scholarly journals Low Income Parents' Reports of Communication Problems with Health Care Providers: Effects of Language and Insurance

2007 ◽  
Vol 122 (2) ◽  
pp. 206-216 ◽  
Author(s):  
Lisa Clemans-Cope ◽  
Genevieve Kenney
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Care Providers ◽  
Communication Problems

Immigrant Communities and COVID-19: Strengthening the Public Health Response

2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Immigrant Communities ◽  
Care Providers ◽  
Public Health Response ◽  
The Public ◽  
Public Health Infrastructure ◽  
Health Infrastructure

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )

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.

Prenatal Care among Low-Income Women

1994 ◽  
Vol 75 (3) ◽  
pp. 152-159 ◽  
Author(s):  
Marjorie A. Schaffer ◽  
Betty Lia-Hoagberg
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Low Income ◽  
Healthcare Personnel ◽  
Care Providers ◽  
Healthy Baby ◽  
Low Income Women ◽  
High Level

Forty low-income pregnant women were interviewed about the personal, family, and provider rewards and costs they experienced in obtaining prenatal care. The women identified important rewards as the health of their babies, their own health, partner's desire for a healthy baby, monitoring of the pregnancy by qualified healthcare personnel, and the evaluation of problems by health-care providers. The authors suggest strategies to strengthen personal, family, and provider rewards aimed at achieving a high level of prenatal care for low-income women.

Successful Strategies to Address Disparities: Insurer and Employer Perspectives

2020 ◽  
pp. 292-300
Author(s):  
Manali I. Patel ◽  
Richard Snyder ◽  
Otis Brawley
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Cancer Disparities ◽  
Care Providers ◽  
High Quality ◽  
Quality Cancer Care

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Addressing social determinants of health, such as removing obstacles to health (e.g., poverty, discrimination, access to housing and education, jobs with fair pay, and health care) can reduce cancer disparities. However, to achieve cancer health equity, multilevel approaches are required to ensure that access to high-quality cancer care and equitable receipt of evidence-based services can reduce cancer disparities. Policy, health system interventions, and innovative delivery and health care coverage approaches by private and public payers, employer-based payers, and labor union organizations can assist in ensuring access to and receipt of high-quality cancer care while addressing the high costs of care delivery. Partnerships among patients, caregivers, employers, health care providers, and health care payers can make impactful changes in the way in which cancer care is delivered and, in turn, can assist in reducing cancer disparities.

scholarly journals THE ROLE OF CULTURE AND LANGUAGE IN DEPRESSION CARE EXPERIENCES AMONG OLDER LATINAS/OS AND HEALTH CARE PROVIDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S585-S586
Author(s):  
Maria P Aranda ◽  
Janelle Christensen ◽  
Iris Aguilar
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Quality Care ◽  
Intervention Development ◽  
Relationship Building ◽  
Care Providers ◽  
Depression Care ◽  
Study Implementation ◽  
Shared Culture

Abstract Older Latinas/os face significant difficulties in accessing quality depression treatment due to cultural and language barriers. In our study, Programa Esperanza (a randomized behavioral trial), we conducted after-treatment, in-depth interviews with two groups: 21 low-income Latinas/os (55+) receiving psychosocial depression care (Problem Solving Treatment, and Psychoeducation) in a health care setting, and 22 staff (interventionists, supervisors) participating in study implementation. Speaking the same language was highlighted by both groups as an overarching factor in effective depression care, although matching providers and patients by country of origin was considered less a priority than a shared language. The mechanisms by which language serves as a facilitator of effective care were highlighted: fomenting rapport; facilitating the expression of feelings; shortening initial relationship-building; understanding nuanced words and linguistic expressions; etc. Similarly, we found that shared culture included themes around intervention uptake, decreased stigma, increased advocacy, enhanced identification of coping strategies, etc. Unlike patients, providers were more likely to speak in diverse narratives of “them,” and “us.” Given that depression is still a stigmatizing disorder in our society, asking for help and receiving quality care remain significant challenges for older persons in general, and older underrepresented minorities, in particular. Our work signals the importance of differentiating language from culture in intervention development for older, primarily Spanish-speaking Latinas/os with high medical comorbidity.

scholarly journals The Pre-Kindergarten Learning Enterprise (PKLE)

2011 ◽  
Vol 15 (3) ◽  
pp. 19
Author(s):  
Kahina Lasfer ◽  
Art Pyster ◽  
Brian Sauser
Keyword(s):  
Health Care ◽  
Home Environment ◽  
Health Care Providers ◽  
Low Income ◽  
Weak Interactions ◽  
Financial System ◽  
Kindergarten Children ◽  
Care Providers ◽  
Role Of Parents ◽  
Effective Development

