首页 > 最新文献

Ethnicity & Disease最新文献

英文 中文
Charting the Future of Health Equity Research: Lessons Learned and Future Aspirations for NHLBI's DECIPHeR Alliance. 描绘健康公平研究的未来:国家卫生与健康研究所 DECIPHeR 联盟的经验教训和未来愿望》。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI: 10.18865/ed.DECIPHeR.135
Shahnaz Khan, Cara Lewis, Xinzhi Zhang, Maliha Ilias, George Mensah

The Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) research program, supported by the National Heart, Lung, and Blood Institute (NHLBI), focuses on developing and testing sustainable interventions to reduce heart and lung disease disparities. This perspective piece reflects on lessons learned during the planning phase (UG3) and outlines the accomplishments of the DECIPHeR Alliance. The article emphasizes the importance of a biphasic (UG3/UH3) funding mechanism, technical assistance, and collaborative subcommittees in achieving success. As DECIPHeR enters phase 2 (UH3), the article anticipates rigorously planned studies addressing social determinants of health and emphasizes the need for effective implementation strategies and equitable research frameworks. The Alliance's contributions, such as the IM4Equity framework, offer novel approaches to community-engaged health equity and implementation science research. The article explores future opportunities, including dissemination strategies, community engagement, and collaboration with diverse partners, to maximize DECIPHeR's impact on health disparities beyond cardiovascular and pulmonary health.

通过协调干预消除差异,预防和控制心肺疾病风险(DECIPHeR)研究计划得到了美国国家心肺血液研究所(NHLBI)的支持,该计划的重点是开发和测试可持续的干预措施,以减少心肺疾病的差异。这篇透视文章回顾了规划阶段(UG3)的经验教训,并概述了 DECIPHeR 联盟所取得的成就。文章强调了双相(UG3/UH3)资助机制、技术援助和合作小组委员会对取得成功的重要性。随着 DECIPHeR 进入第二阶段(UH3),文章预计将针对健康的社会决定因素开展严格规划的研究,并强调需要有效的实施战略和公平的研究框架。联盟的贡献,如 IM4Equity 框架,为社区参与的健康公平和实施科学研究提供了新方法。文章探讨了未来的机遇,包括传播战略、社区参与以及与不同合作伙伴的合作,以最大限度地扩大 DECIPHeR 对心血管和肺部健康以外的健康差异的影响。
{"title":"Charting the Future of Health Equity Research: Lessons Learned and Future Aspirations for NHLBI's DECIPHeR Alliance.","authors":"Shahnaz Khan, Cara Lewis, Xinzhi Zhang, Maliha Ilias, George Mensah","doi":"10.18865/ed.DECIPHeR.135","DOIUrl":"10.18865/ed.DECIPHeR.135","url":null,"abstract":"<p><p>The Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) research program, supported by the National Heart, Lung, and Blood Institute (NHLBI), focuses on developing and testing sustainable interventions to reduce heart and lung disease disparities. This perspective piece reflects on lessons learned during the planning phase (UG3) and outlines the accomplishments of the DECIPHeR Alliance. The article emphasizes the importance of a biphasic (UG3/UH3) funding mechanism, technical assistance, and collaborative subcommittees in achieving success. As DECIPHeR enters phase 2 (UH3), the article anticipates rigorously planned studies addressing social determinants of health and emphasizes the need for effective implementation strategies and equitable research frameworks. The Alliance's contributions, such as the IM4Equity framework, offer novel approaches to community-engaged health equity and implementation science research. The article explores future opportunities, including dissemination strategies, community engagement, and collaboration with diverse partners, to maximize DECIPHeR's impact on health disparities beyond cardiovascular and pulmonary health.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"DECIPHeR Spec","pages":"135-137"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Key Principles Underlying a Research-Practice Alignment in a Federally Qualified Health Center. 联邦合格医疗中心研究与实践相结合的关键原则。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI: 10.18865/ed.DECIPHeR.6
Antoinette Schoenthaler, Doreen Colella, Franze De La Calle, Gisella Bueno, Jacalyn Nay, Masiel Garcia, George Shahin, Cristina Gago, Isaac Dapkins

Context: Minoritized populations such as racial and ethnic minorities and individuals of less privileged socioeconomic status experience a disproportionate burden of poor hypertension (HTN) control in the United States. Multilevel systems interventions have been shown to improve patient-level outcomes in minoritized populations; however, there remains a large translational gap in implementing these approaches into federally qualified health centers (FQHC), which serve those at highest risk of HTN-related morbidity and mortality. The paucity of purposeful collaborations between academic researchers and practice staff throughout the research process remains a significant roadblock to the timely translation of evidence to practice.

Design: This commentary describes the key principles and best practices that underlie the development and sustainment of an equitable research-practice alignment, which is supporting the implementation of multilevel systems intervention for improved HTN care in a large FQHC in Brooklyn, New York. The key principles, which are derived from the central tenants of relationship development and maintenance in community-engaged participatory research, patient-centered outcomes research, and organizational alignment theory include (1) cocreation of a shared mental model, (2) bridging multilevel communication, (3) ensuring mutual accountability, and (4) creating a culture of continuous improvement.

Conclusions: Together, the principles guide how the research and practice teams work together to achieve a shared goal of improving the health and well-being of minoritized patients through the provision of high quality, community-oriented HTN care. Best practices to sustain our alignment require an ongoing and deliberate investment in honest and transparent communication by all members.

