Journal of Health Disparities Research and Practice

In the United States, significant racial and ethnic disparities exist in chronic kidney disease (CKD) and its management. Hemodialysis constitutes the main stay of renal replacement therapy for end-stage kidney disease (ESKD), which is initiated using central venous catheters (CVC) in most CKD patients in the United States. Black ESKD patients have higher usage and greater time on CVC for hemodialysis compared to White patients. This trend places Black patients at a potentially higher risk for CVC-related complications such as central venous stenosis (CVS)...

Young Black/African American men are more likely to experience repeated trauma that escalates throughout young adulthood, compared to young White men. Exposure to trauma has impacts on mental health outcomes, but young Black men face substantial barriers to mental health care. In order to begin to address these disparities, it is imperative to increase understanding of the needs, preferences, and priorities of young Black men for mental health care services following trauma. Yet, young Black men are often underrepresented in mental health services research...

INTRODUCTION: Racial and ethnic disparities in perinatal health outcomes are among the greatest threats to population health in the United States. Black birthing communities are most impacted by these inequities due to structural racism throughout society and within health care settings. Although multiple studies have shown that structural racism and the disrespect associated with this system of inequity are the root causes of observed perinatal inequities, little scholarship has centered the needs of Black birthing communities to create alternative care models...

BACKGROUND: Research shows that pregnant women experiencing housing insecurity are more likely to face barriers to prenatal care that can lead to negative health outcomes for both mother and infant. Previous studies have also shown that prenatal education programs provide pregnant mothers with the knowledge and resources that increase the likelihood of positive health outcomes. An interprofessional healthcare team in Central Arkansas modified an existing prenatal education program to create Motherhood Together, a program specifically tailored for pregnant women facing house insecurity...

BACKGROUND: Thirty years after the Americans with Disabilities Act (ADA) was passed, promising equal access to health services for people with disabilities and serious mental illness, research on Pap testing continues to uncover health disparities among women with disabilities and women with serious mental illnesses, including those that identify as an ethnic/racial minority. AIM: The purpose of this paper is to describe and present the literature on the barriers and facilitators women with disabilities and women with serious mental illnesses face with receiving a Pap test using the social ecological model...

Medical journals play an important role in achieving health equity by diversifying their leadership, but there is a dearth of published data on how they are faring. The objective of this study was to assess the proportions of the underrepresented in medicine (UIM) racial/ ethnic minorities in medical journal leadership. We pre-selected 6 prominent general medicine journals, 9 prominent specialty journals, and 5 "control" journals (covering public health, health equity, and bench research), assembled names of all editors/ editorial board members listed on the website-based journal mastheads and used major public internet search engines to obtain information about sex, race, and ethnicity...

This project evaluated the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors , which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet many on the Navajo Nation have limited knowledge and capacity to garden...

Beneficial social connections are critical to individual-level health. These connections increase access to social support/resources that can be used to avoid or minimize the risks and consequences associated with diseases. How to best measure beneficial social connections to inform social network-level health interventions remains poorly understood. A scoping review of empirical health research studies was conducted to highlight the utility of employing position generators to assess how access to beneficial social connections was associated with population health and disparities...

Background: Oral and pharyngeal cancer (OPC) is a frequent type of cancer in Puerto Rico, with the risk being higher in men relative to women. We assessed differences in OPC risk factors implicated in these sex disparities. Methods: We analyzed data of 740 adult participants (40-65 years) from the San Juan Overweight Adults Longitudinal Study (SOALS). A comprehensive questionnaire was administered to collect information on sociodemographic characteristics, cigarette smoking, binge drinking, oral high-risk HPV infection, fruit and vegetable consumption, sexual behavior, and oral hygiene practices...

Background: Clinical trials (CT) in breast cancer have been crucial for new treatment discoveries. While participation in cancer CT is low, minorities are particularly underrepresented. This study aimed to identify factors influencing the participation in CTs based on the experiences of Latina breast cancer survivors in Puerto Rico (PR), especially their CT knowledge, motivations, and concerns. Method: Focus groups (FG) were conducted by two social workers and the University of Puerto Rico/MD Anderson Community Health Educator...

Background: Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services...

The benefits of genetic counseling and testing for hereditary breast and/or ovarian cancer (HBOC) are well documented; however, Black women are less likely to use these services compared to White women. Mistrust of the medical system has been associated with Black women's use of genetic counseling and testing (GCT). However, relatively little is known about the correlates of medical mistrust in Black women at increased risk of HBOC. In this study, we examined the prevalence and predictors of medical mistrust in 94 Black women at-risk of HBOC...

Although tobacco use among women living with HIV (WLWH) is decreasing, the prevalence is more than double that of women in the general population and remains an important health behavior to target among WLWH. Few smoking cessation interventions specifically focus on the unique social and medical needs of WLWH. Thus, the investigative team engaged WLWH (N=18) in qualitative focus groups to: 1) understand barriers and facilitators to smoking cessation; and 2) inform intervention structure and content priorities...

Community Advisory Boards (CABs) are used in efforts to reduce health disparities; however, there is little documentation in the literature regarding their use in precision medicine research. In this case study, an academic-CAB partnership developed a questionnaire and patient educational materials for two precision smoking cessation interventions that involved use of genetic or genetically-informed information. The community-engaged research (CEnR) literature provided a framework for enhancing benefits to CAB members involved in developing research documents for use with a low-income, ethnically diverse population of smokers...

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in the US. Further, rural US adults experience disproportionately high CVD prevalence and mortality compared to non-rural. Cardiovascular risk-reduction interventions for rural adults have shown short-term effectiveness, but long-term maintenance of outcomes remains a challenge. Faith organizations offer promise as collaborative partners for translating evidence-based interventions to reduce CVD. Methods: We adapted and implemented a collaborative, faith-placed, CVD risk-reduction intervention in rural Illinois...

Purpose: We characterize the costs and cost-effectiveness of a community health worker (CHW)-based intervention to promote screening mammography among US-based non-adherent Latinas. Methods: The parent study was a randomized controlled trial for 536 Latinas aged 42-74 years old who had sought care within a safety net health center in Western Washington. Participants were block-randomized within clinic to the control arm (usual care) or intervention arm (CHW-led motivational interviewing intervention)...

Background: Youth in protective custody (e.g.. foster care) are at higher risk for poorer physical and mental health outcomes compared with those who are not in custody. These differences may be due in part to the lack of research on the population to create evidence-based recommendations for health care delivery. A potential contributor to this lack of research is difficulties in obtaining informed consent for empirical studies in this population. The objective of this study was to describe the approaches to obtaining informed consent in minimal risk studies of foster youth and provide recommendations for future requirements...

Objective: While food insecurity (FI) has been associated with obesity in some studies, few have examined the relationship between FI and health attitudes and behaviors. We hypothesized that families who experienced FI would report lower importance of discussing health-related behavior change, report lower physical activity (PA) and have children who were more likely to be obese. Design/Methods: We conducted a cross-sectional analysis of data collected from 2012 - 2015 from three clinics serving primarily low-income, Latino patients...

This study attempts to clarify the associations between macro-social and social network factors and the continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL...

Patient activation (the knowledge, confidence, willingness, and skills to manage one's healthcare) and health literacy have well-established associations with health and healthcare outcomes in adults. However, little is known about parent activation on behalf of children and its relation to health literacy. Our objective was to examine relations between parent activation, health literacy, and parent-provider relationship quality. We surveyed 316 Spanish- or English-speaking parents of publicly-insured patients of a general pediatrics clinic...