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BackgroundColorectal cancer (CRC) screening is underused, particularly among low-income and minoritized populations, for whom the coronavirus disease 2019 (COVID-19) pandemic has challenged progress in achieving equity.MethodsA hub-and-spoke model was used. The hub was a nonacademic organization and the spokes were three community health center (CHC) systems overseeing numerous clinic sites. Via a cluster-randomized trial design, nine clinic sites were randomized to intervention and 16 clinic sites were randomized to usual care. Patient-level interventions included invitation letters, mailed fecal immunochemical tests (FITs), and call/text-based reminders. Year 1 intervention impact, which took place during the COVID-19 pandemic, was assessed as the proportion completing screening among individuals not up to date at baseline, which compared intervention and nonintervention clinics accounting for intraclinic cluster variation; confidence intervals (CIs) around differences not including 0 were interpreted as statistically significant.ResultsAmong 26,736 patients who met eligibility criteria, approximately 58% were female, 55% were Hispanic individuals, and 44% were Spanish speaking. The proportion completing screening was 11.5 percentage points (ppts) (95% CI, 6.1-16.9 ppts) higher in intervention versus usual care clinics. Variation in differences between intervention and usual care clinics was observed by sex (12.6 ppts [95% CI, 7.2-18.0 ppts] for females; 8.8 ppts [95% CI, 4.7-13.9 ppts] for males) and by racial and ethnic group (13.8 ppts [95% CI, 7.0-20.6 ppts] for Hispanic individuals; 13.0 ppts [95% CI, 3.6-22.4 ppts] for Asian individuals; 11.3 ppts [95% CI, 5.8-16.8 ppts] for non-Hispanic White individuals; 6.1 ppts [95% CI, 0.8-10.4 ppts] for Black individuals).ConclusionsA regional mailed FIT intervention was effective for increasing CRC screening rates across CHC systems serving diverse, low-income populations.

Introduction: Over the past 20 years, palliative care in the United States has grown significantly. Yet, access to and/or engagement with palliative care for minoritized persons with serious illness remains limited. In addition, the focus of palliative and end-of-life care research has not historically focused on equity-informed intervention development that collaborates directly with minoritized populations. Equity-informed interventions within palliative and end-of-life care research have the potential to champion collaborations with persons with serious illness and their families to mitigate health inequities. The purpose of this scoping review was to examine and describe the literature on the approaches used in the design and development of palliative and end-of-life care interventions with minoritized populations with serious illness. Methods: The Joanna Briggs Institute methodology for scoping reviews was followed for tracking and reporting purposes. Included articles were described quantitatively and analyzed qualitatively with content analysis. Results: Thirty-seven articles met the inclusion criteria: eight used quantitative methods, eight used qualitative methods, ten reported a community-based participatory research method, nine used mixed-methods, and two had research designs that could not be determined. The qualitative analysis revealed three themes: (1) stakeholder involvement and feedback, (2) intervention focus, and (3) target intervention population (population vs healthcare clinician). Conclusions: Using an equity-informed research approach is vital to improve palliative and end-of-life care interventions for minoritized communities with serious illness. There is also a need for more robust publishing guidelines related to community-based participatory research methods to ensure publication consistency among research teams that employ this complex research method. [ABSTRACT FROM AUTHOR]

Background: Amidst a national surge in overdose deaths among racial and ethnic minoritized people and people who use stimulants (cocaine or methamphetamines), our objective was to understand how these groups are adapting to a rapidly changing illicit drug supply. Methods: We conducted semi-structured interviews with 64 people who use drugs and who self-identified as Black, Hispanic, Multiracial, or other Non-White race in three states (Michigan, New Jersey, and Wisconsin). Transcribed interviews were coded thematically. Results: Most respondents used stimulants alone or in combination with opioids. Respondents perceived that the drug supply had become more unpredictable and dangerous but differed in their personal perception of risk and their adaptations. For example, respondents had very mixed perceptions of their own risk of being harmed by fentanyl, and differing opinions about whether fentanyl test strips would be useful. Xylazine, a novel adulterant in the opioid drug supply that has received public health and media attention, was not well known within the sample. Conclusion: Our study highlights the challenges experienced by minoritized people who use drugs in responding to a changing drug supply, underscoring the limits of public health approaches focused solely on individual behavioral change. [ABSTRACT FROM AUTHOR]

