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1.
Gynecol Oncol ; 182: 132-140, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38262236

RESUMEN

OBJECTIVE: Despite the within-group heterogeneity, Asian American (AA) and Native Hawaiian and Pacific Islander (NH/PI) patients are often grouped together. We compared the patterns of guideline-concordant care for locally advanced cervical cancer for disaggregated AA and NH/PI patients. METHODS: Patients with stage II-IVA cervical cancer between 2004 and 2020 were identified from the National Cancer Database. AA patients were disaggregated as East Asian (EA), South Asian (SA), and Southeast Asian (SEA). NH/PI patients were classified as a distinct racial subgroup. The primary outcome was the proportion undergoing guideline-concordant care, defined by radiation therapy with concurrent chemotherapy, brachytherapy, and completion of treatment within eight weeks. RESULTS: Of 48,116 patients, 2107 (4%) were AA and 171 (<1%) were NH/PI. Of the AA patients, 36% were SEA, 31% were EA, 12% were SA, and 21% could not be further disaggregated due to missing or unknown data. NH/PI patients were more likely to be diagnosed at an early age (53% NH/PI vs. 30% AA, p < 0.001) and have higher rates of comorbidities (18% NH/PI vs. 14% AA, p < 0.001). Within the AA subgroups, only 82% of SEA patients received concurrent chemotherapy compared to 91% of SA patients (p = 0.026). SA patients had the longest median OS (158 months) within the AA subgroups compared to SEA patients (113 months, p < 0.001). CONCLUSION: Disparities exist in the receipt of standard of care treatment for cervical cancer by racial and ethnic subgroups. It is imperative to disaggregate race and ethnicity data to understand potential differences in care and tailor interventions to achieve health equity.


Asunto(s)
Asiático , Nativos de Hawái y Otras Islas del Pacífico , Neoplasias del Cuello Uterino , Femenino , Humanos , Asiático/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Estadificación de Neoplasias/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/etnología , Neoplasias del Cuello Uterino/terapia , Asia Oriental/etnología , Sur de Asia/etnología , Asia Sudoriental/etnología , Estados Unidos
2.
J Clin Gastroenterol ; 58(3): 259-270, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-36753456

RESUMEN

BACKGROUND: Colorectal cancer screening uptake in the United States overall has increased, but racial/ethnic disparities persist and data on colonoscopy uptake by racial/ethnic subgroups are lacking. We sought to better characterize these trends and to identify predictors of colonoscopy uptake, particularly among Asian and Hispanic subgroups. STUDY: We used data from the New York City Community Health Survey to generate estimates of up-to-date colonoscopy use in Asian and Hispanic subgroups across 6 time periods spanning 2003-2016. For each subgroup, we calculated the percent change in colonoscopy uptake over the study period and the difference in uptake compared to non-Hispanic Whites in 2015-2016. We also used multivariable logistic regression to identify predictors of colonoscopy uptake. RESULTS: All racial and ethnic subgroups with reliable estimates saw a net increase in colonoscopy uptake between 2003 and 2016. In 2015-2016, compared with non-Hispanic Whites, Puerto Ricans, Dominicans, and Central/South Americans had higher colonoscopy uptake, whereas Chinese, Asian Indians, and Mexicans had lower uptake. On multivariable analysis, age, marital status, insurance status, primary care provider, receipt of flu vaccine, frequency of exercise, and smoking status were the most consistent predictors of colonoscopy uptake (≥4 time periods). CONCLUSIONS: We found significant variation in colonoscopy uptake among Asian and Hispanic subgroups. We also identified numerous demographic, socioeconomic, and health-related predictors of colonoscopy uptake. These findings highlight the importance of examining health disparities through the lens of disaggregated racial/ethnic subgroups and have the potential to inform future public health interventions.


