Browsing by Subject "Healthcare Disparities"

Now showing 1 - 5 of 5
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    The Conscientious Use of Images Illustrating Diversity in Medical Education Marketing
    (Wolters Kluwer, 2020) Hernandez, Rachael; Hoffmann-Longtin, Krista; Patrick, Shawn; Tucker-Edmonds, Brownsyne; Livingston, Nikki; Communication Studies, School of Liberal Arts
    An institution's marketing materials are an important part of presenting its culture. In 2018, communication professionals in the Office of Faculty Affairs, Professional Development, and Diversity at the Indiana University School of Medicine recognized after reviewing the literature that using images illustrating diversity in marketing materials may have unintended negative consequences and could potentially reflect poorly on the institution. Representations of diversity that are discordant with the actual demographics of an institution can create distrust among faculty, students, and staff who discover an institution is not as diverse or supportive of diversity as their marketing materials suggest. If institutions adopt an aspirational approach to images and depict more diversity than actual demographics reflect, the authors of this Perspective recommend that they both develop marketing materials that present a widely diverse selection of images and demonstrate transparency in their communication strategies.To improve their promotional materials, the authors conducted an analysis of their institution's strategy for selecting images for these materials, identified institutional goals related to the strategic use of images, created training materials for staff, and drafted a public-facing statement about diversity in images. These measures are a significant step forward in cultivating the ethical use of images illustrating diversity. In the future, institutions should highlight their approaches to using images to portray diversity, as well as photograph and document a wide range of events that represent diverse topics and individuals. When these images are used for marketing purposes, it is also important to ensure that they are used in an appropriate context and not selected with the single goal of presenting diversity. Future research should focus on how underrepresented students and faculty interpret the use of diverse images in marketing, as well as their preferences for the use of their own images in marketing materials portraying diversity.
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    The interaction of patient race, provider bias, and clinical ambiguity on pain management decisions
    (Elsevier, 2015-06) Hirsh, Adam T.; Hollingshead, Nicole A.; Ashburn-Nardo, Leslie; Kroenke, Kurt; Department of Psychology, School of Science
    Although racial disparities in pain care are widely reported, much remains to be known about the role of provider and contextual factors. We used computer-simulated patients to examine the influence of patient race, provider racial bias, and clinical ambiguity on pain decisions. One hundred twenty-nine medical residents/fellows made assessment (pain intensity) and treatment (opioid and nonopioid analgesics) decisions for 12 virtual patients with acute pain. Race (black/white) and clinical ambiguity (high/low) were manipulated across vignettes. Participants completed the Implicit Association Test and feeling thermometers, which assess implicit and explicit racial biases, respectively. Individual- and group-level analyses indicated that race and ambiguity had an interactive effect on providers' decisions, such that decisions varied as a function of ambiguity for white but not for black patients. Individual differences across providers were observed for the effect of race and ambiguity on decisions; however, providers' implicit and explicit biases did not account for this variability. These data highlight the complexity of racial disparities and suggest that differences in care between white and black patients are, in part, attributable to the nature (ie, ambiguity) of the clinical scenario. The current study suggests that interventions to reduce disparities should differentially target patient, provider, and contextual factors. PERSPECTIVE: This study examined the unique and collective influence of patient race, provider racial bias, and clinical ambiguity on providers' pain management decisions. These results could inform the development of interventions aimed at reducing disparities and improving pain care.
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    The Role of Nurses in Eliminating Health Disparities and Achieving Health Equity
    (SLACK, 2020-12-01) Oruche, Ukamaka M.; Zapolski, Tamika C. B.; School of Nursing
    Nurses are the largest and most trusted health care workforce and have both professional and moral responsibility to acknowledge, lead, and act to eliminate health disparities and achieve health equity. However, similar to other health professionals, most nurses indicate that they do not have requisite preparation and, therefore, are not practice-ready to meet the need of patients from diverse backgrounds (Fleckman, Corsco, Ramirez, Begaleiva, & Johnson, 2015; Institute of Medicine, 2011). Nursing students’ preparation and nurse clinicians’ continuing education are increasingly important not only due to the disparities in health outcomes described above, but also due to the increasing diversity of the U.S. population as a whole.
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    Trends in Characteristics of Patients Listed for Liver Transplantation Will Lead to Higher Rates of Waitlist Removal Due to Clinical Deterioration
    (Wolters Kluwer, 2017-10) Yi, Zinan; Mayorga, Maria E.; Orman, Eric S.; Wheeler, Stephanie B.; Hayashi, Paul H.; Barritt IV, A. Sidney; Medicine, School of Medicine
    BACKGROUND: Changes in the epidemiology of end-stage liver disease may lead to increased risk of dropout from the liver transplant waitlist. Anticipating the future of liver transplant waitlist characteristics is vital when considering organ allocation policy. METHODS: We performed a discrete event simulation to forecast patient characteristics and rate of waitlist dropout. Estimates were simulated from 2015 to 2025. The model was informed by data from the Organ Procurement and Transplant Network, 2003 to 2014. National data are estimated along with forecasts for 2 regions. RESULTS: Nonalcoholic steatohepatitis will increase from 18% of waitlist additions to 22% by 2025. Hepatitis C will fall from 30% to 21%. Listings over age 60 years will increase from 36% to 48%. The hazard of dropout will increase from 41% to 46% nationally. Wait times for transplant for patients listed with a Model for End-Stage Liver Disease (MELD) between 22 and 27 will double. Region 5, which transplants at relatively higher MELD scores, will experience an increase from 53% to 64% waitlist dropout. Region 11, which transplants at lower MELD scores, will have an increase in waitlist dropout from 30% to 44%. CONCLUSIONS: The liver transplant waitlist size will remain static over the next decade due to patient dropout. Liver transplant candidates will be older, more likely to have nonalcoholic steatohepatitis and will wait for transplantation longer even when listed at a competitive MELD score. There will continue to be significant heterogeneity among transplant regions where some patients will be more likely to drop out of the waitlist than receive a transplant.