背景:在美国,少数种族和少数民族以及社会经济地位较差的个人等少数群体在高血压(HTN)控制方面承受着过重的负担。多层次系统干预措施已被证明能改善少数群体患者的治疗效果;然而,在联邦合格医疗中心(FQHC)实施这些方法仍存在巨大的转化差距,而这些中心的服务对象是高血压相关发病率和死亡率风险最高的人群。在整个研究过程中,学术研究人员与实践人员之间缺乏有目的的合作,这仍然是将证据及时转化为实践的一大障碍:本评论描述了发展和维持公平的研究与实践相结合的关键原则和最佳实践,这些原则和最佳实践支持在纽约布鲁克林的一家大型 FQHC 实施多层次系统干预,以改善高血压护理。这些关键原则源于社区参与式研究、以患者为中心的结果研究和组织调整理论中的关系发展和维护的核心原则,包括:(1)共同创建一个共享的心理模型;(2)架起多层次沟通的桥梁;(3)确保相互问责;以及(4)创建一种持续改进的文化:这些原则共同指导着研究团队和实践团队如何合作,以实现通过提供高质量、以社区为导向的高血压护理来改善少数民族患者的健康和福祉这一共同目标。要保持我们的一致性,最佳实践要求所有成员在诚实和透明的沟通方面进行持续和审慎的投资。
{"title":"Key Principles Underlying a Research-Practice Alignment in a Federally Qualified Health Center.","authors":"Antoinette Schoenthaler, Doreen Colella, Franze De La Calle, Gisella Bueno, Jacalyn Nay, Masiel Garcia, George Shahin, Cristina Gago, Isaac Dapkins","doi":"10.18865/ed.DECIPHeR.6","DOIUrl":"10.18865/ed.DECIPHeR.6","url":null,"abstract":"<p><strong>Context: </strong>Minoritized populations such as racial and ethnic minorities and individuals of less privileged socioeconomic status experience a disproportionate burden of poor hypertension (HTN) control in the United States. Multilevel systems interventions have been shown to improve patient-level outcomes in minoritized populations; however, there remains a large translational gap in implementing these approaches into federally qualified health centers (FQHC), which serve those at highest risk of HTN-related morbidity and mortality. The paucity of purposeful collaborations between academic researchers and practice staff throughout the research process remains a significant roadblock to the timely translation of evidence to practice.</p><p><strong>Design: </strong>This commentary describes the key principles and best practices that underlie the development and sustainment of an equitable research-practice alignment, which is supporting the implementation of multilevel systems intervention for improved HTN care in a large FQHC in Brooklyn, New York. The key principles, which are derived from the central tenants of relationship development and maintenance in community-engaged participatory research, patient-centered outcomes research, and organizational alignment theory include (1) cocreation of a shared mental model, (2) bridging multilevel communication, (3) ensuring mutual accountability, and (4) creating a culture of continuous improvement.</p><p><strong>Conclusions: </strong>Together, the principles guide how the research and practice teams work together to achieve a shared goal of improving the health and well-being of minoritized patients through the provision of high quality, community-oriented HTN care. Best practices to sustain our alignment require an ongoing and deliberate investment in honest and transparent communication by all members.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"DECIPHeR Spec","pages":"6-11"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perceived Religious Influence on Health Is Associated with Beneficial Health Behaviors in Members of Predominantly Black Churches. 认为宗教对健康的影响与以黑人为主的教会成员的有益健康行为有关。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI: 10.18865/ed.DECIPHeR.81
Farah Allouch, Katherine T Mills, Jodie Laurent, Flor Alvarado, Jeanette Gustat, Hua He, Jiang He, Keith C Ferdinand

Background: Cardiovascular disease is the leading cause of death in the United States, and Black populations are disproportionately affected. Black populations also have high rates of religiosity, which may be an important health motivator, but mechanisms are unclear.

Objective: We examined the relationship between perceived religious influence on health and cardiovascular health behaviors, risk factors, and confidence participating in medical care in Black church congregants.

Methods: We surveyed 302 members of 13 churches with predominantly Black congregations in New Orleans, Louisiana. Participants reported if religious beliefs had an influence on their health and if they avoided harmful behaviors because of religion. Fruit and vegetable intake, physical activity, smoking status, confidence asking questions to health care providers, understanding treatment plans and self-reported hypertension, hypercholesterolemia, and diabetes were assessed. Logistic regression was used adjusting for age, sex, and education.

Results: Survey respondents were 77% female with a median age of 66 years, and 72%, 56%, and 37% reported hypertension, hypercholesterolemia, and diabetes, respectively. Perceived religious influence on health was positively associated with fruit and vegetable intake, physical activity, and confidence asking questions to health care providers. Avoiding harmful behaviors because of religion was positively associated with physical activity. There was no association between perceived religious influence on health and smoking, hypertension, hypercholesterolemia, or diabetes.

Conclusion: Perceived religious influence on health was associated with beneficial cardiovascular health behaviors and confidence participating in medical care. These findings can inform the design and delivery of interventions to reduce cardiovascular disease among Black religious communities.

背景:心血管疾病是导致美国人死亡的主要原因,而黑人受到的影响尤为严重。黑人的宗教信仰率也很高,这可能是一个重要的健康激励因素,但其机制尚不清楚:我们研究了黑人教会信众感知到的宗教对健康的影响与心血管健康行为、风险因素和参与医疗保健的信心之间的关系:我们对路易斯安那州新奥尔良市 13 个以黑人为主的教堂的 302 名成员进行了调查。参与者报告了宗教信仰是否对他们的健康有影响,以及他们是否因宗教信仰而避免有害行为。对水果和蔬菜摄入量、体育锻炼、吸烟状况、向医疗保健提供者提问的信心、对治疗计划的理解以及自我报告的高血压、高胆固醇血症和糖尿病进行了评估。采用逻辑回归法对年龄、性别和教育程度进行了调整:调查对象中 77% 为女性,中位年龄为 66 岁,分别有 72%、56% 和 37% 的人报告患有高血压、高胆固醇血症和糖尿病。认为宗教对健康的影响与水果和蔬菜摄入量、体育锻炼以及向医疗服务提供者提问的信心呈正相关。因宗教而避免有害行为与体育锻炼呈正相关。认为宗教对健康的影响与吸烟、高血压、高胆固醇血症或糖尿病之间没有关联:结论:认为宗教对健康的影响与有益的心血管健康行为和参与医疗保健的信心有关。这些发现可为设计和实施干预措施,减少黑人宗教团体中的心血管疾病提供参考。
{"title":"Perceived Religious Influence on Health Is Associated with Beneficial Health Behaviors in Members of Predominantly Black Churches.","authors":"Farah Allouch, Katherine T Mills, Jodie Laurent, Flor Alvarado, Jeanette Gustat, Hua He, Jiang He, Keith C Ferdinand","doi":"10.18865/ed.DECIPHeR.81","DOIUrl":"10.18865/ed.DECIPHeR.81","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease is the leading cause of death in the United States, and Black populations are disproportionately affected. Black populations also have high rates of religiosity, which may be an important health motivator, but mechanisms are unclear.</p><p><strong>Objective: </strong>We examined the relationship between perceived religious influence on health and cardiovascular health behaviors, risk factors, and confidence participating in medical care in Black church congregants.</p><p><strong>Methods: </strong>We surveyed 302 members of 13 churches with predominantly Black congregations in New Orleans, Louisiana. Participants reported if religious beliefs had an influence on their health and if they avoided harmful behaviors because of religion. Fruit and vegetable intake, physical activity, smoking status, confidence asking questions to health care providers, understanding treatment plans and self-reported hypertension, hypercholesterolemia, and diabetes were assessed. Logistic regression was used adjusting for age, sex, and education.</p><p><strong>Results: </strong>Survey respondents were 77% female with a median age of 66 years, and 72%, 56%, and 37% reported hypertension, hypercholesterolemia, and diabetes, respectively. Perceived religious influence on health was positively associated with fruit and vegetable intake, physical activity, and confidence asking questions to health care providers. Avoiding harmful behaviors because of religion was positively associated with physical activity. There was no association between perceived religious influence on health and smoking, hypertension, hypercholesterolemia, or diabetes.</p><p><strong>Conclusion: </strong>Perceived religious influence on health was associated with beneficial cardiovascular health behaviors and confidence participating in medical care. These findings can inform the design and delivery of interventions to reduce cardiovascular disease among Black religious communities.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"DECIPHeR Spec","pages":"81-88"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-Rated Health and Medically Diagnosed Chronic Disease Association among Adults in Puerto Rico. 波多黎各成年人自评健康状况与医疗诊断慢性病的关联。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-09-01 DOI: 10.18865/ed.33.4.140
Cristina Gago, H June O'Neill, Martha Tamez, Andrea López-Cepero, José F Rodríguez-Orengo, Josiemer Mattei

