IU Indianapolis ScholarWorks :: Browsing by Author "Bigatti, Silvia"

Browsing by Author "Bigatti, Silvia"

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A Community-Engaged Strengths-Based Approach to Fostering Wellbeing in Latinx Communities
(Center for Translating Research Into Practice, IU Indianapolis, 2021-09-24) Bigatti, Silvia
In this presentation, Professor Silvia Bigatti describes her approach to community-based research. This approach allows her to learn from the Latinx community about its culture, strengths, assets, and how these can all be used to foster wellbeing. She also share data from her studies, and describes interventions with the Latinx community that were based on this approach.
Abstract B69: The effects of patient-physician relationships on perceptions of breast cancer treatment in African American women
(Molecular Cancer Research, 2018) Lauray, Alexandria N.; Bigatti, Silvia
According to Indiana.gov, 4,400 new cases of breast cancer are diagnosed in Indiana annually. “During 2008 to 2012, the mortality rates of African American breast cancer patients were almost 40% higher than Caucasian Americans” (Cancer.org), which sheds light on the health disparities African Americans face in the United States. Disparities among cancer patients have not only led to African American women (AAW) being diagnosed in later stages of this disease than their counterparts and thus raising their mortality rates, but AAW tend to be diagnosed with more aggressive forms of cancer such as triple-negative breast cancer, which occurs in 10% to 20% of patients. AAW face many barriers today: limited access to screening services, lack of quality screening equipment, limited access to treatment services, and an unspoken distrust of health care providers. Research indicates that during their breast cancer treatment trajectory, AAW experience delay in initiating chemotherapy after surgery, less satisfaction with treatment, increased symptoms, and lower participation in clinical trials (Mcarthy). Despite this, there is no study that has followed and assessed AAW during the treatment sessions to examine challenges in their lives and their impact. Studies of AAW who have survived breast cancer suggest the need to look not only at factors within the medical care system, but well beyond it into the everyday lives of these women and the resources available to them through social networks and other means to overcome challenges. This project explores themes in the baseline and exit interviews of 38 participants. In their initial interview, we asked questions related to support system, their views of treatment going into the process, and the quality of care that they feel they have received. At the end of treatments, we ask about patient-physician relationships and how the women perceived their care. Women in the study reported the need to readdress concerns with physicians. Patient-physician relationships among AAW diagnosed with breast cancer have been strained and have had a negative impact on patient satisfaction with care.
Cultural Stressors and Depressive Symptoms in Latino/a Adolescents: An Integrative Review
(Journal of the American Psychiatric Nurses Association, 2019) McCord, Allison L.; Burke Draucker, Claire; Bigatti, Silvia
BACKGROUND: Latino/a adolescents experience higher levels of depressive symptoms than Caucasian and African American adolescents. Many studies found that cultural stressors contribute to this disparity, but these findings have not been integrated into a cohesive picture of the specific cultural stressors that contribute to the development of depressive symptoms for Latino/a adolescents. OBJECTIVE: The purpose of this integrative review is to identify cultural stressors that are associated with depressive symptoms in Latino/a adolescents. DESIGN: Procedures outlined by Ganong were used to conduct the review. The results of 33 articles that met inclusion criteria were synthesized. RESULTS: Discrimination, family culture conflict, acculturative and bicultural stress, intragroup rejection, immigration stress, and context of reception were identified as cultural stressors that are associated with depressive symptoms in Latino/a adolescents. CONCLUSIONS: Clinicians should employ strategies to help Latino/a youth cope with cultural stressors and advocate for policies that support the mental health of Latino/a youth.
Does Knowledge of the Risk Factors of Glaucoma Impact Adherence in patients of African descent?
(Investigative Ophthalmology and Visual Science Journal, 2016) Diallo, Kade; Bigatti, Silvia; Sutton, Bradley; Torbit, Julie; Racette, Lyne
Purpose : The first line of treatment for primary open-angle glaucoma (POAG) is the daily use of eye drops. Adherence to this regimen is known to be challenging for patients. While POAG is more prevalent in people of African descent (AD), worse adherence is reported in this high-risk population. The purpose of this prospective clinical study was to determine whether knowledge of the risk factors associated with glaucoma translates into better adherence. Methods : Twenty-nine patients with POAG were included in the study. Participants were on average 60.38±9.93 years of age, identified as being of AD by self-report and 16 were male. Adherence was measured using Medical Event Monitoring System (MEMS) bottles. The cap of these bottles electronically records the date and time at which the bottle is opened. Each participant filled out the Brief Illness Perception questionnaire in which they were asked to “Please list in rank-order the three most important factors that you believe caused your illness”. The adherence of patients who reported 1) at least one accurate risk factor was compared to that of patients who reported no accurate risk factor, 2) race as a risk factor was compared to that of patients who did not report race, and 3) any risk factor (accurate or inaccurate) was compared to that of patients who reported no risk factor. Groups were compared using two-tailed t-tests. Results : Patients who reported at least one accurate risk factor (n=18) had similar adherence (73.39±25.94%) to those who reported no accurate risk factor (n=11) (55.91±33.10%) (p=0.12). Patients who reported race as a risk factor (n=6) had similar adherence (76.50±24.94%) to those who did not report race (n=23) (64.22±30.64%) (p=0.37). Patients reported any risk factor (n=22) had similar adherence (70.36±26.89%) to those who reported no risk factor (n=7) (55.43±36.78%) (p=0.25). While there was an overall trend for higher adherence in patients with more knowledge, statistical significance was not reached in any of the comparisons. Conclusions : We hypothesized that knowledge of the risk factors of glaucoma would result in better adherence because this knowledge could reflect a better understanding of the disease and of the importance of adhering to treatment. Our results suggest that knowledge of the risk factors of glaucoma does not impact adherence. Future studies will investigate whether educating patients can improve adherence.
