Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 754
Filter
1.
Journal of Community Practice ; JOUR(4):378-394, 30.
Article in English | Web of Science | ID: covidwho-2106991

ABSTRACT

Professionals such as social workers, public health officials, cultural networkers, researchers, and community leaders, who are designing and implementing programs and policies, can look to youth to gain a unique perspective on promoting community health. Across the United States, many communities experience inadequate access to nutritious foods that exacerbate poor health outcomes for marginalized populations - people of color, older or disabled adults, and those with lower education or income. To address food access disparities, providing youth voice and building youth empowerment may offer creative strategies to encourage community change. The Youth CAN (Change.Activity.Nutrition) project aimed to engage and empower adolescents to become agents of change for health within their community. Youth became active researchers through participatory action research (PAR) using socially engaged art platforms such as photovoice (photography), street art (graffiti-style art), and spoken word (poetry) to explore their environment and identify facilitators and barriers to healthy eating within their community. The World Cafe activity facilitated conversation among youth and adults to generate ideas to improve community food access. Collaboration between adult and youth researchers, and community leaders led to proposed solutions for improving access to healthy foods within an urban, low-income neighborhood. The Youth CAN project demonstrated how engaging and empowering youth through PAR is fundamental in promoting positive youth development and enabling youth to become advocates for equitable food access in their communities.

2.
eClinicalMedicine ; JOUR:101726, 55.
Article in English | ScienceDirect | ID: covidwho-2104825

ABSTRACT

Summary Background Case investigation and contact tracing (CICT) is an important tool for communicable disease control, both to proactively interrupt chains of transmission and to collect information for situational awareness. We run the first randomized trial of COVID-19 CICT to investigate the utility of manual (i.e., call-based) vs. automated (i.e., survey-based) CICT for pandemic surveillance. Methods Between December 15, 2021 and February 5, 2022, a stepped wedge cluster randomized trial was run in which Santa Clara County ZIP Codes progressively transitioned from manual to automated CICT. Eleven individual-level data fields on demographics and disease dynamics were observed for non-response. The data contains 106,522 positive cases across 29 ZIP Codes. Findings Automated CICT reduced overall collected information by 29 percentage points (SE = 0.08, p < 0.01), as well as the response rate for individual fields. However, we find no evidence of differences in information loss by race or ethnicity. Interpretations Automated CICT can serve as a useful alternative to manual CICT, with no substantial evidence of skewing data along racial or ethnic lines, but manual CICT improves completeness of key data for monitoring epidemiologic patterns. Funding This research was supported in part by the Stanford Office of Community Engagement and the Stanford Institute for Human-Centered Artificial Intelligence.

3.
Front Digit Health ; 4: 944860, 2022.
Article in English | MEDLINE | ID: covidwho-2099119

ABSTRACT

Objectives: The start of the COVID-19 pandemic led the Los Angeles safety net health system to dramatically reduce in-person visits and transition abruptly to telehealth/telemedicine services to deliver clinical care (remote telephone and video visits). However, safety net patients and the settings that serve them face a "digital divide" that could impact effective implementation of such digital care. The study objective was to examine attitudes and perspectives of leadership and frontline staff regarding telehealth integration in the Los Angeles safety net, with a focus on telemedicine video visits. Methods: This qualitative study took place in the Los Angeles County Department of Health Services (LAC DHS), the second-largest safety net health system in the US. This system disproportionately serves the uninsured, Medicaid, racial/ethnic minority, low-income, and Limited English Proficient (LEP) patient populations of Los Angeles County. Staff and leadership personnel from each of the five major LAC DHS hospital center clinics, and community-based clinics from the LAC DHS Ambulatory Care Network (ACN) were individually interviewed (video or phone calls), and discussions were recorded. Interview guides were based on the Consolidated Framework for Implementation Research (CFIR), and included questions about the video visit technology platform and its usability, staff resources, clinic needs, and facilitators and barriers to general telehealth implementation and use. Interviews were analyzed for summary of major themes. Results: Twenty semi-structured interviews were conducted in August to October 2020. Participants included LAC DHS physicians, nurses, medical assistants, and physical therapists with clinical and/or administrative roles. Narrative themes surrounding telehealth implementation, with video visits as the case study, were identified and then categorized at the patient, clinic (including provider), and health system levels. Conclusions: Patient, clinic, and health system level factors must be considered when disseminating telehealth services across the safety net. Participant discussions illustrated how multilevel facilitators and barriers influenced the feasibility of video visits and other telehealth encounters. Future research should explore proposed solutions from frontline stakeholders as testable interventions towards advancing equity in telehealth implementation: from patient training and support, to standardized workflows that leverage the expertise of multidisciplinary teams.

