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Journal of Health Care for the Poor and Underserved

Rosy Chang Weir, Mariko Toyoji, Michael McKee, Vivian Li, Chia C Wang
BACKGROUND: Hepatitis B virus (HBV) infection is a major health disparity between Asian Americans, Native Hawaiians, and Pacific Islanders compared with other racial/ethnic groups in the U.S. AIMS: Our aims were to determine the effectiveness of an electronic health record (EHR) data-driven clinical intervention to improve HBV screening and vaccination rates at a community health center primarily serving Asian American patients. METHODS: Using a community-engaged approach, we conducted a study to compare the differences in screening and vaccination rates for 6,429 patient encounters before and after implementation of the EHR intervention...
2018: Journal of Health Care for the Poor and Underserved
Keely Walgama, Cynthia Wides, Aubri Kottek, Elizabeth Mertz
Residents of long-term care (LTC) facilities have a significantly higher risk of poor oral health status compared with those living independently; moreover, the provision of oral health services to LTC residents is often limited. This study identifies and classifies state-level policies and funding sources for dental services that are available to LTC residents. The research details variability in coverage levels, payment sources, workforce capacity, and care delivery configuration, finding little coherence between policy and the needs of patients or providers...
2018: Journal of Health Care for the Poor and Underserved
Karin E Tobin, Abigail K Winiker, Carlton Smith
Older (mature) Black men who have sex with men (BMSM) are an understudied group disproportionately affected by HIV/AIDS and experience competing priorities such as medical comorbidities, social isolation, and financial stressors. The purpose of this study was to assess the needs and priorities of a sample of urban mature BMSM to inform HIV prevention programming. A cross-sectional survey of BMSM ages 40 and older was conducted among men recruited from community-based organizations. Men ranked priorities from seven domains: financial and housing stability, physical health, mental health, relationships with family, relationships with partners, HIV prevention...
2018: Journal of Health Care for the Poor and Underserved
Karla Thornton, Miranda L Sedillo, Summers Kalishman, Kimberly Page, Sanjeev Arora
INTRODUCTION: Hepatitis C (HCV) is an epidemic in the incarcerated population in the United States. In New Mexico, more than 40% of people entering the prison systems test positive for HCV antibodies. Project ECHO's New Mexico Peer Education Project (NMPEP) was developed to educate prisoners about HCV and impact the cycle of HCV transmission in the prison system. METHODS: Evaluation of NMPEP included multiple methods. Surveys focused on the short-term impact of training...
2018: Journal of Health Care for the Poor and Underserved
Sigolène Ortega, Megan Stamey McAlvain, Katherine J Briant, Sarah Hohl, Beti Thompson
BACKGROUND: Community-academic partnerships are increasingly used to engage community members and researchers in research activities; however, little is known about the motivations and perceptions of community members to participate in such projects. OBJECTIVES: The overall goal was to elicit Community Advisory Board (CAB) members' motivations and perceptions of involvement in a community-academic partnership about cancer prevention. METHODS: An external evaluator conducted 15 one-on-one semi-structured interviews with CAB members of the project...
2018: Journal of Health Care for the Poor and Underserved
Mary E Northridge, Bibhas Chakraborty, Sedigheh Mirzaei Salehabadi, Sara S Metcalf, Carol Kunzel, Ariel P Greenblatt, Luisa N Borrell, Bin Cheng, Stephen E Marshall, Ira B Lamster
Understanding the relationships among diabetes, teeth present, and dental insurance is essential to improving primary and oral health care. Participants were older adults who attended senior centers in northern Manhattan (New York, N.Y.). Sociodemographic, health, and health care information were obtained via intake interviews, number of teeth present via clinical dental examinations, and glycemic status via measurement of glycosylated hemoglobin (HbA1c). Complete data on dental insurance coverage status for 785 participants were available for analysis (1,015 after multiple imputation)...
