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At least 19 recordsLinked to original sources
PubMed1994

A systematic review of the Journal of the National Medical Association 1992.

An analysis of the articles published in 1992 in the Journal of the National Medical Association (JNMA) was performed to assess the content, statistical analysis, and the profile of its contributors. Seventy-six articles were reviewed. The majority of the articles focused on biomedical aspects of health; however, a significant proportion of the remaining articles contained information on the psychosocial aspects of health as it relates to people of African descent in the United States, Africa, and the Caribbean. Most of the literature was derived from physicians in university settings, with the contributions from traditionally black medical schools constituting nearly 30% of the articles. Analysis of data from contingency tables was the most common research method used. This study suggests that the JNMA is contributing to the mission of the National Medical Association. Reasons why authors who perform research with more rigorous scientific method do not publish in JNMA should be explored.

Black or African American↗
PubMed2002

Tobacco control: consensus report of the National Medical Association.

ISSUES: Tobacco Control remains one of the greatest determinants for reducing the morbidity and mortality of African Americans. OBJECTIVE: To examine the scope and consequences of tobacco use among African Americans and characterize its implications for the National Medical Association physician membership and their patients, and identify policy, education, advocacy and research issues in Tobacco Control for the organization. CONSENSUS PROCESS: Literature review using the MEDLINE database from January 1966 to August 1999 Week 1, searching Medical Subject Heading (MeSH) reading combined with text words "Black" or "African American" and "Tobacco" as a search term, identified 130 articles/110 abstracts published between 1988 and February 1999. The panel selected 61 appropriate articles and a paper summarizing the literature review was developed. The summary paper was used as background material for a formal consensus panel discussion on July 16-17, 1999. Consensus among committee members was reached via mail, fax and e-mail using the summary review paper, annotated bibliographies key informant surveys, and previous NMA resolutions on tobacco control. A formal working session was held on July 16-17, 1999 in which four areas of concentration of issues were determined: Policy, Advocacy, Education and Research. All committee members approved the final report. SUMMARY: Because tobacco control issues in African Americans are both complex and poorly understood, the panel views the NMA's role as pivotal in the coordination of resources and capacity-building to address all four areas identified. Stronger partner-ships with traditional federal and nonprofit agencies associated with tobacco control/advocacy in African Americans as well as nontraditional organizations (i.e., churches, academia, marketing and media organizations) also must occur to strengthen the infra-structure needed to assess needs, design appropriate interventions and evaluate the appropriateness, effectiveness and efficacy of tobacco control efforts in African American communities.

Black or African American↗
PubMed1999

Recruiting minority cancer patients into cancer clinical trials: a pilot project involving the Eastern Cooperative Oncology Group and the National Medical Association.

PURPOSE: Minority accrual onto clinical trials is of significant interest to cooperative oncology study groups. The Eastern Cooperative Oncology Group (ECOG) conducted a study to identify barriers and solutions to African American accrual onto clinical trials. METHODS: We hypothesize that the National Medical Association (NMA) might provide insight into ways to increase minority participation and that ECOG might facilitate that participation. Four sites were selected in which NMA chapters existed and ECOG main institutions with less than half of the corresponding percentage of minorities in their communities entered trials for 1992. Fifteen workshops were conducted using discussions and open-ended, self-administered questionnaires. RESULTS: Seventy percent of NMA physicians cited mistrust of the research centers, fear of losing patients, and a lack of respect from ECOG institutions as the most important barriers to minority cancer patient referrals, compared with 30% for ECOG physicians. Sixty-nine percent of NMA and 43% of ECOG physicians cited a lack of information about specific trials. Nearly half of NMA physicians (47%) cited a lack of minority investigators as a barrier, compared with 4% of ECOG physicians. Solutions by both groups were improved communication (73%) and culturally relevant educational materials (40%). ECOG physicians cited more minority outreach staff as a potential solution (22% v 6%). NMA physicians cited increased involvement of referring physicians (44% v4%). CONCLUSION: NMA physicians who serve a significant sector of the African American population demonstrated a willingness to participate and work with a cooperative group effort to increase participation of minority patients and investigators.

Clinical Trials as Topic↗
PubMed2002

The role of the African-American physician in reducing traffic-related injury and death among African Americans: consensus report of the National Medical Association.

