Analyzing the Impact of Race and SES on the Inpatient Treatment and Outcomes of COVID-19 Patients in Arkansas
Principal Investigator: Austin Porter, DrPH, MPH
Primary Mentor: J. Mick Tilford, PhD
Secondary Mentor: Jose Romero, MD, FAAP, FIDSA, FPIDS, FAAAS
For decades, researchers have sounded the alarm that disparities exist within the U.S. healthcare system. These disparities have been highlighted in the treatment of chronic illnesses, injuries, and infectious diseases. The COVID-19 pandemic has shined a bright and undeniable light on the vast inequities and inequalities in the healthcare system. Since the beginning of the COVID-19 pandemic, there have been more than 559,281 deaths in the United States with African-Americans associated with a twofold increased risk of dying earlier in the pandemic. In Arkansas, Pacific-Islanders consist of 0.4% of the population, yet account for more than 1% of the 5,600 deaths in the state due to COVID-19. Similar disparities have been seen among other racial and ethnic groups such as African-Americans and Hispanics. The racial disparities observed in the mortality rates may be due to differences seen in resource utilization such as hospital/ICU length of stay and/or ventilation rates.
- Examine the differences among racial groups and socioeconomic status in the care provided in the inpatient setting.
- Examine the differences among racial groups in mortality while controlling for critical confounding variables.
Managing Stress in Jail: A Mixed Methods Study of Stress Management for Correctional Staff
Principal Investigator: Margaret Gorvine, PhD, CHES, E-RYT
Primary Mentor: Nickolas Zaller, PhD
Secondary Mentor: Geoffrey Curran, PhD
“Managing Stress in Jail” is a De-COHD (Decreasing Correctional Officers’ Health Disparities) project supported by the Arkansas Center for Health Disparities (an NIMHD funded center). Correctional officers (COs) experience high levels of workplace stress due to occupational hazards such as exposure to violence and high-needs populations; extreme control and low autonomy; crowded settings; and shift work. These exposures lead to adverse health outcomes such as poor mental health and cardiovascular disease. Addressing correctional officers’ stress management is one avenue to improving CO health and well-being.
Pre-implementation assessment of the context is essential for successful evidence-based intervention adaptation. This study will use a mixed methods design to identify the needs of the correctional officers through surveys and semi-structured interviews. In addition, we will interview jail administrators to identify how best to deliver a stress management intervention in the jail context.
- To assess the mental health, coping, and stress management preferences of the jail correctional staff.
- To understand the organizational and staff environmental stressors, burnout, coping strategies, needs, and preferences for interventions to address stress management.
- To understand the context including the facilitators and barriers of intervention delivery within the local jail setting, workflows, and factors related to intervention tailoring and implementation.
Racial and Ethnic Disparities in Work Outcomes among Cancer Survivors in Arkansas
Principal Investigator: Jaimi Allen, PhD
Primary mentor: Benjamin C. Amick, III, PhD
Secondary mentor: Thomas Powell, MD, MS
Advances in technology and cancer screening services have resulted in earlier detection and more effective treatment. As a result, more cancer survivors are living long, healthy lives and returning to work. Employment has been shown to aid in cancer recovery, overall quality of life, and financial security. Yet, little is known about work outcomes among cancer survivors in Arkansas and the associated disparities. This study will utilize data from the UAMS electronic health records system to examine the work outcomes and disparities among cancer survivors in Arkansas. Using this information, we will talk with cancer survivors in the community to better understand their unique needs and experiences.
- Analyze AR-CDR data from 2014 to 2021 to examine disparities for UAMS cancer patients.
- Describe the relationship between cancer and employment status.
- Identify whether the relationship between cancer diagnosis and employment status varies by race/ethnicity, urban/rural status, sex, socioeconomic status, and intersectionality across disparities.
- Engage cancer survivors in research process by convening Community Review Boards.
- Discuss results of Aim 1 to better understand why disparities may exist and to understand intersectionality observed in the data.
- Identify perceived barriers to working or returning to work and factors that facilitate the ability to work after cancer diagnosis.
A Moderated Mediation Framework to Identify Disparities and Mechanisms Underlying Hepatitis C Virus Risk in Arkansas
Principal Investigator: George Pro, Ph.D
Primary Mentor: Nickolas Zaller, Ph.D
Secondary Mentor: James Selig, Ph.D
Methamphetamine and opioid use disorders pose substantial public health challenges to the state of Arkansas, and the use of both drugs is increasing in the state. Rates of hepatitis C virus (HCV) have closely followed the increased rates of drug use, primarily the result of corresponding increases in injection drug use. Medication for opioid use disorder (MOUD; methadone, buprenorphine, or extended release naltrexone) is effective at curbing opioid use and improving overall health of people who use both opioids and methamphetamine. The likelihood of initiating and sustaining MOUD, as well as the effect of treatment on HCV risk, likely depends on several individual- and community-level characteristics. While many pieces of the effect of drug use on HCV are known, little research has addressed how drug use effects HCV infection through the indirect path of MOUD. Furthermore, public health researchers have not yet identified when this indirect path becomes effectual, or under what conditions the indirect treatment path affects HCV risk. Using secondary claims data and applying a moderated mediation framework, this study is measuring the effect of drug problem severity on HCV risk through the indirect path of MOUD use in Arkansas. The overarching goal is to identify strategic entry points for interventions to promote drug treatment for the poorest and most rural populations in the state.
- Calculate the prevalence of opioid and methamphetamine use disorders, MOUD service use, and HCV diagnoses in Arkansas, and describe differences by race/ethnicity, income/SES, gender, rurality, and Medicare/Medicaid enrollment.
- Analyze how the effect of problem severity on HCV risk is mediated through the indirect path of MOUD, and whether the direction and magnitude of the mediated path is conditional on race/ethnicity, income/SES, gender, rurality, and Medicare/Medicaid enrollment.