Epidemiology & Biostatistics Research Works

Permanent URI for this collectionhttp://hdl.handle.net/1903/7128

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    Need for ensuring cultural competence in medical programmes of European universities
    (Springer Nature, 2019-01-15) Sorensen, Janne; Norredam, Marie; Suurmond, Jeanine; Carter-Pokras, Olivia; Garcia-Ramirez, Manuel; Krasnik, Allan
    Europe is becoming more social and cultural diverse as a result of the increasing migration, but the medical doctors are largely unprepared. The medical education programmes and teachers have not evolved in line with development of the population. Culturally competent curricula and teachers are needed, to ensure cultural competence among medical doctors and to tackle inequalities in health between different ethnic groups. The objective of this EU financed study is therefore to provide a snapshot of the role of cultural competence in European medical educational programmes. A questionnaire was developed in order to uncover strengths and weaknesses regarding cultural competence in the European medical education programmes. The questionnaire consisted of 32 questions. All questions had an evidence box to support the informants’ understanding of the questions. The questionnaire was sent by email to the 12 European project partners. 12 completed questionnaires were returned. Though over half of the participating medical programmes have incorporated how to handle social determinants of health in the curriculum most are lacking focus on how medical professionals’ own norms and implicit attitudes may affect health care provision as well as abilities to work effectively with an interpreter. Almost none of the participating medical programmes evaluate the students on cultural competence learning outcomes. Most medical schools participating in the survey do not offer cultural competence training for teachers, and resources spent on initiatives related to cultural competences are few. Most of the participating medical programmes acknowledge that the training given to the medical students is not adequate for future jobs in the health care service in their respective country regarding cultural competence. Our results indicate that there are major deficiencies in the commitment and practice within the participating educational programs and there are clear potentials for major improvements regarding cultural competence in programmes. Key challenges include making lasting changes to the curriculum and motivating and engaging stakeholders (teachers, management etc.) within the organisation to promote and allocate resources to cultural competence training for teachers.
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    Overweight status of the primary caregivers of orphan and vulnerable children in 3 Southern African countries: a cross sectional study
    (BioMed Central, 2015) Kanamori, Mariano; Carter-Pokras, Olivia; Madhavan, Sangeetha; Feldman, Robert; He, Xin; Lee, Sunmin
    Background: Africa is facing a nutritional transition where underweight and overweight coexist. Although the majority of programs for orphan and vulnerable children (OVC) focus on undernourishment, the association between OVC primary caregiving and the caregivers’ overweight status remains unclear. We investigated the association between OVC primary caregiving status with women’s overweight status in Namibia, Swaziland and Zambia. Methods: Demographic Health Survey (DHS) cross-sectional data collected during 2006–2007 were analyzed using weighted marginal means and logistic regressions. We analyzed data from 20–49 year old women in Namibia (N 6638), Swaziland (N 2875), and Zambia (N 4497.) Results: The overweight prevalence of the primary caregivers of OVC ranged from 27.0 % (Namibia) to 61.3 % (Swaziland). In Namibia, OVC primary caregivers were just as likely or even less likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were just as likely or more likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were more likely to be overweight than non-primary caregivers living with OVC (Swaziland AOR = 1.56, Zambia AOR = 2.62) and non-primary caregivers not living with OVC (Swaziland AOR = 1.92, Zambia AOR = 1.94). Namibian OVC caregivers were less likely to be overweight than non-caregivers not living with an OVC only in certain age groups (21–29 and 41–49 years old). Conclusions: African public health systems/OVC programs may face an overweight epidemic alongside existing HIV/AIDS, tuberculosis and malaria epidemics. Future studies/interventions to curb overweight should consider OVC caregiving status and address country-level differences.
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    Emergency Preparedness: Knowledge and Perceptions of Latin American Immigrants
    (1999) Carter-Pokras, Olivia; Zambrana, Ruth E.; Mora, Sonia E.; Aaby, Katherine A.
    This paper describes the level of public emergency knowledge and perceptions of risks among Latin American immigrants, and their preferred and actual sources of emergency preparedness information (including warning signals). Five Latino community member focus groups, and one focus group of community health workers, were conducted in a suburban county of Washington D.C. (N51). Participants came from 13 Latin American countries, and 64.7% immigrated during the previous five years. Participants had difficulty defining emergency and reported a wide range of perceived personal emergency risks: immigration problems; crime, personal insecurity, gangs; home/traffic accidents; home fires; environmental problems; and snipers. As in previous studies, few participants had received information on emergency preparedness, and most did not have an emergency plan. Findings regarding key messages and motivating factors can be used to develop clear, prioritized messages for communication regarding emergencies and emergency preparedness for Latin American immigrant communities in the U.S.
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    Assessing Health Concerns and Barriers in a Heterogeneous Latino Community
    (The Johns Hopkins University Press, 2006) Martinez, Iveris L.; Carter-Pokras, Olivia
    Introduction. Major health issues and barriers to health services for Latino immigrants were identified through community-based participatory research in Baltimore city. Methods. In collaboration with community partners, five focus groups were conducted among Latino adults from 10 countries and health service providers. Findings. Priorities across groups included chronic diseases, HIV/AIDS and STDs, mental health, and the need for ancillary services. Community members and providers did not always agree on what health matters were of primary concern. Participants expected to receive health information at the point of service. Barriers to receiving health services and information span linguistic, financial, logistical, legal, and cultural matters. Conclusions. This formative research illustrates the complexity and interrelatedness of health priorities and barriers created by social issues such as employment, legal status, and related stressors.