Mental Healthcare Provider Perceptions of Race and Racial Disparity in the Care of Black and White Clients

Background: Immediate breast reconstruction (IBR) is offered as part of the standard-of-care to females undergoing mastectomy. Racial disparity in IBR has been previously reported with a longstanding call for its elimination, though unknown if this goal is achieved. The aim of this study was to examine the current association between race and IBR and to investigate whether racial disparity is diminishing. Methods: Data was extracted from the National Cancer Database (NCDB) from 2004 to 2016. All variables in the database were controlled so that the comparison would be made solely between Black and White females. We also analyzed the trend in racial disparity to see if there has been a change from 2004 to 2016 after several calls for healthcare equality. Results: After propensity score matching, 69,084 White females were compared to 69,084 Black females. There was a statistically significant difference between the rate of IBR and race (23,386 [33.9%] in White females vs 20,850 [30.2%] in Black females, P-value < .001). Despite a twofold increase in the rate of IBR in both White and Black females, a persistent gap of about 4% was observed over the study period, which translates to more than 2,500 Black females not receiving IBR. Conclusions: Using the NCDB database, a racial disparity was identified for IBR between White and Black females from 2004 and 2016. Unfortunately, the gap between the groups remained constant over this 13-year period.

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Healthcare provider perceptions of disparities in perioperative care

Journal of the National Medical Association ◽

10.1016/j.jnma.2019.07.003 ◽

2019 ◽

Vol 111 (6) ◽

pp. 616-624

Author(s):

Julia M. Rosenbloom ◽

Jaleesa Jackson ◽

Margarita Alegria ◽

Kiara Alvarez

Keyword(s):

Healthcare Provider ◽

Perioperative Care ◽

Provider Perceptions

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The association of birthweight and the racial disparity in hypertension among black and white medicaid beneficiaries

American Journal of Hypertension ◽

10.1016/s0895-7061(00)00389-7 ◽

2000 ◽

Vol 13 (6) ◽

pp. S38

Author(s):

D Lackland

Keyword(s):

Racial Disparity ◽

Black And White ◽

Medicaid Beneficiaries

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Healthcare-provider perceptions of barriers to oxygen therapy for paediatric patients in three government-funded eastern Ugandan hospitals; a qualitative study

BMC Health Services Research ◽

10.1186/s12913-019-4129-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Jonathan W. Dauncey ◽

Peter Olupot-Olupot ◽

Kathryn Maitland

Keyword(s):

Qualitative Study ◽

Healthcare Provider ◽

Oxygen Therapy ◽

Provider Perceptions ◽

Paediatric Patients

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How community and healthcare provider perceptions, practices and experiences influence reporting, disclosure and data collection on stillbirth: Findings of a qualitative study in Afghanistan

Social Science & Medicine ◽

10.1016/j.socscimed.2019.112413 ◽

2019 ◽

Vol 236 ◽

pp. 112413 ◽

Cited By ~ 2

Author(s):

Aliki Christou ◽

Ashraful Alam ◽

Sayed Murtaza Sadat Hofiani ◽

Mohammad Hafiz Rasooly ◽

Adela Mubasher ◽

...

Keyword(s):

Data Collection ◽

Qualitative Study ◽

Healthcare Provider ◽

Provider Perceptions

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Estimated Cardiovascular Risk and Guideline-Concordant Primary Prevention With Statins: Retrospective Cross-Sectional Analyses of US Ambulatory Visits Using Competing Algorithms

Journal of Cardiovascular Pharmacology and Therapeutics ◽

10.1177/1074248419866153 ◽

2019 ◽

Vol 25 (1) ◽

pp. 27-36

Author(s):

Kathleen A. Fairman ◽

David Romanet ◽

Nicole K. Early ◽

Kellie J. Goodlet

Keyword(s):

