Disparities In Knowledge Research Articles

Knowledge, goals, and misperceptions about palliative care in adults with chronic disease or cancer.

Limited evidence investigates how knowledge, misconceptions, and beliefs about palliative care vary across patients with cancerous versus non-cancerous chronic disease. We examined the knowledge of and misconceptions about palliative care among these groups. We used weighted data from the National Cancer Institute Health Information National Trends Survey 5 (Cycle 2) for nationally representative estimates and logistic regression to adjust for respondent characteristics. We identified respondents who reported having (1) cancer ([n=585]; breast, lung, and colorectal), (2) chronic conditions ([n=543]; heart failure, lung disease, or chronic obstructive pulmonary disorder), or (3) neither cancer nor other chronic conditions (n=2,376). Compared to cancer respondents, chronic condition respondents were more likely to report being Black or Hispanic, report a disability, and have lower socioeconomic status. In the sample, 65.6% of cancer respondents and 72.8% chronic conditions respondents reported they had never heard of palliative care. Chronic condition respondents were significantly (p<0.05) less likely to report high palliative care knowledge than cancer respondents (9.1% vs. 16.6%, respectively). In adjusted analyses, cancer respondents had greater odds of high palliative care knowledge (odd ratio [OR]=1.70; 95% confidence interval [CI]=1.01, 2.86) compared to respondents with neither cancer nor chronic disease; chronic condition respondents did not have increased odds (OR=0.96; CI=0.59, 1.54). Disparities in palliative care knowledge exist among people with non-cancerous chronic disease compared to cancer. Supportive educational efforts to boost knowledge about palliative care remains urgent and is critical for promoting equity, particularly for underserved people with chronic illnesses.

Assessing disparities in medical students' knowledge and attitude about monkeypox: a cross-sectional study of 27 countries across three continents.

The recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students' knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries. A cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses. 46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox. There were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control.

Evaluation of Knowledge, Attitude, and Practice towards the Coronavirus Disease 19 Pandemic: A Cross-Sectional Study in Delhi-NCR Regions of India

The SARS-CoV-2-induced pandemic initially began as a local viral outbreak in Wuhan in late December 2019. Thereafter, it rapidly spread to the remaining parts of the globe, causing substantial psychosomatic disorders and socioeconomic disruption. Consequently, millions of lives have been lost due to the ongoing pandemic. Furthermore, common people have also been at the receiving end, and continue to struggle daily on multiple fronts of sustenance, existence, and survival. To date, there has not been the successful development of effective therapeutic drugs (except for a few prophylactic vaccines) to contain this pandemic. Therefore, focus on non-pharmacological interventions, including spread of public health awareness, and inculcating good practices and attitudes among the general population, have become crucial at this juncture, facilitating the transition from pandemic to post- pandemic life. Here, we conducted a questionnaire-based survey to evaluate COVID-19-related knowledge, attitude, and practice (KAP) of the general population residing in and around Delhi, the National capital of India, involving a random sample of 521 participants. Our comprehensive data analyses unravel a statistically significant (p &lt; 0.05) disparity in knowledge, attitude, and practices about COVID-19 in the general population based on contrasting variables, such as gender, educational qualification, location, and economic background. This highlights the crucial need for removing significant disparity concerning basic COVID-19 knowledge by communicating evidence-based information through regular educational programs and awareness campaigns to help the community and common people in fighting against the ongoing pandemic.

Perception Towards Epidemiology of Human Immunodeficiency Virus or Acquired Immunodeficiency Syndrome Among Women of Reproductive Age: Analysis of Nationwide Surveys in India.

The knowledge of HIV prevention, attitudes towards people living with HIV (PLHIV), and beliefs in myths related to HIV/AIDS among women of reproductive age group in India hold immense importance. As this group is particularly vulnerable to HIV infection, having accurate knowledge about prevention methods is crucial to protect themselves and their partners. Positive attitudes towards PLHIV foster support, reduce stigma and encourage early testing and treatment. Additionally, debunking myths and misconceptions surrounding HIV/AIDS can help dispel fear and promote informed decision-making. Empowering women with comprehensive knowledge, fostering positive attitudes, and debunking myths can contribute to effective HIV prevention strategies, reduce transmission rates, and improve women's overall well-being in India. Our objective was to create a regression model to show disparities in knowledge of the prevention of HIV/AIDS, attitude towards people living with HIV/AIDS, and belief in myths among women in India with adjusted odds ratio (aOR) for different socio-demographic factors, and to determine if there are any significant changes in the aOR during both surveys. A comparative study using secondary data analysis of two complex sample surveys. Individual Recode files from datasets obtained from Demographic Health Surveys (DHS) Program were exported to STATA v17.0 MP by STATA Corp LLC. Dependent and independent variables were chosen based on a literature review and computed. The design-adjusted chi-square test was used to assess the association between variables. A multinomial logistic regression analysis was used to derive a model. The model assessment was performed using the Wald test after estimation. The age group of 15-19 years had the highest odds of having sufficient knowledge of the prevention of HIV/AIDS during both National Family Health Surveys (NFHS) (aOR: 1.98 during NFHS-4 and aOR: 1.80 during NFHS-5). No education group had the highest odds of negative attitudes towards people living with HIV/AIDS during both surveys (aOR: 4.85 during NFHS-4 and aOR: 2.69 during NFHS-5). Rural areas had higher odds of believing in myths related to HIV/AIDS during both surveys (aOR: 1.07 during NFHS-4 and aOR: 1.13 during NFHS-5). This research study sheds light on the significant relationship between demographic factors and knowledge, attitudes, and beliefs related to HIV/AIDS among women. Specifically, women in the lower age group, lacking education, and residing in rural areas exhibited substantial levels of inadequate knowledge regarding HIV/AIDS prevention. Furthermore, this group was also associated with higher proportions of negative attitudes towards people living with HIV/AIDS and a greater tendency to believe in myths associated with HIV/AIDS.

