scholarly journals Race-ethnicity and Perceptional Determinants of COVID-19 Vaccination Intentions: A Cross-sectional Study Among Health Workers and the General Population in the San Francisco Bay Area

2021 ◽  
Author(s):  
Yingjie Weng ◽  
Di Lu ◽  
Jenna Bollyky ◽  
Vivek Jain ◽  
Manisha Desai ◽  
...  
Keyword(s):  
General Population ◽  
San Francisco ◽  
Ethnic Differences ◽  
Health Workers ◽  
Study Cohort ◽  
Cross Sectional ◽  
Bay Area ◽  
Race Ethnicity ◽  
To Receive ◽  
Racial Ethnic

AbstractImportanceSurveys in the US have found that Black and Latinx individuals have more reservations than their white counterparts about COVID-19 vaccination. However, little is known about the degree to which racial-ethnic differences in COVID-19 vaccination intentions are explained by differences in beliefs or perceptions about COVID-19 vaccines.ObjectiveTo compare intention to receive COVID-19 vaccination by race-ethnicity, to identify perceptional factors that may mediate the association between race-ethnicity and intention to receive the vaccine, and to identify the demographic and perceptional factors most strongly predictive of intention to receive a vaccine.DesignCross-sectional survey conducted from November, 2020 to January, 2021, nested within two longitudinal cohort studies of prevalence and incidence of SARS CoV-2 among the general population and healthcare workers.SettingSix San Francisco Bay Area counties.Study Cohort3,161 participants in the Track COVID cohort (a population-based sample of adults) and 1,803 participants in the CHART Study cohort (a cohort of employees at three large medical centers).ResultsRates of high vaccine willingness were significantly lower among Black (45.3%), Latinx (62.5%), Asian (65%), multi-racial (67.2%), and other race (61.0%) respondents than among white respondents (77.6%). Black, Latinx, and Asian respondents were significantly more likely than white respondents to endorse reasons to not get vaccinated, especially lack of trust. Participants’ motivations and concerns about COVID-19 vaccination only partially explained racial-ethnic differences in vaccination willingness. Being a health worker in the CHART cohort and concern about a rushed government vaccine approval process were the two most important factors predicting vaccination intention.Conclusions and RelevanceSpecial efforts are required to reach historically marginalized racial-ethnic communities to support informed decision-making about COVID-19 vaccination. These campaigns must acknowledge the history of racism in biomedical research and health care delivery that has degraded the trustworthiness of health and medical science institutions among non-white population and may continue to undermine confidence in COVID-19 vaccines.HighlightsBlack, Latinx, Asian, Multi-racial, and Other race respondents were significantly less likely than white respondents to have high willingness to receive COVID-19 vaccination when surveyed around the time that the first COVID-19 vaccines received Emergency Use Authorization in the US.Racial-ethnic differences in vaccination intention were present for both health workers and the general population.Motivations and concerns about COVID-19 vaccination only partially explained racial-ethnic differences in COVID-19 vaccine willingness.The most important factors explaining COVID-19 vaccination intention were being a health worker, concern about government rushing the vaccine process, concern about having a bad reaction to the vaccine, motivation to protecting one’s self and family from COVID-19, and concern about getting COVID from the vaccine

scholarly journals Race-Ethnicity and COVID-19 Vaccination Beliefs and Intentions: A Cross-Sectional Study among the General Population in the San Francisco Bay Area

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1406
Author(s):  
Yingjie Weng ◽  
Di Lu ◽  
Jenna Bollyky ◽  
Vivek Jain ◽  
Manisha Desai ◽  
...  
Keyword(s):  
General Population ◽  
San Francisco ◽  
San Francisco Bay ◽  
San Francisco Bay Area ◽  
Study Cohort ◽  
Cross Sectional ◽  
Bay Area ◽  
Race Ethnicity ◽  
To Receive ◽  
Racial Ethnic