4.
Health Promot Pract ; : 15248399221129536, 2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2098255

ABSTRACT

Recent nationwide racial justice uprisings following ongoing police violence against Black communities juxtaposed with the COVID-19 pandemic have increased the urgency for a reckoning around the ineffectiveness and harm caused by the carceral apparatus. It is well documented that the correctional system was founded upon and continues the legacy of slavery and white supremacy. Research has shown that incarceration directly contributes to many negative health outcomes, including increased risk and spread of hepatitis C virus (HCV) infections, especially among people who inject drugs. This high burden of HCV disproportionately impacts low-income communities of color, who not only report higher rates of substance use due to pervasive discrimination but are also over-incarcerated as a result of structural racism and the War on Drugs. The COVID-19 pandemic further underscores that correctional facilities are fundamentally structured to promote health inequities. Minoritized communities who are overrepresented in corrections continue to be put at increased risk of COVID-19 in overcrowded facilities, are isolated from social support and medical care, and have been ignored in vaccination strategies. In this perspective, we argue that HCV interventions within the carceral apparatus will remain largely ineffective due to the negative health impacts of incarceration. Instead, we propose adopting abolitionist principles for HCV elimination-divesting from the carceral apparatus to prioritize community-based efforts on promoting HCV screening, treatment, and prevention. In doing so, the nation will have not only the capacity to meaningfully eliminate HCV but also the potential to improve overall societal outcomes.

5.
Am J Health Promot ; : 8901171221136113, 2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2098213

ABSTRACT

PURPOSE: Drawing from the Health Belief Model, we explored how disadvantaged groups in the U.S., including Black, Hispanic, less educated and wealthy individuals, experienced perceived barriers and cues to action in the context of the COVID-19 vaccination. DESIGN: A cross-sectional survey administered in March 2021. SETTING: USA. SUBJECTS: A national sample of U.S. residents (n = 795) recruited from Prolific. MEASURES: Perceived barriers (clinical, access, trust, religion/spiritual), cues to action (authorities, social circles), attitudes toward COVID-19 vaccination. ANALYSIS: Factor analysis and Structural Equation Model (SEM) were performed in STATA 16. RESULTS: Black and less educated individuals experienced higher clinical barriers (CI [.012, .33]; CI [.027, .10]), trust barriers (CI [.49, .92]; CI [.057, .16]), and religious/spiritual barriers (CI [.28, .66]; CI [.026, .11]). Hispanics experienced lower levels of clinical barriers (CI [-.42, .0001]). Clinical, trust, and religious/spiritual barriers were negatively related to attitudes toward vaccination (CI [-.45, -.15]; CI [-.79, -.51]; CI [-.43, -.13]). Black and less educated individuals experienced fewer cues to action by authority (CI [-.47, -.083]; CI [-.093, -.002]) and social ties (CI [-.75, -.33]; CI [-.18, -.080]). Lower-income individuals experienced fewer cues to action by social ties (CI [-.097, -.032]). Cues from social ties were positively associated with vaccination attitudes (CI [.065, .26]). CONCLUSION: Communication should be personalized to address perceived barriers disadvantaged groups differentially experience and use sources who exert influences on these groups.

6.
Curr Dermatol Rep ; : 1-8, 2022 Oct 20.
Article in English | MEDLINE | ID: covidwho-2085609

ABSTRACT

Purpose of Review: Summarize the current evidence for teledermatology in rural, underserved, and isolated environments including its use during the current COVID-19 pandemic. Recent Findings: Teledermatology is a reliable and cost-effective tool that can reduce face-to-face visits and improve the timeliness of care for medically underserved populations. Recent studies have shown many additional benefits of teledermatology, including improving patients' health outcomes and increasing local providers' knowledge of dermatologic conditions. Despite these benefits, many low-income and rural populations lack access to digital technology and high-speed internet, limiting the reach of telemedical services. Summary: Overall, barriers in access to care are unique across the globe, and thus teledermatology interventions should address and adapt to the needs of the local patient population. Certain strategies, such as implementing simple, SF models, using standardized TD consult templets, and providing real-time information technology support could potentially mitigate disparities and improve the effectiveness of TD programs in underserved areas.

