-
International Journal of Environmental... Jan 2023Less than one-third of pregnant women in the U.S. meet prenatal nutrition, exercise, and stress management health behavior guidelines. Low rates of these prenatal health...
Less than one-third of pregnant women in the U.S. meet prenatal nutrition, exercise, and stress management health behavior guidelines. Low rates of these prenatal health behaviors have been especially observed among low-income, ethnic minority women, placing them and their infants at a disproportionally higher risk for health complications. Yet, few studies have identified factors associated with these prenatal health behaviors in this population. This study examined whether certain demographic (e.g., ethnicity) and psychosocial characteristics (i.e., coping, stress, pregnancy-specific stress, and depression) were associated with prenatal nutrition (i.e., high-fat food and fruit and vegetable intake), exercise, and stress management health behaviors in 100 low-income, pregnant women (39% African American, 30% foreign-born Latinas, 15% U.S.-born Latinas, 10% non-Hispanic white, and 6% Asian American/Pacific Islander) in southern California using an embedded, mixed-methods, cross-sectional design. Results demonstrated that ethnic minority women who experienced more stress and used more maladaptive coping strategies (e.g., avoidance) were particularly at risk of consuming more high-fat foods and engaging in less exercise and stress management during pregnancy. Qualitative responses revealed women's experiences with these prenatal health behaviors. These findings highlight the need for interventions and collaborative care models that target psychosocial factors in order to optimize prenatal health behaviors and health outcomes among ethnic minority women.
Topics: Infant; Female; Humans; Pregnancy; Ethnicity; Ethnic and Racial Minorities; Cross-Sectional Studies; Minority Groups; Health Behavior
PubMed: 36767060
DOI: 10.3390/ijerph20031695 -
Anesthesia and Analgesia May 2017Women and minorities are underrepresented in US academic medicine. The Sullivan Commission on Diversity in the Healthcare Workforce emphasized the importance of diverse...
BACKGROUND
Women and minorities are underrepresented in US academic medicine. The Sullivan Commission on Diversity in the Healthcare Workforce emphasized the importance of diverse leadership for reducing health care disparities. The objective of this study was to evaluate the demographics of the American Society of Anesthesiologists leadership. We hypothesized that the percentage of women and underrepresented minorities is less than that of their respective proportions in the general physician workforce.
METHODS
An electronic survey was developed by the authors and mailed to 595 members of the American Society of Anesthesiologists leadership who had valid email addresses, including the members of the 2014 House of Delegates and state society leaders who were not the members of the House of Delegates. Univariate statistics were used to characterize survey responses and the probability distributions were estimated using the binomial distribution. A one-sample t test was used to compare the percentage of women and minorities in the survey pool to that of the corresponding percentages in the general physician workforce (38.0% women and 8.9% minorities), and the US population (51.0% women and 32.0% minorities).
RESULTS
The survey response rate was 54%. A total of 21.1% (95% confidence interval: 16.4%-25.7%) of respondents were women and 6.0% (95% confidence interval: 3.3%-8.7%) were minorities. The proportion of women in the American Society of Anesthesiologist leadership was lower than the general medical workforce and the US population (P < .001 for both); the proportion of underrepresented minorities was lower than the US population (P < .001).
CONCLUSIONS
Women and minorities are underrepresented in the leadership of the American Society of Anesthesiologists. Efforts should be made to increase the diversity of the American Society of Anesthesiologists leadership with the goal of reducing overall anesthesia workforce disparities.
Topics: Anesthesiologists; Anesthesiology; Cultural Diversity; Female; Humans; Leadership; Male; Middle Aged; Minority Groups; Societies, Medical; Surveys and Questionnaires; United States; Women
PubMed: 28277321
DOI: 10.1213/ANE.0000000000001837 -
Clinical Child Psychology and Psychiatry Apr 2018During the summer of 2016, in the midst of one of the biggest refugee crises in centuries, the author of this article joined the team from a shelter for unaccompanied...
