Disparities In Perceptions Research Articles

Patient, Caregiver, and Oncologist Experiences With and Perceptions of Racial Bias and Discrimination in Cancer Care Delivery.

Cancer prevention and treatment systems are significantly impacted by interpersonal, organizational, and structural and systemic racism. A wide body of research has found that racial disparities in access to guideline-adherent cancer care are pervasive throughout the United States and contributing factors include social determinants of health, insurance status, and bias and discrimination in care delivery. Although the existence of racial disparities in cancer care and outcomes is well established, there has been limited research exploring the patient and caregiver experience with bias and discrimination in cancer care. Two national surveys were conducted, one of patients and caregivers and one of oncologists. The surveys examined patient and caregiver experiences with and oncologist perceptions of racial disparities in cancer care. The surveys found that when patients and caregivers were asked about negative care experiences, differences across race were observed. Patients and caregivers identifying as African American/Black (AA/B) or Hispanic/Latino (H/L) were more likely to report at least one negative care experience than patients and caregivers identifying as White (W). Patients who were AA/B or H/L were also more likely than W patients to report that the healthcare system treats people unfairly based on their racial or ethnic background and that racial bias occurs often or very often when a patient and doctor are of different racial/ethnic background. A slight majority of oncologists reported that the healthcare system treats people unfairly based on their racial or ethnic background. The survey results highlight a need for improved racial representation in the oncology professional workforce, improved implicit bias training, and improved clinical trial recruitment efforts.

부동산 거래 에스크로우 서비스 선호 요인에 관한 연구

We analyzed the disparities in perceptions of the factors favoring the use of escrow services for real estate transaction safety between service users, the general public, service providers, and escrow service workers. We identified key factors that should be prioritized to promote service use. Furthermore, AHP methodology was used to determine the relative importance and priority of the upper and lower core factors, weight analysis between factors, and comparative analysis between service users and service providers. Research findings indicate that the measures to prevent transaction accidents are the most important, followed by relieve anxiety about transaction accidents, establishment of a business processing system, reduced fee, and public institutions’ participation. This study contributes to service activation by ranking the factors of preference for escrow service use in order of importance.

Employability skills for civil engineers in Peru. Case study: San Antonio Abad del Cusco National University

Recent modifications to the higher education system aim to ensure an education with high levels of employability; nevertheless, given the current economic climate, it is difficult for young professionals to launch their careers. In light of this circumstance, the authors of this research intend to identify and compare the talents that senior students, graduates, and professionals in civil engineering consider essential for entering the workforce. This study's data were gathered using a questionnaire survey completed by 243 individuals, and descriptive statistics were employed to characterize their perceptions. The results indicate that there are clear disparities in perception; also, it was shown that graduates have negative perceptions of their skills, which generates doubts about their ability to integrate into the market. This research is intriguing since it serves as a decision-making tool for the skills taught at the Professional School of Civil Engineering.

“Who is our real enemy?” internalized racism in the Puerto Rican diaspora and the role of political education within community health intervention

RationalePuerto Ricans experience disproportionately high levels of emotional distress and co-occurring adverse health outcomes. Our study sought to elicit Puerto Rican men's perceptions of health disparities while centering dialogue on stressors, coping mechanisms, and general well-being. This paper focuses on one pronounced finding in our study, that of internalized racism and the effect it has on both individual well-being and intra-group cohesion. A significant gap within racial health disparity work is the role of internalized racism and its connection to psychological distress, ruptures in social unity, and resulting ill-health of racial and ethnic populations. Based on this, we probed this particular finding to further understand internalized racism within this Puerto Rican population. MethodsUsing a hybrid thematic analysis approach, this study presents qualitative findings from in-depth interviews with Latino (92.5% Puerto Rican) men living in Springfield, Massachusetts and conducted between October 2019 and January 2020. ResultsOur findings reveal a duality throughout: The acceptance and propagation of negative Latinx stereotypes and consequent intragroup division exists alongside expressions of community pride and desire for Latinx unity. This duality is analyzed by using W.E.B. Du Bois's theory of double consciousness. Double consciousness not only explains the self-disparagement toward oneself and one's own racial and ethnic group, but also elucidates a liberatory pathway toward political consciousness and well-being. The concept of “second sight” within double consciousness is particularly germane, speaking to one's awakening to the learned self-subjugation imposed by White supremacy. ConclusionsInternalized racism contributes to the persistent propagation of disparate health burdens in minoritized communities. Remediation can and should include community-led frameworks for the development of efficacious multilevel health interventions. The Young Lords community health activism provides such a model. These findings provide viable evidence-based examples of how the academy can synergize with community-led efforts to achieve collective agency.