7.
J Am Geriatr Soc ; 2022 Oct 19.
Article in English | MEDLINE | ID: covidwho-2078561

ABSTRACT

The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare. This intersection exacerbates disparities in social determinants of health, including poor access to healthcare and poor outcomes. These deeply rooted societal injustices have been brought into the forefront of the collective public consciousness at different points throughout history. The COVID-19 pandemic laid bare and exacerbated existing inequities inflicted on historically marginalized communities. Ageist rhetoric and policies during the COVID-19 pandemic further marginalized older adults. Although the detrimental impact of structural racism on health has been well documented in the literature, generative research on the intersection of structural racism and ageism is limited. The AGS is working to identify and dismantle the healthcare structures that create and perpetuate these combined injustices and, in so doing, create a more just US healthcare system. This paper is intended to provide an overview of important frameworks and to guide future efforts to both identify and eliminate bias within healthcare delivery systems and health professions training with a particular focus on the intersection of structural racism and ageism.

8.
Cureus ; 14(10): e30008, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2067185

ABSTRACT

The distribution of coronavirus disease 2019 (COVID-19) infection across the historically marginalized populations in the United States (US) has consistently been inequitable. In addition, systemic racism and prejudice, which have existed for decades, have caused a lack of faith in public health and medical experts and have resulted in the epidemic of misinformation. To counteract the COVID-19 pandemic and widespread misinformation, the political establishment and public health experts must work collaboratively. And because they are closely associated, there had been a significant increase in the prevalence of the disease as well as a spike in the number of hospitalizations and fatalities. Public health professionals have investigated a number of epidemiological strategies to stop the spread of the virus and mitigate its effects, but false information released via various media sources has caused serious harm to a number of people. To create the framework and guidelines for protecting audiences from lies and deceit, and eradicating false information before taking root in society, it is essential to understand the types of misinformation that are being spread since the disadvantaged and uneducated communities suffer disproportionately as a result. According to studies, spreading false information could have a negative impact on a country's health outcomes, as well as its economic and social well-being, if not immediately refuted. Public health themes, such as evidence-based programs, health communication, and health policy, among others need to be evaluated and put into action in order to prevent the dissemination of incorrect information. This review examines a number of public health themes, such as policy and evidence-based strategies that might help in the fight against misinformation that has wreaked havoc on families and communities, particularly the underserved and uninformed populations.

9.
Iconos ; 26(3):73-94, 2022.
Article in Spanish | ProQuest Central | ID: covidwho-2067400

ABSTRACT

Este artículo es el resultado de una investigación sobre las condiciones y los condicionantes de la tarea docente en el nivel secundario de la provincia de Buenos Aires, Argentina, durante la pandemia por la covid-19. El objetivo es analizar cómo se cruzan las desigualdades de género, tecnológicas y sociosanitarias en el quehacer educativo, en un contexto signado por la intensificación de la labor docente y la profundización de las distancias sociales. Consideramos el período comprendido entre marzo de 2020 y marzo de 2021, y analizamos las siguientes particularidades: las regulaciones oficiales, las condiciones laborales docentes, la composición y situación social del hogar de profesoras y profesores, los recursos tecnológicos disponibles y los soportes institucionales que condicionaron la labor pedagógica. Nos basamos en las normativas del período, la estadística oficial, y las encuestas y entrevistas abiertas a docentes de secundaria de cuatro municipios, que reflejan la heterogeneidad de esta provincia argentina. Entre los hallazgos sobresalen la intensificación de la labor de enseñar durante la pandemia y su particular impacto en el nivel secundario por la estructura del puesto de trabajo;en las docentes mujeres la situación se complejiza por la asimetría en el reparto de las tareas de cuidado. La emergencia del trabajo colectivo para afrontar estas condiciones se constituyó como alternativa y soporte a fin de superar el aislamiento.Alternate :This article is the result of an investigation into the conditions and determinants of teaching at the secondary level in the province of Buenos Aires, Argentina, during the COVID-19 pandemic. The objective is to analyze how gender, technological, and socio-health inequalities intersect in educational work, in a context marked by the intensification of teaching work and widening social gaps. We considered the period between March 2020 and March 2021, and analyzed the following particularities: official regulations, teachers' working conditions, the composition and social situation of teachers' households, technological resources available, and institutional support that conditioned pedagogical work. We studied the regulations of the period, official statistics, and surveys and open interviews with secondary school teachers in four municipalities, which reflect the heterogeneity of this Argentine province. Among the findings, we emphasize the intensification of the work of teaching during the pandemic and its particular impact on the secondary level, due to the structure of this job position;among female teachers, the situation became more complex due to asymmetry in the distribution of care work. Collective work emerged to confront these conditions, as an alternative and support mechanism to overcome isolation.

