Racial differences in perception and experiences of adverse treatment by healthcare providers: A cross-sectional analysis of the All of Us data

Health disparities among racial and ethnic groups in the U.S. are well documented. Among the non-medical issues, including discrimination, language barriers, and low health literacy, the patient-provider relationship has been identified as a factor that drives health disparities. Negative interactions with healthcare providers and the healthcare system produce poor health outcomes, exacerbating health inequalities and reducing the likelihood of patients adhering to recommended treatments and therapies. The purpose of this study was to examine racial differences in perceptions and experiences of adverse treatment by healthcare providers. A cross-sectional analysis of select variables from the All of Us research program basic and social determinants of health survey data. The study sample included 57,107 participants, 60% were females, and 83% were white. There were significant differences in the perceptions of provider treatment between Whites and Blacks. The data revealed that in all categories, Blacks perceived their experience as negative or less favorable compared to White respondents. These findings may spur interest in fostering and strengthening the patient-provider relationship and increasing awareness of and eliminating practices that demoralize and devalue the patient, particularly those of differing backgrounds

Determining the Efficacy of the Community Research Fellows Training: An 18-Month Evaluation

Community members equipped with knowledge, training, resources, and opportunity acquired through structured research educational programs can strengthen the research relationship and improve the process for community-based participatory research. The purpose of this research is to explore the sustained efficacy of the Mississippi Community Research Fellows Training conducted by the 18-month post-completion of the first cohort. A mixed method approach that included fielding a brief survey and having a focus group discussion among fellows was applied to the study to determine impact, value, and utility of skills learned. Seventeen of the 25 Cohort 1 fellows completed an online survey. Six participated in a focus group. The participants recognized the relevancy of the skills acquired and had applied their training to forge new collaborations with researchers and community organizations and contributed to the acquisition of resources for their communities and disseminated culturally appropriate health information to the residents. Recommendations for the future training programs were identified. The findings could ensure the long-term utility of the lessons and skills learned

Increasing Research Capacity In Underserved Communities: Formative and Summative Evaluation and Summative Evaluation of the Mississippi Community Research Fellows Training Program (Cohort 1)

Background: The Mississippi Community Research Fellows Training Program (MSCRFTP) is a 15-week program conducted in Jackson, MS, USA consisting of training in the areas of evidence-based public health, research methods, research ethics, and cultural competency. The purpose of the program was to increase community knowledge and understanding of public health research, develop community-based projects that addressed health disparity in the participants’ community, increase individual and community capacity, and to engage community members as equal partners in the research process. Methods: A comprehensive evaluation of the MSCRFTP was conducted that included both quantitative and qualitative methods. All participants were asked to complete a baseline, midterm, and final assessment as part of their program requirements. Knowledge gained was assessed by comparing baseline assessment responses to final assessment responses related to 27 key content areas addressed in the training sessions. Assessments also collected participants’ attitudes toward participating in research within their communities, their perceived influence over community decisions, and their perceptions of community members’ involvement in research, satisfaction with the program, and the program’s impact on the participants’ daily practice and community work. Results: Twenty-one participants, the majority of which were female and African-American, completed the MSCRFTP. Knowledge of concepts addressed in 15 weekly training sessions improved significantly on 85.2% of 27 key areas evaluated (p \u3c 0.05). Two mini-grant community based participatory research projects proposed by participants were funded through competitive application. Most participants agreed that by working together, the people in their community could influence decisions that affected the community. All participants rated their satisfaction with the overall program as “very high” (76.2%, n = 16) or “high” (23.8%, n = 5). Conclusion: The evaluation of the MSCRFTP demonstrates that participants have the necessary knowledge to engage as research partners, and the pilot projects provided an opportunity for application of this objective to be realized. Overall, the MSCRFTP was an intervention that assisted community members in identifying their communities’ strengths and weaknesses, interpret knowledge in a meaningful way, and create a self-reflective community of inquiry for change

Factors Associated with History of Unintended Pregnancy Among Mothers in Mississippi

Background: Mississippi has the highest rate of unintended pregnancy in the nation. Accessibility, availability, and affordability of women’s health services and effective contraceptive methods are key in preventing unintended pregnancies. Purpose: The purpose of this study was to identify factors associated with history of unintended pregnancy among parous women of childbearing age in Mississippi in order to improve understanding of these relationships and to fill a gap in literature about the state. Methods: Through a multi-stage, probability sample, mothers of students in childcare facilities were selected to participate in a survey about health care and contraceptive use. Chi-square tests of independence were used to detect associations between history of unintended pregnancy and other factors. Results: Significant associations were found between history of unintended pregnancy and race, employment status, household income, current receipt of public assistance, age at first birth, payer for women’s health services/birth control, impact of insurance/expenses on birth control, one locus of control item, and length of gestation of firstborn. Conclusion: The women most at risk of an unintended pregnancy in our sample were those who were currently experiencing socioeconomic inequities. Policymakers should strive to address such inequities in order to reduce the unintended pregnancy rate in Mississippi

