scholarly journals Bridging health disparities: a national survey of ambulatory care pharmacists in underserved areas

2021 ◽  
Vol 19 (2) ◽  
pp. 2359
Author(s):  
Morgan P. Stewart ◽  
Rhianna Fink ◽  
Emily Kosirog ◽  
Joseph J. Saseen
Keyword(s):  
Rural Communities ◽  
Ambulatory Care ◽  
Minority Groups ◽  
Underserved Populations ◽  
Resident Training ◽  
Specialized Training ◽  
Clinical Pharmacists ◽  
Faculty Appointment ◽  
Pharmacist Workforce ◽  
Original Survey

Background: There is a shortage of primary care medical providers, particularly in rural communities and communities of racial and ethnic minority groups. Clinical pharmacists can help fill gaps in care among these vulnerable populations. Objective: To identify characteristics of ambulatory care pharmacists that pursue and maintain employment within underserved areas. Methods: An original survey was distributed nationwide to ambulatory care clinical pharmacists in underserved settings. Respondent characteristics were analyzed using descriptive statistics. Results: Of the 111 completed surveys, a majority of respondents were White, non-Hispanic, female, with English as their only spoken language. A majority of pharmacists completed a clinical experience or specialized training focused on underserved care prior to their position. The top three motivators for pharmacists accepting their clinical position as well as staying at their job were passion for caring for underserved populations, the presence of a faculty appointment, or the freedom and flexibility of advanced clinical roles. Conclusions: With a large majority of our respondents identifying as White and unilingual, there remains a large opportunity to increase diversity in the clinical pharmacy ambulatory care workforce caring for underserved populations. There is an observed correlation between early experiential or specialized training in underserved care and pharmacists pursuing employment in these areas. Thus, one potential long-term strategy to diversify and grow the ambulatory care clinical pharmacist workforce in underserved settings is for clinical practice sites to partner with colleges of pharmacy to recruit and maintain quality individuals who can meet the needs of diverse patient populations as well as expand student and resident training opportunities in underserved settings.

SSHAP In-Focus: COVID-19, Uncertainty, Vulnerability and Recovery in India

2020 ◽  
Author(s):  
Justin Pickard ◽  
Shilpi Srivastava ◽  
Mihir R. Bhatt ◽  
Lyla Mehta
Keyword(s):  
Rural Communities ◽  
Migrant Workers ◽  
Disaster Response ◽  
Minority Groups ◽  
Grey Literature ◽  
Mass Movement ◽  
Community Response ◽  
Vulnerable Groups ◽  
Ongoing Research ◽  
Informal Workers

This paper addresses COVID-19 in India, looking at how the interplay of inequality, vulnerability, and the pandemic has compounded uncertainties for poor and marginalised groups, leading to insecurity, stigma and a severe loss of livelihoods. A strict government lockdown destroyed the incomes of farmers and urban informal workers and triggered an exodus of migrant workers from Indian cities, a mass movement which placed additional pressures on the country's rural communities. Elsewhere in the country, lockdown restrictions and pandemic response have coincided with heatwaves, floods and cyclones, impeding disaster response and relief. At the same time, the pandemic has been politicised to target minority groups (such as Muslims, Dalits), suppress dissent, and undermine constitutional values. The paper focuses on how COVID-19 has intersected with and multiplied existing uncertainties faced by different vulnerable groups and communities in India who have remained largely invisible in India's development story. With the biggest challenge for government now being to mitigate the further fall of millions of people into extreme poverty, the brief also reflects on pathways for recovery and transformation, including opportunities for rural revival, inclusive welfare, and community response. This brief is based on a review of existing published and grey literature, and 23 interviews with experts and practitioners from 12 states in India, including representation from domestic and international NGOs, and local civil society organisations. It was developed for the Social Science in Humanitarian Action Platform (SSHAP) by Justin Pickard, Shilpi Srivastava, Lyla Mehta (IDS), and Mihir R. Bhatt. Some of the cases draw on ongoing research of the TAPESTRY project, which explores bottom-up transformations in marginal environments across India and Bangladesh.

