Children from diverse ethnic groups are at significantly increased risk for dental caries. In particular, American Indian (AI) children have the highest incidence of detal caries of any ethnic group. The COVID-19 pandemic dramatically restricted health care access, including preventive oral health care.
View Article and Find Full Text PDFInt J Environ Res Public Health
December 2022
As one of the Research Centers for Minority Institutions (RCMI), the Southwest Health Equity Research Collaborative (SHERC) worked over the first five-year period of funding to foster the advancement of Early Stage Investigators, enhance the quality of health disparities research, and increase institution research capacity in basic Biomedical, Behavioral, and/or Clinical research; all priorities of RCMIs. In year 4, the Technical Assistance Group-Service Center (TAG-SC) was created to help achieve these goals. The TAG-SC provides one-on-one investigator project development support, including research design, data capture, and analysis.
View Article and Find Full Text PDFPurpose: This paper aims to analyze how a tangram activity improved students' abilities to explain sustainability, articulate a positive perception of sustainable design and relate sustainability with innovation in engineering design.
Design/methodology/approach: The concept of paradigm shift was introduced in the classroom by using a tangram activity to help students understand that sustainable design requires out-of-the-box thinking. Instructors from three institutions teaching various levels of sustainability courses to engineering majors used the activity to introduce sustainable design, then measured the understanding and appreciation of the concepts introduced through the tangram activity with pre- and post-activity surveys.
American Indian and Alaska Native (AI/AN) communities have experienced a history of systemic racism and still face significant oral health disparities. These disparities extend to the youngest community members in the form of early childhood caries (ECC). Although behavior and biology contribute to ECC, the conditions where people live, grow, and work, and the systems and political and economic forces that shape individual health outcomes, are thought to greatly impact ECC among AI/AN populations.
View Article and Find Full Text PDFInt J Environ Res Public Health
September 2021
In the United States, children from diverse ethnic groups and those with low socioeconomic status are at a significantly increased risk for early childhood caries. Despite the efforts focused on decreasing early childhood caries in American Indian (AI) populations, these children have the highest incidence of dental caries of any ethnic group, with four times the cases of untreated dental caries compared to white children. This qualitative formative assessment was conducted in two AI communities.
View Article and Find Full Text PDFDespite doing well on antiretroviral therapy, many people living with HIV have expressed a willingness to accept substantial risks for an HIV cure. To date, few studies have assessed the specific quantitative maximal risk that future participants might take; probed whether, according to future participants, the risk can be offset by the benefits; and examined whether taking substantial risk is a reasonable decision. In this qualitative study, we interviewed 22 people living with HIV and used standard gamble methodology to assess the maximum chance of death a person would risk for an HIV cure.
View Article and Find Full Text PDFBackground: Parents and clinicians caring for premature infants face high-stakes and time-sensitive decisions about care. We aimed to characterize how parents and clinicians discuss outcome in the context of decision-making for premature infants.
Methods: In this qualitative descriptive study, we used a case-based, prospective design.
Context: Palliative care (PC) model delivered by two large hospices and PC providers.
Objectives: To understand study participants' knowledge of PC and acceptability of a new community-based PC model.
Methods: Semistructured interview with patients and caregivers; focus groups with taxpayers.
Background: Genomics will play an increasingly prominent role in clinical medicine.
Objective: To describe how primary care physicians (PCPs) discuss and make clinical recommendations about genome sequencing results.
Design: Qualitative analysis.
Antiretroviral (ARV) adherence has largely been considered from the perspective of an individual's behavior with less attention given to potential structural causes for lapses in treatment, such as the cost of medications and care. HIV medication expense is typically covered by third party payers. However, private insurance premiums and deductibles may rise, or policies terminated such as with a change in employment.
View Article and Find Full Text PDFPurpose: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits.
View Article and Find Full Text PDFAntiretroviral therapy (ART) requires lifelong daily oral therapy. While patient characteristics associated with suboptimal ART adherence and persistence have been described in cohorts of HIV-infected persons, these factors are poor predictors of individual medication taking behaviors. We aimed to create and test instruments for the estimation of future ART adherence and persistence for clinical and research applications.
View Article and Find Full Text PDFObjective: High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. Limited data characterize psychiatrist-patient conversations about health care costs.
View Article and Find Full Text PDFAim: Identify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting.
Materials & Methods: We observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Project. Using transcripts of such disclosure interactions, we made qualitative observations of communication behaviors that could limit the usefulness of GS results until reaching the point of thematic saturation.
Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in the way of helping patients navigate out-of-pocket spending. Some behaviors reflected a failure to fully engage with patients' financial concerns, from never acknowledging such concerns to dismissing them too quickly.
View Article and Find Full Text PDFBackground: Nearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations are unclear, and rigorous definitions are lacking.
View Article and Find Full Text PDFBackground: More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized.
Objective: We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs.
An anti-hCG autoantibody was found in a patient with a 9-yr history of secondary infertility. Although the patient had regular menstrual cycles, had conceived spontaneously, and had good hormonal and follicular responses to gonadotropic stimulation regimens during the in vitro fertilization work-up, she presented with apparent recurrent pregnancy loss associated with prolonged raised hCG levels. Initially the presence of a high mol wt hCG complex was demonstrated in the serum by gel chromatography.
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