bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing the Unexpected: Lessons Learned from a Randomized Controlled Trial Conducted in Partnership with a Low-income, Rural Community
Authors: Kratt Polly , Kohler Connie , Schoenberger Yu-Mei M. , Clarke Stephen J. , Kim Young-il , Litaker Mark S. , Martin Michelle Y.
Published: November 2013

Healthy People 2020 objectives include increasing the proportion of individuals who are adherent to their hypertensive medications. In this paper we highlight lessons learned through the implementation of a clinical trial to evaluate a behavioral intervention to increase medication adherence in a rural, low-income, primarily African American community.
Recruiting Underserved Mothers to Medical Research: Findings from North Carolina
Authors: Spears Chaya R. , Sandberg Joanne C. , O’Neill Jenna L. , Grzywacz Joseph G. , Howard Timothy D. , Feldman Steven R. , Arcury Thomas A.
Published: November 2013

Representative samples are required for ethical, valid, and useful health research. Yet, recruiting participants, especially from historically underserved communities, can be challenging. This paper presents findings from in-depth interviews with 40 mothers about factors that might influence their willingness to participate or allow their children to participate in medical research. Saliency analysis organizes the findings. Frequent and important salient themes about research participation included concerns that it might cause participants harm, hope that participants might gain a health benefit, and recognition that time and transportation resources could limit participation. Ultimately, we propose that a theoretical model, such as the Theory of Planned Behavior (TPB), will facilitate more systematic evaluation of effective methods for recruitment and retention of participants in medical research. Future research should explore the utility of such a model for development of effective recruitment and retention strategies.
Contours of Usual Care: Meeting the Medical Needs of Diverse People with Serious Mental Illness
Authors: Ezell Jerel M. , Siantz Elizabeth , Cabassa Leopoldo J.
Published: November 2013

Purpose . To examine practices, barriers, and recommendations for addressing the physical health of racially and ethnically diverse people with serious mental illness (SMI). Methods . Semi-structured interviews and participant observations were conducted with 21 administrators and 25 clinicians representing six mental health care organizations. Data were analyzed using constant comparative methods. Results . Practices included intermittently collecting consumers’ physical health data, connecting consumers with primary care, and providing on-site, culturally-tailored health promotion programs. Barriers included limited care coordination infrastructure, financial and professional boundaries, unhealthy local environments and culturally-specific dietary habits. Recommendations included: strengthening dialogue with medical providers and developing staff training programs. Conclusion . Meeting the physical health needs of diverse consumers with SMI is impeded by organizational, environmental, and consumer-level barriers. Establishing better care coordination networks, increasing mental health provider education on medical issues, and culturally-tailoring health promotion programming provide plausible strategies for improving the physical health of this vulnerable population.
Efficient Identification of Low-Income Asian American Women at High Risk for Hepatitis B
Authors: Joseph Galen , Nguyen Kim , Nguyen Tung , Stewart Susan , Davis Sharon , Kevany Sebastian , Marquez Titas , Pasick Rena
Published: November 2013

Hepatitis B disproportionately affects Asian Americans. Because outreach to promote testing and vaccination can be intensive and costly, we assessed the feasibility of an efficient strategy to identify Asian Americans at risk. Prior research with California’s statewide toll-free phone service where low-income women call for free cancer screening found 50% of English-and Spanish-speaking callers were willing to participate in a study on health topics other than cancer screening. The current study ascertained whether Asian Americans could be recruited. Among 200 eligible callers, 50% agreed to take part (95% confidence interval 43%–57%), a rate comparable to our previous study. Subsequent qualitative interviews revealed that receptivity to recruitment was due to trust in the phone service and women’s need for health services and information. This was a relatively low-intensity intervention in that, on average, only five minutes additional call time was required to identify women at risk and provide a brief educational message. Underserved women from diverse backgrounds may be reached in large numbers through existing communication channels.
Increasing Access to Care for Chronic Myeloid Leukemia Patients: Assessment of a Scaling-up Program
Authors: Ladner Joël , Tekinturhan Ebru , Tavolacci Marie-Pierre , Audureau Etienne , Saba Joseph
Published: November 2013

Background . The Glivec International Patient Assistance Program (GIPAP) is designed to provide access to the cancer therapy Imatinib (Glivec⊠), which is indicated for the treatment of chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors (GIST). Objectives . To identify factors those influence the quality of care and structural improvements. Design . Physicians (n=50), hospital administrators (n=10) and Ministry of Health officials (n=7) in 39 developing countries participated in qualitative interviews. The interviews focused on the impact of GIPAP on service delivery, patient tracking systems and cancer registries, health financing, and workforce. Results . Service delivery, patient management, access to care, diagnostic capacity, and health workers’ skills improved at participants’ institutions following implementation of GIPAP. Conclusions . Positive institutional changes that improve care of CML/GIST patients arose from GIPAP. Some of these changes may strengthen institutions’ capacity to treat other diseases as well. The GIPAP model could be deployed to improve access to care for patients with other chronic diseases.
Strengthening Rural Latinos’ Civic Engagement for Health: The Voceros de Salud Project
Authors: López-Cevallos Daniel , Dierwechter Tatiana , Volkmann Kelly , Patton-López Megan
Published: November 2013

