Publications by authors named "Spero Manson"

Translational research needs to show value through impact on measures that matter to the public, including health and societal benefits. To this end, the Translational Science Benefits Model (TSBM) identified four categories of impact: Clinical, Community, Economic, and Policy. However, TSBM offers limited guidance on how these areas of impact relate to equity.

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Importance: The COVID-19 pandemic has placed a burden on the health of many people, including significant disparities in American Indian and Alaska Native communities.

Objective: This study examines the associations between coping behaviors, social support, and emotional health among American Indian and Alaska Native peoples during the COVID-19 pandemic.

Design, Setting, And Participants: This cross-sectional study included survey data collected from November 2021 to May 2022 from American Indian and Alaska Native adults aged 18 years or older without dementia or other serious cognitive impairments who were seen at 6 urban health organizations primarily in urban settings (in New Mexico, Alaska, Colorado, Minnesota, Utah, and Kansas) in the year prior to the survey.

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Article Synopsis
  • The Resource Centers for Minority Aging Research (RCMAR) program, part of the National Institute on Aging, has successfully advanced minority aging research and diversified the scientific workforce over nearly 30 years.
  • The article outlines the program's development, focusing on enhancing health disparities research methods and preparing future scholars through comprehensive career development and supportive communities.
  • It concludes by discussing RCMAR's successes, ongoing challenges, and future growth opportunities in responding to evolving political and research contexts while maintaining its core mission.
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Article Synopsis
  • * A total of 39,183 adults were analyzed, revealing that the use of metformin and insulin increased while sulfonylureas and thiazolidinediones decreased.
  • * Results showed a notable decline in severe hypoglycaemia and hyperglycaemia rates during the same period, suggesting improved management of T2D among AI/AN populations.
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Objective: To understand the perspectives of key informant experts regarding the relationship between food insecurity and gestational diabetes mellitus risk reduction behaviors among young American Indian and Alaska Native females.

Methods: Participants were adult key informants with expertise in food/nutrition and health within Tribal communities (N = 58) across the US. Data were collected through 1:1 interviews using a semistructured moderator guide and analyzed using thematic content analysis methods.

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Article Synopsis
  • The study examines the link between social determinants of health and the risk of contracting COVID-19 among American Indian and Alaska Native (AI/AN) peoples, highlighting a lack of prior knowledge in this area.
  • A survey of 767 AI/AN patients revealed that living in multigenerational households increased the risk of contracting COVID-19 by 11 percentage points.
  • Additionally, participants who received tribal payments showed a reduced risk of COVID-19, suggesting that targeted interventions and financial support could improve health outcomes for urban AI/AN populations.
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Purpose: The purpose of this study was to examine the association between determinants of health, medication engagement, and A1C levels in adults with type 2 diabetes (T2DM) receiving Tribal health and pharmacy services.

Methods: A retrospective analysis of 2020-2021 electronic health record data was conducted and included adult patients with T2DM using Choctaw Nation Health Services Authority prescribed ≥1 noninsulin glucose-lowering medication in 2020, had ≥1 A1C value in 2020 and 2021, and had a valid zip code in 2021. Patients receiving both insulin and other noninsulin glucose-lowering medication were included.

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Background: The COVID-19 pandemic has substantially impacted American Indian and Alaska Native (AI/AN) communities. Rates of infection, hospitalization, and mortality have been severe relative to non-Hispanic whites. While AI/AN communities have had some of the highest levels of COVID-19 vaccination, utilization rates remain suboptimal and there is a need to identify facilitators and barriers to testing and vaccination.

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Background: American Indian and Alaska Native people (AI/AN) bear a disproportionate burden of diabetes. Growing evidence shows significant associations between several acute diabetes complications and dementia among diabetes patients. However, little is known about these relationships among AI/AN adults.

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Article Synopsis
  • - Multilevel interventions (MLIs) are effective in reducing health disparities among Indigenous peoples by considering their unique histories, cultures, and community dynamics, promoting a shift towards community-level focus rather than individual-level interventions.
  • - The paper reviews three case studies where Indigenous communities collaborated with researchers throughout the MLI process, emphasizing the importance of ongoing conversations, incorporating Indigenous knowledge, and using qualitative methods to better understand health issues.
  • - Key to successful MLIs are building respectful relationships, addressing historical research abuses, and fostering mutual collaboration to create equitable and meaningful solutions that benefit both Indigenous and academic communities.
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Background: Food insecurity is an important social determinant of health that was exacerbated by the COVID-19 pandemic. Both food insecurity and COVID-19 infection disproportionately affect racial and ethnic minority groups, particularly American Indian and Alaska Native communities; however, there is little evidence as to whether food insecurity is associated with COVID-19 infection or COVID-19 preventive behaviors such as vaccination uptake. The purpose of this study was to evaluate associations between food insecurity, COVID-19 infection, and vaccination status among urban American Indian and Alaska Native adults seen at 5 clinics serving urban Native people.

