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Journal of Health Care for the Poor and Underserved

Mary Jo Trepka, Diana M Sheehan, Kristopher P Fennie, Daniel E Mauck, Spencer Lieb, Lorene M Maddox, Theophile Niyonsenga
Delayed initiation of human immunodeficiency virus (HIV) care affects disease progression. To determine the role of HIV testing site and neighborhood- and individual-level factors in racial/ethnic disparities in initiation of care, we examined Florida population-based HIV/AIDS surveillance system records. We performed multilevel Poisson regression to calculate adjusted prevalence ratios (APR) for non-initiation of care by race/ethnicity adjusting for HIV testing site type and individual- and neighborhood-level characteristics...
2018: Journal of Health Care for the Poor and Underserved
Karl Self, Mike T John, Swati Prodduturu, Nidhi Kohli, Amruta Naik, Priscilla Flynn
This study explored the acceptability of dental therapists by respondents' socioeconomic factors and oral health status. METHODS: Data were collected from 405 adults during the 2014 Minnesota State Fair through completion of an electronic questionnaire and a modified Basic Screening Survey (BSS). RESULTS: This study found no relevant and statistically significant relationships between a respondent's various socioeconomic factors and their acceptability of care provided by a dental therapist...
2018: Journal of Health Care for the Poor and Underserved
Umut Sarpel, Marina Heskel, John Henry Spivack, Yael Feferman, Celina Ang, Francesca Gany
OBJECTIVE: In the United States, hepatocellular carcinoma (HCC) is more common among communities with low socioeconomic status (SES), and these groups tend to be diagnosed with later-stage cancers. Sorafenib is the primary treatment for advanced HCC, however its substantial cost raises concern for access to treatment. METHODS: The newly developed Case-Background method was used to estimate odds ratios for the impacts of various sociodemographic factors on sorafenib access in clinically eligible patients...
2018: Journal of Health Care for the Poor and Underserved
Annie Ro, Brandon Osborn
We explored the role of dietary factors, as measured by individual behaviors and neighborhood produce availability, in the relationship between food insecurity and obesity among a representative sample of Latinos in California. We utilized data from the 2012, 2013/2014 California Health Interview Survey and included Latinos aged 18-65 years and under 200% of the federal poverty line (n=5,957). We conducted logistic regressions to first estimate the association between food insecurity and obesity and then examine whether this association remained significant after adjusting for soda and fast food consumption, perceived neighborhood fresh produce environment, and covariates...
2018: Journal of Health Care for the Poor and Underserved
Melissa E Lewis, Laurelle L Myhra
INTRODUCTION: There is increased evidence for the effectiveness of integrated behavioral health care, however, it is unknown if integrated care is effective or culturally appropriate for Indigenous populations-the population with the largest health disparities in the nation. METHODS: We conducted a literature review to analyze the state of Indigenous health care focusing specifically on the appropriateness of integrated care in this population. RESULTS: Integrated care could improve access to comprehensive care, quality of care, and may be a promising model to reduce health disparities for Indigenous people...
2018: Journal of Health Care for the Poor and Underserved
Nwamaka D Eneanya, Kabir Olaniran, Dihua Xu, Katherine Waite, Stanley Crittenden, D Bora Hazar, Angelo E Volandes, Jennifer S Temel, Ravi Thadhani, Michael K Paasche-Orlow
Black patients with chronic kidney disease (CKD) receive more cardiopulmonary resuscitation (CPR) than other racial groups, and knowledge of CPR influences preferences for care. As limited health literacy disproportionately affects Blacks and contributes to disparities in end-of-life (EOL) care, we investigated whether health literacy mediates racial disparities in CPR knowledge. Black and White adult patients with advanced CKD completed CPR knowledge surveys. Health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine...