Asunto(s)
Asiático , Colonoscopía , Neoplasias Colorrectales , Hispánicos o Latinos , Grupos de Población en Estados Unidos , Humanos , Pueblos Caribeños/estadística & datos numéricos , Colonoscopía/estadística & datos numéricos , Colonoscopía/tendencias , Hispánicos o Latinos/etnología , Hispánicos o Latinos/estadística & datos numéricos , Ciudad de Nueva York/epidemiología , Pueblos de América del Norte/estadística & datos numéricos , Estados Unidos/epidemiología , Asiático/estadística & datos numéricos , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/etnología , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/estadística & datos numéricos , Detección Precoz del Cáncer/tendencias , Blanco , Disparidades en Atención de Salud/etnología , Disparidades en Atención de Salud/estadística & datos numéricos , Grupos de Población en Estados Unidos/etnología , Grupos de Población en Estados Unidos/estadística & datos numéricos
3.
Skeletal Radiol ; 2024 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-38459983

RESUMEN

PURPOSE: To report osteoporosis screening utilization rates among Asian American (AsA) populations in the USA. METHODS: We retrospectively assessed the use of dual-energy X-ray absorptiometry (DXA) screening using the Medicare 5% Research Identifiable Files. Using Current Procedural Terminology (CPT) codes indicative of a DXA scan, we identified patients recommended for DXA screening according to the ACR-SPR-SSR Practice Parameters (females ≥ 65 years, males ≥ 70 years). Sociodemographic factors and their association with screening were evaluated using chi-square tests. RESULTS: There were 80,439 eligible AsA beneficiaries, and 12,102 (15.1%) received osteoporosis screening. DXA rate for women was approximately four times greater than the rate for men (19.8% vs. 5.0%; p < 0.001). AsA beneficiaries in zip codes with higher mean household income (MHI) were more likely to have DXA than those in lower MHI areas (17.6% vs. 14.3%, p < 0.001). AsA beneficiaries aged < 80 were more likely to receive DXA (15.5%) than those aged ≥ 80 (14.1%, p < 0.001). There were 2,979,801 eligible non-AsA beneficiaries, and 496,957 (16.7%) received osteoporosis screening during the study period. Non-Hispanic white beneficiaries had the highest overall screening rate (17.5%), followed by North American Native (13.0%), Black (11.8%), and Hispanic (11.1%) beneficiaries. Comparing AsA to non-AsA populations, there were significantly lower DXA rates among AsA beneficiaries when controlling for years of Medicare eligibility, patient age, sex, location, and mean income (p < 0.001). CONCLUSION: We found lower than expected DXA screening rates for AsA patients. A better understanding of the barriers and facilitators to AsA osteoporosis screening is needed to improve patient care.

4.
Epidemiol Rev ; 45(1): 127-139, 2023 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-37045807

RESUMEN

Improving race and ethnicity (hereafter, race/ethnicity) data quality is imperative to ensure underserved populations are represented in data sets used to identify health disparities and inform health care policy. We performed a scoping review of methods that retrospectively improve race/ethnicity classification in secondary data sets. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searches were conducted in the MEDLINE, Embase, and Web of Science Core Collection databases in July 2022. A total of 2 441 abstracts were dually screened, 453 full-text articles were reviewed, and 120 articles were included. Study characteristics were extracted and described in a narrative analysis. Six main method types for improving race/ethnicity data were identified: expert review (n = 9; 8%), name lists (n = 27, 23%), name algorithms (n = 55, 46%), machine learning (n = 14, 12%), data linkage (n = 9, 8%), and other (n = 6, 5%). The main racial/ethnic groups targeted for classification were Asian (n = 56, 47%) and White (n = 51, 43%). Some form of validation evaluation was included in 86 articles (72%). We discuss the strengths and limitations of different method types and potential harms of identified methods. Innovative methods are needed to better identify racial/ethnic subgroups and further validation studies. Accurately collecting and reporting disaggregated data by race/ethnicity are critical to address the systematic missingness of relevant demographic data that can erroneously guide policymaking and hinder the effectiveness of health care practices and intervention.


Asunto(s)
Exactitud de los Datos , Etnicidad , Grupos Raciales , Humanos , Área sin Atención Médica , Estudios Retrospectivos
5.
Cancer Causes Control ; 34(4): 371-387, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36781715