Rural-urban disparities in knowledge, attitude, and practice toward child oral health among mothers of 9-36-month-old children.

Objective: To assess and compare the knowledge, attitude, and practice of mothers of pre-school children in urban and rural areas toward maintaining child oral health. Materials and Methods: A cross-sectional comparative study was conducted in a convenient sample of 400 mothers of pre-school children (aged 9 months to 3 years) visiting the outpatient department of the Department of Dentistry, Shyam Shah Medical College, Rewa (M.P), India between February 1 and April 21, 2022. The study sample was divided into two groups based on whether they belonged to a rural area (Group A) or urban area (Group B). Group A included 236 participants, and Group B 186 participants. They were served a 24-item questionnaire to assess and compare their knowledge, attitude, and practice toward child oral health. The data were represented as mean and proportions, and a student t test and analysis of variance were performed. Results: In Group A and Group B, 93.64% and 98.17% mothers respectively had the knowledge of cariogenic food. While 66.10% of mothers in Group A and 73.78% in Group B were aware that regular cleaning of teeth protects against tooth decay, only 5.49% of mothers in Group B and none in Group A reported taking their children to routine dental visits; the majority (94.07% in Group A and 78.05% in Group B) had never taken their children to the dentist. Urban background was significantly associated with better knowledge, attitude, and practice scores. Mother's' age and education level were significantly associated with better Knowledge, Attitude, and Practice scores in both groups. Conclusion: Mothers can play an important role in promoting positive attitudes and healthy practices toward oral health care in children. Knowledge, attitude, and practice score were found to be significantly low in mothers who belonged to the rural subgroup.

Medical Student Perceptions of Sociocultural Issues in Healthcare: A Multisite Study of Medical Spanish Education

Theory Cultural competence and humility are core elements of medical education in a diverse society. Language is inseparable from culture, as language informs, indexes, frames, and encodes both culture and worldview. Spanish is the most common non-English language taught in U.S. medical schools, yet medical Spanish courses tend to artificially separate language from culture. It is unknown to what extent medical Spanish courses advance students’ sociocultural knowledge or patient care skills. Hypotheses Based on current predominant pedagogy, medical Spanish classes may not adequately integrate sociocultural issues relevant to Hispanic/Latinx health. We hypothesized that students who completed a medical Spanish course would not demonstrate significant gains in sociocultural skills following the educational intervention. Method An interprofessional team developed a sociocultural questionnaire, and 15 medical schools invited their students to complete the questionnaire before and after completing a medical Spanish course. Of participating schools, 12 implemented a standardized medical Spanish course and three served as control sites. Survey data were analyzed regarding: (1) perceived sociocultural competence (recognition of common cultural beliefs, recognition of culturally normative non-verbal cues, gestures, and social behaviors, ability to address sociocultural issues in healthcare context, and knowledge of health disparities); (2) application of sociocultural knowledge; and (3) demographic factors and self-rated language proficiency (Poor, Fair, Good, Very Good, or Excellent) on the Interagency Language Roundtable scale for healthcare (ILR-H). Results Overall, 610 students participated in sociocultural questionnaire between January 2020 and January 2022. After the course, participants reported an increased understanding of cultural aspects of communication with Spanish-speaking patients and the ability to apply sociocultural knowledge to patient care (all p < 0.001). When analyzed by demographic factors, students who identified as Hispanic/Latinx or as heritage speakers of Spanish tended to report increased sociocultural knowledge/skills following the course. When examined by Spanish proficiency, preliminary trends showed that students at both ILR-H Poor and Excellent levels did not demonstrate gains in sociocultural knowledge or ability to apply sociocultural skills. Students at sites with a standardized course were likely to improve sociocultural skills in mental health conversations (p < 0.001) while students at control sites were not (p = 0.05). Conclusions Medical Spanish educators may benefit from additional guidance on teaching sociocultural aspects of communication. Our findings support that students at ILR-H levels of Fair, Good, and Very Good are particularly well-suited for gaining sociocultural skills in current medical Spanish courses. Future studies should explore potential metrics to evaluate cultural humility/competence within actual interactions with patients.