Introduction: Latinos report lower self-rated health (SRH) than non-Hispanic White persons. However, the association between SRH and medically diagnosed chronic diseases (MDCDs) remains understudied in Latino populations. This study assessed the relationship between a single-item SRH indicator and MDCD status among predominantly Latino adults in Puerto Rico.

Methods: Participants (30-75 years; n=965) of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) reported SRH (excellent/very good, good, or fair/poor) and MDCD (ever vs never). We performed multivariate logistic regressions to evaluate the association between SRH and MDCD, which adjusted for key socioeconomic, demographic, and behavioral confounders.

Results: Twenty-seven percent of participants reported excellent/very good SRH, 39% good, and 34% fair/poor. Participants with fair/poor SRH (vs excellent/very good) were more likely to report MDCD for painful inflammation (odds ratio [OR]=4.95 [95% CI, 3.27-7.48]), kidney disease (4.64 [2.16-9.97]), sleep disorder (4.47 [2.83-7.05]), migraine headaches (4.07 [2.52-6.58]), overweight/obesity (3.84 [2.51-5.88]), depression (3.61 [2.28-5.74]), hypertension (3.59 [2.43-5.32]), high blood sugar (3.43 [2.00-5.89]), cardiovascular disease (3.13 [2.01-4.87]), anxiety (2.87 [1.85-4.44]), arthritis (2.80 [1.83-4.30]), diabetes (2.46 [1.57-3.83]), respiratory problems (2.45 [1.59-3.79]), stomach problems (2.44 [1.57-3.81]), eye disease (2.42 [1.44-4.06]), gallbladder disease (2.34 [1.35-4.05]), liver disease (2.26 [1.38-3.70]), heartburn (2.25 [1.55-3.26]), hyperlipidemia (2.10 [1.44-3.06]), and thyroid conditions (2.04 [1.30-3.21]).

Conclusions: SRH may reflect MDCD burden and serve as a valid screener to efficiently identify Latino individuals in high need of clinical services. This is relevant in Puerto Rico, where chronic disease rates remain high amid limited, disparate access to health care.

导言:与非西班牙裔白人相比,拉美裔人的自我健康评价(SRH)较低。然而,在拉丁裔人群中,SRH 与医学诊断慢性病(MDCDs)之间的关系仍未得到充分研究。本研究评估了波多黎各以拉丁裔为主的成年人中单项 SRH 指标与 MDCD 状况之间的关系:波多黎各社会心理、环境和慢性疾病趋势观察研究(PROSPECT)的参与者(30-75 岁;n=965)报告了 SRH(优/很好、好或一般/差)和 MDCD(曾经与从未)。我们进行了多变量逻辑回归来评估 SRH 与 MDCD 之间的关系,并对主要的社会经济、人口和行为混杂因素进行了调整:27%的参与者报告了极好/非常好的性健康和生殖健康状况,39%报告了良好,34%报告了一般/较差。SRH一般/较差(与SRH优秀/非常好相比)的参与者更有可能报告MDCD为疼痛性炎症(几率比[OR]=4.95 [95% CI, 3.27-7.48])、肾脏疾病(4.64 [2.16-9.97] )、睡眠障碍(4.47 [2.83-7.05])、偏头痛(4.07 [2.52-6.58])、超重/肥胖(3.84 [2.51-5.88])、抑郁(3.61 [2.28-5.74])、高血压(3.59 [2.43-5.32])、高血糖(3.43 [2.00-5.89])、心血管疾病(3.13 [2.01-4.87])、焦虑(2.87 [1.85-4.44])、关节炎(2.80 [1.83-4.30])、糖尿病(2.46 [1.57-3.83])、呼吸系统疾病(2.45 [1.59-3.79])、胃病(2.44 [1.57-3.81])、眼病(2.42 [1.44-4.06])、胆囊疾病(2.34 [1.35-4.05])、肝脏疾病(2.26 [1.38-3.70])、胃灼热(2.25 [1.55-3.26])、高脂血症(2.10 [1.44-3.06])和甲状腺疾病(2.04 [1.30-3.21]):SRH可反映多发性硬化症的负担,并可作为有效的筛选器,有效识别出需要大量临床服务的拉丁裔个体。这与波多黎各的情况息息相关,因为在波多黎各,慢性病发病率居高不下,而获得医疗保健的机会却有限且参差不齐。
{"title":"Self-Rated Health and Medically Diagnosed Chronic Disease Association among Adults in Puerto Rico.","authors":"Cristina Gago, H June O'Neill, Martha Tamez, Andrea López-Cepero, José F Rodríguez-Orengo, Josiemer Mattei","doi":"10.18865/ed.33.4.140","DOIUrl":"10.18865/ed.33.4.140","url":null,"abstract":"<p><strong>Introduction: </strong>Latinos report lower self-rated health (SRH) than non-Hispanic White persons. However, the association between SRH and medically diagnosed chronic diseases (MDCDs) remains understudied in Latino populations. This study assessed the relationship between a single-item SRH indicator and MDCD status among predominantly Latino adults in Puerto Rico.</p><p><strong>Methods: </strong>Participants (30-75 years; n=965) of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) reported SRH (excellent/very good, good, or fair/poor) and MDCD (ever vs never). We performed multivariate logistic regressions to evaluate the association between SRH and MDCD, which adjusted for key socioeconomic, demographic, and behavioral confounders.</p><p><strong>Results: </strong>Twenty-seven percent of participants reported excellent/very good SRH, 39% good, and 34% fair/poor. Participants with fair/poor SRH (vs excellent/very good) were more likely to report MDCD for painful inflammation (odds ratio [OR]=4.95 [95% CI, 3.27-7.48]), kidney disease (4.64 [2.16-9.97]), sleep disorder (4.47 [2.83-7.05]), migraine headaches (4.07 [2.52-6.58]), overweight/obesity (3.84 [2.51-5.88]), depression (3.61 [2.28-5.74]), hypertension (3.59 [2.43-5.32]), high blood sugar (3.43 [2.00-5.89]), cardiovascular disease (3.13 [2.01-4.87]), anxiety (2.87 [1.85-4.44]), arthritis (2.80 [1.83-4.30]), diabetes (2.46 [1.57-3.83]), respiratory problems (2.45 [1.59-3.79]), stomach problems (2.44 [1.57-3.81]), eye disease (2.42 [1.44-4.06]), gallbladder disease (2.34 [1.35-4.05]), liver disease (2.26 [1.38-3.70]), heartburn (2.25 [1.55-3.26]), hyperlipidemia (2.10 [1.44-3.06]), and thyroid conditions (2.04 [1.30-3.21]).</p><p><strong>Conclusions: </strong>SRH may reflect MDCD burden and serve as a valid screener to efficiently identify Latino individuals in high need of clinical services. This is relevant in Puerto Rico, where chronic disease rates remain high amid limited, disparate access to health care.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"33 4","pages":"140-149"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suicide Ideation and the Association of Chronic Disease among American Indians. 美国印第安人的自杀意念与慢性疾病的关联。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-09-01 DOI: 10.18865/ed.33.4.150
Felicia Schanche Hodge, Rey Paolo Ernesto Roca, Christine Samuel-Nakamura, Wendie Robbins, Umme Shefa Warda

