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Journal of Health Care for the Poor and Underserved

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https://www.readbyqxmd.com/read/28239023/errata
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2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239021/needs-assessment-of-hcv-infected-individuals-experiencing-homelessness-and-implications
#2
Marguerite Beiser, Casey Leon, Jessie M Gaeta
The advent of tolerable, efficacious therapies for hepatitis C virus (HCV) creates an opportunity to provide HCV treatment for individuals experiencing homelessness. A federally-qualified community health center serving individuals experiencing homelessness in Boston conducted an anonymous needs assessment survey of a sample of HCV-infected patients in order to inform development of an HCV treatment program (N = 240). Primary care providers (PCPs) were identified as the chief source of HCV education. Main motivators to consider HCV treatment were identified as "taking care of your health" (73...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239020/a-pediatric-profile-of-a-homeless-patient-in-san-jose-california
#3
Angela Bymaster, Joyce Chung, Andrea Banke, Hee Jae Choi, Chelsea Laird
The causes of homelessness are complex and poorly understood. This paper describes the homeless population in Santa Clara County, California in terms of Adverse Childhood Events, Traumatic Brain Injuries (TBIs), and family breakdown. Respondents reported severely traumatic childhoods; 78.7% grew up in a household with a person with drug or alcohol dependence and 64.6% endured psychological abuse as a child. Seventy-six percent of subjects recalled at least one TBI, 58.4% with loss of consciousness. Nineteen percent were in foster care as children and 40...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239019/specialty-care-access-in-the-safety-net-the-role-of-public-hospitals-and-health-systems
#4
Lena K Makaroun, Chelsea Bowman, Kevin Duan, Nathan Handley, Daniel J Wheeler, Edgar Pierluissi, Alice Hm Chen
Access to specialty care in the United States safety net, already strained, is fac-ing increasing pressure with an influx of patients following the passage of the Affordable Care Act (ACA). We surveyed 18 public hospitals and health systems across the country to describe the current state of specialty care delivery in safety-net systems. We elicited information regarding challenges, provider models, metrics of access and productivity, and strategies for improving access. Based on our findings, we propose a framework for assessing and improving specialty care access with a focus on population health planning...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239018/rural-african-americans-perspectives-on-mental-health-comparing-focus-groups-and-deliberative-democracy-forums
#5
Greer Sullivan, Ann Cheney, Mary Olson, Tiffany Haynes, Keneshia Bryant, Naomi Cottoms, Christina Reaves, Geoff Curran
A number of approaches have been used to obtain community members' health perspectives. Health services researchers often conduct focus groups while political scientists and community groups may hold forums. To compare and contrast these two approaches, we conducted six focus groups (n = 50) and seven deliberative democracy forums (n = 233) to obtain the perspectives of rural African Americans on mental health problems in their community. Inductive qualitative analysis found three common themes: rural African Americans (1) understood stresses of poverty and racism were directly related to mental health, (2) were concerned about widespread mental illness stigma, and (3) thought community members could not identify mental health problems requiring treatment...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239017/reducing-risky-sex-among-rural-african-american-cocaine-users-a-controlled-trial
#6
Katharine E Stewart, Patricia B Wright, Brooke E Montgomery, Donna Gullette, Leavonne Pulley, Songthip Ounpraseuth, Jeff Thostenson, Brenda Booth
Rural African American cocaine users experience high rates of STIs/HIV. This NIDA-funded trial tested an adapted evidence-based risk reduction program versus an active control condition. Participants were 251 African American cocaine users in rural Arkansas recruited from 2009-2011. Outcomes included condom use skills and self-efficacy, sexual negotiation skills, peer norms, and self-reported risk behavior. The intervention group experienced greater increases in condom use skills and overall effectiveness in sexual negotiation skills...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239016/discrepancy-between-actual-and-perceived-weight-status-in-rural-patients-variations-by-race-and-gender
#7
K Bryant Smalley, Jacob C Warren, B David Morrissey
The study's goal was to determine if differences in weight misperception by race and/or gender occur within a sample of economically disadvantaged rural patients with diabetes and/or hypertension. Diabetic and hypertensive patients were enrolled in the study from a network of federally qualified health centers (FQHCs) in the rural South. Multivari-ate logistic regression analysis suggests that, even when controlling for age, education level, employment status, and poverty, rural African American patients with chronic disease are more likely than their White counterparts to misperceive their weight status (OR = 1...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239015/financial-strain-is-associated-with-medication-nonadherence-and-worse-self-rated-health-among-cardiovascular-patients