2018: Journal of Health Care for the Poor and Underserved
Sydney A Martinez, Laura A Beebe, Deirdra R Terrell, David M Thompson, Janis E Campbell
U.S. General Educational Development diploma (GED) recipients have the highest smoking prevalence of any education level. This paper describes demographic characteristics and tobacco use patterns and examines effect modification and confounding as potential explanations for higher crude prevalence of smoking. METHODS: The study population included adults aged 25 and older in the 2013 National Health Interview Survey. We estimated adjusted prevalence ratios and 95% CIs for smoking and quitting behaviors using weighted multivariable logistic regression...
2018: Journal of Health Care for the Poor and Underserved
Elham Mahmoudi, Alicia Cohen, Jason Buxbaum, Caroline R Richardson, Wassim Tarraf
OBJECTIVE: The continued expansion of Medicaid is under debate; it is critical to evaluate the effect of obtaining Medicaid on access to preventive care. METHODS: We analyzed longitudinal data from the 2013-2014 Medical Expenditure Panel Survey and applied a difference-in-differences approach. Our treatment group included low-income, non-pregnant, non-disabled adults aged 18-64 with no insurance in 2013 who received Medicaid in 2014; the comparison group included individuals who did not have insurance in either year...
2018: Journal of Health Care for the Poor and Underserved
Ju-Young Lee, Nicole Murry, Jisook Ko, Miyong T Kim
OBJECTIVE: To explore the association of maternal health literacy (MHL), parenting self-efficacy and early parenting practices among low-income mothers with infants. DESIGN: A cross-sectional, descriptive correlational design. PARTICIPANTS: Low-income mothers (N=186) with infants. METHODS: Face-to-face interviews were conducted using English and Spanish versions of questionnaires by trained bilingual research assistants...
2018: Journal of Health Care for the Poor and Underserved
Raymona H Lawrence, Bettye A Apenteng, April M Schueths, Swaha Pattanaik, Robert W Gibson
Individuals with sickle cell disease (SCD) often struggle to transition from pediatric to adult-centered medical environments. One probable cause is that many transition programs do not focus on what happens when patients leave the medical environment and return to their communities. Little is known about how individuals with SCD define community. Therefore, we worked with health care providers at four rural Georgia SCD outreach clinics to conduct qualitative interviews with 21 individuals who had transitioned to adult SCD care...
2018: Journal of Health Care for the Poor and Underserved
Susan L Ivey, Arnab Mukherjea, Aashna Patel, Nilesh Kapoor, Sameeha Rau, Eiman Kazi, Jaskirat Bhatia, Ma Somsouk, Winston Tseng
BACKGROUND: Colorectal cancer (CRC) screening rates are low among South Asians. Understanding barriers and facilitators about CRC screening among South Asians may inform effective messaging and interventions. METHODS: We conducted eight focus groups (FGs) among South Asians to gather contextual information about CRC causes, screening barriers and facilitators, and cultural factors affecting screening. FINDINGS: An overarching sentiment across Asian Indian and Bangladeshi FGs was that cancer is considered a death sentence...
2018: Journal of Health Care for the Poor and Underserved
Lisa Hark, Megan Acito, Jennifer Adeghate, Jeffrey Henderer, Joseph Okudolo, Kunal Malik, Jeanne Molineaux, Rita Eburuoh, Tingting Zhan, L Jay Katz
Blindness from glaucoma can be prevented by early detection and treatment. Telemedicine improves access to treatment in high-risk populations that face barriers to receiving adequate ophthalmic care. We used a practice-based telemedicine screening model at two health centers. Telemedicine imaging of the fundus and optic nerve, followed by a complete eye exam at the same location for participants with abnormal findings, unreadable images, or ocular hypertension (OHTN), was performed. A total of 182 participants were screened, of whom 108 qualified for a complete eye exam...
2018: Journal of Health Care for the Poor and Underserved
Jane Hand, Alison Koransky, Jason Feinman, Maria B Pellerano, Manuel E Jimenez, Susan Giordano, Eric Jahn
PURPOSE: Understand how participation in service-learning activities in medical school influenced physicians' early careers. METHODS: Researchers conducted semi-structured interviews with physicians who had completed residency training and held leadership positions within an established medical-student-run, service-learning initiative. The research team analyzed the interviews iteratively, using an editing coding strategy to identify categories, and identified themes by prolonged data immersion...