Objective: To explore associations of chronic disease, perceived wellness, adverse experiences, and suicide ideation among American Indians.

Methods: Thirteen California health clinic registries formed the random household survey sampling frame (N=459) during the first stage of an intervention trial on wellness. Measures included sociodemographics, wellness status, health conditions, suicide ideation, cultural connectivity (speaking tribal language, participating in cultural practices, and feeling connected to the community), and history of physical, sexual, verbal abuse and neglect in childhood, adolescence, and adulthood. Chi square and Fisher exact tests examined bivariate, unadjusted relationships, while multiple logistic regression analysis examined adjusted associations.

Results: Adverse experiences, specifically physical abuse and sexual abuse, were associated with obesity in childhood. Having poor cultural connectivity was significantly associated with (1) low perceptions of wellness; (2) physical abuse in childhood and adolescence; (3) sexual abuse in childhood, adolescence, and adulthood; and (4) verbal abuse and neglect in adulthood. Poor perception of wellness was also correlated with suicide ideation.

Conclusions: The relationships between suicide ideation, chronic disease, connectivity, and perception of wellness among American Indians are explored in this article.

目的探讨美国印第安人中慢性病、健康感知、不良经历和自杀意念之间的关联:在健康干预试验的第一阶段,13 个加利福尼亚州健康诊所登记处组成了随机家庭调查抽样框架(N=459)。调查内容包括社会人口统计学、健康状况、健康状况、自杀意念、文化连通性(讲部落语言、参与文化习俗、感觉与社区有联系),以及童年、青春期和成年期的身体虐待、性虐待、语言虐待和忽视史。卡方检验和费雪精确检验检验了未经调整的二元关系,而多元逻辑回归分析则检验了调整后的关系:结果:不良经历,特别是身体虐待和性虐待,与儿童期肥胖有关。文化连通性差与以下情况有明显关联:(1) 健康感知低;(2) 童年和青春期遭受身体虐待;(3) 童年、青春期和成年期遭受性虐待;(4) 成年期遭受辱骂和忽视。对健康的不良认知也与自杀意念相关:本文探讨了美国印第安人自杀意念、慢性疾病、连通性和健康感知之间的关系。
{"title":"Suicide Ideation and the Association of Chronic Disease among American Indians.","authors":"Felicia Schanche Hodge, Rey Paolo Ernesto Roca, Christine Samuel-Nakamura, Wendie Robbins, Umme Shefa Warda","doi":"10.18865/ed.33.4.150","DOIUrl":"10.18865/ed.33.4.150","url":null,"abstract":"<p><strong>Objective: </strong>To explore associations of chronic disease, perceived wellness, adverse experiences, and suicide ideation among American Indians.</p><p><strong>Methods: </strong>Thirteen California health clinic registries formed the random household survey sampling frame (N=459) during the first stage of an intervention trial on wellness. Measures included sociodemographics, wellness status, health conditions, suicide ideation, cultural connectivity (speaking tribal language, participating in cultural practices, and feeling connected to the community), and history of physical, sexual, verbal abuse and neglect in childhood, adolescence, and adulthood. Chi square and Fisher exact tests examined bivariate, unadjusted relationships, while multiple logistic regression analysis examined adjusted associations.</p><p><strong>Results: </strong>Adverse experiences, specifically physical abuse and sexual abuse, were associated with obesity in childhood. Having poor cultural connectivity was significantly associated with (1) low perceptions of wellness; (2) physical abuse in childhood and adolescence; (3) sexual abuse in childhood, adolescence, and adulthood; and (4) verbal abuse and neglect in adulthood. Poor perception of wellness was also correlated with suicide ideation.</p><p><strong>Conclusions: </strong>The relationships between suicide ideation, chronic disease, connectivity, and perception of wellness among American Indians are explored in this article.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"33 4","pages":"150-155"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Engaging Predominantly Black Churches in an Intervention to Improve Cardiovascular Health and Reduce Racial Inequities. 让以黑人为主的教堂参与干预,改善心血管健康并减少种族不平等。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI: 10.18865/ed.DECIPHeR.89
Katherine T Mills, Jodie Laurent, Farah Allouch, Marilyn J Payne, Jeanette Gustat, Hua He, Flor Alvarado, Andrew Anderson, Joshua D Bundy, Jing Chen, Keith C Ferdinand, Jiang He

