2024
Understanding Barriers and Facilitators to Disaster Preparedness in Federally Qualified Health Centers in the United States: A Mixed Methods Study
Hassan S, Wiciak M, Escobar K, del Mar González Montalvo M, Richards T, Villanueva H, Ortiz J, Evans D, Nunez-Smith M. Understanding Barriers and Facilitators to Disaster Preparedness in Federally Qualified Health Centers in the United States: A Mixed Methods Study. Disaster Medicine And Public Health Preparedness 2024, 18: e138. PMID: 39291834, DOI: 10.1017/dmp.2024.102.Peer-Reviewed Original ResearchConceptsFederally Qualified Health CentersNon-communicable diseasesMultiple non-communicable diseasesMixed-methods study designDisaster preparednessQualified Health CentersQualitative dataMixed methods studyMental health disordersQualitative in-depth interviewsKnowledge of disaster preparednessExperiences of staffHealth disparitiesIn-depth interviewsUnderstanding barriersHealth centersMethods studyHealth disordersStudy designPuerto RicoQuantitative surveyCareNarrative approachPreparednessPerceived gapPeripheral Arterial Disease prevalence and risk factors in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort
Adams O, Galusha D, Martinez-Brockman J, Morris E, Hassan S, Maharaj R, Nazario C, Nunez M, Nunez-Smith M. Peripheral Arterial Disease prevalence and risk factors in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort. PLOS ONE 2024, 19: e0306918. PMID: 39186495, PMCID: PMC11346651, DOI: 10.1371/journal.pone.0306918.Peer-Reviewed Original ResearchConceptsEastern Caribbean Health Outcomes Research NetworkAnkle brachial indexPeripheral arterial disease prevalencePeripheral arterial diseasePotential risk factorsSample of community-dwelling peopleRisk factorsCommunity-dwelling peopleAssociation of potential risk factorsFemale sexLower educational attainmentHistory of heart diseaseRisk factors of peripheral arterial diseaseCohort Study participantsAssociated with peripheral arterial diseaseHigh school educationHeart diseaseBody mass indexMultivariate logistic regressionOscillometric deviceAssociation of increasing ageSmoking statusYears of ageStudy participantsHeart disease historyPrevalence and correlates of alcohol use among the elderly in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study
Ransome Y, Martinez-Brockman J, Galusha D, Thompson T, Adams O, Nazario C, Nunez M, Nunez-Smith M, Maharaj R. Prevalence and correlates of alcohol use among the elderly in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study. Addictive Behaviors 2024, 153: 108001. PMID: 38447411, DOI: 10.1016/j.addbeh.2024.108001.Peer-Reviewed Original ResearchConceptsEastern Caribbean Health Outcomes Research NetworkCorrelates of alcohol useCohort studyAlcohol useAlcohol problemsBinge drinking daysResearch NetworkDrinking daysLogistic regression analysisDrinking statusDescriptive statisticsCollege educationReligious attendanceCaribbean peopleSample characteristicsAlcohol measuresLongitudinal studySchool educationReligious servicesRegression analysisDrinking problemsOddsAlcohol dependenceCohortPrevalence
2023
Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020
Caraballo C, Massey D, Ndumele C, Haywood T, Kaleem S, King T, Liu Y, Lu Y, Nunez-Smith M, Taylor H, Watson K, Herrin J, Yancy C, Faust J, Krumholz H. Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020. JAMA 2023, 329: 1662-1670. PMID: 37191702, PMCID: PMC10189563, DOI: 10.1001/jama.2023.7022.Peer-Reviewed Original ResearchConceptsExcess mortality ratesExcess deathsMortality ratePotential lifeWhite populationExcess mortalitySerial cross-sectional studyHighest excess mortality ratesBlack populationCause-specific mortalityCross-sectional studyHigh mortality rateNon-Hispanic whitesYears of lifeUS national dataMiddle-aged adultsCause mortalityHeart diseaseDeath certificatesNon-Hispanic black populationMAIN OUTCOMEAge groupsDisease controlMortalityBlack males
2022
Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018