Health Professionals' Perceptions of Disparities in Hypertension Control: A Mixed Methods Study.

Health professionals' commitment is needed to address disparities in hypertension control by ancestry, but their perceptions regarding these disparities are understudied. Cross-sectional mixed methods study in a universal healthcare setting in the Netherlands. Snowball sampling was used to include professionals practicing in a large multicity conglomerate including the capital city. Online surveys were collected, and survey participants were randomly selected for in-depth interviews. We used quantitative and qualitative methods to analyze health professionals' awareness, beliefs, and possible interventions regarding these disparities. We analyzed questionnaire data of 77 health professionals (medical doctors n = 70, nurses = 7), whereas 13 were interviewed. Most professionals were women (59%), general practitioners (81%); and White-European (77%), with 79% caring for patients of diverse ancestry. Disparities in hypertension control by ancestry were perceived to exist nationally (83% [95% CI, 75;91]), but less so in health professionals' own clinics (62% [52;73]), or among their own patients (56% [45;67]). Survey respondents emphasized patient rather than provider-level factors as mediators of poor hypertension control by ancestry. The collection of data on patients' ancestry, updating guidelines, and professional training were considered helpful to reduce disparities. Interviewees further emphasized patient-level factors, but also the need to better educate health professionals and increase their awareness. This explorative study finds that health professionals predominantly attribute disparities in hypertension control to patient-level factors. Awareness of disparities was lower for more proximate healthcare settings. These data emphasize the need to consider health professionals' perceptions when addressing disparities in hypertension control.

Examine Race/Ethnicity Disparities in Perception, Intention, and Screening of Dementia in a Community Setting: Scoping Review.

Background: Delayed detection and diagnosis of Alzheimer’s Disease and related dementia (ADRD) can lead to suboptimal care and socioeconomic burdens on individuals, families, and communities. Our objective is to investigate dementia screening behavior focusing on minority older populations and assess whether there are ethnic differences in ADRD screening behavior. Methods: The scoping review method was utilized to examine ADRD screening behavior and contributing factors for missed and delayed screening/diagnosis focusing on race/ethnicity. Results: 2288 papers were identified, of which 21 met the inclusion criteria. We identified six dimensions of ADRD screening behavior: Noticing Symptoms, Recognizing a problem, Accepting Screen, Intending Screen, Action, and Integrating with time. Final findings were organized into study race/ethnicity, theoretical background, the methods of quantitative and qualitative studies, description and measures of ADRD screening behavior, and racial/ethnic differences in ADRD screening behavior. Conclusions: A trend in ethnic disparities in screening for ADRD was observed. Our findings point to the fact that there is a scarcity of studies focusing on describing ethnic-specific ADRD screening behavior as well as a lack of those examining the impact of ethnicity on ADRD screening behavior, especially studies where Asian Americans are almost invisible.

