Sociocultural issues in clinical research

Ethnic disparities in patients with systemic lupus erythematosus

“…Ethnic disparities are likely to originate from differences in health-related behaviors (eating patterns, exercising, drinking, smoking, and recreational drug use), low-to-zero English proficiency (when living in English-speaking countries, eg, Hispanics), poor literacy level, inadequate healthrelated knowledge and beliefs, unhealthy environment exposures, stressors (divorce, joblessness, discrimination, migration, or relocation), inadequate coping strategies (relaying in prayer or wishful thinking) or social support (source, size, quality, and influence of the social network vary depending on ethnicity), limited access to health care and poor treatment adherence (financial resources, type of insurance, availability, care preference, and use of nontraditional remedies), lack of ethnic concordance between patient and clinician, patient's mistrust toward physician, clinician's bias toward minority patients, or lack of cultural sensitivity among health care providers [23,[33][34][35][36][37][38]. The influence of ethnicity on health and disease is complex, and encompasses a combination of these factors, which need measurement in comparative multiethnic studies of SLE so that researchers may fully understand their impact.…”

“…It is unlikely, however, that inequalities in health outcomes can be significantly impacted long-term without a substantial modification of the pervasive inequalities of other socioeconomic indicators between majority and minority ethnic groups. Depression, poor short-term memory, concern about medication side effects, and need for elder or child care were correlates of medication nonadherence among African-Americans; in Caucasians, the only correlate was treatment efficacy; missed appointments were positively associated with depression among AfricanAmericans and with trust in physicians among Caucasians Trust in research (and researchers) Brooks et al [33] A relatively higher level of mistrust still prevails among AfricanAmerican patients; such mistrust affects recruitment and retention in interventional and noninterventional studies Personal characteristics influencing disease expression and outcome…”

A qualitative approach exploring the acceptability of yoga for minorities living with arthritis: ‘Where are the people who look like me?’

“… 12 Specifically, within African American communities, mistrust has been historically documented as a significant factor affecting recruitment and retention. 13 For this study, cultural values such as allocentrism or collectivism (emphasizing the group rather than oneself) and familialism or familismo (strong identification with, feelings of loyalty, and attachment to family) were thought to potentially impact the recruitment of Hispanic participants. Under the concept of simpatía, 14 small talk was used when appropriate to build rapport, facilitate cooperation, and build trusting relationships between the researchers and participants.…”

Time to seizure occurrence and damage in PROFILE, a multi-ethnic systemic lupus erythematosus cohort

“…Nevertheless, given that ethnicity is not merely a biological construct but one that also encompasses ancestry, geography, history, values, culture, and language, the role of socioeconomic factors in the development of seizures or damage caused by seizures should not be easily dismissed. 26 We have confirmed previous findings related to the associations between damage accrual, clinical seizures, or damage caused by seizures, 7 between a previous cerebrovascular accident and clinical seizures, 8 and the observation that male gender may have a role in increasing the risk of damage caused by seizures. 7 In contrast to our study, where a previous episode of psychosis predicted damage caused by seizures, another study showed only a relationship between clinical seizures and psychosis.…”