Search

Systemic low-grade inflammation is a feature of chronic disease. C-reactive protein (CRP) is a common biomarker of inflammation and used as an indicator of disease risk; however, the role of inflammation in disease is not completely understood. Methylation is an epigenetic modification in the DNA which plays a pivotal role in gene expression. In this study we evaluated differential DNA methylation patterns associated with blood CRP level to elucidate biological pathways and genetic regulatory mechanisms to improve the understanding of chronic inflammation. The racially and ethnically diverse participants in this study were included as 50% White, 41% Black or African American, 7% Hispanic or Latino/a, and 2% Native Hawaiian, Asian American, American Indian, or Alaska Native (total n = 13,433) individuals. We replicated 113 CpG sites from 87 unique loci, of which five were novel (CADM3, NALCN, NLRC5, ZNF792, and cg03282312), across a discovery set of 1,150 CpG sites associated with CRP level (p

Background: The dynamic environment of the emergency department (ED) poses unique challenges to the execution of well-designed research. There is limited investigation into the viability of studies conducted in the ED. This paper offers a systematic evaluation of our recruitment of emergency patients for a prospective observational research study, shedding light on the intricate landscape of research feasibility within the ED setting. Results: Research coordinators dedicated 2816.83 h to screening, recruiting, and enrolling patients between June 2018 and September 2023, having to stop recruitment twice due to financial constraints and the COVID-19 pandemic. 485 patients were approached and 84 of them were enrolled, resulting in a 31.94% enrollment rate, with approximately 2.8 participants recruited per month. Of those enrolled, 77 completed all study endpoints. Most participants were Hispanic (n = 44; 52.3%) and/or Black (n = 37; 44%), middle-aged (µ = 51.7 years), and female (n = 48; 57.1%). Participant recruitment was challenged by competing mindsets, the COVID-19 pandemic, and high staff turnover. Conclusions: Recruiting emergency patients for a prospective observational study is feasible given adequate staffing and financial resources. Standardizing feasibility assessments for the recruitment of patients in the emergency department is important to the success of future study. [ABSTRACT FROM AUTHOR]

The diversity of racial/ethnic representation in the health services and policy research (HSPR) workforce plays a crucial role in addressing the health needs of underserved populations. We assessed changes (between 2012 and 2022) in the racial/ethnic composition of students and faculty from departments of Health Policy & Management (HPM) and Health Education & Behavioral Sciences (HEBS) among the Association of Schools and Programs of Public Health member institutions. We analyzed annual data from over 40 institutions that reported student and faculty data in 2012 and 2022 within each department. Racial/ethnic populations included American Indian/Alaska Native (AI/AN), Asian, Hispanic, Native Hawaiian/Pacific Islander (NH/PI), Black, White, Unknown, and Multiracial. We conducted analyses by department and examined racial/ethnic composition by student status, degree level, faculty rank, and tenure status. We found statistically significant increases in Black assistant professors (HPM and HEBS) and tenured faculty (HPM), Hispanic graduates and tenure-track faculty (HPM), Asian professors (HPM: full and tenured, HEBS: associate and tenured), and Multiracial students and graduates (HPM and HEBS). Statistically significant decreases were observed in White professors (HPM: assistant and full, HEBS: all ranks) and tenure-track faculty (HPM and HEBS), AI/AN associate professors and tenured faculty (HEBS), Hispanic associate professors (HPM), Asian assistant professors (HEBS), and NH/PI students (HPM and HEBS). Our findings highlight the importance of increasing racial/ethnic representation. Strategies to achieve this include facilitating workshops to raise awareness about the structural barriers encountered by Hispanic faculty, providing research support, evaluating promotion processes, establishing more pathway programs, and fostering interdisciplinary academic environments studying AI/AN or NH/PI populations. [ABSTRACT FROM AUTHOR]

ABSTRACTSystemic low-grade inflammation is a feature of chronic disease. C-reactive protein (CRP) is a common biomarker of inflammation and used as an indicator of disease risk; however, the role of inflammation in disease is not completely understood. Methylation is an epigenetic modification in the DNA which plays a pivotal role in gene expression. In this study we evaluated differential DNA methylation patterns associated with blood CRP level to elucidate biological pathways and genetic regulatory mechanisms to improve the understanding of chronic inflammation. The racially and ethnically diverse participants in this study were included as 50% White, 41% Black or African American, 7% Hispanic or Latino/a, and 2% Native Hawaiian, Asian American, American Indian, or Alaska Native (total n = 13,433) individuals. We replicated 113 CpG sites from 87 unique loci, of which five were novel (CADM3, NALCN, NLRC5, ZNF792, and cg03282312), across a discovery set of 1,150 CpG sites associated with CRP level (p

