Journal of racial and ethnic health disparities
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J Racial Ethn Health Disparities · Aug 2019
Racial Differences in Smoking-related Disease Risk Perceptions Among Adults Completing Lung Cancer Screening: Follow-up Results from the ACRIN/NLST Ancillary Study.
Previous work suggests that, compared to white adults, black adults have lower perceived risk for smoking-related diseases (SRDs), which may influence cessation behavior and health outcomes; however, racial differences in SRD risk perceptions among high-risk patients (i.e., a group that exhibits elevated risk for SRDs) following lung screening remain unknown. This paper thus examined differences in risk perceptions for lung cancer and other SRDs among black and white National Lung Screening Trial (NLST) participants. We administered a 10-item measure of perceived lifetime risk of lung cancer and other SRD (Smoking Risk Perceptions Scale; SRPS) to NLST participants at 1 year following lung screening to (1) establish the internal consistency of the SRPS for both black and white participants, (2) compare smoking-related disease risk perceptions between black and white participants, and (3) identify predictors of risk perceptions for black and white participants using multivariable linear regression models. ⋯ Findings suggest current and former black smokers are at risk of having lower risk perceptions for lung cancer and SRDs than white adults following lung cancer screening; these differences may explain observed racial differences in cessation outcomes. Although similar factors influence black and white adults' beliefs, risk perceptions may differentially impact smoking behavior among these groups. Behavior change models that guide tobacco treatment approaches, particularly for high-risk black smokers, should consider the influence of cultural factors on risk perceptions and cessation efforts.
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J Racial Ethn Health Disparities · Aug 2019
Socioeconomic, Racial, and Ethnic Disparities in Postpartum Readmissions in Patients with Preeclampsia: a Multi-state Analysis, 2007-2014.
Childbirth is the most common reason for hospitalization for reproductive-aged women, with about 4 million annual deliveries nationally. Hypertension is the leading indication for postpartum readmission and therefore women with preeclampsia are at high risk for readmission. Social determinants of health are associated with increased readmission in postpartum patients; however, no study has specifically investigated readmissions in this higher risk group of patients. We sought to evaluate the effect of social determinants of health on postpartum readmissions in all postpartum patients and in a subgroup analysis of those with a diagnosis of preeclampsia. ⋯ The present study has shown that socioeconomic and racial/ethnic disparities exist in postpartum readmissions. These findings additionally exist among the already highest-risk preeclamptic patients. Future research should further elucidate this relationship and develop amelioration strategies.
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J Racial Ethn Health Disparities · Aug 2019
Spanish-Speaking Caregivers' Experience with an Emergency Department Pediatric Asthma-Care Bundle Quality Initiative.
Most pediatric emergency departments' (ED) quality improvement (QI) initiatives for asthma aim to standardize care based on the priorities of healthcare providers. Perceptions and priorities of the caregiver rarely are addressed, especially in families with limited English-language proficiency. We explored Spanish-speaking caregivers' perceptions, understandings, and barriers with the care they received for asthma, after exposure to an ED asthma-care bundle. ⋯ Three themes emerged regarding the caregivers' perceived barriers: (1) need for improved accessibility to medication, primary care, and insurance; (2) communication barriers, such as timeliness, availability of interpreters, and need for resources in their preferred language; and (3) uncertainty about the child's diagnosis and acuity. Incorporating the caregivers' perspectives into QI projects may yield valuable information when developing new interventions. In the ED, improving accessibility to interpreters and providing discharge materials in their preferred language, as well as addressing misconceptions about asthma, may enhance caregivers' satisfaction.