Browsing by Subject "health care disparities"

Now showing 1 - 5 of 5
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    Centralized Otolaryngology Research Efforts: Stepping‐stones to Innovation and Equity in Otolaryngology–Head and Neck Surgery
    (Wiley, 2022-06) Brenner, Michael J.; Nelson, Rick F.; Valdez, Tulio A.; Moody-Antonio, Stephanie A.; Nathan, Cherie-Anne O.; St John, Maie A.; Francis, Howard W.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    The Centralized Otolaryngology Research Efforts (CORE) grant program coordinates research funding initiatives across the subspecialties of otolaryngology-head and neck surgery. Modeled after National Institutes of Health study sections, CORE grant review processes provide comprehensive reviews of scientific proposals. The organizational structure and grant review process support grant-writing skills, attention to study design, and other components of academic maturation toward securing external grants from the National Institutes of Health or other agencies. As a learning community and a catalyst for scientific advances, CORE evaluates clinical, translational, basic science, and health services research. Amid the societal reckoning around long-standing social injustices and health inequities, an important question is to what extent CORE engenders diversity, equity, and inclusion for the otolaryngology workforce. This commentary explores CORE's track record as a stepping-stone for promoting equity and innovation in the specialty. Such insights can help maximize opportunities for cultivating diverse leaders across the career continuum.
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    Effects of the COVID-19 Pandemic on Black Veterans’ Mental Health: A Qualitative Investigation
    (Johns Hopkins University Press, 2022-08) Matthias, Marianne S.; Adams, Jasma; Burgess, Diana J.; Daggy, Joanne; Gowan, Tayler M.; Perkins, Anthony J.; Eliancin, Johanne; Medicine, School of Medicine
    Although the disproportionate effects of the COVID-19 pandemic on Black Americans are well-documented, we know little about its effects on their day-to-day lives and sense of wellbeing, especially for those who have served in the military. We conducted qualitative interviews with 21 Black veterans to understand their experiences with the pandemic and administered questionnaires about mental health and pandemic impact. Questionnaires indicated mild depression, moderate anxiety and loneliness, and pandemic effects on social support and health care. Interviews revealed that heightened anxiety and stress were driven by not trusting others to take the pandemic seriously, workplace anxiety, comorbidities, and the pandemic's pronounced effects on Black communities. Participants shared insights into these effects, including lack of caution on the part of some and the role of systemic racism. Findings enhance our understanding of how Black veterans have experienced the pandemic and may have important implications for other underserved groups.
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    Increasing Inclusivity and Reducing Reactance During Provider-Patient Interactions
    (Sage, 2023-05) Shields, Lillianna; Stovall, Tony; Colby, Helen; Kelley School of Business
    Background Significant health disparities exist for trans and gender-nonconforming patients, in part caused by a reduced likelihood of seeking health care due to experienced discrimination in health care settings. Increasing inclusivity in patient-provider interactions can decrease barriers to care seeking for these patients, but such advice to providers must be simple to implement and account for potential backlash among certain patient subgroups. Methods In 3 studies, we use online samples to experimentally test patient reactions to 2 methods of provider inclusivity signaling: verbal sharing of the provider’s pronouns and request for the patient’s pronouns (a method frequently suggested in the literature) and the provider wearing a pin indicating their pronouns without verbal sharing or requesting that the patient share their pronouns. Results Study 1 finds that political orientation significantly moderated the effect of pronoun request on patient satisfaction with the visit, P = .003; satisfaction with the doctor, P = .003; and willingness to return to the provider, P = .007, with politically liberal participants being more satisfied and more likely to return when pronouns were requested and politically conservative participants less satisfied and less likely to return. Study 2 replicated these findings and demonstrated that such backlash among conservative participants did not occur when inclusivity was indicated via the provider wearing a pin indicating their pronouns. Study 3 showed that while pronoun pins may be subtle enough to not cause backlash, they are noticed by the target community and increase satisfaction and willingness to return among participants who identify as trans, nonbinary, and genderqueer. Limitations These studies were hypothetical scenario studies run online rather than field studies. Conclusions These results suggest that recommendations for increasing inclusivity should account for potential negative impacts on the practice from more politically conservative patients and that more subtle methods of indicating an inclusive health care environment are likely to be more implementable for practitioners in the field while still positively affecting the target population.
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    Moving Beyond Cultural Competence Toward Cultural Humility and the Delivery of Equitable Patient-Centered Care
    (2019) Maldonado, Maria; Dupras, Denise; Sotto-Santiago, Sylk
    In the Accreditation Council on Graduate Medical Education’s (ACGME) 2016 national report of the Clinical Learning Environment (CLE) Review, it was reported that across most CLEs, education and training on health care disparities and cultural competency was largely generic. A “generic approach” to cultural competency implies that sponsoring institutions where training programs are seated have not made an assessment of the specific needs of the patient population that they are serving. While a targeted approach is a laudable goal, it runs the risk of stereotyping the needs of individuals in a specific cultural group. We propose that the time has come to move beyond the goal of cultural competency toward cultural humility and the delivery of equitable patient centered care – care that is delivered that takes into consideration the specific needs of the patient and does not vary in quality based on personal characteristics like gender, ethnicity, geographic location, religion, sexuality, and socioeconomic status. Graduate medical education should ensure that learners develop skills critical to delivering patient- centered care that emphasize the core qualities of curiosity, empathy and respect.
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    Rural and Urban Differences in the Adoption of New Health Information and Medical Technologies
    (Wiley, 2019-03) Haggstrom, David A.; Lee, Joy L.; Dickinson, Stephanie L.; Kianersi, Sina; Roberts, Jamie L.; Teal, Evgenia; Baker, Layla B.; Rawl, Susan M.; Medicine, School of Medicine
    Background This statewide survey sought to understand the adoption level of new health information and medical technologies, and whether these patterns differed between urban and rural populations. Methods A random sample of 7,979 people aged 18‐75 years, stratified by rural status and race, who lived in 1 of 34 Indiana counties with high cancer mortality rates and were seen at least once in the past year in a statewide health system were surveyed. Results Completed surveys were returned by 970 participants. Rural patients were less likely than urban to use electronic health record messaging systems (28.3% vs 34.5%, P = .045) or any communication technology (43.0% vs 50.8%, P = .017). Rural patients were less likely to look for personal health information for someone else's medical record (11.0% vs 16.3%, P = .022), look‐up test results (29.5% vs 38.3%, P = .005), or use any form of electronic medical record (EMR) access (57.5% vs 67.1%, P = .003). Rural differences in any use of communication technology or EMRs were no longer significant in adjusted models, while education and income were significantly associated. There was a trend in the higher use of low‐dose computed tomography (CT) scan among rural patients (19.1% vs 14.4%, P = .057). No significant difference was present between rural and urban patients in the use of the human papilloma virus test (27.1% vs 26.6%, P = .880). Conclusions Differences in health information technology use between rural and urban populations may be moderated by social determinants. Lower adoption of new health information technologies (HITs) than medical technologies among rural, compared to urban, individuals may be due to lower levels of evidence supporting HITs.