916-P: The Demographic Variables Associated with Diabetes Technology Knowledge or Use in Adults with Type 2 Diabetes

Background: Studies in populations with type 1 diabetes highlight the racial-ethnic disparities in the use of diabetes technology. Our project aims to investigate racial-ethnic and socioeconomic disparities in diabetes technology knowledge and use in adult patients with type 2 diabetes (T2D) in ambulatory setting. Method: We recruited adults aged 40 and older with T2D who visited one of four internal medicine practices between July 1, 2018 and June 30, 2021. We selected patients in the electronic record who use insulin, have English as a primary language, and have an email address. Eligible participants were invited to participate via an email link to a REDCap questionnaire. All variables were summarized descriptively using frequencies and percentages, and were compared across groups using Pearson’s Chi-Square Test or Fisher’s Exact Test. Results: We included 116 patients in the analysis, most of whom were white (62%), elderly Medicare recipients. Those who are of racial-ethnic minoritized groups are less likely to have knowledge of CGM (p = 0.013) or insulin pumps (p = 0.001). Patients who have high school education or less have less awareness of insulin pumps (p = 0.041). Interestingly, neither awareness nor use of CGM or insulin pump were found to be associated with income. Conclusion: This cross-sectional analysis suggests that racial-ethnic minoritized groups or those with lower education have lower knowledge of CGM or insulin pumps and this disparity cannot be explained by differences in socioeconomic status. Providers need to be aware of their potential implicit biases in relation to education and prescription of diabetes technology. Disclosure Y.Ye: None. B.A.Acevedo-mendez: None. S.Izard: None. A.K.Myers: Research Support; Neurocrine Biosciences, Inc.

Game-based learning as training to use a chemotherapy preparation robot.

In 2015, our university hospital pharmacy acquired the PharmaHelp robot system to automate part of its chemotherapy production. Complex technical use, downtime periods, and insufficient training caused a drop in motivation and disparities in operators' knowledge. We created a short, playful, standardized, gamed-based training program to address this, and evaluated its impact. Operators were classified as trainers or trainees according to their knowledge about Information and Communication Technologies. Before, after the training, and at 6 months (6M), their robot knowledge was assessed on a 0-24-scale, motivation and self-efficacy in using it on 0-to-100 scales. Pairwise comparison t-test with Bonferroni adjustment was used (p < 0.05 considered significant). Satisfaction was measured using a six-point Likert scale. Trainer/trainee teams participated in 2-hour training sessions with three games and a debriefing. For "Knowing the manufacturing steps," cards with the steps were placed in the correct order. For "Knowing the criteria for using the robot," teams guessed whether certain compounds could be used with the robot. For "Knowing how to handle production errors," the answer to each error (taken from real-life issues) was selected from four options. Participants (n = 14) were very satisfied about sessions' interactivity and playfulness. Knowledge improved from 57% pretraining to 77% (p < 0.005) to 76.6% (6M) (p < 0.05 compared to pretraining). Motivation and self-efficacy, respectively, improved from 57.6% to 86.6% (p < 0.05) to 70.4% (6M) and from 48.5% to 75.6% (p < 0.05) to 60.2% (6M) (p > 0.1 compared to pretraining) (t-test). This highly appreciated training program efficiently improved knowledge retention out to six months.

Barriers to diversity in cancer therapy: Uncovering disparities in knowledge and interpretation of genetic testing among African Americans, and their direct implications for access to mutation-based therapies.

e18587 Background: African American cancer patients are disproportionately impacted by limited access to health education and resources, limiting their access to advanced care and clinical trials (CTs). In line, African Americans have the highest death rate and shortest survival of any racial/ethnic group in the US for most cancers. In this study we analyzed cancer patients’ knowledge of different parameters of their disease, including biomarker/mutational status knowledge which is vital for making informed treatment decisions. Methods: Leal (formerly, Trialjectory) is an AI-based platform that matches cancer patients to CTs based on a self reported medical profile. The profile includes parameters essential for CT matching including disease status, stage, biomarker/mutational status, treatment history, comorbidities and demographics. This study included a multi-racial sample cohort of 11,302 patients with advanced cancer who completed the questionnaire between 2019-2023. We characterized the general questionnaire completion rate and further focused on whether genetic testing was performed and on biomarker knowledge across varying clinical, demographic and racial/ethnic groups. Results: The general questionnaire completion rate was not affected by age, gender, or ethnic group. Genetic testing performance was associated with cancer types for which treatment guidelines recommend testing. There was no major difference in genetic testing performance between ethnic groups (Pearson’s Χ² = 0.05), with slightly lower rates in African Americans compared to other racial groups. A notable gap was found in the interpretation and reporting of test results across all races. Race and ethnic background had a significant impact on biomarker knowledge (Pearson’s Χ² &lt; 0.0001), with African Americans having a profoundly lower probability of knowing/reporting their mutation status compared to other races/ethnic groups. Clinical trials that require the presence of certain mutations for a match were ranked lower on the matched CT list or were not matched at all for patients who failed to report their biomarker data. Conclusions: African Americans are less likely to know or interpret/report their mutation status compared to other races or ethnic groups. This disparity was not influenced by the completion rate of the questionnaire, suggesting that ethnicity is not a hindrance to accessing technology. Our results highlight a significant gap in access to information and education particularly in regards to biomarker knowledge, which play a crucial role in obtaining the most effective treatment or accessing mutation-specific targeted therapy within or outside of a CT. Addressing these disparities is imperative to ensure that cancer patients can make informed treatment decisions.

