Kathryn Pitkin Derose
RAND Corporation
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Featured researches published by Kathryn Pitkin Derose.
Medical Care Research and Review | 2000
Kathryn Pitkin Derose; David W. Baker
Many Latinos have limited English proficiency and this may negatively affect their use of health care services. To examine this, the authors interviewed 465 Spanish-speaking Latinos and 259 English speakers of various ethnicities who presented to a public hospital emergency department with nonurgent medical problems to assess previous physician visits, sociodemographic characteristics, and level of English proficiency. The proportion of patients who reported no physician visit during the 3 months before study enrollment was not related to English proficiency. However, among the 414 patients who saw a physician at least once, Latinos with fair and poor English proficiency reported approximately 22 percent fewer physician visits (p = 0.020 and p = 0.015, respectively) than non-Latinos whose native language was English, even after adjusting for other determinants of physician visits. The magnitude of the association between limited English proficiency and number of physician visits was similar to that for having poor health, no health insurance, or no regular source of care.
Preventive Medicine | 2010
Deborah A. Cohen; Terry Marsh; Stephanie Williamson; Kathryn Pitkin Derose; Homero Martinez; Claude Messan Setodji; Thomas L. McKenzie
OBJECTIVE To assess how park characteristics and demographic factors are associated with park use. METHODS We studied a diverse sample of parks in a Southern California metropolitan area in 2006-2008 representing a variety of racial and ethnic communities of different socioeconomic strata. We surveyed 51 park directors, 4257 park users and local residents, and observed 30 parks. We explored relationships among the number of people observed, the number of park programs offered, number of organized activities observed, park size, existence of park advisory board, perceptions of safety, and population density and characteristics. RESULTS The strongest correlates of the number of people using the park were the park size and the number of organized activities observed. Neighborhood population density, neighborhood poverty levels, perceptions of park safety, and the presence of a park advisory board were not associated with park use. CONCLUSION While perceptions of low safety have been considered a barrier to park use, perceptions of high safety do not appear to facilitate park use. Having events at the park, including sports competitions and other attractions, appears to be the strongest correlate of park use and community-level physical activity.
Medical Care Research and Review | 2009
Kathryn Pitkin Derose; Danielle M. Varda
There is a growing interest in community-level characteristics such as social capital and its relationship to health care access. To assess the rigor with which this construct has been empirically applied in research on health care access, a systematic review was conducted. A total of 2,396 abstracts were reviewed, and 21 met the criteria of examining some measure of social capital and its effects on health care access. The review found a lack of congruence in how social capital was measured and interpreted and a general inconsistency in findings, which made it difficult to draw firm conclusions about the effects of social capital on health care access. Insights from the social network literature can help improve the conceptual and measurement problems. Future work should distinguish among bonding, bridging, and linking social capital and their sources and benefits, and examine whether three dimensions of social capital actually exist: cognitive, behavioral, and structural.
Journal of General Internal Medicine | 2001
Kathryn Pitkin Derose; Ron D. Hays; Daniel F. McCaffrey; David W. Baker
AbstractOBJECTIVE: To assess the association of physician gender with patient ratings of physician care. DESIGN: Interviewer-administered survey and follow-up interviews 1 week after emergency department (ED) visit. SETTING: Public hospital ED. PATIENTS/PARTICIPANTS: English- and Spanish-speaking adults presenting for care of nonemergent problems; of 852 patients interviewed in the ED who were eligible for follow-up, 727 (85%) completed a second interview. MEASUREMENTS AND MAIN RESULTS: We conducted separate ordered logistic regressions for women and men to determine the unique association of physician gender with patient ratings of 5 interpersonal aspects of care, their trust of the physician, and their overall ratings of the physician, controlling for patient age, health status, language and interpreter status, literacy level, and expected satisfaction. Female patients trusted female physicians more (P=.003) than male physicians and rated female physicians more positively on the amount of time spent (P=.01), on concern shown (P=.04), and overall (P=.03). Differences in ratings by female patients of male and female physicians in terms of friendliness (P=.13), respect shown (P=.74), and the extent to which the physician made them feel comfortable (P=.10) did not differ significantly. Male patients rated male and female physicians similarly on all dimensions of care (overall, P=.74; friendliness, P=.75; time spent, P=.30; concern shown, P=.62; making them feel comfortable, P=.75; respect shown, P=.13; trust, P=.92). CONCLUSIONS: Having a female physician was positively associated with women’s satisfaction, but physician gender was not associated with men’s satisfaction. Further studies are needed to identify reasons for physician gender differences in interpersonal care delivered to women.
Nature | 2006
Federico Girosi; Stuart S. Olmsted; Emmett B. Keeler; Deborah C. Hay Burgess; Yee-Wei Lim; Julia E. Aledort; Maria E. Rafael; Karen A. Ricci; Rob Boer; Lee H. Hilborne; Kathryn Pitkin Derose; Christopher Beighley; Carol A. Dahl; Jeffrey Wasserman
Developing a strategy for investment in diagnostic technologies requires an understanding of the need for, and the health impact of, potential new tools, as well as the necessary performance characteristics and user requirements. In this paper, we outline an approach for modelling the health benefits of new diagnostic tools.