Abstract Background Amidst a national surge in overdose deaths among racial and ethnic minoritized people and people who use stimulants (cocaine or methamphetamines), our objective was to understand how these groups are adapting to a rapidly changing illicit drug supply. Methods We conducted semi-structured interviews with 64 people who use drugs and who self-identified as Black, Hispanic, Multiracial, or other Non-White race in three states (Michigan, New Jersey, and Wisconsin). Transcribed interviews were coded thematically. Results Most respondents used stimulants alone or in combination with opioids. Respondents perceived that the drug supply had become more unpredictable and dangerous but differed in their personal perception of risk and their adaptations. For example, respondents had very mixed perceptions of their own risk of being harmed by fentanyl, and differing opinions about whether fentanyl test strips would be useful. Xylazine, a novel adulterant in the opioid drug supply that has received public health and media attention, was not well known within the sample. Conclusion Our study highlights the challenges experienced by minoritized people who use drugs in responding to a changing drug supply, underscoring the limits of public health approaches focused solely on individual behavioral change.

Conflict-related forced displacement, characterized by the experiences of witnessing violent acts, bombing, torture, separation, and the execution of family members, can severely and negatively impact a child's social determinants of health (SDOH). These experiences are both direct and indirect forms of adverse childhood experiences (ACEs), and urgent attention is needed to understand the impact of forced displacement on children, who are a vulnerable group, and to develop interventions for all systems that influence the child. This phenomenological qualitative study involved in-depth interviews based on the experiences of returnees (n = 20), who are parents of children who experienced forced displacement. This study underscores the direct and indirect impacts of forced displacement on children, with two key themes identified from the data analysis, by concluding that forced displacement: (i) disrupts the positive SDOH of children, and (ii) children's coping mechanisms are influenced by primary and secondary exposure to trauma. The direct effects are visible through the impact of forced displacement on children's mental health as a result of exposure to traumatic material. In contrast, the indirect effects of forced displacement on children are influenced by its subsequential effect on their parents and their community. The study also illuminates systemic inequalities, with participants recommending steps that governmental and non-governmental bodies can take to address this phenomenon. [ABSTRACT FROM AUTHOR]

Conflict-related forced displacement, characterized by the experiences of witnessing violent acts, bombing, torture, separation, and the execution of family members, can severely and negatively impact a child’s social determinants of health (SDOH). These experiences are both direct and indirect forms of adverse childhood experiences (ACEs), and urgent attention is needed to understand the impact of forced displacement on children, who are a vulnerable group, and to develop interventions for all systems that influence the child. This phenomenological qualitative study involved in-depth interviews based on the experiences of returnees (n = 20), who are parents of children who experienced forced displacement. This study underscores the direct and indirect impacts of forced displacement on children, with two key themes identified from the data analysis, by concluding that forced displacement: (i) disrupts the positive SDOH of children, and (ii) children’s coping mechanisms are influenced by primary and secondary exposure to trauma. The direct effects are visible through the impact of forced displacement on children’s mental health as a result of exposure to traumatic material. In contrast, the indirect effects of forced displacement on children are influenced by its subsequential effect on their parents and their community. The study also illuminates systemic inequalities, with participants recommending steps that governmental and non-governmental bodies can take to address this phenomenon.

Background: Disparities in diagnosis persist among persons living with dementia (PLWD); most research on delayed diagnosis relies on medical records or administrative claims. This study aimed to identify factors that delay or facilitate dementia diagnoses in racial or ethnic minoritized PLWD and elicit care partner perspectives on timing and effects of diagnosis. Methods: Maryland‐based participants cared for a PLWD age 60 or older, self‐identified as Black/African/African‐American, Asian, or Hispanic/Latino, and spoke English. Nineteen care partner in‐depth, semi‐structured interviews were conducted and analyzed using conventional qualitative content analysis methods. Results: Biological, sociocultural, and environmental factors delayed dementia diagnosis. Memory loss was the most common early symptom, but the onset was often subtle or perceived as normal aging. Stigma and secrecy surrounding dementia influenced recognition and discussion of dementia among families and communities. Diagnoses were family‐initiated and started in primary care. Care partners were divided in their perceptions of diagnosis timeliness and whether earlier diagnosis would have changed outcomes. Family reactions to dementia diagnoses varied; most participants expressed a strong sentiment of service and duty to care for older family members. Participants overwhelmingly felt the benefits of obtaining a dementia diagnosis outweighed harms. Conclusions: Numerous factors affect dementia diagnosis in racial and ethnic minoritized PLWD. Normalization of brain health discussions and systematic, proactive discussion and detection of dementia in primary care may address multilevel barriers and facilitators to diagnosis. Systems‐level and community‐led public health interventions may also help address disparities in brain health education and dementia diagnosis. [ABSTRACT FROM AUTHOR]