Cardiovascular disease (CVD) is the leading cause of mortality in the United States and disproportionately impacts Black adults. Effective implementation of interventions to improve cardiovascular health in the Black community is needed to reduce health inequities. The Church-Based Health Intervention to Eliminate Health Inequalities in Cardiovascular Health (CHERISH) study is implementing interventions recommended by the 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD in Black communities to improve cardiovascular health and reduce health disparities. The recently completed 3-year planning phase of CHERISH has focused on engaging with the predominantly Black church community in New Orleans with the goals of informing study protocol development and recruiting churches for study participation. Community engagement approaches include convening a community advisory board (CAB), conducting qualitative and quantitative needs assessments, and hosting and attending church events. These activities have resulted in an engaged CAB that has contributed meaningfully to planning activities and the study protocol. The needs assessment found that while there are substantial barriers to cardiovascular health, such as knowledge, access to healthy foods, and safe spaces for physical activity, people are willing to make lifestyle changes and think that the proposed intervention components are feasible. Community engagement activities have resulted in the recruitment of 50 geographically and denominationally diverse predominantly Black churches willing to participate in the study (exceeding our goal of 42). Overall, a multicomponent approach to extensive community engagement has produced effective church enrollment for study participation and meaningful input on study design and implementation.

心血管疾病(CVD)是美国人死亡的主要原因,对黑人成年人的影响尤为严重。为了减少健康不平等现象,需要有效实施干预措施来改善黑人社区的心血管健康状况。消除心血管健康不平等的教会健康干预(CHERISH)研究正在实施 2019 年美国心脏病学会/美国心脏协会关于黑人社区心血管疾病一级预防指南所建议的干预措施,以改善心血管健康并减少健康不平等。CHERISH 最近完成了为期 3 年的规划阶段,重点是与新奥尔良以黑人为主的教会社区接触,目的是为研究方案的制定提供信息,并招募教会参与研究。社区参与方法包括召集社区咨询委员会 (CAB)、开展定性和定量需求评估以及举办和参加教会活动。通过这些活动,社区咨询委员会参与其中,为规划活动和研究方案的制定做出了有意义的贡献。需求评估发现,虽然在心血管健康方面存在大量障碍,如知识、健康食品的获取以及体育活动的安全空间等,但人们愿意改变生活方式,并认为建议的干预措施是可行的。通过社区参与活动,我们招募到了 50 个在地理位置和教派上各不相同、以黑人为主的教堂愿意参与这项研究(超过了我们的目标 42 个)。总之,通过多成分的方法进行广泛的社区参与,有效地招募了教会参与研究,并为研究的设计和实施提供了有意义的意见。
{"title":"Engaging Predominantly Black Churches in an Intervention to Improve Cardiovascular Health and Reduce Racial Inequities.","authors":"Katherine T Mills, Jodie Laurent, Farah Allouch, Marilyn J Payne, Jeanette Gustat, Hua He, Flor Alvarado, Andrew Anderson, Joshua D Bundy, Jing Chen, Keith C Ferdinand, Jiang He","doi":"10.18865/ed.DECIPHeR.89","DOIUrl":"10.18865/ed.DECIPHeR.89","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is the leading cause of mortality in the United States and disproportionately impacts Black adults. Effective implementation of interventions to improve cardiovascular health in the Black community is needed to reduce health inequities. The Church-Based Health Intervention to Eliminate Health Inequalities in Cardiovascular Health (CHERISH) study is implementing interventions recommended by the 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD in Black communities to improve cardiovascular health and reduce health disparities. The recently completed 3-year planning phase of CHERISH has focused on engaging with the predominantly Black church community in New Orleans with the goals of informing study protocol development and recruiting churches for study participation. Community engagement approaches include convening a community advisory board (CAB), conducting qualitative and quantitative needs assessments, and hosting and attending church events. These activities have resulted in an engaged CAB that has contributed meaningfully to planning activities and the study protocol. The needs assessment found that while there are substantial barriers to cardiovascular health, such as knowledge, access to healthy foods, and safe spaces for physical activity, people are willing to make lifestyle changes and think that the proposed intervention components are feasible. Community engagement activities have resulted in the recruitment of 50 geographically and denominationally diverse predominantly Black churches willing to participate in the study (exceeding our goal of 42). Overall, a multicomponent approach to extensive community engagement has produced effective church enrollment for study participation and meaningful input on study design and implementation.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"DECIPHeR Spec","pages":"89-95"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Process of Engaging Community and Scientific Partners in the Development of the CIRCL-Chicago Study Protocol. 让社区和科学合作伙伴参与制定 CIRCL-Chicago 研究方案的过程。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI: 10.18865/ed.DECIPHeR.18
Justin D Smith, Allison J Carroll, Olutobi A Sanuade, Rebecca Johnson, Emily M Abramsohn, Hiba Abbas, Faraz S Ahmad, Alice Eggleston, Danielle Lazar, Stacy Tessler Lindau, Megan McHugh, Nivedita Mohanty, Sarah Philbin, El A Pinkerton, Linda L Rosul, James L Merle, Yacob G Tedla, Theresa L Walunas, Paris Davis, Abel Kho

Objectives: Hypertension affects 1 in 3 adults in the United States and disproportionately affects African Americans. Kaiser Permanente demonstrated that a "bundle" of evidence-based interventions significantly increased blood pressure control rates. This paper describes a multiyear process of developing the protocol for a trial of the Kaiser bundle for implementation in under-resourced urban communities experiencing cardiovascular health disparities during the planning phase of this biphasic award (UG3/UH3).

Methods: The protocol was developed by a collaboration of faith-based community members, representatives from community health center practice-based research networks, and academic scientists with expertise in health disparities, implementation science, community-engaged research, social care interventions, and health informatics. Scientists from the National Institutes of Health and the other grantees of the Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) Alliance also contributed to developing our protocol.

Results: The protocol is a hybrid type 3 effectiveness-implementation study using a parallel cluster randomized trial to test the impact of practice facilitation on implementation of the Kaiser bundle in community health centers compared with implementation without facilitation. A central strategy to the Kaiser bundle is to coordinate implementation via faith-based and other community organizations for recruitment and navigation of resources for health-related social risks.

Conclusions: The proposed research has the potential to improve identification, diagnosis, and control of blood pressure among under-resourced communities by connecting community entities and healthcare organizations in new ways. Faith-based organizations are a trusted voice in African American communities that could be instrumental for eliminating disparities.