Americans' perceptions of health disparities over the first year of the COVID-19 pandemic: Results from three nationally-representative surveys

COVID-19 has illuminated health inequity in the United States. The burdens of disease are much higher among Black and Indigenous people and other people of color. Disparities by income are also profound, as lower-wage workers were less able to adopt mitigating behaviors compared to higher-income counterparts. These disparities became part of public health discourse in 2020, with commentators frequently highlighting the connection between racism, socioeconomic position, and COVID-19. But what proportion of the public—and among key subgroups—recognized these social group disparities, relative to disparities associated with age and chronic illness, and did public recognition change over the first year of the pandemic? To address these questions, we analyzed data from three nationally-representative cross-sectional public opinion surveys, collected using the NORC AmeriSpeak panel in April 2020 (N = 1007), August 2020 (N = 2716), and April 2021 (N = 1020). The key outcomes were respondents' agreement with statements about disparities in COVID-19 mortality by age, chronic illness, income, and race. We found little change from 2020 to 2021 in Americans' recognition of disparities. At all three time points, most respondents acknowledged age and chronic illness disparities, while no more than half at any time point recognized income- and race-based disparities. Political party affiliation was not statistically associated with agreement with age or illness-related disparities, but was strongly associated with views about income- and race-based disparities. Efforts to promote recognition of racial and socioeconomic health disparities in the United States need to be mindful of the ways in which public understanding of health inequities is linked to partisanship.

Recent Transformation of Marginal Rural Areas in the Sudetes Mountains in Poland—Drivers and Effects of Changes in Perception of their Inhabitants☆

AbstractThe study aims to analyze inhabitants' perceptions vis‐a‐vis the actual demographic, economic, functional, and land use transformation taking place in the peripheral area of Kłodzko County in the Sudetes Mountains in southwestern Poland. Recently, new socio‐economic processes can be observed in the region, suggesting a revival after a period of stagnation. It employs qualitative data from semi‐structured interviews and observation, and quantitative data from an online survey. Findings on inhabitants' perception are discussed against evidence from diverse statistical databases based on the literature. Results show that changes to physical built environment are most perceived, but tourism is seen as the main positive driver. The most acute negative change is depopulation, which is also considered to have a damaging effect on the transformation. The results show some disparities in perceptions across different socio‐demographic and spatially defined categories of inhabitants, as well as ambiguity of assessment of rural transformations that are interpreted in relation to the socio‐economic context of interviewees. The study contributes to discussion on perceived and actual change in rural areas by pointing to patterns of perception. It provides social feedback on changes and depicts collective attitudes towards rural revival—knowledge that is necessary to formulate policies tailored to site‐specific preconditions.

18. Resident Perception of Gender Disparities in Plastic Surgery Training

18. Resident Perception of Gender Disparities in Plastic Surgery Training

Women in Surgery Events Alone do not Change Medical Student Perceptions of Gender Bias and Discrimination in Orthopaedic Surgery.

AimsThis study investigated the perceptions of medical students regarding the barriers to pursuing a career in trauma and orthopaedics (T&O); and whether these perceptions were altered by attending an event promoting women in T&O.MethodsAn event consisting of presentations and interactive sessions from two female T&O trainees was hosted online. Attendees completed pre and post-event questionnaires. Students were asked about their previous exposure to T&O, perceptions of gender imbalances in T&O and what barriers they perceived prevented women from entering T&O. Univariate analysis was performed to identify changes in perceptions following the event.ResultsPre-event questionnaires were completed by 102 people; and post-event by 52. Although 64/102 respondents were considering a career in T&O, 26/102 were dissuaded by perceived gender disparities. Perceptions of gender disparities were significantly higher in UK based attendees compared to other nationalities (p = 0.047). Attendees were more likely to want to pursue a career in T&O if they had been directly exposed at medical school (p = 0.044), but exposure did not alter perceptions of women in T&O. The most common perceived barrier was the orthopaedic stereotype followed by male dominated workplace culture, and lack of female role models. Pre and post-event responses did not differ significantly for any areas examined.ConclusionThere are significant concerns amongst medical students regarding gender based discrimination within T&O, and these perceptions were not altered by attending a one-off women in T&O event. Early exposure to T&O appears important to improve interest in orthopaedics, whereas negative stereotyping is a barrier.