ISSUE: Traffic-related injuries and fatalities disproportionately affect the African American community. These high rates of traffic-related death and injury among African Americans manifest in multiple areas of traffic safety, including: Failure to use seat belts and child restraints. High incidence of alcohol-impaired driving. Failure to follow child passenger and seat belt safety laws and recommendations. High rates of pedestrian accidents, ofen brought on by impairments of drivers and/or pedestrians. Research indicates that national public information campaigns, with general messages only slightly modified for African American audiences, have not been culturally appropriate or effective in changing traffic safety behavior. In addition, traditional distribution mechanisms for these messages have not effectively reached the target population. Evidence suggests that in the African American community, there is a pervasive lack of knowledge of the devastating impact of traffic-related accidents on the overall health status of the community. This lack of information has resulted in a tragic cycle, in which parents fail to model safe operation of motor vehicles, and generation after generation copy this behavior, increasing the community's vulnerability to serious injuries and untimely deaths. This trend toward improper traffic safety habits among African Americans persists despite federal, state and local laws to enforce and promote sound traffic safety practices. OBJECTIVE: To study the existence of disparities in traffic-related injury and death among African Americans and to determine what kinds of traffic safety messages and campaigns will be effective in encouraging African Americans to respond to safety laws in sufficient numbers to reduce the disproportionately high rate of injury and death. Traffic safety issues were examined to effectively recommend policy, address barriers, best practices, and intervention strategies for the National Medical Association, its physician members, their patients, and their communities. CONSENSUS PROCESS: A literature review, driven by research instruments from numerous organizations included reports and materials from the National Highway Traffic Safety Administration (NHTSA), American Academy of Pediatrics, National Committee for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention (CDC), Mothers Against Drunk Driving (MADD), and the National SAFE KIDS Campaign. Both the Meharry Medical College report, Achieving a Credible Health and Safety Approach to Increasing Seat Belt Use Among African-Americans, and the U.S. Department of Transportation's Blue Ribbon Panel to Increase Seat Belt Use Among African Americans: A Report to the Nation, provided substantial background for the panel. More than 60 pieces of traffic safety literature have been examined to date. Based on the literature review, a short list of the most relevant issues affecting African Americans and traffic safety was devised. It includes: The disproportionately high rate of traffic-related injury and death among African Americans. The cost in health, monetary costs and other associated costs of traffic safety accidents and injuries. The number of traffic-related injuries and deaths that could be prevented if more African Americans observed good traffic safety practices. Barriers to practicing good traffic safety habits among African Americans. Failure of laws and public information campaigns to influence improved traffic safety practices among African Americans sufficient to reduce disparities in traffic-related injury and death. In July 2001, NMA convened a consensus panel of experts in St. Thomas, U.S. Virgin Islands, to review a briefing document summarizing the most salient traffic safety issues among African Americans. The panel elaborated on key issues, including existing policy and standards for the use of child restraint devices to secure infants and toddlers, existing data regarding disparities in traffic-related injury and death among African Americans, and the cultural, age and developmental appropriateness of existing safety campaigns. SUMMARY: Public information campaigns have successfully improved traffic safety practices among the general public but in large part have been unsuccessful among minority populations-including African Americans. This may be due to: A failure to use techniques and messages that are culturally sensitive to African Americans. Campaigns that have targeted geographic and social centers where African Americans are not broadly present. Lack of awareness of the disproportionate effect motor vehicle crashes are having on African Americans. Scientifically based, culturally appropriate intervention strategies need to be devised and implemented by African American institutions and organizations to improve traffic safety practices and reduce the high rate of traffic-related injury and deaths among African Americans.

Accidents, Traffic↗
PubMed2002

Practitioner policies and beliefs and practice immunization rates: a study from Pediatric Research in Office Settings and the National Medical Association.

