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1.
Health Equity ; 6(1): 278-290, 2022.
Article in English | MEDLINE | ID: covidwho-1774316

ABSTRACT

Introduction: Community-based organizations (CBOs) have provided critical resources during the pandemic, particularly for marginalized communities, and are trusted liaisons who connect socially and linguistically isolated community members, such as the highly diverse Asian American population, to care during public health emergencies. Stereotypes such as the model minority myth have permeated public perception of Asian Americans' health status and health care access needs, fueling widespread belief that Asian Americans do not experience health disparities, and mask the high rates of coronavirus disease 2019 (COVID-19) infection, hospitalization, and mortality among Asian Americans. The unequal burden of COVID-19 on Asian American communities has largely remained absent from the public health and national discourse, with exceptions such as community voices that have directed news media coverage and leading roles of CBOs in offering culturally adapted, in-language programming on COVID-19 infection prevention and control. Methods: CBOs and their staff are well-equipped with the cultural acuity, language capacity, and familiarity with local norms to improve structural gaps affecting health outcomes and support health care delivery. Results: We discuss the roles and responsibilities of CBOs in strengthening the health care workforce and expanding community-clinic linkages and provide two case studies illustrating the efforts of two community organizations serving Asian American and immigrant communities, who have been disproportionally affected by the COVID-19 pandemic. Discussion: CBOs are essential to supporting health service coordination and care delivery for structurally vulnerable populations, and are vital to sustaining the coordinated, multilevel public health response to improving community health. Conclusion: Bolstering the current infrastructure to support CBOs is necessary to facilitating immediate responses to serve community needs.

2.
Journal of clinical and translational science ; 5(Suppl 1):78-78, 2021.
Article in English | EuropePMC | ID: covidwho-1728367

ABSTRACT

IMPACT: This poster will demonstrate how input from a CTSI Community Advisory Board was used to develop a large, annual dissemination event focused on health disparities, health equity, and community engagement. OBJECTIVES/GOALS: The NYU Langone Annual Health Disparities Symposium began in response to the NYU-H+H CTSI’s Community Advisory Board, which expressed a desire to 1) learn about health disparities research at NYU, H+H, and beyond;2) build connections and interdisciplinary collaborations;3) support bidirectional dissemination between community and researchers. METHODS/STUDY POPULATION: The annual symposium, a collaboration between NYU Langone’s CTSI, Department of Population Health, Office of Diversity Affairs, and the NYU-CUNY Prevention Research Center, features a keynote, a series of rapid-fire talks, panels on current controversies in population health and the work of the Community Engagement Cores of NYC-based CTSAs, and poster sessions. Each year the event is focused around a specific theme, with the 2020 theme being ‘Research Into Action’. Audience members include faculty, staff, students, health care providers, community health workers, and representatives from community-based organizations, health care facilities, and the NYC Department of Health and Mental Hygiene. For the very first time, the event was held virtually days and CME/CNE credits were provided free of cost. RESULTS/ANTICIPATED RESULTS: The conference explored how institutions have turned research into action, and speakers addressed the ways in which COVID-19 has highlighted structural inequities that have existed across time. 585 attendees participated in the event, with 63 claiming an average of 7.8 hours of continuing education credits. 46 individuals completed the post-event evaluation, with 95% agreeing/strongly agreeing that the symposium increased their awareness of health disparities research taking place at NYU, H+H, and beyond, 91% agreeing/strongly agreeing that they are likely to apply the information learned to their own work, and 91% agreeing/strongly agreeing that the symposium increased their interest in health disparities research. 86% were very/extremely satisfied with the quality of the meeting overall. DISCUSSION/SIGNIFICANCE OF FINDINGS: The 2020 event had the greatest proportion of health care provider attendees (24%), likely due to the opportunity to earn CME/CNE credits. Attendance also grew over the years, from 150 in 2015 to 585 in 2020. This increase is likely due to increased awareness of the event, as well as well as virtual the format, which made it more convenient for attendees.