Getting a Grip on My Depression: How Latina Adolescents Experience, Self-Manage, and Seek Treatment for Depressive Symptoms
(Sage, 2019-10) McCord Stafford, Allison; Aalsma, Matthew; Bigatti, Silvia; Oruche, Ukamaka M.; Burke Draucker, Claire; Pediatrics, School of Medicine
Latina (female) adolescents are more likely to experience depressive symptoms and less likely to receive mental health services than their non-Latina White peers. We aimed to develop a framework that explains how Latina adolescents experience, self-manage, and seek treatment for depressive symptoms. Latina young women (n = 25, M age = 16.8 years) who experienced depressive symptoms during adolescence were recruited from clinical and community settings and interviewed about experiences with depressive symptoms. The framework was developed using constructivist grounded theory methods. Participants experienced a psychosocial problem that we labeled being overburdened and becoming depressed. They responded to this problem through a five-phase psychosocial process that we labeled Getting a Grip on My Depression. Family members, peer groups, and mainstream authorities were influential in how participants experienced these phases. Future research should further develop this framework in diverse samples of Latino/a youth. Clinicians can use this framework in discussions with Latina adolescents about depressive symptoms.
Impact of self-efficacy and demographic factors on adherence to treatment in glaucoma patients of African descent
(Investigative Ophthalmology and Visual Science Journal, 2017) Alkhairy, Sameerah; Chu, Fang-I; Ramezani, Koosha; McIntyre, Elizabeth; Sutton, Bradley; Torbit, Julie; Bigatti, Silvia
Purpose : To determine whether self-efficacy and demographic factors influence adherence to the medical treatment of glaucoma in patients of African descent. Methods : 37 patients with a clinical diagnosis of primary open-angle glaucoma were included in this cross-sectional study. All patients were of African descent, used self-administered once-daily prostaglandin analog eye drops. Adherence was measured in 34 patients during a one-month period (mean 28.8 days) using Medical Event Monitoring System (MEMS) caps. The caps of these bottles electronically record the date and time at which the bottle is opened. All patients completed the four following questionnaires: Q1) glaucoma medication self-efficacy scale, Q2) eye drop technique self-efficacy scale, Q3) reported adherence to medication questionnaire and Q4) brief illness perception questionnaire. All answers were treated as ordinal variable and total scores for each questionnaire were computed. The impact of these four self-efficacy scores on adherence was assessed using linear regression models. We also determined how demographic factors (age, gender, education, marital status, employment status, and income) modulated this relationship. Finally, we assessed the influence of these demographic factors on the self-efficacy scores. Results : The mean age was 60.89±9.81 and 45.95% of patients were female. Eye drop technique self-efficacy (Q2) had a borderline negative impact on adherence (slope=−3.64, p=0.05), such that higher self-efficacy resulted in lower adherence. This result was minimized by being older (p=0.03) or divorced/separated (p=0.04) compared to being single/widowed (increase in the impact of self-efficacy on adherence). Similarly, the relationship between glaucoma medication self-efficacy (Q1) and adherence was negatively modulated by being married/partnered (p=0.04) compared to being single/widowed (decrease in the impact of self-efficacy on adherence). A negative impact of being male was also observed on Q1 (score=−6.28, p=0.05). Conclusions : Overall, patients who were confident in how to administer their eye drops had worse adherence, but this effect was minimized in older and divorced individuals. Overall, being male had a negative impact on self-efficacy as it relates to glaucoma medication. These results suggest that the relationship between self-efficacy and adherence is complex and affected by several factors. This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Latino immigrant parents of adolescents: Need for parenting support
(2014) Bigatti, Silvia; Diaz, Virna; Conrad, Katrina; Weathers, Tess; Mirabal, Magdy
Statement of problem: Latino immigrants in Indianapolis report difficulties parenting their adolescents, meanwhile higher rates of suicide attempts among Latino adolescents have been documented. Relevance: Successful transition through adolescence leads to family and individual well-being. This is especially important for families dealing with the stress of migration and acculturation. Methods: As part of a larger study to identify predictors of Latino adolescent depression, the community partner recruited adolescents and their parents from the population they serve. While the adolescents completed survey instruments, parents (roughly 100) participated in focus groups (n = 8) at various locations around the metropolitan area. One community partner and one academic partner ran the focus groups jointly, asking parents about their concerns regarding parenting and their children. Results: Parents reported problematic behaviors in their children, including aggression, isolation, and cutting. Several themes emerged, with two highlighted here: 1) an understanding that depression and anxiety explained some of the more extreme adolescent behaviors, and 2) a concern that their children would lose their identity and acculturate so much that they would disconnect from the family and its values. Parents reported need for parenting resources to help them navigate the adolescent years. Conclusions: It is challenging to parent adolescents, especially those who have the additional burden of straddling two very distinct cultures. When the parents themselves are adjusting to the new culture it is even more difficult. Culturally-tailored parenting guidance is desired by this Latino community and is likely to improve family functioning and adolescent adjustment.