An intersectional approach to cervical cancer screening disparities by race/ethnicity and immigrant status.

6536 Background: Racial/ethnic minority and immigrant groups individually experience lower rates of cervical cancer (CC) screening. Although immigrants represent large proportions of racial/ethnic minorities, few studies have explored the interacting health consequences of these social categories. Intersectionality is a theoretical framework which recognizes that studying social categories independently cannot capture their cumulative effects on health. In the context of CC screening, only one study took this approach but did not analyze several important barriers to care. This study aims to analyze the joint influence of race/ethnicity and immigrant status on screening and identify barriers unique to each intersectional group. Methods: Data from the National Health Interview Survey years 2005, 2010 and 2015 were drawn from IPUMS. Analyses were restricted to those eligible for CC screening (n=17,941). Multivariable logistic regression was used to model the interactional effect of race/ethnicity and immigrant status on screening up to date (UTD) status adjusting for confounders. Variables reflecting socioeconomic status (SES), access to care, acculturation and language were separately included to see whether they explained identified disparities. Finally, amongst women not UTD on screening, reasons for this were analyzed. All analyses were adjusted for complex survey design. Results: US born Non-Hispanic Black women had higher odds of being UTD on screening (OR 1.63, 95% CI [1.23, 2.18]) while immigrant Non-Hispanic White (OR 0.45 [0.29, 0.7]), immigrant Asian (OR 0.29 [0.2, 0.42]) and immigrant Hispanic/Latinx women (OR 0.51 [0.39, 0.67]) had lower odds compared to US born Non-Hispanic White women. Adjusting for SES (OR 0.87 [0.65, 1.16]) and access (OR 1 [0.74, 1.36]) attenuated the ORs for immigrant Hispanic/Latinx women but not immigrant Asian and White women. Adjusting for acculturation attenuated the ORs for immigrant Hispanic/Latinx (OR 0.84 [0.58, 1.22]) and White women (OR 0.68 [0.42, 1.12]) only. Adjusting for language increased but did not attenuate the ORs for all immigrant groups. Analyses of reasons for not screening showed immigrant Non-Hispanic White, Black and Asian women had greater proportions selecting “Didn’t need or know needed this test” versus other groups (10-12% vs. 5.4-8.4%). Conclusions: Immigrant status continues to explain much of the CC screening disparities previously attributed to race/ethnicity. SES and access to care remain important barriers for immigrant Hispanic/Latinx women but less so for other immigrant groups. This study reveals that acculturation is an important barrier for immigrant Non-Hispanic White and Hispanic/Latinx women, possibly representing disparities in knowledge. Language barriers may also contribute in all immigrant women. Further intersectional studies are needed to identify remaining barriers.

Influence of Race on Utilization and Outcomes in Shoulder Arthroplasty

Background: Studies have shown that utilization and outcomes after shoulder arthroplasty vary by sociodemographic factors, highlighting disparities in care. This systematic review synthesized all available literature regarding the relationship between utilization and outcomes of shoulder arthroplasty and race/ethnicity. Methods: Studies were identified using PubMed, MEDLINE (through Ovid), and CINAHL databases. All English language studies of Level I through IV evidence that specifically evaluated utilization and/or outcomes of hemiarthroplasty, total shoulder arthroplasty, or reverse shoulder arthroplasty by race and/or ethnicity were included. Outcomes of interest included rates of utilization, readmission, reoperation, revision, and complications. Results: Twenty-eight studies met inclusion criteria. Since the 1990s, Black and Hispanic patients have demonstrated a lower utilization rate of shoulder arthroplasty compared with White patients. Although utilization has increased among all racial groups throughout the present decade, the rate of increase is greater for White patients. These differences persist in both low-volume and high-volume centers and are independent of insurance status. Compared with White patients, Black patients have a longer postoperative length of stay after shoulder arthroplasty, worse preoperative and postoperative range of motion, a higher likelihood of 90-day emergency department visits, and a higher rate of postoperative complications including venous thromboembolism, pulmonary embolism, myocardial infarction, acute renal failure, and sepsis. Patient-reported outcomes, including the American Shoulder and Elbow Surgeon's score, did not differ between Black and White patients. Hispanics had a significantly lower revision risk compared with White patients. One-year mortality did not differ significantly between Asians, Black patients, White patients, and Hispanics. Conclusion: Shoulder arthroplasty utilization and outcomes vary by race and ethnicity. These differences may be partly due to patient factors such as cultural beliefs, preoperative pathology, and access to care, as well as provider factors such as cultural competence and knowledge of health care disparities. Level of Evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.