During the summer of 2016, in the midst of one of the biggest refugee crises in centuries, the author of this article joined the team from a shelter for unaccompanied refugee minors on Samos, Greece, in an effort to provide young boys seeking asylum in Europe with an opportunity to engage in speaking about the difficulties they have encountered in life. The team used a collective narrative methodology called the "Tree of Life", originally developed by Ncube-Mlilo and Denborough. In addition to traditional psychological treatments, collective narrative practice creates a secure foundation for addressing trauma, suffering, and hardship. This approach takes into consideration cultural differences and is easy to access for refugees with perceived stigma of traditional mental health services. The Tree of Life is a minimum of 8-hour workshop involving a strength-based narrative methodology, using the tree as a metaphor. This enables participants to share and develop enriching stories about their lives, which are rooted in their cultural and social histories. The workshop conducted on Samos proved to be an effective way to invite young unaccompanied minors to speak about their difficulties in ways that were not retraumatizing, but instead made them stronger.
Topics: Adolescent; Female; Humans; Male; Mental Health Services; Minors; Narration; Power, Psychological; Refugees; Stress Disorders, Post-Traumatic
PubMed: 29277109
DOI: 10.1177/1359104517744246 -
The British Journal of Social Psychology Jul 2022Ethnic minority group members' responses to their prejudicial treatment can take several forms. One involves identity concealment (e.g., 'passing'). In order to...
Ethnic minority group members' responses to their prejudicial treatment can take several forms. One involves identity concealment (e.g., 'passing'). In order to understand such a response, we must explore participants' understandings of the interactional context before them, their meta-perceptions of the identity others ascribe to them, and the varied meanings that identity concealment/non-disclosure may have in that context. Our analysis of interview data (N = 30) obtained with Roma in Hungary reveals diverse forms of, and motivations for, the concealment of their Roma identity. Some participants reported examples of proactive identity concealment, others reported more reactive forms (in which they went along with others' mistaken assumptions concerning their identity). The motivations for identity concealment (whether proactive or reactive) included the desire to: secure material benefits; avoid conflict; take pleasure from seeing others' assumptions blinding them to the reality before them; test (and expose) majority group members' attitudes; allow themselves opportunities to experience the world in new ways. Our analysis highlights the importance of social identity researchers recognizing the diverse motivations for ethnic identity concealment: From the actors' perspective concealment is not always assimilatory, and in some contexts can be experienced as empowering.
Topics: Ethnicity; Humans; Hungary; Minority Groups; Prejudice; Social Identification
PubMed: 34747018
DOI: 10.1111/bjso.12507 -
The Clinical Teacher Oct 2018Although the proportion of ethnicities representing under-represented minorities in medicine (URM) in the general population has significantly increased, URM enrolment...
BACKGROUND
Although the proportion of ethnicities representing under-represented minorities in medicine (URM) in the general population has significantly increased, URM enrolment in medical schools within the USA has remained stagnant in recent years.
METHODS
This study sought to examine the effect of an immersion in community medicine (ICM) programme on secondary school students' desire to enter the field of medicine and serve their communities. The authors asked all 69 ICM alumni to complete a 14-question survey consisting of six demographic, four programme and four career questions, rated on a Likert scale of 1 (completely disagree) to 5 (completely agree), coupled with optional free-text questions. Data were analysed using GraphPad prism and nvivo software.
RESULTS
A total of 61 students responded, representing a response rate of 88.4 per cent, with a majority of respondents (73.7%) from URM backgrounds. An overwhelming majority of students agreed (with a Likert rating of 4 or 5) that the ICM programme increased their interest in becoming a physician (n = 56, 91.8%). Students reported shadowing patient-student-physician interactions to be the most useful (n = 60, 98.4%), and indicated that they felt that they would be more likely to lead to serving the local community as part of their future careers (n = 52, 85.3%). Of the students that were eligible to apply to medical school (n = 13), a majority (n = 11, 84.6%) have applied to medical school. URM enrolment in medical schools within the USA has remained stagnant in recent years DISCUSSION: Use of a community medicine immersion programme may help encourage secondary students from URM backgrounds to gain the confidence to pursue a career in medicine and serve their communities. Further examination of these programmes may yield novel insights into recruiting URM students to medicine.