This article describes the Latino Health Ambassadors Network ( Voceros de Salud ) project created to support and mobilize Latino community leaders to address health inequalities in a rural Oregon county. Voceros de Salud is discussed as a model that other rural communities may implement towards strengthening Latino civic engagement for health.
Nurse versus Community Health Worker Identification of Psychosocial Risks in Pregnancy through a Structured Interview
Authors: Godecker Amy L. , Harrison Patricia A. , Sidebottom Abbey C.
Published: November 2013

A structured psychosocial risk screening interview, the Prenatal Risk Overview, was administered to 733 women in prenatal care. Either a community health worker (CHW) or a registered nurse (RN) conducted the interview based on day of the week. A comparison of identified risk factors found no significant differences between study samples for six of 13 domains. For CHW interviews, significantly more participants were classified as Moderate/ High Risk for Depression, Lack of Telephone Access, Food Insecurity, and Housing Instability, and as High Risk for Lack of Social Support, Lack of Transportation Access, and Housing Instability. For RN interviews, significantly more participants were classified as High Risk for Alcohol Use. Community health workers successfully conducted psychosocial screening and elicited more self-reported risk than RNs, especially lack of basic needs. Comparing the hourly salary/ wage, the cost for CHWs was 56% lower than for RNs. Preliminary findings support use of paraprofessionals for structured screening interviews.
Prevalence and Correlates of Breast and Cervical Cancer Screening Among a Midwest Community Sample of Low-Acculturated Latinas
Authors: Martínez-Donate Ana P. , Vera-Cala Lina M. , Zhang Xiao , Vedro Rhea , Angulo Rosario , Atkinson Tanya
Published: November 2013

Background . Low adherence to cervical and breast cancer (CBC) screening recommendations contributes to high CBC mortality among Latinas. Purpose . To estimate the prevalence of, and factors associated with, last 12-month Pap smear and mammogram receipt among a Midwest community sample of low-acculturated Latinas. Methods . We conducted a cross-sectional study with 278 Latina immigrants in Dane County, Wisconsin. Participants completed a self-administered questionnaire. We estimated multivariate logistic regression models to identify factors associated with CBC screening receipt. Results . Rates of last 12-month Pap smear and mammogram receipt were 56.8% and 39.4%, respectively. Age, knowledge of screening recommendations, and having a regular health care provider were independently associated with both Pap smear and mammogram receipt. Having ever used Planned Parenthood and fear of cancer were uniquely correlated with Pap smear and mammogram receipt, respectively. Conclusions . Modifiable individual, structural, and cultural factors contribute to suboptimal rates of CBC screening among low-acculturated Latino immigrants.
Are Differences between Patient and Provider Explanatory Models of Diabetes Associated with Patient Self-Management and Glycemic Control?
Authors: Weller Susan C. , Baer Roberta D. , de Alba Garcia Javier Garcia , Salcedo Rocha Ana L.
Published: November 2013

In this study we test whether differences between patient and provider explanatory models of diabetes affect self-management and glucose control in type 2 diabetes patients. Diabetic patients (n=60) and family practice physicians (n=39) in Guadalajara, Mexico, responded to a structured explanatory model interview (130 questions on causes, symptoms, and treatments). A cultural consensus analysis indicated a widely shared model among physicians and provided a single shared set of answers to the questions. Patient-provider congruence in beliefs was assessed by comparing each patient’s responses with the physician answer set. Congruence in beliefs predicted self-management behaviors (r=0.27, p=.03), more than educational level (r=0.16, p=.23), but was not predictive of A1C (r=0.12, p=.40). Differences between patient and physician explanatory models can adversely affect patient-directed activities and may indirectly affect glycemic control by affecting self-management. These differences may be due to low patient educational level and resulting problems in understanding biomedical approaches to diabetes.
Understanding and Reducing Obstacles in a Collaboration between a Minority Institution and a Cancer Center
Authors: Thompson Beti , O’Connell Mary , Löest Helena , Anderson Jennifer , Westcott Rick
Published: November 2013

Reducing the cancer incidence and mortality rates of underserved populations will require multidisciplinary efforts involving diverse teams of investigators. We describe a collaborative program between a National Cancer Institute-designated cancer center and a minority-serving institution. The organizations worked together to discover institutional and cultural barriers and facilitators to productive collaboration.
Health, Hope, and Human Development: Building Capacity in Public Housing Communities on the U.S.-Mexico Border
Authors: Mata Holly , Flores Maria , Castañeda Ernesto , Medina-Jerez William , Lachica Josue , Smith Curtis , Olvera Hector
Published: November 2013

Summary : In this paper we highlight results from our recent survey of public housing residents living in the U.S.-Mexico border region. Our data inform our interdisciplinary (public health, education, environmental engineering, sociology) efforts to improve health and educational equity in our community, and provide ripe opportunities for policy advocacy.
Patients’ Perceived Cultural Sensitivity of Health Care Office Staff and Its Association with Patients’ Health Care Satisfaction and Treatment Adherence
Authors: Wall Whitney , Tucker Carolyn M. , Roncoroni Julia , Allan Blake A. , Nguyen Phillip
Published: November 2013

