Hypertension and race/ethnicity.
Deere BP, Ferdinand KC.Curr Opin Cardiol. 2020 Jul;35(4):342-350. doi: 10.1097/HCO.0000000000000742.PMID: 32398604 Review.
Purpose of review: United States racial/ethnic minorities may experience disproportionate hypertension (HTN) morbidity and mortality. This review discusses recent literature regarding the differential impact of HTN, especially among African Americans and Hispanics.
Recent findings: Although disparities in HTN prevalence, control, and outcomes persist in racial/ethnic minorities relative to non-Hispanic Whites, racial/ethnic minorities are frequently underrepresented in genetic and clinical studies. Genomics have improved our understanding of HTN, but with no clinically useful application, the role of social determinants of health in HTN disparities is increasingly recognized. Team-based approaches with targeted, multilevel interventions may overcome barriers that uniquely impact racial/ethnic minorities.
Summary: Despite extensive epidemiological research, racial/ethnic minorities remain at higher risk HTN-related morbidity and mortality. Translational efforts may address the differential impact of HTN in racial/ethnic minorities. This review highlights recent research and concepts related to HTN and race/ethnicity.
Evidence-Based Strategies for Clinical Organizations to Address COVID-19 Vaccine Hesitancy. (requires PCOM login)
Finney Rutten LJ, Zhu X, Leppin AL, Ridgeway JL, Swift MD, Griffin JM, St Sauver JL, Virk A, Jacobson RM.
Mayo Clin Proc. 2021 Mar;96(3):699-707. doi: 10.1016/j.mayocp.2020.12.024. Epub 2020 Dec 30.
Building upon efforts at the policy and community level to ensure population access to COVID-19 vaccination, a strong health care system response is critical to address vaccine hesitancy.
PMID: 33673921 Free PMC article. Review.
The success of vaccination programs is contingent upon irrefutable scientific safety data combined with high rates of public acceptance and population coverage. Vaccine hesitancy, characterized by lack of confidence in vaccination and/or complacency about vaccination that may lead to delay or refusal of vaccination despite the availability of services, threatens to undermine the success of coronavirus disease 2019 (COVID-19) vaccination programs. The rapid pace of vaccine development, misinformation in popular and social media, the polarized sociopolitical environment, and the inherent complexities of large-scale vaccination efforts may undermine vaccination confidence and increase complacency about COVID-19 vaccination. Although the experience of recent lethal surges of COVID-19 infections has underscored the value of COVID-19 vaccines, ensuring population uptake of COVID-19 vaccination will require application of multilevel, evidence-based strategies to influence behavior change and address vaccine hesitancy. Recent survey research evaluating public attitudes in the United States toward the COVID-19 vaccine reveals substantial vaccine hesitancy. Building upon efforts at the policy and community level to ensure population access to COVID-19 vaccination, a strong health care system response is critical to address vaccine hesitancy. Drawing on the evidence base in social, behavioral, communication, and implementation science, we review, summarize, and encourage use of interpersonal, individual-level, and organizational interventions within clinical organizations to address this critical gap and improve population adoption of COVID-19 vaccination.
Considering Emotion in COVID-19 Vaccine Communication: Addressing Vaccine Hesitancy and Fostering Vaccine Confidence. (requires PCOM login)
Chou WS, Budenz A.
Health Commun. 2020 Dec;35(14):1718-1722. doi: 10.1080/10410236.2020.1838096. Epub 2020 Oct 30.
There are opportunities to consider the role of emotion in communication efforts. In this commentary, we highlight several ways negative as well as positive emotions may be considered and leveraged.
Long-term control of the COVID-19 pandemic hinges in part on the development and uptake of a preventive vaccine. In addition to a segment of population that refuses vaccines, the novelty of the disease and concerns over safety and efficacy of the vaccine have a sizable proportion of the U.S. indicating reluctance to getting vaccinated against COVID-19. Among various efforts to address vaccine hesitancy and foster vaccine confidence, evidence-based communication strategies are critical. There are opportunities to consider the role of emotion in communication efforts. In this commentary, we highlight several ways negative as well as positive emotions may be considered and leveraged. Examples include attending to negative emotions such as fear and anxiety, raising awareness of emotional manipulations by anti-vaccine disinformation efforts, and activating positive emotions such as altruism and hope as part of vaccine education endeavors.
Public awareness about coronavirus vaccine, vaccine acceptance, and hesitancy. (requires PCOM login)
Elgendy MO, Abdelrahim MEA.
J Med Virol. 2021 Jul 13. doi: 10.1002/jmv.27199. Online ahead of print.