Objective: The study was designed to compare intentions to receive COVID-19 vaccination by race–ethnicity, to identify beliefs that may mediate the association between race–ethnicity and intention to receive the vaccine and to identify the demographic factors and beliefs most strongly predictive of intention to receive a vaccine. Design: Cross-sectional survey conducted from November 2020 to January 2021, nested within a longitudinal cohort study of the prevalence and incidence of SARS-CoV-2 among a general population-based sample of adults in six San Francisco Bay Area counties (called TrackCOVID). Study Cohort: In total, 3161 participants among the 3935 in the TrackCOVID parent cohort responded. Results: Rates of high vaccine willingness were significantly lower among Black (41%), Latinx (55%), Asian (58%), Multi-racial (59%), and Other race (58%) respondents than among White respondents (72%). Black, Latinx, and Asian respondents were significantly more likely than White respondents to endorse lack of trust of government and health agencies as a reason not to get vaccinated. Participants’ motivations and concerns about COVID-19 vaccination only partially explained racial–ethnic differences in vaccination willingness. Concerns about a rushed government vaccine approval process and potential bad reactions to the vaccine were the two most important factors predicting vaccination intention. Conclusions: Vaccine outreach campaigns must ensure that the disproportionate toll of COVID-19 on historically marginalized racial–ethnic communities is not compounded by inequities in vaccination. Efforts must emphasize messages that speak to the motivations and concerns of groups suffering most from health inequities to earn their trust to support informed decision making.

scholarly journals Racial and Ethnic Differences in COVID-19 Outcomes, Stressors, Fear, and Prevention Behaviors Among US Women: Web-Based Cross-sectional Study (Preprint)

2020 ◽  
Author(s):  
Jamila K Stockman ◽  
Brittany A Wood ◽  
Katherine M Anderson
Keyword(s):  
United States ◽  
Ethnic Differences ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Web Based ◽  
Racial And Ethnic Differences ◽  
Race Ethnicity ◽  
Racial Ethnic

BACKGROUND In the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence. OBJECTIVE The purpose of this study is to examine racial and ethnic differences in the prevalence of COVID-19 outcomes, stressors, fear, and prevention behaviors among adult women residing in the United States. METHODS Between May and June 2020, women were recruited into the Capturing Women’s Experiences in Outbreak and Pandemic Environments (COPE) Study, a web-based cross-sectional study, using advertisements on Facebook; 491 eligible women completed a self-administered internet-based cross-sectional survey. Descriptive statistics were used to examine racial and ethnic differences (White; Asian; Native Hawaiian or other Pacific Islander; Black; Hispanic, Latina, or Spanish Origin; American Indian or Alaskan Native; multiracial or some other race, ethnicity, or origin) on COVID-19 outcomes, stressors, fear, and prevention behaviors. RESULTS Among our sample of women, 16% (73/470) reported COVID-19 symptoms, 22% (18/82) were concerned about possible exposure from the people they knew who tested positive for COVID-19, and 51.4% (227/442) knew where to get tested; yet, only 5.8% (27/469) had been tested. Racial/ethnic differences were observed, with racial/ethnic minority women being less likely to know where to get tested. Significant differences in race/ethnicity were observed for select stressors (food insecurity, not enough money, homeschooling children, unable to have a doctor or telemedicine appointment) and prevention behaviors (handwashing with soap, self-isolation if sick, public glove use, not leaving home for any activities). Although no racial/ethnic differences emerged from the Fear of COVID-19 Scale, significant racial/ethnic differences were observed for some of the individual scale items (eg, being afraid of getting COVID-19, sleep loss, and heart racing due to worrying about COVID-19). CONCLUSIONS The low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the United States, particularly among racial/ethnic minority women. Although the overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities are warranted in communities of color, particularly with consideration for stressors and adverse mental health.

scholarly journals Race/Ethnicity Matters: Differences in Poststroke Inpatient Rehabilitation Outcomes

