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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Now showing 1 - 10 of 718
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    Feasibility Study of Engaging Barbershops for Prostate Cancer Education in Rural African-American Communities
    (2015) Luque, J. S.; Siddartha, Roy; Tarasenko, Yelena; Levi, Ross; Johnson, Jarrett; Gwede, Clement K.
    The barbershop is a promising setting where African-American men might receive information and education about prostate cancer. In this study, we assessed the feasibility of engaging rural barbershops as venues for barbers to deliver a prostate cancer education intervention to increase informed decision-making for prostate cancer screening among customers. Twelve barbershops were recruited from two separate micropolitan areas in Georgia as intervention and control sites. Structured interviews were conducted with 11 barbers in both sites about customer characteristics as well as their willingness to participate in the study. The interviews were audio recorded and transcribed for analysis. In the intervention site, six barbers completed a survey and a pre-/posttest prostate cancer knowledge instrument following training classes. Barbers reported a wide average range of customers served per week (50 to 300). African-American men made up an average of 87 % of customers. Barbers thought prostate cancer was an important discussion topic, felt they would be comfortable discussing it, and supported the participation of their barbershop in the study. For intervention group barbers, there was a statistically significant difference between the average pretest knowledge score of 72 % (mean 12.2, SD = 3.2) and the posttest knowledge score of 89 % (mean 15.2, SD = 1.1) (P = 0.03) on the 17-item prostate cancer knowledge instrument. Based on the multiple interactions with the barbers, there was high receptivity to the topic and consensus about the importance of addressing prostate cancer with their customers. Rural barbershops represent feasible venues for delivering a prostate cancer education intervention.
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    The Systolic Blood Pressure Difference Between Arms and Cardiovascular Disease in the Framingham Heart Study
    (2014) Weinberg, Ido; Gona, Philimon; O'Donnell, Christopher; Jaff, Michael; Murabito, Joanne
    Abstract Background An increased interarm systolic blood pressure difference is an easily determined physical examination finding. The relationship between interarm systolic blood pressure difference and risk of future cardiovascular disease is uncertain. We described the prevalence and risk factor correlates of interarm systolic blood pressure difference in the Framingham Heart Study (FHS) original and offspring cohorts and examined the association between interarm systolic blood pressure difference and incident cardiovascular disease and all-cause mortality. Methods An increased interarm systolic blood pressure difference was defined as ≥10 mm Hg using the average of initial and repeat blood pressure measurements obtained in both arms. Participants were followed through 2010 for incident cardiovascular disease events. Multivariable Cox proportional hazards regression analyses were performed to investigate the effect of interarm systolic blood pressure difference on incident cardiovascular disease. Results We examined 3390 (56.3% female) participants aged 40 years and older, free of cardiovascular disease at baseline, mean age of 61.1 years, who attended a FHS examination between 1991 and 1994 (original cohort) and from 1995 to 1998 (offspring cohort). The mean absolute interarm systolic blood pressure difference was 4.6 mm Hg (range 0-78). Increased interarm systolic blood pressure difference was present in 317 (9.4%) participants. The median follow-up time was 13.3 years, during which time 598 participants (17.6%) experienced a first cardiovascular event, including 83 (26.2%) participants with interarm systolic blood pressure difference ≥10 mm Hg. Compared with those with normal interarm systolic blood pressure difference, participants with an elevated interarm systolic blood pressure difference were older (63.0 years vs 60.9 years), had a greater prevalence of diabetes mellitus (13.3% vs 7.5%,), higher systolic blood pressure (136.3 mm Hg vs 129.3 mm Hg), and a higher total cholesterol level (212.1 mg/dL vs 206.5 mg/dL). Interarm systolic blood pressure difference was associated with a significantly increased hazard of incident cardiovascular events in the multivariable adjusted model (hazard ratio 1.38; 95% CI, 1.09-1.75). For each 1-SD-unit increase in absolute interarm systolic blood pressure difference, the hazard ratio for incident cardiovascular events was 1.07 (95% CI, 1.00-1.14) in the fully adjusted model. There was no such association with mortality (hazard ratio 1.02; 95% CI 0.76-1.38). Conclusions In this community-based cohort, an interarm systolic blood pressure difference is common and associated with a significant increased risk for future cardiovascular events, even when the absolute difference in arm systolic blood pressure is modest. These findings support research to expand clinical use of this simple measurement.