Leadership Imperatives to Improve Access for Older Adults to the Meals-on-Wheels Programs in California and Florida, Post-COVID-19
(2023-07) Powell, Naci; Stone, Cynthia; Bigatti, Silvia; Czabanowska, Kasia
The United States is witnessing a growing aging population stemming from medical advancements allowing people to live decades longer than the previous generations. The Older Americans Act of 1965 (OAA) was the first federal-level initiative providing comprehensive services for older persons. Title III-C: The Nutrition Service Program of OAA endeavors to “(i) reduce hunger and food insecurity among older individuals, (ii) promote socialization of older individuals, (iii) promote the health and well-being of older individuals, and (iv) delay adverse health conditions for older individuals. Title III-C2: the Home-delivered meals or MOWs program cannot keep up with the demands for their services and have waitlists across the U.S. This descriptive qualitative study used the multiple case study design. Two states with the highest population of older adults, California, and Florida, were examined. Semi-structured interviews were conducted via telephone, and post-reflection memos were created after each interview, along with the completion of a comprehensive document review. Interviews revealed that approximately 499 older adults in California and 22,520 older adults in Florida are waiting for access to MOWs. Kotter’s 8-Step change model was used to formulate a plan for change. This study contributes to the knowledge of the challenges faced by older adults and MOWs programs, and it also highlights how leaders responded to the COVID-19 pandemic.
Multicultural Teaching: Barriers and Recommendations
(2010) Khaja, Khadija; Springer, Jennifer Thorington; Bigatti, Silvia; Gibau, Gina Sanchez; Whitehead, Dawn; Grove, Kathleen; Office of Academic Affairs
A pedagogy that serves students of all backgrounds and trains them to compete in a diverse world is becoming imperative. University educators have been slow to accept the challenge of multicultural teaching, yet it is not clearly understood why this is the case. The authors surveyed 464 faculty members from across disciplines at a large urban, Midwestern campus. This mixed-methods study assessed faculty conceptualizations of multicultural teaching, the degree to which they may be engaged in this practice, and what challenges they face. The findings revealed that faculty members perceived several barriers to multicultural teaching, including student resistance, language barriers, lack of teaching resources, time constraints, and lack of knowledge about multicultural teaching pedagogies. Although the faculty perceived that most barriers were related to student factors, they revealed some degree of insight into their own role in terms of relative effort and lack of knowledge. Furthermore, faculty identified various institutional barriers that could be addressed to facilitate multicultural teaching at institutions of higher education. The importance of multicultural teaching in the current economic and political environment is discussed.
Perfectionism, impostor phenomenon, and mental health in medicine: a literature review
(IJME, 2020-09-28) Thomas, Mary; Bigatti, Silvia; Social and Behavioral Sciences, School of Public Health
Objectives: The aims of this review, focused on medical students, residents, and physicians, were a) to determine the levels of perfectionism and prevalence of impostor phenomenon, b) to assess the relationship between perfectionism, impostor phenomenon, and mental health, and c) explore how medical culture may influence these personality characteristics. Methods: A narrative literature review was conducted. Search terms were entered into PubMed, PsychINFO, Web of Science, EMBASE, and Google Scholar without date or geographic restrictions. The McMaster Critical Review Forms for Quantitative and Qualitative Studies were used for article appraisal. Final decisions on inclusion and exclusion were reached through discussion. Sixteen articles were included in this review and summarized in a data extraction table. Results: Medical students had similar perfectionism scores to other student groups but scored lower in maladaptive perfectionism. The overall prevalence of the impostor phenomenon ranged from 22.5% to 46.6%. More females (41% - 52%) experienced clinical levels of impostor phenomenon compared to males (23.7% - 48%). Most studies did not find an association between the impostor phenomenon and academic year of training. Both personality characteristics were associated with negative mental health effects. Medical culture can train for and/or exacerbate these characteristics, affecting professional identity formation. Both characteristics contribute to distress for learners during commonly-used teaching methods in medical education. Conclusions: Comprehensive changes in medical education that consider the relationship between medical culture, professional identity formation, impostor phenomenon, and perfectionism are needed. Longitudinal studies will help identify the implications of these findings for professional identity formation and medical education.

Browsing by Author "Bigatti, Silvia"

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