Research suggests that patients’ interactions with their front desk office staff and patient-centered culturally sensitive health care are important factors in diverse patients’ overall health care satisfaction. Yet, patient-centered culturally sensitive health care research has focused almost exclusively on provider care. This study tested the hypothesis that patient-perceived cultural sensitivity of front desk office staff has a significant positive association with patient treatment adherence and that this relationship is mediated by patient health care satisfaction. Study participants were a culturally diverse sample of 1,191 patients from health care sites across the U.S. Results of a meditational analysis supported the tested hypothesis. Patient health care satisfaction fully mediated the relationship between patient-perceived cultural sensitivity of front desk office staff and patient treatment adherence. The patient satisfaction and cultural sensitivity variables explained 10% of the variance in patient treatment adherence. Training front desk office staff in patient-centered culturally sensitive health care may improve patients’ health care satisfaction and treatment adherence.
Triglyceride Screening May Improve Cardiometabolic Disease Risk Assessment in Latinos with Poorly Controlled Type 2 Diabetes
Authors: Vega-López Sonia , Calle Mariana C. , Fernandez Maria Luz , Kollannoor-Samuel Grace , Chhabra Jyoti , Todd Michael , Segura-Pérez Sofia , D’Agostino Darrin , Damio Grace , Pérez-Escamilla Rafael
Published: November 2013

To characterize metabolic syndrome (MetS) prevalence and cardiometabolic risk, HbA1c, fasting plasma glucose (FPG), plasma lipids, blood pressure, BMI, and waist circumference were measured in 211 Latino adults with type 2 diabetes. Participants were obese (BMI=33.7±7.8 kg/m 2 ) and had poor glycemic control (HbA1c=9.6±1.8 %; FPG=190±85 mg/dL), but normal LDL and HDL cholesterol concentrations (98±38 mg/dL, and 52±14 mg/dL, respectively). Relative to the lowest, participants in the highest quintile of plasma triglycierides had higher total cholesterol (23%; p<.0001), FPG (47%; p<.0001), systolic blood pressure (3%; p<.05) and diastolic blood pressure (6%; p<.05), and lower HDL cholesterol (23%; p<.01). Comparable relationships were observed in an age-adjusted regression model. Framingham risk was equivalent to 9.4±6.4% and 12.2±9.6% 10-year CHD risk in men and women, respectively (p<.05). Cardiometabolic risk in this population is associated with a high prevalence of the MetS despite the relatively low cholesterol concentrations. Triglyceride screening may help identify individuals at higher risk.
Hypertension among Oral Contraceptive Users in El Paso, Texas
Authors: White Kari , Potter Joseph E. , Hopkins Kristine , Amastae Jon , Grossman Daniel
Published: November 2013

On the U.S.-Mexico border, residents frequently cross into Mexico to obtain medications or medical care. We previously reported relatively high prevalence of hypertension among Latina oral contraceptive users in El Paso, particularly those obtaining pills over the counter (OTC) in Mexico. Here, we examine factors associated with having hypertension among 411 OTC users and 399 clinic users. We also assess hypertension awareness and interest in using blood pressure kiosks. Women age 35 to 44 and who had BMI ≥ 30 kg/m 2 had higher odds of having hypertension. 59% of hypertensive women had unrecognized hypertension, and 77% of all participants would use a blood pressure kiosk; there were no significant differences between clinic and OTC users. Alternative approaches to increase access to health screenings are needed in this setting, where OTC pill use among women with unrecognized hypertension confers unique health risks.
Cigarillo use among High-Risk Urban Young Adults
Authors: Milam Adam J. , Bone Lee R. , Byron M. Justin , Hoke Kathleen , Williams Carla D. , Furr-Holden C. Debra , Stillman Frances A.
Published: November 2013

In the U.S., cigar use doubled from 5.0 to 10.6 billion cigars consumed annually between 1997 and 2007, driven in large part by increased sales of cigarette-sized “little cigars” and narrow, mid-sized “cigarillos.” The present study examined prevalence of cigarillo use as well as attitudes, knowledge and behaviors related to cigarillo use among a sample of predominantly urban African American young adults 18–24 not in school and not employed. Survey data were collected from 131 young adults attending education and job training centers in Baltimore, Maryland and from 78 young adults attending education, job training, or recreational programs in Washington, D.C. In Baltimore, 22% of young adults had smoked a cigarillo in the past 30 days, compared with nearly 63% in D.C. Both populations were heavily exposed to cigarillo advertising and marketing. Cigarillo use in this urban young adult population is a growing public health problem and undermines the progress made in decreasing cigarette use.
Utility and Effectiveness of Orbito-ocular B-scan Ultrasonography in an African Developing Country
Authors: Eze Boniface I , Onu Augustine C , Imo Augustine O , Mgbor Samuel O
Published: November 2013