Measurement of the population’s general knowledge of the coronavirus vaccine is very important to improve public acceptance and decrease vaccine hesitancy in confronting the disease.
Measurement of the population’s general knowledge of the coronavirus vaccine is very important to improve public acceptance and decrease vaccine hesitancy in confronting the disease. This study aimed to evaluate the knowledge, attitude, and practices of the participants towards the coronavirus vaccine. Data were collected using an online survey, in the form of a structured questionnaire, conducted during April-May 2021 in Egypt, and subjects from all over Egypt participated. The questionnaire was divided into three parts to assess the knowledge and attitude regarding coronavirus. The first part was to assess participants’ experience about coronavirus infection (eight items), the second was to assess the health beliefs about coronavirus and vaccine (16 items) and the third was to assess general knowledge, attitude, and practices of the participants towards vaccine (28 items). A total of 871 (465 females) participants participated, 81% of them were still committed to the precautionary measures for protection. Eighty-eight percent of them accepted to take the vaccine. Eighty-three percent of the participants answered that they will encourage family, friends, and colleagues to get the vaccine. Ninety-four percent knew that the coronavirus vaccine provides immunity against infection for a period of 6-12 months. 91.9% believed that the current infection with coronavirus is one of the main contraindications to vaccination. Eighty-nine percent believed that both pregnant women and chronic disease patients can get vaccinated and also that there is no specific age for a specific type of vaccination. Ninety-four percent of them knew that subjects taking immunosuppressive drugs should be prescribed Sinopharm, not AstraZeneca vaccine. The median score of this survey was 20/22 regarding knowledge about the coronavirus vaccine. Overall, the study participants had good knowledge about the coronavirus vaccine and accepted to take the vaccine, which indicates the highly commendable efforts to confront the coronavirus.
(© 2021 Wiley Periodicals LLC.)
Kim PY, Park IJ. Testing a multiple mediation model of Asian American college students’ willingness to see a counselor. Cultur Divers Ethnic Minor Psychol. 2009 Jul;15(3):295-302. doi: 10.1037/a0014396. PMID: 19594258.
Adapting the theory of reasoned action, the present study examined help-seeking beliefs, attitudes, and intent among Asian American college students (N = 110). A multiple mediation model was tested to see if the relation between Asian values and willingness to see a counselor was mediated by attitudes toward seeking professional psychological help and subjective norm. A bootstrapping procedure was used to test the multiple mediation model. Results indicated that subjective norm was the sole significant mediator of the effect of Asian values on willingness to see a counselor. The findings highlight the importance of social influences on help-seeking intent among Asian American college students.
Cheng HL, Kwan KL, Sevig T. Racial and ethnic minority college students’ stigma associated with seeking psychological help: Examining psychocultural correlates. J Couns Psychol. 2013 Jan;60(1):98-111. doi: 10.1037/a0031169. PMID: 23356468.
Many college students underuse professional psychological help for mental health difficulties. The stigma associated with seeking such help appears to be one of the reasons for this underuse. Levels of psychological distress and past use of counseling/psychotherapy have been found to be important correlates of stigma associated with seeking psychological help (Obasi & Leong, 2009; Vogel, Wade, & Haake, 2006). For racial and ethnic minorities, the hindering effects of self-stigma and perceived stigmatization by others on treatment seeking may further be compounded by their relationships with their own ethnic groups, with other ethnic groups, and with the dominant society. This study used structural equation modeling (SEM) to test a model that explored the effects of psychological distress and psychocultural variables (i.e., ethnic identity, other-group orientation, perceived discrimination) on perceived stigmatization by others and self-stigma for seeking psychological help, controlling for past use of counseling/psychotherapy. The sample consisted of 260 African American, 166 Asian American, and 183 Latino American students. SEM multigroup analyses indicated measurement invariance, but partial structural invariance, across racial/ethnic groups. Across all 3 groups, higher levels of psychological distress and perceived racial/ethnic discrimination, respectively, predicted higher levels of perceived stigmatization by others for seeking psychological help, which, in turn, predicted greater self-stigma for seeking psychological help. Higher levels of other-group orientation predicted lower levels of self-stigma of seeking psychological help across groups. Higher levels of ethnic identity predicted lower levels of self-stigma of seeking psychological help only for African Americans. Implications for research and practice are discussed.
Miller MJ, Yang M, Hui K, Choi NY, Lim RH. Acculturation, enculturation, and Asian American college students’ mental health and attitudes toward seeking professional psychological help. J Couns Psychol. 2011 Jul;58(3):346-57. doi: https://doi.org/10.1037/a0023636. PMID: 21574693.
