Healthcare Utilization, Unmet Service Needs, and HIV Treatment Outcomes among Racial/Ethnic Groups

2020 ◽  
Vol 7 (6) ◽  
pp. 584-595
Author(s):  
Xiangjun Zhang ◽  
◽  
Roy Oman ◽  
Trudy Larson ◽  
Elizabeth Christiansen ◽  
...  
Keyword(s):  
African American ◽  
Medication Adherence ◽  
Ethnic Groups ◽  
Service Utilization ◽  
Linkage To Care ◽  
Group Differences ◽  
People Living With Hiv ◽  
Service Needs ◽  
Race Ethnicity ◽  
Racial Ethnic

Objectives: In this study, we aimed to investigate possible racial/ethnic differences regarding service utilization, linkage to care, and medication adherence among people living with HIV/AIDS (PLWHA). Methods: PLWHA (N = 142) 18 years or older were recruited from a needs assessment project conducted in Nevada in 2016. Participants completed a self-administered questionnaire. The study variables included participants’ race/ethnicity (Caucasian, African-American, and Hispanic), service utilization, unmet service needs, linkage to care, and medication adherence. Significant between-group (race/ethnicity) differences regarding service utilization, linkage to care, and medication adherence were assessed. Results: There were no statistically significant between-group differences regarding utilized services, unmet service needs, linkage to care, and medication adherence (p > .05). However, there were statistically significant between-group differences for 4 individual utilized services. For example, African-American participants were 72% less likely to have utilized medical care services than Caucasians (AOR = 0.28, 95% CI = 0.10-0.74) and Hispanics were 84% less likely to have utilized mental health services than Caucasians (AOR = 0.16, 95% CI = 0.04-0.60). Conclusions: Health disparities among racial/ethnic groups exist, specifically regarding certain individual medical and support services. Federal and regional programs must allocate funding to address specific service needs and improve healthcare services for certain racial/ethnic groups.

Abstract P228: Lower Serum 25-hydroxyvitamin D Concentration is Associated With Greater Risk of Non-alcoholic Fatty Liver Disease Among Caucasians but Not Other Racial-ethnic Groups in the Multi Ethnic Study of Atherosclerosis

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Samar R El Khoudary ◽  
Saad Samargandy ◽  
Irfan Zeb ◽  
Temitope Foster ◽  
Ian De Boer ◽  
...  
Keyword(s):  
Risk Factors ◽  
African American ◽  
Liver Disease ◽  
Ethnic Groups ◽  
Alcoholic Fatty Liver ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Alcoholic Fatty Liver Disease

Objective: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in developed nations and is independently associated with increased overall morality from all causes as well as from CVD. Growing evidence support that low serum 25-hydroxyvitamin D ((25OH)D) is associated with NAFLD. However, significant racial/ethnic differences exist in serum 25(OH)D and the prevalence of NAFLD: African Americans have lower 25(OH)D than Caucasians, and NAFLD prevalence is higher in Caucasians. We tested whether the association between 25(OH)D and NAFLD vary by race/ethnicity, adjusting for common risk factors for low 25(OH)D and NAFLD. Methods: Participants were from the MESA study, who were free from CVD and liver conditions, were not taking oral corticosteroids, did not report heavy alcohol intake (>7 drinks/week for women and > 14 drinks/week for men), and had serum 25(OH)D and upper abdominal non-contrast CT images available at baseline. 25(OH)D was adjusted for season. NAFLD was defined if liver-to-spleen Hounsfield units ratio was <1. Logistic regression was used for statistical analyses. Final models were adjusted for study site, age, gender, education, income, BMI, triglycerides, high-density lipoproteins, systolic blood pressure, smoking, diabetes, interlukine-6 and C-reactive protein. Results: The study included3,484 participants (mean age (SD): 62.7(10.4) Yr; 44% of participants were male; 38.4% Caucasian, 27.8% African American, 23.5% Hispanic, and 10.3% Chinese American). Serum 25(OH)D significantly varied by race/ethnicity; with Caucasian have the highest levels and African American have the lowest levels (mean(SD): 29.5(10.4)ng/ml vs. 19.6(9.1)ng/ml, respectively, p<0.0001). NAFLD was present among 17.5% (n=611) of the participants; with Hispanic showing the highest prevalence rate (26.2%) followed by Chinese American (19.8%), Caucasian (15.8%) and African American (11.7%), P=<0.0001. In unadjusted and final models, the association of 25(OH)D with NAFLD differed significantly by race/ethnicity (P<0.01). Stratification analyses showed significant negative association only in Causations; such that lower 25(OH)D was significantly associated with higher risk of NAFLD (adjusted OR (95% CI):1.23(1.03, 1.47) per 1 SD decrease in serum 25(OH)D). For other racial/ethnic groups, BMI, triglycerides, diabetic status and/or smoking, but not serum 25(OH)D, were common independent risk factors for NAFLD. Conclusions: The association of 25(OH)D with NAFLD varies by race/ethnicity. Future studies should assess if targeting vitamin D deficiency in Caucasians may reduce their higher risk of NAFLD above and beyond controlling other modifiable risk factors, whereas, controlling modifiable risk factors, excluding vitamin D, may be more important in reducing NAFLD risk in other racial/ethnic groups.