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Article Synopsis
  • The study compared responses from American Indian and/or Alaska Native adolescents using two tools, Skindex-29 and Skindex-Teen, to evaluate how skin conditions affect their quality of life.
  • Conducted during regional powwows in Denver, Colorado, the research involved 86 adolescents, most of whom self-identified as American Indian and/or Alaska Native, highlighting the lack of representation in dermatology research for this group.
  • Results showed that a significant number of respondents experienced a negative impact on their quality of life due to skin issues, with older adolescents reporting greater emotional and quality-of-life challenges related to dermatological conditions.
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Introduction: American Indian and Alaska Natives serve in the military at one of the highest rates of all racial and ethnic groups. For Veterans, the already significant healthcare disparities Natives experience are aggravated by barriers to accessing care, care navigation, and coordination of health care within the Veterans Health Administration (VHA) between the VHA and tribal health systems. To mitigate these barriers, the VHA is developing a patient navigation program designed specifically for rural Native Veterans.

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Dementia research lacks appropriate representation of diverse groups who often face substantial adversity and greater risk of dementia. Current research participants are primarily well-resourced, non-Hispanic White, cisgender adults who live close to academic medical centers where much of the research is based. Consequently, the field faces a knowledge gap about Alzheimer's-related risk factors in those other groups.

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Article Synopsis
  • - American Indians face higher risks of dementia due to air pollution, yet research specifically targeting this population is limited.
  • - A study involving 26,871 American Indians aged 55+ found a significant connection between ozone levels and increased dementia risk while examining various air pollutants.
  • - Findings indicate that for every increase in ozone, the risk of developing dementia increases by 24%, whereas particulate matter and nitrogen oxides showed no significant association.
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Background: Food insecurity is an important social determinant of health that was exacerbated by the COVID-19 pandemic. Both food insecurity and COVID-19 infection disproportionately affect racial and ethnic minority groups, particularly American Indian and Alaska Native communities; however, there is little evidence as to whether food insecurity is associated with COVID-19 infection or COVID-19 preventive behaviors such as vaccination uptake. The purpose of this study was to evaluate associations between food insecurity, COVID-19 infection, and vaccination status among urban American Indian and Alaska Native adults seen at 5 clinics serving urban Native people.

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American Indian and Alaska Native (Native) Veterans enrolled in the U.S. Department of Veterans Affairs (VA) benefits program are far less likely to access health care compared to other racial/ethnic groups, in part driven by challenges posed by often distant, complex, and culturally unresponsive health care that does not easily interface with the Indian Health Service (IHS) and local Tribal Health Care.

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Background: Little is known about vaccination rates for American Indian and Alaska Native (AI/AN) parents and their children, or parental decisions in this regard. Improving vaccination rates is a serious concern due to the disproportionate incidence and morbidity of COVID-19 in AI/AN people.

Purpose: Our goal was to describe urban AI/AN parental attributes associated with COVID-19 vaccination of their children.

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Article Synopsis
  • The text outlines a research agenda aimed at addressing healthcare inequities, derived from insights gathered during the AHRQ's Health Equity Summit in July 2022.
  • A multi-stakeholder approach was used to create a framework identifying knowledge gaps and facilitating comprehensive recommendations on improving access to care through research.
  • The study emphasizes the importance of considering racism and intersectionality when addressing healthcare access, recommending funding for research that evaluates anti-racist practices and promotes best practices in healthcare delivery.
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Objectives: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a "revolving door" of discharges and admissions. This pattern disproportionately affects some groups such as Alaska Native and American Indian (AN/AI) people.

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Article Synopsis
  • A working group from the National Institute of Neurological Disorders and Stroke created a framework called Determinants of Inequities in Neurological Disease to advance research focused on health equity and social justice in neurology.
  • The framework aims to address systemic issues, like racism and socioeconomic disparities, emphasizing that these social determinants are not fixed and can be changed to help improve neurological health outcomes.
  • It encourages researchers and policymakers to consider the complex interactions between behavioral, biological, and social factors when developing programs and policies to reduce health inequities in neurological diseases.
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Objective: The COVID-19 pandemic has disproportionately affected American Indian and Alaska Native (AI/AN) people, who experience a 3.2 times higher age-adjusted rate of hospitalization and nearly double the attributed deaths compared to non-Hispanic Whites. We examined pandemic effects on emotional health and substance use in urban AI/AN people.

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Article Synopsis
  • The number of American Indian and Alaska Native individuals living with dementia is projected to rise significantly by 2060, highlighting the need to understand health disparities related to Alzheimer's disease.
  • The study analyzed Alzheimer disease mortality rates and various social determinants across 646 counties, finding that areas with more AI/AN residents had lower mortality rates, while deprived counties had higher rates of Alzheimer's mortality.
  • The results suggest a need for targeted resources and intervention strategies in regions facing higher Alzheimer's mortality, particularly those that are more deprived or urban.
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