In the present study, we tested a theoretically and empirically derived partially indirect effects acculturation and enculturation model of Asian American college students’ mental health and attitudes toward seeking professional psychological help. Latent variable path analysis with 296 self-identified Asian American college students supported the partially indirect effects model and demonstrated the ways in which behavioral acculturation, behavioral enculturation, values acculturation, values enculturation, and acculturation gap family conflict related to mental health and attitudes toward seeking professional psychological help directly and indirectly through acculturative stress. We also tested a generational status moderator hypothesis to determine whether differences in model-implied relationships emerged across U.S.- (n = 185) and foreign-born (n = 107) participants. Consistent with this hypothesis, statistically significant differences in structural coefficients emerged across generational status. Limitations, future directions for research, and counseling implications are discussed.
Cary Wu, Yue Qian & Rima Wilkes (2021) Anti-Asian discrimination and the Asian-white mental health gap during COVID-19, Ethnic and Racial Studies, 44:5, 819-835, DOI: https://doi.org/10.1080/01419870.2020.1851739
Altmetrics: Who’s talking about this? https://routledge.altmetric.com/details/95967721
In this article, we consider how, due to a spike in anti-Asian hate crimes, Asians might face a disproportionate mental health impact of the COVID-19 pandemic. Analyzing data from the University of Southern California’s Center for Economic and Social Research Understanding Coronavirus in America survey, we report several findings. First, since the onset of the pandemic, Asians (Asian Americans in particular) have experienced higher levels of mental disorders than whites. Second, Asian Americans and Asian immigrants are about twice as likely as whites to report having encountered instances of COVID-19-related acute discrimination. Third, experiences of COVID-19-related discrimination increase mental disorders for all Americans. Finally, COVID-19-related discrimination partially explains the disproportionate mental health impact of the pandemic on Asians. In conclusion, we highlight the importance of tackling hate, violence, and discrimination so as to address the disproportionate mental health impacts of COVID-19 on minority populations.
Grein J, Ohmagari N, Shin D, et al. Compassionate use of remdesivir for patients with severe covid-19. N Engl J Med. 2020;382(24):2327-2336. https://doi.org/10.1056/NEJMoa2007016.
Altmetrics: Who’s talking about this?
Remdesivir, a nucleotide analogue prodrug that inhibits viral RNA polymerases, has shown in vitro activity against SARS-CoV-2.
We provided remdesivir on a compassionate-use basis to patients hospitalized with Covid-19, the illness caused by infection with SARS-CoV-2. Patients were those with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94% or less while they were breathing ambient air or who were receiving oxygen support. Patients received a 10-day course of remdesivir, consisting of 200 mg administered intravenously on day 1, followed by 100 mg daily for the remaining 9 days of treatment. This report is based on data from patients who received remdesivir during the period from January 25, 2020, through March 7, 2020, and have clinical data for at least 1 subsequent day.
Of the 61 patients who received at least one dose of remdesivir, data from 8 could not be analyzed (including 7 patients with no post-treatment data and 1 with a dosing error). Of the 53 patients whose data were analyzed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated. A total of 25 patients (47%) were discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive ventilation.
In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomized, placebo-controlled trials of remdesivir therapy.
Gao M, Yang L, Chen X, et al. A study on infectivity of asymptomatic SARS-CoV-2 carriers. Respir Med. 2020;169:106026. https://doi.org/10.1016/j.rmed.2020.106026.
Altmetrics: Who’s talking about this?
Background: An ongoing outbreak of coronavirus disease 2019 (COVID-19) has spread around the world. It is debatable whether asymptomatic COVID-19 virus carriers are contagious. We report here a case of the asymptomatic patient and present clinical characteristics of 455 contacts, which aims to study the infectivity of asymptomatic carriers.
Material and methods: 455 contacts who were exposed to the asymptomatic COVID-19 virus carrier became the subjects of our research. They were divided into three groups: 35 patients, 196 family members and 224 hospital staffs. We extracted their epidemiological information, clinical records, auxiliary examination results and therapeutic schedules.
Results: The median contact time for patients was four days and that for family members was five days. Cardiovascular disease accounted for 25% among original diseases of patients. Apart from hospital staffs, both patients and family members were isolated medically. During the quarantine, seven patients plus one family member appeared new respiratory symptoms, where fever was the most common one. The blood counts in most contacts were within a normal range. All CT images showed no sign of COVID-19 infection. No severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections was detected in 455 contacts by nucleic acid test.
Conclusion: In summary, all the 455 contacts were excluded from SARS-CoV-2 infection and we conclude that the infectivity of some asymptomatic SARS-CoV-2 carriers might be weak.