicaid sterilization consent form validity. Patient demographics were abstracted from the electronic medical record. Clinician demographics were obtained both through self- and peer-report. Descriptive, random effects modeling, and multivariable logistic regression analyses were utilized.</p><p><strong>Results: </strong>Of the 1644 patients delivered by 124 clinicians in our cohort, 840 (51 %) had a valid Medicaid sterilization consent form. Descriptively, patients who were Black, unmarried, and not college educated were more likely to have valid forms (p < 0.001). The religious affiliation of the clinician (p < 0.001), but no other clinician characteristics, was associated with form validity. In multivariable models, patients who were of a different racial identity than their clinicians were more likely to have a valid form (aOR 1.32, 95 % confidence interval (CI) 1.05-1.66).</p><p><strong>Conclusion(s): </strong>While unable to determine the causes of our findings, the differential proportion of Medicaid sterilization consent form validity based on patient characteristics is concerning. Differences in form validity based on patient-clinician racial and ethnic concordance is deserving of further study.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal reflections on race-based medicine: narrative analysis of a case study using a situated lens.","authors":"Breanna Thompson, Rasheda J Vereen, Torie C Plowden, Monica A Lutgendorf","doi":"10.1016/j.jnma.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.04.009","url":null,"abstract":"<p><strong>Background: </strong>Race-based medicine was initially established to risk-stratify patients using algorithms based on biological similarities. This generalized form of medicine resulted in harmful practices and health inequities. Although race-based medicine has received increasing attention as a harmful practice contributing to structural and systemic racism in medicine, the individual patient perspective remains relatively under-studied, particularly in obstetrics. This qualitative case study uses a situated lens to explore the individual experience and perspective of race-based medicine in perinatal care.</p><p><strong>Methods: </strong>This was an institutional review board approved qualitative study utilizing semi-structured interviews as part of a larger study investigating the birth experiences of military beneficiaries. The interview was recorded and transcribed with data inductively analyzed using narrative analysis with positioning theory to identify positions and lived experiences during the individual's care experiences.</p><p><strong>Results: </strong>Narrative analysis yielded the following themes: (1) self-identity; (2) reinforcing racial sensitivity; (3) health individualization; (4) internal conflict with external perception and honesty; (5) trust and respect; (6) resisting negative influence and press/stories; (7) intellectualization; and (8) fear vs. empowerment for personalized birth wishes. Each theme represented valid concerns patients may experience with race-based medicine in a healthcare setting.</p><p><strong>Conclusions: </strong>The application of race-based medicine during prenatal care may harm the relationship between pregnant individuals and clinicians, leading to an overall negative experience and erosion of trust in the healthcare system. Implementing personalized race-conscious healthcare rather than race-based medicine is essential to improving patient-doctor relationships by building trust and eliminating unnecessary medical practices.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary healthcare utilization patterns among sickle cell disease patients in tribal India: A multi-centric study.","authors":"Shaily B Surti, Shubhangi Patel, Yogita Sharma, Parikipandla Sridevi, Deepa Bhat, Jatin Sarmah, Manoranjan Ranjit, Madhusmita Bal, Bontha V Babu","doi":"10.1016/j.jnma.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.04.004","url":null,"abstract":"<p><strong>Background: </strong>Prevention and management of chronic diseases have been integrated into the primary healthcare system in recent years. However, due to the social, cultural and geographical barriers, patients of one of such chronic illnesses, viz., sickle cell disease (SCD) have poor utilization and access to healthcare services. Hence, this study explored the utilization of outpatient services by SCD patients and associated factors in five SCD-endemic tribal districts of India.</p><p><strong>Methods: </strong>This cross-sectional quantitative study was conducted on 263 SCD patients or their caregivers and 263 corresponding controls recruited from 5 SCD endemic districts. Data on utilizing outpatient services and health system-related characteristics were collected using a pretested questionnaire. Multiple logistic regression was conducted to explore the association between utilization of outpatient services and independent variables.</p><p><strong>Results: </strong>About 80% of the patients reported the public healthcare system as a regular source of healthcare. 86% of the patients and 65% of the controls or their families visited primary health centres (PHCs) in the past year. More than two-thirds of the patients (67.7%) and more than half of the controls (50.6%) didn't face any problems accessing PHC services. Patients with 6-10 years of schooling (adjusted odds ratio (AOR)=0.45), annual family income of USD 480 to USD 720 (AOR=0.41) and more than USD 720 (AOR=0.35), >15 kilometres of distance to PHCs (AOR=0.32) are less likely to visit PHCs.</p><p><strong>Conclusion: </strong>The primary healthcare system was a regular source of medical care for the majority of the population, and utilization of outpatient services at PHCs was high in our study. Hence, this study emphasizes strengthening screening and management of SCD right from the primary healthcare level so that the healthcare needs of SCD patients can be met for the continuum of care.