Taking Social Cohesion to Task: Perceptions of Transgender Military Inclusion and Concepts of Cohesion

2019 ◽  
Author(s):  
Jennifer Spindel ◽  
Robert Ralston
Keyword(s):  
Political Ideology ◽  
General Public ◽  
Minority Groups ◽  
Us Military ◽  
The Us ◽  
Elite Level ◽  
Unit Effectiveness ◽  
Original Survey ◽  
The Impact ◽  
Unit Cohesion

Abstract Recent political debates over the inclusion of transgender servicemembers in the US military center around the impact such inclusion will have on unit cohesion and effectiveness. Missing from the debate, however, are the perceptions of those who do the soldiering. What are their perceptions of cohesion? Do they, like political leaders and the general public, believe unit cohesion leads to military effectiveness? In other words, how much does the narrative at the elite level—that insists excluding minority groups is a military necessity—match the perceptions of those who serve? Drawing on an original survey of 151 current and former members of the US military, our results suggest that servicemembers’ perceptions mirror those in the general public: political ideology is correlated with beliefs that minority groups disrupt unit cohesion. We find that conservatives are more likely to believe that the inclusion of transgender soldiers will negatively impact cohesion and undermine unit effectiveness. Moreover, conservatives are more likely to endorse a conceptualization of cohesion that hinges on the social—“people like me” or “band of brothers”—dynamics of cohesion rather than more professional, task-oriented conceptions of cohesion. However, military experience affects these perceptions: respondents with combat experience, who held/hold a higher rank, and who are currently serving are more likely to endorse a task-based conception of cohesion that ties cohesion to professionalism and competence, rather than social identity.

Service Learning in Health Care for Underserved Communities: University of Iowa Mobile Clinic, 2019

2020 ◽  
Vol 110 (9) ◽  
pp. 1304-1307
Author(s):  
Melissa L. Palma ◽  
Andrea Arthofer ◽  
Kristen M. Halstead ◽  
Joyce M. Wahba ◽  
Denise A. Martinez
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Service Learning ◽  
Low Income ◽  
Underserved Populations ◽  
Safety Net ◽  
Mobile Clinic ◽  
University Of Iowa ◽  
Basic Services ◽  
Source Of Care

The University of Iowa Mobile Clinic (UIMC) is an interdisciplinary student-run free medical clinic founded in 2002. UIMC provides free health screenings, education, and basic services to underserved populations in Iowa: immigrants, refugees, migrant farmworkers, individuals experiencing homelessness, low-income individuals, and people who live in rural communities. Forty-four percent of patients surveyed use UIMC as their only source of care. Ninety-seven percent of patients surveyed rate care as excellent or good. UIMC is a crucial safety net health care resource in Iowa to improve health equity.

Workload evaluation of clinical pharmacists in the ambulatory care setting

2020 ◽  
Author(s):  
Elizabeth Van Dril ◽  
Christine Schumacher ◽  
Mary Ann Kliethermes ◽  
Jill S. Borchert ◽  
Amy Buros Stein
Keyword(s):  
Ambulatory Care ◽  
Care Setting ◽  
Ambulatory Care Setting ◽  
Clinical Pharmacists

Perceived Benefits of Kripalu Yoga Classes in Diverse and Underserved Populations

2008 ◽  
Vol 18 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Angela Wilson ◽  
Kate Marchesiello ◽  
Sat Bir Khalsa
Keyword(s):  
Qualitative Data ◽  
Minority Groups ◽  
Underserved Populations ◽  
The Elderly ◽  
Perceived Benefits ◽  
Experience Teaching ◽  
Yoga Class ◽  
The Individual ◽  
Intention To Continue ◽  
Yoga Meditation

Objective: To determine if diverse and underserved populations report benefit from Yoga practices and report an intention to continue with Yoga, meditation, or breathing practices. Design: This was a retrospective study using archival data from exit questionnaires acquired at the end of Yoga programs serving diverse populations. Qualitative data was also collected from the Yoga teachers. Setting: Free Kripalu Yoga classes offered to diverse and underserved/underprivileged populations (e.g., minority groups, the elderly, gay populations), as part of the Teaching for Diversity (TFD) program through the Kripalu Center for Yoga and Health (KCYH). Participants: 220 participants, ranging in age from adolescence through old age. Measures: Nine questions about the perceived benefits and usefulness of Yoga practices in everyday life were administered to participants on the last day of class. Qualitative data was collected from teachers regarding their experience teaching underserved populations. Results: Of the 220 respondents, 89% reported that the Yoga class left them with a feeling of overall wellness, and 83% found the practices helpful. 98% reported that they would recommend this Yoga class to others. Participants found the individual Yoga components of the breathing, Yoga postures, and meditation practices effective and said they were useful in their daily life. Pairwise t-test comparisons of average scores between these three practices indicated that participants were more likely to rate breathing useful as compared to either the postures or meditation (p < 0.01). Conclusion: Diverse and underserved populations report benefit from and interest in Yoga, meditation, and breathing practices.

