Browsing by Author "Martinez-Bianchi, Viviana"
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Item Open Access A Framework for Resident Participation in Population Health.(Academic medicine : journal of the Association of American Medical Colleges, 2018-09-25) Jiménez, Jonathan; Andolsek, Kathryn M; Martinez-Bianchi, Viviana; Michener, J LloydPopulation health experiences have become more common in medical education. Yet, most resident population health experiences are in patient panel management and fail to connect with the rapidly growing movement of cross-sector, data-driven, and community-led initiatives dedicated to improving the health of populations defined by geography rather than insurer or employer. In this Perspective, the authors present a five-stage framework for residents' participation in the work of these initiatives. The five stages of this framework are (1) organize and prepare, (2) plan and prioritize, (3) implement, (4) monitor and evaluate, and (5) sustain. In applying this approach, residents stand to acquire new population health skills and augment the value and meaning of their work, while institutions stand to improve the health of the communities they serve, including the health of their own employees. However, a paucity of experienced role models and demanding residency schedules present significant challenges to residents effectively partnering with the community. Residencies and institutions will have to be flexible and committed to being a part of these cross-sector, data-driven, and community-led partnerships over the long-term.Item Open Access MP25-15 INITIAL PHARMACOTHERAPY FOR OVERACTIVE BLADDER SYMPTOMS AMONG MEDICARE BENEFICIARIES(The Journal of Urology, 2016-04) Scales, Charles; Greiner, Melissa; Curtis, Lesley; Hammill, Brad; Peterson, Andrew; Amundsen, Cindy; Martinez-Bianchi, Viviana; Heflin, Mitchell; Schmader, KennethItem Open Access MP25-16 MEDICATION SWITCHING AFTER INITIAL PHARMACOTHERAPY FOR OVERACTIVE BLADDER(The Journal of Urology, 2016-04) Scales, Charles; Greiner, Melissa; Curtis, Lesley; Hammill, Brad; Peterson, Andrew; Amundsen, Cindy; Martinez-Bianchi, Viviana; Heflin, Mitchell; Schmader, KennethItem Open Access ¿No Hay Racismo?: application of the levels of racism framework to Latinx perspectives on barriers to health and wellbeing.(BMC public health, 2024-08) Plasencia, Gabriela; Kaalund, Kamaria; Gupta, Rohan; Martinez-Bianchi, Viviana; Gonzalez-Guarda, Rosa; Sperling, Jessica; Thoumi, AndreaBackground
The purpose of this study is to increase understanding of the forms of systemic racism experienced by Latinx communities in North Carolina during the COVID-19 pandemic as identified by Latinx community health workers (CHWs) and community-based organization (CBO) leaders.Methods
We held three focus groups in July 2022 (N = 16) with CHWs and CBO leaders in Spanish to discuss policy and community interventions that improved access to resources during the COVID-19 pandemic; policy or community interventions needed to improve care of Latinx communities; and lessons learned to improve the health of Latinx communities in the future. We performed directed and summative qualitative content analysis of the data in the original language using the Levels of Racism Framework by Dr. Camara Jones to identify examples of implicitly and explicitly discussed forms of systemic racism.Results
Latinx CHWs and CBO leaders implicitly discussed numerous examples of all levels of racism when seeking and receiving health services, such as lack of resources for undocumented individuals and negative interactions with non-Latinx individuals, but did not explicitly name racism. Themes related to institutionalized racism included: differential access to resources due to language barriers; uninsured or undocumented status; exclusionary policies not accounting for cultural or socioeconomic differences; lack of action despite need; and difficulties obtaining sustainable funding. Themes related to personally-mediated racism included: lack of cultural awareness or humility; fear-inciting misinformation targeting Latinx populations; and negative interactions with non-Latinx individuals, organizations, or institutions. Themes related to internalized racism included: fear of seeking information or medical care; resignation or hopelessness; and competition among Latinx CBOs. Similarly, CHWs and CBO leaders discussed several interventions with systems-level impact without explicitly mentioning policy or policy change.Conclusion