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    Charting the Course
    (National Institute of Health - Office of Disease Prevention, 2014) UNSPECIFIED
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    Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health
    (2014) Aguilar-Gaxiola, Sergio; Ahmed, Syed; Zeno, Franco; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton; Ferrans, Carol; Hacker, Karen; Rumala, Bernice; Strelnick , Hal; Wallerstein, N.
    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.
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    Racial Formation in Perspective: Connecting Individuals, Institutions, and Power Relations
    (2013) Saperstein, Aliya; Penner, Andrew M.; Light, Ryan
    Over the past 25 years, since the publication of Omi & Winant's Racial Formation in the United States, the statement that race is socially constructed has become a truism in sociological circles. Yet many struggle to describe exactly what the claim means. This review brings together empirical literature on the social construction of race from different levels of analysis to highlight the variety of approaches to studying racial formation processes. For example, macro-level scholarship often focuses on the creation of racial categories, micro-level studies examine who comes to occupy these categories, and meso-level research captures the effects of institutional and social context. Each of these levels of analysis has yielded important contributions to our understanding of the social construction of race, yet there is little conversation across boundaries. Scholarship that bridges methodological and disciplinary divides is needed to continue to advance the racial formation perspective and demonstrate its broader relevance.
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    Providing linguistically appropriate services to persons with limited English proficiency: a needs and resources investigation.
    (2004) Carter-Pokras, Olivia; O'Neill, Marla J F; Cheanvechai, Vasana; Menis, Mikhail; Fan, Tao; Solera, Angelo
    Increasing numbers of persons in the United States cannot speak, read, write, or understand the English language at a level that permits them to interact effectively. These limitations can hamper encounters between patients and healthcare providers, often leading to misunderstandings as to diagnosis and treatment, which in turn may result in poor patient compliance, unsatisfactory outcomes, and increased costs. A questionnaire was developed and distributed to clinical practice managers at the University of Maryland School of Medicine to assess the needs for language interpretation services and resources among clinical faculty providing healthcare to persons with limited English proficiency (LEP). Literature review, search of key Web sites, and consultation with national experts on issues pertaining to language access, health services, and reimbursement strategies also were done. Then, recommendations regarding the costs and benefits of language interpretation in healthcare settings were developed. Because recipients of federal financial assistance from the Department of Health and Human Services must provide meaningful access to persons with LEP at no cost to the client, there are clear benefits to providing language interpretation. Providers and managers should be made aware of interpretation service options and cost-saving strategies.
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    Racism and Health II: A Needed Research Agenda for Effective Interventions
    (2013) Williams, D. R.; Mohammed, S. A.
    This article reviews the empirical evidence that suggests that there is a solid foundation for more systematic research attention to the ways in which interventions that seek to reduce the multiple dimensions of racism can improve health and reduce disparities in health. First, research reveals that policies and procedures that seek to reduce institutional racism by improving neighborhood and educational quality and enhancing access to additional income, employment opportunities, and other desirable resources can improve health. Second, research is reviewed that shows that there is the potential to improve health through interventions that can reduce cultural racism at the societal and individual level. Finally, research is presented that suggests that the adverse consequences of racism on health can be reduced through policies that maximize the health-enhancing capacities of medical care, address the social factors that initiate and sustain risk behaviors, and empower individuals and communities to take control of their lives and health. Directions for future research are outlined.
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    Spatial Polygamy and Contextual Exposures (SPACEs): Promoting Activity Space Approaches in Research on Place And Health
    (2013) Matthews, S. A.; Yang, T.-C.
    Exposure science has developed rapidly and there is an increasing call for greater precision in the measurement of individual exposures across space and time. Social science interest in an individual’s environmental exposure, broadly conceived, has arguably been quite limited conceptually and methodologically. Indeed, in social science, we appear to lag behind our exposure science colleagues in our theories, data, and methods. In this article, we discuss a framework based on the concept of spatial polygamy to demonstrate the need to collect new forms of data on human spatial behavior and contextual exposures across time and space. Adopting new data and methods will be essential if one wants to better understand social inequality in terms of exposure to health risks and access to health resources. We discuss the opportunities and challenges focusing on the potential seemingly offered by focusing on human mobility and, specifically, the utilization of activity space concepts and data. A goal of the article is to spatialize social and health science concepts and research practice vis-à-vis the complexity of exposure. The article concludes with some recommendations for future research, focusing on theoretical and conceptual development promoting research on new types of places and human movement, the dynamic nature of contexts, and training.