2018: Journal of Health Care for the Poor and Underserved
Marla B Hall, Paul Vos, Jukelia J Bess, Kelly L Reburn, Gavin D Locklear, Jamila McAlister, Ronny A Bell
BACKGROUND: This study examined the relationship of medical mistrust using the Group-based Medical Mistrust Scale (GBMMS), and Papanicolaou testing behaviors among rural Black and White women. METHODS: Utilizing a convenience sample, a cross-sectional study was performed. Inclusion criteria included self-identification as a non-Hispanic Black or White woman, at least 21 years of age, and a resident of one of the selected counties in the region. Analyses conducted were two-sample t-tests, Fisher's exact tests, Spearman's rho, and logistical regression...
2018: Journal of Health Care for the Poor and Underserved
Preeti Dalawari, Amar Kantipudi, Jennifer Fitzgerald
OBJECTIVE: The objective was to assess the number of emergency department patients with selected chronic medical conditions having medicine on a generic drug discount program list (GDDP), and to see if providing information about GDDPs would lead to cost savings. METHODS: A survey was given to consenting patients with at least one of 16 chronic medical conditions. Participants were offered education, which provided information about the three pharmacies closest to the participant...
2018: Journal of Health Care for the Poor and Underserved
Avik Chatterjee, Rory Brown, Jason P Block
Families experiencing homelessness struggle with food access and face a high burden of nutrition-related diseases. We assessed feasibility of Feastworthy, a prepared meal delivery program for families in motel-shelters with meals made from surplus food from local colleges. We used pre-and post-program surveys and semi-structured interviews, comparing participating families with families in a nearby shelter. During the three-month pilot, Feastworthy delivered 4,875 meals to 38 families; 33 families participated in the study (20 intervention and 13 control)...
2018: Journal of Health Care for the Poor and Underserved
Jessica Bull, Kimberly Cabral, Elizabeth Kvach
OBJECTIVE: This quality improvement (QI) project aimed to improve primary care for immigrant and refugee children with failure to thrive (FTT) in a diverse clinic where elevated rates of FTT were noted. METHODS: The QI intervention included a patient registry managed by a care coordinator, a manual to educate providers, and group visits for patients with shared primary language. Rates of clinical follow-up, growth parameters of children in group visits versus standard care, and provider confidence/satisfaction were evaluated...
2018: Journal of Health Care for the Poor and Underserved
Aleta Baldwin, Brian Dodge, Vanessa R Schick, Brenda Light, Phillip W Scharrs, Debby Herbenick, J Dennis Fortenberry
Research demonstrates health disparities between gender-minority individuals and cisgender individuals. These disparities arise from multiple sources, including negative health care experiences. This study examines interactions between transgender and gender non-binary (TGGNB) individuals and their health care providers. We analyzed 119 participants' descriptions of positive and negative health care experiences, and what they wish providers knew about caring for TGGNB patients. Health care experiences went well when providers and staff used inclusive language, demonstrated their experience and education, and treated identity disclosure as routine...
2018: Journal of Health Care for the Poor and Underserved
J Deanna Wilson, Katherine Clair Shaw, Leonard Samuel Feldman
BACKGROUND: Patient-centered discharge planning improves transitional care and health outcomes for vulnerable adults. The HOME Initiative was an educational intervention aiming to improve trainees' patient-centered discharge planning skills. METHODS: Using a quasi-experimental design, 52 internal medicine residents at an academic medical center were randomized to intervention or control in 2014-2015. Intervention interns visited recently discharged patients during inpatient rotations...
2018: Journal of Health Care for the Poor and Underserved
John Njugun
INTRODUCTION: Nurses in Kenya provide significant health care including immunization in government-run health facilities. Nurses' went on strike for 150 days in 2017. This study sought to determine the strike's effect on immunization services. METHODS: Data on number of fully immunized infants reported in 18 county referral hospitals was extracted from the Kenya Health Information System and analyzed for strike and similar non-strike months. A similar analysis was conducted for 14 faith-based health facilities that were not affected by the strike...
2018: Journal of Health Care for the Poor and Underserved
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