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U of U Research

Cross-State Travel for Cancer Care and Implications for Telehealth Reciprocity

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of Medicare claims data, a notable proportion of cancer services occurred across state lines, particularly for rural-residing patients. These results highlight the need for cross-state telehealth policies that recognize the prevalence of care delivery from geographically distant specialized oncology services.

GHEARD: An Open-Access Modular Curriculum to Incorporate Equity, Anti-Racism, and Decolonization Training Into Global Health Education

Background Global health (GH) interest is rising among graduate medical education (GME) trainees, yet GH engagement is marred by the impact of colonization or racism, and there remains a lack of training to confront these challenges. Objective To develop a modular, open-access curriculum that provides training in decolonization for GH GME and evaluate its feasibility and impact on learners' critical reflection on decolonization. Methods From 2019 to 2022, 40 GH educators, including international...

Barriers and Facilitators to Colorectal Cancer Screening Among Health Fair Attendees in Utah

CONCLUSION: We observed that study participants faced procedural barriers to complete CRC screening and preferred to learn about CRC screening options through their providers. Younger age groups were less likely to receive screening within our study sample. Future, targeted interventions to increase CRC screening should focus on increasing the awareness of the importance of CRC screening and educating patients on the various screening options available and their benefits, especially as they...

Cardiovascular Disease Risk Among Older Asian, Native Hawaiian, Pacific Islanders Lung Cancer Survivors

CONCLUSION: While ANHPI lung cancer patients had lower risks of heart failure and ischemic heart disease than NHW lung cancer patients, heterogeneity in risk was observed among ANHPI subgroups. Further research is needed to investigate the reasons for the higher risk of several CVDs among Pacific Islander, South Asian, and Southeast Asian lung cancer patients.

Brief Report: The Implications of Removing Race From Interpretation of Pulmonary Function Among Persons With or Without HIV

CONCLUSIONS: The race-neutral application of pulmonary function reference equations continues to identify lung function impairment in persons with or at risk for HIV and, for DLCO, may be superior to the use of race-specific reference equations in identifying clinically relevant impairments.

Disparities in Standard-of-Care, Advanced, and Same-Day Diagnostic Services among Patients with Abnormal Screening Mammography

Background Diagnostic imaging and biopsy are used to evaluate abnormal screening mammography. Differences in on-site availability and receipt of these diagnostic services may contribute to disparities in breast cancer outcomes across sociodemographic groups. Purpose To identify multilevel factors associated with on-site availability and receipt of diagnostic imaging and biopsy after screening mammography. Materials and Methods This retrospective study included female patients (age range, 40-89...

Geospatial Access to Extracorporeal Membrane Oxygenation in the United States

CONCLUSIONS: While 67% of the U.S. population had access to ECMO-capable centers by ground transportation, significant disparities in access exist. These findings emphasize the need for thoughtful implementation of ECMO systems of care to ensure equitable access. Future work should focus on developing novel systems of care that increase access utilizing advanced technology, such as aeromedical transport services.

Exploring the Feasibility of Tele-Audiology in Rural Communities to Reduce Care Disparities for At-Risk Newborns

CONCLUSION: Tele-ABR participants benefited from shorter travel distances compared to in-person participants while still receiving timely diagnosis. Given that the tele-ABR group included more American Indians, this approach may enable evaluation of an underserved population. Tele-ABR is a viable diagnostic tool to reduce barriers to timely testing.

Colorectal Cancer Racial Equity Post Volume, Content, and Exposure: Observational Study Using Twitter Data

CONCLUSIONS: This study emphasizes the critical roles played by expert and broker accounts in disseminating CRC racial equity information on social media. Despite the limited volume of equity-focused content, broker accounts were crucial in reaching otherwise unexposed audiences. Public health practitioners should focus on encouraging equity disseminators to share more actionable information, such as symptoms and screening benefits, and implement measures to amplify the reach of such content on...

Health disparities in HIV care and strategies for improving equitable access to care

The US HIV/AIDS Strategy and Ending the HIV Epidemic (EHE) initiatives aim to reduce HIV transmission by 90% by 2030 through targeted care and prevention initiatives such as the Undetectable = Untransmittable strategy. Effective HIV management involves implementation of widely available testing to ensure early diagnosis, immediate or early initiation of antiretroviral therapy (ART), patient adherence to medication, and retention in care to achieve viral suppression and improve clinical outcomes....

Social vulnerability and genetic service utilization among unaffected BRIDGE trial patients with inherited cancer susceptibility

CONCLUSIONS: These results underscore the importance of investigating social and structural mechanisms as potential pathways to increasing genetic testing uptake among patients with increased inherited risk of cancer. Census information is publicly available but seldom used to assess social determinants of genetic testing uptake among unaffected populations. Existing and future cohort studies can incorporate census data to derive analytic insights for clinical scientists.

Workplace Prejudice Toward Nurses (WPtN): Scale Development and Validation

Measuring and understanding experiences of workplace prejudice faced by underrepresented nurses comprise a first step toward workplace equality and enhanced morale and retention. With no existing instruments to measure prejudice directed toward nurses, the primary goal of the current study was to report the results and validation of the newly developed Workplace Prejudice toward Nurses (WPtN) scale. Participants (1692 nurses, 65% whom identified as an underrepresented racial or ethnic group)...

Variability in technical fee billing for cardiac CT across congenital cardiac centers

CONCLUSION: There is significant variability in the charges for the technical component of CCT in CHD, not correlated with national ranking or surgical volume. Variability in charges for identical services across centers may have a disproportionate impact on uninsured and underinsured populations. and lead to inequity. This data may inform negotiations for reimbursement for this time-consuming skill set. The variability of technical fee associated with CT for CHD has not been previously analyzed...

Race and Ethnicity as Factors in Healthcare Discrimination in the United States: A Cross-Sectional Study

CONCLUSION: Discrimination in health care is associated with being part of a minority racial and ethnic groups, being female, being an older individual, being a smoker and living in poverty. These associations may contribute to inequitable health outcomes in the United States.

Insurance-Based Disparities in Cardiac Allograft Vasculopathy Following Heart Transplantation Are Mediated by Care at High Volume Centers

CONCLUSIONS: Medicaid-insured recipients faced inferior survival and greater risk of CAV over 5-years. Our work encourages closer follow-up and treatment for vulnerable populations in the months and years post-transplantation.