Abstract P207: Food Insecurity, Anxiety And Depression In An Underserved Heart Failure Population

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Erin B Clarkson ◽  
Stephen Clarkson ◽  
Reid Eagleson ◽  
Connie White-Williams
Keyword(s):  
Heart Failure ◽  
African American ◽  
Food Insecurity ◽  
Health Care Providers ◽  
Clinical Characteristics ◽  
Underserved Populations ◽  
Vital Signs ◽  
Social Determinant ◽  
Depression And Anxiety ◽  
Care Providers

Objective: The HRTSA (HeaRt -Failure Transitional Services for Adults) Clinic at the University of Alabama at Birmingham Hospital serves underinsured individuals with heart failure (HF). We examined the differences in sociodemographic, clinical characteristics, and depression and anxiety among food secure and insecure patients who established care in clinic. Methods: Between May 2018 and December 2019, 291 patients established care in the HRTSA Clinic post-hospitalization. Patients were adults ≥18 years of age with heart failure. At the first clinic visit, baseline sociodemographic and medical history were obtained. Additionally, each patient was screened for depression using the Patient Health Questionaire-9 (PHQ-9) and anxiety using the General Anxiety Disorder-7 (GAD-7) questionnaire. Patients were also screened for food insecurity (FI) using the Hunger Vital Signs screener, a validated 2-item tool created for clinical settings to rapidly identify FI. Using descriptive statistics and t-tests, we compared demographic and clinical characteristics of FI and FS clinic patients. Results: Of the 291 newly referred patients seen in the HRTSA Clinic and screened for food insecurity, the mean age was 50 years, 58% were African American and 29% were female. A total of 80 patients (27%) screened positive for food insecurity. FI patients tended to be female (37% vs 27%, p=0.108) and African American (68% vs. 58%, p=0.142), although not statistically significant. FI patients had statistically significant higher depression scores and had anxiety scores that trended to higher values. Conclusions: Food insecurity, an important social determinant of health, is associated with more depression and anxiety. Depression and anxiety are important contributors to patient-centered outcomes for heart failure patients, specifically in underserved populations. This has implications for health care providers to implement screening interventions to improve mental health in underserved populations.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Social Media Preference and Condom Use Behaviors: An Analysis of Digital Spaces With Young African American Males

2021 ◽  
Vol 48 (2) ◽  
pp. 190-198
Author(s):  
Jade C. Burns ◽  
Shawtaabdee Chakraborty ◽  
Denise Saint Arnault
Keyword(s):  
Social Media ◽  
African American ◽  
Condom Use ◽  
Health Care Providers ◽  
Sexual Behaviors ◽  
African American Males ◽  
African American Adolescents ◽  
Lifestyle Changes ◽  
Perceived Behavioral Control ◽  
Care Providers

Background. African American adolescents and young adults have an increased likelihood of engaging in risky sexual behaviors. With rising rates of sexually transmitted infections among this population, deeper consideration is now being focused on using social media to engage, educate, and improve sexual behavior in this group. Purpose. To determine why social media is useful and how it may affect the attitude, norms, and perceived behavioral control on condom use among young African American males (YAAMs) ages 18 to 21. Method. Group-depth interviews ( n = 41, mean age = 19, SD = 1.2) were conducted in metro Detroit to understand and describe the who, what, where, why, and how regarding social media use and preference among YAAMs) ages 18 to 21, and their condom use behaviors. Results. The most popular reasons for using social media were for educational purposes, entertainment, browsing the site, self-expression, seeking out or maintaining relationships with friends and family, and social justice. YouTube was stated as the easiest site to promote condom use education. YAAMs would seek out condom use education on social media sites if someone respected in the community or someone famous promoted condom use messages on the sites or if it was used to show where condoms were available for free or for purchase. Conclusion. Understanding how YAAMs use social media may help researchers design better questions to address disparities within this population. More important, it can help health care providers, families, and the community promote healthy behaviors and lifestyle changes among YAAMs.