2019 ◽  
Vol 29 (4) ◽  
pp. 599-608 ◽  
Author(s):  
James J. García ◽  
Karlita L. Warren
Keyword(s):  
Ethnic Differences ◽  
Inpatient Rehabilitation ◽  
Hierarchical Regression ◽  
Cross Sectional ◽  
Rehabilitation Outcomes ◽  
Motor Efficiency ◽  
Inpatient Rehabilitation Facility ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Lower Discharge

Objective: To examine racial/ethnic differ­ences in poststroke inpatient rehabilitation outcomes.Design: Cross-sectional and retrospective study of administrative data across 2002- 2018.Setting: An inpatient rehabilitation facility in Southern California.Participants: 3,876 racial/ethnic people aged ≥ 18 years.Main Outcome Measures: Functional In­dependence Measure (FIM®) and discharge disposition.Results: Participants were non-Hispanic Whites (NHWs, 68.5%), Hispanics (17.1%), non-Hispanic Asians (NHAs, 7.4%), and non-Hispanic Blacks (NHBs, 6.4%) aged 18-102 years (Mage = 68.47±14.66 years; MLOS = 19.47±10.05 days). Above and beyond covariates, multivariate hierarchical regression analyses showed race/ethnicity significantly predicted admission, motor efficiency, and discharge FIM® scores. Compared with NHWs, the Hispanic and NHA groups were associated with lower cognitive, motor, and total FIM® scores at admission; the NHB group was associated with lower motor efficiency, lower discharge motor and total FIM® scores, whereas the Hispanic group was associated with higher discharge total FIM® scores. Lastly, Hispanics had higher odds of a discharge home compared with NHWs.Conclusions: Findings suggest racial/ethnic differences exist in poststroke rehabilitation outcomes. Ethn Dis. 2019;29(4):599-608; doi:10.18865/ed.29.4.599

scholarly journals Experiences and factors associated with transphobic hate crimes among transgender women in the San Francisco Bay Area: comparisons across race

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Akua O. Gyamerah ◽  
Glenda Baguso ◽  
Edda Santiago-Rodriguez ◽  
Aria Sa’id ◽  
Sean Arayasirikul ◽  
...  
Keyword(s):  
Gender Identity ◽  
San Francisco ◽  
Hate Crime ◽  
San Francisco Bay Area ◽  
Hate Crimes ◽  
Factors Associated ◽  
Bay Area ◽  
Police Reporting ◽  
Trans Women ◽  
Racial Ethnic

Abstract Background Trans women experience high rates of gender-based violence (GBV)—a risk factor for adverse health outcomes. Transphobic hate crimes are one such form of GBV that affect trans women. However, little is understood about factors that shape transphobic hate crimes and racial/ethnic variation in these experiences. To contextualize GBV risk and police reporting, we examined self-reported types and correlates of transphobic hate crimes by racial/ethnic group of trans women in the San Francisco Bay Area. Methods From 2016 to 2018, trans women participated in a longitudinal cohort study of HIV. Secondary data analyses (N = 629) examined self-reported experiences of transphobic hate crimes (i.e., robbery, physical assault, sexual assault, and battery with weapon) by race/ethnicity, and whether hate crimes were reported to the police. Chi-square tests and simple logistic regression examined demographic, sociocultural, and gender identity factors associated with transphobic violence experiences and police reporting. Results About half (45.8%) of participants reported ever experiencing a transphobic hate crime; only 51.1% of these were reported to the police. Among those who reported a hate crime experience, Black (47.9%) and Latina (49.0%) trans women reported a higher prevalence of battery with a weapon; White (26.7%) and trans women of “other” race/ethnicities (25.0%) reported a higher prevalence of sexual assault (p = 0.001). Having one’s gender questioned, history of sex work, homelessness as a child and adult, and a history incarceration were associated with higher odds of experiencing a transphobic hate crime. Trans women who felt their gender identity questioned had lower odds of reporting a hate crime to the police compared to those did not feel questioned. Conclusions A high proportion of trans women experienced a transphobic hate crime, with significant socio-structural risk factors and racial differences by crime type. However, crimes were underreported to the police. Interventions that address structural factors, especially among trans women of color, can yield violence prevention benefits.