Background . Diagnostic orbito-ocular ultrasonography is a safe, affordable, and cost-effective procedure that is especially suited for resource-poor developing countries. Periodic evaluation of its utility and effectiveness is important in the light of phenomenal advances in medical imaging. Objectives . To assess the utility and effectiveness of B-scan orbito-ocular ultrasonography in a Nigerian ophthalmic patient population. Methods . The Hansa Clinic’s database was retrospectively reviewed, between January 2006 and December 2010, to obtain patients’ relevant demographic and clinical data. Results . The subjects comprised 119 males and 81 females. The leading sonographic diagnoses were ocular (90.4%): retinal detachment—23.3%, cataract—14.0%, and vitreous haemorrhage—10.5%; orbital (8.3%): ‘mass lesion’—4.8% and myopathies—0.8%. The agreement between clinical and sonographic diagnoses was complete in 35.5% eyes. Conclusion . At Hansa Clinics, intraocular lesions are the main findings of diagnostic orbito-ocular sonography. There is poor agreement between clinical and sonographic diagnoses. Improved correlation of patients’ clinic-pathologic data is suggested.
Efficiency Disparities among Community Hospitals in Tennessee: Do Size, Location, Ownership, and Network Matter?
Authors: Roh Chul-Young , Moon M. Jae , Jung Kwangho
Published: November 2013

This study examined the impact of ownership, size, location, and network on the relative technical efficiency of community hospitals in Tennessee for the 2002–2006 period, by applying data envelopment analysis (DEA) to measure technical efficiency (decomposed into scale efficiency and pure technical efficiency). Data envelopment analysis results indicate that medium-size hospitals (126–250 beds) are more efficient than their counterparts. Interestingly, public hospitals are significantly more efficient than private and nonprofit hospitals in Tennessee, and rural hospitals are more efficient than urban hospitals. This is the first study to investigate whether hospital networks with other health care providers affect hospital efficiency. Results indicate that community hospitals with networks are more efficient than non-network hospitals. From a management and policy perspective, this study suggests that public policies should induce hospitals to downsize or upsize into optional size, and private hospitals and nonprofit hospitals should change their organizational objectives from profit-driven to quality-driven.
Health Literacy, Physician Trust, and Diabetes-related Self-care Activities in Hispanics with Limited Resources
Authors: White Richard O. , Osborn Chandra Y. , Gebretsadik Tebeb , Kripalani Sunil , Rothman Russell L.
Published: November 2013

Background . Hispanics with diabetes often have deficits in health literacy (HL). We examined the association among HL, psychosocial factors, and diabetes-related self-care activities. Methods . Cross-sectional analysis of 149 patients. Data included patient demographics and validated measures of HL, physician trust, self-efficacy, acculturation, self-care behaviors, and A1c. Results . Participants (N=60) with limited HL were older and less educated, and had more years with diabetes compared with adequate HL participants (N=89). Limited HL participants reported greater trust in their physician, greater self-efficacy, and better diet, foot care, and medication adherence. Health literacy status was not associated with acculturation or A1c. In adjusted analyses, HL status remained associated with physician trust, and we observed a notable but nonsignificant trend between HL status and medication adherence. Discussion . Lower HL was associated with greater physician trust and better medication adherence. Further research is warranted to clarify the role of HL and physician trust in optimizing self-care for Hispanics.
Consulting Psychiatry within an Integrated Primary Care Model
Authors: Zeidler Schreiter Elizabeth A. , Pandhi Nancy , Fondow Meghan D. M. , Thomas Chantelle , Vonk Jantina , Reardon Claudia L. , Serrano Neftali
Published: November 2013

After implementation of an integrated consulting psychiatry model and psychology services within primary care at a federally qualified health center, patients have increased access to needed mental health services, and primary care clinicians receive the support and collaboration needed to meet the psychiatric needs of the population.
An Examination of End-of-Life Care in a Safety Net Hospital System: A Decade in Review
Authors: Rhodes Ramona L. , Xuan Lei , Paulk M. Elizabeth , Stieglitz Heather , Halm Ethan A.
Published: November 2013

Objectives . To examine patterns of use of end-of-life care in patients receiving treatment at a large, urban safety-net hospital from 2000 to 2010. Methods . Data from the Parkland Hospital palliative care database, which tracked all consults for this period, were analyzed. Logistic regression was used to identify predictors of hospice use, and Cox proportional hazards modeling to examine survival. Results . There were 5,083 palliative care consults over the study period. More patients were Black (41%) or White (31%), and younger than 65 years old (75%). Cancer patients or those who received palliative care services longer were more likely to receive hospice; those who had no form of health care assistance were less likely. There were no racial/ethnic differences in hospice use. Conclusion . In this cohort, there were no racial/ethnic disparities in hospice use. Those who had no form of health care assistance were less likely to receive hospice.
Community Health Workers, Social Support and Cervical Cancer Screening among High-risk Groups in Rural Mexico
Authors: Elliott Patrick F. , Belinson Suzanne E. , Ottolenghi Emma , Smyth Kathleen , Belinson Jerome L.
Published: November 2013

