Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Race/ethnic disparities in risk factor control and survival in the bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) trial.(2013) Beohar, Nirat; Sansing, Veronica V.; Davis, Andrew M.; Srinivas, V. S.; Helmy, Tarek; Althouse, Andrew D.; Thomas, Stephen B.; Brooks, Maria MoriThis study sought to evaluate the impact of race/ethnicity on cardiovascular risk factor control and on clinical outcomes in a setting of comparable access to medical care. The BARI 2D trial enrolled 1,750 participants from the United States and Canada that self-reported either White non-Hispanic (n [ 1,189), Black non-Hispanic (n =349), or Hispanic (n =212) race/ethnicity. Participants had type 2 diabetes and coronary artery disease and were randomized to cardiac and glycemic treatment strategies. All patients received intensive target-based medical treatment for cardiac risk factors. Average follow-up was 5.3 years. Kaplan-Meier survival curves and Cox proportional hazards regression models were constructed to assess potential differences in mortality and cardiovascular outcomes across racial/ethnic groups. Long-term risk of death and death/myocardial infarction/stroke did not vary significantly by race/ethnicity (5-year death: 11.0% Whites, 13.7% Blacks, 8.7% Hispanics, p =0.19; adjusted hazard ratio 1.18 Black versus White, 95% confidence interval 0.84 to 1.67, p = 0.33 and 0.82 Hispanic versus White, 95% confidence interval 0.51 to 1.34, p =0.43). Among the 1,168 patients with suboptimal risk factor control at baseline, the ability to attain better risk factor control during the trial was associated with higher 5-year survival (71%, 86% and 95% for patients with 0 or 1, 2, and 3 factors in control, respectively, p <0.001); this pattern was observed within each race/ethnic group. In conclusion, significant race/ethnic differences in cardiac risk profiles that persisted during follow-up did not translate into significant differences in 5-year death or death/MI/stroke.Item Attributes of researchers and their strategies to recruit minority populations: Results of a national survey(2012) Quinn, Sandra Crouse; Butler, James; Fryer, Craig S.; Garza, Mary A.; Kim, Kevin H.; Ryan, Christopher; Thomas, Stephen B.Despite NIH mandates for inclusion, recruiting minorities is challenging for biomedical and public health researchers. Little is known about how attributes of researchers affect their choice of recruitment strategies. The purpose of this study was to address this gap by examining how use of recruitment strategies relates to other researcher characteristics. To do this, we conducted an online survey from May to August 2010 with researchers (principal investigators, research staff, and IRB members) in which we measured the number and types of recruitment strategies utilized, along with other characteristics of the researchers and their research. We identified two clusters of researchers: comprehensive researchers who utilized a greater number and more diverse and active recruitment strategies, and traditional researchers, who utilized fewer and more passive strategies. Additional characteristics that distinguished the two groups were that comprehensive researchers were more likely than traditional researchers to 1) report racial and ethnic differences as one of their specific aims or hypotheses, 2) receive federal (CDC and NIH) funding, 3) conduct behavioral or epidemiological research, and 4) have received training in conducting research with and recruiting minorities. Traditional researchers, on the other hand, were more likely to conduct clinical research and a greater (though non-significant) percentage received funding from pharmaceutical sources. This study provides a novel description of how researcher attributes are related to their recruitment strategies and raises a number of future research questions to further examine the implications of this relationship.Item A Plan to Facilitate the Early Career Development of Minority Scholars in the Health Sciences(2010) Berget, Rachael J.; Reynolds, Charles F.; Ricci, Edmund M.; Quinn, Sandra C.; Mawson, Anthony R.; Payton, Marinelle; Thomas, Stephen B.Item The National Bioethics Research Infrastructure Initiative: Building Trust Between Minorities and Researchers.(University of Maryland Center for Health Equity, 2012) Thomas, Stephen B.This video short is one product of our Building Trust between Minorities and Researchers training curriculum. This work is made possible through a grant from the NIH National Institute on Minority Health and Health Disparities. For more information visit www.healthequity.umd.eduItem Attitudes and Beliefs of African-Americans Toward Genetics, Genetic Testing, and Sickle Cell Disease Education and Awareness(2011) Long, Katie A.; Thomas, Stephen B.; Grubs, Robin E.; Gettig, Elizabeth A.; Krishnamurti, LakshmananResearch among African-Americans indicates this population perceives sickle cell (SCD) to be a serious disease and sickle cell trait (SCT) screening an important intervention. However, studies have consistently demonstrated a lower than desired uptake of SCD education, inadequate knowledge regarding personal and family trait status, and a low perceived susceptibility of giving birth to a child with the disease. We examined general attitudes and beliefs regarding genetics and genetic testing including prenatal testing and newborn screening; we used this information as the foundation to more specifically assess attitudes and beliefs regarding SCD and perceived barriers to SCD education and awareness. Thirty-five African-American adult men and women participated in one of four focus groups. Thematic analysis identified that both prenatal testing and newborn screening are acceptable forms of genetic testing. Based largely on their personal experiences, participants possessed an understanding of the natural progression of SCD but had a limited understanding of the inheritance and probable