Background: Interracial romantic relationships and unions are a marker of social distance between racial and ethnic groups, but the role of geographic context at schools and neighborhoods during adolescence in shaping interracial romantic relationship formation in the transition to adulthood has been underexplored, which is important for understanding how intergroup contact in the school and neighborhood contexts during adolescence may have subsequent consequences for interracial union formation later in emerging and young adulthood. Methods: Using data from Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health, this study examines the roles of exposure to racial and ethnic diversity in schools and geographic regions in adolescence in shaping the likelihood of being in an interracial romantic relationship in emerging and young adulthood. Results: Adolescents who lived in a Census tract that had fewer of their own racial and ethnic groups were significantly more likely to be in interracial romantic relationships in emerging and in young adulthood. Adolescents who attended more racially and ethnically diverse high schools were also more likely to be in interracial romantic relationships in emerging adulthood. In young adulthood, Hispanic adolescents who went to primarily White high schools were more likely to be in interracial romantic relationships in emerging adulthood and young adulthood. Conclusions: Exposure to racially and ethnically diverse neighborhoods and schools is associated with an increased likelihood of interracial union formation in emerging and young adulthood. [ABSTRACT FROM AUTHOR]

Objective: This study aims to identify types of gender‐identity‐specific social support provided by parents that helps transgender and gender‐expansive (TGE) youth of color thrive. Background: TGE youth of color benefit from parental social support, though less is known about supportive practices that specifically affirm marginalized gender identities—gender‐identity‐specific social support. Guided by a counter‐storytelling framework that highlights the voices of TGE youth of color, this study investigates how TGE youth of color perceive such support from parents. Method: Data were collected via semistructured interviews with 18 youth (14–25 years, Mage = 20.28) who identified as TGE and as persons of color. Transcripts were analyzed using a modified thematic coding approach to identify themes related to youth perceptions of parental support of their gender identities. Results: Findings revealed four major themes related to parental provision of gender‐identity‐specific social support: self‐work, support of gender‐atypical behavior during early development, current affirmational and instrumental support, and family cohesion. Participants discussed parental gender‐identity‐specific support as a valued source of strength. Conclusion: TGE youth well‐being can be enhanced by facilitating parents' provision of gender‐identity‐specific social support. Implications: Specific insight into sources of resilience and strength for TGE youth of color are offered for researchers and practitioners. [ABSTRACT FROM AUTHOR]

Introduction: Irritable bowel syndrome (IBS) is a disorder of gut–brain interaction (DGBI), and associated co-morbidities worsen quality of life. Research concerning IBS co-morbidities in different racial/ethnic groups is very sparse. This study aimed to determine the prevalence rates of co-morbidities and possible differences in a multiracial/ethnic IBS cohort. Methods: Based on ICD-9-coded IBS diagnosis, 740 outpatients (≥18 years) were included in this retrospective study at Boston Medical Center. Demographics and ICD-9-coded co-morbidities were extracted from electronic records. Descriptive statistics and multiple logistic regression were used for data analyses. Results: The most prevalent co-morbidities in this IBS cohort included gastroesophageal reflux disorder (GERD) (30%), depression (27%), anxiety (23%), (chronic obstructive pulmonary disease) COPD/asthma (16%), and obesity (10%). GERD was more prevalent in Hispanics and Blacks (p = 0.0005), and non-ulcer dyspepsia (NUD) was more prevalent in Blacks and Asians (p = 0.003). Higher rates of diabetes mellitus type 2 (DMT2) (p = 0.0003) and depression (p = 0.03), but not anxiety (p = 0.9), were present in Blacks and Hispanics. GERD was significantly associated with Hispanics (p = 0.003), dependent on age, overweight, and obesity. NUD was significantly associated with Blacks (p = 0.01) and Asians (p = 0.006), independent of sex, age, and BMI. Cancer of the thyroid, ovaries, and testis occurred at a five-fold higher rate than expected. Conclusions: Significant racial/ethnic differences exist for IBS co-morbidities in this study cohort, including depression, DMT2, GERD, and NUD. Certain cancers were found to be more frequent in this IBS sample as compared with the general population. [ABSTRACT FROM AUTHOR]

