Health Disparities
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21657
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Browsing Health Disparities by Author "Suzuki, Sumihiro"
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Item Does Alcohol Use Affect the Relationship Between Social Support and Depression? An Examination of Permanent Supportive Housing (PSH) Residents in Fort Worth, Texas(2018-03-14) Walters, Scott; Suzuki, Sumihiro; Tan, ZhengqiBackground: Social support tends to be protective against depression in a wide variety of groups. However, relatively little is known about how alcohol use might affect this relationship over time, especially among supportive housing residents, who are at risk for both depression and poor social support. Purpose: This study examined whether the association between social support and depression was modified by alcohol consumption among permanent supportive housing (PSH) residents in Fort Worth, Texas. Methods: We used the baseline and 6-month follow-up data from the Mobile Community Health Assistance for Tenants (m.chat) program, collected during 2014-2017. m.chat was a technology-assisted health coaching program for people with mental health conditions residing in PSH in Fort Worth, Texas. Participants’ current levels of depression and social support were measured using Patient Health Questionnaire-9 (PHQ-9) and Interpersonal Support Evaluation List (ISEL), respectively; alcohol consumption was measured via a self-report frequency measure that ranged from “0” (never) to “4” (more than 4 times a week). The association between social support and depression was studied using generalized estimating equation (GEE) models including alcohol use as an effect modifier and sex, age, race, marital status and perceived physical health as a priori covariates. This analysis included 567 participants. Results: At baseline, about 38.2% of participants reported some alcohol consumption in the past 90 days. Greater baseline social support was associated with improvements in depression severity. One unit increase in the baseline ISEL score predicted a 4.3% reduction (95%CI: 2.6%, 6.1%) in depression scores over time. Greater baseline alcohol consumption predicted an 11.9% increase (95%CI: 0.8%, 21.6%) in depression scores over time. We did not find a significant interaction between alcohol consumption and social support and changes in depression severity after adjusting for sex, age, race, marital status and perceived physical health. Conclusions: Among PSH residents in Fort Worth, Texas, greater social support was associated with a reduction in depression scores. Higher alcohol consumption was associated with an increase in depression scores. The protective effect of social support did not differ by alcohol consumption level. These findings can be used to design more robust health coaching programs for formerly homeless persons that integrate positive social support.Item Mapping, Characterization and Description of HIV-APPE Rotations at ACPE Accredited Colleges of Pharmacy(2018-03-14) Hall, Brenton; Thomas, Drew; Suzuki, Sumihiro; Clay, Patrick; Rivera, MivielisBackground: Despite aggressive HIV testing programs and the introduction of preventative antiretroviral regimens (PrEP), the number of persons living with HIV in the United States (US) continues to increase by over 30,000 every year. As over 50% of PLWH are now over the age of 50, they represent an especially challenging population to provide care as they develop co-morbid conditions consistent with their non-PLWH counterparts of the same age, gender, race and ethnicity. In order for healthcare teams to optimally care for this population, pharmacists with focused training in this disease state are required. Accredited colleges of pharmacy, federal training programs and other large healthcare systems must first be knowledgeable of where to send trainees, yet no comprehensive database of HIV-specialized pharmacist training sites currently exists. Objective: This study's primary aims were to (1) create a map of US-based pharmacy student training sites, then describe (2) the training environment and (3) qualifications of the trainer present. Methods/Materials: A forced-choice, logic, algorithm based, Qualtrics™ survey was developed, validated, IRB-approved and deployed using a four-pronged approach. From October to November 2017, this anonymous survey was distributed through (1) professional organizations membership lists (pharmacy and medicine, HIV and non-HIV focused), (2) ACPE accredited pharmacy schools' experiential coordinators, and (3) a nationwide pharmacy chain. The 4th prong was via grassroots, snowball distribution whereby recipients forwarded it to their contacts. Results: Of 170 survey respondents, 143 consented to participate. Not all responded to each question. Results reflect proportion of question responses. Respondents reported 65% (n=94) primarily provide care for PLWH, 48% have at least 100 HIV patients served annually, and 79% (n=143) receive some form of government funding. Of the 143, 78 (59%) are APPE sites, 55 of which take over 6 students annually. Most students (93%) engaged 10 patients per week and 8 of 10 patients were PLWH. While 60 (42%) of these APPE sites report affiliation with at least 1 college of pharmacy, 18 states were not captured, including areas with high prevalence of PLWH. Conclusion: The survey successfully identified predominantly high patient volume HIV training sites, with experienced preceptors in 32 states. Serial deployment with enhanced marketing is needed to identify the regions not represented. Research Area: HIV Training Presentation Type: Poster