Background . Rural Mexico has a low screening prevalence and high burden of cervical cancer. One strategy to increase screening coverage utilizes community health workers (CHWs) to recruit high-risk women and address barriers. Methods . We conducted a systematic cross-sectional survey of 196 women residing in Chiapas, Mexico who were recruited by either CHWs or traditional means for screening. This analysis compares 110 rural women’s risk factors, attitudes and knowledge of cervical cancer and socioeconomic factors stratified by type of recruitment. Results . Women who were informed of screening by CHWs were more likely to be of high risk sub-groups and report higher scores of social support but were also more likely to endorse difficulty with access and fatalistic attitudes about cancer. Discussion . Utilizing CWHs results in increased screening among high-risk women and increased social support for screening among rural women, addressing a significant barrier, but may have limited effects on other barriers.
Development and Implementation of a Navigator-Facilitated Care Coordination Algorithm to Improve Clinical Outcomes of Underserved Latino Patients with Uncontrolled Diabetes
Authors: Congdon Heather Brennan , Eldridge Barbara Hoffman , Truong Hoai-An
Published: November 2013

Development and implementation of an interprofessional navigator-facilitated care coordination algorithm (NAVCOM) for low-income, uninsured patients with uncontrolled diabetes at a safety-net clinic resulted in improvement of disease control as evidenced by improvement in hemoglobin A1C. This report describes the process and lessons learned from the development and implementation of NAVCOM and patient success stories.
Race, Ethnicity, and Language Data Collection by Health Plans: Findings from 2010 AHIPF-RWJF Survey
Authors: Nerenz David R. , Carreón Rita , Veselovskiy German
Published: November 2013

Background . Previous national surveys have documented the increase in collection of race, ethnicity, and language (REL) data by health plans. The latest 2010 survey created an opportunity to examine recent trends and to determine whether the Patient Protection and Affordable Care Act (ACA) had an effect on plans’ practices. Methods . A 51-item survey was sent to all health plans included in a national listing of plans (N = 250). Results . The majority of responding plans collect data on members’ REL. The frequency of race and ethnicity data collection was only slightly greater in 2010 than in 2008, 78.7% and 75% respectively. By 2010, 89.3% of health plans were collecting language data of their members, up from 74% in 2008 and 57.3% in 2003. Conclusions . Since 2008, collection and use of REL data continues gradually to increase among health plans, demonstrating the industry’s commitment to address racial/ethnic gaps in care.
The Influence of Perceived Discrimination on Health-Related Quality of Life in an East Coast American Indian Tribe
Authors: Johansson Patrik , Muller Clemma J. , Samos Markos W. , Goldberg Jack
Published: November 2013

Objective . To examine the association of perceived discrimination and health-related quality of life using cross- sectional survey. Methods . We measured perceived discrimination using a nine-item discrimination scale and measured health-related quality of life with the mental component summary (MCS) and physical component summary (PCS) scores of the Short Form-12 questionnaire. The sample was drawn from adult members of an East Coast American Indian Tribe. Results . After adjusting for age, sex, marital status, education, and smoking status, perceived discrimination scores greater than the sample median were associated with higher odds of poor mental functioning (odds ratio = 2.25, 95% CI = 1.03–4.91) but not with poor physical functioning (odds ratio = 1.18, 95% CI = 0.53–2.63). Conclusions . Our findings support results from previous studies linking perceived discrimination to worse mental health outcomes.
Patterns of Clinical Response to PSA Elevation in American Indian/Alaska Native Men: A Multi-center Pilot Study
Authors: Tilburt Jon C. , Koller Kathryn , Tiesinga James J. , Wilson Robin T. , Trinh Anne C. , Hill Kristin , Hall Ingrid J. , Smith Judith Lee , Ekwueme Donatus U. , Petersen Wesley O.
Published: November 2013

Objective . To assess clinical treatment patterns and response times among American Indian/Alaska Native men with a newly elevated PSA. Methods . We retrospectively identified men ages 50–80 receiving care in one of three tribally-operated clinics in Northern Minnesota, one medical center in Alaska, and who had an incident PSA elevation (> 4 ng/ml) in a specified time period. A clinical response was considered timely if it was documented as occurring within 90 days of the incident PSA elevation. Results . Among 82 AI/AN men identified from medical records with an incident PSA elevation, 49 (60%) received a timely clinical response, while 18 (22%) had no documented clinical response. Conclusions . One in five AI/AN men in our study had no documented clinical action following an incident PSA elevation. Although a pilot study, these findings suggest the need to improve the documentation, notification, and care following an elevated PSA at clinics serving AI/AN men.
Are Very Poor Women More Vulnerable to Violence Against Women?: Comparison of Experiences of Female Beggars with Homemakers in an Urban Slum Settlement in Ibadan, Nigeria
Authors: Fawole Olufunmilayo I. , Asekun-Olarinmoye Esther O. , Osungbade Kayode O.
Published: November 2013

