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Underserved populations

Titilola Balogun, Catherine Troisi, Michael D Swartz, Linda Lloyd, Rebecca Beyda
Youth involved in the juvenile justice system represent a medically underserved population. Recidivist youth have poorer health outcomes compared to youth detained for the first time. This study determined differences in immunization history, substance use, mental health symptoms, and sexual behavior between recidivist youth and first-time detainees following improvements in intake screenings at a large, urban juvenile detention center in the Southeastern United States. Multivariable logistic regression analysis found that recidivist youth had significantly higher acellular pertussis immunization rates compared with first-time detainees (odds ratio [ OR] = 3...
January 1, 2018: Journal of Correctional Health Care
Marcia C Inhorn, Pasquale Patrizio
Reproductive health services, including infertility care, are important in countries with infrastructure deficits, such as Lebanon, which now hosts more than one million Syrian refugees. Islamic prohibitions on child adoption and third-party reproductive assistance (donor eggs, sperm, embryos, and surrogacy) mean that most Muslim couples must turn to in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) to overcome their childlessness. Attempts to bring low-cost IVF-ICSI to underserved populations might help infertile couples where no other services are available...
March 1, 2018: AMA Journal of Ethics
Amy Y Carney
Public Health Nurses are the largest group of public health practitioners in both local and state health departments across the United States. Essential for the delivery of health services in the community, Public Health Nurses frequently provide care for underserved and vulnerable populations. Among these populations are the victims of campus sexual assault, a growing problem on college and university campuses. Both nationally and internationally, sexual assault has been described as a public health and human rights concern...
March 15, 2018: Public Health Nursing
Michael Thomas LeCompte, Connor Goldman, John L Tarpley, Margaret Tarpley, Erik N Hansen, Peter M Nthumba, Kyla P Terhune, Rondi M Kauffmann
INTRODUCTION: Global surgery is increasingly recognized as a vital component of international public health. Access to basic surgical care is limited in much of the world, resulting in a global burden of treatable disease. To address the lack of surgical workforce in underserved environments and to foster ongoing interest in global health among US-trained surgeons, our institution established a residency rotation through partnership with an academic hospital in Kijabe, Kenya. This study evaluates the perceptions of residents involved in the rotation, as well as its impact on their future involvement in global health...
March 14, 2018: World Journal of Surgery
B Josea Kramer, Beth Creekmur, Michael N Mitchell, Debra Saliba
BACKGROUND/OBJECTIVES: Home-based primary care (HBPC) is a comprehensive, interdisciplinary program to meet the medical needs of community-dwelling populations needing long-term care (LTC). The U.S. Department of Veterans Affairs (VA) expanded its HBPC program to underserved rural communities, including American Indian reservations, providing a "natural laboratory" to study change in access to VA LTC benefits and utilization outcomes for rural populations that typically face challenges in accessing LTC medical support...
March 12, 2018: Journal of the American Geriatrics Society
Amirhossein Moaddab, Gary A Dildy, Haywood L Brown, Zhoobin H Bateni, Michael A Belfort, Haleh Sangi-Haghpeykar, Steven L Clark
OBJECTIVE: To quantitate the contribution of various demographic factors to the U.S. maternal mortality ratio. METHODS: This was a retrospective observational study. We analyzed data from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics database and the Detailed Mortality Underlying Cause of Death database (CDC WONDER) from 2005 to 2014 that contains mortality and population counts for all U.S. counties. Bivariate correlations between the maternal mortality ratio and all maternal demographic, lifestyle, health, and medical service utilization characteristics were calculated...
March 8, 2018: Obstetrics and Gynecology
A Pablo Juárez, Amy S Weitlauf, Amy Nicholson, Anna Pasternak, Neill Broderick, Jeffrey Hine, J Alacia Stainbrook, Zachary Warren
Increasing access to diagnostic services is crucial for identifying ASD in young children. We therefore evaluated a telemedicine assessment procedure. First, we compared telediagnostic accuracy to blinded gold-standard evaluations (n = 20). ASD cases identified via telemedicine were confirmed by in-person evaluation. However, 20% of children diagnosed with ASD in-person were not diagnosed via telemedicine. Second, we evaluated telediagnostic feasibility and acceptability in a rural catchment. Children (n = 45) and caregivers completed the telemedicine procedure and provided feedback...
March 12, 2018: Journal of Autism and Developmental Disorders
Jessica Snowden, Paul Darden, Paul Palumbo, Phil Saul, Jeannette Lee
PURPOSE OF REVIEW: The institutional development award (IDeA) program was created to increase the competitiveness of investigators in states with historically low success rates for National Institutes of Health (NIH) research funding applications. IDeA states have high numbers of rural and medically underserved residents with disproportionately high rates of infant mortality, obesity, and poverty. This program supports the development and expansion of research infrastructure and research activities in these states...
April 2018: Current Opinion in Pediatrics
Larry Charleston, Jeffrey Royce, Teshamae S Monteith, Susan W Broner, Hope L O'Brien, Salvador L Manrriquez, Matthew S Robbins
OBJECTIVE: To review the scope of the problem facing individuals with migraine who are under- or uninsured. In this first of a 2-part narrative review, we will explore migraine epidemiology and the challenges that face this vulnerable population. BACKGROUND: Implementation of the Affordable Care Act has improved access to health care for many individuals who were previously uninsured, but there are many, particularly those of certain demographics, who are at high risk for worse outcomes...
March 8, 2018: Headache
Mario Ramos, Constanza E Fernández, Larry Williams
No abstract text is available yet for this article.