Minoritized communities in the United States have had higher COVID-19 mortality and lower vaccine uptake. The influence of previous SARS-CoV-2 infection, initial disease severity, and persistent symptoms on COVID-19 vaccine uptake in Black and Latinx communities has not been examined. To investigate whether initial COVID-19 severity, persistent symptoms, and other correlates affected vaccine uptake in a predominantly minoritized cohort hospitalized for COVID-19 during the early pandemic in New York City. In this historical cohort study, we abstracted electronic health record data on demographics, comorbidities, hospital oxygen requirements, symptoms at 3 and 6 months post-admission, COVID-19 vaccinations through November 2022, and influenza vaccinations during the 2018–2019 through 2021–2022 seasons. Unadjusted and adjusted odds ratios were estimated through logistic regression analyses of correlates of COVID-19 vaccination, on-time vaccination, and boosting. Survivors among the first 1186 adult patients hospitalized for COVID-19 between March 1 and April 8, 2020 at a large quaternary care medical center in Northern Manhattan. Uptake of at least one COVID-19 vaccine dose, uptake of at least one booster, and on-time vaccination. The 890 surviving individuals were predominantly Latinx (54%) and Non-Hispanic Black (15%). Most had one or more comorbidities (67%), and received at least one COVID-19 vaccine dose (78%). Among those vaccinated, 57% received at least one booster, and 31% delayed vaccination. 67% experienced persistent symptoms. Multiple logistic regression showed no association between vaccine uptake and disease severity or symptom persistence. However, older age and influenza vaccination during the COVID-19 era were associated with increased vaccination, booster uptake, and on-time vaccination. Pinpointing drivers of vaccine uptake and hesitancy is critical to increasing and sustaining COVID-19 vaccination as the field transitions to annual boosters. The association between influenza vaccination and increased vaccine uptake suggests that bundling vaccines for adults may be an effective delivery strategy. [ABSTRACT FROM AUTHOR]

With recent shifts in guideline-recommended cervical cancer screening in the U.S., it is important to accurately measure screening behavior. Previous studies have indicated the U.S. National Health Interview Survey (NHIS), a resource for measuring self-reported screening adherence, has lower validity among non-White racial/ethnic groups and non-English speakers. Further, measuring diverse population groups’ comprehension of items and attitudes toward HPV self-sampling merits investigation as it is a modality likely to be recommended in the U.S. soon. This study cognitively tested NHIS items assessing recency of and reasons for receiving cervical cancer screening and attitudes toward HPV self-sampling. We conducted cognitive interviews between April 2021 - April 2022 in English and Spanish with individuals screened in the past two years by either a medical center in metropolitan Seattle, Washington or a safety-net healthcare system in Dallas, Texas. Interviews probed understanding of reasons for screening, experiences with abnormal results, and interest in HPV self-sampling. We completed 32 interviews in Seattle and 42 interviews in Dallas. A majority of participants were unaware that two different tests for cervical cancer screening exist (Pap and HPV). Many did not know which type(s) of test they received. Dallas participants had more limited and inaccurate knowledge of HPV compared to Seattle participants, and fewer responded favorably toward HPV self-sampling (32% vs. 55%). To improve comprehension and accurate reporting of cervical cancer screening, we suggest specific refinements to currently used survey questions. Attitudes toward self-sampling should be explored further as differences may exist by region and/or sociodemographic factors.

