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32


Moving to patient reported collection of race and ethnicity data: implementation and impact in ten hospitals

Berry, Carolyn; Kaplan, Sue A; Mijanovich, Tod; Mayer, Andrea
PURPOSE: The purpose of this paper is to examine the feasibility of collecting standardized, patient reported race and ethnicity (RE) data in hospitals, and to assess the impact on data quality and utility. DESIGN/METHODOLOGY/APPROACH: Part of a larger evaluation that included a comprehensive assessment. Sites documented RE data collection procedures before and after program implementation. Primary data collected through qualitative interviewing with key respondents in ten hospitals to assess implementation. Nine hospitals provided RE data on the same patients before and after implementation new data collection procedures were implemented to assess impact. FINDINGS: Implementation went smoothly in nine of ten hospitals and had substantial effects on the hospital staff awareness on the potential for disparities within their hospitals. New procedures had minimal impact on characterization of readmitted patients. PRACTICAL IMPLICATIONS: This study demonstrated that it is feasible for staff in a diverse group of hospitals to implement systematic, internally standardized methods to collect self-reported RE data from patients. ORIGINALITY/VALUE: Although this study found little impact patients' demographic characterizations, other benefits included greater awareness of and attention to disparities, uncovering small pockets of minorities, and dramatically increased RE data use in quality improvement efforts.
PMID: 25076602
ISSN: 0952-6862
CID: 1930622

The perception of stress and its impact on health in poor communities

Kaplan, Sue A; Madden, Vivienne Patricia; Mijanovich, Todor; Purcaro, Ellenrita
With the increased understanding of the relationship between stress and disease, the role of stress in explaining persistent disparities in health outcomes has received growing attention. One body of research has focused on allostatic load-the "wear and tear" that results from chronic or excessive activation of the stress response. Other research has looked at the link between stress and health behaviors. In this study, we conducted 7 focus groups with a total of 56 people to understand how people living in Highbridge, South Bronx, New York, a low income community with poor health outcomes, perceive stress and its relationship to health. Focus group participants described a direct causal pathway between stress and poor health as well as an indirect pathway through health behaviors, including uncontrolled eating, sleep deprivation, substance abuse, smoking, violence and aggression, and withdrawal and inactivity. Participants articulated a number of theories about why stress leads to these unhealthy behaviors, including self-medication, adaptive behavior, discounting the future, depletion of willpower, and competing priorities. Their nuanced understanding of the link between stress and health elucidates the mechanisms and pathways by which stress may result in disparities in health outcomes and create challenges in changing health behaviors in poor communities like the South Bronx.
PMID: 22806256
ISSN: 0094-5145
CID: 213232

Symptomatic and urodynamic responses in patients with reduced or no seminal emission during silodosin treatment for LUTS and BPH

Roehrborn, C G; Kaplan, S A; Lepor, H; Volinn, W
Data from phase 3 studies (NCT00224107, NCT00224120) of silodosin for treatment of BPH symptoms were analyzed to examine the relationship between treatment efficacy and occurrence of abnormal ejaculation. Men aged >/=50 years with International Prostate Symptom Scores (IPSS) >/=13 and peak urinary flow rates (Qmax) of 4-15 ml s(-1) received placebo or silodosin 8 mg once daily for 12 weeks. Silodosin-treated patients were stratified by absence or presence of 'retrograde ejaculation' (RE). Groups were compared using analysis of covariance (for change from baseline) and responder analyses. Of the 466 patients receiving silodosin, 131 (28%) reported RE and 335 (72%) did not; 4 of the 457 patients receiving placebo (0.9%) reported RE. Most RE events in silodosin-treated patients (110/134; 82%) were reported as 'orgasm with absence of seminal emission.' Silodosin-treated patients with (+) and without (-) RE showed significant improvement in IPSS, Qmax and quality of life versus placebo (P<0.02). RE+ patients versus RE- patients experienced numerically greater improvement, but differences were not statistically significant (P>0.05). For RE+ patients, the odds of achieving improvement of >/=3 points in IPSS and >/=3 ml s(-1) in Qmax by study end were 1.75 times those for RE- patients (P=0.0127). Absence of seminal emission may predict superior treatment efficacy of silodosin in individual patients.
PMCID:3094762
PMID: 21135869
ISSN: 1365-7852
CID: 854162