Veteran perspectives of epilepsy care: Impact of Veteran satisfaction, knowledge, and proactivity

ObjectiveVeterans are at elevated risk of epilepsy due to higher rates of traumatic brain injury (TBI). However, little work has examined the extent to which quality of care is associated with key outcomes for Veterans with epilepsy (VWE). This study aimed to examine the impact of quality of care on three outcomes: patients’ knowledge of epilepsy self-care, proactive epilepsy self-management, and satisfaction with care. MethodWe conducted a cross-sectional study of Post-9/11 Veterans with validated active epilepsy who received VA care (n = 441). Veterans were surveyed on care processes using American Academy of Neurology epilepsy quality measures, and a patient-generated measure related to the use of emergency care. Outcome measures included epilepsy self-care knowledge, proactive epilepsy self-management, and satisfaction with epilepsy care. Covariates included sociodemographic and health status variables and a measure of patient-provider communication. An ordinary least-squares (OLS) regression model was used to determine if the quality of care was associated with the outcomes adjusting for multiple comparisons. ResultsSelf-reported measures of quality of care were broadly associated with satisfaction with care and epilepsy knowledge. OLS modeling indicated that healthcare provider guidance on when to seek emergency care was significantly associated with higher Veteran satisfaction with care (p < 0.01). Veterans who were asked about seizure frequency at every visit by their provider also reported higher satisfaction with care (p < 0.01) and increased epilepsy knowledge (p < 0.01). Veteran-provider communication was positively associated with epilepsy knowledge and proactive epilepsy self-management. Veterans with epilepsy with drug resistance epilepsy were significantly less satisfied with their care and reported lower proactivity compared to epilepsy controlled with medications. Further analysis indicated Black VWEs reported lower scores on epilepsy self-care knowledge compared to Whites (p < 0.001). ConclusionsThis study found that quality measures were associated with satisfaction and epilepsy knowledge but not associated with proactive self-management in multivariable models. The finding that better communication between providers and Veterans suggests that in addition to technical quality, interpersonal quality is important for patient outcomes. The secondary analysis identified racial disparities in epilepsy knowledge. This work offers opportunities to improve the quality of epilepsy care through the practice of patient-centered care models that reflect Veteran priorities and perceptions.

Income and Residence related Disparities of Information and Knowledge about COVID-19 and Behavioral response: Evidence from COVID-19 Community Risk Perception and Behavioral Response survey in Ethiopia

Introduction: The Coronavirus disease-19 (COVID-19) has caused enormous stress among the public in China initially and then after the whole world. This study aims to examine the income and residence-related disparities in information and knowledge about COVID-19 in Ethiopia. Methods: The data for this study was extracted from the community risk perception and behavioral response toward the COVID-19 survey data set. Out of 8005 survey participants, 7970 participants were used for the current study. Results of this study were presented by frequency, percent, concentration curve, tables and p-values used to indicate the significance level. Result: The concentration index of Knowledge of COVID-19 causes, COVID-19 transmission, COVID-19 symptoms, and its prevention across income status was (0.08, 0.02, 0.02, and 0.01), respectively. Indicating that participants of the highest income level had better knowledge than participants of the lowest income level. Similarly, the concentration index of information about COVID-19 from multimedia, print media, and social media across income status was (0.05, 0.37, and 0.07) respectively. The concentration index information about COVID-19 from health care professionals and community networks across residences was (-0.10) and (-0.07) respectively. Implying that participants of the rural resident had better access to information about COVID-19 from health care professionals and community networks than participants of the urban resident. Conclusion: COVID-19 causes, spread, symptoms, and prevention strategies were disproportionately more known to those with the highest income levels and those who lived in urban areas. Also, those with the highest income and those who live in urban areas have disproportionately more access to COVID-19 information from multimedia, print media, and social media than those with the lowest income level, and rural residents have disproportionately more access to COVID-19 information from health care professionals and community networks than urban residents.

Healthcare disparities in pediatric neurosurgery: a scoping review.