Background/Aims: Determining whether clinical trial findings are applicable to diverse, real-world patient populations can be challenging when the full demographic characteristics of enrolled patients are not consistently reported. Here, we present the results of a descriptive analysis of racial and ethnic demographic information for patients in Bristol Myers Squibb (BMS)–sponsored oncology trials in the United States (US) and describe factors associated with increased patient diversity. Methods: BMS–sponsored oncology trials conducted at US sites with study enrollment dates between 1 January 2013 and 31 May 2021 were analyzed. Patient race/ethnicity information was self-reported in case report forms. As principal investigators (PIs) did not report their own race/ethnicity, a deep-learning algorithm (ethnicolr) was used to predict PI race/ethnicity. Trial sites were linked to counties to understand the role of county-level demographics. The impact of working with patient advocacy and community-based organizations to increase diversity in prostate cancer trials was analyzed. The magnitude of associations between patient diversity and PI diversity, US county demographics, and recruitment interventions in prostate cancer trials were assessed by bootstrapping. Results: A total of 108 trials for solid tumors were analyzed, including 15,763 patients with race/ethnicity information and 834 unique PIs. Of the 15,763 patients, 13,968 (89%) self-reported as White, 956 (6%) Black, 466 (3%) Asian, and 373 (2%) Hispanic. Among 834 PIs, 607 (73%) were predicted to be White, 17 (2%) Black, 161 (19%) Asian, and 49 (6%) Hispanic. A positive concordance was observed between Hispanic patients and PIs (mean = 5.9%; 95% confidence interval (CI) = 2.4, 8.9), a less positive concordance between Black patients and PIs (mean = 1.0%; 95% CI = −2.7, 5.5), and no concordance between Asian patients and PIs. Geographic analyses showed that more non-White patients enrolled in study sites in counties with higher proportions of non-White residents (e.g. a county population that was 5%–30% Black had 7%–14% more Black patients enrolled in study sites). Following purposeful recruitment efforts in prostate cancer trials, 11% (95% CI = 7.7, 15.3) more Black men enrolled in prostate cancer trials. Conclusion: Most patients in these clinical trials were White. PI diversity, geographic diversity, and recruitment efforts were related to greater patient diversity. This report constitutes an essential step in benchmarking patient diversity in BMS US oncology trials and enables BMS to understand which initiatives may increase patient diversity. While complete reporting of patient characteristics such as race/ethnicity is critical, identifying diversity improvement tactics with the highest impact is essential. Strategies with the greatest concordance to clinical trial patient diversity should be implemented to make meaningful improvements to the diversity of clinical trial populations. [ABSTRACT FROM AUTHOR]

Objective: This study is a follow-up to a study in 2020 that reviewed changes in the racial and ethnic composition of public health students, graduates, and faculty among Association of Schools and Programs of Public Health (ASPPH)–member institutions. In the current study, we evaluated how the racial and ethnic composition among biostatistics and epidemiology students, graduates, and faculty changed from 2010 to 2020. Methods: We analyzed data on race and ethnicity of enrolled graduate students, graduates (master's and doctoral), and faculty at ASPPH-member institutions by using institutionally reported data from the ASPPH Data Center. We tabulated frequencies, percentages, and percentage-point changes by race and ethnicity. We measured differences between groups by using a test for difference in 2 proportions. Results: The number of enrolled students, graduates, and faculty in all departments increased during the study period, while the number of tenure-track faculty in biostatistics decreased. The percentage of enrolled Hispanic/Latino biostatistics graduate students increased from 5.6% in 2010 to 10.2% in 2020 (P =.007), and the percentage of epidemiology graduates increased from 8.8% to 13.8% (P =.008). We found no differences among other underrepresented racial and ethnic groups. Most biostatistics and epidemiology professors at all ranks were non-Hispanic White, despite substantial decreases. The percentage of underrepresented racial and ethnic minority biostatistics and epidemiology professors was constant across all ranks. Conclusion: Although more Hispanic/Latino students are enrolled in and graduating from biostatistics and epidemiology departments at ASPPH-member institutions, we found no change among faculty. More work is needed to recruit and retain other (American Indian/Alaska Native, Black or African American, Native Hawaiian/Other Pacific Islander) underrepresented students and faculty. [ABSTRACT FROM AUTHOR]