The recent academic and commercial development, and regulatory approvals, of blood-based Alzheimer's disease (AD) biomarkers are breakthrough developments of immense potential. However, clinical validation studies and therapeutic trial applications are limited almost exclusively to non-Hispanic White cohorts often including highly-educated, high-earning participants. This commentary argues that the true benefits of blood tests for AD will be realized by active inclusion of diverse groups including minoritized populations, people of socioeconomic status different from those included in existing cohorts, and residents of low- and middle-income countries. The article discusses key factors that are critical for a successful implementation of diversity programs. [ABSTRACT FROM AUTHOR]

Civic science (CS) is an approach to science learning and action in which youth determine issues of concern in their communities and use science, technology, engineering, and math (STEM) knowledge and methods to address them. In this article, we focus on CS as it is applied to environmental concerns and enacted by children and youth in urban communities. Core CS practices include relevance of local place and culturally responsive principles for youth's learning and community contributions, egalitarian intergenerational partnerships with adults from community‐based organizations, teamwork and collective action, and public regard for youth's community environmental contributions. We discuss CS's potential to address the marginalization of youth from minoritized backgrounds in traditional STEM and environmental education. We also argue that the way CS frames science for the public good will prepare younger generations to meet 21st‐century environmental challenges. [ABSTRACT FROM AUTHOR]

Self-reported food allergies (FAs) affect approximately 8% of the US pediatric and approximately 10% of the adult population, which reflects potentially disproportionate increases among ethnically and racially minoritized groups. Multiple gaps and unmet needs exist regarding FA disparities. There is reported evidence of disparities in FA outcomes, and the FA burden may also be disproportionate in low-income families. Low family income has been associated with higher emergency care spending and insecure access to allergen-free food. Pharmacoinequity arises in part as a result of structural racism still experienced by historically marginalized populations today. Historically redlined communities continue to experience greater rates of neighborhood-level air pollution and indoor allergen exposure, lack of transportation to medical appointments, poverty, and lower prescription rates of necessary medications. Clinical research needs racially and ethnically diverse participation to ensure generalizability of research findings and equitable access to medical advances, but race reporting in clinical trials has been historically poor. Addressing health disparities in FA is a priority of clinical care, with professional organizations such as the American Academy of Allergy, Asthma & Immunology having a prominent role to play in mitigating the challenges faced by these individuals. In this position statement we recommend some key steps to address this important issue., Competing Interests: Disclosure statement Disclosure of potential conflict of interest: A. Anagnostou reports institutional funding from Aimmune Therapeutics and Novartis; is an advisory board member for Genentech, Novartis, Bryn, and Ready Set Food; and receives consultation/speaker fees from ALK-Abelló, Adelphi, Aimmune Therapeutics, MJH, FARE, Genentech, EPG Health, and Medscape. J. Wang receives research support paid to institution from the National Institute of Allergy and Infectious Diseases, Aimmune Therapeutics, DBV Technologies, and Siolta; receives consultancy fees from ALK-Abelló and Novartis; and receives royalty payments from UpToDate. R. S. Chinthrajah receives grant support from the Consortium for Food Allergy Research, the National Institute of Allergy and Infectious Disease, FARE, and Aimmune Therapeutics; and is an advisory board member for Alladapt Immunotherapeutics, Novartis, Allergenis, Intrommune Therapeutics, Phylaxis, and Genentech. R. Gupta receives research grant support from the National Institutes of Health, FARE, the Melchiorre Family Foundation, the Sunshine Charitable Foundation, the Walder Foundation, the UnitedHealth Group, Thermo Fisher Scientific, and Genentech; serves as a medical consultant/advisor for Genentech, Novartis, Aimmune Therapeutics, Allergenis LLC, and FARE; and has ownership interest in Yobee Care, Inc. C. M. Davis reports research grant support from the National Institutes of Health/National Institute of Allergy and Infectious Diseases, CBV Technologies, Regeneron Pharmaceuticals, Takeda Pharmaceuticals, Allergenis, and Novartis; serves on the editorial board of the Journal of Allergy and Clinical Immunology: In Practice; serves on the board of directors of the American Academy of Allergy, Asthma & Immunology as Secretary-Treasurer; is past president of the Texas Allergy, Asthma, and Immunology Society; and has received honoraria from MJH Life Sciences. C. Parrish receives research support from the National Institutes of Health/National Institute of Allergy and Infectious Diseases, Regeneron Pharmaceuticals, and DBV Technologies (all funds to institution); and receives speaking/consulting fees from Sanofi, Takeda Pharmaceuticals, and Magellan Rx. M. Groetch reports royalties from UpToDate and the Academy of Nutrition and Dietetics; receives consulting fees from Food Allergy Research Education; serves on the medical advisory board of IFPIES; serves as a senior advisor for FARE; serves as a health sciences advisor for APFED; serves on the editorial board of the Journal of Food Allergy; and has no commercial interests to disclose. J. Shroba was an employee at Children’s Mercy; is now employed at DBV Technologies; and served on the advisory board for Thermo Fisher Scientific and Genentech. M. Shaker is a member and cochair of the Joint Task Force on Practice Parameters; serves on the editorial board of the Journal of Allergy and Clinical Immunology: In Practice; is an associate editor for the Annals of Allergy, Asthma & Immunology; serves on the board of directors of the American Academy of Allergy, Asthma & Immunology (views expressed are his own); and has participated in research that has received funding from DBV Technologies. M. Greenhawt is a consultant for Aquestive; is a member of physician/medical advisory boards for DBV Technologies, Nutricia, Novartis, Aquestive, Allergy Therapeutics, AstraZeneca, ALK-Abelló, Bryn, Genentech, and Prota; is a speaker for Genentech; is an unpaid member of the Scientific Advisory Council for the National Peanut Board and the Medical Advisory Board of the International Food Protein Induced Enterocolitis Syndrome Association; is a member of the Brighton Collaboration Criteria Vaccine Anaphylaxis 2.0 Working Group; is the senior associate editor for the Annals of Allergy, Asthma & Immunology; is a member of the Joint Task Force on Allergy Practice Parameters; and has received honoraria for lectures from ImSci, Red Nucleus, Medscape, Paradigm Medical Communications, and multiple state/local allergy societies., (Copyright © 2024 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Using my personal story, I reflect on the history of the field of child development from the 1970's to the present. I recount how far have we come...but also, how far we still have to go on creating a literature where contextual forces, such as racism and other sources of oppression are considered at the core rather than the perifery of research with minoritized BILPOC (Black, Indigenous, Latinx, People of Color) families and children. As scholars of color, we not only have had to conduct/fund/publish research and teach, but also push our institutions and organizations to create the systemic and political change necessary for others to follow. [ABSTRACT FROM AUTHOR]

