Browsing by Subject "Health Equity"

Now showing 1 - 3 of 3
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    "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.
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    Examining the Relationship between Race, Ethnicity, and Sociodemographic Factors and Coverage of Three Vaccines: COVID-19, MMR, and HPV
    (2024) Mohammed, Inari
    The incidence of vaccine-preventable diseases is on the rise in the United States and globally. This is due to multiple factors including a recent surge in vaccine hesitancy, which the WHO has named a top ten global health threat, and persistent barriers to accessing vaccination. These factors have led to larger numbers of unprotected individuals who are at increased risk for contracting diseases such as COVID-19, measles, and the human papillomavirus (HPV). This dissertation aimed to identify racial, ethnic, and sociodemographic disparities in vaccine coverage for, 1) measles, mumps, and rubella (MMR) and 2) HPV, and explored the reasons behind COVID-19 vaccine hesitancy among Black women. In Manuscript 1, I used qualitative methods to understand COVID-19 vaccine decision-making among a diverse set of Black women in the Minneapolis-Saint Paul metropolitan area. I identified myths and misinformation about the vaccine, some of which were specific to ethnic groups. I found that historical trauma and culturally appropriate messaging influenced vaccine decision-making. In Manuscript 2, I used data from the Minnesota Department of Health’s Minnesota Immunization Information Connection (MIIC) and birth certificate data from the Center for Health Statistics (CHS) to assess on-time MMR vaccine coverage among Minnesota-born children. Findings indicated substantial gaps by ethnicity and socioeconomic status for on-time MMR vaccination. This has implications for how measles cases and outbreaks in the state might emerge and how to target immunization access campaigns. In Manuscript 3, I used MIIC and CHS data to assess on-time HPV vaccine coverage among Minnesota-born adolescents. Findings indicated low coverage overall, gaps by ethnicity, and significant urban/rural differences. These low rates of on-time HPV vaccination could have consequences for the epidemiology of future HPV-associated cancers in Minnesota. In summary, my findings contribute to the understanding of racial, ethnic and sociodemographic inequities in the coverage of three important vaccines: COVID-19, MMR, and HPV. These findings can inform public health interventions targeted to improve vaccine coverage among marginalized groups.
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    Timeliness and Equity as Overlooked Quality Domains: Racial/Ethnic Disparities in Timeliness of Adjuvant Chemotherapy Receipt for Stage III Colon Cancer
    (2018-12) Joseph, Jennifer
    Consensus and evidence-based guidelines or quality measures provide treatment recommendations to promote standardized, high-quality health care. This research focused on a specific guideline which recommends stage III colon cancer patients to receive adjuvant chemotherapy within 4 months of diagnosis. It was endorsed by the National Quality Forum (NQF) in 2007 and has yet to be investigated for two important yet understudied health care quality domains: timeliness and racial/ethnic equity of care. Data from the linked Surveillance and Epidemiology and End Results (SEER) cancer registry and Medicare claims were used to investigate the following topics: 1. disparities in guideline-concordant adjuvant chemotherapy receipt, distinguishing between omitted and delayed chemotherapy as forms of guideline discordance; 2. racial/ethnic disparities in timeliness of adjuvant chemotherapy receipt, while assessing wait time disparities before and after tumor resection; 3. the impact of the guideline in changing rates of timely adjuvant chemotherapy receipt and racial differences in trends over time. This research provides important new insights into racial/ethnic equity of cancer care for White, Black, Hispanic, and Asian/Pacific Islander patients, with a nuanced focus on timeliness and delay that is overlooked in the quality of care literature.