Caraballo C, Mahajan S, Valero-Elizondo J, Massey D, Lu Y, Roy B, Riley C, Annapureddy AR, Murugiah K, Elumn J, Nasir K, Nunez-Smith M, Forman HP, Jackson CL, Herrin J, Krumholz HM. Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018. JAMA Network Open 2022, 5: e226385. PMID: 35389500, PMCID: PMC8990329, DOI: 10.1001/jamanetworkopen.2022.6385.Peer-Reviewed Original ResearchMeSH KeywordsAdultBlack PeopleCross-Sectional StudiesEthnicityFemaleHispanic or LatinoHumansMaleMiddle AgedSleepConceptsCross-sectional studyLong sleep durationSleep durationWhite individualsBlack individualsLatino individualsEthnic differencesSerial cross-sectional studyNational Health Interview Survey dataHealth Interview Survey dataSelf-reported sleep durationShort sleep durationInterview Survey dataMiddle-aged adultsSelf-reported raceEstimated prevalenceMAIN OUTCOMELong sleepSleep deficiencyHigher household incomeEthnic disparitiesAge groupsHealth disparitiesPrevalenceSleep disparitiesEvaluation of Racial Disparities in Quality of Care for Patients With Gastrointestinal Tract Cancer Treated With Surgery
Bakkila BF, Kerekes D, Nunez-Smith M, Billingsley KG, Ahuja N, Wang K, Oladele C, Johnson CH, Khan SA. Evaluation of Racial Disparities in Quality of Care for Patients With Gastrointestinal Tract Cancer Treated With Surgery. JAMA Network Open 2022, 5: e225664. PMID: 35377425, PMCID: PMC8980937, DOI: 10.1001/jamanetworkopen.2022.5664.Peer-Reviewed Original ResearchConceptsGastrointestinal tract cancerNegative resection marginsTract cancerNegative surgical marginsBlack patientsAdequate lymphadenectomyWhite patientsQuality of careRacial disparitiesSurgical resectionResection marginsSurgical marginsSurgical careNational Cancer DatabaseRetrospective cohort studySite of cancerLonger median survivalHealth careStandard of careCommon age rangeSignificant racial disparitiesAdjuvant chemotherapyBiliary resectionAdjuvant therapyAdult patients
2021
Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018
Mahajan S, Caraballo C, Lu Y, Valero-Elizondo J, Massey D, Annapureddy AR, Roy B, Riley C, Murugiah K, Onuma O, Nunez-Smith M, Forman HP, Nasir K, Herrin J, Krumholz HM. Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. JAMA 2021, 326: 637-648. PMID: 34402830, PMCID: PMC8371573, DOI: 10.1001/jama.2021.9907.Peer-Reviewed Original ResearchConceptsHealth care accessFair health statusSelf-reported health statusCare accessHealth statusWhite individualsEthnic differencesLatino/HispanicNational Health Interview Survey dataSerial cross-sectional studySelf-reported functional limitationsBlack individualsHealth Interview Survey dataLow incomeCross-sectional studyCross-sectional survey studyInterview Survey dataSelf-reported raceSelf-report measuresMAIN OUTCOMEUS adultsFunctional limitationsPercentage of peopleSignificant decreaseAdultsOlder immigrants perceived health after migration to the United States: Influence of age and level of acculturation
Kang G, Hajduk A, Marottoli R, Nunez‐Smith M. Older immigrants perceived health after migration to the United States: Influence of age and level of acculturation. Journal Of The American Geriatrics Society 2021, 69: 2625-2637. PMID: 34252200, PMCID: PMC8440395, DOI: 10.1111/jgs.17363.Peer-Reviewed Original ResearchConceptsHealth statusAge groupsWorse healthWorse health statusCross-sectional studyLevel of acculturationSpecific health needsYears of ageInfluence of ageAge-related differencesRepresentative cohortFunctional comorbiditiesHealth needsAcculturation levelDemographic characteristicsMain predictorsAgeHealthLate-life immigrantsSecondary variablesUnited StatesStatusAssociationGroupYearsMedical Students’ Demographic Characteristics and Their Perceptions of Faculty Role Modeling of Respect for Diversity
