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Racial-ethnic minorities receive lower quality and intensity of health care compared with whites across a wide range of preventive, diagnostic, and therapeutic services and disease entities. These disparities in health care contribute to continuing racial-ethnic disparities in the burden of illness and death. Several national medical organizations and the Institute of Medicine have issued position papers and recommendations for the elimination of health care disparities. However, physicians in practice are often at a loss for how to translate these principles and recommendations into specific interventions in their own clinical practices. This paper serves as a blueprint for translating principles for the elimination of racial-ethnic disparities in health care into specific actions that are relevant for individual clinical practices. We describe what is known about reducing racial-ethnic disparities in clinical practice and make recommendations for how clinician leaders can apply this evidence to transform their own practices. [ABSTRACT FROM AUTHOR]

Increasingly, the mental health needs of populations are measured using large-sample surveys with standardized measures and methods. Such efforts, however, rarely include sufficient number of smaller, culturally defined populations to draw defensible conclusions about their needs. Furthermore, without some adaptation, the standardized methods and measures may yield invalid results in such populations. Using a recently completed psychiatric epidemiology and services study with American Indian populations as a case example, this paper outlines issues facing epidemiologists working in such culturally diverse contexts. The issues discussed include the following: (1) persuading the scientific community and potential sponsors that work with distinct or culturally defined populations is important; (2) framing research questions and activities to meet the needs of communities; (3) defining a population of inference; (4) balancing the needs for comparability and cultural specificity; (5) maximizing scientific validity in light of the challenges in sample acquisition; and (6) developing and implementing data collection methods that uphold scientific standards but are also realistic given the context. The authors draw on their experiences--most recently in the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP)--to illustrate these issues and suggest ways to address each. A goal of this paper is to challenge those invested in conducting culturally valid epidemiologic work in such populations to better articulate the nature of these efforts. [ABSTRACT FROM AUTHOR]

In this paper we report on the process of translating five mental health outcome measures into Spanish and adapting them to Latino culture. The instruments considered are the World Health Organization-Disability Assessment Scale, the Burden Assessment Scale, the Family Burden Scale, Lehman's Quality of Life Interview and the Continuity of Care in Mental Health Services Interview. A systematic process of translation and adaptation of the instruments was followed with the goal of achieving cultural equivalence between the English and Spanish versions of the instruments in five dimensions: semantic, content, technical, construct, and criterion equivalence. In this paper we present data about the semantic, content, and technical equivalence. Various steps were taken to achieve equivalence in these dimensions, including the use of a bilingual committee, a multi-national bilingual committee, back-translation, and focus groups with mental health patients and their relatives. [ABSTRACT FROM AUTHOR]

Growing evidence has revealed the crucial role of motor simulation and spatial perspective-taking in action language. However, there is still a lack of understanding of how motor and spatial processes interact when there are multiple actors involved, and if embodied processes are consistent across different cultures. To address this gap, we examined the interaction between motor simulation and spatial perspective-taking in action-sentences comprehension, along with the consistency of embodied processes across cultures. We collected data from Italian and US English speakers using an online sentence-picture verification task. The participants completed four conditions: two congruent (i.e., the participant is the agent in the sentence and the photo; the agent is someone else interacting with the participant in both the sentence and the picture) and two incongruent (i.e., the agents of the sentence and the picture do not match). The results show that when the perspective of the picture matched that described in the sentence-processing reaction times (RTs) were faster than in the incongruent conditions. In the congruent conditions where the agent is someone else, RTs were slower compared to the condition where the participant is the agent. This has been interpreted as claiming that motor simulation and perspective-taking are independent processes interacting during sentence comprehension (e.g., motor simulation is always run in the role of the agent, but we can adopt multiple perspectives depending on the pronouns and the contextual cues). Furthermore, Bayesian analysis provided evidence that embodied processing of action language entwines a common mechanism, suggesting cross-cultural consistency of embodied processes. [ABSTRACT FROM AUTHOR]

Little research has examined the associations between perceived inclusivity within informal science learning sites, youth program belonging and perceptions of program career preparation. This study explored relations between these factors at three timepoints (T1 = start of program, T2 = 3 months and T3 = 12 months after start). Participants were a diverse sample of 209 adolescents participating in STEM youth programs within informal science learning sites situated in the United States and United Kingdom (70% females: Mage = 15.27, SDage = 1.60), with 53.1% British and 64.1% non-White. Path analysis revealed that only perceptions of inclusivity for own social identity group (i.e., gender, ethnicity) at T1 were associated with T2 STEM youth program belonging. There was a significant indirect effect of T1 perceptions of inclusivity for one's own social identity groups on T3 perceptions of program career preparation via T2 program belonging. This study highlights that, over time, perceptions of inclusivity around youth's own social identity groups (i.e., gender and ethnicity/culture) are related to a sense of youth program belonging, which in turn is later associated with perceptions of program career preparation. [ABSTRACT FROM AUTHOR]

