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ObjectiveTo describe the National Heart Lung and Blood Institute (NHLBI) sponsored Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease (DECIPHeR) Alliance to support late-stage implementation research aimed at reducing disparities in communities with high burdens of cardiovascular and/or pulmonary disease.Study settingNHBLI funded seven DECIPHeR studies and a Coordinating Center. Projects target high-risk diverse populations including racial and ethnic minorities, urban, rural, and low-income communities, disadvantaged children, and persons with serious mental illness. Two projects address multiple cardiovascular risk factors, three focus on hypertension, one on tobacco use, and one on pediatric asthma.Study designThe initial phase supports planning activities for sustainable uptake of evidence-based interventions in targeted communities. The second phase tests late-stage evidence-based implementation strategies.Data collection/extraction methodsNot applicable.Principal findingsWe provide an overview of the DECIPHeR Alliance and individual study designs, populations, and settings, implementation strategies, interventions, and outcomes. We describe the Alliance's organizational structure, designed to promote cross-center partnership and collaboration.ConclusionsThe DECIPHeR Alliance represents an ambitious national effort to develop sustainable implementation of interventions to achieve cardiovascular and pulmonary health equity.

Internalized sexual stigma is an important contributor to LGBT mental health disparities. In Thailand, the absence of validated instruments represents a research barrier. The study's purpose was to translate and evaluate the psychometric properties of the Revised Internalized Homophobia (IHP-R) scale. Based on the cross-cultural principle, team translation was applied. The IHP-R was translated by the principal author and reviewed by bilingual Thai nurses, and clarifications were made. Multidisciplinary experts provided back translation and reconciled the finalized Thai version. The psychometric properties were established in 412 Thai LGBT individuals. Data was collected via online and paper-pencil surveys and analyzed using SPSS. Most participants were male, age ranged 18–53, with moderate levels of internalized homophobia (M = 2.3, SD = 1.04). The inter-item and item-total correlations were.38-.63 and.55-.68. The content validity index was high (I-CVI, S-CVI/UA/Ave = 1). The exploratory factor analysis confirmed one construct of internalized sexual self-stigma (factor loading =.702–.816). Scores on IHP-R were correlated with stress and experiences of discrimination (r =.14 and.12). Internal consistency reliability was also high (Cronbach's alpha coefficient =.83). The IHP-R Thai version has high psychometric properties and is appropriate for LGBT research in Thailand. [ABSTRACT FROM AUTHOR]

Federally qualified health centers (FQHC) aim to improve cancer prevention by providing screening options and efforts to prevent harmful behavior. Patient portals are increasingly being used to deliver health promotion initiatives. However, little is known about patient portal activation rates in FQHC settings and the factors associated with activation. This study examined patient portal activation among FQHC patients and assessed correlations with demographic, clinical, and health service use variables. We analyzed electronic health record data from adults >18 years old with at least one appointment. Data were accessed from the electronic health records for patients seen between 1 September 2018 and 31 August 2022 (n = 40,852 patients). We used multivariate logistic regression models to examine the correlates of having an activated EPIC-supported MyChart patient portal account. One-third of patients had an activated MyChart portal account. Overall, 35% of patients with an activated account had read at least one portal message, 69% used the portal to schedule an appointment, and 90% viewed lab results. Demographic and clinical factors associated with activation included younger age, female sex, white race, English language, being partnered, privately insured, non-smoking, and diagnosed with a chronic disease. More frequent healthcare visits were also associated with an activated account. Whether or not a patient had an email address in the EHR yielded the strongest association with patient portal activation. Overall, 39% of patients did not have an email address; only 2% of those patients had activated their accounts, compared to 54% of those with an email address. Patient portal activation rates were modest and associated with demographic, clinical, and healthcare utilization factors. Patient portal usage to manage one's healthcare needs is increasing nationally. As such, FQHC clinics should enhance efforts to improve the uptake and usage of patient portals, including educational campaigns and eliminating email requirements for portal activation, to reinforce cancer prevention efforts. [ABSTRACT FROM AUTHOR]