The lack of diversity among the environmental health sciences (EHS) workforce has been an ongoing concern. However, limited research exists on the racial and ethnic composition of EHS students and faculty over time. We analyzed 2011 and 2021 data on EHS students, graduates, and faculty to compare changes in the racial and ethnic composition among Association of Schools and Programs of Public Health-member institutions. Among the institutions that reported data in both years, we observed significant proportion increases among Hispanic enrolled students (overall and master's: both P =.01), Multiracial enrolled students and graduates (overall: both P <.05, master's level: both P <.05), and Asian tenured professors (P =.01). Significant decreases were observed among Unknown enrolled students (overall: P =.01, master's level: P <.001), Unknown master's level graduates (P =.01), AI/AN enrolled students (overall and master's: both P <.05), and White full professors (P <.001) and tenured faculty (P <.001). Despite these findings, no substantial change existed among the other racial and ethnic groups. More efforts are needed to recruit, train, and promote racial and ethnic minorities who can leverage their lived experiences to provide novel solutions to environmental challenges. [ABSTRACT FROM AUTHOR]

The relationship between the onset of the COVID-19 pandemic and interest in master of public health (MPH) programs is unknown. We examined trends in MPH application rates for 31 MPH concentrations and specifically for the MPH concentration in epidemiology and differences by race and ethnicity before and after the onset of the COVID-19 pandemic.We constructed a quasi-experimental design to examine trends in MPH application rates from academic years 2015-2016 through 2022-2023 by using Centralized Application Service for Schools and Programs of Public Health data. We used an interrupted time-series analysis to test whether application rates surged after the pandemic’s onset (academic years 2019-2020 through 2020-2021) and whether this increase persisted during the pandemic (academic years 2020-2021 through 2022-2023). We fit models for the overall sample, a combined racially and ethnically minoritized sample, each racial and ethnic group separately, and a non–US citizen sample.The pandemic’s onset correlated with an immediate increase in application rates across most samples: overall (38%) and among American Indian/Alaska Native/Native Hawaiian/Pacific Islander (91%), Asian (35%), Black (42%), Hispanic (60%), multiracial (30%), racially and ethnically minoritized (44%), and White (53%) samples. However, this trend was not sustained; application rate trends during the pandemic were significantly lower than prepandemic trends. Application rate trends for all MPH concentrations and the MPH in epidemiology concentration among non–US citizens were significantly higher during the pandemic than prepandemic.Our results highlight the need for innovative strategies to sustain MPH degree interest and a diverse applicant pool. [ABSTRACT FROM AUTHOR]

The Five Facet Mindfulness Questionnaire (FFMQ), Engaged Living Scale (ELS), and Acceptance and Action Questionnaire-II (AAQ-II) are three commonly used contextual cognitive behavioral therapy (CBT)-informed self-report questionnaires. The present study aimed to psychometrically validate these three scales with racially and ethnically diverse adults in Hawaiʻi (N = 1102). Using a cross-validation strategy with an iterative process of exploratory and confirmatory factor analyses, findings revealed that factor structures of the FFMQ, ELS, and AAQ-II were theoretically consistent with extant literature. However, we also found slight factorial structure differences in the present sample, which may have practical implications when assessing these constructs within racially and ethnically diverse adults. Evidence of reliability, convergent validity, and measurement invariance of these scales are also provided. Implications and limitations of these findings are discussed. • The present study investigated the psychometric properties of the FFMQ, ELS, and AAQ-II. • The study sample was a group of ethnically diverse adults in Hawaii. • Results provide evidence of structural validity, reliability, and measurement invariance. • Implications of findings and the conditional nature of a scale's psychometric characteristics are explored. [ABSTRACT FROM AUTHOR]

The field of otolaryngology has one of the lowest rates of racial and ethnic diversity. An anonymous survey was distributed to members of the Student National Medical Association at different medical schools to identify factors that may contribute to this disparity. Responses were received from 104 students at 36 allopathic medical schools. Most respondents identified as black (86.5%). One-third of students (34.6%) noted that they were discouraged from pursuing otolaryngology due to lack of mentorship, and among these students, most noted that they lack mentors of the same race (75%). One-fourth of respondents (25%) indicated that they lack a home otolaryngology program. The most common reasons for participants' disinterest in otolaryngology included competitiveness, inadequate exposure, research, and the high board scores needed to match. This hypothesis-generating, proof-of-concept study highlights potential barriers that may discourage underrepresented medical students from pursuing a career in otolaryngology. [ABSTRACT FROM AUTHOR]

