RESUMEN
BACKGROUND: Alzheimer disease (AD), the most common neurodegenerative disorder in the United States, disproportionately burdens minority populations. OBJECTIVE: To explore barriers to AD clinical trial participation by Asian and Native Hawaiian patients diagnosed with AD or mild cognitive impairment. METHOD: We surveyed 187 patients with a Mini-Mental State Examination score ≥14 between January 2022 and June 2022. The score cutoff for clinical trial eligibility was set by the institution. Individuals also completed a 15-question telephone survey that assessed demographics, barriers to clinical trial participation, and clinical trial improvement methods. RESULTS: Forty-nine patients responded, with a response rate of 26%. Asian and Native Hawaiian patients were less likely than White patients to participate in AD trials. The main barrier to participation was a lack of information about AD trials. Providing additional information regarding AD trials to patients and family members were listed as the top two reasons patients would consider participating in a clinical trial. CONCLUSION: Insufficient information about AD clinical trials is the primary barrier to participation among Asian and Native Hawaiian patients, followed by difficulty coordinating transportation and, in the case of Asians, the time required for clinical trials. Increased outreach, education, and assistance with logistics in these populations should be pursued to improve rates of participation in clinical trials.
Asunto(s)
Enfermedad de Alzheimer , Disfunción Cognitiva , Humanos , Estados Unidos , Enfermedad de Alzheimer/psicología , Escolaridad , Poblaciones Minoritarias, Vulnerables y Desiguales en Salud , HawaiiRESUMEN
This integrative literature review focuses on the impact of maternal depression on children with asthma. Maternal depression has a negative impact on a child's growth, development, behavior, mental health, safety, and health care utilization. Mothers of children with chronic conditions such as asthma have higher rates of depression compared to mothers of children without a chronic condition. Research has shown that maternal depression has the potential to increase asthma morbidity and health care utilization. In addition, mothers with depressive symptoms report lower self-efficacy in their ability to care for their children with asthma, which can affect their ability to manage their child's asthma with the prescribed medication regimen. To provide optimal care for children with asthma and their families, pediatric care providers must perform periodic depression screening to mothers or caregivers. Depressed mothers or caregivers of children with asthma require care coordination and management that consists of increased education on asthma and depression, and more frequent follow up than families without maternal/caregiver depression. These additional care measures have numerous positive benefits, including enhancing the quality of life in both the child and caregiver by improving asthma management in the child and depressive symptoms in the mother, as well as decreasing costs imposed on the economy through reduced emergency department visits, hospitalizations, missed work days, and missed school days.