Stirring up the mud: using a community-based participatory approach to address health disparities through a faith-based initiative

Kaplan, Sue A; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert Sr; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil
This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institutionalization and sustainability
PMCID:3065238
PMID: 20168022
ISSN: 1548-6869
CID: 109697

The viability of community partnerships initiated by external funders

Berry, Carolyn; Kaplan, Sue A; Reid, Aileen; Albert, Stephanie
PMCID:2693174
PMID: 19618797
ISSN: 0033-3549
CID: 109698

Engaging the next generation in family philanthropy

[Kaplan, SA; Schall, Ellen]
[New York] : Andrea and Charles Bronfman Philanthropies : 21/64, [2007?]
Extent: 2 volumes ; 25 cm
ISBN: n/a
CID: 1941932

Fostering organizational change through a community-based initiative

Kaplan, Sue A; Calman, Neil S; Golub, Maxine; Ruddock, Charmaine; Billings, John
Program funders and managers are increasingly interested in fostering changes in the policies, practices, and procedures of organizations participating in community-based initiatives. But little is known about what factors contribute to the institutionalization of change. In this study, the authors assess whether the organizational members of the Bronx Health REACH Coalition have begun to change their functioning and role with regard to their clients and their staff and in the broader community, apart from their implementation of the funded programs for which they are responsible. The study identifies factors that seemed to contribute to or hinder such institutional change and suggests several strategies for coalitions and funders that are seeking to promote and sustain organizational change
PMID: 16760250
ISSN: 1524-8399
CID: 109700

The role of faith-based institutions in addressing health disparities: a case study of an initiative in the southwest Bronx

Kaplan, Sue A; Calman, Neil S; Golub, Maxine; Ruddock, Charmaine; Billings, John
Although many public health initiatives have been implemented through collaborations with faith-based institutions, little is known about best practices for developing such programs. Using a community-based participatory approach, this case study examines the implementation of an initiative in the Bronx, New York, that is designed to educate community members about health promotion and disease management and to mobilize church members to seek equal access to health care services. The study used qualitative methods, including the collaborative development of a logic model for the initiative, focus groups, interviews, analysis of program reports, and participant observation. The paper examines three key aspects of the initiative's implementation: (1) the engagement of the church leadership; (2) the use of church structures as venues for education and intervention; and (3) changes in church policies. Key findings include the importance of pre-existing relationships within the community and the prominent agenda-setting role played by key pastors, and the strength of the Coalition's dual focus on health behaviors and health disparities. Given the churches' demonstrated ability to pull people together, to motivate and to inspire, there is great potential for faith-based interventions, and models developed through such interventions, to address health disparities
PMID: 16809872
ISSN: 1049-2089
CID: 109699

Racial and ethnic disparities in health: a view from the South Bronx

Kaplan, Sue A; Calman, Neil S; Golub, Maxine; Davis, Joyce H; Ruddock, Charmaine; Billings, John
This study seeks to understand the perspective of Black and Hispanic/Latino residents of the South Bronx, New York, on the causes of persistent racial and ethnic disparities in health outcomes. In particular, it focuses on how people who live in this community perceive and interact with the health care system. Findings from 9 focus groups with 110 participants revealed a deep and pervasive distrust of the health care system and a sense of being disrespected, exacerbated by difficulties that patients experience in communicating with their providers. The paper suggests how health care institutions might respond to these perceptions
PMID: 16520520
ISSN: 1049-2089
CID: 109701

The use of logic models by community-based initiatives

Kaplan, Sue A.; Garrett, Katherine E.
Many grant programs now require community-based initiatives to develop logic models as part of the application process or to facilitate program monitoring and evaluation. This paper examines three such programs to understand the benefits and challenges of using logic models to help build consensus and foster collaboration within a community coalition, strengthen program design, and facilitate internal and external communication. The paper concludes with recommendations for how to make the logic model development process more useful for community-based initiatives. © 2005 Elsevier Ltd. All rights reserved.
SCOPUS:15344347311
ISSN: 0149-7189
CID: 4670212