abstract: 'There is expansive literature documenting the presence of health

  disparities, but there are disproportionately few studies describing

  interventions to reduce disparity. In this narrative review, we

  categorize interventions to reduce health disparity in pulmonary disease

  within the US health care system to support future initiatives to reduce

  disparity. We identified 211 articles describing interventions to reduce

  disparity in pulmonary disease related to race, income, or sex. We

  grouped the studies into the following four categories: biologic,

  educational, behavioral, and structural. We identified the following

  five main themes: (1) there were few interventional trials compared with

  the breadth of studies describing health disparities, and trials

  involving patients with asthma who were Black, low income, and living in

  an urban setting were overrepresented; (2) race or socioeconomic status

  was not an effective marker of individual pharmacologic treatment

  response; (3) telehealth enabled scaling of care, but more work is

  needed to understand how to leverage telehealth to improve outcomes in

  marginalized communities; (4) future interventions must explicitly

  target societal drivers of disparity, rather than focusing on individual

  behavior alone; and (5) individual interventions will only be maximally

  effective when specifically tailored to local needs. Much work has been

  done to catalog health disparities in pulmonary disease. Notable gaps in

  the identified literature include few interventional trials, the need

  for research in diseases outside of asthma, the need for high quality

  effectiveness trials, and an understanding of how to implement proven

  interventions balancing fidelity to the original protocol and the need

  to adapt to local barriers to care.'
affiliation: 'Harper, LJ (Corresponding Author), Cleveland Clin, Resp Inst, Dept Pulm
  Med, Cleveland, OH 44103 USA.

  Harper, Logan J.; Khatri, Sumita B.; Culver, Daniel A., Cleveland Clin, Resp Inst,
  Dept Pulm Med, Cleveland, OH 44103 USA.

  Kidambi, Pranav, Michigan State Univ, Coll Human Med, E Lansing, MI USA.

  Kidambi, Pranav, Corewell Hlth Med Grp, Div Pulm \& Crit Care Med, Grand Rapids,
  MI USA.

  Kirincich, Jason M., Cleveland Clin, Community Care Inst, Dept Internal Med, Cleveland,
  OH USA.

  Thornton, J. Daryl, Metrohlth Campus Case Western Reserve Univ, Ctr Reducing Hlth
  Dispar, Populat Hlth Res Inst, Cleveland, OH USA.

  Thornton, J. Daryl, Metro Hlth Campus Case Western Reserve Univ, Div Pulm Crit Care
  \& Sleep Med, Cleveland, OH USA.'
author: Harper, Logan J. and Kidambi, Pranav and Kirincich, Jason M. and Thornton,
  J. Daryl and Khatri, Sumita B. and Culver, Daniel A.
author-email: Harperl3@ccf.org
author_list:
- family: Harper
  given: Logan J.
- family: Kidambi
  given: Pranav
- family: Kirincich
  given: Jason M.
- family: Thornton
  given: J. Daryl
- family: Khatri
  given: Sumita B.
- family: Culver
  given: Daniel A.
da: '2023-09-28'
doi: 10.1016/j.chest.2023.02.033
earlyaccessdate: JUL 2023
eissn: 1931-3543
files: []
issn: 0012-3692
journal: CHEST
keywords: 'asthma; COPD; health care disparities; health inequalities; lung cancer;

  lung cancer screening; racial disparity; social determinants of health'
keywords-plus: 'INNER-CITY CHILDREN; RANDOMIZED CONTROLLED-TRIAL; IMPROVING ASTHMA

  OUTCOMES; LUNG-CANCER; MINORITY CHILDREN; AFRICAN-AMERICANS; URBAN

  CHILDREN; PROGRAM; CARE; THERAPY'
language: English
month: JUL
number: '1'
number-of-cited-references: '73'
pages: 179-189
papis_id: 7d978a783cda884a28852c43c0564495
ref: Harper2023healthdisparities
tags:
- review
times-cited: '0'
title: Health Disparities Interventions for Pulmonary Disease-A Narrative Review
type: article
unique-id: WOS:001035931400001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '164'
web-of-science-categories: Critical Care Medicine; Respiratory System
year: '2023'