Health disparities persist among minoritized populations. A diverse clinician workforce may help address these disparities and improve patient outcomes; however, diversity in the critical are workforce (particularly among women and those historically underrepresented in medicine (URiM)) is lacking. This review describes factors contributing to low respresentation of women and URiM in critical care medicine, and proposes strategies to overcome those barriers., Competing Interests: Disclosure The authors have nothing to disclose., (Published by Elsevier Inc.)

The bystander intervention approach to campus sexual violence has received increased attention as a promising prevention strategy. However, there lacks research on the perspective of historically minoritized students, such as students of color, LGBTQ-spectrum students, and the intersections thereof. As such, the purpose of this paper is to present the findings from an exploratory study regarding bystander intervention that focused exclusively on the perspectives of 101 racialized and/or LGBTQ-spectrum students at three campuses across a large public university. Using concept mapping methodology, the study was conducted in three phases: brainstorming of statements about bystander intervention, sorting and rating of statements, and mapping and interpretation of the results. Using multidimensional scaling and hierarchical cluster analysis, a six-cluster solution was determined, representing key themes related to supporting students' efforts as helpful bystanders. Overall, findings indicate a need for bystander intervention efforts to widen their focus by employing an intersectional, social justice lens. Study participants identified various forms of racism, homophobia, transphobia, and microaggressions as intertwined with their ability to be active bystanders on college campuses. [ABSTRACT FROM AUTHOR]