Perceptions of Gender Disparities in Access to Surgical Care in Malawi: A Community Based Survey.

Gender disparities in surgical care exist but have been minimally studied, particularly in low- and middle-income countries. This study explored perceptions and gender differences in health-seeking behavior and attitudes toward surgical care in Malawi among community members. A survey tool was administered to adults ≥18years old at a central hospital, district hospital, and two marketplaces in Malawi from June 2018 to December 2018. Responses from men and women were compared using chi-squared tests. Four hundred eighty-five adults participated in the survey, 244 (50.3%) men and 241 (49.7%) women. Women were more likely to state that fear of surgery might prevent them from seeking surgical care (29.1% of men, 43.6% of women, P = .0009). Both genders reported long wait times, medicine/physician shortages, and lack of information about when surgery is needed as potential barriers to seeking surgical care. More men stated that medical preference should be given to sons (17.1% of men, 9.3% of women, P = .01). Men were more likely to report that men should have the final word about household decisions (28.7% of men vs 19.5% of women, P < .0001) and were more likely to spend money independently (68.7% of married men, 37.5% of married women, P < .0001). Few participants reported believing gender equality had been achieved (61% of men and 66.8% of women). A multi-pronged approach is needed to reduce gender disparities in surgical care in Malawi, including addressing paternalistic societal norms, education, and improving health infrastructure.

Beauty Is in the Eye of the Beholder: Factors Influencing Disparity in Perceptions of Breast Reconstruction Aesthetic Outcomes.

Patient-reported outcomes are the primary measurement of breast reconstruction success, but results may be affected by nontechnical factors such as socioemotional determinants. Third-party observers provide an independent assessment of aesthetic outcomes. Factors associated with disparity between patient and observer perceptions of outcomes are not well understood. One hundred forty-seven patients underwent breast reconstruction at the authors' institution between 2009 and 2011, completed the BREAST-Q, and had photographs graded by a diverse panel using the Validated Breast Aesthetic Scale. Patient satisfaction with breasts scores that aligned with observer scores were categorized as group 2; patient satisfaction that exceeded observer scores were group 1; and those lower than observer scores were group 3. Statistical analysis was performed using SPSS, with values of p < 0.05 considered statistically significant. Twenty-eight patients (19 percent) were categorized as group 1, 93 (63 percent) in group 2, and 26 (18 percent) in group 3. Median overall appearance was highest in group 3 (median, 4.0; interquartile range, 4 to 4) and lowest in group 1 (median, 3.0; interquartile range, 2 to 3) ( p < 0.001). Psychosocial, sexual, and physical well-being were significantly associated with disparity (group 1 or 3 status) ( p < 0.01). Satisfaction with outcomes, nipples, abdomen, and breasts were significantly associated with disparity. Factors not significantly associated with disparity include age, body mass index, autologous or implant-based, adjuvant therapies, and timing of reconstruction. Incongruously high patient satisfaction with breast reconstruction aesthetics relative to third-party perception of aesthetic outcomes is associated with high quality-of-life scores. Incongruously low patient satisfaction with breast cosmesis compared with higher third-party perceptions was associated with low quality-of-life scores. Risk, II.

Global integration barriers at international branch campuses: the IBC Othering Loop