Senior centers must re-envision their programs to appeal to today's increasingly older and more diverse older adults. Using a purposeful aging framework, this study aims to inform senior center programming by capturing diverse older adults' perspectives on future goals, perceptions of aging, attitudes about senior centers, and experience with technology. Participants age 70 and older (N = 64) joined one of eight focus groups organized by race/ethnicity and preferred spoken language. Transcripts were coded using a grounded theory approach to identify perspectives in each domain. Across groups, shared perspectives included aspirations to make a difference, maintain health and independence, continue learning, and embrace positive perceptions of aging. However, both positive and negative attitudes about participating in senior centers and the effects of technology were presented. We discuss how to redesign senior center programming to meet members' proactive approach to aging and future goals, and facilitate more confidence with new technology. [ABSTRACT FROM AUTHOR]

• Increasing nursing workforce diversity is essential to quality health care. • Private for-profit ADN programs had the highest percentages of non-White students. • Private for-profit institutions provided the highest percentages of student aid. • Private for-profit ADN programs had smaller numbers of graduates. • Public ADN programs contributed the highest total number of diverse graduates. Increasing nursing workforce diversity is essential to quality health care. Associate Degree in Nursing (ADN) programs are a primary path to becoming a registered nurse and an important source of nursing diversity. To examine how the number of graduates and racial/ethnic student composition of ADN programs have changed since the Institute of Medicine's recommendation to increase the percentage of bachelor's-prepared nurses to 80%. Using data from the Integrated Postsecondary Education System, we analyzed the number of graduates and racial/ethnic composition of ADN programs across public, private not-for-profit, and private for-profit institutions, and financial aid awarded by type of institution from 2012-2018. Racial/ethnic diversity among ADN programs grew from 2012-2018. Although private for-profits proportionally demonstrated greater ADN student diversity and provided financial aid institutionally to a higher percentage of students, public schools contributed the most to the number and racial/ethnic diversity of ADN graduates. Given concerns regarding private for-profits, promoting public institutions may be the most effective strategy to enhance diversity among ADN nurses. [ABSTRACT FROM AUTHOR]

The role of the food environment in shaping nutrition and health has gained substantial attention from policymakers, public health researchers, and advocacy groups. To promote equities in food access and nutrition outcomes, understanding factors linked with the utilization of local community food resources is crucial. Using Andersen's service utilization model, we explained how adults use their neighborhood food resources. In a cross-sectional study design, an online survey was conducted in REDCap Version 13.4.0 via the Amazon Mechanical Turk (MTurk) involving 1830 adults with a mean age of 37.9  ±  12.1 years. Participants answered questions on predisposing, enabling, and need factors that influence their use of different community food resources. The predisposing factors that were statistically significant included age, family size, marital status, race, and ethnicity. The enabling factors included travel time, travel mode, income, and shopping decision motivators (such as being able to use Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) vouchers, delivery services, great sales, and coupons). Food security and community food resources need for lower food price were the significant need factors. However, these factors vary by the types of food resources. In conclusion, enhancing the utilization of community-based food access initiatives and programs among underserved families requires consideration of family composition, racial and ethnic diversity, and transportation access.

Objective: To investigate how the internet presence of Otolaryngology residency programs influences recruitment of diverse applicants., Study Design: Retrospective cohort study., Setting: Website, Instagram, and AAMC Residency Explorer data from all US, non-military, allopathic otolaryngology residency programs., Methods: We identified 10 common ways in which residency programs communicate their commitment to diversity through web-based platforms. We then analyzed program websites and Instagram pages for the presence of these 10 diversity elements. Univariate and multivariate linear regression were used to evaluate the association between presence of a diversity elements and the proportion of underrepresented minority residents in the program., Results: Review of 106 Otolaryngology residency program websites and Instagram pages was completed from February to May 2021. Most programs (69.8%) satisfied at least one diversity element. Of the programs reviewed, 83 had demographic information available for comparison. After adjusting for Doximity ranking, multivariate linear regression demonstrated that several elements were positive predictors of program diversity. Diversity and inclusion message (p < 0.0001), statement encouraging URM applicants (p < 0.0001), dedicated diversity chair/committee (p = 0.005), and diversity related articles/blog posts (p = 0.006) were independently associated with a greater proportion of URM residents in a given program., Conclusion: These data demonstrate that providing diversity related information on residency program websites may play a role in improving program diversity. The large percentage of programs that lack the presence of any diversity element (30.2%) demonstrates that there is significant room for improvement. This study presents a promising strategy through which programs can improve recruitment of diverse residents., (Copyright © 2022 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Despite agreement among stakeholders that senior centers can promote physical and mental health, research on senior center use in urban populations is limited. Our objective was to describe demographic and health factors associated with senior center use among urban, low-income older adults in order to inform programming and outreach efforts. We used data from a 2009 telephone survey of 1036 adults randomly selected from rosters of New York City public housing residents aged 65 and older. We analyzed senior center use by race/ethnicity, age, gender, health, housing type, and income, and used a forward selection approach to build best-fit models predicting senior center use. Older adults of all ages and of both genders reported substantial use of senior centers, with nearly one third (31.3%) reporting use. Older adults living alone, at risk of depression, or living in specialized senior housing had the greatest use of centers. Senior center use varied by race/ethnicity, and English-speaking Hispanics had a higher prevalence of use than Spanish-speaking Hispanics (adjusted prevalence ratio [PR]=1.69, 95% CI: 1.11-2.59). Spanish-speaking communities and older adults living in non-senior congregate housing are appropriate targets for increased senior center outreach efforts. [ABSTRACT FROM AUTHOR]