目标:在美国,每 3 个成年人中就有 1 人患有高血压,非裔美国人受到的影响尤为严重。凯泽医疗集团(Kaiser Permanente)证明,以证据为基础的 "捆绑 "干预措施可显著提高血压控制率。本文介绍了在双相奖(UG3/UH3)的规划阶段,为在资源匮乏、心血管健康存在差异的城市社区实施凯撒捆绑疗法制定试验方案的多年过程:该方案由信仰社区成员、社区卫生中心实践研究网络代表以及在健康差异、实施科学、社区参与研究、社会护理干预和健康信息学方面具有专长的学术科学家合作制定。来自美国国立卫生研究院和 "通过协调干预消除差异,预防和控制心肺疾病风险(DECIPHeR)联盟 "其他受赠方的科学家也为我们制定方案做出了贡献:该方案是一项混合型 3 效能-实施研究,采用平行分组随机试验的方法,以检验实践促进对社区卫生中心实施凯泽捆绑疗法的影响,并与没有促进的实施情况进行比较。凯泽捆绑疗法的一项核心策略是通过信仰组织和其他社区组织协调实施,以招募和引导与健康相关的社会风险资源:建议的研究通过以新的方式将社区实体和医疗机构联系起来,有可能改善资源不足社区的血压识别、诊断和控制。基于信仰的组织是非裔美国人社区中值得信赖的声音,可以在消除差异方面发挥重要作用。
{"title":"Process of Engaging Community and Scientific Partners in the Development of the CIRCL-Chicago Study Protocol.","authors":"Justin D Smith, Allison J Carroll, Olutobi A Sanuade, Rebecca Johnson, Emily M Abramsohn, Hiba Abbas, Faraz S Ahmad, Alice Eggleston, Danielle Lazar, Stacy Tessler Lindau, Megan McHugh, Nivedita Mohanty, Sarah Philbin, El A Pinkerton, Linda L Rosul, James L Merle, Yacob G Tedla, Theresa L Walunas, Paris Davis, Abel Kho","doi":"10.18865/ed.DECIPHeR.18","DOIUrl":"10.18865/ed.DECIPHeR.18","url":null,"abstract":"<p><strong>Objectives: </strong>Hypertension affects 1 in 3 adults in the United States and disproportionately affects African Americans. Kaiser Permanente demonstrated that a \"bundle\" of evidence-based interventions significantly increased blood pressure control rates. This paper describes a multiyear process of developing the protocol for a trial of the Kaiser bundle for implementation in under-resourced urban communities experiencing cardiovascular health disparities during the planning phase of this biphasic award (UG3/UH3).</p><p><strong>Methods: </strong>The protocol was developed by a collaboration of faith-based community members, representatives from community health center practice-based research networks, and academic scientists with expertise in health disparities, implementation science, community-engaged research, social care interventions, and health informatics. Scientists from the National Institutes of Health and the other grantees of the Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) Alliance also contributed to developing our protocol.</p><p><strong>Results: </strong>The protocol is a hybrid type 3 effectiveness-implementation study using a parallel cluster randomized trial to test the impact of practice facilitation on implementation of the Kaiser bundle in community health centers compared with implementation without facilitation. A central strategy to the Kaiser bundle is to coordinate implementation via faith-based and other community organizations for recruitment and navigation of resources for health-related social risks.</p><p><strong>Conclusions: </strong>The proposed research has the potential to improve identification, diagnosis, and control of blood pressure among under-resourced communities by connecting community entities and healthcare organizations in new ways. Faith-based organizations are a trusted voice in African American communities that could be instrumental for eliminating disparities.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"DECIPHeR Spec","pages":"18-26"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Family Health Equity in Chronic Disease Prevention and Management. 慢性病预防和管理中的家庭健康平等。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-09-01 DOI: 10.18865/ed.33.4.194
Katrina R Ellis, Tiffany L Young, Aisha T Langford

Introduction/purpose: Efforts to improve chronic disease outcomes among US adults highlight families, particularly support from families, as a key aspect of disease prevention and management. To date, however, an overwhelming focus on individual-level outcomes and unidirectional support (eg, from a family caregiver to an identified care recipient) belies the existence of co-occurring health concerns and interdependent care. There are increasing calls for more sophisticated and intensive family health interventions that better integrate family-level factors, processes, and outcomes to provide comprehensive family support services in health care and community-based settings.

Methods: This commentary provides key considerations for advancing this work while centering family health equity and families themselves in health initiatives.

Results: Several critical barriers are identified and discussed. For example, a narrow focus on family and inadequate measures of family-level disease burden make it challenging to understand how the disproportionate burden of chronic disease observed among individuals of lower socioeconomic status and certain racial and ethnic groups compounds and complicates family health experiences. In addition, limited attention to the interaction between individuals, families, and broader sociocultural factors that influence family resources and constraints, such as racism, hamper program design, implementation, and evaluation.

Conclusion: To center families in efforts to reduce chronic disease disparities, it is necessary to move beyond superficial attention to the complexity of disease prevention and management within the family context. This commentary serves to enhance understanding of important drivers of family-level chronic disease outcomes, while providing important considerations for advancing research and practice.