SGLT2 inhibitors: A revolution in therapeutics of a major Non-Communicable Disease

2021 ◽  
pp. 1-3
Author(s):  
Muhammad Sami Khan
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Communicable Disease ◽  
Health Care Expenditure ◽  
Health Care Expenditures ◽  
Sglt2 Inhibitors ◽  
Care Providers ◽  
Cardiovascular Outcome Trials ◽  
Non Communicable Disease

Pakistan is facing an exorbitant burden of Non-communicable diseases among which Cardiovascular diseases are the most prominent which has not only caused mortality but also posed a big threat on weakened economy and health care system of the country. Amidst of this growing crisis, Sodium glucose co-transporter 2 (SGLT2) inhibitors emerge as a ray of hope by reducing simultaneously the complication and health care expenditure associated with the management of this major mortality-bringing Non-communicable disease. SGLT2 inhibitors, including Dapagliflozin and Empagliflozin, are evidence-based standardized novel anti-diabetic agents tested in cardiovascular outcome trials namely DAPA-HF and EMPEROR-Reduced, when added to standard care in heart failure patients with reduced ejection fraction, provides breakthrough heart failure outcomes and also addresses massive health care expenditures. This novel finding provides an impetus to promote its beneficial effects among health care providers and early implementation. Continuous....

scholarly journals A Personal Touch: The Most Important Strategy for Recruiting Latino Research Participants

2016 ◽  
Vol 28 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Alexandra A. García ◽  
Julie A. Zuñiga ◽  
Czarina Lagon
Keyword(s):  
Cultural Values ◽  
Health Care Providers ◽  
Low Socioeconomic Status ◽  
Mexican American ◽  
Underserved Populations ◽  
Racial Groups ◽  
Care Providers ◽  
Community Settings ◽  
Low Socioeconomic ◽  
The Common

People from non-White racial groups and other underserved populations, including Latinos, are frequently reluctant to participate in research. Yet their participation into research is foundational to producing information that researchers and health care providers need to address health disparities. The purpose of this article is to describe challenges we have encountered along with culturally relevant strategies we used in five research studies to recruit Mexican American participants from community settings, some of whom were also of low socioeconomic status. We found that the most effective recruitment strategies reflect the common cultural values of personalismo, simpátia, confianza, respeto, and familismo.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

scholarly journals Family-Centered Care: How Close Do We Get When Talking to Parents of Children Undergoing Diagnosis for Autism Spectrum Disorders?

2020 ◽  
Author(s):  
Lynnea Myers ◽  
Sharon M. Karp ◽  
Mary S. Dietrich ◽  
Wendy S. Looman ◽  
Melanie Lutenbacher
Keyword(s):  
Health Care Providers ◽  
Autism Spectrum ◽  
Diagnostic Process ◽  
Family Centered Care ◽  
Depression And Anxiety ◽  
Care Providers ◽  
Symptoms Of Depression ◽  
Centered Care ◽  
Spectrum Disorders ◽  
Family Centered

Abstract Autism spectrum disorder (ASD) affects 1:59 children, yet little is known about parents’ perceptions of family-centered care (FCC) during the diagnostic process leading up to diagnosis. This mixed-methods study explored key elements of FCC from 31 parents of children recently diagnosed with ASD using parallel qualitative and quantitative measures. Parents rated highly their receipt of FCC and discussed ways providers demonstrated FCC. However, the majority of parents indicated that the period when their child was undergoing diagnosis was stressful and reported symptoms of depression and anxiety. The study points to ways in which health care providers can enhance FCC provided to families when a child is undergoing ASD diagnosis.

scholarly journals Designing a Cocreated Intervention with African American Older Adults for Hypertension Self-Management

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Kathy D. Wright ◽  
Carolyn H. Still ◽  
Lenette M. Jones ◽  
Karen O. Moss
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
African American ◽  
Health Care Providers ◽  
Mode Of Delivery ◽  
Self Management ◽  
Semistructured Interview ◽  
Care Providers ◽  
Group Sessions ◽  
African American Older Adults

