IU Indianapolis ScholarWorks :: Browsing by Subject "Health equity"

Browsing by Subject "Health equity"

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196 Measuring the Impact of Community Engagement Brokers through Qualitative Interviews
(Cambridge University Press, 2023-04-24) Piechowski, Patricia; Claxton, Gina; Spencer, Nicola 'Nicki'; Vasile, Elizabeth; Zender, Robynn; Medicine, School of Medicine
OBJECTIVES/GOALS: As the clinical and translational research enterprise evolves toward addressing health equity and the science of translational science, the CE Brokers are exploring new avenues for impacting the CTSA consortium. METHODS/STUDY POPULATION: Since 2013, managers of Community Engagement (CE) programs across the NCATS CTSA institutes have met monthly to build connections, share knowledge, and advocate for the boundary spanner role. As the clinical and translational research enterprise evolves toward addressing health equity and the science of translational science, the CE Brokers are exploring new avenues for impacting the CTSA consortium. The CE Brokers are composed of 140 individuals from 58 CTSA-associated institutions, and have a long history that has fostered rich, trusting relationships. The growth and strength of this group has primed it to pivot with the new NCATS direction to contribute meaningfully to the science of community engagement and continue the work of improving health equity within the communities we serve. RESULTS/ANTICIPATED RESULTS: In 2022; we surveyed its members about their roles and responsibilities; the ways the network has contributed to their hub’s adoption and development of best practices and innovations; resources and lessons learned; the creation of opportunities for members to collaboratively conduct and disseminate original research; and research on the science of CE. Grounding ourselves in this initial data, we have developed interview questions to take the inquiry further, by gathering qualitative data on the impact of the group: How the Brokers group impacted them personally and professionally; How the Brokers impacted the work of their CTSA; In three words, describe the group; How could the CE Brokers contribute to the science of community engagement? DISCUSSION/SIGNIFICANCE: Together, we will identify themes supported by quotes to inform how the CE Broker group is most effectively moving the CTSAs’ mission forward and how it can be improved. These will be shared at the Translational Science Meeting, 2023.
2023 Inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium
(Wiley, 2024-07-04) Orechwa, Allison Z.; Abhat, Anshu; Amezcua, Lilyana; Boden-Albala, Bernadette; Buchanan, Thomas A.; Chen, Steve; Daskivich, Lauren P.; Feldman, Brett; Gould, Michael K.; Lee, Wei-an; Lynch, Christopher; Meltzer, Carolyn C.; Mittman, Brian S.; Pereyda, Margarita; Raff, Evan; Robinson, Jehni; Saluja, Sonali; Turner, Barbara J.; Taira, Breena R.; Trotzky-Sirr, Rebecca; Williams, Linda; Wu, Shinyi; Yee, Hal, Jr.; Towfighi, Amytis; Neurology, School of Medicine
Introduction: This article provides an overview of presentations and discussions from the inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium. Methods: The symposium brought together esteemed experts from various disciplines to explore models for translating evidence-based interventions into practice. Results: The symposium highlighted the importance of disruptive innovation in healthcare, the need for multi-stakeholder engagement, and the significance of family and community involvement in healthcare interventions. Conclusions: The article concluded with a call to action for advancing healthcare delivery science to achieve health equity.
A Global Health Reciprocal Innovation grant programme: 5-year review with lessons learnt
(BMJ Publishing, 2023) Ruhl, Laura J.; Kiplagat, Jepchirchir; O'Brien, Rishika; Wools-Kaloustian, Kara; Scanlon, Michael; Plater, David; Thomas, Melissa R.; Pastakia, Sonak; Gopal-Srivastava, Rashmi; Morales-Soto, Nydia; Nyandiko, Winstone; Vreeman, Rachel C.; Litzelman, Debra K.; Laktabai, Jeremiah; Medicine, School of Medicine
Unilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as 'reciprocal innovation' (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core elements of RI, a concept informed by a 30-year partnership started between IU (Indiana) and Moi University (Kenya), which leverages knowledge sharing, transformational learning and translational innovations to address shared health challenges. In this paper, we describe the evolution and implementation of an RI grants programme, as well as the challenges faced. We aim to share the successes of our RI engagement and encourage further funding opportunities to promote innovations grounded in the RI core elements. From the complex series of challenges encountered, three major lessons have been learnt: dedicating extensive time and resources to bring different settings together; establishing local linkages across investigators; and addressing longstanding inequities in global health research. We describe our efforts to address these challenges through educational materials and an online library of resources for RI projects. Using perspectives from RI investigators funded by this programme, we offer future directions resulting from our 5-year experience in applying this RI-focused approach. As the understanding and implementation of RI grow, global health investigators can share resources, knowledge and innovations that have the potential to significantly change the face of collaborative international research and address long-standing health inequities across diverse settings.
