(25/1465) Recruitment and retention: the development of an action plan for African-American health professions students.
This article presents results of a survey of African-American students enrolled in the colleges of medicine, dentistry, allied health, pharmacy, and nursing at the University of Kentucky. The survey was designed to determine the students' perceptions of factors that affect recruitment, enrollment, and academic progress of African-American students. Fifty-three of seventy students responded to survey questions addressing recruitment; admissions; and financial, social, personal, and academic support. Over 50% of medical students decided by junior high to enter a health career; only 15% of other students decided that early. The influence of a family member was more important in student decisions to enter nursing or medicine than in decisions by other students. Only 17% of medical students reported difficulty in locating sources of financial aid compared to 48% of those from other colleges. Perceptions regarding lack of social outlets were consistent among respondents from all colleges. Findings emphasize the importance of early exposure to the health professions, early outreach strategies, ongoing financial assistance, and the importance of establishing social networks for African-American students enrolled in a majority institution. The survey results were used to develop an action plan for the offices of minority affairs, student services, and academic affairs to address identified problems and concerns. (+info)
(26/1465) Using cultural beliefs and patterns to improve mammography utilization among African-American women: the Witness Project.
Breast cancer and early detection of the disease is a significant issue for all women. Moreover, the sociocultural implications in the differential mortality rates increased interest in possible barriers to screening practices. Recently, a number of studies have investigated African Americans' cultural beliefs associated with breast cancer. This study is based upon qualitative focus group data gathered from 1989 to 1991 and 1996. This article provides focus group data that informed a culturally competent community-based cancer education program for African-American women--the Witness Project. Analysis of the qualitative data along with the quantitative outcome data revealed a direct relationship between cultural beliefs and patterns with mammography utilization. The once perceived cultural barriers can actually be applied as a cultural intervention strategy to improve breast cancer screening initiatives designed specifically for African-American women. (+info)
(27/1465) "We don't carry that"--failure of pharmacies in predominantly nonwhite neighborhoods to stock opioid analgesics.
BACKGROUND: We have observed that many black and Hispanic patients receiving palliative care at a major urban teaching hospital are unable to obtain prescribed opioids from their neighborhood pharmacies. In this study, we investigated the availability of commonly prescribed opioids in New York City pharmacies. METHODS: We surveyed a randomly selected sample of 30 percent of New York City pharmacies to obtain information about their stock of opioids. For each pharmacy, U.S. Census estimates for 1997 were used to determine the racial and ethnic composition of the neighborhood (defined as the area within a 0.4-km [0.25-mile] radius of the pharmacy) and the proportion of residents who were more than 65 years old. Data on robberies, burglaries, and arrests involving illicit drugs in 1997 were obtained for the precinct in which each pharmacy was located. We used a generalized linear model to examine the relation between the racial or ethnic composition of neighborhoods and the opioid supplies of pharmacies, while controlling for the proportion of elderly persons at the census-block level and for crime rates at the precinct level. RESULTS: Pharmacists representing 347 of 431 eligible pharmacies (81 percent) responded to the survey. A total of 176 pharmacies (51 percent) did not have sufficient supplies of opioids to treat patients with severe pain. Only 25 percent of pharmacies in predominantly nonwhite neighborhoods (those in which less than 40 percent of residents were white) had opioid supplies that were sufficient to treat patients in severe pain, as compared with 72 percent of pharmacies in predominantly white neighborhoods (those in which at least 80 percent of residents were white) (P<0.001). CONCLUSIONS: Pharmacies in predominantly nonwhite neighborhoods of New York City do not stock sufficient medications to treat patients with severe pain adequately. (+info)
(28/1465) Racial disparities in participation in biomedical research.
To determine whether minority patients were less likely to participate in biomedical research, perceive positive benefits from such participation, or to recommend research participation to other patients, an observational study was conducted. Sociodemographic and survey data were collected from 5436 users of Department of Veterans Affairs (VA) Ambulatory Care, which included questions about veterans' research participation and related attitudes. Bivariate and multivariate analyses were performed to determine if there were racial differences in the outcomes of interest, controlling for relevant sociodemographic factors. Bivariate and multivariate analyses indicated that there were no racial differences in self-reported research participation, but minority veterans were more likely to perceive a positive effect of research and less likely to recommend research to other veterans. However, subgroup analyses indicated that, of those veterans having negative attitudes about research, minority and less educated veterans were disproportionately represented. In the VA system, racial differences in research participation may dissipate because many sociodemographic factors are controlled. Although we did not observe consistent racial differences in research participation or attitudes, the fact that minority veterans were disproportionately represented among the group with the most negative attitudes about research suggests that further research is necessary to fully understand the racial dynamics of research participation in the VA. (+info)
(29/1465) The multiple-race population of the United States: issues and estimates.