引言/目的:改善美国成年人慢性病治疗效果的努力强调了家庭,尤其是来自家庭的支持,是疾病预防和管理的一个关键方面。然而,迄今为止,人们普遍关注个人层面的结果和单向支持(例如,从家庭照顾者到确定的照顾对象),这掩盖了并发健康问题和相互依赖的照顾的存在。越来越多的人呼吁采取更复杂、更深入的家庭健康干预措施,更好地整合家庭层面的因素、过程和结果,在医疗保健和社区环境中提供全面的家庭支持服务:方法:本评论提供了推进这项工作的主要考虑因素,同时将家庭健康公平和家庭本身作为健康倡议的中心:结果:确定并讨论了几个关键障碍。例如,对家庭的狭隘关注以及对家庭层面疾病负担的不充分衡量,使得人们难以理解在社会经济地位较低的个人以及某些种族和民族群体中观察到的不成比例的慢性疾病负担是如何加剧家庭健康体验并使之复杂化的。此外,对个人、家庭以及影响家庭资源和制约因素(如种族主义)的更广泛的社会文化因素之间的相互作用的关注有限,阻碍了计划的设计、实施和评估:要以家庭为中心努力减少慢性疾病的差异,就有必要超越表面关注家庭背景下疾病预防和管理的复杂性。这篇评论有助于加深对家庭层面慢性病结果的重要驱动因素的理解,同时为推进研究和实践提供了重要的考虑因素。
{"title":"Family Health Equity in Chronic Disease Prevention and Management.","authors":"Katrina R Ellis, Tiffany L Young, Aisha T Langford","doi":"10.18865/ed.33.4.194","DOIUrl":"10.18865/ed.33.4.194","url":null,"abstract":"<p><strong>Introduction/purpose: </strong>Efforts to improve chronic disease outcomes among US adults highlight families, particularly support from families, as a key aspect of disease prevention and management. To date, however, an overwhelming focus on individual-level outcomes and unidirectional support (eg, from a family caregiver to an identified care recipient) belies the existence of co-occurring health concerns and interdependent care. There are increasing calls for more sophisticated and intensive family health interventions that better integrate family-level factors, processes, and outcomes to provide comprehensive family support services in health care and community-based settings.</p><p><strong>Methods: </strong>This commentary provides key considerations for advancing this work while centering family health equity and families themselves in health initiatives.</p><p><strong>Results: </strong>Several critical barriers are identified and discussed. For example, a narrow focus on family and inadequate measures of family-level disease burden make it challenging to understand how the disproportionate burden of chronic disease observed among individuals of lower socioeconomic status and certain racial and ethnic groups compounds and complicates family health experiences. In addition, limited attention to the interaction between individuals, families, and broader sociocultural factors that influence family resources and constraints, such as racism, hamper program design, implementation, and evaluation.</p><p><strong>Conclusion: </strong>To center families in efforts to reduce chronic disease disparities, it is necessary to move beyond superficial attention to the complexity of disease prevention and management within the family context. This commentary serves to enhance understanding of important drivers of family-level chronic disease outcomes, while providing important considerations for advancing research and practice.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"33 4","pages":"194-199"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Barriers and Facilitators to Improving Cardiovascular Health in Churches with Predominantly Black Congregations. 在以黑人会众为主的教堂中改善心血管健康的障碍和促进因素。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI: 10.18865/ed.DECIPHeR.96
Ana Peralta-Garcia, Jodie Laurent, Alessandra N Bazzano, Marilyn J Payne, Andrew Anderson, Flor Alvarado, Keith C Ferdinand, Jiang He, Katherine T Mills

Objective: Black communities bear a disproportionate burden of cardiovascular disease (CVD). Barriers and facilitators for improving cardiovascular health (CVH) in churches with predominantly black congregations were explored through a qualitative needs assessment.

Methods: Four focus groups with church members (n=21), 1 with wellness coordinators (n=5), and 1 with primary care providers (n=4) and 7 individual interviews with church leaders were completed in New Orleans and Bogalusa, Louisiana. Virtual, semistructured interviews and focus groups were held between October 2021 and April 2022. The Theorical Domains Framework (TDF) guided a framework analysis of transcribed data based on inductive and deductive coding to identify themes related to determinants of CVH.

Results: The following four domains according to the TDF were identified as the most relevant for improving CVH: knowledge, professional role, environmental context, and emotions. Within these domains, barriers expressed by church leadership and members were a lack of knowledge of CVD, provider distrust, and little time and resources for lifestyle changes; facilitators included existing church wellness programs and social support, community resources, and willingness to improve patient-provider relationships. Primary care providers recognized a lack of effective communication and busy schedules as obstacles and the need to strengthen communication through increased patient autonomy and trust. Potential strategies to improve CVH informed by the Expert Recommendation for Implementing Change compilation of implementation strategies include education and training, task shifting, dissemination of information, culturally tailored counselling, and linkage to existing resources.

Conclusions: These findings can inform the implementation of interventions for improving cardiovascular health and reducing disparities in black church communities.

目的:黑人社区的心血管疾病(CVD)负担过重。通过一项定性需求评估,探讨了在以黑人会众为主的教会中改善心血管健康(CVH)的障碍和促进因素:在路易斯安那州的新奥尔良市和博格卢萨市,与教会成员(21 人)、健康协调员(5 人)和初级保健提供者(4 人)分别进行了 4 次焦点小组讨论,并与教会领袖进行了 7 次个别访谈。在 2021 年 10 月至 2022 年 4 月期间进行了虚拟半结构式访谈和焦点小组讨论。在理论领域框架(TDF)的指导下,根据归纳和演绎编码对转录数据进行了框架分析,以确定与 CVH 决定因素相关的主题:结果:根据 TDF,以下四个领域被认为与改善 CVH 最为相关:知识、专业角色、环境背景和情感。在这些领域中,教会领导和成员所表达的障碍包括缺乏心血管疾病知识、对提供者的不信任以及没有时间和资源改变生活方式;促进因素包括现有的教会健康计划和社会支持、社区资源以及改善患者与提供者关系的意愿。初级医疗服务提供者认为,缺乏有效的沟通和繁忙的日程安排是障碍,需要通过提高患者的自主性和信任度来加强沟通。根据《专家建议实施变革》汇编的实施策略,改善 CVH 的潜在策略包括教育和培训、任务转移、信息传播、针对不同文化背景的咨询以及与现有资源的联系:这些发现可为实施干预措施提供信息,以改善心血管健康并减少黑人教会社区的不平等现象。
{"title":"Barriers and Facilitators to Improving Cardiovascular Health in Churches with Predominantly Black Congregations.","authors":"Ana Peralta-Garcia, Jodie Laurent, Alessandra N Bazzano, Marilyn J Payne, Andrew Anderson, Flor Alvarado, Keith C Ferdinand, Jiang He, Katherine T Mills","doi":"10.18865/ed.DECIPHeR.96","DOIUrl":"10.18865/ed.DECIPHeR.96","url":null,"abstract":"<p><strong>Objective: </strong>Black communities bear a disproportionate burden of cardiovascular disease (CVD). Barriers and facilitators for improving cardiovascular health (CVH) in churches with predominantly black congregations were explored through a qualitative needs assessment.</p><p><strong>Methods: </strong>Four focus groups with church members (n=21), 1 with wellness coordinators (n=5), and 1 with primary care providers (n=4) and 7 individual interviews with church leaders were completed in New Orleans and Bogalusa, Louisiana. Virtual, semistructured interviews and focus groups were held between October 2021 and April 2022. The Theorical Domains Framework (TDF) guided a framework analysis of transcribed data based on inductive and deductive coding to identify themes related to determinants of CVH.</p><p><strong>Results: </strong>The following four domains according to the TDF were identified as the most relevant for improving CVH: knowledge, professional role, environmental context, and emotions. Within these domains, barriers expressed by church leadership and members were a lack of knowledge of CVD, provider distrust, and little time and resources for lifestyle changes; facilitators included existing church wellness programs and social support, community resources, and willingness to improve patient-provider relationships. Primary care providers recognized a lack of effective communication and busy schedules as obstacles and the need to strengthen communication through increased patient autonomy and trust. Potential strategies to improve CVH informed by the Expert Recommendation for Implementing Change compilation of implementation strategies include education and training, task shifting, dissemination of information, culturally tailored counselling, and linkage to existing resources.</p><p><strong>Conclusions: </strong>These findings can inform the implementation of interventions for improving cardiovascular health and reducing disparities in black church communities.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"DECIPHeR Spec","pages":"96-104"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing a Social Determinants of Health Needs Assessment for Colorado Kids (SNACK) Tool for a School-Based Asthma Program: Findings from a Pilot Study. 为学校哮喘计划开发科罗拉多儿童健康需求社会决定因素评估 (SNACK) 工具:试点研究结果。
IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI: 10.18865/ed.DECIPHeR.126
Sarah E Brewer, Lisa R DeCamp, Julia Reedy, Rachel Armstrong, Heather H DeKeyser, Monica J Federico, Arthur McFarlane, Gino Figlio, Amy G Huebschmann, Stanley J Szefler, Lisa Cicutto