Healthcare Utilization, Unmet Service Needs, and Medication Adherence Among People Living with HIV/AIDS

2020 ◽  
Vol 18 (6) ◽  
pp. 436-442
Author(s):  
Xiangjun Zhang ◽  
Roy F. Oman ◽  
Trudy A. Larson ◽  
Elizabeth J. Christiansen ◽  
Michelle L. Granner ◽  
...  
Keyword(s):  
Health Promotion ◽  
Service Utilization ◽  
Medical Service ◽  
Outcome Variable ◽  
People Living With Hiv ◽  
Service Needs ◽  
Art Adherence ◽  
Living With Hiv ◽  
Adherence Group ◽  
Hiv Aids

Background: Comorbidity rates and service needs are high among people living with HIV/AIDS (PLWHA). The effects of service utilization and unmet service needs on antiretroviral therapy (ART) adherence are not well understood. The purpose of this study was to investigate associations among PLWHA’s service utilization, unmet service needs, and ART adherence. Methods: PLWHA (N=162) 18 years or older were recruited from a Nevada statewide needs assessment project in 2016. Participants completed a self-administered questionnaire on paper or online. The independent variables were service utilization and unmet service needs. The outcome variable was ART adherence. Multivariable logistic regression analyses were conducted to examine associations between the amount of utilized services and unmet service needs with ART adherence. Results: Only 12 (7.5%) participants reported they received all needed services. The ART non-adherence group showed significantly higher unmet medical service needs compared to the ART adherence group (p=0.007). Unmet medical service needs (Adjusted Odds Ratio (AOR) 0.69, CI 0.53-0.90) and unmet support service needs (AOR 0.68, CI 0.48-0.97) were negatively associated with ART adherence. However, utilizing medical services (AOR 1.06, CI 0.87-1.30) and support services (AOR 0.88, CI 0.74-1.04) in the current year were not significantly associated with ART adherence. Conclusion: The results of this study indicate that health promotion programming should focus not only on introducing new services at the community level, but also work to optimize the availability and awareness of current services. Furthermore, health promotion programs should focus on filling service coverage gaps and improving the facilitation of services.

scholarly journals Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Priya Bhagwat ◽  
Shashi N Kapadia ◽  
Heather J Ribaudo ◽  
Roy M Gulick ◽  
Judith S Currier
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Socioeconomic Factors ◽  
Ethnic Groups ◽  
Virologic Failure ◽  
Virologic Suppression ◽  
Factors Associated ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

Racial/Ethnic Differences in Alcohol and Drug Misuse Among IPV-Victimized Women: Exploring the Role of Difficulties Regulating Positive Emotions

2020 ◽  
pp. 088626052094373
Author(s):  
Nicole H. Weiss ◽  
Melissa R. Schick ◽  
Ateka A. Contractor ◽  
Miranda E. Reyes ◽  
Nazaret C. Suazo ◽  
...  
Keyword(s):  
African American ◽  
Partner Violence ◽  
Positive Emotions ◽  
Past Research ◽  
Drug Misuse ◽  
Emotional Dysfunction ◽  
Culturally Sensitive Interventions ◽  
Race Ethnicity ◽  
Racial Ethnic

