- Author: Amy Quinton, UC Davis
Study finds even fewer screened during virtual appointments
As jobless rates rose during the COVID-19 pandemic, millions more Americans experienced food insecurity because they lacked consistent access to food. National health organizations recommend primary care providers screen patients for food insecurity, since not having access to enough food can lead to chronic diseases.
But research from the University of California, Davis, finds that only 7% of primary care providers screened patients for food insecurity. If the appointment was virtual or telehealth, only 3% asked patients about their access to food. The American Journal of Preventive Medicine published the research.
“These rates are surprising and seem relatively small in comparison with what seems like a growing awareness of food insecurity during the pandemic,” said lead author Cassandra Nguyen, an assistant professor of Cooperative Extension in the UC Davis Department of Nutrition.
She said the findings may indicate that health care providers were prioritizing emergency responses to COVID-19. The research showed that once people had access to COVID-19 vaccines, screening for food insecurity increased to 10%.
Barriers to telehealth screenings
Screening for food insecurity at telehealth appointments remained low even after vaccines became available. Nguyen said that may suggest telehealth appointments have unique barriers.
“One of those barriers could be a concern about privacy and whether the patient is alone or feels comfortable discussing a potentially stigmatizing experience such as food insecurity. This may deter a primary care provider from asking about it,” Nguyen said.
Screening might also be more difficult if patients aren't familiar with the technology needed or if there are technological disruptions during telehealth appointments. Nguyen said more study is needed about potential barriers given the increased popularity of telehealth appointments since the pandemic.
The research examined electronic health records and clinic data from a national network of more than 400 community health centers in 16 states. It examined encounters between March 11, 2020, and Dec. 31, 2021. Screening typically involves a primary care provider asking the patient to answer that either or both of the following two statements is often true or sometimes true:
- Within the past 12 months we worried whether our food would run out before we got money to buy more.
- Within the past 12 months the food we bought just didn't last and we didn't have money to get more.
Co-authors include Rachel Gold with OCHIN Inc. and Kaiser Permanente Northwest Center for Health Research; Alaa Mohammad, Dedra Buchwald and Clemma Muller with Washington State University; Molly Krancari, Megan Hoopes and Suzanne Morrissey with OCHIN Inc.
The National Center for Advancing Translational Sciences of the National Institutes of Health, and the National Institute of Diabetes and Digestive and Kidney Diseases supported the research.
/h3>/h3>- Author: AJMC.com by Alison Rodriguez
There is a significant prevalence of diagnosed HIV infection among Hispanics/Latinos in the United States compared with non-Hispanic whites. Researchers recently aimed to describe characteristics of Hispanics/Latinos in medical care by sex in order to identify disparities, emphasizing the need to decrease ethnic disparities in order to reach national prevention goals across populations.
The report, published by the CDC, used the 2013 and 2014 cycles of the Medical Monitoring Project (MMP) to collect demographic, behavioral, and clinical characteristic data among Hispanics/Latinos by sex.
The data revealed that Hispanic/Latina women were significantly more likely than men to live in poverty, report not speaking English well, and receive interpreter, transportation, and meal services. However, there were no significant differences between Hispanic/Latino women and men in prescription of antiretroviral therapy or sustained viral suppression, according to the report.
The lack of significant differences in clinical outcomes among Hispanic/Latino women and men may demonstrate a higher use of ancillary services by women, according to the authors.
“Levels of viral suppression for Hispanics/Latinos are lower than those found among non-Hispanic whites and lower than the national prevention goal of at least 80% of persons with diagnosed HIV infection,” the authors noted. “Providers should be cognizant of the challenges faced by Hispanics/Latinos with HIV infection in care and provide referrals to needed ancillary services.”
The data collected from the MMP included 1774 men and 577 woman who self-identified as Hispanic or Latino. The report noted that 78% of Hispanic/Latina women receiving HIV care lived at or below the federal household poverty level, compared with 54% of men. This is significant because the management of HIV care is known to be affected by poverty at all stages of the HIV care continuum. However, the higher reportage of meal and transportation services among women may helped certain negative consequences to their clinical outcomes.
“Overall, 38% of women and 21% of men reported not speaking English well, which can affect ability to understand a provider's instructions and ability to navigate the healthcare system,” the report stated. “In addition, the language barrier might prevent care providers from understanding the patient and could lead to missed opportunities to provide needed support or direction. Bilingual providers or interpreter services might have mitigated linguistic barriers.”
The report concluded it is necessary for providers to be aware of the challenges faced by this population and to improve access to ancillary services. Ethnic disparities need to be reduced in order to attain national prevention goals among this population, despite the lack of disparity found in viral suppression in HIV care in this report.
Source: Published originally on www.ajmc.com, Disparities in HIV Care Among Hispanic/Latino Men and Women, by Alison Rodriguez, December 1st, 2018.
- Author: Foxnews.com
When researchers studied 31,000 patients with diabetes who received insurance and healthcare through Kaiser Permanente in Northern California, they found that about 60 percent of Spanish-speaking Latino patients skipped filling prescriptions at least 20 percent of the time in the two years after they were told they needed the drugs to help control the disease.
That rate was only about 52 percent among English-speaking Latino patients and 38 percent among white patients.
"Latino patients with diabetes, even when insured and facing relatively low barriers to healthcare, are much more likely to have poor medication adherence than their white counterparts," said lead study author Dr. Alicia Fernandez, a researcher at San Francisco General Hospital and the University of California, San Francisco.
The study didn't find any difference in medication adherence for diabetics with limited English based on whether they saw Spanish-speaking doctors.