10.
Int J Environ Res Public Health ; 19(19)2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2065941

ABSTRACT

Health outcomes for Asian American subgroups are often aggregated, masking unique experiences and disparities exacerbated by the COVID-19 pandemic, specifically among Filipino Americans (FilAms). The FILLED (Filipino Lived Experiences during COVID-19) Project launched a cross-sectional online survey between April-August 2021 among FilAm adults in Southern California to document community issues and outcomes during the pandemic. Among 223 participants, 47.5% were immigrants, 50.9% identified as essential workers, and 40.6% had a pre-existing health condition before the pandemic. Despite high rates of health insurance (93.3%), 24.4% of the sample did not have a regular health care provider. During the pandemic, 32.7% needed mental health help but did not get it and 44.2% did not know where to get such services. Most respondents felt that the COVID-19 vaccination was a personal responsibility to others (76.9%) and the majority had received at least one dose of a COVID-19 vaccine (82.4%). Regarding COVID-19 impact, participants reported moderate-severe changes in their daily routines (73.5%), access to extended social support (38.9%), housing issues (15.4%), and access to medical care (11.6%). To our knowledge, this study is the first community-driven effort highlighting FilAm community experiences in Southern California, where the highest proportion of FilAms in the United States reside, specifically after the COVID-19 vaccine was made widely available. The observational findings may help community leaders, policy makers, and public health researchers in the design, development, and implementation of post-pandemic intervention strategies used by community-partnered projects that address FilAm and sub-Asian group health disparities at grassroots to societal levels.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , COVID-19 Vaccines , Cross-Sectional Studies , Health Personnel/psychology , Humans , Pandemics , United States
11.
Front Public Health ; 10: 880774, 2022.
Article in English | MEDLINE | ID: covidwho-2065640

ABSTRACT

Objectives: Knowledge, attitude, and practices (KAP) have been widely used during times of pandemic to quantify and locate gaps of care during pandemics. Using this tool, we can identify and target populations who underwent solid organ transplant (SOT) to bolster preventative practices in these patients during COVID-19. Materials and methods: An institution-based cross-sectional study was conducted between June 1, 2020 and June 30, 2021 on patients who underwent a liver and/or kidney transplant at Methodist Dallas Medical Center in Dallas, Texas, USA. A KAP questionnaire of 26 questions about COVID-19 was designed based on the clinical and community management guidelines published by the WHO. The participant's overall KAP was categorized using Bloom's cut-off point. A KAP domain was considered sufficient if the score was between 60 and 100% and insufficient if the score was <60%. The strength of association was assessed by using odds ratio (OR); only significant independent factors in each tested area were assessed. Results: Respondents with children in the household were less likely to have sufficient practices than those who did not [OR = 0.2491, 95% Confidence Interval (0.0893-0.6120), p = 0.001]. We also found that sufficient levels of knowledge correlated with higher likelihood of sufficient levels of practices [OR = 4.94, 95% CI (1.646-14.2159), p < 0.005]. Interestingly, we found that sufficient levels of attitude did not correlate with sufficient levels of practice (p = 0.201). Conclusion: Our study found that knowledge and having children in the household correlated with higher levels of practice.


Subject(s)
COVID-19 , Organ Transplantation , COVID-19/epidemiology , Child , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Pandemics , United States
12.
JMIR Res Protoc ; 11(10): e40381, 2022 Oct 17.
Article in English | MEDLINE | ID: covidwho-2065329

