Improving Health Equity and Reducing Pediatric Cancer Disparities: The Role of the Medical Home

2022 ◽  
Vol 51 (1) ◽  
Author(s):  
Alexandra Rodriguez-Hernandez ◽  
Justine M. Kahn
Keyword(s):  
Health Equity ◽  
Pediatric Cancer ◽  
Medical Home ◽  
Cancer Disparities

ACE2/Angiotensin-(1-7)/Mas Receptor Axis in Human Cancer: Potential Role for Pediatric Tumors

2020 ◽  
Vol 21 (9) ◽  
pp. 892-901 ◽  
Author(s):  
Ana Luiza Ataide Carneiro de Paula Gonzaga ◽  
Vitória Andrade Palmeira ◽  
Thomas Felipe Silva Ribeiro ◽  
Larissa Braga Costa ◽  
Karla Emília de Sá Rodrigues ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Angiotensin Ii ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Human Cancer ◽  
Experimental Studies ◽  
At1 Receptor ◽  
Pediatric Tumors ◽  
Mas Receptor

Background: Pediatric tumors remain the highest cause of death in developed countries. Research on novel therapeutic strategies with lesser side effects is of utmost importance. In this scenario, the role of Renin-Angiotensin System (RAS) axes, the classical one formed by angiotensinconverting enzyme (ACE), Angiotensin II and AT1 receptor and the alternative axis composed by ACE2, Angiotensin-(1-7) and Mas receptor, have been investigated in cancer. Objective: This review aimed to summarize the pathophysiological role of RAS in cancer, evidence for anti-tumor effects of ACE2/Angiotensin-(1-7)/Mas receptor axis and future therapeutic perspectives for pediatric cancer. Methods: Pubmed, Scopus and Scielo were searched in regard to RAS molecules in human cancer and pediatric patients. The search terms were “RAS”, “ACE”, “Angiotensin-(1-7)”, “ACE2”, “Angiotensin II”, “AT1 receptor”, “Mas receptor”, “Pediatric”, “Cancer”. Results: Experimental studies have shown that Angiotensin-(1-7) inhibits the growth of tumor cells and reduces local inflammation and angiogenesis in several types of cancer. Clinical trials with Angiotensin-( 1-7) or TXA127, a pharmaceutical grade formulation of the naturally occurring peptide, have reported promising findings, but not enough to recommend medical use in human cancer. In regard to pediatric cancer, only three articles that marginally investigated RAS components were found and none of them evaluated molecules of the alternative RAS axis. Conclusion: Despite the potential applicability of Angiotensin-(1-7) in pediatric tumors, the role of this molecule was never tested. Further clinical trials are necessary, also including pediatric patients, to confirm safety and efficiency and to define therapeutic targets.

scholarly journals Using qualitative and participatory methods to refine implementation strategies: universal family psychosocial screening in pediatric cancer

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Janet A. Deatrick ◽  
Anne E. Kazak ◽  
Rebecca E. Madden ◽  
Glynnis A. McDonnell ◽  
Katherine Okonak ◽  
...  
Keyword(s):  
Health Equity ◽  
Pediatric Cancer ◽  
Universal Screening ◽  
Implementation Strategies ◽  
Interactive Systems ◽  
Psychosocial Risk ◽  
Care Providers ◽  
Psychosocial Screening ◽  
Universal Family ◽  
Key Stakeholders

Abstract Background Children with cancer and their families are at risk for short- and long-term psychosocial difficulties. Screening for psychosocial risk remains inconsistent, leading to inequitable access to psychosocial services. The Psychosocial Assessment Tool (PAT) is an evidence-based caregiver report screener of family psychosocial risk ready for implementation in a nationwide cluster randomized trial that will test two implementation strategies across 18 pediatric cancer centers. The current study, conducted in preparation for the trial, solicited the perspectives of key stakeholders about two proposed implementation strategies identified during previous research which focus on health equity and screening of all families (universal screening). Results were used to refine the implementation strategies for testing in the subsequent trial. Methods Semi-structured interviews with 19 key stakeholders (parents, health care providers, pediatric oncology organizations, and pediatric healthcare leaders) were conducted regarding the two implementation strategies. Strategy I is a training webinar; Strategy II is training + implementation enhanced resources, which includes a champion at each site and monthly peer support consultation calls. Data were analyzed using directed content analysis with deductively derived codes based on the Interactive Systems Framework and inductive codes based on emerging data. Results Stakeholder interviews provided rich data to rigorously modify the proposed implementation strategies. Implementation strategies were modified in consistent with these recommendations: engaging providers by framing family psychosocial screening as an opportunity for more efficient and effective practice; setting clear expectations about the importance of screening 100% of children and their families to achieve the goal of universal screening, equity of care, and reduction of disparities; and adapting successful strategies for systematic implementation of screening to ensure optimal engagement with children and their families throughout their care. Conclusions Stakeholder input strengthened implementation strategies by suggesting modifications that emphasized health equity and reduction in health disparities. Using implementation science methods to build on a long-standing program of research provided practical insights about immediate needs of families and historical insights regarding structural inequities such as language differences and access to services. Resulting strategies address all levels of the social ecology for children’s cancer care, including the patient, family, provider, healthcare system, and community. Trial registration NCT04446728 June 23, 2020

Focusing urban policies on health equity: the role of evidence in stakeholder engagement in an Italian urban setting

2021 ◽  
pp. 1-13
Author(s):  
Nicolás Zengarini ◽  
Silvia Pilutti ◽  
Michele Marra ◽  
Alice Scavarda ◽  
Morena Stroscia ◽  
...  
Keyword(s):  
Health Equity ◽  
Stakeholder Engagement ◽  
Urban Setting ◽  
Urban Policies

scholarly journals The Role of Patient Navigators in Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations

2017 ◽  
Vol 23 (3) ◽  
pp. 276-282 ◽  
Author(s):  
Mariana Sarango ◽  
Alexander de Groot ◽  
Melissa Hirschi ◽  
Chukwuemeka Anthony Umeh ◽  
Serena Rajabiun
Keyword(s):  
Medical Home ◽  
Hiv Positive ◽  
Patient Navigators

The Role of Citizen Science in Promoting Health Equity

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Lisa G. Rosas ◽  
Patricia Rodriguez Espinosa ◽  
Felipe Montes Jimenez ◽  
Abby C. King
Keyword(s):  
Public Health ◽  
Citizen Science ◽  
Health Equity ◽  
Healthy Eating ◽  
Mobile Applications ◽  
Health Inequities ◽  
Annual Review ◽  
Publication Date ◽  
Scientific Process

While there are many definitions of citizen science, the term usually refers to the participation of the general public in the scientific process in collaboration with professional scientists. Citizen scientists have been engaged to promote health equity, especially in the areas of environmental contaminant exposures, physical activity, and healthy eating. Citizen scientists commonly come from communities experiencing health inequities and have collected data using a range of strategies and technologies, such as air sensors, water quality kits, and mobile applications. On the basis of our review, and to advance the field of citizen science to address health equity, we recommend ( a) expanding the focus on topics important for health equity, ( b) increasing the diversity of people serving as citizen scientists, ( c) increasing the integration of citizen scientists in additional research phases, ( d) continuing to leverage emerging technologies that enable citizen scientists to collect data relevant for health equity, and ( e) strengthening the rigor of methods to evaluate impacts on health equity. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Cancer Disparities and Health Equity: A Policy Statement From the American Society of Clinical Oncology

2020 ◽  
Vol 38 (29) ◽  
pp. 3439-3448 ◽  
Author(s):  
Manali I. Patel ◽  
Ana Maria Lopez ◽  
William Blackstock ◽  
Katherine Reeder-Hayes ◽  
E. Allyn Moushey ◽  
...  
Keyword(s):  
Health Equity ◽  
Cancer Care ◽  
Care Delivery ◽  
Sociodemographic Factors ◽  
Cancer Disparities ◽  
Policy Statement ◽  
Structural Barriers ◽  
Cancer Outcomes ◽  
Research Education ◽  
And Gender

ASCO strives, through research, education, and promotion of the highest quality of patient care, to create a world where cancer is prevented and every survivor is healthy. In this pursuit, cancer health equity remains the guiding institutional principle that applies to all its activities across the cancer care continuum. In 2009, ASCO committed to addressing differences in cancer outcomes in its original policy statement on cancer disparities. Over the past decade, despite novel diagnostics and therapeutics, together with changes in the cancer care delivery system such as passage of the Affordable Care Act, cancer disparities persist. Our understanding of the populations experiencing disparate outcomes has likewise expanded to include the intersections of race/ethnicity, geography, sexual orientation and gender identity, sociodemographic factors, and others. This updated statement is intended to guide ASCO’s future activities and strategies to achieve its mission of conquering cancer for all populations. ASCO acknowledges that much work remains to be done, by all cancer stakeholders at the systems level, to overcome historical momentum and existing social structures responsible for disparate cancer outcomes. This updated statement affirms ASCO’s commitment to moving beyond descriptions of differences in cancer outcomes toward achievement of cancer health equity, with a focus on improving equitable access to care, improving clinical research, addressing structural barriers, and increasing awareness that results in measurable and timely action toward achieving cancer health equity for all.

scholarly journals Towards Health Equity in a National Autism Strategy: A Lens on Disparities, Barriers, and Solutions

2021 ◽  
Vol 1 (1) ◽  
pp. 62-72
Author(s):  
Kaela Scott ◽  
Megan Krasnodembski ◽  
Shivajan Sivapalan ◽  
Bonnie Brayton ◽  
Neil Belanger ◽  
...  
Keyword(s):  
Health Care ◽  
Health Equity ◽  
Panel Discussion ◽  
Determinants Of Health ◽  
The Public ◽  
Autistic People ◽  
People First ◽  
The Government ◽  
Services And Supports

Health equity allows people to reach their full health potential and access and receive care that is fair and suitable to them and their needs regardless of where they live, what they have, or who they are. To achieve health equity, equity in healthcare focuses on the role of the health system to provide timely and appropriate care. When viewed in the context of a National Autism Strategy, this extends to ensuring access to the resources that each Autistic person requires to meet their health needs, such as an autism diagnosis, services, and supports. Based on the equity panel discussion held at the Canadian Autism Leadership Summit 2020, this article reflects on the current disparities and barriers to achieving health equity in a National Autism Strategy, and outlines ways to address them. Disparities to equitable care within the autism community extend from the level of support needs of an individual to how those intersect with several key determinants of health including: geography, culture, gender, and socioeconomic status. Notably, barriers arise due to a “lack of” theme, including lack of awareness, knowledge, access, and voice. Four reoccurring ideas were identified for how to address inequities in health care for Autistic people. First, allocate resources for regional or in-community endeavours; second, improve Autistic representation and connection; third, establish a community of allies to advocate and collaborate; and fourth, establish leadership within the community and government to make disability a priority for Canada. To achieve equity in health care in a National Autism Strategy, we need to look at the intersectionality of autism with the key determinants of health. Moreover, to effectively engage with the government, health professionals, and the public, the autism community should strive to find a unified and diverse voice. And finally, conversation must turn to action. 

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