Weiss J, Balasuriya L, Cramer LD, Nunez-Smith M, Genao I, Gonzalez-Colaso R, Wong AH, Samuels EA, Latimore D, Boatright D, Sharifi M. Medical Students’ Demographic Characteristics and Their Perceptions of Faculty Role Modeling of Respect for Diversity. JAMA Network Open 2021, 4: e2112795. PMID: 34086032, PMCID: PMC8178710, DOI: 10.1001/jamanetworkopen.2021.12795.Peer-Reviewed Original ResearchConceptsFaculty role modelingStudent demographic characteristicsLack of respectStudents' perceptionsRole modelingProfessional developmentWhite studentsFemale studentsFaculty role modelsMedical School Graduation QuestionnaireMedical students' professional developmentAllopathic US medical schoolsUS medical school graduatesStudents' professional developmentMedical students' perceptionsAfrican American studentsUS medical schoolsUnknown sexual orientationMedical school graduatesDemographic characteristicsLearning environmentGraduation QuestionnaireIndependent variables sexLGB studentsAmerican studentsRecognizing Cross-Institutional Fiscal and Administrative Barriers and Facilitators to Conducting Community-Engaged Clinical and Translational Research
Carter-Edwards L, Grewe ME, Fair AM, Jenkins C, Ray NJ, Bilheimer A, Dave G, Nunez-Smith M, Richmond A, Wilkins CH. Recognizing Cross-Institutional Fiscal and Administrative Barriers and Facilitators to Conducting Community-Engaged Clinical and Translational Research. Academic Medicine 2021, 96: 558-567. PMID: 33332904, PMCID: PMC7996237, DOI: 10.1097/acm.0000000000003893.Peer-Reviewed Original ResearchConceptsCommunity-engaged researchFiscal capacityAdministrative processesInstitutional policiesKey themesCommunity-engaged research partnershipStakeholder groupsAcademic researchersAdministrative barriersCommunity partnersResearch administratorsCTSA institutionsCross-cutting challengeBest practicesRapid Assessment ProcessTranslational Science Award institutionsEquitable processKey informantsResearch partnershipsPartnership collaborationQualitative studyCollective awarenessTranscribed interviewsManagement culturePurposive sampleAnthropometric measures of obesity and associated cardiovascular disease risk in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study
Hassan S, Oladele C, Galusha D, Adams OP, Maharaj RG, Nazario CM, Nunez M, Nunez-Smith M. Anthropometric measures of obesity and associated cardiovascular disease risk in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study. BMC Public Health 2021, 21: 399. PMID: 33632164, PMCID: PMC7905572, DOI: 10.1186/s12889-021-10399-3.Peer-Reviewed Original ResearchConceptsEastern Caribbean Health Outcomes Research Network (ECHORN) Cohort StudyCVD riskCardiovascular disease riskHigh-risk groupAnthropometric measuresElevated waistCohort studyDisease riskElevated body mass indexASCVD risk scoreOverweight/obeseBody mass indexAmerican Heart AssociationObesity-related riskDifferent anthropometric measuresElevated WHRResultsMean ageWaist circumferenceMass indexHip ratioHeart AssociationRisk groupsRisk scoreRisk algorithmObesity
2020
Feasibility and acceptability of intensive, real‐time biobehavioral data collection using ecological momentary assessment, salivary biomarkers, and accelerometers among middle‐aged African Americans
Nam S, Dunton GF, Ordway MR, Ash GI, Jeon S, Vlahov D, Whittemore R, Nelson LE, Sinha R, Nunez‐Smith M, Granger DA. Feasibility and acceptability of intensive, real‐time biobehavioral data collection using ecological momentary assessment, salivary biomarkers, and accelerometers among middle‐aged African Americans. Research In Nursing & Health 2020, 43: 453-464. PMID: 32856310, PMCID: PMC8985242, DOI: 10.1002/nur.22068.Peer-Reviewed Original ResearchRacial and Ethnic Disparities in Population-Level Covid-19 Mortality
Gross CP, Essien UR, Pasha S, Gross JR, Wang SY, Nunez-Smith M. Racial and Ethnic Disparities in Population-Level Covid-19 Mortality. Journal Of General Internal Medicine 2020, 35: 3097-3099. PMID: 32754782, PMCID: PMC7402388, DOI: 10.1007/s11606-020-06081-w.Peer-Reviewed Original ResearchA Protocol for the Study of Polymorphisms and Response to Metformin in Patients with Type 2 Diabetes in Trinidad.