March 2018: General Dentistry
Jawad Chishtie, Farrukh Chishtie, Karen Yoshida, Robert Balogh
BACKGROUND: The 2005 South Asian earthquake led to large-scale injuries and disabilities in northern Pakistan, which were dealt with using various approaches. In this regard, a community-based rehabilitation approach was initiated in the Muzaffarabad district of Pakistan in early 2006, focused on preventing complications among persons with Spinal Cord Injury. This case study briefly describes its development, aims and service provision components, in addition to the distribution of injuries from the disaster...
March 7, 2018: Disability and Rehabilitation
Omar T Sims, Pamela A Melton, Shaonin Ji
This study describes clinical characteristics of poor and uninsured patients living with hepatitis C virus (HCV) who received care from a multidisciplinary HCV clinic, reports treatment completion and cure rates, and estimates the cost of HCV medications provided at no cost to uninsured patients. A retrospective chart review was performed and identified 69 uninsured HCV patients who received medical care at Mercy Health Center, a small non-profit community clinic, between January 2008 and March 2015. Three-fourths of the patients were unemployed, a third had multiple HCV exposures, nearly half acquired HCV due to illicit drug use, and more than half had active psychiatric disorders...
March 6, 2018: Journal of Community Health
Elizabeth Fam, Jeanne M Ferrante
To help understand and mitigate health disparities, it is important to conduct research with underserved and underrepresented minority populations under real world settings. There is a gap in the literature detailing real-time research staff experience, particularly in their own words, while conducting in-person patient recruitment in urban community health centers. This paper describes challenges faced at the clinic, staff, and patient levels, our lessons learned, and strategies implemented by research staff while recruiting predominantly low-income African-American women for an interviewer-administered survey study in four urban Federally Qualified Health Centers in New Jersey...
February 2018: Journal of the National Medical Association
B Wood, MSc, A Lofters, M Vahabi
Background: Self-sampling for human papillomavirus (hpv) has the potential to reach marginalized populations that are underserved for cervical cancer screening. However, before implementing an alternative screening strategy such as self-sampling for under- and never-screened women, the key processes, facilitators, and barriers to reform need to be understood. Methods: A descriptive qualitative study was conducted that involved semi-structured interviews with Canadian and international cancer screening health care providers and policy-makers...
February 2018: Current Oncology
Joseph Burns, Dharam Persaud-Sharma, Dollie Green
In the United States, hypertension is a significant medical problem that affects nearly 1 in 3 adults, causes thousands of deaths annually, and costs the nation billions of dollars annually for medical management in terms of hospitalisations, lost wages, and pharmacotherapy. The management guidelines of hypertension have greatly varied between different healthcare organisations including the American College of Cardiology (ACC), the European Society of Cardiology (ESC) and the Joint National Committee (JNC-7, 8)...
March 5, 2018: Acta Cardiologica
Cyndy R Snyder, Bianca K Frogner, Susan M Skillman
Racial and ethnic diversity in the health workforce can facilitate access to healthcare for underserved populations and meet the health needs of an increasingly diverse population. In this study, we explored 1) changes in the racial and ethnic diversity of the health workforce in the United States over the last decade, and 2) evidence on the effectiveness of programs designed to promote racial and ethnic diversity in the U.S. health workforce. Findings suggest that although the health workforce overall is becoming more diverse, people of color are most often represented among the entry-level, lower-skilled health occupations...
2018: Journal of Allied Health
Dori Pekmezi, Cole Ainsworth, Taylor Holly, Victoria Williams, Tanya Benitez, Kaiying Wang, Laura Q Rogers, Bess Marcus, Wendy Demark-Wahnefried
Telephone-delivered interventions do not require frequent clinic visits, literacy, or costly technology and thus may represent promising approaches to promoting physical activity in the Deep South, a largely rural U.S. region, with generally lower physical activity, income, and education levels. Building on past Interactive Voice Response (IVR) system-based HIV studies and extensive formative research (11 focus groups on physical activity intervention needs/preferences in the Deep South), the resulting IVR-supported physical activity intervention is now being tested in a randomized controlled trial with a waitlist control...
December 2017: Contemporary Clinical Trials Communications
J Nwando Olayiwola, Rachel Willard-Grace, Kate Dubé, Danielle Hessler, Rebecca Shunk, Kevin Grumbach, Laura Gottlieb
PURPOSE: Primary care physicians (PCP) experience high rates of professional burnout. These symptoms may be magnified in underserved populations. This study explores relationships between clinic capacity to address patients' social needs (SN) and PCP burnout. METHODS: We conducted a cross-sectional survey of PCPs from three delivery systems in San Francisco. Surveys included three components of burnout, measured by the Maslach Burnout Inventory (MBI) and a four-item instrument exploring attitudes, confidence, individual skills and organizational capacity to address patients' SN...
2018: Journal of Health Care for the Poor and Underserved
Kathleen M Nemer, Larry R Churchill
The purpose of this study was to identify physician actions that facilitate meaningful doctor-patient relationships, from the perspective of the medically underserved patient. Twenty-five patients were interviewed at the United Neighborhood Health Services Northeast Clinic in Nashville, Tennessee, which serves an underinsured patient population. Patients were asked to identify the qualities of engagement with their doctor that move beyond simple diagnosis and treatment. Interviews were audio-recorded, professionally transcribed, made anonymous, and analyzed by the grounded theory method of qualitative research...
2018: Journal of Health Care for the Poor and Underserved
Junjun Xu, Arletha Williams-Livingston, Anne Gaglioti, Calvin McAllister, George Rust
The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes...
2018: Journal of Health Care for the Poor and Underserved
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