scholarly journals A Portfolio Analysis of Culturally Tailored Trials to Address Health and Healthcare Disparities

2018 ◽  
Vol 15 (9) ◽  
pp. 1859 ◽  
Author(s):  
Marisa Torres-Ruiz ◽  
Kaitlynn Robinson-Ector ◽  
Dionna Attinson ◽  
Jamie Trotter ◽  
Ayodola Anise ◽  
...  
Keyword(s):  
Behavioral Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Healthcare Disparities ◽  
Clinical Effectiveness ◽  
Patient Centered ◽  
Low Health Literacy ◽  
Bisexual And Transgender ◽  
Cultural Tailoring ◽  
Priority Populations

In 2010, Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to improve the quality and relevance of evidence available to help patients, caregivers, employers, insurers, and policy makers make better-informed health decisions. We conducted a qualitative analysis of behavioral health trials in the PCORI Addressing Disparities portfolio to examine cultural tailoring strategies across the following priority populations: racial and ethnic minorities, rural populations, people with low-income or low socioeconomic status, individuals with disabilities, people with low health literacy, and lesbian, gay, bisexual, and transgender (LGBT) communities. The Common Strategies for Enhancing Cultural Appropriateness model was used to examine cultural tailoring strategies within trials. We hypothesized increased intersectionality within a patient population at risk for disparities would correlate with the dosage and type of cultural tailoring strategies applied. Thirty-three behavioral health trials applied cultural tailoring strategies and a majority of trials (n = 30) used three or more strategies. Trends in cultural tailoring were associated with certain racial and ethnic groups; however, increased use of tailoring was not associated with the number of priority populations included in a trial. The PCORI Addressing Disparities portfolio demonstrates how a range of cultural tailoring strategies are used, within comparative clinical effectiveness research trials, to address the needs and intersectionality of patients to reduce health and healthcare disparities.

scholarly journals Socioeconomic Disparities in Foods/Beverages and Nutrients Consumed by U.S. Adolescents When Snacking: National Health and Nutrition Examination Survey 2005–2018

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2530
Author(s):  
Navika Gangrade ◽  
Janet Figueroa ◽  
Tashara M. Leak
Keyword(s):  
National Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
High Income ◽  
Future Research ◽  
Nutrition Examination Survey ◽  
Middle Income ◽  
Low Socioeconomic ◽  
Health And Nutrition ◽  
Income Ratio

Snacking contributes a significant portion of adolescents’ daily energy intake and is associated with poor overall diet and increased body mass index. Adolescents from low socioeconomic status (SES) households have poorer snacking behaviors than their higher-SES counterparts. However, it is unclear if the types of food/beverages and nutrients consumed during snacking differ by SES among adolescents. Therefore, this study examines SES disparities in the aforementioned snacking characteristics by analyzing the data of 7132 adolescents (12–19 years) from the National Health and Nutrition Examination Survey 2005–2018. Results reveal that adolescents from low-income households (poverty-to-income ratio (PIR) ≤ 1.3) have lower odds of consuming the food/beverage categories “Milk and Dairy” (aOR: 0.74; 95% CI: 0.58-0.95; p = 0.007) and “Fruits” (aOR: 0.62, 95% CI: 0.50–0.78; p = 0.001) as snacks and higher odds of consuming “Beverages” (aOR: 1.45; 95% CI: 1.19-1.76; p = 0.001) compared to those from high-income households (PIR > 3.5). Additionally, adolescents from low- and middle-income (PIR > 1.3–3.5) households consume more added sugar (7.98 and 7.78 g vs. 6.66 g; p = 0.012, p = 0.026) and less fiber (0.78 and 0.77 g vs. 0.84 g; p = 0.044, p = 0.019) from snacks compared to their high-income counterparts. Future research is necessary to understand factors that influence snacking among adolescents, and interventions are needed, especially for adolescents from low-SES communities.

scholarly journals Low socioeconomic status is associated with self-reported HIV positive status among young MSM in Brazil and Peru