RESUMEN

Reflecting their commitment to advancing health equity, the Cancer Prevention and Control Research Network (CPCRN) established a Health Equity Workgroup to identify and distill guiding principles rooted in health equity, community-engaged participatory research (CBPR), social determinants of health, and racial equity frameworks to guide its collective work. The Health Equity Workgroup utilized a multi-phase, participatory consensus-building approach to: (1) identify recurrent themes in health and racial equity frameworks; (2) capture perspectives on and experiences with health equity research among CPCRN members through an online survey; (3) engage in activities to discuss and refine the guiding principles; and (4) collect case examples of operationalizing equity principles in cancer research. Representatives from all CPCRN centers endorsed nine core principles to guide the Network's strategic plan: (1) Engage in power-sharing and capacity building with partners; (2) Address community priorities through community engagement and co-creation of research; (3) Explore and address the systems and structural root causes of cancer disparities; (4) Build a system of accountability between research and community partners; (5) Establish transparent relationships with community partners; (6) Prioritize the sustainability of research benefits for community partners; (7) Center racial equity in cancer prevention and control research; (8) Engage in equitable data collection, analysis, interpretation, and dissemination practices; and (9) Integrate knowledge translation, implementation, and dissemination into research plans. Dissemination products, such as toolkits and technical assistance workshops, reflecting these principles will foster knowledge transfer to intentionally integrate health and racial equity principles in cancer prevention and control research.


Asunto(s)
Equidad en Salud , Neoplasias , Humanos , Proyectos de Investigación , Neoplasias/prevención & control
6.
Cancer Causes Control ; 34(12): 1043-1058, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37481755

RESUMEN

PURPOSE: To apply principles of group model building (GMB), a participatory systems science approach, to identify barriers and opportunities for collective impact around nutrition programming to reduce cancer risk for immigrant communities in an urban environment. METHODS: We convened four in-person workshops applying GMB with nine community partners to generate causal loop diagrams (CLDs)-a visual representation of hypothesized causal relationships between variables and feedback structures within a system. GMB workshops prompted participants to collaboratively identify programmatic goals and challenges related to (1) community gardening, (2) nutrition education, (3) food assistance programs, and (4) community-supported agriculture. Participants then attended a plenary session to integrate findings from all workshops and identify cross-cutting ideas for collective action. RESULTS: Several multilevel barriers to nutrition programming emerged: (1) food policies center the diets and practices of White Americans and inhibit culturally tailored food guidelines and funding for culturally appropriate nutrition education; (2) the lack of culturally tailored nutrition education in communities is a missed opportunity for fostering pride in immigrant food culture and sustainment of traditional food practices; and (3) the limited availability of traditional ethnic produce in food assistance programs serving historically marginalized immigrant communities increases food waste and worsens food insecurity. CONCLUSION: Emergent themes coalesced around the need to embed cultural tailoring into all levels of the food system, while also considering other characteristics of communities being reached (e.g., language needs). These efforts require coordinated actions related to food policy and advocacy, to better institutionalize these practices within the nutrition space.


Asunto(s)
Alimentos , Eliminación de Residuos , Humanos , Estado Nutricional , Dieta , Política Nutricional
7.
J Clin Gastroenterol ; 2023 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-37556383

RESUMEN

BACKGROUND: Asian Americans have the lowest colorectal cancer screening uptake of any racial and ethnic group in the United States. Asian Indians are among the most under-screened Asian American subgroups, but there is limited data for this population. We sought to characterize predictors of colonoscopy use among Asian Indians in New York City. METHODS: Using 2003 to 2016 data from the New York City Community Health Survey, we identified all Asian Indian participants aged 50 years or older. We examined the association between sociodemographic and medical factors and up-to-date colonoscopy use (defined as colonoscopy within the last 10 y) using logistic regression over 4 time periods: 2003 to 2008, 2009 to 2012, 2013 to 2014, 2015 to 2016. RESULTS: On multivariable analysis, language, age, income, recent exercise, body mass index, and influenza vaccination were associated with colonoscopy uptake in 1 time period. Compared with participants who preferred English, those who preferred an Indian language were less likely to have been up-to-date in 2013 to 2014 (odds ratio 0.12, 95% CI 0.02-0.66). Individuals older than 65 years were more likely than those aged 50 to 64 years to have received a colonoscopy in 2009 to 2012 (odds ratio 3.91, 95% CI 1.49-10.24), although the risk estimates were also consistently positive in the other 3 time periods. CONCLUSIONS: Among Asian Indians living in New York City, several demographic, socioeconomic, and health-related characteristics predict colonoscopy use. These findings highlight the importance of examining determinants of colonoscopy uptake in this understudied population to inform future public health interventions.

