Racial disparities exist for a number of clinical preventive services for which scientific evidence documents improved morbidity and mortality outcomes as a result of their use (routine childhood immunizations, tetanus and flu/pneumonia immunizations, mammography, cholesterol screening, having a regular source of care, routine oral exams, sigmoidoscopy, and colonoscopy). To improve our ability to design cost- effective interventions to increase the appropriate use of clinical preventive services by members of racial and ethnic minority groups, we will: 1. Analyze the individual and contextual predictors of clinical preventive service use by racial and ethnic minorities to determine the extent to which disparities exist. 2. Compare the effects of these predictors using logistic regression across (a) different racial and ethnic groups to identify how differences result from (i) differences in population characteristics and/or (ii) differences in the effects of predictors across population AND (b) compare effects of these predictors across different clinical preventive services to identify common mutable factors. 3. Drawing on existing estimates from the literature of preventive services' health status improvements, the parameter estimates developed above, and """"""""best estimate"""""""" costs of modifying each factor, conduct Monte Carlo simulations of the relative merits of different interventions. 4. Design and solicit additional funding for at least one intervention trial that would address a cross-cutting determinant of clinical preventive service disparities identified above. Analyses will be conducted using the MEPS, MCBS, NHIS, and California Health Interview Survey. The first two datasets provide extensive detail on independent variables with smaller sample sizes and fewer dependent variables. The latter datasets contain extensive detail on dependent variables with some loss of detail on independent variables.
| Calderón, José Luis; Bazargan, Mohsen; Sangasubana, Nisaratana et al. (2010) A comparison of two educational methods on immigrant Latinas breast cancer knowledge and screening behaviors. J Health Care Poor Underserved 21:76-90 |
| Tobias, Carol; Cunningham, William E; Cunningham, Chinazo O et al. (2007) Making the connection: the importance of engagement and retention in HIV medical care. AIDS Patient Care STDS 21 Suppl 1:S3-8 |
| Rumptz, Maureen H; Tobias, Carol; Rajabiun, Serena et al. (2007) Factors associated with engaging socially marginalized HIV-positive persons in primary care. AIDS Patient Care STDS 21 Suppl 1:S30-9 |
| Calderon, Jose L; Baker, Richard S; Fabrega, Horacio et al. (2006) An ethno-medical perspective on research participation: a qualitative pilot study. MedGenMed 8:23 |
| Morales, Leo S; Staiger, Douglas; Horbar, Jeffrey D et al. (2005) Mortality among very low-birthweight infants in hospitals serving minority populations. Am J Public Health 95:2206-12 |
| Wong, Mitchell D; Tagawa, Tomoko; Hsieh, Hsin-Ju et al. (2005) Differences in cause-specific mortality between Latino and white adults. Med Care 43:1058-62 |
| Calderon, Jose L; Shaheen, Magda; Pan, Deyu et al. (2005) Multi-cultural surveillance for ectopic pregnancy: California 1991-2000. Ethn Dis 15:S5-20-4 |
| Rogowski, Jeannette A; Staiger, Douglas O; Horbar, Jeffrey D (2004) Variations in the quality of care for very-low-birthweight infants: implications for policy. Health Aff (Millwood) 23:88-97 |
| Calderon, Jose Luis; Zadshir, Ashraf; Norris, Keith (2004) A survey of kidney disease and risk-factor information on the World Wide Web. MedGenMed 6:3 |
| Calderon, Jose Luis; Zadshir, Ashraf; Norris, Keith (2004) Structure and content of chronic kidney disease information on the World Wide Web: barriers to public understanding of a pandemic. Nephrol News Issues 18:76, 78-9, 81-4 |
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