3.
Health Aff (Millwood) ; 41(2): 296-303, 2022 02.
Article in English | MEDLINE | ID: covidwho-1686117

ABSTRACT

The Asian American health narrative reflects a long history of structural racism in the US and the complex interplay of racialized history, immigrant patterns, and policies regarding Asians in the US. Yet owing to systematic issues in data collection including missing or misclassified data for Asian Americans and practices that lead to indiscriminate grouping of unlike individuals (for example, Chinese, Vietnamese, and Bangladeshi) together in data systems and pervasive stereotypes of Asian Americans, the drivers and experiences of health disparities experienced by these diverse groups remain unclear. The perpetual exclusion and misrepresentation of Asian American experiences in health research is exacerbated by three racialized stereotypes-the model minority, healthy immigrant effect, and perpetual foreigner-that fuel scientific and societal perceptions that Asian Americans do not experience health disparities. This codifies racist biases against the Asian American population in a mutually reinforcing cycle. In this article we describe the poor-quality data infrastructure and biases on the part of researchers and public health professionals, and we highlight examples from the health disparities literature. We provide recommendations on how to implement systems-level change and educational reform to infuse racial equity in future policy and practice for Asian American communities.


Subject(s)
Asian Americans , Emigrants and Immigrants , Data Accuracy , Humans , Minority Groups
4.
Public Health Rep ; 137(2): 226-233, 2022.
Article in English | MEDLINE | ID: covidwho-1643027

ABSTRACT

For more than 30 years, the network of Centers for Disease Control and Prevention (CDC)-funded Prevention Research Centers (PRCs) has worked with local communities and partners to implement and evaluate public health interventions and policies for the prevention of disease and promotion of health. The COVID-19 pandemic tested the PRC network's ability to rapidly respond to multiple, simultaneous public health crises. On April 28, 2020, to assess the network's engagement with activities undertaken in response to the early phase of the pandemic, PRC network leadership distributed an online survey to the directors of 34 currently or formerly funded PRCs, asking them to report their PRCs' engagement with predetermined activities across 9 topical areas and provide case studies exemplifying that engagement. We received responses from 24 PRCs, all of which reported engagement with at least 1 of the 9 topical areas (mean, 5). The topical areas with which the greatest number of PRCs reported engagement were support of frontline agencies (21 of 24, 88%) and support of activities related to health care (21 of 24, 88%). The mean number of activities with which PRCs reported engagement was 11. The PRCs provided more than 90 case studies exemplifying their work. The results of the survey indicated that the PRCs mobilized their personnel and resources to support the COVID-19 response in less than 6 weeks. We posit that the speed of this response was due, in part, to the broad and diverse expertise of PRC personnel and long-standing partnerships between PRCs and the communities in which they work.


Subject(s)
COVID-19/prevention & control , Community Participation , Health Services Research/organization & administration , Preventive Health Services/organization & administration , Public Health , Centers for Disease Control and Prevention, U.S. , Health Services Research/statistics & numerical data , Humans , Intersectoral Collaboration , Organizational Case Studies , Preventive Health Services/statistics & numerical data , Surveys and Questionnaires , United States
5.
BMJ Open ; 12(1): e053641, 2022 01 06.
Article in English | MEDLINE | ID: covidwho-1613006