#8
Chandra Y Osborn, Sunil Kripalani, Kathryn M Goggins, Kenneth A Wallston
Non-traditional indicators of socioeconomic status (SES; e.g., home ownership) may be just as or even more predictive of health outcomes as traditional indicators of SES (e.g., income). This study tested whether financial strain (i.e., difficulty paying monthly bills) predicted medication non-adherence and worse self-rated health. Research assistants administered surveys to 1,527 patients with acute coronary syndromes or acute decom-pensated heart failure. In adjusted models, having a higher income was associated with being more adherent (p < ...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239014/-we-as-black-men-have-to-encourage-each-other-facilitators-and-barriers-associated-with-hiv-testing-among-black-african-american-men-in-rural-florida
#9
Ashley Murray, Lauren Toledo, Emma Ej Brown, Madeline Y Sutton
HIV testing for some African American men remains a challenge, and effective interventions are lacking. We explored facilitators and barriers associated with HIV testing among heterosexual African American men in rural Florida. We conducted focus group interviews with 67 African American men who were low-income, and HIV-uninfected based on prior testing or had unknown HIV status. Using computer-assisted thematic analyses, we examined transcribed focus group responses for main themes. Thematic analyses revealed three main themes regarding facilitators of HIV testing: 1) using preferred HIV testing community locations (park, library, gym); 2) receiving incentives (food or money); and 3) the importance of peer-led messaging for free, rapid HIV testing...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239013/recruitment-and-baseline-characteristics-of-participants-in-the-lifestyle-improvement-through-food-and-exercise-life-study
#10
Elizabeth Lynch, Laurin J Mack, Kelly Karavolos, Elizabeth Avery, Rebecca Liebman, Kathryn S Keim, Crystal M Glover, Leon Fogelfeld
African Americans experience poorer diabetes outcomes than non-Hispanic Whites. Few clinical trials of diabetes self-management interventions specifically target African Americans, perhaps due to well-documented barriers to recruitment in this population. This paper describes strategies used to successfully recruit 211 low-income African Americans from community clinics of a large, urban public hospital system to a randomized clinical trial of an 18-month diabetes self-management intervention. Diabetes-related physiological, psychosocial, and behavioral characteristics of the sample are reported...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239012/neighborhood-trauma-due-to-violence-a-multilevel-analysis
#11
Sandra D Lane, Robert A Rubinstein, Dessa Bergen-Cico, Timothy Jennings-Bey, Linda Stone Fish, David A Larsen, Mindy Thompson Fullilove, Tracey Reichert Schimpff, Kishi Animashaun Ducre, Jonnell Allen Robinson
In Syracuse, New York the social determinants of trauma from neighborhood violence are rooted in historical processes, including urban renewal, the Rockefeller drug laws, and de-industrialization. These contributed to destabilizing Syracuse communities of color, resulting in disproportionate incarceration, family disruption, and economic devastation. Community violence, clustering in densely populated neighborhoods, creates unmanageable stress for the families who live in them. A map of gunshots and gun fatalities (2009 to 2014) illustrates the continuing onslaught of bullets being fired, often in close proximity to elementary schools...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239011/the-changing-face-of-treatment-mental-health-concerns-and-integrated-care-in-an-hiv-clinic
#12
Eliot J Lopez, Thomas Toomey, Kimberly Lewis, Shirin Khazvand, Rebecca M Floyd, Kena R Arnold, Lara M Stepleman
Though advances in medical treatment have increased lifespans for those living with HIV, quality of life concerns often remain under-treated by health care providers. The integration of mental health services within the HIV medical setting can provide comprehensive care for patients, including brief screening, intervention, and appropriate follow-up. In this study, investigators examined mental health concerns identified during behavioral health screens at appointments in an Infectious Disease Clinic and compared them with previously published data from the same setting to assess changes in patient-reported problems...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239010/antiretroviral-therapy-racial-disparities-among-publicly-insured-californians-with-hiv
#13
Raphael J Landovitz, Katherine A Desmond, Arleen A Leibowitz
Only 43% of Americans with HIV are virally suppressed; the rate is lower for African Americans, even among insured populations. This study uses 2010 Medicare and Medicaid data for HIV-positive Californians to examine how antiretroviral treatment (ART) relates to patient and provider characteristics. Logistic regressions isolated the effect of race/ethnicity on receipt of ART. Over 90% of the full sample received any ART. Nearly 80% of ART users received a recommended combination for at least half the year; half had a recommended combination for 90% of the year...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239009/life-begins-at-60-identifying-the-social-support-needs-of-african-american-women-aging-with-hiv
#14