Incorporating a clinical oncology pharmacist into an ambulatory care pharmacy in pediatric hematology–oncology and transplant clinic: Assessment and significance

2020 ◽  
pp. 107815522093416
Author(s):  
Kashif Ali ◽  
Osama Al-Quteimat ◽  
Rida Naseem ◽  
Saima Mehmood Malhi ◽  
Mehwish wajdi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Ambulatory Care ◽  
Clinical Oncology ◽  
Marrow Transplantation ◽  
Beta Thalassemia ◽  
Genomic Profiling ◽  
Specialized Training ◽  
Pediatric Hematology ◽  
Hematological Cancers

Background Beta thalassemia patients, post-bone marrow transplant, and leukemia patients require long term therapy with an intense care follow-up especially for pediatric hematology–oncology origin. Emergence of side effects and noncompliance to therapy lead to reduced efficacy of medicines resulting in relapse of diseases. There is an increasing fact to support the incorporation of a pharmacist into clinical team due to their distinctive skills. Clinical oncology pharmacist with experience and specialized training in hematological cancers and bone marrow transplantation (BMT) patient care has in-depth knowledge and skills of chemotherapy regimens including drug information, monitoring parameters of cancer treatment, dose adjustment, drug–drug interactions, adverse effects, and patient counseling skills. Aim and objectives The main objective of our study was to assess the significance of incorporation of clinical oncology pharmacist in ambulatory care in pediatric hematology–oncology and transplant clinic. Material and method This study was conducted at National Institute of Blood Diseases and Bone Marrow Transplantation hospital with duration of five months from 17 March 2019 to 16 July 2019. In this study the clinical oncology pharmacist was made available at ambulatory clinic of hematology–oncology and transplantation. The activities performed by a clinical oncology pharmacist were observed by resident BMT clinical pharmacist during the visits of patients and their families in a clinic. The BMT pharmacist is a clinical oncology pharmacist with experience and specialized training in hematological cancers and BMT patient care. Only pediatrics patients with beta thalassemia major and those who were on chemotherapy treatment and post-transplant patient were included in this study. Results During the five months’ tenure, there were 1820 pediatric patients’ visits in total. The clinical oncology pharmacist performed 980 direct patient interviews and documented 1665 pharmacist interventions. The majority of the documented clinical oncology pharmacist interventions were review of medication histories (n: 404, 24%) and “deferiprone” dose adjustments (n:400, 24%). Genomic profiling interventions were also among the commonly reported activities by the clinical oncology pharmacist. For beta thalassemia patients undergoing hydroxyurea therapy, the genomic profiling was performed to assess whether the hydroxyurea treatment is clinically effective or not (n:396, 23%). Conclusion The involvement of clinical oncology pharmacist into a specialized outpatient clinic of hematology–oncology and transplant clinic plays an integral role in minimizing the adverse effect and reduction in readmission into the hospital. This is new expansion of pharmacist’s role especially in underdeveloped country, considering the relevant clinical participation of clinical oncology pharmacist into specialized clinic revealing through optimized therapy and future prospect of clinical oncology pharmacist in pediatric hematology.

scholarly journals Ambulatory monitoring promises equitable personalized healthcare delivery in underrepresented patients

2021 ◽  
Vol 2 (3) ◽  
pp. 494-510
Author(s):  
Kanchan Kulkarni ◽  
Rahul Kumar Sevakula ◽  
Mohamad B Kassab ◽  
John Nichols ◽  
Jesse D. Roberts ◽  
...  
Keyword(s):  
Rural Communities ◽  
Data Collection ◽  
Underserved Populations ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Ambulatory Monitoring ◽  
Physiological Data ◽  
Time Data ◽  
Health Technologies ◽  
Essential Components

Abstract The pandemic has brought to everybody’s attention the apparent need of remote monitoring, highlighting hitherto unseen challenges in healthcare. Today, mobile monitoring and real-time data collection, processing and decision-making, can drastically improve the cardiorespiratory–haemodynamic health diagnosis and care, not only in the rural communities, but urban ones with limited healthcare access as well. Disparities in socioeconomic status and geographic variances resulting in regional inequity in access to healthcare delivery, and significant differences in mortality rates between rural and urban communities have been a growing concern. Evolution of wireless devices and smartphones has initiated a new era in medicine. Mobile health technologies have a promising role in equitable delivery of personalized medicine and are becoming essential components in the delivery of healthcare to patients with limited access to in-hospital services. Yet, the utility of portable health monitoring devices has been suboptimal due to the lack of user-friendly and computationally efficient physiological data collection and analysis platforms. We present a comprehensive review of the current cardiac, pulmonary, and haemodynamic telemonitoring technologies. We also propose a novel low-cost smartphone-based system capable of providing complete cardiorespiratory assessment using a single platform for arrhythmia prediction along with detection of underlying ischaemia and sleep apnoea; we believe this system holds significant potential in aiding the diagnosis and treatment of cardiorespiratory diseases, particularly in underserved populations.

