2023-09-28 14:46:10 +00:00
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abstract: 'There is expansive literature documenting the presence of health
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disparities, but there are disproportionately few studies describing
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interventions to reduce disparity. In this narrative review, we
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categorize interventions to reduce health disparity in pulmonary disease
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within the US health care system to support future initiatives to reduce
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disparity. We identified 211 articles describing interventions to reduce
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disparity in pulmonary disease related to race, income, or sex. We
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grouped the studies into the following four categories: biologic,
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educational, behavioral, and structural. We identified the following
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five main themes: (1) there were few interventional trials compared with
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the breadth of studies describing health disparities, and trials
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involving patients with asthma who were Black, low income, and living in
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an urban setting were overrepresented; (2) race or socioeconomic status
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was not an effective marker of individual pharmacologic treatment
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response; (3) telehealth enabled scaling of care, but more work is
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needed to understand how to leverage telehealth to improve outcomes in
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marginalized communities; (4) future interventions must explicitly
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target societal drivers of disparity, rather than focusing on individual
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behavior alone; and (5) individual interventions will only be maximally
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effective when specifically tailored to local needs. Much work has been
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done to catalog health disparities in pulmonary disease. Notable gaps in
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the identified literature include few interventional trials, the need
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for research in diseases outside of asthma, the need for high quality
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effectiveness trials, and an understanding of how to implement proven
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interventions balancing fidelity to the original protocol and the need
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to adapt to local barriers to care.'
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affiliation: 'Harper, LJ (Corresponding Author), Cleveland Clin, Resp Inst, Dept Pulm
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Med, Cleveland, OH 44103 USA.
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Harper, Logan J.; Khatri, Sumita B.; Culver, Daniel A., Cleveland Clin, Resp Inst,
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Dept Pulm Med, Cleveland, OH 44103 USA.
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Kidambi, Pranav, Michigan State Univ, Coll Human Med, E Lansing, MI USA.
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Kidambi, Pranav, Corewell Hlth Med Grp, Div Pulm \& Crit Care Med, Grand Rapids,
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MI USA.
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Kirincich, Jason M., Cleveland Clin, Community Care Inst, Dept Internal Med, Cleveland,
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OH USA.
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Thornton, J. Daryl, Metrohlth Campus Case Western Reserve Univ, Ctr Reducing Hlth
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Dispar, Populat Hlth Res Inst, Cleveland, OH USA.
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Thornton, J. Daryl, Metro Hlth Campus Case Western Reserve Univ, Div Pulm Crit Care
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\& Sleep Med, Cleveland, OH USA.'
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author: Harper, Logan J. and Kidambi, Pranav and Kirincich, Jason M. and Thornton,
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J. Daryl and Khatri, Sumita B. and Culver, Daniel A.
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author-email: Harperl3@ccf.org
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author_list:
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- family: Harper
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given: Logan J.
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- family: Kidambi
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given: Pranav
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- family: Kirincich
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given: Jason M.
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- family: Thornton
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given: J. Daryl
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- family: Khatri
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given: Sumita B.
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- family: Culver
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given: Daniel A.
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da: '2023-09-28'
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doi: 10.1016/j.chest.2023.02.033
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earlyaccessdate: JUL 2023
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eissn: 1931-3543
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files: []
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issn: 0012-3692
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journal: CHEST
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keywords: 'asthma; COPD; health care disparities; health inequalities; lung cancer;
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lung cancer screening; racial disparity; social determinants of health'
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keywords-plus: 'INNER-CITY CHILDREN; RANDOMIZED CONTROLLED-TRIAL; IMPROVING ASTHMA
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OUTCOMES; LUNG-CANCER; MINORITY CHILDREN; AFRICAN-AMERICANS; URBAN
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CHILDREN; PROGRAM; CARE; THERAPY'
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language: English
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month: JUL
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number: '1'
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number-of-cited-references: '73'
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pages: 179-189
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papis_id: 7d978a783cda884a28852c43c0564495
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ref: Harper2023healthdisparities
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tags:
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- review
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times-cited: '0'
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title: Health Disparities Interventions for Pulmonary Disease-A Narrative Review
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:001035931400001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '164'
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web-of-science-categories: Critical Care Medicine; Respiratory System
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year: '2023'
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