PurposeThe quality and market viability of international branch campuses (IBCs) depend upon their integration with university headquarters. Recent trends toward localizing branch-campus hiring have raised questions about the extent to which non-parent-campus lecturers will support global integration pursuits. This paper aims to examine IBC lecturers’ orientations towards global integration, exploring how they identify themselves and their campuses as part of their wider universities.Design/methodology/approachEmploying constructivist grounded theory methodology, 37 lecturers and leaders at four Australian branch campuses in Southeast Asia were interviewed, engaging them in semi-structured discussions of their identities and experiences. Interviews were recorded, transcribed and analyzed using NVivo in an iterative process of theory development.FindingsBranch-campus lecturers interviewed generally construct their individual and campus identities as separate from their wider universities. Barriers to branch campuses’ global integration include low organizational identification of lecturers, challenges in their relationships with headquarters colleagues and perceptions of cross-campus disparities in resources and students. Branch campuses’ organizationally separate identities are enacted in practice, fueling a self-reinforcing “Othering Loop” that could undermine these campuses’ quality and viability.Originality/valueThis research is the first emic exploration of locally-hired branch-campus lecturers’ views toward global integration. These findings provide an important corrective to the existing literature on this topic, challenging assumptions that localizing branch-campus hiring is the primary risk to integration. Multiple points of potential managerial intervention were identified, highlighting opportunities for university leaders to address contextual barriers and improve international branch campuses’ global integration while continuing current trends toward localized hiring.

Fake news on you, Not me: The Third-Person Effects of Fake News in South Korea

ABSTRACT This study explored the perceptual components of the third-person effects of fake news during the 2017 presidential election in South Korea. Specifically, we examined self-other disparities in perceptions of the effects of fake news using data from an online panel survey. The results indicated that the participants considered the influence of fake news to be greater on others than on themselves. We also found political interest and fact-checking to be significant predictors of the self-other disparities associated with perceptions of fake news. The findings of this study offer fresh insights into third-person effects in the age of post-truth politics.

A Community Divided: The Ho Lawsuit and Chinese San Franciscans’ Search for Education Equality and Racial Inclusion

Abstract The Brian Ho lawsuit in the 1990s, brought about by several school children of Chinese descent in the San Francisco United School District against the school district, state defendants, and the San Francisco NAACP, signified a shift in the understanding of education equality that spotlighted divergent views, motivations, and actions concerning race-conscious education policies among Chinese San Franciscans. This article examines the intra-community dynamics and conflicts in Chinese San Franciscans’ pursuit of education rights and racial equality in the 1980s and 1990s by reconstructing their various claims to education equality. These divergent yet analogous struggles for equal educational opportunities reflected varied racial attitudes and conceptions of Chinese American racial identity. What these disparate racial perceptions and identity conceptions embodied fundamentally was a range of arguments for racial inclusion and equality. The contrast and contradictions between these distinct views persisted, reemerging in Chinese Americans’ continued apprehension of their racial identity in the wake of the renewed debate about race-based education policies that was juxtaposed with the rising racial hatred toward Asian Americans during the COVID-19 pandemic.

Highlighting COVID-19 racial disparities can reduce support for safety precautions among White U.S. residents

U.S. media has extensively covered racial disparities in COVID-19 infections and deaths, which may ironically reduce public concern about COVID-19. In two preregistered studies (conducted in the fall of 2020), we examined whether perceptions of COVID-19 racial disparities predict White U.S. residents’ attitudes toward COVID-19. Utilizing a correlational design (N = 498), we found that those who perceived COVID-19 racial disparities to be greater reported reduced fear of COVID-19, which predicted reduced support for COVID-19 safety precautions. In Study 2, we manipulated exposure to information about COVID-19 racial disparities (N = 1,505). Reading about the persistent inequalities that produced COVID-19 racial disparities reduced fear of COVID-19, empathy for those vulnerable to COVID-19, and support for safety precautions. These findings suggest that publicizing racial health disparities has the potential to create a vicious cycle wherein raising awareness reduces support for the very policies that could protect public health and reduce disparities.

Discourse analysis of the perceptions of environmental justice and respiratory health disparities in Dallas, TX

ABSTRACT This article examines the perceived relationships between environmental justice and health disparities among minority populations in the Dallas, TX metropolitan area. We study the varying discourses on EJ and respiratory health disparities, and how the local discourses are different from what is understood by planners and environmental advocates. We also ask how a participatory approach can provide an inclusive platform to strengthen the efforts to reduce health disparities. Utilizing a survey, a focus group of local residents, and in-depth interviews with local government officials, urban planners, environmental and health advocates, and urban ecologists, we identify and discuss key discourses of health disparities and environmental (in) justice to better understand different positionalities. Using Foucauldian discourse analysis, three discursive approaches were identified: “institutional racism”, “inclusion and recognition”, and “scientific evidence”. Drawing on these identified discourses we illustrate the importance of the political and social framings of environmental justice and health concerns and perceptions to better inform community health promotion efforts. The results highlight the importance of incorporating knowledges from various stakeholders in the analysis of environmental inequalities in parallel with the ecological understanding of environmental and human health disparities.

