Illness Narratives of African Americans Living With Coronary Heart Disease

Dubbin, Leslie; McLemore, Monica R.; Shim, Janet K.

doi:10.1177/1049732316645319

Cited by 16 publications

(15 citation statements)

References 46 publications

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“…We therefore saw the value of preserving and presenting this data as intact narratives. Although this differs from the traditional method of presenting qualitative findings, it better aligns with strengths-based [4] and critical interactionist methodologies [37]. These methodologies center the experience and worldview of the participants, and prioritize the speakers/storytellers, rather than the researchers, in defining the meaning and purpose of the information they share, and the ways in which key issues are interconnected [4,[13][14][15]37] (see S3 Appendix for more details on these methodologies).…”

Section: Data Collection and Analysismentioning

confidence: 99%

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

et al. 2021

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Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a ‘deficit-based’ discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants’ knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants’ communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09–4.63), people with disabilities (OR: 2.43; 95% CI: 1.28–4.64), and unemployed people (OR: 2.64; 95% CI: 1.28–5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25–4.09), unemployment (OR: 4.07; 95% CI: 1.64–10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03–1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants’ knowledge, experience, and strengths has the potential to improve individuals’ diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.

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Section: Data Collection and Analysismentioning

confidence: 99%

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

et al. 2021

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“…Cultural capital of the provider and the patient impact the perceptions of quality care and, more importantly, can facilitate or impede authentic engagement between patients and their healthcare providers (Chang et al, 2016;Dubbin et al, 2013;Shim, 2010). Lastly, our recent work (Dubbin et al, 2017) has shown that African-Americans perceive categories of illness, such as coronary heart disease and diabetes, as products of ongoing racial and socio-structural dynamics that create and maintain health burdens, as opposed to lifestyle diseases where the ultimate culprits are their personal health behaviors and lack of healthy choices. A tension between the effectiveness of personal health behaviors and living with illness was described by AfricanAmericans when communicating with their healthcare providers about their care.…”

Section: Background and Significancementioning

confidence: 99%

Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth

McLemore¹,

Altman²,

Cooper

et al. 2018

Social Science & Medicine

256

251

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Background: Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth. Methods: This study was a secondary analysis of focus group data generated as part of a larger project focused on patient and community involvement in preterm birth research. English and Spanish speaking women, age 18 or greater with social and/or medical risk factors for preterm birth participated in two focus groups, six weeks apart. Data from the first focus groups are included in this analysis. Results: Five themes emerged from thematic analysis of the transcripts. Participants described disrespect during healthcare encounters, including experiences of racism and discrimination; stressful interactions with all levels of staff; unmet information needs; and inconsistent social support. Despite these adverse experiences, women felt confidence in parenting and newborn care. Participant recommendations for healthcare systems improvement included: greater attention to birth plans, better communication among multiple healthcare providers, more careful listening to patients during clinical encounters, increased support for social programs such as California's Black Infant Health, and less reliance on past carceral history and/or child protective services involvement. Discussion: The women in this study perceived their prenatal healthcare as a largely disrespectful and stressful experience. Our findings add to the growing literature that women of color experience discrimination, racism and disrespect in healthcare encounters and that they believe this affects their health and that of their infants.

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“…Given the strength of qualitative research to uncover complex social phenomenon such as health disparities (Jones, Trivedi, & Ayanian, 2010; Sinding, 2010; Wheatley, Kelley, Peacock, & Delgado, 2008), the purpose of this study is to conduct the first systematic review of qualitative research on autism disparities in the United States. Synthesizing and interpreting knowledge gained from qualitative research is important because it has the potential to offer a nuanced and contextualized understanding of health disparities based on individual lived experiences, while putting illness experiences into the context of socio-structural dynamics through which health disparities are created, sustained, and reproduced (Dubbin, McLemore, & Shim, 2017). Meta-reviews of qualitative research allow for attention to be drawn to mechanisms leading up to social phenomena like health disparities as well as the ability to connect these experiences to larger social, political, and economic contexts (Angus et al, 2013; Kingod, Cleal, Wahlberg, & Husted, 2017; McPherson & Armstrong, 2012).…”

mentioning

confidence: 99%

Autism Disparities: A Systematic Review and Meta-Ethnography of Qualitative Research

Singh

Bunyak

2018

Qual Health Res

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Racial, ethnic, and socioeconomic disparities associated with autism spectrum disorder (ASD) are evident across many service domains including access to early assessment, diagnosis, and therapeutic interventions. To better understand the complex social and structural factors contributing to these disparities, this article offers a systematic review of peer-reviewed qualitative research conducted from 2010 to 2016 in the United States that investigates autism disparities experienced by marginalized communities. Based on these criteria, we identified 24 qualitative research studies and conducted an analysis using meta-ethnography and an intersectional interpretive lens. We identified three interdependent themes contributing to autism disparities, including familial, cultural, and structural barriers. Omissions in the literature were also evident, including a lack of research on underserved adults with ASD and the gendered inequities of caregiving. We discuss the implications of our findings and offer new questions that take an intersectional approach using qualitative research to investigate autism disparities.

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Illness Narratives of African Americans Living With Coronary Heart Disease

Cited by 16 publications

References 46 publications

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth

Autism Disparities: A Systematic Review and Meta-Ethnography of Qualitative Research

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