risk of giving birth to a child with the disease. Barriers to education and greater awareness of SCD were classified as personal, familial, and societal. Community based interventions focused on sharing the stories of individuals with first-hand experiences with SCD should be considered.Item The Urban Context: A Place to Eliminate Health Disparities and Build Organizational Capacity(2010) Gilbert, Keon L.; Quinn, Sandra Crouse; Ford, Angela F.; Thomas, Stephen B.This study seeks to examine the process of building the capacity to address health disparities in several urban African American neighborhoods. An inter-organizational network consisting of a research university, community members, community organizations, media partners, and foundations was formed to develop a community-based intervention designed to provide health promotion and disease prevention strategies for type 2 diabetes and hypertension. In-depth qualitative interviews (n = 18) with foundation executives and project directors, civic organization leadership, community leaders, county epidemiologist, and university partners were conducted. Our study contextualizes a process to build a public health partnership using cultural, community, organizational, and societal factors necessary to address health disparities. Results showed 5 important factors to build organizational capacity: leadership, institutional commitment, trust, credibility, and inter-organizational networks. These factors reflected other important organizational and community capacity indicators such as: community context, organizational policies, practices and structures, and the establishment of new commitments and partnerships important to comprehensively address urban health disparities. Understanding these factors to address African American health disparities will provide lessons learned for health educators, researchers, practitioners, foundations, and communities interested in building and sustaining capacity efforts through the design, implementation, and maintenance of a community-based health promotion interventionItem A comparison of the frequencies of risk factors for depression in older black and white participants in a study of indicated prevention(2010) Sriwattanakomen, Roy; McPherron, Jesse; Chatman, Jamie; Morse, Jennifer Q.; Martire, Lynn M.; Karp, Jordan F.; Houck, Patricia R.; Bensasi, Salem; Houle, Jill; Stack, Jacqueline A.; Woods, Mattie; Block, Bruce; Thomas, Stephen B.; Quinn, Sandra; Reynolds, Charles F.BACKGROUND: To compare the frequencies of risk factors, we describe risks for depression as a function of race among consecutively admitted participants in a randomized clinical trial of indicated depression prevention in later life. METHODS: Seventy-two black and 143 white participants were screened for risk factors for depression. RESULTS: Black participants were more likely to have fewer years of education and lower household income. They were more likely to be obese, live alone, experience functional disability, have a history of alcohol and drug abuse, and have lower scores on the Mini-mental State Examination and the Executive Interview (EXIT). White participants were not found to have greater prevalence or higher mean score on any risk factor. On average, black participants experienced approximately one more risk factor than white participants (t(213) = 3.32, p = 0.0011). CONCLUSIONS: In our sample, black participants had higher frequencies of eight risk factors for depression and a greater mean number of risk factors compared to white participants.Item Toward a fourth generation of disparities research to achieve health equity(2011) Thomas, Stephen B.; Quinn, Sandra Crouse; Butler, James; Fryer, Craig S.; Garza, Mary A.Achieving health equity, driven by the elimination of health disparities, is a goal of Healthy People 2020. In recent decades, the improvement in health status has been remarkable for the U.S. population as a whole. However, racial and ethnic minority populations continue to lag behind whites with a quality of life diminished by illness from preventable chronic diseases and a life span cut short by premature death. We examine a conceptual framework of three generations of health disparities research to understand (a) data trends, (b) factors driving disparities, and (c) solutions for closing the gap. We propose a new, fourth generation of research grounded in public health critical race praxis, utilizing comprehensive interventions to address race, racism, and structural inequalities and advancing evaluation methods to foster our ability to eliminate disparities. This new generation demands that we address the researcher's own biases as part of the research process.Item Mapping a Course for Community Action and Research to Eliminate Disparities: Welcoming Remarks and Introductions(2001) Thomas, Stephen B.MP3 audio files recorded by the Pennsylvania and Ohio Public Health Training Center at the First Annual Minority Health Leadership SummitItem Racial Differences in Parents' Distrust of Medicine and Research(2009) Rajakumar, Kumaravel; Thomas, Stephen B.; Musa, Donald; Almario, Donna; Garza, Mary A.Objective To assess and compare the attitudes and trust that African American and white parents have toward their children participating in research. Design Self-administered, cross-sectional survey of a convenience sample of parents. Setting Primary Care Center at Children's Hospital of Pittsburgh from August 2004 through April 2005. Participants One hundred ninety parents (140 African American and 50 white parents). Outcome Measure Parental distrust of medical research as measured by a summative score of distrusting responses to 8 questions assessing trust in research. Results African American parents had significantly greater distrust than white parents (67% vs 50%, P = .04). Education was also associated with having significantly greater distrust (74% of those with
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