A Systematic Approach to Developing Virtual Patient Vignettes for Pediatric Health Equity Research
(Mary Ann Liebert, 2022-11-22) Mulchan, Siddika S.; Miller, Megan; Theriault, Christopher B.; Zempsky, William T.; Hirsh, Adam; Psychology, School of Science
Objective: The aim of this study was to describe a systematic approach to developing virtual patient (VP) vignettes for health equity research in pediatric pain care. Methods: VPs were initially developed to depict the body posture and movements of actual children experiencing pain. Researchers and clinicians with expertise in pediatric pain worked closely with a professional animator to portray empirically supported pain expression in four, full-motion, virtual male characters of two races (i.e., White and Black). Through an iterative process, VPs were refined to (1) appear realistic in a clinical setting and (2) display archetypal pain behavior and expression during a 1-min video clip without sound. Text vignettes were developed with consultation from experts in pain care and presented alongside VPs to assess clinical decision-making. VP vignettes were piloted in a sample of pediatric providers (N=13). Results: Informed by the literature and expertise of stakeholders, several revisions were made to improve VPs' facial grimacing and realism before piloting. VPs appeared to accurately capture important aspects of pain expression and behavior common among pediatric patients with pain disorders. Additional refinements to the text vignettes were made based on provider feedback to improve clarity and clinical relevance. Conclusions: This article presents a working framework to facilitate a systematic approach to developing VP vignettes. This framework is a first step toward advancing health equity research by isolating psychosocial and interpersonal factors affecting provider behavior and decision-making. Future research is needed to validate the use of VP vignettes for assessing provider behavior contributing to health inequities for youth with pain disorders.
Addressing Inequities in Cardiovascular Disease and Maternal Health in Black Women
(American Heart Association, 2021) Cortés, Yamnia I.; Breathett, Khadijah; Medicine, School of Medicine
Association Between the Affordable Care Act Medicaid Expansion and Receipt of Cardiac Resynchronization Therapy by Race and Ethnicity
(American Heart Association, 2022) Mwansa, Hunter; Barry, Ibrahim; Knapp, Shannon M.; Mazimba, Sula; Calhoun, Elizabeth; Sweitzer, Nancy K.; Breathett, Khadijah; Medicine, School of Medicine
Background: Black and Hispanic patients are less likely to receive cardiac resynchronization therapy (CRT) than White patients. Medicaid expansion has been associated with increased access to cardiovascular care among racial and ethnic groups with higher prevalence of underinsurance. It is unknown whether the Medicaid expansion was associated with increased receipt of CRT by race and ethnicity. Methods and Results: Using Healthcare Cost and Utilization Project Data State Inpatient Databases from 19 states and Washington, DC, we analyzed 1061 patients from early‐adopter states (Medicaid expansion by January 2014) and 745 patients from nonadopter states (no implementation 2013–2014). Estimates of change in census‐adjusted rates of CRT with or without defibrillator by race and ethnicity and Medicaid adopter status 1 year before and after January 2014 were conducted using a quasi‐Poisson regression model. Following the Medicaid expansion, the rate of CRT did not significantly change among Black individuals from early‐adopter states (1.07 [95% CI, 0.78–1.48]) or nonadopter states (0.79 [95% CI, 0.57–1.09]). There were no significant changes in rates of CRT among Hispanic individuals from early‐adopter states (0.99 [95% CI, 0.70–1.38]) or nonadopter states (1.01 [95% CI, 0.65–1.57]). There was a 34% increase in CRT rates among White individuals from early‐adopter states (1.34 [95% CI, 1.05–1.70]), and no significant change among White individuals from nonadopter states (0.77 [95% CI, 0.59–1.02]). The change in CRT rates among White individuals was associated with the timing of the Medicaid implementation (P=0.003). Conclusions: Among states participating in Healthcare Cost and Utilization Project Data State Inpatient Databases, implementation of Medicaid expansion was associated with increase in CRT rates among White individuals residing in states that adopted the Medicaid expansion policy. Further work is needed to address disparities in CRT among Black and Hispanic patients.