The aim of this scoping review was to identify relevant articles that have contributed to the body of knowledge describing pediatric neurosurgical healthcare disparities. Identifying healthcare disparities in pediatric neurosurgery is essential to understanding how to best provide care for this unique patient population. Although it is undoubtedly important to increase the knowledge of pediatric neurosurgical healthcare disparities, it is also important to understand the current state of the literature. This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The search terms "pediatric neurosurgical disparities" and "pediatric neurosurgical inequities" were entered into the following databases: PubMed, Scopus, and Embase. The initial database search returned a total of 366 results from the PubMed, Embase, and Scopus databases. One hundred thirty-seven duplicates were removed, and the remaining articles were screened by title and abstract. Articles were excluded on the basis of the inclusion and exclusion criteria. Of the remaining 229 articles, 168 were excluded. Sixty-one full-text articles were then examined for eligibility, and 28 did not reach the specified inclusion and exclusion criteria. The remaining 33 articles were included for final review. The results of the reviewed studies were stratified on the basis of disparity type. Although there has been an increase in the number of publications discussing pediatric neurosurgical healthcare disparities within the last decade, there still remains a scarcity of information regarding healthcare disparities in neurosurgery. Furthermore, less information exists that specifically addresses healthcare disparities in the pediatric population.

Knowledge of tropical diseases and response capabilities of healthcare providers in Kaduna State, Nigeria.

The public health impact of neglected tropical diseases (NTDs) is quite substantial. The objective of this study was to assess the knowledge and response capability of health professionals regarding NTDs in Kaduna State, Nigeria. A pre-tested questionnaire with a Cronbach's α coefficient of 0.716 was administered to 350 health professionals. The questionnaire assessed the knowledge, resource availability and capacity to handle NTD cases. Only 38 (12.6%) respondents were familiar with the World Health Organization's definition of NTDs. Although self-reported knowledge was highest for physicians (37 [82.2%]), there was no statistically significant knowledge disparity between cadres of health professionals. Only 12 (46.2%) practitioners in private health facilities reported adequate knowledge. The tier of practice was significantly associated with management of NTDs (χ2=10.545; df 2; p=0.005). Only 24 (47.1%) medical laboratory scientists and 18 (40.0%) physicians had adequate clinical resources for management of NTDs. Nearly three-quarters (211 (70.1%)] of respondents had never been trained in the management of NTDs. More than half (177 [58.8%]) of facilities lacked pharmaceuticals or standard operating procedures for management of NTDs. Self-reported knowledge of NTDs was suboptimal. Physical and clinical resources for the diagnosis and treatment of NTDs were inadequate. Targeted training, increased funding and provision of adequate resources are needed in order to ameliorate the situation.

418 Disparities in knowledge about skin cancer diagnoses in U.S. adults

418 Disparities in knowledge about skin cancer diagnoses in U.S. adults

Cardiac amyloidosis: A survey of current awareness, diagnostic modalities, treatment practices, and clinical challenges among cardiologists in selected Middle Eastern countries.

Cardiac amyloidosis (CA) is a chronic progressive disease caused by the deposition of amyloid fibrils in cardiac tissues. Diagnosis and management of CA are complicated and have developed over the years. Middle Eastern countries have significant knowledge disparities in diagnosing, managing, and treating different subtypes of CA. An online survey was sent to cardiologists in four countries (Saudi Arabia, Lebanon, Egypt, and Iraq) interested in heart failure and practicing for more than a year. The survey questioned the characteristics of the participants and their institutions. It addressed their knowledge and practices in CA specifically diagnostic modalities, treatment options, and interest in education and knowledge exchange. A total of 85 physicians participated in the survey. There was a variation in the participating cardiologists'knowledge, experience level, and readiness of their institutes to manage patients with ATTR-CM. Most participants believed that a high rate of ATTR-CM misdiagnosis existed. Participants'knowledge of the diagnostic modalities and "red flags"raising suspicion about ATTR-CM varied. Another challenge was the availability of essential diagnostic modalities among various cardiology centers. A knowledge gap was also observed regarding updates in ATTR-CM management. However, there was a high endorsement of the need for more education, physician networking, and knowledge exchange. This survey highlighted the need for increasing awareness levels among cardiologists in the four selected Middle Eastern countries. Cardiologists are most likely to benefit from additional training and knowledge exchange on the latest management advances of this disease. Thus, measures must be taken to focus on the physician's awareness of ATTR-CM patient journey to achieve a better quality of care and outcome.