This paper presents national estimates of the population likely to identify with more than one race in the 2000 census as a result of a new federal policy allowing multiple racial identification. A large number of race-based public policies-including affirmative action and the redistricting provisions of the Voting Rights Act-may be affected by the shift of some 8-18 million people out of traditional single-race statistical groups. The declines in single-race populations resulting from the new classification procedure are likely to be greater in magnitude than the net undercount in the U.S. census at the center of the controversy over using census sampling. Based on ancestry data in the 1990 census and experimental survey results from the 1995 Current Population Survey, we estimate that 3. 1-6.6% of the U.S. population is likely to mark multiple races. Our results are substantially higher than those suggested by previous research and have implications for the coding, reporting, and use of multiple response racial data by government and researchers. The change in racial classification may pose new conundrums for the implementation of race-based public policies, which have faced increasing criticism in recent years. (+info)
(30/1465) Are orthognathic patients different?
This questionnaire-based study investigated the psychological profile of orthognathic patients prior to starting treatment and compared the findings with a control group of non-patients. Comparison of the data used multivariate multiple regression analysis where outcome variables and independent variables were studied simultaneously. Some differences were found in the psychological profile of the orthognathic patient. They displayed higher levels of state anxiety (P < 0.001), higher numbers of individuals in their social support network (P < 0.05), and lower body image and facial body image (P < 0.001). Self-esteem was also found to be lower, but only at borderline levels of significance (P = 0.052). (+info)
(31/1465) Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes.
OBJECTIVE: Self-monitoring of blood glucose (SMBG) is a cornerstone of diabetes care, but little is known about barriers to this self-care practice. RESEARCH DESIGN AND METHODS: This cross-sectional study examines SMBG practice patterns and barriers in 44,181 adults with pharmacologically treated diabetes from the Kaiser Permanente Northern California Region who responded to a health survey (83% response rate). The primary outcome is self-reported frequency of SMBG. RESULTS: Although most patients reported some level of SMBG monitoring, 60% of those with type 1 diabetes and 67% of those with type 2 diabetes reported practicing SMBG less frequently than recommended by the American Diabetes Association (three to four times daily for type 1 diabetes, and once daily for type 2 diabetes treated pharmacologically). Significant independent predictors of nonadherent practice of SMBG included longer time since diagnosis, less intensive therapy, male sex, age, belonging to an ethnic minority, having a lower education and neighborhood income, difficulty communicating in English, higher out-of-pocket costs for glucometer strips (especially for subjects with lower incomes), smoking, and excessive alcohol consumption. CONCLUSIONS: Considerable gaps persist between actual and recommended SMBG practices in this large managed care organization. A somewhat reduced SMBG frequency in subjects with linguistic barriers, some ethnic minorities, and subjects with lower education levels suggests the potential for targeted, culturally sensitive, multilingual health education. The somewhat lower frequency of SMBG among subjects paying higher out-of-pocket expenditures for strips suggests that removal of financial barriers by providing more comprehensive coverage for these costs may enhance adherence to recommendations for SMBG. (+info)
(32/1465) Impact of environmental inequity on health outcome: where is the epidemiological evidence?
A significant amount of evidence reveals a presence of environmental inequity. Although there is a disproportionate distribution of waste treatment, storage and disposal facilities, and chemical and manufacturing plants in minority and low-income communities in the United States, little research has been devoted to show any associations based on analytic epidemiological methods. To date, attempts to quantify health disparities have included demographic data, race, sex, income, other socioeconomic factors, and broad symptomatic survey instruments. To study this, we examined the latest epidemiological evidence documenting the existence of adverse health impacts resulting from environmental inequity. We observed that the overwhelming majority of studies were descriptive in nature and lacked comparison populations. As a result, we believe that further research based on analytic epidemiological methods would further contribute to the determination of the cause-effect relationship between environmental exposure and health outcome. (+info)