8.
J Cancer Educ ; 38(2): 682-690, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-35585475

RESUMEN

We examine the efficacy of MARHABA, a social marketing-informed, lay health worker (LHW) intervention with patient navigation (PN), to increase breast and cervical cancer screening among Muslim women in New York City. Muslim women were eligible if they were overdue for a mammogram and/or a Pap test. All participants attended a 1-h educational seminar with distribution of small media health education materials, after which randomization occurred. Women in the Education + Media + PN arm received planned follow-ups from a LHW. Women in the Education + Media arm received no further contact. A total of 428 women were randomized into the intervention (214 into each arm). Between baseline and 4-month follow-up, mammogram screening increased from 16.0 to 49.0% in the Education + Media + PN arm (p < 0.001), and from 14.7 to 44.6% in the Education + Media arm (p < 0.001). Pap test screening increased from 16.9 to 42.3% in the Education + Media + PN arm (p < 0.001) and from 17.3 to 37.1% in the Education + Media arm (p < 0.001). Cancer screening knowledge increased in both groups. Between group differences were not statistically significant for screening and knowledge outcomes. A longer follow-up period may have resulted in a greater proportion of up-to-date screenings, given that many women had not yet received their scheduled screenings. Findings suggest that the educational session and small media materials were perhaps sufficient to increase breast and cervical cancer screening among Muslim American women. ClinicalTrials.gov NCT03081507.


Asunto(s)
Neoplasias de la Mama , Neoplasias del Cuello Uterino , Humanos , Femenino , Detección Precoz del Cáncer/métodos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Islamismo , Ciudad de Nueva York , Educación en Salud/métodos , Tamizaje Masivo/métodos , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/prevención & control
9.
Health Promot Pract ; 24(1): 76-80, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-34344202

RESUMEN

No brief dietary screeners are available that capture dietary consumption patterns of Asian Americans. The purpose of this article is to describe the cultural adaptation of the validated Dietary Screener Questionnaire (DSQ) for use by clinicians, researchers, and community-based partners seeking to understand and intervene on dietary behaviors among English-speaking Asian Americans, for the six largest Asian subgroups (Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese) in the United States. This was mainly accomplished by adding culturally specific examples of foods to the questionnaire items via searching online databases and soliciting input from members of our community partner network representing each of the six largest Asian subgroups. Over half of the 26 items on the DSQ were modified to include more culturally specific foods. Developing high-quality tools that reflect the diversity of the U.S. population are critical to implement nutrition interventions that do not inadvertently widen health disparities.


Asunto(s)
Asiático , Dieta , Humanos , Estados Unidos , Encuestas y Cuestionarios , Alimentos , Vietnam
10.
BMC Public Health ; 22(1): 778, 2022 04 18.
Artículo en Inglés | MEDLINE | ID: mdl-35436904

RESUMEN

BACKGROUND: COVID-19 mitigation strategies have had an untold effect on food retail stores and restaurants. Early evidence from New York City (NYC) indicated that these strategies, among decreased travel from China and increased fears of viral transmission and xenophobia, were leading to mass closures of businesses in Manhattan's Chinatown. The constantly evolving COVID -19 crisis has caused research design and methodology to fundamentally shift, requiring adaptable strategies to address emerging and existing public health problems such as food security that may result from closures of food outlets. OBJECTIVE: We describe innovative approaches used to evaluate changes to the food retail environment amidst the constraints of the pandemic in an urban center heavily burdened by COVID-19. Included are challenges faced, lessons learned and future opportunities. METHODS: First, we identified six diverse neighborhoods in NYC: two lower-resourced, two higher-resourced, and two Chinese ethnic enclaves. We then developed a census of food outlets in these six neighborhoods using state and local licensing databases. To ascertain the status (open vs. closed) of outlets pre-pandemic, we employed a manual web-scraping technique. We used a similar method to determine the status of outlets during the pandemic. Two independent online sources were required to confirm the status of outlets. If two sources could not confirm the status, we conducted phone call checks and/or in-person visits. RESULTS: The final baseline database included 2585 food outlets across six neighborhoods. Ascertaining the status of food outlets was more difficult in lower-resourced neighborhoods and Chinese ethnic enclaves compared to higher-resourced areas. Higher-resourced neighborhoods required fewer phone call and in-person checks for both restaurants and food retailers than other neighborhoods. CONCLUSIONS: Our multi-step data collection approach maximized safety and efficiency while minimizing cost and resources. Challenges in remote data collection varied by neighborhood and may reflect the different resources or social capital of the communities; understanding neighborhood-specific constraints prior to data collection may streamline the process.