Clement Y, Singh S, Motilal S, Maharaj R, Nunez-Smith M. A Protocol for the Study of Polymorphisms and Response to Metformin in Patients with Type 2 Diabetes in Trinidad. Ethnicity & Disease 2020, 30: 211-216. PMID: 32269463, PMCID: PMC7138437, DOI: 10.18865/ed.30.s1.211.Peer-Reviewed Original ResearchConceptsType 2 diabetesMetformin monotherapyPrimary health care facilitiesGenotype frequenciesHealth care facilitiesHealth Authority regionMedication initiationAdherent patientsClinical responseMost patientsDiabetic patientsGlycemic controlMaximal dosesStudy populationOrganic cation transportersBlood samplesCare facilitiesPatientsMetformin responseMonotherapyDiabetesMetforminFirst choiceGenetic polymorphismsSingle nucleotide polymorphismsIs hypertension in African-descent populations contributed to by an imbalance in the activities of the ACE2/Ang-(1-7)/Mas and the ACE/Ang II/AT1 axes?
Cohall D, Ojeh N, Ferrario CM, Adams OP, Nunez-Smith M. Is hypertension in African-descent populations contributed to by an imbalance in the activities of the ACE2/Ang-(1-7)/Mas and the ACE/Ang II/AT1 axes? Journal Of The Renin-Angiotensin-Aldosterone System 2020, 21: 1470320320908186. PMID: 32089050, PMCID: PMC7036504, DOI: 10.1177/1470320320908186.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAngiotensin IAngiotensin IIAngiotensin-Converting Enzyme 2Black PeopleHumansHypertensionMiddle AgedPeptide FragmentsPeptidesPeptidyl-Dipeptidase AProto-Oncogene MasProto-Oncogene ProteinsReceptor, Angiotensin, Type 1Receptors, G-Protein-CoupledRenin-Angiotensin SystemYoung AdultConceptsRenin angiotensin aldosterone systemAngiotensin aldosterone systemAldosterone systemClinical blood pressure readingsType 2 diabetes mellitusACE2/AngEnzyme 2 activityChronic renal diseaseBlood pressure readingsVenous blood samplesAfro-Caribbean originAntihypertensive treatmentMineralocorticoid blockersPressor armDiabetes mellitusRenal diseaseReceptor axisAfrican descentUrine collectionEnzyme 2Blood samplesHypertensionPressure readingsAnthropometric dataAfrican descent populations
2019
Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study.