ABSTRACT

BACKGROUND: As COVID-19 ravages the globe and cases increase rapidly, countries are presented with challenging policy choices to contain and mitigate its spread. In Canada and globally, the COVID-19 pandemic has added a new stratum to the debate concerning the root causes of global and racial health inequities and disparities. Individuals who exist as targets of systemic inequities are not only more susceptible to contracting COVID-19, but also more likely to bear the greatest social, economic, and physical burdens. Therefore, data collection that focuses on the impact of COVID-19 on the lives and health of African/Black communities worldwide is needed to develop intersectional, culturally relative, antiracist/antioppression, and empowerment-centered interventions and social policies for supporting affected communities. OBJECTIVE: The primary objective of this review is to investigate the impact and management of COVID-19 among African/Black individuals and communities, and understand how anti-Black racism and intersectional violence impact the health of African/Black communities during the pandemic. Moreover, the study aims to explore research pertaining to the impact of COVID-19 on Black communities in the global context. We seek to determine how Black communities are impacted with regard to structural violence, systematic racism, and health outcomes, and the ways in which attempts have been made to mitigate or manage the consequences of the pandemic and other injurious agents. METHODS: A systematic search of quantitative and qualitative studies published on COVID-19 will be conducted in MEDLINE (Ovid), Embase (Ovid), Cumulative Index to Nursing and Allied Health Literature (EBSCO), Cochrane Library, PsychInfo (Ovid), CAB Abstracts (Ovid), Scopus (Elsevier), Web of Science (Clarivate), and Global Index Medicus. To be included in the review, studies should present data on COVID-19 in relation to African/Black individuals, populations, and communities in the global sphere. Studies must discuss racism, oppression, antioppression, or systemic and structural violence and be published in English, French, Spanish, or Portuguese. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, the findings will be synthesized quantitatively and qualitatively through thematic analysis. The risk of bias will not be assessed. RESULTS: Title, abstract, and full-text screening concluded in June 2022. Data collection is in progress and is expected to be completed by December 2022. Data analysis and drafting of the manuscript will be done thereafter. Findings from the scoping review are expected to be provided for peer review in 2023. CONCLUSIONS: This review will collect important data and evidence related to COVID-19 in African/Black communities. The findings could help identify existing gaps in COVID-19 management in African/Black communities and inform future research paradigms. Furthermore, the findings could be applied to decision-making for health policy and promotion, and could potentially influence services provided by health care facilities and community organizations around the globe. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40381.

13.
Transl Behav Med ; 12(9): 945-955, 2022 10 07.
Article in English | MEDLINE | ID: covidwho-2062986

ABSTRACT

Our objective was to systematically adapt Interrupting Prolonged sitting with ACTivity (InPACT), a classroom-based physical activity intervention, for home delivery to equitably increase access to structured youth physical activity opportunities during the COVID-19 pandemic. Key steps in the rapid-cycle research adaptation process included: (Step 1) identifying partner organizations; (Steps 2 and 3) engaging in problem and knowledge exploration to examine the problem from different perspectives; (Steps 4 and 5) initiating solution development and testing by selecting an intervention and adapting the format and content for home delivery. Using Rapid RE-AIM to guide online assessment and refinement of InPACT at Home; and (Step 6) utilizing dissemination strategies to extend the reach of the program. Core elements of the InPACT program that were retained included: the use of exercise videos, maintenance of the intervention dose, and teacher-led physical activities. Key adaptations included: utilization of physical education specialists to develop the exercise videos, incorporation of health messaging in videos, and utilization of dissemination strategies (intervention website) to reach K-12 students across the state. Intervention website reach included all 83 counties in Michigan, but goals were not met for website pageviews (5,147; 85% of goal) and video view duration (7 min 19 sec; 37% of goal). Accordingly, dissemination was expanded to include public television broadcasting (monthly viewers: 500,000) and videos were shortened to 8 minutes. Dissemination and implementation science frameworks guided the rapid adaptation of an existing intervention, InPACT, to equitably increase access to structured youth physical activity opportunities at home during the pandemic.


Subject(s)
COVID-19 , Health Promotion , Adolescent , COVID-19/prevention & control , Exercise , Humans , Pandemics/prevention & control , Physical Education and Training
14.
Transl Behav Med ; 12(9): 919-926, 2022 10 07.
Article in English | MEDLINE | ID: covidwho-2062985

