Engaging underrepresented groups in outcomes research is a public health priority for reducing health and health care disparities; yet, engaging these groups is challenging. Failure to involve these underrepresented populations in research further exacerbates these disparities. This article presents the health and research priorities of diverse groups of underrepresented populations in biomedical research, their concerns for participating in research, and strategies to engage them in their healthcare and research studies. Eleven community listening sessions, ranging from 7 to 13 community members each (N = 117), representing racial/ethnic minority, economically disadvantaged (e.g., uninsured), and hearing impaired communities. We used an inductive, qualitative content analysis approach to analyze the data for emerging themes. We identified the following themes: Uncertainties of underrepresented populations regarding research participation; Ineffective communication about research opportunities and research findings; Research on primary care and prevention are priorities for underrepresented populations in research; and Research teams need training in cultural competence and humility. Underrepresented groups provided research priorities, concerns, and strategies to engage them in their healthcare and in research studies. Findings from this study could facilitate improvement of research participation among underrepresented groups, ultimately reducing health disparities and improving quality of life among groups commonly omitted from research recruitment and participation.
Lack of insurance coverage and education explained some of the racial/ethnic disparities observed in diabetes quality of care. Improving quality of diabetes care could help reduce rates of diabetes complications, healthcare costs, and mortality.
Precision medicine has grown over the past 20 years with the availability of genetic tests and has changed the one‐size‐fits‐all paradigm in medicine. Precision medicine innovations, such as newly available genetic tests, could potentially widen racial and ethnic disparities if access to them is unequal and if interest to use them differs across groups. The objective of this systematic review was to synthesize existing evidence on racial and ethnic differences in knowledge of and attitudes toward genetic testing among adult patients and the general public in the US, focusing on research about the use of genetic testing in general, not disease‐specific tests. Twelve articles published in 1997–2017 met inclusion and exclusion criteria, with 10 including knowledge variables and seven including attitude variables. Studies found consistent patterns of lower awareness of genetic testing in general among non‐Whites compared to Whites, lower factual knowledge scores among Blacks and Hispanics/Latinos, and mixed findings of differences in awareness of direct‐to‐consumer (DTC) genetic testing or the term precision medicine. Blacks, Hispanics/Latinos, and non‐Whites generally had more concerns about genetic testing than Whites. The findings suggest that patients and the general public need access to culturally appropriate educational material about the use of genetic testing in precision medicine.
Purpose
Motivational interviewing (MI), a patient-centered behavioral counseling style, is a common behavioral intervention strategy. Since intervention outcomes are highly dependent on patient responsiveness to intervention strategy, we evaluated MI perceptions among rural African American women with Type 2 diabetes prior to a physical activity intervention.
Methods
Four moderator-led focus groups were conducted with patients age 21–50 who had never participated in a MI intervention and who receive diabetes care in a rural community health center. Patients were asked to share their perceptions of an MI consultation after viewing a DVD-based example. They were also asked to discuss their physical activity perceptions and readiness. A comprehensive content analysis based on grounded theory was performed by two raters in order to identify main themes.
Main Findings
Though patients (n=31) had an appreciation for physical activity benefits and high levels of physical activity readiness, themes related to physical activity barriers and lack of motivation were pervasive. Patients regarded the MI consultation as an effective health communication but the patient-centeredness of the approach was negatively perceived. Compared to MI, patients agreed that more traditional paternalistic approaches (i.e. physician-led interactions) were more representative of “good counseling” and more familiar to them. Patients shared deeply about personal experiences and provided words of encouragement to one another.
Conclusion
Physical activity interventions including rural African American women should include activities that focus on barrier management and increasing motivation. MI might be an appropriate behavioral counseling model when added to a more traditional cognitive-behavioral physical activity intervention that is group-based and tailored to patients’ communication preferences and the clinical setting.
Background: The Problem Areas in Diabetes (PAID) survey is a measure of diabetes-related stress for which reported use has been in largely Caucasian populations. Our purpose was to assess the psychometric properties of the PAID in Southern rural African American women with Type 2 diabetes.
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