Asunto(s)
COVID-19 , COVID-19/epidemiología , Comercio , Alimentos , Abastecimiento de Alimentos , Humanos , Pandemias , Características de la Residencia , Restaurantes
11.
J Cancer Educ ; 37(5): 1510-1518, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-33723796

RESUMEN

Despite improvements in colorectal cancer (CRC) screening in New York City (NYC) since the early 2000s, the degree to which disparities persist for specific Asian American subgroups has yet to be fully elucidated. The purpose of this study is to examine disparities in rates of timely colonoscopy screening among five racial/ethnic groups in NYC. We performed a retrospective cross-sectional analysis of combined 2014-2018 NYC Community Health Survey data. Prevalence estimates of timely colonoscopy screening (within the past 10 years) among individuals ≥ 50 years of age were calculated and presented overall (n = 24,288) and by socio-demographic variables. Racial/ethnic categories included White, Black, Hispanic, East Asian, and South Asian. Multivariable models examined socio-demographic and racial/ethnic predictors of timely colonoscopy screening. A trend analysis examined colonoscopy screening by race/ethnicity and year from 2012 to 2018 (n = 33,130). Age-adjusted prevalence of timely colonoscopy screening was lowest among Asian Americans (South Asian 61.1% and East Asian 65.9%) compared to Hispanics (71.3%), Blacks (70.2%), and Whites (68.6%). Adjustment by socio-demographics, including insurance status, further explained disparities for South Asians (adjusted risk ratio [RR] = 0.84, 95% CI = 0.73-0.97) compared to Hispanics; additionally, Whites (adjusted RR=0.88, 95% CI = 0.84-0.92) were less likely to have received a timely colonoscopy compared to Hispanics. Age, health insurance, poverty group, and education were significant predictors in adjusted regression. Results indicate that South Asians have not equally benefited from campaigns to increase colonoscopy screening in NYC. Our findings support the development of targeted, and linguistically and culturally adapted campaigns that facilitate access to health systems and leverage existing community assets and social support systems among South Asian populations.


Asunto(s)
Neoplasias Colorrectales , Detección Precoz del Cáncer , Asiático , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/prevención & control , Estudios Transversales , Disparidades en Atención de Salud , Humanos , Ciudad de Nueva York/epidemiología , Estudios Retrospectivos
12.
Am J Public Health ; 111(S3): S224-S231, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34709878

RESUMEN

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224-S231. https://doi.org/10.2105/AJPH.2021.306433).


Asunto(s)
COVID-19 , Emigrantes e Inmigrantes/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Salud Pública , Asistencia Sanitaria Culturalmente Competente/etnología , Empleo , Humanos , Racismo
13.
Dig Dis Sci ; 66(9): 2907-2915, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33063189

RESUMEN

BACKGROUND: Colorectal cancer is the second leading cause of cancer death among Hispanic Americans. Puerto Ricans are the second largest Hispanic subgroup in the USA and the largest in New York City, but little is known about predictors of colorectal cancer screening uptake in this population. AIMS: We used the New York City Community Health Survey, a population-based telephone survey, to investigate predictors of up-to-date colonoscopy use over time among Puerto Ricans aged ≥ 50 years in NYC. METHODS: We assessed the association between sociodemographic and medical factors and up-to-date colonoscopy use (defined as colonoscopy within the last 10 years) using univariable and multivariable logistic regression over six time periods: 2003-2005, 2006-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016. RESULTS: On multivariable analysis, age ≥ 65 years (OR 1.64-1.93 over three periods) and influenza vaccination (OR 1.86-2.17 over five periods) were the two factors most consistently associated with up-to-date colonoscopy use. Individuals without a primary care provider (OR 0.38-0.50 over three periods) and who did not exercise (OR 0.49-0.52 over two periods) were significantly less likely to have an up-to-date colonoscopy. CONCLUSIONS: Older age, influenza vaccination, having a primary care provider, and exercise are independent predictors of up-to-date colonoscopy use among Puerto Ricans in NYC. Interventions to improve screening colonoscopy uptake among Puerto Ricans should be targeted to those aged 50-64 years and who do not have a primary care provider.