Designing a Community Engaged Training Program for African American and Latinx Communities on COVID-19 in South Mississippi: Results from Qualitative Focus Groups Exploring Community Member Perceptions

Objective: The purpose of this study was to explore attitudes and perceptions on COVID awareness and education among African American and Latinx community members and stakeholders in South Mississippi through qualitative methods. Design: Virtual focus groups were conducted in Forrest, Hancock, Harrison, Hinds, and Jackson Counties through Zoom meetings. Community residents and stakeholders (N=56 total) participated. Zoom meetings were audio and video recorded, transcribed, and analyzed utilizing thematic analysis. A demographic survey was also administered. Results: Knowledge about COVID 19, vaccines, attitudes towards and beliefs about preventing COVID-19, intentions to prevent COVID-19, information seeking on COVID-19 preventative behaviors, and impact of COVID were identified as themes. Conclusion: Themes identified were consistent with other underserved areas in the South and provided key topics for development of Community Health Advisor training session curriculum

A survey tool for measuring evidence-based decision making capacity in public health agencies

BACKGROUND: While increasing attention is placed on using evidence-based decision making (EBDM) to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. METHODS: Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA) to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability) in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. RESULTS: In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. CONCLUSIONS: The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence-based. The survey can serve as a valuable tool for other health departments and non-governmental organizations to assess EBDM capacity within their own workforce and to assist in the identification of approaches that will enhance the uptake of EBDM processes in public health programming and policymaking. Localized survey findings can provide direction for focusing workforce training programs and can indicate the types of incentives and policies that could affect the culture of EBDM in the workplace

The Perceptions and Lived Experiences of African-American Pastors at the Onslaught of the COVID-19 Pandemic in Mississippi

The purpose of this phenomenological study was to explore perceptions and lived experiences of African-American pastors addressing the onslaught of COVID-19 with their congregation. Thirty-seven pastors representing various denominations from across Mississippi participated in semi-structured, in-depth interviews. From the data, five themes emerged including (1) Pastors’ relentlessness, (2) Pastors’ adoption of new technology, (3) Maximized social capital, (4) Unintended consequences resulting from COVID-19, and (5) Unintended benefits resulting from COVID-19

Test to Protect Family and Self—A Hepatitis B Screening and Care-Linkage Initiative In the Coastal Mississippi Vietnamese Community

Although Asian Americans and Pacific Islanders represent less than 5% of the U.S. population, they represent approximately half of all people living with chronic hepatitis B virus (HBV). Harrison, Hancock, and Jackson counties are home to the largest portion of Vietnamese individuals in Mississippi, and have high prevalence rates of HBV. Most people living with HBV do not know they are infected. In 2015, Mississippi State Department of Health began a five-year initiative to implement system-level, evidence-based, community-informed strategies to address HBV in the Vietnamese population of Harrison, Hancock, and Jackson Counties of Mississippi’s Gulf Coast region. Presented are results from focus groups conducted with the Vietnamese population that define health issues affecting the Vietnamese community, health care services availability, and knowledge, beliefs, and attitudes regarding HBV and screening. Findings from the focus groups were used to develop a culturally and linguistically tailored HBV screening and care-linkage initiative for the prioritized population

Engaging African American Pastors in COVID-19 Research During a Pandemic: Lessons Learned

African American pastors are recognized as trusted information sources for their communities. The pastors willing to address health-related concerns such as preventing the spread of the coronavirus are invaluable for leading their congregation through relevant health programs. Underlining the importance of religion, spirituality, and faith-based leaders in addressing and furthering health promotion research, the article discusses lessons learned during the study implementation and the recommendations for engaging minority pastors in research during a global health pandemic

Investing in Gulfport: Development of an Academic-Community Partnership to Address Health Disparities

Background: Invest Health, a collaboration between the Robert Wood Johnson Foundation and The Reinvestment Fund, selected 50 midsized cities to participate in a health initiative that encourages cross-sector alliances to think creatively about mechanisms that address barriers to reducing health disparities among low-income populations. Gulfport, Mississippi, was 1 of 50 teams chosen to participate. Objective: To develop an academic–community partnership among the University of Southern Mississippi, Coastal Family Health Center (CFHC), Mercy Housing and Human Development (MHHD), the Mississippi State Department of Health Office of Health Disparity Elimination, and Gulfport residents to create the Healthy Gulfport Initiative, and, ultimately, the Gulf Coast Healthy Communities Collaborative (GCHCC). Methods: A Gulfport City team was developed per Invest Health guidelines and included five individuals who represented the public sector, community development, and an academic or health-related anchor institution in the community. Several data sources were used to develop city-wide priority health outcomes. A priority neighborhood experiencing health disparities related to the priority health outcomes was identified. A community-engaged needs assessment was conducted in the priority neighborhood. Residents were engaged in prioritizing the health, education, and activity needs of their community via a participatory nominal group process and survey data collection. Results: Residents in the priority neighborhood lack access to health care and healthy food options owing to transportation difficulties and proximity to resources. Conclusions: The GCHCC will be established to act as a backbone organization, so that a common agenda can be created with an emphasis on potential for collective impact