Hypertension is a lifelong disease that requires self-management. Additionally, there are disparities in hypertension self-management that disproportionately affect African Americans. Interventions designed in collaboration with older adults have the potential to improve hypertension self-management. The purpose of this design paper is to describe the process in which African American older adults and nurse researchers cocreated an intervention to address stress in the self-management of hypertension. A semistructured interview guide was used to elicit feedback on self-management behaviors to cocreate an intervention with the participants. Participants provided constant iterative feedback on the design used for the intervention. Participants prioritized the content and mode of delivery. African American older adults with hypertension (N=31; 87% women) participated in two focus group sessions. The primary stressors identified by the group that influenced their blood pressure self-management were as follows: (a) measuring blood pressure and using home blood pressure monitors; (b) difficulty communicating with family and friends; (c) sleep management and pain at night; and (d) healthy eating. Based on the participants’ feedback, we created four biweekly (2-hour) group sessions that incorporated their suggestions and addressed their concerns. Health care providers can use this technique to engage African American older adults in participant-centered hypertension self-management.

scholarly journals Recovery rate and determinants of severe acute malnutrition children treatment in Ethiopia: a systematic review and meta-analysis

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Kassahun Gebeyehu Yazew ◽  
Chanyalew Worku Kassahun ◽  
Amare Wondim Ewnetie ◽  
Habtamu Kerebih Mekonen ◽  
Endalamaw Salilew Abagez
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Congestive Heart Failure ◽  
Health Care Providers ◽  
Recovery Rate ◽  
Severe Acute Malnutrition ◽  
Meta Analysis ◽  
Acute Malnutrition ◽  
Cochrane Library ◽  
Care Providers

Abstract Background Severe acute malnutrition affects more than 20 million children. Africa is pointed out as a region where the problem is highly prevalent. There were individual studies on the recovery rate and its determinants among children with severe acute malnutrition in Ethiopia. But, there is no national pooled estimate. Therefore, this systematic review and meta-analysis aimed to estimate the recovery rate and determinants among children with severe acute malnutrition admitted to the therapeutic feeding unit in Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed in this study. Studies were accessed through electronic web-based search from PubMed, Cochrane Library, Google Scholar, and EMBASE. The statistical analysis was conducted using STATA version-11 software. The pooled prevalence was estimated with 95% confidence intervals using a random-effects model. Result A total of 12 studies were included with 2658 participants in the analysis. The overall pooled estimated recovery rate among children with severe acute malnutrition admitted to the inpatient therapeutic feeding unit in Ethiopia was 72.02 % (CI, 64.83, 79.22%). In the subgroup analysis, the highest estimate (80.29%) was observed in studies conducted in Oromia regional state, while 68.63% was observed in studies Southern Nation Nationality of people region 68.63%. Children who had no congestive heart failure were 4.88 times (OR, 4.88; 95% CI, 2.246, 10.586) more likely to recover than their counterparts. Conclusion The recovery rate among severe acute malnourished children on the therapeutic feeding unit in Ethiopia lied within the international minimum sphere. Hence, health care providers shall strengthen the management of severe acute malnutrition and management other co-morbidities like congestive heart failure. Systematic review registration PROSPERO CRD42019119124

Using On-scene EMS Responders’ Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers

2016 ◽  
Vol 31 (1) ◽  
pp. 46-57 ◽  
Author(s):  
Greg Scott ◽  
Jeff Clawson ◽  
Mark C. Fivaz ◽  
Jennie McQueen ◽  
Marie I. Gardett ◽  
...  
Keyword(s):  
Patient Care ◽  
Health Care Providers ◽  
Vital Sign ◽  
Clinical Status ◽  
Vital Signs ◽  
Care Providers ◽  
Emergency Medical Dispatch ◽  
Emergency Medical ◽  
Alpha Level ◽  
Nurse Triage

AbstractIntroductionUsing the Medical Priority Dispatch System (MPDS) – a systematic 911 triage process – to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews.ObjectivesThe primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews’ patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN).MethodsIn this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a “hot” (lights-and-siren) transport.ResultsOut of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren.ConclusionWith the exception of the low-acuity, ALPHA-level seizure cases, the ALPHA-level patients are suitable to transfer for secondary triage in a best-practices, accredited, emergency medical dispatch center that utilizes the MPDS at very high compliance rates. The secondary nurse triage process should identify the few at-risk patients that exist in the low-acuity calls.ScottG, ClawsonJ, FivazMC, McQueenJ, GardettMI, SchultzB, YoungquistS, OlolaCHO. Using on-scene EMS responders’ assessment and electronic patient care records to evaluate the suitability of EMD-triaged, low-acuity calls for secondary nurse triage in 911 centers. Prehosp Disaster Med. 2016;31(1):46–57.

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