Collection of legal status information: caution!
Explore the source record for details and available documents.
Confidentiality↗
Biomedical subjects
Olivia Carter-Pokras
Publications and source records attributed to Olivia Carter-Pokras.
Surveying free and low-cost survey software.
Surveys are widely used to gather health information from a sample of individuals. This brief report reviews 14 free and low-cost software packages (< dollar 1,000) that can be used when conducting health surveys with a limited budget. Information available on the Internet or directly from the provider in response to inquiry was reviewed for key features used by health survey researchers. Many free or low-cost software options appropriate for questionnaire development are readily available. Questionnaire mode and complexity, data management and analytical needs, and computing environment are all important considerations in selecting survey software.
Costs and Cost Analysis↗
Stakeholder views regarding cultural diversity teaching outcomes: a qualitative study.
BACKGROUND: Cultural diversity teaching is increasingly present in both undergraduate and postgraduate training programmes. This study explored the views of stakeholders in medical education about the potential outcomes of cultural diversity teaching and how they thought cultural diversity programmes might be effectively evaluated. METHODS: A semi-structured interview was undertaken with 61 stakeholders (including policymakers, diversity teachers, students and users). The data were analysed and themes identified. RESULTS: Many participants felt that clinical practice was improved through 'cultural diversity teaching' and this was mostly as a result of improved doctor-patient communication. There was a strong view that service users need to participate in the evaluation of outcomes of cultural diversity teaching. CONCLUSION: There is a general perception, rather than clear evidence, that cultural diversity teaching can have a positive effect on clinical practice. Cultural diversity teaching needs to be reviewed in undergraduate and postgraduate medicine and better evaluation tools need to be established.
Adult↗
Methodological issues in measuring health disparities.
OBJECTIVES: This report discusses six issues that affect the measurement of disparities in health between groups in a population: Selecting a reference point from which to measure disparity. Measuring disparity in absolute or in relative terms. Measuring in terms of favorable or adverse events. Measuring in pair-wise or in summary fashion. Choosing whether to weight groups according to group size. Deciding whether to consider any inherent ordering of the groups. These issues represent choices that are made when disparities are measured. METHODS: Examples are used to highlight how these choices affect specific measures of disparity. RESULTS: These choices can affect the size and direction of disparities measured at a point in time and conclusions about the size and direction of changes in disparity over time. Eleven guidelines for measuring disparities are presented. CONCLUSIONS: Choices concerning the measurement of disparity should be made deliberately, recognizing that each choice will affect the results. When results are presented, the choices on which the measurements are based should be described clearly and justified appropriately.
Data Collection↗
Re: "Four-year review of the use of race and ethnicity in epidemiologic and public health research".
Explore the source record for details and available documents.
Bibliometrics↗
Racial differences in clinical presentation of patients with sleep-disordered breathing.
We characterized differences in severity, presentation, and treatment compliance in sleep-disordered breathing (SDB) between African Americans (AA) and Caucasians (W). We retrospectively analyzed demographics, proxy measures of socioeconomic position, concurrent illness, presenting complaints, polysomnographic data including respiratory disturbance index (RDI) and time less than 90% O2 saturation (T90), and acceptance of and long-term compliance with CPAP therapy. Over 1 year there were 128 AA, 102 W, and 3 "other." AA were younger (44.9+/-14.1 vs. 49.2+/-14.5 years; P=0.022), had greater body mass index (BMI) (39.7+/-10.7 vs. 33.4+/-9.2 kg/m2; p<0.0001), and reported lower estimated median household income (MHI) than W ($33,365+/-15,236 vs. $52,641+/-20,209; p<0.0001). OSA was more severe among AA: (median RDI: AA 32.9, W 29.1 events/h; p=0.008; median T90: AA 17.6 vs. W 5.3 per minute; P=0.006). However, after adjustment for BMI and MHI, differences between AA and W in RDI were not significant. Equal frequencies of AA and W accepted and were compliant with CPAP. We conclude that while AA present with more severe OSA than W this was accounted for by factors known to influence OSA severity. Further, there were no racial differences in accepting and adhering to therapy with CPAP.
Adolescent↗
Improving health insurance coverage for Latino children: a review of barriers, challenges and State strategies.
