Engaging African American Veterans with Health Care Access Challenges in a Community Partnered Care Coordination Initiative: A Qualitative Needs Assessment

Izquierdo, Adriana; Ong, Michael; Jones, Felica; Jones, Loretta; Ganz, David A.; Rubenstein, Lisa V.

doi:10.18865/ed.28.s2.475

Cited by 6 publications

(7 citation statements)

References 22 publications

(24 reference statements)

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“…65 This, in turn, makes African American communities wary of engaging in research, 15,21,[69][70][71] as well as taking vaccines, [60][61][62] receiving antiretroviral therapy, 72 or considering kidney transplants. 73,74 To make matters worse, broader systemic issues are cast in the background, including limited access to health care 75 and timely dementia diagnoses 3 for African Americans, high costs, 76 and bias on behalf of medical providers (specifically in the area of who is eligible for transplantation), 77 which creates and sustains health disparities.…”

Section: Discussionmentioning

confidence: 99%

Earning the Trust of African American Communities to Increase Representation in Dementia Research

et al. 2020

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Black/African American populations are underrepresented as participants in dementia research. A major barrier to participation of African American older adults in dementia research is a tendency to distrust research institutions owing to both historical and contemporary racism. Building on the Ford framework, the objective of our study was to examine factors that influence participation in dementia research among African American older adults and caregivers, with an emphasis on understanding factors related to trust. Data were collected during January 2019 and March 2020 from 10 focus groups with African American older adults (n=91), 5 focus groups with caregivers (n=44), and interviews with administrators of community-based organizations (n=11), and meetings with our Community Advisory Board. Inductive/deductive content analysis was used to identify themes. The results identified an overall tension between distrust of researchers and a compelling desire to engage in dementia research. This overarching theme was supported by six themes that provided insights about the multiple layers of distrust, as well as expectations about the appropriate conduct of researchers and academic institutions. Strong commitment to the community was identified as a priority. The findings suggest that a paradigm shift is needed to increase the representation of African Americans in dementia research. In this new paradigm, earning the trust of African American communities becomes a systemic endeavor, with academic, state, and national institutions deeply committed to earning the trust of African American communities and guiding researchers in this endeavor. The findings also generated actionable recommendations to help improve representation of African American older adults in dementia research.Ethn Dis. 2020;30(Suppl 2):719-734; doi:10.18865/ed.30.S2.719

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Section: Discussionmentioning

confidence: 99%

Earning the Trust of African American Communities to Increase Representation in Dementia Research

et al. 2020

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“…Trust in Health Care Providers Among Veterans and Active Duty Military the past several decades, medical mistrust has emerged as an important and prevalent public health problem (e.g., Izquierdo et al, 2018). According to one survey, only 23% of Americans express a great deal or quite a lot of confidence in the health care system (Richmond, 2021).…”

Section: Listen To Your Commandermentioning

confidence: 99%

Freedom of Expression Across Borders: Communication, Culture, and Language

2023

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This book examines how freedom of expression can be defined, shared, acted upon and responded to globally. In curating this volume, the editors collected works on freedom of expression and communication, culture and identity from a broad swath of viewpoints. Scholarly contributions come from a variety of disciplines, including communication, literature, linguistics, translation, journalism, cultural studies, art, and other humanities and social science perspectives. This compilation addresses ideas such as censorship and free speech, minority and migration discourse, language and translation, mass media, including social media and advertising, and humor and political satire.

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“…In a systematic review of studies examining the effect of race on patient-provider communication, the majority of studies measuring the quality of patient-physician communication found lower quality communication for Black patients (32). Other studies have found that, compared to White patients, Black patients are less satisfied with their communication with physicians, reported receiving less information (33)(34)(35)(36)(37) from their physician (38,39), experiencing less partnership building (40), and were less likely to be asked to participate in treatment decision-making (40)(41)(42)(43). They also reported experiencing more negative affect from physicians (44,45) and are given less time to talk and have shorter visit times (38,46).…”

Section: Introductionmentioning

confidence: 99%

Pre-implementation Evaluation of PARTNER-MH: A Mental Healthcare Disparity Intervention for Minority Veterans in the VHA

Eliacin

Matthias

Burgess³

et al. 2020

Adm Policy Ment Health

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Objectives: To design PARTNER-MH, a peer-led, patient navigation program for implementation in Veterans Health Administration (VHA) mental health care settings, we conducted a pre-implementation evaluation during intervention development to assess stakeholders' views of the intervention and to explore implementation factors critical to its future adoption.Methods: This is a convergent mixed-methods study that involved qualitative semi-structured interviews and survey data. Data collection was guided by the Consolidated Framework for Implementation Research (CFIR). We interviewed and administered the surveys to 23 peers and 10 supervisors from 12 midwestern VHA facilities. We used deductive and inductive approaches to analyze the qualitative data. We also conducted descriptive analysis and Fisher Exact Test to compare peers and supervisors' survey responses. We triangulated findings to refine the intervention.Results: Overall, participants viewed PARTNER-MH favorably. However, they saw the intervention's focus on minority Veterans and social determinants of health framework as potential barriers, believing this could negatively affect the packaging of the intervention, complicate its delivery process, and impact its adoption. They also viewed clinic structures, available resources, and learning climate as potential barriers. Peers and supervisors' selections and discussions of CFIR items were similar. Conclusion:Our findings informed PARTNER-MH development and helped identify factors that could impact its implementation. Implications for D&I Research:This project is responsive to the increasing recognition of the need to incorporate implementation science in healthcare disparities research. Understanding the resistance to the intervention's focus on minority Veterans and the potential barriers presented by contextual factors positions us to adjust the intervention prior to testing, in an effort to maximize implementation success.

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Engaging African American Veterans with Health Care Access Challenges in a Community Partnered Care Coordination Initiative: A Qualitative Needs Assessment

Cited by 6 publications

References 22 publications

Earning the Trust of African American Communities to Increase Representation in Dementia Research

Earning the Trust of African American Communities to Increase Representation in Dementia Research

Freedom of Expression Across Borders: Communication, Culture, and Language

Pre-implementation Evaluation of PARTNER-MH: A Mental Healthcare Disparity Intervention for Minority Veterans in the VHA

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