Although findings are mixed, discrimination has been identified as a risk factor for smoking in sexual minority women (SMW; e.g., lesbian and bisexual). We examined associations between past-year discrimination and cigarette smoking among SMW. Using regression analyses we examined associations of past-year discrimination including count of types of discriminatory experiences and attributions of the main reason for discrimination (i.e., sexual orientation, race/ethnicity, gender) with smoking outcomes (e.g., current smoking, nicotine dependence, smoking more cigarettes now than 12 months ago). We conducted exploratory analyses to examine whether race/ethnicity and sexual identity moderated the associations of past-year discrimination with smoking outcomes. The sample included 619 SMW. Most identified as lesbian (74.3%) and non-White (61.1%). SMW who reported a higher count of types of discriminatory experiences (AOR 1.54, 95% CI 1.12-2.12) and any gender-based discrimination in the past year (AOR 4.79, 95% CI 1.39-16.45) reported smoking more cigarettes now than 12 months ago. Associations of other past-year discrimination measures with other smoking outcomes were not significant. Compared to White SMW, any discrimination [B (SD) = 2.56 (0.83)] and a higher count of types of discriminatory experiences in the past year [B (SD) = 0.88 (0.31)] were associated with higher nicotine dependence scores in Black/African American SMW. Past-year discrimination are associated with smoking outcomes in SMW. Black/African American race moderated the associations of any past-year discrimination and a higher count of types of discriminatory experiences with nicotine dependence scores in SMW. Targeted interventions to mitigate the influence of discrimination on smoking among SMW are needed., Author(s): Billy A. Caceres [sup.1] , Tonda L. Hughes [sup.1] , Cindy B. Veldhuis [sup.1] , Alicia K. Matthews [sup.2] Author Affiliations: (1) grid.21729.3f, 0000000419368729, Columbia University School of Nursing, [...]

Gender minority refers to transgender and gender-nonconforming people whose sex assigned at birth is different from their current gender identity. US health surveillance systems do not routinely include questions to identify gender minority respondents, resulting in a lack of representative health data that can be used to evaluate the health of gender minorities. This omission represents a missed opportunity to understand the health and well-being of transgender and gender-nonconforming people as well as to learn more about sex and gender differences that may be relevant for the health of all people—gender minority and majority alike. In 2011, the Williams Institute at the University of California, Los Angeles, School of Law convened the Gender Identity in US Surveillance (GenIUSS) Group, bringing together a multidisciplinary and multi-institutional group of experts to increase population-based data about gender minority people through the inclusion of gender-related measures (e.g., assigned sex at birth, gender identity, transgender status) in surveys, with a particular consideration for publicly funded data-collection efforts. Drawing on the expertise and experience of the GenIUSS Group, this article provides an overview of challenges and opportunities and makes eight recommendations for “counting” gender minority adults in health research, with an emphasis on adult population-based surveys.

Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships. [ABSTRACT FROM AUTHOR]

Research (Gurin, Nagda, & Zúñiga, 2009) on intergroup dialogue (IGD) has primarily focused on student outcomes in traditional semester-long, 3-credit courses, documenting the positive impact IGD has on college students' (a) intergroup understanding, (b) intergroup relationships, (c) intergroup collaboration and action, and (d) perceived relevancy of diversity in higher education. The University of Illinois at Chicago's First-Year Dialogue Seminar (FYDS) was designed as a 1-credit, half-semester course based on traditional IGD courses and associated outcomes. Approximately 100 freshman students participated in the pilot of the seminar, completing both pre- and posttest measures of intergroup understanding, intergroup relationships, intergroup collaboration and action, and relevancy of diversity in higher education. In addition, a comparison group of approximately 80 freshman students, not enrolled in the course, were administered the posttest survey at Time 2. The results showed significant gains across measures of intergroup understanding, intergroup collaboration and action, and relevancy of diversity in higher education. Furthermore, FYDS students had significantly higher means across several of the same measures of intergroup understanding and intergroup collaboration and action than the comparison group. These results suggest the potential efficacy of a new model of IGD-based pedagogy and learning.