Understanding multi-level barriers to medication adherence among adults living with sickle cell disease.

There is limited research that identifies and examines multi-level barriers to medication adherence among adults with Sickle Cell Disease (SCD); Identify multi-level barriers to medication adherence among adults with SCD; and Examine the relationship between multi-level barriers and medication adherence levels. A cross-sectional study included 130 adults (ages ≥ 18 years old) living with SCD who receive treatment/care from one of the 10 adult SCD clinics within the Networking California for sickle cell care initiative. Study measures included the medication adherence report scale (Professor Rob Horne), Beliefs about Medicine Questionnaire (Professor Rob Horne), and patient reported outcomes measurement information system. Participants reported barriers to medication adherence across 3 levels: Community-level barriers (e.g., COVID-19 pandemic); Institutional-level barriers (e.g., bad experiences with the health care system); and Individual-level barriers (e.g., beliefs and depression severity). Depression severity and patient concerns about SCD medication were inversely correlated with medication adherence (rs = -0.302, P < .001; rs = -0.341, P < .001 respectively). Patient beliefs about the necessity of SCD medication were insignificantly correlated with medication adherence (rs = 0.065, P = .464). Medication adherence was higher among patients who had fewer adherence barriers than multiple adherence barriers (Median medication adherence: fewer barriers = 22 vs multiple barrier = 20.50, P = .085), suggesting clinical significance although statistically insignificant. Identifying multi-level adherence barriers and examining their relationship with medication adherence will help develop targeted public health strategies to promote improved medication adherence and wellness among adults with SCD.

Predictors of fall-related injuries due to common consumer products among elderly adult emergency department visits in the United States during 2007-2017.

Falls are the leading cause of injuries and death among the elderly in the United States (U.S.). This study examined unintentional fall related-injuries and potential associations between various consumer products. Data was analyzed from the National Electronic Injury Surveillance System (NEISS) of hospital emergency department (ED) visits for unintentional injuries among the elderly between 2007 and 2017. Multiple logistic regression was used to examine the association between consumer products and fall-related injury ED visits. A total of 537,703 injury-related ED visits were analyzed. Two-thirds of visits were fall-related. Of those, 33% were among those 85 years and older, 62.5% occurred at home, 37.6% had head trauma, and 28.7% resulted in hospitalization. Flooring materials accounted for 29.1% of injuries. Ladders were significantly associated with fall-related injuries (adjusted odds ratio [AOR] 5.48, 95% confidence interval [CI] 4.72-6.36), followed by flooring materials (AOR 3.09, 95% CI 2.60-3.67), and porches and balconies (AOR 2.61, 95% CI 2.30-2.96). Several common consumer products are associated with fall-related injuries among the elderly. Increased awareness and education are critical.

Increasing Diversity in the Health Professions: Reflections on Student Pipeline Programs.

Despite major advances and technological improvements in public health and medicine, health disparities persist by race and ethnicity, income and educational attainment, and in some cases are increasing (Jackson & Garcia, 2014). These health disparities among these populations have even worsened or remained about the same since the landmark 1985 Report of the Secretary's Task Force on Black & Minority Health released by then Secretary Margaret M. Heckler. Ensuring diverse public health and healthcare workforces to provide services to diverse populations, in combination with other strategies, can increase access to and quality of healthcare for vulnerable populations and decrease healthcare disparities. One mechanism for achieving a diverse public health and healthcare workforce is to establish, promote, and conduct student training programs in public health. The Office of Minority Health and Health Equity, Centers for Disease Control and Prevention (CDC), has partnered with institutions, colleges, universities, foundations, national organizations and associations to form and implement student training programs. This paper highlights a session "Public Health Professions Enhancement Programs" that was held during the 2015 symposium titled "National Negro Health Week to National Minority Health Month: 100 Years of Moving Public Health Forward" in Atlanta, Georgia. Presenters at the symposium consisted of interns and fellows who had participated in student programs in the Office of Minority Health and Health Equity at the CDC.

African Americans' organ donor intentions: who has used which registration mode to express her or his intentions?

AIM: To describe the various means that African American adults had used to express their intention to become an organ donor, as well as to determine whether there were characteristics that distinguished those individuals who had expressed their intention from those individuals who had not. PARTICIPANTS: Participants were 1 567 African American adults who resided in four urban areas in New Jersey. METHODS: From July 2005 to April 2006, university survey center interviewers conducted 7-minute, random-digit-dial telephone interviews. RESULTS: Approximately 3.2 percent reported that they had donated an organ; 3.4 percent reported being an organ recipient; 11.4 percent reported that a family member had donated an organ or tissue; and 12 percent reported that a family member was a recipient. Forty-six percent reported that they had indicated their willingness to be an organ donor when they applied for a driver's license; 37 percent had done so by discussing their wishes with family members. Fewer had signed an organ donor card (21%) or had signed up with an organ donor registry (16%). A multiple logistic regression model revealed a negative association between the respondent's age and whether the respondent had expressed an intention to be a donor, and a positive association between having known a family member who had received or donated an organ and the respondent's intention. Neither gender nor marital status was associated with the intention to donate. CONCLUSIONS: As the driver's license was the means favored by African Americans for declaring their intentions to be organ donors, motor vehicle registries appear to hold the greatest promise for documenting and communicating this intention.

How African Americans express their intentions to be organ donors.

CONTEXT: As part of an organ sharing network's outreach, African American adults were interviewed to assess their awareness of the network's efforts and willingness to donate their organs after death. OBJECTIVE: To describe (1) the proportion who expressed their intentions to be an organ donor, (2) the means they had used, and (3) sociodemographic characteristics of the participants who used a particular means. DESIGN: A repeated, cross-sectional, random-digit dialing telephone interview was conducted from July 2005 (start of wave 1) to April 2006 (end of wave 3). Each interview averaged 7 minutes and consisted of 60 items. SETTING: Trained interviewers placed telephone calls to the residences of African Americans who resided in 1 of 4 New Jersey locales: East Orange/Orange, Irvington, Jersey City/Newark, and Trenton. PARTICIPANTS: One thousand five hundred sixty-seven African Americans, aged 18 to 95 years. MAIN OUTCOME MEASURES: Five Yes/No items were used to determine if participants had declared their intention to be an organ donor via driver's license application, donor card, donor registry, will/healthcare directive, or discussion with a family member. RESULTS: Twenty-seven percent of the participants had expressed their intentions to be an organ donor with an organ donor card, driver's license, donor registry, or will/healthcare directive. The participants who had used one or more of these formal means were 14.4 times more likely to have discussed their intention to be an organ donor with a family member than were the participants who had not.

A diagnostic approach to understanding entrepreneurship in health care.

Health care is quite different from other industries because of its organizational structure, service delivery, and financing of health services. Balancing costs, quality, and access presents unique challenges for each stakeholder group committed to promoting the health and healing of its citizens. Using the diagnostic approach to health care entrepreneurship, we created a framework from research in the field to understand the predisposing, enabling, and reinforcing factors most relevant to successful entrepreneurship.

Entrepreneurial propensity in health care: models and propositions for empirical research.

We maintain that entrepreneurial propensity is a focal construct in entrepreneurial research. We synthesize the literature to develop models depicting the antecedents and consequents of entrepreneurial propensity in a network of other constructs and variables of interest in the health care industry. We advance propositions for empirical investigation and validation of competing research models associated with entrepreneurial propensity. We conclude with a discussion of directions of future research.