Asunto(s)
Colonoscopía , Neoplasias Colorrectales , Detección Precoz del Cáncer , Hispánicos o Latinos/estadística & datos numéricos , Aceptación de la Atención de Salud , Causalidad , Colonoscopía/métodos , Colonoscopía/estadística & datos numéricos , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/etnología , Planificación en Salud Comunitaria/estadística & datos numéricos , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/estadística & datos numéricos , Ejercicio Físico , Femenino , Encuestas Epidemiológicas , Humanos , Vacunas contra la Influenza/uso terapéutico , Masculino , Salud de las Minorías , Ciudad de Nueva York/epidemiología , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/estadística & datos numéricos , Médicos de Atención Primaria/estadística & datos numéricos
14.
J Gerontol Nurs ; 47(12): 35-41, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34846256

RESUMEN

The aim of the current study was to collect qualitative data to understand the nature of sleep and sleep difficulties among Asian American older adults and identify daily routines that may lend insight into modifiable targets for future nursing interventions. We recruited Chinese and Bangladeshi older adults with low English proficiency from community-based settings in New York City. Eligible participants were aged ≥55 years and reported China or Bangladesh as their country of origin. Focus groups were conducted in their native language. Participants completed a questionnaire before joining the discussion. Participants (N = 32) were 57% Chinese American and 43% Bangladeshi American. Average age was 73 years, 50% of the sample reported diabetes, and 22% reported sleep apnea. Our analysis revealed the daily routines among Chinese and Bangladeshi American older adults. Both groups reported general sleep difficulties and sleep difficulties related to health conditions as well as some subgroup differences. Future research may consider designing tailored nursing interventions to improve sleep among these groups. [Journal of Gerontological Nursing, 47(12), 35-41.].


Asunto(s)
Lenguaje , Sueño , Anciano , China , Grupos Focales , Humanos , Ciudad de Nueva York
15.
Prev Med ; 141: 106298, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33148519

RESUMEN

In the United States (US), chronic disease risk factors are highly prevalent among Asian immigrant communities, who also exhibit low health screening rates. Perceived neighborhood social cohesion (NSC) has been associated with preventive healthcare use in the general US population, although it remains unexplored among Asian Americans (AAs). The aim of this study is to evaluate the association between NSC and preventive screening for hypertension, high cholesterol, diabetes, and depression among East, South and Southeast Asian American (EAA, SAA, SEAA) communities in New York City (NYC) using cross-sectional, locally collected data from 2013 to 2016. NSC was assessed using a 4-question scale to create an additive score between 4 and 16 and was analyzed both as a continuous and categorial variable (High, Medium, and Low tertiles). Recent screening was defined as a check-up within the last year for each of the included health conditions. A one-unit increase in NSC score was associated with increased odds of recent screening for high cholesterol in EAAs (AOR = 1.09, 95%CI:1.00-1.20); for high cholesterol, diabetes, and depression in SAAs (AOR = 1.08, 95%CI:1.00-1.20; AOR = 1.07, 95%CI:1.00-1.15; AOR = 1.15, 95%CI:1.06-1.25); and with high cholesterol among SEAAs (AOR = 1.12, 95%CI:1.00-1.25). Overall, NSC was an important facilitator for preventive screening behaviors for specific conditions in different groups, though was consistently associated with screening for high cholesterol in our sample. Enhancing NSC through family and community-based programming may be one strategy to encourage screening for preventive behaviors, though more research is needed to elucidate a precise mechanism.


Asunto(s)
Conducta Cooperativa , Emigrantes e Inmigrantes , Asiático , Estudios Transversales , Atención a la Salud , Humanos , Ciudad de Nueva York , Características de la Residencia , Estados Unidos
16.
Prev Chronic Dis ; 17: E139, 2020 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-33155971

RESUMEN

INTRODUCTION: Added sugars and high glycemic index (GI) foods might play a role in cardiometabolic pathogenesis. Our study aimed to describe the top sources of added sugars and types of high GI foods in diets of children by race/ethnicity. METHODS: We examined data for 3,112 children, aged 6 to 11 years from the National Health and Nutrition Examination Survey (NHANES), 2011 to 2016. Mean intake was estimated and linear regression models tested for differences by race/ethnicity. Population proportions for food sources were created and ranked, accounting for survey weighting when appropriate. RESULTS: Asian American and Mexican American children had the lowest reported added sugar intake. Cereals were observed to contribute highly to added sugar intake. Soft drinks did not contribute as much added sugar intake for Asian American children as it did for children of other races/ethnicities. Asian American children consumed significantly more high GI foods than other groups. Types of high GI foods differed meaningfully across racial/ethnic groups (ie, Mexican American: burritos/tacos; other Hispanic, White, and Black: pizza; Asian American: rice). Rice accounted for 37% of total high GI foods consumed by Asian American children. CONCLUSIONS: Sources of added sugars and types of high GI foods in children's diets vary across racial/ethnic groups. Targeting foods identified as top sources of added sugars for all race/ethnicities and focusing on substitution of whole grains may reduce obesity, diabetes, and related cardiometabolic risk more equitably.