Background: Racial and ethnic diversification of the physician and nurse workforce is recommended as a leverage point to address the impact of structural racism in maternal care, but empirical evidence supporting this recommendation is currently lacking., Objective: This study aimed to assess the association between state-level registered nurse workforce racial and ethnic diversity and severe adverse maternal outcomes during childbirth., Study Design: This population-based cross-sectional study analyzed 2017 US birth certificate data. Severe adverse maternal outcomes included eclampsia, blood transfusion, hysterectomy, or intensive care unit admission. Proportions of minoritized racial and ethnic registered nurses in each state were abstracted from the American Community Survey (5-year estimate, 2013-2017). This proportion was categorized into 3 terciles, with the first tercile corresponding to the lowest proportion and the third tercile corresponding to the highest proportion. Crude and adjusted odds ratios and 95% confidence intervals of severe adverse maternal outcomes associated with terciles of the state proportion of minoritized racial and ethnic nurses were estimated using logistic regression models., Results: Of the 3,668,813 birth certificates studied, 29,174 recorded severe adverse maternal outcomes (79.5 per 10,000; 95% confidence interval, 78.6-80.4). The mean state proportion of minoritized racial and ethnic nurses was 22.1%, ranging from 3.3% in Maine to 68.2% in Hawaii. For White mothers, the incidence of severe adverse outcomes was 85.3 per 10,000 for those who gave births in states in the first tercile of the proportion of minoritized racial and ethnic nurses and 53.9 per 10,000 for those who gave birth in states in the third tercile (risk difference, -31.4 per 10,000; 95% confidence interval, -34.4 to -28.5). It corresponds to a 37% decreased risk of severe adverse maternal outcomes associated with giving birth in a state in the third tercile (crude odds ratio, 0.63; 95% confidence interval, 0.60-0.66). A decreased risk of severe adverse maternal outcomes was observed for Black mothers (crude odds ratio, 0.65; 95% confidence interval, 0.61-0.70), Hispanic mothers (crude odds ratio, 0.51; 95% confidence interval, 0.48-0.54), and Asian and Pacific Islander mothers (crude odds ratio, 0.65; 95% confidence interval, 0.58-0.72) but not for Native American mothers (crude odds ratio, 0.89; 95% confidence interval, 0.72-1.09) or mothers with >1 race (crude odds ratio, 1.44; 95% confidence interval, 0.72-1.09). After adjustment for patients and hospital characteristics, giving birth in states in the third tercile was associated with a reduced risk of severe adverse outcomes as follows: 32% for White mothers (adjusted odds ratio, 0.68; 95% confidence interval, 0.59-0.77), 20% for Black mothers (adjusted odds ratio, 0.80; 95% confidence interval, 0.65-0.99), 31% for Hispanic mothers (adjusted odds ratio, 0.69; 95% confidence interval, 0.58-0.82), and 50% for Asian and Pacific Islander mothers (adjusted odds ratio, 0.50; 95% confidence interval, 0.38-0.65). The associations of the proportion of minoritized racial and ethnic nurses with the risk of severe adverse maternal outcomes were not statistically significant for Native American mothers and more than 1 race mothers. Results were similar when blood transfusion was excluded from the outcome measure., Conclusion: A diverse state registered nurse workforce was associated with a reduced risk of severe adverse maternal outcomes during childbirth., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Social work programs have a long-standing commitment to recruiting and educating racially and ethnically diverse students. However, some programs in rural areas have greater difficulty meeting this commitment. This study examined racial and ethnic diversity within baccalaureate social work (BSW) programs, focusing primarily on student enrollment, faculty, perceptions of diversity, and interventions to attract students. Program directors of BSW programs from 10 Midwestern states were surveyed. Forty-two programs responded. The results indicate that as a whole, social work programs differ in their levels of racial and ethnic diversity. However, BSW programs in rural areas tend to have fewer students and fewer faculty who are racially or ethnically diverse. BSW program directors recognize lack of diversity as an issue, yet strategies that have been used to increase diversity have been only minimally effective. Implications for social work programs and strategies to enhance diversity are discussed. [ABSTRACT FROM AUTHOR]