Spatz ES, Martinez-Brockman JL, Tessier-Sherman B, Mortazavi B, Roy B, Schwartz JI, Nazario CM, Maharaj R, Nunez M, Adams OP, Burg M, Nunez-Smith M. Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study. Ethnicity & Disease 2019, 29: 535-544. PMID: 31641320, PMCID: PMC6802166, DOI: 10.18865/ed.29.4.535.Peer-Reviewed Original ResearchConceptsAmbulatory blood pressure measurementsABPM patternsBP patternAmbulatory blood pressure patternsMore precision-based approachesAmbulatory BP patternsDiagnosis of HTNTreatment of HTNBlood pressure patternWave 2High-risk populationBlood pressure measurementsCommunity-residing adultsPrecision-based approachesAntihypertensive medicationsBlood pressureProspective studyHypertension StudyHypertensive phenotypeCardiovascular diseaseParent studyHTNEcological momentary assessmentSelf-report surveyHigh rate
2018
Minority Resident Physicians’ Views on the Role of Race/Ethnicity in Their Training Experiences in the Workplace
Osseo-Asare A, Balasuriya L, Huot SJ, Keene D, Berg D, Nunez-Smith M, Genao I, Latimore D, Boatright D. Minority Resident Physicians’ Views on the Role of Race/Ethnicity in Their Training Experiences in the Workplace. JAMA Network Open 2018, 1: e182723. PMID: 30646179, PMCID: PMC6324489, DOI: 10.1001/jamanetworkopen.2018.2723.Peer-Reviewed Original ResearchNon-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study
Wang KH, Thompson TA, Galusha D, Friedman H, Nazario CM, Nunez M, Maharaj RG, Adams OP, Nunez-Smith M, on behalf of the ECHORN Writing Group. Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study. Cancer Causes & Control 2018, 29: 315-324. PMID: 29423760, PMCID: PMC6587190, DOI: 10.1007/s10552-018-1005-4.Peer-Reviewed Original ResearchConceptsNon-communicable chronic diseasesTimely breast cancer screeningBreast cancer screeningChronic diseasesCancer screeningBreast cancerEastern Caribbean Health Outcomes Research Network (ECHORN) Cohort StudyUsual sourceReceipt of mammographyChronic disease controlCohort studyEligible womenCancer deathCross-sectional data analysisPreventive screeningCancer preventionSubstantial burdenClinical providersTimely screeningDiabetesTimely mammographyBivariate analysisHypertensionDisease controlDisease
2017
Racial Disparities in Medical Student Membership in the Alpha Omega Alpha Honor Society
Boatright D, Ross D, O’Connor P, Moore E, Nunez-Smith M. Racial Disparities in Medical Student Membership in the Alpha Omega Alpha Honor Society. JAMA Internal Medicine 2017, 177: 659-665. PMID: 28264091, PMCID: PMC5818775, DOI: 10.1001/jamainternmed.2016.9623.Peer-Reviewed Original ResearchAdultAsianAwards and PrizesBlack or African AmericanClinical CompetenceEducation, Medical, UndergraduateEducational MeasurementEthnicityFemaleHispanic or LatinoHumansLeadershipLogistic ModelsMaleMiddle AgedMinority GroupsMultivariate AnalysisOdds RatioProfessionalismRacismSocial WelfareSocieties, MedicalStudents, MedicalUnited StatesWhite PeopleYoung Adult
2016
Estimating healthcare mobility in the Veterans Affairs Healthcare System
Wang KH, Goulet JL, Carroll CM, Skanderson M, Fodeh S, Erdos J, Womack JA, Abel EA, Bathulapalli H, Justice AC, Nunez-Smith M, Brandt CA. Estimating healthcare mobility in the Veterans Affairs Healthcare System. BMC Health Services Research 2016, 16: 609. PMID: 27769221, PMCID: PMC5075153, DOI: 10.1186/s12913-016-1841-4.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overDelivery of Health CareElectronic Health RecordsEmigration and ImmigrationFemaleHospitals, VeteransHumansMaleMental DisordersMiddle AgedPatient Acceptance of Health CareRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthYoung AdultConceptsHealthcare systemVeterans Health Administration electronic health recordsVeterans Affairs Healthcare SystemHealthcare mobilityRetrospective cohort studyHepatitis C virusOutcomes of careDifferent healthcare systemsDistinct healthcare systemsElectronic health recordsClinical characteristicsCohort studyHealthcare utilizationC virusSpecialty carePsychiatric disordersYounger veteransDisease preventionYounger agePopulation healthHealth recordsVeteransStatus changesCareYear period