Our research demonstrates community-identified examples of racism and confirms that Latinx populations often do not name racism explicitly. Such language gaps limit the ability of CHWs and CBOs to highlight injustices and limit the ability of communities to advocate for themselves. Although generally COVID-19 focused, themes identified represent long-standing, systemic barriers affecting Latinx communities. It is therefore critical that public and private policymakers consider these language gaps and engage with Latinx communities to develop community-informed anti-racist policies to sustainably reduce forms of racism experienced by this unique population.Item Open Access Partnerships to Care for Our Patients and Communities During COVID-19(The Journal of the American Board of Family Medicine, 2021-09) Viera, Anthony J; Barnett, Jacqueline; Case, Matthew; Epling, Carol; Halstater, Brian; Lyn, Michelle; Martinez-Bianchi, Viviana; Ragsdale, John; Railey, Kenyon; Said, Kristen; Sawin, Gregory; Spotts, Hunter; Vaughn, John; Weigle, Nancy; Michener, J LloydItem Open Access Promoting Latinx health equity through community-engaged policy and practice reforms in North Carolina.(Frontiers in public health, 2023-01) Thoumi, Andrea; Plasencia, Gabriela; Madanay, Farrah; Ho, Ethan Shih-An; Palmer, Caroline; Kaalund, Kamaria; Chaudhry, Nikhil; Labrador, Amy; Rigsby, Kristen; Onunkwo, Adaobi; Almonte, Ivan; Gonzalez-Guarda, Rosa; Martinez-Bianchi, Viviana; Cholera, RushinaIntroduction
The Latinx Advocacy Team & Interdisciplinary Network for COVID-19 (LATIN-19) is a unique multi-sector coalition formed early in the COVID-19 pandemic to address the multi-level health inequities faced by Latinx communities in North Carolina.Methods
We utilized the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to conduct a directed content analysis of 58 LATIN-19 meeting minutes from April 2020 through October 2021. Application of the NIMHD Research Framework facilitated a comprehensive assessment of complex and multidimensional barriers and interventions contributing to Latinx health while centering on community voices and perspectives.Results
Community interventions focused on reducing language barriers and increasing community-level access to social supports while policy interventions focused on increasing services to slow the spread of COVID-19.Discussion
Our study adds to the literature by identifying community-based strategies to ensure the power of communities is accounted for in policy reforms that affect Latinx health outcomes across the U.S. Multisector coalitions, such as LATIN-19, can enable the improved understanding of underlying barriers and embed community priorities into policy solutions to address health inequities.Item Open Access Prostate cancer screening(2014) Ragsdale, John W; Halstater, Brian; Martinez-Bianchi, VivianaUniversal screening for prostate cancer (Pca) using prostate-specific antigen-based testing is not recommended, as the potential harms of screening (overdiagnosis and overtreatment) outweigh potential benefits. The case for Pca screening requires a paradigm shift, which emphasizes the risks of screening over the risks of undetected cancer. Physicians are encouraged to use shared decision making with patients who express an interest in Pca screening, taking into account both the patient's screening preferences and individual risk profile. New models of care informed by the Patient Protection and Affordable Care Act are intended to assist clinicians in providing recommended preventive services. © 2014 Elsevier Inc.Item Open Access Urologic chronic pelvic pain syndrome.(2010-09) Martinez-Bianchi, Viviana; Halstater, Brian HPainful bladder syndrome or urologic chronic pelvic pain syndrome is a chronic condition that presents with lower urinary tract symptoms that include dysuria, urgency, frequent urination, and chronic pelvic pain. Diagnoses included in the painful bladder syndrome are interstitial cystitis and prostatodynia. The history, physical examination, and laboratory evaluation of patients with lower urinary tract symptoms are important in ruling out other diagnoses. Treatment options that are US Food and Drug Administration approved and evidence based are limited; however, many symptom-based treatment options can reduce symptoms and improve quality of life.Item Open Access We Are Not All the Same: Implications of Heterogeneity Among Latiné/e/x/o/a, Hispanic, and Spanish Origin People.(Annals of family medicine, 2024-05) Carvajal, Diana N; Anaya, Yohualli B; McLean, Ivonne; Aragón, Miranda; Figueroa, Edgar; Plasencia, Gabriela; Martinez-Bianchi, Viviana; Rodríguez, José EThere is great variation in the experiences of Latiné/e/x/o/a, Hispanic, and/or Spanish origin (LHS) individuals in the United States, including differences in race, ancestry, colonization histories, and immigration experiences. This essay calls readers to consider the implications of the heterogeneity of lived experiences among LHS populations, including variations in country of origin, immigration histories, time in the United States, languages spoken, and colonization histories on patient care and academia. There is power in unity when advocating for community, social, and political change, especially as it pertains to equity, diversity, and inclusion (EDI; sometimes referred to as DEI) efforts in academic institutions. Yet, there is also a critical need to disaggregate the LHS diaspora and its conceptualization based on differing experiences so that we may improve our understanding of the sociopolitical attributes that impact health. We propose strategies to improve recognition of these differences and their potential health outcomes toward a goal of health equity.