Asunto(s)
Dieta/estadística & datos numéricos , Sacarosa en la Dieta/administración & dosificación , Niño , Estudios Transversales , Dieta/etnología , Femenino , Humanos , Masculino , Encuestas Nutricionales , Estados Unidos/epidemiología
19.
J Community Health ; 44(3): 479-486, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30874956

RESUMEN

Despite the high prevalence of smokeless tobacco (SLT) use in South Asia, little is known about the use of cultural smokeless tobacco among South Asians in the United States (US). This study examines the prevalence and correlates of SLT products among South Asians living in New York City (NYC). A total of 602 South Asians living in NYC completed a community health needs and resource assessment and answered questions about the use of SLT. Multivariable logistic regression models were run to examine predictors of SLT use (ever and current use). A total of 28.2% South Asian individuals reported ever use of SLT (35.9% among men and 21.5% among women) and a total of 12.9% reported current use of SLT (16.5% among men and 9.7% among women). Logistic regression models were stratified by sex. Among men, factors associated with ever or current use included: Bangladeshi and Himalayan ethnic subgroup, speaking English very well, attending a religious service a few times a year (ever use only), and current or former cigarette smoking. Among women, factors associated with ever use included: Bangladeshi ethnic subgroup, self-reporting condition of mouth and teeth as fair/poor, and at risk for depression. No factors were significant among women for current use. Overall, prevalence of current and ever use of SLT is high, and important differences exist by sex. Future studies are needed to better understand SLT use patterns in South Asian communities in the US and to inform culturally relevant interventions aiming to decrease overall tobacco use.


Asunto(s)
Asiático , Uso de Tabaco/etnología , Tabaco sin Humo , Adolescente , Adulto , Anciano , Análisis de Varianza , Asia Occidental/etnología , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Prevalencia , Autoinforme , Estados Unidos , Adulto Joven
20.
Prev Chronic Dis ; 16: E106, 2019 08 08.
Artículo en Inglés | MEDLINE | ID: mdl-31400096

RESUMEN

Minority populations, including Asian Americans, face disparities in hypertension compared with non-Hispanic whites. This underscores the need for culturally adapted programs in settings that reach Asian American communities, such as faith-based organizations. We worked collaboratively with community partners to culturally adapt and implement an evidence-based community blood pressure monitoring program for Asian Americans (Asian Indians, Koreans, Filipinos, and Bangladeshis) in metropolitan New York during 2015 and 2016. The program included regularly scheduled volunteer-led screening and counseling events with congregants at faith-based organizations. Among participants with complete 6-month data (n = 348), health-related self-efficacy significantly improved after 6 months, and systolic and diastolic blood pressure was significantly reduced in some subgroups; reductions were highest in participants who self-reported a previous diagnosis of hypertension. Among Asian Americans, faith-based programs may be a replicable, low-cost, sustainable way to increase health-related self-efficacy and decrease blood pressure, specifically among individuals with self-reported hypertension.


Asunto(s)
Asiático , Asistencia Sanitaria Culturalmente Competente/métodos , Atención a la Salud/métodos , Hipertensión , Servicios Preventivos de Salud , Asiático/psicología , Asiático/estadística & datos numéricos , Monitoreo Ambulatorio de la Presión Arterial/métodos , Monitoreo Ambulatorio de la Presión Arterial/estadística & datos numéricos , Emigrantes e Inmigrantes/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hipertensión/diagnóstico , Hipertensión/etnología , Hipertensión/prevención & control , Masculino , Área sin Atención Médica , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Servicios Preventivos de Salud/métodos , Servicios Preventivos de Salud/organización & administración , Evaluación de Programas y Proyectos de Salud , Autoeficacia
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