Topics: Adolescent; Career Choice; Community Medicine; Cultural Diversity; Female; Humans; Male; Mentors; Minority Groups; Physical Examination; Residence Characteristics; Schools; Socioeconomic Factors
PubMed: 28805356
DOI: 10.1111/tct.12694 -
The American Journal of Medicine Dec 2005Recent clinical trials have confirmed the value of intervention on major risk factors, particularly hypertension and hyperlipidemia, in preventing the progression and... (Review)
Review
Recent clinical trials have confirmed the value of intervention on major risk factors, particularly hypertension and hyperlipidemia, in preventing the progression and clinical sequelae of atherosclerosis. Less is known about the prevalence and impact of atherosclerosis risk factors in minorities. A review of recent literature reporting the prevalence of established and new predictors of atherosclerotic events in minority populations and the inclusion of minorities in clinical trials is presented. The prevalence of risk factors differs considerably in minority populations. The role of "premature" coronary death and the level of some risk factors, particularly obesity and blood pressure in African descendants and high triglycerides, low high-density lipoproteins, and diabetes in some Hispanics, is higher than in whites. With few exceptions, however, minorities have not been included in clinical trials in sufficient numbers to determine whether significant differences in the benefit of risk factor intervention exists. Prevalence of key risk factors differs among minority groups. Risk factor intervention should be pursued in minority groups but with the understanding that clinical trials have not ruled out the possibility of qualitative or quantitative differences in response rates among different groups.
Topics: Cardiovascular Diseases; Clinical Trials as Topic; Diabetes Complications; Humans; Hypertension; Minority Groups; Obesity; Risk Factors; Smoking
PubMed: 16378771
DOI: 10.1016/j.amjmed.2005.04.041 -
Person-Centered Cultural Assessment Can Improve Child Mental Health Service Engagement and Outcomes.Journal of Clinical Child and... 2022Disparities in child mental health service engagement suggest traditional evidence-based practices do not properly consider cultural and contextual factors relevant for...
OBJECTIVE
Disparities in child mental health service engagement suggest traditional evidence-based practices do not properly consider cultural and contextual factors relevant for marginalized families. We propose a person-centered approach to improve the cultural responsiveness of services. Preliminary research supports broadening standard assessments to include a person-centered evaluation of patient cultural factors, however, controlled studies have not been conducted in the context of children's mental health care.
METHODS
Participants included families (N = 89; 89% racial/ethnic minority) receiving services for child externalizing problems. Prior to intake, caregivers were randomized to receive either Assessment as Usual (AAU) or AAU augmented with the Cultural Formulation Interview (CFI+AAU), a brief caregiver assessment of cultural factors affecting their child's problems and family help-seeking.
RESULTS
Implementation data showed strong provider fidelity and clinical utility. Following assessments, CFI+AAU caregivers (relative to AAU caregivers) reported feeling better understood by their provider, and providers reported better understanding CFI+AAU families' values. Caregiver satisfaction was rated highly overall, yet providers reported being more satisfied with the assessment when the CFI was incorporated. Engagement outcomes found CFI+AAU families were significantly more likely than AAU families to subsequently complete the first phase of treatment. Further, among families receiving services in Spanish, CFI+AAU, relative to AAU, was associated with significantly higher treatment attendance, homework completion, and treatment response.
CONCLUSIONS
The results underscore the utility of incorporating a brief cultural assessment in pretreatment assessments. To improve the cultural responsiveness of services, efforts may do well to promote the uptake of person-centered approaches such as cultural assessment into usual care. Registered at clinicaltrials.gov (NCT03499600).