OBJECTIVE: To identify vaccination policies and beliefs associated with practice immunization rates (PIR) among office-based pediatricians. METHODS: Primary care pediatricians recruited from the Pediatric Research in Office Settings (PROS) network of the American Academy of Pediatrics or the Pediatric Section of the National Medical Association abstracted immunization data from a consecutive sample of children who were 8 to 35 months old and seen in the office for any reason; 1 provider per practice collected this information. PIR were determined at 8 and 19 months of age by calculating the percentage of children in the sample who were fully immunized at that age. Before collecting the immunization data, all practitioners in each participating practice completed a questionnaire detailing his or her policies and beliefs regarding the administration of vaccines. Part of the questionnaire was a scenario involving a 4-month-old child who was due for a diphtheria-tetanus-acellular pertussis immunization at a health supervision visit. A list of 13 possible clinical conditions in this hypothetical patient were presented; practitioners were asked which of these were a contraindication to vaccination. One set of policies and beliefs was computed for each practice using a weighted average of the responses of each provider in a particular practice. Regression analyses were used to assess the association between each policy and belief and PIR at 8 and 19 months, after controlling for potentially confounding sociodemographic characteristics. RESULTS: Data were analyzed from 112 practices; median PIR at 8 and 19 months were 85% and 71%, respectively. The following policies and beliefs were not statistically associated with PIR at either 8 or 19 months: use of acute visits for vaccinations, conducting an immunization audit within the previous 12 months, perceived difficulties in implementing new vaccine recommendations or staying informed about new recommendations, conducting practice meetings to discuss immunization policies, perception of profitability of providing vaccinations, appointment reminders for scheduled visits, and specific tracking mechanisms for patients who are due for or behind in immunizations. After controlling for sociodemographic characteristics, recommending inactivated poliovirus vaccine and having fewer contraindications to vaccination were associated with statistically higher PIR at 8 months and 19 months. Increasing the maximum number of injections administered at 1 visit was associated with a higher PIR at 8 months but not 19 months of age. CONCLUSION: Policies and beliefs linked to many official recommendations for increasing immunization rates were not associated with higher PIR. However, accepting fewer contraindications to vaccination, administering all vaccines for which an infant is eligible at each health supervision visit, and adopting recommended changes in immunization schedules may help providers fully vaccinate a higher percentage of their patients.

Attitude of Health Personnel↗
PubMed2006

The bridge to diversity: the role of the National Medical Association and the African-American physician.

Three major reports confirming the presence of health disparities have made significant recommendations toward their elimination. One of the major recommendations is to increase the number of African-American and minority physicians. These recommendations come at a time when some communities are experiencing a physician shortage and some are forecasting a nationwide physician shortage. The National Medical Association and members of the African-American and minority physician community are in the best position to bring the necessary parties together to address this issue on local and national levels. Are we ready to respond to the call to action?

Black or African American↗
PubMed1995

National Medical Association Surgical Section position paper on violence prevention. A resolution of trauma surgeons caring for victims of violence.

The epidemic of intentional injury continues to be a leading cause of premature death in America. The ravages of violence are particularly devastating within the minority community. With this position paper from the Surgical Section of the National Medical Association (the country's oldest and largest organization of minority physicians), a group of trauma surgeons and surgical intensivists resolve to focus on underused violence prevention opportunities and to extend their spheres of influence beyond the walls of their institutions and emphasize violence prevention activities.

Humans↗
PubMed2001

Impact of the change to inactivated poliovirus vaccine on the immunization status of young children in the United States: a study from pediatric research in office settings and the National Medical Association.

OBJECTIVE: To determine whether the change from an all oral poliovirus vaccine (OPV) schedule to an inactivated poliovirus vaccine (IPV)-containing schedule has adversely affected the immunization status of young children in the United States. METHODS: Immunization data were abstracted from the medical records of children 8 to 35 months old seen consecutively for any reason in the offices of practicing pediatricians who are members of the Pediatric Research in Office Settings network of the American Academy of Pediatrics or the National Medical Association. Data on up to 120 eligible children were collected in each practice between March 1998 and January 2000. Patients were classified as fully immunized at 8 months old if they had received 3 diphtheria-tetanus-pertussis, 2 Haemophilus influenzae type b, 2 hepatitis B, and 2 poliovirus vaccines. Study children who were >/=12 months of age at the time that data were collected were categorized as being fully immunized at 12 months if they had received the same vaccines before their first birthday. To assess the effect of type of poliovirus vaccines on these outcomes, study patients were classified as being in an IPV or OPV group based on the initial type of vaccine received. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for IPV as a predictor of being fully immunized at 8 and 12 months of age, after adjusting for race/ethnicity of the patient, maternal education level, year of birth, and method of payment for vaccines. In addition, the effect of clustering of children within practices was accounted for by the use of generalized estimation equation techniques. RESULTS: Data were analyzed on 13 520 children from 177 practices in 42 states; 79.4% of patients were fully immunized at 8 months of age, and 88.7% of those eligible were fully immunized at 12 months of age. A total of 6910 patients (51.1%) were classified as OPV recipients, wheras 5282 (39.1%) received IPV. In addition, 1328 children (9.8%) were documented as having received poliovirus vaccine, but the particular type could not be determined. Compared with OPV recipients and after controlling for the confounding variables and the effect of clustering within practices, children in the IPV group were as likely as were OPV recipients to be fully immunized at 8 months of age (OR: 1.04; 95% CI: 0.88,1.23). At 12 months of age, the OR for IPV as a predictor of being fully immunized was 1.08 (95% CI: 0.90,1.30). When compared with OPV recipients, adjusted ORs for children in the undetermined poliovirus vaccine type group being fully immunized at 8 and 12 months of age were 0.84 (95% CI: 0.68,1.04) and 0.84 (95% CI: 0.67,1.07), respectively. CONCLUSIONS: The results of this national study indicate that the implementation of an IPV-containing poliovirus vaccine schedule has not had an adverse effect on the immunization status of young children who were vaccinated in the offices of practicing pediatricians.