The 2008 Health Indicators Project surveyed a probability sample (N = 1,870) of New York City senior center participants. Attendees of racially and ethnically diverse and nondiverse senior centers were compared across 5 domains: demographics; health and quality of life; social support networks; neighborhood perceptions and engagement; health service access/utilization. Although homogeneous and diverse center participants demonstrate similar health and quality-of-life outcomes, those from diverse centers demonstrate greater risk of social isolation, receive less family support, and more likely seek medical care from hospitals or community clinics. Implications and future directions for research, practice and policy are discussed. [ABSTRACT FROM PUBLISHER]

In recent decades, schools located in English Canada have experienced important demographic changes in their student population. This article examines the racial, ethnic, linguistic, and cultural diversity in these schools, through the discourses of those who spend the most time with the students: teachers and principals. Here, the concept of discourse is understood as a way of framing the world; it is far more than a simple tool for communicating with others. Since education operates under provincial and territorial jurisdiction in Canada, these discourses are examined in the context of provincial school policies that specifically address the issue of diversity among students. Using qualitative data collected in a national study completed in 2007, the analysis shows how teachers and/or principals make sense of this changed reality in their schools and its impact on their daily work. [ABSTRACT FROM AUTHOR]

It is well known that there is a large disparity between the proportions of African Americans, Hispanics, and American Indians in the general U.S. population and in the nation's dental profession. While these underrepresented minorities (URMs) together make up almost 30 percent of the population, they comprise only about 6 percent of U.S. dentists. For years, the American Dental Education Association has been diligently working with U.S. dental schools to reduce this disparity by increasing the diversity of their student bodies. However, with approximately 13 percent of first-year dental students coming from URM groups, the proportion of URM students entering dental school continues to remain significantly below that of the general population. Diversifying the dental profession is important for improving access to care for underrepresented groups, and student diversity provides better educational experiences for all students. Texas A&M Health Science Center Baylor College of Dentistry's strategy for increasing the number of URM dentists was to create a series of initiatives that together form a successful comprehensive program addressing students' awareness of and attraction to a dental career, academic enrichment, admissions, and graduation. The cumulative impact of this program is that the college enrolled greater numbers and proportions of URM students than any other non-minority U.S. dental school from 2006 to 2009. This article describes the program that led to these successes. [ABSTRACT FROM AUTHOR]

While public health has gained increased attention and placement on the national health agenda, little progress has been made in achieving a critical mass of underrepresented minority (URM) academicians in the public health workforce. In 2008, a telephone-based qualitative assessment was conducted with URM faculty of schools of public health to discuss this issue. As a result, we present successful strategies that institutional leaders can employ to extend the discourse about addressing limited diversity in the public health academy. [ABSTRACT FROM AUTHOR]

Introduction: Many cancer centers and community hospitals are developing novel models of survivorship care. However, few are specifically focused on services for socio-economically disadvantaged cancer survivors.Aims: To describe a new model of survivorship care serving culturally diverse, urban adult cancer patients and to present findings from a feasibility evaluation.Setting: Adult cancer patients treated at a public city hospital cancer center.Program Description: The clinic provides comprehensive medical and psychosocial services for patients within a public hospital cancer center where they receive their oncology care.Program Evaluation: Longitudinal data collected over a 3-year period were used to describe patient demographics, patient needs, and services delivered. Since inception, 410 cancer patients have been served. Demand for services has grown steadily. Hypertension was the most frequent comorbid condition treated. Pain, depression, cardiovascular disease, hyperlipidemia, and bowel dysfunction were the most common post-treatment problems experienced by the patients. Financial counseling was an important patient resource.Discussion: This new clinical service has been well-integrated into its public urban hospital setting and constitutes an innovative model of health-care delivery for socio-economically challenged, culturally diverse adult cancer survivors. [ABSTRACT FROM AUTHOR]