Alcohol and drug misuse is prevalent and problematic among women who experience intimate partner violence (IPV). Emotional dysfunction has been identified as a key mechanism in the etiology, maintenance, and treatment of alcohol and drug misuse. However, existing research has not considered the role of race/ethnicity in the relations between emotional dysfunction and alcohol and drug misuse. Furthermore, past research in this area has focused almost exclusively on emotional dysfunction stemming from negative (vs. positive) emotions. The goals of the current study were as follows: (a) to explore whether levels of difficulties regulating positive emotions differ among Latina, African American, and White IPV-victimized women, and (b) to examine the moderating role of race/ethnicity in the relations between difficulties regulating positive emotions and alcohol and drug misuse. Participants were 197 IPV-victimized women recruited through the criminal justice system ( Mage = 36.14; 51.8% African American, 31.5% White, and 16.8% Latina). Difficulties regulating positive emotions did not differ as a function of race/ethnicity. However, relations among difficulties regulating positive emotions and alcohol and drug misuse were significant for Latina and White but not African American IPV-victimized women. Moreover, race/ethnicity moderated an association between difficulties regulating positive emotions and drug misuse; this relation was significant and positive for White (compared with African American) IPV-victimized women. While preliminary, these results may inform culturally sensitive interventions for alcohol and drug misuse that are tailored to the unique needs of Latina, African American, and White IPV-victimized women.

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.

Race, Ethnicity, and the Scarr-Rowe Hypothesis: A Cautionary Example of Fringe Science Entering the Mainstream

2021 ◽  
Author(s):  
Evan Giangrande ◽  
Eric Turkheimer
Keyword(s):  
Systematic Review ◽  
Ethnic Groups ◽  
Meta Analysis ◽  
Scientific Journal ◽  
The United States ◽  
Open Science ◽  
Group Differences ◽  
Ethnic Group Differences ◽  
Race Ethnicity ◽  
Mean Differences

In 2020, Pesta et al. published “Racial and ethnic group differences in the heritability of intelligence: A systematic review and meta-analysis” in Intelligence. The authors frame their analysis as an examination of the Scarr-Rowe hypothesis, which holds that the heritability of intelligence varies as a function of socioeconomic status. Pesta et al. (2020) conclude that the heritability of intelligence does not differ across racial and ethnic groups in the United States. They claim their results challenge the Scarr-Rowe hypothesis and support the hereditarian position that mean differences in IQ among racial and ethnic groups are attributable to genetic differences rather than environmental disparities. In this reply, we outline severe theoretical, methodological, and rhetorical flaws in every step of Pesta et al.’s meta-analysis. The most reliable finding Pesta et al. report is consistent with the Scarr-Rowe hypothesis and directly contradicts a hereditarian understanding of group differences in intelligence. Finally, we suggest that Pesta et al. (2020) serves as an example of how racially motivated and poorly executed work can find its way into a mainstream scientific journal, underscoring the importance of robust peer review and rigorous editorial judgement in the open science era.

scholarly journals New Measures Assessing Predictors of Academic Persistence for Historically Underrepresented Racial/Ethnic Undergraduates in Science

2016 ◽  
Vol 15 (3) ◽  
pp. ar32 ◽  
Author(s):  
Angela Byars-Winston ◽  
Jenna Rogers ◽  
Janet Branchaw ◽  
Christine Pribbenow ◽  
Ryan Hanke ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Undergraduate Students ◽  
Self Efficacy ◽  
Outcome Expectations ◽  
National Sample ◽  
Group Differences ◽  
Internal Reliability ◽  
Black African ◽  
Broadening Participation ◽  
Racial Ethnic

An important step in broadening participation of historically underrepresented (HU) racial/ethnic groups in the sciences is the creation of measures validated with these groups that will allow for greater confidence in the results of investigations into factors that predict their persistence. This study introduces new measures of theoretically derived factors emanating from social cognitive and social identity theories associated with persistence for HU racial/ethnic groups in science disciplines. The purpose of this study was to investigate: 1) the internal reliability and factor analyses for measures of research-related self-efficacy beliefs, sources of self-efficacy, outcome expectations, and science identity; and 2) potential group differences in responses to the measures, examining the main and interaction effects of gender and race/ethnicity. Survey data came from a national sample of 688 undergraduate students in science majors who were primarily black/African American and Hispanic/Latino/a with a 2:1 ratio of females to males. Analyses yielded acceptable validity statistics and race × gender group differences were observed in mean responses to several measures. Implications for broadening participation of HU groups in the sciences are discussed regarding future tests of predictive models of student persistence and training programs to consider cultural diversity factors in their design.

scholarly journals Imagining Her Future: Diversity in Mothers’ Socialization Goals for Their Adolescent Daughters