This introduction to the special section on hidden populations across contexts in developmental science defines what is meant by "hidden populations" and summarizes the studies along thematic lines. Hidden populations are generally minoritized populations embedded in larger systems of oppression and inequality encapsulated within historical time and place, and importantly, they are underrepresented in developmental science. The set of 8 empirical articles discusses how being "hidden" is contextualized and operationalized through explicit and implicit ways and uses multiple methodologies to elucidate the experiences of children, youth, and families. The collection of articles is grounded in developmental and sociocultural developmental theories highlighting important cultural and contextual developmental mechanisms that impact and promote the well-being of hidden populations. Thematically, the set of articles, implicitly and explicitly, addresses minoritization and its consequences as well as elucidates resilience through multiple processes at different levels. Together, the special section advances developmental science by diversifying the populations that are represented to understand normative and culturally and contextually dependent development. [ABSTRACT FROM AUTHOR]

With recent shifts in guideline-recommended cervical cancer screening in the U.S., it is important to accurately measure screening behavior. Previous studies have indicated the U.S. National Health Interview Survey (NHIS), a resource for measuring self-reported screening adherence, has lower validity among non-White racial/ethnic groups and non-English speakers. Further, measuring diverse population groups' comprehension of items and attitudes toward HPV self-sampling merits investigation as it is a modality likely to be recommended in the U.S. soon. This study cognitively tested NHIS items assessing recency of and reasons for receiving cervical cancer screening and attitudes toward HPV self-sampling. We conducted cognitive interviews between April 2021 - April 2022 in English and Spanish with individuals screened in the past two years by either a medical center in metropolitan Seattle, Washington or a safety-net healthcare system in Dallas, Texas. Interviews probed understanding of reasons for screening, experiences with abnormal results, and interest in HPV self-sampling. We completed 32 interviews in Seattle and 42 interviews in Dallas. A majority of participants were unaware that two different tests for cervical cancer screening exist (Pap and HPV). Many did not know which type(s) of test they received. Dallas participants had more limited and inaccurate knowledge of HPV compared to Seattle participants, and fewer responded favorably toward HPV self-sampling (32% vs. 55%). To improve comprehension and accurate reporting of cervical cancer screening, we suggest specific refinements to currently used survey questions. Attitudes toward self-sampling should be explored further as differences may exist by region and/or sociodemographic factors., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

• Primary school consolidation is a policy response to changing demographics in middle income countries with large rural populations. • We analyze the effects of consolidation on educational attainment and language ability among rural minority populations in China. • After closure, better resourced and farther away schools offer less minority language instruction and have more Han teachers. • Minority youth were negatively affected by closure, in terms of both educational attainment and written Mandarin facility. • Penalties were heavier for girls from poorer villages and for boys from more ethnically segregated minority villages. Primary school consolidation—the closure of small community schools or their mergers into larger, better-resourced schools—is emerging as a significant policy response to changing demographics in middle income countries with large rural populations. In China, large-scale consolidation took place in the early 21st century. Because officially-recognized minority populations disproportionately reside in rural and remote areas, minority students were among those at elevated risk of experiencing school consolidation. We analyze heterogeneous effects of consolidation on educational attainment and reported national language ability in China by exploiting variations in closure timing across villages and cohorts captured in a 2011 survey of provinces and autonomous regions with substantial minority populations. We consider heterogeneous treatment effects across groups defined at the intersections of minority status, gender, and community ethnic composition and socioeconomic status. Compared to villages with schools, villages whose schools had closed reported that the schools students now attended were better resourced, less likely to offer minority language of instruction, more likely to have Han teachers, farther away, and more likely to require boarding. Much more than Han youth, ethnic minority youth were negatively affected by closure, in terms of its impact on both educational attainment and written Mandarin facility. However, for both outcomes, significant penalties accruing to minority youth occurred only in the poorest villages. Penalties were generally heavier for girls, but in the most ethnically segregated minority villages, boys from minority families were highly vulnerable to closure effects on attainment and written Mandarin facility. Results show that intersections of minority status, gender, and community characteristics can delineate significant heterogeneities in policy impacts. [ABSTRACT FROM AUTHOR]

Using my personal story, I reflect on the history of the field of child development from the 1970's to the present. I recount how far have we come…but also, how far we still have to go on creating a literature where contextual forces, such as racism and other sources of oppression are considered at the core rather than the perifery of research with minoritized BILPOC (Black, Indigenous, Latinx, People of Color) families and children. As scholars of color, we not only have had to conduct/fund/publish research and teach, but also push our institutions and organizations to create the systemic and political change necessary for others to follow., (© 2022 Society for Research on Adolescence.)