Cherlie Magny-Normilus

Abstract

Weight discrimination refers to bias against individuals whose body weight and shape do not align with predominant social norms. Weight discrimination is prevalent and negatively impacts health outcomes. The prevalence and impact of weight discrimination vary by race; however, there is a dearth of research describing the potential health effects across racial and ethnic groups. This scoping review aimed to assess the literature for associations between weight discrimination and health outcomes, with a focus on racial and ethnic differences. A literature search was conducted across five databases for original studies that examined health outcomes associated with weight discrimination and delineated results by race. After quality assessment, thematic analysis was performed to generate themes, and consensus was reached. Twenty articles met the selected inclusion criteria, revealing racial differences in several health outcomes and disease management linked to weight-based discrimination. Social determinants of health and cultural beliefs about body size emerged as potential modifiers of these disparities. Although most studies investigated unique populations and variables, complicating comparisons, the review highlighted racial variances in the prevalence of weight discrimination. Additionally, 25 physical and mental health outcomes were associated with weight discrimination, with body mass index (BMI) being the most common. Future research should further explore the intersection of weight discrimination and race and ethnicity, identifying contributing factors and incorporating personal narratives. Clinicians must consider the influence of culture and social determinants of health to provide equitable care across body size spectrums.

Abstract

The purpose of the study was to explore perceptions of using continuous glucose monitor (CGM) use and how it affects diabetes self-management behaviors in adult patients with diabetes.

Abstract

To advance the understanding of chronic illness self-management among Chinese immigrants in Western countries by synthesising evidence and through the lens of the Middle Range Theory of Self- and Family Management of Chronic Illness.

Abstract

~

Abstract

~

Abstract

Psychological safety is considered an essential component of highly effective teamwork in organizations, including healthcare organizations. This systematic review examines essential elements and outcomes of psychological safety in healthcare practice teams to determine best practices for implementing psychological safety.

Abstract

Racial and ethnic minorities experience a disproportionate burden of the type 2 diabetes (T2D) and are at a 2 to 5 times higher risk of developing macrovascular disease. The purpose of the study was to describe the perspectives of Haitian American immigrants' challenges to effective T2D self-management.

Abstract

Diabetes mellitus is seventh-leading cause of death in the United States, and has a substantial economic burden, contributing $237 billion in direct medical costs. The incidence rate of type 2 diabetes (T2DM) is expected to continue to increase, disproportionally impacting vulnerable groups. The increasing prevalence and disproportionate burden emphasize the need for health systems to effectively integrate and implement large- and small-scale, culturally tailored nurse-led diabetes prevention programs (DPP) and diabetes self-management education programs (DSME). This two-stage analysis uses a health system approach to provide a synopsis of evidence-based nurse-led DPP and DSME implementation across various health system settings. Using the results from an integrative review, a health system focused framework was developed and applied to two case studies highlighting specific aspects of how successful large- and small-scale nurse-led interventions are integrated into health systems across varying vulnerable populations specifically Veterans, Asian Americans and Haitians. Case study results use examples to show large-scale implementation of DSME across the federal Veterans Health Administration (VHA) improves diabetes self-management and access for Veterans and smaller-scale DPP and DSME programs within community health centers targeting vulnerable populations impact health literacy and diabetes self-management. These examples demonstrate key steps toward improving access and outcomes for diabetes management and the critical role of nurse-led diabetes interventions as a priority across the health system and the importance of financial and organizational support for DPP and DSME programs to overcome access barriers to improve diabetes interventions and management.

Abstract

Diabetes mellitus (DM) technology (i.e., continuous glucose monitors (CGMs) and insulin pumps) can improve clinical outcomes and use is on the rise. However, some studies highlight disparities in DM technology prescription rates across various race/ethnicity groups. Specifically, recent studies note baseline DM technology use was significantly lower for Black patients compared to their non-Black counterparts. This systematic review examined the available evidence on the association of prescription rates for DM technology (CGM and insulin pumps) use by race/ethnicity. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analysis- Equity guidelines (PRISMA-Equity), a literature search of observational studies published between 2017-2024 was conducted using Medline, Cochrane, PubMed, CINAHL, and Embase databases. Articles were included if they reported data on DM technology use by race/ethnicity. All studies reported significant differences in DM technology use by race/ethnicity; with White non-Hispanic (WNH) patients having the highest prescription rates (average 56.3% (range 12-79%)), followed by patients that identify as Hispanic (average 28.8% (range 4-76%)), and Black (average 21.3% (range 3-52%)). Secondary analyses examining the influence of glycemic control, patient experience, and social determinants of health (SDoH) on the relationship between race/ethnicity and DM technology use were conducted. Limitations of included studies are discussed including 1) inaccurate measurements of race and ethnicity that failed to identify the contextual detail of ethnicity and 2) limited measurements of health outcomes and SDoH. Further research is needed to more accurately examine the social and environmental factors that influence the identified race/ethnicity disparities and to develop strategies that ensure equitable access to beneficial DM technology.

Abstract

~