OBJECTIVES: To summarize key findings on disparities in health insurance coverage for latino children, to present selected socioeconomic and healthcare access indicators for the nine states with latino populations over 500,000, and to recommend state strategies to increase public health insurance coverage for latino children. METHODS: Literature review performed on latino children and health insurance coverage, key informant interviews with frontline service providers, review of outreach sections of eight state 1115 waiver requests approved by the Secretary of the U.S. Department of Health and Human Services, and national and state data compiled on sociodemographic and healthcare access indicators for nine states with the largest latino populations. RESULTS: Eligibility and enrollment into Medicaid and State Children's Health Insurance Program (SCHIP) are hindered by financial, nonfinancial, and social policy barriers. Disparities in insurance and access indicators show that lack of parental employment-linked benefits, procedural barriers to enrollment, and lack of clarification on eligibility for children of noncitizen parents are associated with low levels of insurance coverage among latino children. CONCLUSION: To state strategies consistent with the overarching goal of Healthy People 2010 to eliminate health disparities can increase health insurance coverage for children of low-wage latino workers.
Child↗
Healthcare disparities and models for change.
With Healthy People 2010 making the goal of eliminating health disparities a national priority, policymakers, researchers, medical centers, managed care organizations (MCOs), and advocacy organizations have been called on to move beyond the historic documentation of health disparities and proceed with an agenda to translate policy recommendations into practice. Working models that have successfully reduced health disparities in managed care settings were presented at the National Managed Health Care Congress Inaugural Forum on Reducing Racial and Ethnic Disparities in Health Care on March 10-11, 2003, in Washington, DC. These models are being used by federal, state, and municipal governments, as well as private, commercial, and Medicaid MCOs. Successful models and programs at all levels reduce health disparities by forming partnerships based on common goals to provide care, to educate, and to rebuild healthcare systems. Municipal models work in collaboration with state and federal agencies to integrate patient care with technology. Several basic elements of MCOs help to reduce disparities through emphasis on preventive care, community and member health education, case management and disease management tracking, centralized data collection, and use of sophisticated technology to analyze data and coordinate services. At the community level, there are leveraged funds from the Health Resources and Services Administration's Bureau of Primary Health Care. Well-designed models provide seamless monitoring of patient care and outcomes by integrating human and information system resources.
Cultural Diversity↗
Providing linguistically appropriate services to persons with limited English proficiency: a needs and resources investigation.
Increasing numbers of persons in the United States cannot speak, read, write, or understand the English language at a level that permits them to interact effectively. These limitations can hamper encounters between patients and healthcare providers, often leading to misunderstandings as to diagnosis and treatment, which in turn may result in poor patient compliance, unsatisfactory outcomes, and increased costs. A questionnaire was developed and distributed to clinical practice managers at the University of Maryland School of Medicine to assess the needs for language interpretation services and resources among clinical faculty providing healthcare to persons with limited English proficiency (LEP). Literature review, search of key Web sites, and consultation with national experts on issues pertaining to language access, health services, and reimbursement strategies also were done. Then, recommendations regarding the costs and benefits of language interpretation in healthcare settings were developed. Because recipients of federal financial assistance from the Department of Health and Human Services must provide meaningful access to persons with LEP at no cost to the client, there are clear benefits to providing language interpretation. Providers and managers should be made aware of interpretation service options and cost-saving strategies.
Communication↗
The health of Latino children: urgent priorities, unanswered questions, and a research agenda.
Latinos recently became the largest racial/ethnic minority group of US children. The Latino Consortium of the American Academy of Pediatrics Center for Child Health Research, consisting of 13 expert panelists, identified the most important urgent priorities and unanswered questions in Latino child health. Conclusions were drawn when consensus was reached among members, with refinement through multiple iterations. A consensus statement with supporting references was drafted and revised. This article summarizes the key issues, including lack of validated research instruments, frequent unjustified exclusion from studies, and failure to analyze data by pertinent subgroups. Latino children are at high risk for behavioral and developmental disorders, and there are many unanswered questions about their mental health needs and use of services. The prevalence of dental caries is disproportionately higher for Latino children, but the reasons for this disparity are unclear. Culture and language can profoundly affect Latino children's health, but not enough cultural competency training of health care professionals and provision of linguistically appropriate care occur. Latinos are underrepresented at every level of the health care professions. Latino children are at high risk for school dropout, environmental hazards, obesity, diabetes mellitus, asthma, lack of health insurance, nonfinancial barriers to health care access, and impaired quality of care, but many key questions in these areas remain unanswered. This article suggests areas in which more research is needed and ways to improve research and care of Latino children.
Asthma↗