ABSTRACT

OBJECTIVES: To examine the factors associated with COVID-19 vaccine receipt among healthcare workers and the role of vaccine confidence in decisions to vaccinate, and to better understand concerns related to COVID-19 vaccination. DESIGN: Cross-sectional anonymous survey among front-line, support service and administrative healthcare workers. SETTING: Two large integrated healthcare systems (one private and one public) in New York City during the initial roll-out of the COVID-19 vaccine. PARTICIPANTS: 1933 healthcare workers, including nurses, physicians, allied health professionals, environmental services staff, researchers and administrative staff. PRIMARY OUTCOME MEASURES: The primary outcome was COVID-19 vaccine receipt during the initial roll-out of the vaccine among healthcare workers. RESULTS: Among 1933 healthcare workers who had been offered the vaccine, 81% had received the vaccine at the time of the survey. Receipt was lower among black (58%; OR: 0.14, 95% CI 0.1 to 0.2) compared with white (91%) healthcare workers, and higher among non-Hispanic (84%) compared with Hispanic (69%; OR: 2.37, 95% CI 1.8 to 3.1) healthcare workers. Among healthcare workers with concerns about COVID-19 vaccine safety, 65% received the vaccine. Among healthcare workers who agreed with the statement that the vaccine is important to protect family members, 86% were vaccinated. Of those who disagreed, 25% received the vaccine (p<0.001). In a multivariable analysis, concern about being experimented on (OR: 0.44, 95% CI 0.31 to 0.6), concern about COVID-19 vaccine safety (OR: 0.39, 95% CI 0.28 to 0.55), lack of influenza vaccine receipt (OR: 0.28, 95% CI 0.18 to 0.44), disagreeing that COVID-19 vaccination is important to protect others (OR: 0.37, 95% CI 0.27 to 0.52) and black race (OR: 0.38, 95% CI 0.24 to 0.59) were independently associated with COVID-19 vaccine non-receipt. Over 70% of all healthcare workers responded that they had been approached for vaccine advice multiple times by family, community members and patients. CONCLUSIONS: Our data demonstrated high overall receipt among healthcare workers. Even among healthcare workers with concerns about COVID-19 vaccine safety, side effects or being experimented on, over 50% received the vaccine. Attitudes around the importance of COVID-19 vaccination to protect others played a large role in healthcare workers' decisions to vaccinate. We observed striking inequities in COVID-19 vaccine receipt, particularly affecting black and Hispanic workers. Further research is urgently needed to address issues related to vaccine equity and uptake in the context of systemic racism and barriers to care. This is particularly important given the influence healthcare workers have in vaccine decision-making conversations in their communities.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated , Influenza Vaccines , COVID-19 Vaccines , Cross-Sectional Studies , Health Personnel , Humans , New York City , SARS-CoV-2 , Vaccination
6.
Public Health Rep ; 137(2): 317-325, 2022.
Article in English | MEDLINE | ID: covidwho-1582749

ABSTRACT

OBJECTIVES: Data on the health burden of COVID-19 among Asian American people of various ethnic subgroups remain limited. We examined COVID-19 outcomes of people of various Asian ethnic subgroups and other racial and ethnic groups in an urban safety net hospital system. METHODS: We conducted a retrospective analysis of 85 328 adults aged ≥18 tested for COVID-19 at New York City's public hospital system from March 1 through May 31, 2020. We examined COVID-19 positivity, hospitalization, and mortality, as well as demographic characteristics and comorbidities known to worsen COVID-19 outcomes. We conducted adjusted multivariable regression analyses examining racial and ethnic disparities in mortality. RESULTS: Of 9971 Asian patients (11.7% of patients overall), 48.2% were South Asian, 22.2% were Chinese, and 29.6% were in other Asian ethnic groups. South Asian patients had the highest rates of COVID-19 positivity (30.8%) and hospitalization (51.6%) among Asian patients, second overall only to Hispanic (32.1% and 45.8%, respectively) and non-Hispanic Black (27.5% and 57.5%, respectively) patients. Chinese patients had a mortality rate of 35.7%, highest of all racial and ethnic groups. After adjusting for demographic characteristics and comorbidities, only Chinese patients had significantly higher odds of mortality than non-Hispanic White patients (odds ratio = 1.44; 95% CI, 1.04-2.01). CONCLUSIONS: Asian American people, particularly those of South Asian and Chinese descent, bear a substantial and disproportionate health burden of COVID-19. These findings underscore the need for improved data collection and reporting and public health efforts to mitigate disparities in COVID-19 morbidity and mortality among these groups.


Subject(s)
Asian Americans/statistics & numerical data , COVID-19/ethnology , Ethnic and Racial Minorities/statistics & numerical data , Health Status Disparities , Social Determinants of Health/ethnology , Adult , Aged , Female , Hospitalization , Hospitals, Public , Humans , Male , Middle Aged , New York City , Retrospective Studies , SARS-CoV-2 , Safety-net Providers , Young Adult
8.
Diabetes ; 70, 2021.
Article in English | ProQuest Central | ID: covidwho-1362212

