Decreasing Older Adult COVID-19 Risk Factors Using Digital Technology to Implement a Plant-Based-Diet: An Opinion Paper.

UNSTRUCTURED: A disproportionate number of COVID-19 cases affect older, minority populations. Obese older adults are at higher risk for severe COVID-19 complications and lower survival rates; minority older adults often experience higher rates of obesity. A plant-based diet intervention may improve COVID-19 obesity modifiable risk factors. Encouraging the consumption plant-based diets consisting of vegetables, fruits, whole grains, legumes, seeds, and nuts utilizing community outreach strategies and digital technology can contribute to improving COVID-19 risk factors.

Does the Hispanic Mortality Advantage Vary by Marital Status Among Postmenopausal Women in the Women's Health Initiative?

BACKGROUND: Literature assessing the effect of marital status on mortality has underrepresented, or altogether omitted Hispanics and the potential moderating effect of Hispanic ethnicity on these relationships. Given cultural and network dynamics, marital advantages in older Hispanic women may be greater than other groups given their family-focused, collectivist orientation. PURPOSE: The purpose of this study was to understand whether older Hispanic women exhibited a more pronounced marital advantage as compared with non-Hispanic Whites. METHODS: We used longitudinal data from the Women's Health Initiative (WHI) Observational Study and Clinical Trials (N = 161,808) collected initially from 1993 to 1998 and followed until 2018. Our sample excluded those respondents indicating "other" as their race-ethnicity and those missing marital status and race-ethnicity variables (N = 158,814). We used Cox-proportional hazards models to assess the association between race-ethnicity, marital status, and the interactive effect of race-ethnicity and marital status on survival. RESULTS: After controlling for socioeconomic status (SES) and health controls, we found a Hispanic survival advantage when compared with non-Hispanic Whites and all other racial-ethnic groups with the exception of Asian/Pacific Islander women (all significant HRs < 0.78, all ps ≤ 0.001). Hispanics had a higher rate of divorce when compared with non-Hispanic Whites. The interactive effect of race-ethnicity and marital status was not significant. CONCLUSIONS: U.S. Hispanic, postmenopausal women exhibit a mortality advantage over and above marital status despite their high rates of divorce. Implications and potential explanations are discussed. CLINICAL TRIAL REGISTRATION: NCT00000611.

Correlates of Successful Aging in Racial and Ethnic Minority Women Age 80 Years and Older: Findings from the Women's Health Initiative.

BACKGROUND: Most research has focused on definitions and predictors of successful aging. However, racial/ethnic minorities are often under represented in this research. Given that the U.S. population is aging and becoming more racially diverse, we examined correlates of "successful aging," as defined by physical functioning and overall quality of life (QOL), among racial/ethnic minority women aged 80 years and older in the Women's Health Initiative. METHODS: Participants included 1,924 racial/ethnic minority women (African Americans, Asian/Pacific Islanders, Hispanic/Latinos, and American Indian/Alaskan Natives) 80 years of age and older who are enrolled in the Women's Health Initiative and have physical functioning data after turning 80 years of age. Analysis of covariance was used to examine between and within group differences in physical functioning and selfrated overall QOL for African Americans, Asian/Pacific Islanders, and Hispanic/Latinos. RESULTS: We found no significant differences in physical functioning between racial/ethnic minority groups in adjusted analyses. However, overall QOL was significantly different between racial/ethnic minority groups. Age, recreational physical activity, and overall selfrated health were independent correlates of physical functioning across racial/ethnic minority groups, whereas overall selfrated health was the only consistent correlate of overall QOL across the minority groups for the within minority group comparisons. CONCLUSIONS: Between racial/ethnic minority group differences in physical functioning are largely explained by demographic, psychosocial, behavioral, and health-related variables. We found statistically significant differences in selfrated overall QOL between racial/ethnic minority groups.

Important considerations when applying for a postdoctoral fellowship.

PURPOSE: To examine important decision points that graduates should consider before applying for a postdoctoral fellowship. METHODS: A literature review was performed. FINDINGS AND CONCLUSIONS: A synthesis of the present data on the postdoctoral fellowship, eligibility criteria, application process, and important considerations was provided. Experiential knowledge from four present postdoctoral fellows was included. The goals, advantages, and disadvantages of the fellowship were discussed. In conclusion, the postdoctoral fellowship was examined to offer important considerations in the decision to pursue this opportunity. CLINICAL RELEVANCE: The clinical relevance of this article is related to the training and education of nurses to become the next generation of independent, successful scholars and scientists. Postdoctoral training adds valuable contributions and quality to the field of nursing.

The health status of latino immigrant women in the United States and future health policy implications of the affordable care act.

Immigrant women of Mexican birth face unique health challenges in the United States. They are at increased risk for developing many preventable health conditions due in part to limited access to healthcare and benefits, legal status, and inadequate income. Increased vulnerability of women has established a growing need to focus on their healthcare needs because of their role, position, and influence in the family. The purpose of this article is to review factors that impact the health status of Mexican-born women living in the United States and review policy implications of the Affordable Care Act for this population. Mexican-born women are the largest female immigrant group in the United States. Therefore, they comprise the group that will need health coverage in the greatest proportion. As a result, there will be a need for culturally and linguistically appropriate healthcare services and culturally sensitive providers.

Las mujeres inmigrantes originarias de México se enfrentan en los Estados Unidos a problemas sanitarios únicos. Corren un alto riesgo de desarrollar muchas patologías prevenibles, en parte debido a su acceso limitado a atención y prestaciones sanitarias, a su estatus legal y a sus ingresos insuficientes. La mayor vulnerabilidad de las mujeres ha hecho que cada vez resulte más apremiante que se centren en sus necesidades de atención sanitaria debido a su papel, posición e influencia en la familia.El objetivo de este artículo es revisar los factores que afectan al estado de salud de las mujeres originarias de México que viven en los Estados Unidos, y las implicaciones en el ámbito de las políticas de la Ley de Cuidado de la Salud Asequible (Affordable Care Act) para esa población.Las mujeres originarias de México constituyen en los Estados Unidos el colectivo inmigrante femenino más numeroso. Por esa razón, conforman el grupo que necesitará cobertura sanitaria en una proporción más alta. Como resultado, surgirá una necesidad de servicios de asistencia sanitaria que sean adecuados desde el punto de vista cultural y lingüístico, y de proveedores de atención culturalmente sensibles.

Self-assessment of cultural and linguistic competence in an ambulatory health system.

The University Health System (UHS) leaders organized a comprehensive planning process of its ambulatory care system. As part of this planning process, UHS assessed the cultural and linguistic competence of its outpatient environment. This assessment was conducted within the context of standards outlined in the U.S. Department of Health & Human Services (2001) Standards for Cultural and Linguistically Appropriate Services, using a multimethod approach. This multimethod approach included (1) a review of the organizational profile, (2) a review of organizational documents, (3) a review of policies and procedures, (4) clinic site visits, (5) a staff survey, (6) patient and provider focus groups, and (7) interviews with key stakeholders in the community. Generally, the UHS was found to have several strengths that enable it to continue meeting the medical needs of its target populations. To develop greater capacity in the areas of cultural and linguistic competencies, the UHS should continue to promote respect for diversity by focusing on attitudes; beliefs; behaviors; practices; and communication patterns associated with race, ethnicity, religion, socioeconomic status, historical and social context, physical or mental ability, age, gender, sexual orientation, generational status, and acculturation level. Recommendations for achieving a more culturally competent healthcare organization are provided.