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thiago S. Torres ◽  
Lara E. Coelho ◽  
Kelika A. Konda ◽  
E. Hamid Vega-Ramirez ◽  
Oliver A. Elorreaga ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Latin American ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Sexual Attraction ◽  
Hiv Positive ◽  
Sociodemographic Characteristics ◽  
Hiv Status ◽  
Hiv Test ◽  
Young Msm

Abstract Background Despite efforts to stop HIV epidemic in Latin America, new HIV cases continue to increase in the region especially among young MSM (YMSM). This study aims to assess if sociodemographic characteristics are associated with self-reported HIV positive status among YMSM from three Latin American countries. Methods Cross-sectional web-based survey advertised on dating apps (Grindr and Hornet) and Facebook in Brazil, Mexico and Peru. For this analysis, we included YMSM aged 18–24 years who self-reported their HIV status. We used multivariable logistic regression models for each country separately to verify if sociodemographic characteristics (race, education and income) were associated with HIV self-reported status after adjusting for behavior characteristics (sexual attraction and steady partner). Results Among 43,687 MSM who initiated the questionnaire, 27,318 (62.5%) reported their HIV status; 7001 (25.6%) of whom were YMSM. Most YMSM (83.4%) reported an HIV test in the past year, and 15.7% reported an HIV positive status in Peru, 8.4% in Mexico and 7.7% in Brazil. In adjusted models, low-income was associated with higher odds of self-reported HIV positive status in Brazil (aOR = 1.33, 95%CI: 1.01–1.75) and Peru (aOR = 1.56, 95%CI: 1.02–2.40), but not in Mexico. Lower education was associated with higher odds of self-reported HIV positive status only in Brazil (aOR = 1.35, 95%CI: 1.05–1.75). Conclusions In this large, cross-country study, self-reported HIV positive status among YMSM was high. Lower socioeconomic status was associated with higher odds of self-reported HIV positive status in Brazil and Peru. There is an urgent need for HIV prevention interventions targeting YMSM, and efforts to address low-income YMSM are especially needed in Peru and Brazil.

Longitudinal Links between Income Dynamics and Young Adult Socioeconomic and Behavioral Health Outcomes

2021 ◽  
pp. 0044118X2199638
Author(s):  
Kendra Whitfield ◽  
Laura Betancur ◽  
Portia Miller ◽  
Elizabeth Votruba-Drzal
Keyword(s):  
Young Adult ◽  
Health Outcomes ◽  
Behavioral Health ◽  
Low Income ◽  
Family Income ◽  
Adult Outcomes ◽  
Income Volatility ◽  
Income Loss ◽  
Socioeconomic Outcomes ◽  
Young Adult Outcomes

Longitudinal links between childhood family income and adult outcomes are well documented. However, research on childhood income volatility and young adult outcomes is limited. This study utilizes data from the NLSY ( N = 6,410) to examine how childhood family income and income volatility relate to socioeconomic outcomes and mental/behavioral health in emerging adulthood. Results show that lower childhood income was associated with young adult socioeconomic and behavioral health outcomes. Higher income volatility was associated with increased depression and teen parenthood during young adulthood. Additional analyses examining trajectories of income volatility illustrated that children in families with unstable income trajectories (i.e., frequent income losses and gains) showed higher depression scores than those with stable trajectories. These findings suggest that income volatility, not just income level or income loss, is important to consider when studying economic disparities in young adult outcomes. Implications for policies and programs for low-income, high-volatility households are discussed.

scholarly journals Current Evidence and Future Perspectives on the Effective Practice of Patient-Centered Laboratory Medicine

2015 ◽  
Vol 61 (4) ◽  
pp. 589-599 ◽  
Author(s):  
Mike J Hallworth ◽  
Paul L Epner ◽  
Christoph Ebert ◽  
Corinne R Fantz ◽  
Sherry A Faye ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Clinical Effectiveness ◽  
Laboratory Medicine ◽  
Current Evidence ◽  
Patient Centered ◽  
Definition Of ◽  
Current Utilization ◽  
Measures Of Effectiveness ◽  
The Impact ◽  
Primary Measure

