Allison P Squires

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Telehealth's uptake has increased substantially in recent years, with an especially large jump in 2020 due to the emergence of COVID-19. This article provides background on and explores "telepresence" in healthcare literature. Telepresence strongly impacts the patient experience, but it is poorly defined in current research. The aim was to conceptually define telepresence using qualitative methods.

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Background: Disparities in breastfeeding patterns by race and ethnicity in the United States have been documented, and Latinx ethnicity is often associated with higher rates of breastfeeding initiation and longer breastfeeding duration compared to other U.S. racial and ethnic groups. Despite marked differences in infant feeding practices in Latinx countries of origin, U.S. breastfeeding data are routinely presented with Latinx as a single category. Objective: To analyze breastfeeding duration of New York City Latinx mothers by birth region. Methods: Using data from the 2016 New York City Work and Family Leave Survey (WAFLS) surveying residents who gave birth in 2014, we conducted a survival analysis of breastfeeding duration in a sample of Latinx-identifying mothers (n = 271), who reported having ever breastfed their child. Kaplan-Meier survival curves for time to breastfeeding cessation were created for four birth regions (United States, Caribbean, Mexico/Central America, and South America) and compared using the log-rank test. Adjusted hazard ratios (AHRs) were calculated using Cox regression. Results: Survival curves and median breastfeeding duration were significantly different between the four regions. AHR models found that non-Caribbean birthplace was significantly associated with a lower risk of early breastfeeding cessation. Being partnered at the time of childbirth and neonate hospitalization of 6 days or longer was associated with a greater risk of earlier breastfeeding cessation. Conclusion: The significant differences reinforce the need to separate breastfeeding findings by birth region in the Latinx population. Within-group differences are lost in combined analyses and reinforce conclusions that Latinx mothers have optimal breastfeeding behaviors.

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Purpose of review The purpose of this review was to assess the prevalence of United States chronic kidney disease (CKD) health disparities, focusing on racial/ethnic groups, immigrants and refugees, sex or gender, and older adults. Recent findings There are major racial/ethnic disparities in CKD, with possible contributions from the social determinants of health, socioeconomics, and racial discrimination. Racial/ethnic minority patients experience faster progression to end-stage kidney disease (ESKD) and higher mortality predialysis, however, once on dialysis, appear to live longer. Similarly, men are quicker to progress to ESKD than women, with potential biological, behavioral, and measurement error factors. There is a lack of substantial evidence for intersex, nonbinary, or transgender patients. There are also strikingly few studies about US immigrants or older adults with CKD despite the fact that they are at high risk for CKD due to a variety of factors. Summary As providers and scientists, we must combat both conscious and unconscious biases, advocate for minority patient populations, and be inclusive and diverse in our treatment regimens and provision of care. We need to acknowledge that sufficient evidence exists to change treatment guidelines, and that more is required to support the diversity of our patient population.

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PURPOSE: As global health education and training shift toward competency-based approaches, academic institutions and organizations must define appropriate assessment strategies for use across health professions. The authors aim to develop entrustable professional activities (EPAs) for global health to apply across academic and workplace settings. METHOD: In 2019, the authors invited 55 global health experts from medicine, nursing, pharmacy, and public health to participate in a multiround, online Delphi process; 30 (55%) agreed. Experts averaged 17 years of global health experience, and 12 (40%) were from low- to middle-income countries. In round one, participants listed essential global health activities. The authors used in vivo coding for round one responses to develop initial EPA statements. In subsequent rounds, participants used 5-point Likert-type scales to evaluate EPA statements for importance and relevance to global health across health professions. The authors elevated statements that were rated 4 (important/relevant to most) or 5 (very important/relevant to all) by a minimum of 70% of participants (decided a priori) to the final round, during which participants evaluated whether each statement represented an observable unit of work that could be assigned to a trainee. Descriptive statistics were used for quantitative data analysis. The authors used participant comments to categorize EPA statements into role domains. RESULTS: Twenty-two EPA statements reached at least 70% consensus. The authors categorized these into 5 role domains: partnership developer, capacity builder, data analyzer, equity advocate, and health promoter. Statements in the equity advocate and partnership developer domains had the highest agreement for importance and relevance. Several statements achieved 100% agreement as a unit of work but achieved lower levels of agreement regarding their observability. CONCLUSIONS: EPAs for global health may be useful to academic institutions and other organizations to guide the assessment of trainees within education and training programs across health professions.

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Understanding how previous experiences with interprofessional education and collaboration inform health care provider perspectives is important for developing interprofessional interventions at the graduate level. The purpose of this study was to examine how previous work experiences of graduate level health professions students inform perspectives about interprofessional education and collaboration. Drawing from program evaluation data of two separate graduate level interprofessional education interventions based in primary care and home health care, we conducted a qualitative secondary data analysis of 75 interviews generated by focus groups and individual interviews with graduate students from 4 health professions cadres. Using directed content analysis, the team coded to capture descriptions of interprofessional education or collaboration generated from participants’ previous work experiences. Coding revealed 173 discrete descriptions related to previous experiences of interprofessional education or collaboration. Three themes were identified from the analysis that informed participant perspectives: Previous educational experiences (including work-based training); previous work experiences; and organizational factors and interprofessional collaboration. Experiences varied little between professions except when aspects of professional training created unique circumstances. The study reveals important differences between graduate and undergraduate learners in health professions programs that can inform interprofessional education and collaboration intervention design.

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Recommended personal protective equipment (PPE) is routinely limited or unavailable in low-income countries, but there is limited research as to how clinicians adapt to that scarcity, despite the implications for patients and workers.

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Numerous studies have found that organizational features connected with the work environment of nurses have a significant influence on patients’ safety. The aim of this research was to capture nurses’ opinions about patients’ safety and discern relationships with work environment characteristics. This cross-sectional study surveyed 1825 nurses. The research used questionnaire consisting of four parts: (1) covered The Practice Environment Scale of the Nursing Work Index (PES-NWI); (2) assessed the quality of nursing care and care safety; (3) contained information on the most recent duty served by the nurses and (4) captured social and demographic data of participants. The research identified strong association between patient safety assessment and work environment of nurses in the aspect of employment adequacy, cooperation between nurses and doctors, support for nurses from the managing staff, the possibility to participate in the management as well as professional promotion of nurses employed in the hospital (p < 0.001). Nurses rated patient safety higher when responsible for a smaller number of patients. Work environment factors such as proper staffing, good cooperation with doctors, support from the management, as well as professional independence are significantly related to nurses’ assessment of patients’ safety.

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Depression represents a growing health problem and African American women (AAW) disproportionally experience increased risk and broad disparities in health care. This integrative review examines what is known about the equity of depression care provided to AAW. PubMed, PsychINFO, and Web of Science were searched through April 2020 for studies in peer-reviewed journals from 2015 to 2020. Across the studies (n = 7), AAW received inequitable care across a depression care cascade including lower rates of screening, treatment initiation, and guideline-concordant care. Here we explore individual-, relational-, and structural-level factors related to these disparities and implications for research, practice, and education.

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Effective management of health emergencies is an important strategy to improve health worldwide. One way to manage health emergencies is to build and sustain national capacities. The Ebola epidemic of 2014 to 2015 resulted in greater infection prevention and control (IPC) capacity in Liberia, but few studies have investigated if and how that capacity was sustained. The purpose of this study was to examine the maintenance of IPC capacity in Liberia after Ebola.