2017 ◽  
Vol 48 (4) ◽  
pp. 593-610 ◽  
Author(s):  
Jennifer Ramirez ◽  
Linda Oshin ◽  
Stephanie Milan
Keyword(s):  
United States ◽  
African American ◽  
Ethnic Groups ◽  
Low Income ◽  
The United States ◽  
Social Traits ◽  
Socialization Goals ◽  
Racial Ethnic ◽  
Q Sort

According to developmental niche theory, members of different cultural and ethnic groups often have distinct ideas about what children need to become well-adapted adults. These beliefs are reflected in parents’ long-term socialization goals for their children. In this study, we test whether specific themes that have been deemed important in literature on diverse families in the United States (e.g., Strong Black Woman [SBW], marianismo, familismo) are evident in mothers’ long-term socialization goals. Participants included 192 mothers of teenage daughters from a low-income city in the United States (58% Latina, 22% African American, and 20% European American [EA]/White). Socialization goals were assessed through a q-sort task on important traits for a woman to possess and content analysis of open-ended responses about what values mothers hoped they would transmit to their daughters as they become adults. Results from ANCOVAs and logistic regression indicate significant racial/ethnic differences on both tasks consistent with hypotheses. On the q-sort task, African American mothers put more importance on women possessing traits such as independence than mothers from other racial/ethnic groups. Similarly, they were more likely to emphasize self-confidence and strength in what they hoped to transmit to their daughters. Contrary to expectation, Latina mothers did not emphasize social traits on the q-sort; however, in open-ended responses, they were more likely to focus on the importance of motherhood, one aspect of marianismo and familismo. Overall, results suggest that these mothers’ long-term socialization goals incorporate culturally relevant values considered important for African American and Latino families.

scholarly journals Racial/Ethnic Disparities in Mammogram Frequency Among Women With Intellectual Disability

2019 ◽  
Vol 57 (3) ◽  
pp. 177-187 ◽  
Author(s):  
Evelyn Arana ◽  
Amy Carroll-Scott ◽  
Philip M. Massey ◽  
Nora L. Lee ◽  
Ann C. Klassen ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Black Women ◽  
Medical Record ◽  
Ethnic Groups ◽  
White Women ◽  
Ethnic Disparities ◽  
Medical Record Data ◽  
Record Data ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Little information exists on the associations between intellectual disability (ID) and race/ethnicity on mammogram frequency. This study collected survey and medical record data to examine this relationship. Results indicated that Hispanic and Black women with ID were more likely than White women with ID to have mammograms every 2 years. Participants who live in a state-funded residence, were aged 50+, and had a mild or moderate level of ID impairment were more likely to undergo mammography compared to participants living with family or alone, were &lt;50, and had severe ID impairment. Further research is needed to understand the mechanisms explaining disparities in mammograms between these racial/ethnic groups.

Worshiping across the Color Line: The Influence of Congregational Composition on Whites’ Friendship Networks and Racial Attitudes

2018 ◽  
Vol 5 (1) ◽  
pp. 100-114 ◽  
Author(s):  
Edward C. Polson ◽  
Kevin D. Dougherty
Keyword(s):  
Ethnic Groups ◽  
Ethnic Diversity ◽  
Ethnic Composition ◽  
Friendship Networks ◽  
Color Line ◽  
Recent Scholarship ◽  
Multiracial Congregations ◽  
Race Ethnicity ◽  
American Society ◽  
Racial Ethnic

Religious participation has reinforced the color line in American society for generations. Despite rising racial and ethnic diversity across U.S. communities, most Americans continue to belong to congregations composed primarily of others from their own racial/ethnic groups. Yet recent scholarship suggests that the presence of multiple racial or ethnic groups in the same congregation is increasing. The authors examine how the racial/ethnic composition of U.S. congregations is related to white attenders’ friendship networks and comfort with other racial/ethnic groups (i.e., blacks, Hispanics, and Asians). Using national survey data, the authors find that whites in multiracial congregations report more diverse friendship networks and higher levels of comfort with nonwhites than do whites in nonmultiracial congregations. However, the influence of worshipping with another race/ethnicity seems to be most pronounced for whites in congregations with Hispanics. Moreover, neighbors and friends of other races have more impact on whites’ friendship networks and attitudes than do congregations. The authors discuss implications of these findings for understanding U.S. intergroup relations and the potential of congregations to address the color line.

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