This study compared the prevalence and nature of violence against women (VAW) experienced by 104 female beggars with those of 219 homemakers in Sabo, an urban migrant slum settlement in Ibadan, Nigeria. The lifetime experience of VAW was 66.3% (95%CI: 62.5–70.1) among the beggars and 54.8% (95%CI: 52.2–57.6) among the homemakers (p=.05), while six months preceding the survey was: 56.7% (95%CI: 55.2–58.2) and 21.9% (95%CI: 20.8.2–23.0) respectively p=.0001). Psychological violence was experienced by 34.7% and 20.8% (p=.05); physical violence by 31.9% and 16.7% (p=.02) and sexual by 20.3% and 0.8% (p=.0001) of the beggars and homemakers respectively. Beggars with higher knowledge levels (aOR 0.23; 95%CI 0.07–0.80) and with more egalitarian attitudes (aOR 0.38; 95%CI 0.12–0.91) were less likely to experience violence. Suggestions to end VAW included female education (27.8%) and economic empowerment (59.2%). There is need to protect beggars by increasing access to health information, schooling, vocational training and income generating activities.
Establishing the Infrastructure to Comprehensively Address Cancer Disparities: A Model for Transdisciplinary Approaches
Authors: Green B. Lee , Rivers Desiree A. , Kumar Nagi , Baldwin Julie , Rivers Brian M. , Sultan Dawood , Jacobsen Paul , Gordon Leslene E. , Davis Jenna , Roetzheim Richard
Published: November 2013

The Center for Equal Health (CEH), a transdisciplinary Center of Excellence, was established to investigate cancer disparities comprehensively and achieve health equity through research, education, training, and community outreach. This paper discusses challenges faced by CEH, strategies employed to foster collaborations, lessons learned, and future considerations for establishing similar initiatives.
African American Men’s and Women’s Perceptions of Clinical Trials Research: Focusing on Prostate Cancer among a High-Risk Population in the South
Authors: Owens Otis L. , Jackson Dawnyéa D. , Thomas Tracey L. , Friedman Daniela B. , Hébert James R.
Published: November 2013

While African Americans are at a significantly higher risk for developing certain cancers, they also have low rates of participation in cancer research, particularly clinical trials. This study assessed both African American men’s and African American women’s (1) knowledge of and participation in cancer-related clinical research and (2) barriers to and motivations for participating in clinical research. Data were collected from a total of 81 participants. Phase I of this research consisted of qualitative focus groups (all 81 participants). Phase II included quantitative pre/post survey data from an education program (56 participants). Findings from the study revealed that African American men and women had poor knowledge about clinical trials and the informed consent process, limited experience in participating in clinical trials, and they feared and mistrusted cancer research. Participants identified incentives, assurance of safety, knowledge and awareness, and benefiting others as motivators to participate in clinical trials research.
Ethnically Diverse Patients’ Perceptions of Clinician Computer Use in a Safety-net Clinic
Authors: Ratanawongsa Neda , Barton Jennifer L. , Schillinger Dean , Yelin Edward H. , Hettema Jennifer E. , Lum Paula J.
Published: November 2013

Electronic health record (EHR) implementation may affect patient-clinician communication for diverse safety-net populations. We conducted a cross-sectional survey of English-, Spanish-, and Cantonese-speaking patients in a public hospital clinic with a basic EHR. We examined multivariate associations of patient race/ethnicity, language, and education with perceptions of primary-care provider (PCP) computer use. Among 399 respondents, 25% had less than a high school education, 22% preferred Spanish, and 17% Cantonese. Asian (AOR 3.1), non-English-speakers (AOR 3.6) were more likely to report that PCPs used the computer half or more of the visit. Asians were more likely to report that computers helped PCPs remember patient concerns (AOR 5.6). Non-English-speakers had lower odds of reporting that PCPs listened less carefully to them because of computers (AOR 0.3). Patients at risk for communication barriers may perceive advantages of PCP computer use. Safety-net clinics should consider EHR impact on communication disparities.
Predictors of End-stage Renal Disease in the Urban Poor
Authors: Hall Yoshio N. , Choi Andy I , Xu Ping , Smith Nicholas L. , Boyko Edward J.
Published: November 2013

We sought to examine the influence of social and clinical factors on risk of progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD) in the urban poor. We studied 15,353 individuals with moderate-to-advanced CKD who received ambulatory care within a large public health system during 1996–2005. The primary outcome was progression to ESRD. Overall, 559 cases of ESRD occurred over a median follow-up of 2.8 years. Among traditional predictors of ESRD, younger age, male sex, non-White race/ethnicity, public health insurance coverage, diabetes, lower kidney function, higher proteinuria, lower hemoglobin level, and lower serum albumin concentration were significantly associated with a higher adjusted ESRD risk (p<.001 for all). There was no significant association between HIV/AIDS (p=.07), viral hepatitis (p=.11), or non-English language (p=.27) and ESRD risk. Our results highlight the importance of addressing traditional risk factors for progressive CKD to reduce the disproportionate burden of ESRD among disadvantaged populations.
Cybercafés in China: Community Access beyond Gaming and Tight Government Control
Authors: Qiu 邱林川 Jack Linchuan
Published: November 2013