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the impact of race/ethnicity on medical student's away rotations and residency match.","authors":"Chinecheta Ani, Lidia Ani, Traci F Gardner","doi":"10.1016/j.jnma.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>Many studies have examined the impact away rotations have on the residency match outcomes of medical students, the common impression being that they are beneficial for match success. Little is known about whether race/ethnicity affects the relationship between away rotations and match success. This study explored the impact that race/ethnicity has on the likelihood of a medical student matching at a program where they did an away rotation to help inform student's decision making.</p><p><strong>Methods: </strong>Alumni and post-match medical students at a US medical school, residents and attendings at the hospital associated with the medical school, and Black medical organization members completed a survey about their away rotation and match experience. Responses were collected from August 2023 to March 2024. The statistical analysis was done with Graphpad Prism.</p><p><strong>Results: </strong>We analyzed 298 survey responses and found that while the respondents of all races did not feel that attending away rotations affected their match outcomes, Black respondents were significantly less likely to match at a program where they did an away rotation (p=0.02). There was a difference in the rates of students going into competitive specialties who matched at a place where they rotated between those who are underrepresented in medicine (23.1 %) and those who are not (44.1 %), but this difference was not statistically significant (p=0.16).</p><p><strong>Conclusion: </strong>A one-size-fits-all recommendation for away rotations does not take into account the different realities faced by medical students. The impact that race/ethnicity can have on a student's match success should be acknowledged by students and advisors when making decisions about away rotations.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing health attitudes and information engagement among African American men using an online health education intervention.","authors":"Shawnta L Lloyd, Kelvin L Williams, Allison Caban-Holt, Suzanne Craft, Laura D Baker, Goldie S Byrd","doi":"10.1016/j.jnma.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.04.002","url":null,"abstract":"<p><strong>Background and objectives: </strong>In this article, we describe the results of a 6-month follow-up assessment among African American (AA) men who participated in the Black Men's Health Forum, a 6-week online health education intervention.</p><p><strong>Methods: </strong>A pre-post survey design was used to capture attitudes and behaviors before and 6-months after the intervention. The 6-month follow-up used the health conscious scale, Health Information Orientation Scale (HIOS), and the Short Multidimensional Inventory Lifestyle Evaluation (SMILE) to assess changes in attitudes toward health, health information seeking, and health behaviors. In addition, the influence of accountability partners among AA male participants of the forum was examined.</p><p><strong>Results: </strong>A sample of 24 AA men [61.7 years of age (range: 34.1 to 75.9 years of age)] completed the follow-up. Participants became more self-aware of their health (5.6 to 6.2, p = 0.0093), more motivated to improve health (5.8 to 6.5, p = 0.0181), and took more personal responsibility for their health (5.6 to 6.4, p = 0.0099). Results from the HIOS revealed that health information engagement increased among participants (2.7 to 3.1, p = 0.0168).</p><p><strong>Conclusions: </strong>AA men's attitudes towards health and information engagement were successfully improved through an online health education intervention. In addition, we leveraged family and friends in the lives of men to serve as a support system for men in the study to help improve health behaviors.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of knowledge of breast cancer risk factors and practice of breast self-examination among students at CSJM university, Kanpur.","authors":"Tanisha Anand, Priya Mishra, Mahima Saxena, Umra Naeem, Anushka Jauhari, Himanshi Chauhan, Santosh Kumar Yadav, Pankaj Kumar, Dheeraj Kumar","doi":"10.1016/j.jnma.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.jnma.2025.04.005","url":null,"abstract":"<p><p>Breast cancer is still one of the leading malignancies among women in the world and accounts for 19-34 % of all cancers in India. This cross-sectional study was conducted to evaluate the knowledge of risk factors of breast cancer and the practice of BSE among students at CSJM University, Kanpur. A structured online questionnaire was used to collect data from 375 participants, including undergraduate, postgraduate, and PhD students, as well as faculty members. The study revealed a moderate awareness of breast cancer risk factors such as family history (62.7 %) and radiation exposure (50.4 %), while it was lower for lifestyle-related risks like smoking (44.3 %). Only 36.3 % of the participants practiced BSE monthly, and barriers included a lack of knowledge (51.2 %), forgetfulness (24 %), and fear (14.9 %). Online tutorials (51.5 %) and interactive workshops (41.9 %) emerged as preferred educational materials. The findings indicate wide knowledge gaps and practice gaps; hence, there is an urgent need for educational intervention and curricular reforms, along with increased awareness programs, in improving breast health literacy and related preventive behaviors.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}