What Matters Most? Intersectional Correlates of Caregiver Burdens.

Increasing numbers of older adults require caregiver support from unpaid caregivers. Yet, there is limited research on caregiver burden type and interactions across race, gender, and other sociodemographic characteristics. This quantitative study uses an intersectional framework to examine associations between caregiving burden and sociodemographic factors.

Correction to: Physician Knowledge of Human Genetic Variation, Beliefs About Race and Genetics, and Use of Race in Clinical Decision-making.

We discovered that two of the items in the knowledge index were incorrectly identified. We reran all the analyses and none of the major findings changed. However, we would like to correct the error since our hope is that others will use the measure.

A Comparison of Physicians' and Nurse Practitioners' Use of Race in Clinical Decision-Making.

Objective: The debate over use of race as a proxy for genetic risk of disease continues, but little is known about how primary care providers (nurse practitioners and general internal medicine physicians) currently use race in their clinical practice. Our study investigates primary care providers' use of race in clinical practice.

Methods: Survey data from three cross-sectional parent studies were used.

Physician Knowledge of Human Genetic Variation, Beliefs About Race and Genetics, and Use of Race in Clinical Decision-making.

Background: Race in the USA has an enduring connection to health and well-being. It is often used as a proxy for ancestry and genetic variation, although self-identified race does not establish genetic risk of disease for an individual patient. How physicians reconcile these seemingly paradoxical facts as they make clinical decisions is unknown.

Primary Care Physicians' Collection, Comfort, and Use of Race and Ethnicity in Clinical Practice in the United States.

Purpose: The clinical utility of race and ethnicity has been debated. It is important to understand if and how race and ethnicity are communicated and collected in clinical settings. We investigated physicians' self-reported methods of collecting a patient's race and ethnicity in the clinical encounter, their comfort with collecting race and ethnicity, and associations with use of race in clinical decision-making.

Nurses' Use of Race in Clinical Decision Making.

Purpose: To examine nurses' self-reported use of race in clinical evaluation.

Design: This cross-sectional study analyzed data collected from three separate studies using the Genetics and Genomics in Nursing Practice Survey, which includes items about use of race and genomic information in nursing practice. The Racial Attributes in Clinical Evaluation (RACE) scale was used to measure explicit clinical use of race among nurses from across the United States.

Development and psychometric assessment of the healthcare provider cultural competence instrument.

This study presents the measurement properties of 5 scales used in the Healthcare Provider Cultural Competence Instrument (HPCCI). The HPCCI measures a health care provider's cultural competence along 5 primary dimensions: (1) awareness/sensitivity, (2) behaviors, (3) patient-centered communication, (4) practice orientation, and (5) self-assessment. Exploratory factor analysis demonstrated that the 5 scales were distinct, and within each scale items loaded as expected.

Physicians' knowledge, beliefs, and use of race and human genetic variation: new measures and insights.

Background: Understanding physician perspectives on the intersection of race and genomics in clinical decision making is critical as personalized medicine and genomics become more integrated in health care services. There is a paucity of literature in the United States of America (USA) and globally regarding how health care providers understand and use information about race, ethnicity and genetic variation in their clinical decision making. This paper describes the development of three scales related to addressing this gap in the literature: the Bonham and Sellers Genetic Variation Knowledge Assessment Index--GKAI, Health Professionals Beliefs about Race-HPBR, and Racial Attributes in Clinical Evaluation-RACE scales.

Physicians' anxiety due to uncertainty and use of race in medical decision making.

Background: The explicit use of race in medical decision making is contested. Researchers have hypothesized that physicians use race in care when they are uncertain.

Objectives: The aim of this study was to investigate whether physician anxiety due to uncertainty (ADU) is associated with a higher propensity to use race in medical decision making.

Erratum to: Interpersonal discrimination and health-related quality of life among black and white men and women in the United States.

Objective: We assessed associations between discrimination and health-related quality of life among black and white men and women in the United States.