ABSTRACT

The COVID-19 pandemic has exacerbated disparities in mental health treatment for people of color in the USA. Meeting the needs of those most burdened by this disparity will require swift and tactical action in partnership with these communities. The purpose of this paper is to describe how a community-based participatory research approach was employed to assess the priorities and needs of four communities of color (African immigrant, Hispanic/Latino, Black/African American, and Pacific Islander) in a major U.S. city. A brief quantitative survey devised jointly by community leaders and the research team was deployed to community members (N = 59) in the fall of 2020. The most endorsed mental health issues across the communities were excessive worry (51%) and stress regarding COVID-19, racism, and immigration policies (49%). The most endorsed physical health concerns included sleep difficulties (44%), headaches, and backaches (each 39%). Physical symptoms predicted the endorsement of a mental health issue above and beyond COVID-19-related hardships, multiplying the odds of reporting an issue by 1.73 per physical health concern endorsed. Based on these findings, the community-research team conceptualized and proposed an evidence-based, effectiveness-implementation hybrid type-2 intervention approach for chronic worry and daily stress. This paper highlights detail on how the community-research team arrived at the proposed multilevel intervention that addresses community-stated barriers to mental health treatment (e.g., preferring trusted health workers to deliver emotional health treatments) and considers the burden of the additional stressful context of COVID-19.


Diverse community members and university researchers collaborated on the development of an equitable intervention approach for community members' mental health needs.


Subject(s)
COVID-19 , Emigrants and Immigrants , Community-Based Participatory Research , Humans , Mental Health , Pandemics , United States/epidemiology
15.
Am J Surg ; 2022 Oct 07.
Article in English | MEDLINE | ID: covidwho-2060323

ABSTRACT

INTRODUCTION: Natural disasters may lead to increases in community violence due to broad social disruption, economic hardship, and large-scale morbidity and mortality. The effect of the COVID-19 pandemic on community violence is unknown. METHODS: Using trauma registry data on all violence-related patient presentations in Connecticut from 2018 to 2021, we compared the pattern of violence-related trauma from pre-COVID and COVID pandemic using an interrupted time series linear regression model. RESULTS: There was a 55% increase in violence-related trauma in the COVID period compared with the pre-COVID period (IRR: 1.55; 95%CI: 1.34-1.80; p-value<0.001) driven largely by penetrating injuries. This increase disproportionately impacted Black/Latinx communities (IRR: 1.61; 95%CI: 1.36-1.90; p-value<0.001). CONCLUSION: Violence-related trauma increased during the COVID-19 pandemic. Increased community violence is a significant and underappreciated negative health and social consequence of the COVID-19 pandemic, and one that excessively burdens communities already at increased risk from systemic health and social inequities.

16.
Practical Diabetes ; 39(5):13-18, 2022.
Article in English | ProQuest Central | ID: covidwho-2059591

ABSTRACT

The risk of type 2 diabetes (T2DM) is two‐ to four‐fold higher in ethnic minority populations compared to White populations in the UK and is also associated with an increased risk of certain macrovascular and microvascular complications. Additionally, T2DM has an earlier onset in ethnic minority groups of around 10–12 years than in White populations. The exact reasons for the higher prevalence are unclear but include the complex interplay of biological, lifestyle, environmental and socioeconomic factors. This is further compounded by disparities in care received by ethnic minority populations. The UK was the first country to report on the disproportionate impact of COVID‐19 on ethnic minority groups. Diabetes is also a major risk factor for severe COVID‐19 and, combined with pre‐existing ethnic disparities in diabetes care, has been a significant contributor to inequalities in COVID‐19 outcomes for ethnic minority populations with diabetes including disproportionate hospitalisation and mortality. Major ethnic disparities in diabetes care in the US and UK, especially intermediate outcomes and diabetes complications, were evident prior to the COVID‐19 pandemic. However, the COVID‐19 pandemic has exposed these pre‐pandemic health disparities for ethnic minority populations with diabetes. Similar to the higher risk of T2DM in ethnic minority populations, the exact reasons for higher risk of COVID‐19 in minority ethnic groups are complex and include comorbidities, risk factor control, deprivation and access to care including wider structural issues. As we now plan for recovery, it is imperative that those delivering diabetes care urgently address the disproportionate impact the pandemic has had on ethnic minority populations. Reducing these inequalities will require a greater understanding of the causes. Copyright © 2022 John Wiley & Sons.

17.
Generations ; 46(1), 2022.
Article in English | Scopus | ID: covidwho-2057716

ABSTRACT

Within the discipline of public health, it is commonly understood that health outcomes are influenced by more than genetics and behavior. Many health problems can be firmly linked to a political determinant that created and is perpetuating health inequities in the United States. The COVID-19 pandemic has exacerbated these inequities, causing disproportionate outcomes, particularly for vulnerable and minoritized groups, including older adults. This article addresses the "isms"plaguing America's health, while offering novel solutions to forge a path toward recovery and, ultimately, advancing health equity. Copyright 2022 American Society on Aging;all rights reserved.