This article offers a historical overview and critique of cybercafés in China. Four phases of development are introduced: the initial "technological enlightenment" phase of the late 1990s; the turbulent, "crackdown" years after 1999; the new growth period of 2004-2008; and the latest phase of consolidation since 2009. By reviewing the key incidents, players, and official statistics, this paper goes beyond the popular issues of gaming and crackdowns to offer a more comprehensive contextualization and explanation. It interrogates the relationship between the cybercafé and the community, and offers analysis of three fundamental issues—job creation in the community, affordable leisure activities, and youth socialization beyond family. Results from a news discourse analysis are then presented to show how the Chinese press reported on cybercafés from 2000-2009, how their news frames changed, and alternative modes of understanding and operating cybercafés. The paper concludes by presenting the broader implications for community informatics in China that can be drawn from the examination of cybercafés.
The Development, Current State, and Effects of Community Informatization in Mainland China
Authors: Lai Maosheng 赖茂生 , Fan Zhenjia 樊振佳 , Zhang Lili 张丽丽
Published: November 2013

In recent years, community informatization initiatives have developed throughout mainland China. The meaning of "community informatization" in China is similar to "community informatics" in the U.S. This paper aims to investigate the current state of community informatization in mainland China—with a focus on best practices, major challenges, patterns of development, developing trends, and effects. Comparing the theory and practice of China's community informatization to community informatics in other countries, especially in the U.S. and Europe, this paper asks: can government-sponsored or independent informatization efforts bridge the digital divide and help China realize digital—or information—equity?
Three Digital Platforms: Hangzhou Public Library Widens Access to Resources
Authors: Clarke Christopher Peter , Su Hui 粟慧 , Ruan Li 阮立
Published: November 2013

This article investigates the "three digital platforms" of Hangzhou Public Library 杭州图书馆 through a discussion of information inequality, the digital divide, and community informatics. After an introduction to the context of contemporary China, and in particular Hangzhou, the authors consider the resources themselves with special reference to their ability to reduce information inequality. These resources—the "Three Platforms" referenced in the title of this essay—are: the library's Website (which can be accessed through standard browser applications), a Wireless Application Protocol (WAP) service that is available to mobile users, and a unique digital television service (that is supplied in collaboration with a local cable television company). As part of this discussion, the authors provide data on the number of users and views each service has had in the time since their implementation; offer detailed information on the profile of Website use and the numbers of library patrons taking part in library activities; assess the impact of these services; and debate their implications for community informatics and digital inequality in Hangzhou. Finally, the authors discuss potential future developments.
The Top-Down Approach to Providing ICT Access to Rural Communities in China: Opportunities for Community Informatics
Authors: Yu Liangzhi 于良芝 , Yu Binbin 于斌斌
Published: November 2013

Community informatics (CI)—as practiced by Western academics and social activists—was introduced to China by a group of library and information science scholars in about 2010. But before this encounter, there was already a growing push in China to connect local communities with information communication technologies (ICTs). This work is generally known in China as community or rural "informatization." Although the new, Western-origin community informatics efforts did not completely overlook existing Chinese endeavors, they have so far done little to relate to ongoing domestic projects. This article attempts to place community informatics in relation to Chinese rural informatization programs in general, and to public access projects in particular. In the process, it examines the opportunities and challenges facing the newly imported community informatics projects. It shows that while CI brings a new perspective to Chinese endeavors, it faces a very different political, institutional, and social environment from what it has known before—one which favors a top-down approach to providing community-based ICT. This calls for prudent assessment of the relationship between CI and both rural communities and government-led projects.
Private Libraries in China: Their Diversity, Informatization, and Role as Public Spaces
Authors: Wang Zizhou 王子舟 , Yin Peili 尹培丽 , Wu Hanhua 吴汉华
Published: November 2013

Private libraries in China—most of which were created by bottom-up processes, not top-down government mandates—offer a diversity of services to a range of constituencies. They offer individuals space for reading and study, information exchange, interpersonal communication, IT training, amusement, recreation, and entertainment. They offer schools and communities an aggregated abundance of social resources in a learning-centered atmosphere, which in turn enhances school- and community-based cooperation. For society as a whole , they offer support for the elimination of "knowledge poverty," and a boost for public service and civil society. Thus they function, to some degree, as community informatization commons and community-based public space.
Social Inclusion or Exclusion?: When Weibo (Microblogging) Meets the "New Generation" of Rural Migrant Workers
Authors: Zhang Pengyi 张鹏翼
Published: November 2013

The rapid development of social media has had a profound impact on how people access and share information in China. Some researchers suggest that the new social media has broken through the monolithic propaganda of traditional Chinese media and brought a diversity of topics and perspectives into view. Others argue that platforms such as Weibo (microblogging) largely privilege the opinions of well-educated, middle class individuals, keeping working class industrial and rural workers' voices on the margins. The question remains: has the development of social media bridged or deepened the "digital divide"? In an effort to address this question, this paper explores the appearance of members of a "new generation" of migrant workers on Sina Weibo, the most popular microblogging service in China. Drawing on the results a study of Sina Weibo posts, reposts, and authors, this paper offers three main arguments: (1) Weibo is not only a means for sharing information and expressing opinions, it is also a platform where users mobilize to improve the lives of migrant workers in cities; (2) Weibo provides an emotional outlet, offering members of the "new generation" of migrant workers the opportunity to express dissatisfaction with the bitter reality of their lives and a longing for a better life; and (3) The most influential users of this microblogging platform tend to be media figures, scholars, government officials, and other individuals from outside the community. The author concludes that more effort needs to be made so that, instead of creating new inequalities, social media technology can be of assistance to members of socially marginalized groups.
The Role of Information Technology in Academic Libraries' Resource Sharing in Western China
Authors: Ruan 阮炼 Lian , Zhu Qiang 朱强
Published: November 2013