Background: School-based asthma programs effectively address poorly controlled asthma and asthma disparities, especially when coupled with screening for and addressing social determinants of health (SDOH) needs. Existing screening tools are tailored to clinical settings; therefore, we sought to develop a community-based SDOH screening tool.

Design/methods: We used a four-phase iterative design process to develop and pilot a community-based screening tool. We used a modified Delphi process to identify screening tool domains, identified validated items for inclusion, and developed an appropriate tool layout for populations with limited health/general literacy. Community advisory boards reviewed and refined a draft tool. Next, we conducted a qualitative pilot test of acceptability to parents and feasibility for staff in a community health center.

Results: Six domains are included in our SDOH screening tool: health care access, transportation, food insecurity, public benefits, housing, and utilities. In the pilot test, 41 screenings were completed, and 36 parents (16.7% Spanish speaking) provided feedback. Most families understood the purpose of the screening; felt that the questions were clear, appropriate, and quick to complete; and liked the pictures. The clinic's care coordinator expressed a preference for the pilot tool compared to their existing screening tool and recommended improvements to encourage honest reporting by patients.

Conclusion: This community-based screening tool addresses key SDOH needs that impact asthma and is acceptable to families. The next steps are to implement the tool in school-based asthma programs to support improvements in asthma outcomes and disparities by identifying and addressing families' unmet SDOH needs.

背景:校本哮喘计划能有效解决哮喘控制不佳和哮喘差异问题,尤其是在筛查和解决健康的社会决定因素(SDOH)需求时。现有的筛查工具是为临床环境量身定制的;因此,我们试图开发一种基于社区的 SDOH 筛查工具:设计/方法:我们采用了四阶段迭代设计流程来开发和试用基于社区的筛查工具。我们采用改良的德尔菲流程来确定筛查工具的领域,确定可纳入的有效项目,并为健康/综合素养有限的人群开发合适的工具布局。社区咨询委员会审查并完善了工具草案。接下来,我们对家长的接受程度和社区卫生中心工作人员的可行性进行了定性试点测试:我们的 SDOH 筛查工具包括六个领域:医疗保健、交通、食品不安全、公共福利、住房和公用事业。在试点测试中,共完成了 41 次筛查,36 位家长(16.7% 讲西班牙语)提供了反馈意见。大多数家庭都理解筛查的目的;认为问题清晰、恰当、填写快捷;并喜欢筛查图片。诊所的护理协调员表示,与现有的筛查工具相比,他们更喜欢试点工具,并建议对其进行改进,以鼓励患者如实报告:结论:这一基于社区的筛查工具满足了影响哮喘的主要 SDOH 需求,并为家庭所接受。下一步将在学校哮喘项目中实施该工具,通过识别和解决家庭未满足的 SDOH 需求,支持哮喘结果和差异的改善。
{"title":"Developing a Social Determinants of Health Needs Assessment for Colorado Kids (SNACK) Tool for a School-Based Asthma Program: Findings from a Pilot Study.","authors":"Sarah E Brewer, Lisa R DeCamp, Julia Reedy, Rachel Armstrong, Heather H DeKeyser, Monica J Federico, Arthur McFarlane, Gino Figlio, Amy G Huebschmann, Stanley J Szefler, Lisa Cicutto","doi":"10.18865/ed.DECIPHeR.126","DOIUrl":"10.18865/ed.DECIPHeR.126","url":null,"abstract":"<p><strong>Background: </strong>School-based asthma programs effectively address poorly controlled asthma and asthma disparities, especially when coupled with screening for and addressing social determinants of health (SDOH) needs. Existing screening tools are tailored to clinical settings; therefore, we sought to develop a community-based SDOH screening tool.</p><p><strong>Design/methods: </strong>We used a four-phase iterative design process to develop and pilot a community-based screening tool. We used a modified Delphi process to identify screening tool domains, identified validated items for inclusion, and developed an appropriate tool layout for populations with limited health/general literacy. Community advisory boards reviewed and refined a draft tool. Next, we conducted a qualitative pilot test of acceptability to parents and feasibility for staff in a community health center.</p><p><strong>Results: </strong>Six domains are included in our SDOH screening tool: health care access, transportation, food insecurity, public benefits, housing, and utilities. In the pilot test, 41 screenings were completed, and 36 parents (16.7% Spanish speaking) provided feedback. Most families understood the purpose of the screening; felt that the questions were clear, appropriate, and quick to complete; and liked the pictures. The clinic's care coordinator expressed a preference for the pilot tool compared to their existing screening tool and recommended improvements to encourage honest reporting by patients.</p><p><strong>Conclusion: </strong>This community-based screening tool addresses key SDOH needs that impact asthma and is acceptable to families. The next steps are to implement the tool in school-based asthma programs to support improvements in asthma outcomes and disparities by identifying and addressing families' unmet SDOH needs.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"DECIPHeR Spec","pages":"126-131"},"PeriodicalIF":3.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Ethnicity & Disease
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1