Stakeholder Perceptions of Sustainable Infrastructure Project Delivery: A Comparative Analysis between Guangdong, Hong Kong, and Macao.

China is experiencing the rapid development of infrastructure projects throughout the country, especially in the Guangdong-Hong Kong SAR-Macao SAR Greater Bay Area. This is placing the Chinese construction industry under tremendous pressure to transition to a sustainability orientation due to the various economic, social, and environmental challenges involved. The transition to more sustainable infrastructure projects requires the involvement of more stakeholders, while the multistakeholder context is of less importance when making project decisions, and this may create an adverse effect on the sustainability level of infrastructure projects. Based on the questionnaire data collected, this study addresses this issue by comparatively analysing stakeholder perceptions of sustainable infrastructure delivery between Guangdong province, Hong Kong SAR, and Macao SAR. Through independent sample t-tests, the disparity in perceptions between paired stakeholder groups in the Greater Bay Area (as a whole) is revealed. Three pairs, i.e., government department and supervising engineers, owners and designers, and supervising engineers and operators, are found to be the most conflicting, while contractors and supervising engineers are the least. Of the 18 sustainability items analysed, shaped local identity and international reputation (SOC, social factor 8) is the most controversial, while value-for-money of the proposed project during its lifecycle (EOC, economic factor 5) and green design and construction (ENV, environmental factor 2) have the greatest consensus towards their roles in achieving project sustainability. Significantly, different stakeholder perceptions between the three are also identified, and the contractor group is found to share the least consensus geographically, while the operators have the least conflict rating of the relevant importance of various sustainability factors. The thorough analysis of sustainability-related items of economy, society, and environment contributes to understanding the attitudes of the various stakeholder groups involved, which then helps reduce their conflicts during sustainable infrastructure delivery.

Perceptions of Gender Disparities in Access to Surgical Care in Malawi: A Community Based Survey

Perceptions of Gender Disparities in Access to Surgical Care in Malawi: A Community Based Survey

Mask On, Mask Off: Risk Perceptions for COVID-19 and Compliance with COVID-19 Safety Measures

Since early 2020, COVID-19 has spread throughout the United States (US), killing more than 700,000. Mask-wearing, social-distancing, and hand hygiene can curb the spread of COVID-19 and other infectious diseases. However, the adherence to COVID-19 safety measures varies considerably among the US public, likely due to disparate perceptions of COVID-19’s risk. The current study examines risk perceptions for COVID-19 (RP-C) in a nationally representative sample of US residents (N = 512), as well as their political preferences, news media consumption, COVID-19 safety attitudes (SA-C) and reported COVID-19 safety behaviors (SB-C; e.g., mask-wearing and social-distancing). Using structural equation modeling, we tested a comprehensive measure for RP-C with a single latent factor, finding good model fit. We found that higher RP-C was associated with being more liberal, consuming more traditional news media, having attitudes that supported compliance with COVID-19 safety measures, and having greater reported compliance with COVID-19 safety measures. In addition, factor loadings for RP-C items indicate that people’s RP-C was more strongly determined by personal and family, rather than collective or societal risk, which suggests risk communication may be improved by focusing on personal and family risk. Public health efforts to combat COVID-19 are only as good as compliance allows, and RP-C’s strong relationship with SB-C indicates a potential means for risk communicators to increase compliance with COVID-19 safety measures. This finding will remain important as new COVID-19 variants, such as the Delta variant, emerge.