scholarly journals The characteristics of patients with possible familial hypercholesterolemia—screening a large payer/provider healthcare delivery system

QJM ◽  
2019 ◽  
Vol 113 (6) ◽  
pp. 411-417 ◽  
Author(s):  
A Elis ◽  
M Leventer-Roberts ◽  
A Bachrach ◽  
N Lieberman ◽  
R Durst ◽  
...  
Keyword(s):  
General Population ◽  
Health Services ◽  
Familial Hypercholesterolemia ◽  
Chronic Kidney Disease Stage ◽  
Healthcare Delivery ◽  
Disease Stage ◽  
Study Cohort ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
History Of

Abstract Background Familial hypercholesterolemia (FH) is an under-diagnosed condition. Aim We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH. Methods A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age <10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein >300 mg/l, HDL-C>80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population. Results The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated. Conclusions By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.

Applying the Health Belief Model to Characterize Racial/Ethnic Differences in Digital Conversations Related to Depression Pre– and Mid–COVID-19 (Preprint)

2021 ◽  
Author(s):  
Ruby Castilla-Puentes ◽  
Jacqueline Pesa ◽  
Caroline Brethenoux ◽  
Patrick Furey ◽  
Liliana Gil Valletta ◽  
...  
Keyword(s):  
Health Belief Model ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Health Belief ◽  
Depression Symptoms ◽  
Seeking Help ◽  
Key Drivers ◽  
Race Ethnicity ◽  
Belief Model ◽  
Racial Ethnic

BACKGROUND The prevalence of depression symptoms in the United States is >3 times higher mid–COVID-19 versus pre-pandemic. Racial/ethnic differences in mindsets around depression and the potential impact of the COVID-19 pandemic are not well characterized. OBJECTIVE To describe attitudes, mindsets, key drivers, and barriers related to depression pre– and mid–COVID-19 by race/ethnicity using digital conversations about depression mapped to health belief model (HBM) concepts. METHODS Advanced search, data extraction, and AI-powered tools were used to harvest, mine, and structure open-source digital conversations of US adults who engaged in conversations about depression pre– (February 1, 2019-February 29, 2020) and mid–COVID-19 pandemic (March 1, 2020-November 1, 2020) across the internet. Natural language processing, text analytics, and social data mining were used to categorize conversations that included a self-identifier into racial/ethnic groups. Conversations were mapped to HBM concepts (ie, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy). Results are descriptive in nature. RESULTS Of 2.9 and 1.3 million relevant digital conversations pre– and mid–COVID-19, race/ethnicity was determined among 1.8 million (62%) and 979,000 (75%) conversations pre– and mid–COVID-19, respectively. Pre–COVID-19, 1.3 million conversations about depression occurred among non-Hispanic Whites (NHW), 227,200 among Black Americans (BA), 189,200 among Hispanics, and 86,800 among Asian Americans (AS). Mid–COVID-19, 736,100 conversations about depression occurred among NHW, 131,800 among BA, 78,300 among Hispanics, and 32,800 among AS. Conversations among all racial/ethnic groups had a negative tone, which increased pre– to mid–COVID-19; finding support from others was seen as a benefit among most groups. Hispanics had the highest rate of any racial/ethnic group of conversations showing an avoidant mindset toward their depression. Conversations related to external barriers to seeking treatment (eg, stigma, lack of support, and lack of resources) were generally more prevalent among Hispanics, BA, and AS than among NHW. Being able to benefit others and building a support system were key drivers to seeking help or treatment for all racial/ethnic groups. CONCLUSIONS Applying concepts of the HBM to data on digital conversation about depression allowed organization of the most frequent themes by race/ethnicity. Individuals of all groups came online to discuss their depression. There were considerable racial/ethnic differences in drivers and barriers to seeking help and treatment for depression pre– and mid–COVID-19. Generally, COVID-19 has made conversations about depression more negative, and with frequent discussions of barriers to seeking care. These data highlight opportunities for culturally competent and targeted approaches to address areas amenable to change that might impact the ability of people to ask for or receive mental health help, such as the constructs that comprise the HBM.