This suggests factors beyond just language and communication may come into play, researchers conclude in JAMA Internal Medicine.
"Physicians who care for Latino patients with diabetes should focus on medication adherence and explore individual barriers to adherence," Fernandez added by email. "These may include lack of 'buy-in' to medication treatment, concern regarding side effects, concerns regarding costs, and competing life demands on medication use and self-care."
But while this study didn't find that having Spanish-speaking doctors improved medication adherence, a separate study of Latino diabetics published in the same journal did see some benefit.
The researchers on the second study also looked at data from Kaiser Permanente, in this case to see whether patients with limited English proficiency might have better blood sugar control when they switched from English-speaking to Spanish-speaking primary care physicians.
This study included about 1,600 Latino patients who preferred speaking Spanish to English.
At the start of the study, 54 percent of these patients saw a primary care provider who didn't speak Spanish. During the study, 48 percent of this group of patients switched to a Spanish-speaking doctor.
After this switch to Spanish-speaking doctors, 74 percent of these patients had blood sugar in a healthy range, up from 63 percent when they saw English-speaking doctors. This increase was 10 percent more than the patients who just switched from one English-speaking doctor to another.
"Having a primary care provider that speaks your language appears to be important for several reasons; it improves lines of communication, may reduce the risk of misunderstandings, increases patient satisfaction and now there is evidence that it may also improve management of diabetes," said lead study author Melissa Parker, a researcher at Kaiser Permanente in Oakland, California.
Both studies have some limitations, including the lack of data on some factors that can influence how much patients take their medicine or follow advice from doctors, such as health literacy or the degree of spoken or written abilities in English and Spanish for physicians and patients.
Still, the results from these studies suggest that it would make sense to prioritize access to Spanish-speaking doctors for Latinos with limited English who are newly diagnosed with diabetes, Dr. Eliseo Perez-Stable, director of the National Institute on Minority Health and Health Disparities, writes in an accompanying editorial.
That's because seeing a doctor who speaks Spanish may be more important for establishing a treatment regimen than maintaining one, Perez-Stable writes.
"Communication between clinicians and patients is essential in most aspects of medicine but it is especially true in management of a chronic disease such as diabetes," Perez-Stable said by email.
Ideally, there would be more Spanish-speaking and bilingual doctors, Perez-Stable added by email. Absent that, patients should make sure there's a professional interpreter available and also bring someone to clinic visits who is bilingual and can help support the treatment plan after patients go home.
Source: Published originally on foxnews.com, Language may impact diabetes care for Latinos with limited English,, January 24, 2017.
- Author: Lisa M. Rawleigh
The results were consistent with research conducted by Pew in 2008. Hispanics have the same motivators and attitudes in how they receive healthcare information, and they can still be reached the same way, too—whether it's through clinics, doctors or TV. Here are some of the findings.
Trust Multiple Sources
Doctors are the most trusted source of healthcare information for both Hispanics and non-Hispanics. However, Hispanics seem to trust significantly more. In fact, Hispanics are much more likely to say doctors (66% vs. 58% for non-Hispanics), clinics (54% vs. 31% for non-Hispanics) and hospitals (56% vs. 37% for non-Hispanics) are extremely trustworthy.
Pharmacists, however, have a lower trust score – only 38% say they find pharmacists extremely trustworthy vs. 50 percent of non-Hispanics. This may be because the role of the pharmacist is very different in the U.S. than in many Hispanic countries of origin. In Latin America, pharmacists develop relationships with their customers and spend time listening to their needs. They are considered true partners in the Latino healthcare universe. U.S. pharmacies stand to gain a lot with Hispanic patients if they work on building those relationships, too.
More Likely to Take Action
TV, radio and digital play a strong role in how Hispanics receive health information. And, across the board, Hispanics are more likely to take action from the information they receive vs. non-Hispanics. For example, Hispanics are at least 23 percent more likely than non-Hispanics to say that online, TV or radio healthcare messages “led me to see a doctor or medical professional about a specific drug.” When you dig deeper, Hispanic women are even more likely to take action than their male counterparts. This suggests that healthcare marketers may see better results if they target their campaigns toward these Chief Medical Officers of the household.
Hispanics are listening to, trusting and reacting to healthcare messages from many sources. They also tend to worry more about the health and wellness of their families (78 percent say they worry a “great deal” vs. 59 percent of non-Hispanics).
Source: Published originally on Univision Hispanic Insights Weekly Digest as New Findings Show Hispanics' Sources for Healthcare Information byEric Talbot, August 6, 2014.
- Author: Myriam Grajales-Hall
Among all Americans and U.S. registered voters, healthcare, economic growth, and the federal deficit roughly tie as the most important issues, while immigration ranks last among both groups of Americans.
The new USA Today/Gallup poll makes it clear that economic issues -- particularly unemployment and economic growth -- are more important to Hispanic voters nationwide than immigration.
Hispanic immigrants and first-generation Hispanic Americans are more likely to mention immigration than those whose family has been in the U.S. longer than that. Specifically, 16% of Hispanic voters who are themselves immigrants to the U.S. name immigration as a priority, similar to the 14% of those who were born here but with at least one parent born abroad. By contrast, 7% of Hispanic voters who, along with their parents, were U.S.-born do the same.
The findings are based on Gallup Daily tracking interviews with 1,753 Hispanic adults in all 50 U.S. states and the District of Columbia conducted April 16-May 31. The sample includes 1,005 Hispanic registered voters who, on a weighted basis, represent 47% of the total sample of U.S. Hispanics.
Source: Gallup, Hispanic Voters Put Other Issues Before Immigration, www.gallup.com, June 25, 2012.
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