Methods: We examined data from the National Health Measurement Study, a nationally representative sample of 3,648 adults aged 35-89 in the non-institutionalized US population. These data include self-reported lifetime and everyday discrimination as well as several health utility indexes (EQ-5D, HUI3, and SF-6D).

The impact of goal-striving stress on physical health of white Americans, African Americans, and Caribbean blacks.

Objective: To contribute to the growing understanding of U.S. black-white health disparities by examining psychosocial stress as an important contributor to physical health problems.

Goal-striving stress and the mental health of college-educated Black American men: the protective effects of system-blame.

The present study examined the relationship between goal-striving stress and well-being in a survey of 399 college-educated Black American men who were members of a Black fraternal organization. Regression analyses revealed that goal-striving stress was associated with decreased psychological well-being, controlling for demographics and various psychosocial factors. When asked to explain their failure to reach life goals, half of the men attributed setbacks to racial discrimination.

Is race medically relevant? A qualitative study of physicians' attitudes about the role of race in treatment decision-making.

Background: The role of patient race in medical decision-making is heavily debated. While some evidence suggests that patient race can be used by physicians to predict disease risk and determine drug therapy, other studies document bias and stereotyping by physicians based on patient race. It is critical, then, to explore physicians' attitudes regarding the medical relevance of patient race.

Effects of incentives and prenotification on response rates and costs in a national web survey of physicians.

Little is known about what strategies are cost-effective in increasing participation among physicians in surveys that are conducted exclusively via the web. To assess the effects of incentives and prenotification on response rates and costs, general internists (N = 3,550) were randomly selected from the American Medical Association (AMA) Masterfile and assigned to experimental groups that varied in the amount of a promised incentive (none, entry into a $200 lottery, $50, or $100) and prenotification (none, prenotification letter only, or prenotification letter containing a $2 preincentive). Results indicated that the response rates were highest in the groups promised $100 and $50, respectively.

Primary care physicians' attitudes regarding race-based therapies.

Background: There is little to no information on whether race should be considered in the exam room by those who care for and treat patients. How primary care physicians understand the relationship between genes, race and drugs has the potential to influence both individual care and racial and ethnic health disparities.

Objective: To describe physicians' use of race-based therapies, with specific attention to the case of BiDil (isosorbide dinitrate/hydralazine), the first drug approved by the FDA for a race-specific indication, and angiotensin-converting enzyme (ace) inhibitors in their black and white patients.

Physicians' attitudes toward race, genetics, and clinical medicine.

Purpose: This qualitative study explored black and white general internists' attitudes about the relevance of race in clinical care; views of the relationships among race, genetics, and disease; and expectations about the future of genetics and health.

Methods: We conducted 10 racially concordant focus groups of primary care physicians in five metropolitan areas in the United States. Ninety board certified or eligible general internists (50 self-identified whites and 40 self-identified blacks) participated in the study.

Effects of goal-striving stress on the mental health of black Americans.

Although many scholars have theorized about how responding to the stress of blocked opportunities can affect the well-being of black Americans, few scholars have empirically examined the relationships between striving efforts, personal goals, and mental health among black Americans. This investigation examines the relationship between goal-striving stress and mental health in a national sample of black Americans. Results indicate that goal-striving stress is significantly related to lower levels of happiness, life satisfaction, self-esteem, and higher levels of psychological distress.

Effects of racial discrimination and health behaviors on mental and physical health of middle-class African American men.

This research is an examination of the effects of racial discrimination and health-promoting behaviors on the physical and mental health of a sample of 399 well-educated African American men. One would think that the attainment of higher education would increase health-promoting behaviors and might decrease discriminatory experiences that impact health. However, regression analysis indicated a more complex picture.

John Henryism and self-reported physical health among high-socioeconomic status African American men.

We performed a cross-sectional survey of high-socioeconomic status (SES) African American men and their health to examine the relationship between John Henryism (the strong behavioral predisposition to directly confront barriers to upward social mobility) and self-reported physical health status. We found a positive association between John Henryism and better physical health among high-SES African American men. The study of social and behavioral implications of health of men of differing SES is required to develop strategies to improve the health of African American men.