Abstract P352: Racial/Ethnic Differences in Cardiovascular Disease Outcomes among Patients with Hypertension or Type 2 Diabetes

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jia Pu ◽  
Sukyung Chung ◽  
Beinan Zhao ◽  
Vani Nimbal ◽  
Elsie J Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Asian Indian ◽  
Ethnic Differences ◽  
Elevated Risk ◽  
Stroke Incidence ◽  
Men And Women ◽  
Hazard Ratios ◽  
Race Ethnicity ◽  
Racial Ethnic

Background: This study assesses racial/ethnic differences in CVD outcomes among patients with hypertension (HTN) or type 2 diabetes (T2DM) across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese), Mexican, non-Hispanic black (NHB), and non-Hispanic White (NHW) in a large, mixed payer ambulatory care setting in northern California. Study Design: We estimated the rate of CVD incidence among adult patients with HTN (N=171,864) or T2DM (N=10,570), or both (N=36,589) using electronic health records between 2000-2013. Average follow-up was 4.5 years. CVD, including CHD (410-414), PVD (415, 440.2, 440.3, 443.9, 451, 453), and stroke (430-434), was defined by ICD-9 codes; HTN and T2DM were defined by ICD-9 codes, medication history, or two or more elevated blood pressure measures/abnormal glucose lab test results. Cox proportional hazard models were used to estimate hazard ratios for CHD, PVD, and stroke across race/ethnicity. Results: Among these patients, 10.5% developed CVD by the end of year 2013 (5.4% CHD, 3.4%PVD, 3.6% stroke). There was a gender difference in the risk of incident CHD. Among males, the age-adjusted hazard ratios for CHD were significantly higher for Asian Indians (HR: 1.3, 95% CI: 1.2-1.5) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.8, CI: 0.6-0.9) compared to NHWs. Among females, the age-adjusted hazard ratios for CHD were significantly higher for Mexican (HR: 1.3, CI: 1.1-1.5) and NHBs (HR: 1.7, CI: 1.4-2.0) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.5, CI: 0.4-0.7). NHB men and women also had significantly higher age-adjusted hazard ratios for PVD (men: HR: 1.5, CI: 1.2-1.9; women: HR: 1.6, CI: 1.3-1.9) and stroke (men: HR: 1.3, CI: 1.1-1.7; women: HR: 1.3, CI: 1.1-1.6) compared to NHWs. The age-adjusted hazard ratios for PVD and stroke were lower or equivalent to NHWs for all Asian subgroups and Mexican men and women. Patients with both HTN and T2DM were at elevated risk to develop CVD compared to patients with only one of the two conditions, regardless of their race/ethnicity. Conclusions: Compared to previous studies, we found less racial/ethnic variation in CVD outcomes, in particular stroke, among patients with HTN or T2DM. Our finding suggests the higher stroke incidence rates in several races/ethnicities are likely to be explained by the higher prevalence of HTN and T2DM among these groups. However, Asian Indian men and NHB and Mexican women with HTN or T2DM were at elevated risk for CHD compared to NHWs. Since the majority of patients in the study cohort had health insurance, further studies are needed to better understand the reasons for the observed racial/ethnic differences beyond disparities in access to health care. Special attention needs to be paid to patients with multiple conditions.

scholarly journals Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey

2021 ◽  
Author(s):  
Farah Yasmin ◽  
Waleed Asghar ◽  
Maryam Salma Babar ◽  
Hiba Khan ◽  
Shoaib Ahmad ◽  
...  
Keyword(s):  
General Population ◽  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Public ◽  
Polio Vaccination ◽  
Acceptance Rates ◽  
To Receive ◽  
Do So

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.

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