18.
Trials ; 23(1): 824, 2022 Sep 30.
Article in English | MEDLINE | ID: covidwho-2053955

ABSTRACT

BACKGROUND: This update summarises key changes made to the protocol since the publication of the original protocol for the NAVKIDS2 trial of patient navigators for children with chronic kidney disease (CKD) experiencing social disadvantage and provides the statistical analysis plan (SAP) which has not previously been published. METHODS/DESIGN: The original protocol was published in BMC Nephrology ( https://doi.org/10.1186/s12882-019-1325-y ) prior to the commencement of trial recruitment. During the course of the trial, some key methodological changes needed to be made including changes to eligibility criteria (addition of patients with CKD stages 1-2, broadening of financial status eligibility criterion, addition of patients living in rural/remote areas, modification of age eligibility to 0-16 years, addition of limits related to the language spoken by family, guidance regarding families with multiple eligible children), changes to sites, reduction of sample size, addition of virtual options for consent and study procedures in response to the COVID-19 pandemic, removal of staggered recruitment across sites, addition of outcomes, and changes to the timing and number of assessments. This update summarises the changes made and their rationale and provides the detailed plan for statistical analysis of the trial. These changes have been finalised prior to the completion of study follow-up and the commencement of data analysis. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618001152213 . Prospectively registered on 12 July 2018.


Subject(s)
COVID-19 , Patient Navigation , Renal Insufficiency, Chronic , Australia , Child , Humans , Multicenter Studies as Topic , Pandemics , Randomized Controlled Trials as Topic , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/therapy , SARS-CoV-2 , Treatment Outcome
19.
Health Promot Pract ; : 15248399221118394, 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2053750

ABSTRACT

African American (AA) churches are valuable partners in implementing health promotion programming (HPP) to combat health disparities. The study purpose was to evaluate AA church characteristics associated with enrollment into the FAITH! (Fostering African American Improvement in Total Health) Trial, a community-based, cluster randomized controlled trial (RCT) of a mobile health intervention for cardiovascular health promotion among AA churches. Churches located in Minneapolis-St. Paul and Rochester, Minnesota were invited to complete an electronic screening survey and follow-up telephone interview including the PREACH (Predicting Readiness to Engage African American Churches in Health) tool to assess church characteristics and infrastructure for HPP. The primary outcome was church enrollment in the FAITH! Trial. Key predictors included overall PREACH scores and its subscales (Personnel, Physical Structure, Faith-based Approach, Funding), congregation size, and mean congregation member age. Of the 26 churches screened, 16 (61.5%) enrolled in the trial. The enrolled churches had higher overall mean PREACH scores (36.1 vs. 30.2) and subscales for Personnel (8.8 vs. 5.6), Faith-based Approach (11.0 vs. 9.6), and Funding (7.3 vs. 4.8) compared with non-enrolled churches; all differences were not statistically significant due to small sample size. Twelve (75.0%) of the enrolled churches had >75 members versus six (60.0%) of the non-enrolled churches. Twelve (80.0%) of the enrolled churches had an average congregation member age ≤54 years versus six (67.0%) of the non-enrolled churches. AA churches enrolling into a community-based RCT reported greater infrastructure for HPP, larger congregations, and members of younger age. These characteristics may be helpful to consider among researchers partnering with AA churches for HPP studies.

20.
Epidemiology for the Advanced Practice Nurse: A Population Health Approach ; : 1-446, 2022.
Article in English | Scopus | ID: covidwho-2054640

ABSTRACT

This graduate-level text disseminates the core principles of epidemiology within a population health framework and provides practical knowledge nurses can use to analyze and improve healthcare in the community. Informed by the evolution of epidemiological science resulting from the COVID-19 pandemic, this book demonstrates how epidemiology can have a profound impact on health. It showcases a variety of settings and epidemiological roles demonstrating the importance and practicality of this discipline. Clear and concise, this text explains the basics of population health followed by epidemiological concepts and designs. It is distinguished by its application-based case studies, analytical tools of epidemiology, and calculations, which foster skill development and necessary familiarity of the subject. Also included is an important Biostatistics Primer, relevant content from Healthy People 2030, and an Epidemiology in Practice section focusing on examples from different epidemiological arenas. © 2023 Springer Publishing Company, LLC.

SELECTION OF CITATIONS
SEARCH DETAIL