Child, Preschool↗
PubMed1990

Comments from the National Medical Association concerning a "white paper" on proposed strategies for fulfilling primary care manpower needs.

The NMA has long had the participation and leadership of those in primary care and those who practice in medically underserved or medically indigent areas. We, therefore, are most supportive of the objectives and goals you have presented. We have offered suggestions to strengthen your "White Paper" by emphasizing the vital nature of the current and future role of primary health care delivery; by stating the effects that changes in physician reimbursement, especially utilizing the Relative Value Scale, will have on the expectations of those who are considering primary care; by continuing to offer scholarship assistance and loan forgiveness to those who are willing to commit during their medical education to a primary care career through the NHSC; by making a priority the effort to recruit older physicians by providing well-defined incentives, including liability relief; and by emphasizing the continued recruitment, retention, and encouragement of minority and disadvantaged applicants entering health care careers and stressing the support they must receive to be able to afford to practice in underserved areas. The National Medical Association welcomes the chance to undertake any collaborative efforts which may aid our mutual missions. Therefore, we are willing to assist you in helping to solve the critical need for primary care physicians in medically underserved communities.

Black or African American↗
PubMed2002

Association between parents' preferences and perceptions of barriers to vaccination and the immunization status of their children: a study from Pediatric Research in Office Settings and the National Medical Association.

OBJECTIVES: To assess the association between parents' perceptions of various barriers to vaccination and their preferences regarding specific strategies designed to reduce missed vaccination opportunities and the immunization status of their children and to estimate the overall contribution of the perception of barriers on underimmunization among children who are vaccinated in pediatricians' offices. METHODS: As part of a nationwide study on the immunization status of children followed by practicing pediatricians, parents of children who were 8 to 35 months of age and seen consecutively at 177 participating practice sites completed a survey on health beliefs regarding the vaccination process. In addition to demographic information, parents were asked to identify the most difficult thing about obtaining immunizations, as well as their preferences regarding the maximum number of vaccine injections that should be administered to their child at 1 visit and for receiving a needed immunization during an office visit for a mild illness. Immunization data on study children were abstracted from the practice medical record, and specific survey responses for each parent were compared with the immunization status of his or her child at 8 months of age using chi2 tests. For parental health beliefs associated with immunization status by bivariate analyses, the relative risks for underimmunization and population-attributable risk percentages of each belief were calculated after potentially confounding variables were adjusted for. RESULTS: Immunization data were collected on 13 520 children; 13 516 parents responded to at least 1 question regarding vaccination health beliefs. Two thirds of the responding parents indicated that their child should receive no more than 2 immunizations at 1 visit. However, there was no difference in the preferred maximum number of vaccines between parents of children who were fully immunized at 8 months of age and those of underimmunized children. Similarly, there was no difference in a stated preference for receiving a needed immunization during an illness visit. Overall, 74% of respondents indicated that there was "nothing" difficult about obtaining vaccines for their children. The most commonly cited barrier was concern about the side effects of vaccines, identified by 22.6% of parents. However, this barrier was not associated with immunization status. Each of the remaining barriers-including the confusing vaccination schedule, expense of vaccines, the inconvenience of the vaccination process, having a child who was often too ill to receive vaccines, religious objections, and other identified barriers-was statistically associated with immunization status, with adjusted relative risks for underimmunization ranging from 1.42 to 3.04. However, because each of these barriers was identified as important by <5% of parents, the population-attributable risk percentage for each was < or =2.5%. Overall, it was estimated that parental perception of barriers associated with immunization status accounts for 8.0% of the underimmunization observed among children who are vaccinated in the offices of primary care pediatricians. CONCLUSIONS: Parental preferences regarding vaccination practices designed to reduce missed opportunities were not associated with the immunization status of their children. Although several barriers to vaccination were associated with immunization status, individual barriers were identified by a small minority of parents. Overall, parental perceptions of barriers to vaccination do not seem to be a significant cause of underimmunization in this population of children.

Attitude to Health↗