ABSTRACT

Purpose: Access to in-person diabetes self-management education (DSME) programs is limited in underserved immigrant communities. In this report, we examined the feasibility, acceptability, and potential efficacy of a social media-based DSME intervention in low-income older Chinese immigrants with type 2 diabetes (T2D). Methods: This was a single-group study in 30 Chinese immigrants with T2D living in NYC. The intervention included 24 culturally and linguistically tailored DSME videos. Over 12 weeks, participants received 2 brief videos each week via WeChat, a free social media app popular among Chinese immigrants. Feasibility was defined as ability to achieve: 1) the recruitment goal (n=30);2) >80% retention;and 3) >80% watch rate. Acceptability was assessed via a satisfaction survey at 6 months. HbA1c was collected at baseline and 6 months Results: Recruitment was completed prior to the NYC COVID-19 lockdown. Despite COVID-19, the intervention continued without interruption. Participants were mostly female (70.0%), married (63.3%), with limited English proficiency (86.7%), and a mean age of 61.2 (SD=6.7) years old. Most reported an annual household income of < $25,000 (84.0%) and an education of high school or less (63.3%). Thirty participants were recruited within 2 months, 93.3% were retained at 6 months, and a video watch rate of 92.2% was achieved. The mean baseline HbA1c was 7.4% (SD=1.2) and declined by 0.6% (95% CI: 0.3%-0.9%, p=0.001) to 6.8% (SD=0.8) at 6 months. Participants expressed high satisfaction (96.4%), and all strongly agreed or agreed that they preferred this video-based DSME to face-to-face visits. Conclusions: This pilot study demonstrated that a social media-based DSME intervention is feasible, acceptable, and potentially efficacious in an aging low-income immigrant population with T2D. These findings provide timely implications in the era of COVID-19, suggesting older low-income immigrants can be engaged in mHealth interventions.

9.
J Med Internet Res ; 23(7): e27682, 2021 07 08.
Article in English | MEDLINE | ID: covidwho-1278297

ABSTRACT

The COVID-19 pandemic created numerous barriers to the implementation of participant-facing research. For most, the pandemic required rapid transitioning to all virtual platforms. During this pandemic, the most vulnerable populations are at highest risk of falling through the cracks of engagement in clinical care and research. Nonetheless, we argue that we should reframe the discussion to consider how this transition may create opportunities to engage extensively to reach populations. Here, we present our experience in Atlanta (Georgia, United States) in transitioning a group visit model for South Asian immigrants to a virtual platform and the pivotal role community members in the form of community health workers can play in building capacity among participants. We provide details on how this model helped address common barriers to group visit models in clinical practice and how our community health worker team innovatively addressed the digital challenges of working with an elderly population with limited English proficiency.


Subject(s)
COVID-19 , Community Health Workers , Digital Divide , Emigrants and Immigrants , Pandemics , Telemedicine , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Capacity Building , Female , Georgia/epidemiology , Humans , Male , Middle Aged , SARS-CoV-2 , Vulnerable Populations
10.
Curr Hypertens Rep ; 23(1): 5, 2021 01 22.
Article in English | MEDLINE | ID: covidwho-1040876

ABSTRACT

PURPOSE OF REVIEW: To outline intervention efforts focused on reducing hypertension disparities in immigrant communities in the U.S. and to identify areas in the design, implementation, and evaluation of these interventions that warrant further exploration guided by an implementation science framework. RECENT FINDINGS: Studies examined (n = 11) included immigrant populations of African, Hispanic, and Asian origin. Men were underrepresented in most studies. Culturally tailored group-based educational sessions in religious or community spaces were common. Intervention agents included research assistants, registered nurses, community health workers, and faith-based organization volunteers. Community stakeholders were engaged in most studies, although most commonly for recruitment efforts. Surveys/interviews were used for intervention evaluation, and documentation of intervention activities and trainings was used to assess fidelity. Identified pathways for further intervention innovation included gender or migration-status-based targeting, diversifying intervention agents, enhancing mixed-method process evaluations, and tailoring to emerging needs during the COVID-19 pandemic.


Subject(s)
COVID-19 , Emigrants and Immigrants , Hypertension , Humans , Hypertension/prevention & control , Male , Pandemics , SARS-CoV-2
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