MP12-16 DISPARITIES REMAIN IN KNOWLEDGE OF PENILE CANCER AND HUMAN PAPILLOMA VIRUS AMONG RACIAL MINORITIES AFTER ACCOUNTING FOR REGULAR PROVIDER VISITS AND SOCIOECONOMIC FACTORS

You have accessJournal of UrologyCME1 Apr 2023MP12-16 DISPARITIES REMAIN IN KNOWLEDGE OF PENILE CANCER AND HUMAN PAPILLOMA VIRUS AMONG RACIAL MINORITIES AFTER ACCOUNTING FOR REGULAR PROVIDER VISITS AND SOCIOECONOMIC FACTORS Hanna Jia, Chris Herrera, Hyezo Kwun, Colin Sperling, Ankur Shah, Thomas Guzzo, and Daniel Lee Hanna JiaHanna Jia More articles by this author , Chris HerreraChris Herrera More articles by this author , Hyezo KwunHyezo Kwun More articles by this author , Colin SperlingColin Sperling More articles by this author , Ankur ShahAnkur Shah More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , and Daniel LeeDaniel Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003227.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Non-Hispanic Blacks (NHB) and Hispanics are disproportionately impacted by HPV and HPV-associated cancers, but are much less likely to receive an HPV vaccination compared to Non-Hispanic Whites (NHW). It is essential to understand racial and ethnic differences in the awareness of HPV and the HPV vaccine in order to address these disparities. METHODS: The National Cancer Institute’s Health Information National Trends Survey (HINTS) 5 is a nationally representative survey of United States adults. Multivariable logistic regression models were used to examine HPV knowledge within each racial/ethnic group after adjusting for sociodemographic characteristics. A second fully adjusted model was used to determine if health care provider status had an impact on the association between race and HPV knowledge. RESULTS: Of the 8,792 total respondents, 1,158 (14.3%) were NHB, 1,326 (16%) were Hispanic, and 431 (5.3%) were Asian. Only 20.1% of respondents were aware that HPV could cause penile cancer. 37% of NHB, 42% of Hispanics, and 51% of Asians did not know what HPV was, as compared to 29% of NHWs (p<0.01). Those who had no knowledge of HPV were less likely to have regular providers, trust information from doctors, and reported difficulty finding health information (p<0.01). After adjusting for sociodemographic factors, all minority groups had significantly lower odds compared to NHWs of correctly identifying all HPV knowledge statements (p<0.01). Having a regular healthcare provider did not attenuate the racial disparities in HPV knowledge or awareness of the vaccine in the adjusted model (p<0.01). Moreover, adequate visit time, clear explanations, and increased shared decision making also did not impact the disparities in knowledge (p<0.01). CONCLUSIONS: The racial disparities in penile cancer awareness and HPV knowledge remain immense. Asians and Hispanics reported the lowest rates of knowledge of a connection between HPV and penile cancer, and awareness of the HPV vaccine. Surprisingly, having a regular provider does not appear to attenuate these significant racial disparities. Future studies are required to understand the best methods to improve knowledge of the HPV vaccine and vaccination rates among minority populations. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e140 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hanna Jia More articles by this author Chris Herrera More articles by this author Hyezo Kwun More articles by this author Colin Sperling More articles by this author Ankur Shah More articles by this author Thomas Guzzo More articles by this author Daniel Lee More articles by this author Expand All Advertisement PDF downloadLoading ...

MP54-04 EXAMINING THE INFLUENCE OF RACE AND PELVIC FLOOR DISORDER SEVERITY ON HEALTH-RELATED SOCIAL NEEDS AMONG MINORITY WOMEN

You have accessJournal of UrologyCME1 Apr 2023MP54-04 EXAMINING THE INFLUENCE OF RACE AND PELVIC FLOOR DISORDER SEVERITY ON HEALTH-RELATED SOCIAL NEEDS AMONG MINORITY WOMEN Jasmine Kannikal, Sanjana Satish, Aaron Gurayah, Erin Kobetz, Katherine Amin, Ekene Enemchukwu, and Raveen Syan Jasmine KannikalJasmine Kannikal More articles by this author , Sanjana SatishSanjana Satish More articles by this author , Aaron GurayahAaron Gurayah More articles by this author , Erin KobetzErin Kobetz More articles by this author , Katherine AminKatherine Amin More articles by this author , Ekene EnemchukwuEkene Enemchukwu More articles by this author , and Raveen SyanRaveen Syan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003307.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pelvic floor disorders (PFD) affect 25% of American women 20 years or older and continues to increase in prevalence. While studies have explored racial disparities in PFD knowledge and treatment, few have analyzed the impact of health-related social needs (HRSN). This study aims to characterize unmet HRSN among minority women, as well as assess the impact of race and PFD severity. METHODS: Our IRB-approved, ongoing prospective study began recruitment in June 2022 from private urogynecology clinics; a general urology clinic at the public safety net hospital (SNH); and a community outreach mobile clinic (MC). The standardized Urinary Distress Index-6 (UDI), Pelvic Organ Prolapse Distress Inventory-6 (POPDI), and Female Genitourinary Pain Index (GUPI) were used to identify PFDs. PFDs exceeding the 33.3 (UDI) or third quartile (POPDI, GUPI) thresholds were characterized as severe. Unmet HRSN were based on the Centers for Medicare & Medicaid Services Accountable Health Communities HRSN Screening Tool: mild and severe represented <8 and >8 unmet HSRN, respectively. Chi-squared tests for PFD presence and severity by race and location were conducted using R. RESULTS: The study cohort (n=107) had a median age of 53 years [IQR 24]. 53 (49.5%) women identified as Hispanic, 38 (35.5%) as Black, and 16 (15%) as Other. Unmet HRSN ranged from 1 to 18. Private clinic participants were 20% less likely to report unmet social needs, compared to MC participants (p=0.020). No statistically significant differences in reported unmet HRSN between SNH and MC, or between racial groups, were observed. Upon chi-squared analysis, no association was found between participants with severe unmet HRSN and those scoring higher on UDI, POPDI, and GUPI (p>0.05). CONCLUSIONS: Community mobile clinic participants were more likely to report severe unmet HRSN, compared to private clinic participants. Black women have a higher prevalence of unmet HRSN, however this did not reach statistical significance with our sample size. This study contributes to an understanding of the role of social determinants of health in disease severity and access to care. This study is ongoing, with a focus on increasing our community-based participant population to better understand health determinants among underserved minorities in non-hospital settings. Source of Funding: Urology Care Foundation Research Scholar Award 2021 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e754 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jasmine Kannikal More articles by this author Sanjana Satish More articles by this author Aaron Gurayah More articles by this author Erin Kobetz More articles by this author Katherine Amin More articles by this author Ekene Enemchukwu More articles by this author Raveen Syan More articles by this author Expand All Advertisement PDF downloadLoading ...

