Calling for a Bold New Vision of Health Disparities Intervention Research

Cooper, Lisa A.; Ortega, Alexander N.; Ammerman, Alice S.; Buchwald, Dedra; Paskett, Electra D.; Powell, Lynda H.; Thompson, Beti; Tucker, Katherine L.; Warnecke, Richard B.; McCarthy, William J.; Viswanath, Kasisomayajula; Henderson, Jeffrey A.; Calhoun, Elizabeth A.; Williams, David R.

doi:10.2105/ajph.2014.302386

Cited by 57 publications

(48 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Research on cancer survivorship and disparities is ongoing. 25 While the CCI has been employed widely in research and remains an effective tool, 20 the list of clinical conditions in the index was developed and validated in cohorts almost exclusively consisting of patients of European descent. High blood pressure is not among the 17-item list, however, although it is established that HBP is found in higher rates of among African-Americans.…”

Section: Discussionmentioning

confidence: 99%

Mortality risk from comorbidities independent of triple-negative breast cancer status: NCI-SEER-based cohort analysis

Swede

Sarwar

Magge

et al. 2016

Cancer Causes Control

View full text Add to dashboard Cite

Purpose A comparatively high prevalence of co-morbidities among African-American/Blacks (AA/B) has been implicated in disparate survival in breast cancer. There is a scarcity of data, however, if this effect persists when accounting for the adverse triple-negative breast cancer (TNBC) subtype which occurs at three-fold the rate in AA/B compared to white breast cancer patients. Methods We reviewed charts of 214 white and 202 AA/B breast cancer patients in the NCI-SEER Connecticut Tumor Registry who were diagnosed in 2000-07. We employed the Charlson Co-Morbidity Index (CCI), a weighted 17-item tool to predict risk of death in cancer populations. Cox Survival Analyses estimated hazard ratios (HR) for all-cause mortality in relation to TNBC and CCI adjusting for clinicopathological factors. Results Among patients with SEER-Local Stage, TNBC increased the risk of death (HR=2.18, 95% CI 1.14-4.16), which was attenuated when the CCI score was added to the model (Adj. HR=1.50, 95% CI 0.74-3.01). Conversely, the adverse impact of the CCI score persisted when controlling for TNBC (Adj. HR=1.49, 95% CI 1.29-1.71; per one point increase). Similar patterns were observed in SEER-Regional Stage but estimated HRs were lower. AA/B patients with a CCI score of ≥3 had a significantly higher risk of death compared to AA/B patients without comorbidities (Adj. HR=5.65, 95% CI 2.90-11.02). A lower and non-significant effect was observed for whites with a CCI of ≥3 (Adj. HR=1.90, 95% CI 0.68-5.29). Conclusions Co-morbidities at diagnosis increase risk of death independent of TNBC, and AA/B patients may be disproportionately at risk.

show abstract

Section: Discussionmentioning

confidence: 99%

Mortality risk from comorbidities independent of triple-negative breast cancer status: NCI-SEER-based cohort analysis

Swede

Sarwar

Magge

et al. 2016

Cancer Causes Control

View full text Add to dashboard Cite

show abstract

“…11 It was funded by the National Heart, Lung, and Blood Institute (NHLBI) as part of an initiative with the National Cancer Institute ‘to develop and test multilevel interventions to reduce health disparities.’12 This paper focuses on participants who took part in the HHL lifestyle study,11 one of three coordinated HHL studies which also included a study to improve high blood pressure (BP) management at local practices and a study examining associations between genetic markers and change in CVD risk factors. These studies were conducted in Lenoir County because of its location in the ‘stroke belt’9 of eastern North Carolina, where rates of CVD are higher than state and national averages13 and because it has a large minority population (40% African-American) that experiences disproportionally higher rates of CVD 14.…”

Section: Methodsmentioning

confidence: 99%

Successful long-term weight loss among participants with diabetes receiving an intervention promoting an adapted Mediterranean-style dietary pattern: the Heart Healthy Lenoir Project

Embree

Samuel‐Hodge

Johnston

et al. 2017

BMJ Open Diab Res Care

View full text Add to dashboard Cite

ObjectiveTo examine weight change by diabetes status among participants receiving a Mediterranean-style diet, physical activity, and weight loss intervention adapted for delivery in the southeastern USA, where rates of cardiovascular disease (CVD) are disproportionately high.Research design and methodsThe intervention included: Phase I (months 1–6), an individually tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7–12), option of a 16-week weight loss intervention for those with BMI≥25 kg/m2 offered as 16 weekly group sessions or 5 group sessions and 10 phone calls, or a lifestyle maintenance intervention; and Phase III (months 13–24), weight loss maintenance intervention for those losing ≥8 pounds with all others receiving a lifestyle maintenance intervention. Weight change was assessed at 6, 12, and 24-month follow-up.ResultsBaseline characteristics (n=339): mean age 56, 77% female, 65% African-American, 124 (37%) with diabetes; mean weight 103 kg for those with diabetes and 95 kg for those without. Among participants with diabetes, average weight change was −1.2 kg (95% CI −2.1 to −0.4) at 6 months (n=92), −1.5 kg (95% CI −2.9 to −0.2) at 12 months (n=96), and −3.7 kg (95% CI −5.2 to −2.1) at 24 months (n=93). Among those without diabetes, weight change was −0.4 kg (95% CI −1.4 to 0.6) at 24 months (n=154).ConclusionsParticipants with diabetes experienced sustained weight loss at 24-month follow-up. High-risk US populations with diabetes may experience clinically important weight loss from this type of lifestyle intervention.Trial registration numberNCT01433484.

show abstract

“…their local environment, 44,45 which can affect health patterns across the life span. 46 However, we recognize that optimal implementation of the conceptual framework requires multi-level interventions that address several targets, including health care systems and policy.…”

Section: Framework To Address Health Inequities -Lopez-class Et Almentioning

confidence: 99%

A Strategic Framework for Utilizing Late-Stage (T4) Translation Research to Address Health Inequities

et al. 2016

View full text Add to dashboard Cite

show abstract

Calling for a Bold New Vision of Health Disparities Intervention Research

Cited by 57 publications

References 10 publications

Mortality risk from comorbidities independent of triple-negative breast cancer status: NCI-SEER-based cohort analysis

Mortality risk from comorbidities independent of triple-negative breast cancer status: NCI-SEER-based cohort analysis

Successful long-term weight loss among participants with diabetes receiving an intervention promoting an adapted Mediterranean-style dietary pattern: the Heart Healthy Lenoir Project

A Strategic Framework for Utilizing Late-Stage (T4) Translation Research to Address Health Inequities

Contact Info

Product

Resources

About