Since the turn of the twentieth century, the relationships among race, citizenship and culture have been central to debates about the goals of social policy and social work in the USA. To date, however, even the best histories of social work have focused primarily on the influence of mainstream (i.e. white) organizations and their leaders, ignoring and often objectifying the contributions of minorities. Based on extensive primary source materials, this essay—part of a larger scholarly project—analyses the differential responses of US social work to demographic and cultural changes during the past century. The findings illuminate discussions not only of social work's past, but how the profession could address such contemporary issues as the compatibility between multiculturalism and other social justice-related goals; the congruence between social equality and professional identity; and the means by which social work practice and ethics can adapt successfully to demographic and cultural transformation. [ABSTRACT FROM AUTHOR]

This research note provides a synopsis of the current state of gender representation among racial groups in the federal workforce. Although the trend of representation is toward more diversity, disparities persist between males and females. Aggregating data from the 2000 Demographic Profile of the Federal Workforce, we examine federal workers' demographic characteristics of gender and race/ethnicity and ask why male and female representation differs from one racial group to another. We find that although women are rep resented demographically in total federal positions, they are under represented in higher level positions. This trend varies among racial groups. We propose three factors for further research that may account for differences in gender representation: the glass ceiling, the educational attainment gap, and gender roles. [ABSTRACT FROM AUTHOR]

Menopause is a naturally occurring “equal opportunity” event that every woman who lives beyond the age of approximately 52 years will experience. During the next 20 years, approximately 3.5 million African American women, 2 million Latinas, and 1 million Asian American women will enter the menopause. How a woman approaches the menopausal transition depends on a number of factors, from educational level to socioeconomic status; health-related factors, including stress; and marital status. Increasingly, the roles of race and ethnicity, as they relate to menopausal symptoms, are being explored. Understanding similarities and differences among women of color in perceptions, attitudes, and expectations surrounding the menopause can help provide culturally appropriate care and promote lifestyles that may decrease symptoms and increase quality of life. For example, minority women are usually the gatekeepers for healthcare for themselves and their families and have a highly developed social support network, often including extended family, a church community, and involvement in sororal or social organizations. In the future, research on menopausal symptoms among women of different racial/ethnic groups should focus on exploring in greater detail the effect of dietary factors and body mass index, additional evaluation of pituitary sensitivity, and use of complementary and alternative medicines in symptom management, with a better understanding of the risks and benefits of such therapies. [Copyright &y& Elsevier]

This paper reviews the experience of evaluating a cultural competence workshop series for social workers practicing in a mental health care setting. The study used a pretest-posttest nonequivalent comparison group design, and evaluation was based on both quantitative and qualitative data collections. Between subjects analyses suggested that there were no differences between the intervention and comparison group after the intervention was completed, hut within-subjects analyses revealed that the intervention group had made superior gains in their scores on the Awareness subscale of the Multicultural Counseling Inventory. Qualitative data contributed additional information about important individual and group processes that affected the experience of training and contributed to self-reported outcomes from training. The study suggests that evaluating process and outcomes of training at both the individual and group levels may be particularly important to understanding how cultural competence develops for social work practitioners in interdisciplinary settings. [ABSTRACT FROM AUTHOR]

Intercultural competence is an important component of the doctor-patient relationship in the multicultural climate evolving in the United States. We hypothesized that 1) exposure to racial and ethnic diversity in the student body, faculty, staff, and patient population in dental school and 2) a dental school curriculum that includes presentations on issues concerning racial and ethnic diversity will contribute to students' feeling more competent and confident to enter the multicultural work environment that is rapidly developing in the United States. A Likert-type scale questionnaire was administered to 627 fourth-year dental students enrolled in seven dental schools representing geographically diverse regions of the United States. Of these, 376 questionnaires were returned for a response rate of 60 percent. Results indicated that both the perception of diversity in the school environment and the presentation of diversity-specific content in the curriculum had moderately positive and significant correlations with the students' perception of their competency or ability to serve and work with diverse populations. The respective Pearson correlation coefficients for diversity in the school environment and diversity curriculum were .497 (p<.001) and .459 (p<.001). These results support the hypotheses that diversity exposure and training in the dental school environment are important for dental students entering a multicultural workplace. [ABSTRACT FROM AUTHOR]