A System for Rapidly and Accurately Collecting Patients’ Race and Ethnicity

Baker, David W.; Cameron, Kenzie A.; Feinglass, Joseph; Thompson, Jason A.; Georgas, Patricia; Foster, S. Thomas; Pierce, Deborah; Hasnain‐Wynia, Romana

doi:10.2105/ajph.2005.062620

Cited by 41 publications

(31 citation statements)

References 24 publications

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“…30 Our survey findings are consistent to prior surveys of cardiovascular specialists in some respects but different in others. Like our survey, prior studies of cardiovascular specialists found a substantially higher proportion acknowledging racial differences in cardiac care among patients nationally (34%) than among patients they personally treat (5%).…”

Section: Discussionsupporting

confidence: 89%

Primary-care Clinician Perceptions of Racial Disparities in Diabetes Care

et al. 2008

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BACKGROUND: Primary-care clinicians can play an important role in reducing racial disparities in diabetes care. OBJECTIVE:The objective of the study is to determine the views of primary-care clinicians regarding racial disparities in diabetes care. DESIGN:The design of the study is through a survey of primary-care clinicians (response rate=86%). PARTICIPANTS:The participants of the study were 115 physicians and 54 nurse practitioners and physician assistants within a multisite group practice in 2007. MEASUREMENTS AND MAIN RESULTS:We identified sociodemographic characteristics of each clinician's diabetic patient panel. We fit multivariable logistic regression models to identify predictors of supporting the collection of data on patients' race and acknowledging the existence of racial disparities among patients personally treated. Among respondents, 79% supported the collection of data on patients' race. Whereas 88% acknowledged the existence of racial disparities in diabetes care within the U.S. health system, only 40% reported their presence among patients personally treated. Clinicians caring for greater than or equal to 50% minority patients were more likely to support collection of patient race data (adjusted odds ratio [OR] 9.0; 95% confidence interval [CI] 1.2-65.0) and report the presence of racial disparities within their patient panel (adjusted OR 12.0; 95% CI 2.5-57.7). Clinicians were more likely to perceive patient factors than physician or health system factors as mediators of racial disparities; however, most supported interventions such as increasing clinician awareness (84%) and cultural competency training (88%). CONCLUSIONS:Most primary-care clinicians support the collection of data on patients' race, but increased awareness about racial disparities at the local level is needed as part of a targeted effort to improve health care for minority patients. INTRODUCTIONRacial disparities in the quality of diabetes care are persistent across all sectors of the U.S. health care system. Black patients with diabetes are less likely than white patients to receive appropriate hemoglobin A1c and lipid testing 1,2 and less likely to achieve treatment goals including glycemic, cholesterol, and blood pressure control. [3][4][5][6][7][8] Blacks also experience worse long-term diabetes-related outcomes than whites, including diabetic retinopathy, 9 lower extremity amputations, 2,10,11 and chronic kidney disease. 12 Hispanics and Native Americans have also been found to receive lower-quality diabetes care, with Native Americans experiencing disproportionately high rates of lower extremity amputations, chronic kidney disease, and diabetes-related mortality. 2,[13][14][15][16][17] The etiology of these racial disparities is multifactorial involving health system, provider, and patient factors, all within the context of broader social issues. 18 Physicians can play an important role in addressing racial disparities in care through their direct interface with patients and the health care system. For example, clinica...

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Section: Discussionsupporting

confidence: 89%

Primary-care Clinician Perceptions of Racial Disparities in Diabetes Care

et al. 2008

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“…Eligibility Criterion 2 was chosen because self-identification of race/ethnicity by research participants has been shown to be feasible, efficient, accurate, and to result in lower rates of missing and unusable data than do standard questions [22]. …”

Section: Methodsmentioning

confidence: 99%

Design, methods, and baseline characteristics of the Kids' Health Insurance by Educating Lots of Parents (Kids' HELP) trial: A randomized, controlled trial of the effectiveness of parent mentors in insuring uninsured minority children11Clinical Trials.gov NCT01264718.

Flores¹,

Walker²,

Lin³

et al. 2015

Contemporary Clinical Trials

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Background & objectives Six million US children have no health insurance, and substantial racial/ethnic disparities exist. The design, methods, and baseline characteristics are described for Kids’ Health Insurance by Educating Lots of Parents (Kids’ HELP), the first randomized, clinical trial of the effectiveness of Parent Mentors (PMs) in insuring uninsured minority children. Methods & research design Latino and African-American children eligible for but not enrolled in Medicaid/CHIP were randomized to PMs, or a control group receiving traditional Medicaid/CHIP outreach. PMs are experienced parents with ≥ 1 Medicaid/CHIP-covered children. PMs received two days of training, and provide intervention families with information on Medicaid/CHIP eligibility, assistance with application submission, and help maintaining coverage. Primary outcomes include obtaining health insurance, time interval to obtain coverage, and parental satisfaction. A blinded assessor contacts subjects monthly for one year to monitor outcomes. Results Of 49,361 candidates screened, 329 fulfilled eligibility criteria and were randomized. The mean age is seven years for children and 32 years for caregivers; 2/3 are Latino, 1/3 are African-American, and the mean annual family income is $21,857. Half of caregivers were unaware that their uninsured child is Medicaid/CHIP eligible, and 95% of uninsured children had prior insurance. Fifteen PMs completed two-day training sessions. All PMs are female and minority, 60% are unemployed, and the mean annual family income is $20,913. Post-PM-training, overall knowledge/skills test scores significantly increased, and 100% reported being very satisfied/satisfied with the training. Conclusions Kids’ HELP successfully reached target populations, met participant enrollment goals, and recruited and trained PMs.

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“…In the United States where intermarriage and intermingling of health behaviors is common the strength of an individual’s self-identified ethnic identity may be a more significant determinant of behavior than the individual’s actual ethnicity (Baker et al, 2006). However, the discrepancies between interviewer data on self-identity and self-report mentioned earlier may stem in part from the use of forced categories that do not always match the words that patients would use to identify themselves.…”

Section: Challenges In Collecting Self-identity Of Race and Ethnicitymentioning

confidence: 99%