scholarly journals The synchronicity of COVID-19 disparities: Statewide epidemiologic trends in SARS-CoV-2 morbidity, hospitalization, and mortality among racial minorities and in rural America

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255063
Author(s):  
Brian E. Dixon ◽  
Shaun J. Grannis ◽  
Lauren R. Lembcke ◽  
Nimish Valvi ◽  
Anna R. Roberts ◽  
...  
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Urban Areas ◽  
Minority Groups ◽  
Mortality Rates ◽  
Urban Environments ◽  
Racial Minorities ◽  
Morbidity And Mortality ◽  
Multiple Time ◽  
Over Time

Background Early studies on COVID-19 identified unequal patterns in hospitalization and mortality in urban environments for racial and ethnic minorities. These studies were primarily single center observational studies conducted within the first few weeks or months of the pandemic. We sought to examine trends in COVID-19 morbidity, hospitalization, and mortality over time for minority and rural populations, especially during the U.S. fall surge. Methods Data were extracted from a statewide cohort of all adult residents in Indiana tested for SARS-CoV-2 infection between March 1 and December 31, 2020, linked to electronic health records. Primary measures were per capita rates of infection, hospitalization, and death. Age adjusted rates were calculated for multiple time periods corresponding to public health mitigation efforts. Comparisons across time within groups were compared using ANOVA. Results Morbidity and mortality increased over time with notable differences among sub-populations. Initially, hospitalization rates among racial minorities were 3–4 times higher than whites, and mortality rates among urban residents were twice those of rural residents. By fall 2020, hospitalization and mortality rates in rural areas surpassed those of urban areas, and gaps between black/brown and white populations narrowed. Changes across time among demographic groups was significant for morbidity and hospitalization. Cumulative morbidity and mortality were highest among minority groups and in rural communities. Conclusions The synchronicity of disparities in COVID-19 by race and geography suggests that health officials should explicitly measure disparities and adjust mitigation as well as vaccination strategies to protect those sub-populations with greater disease burden.

scholarly journals A day of immersive physiology experiments increases knowledge and excitement towards physiology and scientific careers in Native American students

2017 ◽  
Vol 41 (1) ◽  
pp. 137-144 ◽  
Author(s):  
Bryan K. Becker ◽  
Alicia M. Schiller ◽  
Irving H. Zucker ◽  
Eric A. Eager ◽  
Liliana P. Bronner ◽  
...  
Keyword(s):  
Native American ◽  
Native Americans ◽  
South Dakota ◽  
Minority Groups ◽  
Underserved Populations ◽  
Medical Center ◽  
Health Science ◽  
Stem Fields ◽  
Scientific Careers ◽  
And Mathematics

Underserved minority groups are disproportionately absent from the pursuit of careers in science, technology, engineering, and mathematics (STEM) fields. One such underserved population, Native Americans, are particularly underrepresented in STEM fields. Although recent advocacy and outreach designed toward increasing minority involvement in health care-related occupations have been mostly successful, little is known about the efficacy of outreach programs in increasing minority enthusiasm toward careers in traditional scientific professions. Furthermore, very little is known about outreach among Native American schools toward increasing involvement in STEM. We collaborated with tribal middle and high schools in South Dakota and Nebraska through a National Institutes of Health Science Education Partnership Award to hold a day-long physiology, activity-based event to increase both understanding of physiology and enthusiasm to scientific careers. We recruited volunteer biomedical scientists and trainees from the University of Nebraska Medical Center, Nebraska Wesleyan University, and University of South Dakota. To evaluate the effectiveness of the day of activities, 224 of the ~275–300 participating students completed both a pre- and postevent evaluation assessment. We observed increases in both students self-perceived knowledge of physiology and enthusiasm toward scientific career opportunities after the day of outreach activities. We conclude that activity-based learning opportunities in underserved populations are effective in increasing both knowledge of science and interest in scientific careers.

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