2018: Journal of Health Care for the Poor and Underserved
Ying Zhang, Cam Solomon, Gerardo Moreno, Eva Chang, Elizabeth H Lin, Ron L Johnson, Heidi Berthoud, Leo S Morales
This study examines medication-related self-efficacy in a linguistically diverse group of patients with diabetes, hypertension, and elevated cholesterol. A telephone survey of 509 adults conducted in six languages (English, Spanish, Korean, Vietnamese, Mandarin, and Cantonese) was analyzed. Self-efficacy was assessed with the overall Medication Understanding and Use Self-Efficacy (MUSE) score and its two subscale scores on taking medication and learning about medications. Compared with English proficient (EP) patients, patients with limited English proficiency (LEP) had a lower mean learning self-efficacy subscale score (LEP: 14...
2018: Journal of Health Care for the Poor and Underserved
David Scales
Communicating with patients who speak different languages in health care environments is a well-known challenge, for which there are myriad solutions to provide increased access for patients with low proficiency in the language of care. Clinicians often overlook communication challenges with patients for whom language is not a barrier, but mismatches in cultural and personal communication styles can lead to poor communication between doctor and patient that can negatively affect the clinical relationship and patient care...
2018: Journal of Health Care for the Poor and Underserved
Yuan E Zhou, Maciej S Buchowski, Richmond A Akatue, Jie Wu, Jianguo Liu, Margaret K Hargreaves
Limited information is available regarding the effects of physical activity on risks of cardiometabolic diseases among obese African American adults. We conducted a church-based 12-week weight control and cardiometabolic risk reduction intervention (n=30, 22 females, 56.7±11.4 years old, BMI 37.4±6.7 kg/m2), after which body weight was slightly reduced (98.3±18.4 and 97.3±19 kg, p=.052); body fat percentage was significantly decreased among males (34.7±8.9 to 28.5±8.4 %; p=.049); and walking steps were increased, but not significantly...
2018: Journal of Health Care for the Poor and Underserved
Shams Rahman, Abu-Sayeef Mirza, Jennifer Stenback, Shikerria Green, Yeshuwa Mayers, Elhaam Iranmanesh, Abby Pribish, Saneeya Islam, Laurie Woodard
INTRODUCTION: There is limited research about the poor and uninsured patients who visit free clinics. METHODS: We conducted a retrospective chart review of uninsured adult patients in four free clinics seen between January and December 2015. Prevalence of chronic conditions and their association with socioeconomic factors were investigated. RESULTS: In 2015, 3,196 adult patients with chronic conditions were managed in four free clinics. Many of these patients were women (60...
2018: Journal of Health Care for the Poor and Underserved
Monil Mehta, Paul Campbell Erwin
OBJECTIVES: To determine Tennessee dentists' knowledge and attitudes about the Dental Therapist Workforce Model (DTWM), as one means of expanding access to oral health care. METHODS: We surveyed 1,047 general dentists in Tennessee to determine their attitudes and perceptions of the DTWM. We used descriptive statistics such as frequency distributions for demographic variables. For additional analyses, we used analysis of variance and chi-square. RESULTS: We received 418 completed responses, for a response rate of 40%...
2018: Journal of Health Care for the Poor and Underserved
Molly Crenshaw, Molly Gribbin, Saba Qasmieh, Jessica Heil, Caitlin Ward, Steven Kariya, Jeremy Kern
INTRODUCTION: George Washington Students for Haiti conducts mobile clinics in the Central Plateau of Haiti. Baseline health data for specific rural areas of Haiti are needed. METHODS: Medical teams conducted mobile clinics in rural locations of Haiti's Central Plateau. Diagnoses, blood pressure, growth parameters, medications prescribed, and referrals were recorded. RESULTS: Analyses included 865 patients. The leading pediatric diagnoses were acute respiratory infection, dermatitis, and abdominal pain...
2018: Journal of Health Care for the Poor and Underserved
Jennifer K Carroll, Kevin Fiscella, Andrea Cassells, Mechelle R Sanders, Stephen K Williams, Brianna D'Orazio, Tameir Holder, Subrina Farah, Chamanara Khalida, Jonathan N Tobin
Patient-centered communication is a means for engaging patients in partnership. However, patient centered communication has not always been grounded in theory or in clinicians' pragmatic needs. The objective of this report is to present a practical approach to hypertension counselling that uses the 5As framework and is grounded in theory and best communication practices.