This essay examines the work of China Academic Library and Information System (CALIS), an academic library community that has established resource sharing in a network environment. More specifically, it examines CALIS's work in the developed Eastern and the underdeveloped Western regions in China and considers how CALIS has used information technology to narrow the gap between academic library communities in these distinct regions. It also attempts to promote professional understanding about academic libraries in China's Western region, especially around the ways in which these libraries have used information technology and digital databases of local culture to help transform communities across their regions.
The Flow of Information as Empowerment and the Changing Social Networking Landscape in Rural China
Authors: Cheng 鄭松泰 Chung-tai
Published: November 2013

The article explores the ways in which Chinese villagers adapt cell phone technology to their needs and desires in the context of rural urbanization. The first part of the article uses an example from two villages in Western China to trace the adoption of cell phone technology by rural people, particularly those with minimal experience using landline phones. Then, by examining a case in which cell phones are being used as gifts in rural Chinese society, it goes on to reflect upon the ways in which ICTs are changing everyday interactions between family and kinship members. The second part of the article looks at how villagers use cell phones as substitutes for landline phones to obtain and exchange information in markets. Mobile adoption not only enables individuals to possess greater bargaining power in market exchange but also indicates that community-based information inclusion may be an effective means for diminishing regional disparities in China.
A Tale of Two Counties: How Two School Libraries in Rural Western China Serve Local Needs
Authors: Wei Zhipeng 魏志鹏 , Jiang Guodong 蒋国栋 , Niu Tuowen 牛托稳 , Zou 邹际平 Tim , Dong 董小芬 Elaine
Published: November 2013

This report presents a case study of school library programs in two rural counties in Western China. Since 2002, the libraries of Tianzhu and Tongwei high schools have undertaken a series of outreach initiatives to improve local residents' access to information and to address their cultural and educational needs. Over the past decade, both school libraries have played a leading role in improving the quality of life and enhancing the information literacy of local residents. Tianzhu No. 1 High School Library 天祝一中图书馆—which serves a large Tibetan and other minority populations—has gained a reputation for its oral history of local culture program. This program trains students to conduct interviews with folk artists and scholars and then post their audiovisual recordings on websites. Tongwei No. 1 High School Library 通渭一中图书馆 is known for providing health care information through both in-person workshops and online. Recently, it implemented a tutoring service aimed at teaching residents to use online resources. These programs have been successful and sustainable in part because of the sponsorship and funding of the U.S.-based Evergreen Education Foundation (EEF) 美国青树教育基金会. This report analyzes the results of these major initiatives, both of which do a great deal to reach out to rural residents, particularly farmers and the elderly.
Farmers' Reading Rooms and Information and Communications Technology in Rural Areas of Beijing
Authors: Tian Rui 田瑞
Published: November 2013

The reading rooms in the rural areas of Beijing are among the oldest farmers' reading rooms in China. By 2011, 3,974 farmers' reading rooms had been established in rural areas of Beijing; there is now one farmers' reading room in each village. This essay investigates the use of farmers' reading rooms and information and communication technology (ICT) by villagers in eight villages of Fangshan District in Beijing from the perspective of community informatics. The study that forms the basis of this essay found that the "hollowing-out" of the rural population is one of the major reasons why the utilization rate of farmers' reading rooms, computers, and the Internet is still low in the rural areas of Beijing. Thus, the author argues that although mobile Internet applications may narrow the urban-rural digital divide, it is necessary to accelerate the digitization upgrade of the farmers' reading rooms in rural areas. The government should also develop appropriate related policies, give subsidies to reduce Internet access fees, and prioritize training farmers in the use of ICT.
Social Capital, Digital Inequality, and a "Glocal" Community Informatics Project in Tianzhu Tibetan Autonomous County, Gansu Province
Authors: Yan Hui 闫慧 , Zhou Wenjie 周文杰 , Han Shenglong 韩圣龙
Published: November 2013

This article examines a "glocal" community informatics project that is transforming villages in Western China. Funded and initiated by the U.S.-based Evergreen Education Foundation (EEF)—an organization that makes public computing resources available to the digital poor and digital extremely poor communities—the project supports the establishment of public computing sites in primary and middle schools, thereby improving villagers' digital consciousness and digital literacy. This study uses a digital inequality model—organized around a pyramid of five classes comprising the digital elite, the digital rich, the digital middle class, the digital poor, and the digital extremely poor—to assess the impact of this project. The authors found that, on the whole, the EEF's training programs helped people move up the pyramid of digital inequality.