PD20-05 CORRELATES OF KNOWLEDGE OF CLINICAL TRIALS AMONG UROLOGIC CANCER SURVIVORS: FINDINGS FROM THE HEALTH INFORMATION NATIONAL TRENDS SURVEY

You have accessJournal of UrologyCME1 Apr 2023PD20-05 CORRELATES OF KNOWLEDGE OF CLINICAL TRIALS AMONG UROLOGIC CANCER SURVIVORS: FINDINGS FROM THE HEALTH INFORMATION NATIONAL TRENDS SURVEY Hanna Jia, Daniel Roberson, Leilei Xia, James Ding, Thomas Guzzo, and Daniel Lee Hanna JiaHanna Jia More articles by this author , Daniel RobersonDaniel Roberson More articles by this author , Leilei XiaLeilei Xia More articles by this author , James DingJames Ding More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , and Daniel LeeDaniel Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003286.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Clinical trials remain the gold standard for evaluating therapeutic interventions. However, diversity and representation in clinical trials remains very low. Therefore, it is essential to understand potential factors that are associated with knowledge or awareness of clinical trials. METHODS: The National Cancer Institute’s Health Information National Trends Survey (HINTS) 5 was evaluated. Data from Cycles 1 (2017) and 4 (2020) were obtained. General interaction with healthcare providers and the internet was evaluated, and knowledge of clinical trials were evaluated. Multivariable logistic regression models were used to examine clinical trial knowledge after adjusting for sociodemographic characteristics such as age, gender, income, and census region. RESULTS: Of the 200 prostate, kidney, and bladder cancer survivors, 32 (16%) were Non-hispanic Black, 24 (12%) were Hispanic, and 14 (7%) were Asian / Other. Thirty-two percent of the cancer survivors stated having no knowledge of clinical trials. When asked about potential factors that would influence the decision to join a clinical trial, urologic cancer survivors reported a much lower potential influence of getting paid (41% vs 27%) and support in the form of transportation or childcare (45% vs. 31%), but a much higher influence of a doctor recommendation (38% vs. 30%) compared to non-cancer survivors (all p<0.01). Only 4.5% of urologic cancer survivors reported knowledge of the ClinicalTrials.gov website. In adjusted logistic regression analysis, Hispanics (OR 0.26, p<0.01) had significantly lower odds of clinical trial knowledge than Non-hispanic Whites. Having a provider who discussed clinical trials (OR 3.85, p=0.03) and having a lot of trust in the provider (OR 9.9, p=0.01) were significantly associated with knowledge of clinical trials. Respondents who reported needing a lot of effort to obtain medical information had a significantly lower odds of having knowledge of clinical trials (OR 0.04, p=0.01). CONCLUSIONS: Knowledge of clinical trials remains low among urologic cancer survivors. This is particularly true among Hispanic patients and those who reported difficulty obtaining medical information. Improving access to and awareness of knowledge sources, such as the ClinicalTrials.gov website, may improve knowledge of clinical trials. Importantly, providers could play a large role in decreasing this knowledge disparity. Use of this information may be helpful to decrease disparities in clinical trial enrollment. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e585 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hanna Jia More articles by this author Daniel Roberson More articles by this author Leilei Xia More articles by this author James Ding More articles by this author Thomas Guzzo More articles by this author Daniel Lee More articles by this author Expand All Advertisement PDF downloadLoading ...