Primary Prevention ◽

Racial Disparity ◽

Task Force ◽

Demographic Data ◽

Statin Treatment ◽

Office Visits ◽

Cross Sectional ◽

Black And White ◽

Nationally Representative ◽

White Patients

Introduction: The 2013 pooled cohort equations (PCE) may misestimate cardiovascular event (CVE) risk, particularly for black patients. Alternatives to the original PCE (O-PCE) to assess potential statin benefit for primary prevention—a revised PCE (R-PCE) and US Preventive Services Task Force (USPSTF) algorithms—have not been compared in contemporary US patients in routine office-based practice. Methods: We performed retrospective, cross-sectional analysis of a nationally representative, US sample of office visits made from 2011 to 2014. Sampling criteria matched those used for PCE development: aged 40 to 79 years, black or white race, no cardiovascular disease. Original PCE, R-PCE, and USPSTF algorithms were applied to biometric and demographic data. Outcomes included estimated 10-year CVE risk, percentage exceeding each algorithm’s statin-treatment threshold (>7.5% risk for O-PCE and R-PCE, and >10% O-PCE plus >1 risk factor for USPSTF), and percentage prescribed statin therapy. Results: In 12 556 visits (representing 285 330 123 nationwide), 10.8% of patients were black, 27.1% had diabetes, and 15.7% were current smokers. Replacing O-PCE with R-PCE decreased mean (95% confidence interval [CI]) estimated CVE risk from 12.4% (12.0%-12.7%) to 8.5% (8.2%-8.8%). Significant ( P < 0.05) racial disparity in the rate of CVE risk >7.5% was identified using O-PCE (black and white patients [95% CI], respectively: 58.8% [54.6%-62.9%] vs 52.8% [51.1%-54.4%], P = .006) but not R-PCE (41.6% [37.6%-45.7%] vs 39.9% [38.3%-41.5%], P = .448). Revised PCE and USPSTF recommendations were concordant for 90% of patients. Significant racial disparity in guideline-concordant statin prescribing was found using O-PCE (black and white patients, respectively, 35.0% [30.5%-39.9%] vs 41.8% [39.9%-44.4%], P = .013), but not R-PCE (40.6% [35.0%-46.6%] vs 43.0% [40.0%-45.9%], P = .482) or USPSTF recommendations (39.0% [33.8%-44.5%] vs 44.4% [41.5%-47.5%], P = .073). Conclusions: Use of an alternative to O-PCE may reduce racial disparity in estimated CVE risk and may facilitate shared decision-making about primary prevention.

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Perceived Importance of Counselor Characteristics Among Vocational Rehabilitation Counselors and Clients

Journal of Applied Rehabilitation Counseling ◽

10.1891/0047-2220.19.3.28 ◽

1988 ◽

Vol 19 (3) ◽

pp. 28-31

Author(s):

Carolyn M. Tucker ◽

J. Stephen Parker ◽

Gerald D. Parham ◽

Beverly A. Brady ◽

James G. Brown

Keyword(s):

Vocational Rehabilitation ◽

Goal Setting ◽

Multivariate Analyses ◽

Rehabilitation Counselors ◽

Counselor Characteristics ◽

Black And White ◽

Vocational Rehabilitation Counselors ◽

Counselor Performance ◽

White Clients ◽

Task Oriented

The differences between counselors' and clients' perceptions of what is important to be an effective Vocational Rehabilitation (VR) counselor were investigated. Questionnaires completed by 187 counselors and 122 clients were utilized to identify counselor characteristics, knowledge, attitudes, and behaviors/skills perceived to be most important. Multivariate analyses of the data revealed some significant differences between and within counselors' and clients' ratings of the importance of specific counselor performance items. Counselors were found to value task-oriented behaviors including goal setting, problem-solving, and decision-making more than clients. Results also indicated that female counselors and clients, as compared to their male counterparts, believe that it is more important for counselors to be caring, encouraging, and supportive. It was also found that Hispanic clients differed from both black and white clients on the importance of several counselor characteristics. Implications of these findings for improving the delivery of services to clients are discussed.

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