Aim: Diets rich in fruit and vegetables (FV) are associated with favorable public health outcomes, including lower prevalence of cancer and obesity. However, children's FV consumption in many Western countries fails to meet the minimum recommendations. Because parental behaviors influence children's diet from birth, it is important to examine potential interactions between taste preferences and parental behaviors on FV consumption in early childhood. This study tested the moderating effect of an authoritative feeding style on the link between child's FV taste preferences and FV intake. Subjects and methods: Racially/ethnically diverse, low-income parents of 3–5-year-old children were recruited for the study. Parents completed an interviewer-assisted FV food frequency questionnaire and a survey on sociodemographic and other characteristics of the child/parent/family. Hierarchal linear regression models tested the main and interactive effects of taste preferences and authoritative feeding style on children's FV frequency intake, controlling for known covariates, including race/ethnicity and household availability. Results: A total of 281 parents participated in the study, with 16% being authoritative feeders. Authoritative feeding style did not interact with child taste preference to predict fruit intake (β = 0.084; p = 0.98) or vegetable intake (β = −2.908; p = 0.24). Child's taste preference, after controlling for home availability, was the strongest predictor of FV intake in the sample (p < 0.05). Conclusion: Nutrition education efforts targeting FV promotion in low-income families should focus on strategies that help parents increase children's FV taste preferences as early in life as possible. [ABSTRACT FROM AUTHOR]

Although the trend toward greater ethnoracial diversity in the United States has been documented at a variety of geographic scales, most research tracks diversity one scale at a time. Our study bridges scales, asking how the diversity and segregation patterns of metropolitan areas are influenced by shifts in the racial/ethnic composition of their constituent places. Drawing on 1980-2010 decennial census data, we use a new visual tool to compare the distributions of place diversity for 50 U.S. metro areas over three decades. We also undertake a decomposition analysis of segregation within these areas to evaluate hypotheses about the roles of different types of places in ethnoracial change. The decomposition indicates that although principal cities continue to shape the overall diversity of metro areas, their relative impact has declined since 1980. Inner suburbs have experienced substantial increases in diversity during the same period. Places with large white majorities now contribute more to overall metropolitan diversity than in the past. In contrast, majority black and majority Hispanic places contribute less to metropolitan diversity than in the past. The complexity of the patterns we observe is underscored through an inspection of two featured metropolises: Chicago and Dallas. [ABSTRACT FROM AUTHOR]

This study investigated the psychometric properties of the modified checklist for autism in toddlers (M-CHAT) in a diverse rural American low-socioeconomic status (SES) sample. Four hundred and forty-seven English ( n = 335) and Spanish ( n = 112) speaking caregivers completed the M-CHAT during their toddler's 18- or 24-month well visit in a Southwest Virginia pediatric clinic. The M-CHAT did not show acceptable internal consistency in groups with low maternal education or minority status. Caregivers reporting low maternal education and minority status were more likely to endorse items suggestive of autism. These results indicate that the M-CHAT may require modifications to be more internally consistent and accurate across ethnic and educational groups in rural areas with low levels of SES. Recommendations to increase the utility of the M-CHAT are discussed. [ABSTRACT FROM AUTHOR]

Background: The National Consortium for Multicultural Education for Health Professionals (Consortium) comprises educators representing 18 US medical schools, funded by the National Institutes of Health. Collective lessons learned from curriculum implementation by principal investigators (PIs) have the potential to guide similar educational endeavors.Objective: Describe Consortium PI's self-reported challenges with curricular development, solutions and their new curricular products.Methods: Information was collected from PIs over 2 months using a 53-question structured three-part questionnaire. The questionnaire addressed PI demographics, curriculum implementation challenges and solutions, and newly created curricular products. Study participants were 18 Consortium PIs. Descriptive analysis was used for quantitative data. Narrative responses were analyzed and interpreted using qualitative thematic coding.Results: Response rate was 100%. Common barriers and challenges identified by PIs were: finding administrative and leadership support, sustaining the momentum, continued funding, finding curricular space, accessing and engaging communities, and lack of education research methodology skills. Solutions identified included engaging stakeholders, project-sharing across schools, advocacy and active participation in committees and community, and seeking sustainable funding. All Consortium PIs reported new curricular products and extensive dissemination efforts outside their own institutions.Conclusion: The Consortium model has added benefits for curricular innovation and dissemination for cultural competence education to address health disparities. Lessons learned may be applicable to other educational innovation efforts. [ABSTRACT FROM AUTHOR]

Schools are the primary environment in which to conduct prevention programs for school-age children. Educators, policy makers, and psychologist argue that prevention efforts should begin as early as possible to maximize their effectiveness. Surprisingly, there are relatively few school-based prevention programs targeted for preschoolers. Given the evidence supporting earlier rather than later prevention efforts and the fact that many children in the United States attend preschool programs, more research on the feasibility and effectiveness of prevention programs administered in preschool environments is warranted. In this article, we review the existing literature on school-based prevention programs targeted for preschool children. We examine whether school-based prevention programs are theory driven, developmentally appropriate, culturally sensitive, and aimed specifically at symptom reduction or behavior promotion. Based on the findings of this review, our aim is to identify gaps in the prevention research literature regarding programs for preschoolers and propose research to address such gaps to create more effective school-based prevention programs for young children. [ABSTRACT FROM AUTHOR]