Topics: Caregivers; Child; Ethnic and Racial Minorities; Ethnicity; Family; Humans; Mental Health Services; Minority Groups
PubMed: 34905434
DOI: 10.1080/15374416.2021.1981340 -
Journal of Dental Hygiene : JDH 2002The United States is rapidly becoming a more multicultural society. Although minority groups are the fastest growing segment of the U.S. population, minorities are not... (Review)
Review
PURPOSE
The United States is rapidly becoming a more multicultural society. Although minority groups are the fastest growing segment of the U.S. population, minorities are not pursuing careers in health care professions in the same proportions. The literature suggests that increasing the number of minorities in the health care professions will increase access to health care for minority populations and help non-minority health care professionals become more aware of and sensitive to minority issues. The results reported here are part of a larger national survey that examined the commitment of entry-level dental hygiene programs to ethnic/racial diversity.
METHODS
A 19-item survey was mailed in 1998 to all 233 entry-level dental hygiene program directors in the United States. The survey was piloted using a random sample of six entry-level dental hygiene program directors in the United States. Data were collected on demographics, formal written mission statements that support ethnic/racial diversity, minority recruitment programs, and recruitment mechanisms. Data were analyzed using frequencies, chi-square, t-tests, F-tests and Pearson correlation coefficients. The response rate was 60.1% (140).
RESULTS
Results indicate that 10.5% of dental hygiene students and 6.7% of dental hygiene faculty are members of ethnic/racial minorities. Results also indicate that Asian and Pacific Islander (API) students are not underrepresented in U.S. entry-level dental hygiene programs, but Asian and Pacific Islander faculty are.
CONCLUSIONS
A statistically significant relationship was found between the percentage of 1) minority faculty and students in entry-level dental hygiene programs; and 2) minority students and minorities in the state where the entry-level dental hygiene program resides.
Topics: Data Collection; Dental Hygienists; Faculty, Dental; Health Services Accessibility; Healthy People Programs; Humans; Minority Groups; Statistics, Nonparametric; Students, Health Occupations; United States
PubMed: 12271864
DOI: No ID Found -
Journal of Healthcare Management /...Board diversity is increasingly important for hospitals and healthcare systems, with national attention focused on eliminating health disparities and improving health...
GOAL
Board diversity is increasingly important for hospitals and healthcare systems, with national attention focused on eliminating health disparities and improving health equity. Yet, it remains a challenge despite concerted efforts by leading professional associations (e.g., American College of Healthcare Executives) to galvanize their constituents around the importance of the issue.
METHODS
This study used survey data from The Governance Institute to explore the ethnoracial and gender diversity of hospital boards spanning 2011 through 2021.
PRINCIPAL FINDINGS
The results showed modest gains in the mean number of female board members, although a small proportion of hospital boards still have no female representation. There was little change in the number of boards with ethnic minority representation until an uptick in 2021, likely in direct response to high-profile racial incidents and protests.
PRACTICAL APPLICATIONS
Intentional and sustained efforts are necessary to increase diversity and create a culture of inclusion that fosters meaningful engagement of diverse board members.
Topics: Humans; United States; Ethnicity; Minority Groups; Hospitals; Governing Board; Health Equity
PubMed: 36692421
DOI: 10.1097/JHM-D-22-00068 -
Obstetrics and Gynecology Clinics of... Jun 2009Obesity is increasing at epidemic rates in all women, but especially in minority women and children. Factors that contribute to this include changes in caloric intake... (Review)
Review
Obesity is increasing at epidemic rates in all women, but especially in minority women and children. Factors that contribute to this include changes in caloric intake and expenditure (calories), cost and ease of acquiring food along with pressures from the marketplace and media (commerce) and the community response to the increasing prevalence of obesity and sedentary lifestyle (culture).
Topics: Advertising; Commerce; Energy Intake; Ethnicity; Female; Humans; Life Style; Minority Groups; Obesity; Prevalence
PubMed: 19501320
DOI: 10.1016/j.ogc.2009.04.003