Browsing by Subject "Health Disparities"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    "Death is due to lack of knowledge": community practices of a successful multi-partnered health disparities intervention for low-income African Americans in South Carolina
    (2013-05) Littleton, Dawn
    The purpose of this study was to describe the methods--including practices, policies, and roles--used by public and academic library staff in a Centers for Disease Control and Prevention (CDC) Racial and Ethnic Approach to Community Health (REACH) intervention that proved successful in reducing or eliminating several diabetes-related health disparities in a vulnerable population. An intrinsic case study methodology was used to identify effective services, resources, and practices for library staff. A semi-structured telephone interview was completed by 11 community partners from a successful multi-partnered, community-based, diabetes-related health disparities intervention that included librarians as community partners. Questions included (a) What were some traditional or innovative library roles, services, or resources used in this successful intervention? (b) How was helicopter research avoided? (c) How was trust with the vulnerable community members established and maintained? (d) How were community members with low literacy included? Data were audio-recorded and transcribed. Eight major themes consistent with transformative adult learning theories were identified from the coded transcripts, including (a) autonomy, (b) community-based and community-led, (c) incentives, (d) a new role for professionals, (e) participants realizing success, (f) church participation, (g) transformation, and (h) perspective of the librarians. The insights and guidelines suggested by this research may be helpful when deciding how or when to participate in community-based health disparities interventions for vulnerable populations.
  • Thumbnail Image
    Item
    Exploring the Gap Between a Morally Valid and a Legally Adequate Consent; Investigating Latino Understanding of an Informed Consent Conference
    (2015-06) Pigozzi, Laura
    Abstract Enrollment of members of minority communities in clinical trials is an important step towards the elimination of health disparities and increases the generalizability of research results. Latinos are disproportionally affected by a number of health issues such as diabetes. Having Latinos participate in research is essential since limited participation leads to limited data specific for this population. Furthermore, for some patients, inclusion in clinical trials represents an opportunity to receive new therapies not otherwise available. This project explores Latinos’ understanding of the informed consent conference considered on a broad level, including oral, textual, and visual components. Grounded theory is used as the analytic methodology. This bioethics question is explored by situating the theory within relevant literature in bioethics, rhetoric, scientific and technical communication, and intercultural communication. Data was gathered in three studies using the methodology of analogue participants. A simulation of a healthy patient consent conference was used in Study 1 and Study 2, while a simulation of a multi-arm diabetes trial was used in Study 3. The analogue participants were recruited from urban Catholic parishes that serve a large immigrant Latino population. In order to secure a moral consent and honor the autonomy of members of this community during trial enrollment, the researcher must thoroughly understand the social context that forms the identity of the Latino community member. Although the level of autonomy varies with each individual, the social context shaped by this data suggests a compromised autonomy. The social context of this community is complex and dynamic. Latino immigrants in this study live in a closely-knit community, sharing a culture, language, faith, for the most part their country of origin, and the immigrant experience. These community members demonstrate care and concern for one another in their shared struggles to acculturate while living with a steady sense of disquietude surrounding the immigration status of themselves, family members, or friends. An undocumented status affects all areas of an immigrant’s life, limiting many potential opportunities. The grounded theory resulting from the data gathered in Study 1, Study 2, and Study 3 suggests a culturally specific way to present trial information to members of this community, describes how that information might be understood, and illustrates the community’s social context. Understanding the social context is necessary to understand how to present trial information and to understand the autonomy of community members.
  • Thumbnail Image
    Item
    Imperial Medicine: An Ethnography of Immigrant Experiences after the Affordable Care Act
    (2019-07) Jimenez, Anthony
    My dissertation illustrates affinity between the US health care system and border control. I conducted 11 months of ethnography at Justicia y Paz (JyP), a volunteer-run NGO based in Houston, Texas that provides free food, clothing, basic medical services and temporary shelter to hundreds of undocumented immigrants from Latin America, Africa, and Asia each year. I supplement this data with hundreds of informal interviews and 36 semi-structured in-depth interviews with migrants, volunteers, and city employees affiliated with Houston's medical district. I find that immigrant health care is premised less on legality (i.e., being documented) and more on legibility (i.e. being recognizable to health care practitioners in particular ways). Drawing on Harsha Walia's theory of border imperialism, which draws insights from critical race theory, Marxist analysis, feminist studies, and poststructuralism, I argue that illegality is not simply a determinant of but also determined by health disparities. Today's health care system operates like a border where the racialized terms of illegality are regulated, (re)produced and actively contested. My research illuminates these processes through examining how health care is understood, provided, and received at the medical district, NGO, and migrant levels. In doing so, I make several theoretical contributions to the areas of medical sociology and immigration and develop practical considerations for health practitioners and NGOs with health equity aims. On a theoretical level, I illustrate convergence between the welfare and carceral state, advance theoretical debates around medicalization, and add nation to analyzes between caregiving and masculinity. On a practical level, I implicate health practitioners and equity-oriented NGOs like JyP in different forms of migrant suffering and offer considerations for becoming social justice allies.
  • Thumbnail Image
    Item
    Osseo Health and Wellness Project: A Community-Driven Model to Address Inequities in Students’ Nutrition, Health and Wellness in a Culturally Diverse School District.
    (2021-09) Mutiga-Waititu, Murugi
    Osseo Health and Wellness Project (OHWP) is a community-driven initiative led by African Immigrant Services (AIS), a community organization serving African immigrants in the Northwest suburbs of Hennepin County. OHWP partnership includes Osseo Area Schools Nutrition Services (OAS-NS), community members, and other stakeholders including the University of Minnesota. The main purpose of OHWP was to increase parents' and students' voices in shaping culturally responsive and equitable health and wellness practices, systems, and outcomes within OAS-NS. Using a community-driven action research approach, OHWP organized and convened a community focus group to which students, parents, community members, and OAS staff were invited. Based upon input from parents, students, and community members, the Osseo District School Board approved the new OAS wellness policy in 2017. The superintendent subsequently appointed four wellness coordinators to manage the district-wide implementation of the wellness policy. AIS provided two African community chefs who trained the kitchen staff on the preparation of five different recipes. The students loved the new recipes, and they were incorporated into the school lunch menus. Clear labeling of food was carried out across all schools allowing students with different cultural, religious, and medical needs to better participate in the School Lunch Program. OAS is now working on hiring more staff from the community and continuing to work on making the menus healthier. The school district better appreciates the African immigrant community as a valuable resource and the community holds greater power and voice in continuing the work. The AIS model offers the opportunity for transferable experiences in cross-cultural relationship building between communities and the educational institutions serving those communities. To the extent these experiences can be replicated in other settings, they hold promise to break down barriers and pave ways for the parents to be a greater part of their children's lives in school.