Journal of Racial and Ethnic Health Disparities最新文献

Background: Healthcare providers' knowledge and perceptions significantly influence the quality of the treatment provided to the patients and thereby, effective implementation of healthcare programs. Hence, this study attempted to explore the knowledge and perceptions of the healthcare providers related to Sickle Cell Disease and effectiveness of the interventions.

Methods: This qualitative study was conducted during evaluation phase of the quasi-experimental study at Chhotaudepur district, Gujarat. It included 26 healthcare providers of four cadres, namely peripheral health workers (PHWs), lab technicians (LTs), pharmacists, and medical officers (MOs) from two intervention Primary Health Centres. Data was collected through in-depth interviews.

Results: Most of the respondents were aware of the correct cause, etiology, and symptoms of SCD. They had knowledge of management as well, although it was mainly focused on symptomatic treatment delivered through this intervention study. Respondents shared that the disease can be prevented by mass screening, awareness generation, and counselling. Almost all respondents unanimously believed that this intervention study had positive impacts on community by establishing three tier screening mechanism and strengthening health system capacities.

Conclusion: Study findings revealed adequate knowledge and positive attitude among healthcare providers related to SCD. They also perceived positive impacts of the interventions on the community in terms of improved knowledge, and awareness related to SCD diagnosis and treatment. Thus, it underscores the significance of knowledge and positive attitude in the primary healthcare providers to deal with the burden of the disease on the ground level.

Background: Cardiovascular diseases (CVD) are the leading cause of death globally, with a significant burden on the Asian and Central Asian populations. Ethnic discrimination is an emerging determinant of CVD risk, yet comprehensive analyses in these populations are sparse.

Objectives: This systematic review aimed to assess the association between ethnic discrimination and CVD among Asian and Central Asian populations, quantifying risks and examining contributing factors.

Methods: Following the PRISMA guidelines, we reviewed 23 studies across PubMed, Scopus, and the Web of Science, including 10 on Central Asian and 13 on broader Asian populations. Risk measures such as odds ratios (ORs) and hazard ratios (HRs) were extracted where available.

Results: The findings indicate a robust association between ethnic discrimination and increased CVD risks. Among Kyrgyz and Kazakh populations, discrimination was linked to hypertension with an OR of 2.4, while ethnic Kazakhs experiencing discrimination had a 70% higher risk of all-cause mortality (HR 1.7). In South Asians, discrimination was associated with a 30% higher prevalence of premature cardiovascular events, while Chinese populations exposed to everyday discrimination demonstrated a 15.2% higher prevalence of hypertension. Rural populations in Central Asia showed clustering of CVD risk factors with an OR of 1.9.

Conclusions: Discrimination is a significant contributor to CVD disparities, with its effects varying across ethnic groups and regions. These findings underscore the need for culturally tailored public health interventions and policies addressing social determinants of health. Future research should explore longitudinal impacts and the efficacy of targeted community-based programs to mitigate these risks.

Background and objective: Lung cancer is the leading cause of cancer death worldwide and is often diagnosed at a late stage when treatment options are limited. Lung cancer screening (LCS) via low-dose computed tomography (LDCT) has been shown to reduce mortality rates in high-risk individuals. However, utilization remains low, particularly among those with lower socioeconomic status (SES) and language barriers. This narrative review aims to summarize pertinent literature which focuses on perspectives and experiences of Spanish-speaking populations involved in lung cancer screening and evaluation programs. A secondary aim is to explore cultural factors and beliefs which affect perceptions of underserved populations in lung cancer screening.

Key content and findings: Lung cancer screening with LDCT; Hispanic/Latino population; Lung cancer; Barriers, Interests, and Emotions that play a role in beliefs about cancer and lung cancer screening; Underserved communities.

Methods: Six authors extracted articles from the PubMed, Google Scholar, and Cochrane databases. The inclusion and exclusion criteria were designed to ensure the appropriate selection of studies that align with the primary aim of understanding the cultural and systemic barriers to lung cancer screening (LCS) within the Spanish-speaking population in the United States over the past two decades. Case reports and systematic reviews were excluded to facilitate a more comprehensive analysis rather than focusing on individual cases or summaries of existing literature. Additionally, studies involving patients with advanced lung cancer were excluded, as the focus of this narrative review is to recognize the barriers to early detection of the disease, rather than the management of advanced-stage lung cancer or its treatment. The inclusion criteria were as follows: Qualitative studies, cross-sectional studies, randomized trials. Studies performed in the United States. Studies done from 2005-2024. Studies that discuss barriers to and perceptions of lung cancer screening in underserved populations including patients who identified as Latino and who speak Spanish. Studies involving lung cancer patient also describing ways cultural barriers and beliefs affect the perception of cancer screening. The exclusion criteria were as follows: Case reports and systematic reviews. Studies performed outside the United States. Studies that did not include lung cancer screening. Studies on patients with advanced lung cancer.

Autism spectrum disorder (ASD) occurs within all racial, ethnic, and demographic pediatric groups. However, Black children with ASD are diagnosed at later stages of their development, and as a result may not receive or may age out of early intervention services, and demonstrate poorer long-term outcomes, across a range of factors. African American parent's perceptions regarding access to and utilization of healthcare services for their autistic children vary. Research examining autism spectrum disorder and parental perceptions of service utilization among African American (AA) families is limited. This qualitative study aimed to understand the challenges African American parents face when initiating healthcare services for their autistic children. Eleven AA mothers of autistic children participated in individual semi-structured interviews. Six themes related to pediatric treatment needs, interactions with providers, and parents' roles as experts and advocates were generated. Implications for pediatric treatment needs of autistic children and areas of opportunity for providers working with AA autistic children are discussed.

Background: Racial bias in healthcare settings can manifest as biased communication, discriminatory treatment, lower quality of care, and a lack of empathy toward women of color [WoC; Nong et al. in JAMA Netw Open 3:e2029650-e2029650, 1; McLemore et al. in Soc Sci Med 201:127-135, 2; Hagiwara et al. in Patient Educ Couns 102:1738-1743, 3]. Despite a large body of research on racial bias, more research is needed to understand how bias translates into specific communication behaviors to develop interventions that reduce racial mistreatment in communication with WoC (Hagiwara et al. in Patient Educ Couns 102:1738-1743, 3). This study contributes to the existing research by exploring the impact of colorblind racial ideology (i.e., the denial and minimization of racism) and ethnocultural empathy (i.e., the ability to understand and relate to others from different ethnic or cultural groups) on health providers' observed empathic communication behaviors.

Methods: Providers were recruited through US hospital listservs. Inclusion criteria required that participants work in the field of maternal health. A total of 65 healthcare providers completed a survey, which included measures of colorblindness and ethnocultural empathy, and simulated interaction over HIPAA Zoom with trained actors playing patients. Participants were randomly assigned to administer the Edinburgh Postpartum Depression Scale to a Black, Asian, or White patient in a simulated postpartum 4-week checkup.

Results: Path analyses were conducted using Mplus. Findings indicated that colorblind racial ideology and ethnocultural empathy were associated with racially biased reasoning, which in turn was related to a lack of providers' empathic communication behaviors.

Conclusion: Study findings suggest racial bias can lead to less empathic patient-provider communication interaction and support changes aimed at both reducing racial bias and increasing empathic interaction.