2018: Journal of Health Care for the Poor and Underserved
Jessica F Deerin, Meriam Mikre, Amanda D Castel, A Toni Young, Irene Kuo
Community-based hepatitis C virus screening can identify individuals who are unaware of their infection and not regularly engaged in care. We report on a pilot study exploring the utility of using HIV surveillance data to identify targeted, geographical areas with high HIV prevalence and poor care indicators for screening baby boomers at risk for HCV. Between August-September 2014, we conducted community-based HCV rapid testing in high-risk census tracts. Eligible participants were born from 1945-1965 and not currently engaged in HCV care...
2018: Journal of Health Care for the Poor and Underserved
Erika K Cottrell, Rachel Gold, Sonja Likumahuwa, Heather Angier, Nathalie Huguet, Deborah J Cohen, Khaya D Clark, Laura M Gottlieb, Jennifer E DeVoe
Several recent national initiatives have called for increased efforts to integrate social determinants of health (SDH) into health care settings using health information technology (HIT). However, there is limited evidence to guide the implementation of these recommendations in practice. Research is needed to understand what SDH information is most important to collect, how SDH information can be used to inform clinical care and referrals, and ultimately, whether and how integrating SDH screening and action into primary care affects individual and population health...
2018: Journal of Health Care for the Poor and Underserved
K Marie Douglass, Ann Polcari, Nadine Najjar, Joshua Kronenfeld, Amar R Deshpande
Transgender individuals disproportionately experience homelessness and health disparities, including lack of access to gender-affirming care. The student-run Lotus Wellness Center provides care to transgender individuals experiencing homelessness, including primary care, mental health stabilization, and transition via hormone therapy, while medical students learn of the unique health needs of this community.
2018: Journal of Health Care for the Poor and Underserved
Jodi A Ray, Avery Rosnick-Slyker, James M Brumley, Linda A Detman, Kristopher M Bryant, Brian L Kirk
Military-provided health insurance does not adequately cover children with special needs and children of veterans. Medicaid and the Children's Health Insurance Program (CHIP) can help eliminate insurance gaps, if promoted within the military community. This manuscript describes a Military Outreach Program to educate and reach Florida military families about insurance.
2018: Journal of Health Care for the Poor and Underserved
Sarah Hart Shuford, Annie Gjelsvik, Jennifer Clarke, Jacob J van den Berg
Risk factors for depression among 179 women recently released from prison or jail in a state correctional facility in the northeastern United States were examined in this study. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to measure longitudinal, self-reported depression data. In addition, potential risk factors for depression among women recently released from prison and jail were analyzed. Findings of this study indicated that approximately 83% of the women suffered depression throughout baseline and/or at least one follow up period after release...
2018: Journal of Health Care for the Poor and Underserved
Shana O Ntiri, Elena N Klyushnenkova, Søren M Bentzen
INTRODUCTION: African American women have disproportionately high breast cancer (BC) mortality in comparison with White women. Early BC detection rates are lower in African American women than White women, reflecting sub-optimal use of screening mammography particularly among women who are uninsured. METHODS: A descriptive analysis of a community-based, cancer control program targeted at uninsured African Americans is presented. Program outcomes and correlates of program retention and BC detection are summarized...
2018: Journal of Health Care for the Poor and Underserved
Bouapanh Lor, India J Ornelas, Maya Magarati, H Hoai Do, Ying Zhang, J Carey Jackson, Victoria M Taylor
Refugee women are at increased risk for cervical cancer and have low rates of cervical cancer screening both in their countries of origin and in the U.S. Using the Behavioral Model for Vulnerable Populations as a conceptual framework, we conducted eight focus groups with Burmese and Bhutanese refugee women to gather information about factors influencing cervical cancer screening (31 Burmese and 27 Bhutanese participants). Less than one-third (28%) reported being screened for cervical cancer before coming to the U...
2018: Journal of Health Care for the Poor and Underserved
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