Search

We examined associations of different levels of same-ethnicity neighborhood concordance with health care access and utilization among all Asian American, Chinese, Filipino, and Vietnamese adults (aged 18–64 years) using the 2005, 2007, and 2009 California Health Interview Survey and the 2010 US Census. Although associations varied by subgroup, Asian Americans in highly concordant neighborhoods were more likely to lack a usual source of care but did not lack doctor visits or experience delays in medical care and prescriptions. [ABSTRACT FROM AUTHOR]

Abstract: Residential characteristics influence opportunities, life chances and access to health services in the United States but what role does residential segregation play in differential access and mental health service utilization? We explore this issue using secondary data from the 2006 Medical Expenditure Panel Survey, 2006 American Medical Association Area Research File and the 2000 Census. Our sample included 9737 whites, 3362 African Americans and 5053 Latinos living in Metropolitan Statistical Areas. Using logistic regression techniques, results show respondents high on Latino isolation and Latino centralization resided in psychiatrist shortage areas whereas respondents high on African American concentration had access to psychiatrists in their neighborhoods. Predominant race of neighborhood was associated with the type of mental health professional used where respondents in majority African American neighborhoods were treated by non-psychiatrists and general doctors whereas respondents in majority Latino neighborhoods saw general doctors. Respondents high on Latino Isolation and Latino Centralization were more likely to utilize non-psychiatrists. These findings suggest that living in segregated neighborhoods influence access and utilization of mental health services differently for race/ethnic groups which contradicts findings that suggest living in ethnic enclaves is beneficial to health. [Copyright &y& Elsevier]

Objective: To examine the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association.Methods: We conducted a cross-sectional secondary data analysis with the 2011-2013 Medical Expenditures Panel Survey of parents with children ages 6-12 (n=5390). We used multivariable logistic regression to examine the association of parent-reported healthcare provider communication quality (explaining well, listening carefully, showing respect, and spending enough time) with child obesity status, and effect modification by parent obesity and child race/ethnicity.Results: Parents of obese children were more likely to report that their child's healthcare provider listened carefully (OR=1.41, p=0.002) and spent enough time (OR=1.33, p=0.022) than parents of non-obese children. Non-obese parents of obese children experienced better communication in the domains of listening carefully (p<0.001) and spending enough time (p=0.007). Parents of obese non-Hispanic Asian children and non-Hispanic Black children were more likely to report that providers explained things well (p=0.043) and listened carefully (p=0.012), respectively.Conclusion: Parents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian.Practice Implications: Healthcare providers should ensure effective communication with obese parents of obese children. [ABSTRACT FROM AUTHOR]

The present study extends the item-level psychometric information of the Leeds Dependence Questionnaire (LDQ; Raistrick et al., 1994) that has been purported to measure psychological dependence and the International Statistical Classification of Diseases and Related Health Problems-10th edition substance dependence criteria. Prior research on the LDQ has not established item-level properties or the degree of differential item functioning (DIF) by gender and substance type. Principal component and Mokken scale analyses were used to assess unidimensionality and monotonicity of the responses to the scale items, respectively. Graphical and statistical methods examined the model-data fit of the graded response model and two-parameter logistic model of LDQ responses (n = 1,681) obtained from 2 community treatment centers. DIF analysis was performed on gender (men = 1,313, women = 353) and substance (alcohol = 821, opiates = 528) groups. The 2PL achieved the best model-data fit. Three items provided little information about standing on the underlying construct, indicating that they are likely not good indicators of the "pure" psychological construct the LDQ aims to measure. Overall, the LDQ offers the greatest precision in quantifying psychological dependence in a clinical sample along the lower to mid ranges of this construct. Uniform DIF was present in Item 7 of the dichotomized responses by substance (alcohol vs. opiates). DIF by gender was not found in any of the LDQ items. Recommendations include revising the scaling and discussing the need to obtain LDQ data from different levels of care and primary identified substance. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]