Baseline Racial and Ethnic Differences in Access to Transplantation in Medicare’s ESRD Treatment Choices Payment Model
(Elsevier, 2023-12-15) Drewry, Kelsey M.; Mora, Ariana N.; Kim, Daeho; Koukounas, Kalli; Wilk, Adam S.; Trivedi, Amal N.; Patzer, Rachel E.; Surgery, School of Medicine
Better together: Coalitions committed to advancing health equity
(Elsevier, 2022-11) Crowder, Sharron J.; Tanner, Andrea L.; Dawson, Martha A.; Felsman, Irene C.; Hassmiller , Susan B.; Miller, Lisa C.; Reinhard, Susan C.; Toney, Debra A.; School of Nursing
The Future of Nursing 2020–2030 report identifies coalitions as a driving force for advancing health equity. Five coalitions provided insight into their accomplishments, lessons learned, and role in advancing health equity. The exemplar coalitions included Latinx Advocacy Team and Interdisciplinary Network for COVID-19, Black Coalition Against COVID, Camden Coalition, National Coalition of Ethnic Minority Nurse Associations, and The Future of Nursing: Campaign for Action. While all exemplar coalitions, credited relationship building and partnerships to their success, they used unique strategies for striving to meet their populations’ needs, whether the needs arose from COVID-19, racial and/or ethnic disparities, socioeconomic disparities, or other barriers to health. Research and policy implications for coalitions are discussed. Nurses play a critical role in every highlighted coalition and in the national effort to make health and health care more equitable.
Business of Medicine: Developing Leaders in Academic Medicine and Learning Health Systems
(Dove Press, 2024-06-24) Sotto-Santiago, Sylk; Neal, Chemen; Caudill, Darren; Gist, Amanda; Eastwick, Susannah; Palmer, Megan M.; Geraci, Mark W.; Aronoff, David M.; Medicine, School of Medicine
Purpose: To develop healthcare professionals as clinical leaders in academic medicine and learning health system; and uncover organizational barriers, as well as pathways and practices to facilitate career growth and professional fulfillment. Methods: The Department of Medicine strategic plan efforts prompted the development of a business of medicine program informed by a needs assessment and realignment between academic departments and the healthcare system. The business of medicine leadership program launched in 2017. This descriptive case study presents its 5th year evaluation. Competencies were included from the Physician MBA program and from specific departmental needs and goals. Results: The program hosted a total of 102 clinical faculty. We had a 37% response rate of those retained at Indiana University School of Medicine. Overall, responses conveyed a positive experience in the course. Over 80% of participants felt that they gained skills in professional reflection, professional socialization, goal orientation, critical thinking, and commitment to profession. Financial literacy was overwhelmingly the skill that was reported to be the most valuable. Finance and accounting were mentioned as the most difficult concepts to understand. Familiar concepts included communication, LEAN, and wellness related topics. One hundred percent of participants said they are utilizing the skills gained in this program in their current role and that they would recommend the course to others. Conclusion: Business of medicine courses are more common now with programs describing elements informed by health system operations. However, few programs incorporate aspects of wellness, equity, diversity, inclusion, and health equity. Our program makes the case for multiple ways to develop inclusive leaders through a focused five-month program. It also recognizes that to really impact the learning health system, health professionals need leadership development and leaders suited to work alongside career administrators, all aiming towards a common goal of equitable patient-centered care.
Capabilities and Limitations of Student-Led Free Vision Screening Programs in the United States
(Association for Research in Vision and Ophthalmology (ARVO), 2024) Devanathan, Nirupama; Scheive, Melanie; Nawash, Baraa S.; Selvam, Amrish; Murphy, Alec; Morrow, McKenna; Anant, Shruti; Chen, Nickolas; Martin, Elizabeth A.; Kruger, Jessica S.; Yung, Chi-Wah Rudy; Johnson, Thomas V.; Ophthalmology, School of Medicine
Purpose: The Consortium of Student-Led Eye Clinics (CSLEC), founded in 2021, administered a comprehensive survey to document the types of services, most common diagnoses, and follow-up care protocols offered by student-led free vision screening programs (SLFVSP) in the United States. Methods: An 81-question institutional review board (IRB)-approved survey was administered to student-led vision screening eye clinics from October 1, 2022 to February 24, 2023. Results: Sixteen SLFVSPs were included in the final analysis, of which 81% (n = 13) conducted variations of fundoscopic examinations and 75% (n = 12) measured intraocular pressure. Cataracts and diabetic retinopathy were reported as the most frequent diagnoses by the majority of SLFVSPs (n = 9, 56%); non-mobile SLFVSPs more commonly reported cataract as a frequent diagnosis (P < 0.05). Most patients screened at participating programs were uninsured or met federal poverty guidelines. Prescription glasses were offered by 56% of the programs (n = 9). SLFVSPs that directly scheduled follow-up appointments reported higher attendance rates (66.5%) than those that only sent referrals (20%). Transportation was the most cited barrier for follow-up appointment attendance. Conclusions: SLFVSPs, one community vision screening initiative subtype, vary significantly in scope and capabilities of identifying vision threatening disease. The follow-up infrastructure is not uniformly robust and represents a key target for improving care delivery to at-risk populations. Translational relevance: The CSLEC aims to develop a consensus-based standardization for the scope of screening services, offer guidelines for diagnostic criteria, promote real-time data stewardship, and identify means to improve follow-up care mechanisms in member communities.

Browsing by Subject "Health equity"

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