Lari Warren-Jeanpiere, Heather Dillaway, Pilar Hamilton, Mary Young, Lakshmi Goparaju
HIV chronicity has resulted in increased life expectancy for many African American women who acquired the disease during the epidemic's peak years. As these women live longer and age, their social support needs may increase. Five focus groups were conducted in Washington, DC with 23 HIV-positive African American women aged 52-65 to explore women's perceptions about how aging and HIV chronicity affects their social support needs. Participants were recruited from the longitudinal Women's Interagency HIV Study (WIHS) participant pool...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239008/health-ministry-and-activities-in-african-american-faith-based-organizations-a-qualitative-examination-of-facilitators-barriers-and-use-of-technology
#15
Cheryl L Holt, Anita L Graham-Phillips, C Daniel Mullins, Jimmie L Slade, Alma Savoy, Roxanne Carter
African American faith-based organizations (FBOs) play an important role in addressing health disparities. Increasingly, churches offer health fairs, screenings, or education through health ministries. However, little is known about linking these organizations with evidence-based interventions (EBIs) developed by research. This study explored 1) factors that facilitate or impede health ministry activities, including the adoption of EBIs, and 2) opportunities to use technology to support/enhance the capacity of FBOs to sustain health-related activities...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239007/inadequate-cancer-screening-lack-of-provider-continuity-is-a-greater-obstacle-than-medical-mistrust
#16
Lauren D Arnold, Martha M McGilvray, J Kyle Cooper, Aimee S James
BACKGROUND: Racial minorities and low-income individuals are generally less likely to have adequate cancer screening than Whites or higher-income individuals. PURPOSE: To examine the roles of medical mistrust and lack of provider continuity in cancer screening in a low-income minority population. METHODS: A total of 144 urban federally qualified health center patients completed a cross-sectional survey that included the Group Based Medical Mistrust Scale and questions on provider continuity and cancer-screening-history...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239006/cancer-treatment-delays-in-american-indians-and-alaska-natives-enrolled-in-medicare
#17
Scott V Adams, Aasthaa Bansal, Andrea N Burnett-Hartman, Stacey A Cohen, Andrew Karnopp, Victoria Warren-Mears, Scott D Ramsey
To assess whether timing of initial post-diagnosis cancer care differs between American Indian and Alaska Native (AI/AN) and non-Hispanic White (NHW) patients, we accessed SEER-Medicare data for breast, colorectal, lung, and prostate cancers (2001-2007). Medicare claims data were examined for initiation of cancer-directed treatment. Overall, AI/ANs experienced longer median times to starting treatment than NHWs (45 and 39 days, p < .001) and lower rates of treatment initiation (HR[95%CI]: 0.86[0.79-0.93])...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239005/public-housing-relocations-and-relationships-of-changes-in-neighborhood-disadvantage-and-transportation-access-to-unmet-need-for-medical-care
#18
Danielle F Haley, Sabriya Linton, Ruiyan Luo, Josalin Hunter-Jones, Adaora A Adimora, Gina M Wingood, Loida Bonney, Zev Ross, Hannah L Cooper
INTRODUCTION: Cross-sectional research suggests that neighborhood characteristics and transportation access shape unmet need for medical care. This longitudinal analysis explores relationships of changes in neighborhood socioeconomic disadvantage and trans- portation access to unmet need for medical care. METHODS: We analyzed seven waves of data from African American adults (N = 172) relocating from severely distressed public housing complexes in Atlanta, Georgia...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239004/cancer-mortality-in-the-mississippi-delta-region-descriptive-epidemiology-and-needed-future-research-and-interventions
#19
Whitney E Zahnd, Wiley D Jenkins, Georgia S Mueller-Luckey
The Delta Region is a federally designated, socioeconomically disadvantaged region of the United States covering 252 counties in eight states along the Mississippi River. The objective of this study is to describe the Region's cancer mortality burden. National Center for Health Statistics data were used to calculate age-adjusted mortality rates and rate ratios for the Delta Region for all cancers, lung, colorectal, breast (female), cervical, and prostate cancers. Rates were also calculated for comparison groups, and were stratified by gender, race, rurality, and socioeconomic status...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28239003/cardiovascular-risk-factors-and-use-of-health-care-services-in-low-income-minority-preschool-children
#20
Michele Montgomery, Paige Johnson, Patrick Ewell
BACKGROUND: The association between weight, blood pressure, and use of health care services is not well understood in low-income, preschool children. METHODS: This study was a secondary data analysis of previously collected data. Body mass index (BMI) and blood pressure were collected during health screenings, and information regarding use of health care services was collected by parent report. RESULTS: Of the 660 children screened, 22.1% of the sample was classified as obese and 15...
2017: Journal of Health Care for the Poor and Underserved
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