To meet the challenges that todays pre-Kindergarten children will face as adults, they need effective development and learning organizations. Together, those organizations form the pre-Kindergarten (pre-K) learning enterprise, whose characteristics and behaviors greatly influence what pre-K children learn and how well they learn it. In this paper, the pre-K learning enterprise is explicitly defined and modeled for the first time and then analyzed through a systems thinking lens using systemigrams and related causal loop diagrams. Defining and modeling the pre-K learning enterprise is itself valuable as a means to understand the various relationships that exist among the identified constituent systems (e.g., home environment, preschool, financial, health care, state, and government) and the stakeholders identified within the enterprise (e.g., parents, educators, health care providers, and policy makers). That value is enhanced through an analysis which reveals the predominant reliance of several key pre-K learning enterprise component systems on the financial system while exposing weak interactions among the three main participating systems (preschools, home environment, and government). Heavy reliance on the financial system in todays economy reduces the effectiveness of the pre-K learning enterprise. To ease such reliance on the financial system while enhancing key interrelationships, three improvements to the existing enterprise are postulated: (1) enhance the role of parents through better education on child development, learning, health and nutrition and their increased voluntary involvement with preschools, (2) reduce the dependency on the financial system and promote partnerships among preschools, sports facilities, libraries and other learning systems to share resources, and (3) enhance government role through implementation of curriculum standardization, assessment and evaluation, and an effective policy towards mandatory education of low-income children.

scholarly journals Parent’s Perceptions of Health Care Providers Actions Around Child ICU Death

2012 ◽  
Vol 30 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Dorothy Brooten ◽  
JoAnne M. Youngblut ◽  
Lynn Seagrave ◽  
Carmen Caicedo ◽  
Dawn Hawthorne ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Health Care Providers ◽  
Care Setting ◽  
Child Death ◽  
Racial Group ◽  
Care Providers ◽  
Communication Problems ◽  
Semistructured Interviews ◽  
Parents Involvement

Purpose: To describe parents’ perspectives of health care provider actions that helped or did not around the time of infant/child’s intensive care unit (ICU) death. Semistructured interviews with 63 parents (Black, White, and Hispanic) 7 months post infant/child death were audio-recorded, transcribed, analyzed, and themes identified. Findings: What helped most: compassionate, sensitive staff; understandable explanations of infant’s/child’s condition; experienced, competent nurses; providers did everything to help infant/child; and parents’ involvement in care decisions. What did not help: insensitive, nonsupportive staff; conflict between providers and parents; communication problems around the death; inexperienced nurses and doctors; parents not understanding child’s disease, care, complications. Conclusions: Compassionate, sensitive staff and understandable explanations of children’s conditions were most helpful; insensitive, nonsupportive staff least helpful by gender, racial group, or care setting. Conflict between providers and parents was most problematic for minority parents and mothers.

Communication Between Provider and Patient: Values, Biography, and Empowerment in Clinical Practice

1996 ◽  
Vol 16 (6) ◽  
pp. 747-774 ◽  
Author(s):  
Phillip G. Clark
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Communication Process ◽  
Care Providers ◽  
New Approaches ◽  
Communication Problems ◽  
Patient Values ◽  
The Individual

AbstractCommunication between elderly people and their health care providers is becoming more important due to the chronic nature of geriatric health problems and their impact on quality of life. At the core of the challenge of improving this dialogue are factors related to essential human values and the clash between two different cultures – one scientific and the other personal. Only by gaining an understanding of this clinical decisionmaking interaction can new approaches to bridge the communication gap be developed. The purpose of this paper is fourfold: (1) to summarise the fundamentally different bases for communication between health care provider and patient, (2) to discuss the shortcomings of various methods (such as advance directives) to embody patients’ wishes about their care, (3) to review new models of geriatric care that have implications for this communication process, and (4) to develop a framework – based on biographical methods and the concept of empowerment – that suggests some potential solutions to these communication problems. Such methods reflect new approaches to developing life stories and themes suggestive of ways to retain the personal life voice of the individual in the development of a clinical partnership with the health care provider.

scholarly journals Lessons from the Research Field on Partnership in Pediatric Primary Care with Urban, Low-Income African American Parents

2019 ◽  
Vol 6 (3) ◽  
pp. 5
Author(s):  
Kara Koschmann ◽  
Mary C. Hooke
Keyword(s):  
Health Care ◽  
African American ◽  
Data Collection ◽  
Health Care Providers ◽  
Low Income ◽  
Research Field ◽  
Lessons Learned ◽  
African American Parents ◽  
Care Providers ◽  
Research Findings

Qualitative data collection offers a unique opportunity to partner with research participants. Lessons learned through the process of data collection with urban, low-income, African American parents are reflective of the research findings themselves. Carefully designed research studies can remove barriers and empower participants, broadening the reach and results. Recruitment within communities develops trust, and focus groups offer a more empowering method for interviewing marginalized populations. Parents desire to have solid partnerships with their children’s health-care providers so that with their providers’ guidance, their children can flourish. The process of implementing the research itself, and not just the results, reveals strategies for improving partnership between parents and health-care providers.

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