AbstractBACKGROUNDSystematic evidence of the contribution made by laboratory medicine to patient outcomes and the overall process of healthcare is difficult to find. An understanding of the value of laboratory medicine, how it can be determined, and the various factors that influence it is vital to ensuring that the service is provided and used optimally.CONTENTThis review summarizes existing evidence supporting the impact of laboratory medicine in healthcare and indicates the gaps in our understanding. It also identifies deficiencies in current utilization, suggests potential solutions, and offers a vision of a future in which laboratory medicine is used optimally to support patient care.SUMMARYTo maximize the value of laboratory medicine, work is required in 5 areas: (a) improved utilization of existing and new tests; (b) definition of new roles for laboratory professionals that are focused on optimizing patient outcomes by adding value at all points of the diagnostic brain-to-brain cycle; (c) development of standardized protocols for prospective patient-centered studies of biomarker clinical effectiveness or extraanalytical process effectiveness; (d) benchmarking of existing and new tests in specified situations with commonly accepted measures of effectiveness; (e) agreed definition and validation of effectiveness measures and use of checklists for articles submitted for publication. Progress in these areas is essential if we are to demonstrate and enhance the value of laboratory medicine and prevent valuable information being lost in meaningless data. This requires effective collaboration with clinicians, and a determination to accept patient outcome and patient experience as the primary measure of laboratory effectiveness.

Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis

2021 ◽  
pp. 238008442110356
Author(s):  
D.J. Gaskin ◽  
H. Zare ◽  
R. McCleary ◽  
O. Kanwar ◽  
A.L. Davis
Keyword(s):  
Socioeconomic Status ◽  
Oral Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
The United States ◽  
Permanent Teeth ◽  
Dental Visit ◽  
Low Socioeconomic ◽  
The Past ◽  
Dental Needs

Objective: To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. Method: Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents. Results: Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y. Conclusion: Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health. Knowledge Transfer Statement: Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.

Patient-Centered Medical Home Membership Is Associated with Decreased Hospital Admissions for Emergency Department Behavioral Health Patients

2018 ◽  
Vol 21 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Akuh Adaji ◽  
Gabrielle J. Melin ◽  
Ronna L. Campbell ◽  
Christine M. Lohse ◽  
Jessica J. Westphal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Behavioral Health ◽  
Medical Home ◽  
Hospital Admissions ◽  
Patient Centered Medical Home ◽  
Patient Centered

“Broken windows”: Relationship between neighborhood conditions and behavioral health among low-income African American adolescents

2016 ◽  
Vol 23 (4) ◽  
pp. 527-537 ◽  
Author(s):  
Dexter R Voisin ◽  
Dong Ha Kim
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
African American ◽  
Behavioral Health ◽  
Low Income ◽  
Mental Health Problems ◽  
African American Youth ◽  
African American Adolescents ◽  
Broken Windows ◽  
Neighborhood Conditions

This study explored the association between neighborhood conditions and behavioral health among African American youth. Cross-sectional data were collected from 683 African American youth from low-income communities. Measures for demographics, neighborhood conditions (i.e. broken windows index), mental health, delinquency, substance use, and sexual risk behaviors were assessed. Major findings indicated that participants who reported poorer neighborhood conditions compared to those who lived in better living conditions were more likely to report higher rates of mental health problems, delinquency, substance use, and unsafe sexual behaviors. Environmental factors need to be considered when addressing the behavioral health of low-income African American youth.

scholarly journals Clinical effectiveness of drugs in hospitalized patients with COVID-19 infection: a systematic review and meta-analysis.

2020 ◽  
Author(s):  
Roberto Ariel Abeldano Zuniga ◽  
Silvia Coca ◽  
Giuliana Abeldano ◽  
Ruth Ana Maria Gonzalez Villoria
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Low Income ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Hospitalized Patients ◽  
Low Income Countries ◽  
Qualitative Synthesis

Objective. The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. Method. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization), virological clearance, and severe adverse events. Results. A total of 48 studies were retrieved from the databases. Ten articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. Conclusions. Dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. Significance of results. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries; since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources. Keywords: Drugs; Antivirals; Clinical improvement; Mortality; COVID-19; SARS-CoV2.

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