Health Education & Behavior | 2000
Kathryn Pitkin Derose; Jennifer Hawes-Dawson; Sarah A. Fox; Noris Maldonado; Audrey Tatum; Raynard Kington
There is little documentation about the recruitment process for church-based health education programs. In this study, the authors recruit African American, Latino, and white churches and women members (age 50 to 80) for a randomized church-based trial of mammography promotion in Los Angeles County. Efforts to enhance recruitment began 10 months before churches were invited to participate and included a variety of community-based strategies. Subsequently, 45 churches were recruited over a 5-month period through group pastor breakfast meetings and church-specific follow-up. In close collaboration with the 45 churches, the authors administered church-based surveys over 6 months and identified 1,967 age-eligible women who agreed to be contacted by the program team. It was found that an extended resource intensive period of relationship-building and community-based activities were necessary to conduct church-based programs effectively, particularly among older and ethnically diverse urban populations.
Journal of Urban Health-bulletin of The New York Academy of Medicine | 2011
Malcolm Williams; Kartika Palar; Kathryn Pitkin Derose
Religious organizations may be uniquely positioned to address HIV by offering prevention, treatment, or support services to affected populations, but models of effective congregation-based HIV programs in the literature are scarce. This systematic review distils lessons on successfully implementing congregation HIV efforts. Peer-reviewed articles on congregation-based HIV efforts were reviewed against criteria measuring the extent of collaboration, tailoring to the local context, and use of community-based participatory research (CBPR) methods. The effectiveness of congregations’ efforts and their capacity to overcome barriers to addressing HIV is also assessed. We found that most congregational efforts focused primarily on HIV prevention, were developed in partnerships with outside organizations and tailored to target audiences, and used CBPR methods. A few more comprehensive programs also provided care and support to people with HIV and/or addressed substance use and mental health needs. We also found that congregational barriers such as HIV stigma and lack of understanding HIV’s importance were overcome using various strategies including tailoring programs to be respectful of church doctrine and campaigns to inform clergy and congregations. However, efforts to confront stigma directly were rare, suggesting a need for further research.
Social Science & Medicine | 2012
Deborah A. Cohen; Bing Han; Kathryn Pitkin Derose; Stephanie Williamson; Terry Marsh; Jodi Rudick; Thomas L. McKenzie
A rich literature indicates that individuals of lower socio-economic status engage in less leisure time physical activity than individuals of higher socio-economic status. However, the source of the difference is believed to be, in part, due to differential access to resources that support physical activity. However, it has not been shown as to whether equal access to parks can mitigate differences in leisure time physical activity. Using systematic direct observation, we quantified physical activity in neighborhood parks in a large Southern California city located in areas with high, medium, and a low percentage of households in poverty. We documented how neighborhood parks are managed and programmed and also interviewed both a sample of park users and a random sample of households within a mile radius of the parks. We found that parks are used less in high-poverty areas compared to medium- and low-poverty area parks, even after accounting for differences in size, staffing, and programming. The strongest correlates of park use were the number of part time staff, the number of supervised and organized programs, and knowing the park staff. Perceptions of safety were not relevant to park use among those interviewed in the park, however it had a small relationship with reported frequency of park use among local residents. Among park users, time spent watching electronic media was negatively correlated with the frequency of visiting the park. Future research should test whether increasing park staffing and programming will lead to increased park use in high-poverty neighborhoods.
Aids and Behavior | 2011
Kathryn Pitkin Derose; Peter Mendel; Kartika Palar; David E. Kanouse; Ricky N. Bluthenthal; Laura Werber Castaneda; Dennis E. Corbin; Blanca X. Domínguez; Jennifer Hawes-Dawson; Michael A. Mata; Clyde W. Oden
Comparative case studies were used to explore religious congregations’ HIV involvement, including types and extent of activities, interaction with external organizations or individuals, and how activities were initiated and have changed over time. The cases included 14 congregations in Los Angeles County representing diverse faith traditions and races-ethnicities. Activities fell into three broad categories: (1) prevention and education; (2) care and support; and (3) awareness and advocacy. Congregations that engaged early in the epidemic focused on care and support while those that became involved later focused on prevention and education. Most congregations interacted with external organizations or individuals to conduct their HIV activities, but promoting abstinence and teaching about condoms were conducted without external involvement. Opportunities exist for congregations to help address a variety of HIV-related needs. However, activities that are mission-congruent, such as providing pastoral care for people with HIV, raising HIV awareness, and promoting HIV testing, appear easier for congregations to undertake than activities aimed at harm reduction.
Journal of General Internal Medicine | 2011
Laurie T. Martin; Matthias Schonlau; Ann C. Haas; Kathryn Pitkin Derose; Rima E. Rudd; Eric B. Loucks; Lindsay Rosenfeld; Stephen L. Buka
BackgroundCoronary heart disease (CHD) is a leading cause of morbidity and mortality. Reducing the disease burden requires an understanding of factors associated with the prevention and management of CHD. Literacy skills may be one such factor.ObjectivesTo examine the independent and interactive effects of four literacy skills: reading, numeracy, oral language (speaking) and aural language (listening) on calculated 10-year risk of CHD and to determine whether the relationships between literacy skills and CHD risk were similar for men and women.DesignWe used multivariable linear regression to assess the individual, combined, and interactive effects of the four literacy skills on risk of CHD, adjusting for education and race.ParticipantsFour hundred and nine English-speaking adults in Boston, MA and Providence, RI.MeasuresTen-year risk of coronary heart disease was calculated using the Framingham algorithm. Reading, oral language and aural language were measured using the Woodcock Johnson III Tests of Achievement. Numeracy was assessed through a modified version of the numeracy scale by Lipkus and colleagues.Key ResultsWhen examined individually, reading (p = 0.007), numeracy (p = 0.001) and aural language (p = 0.004) skills were significantly associated with CHD risk among women; no literacy skills were associated with CHD risk in men. When examined together, there was some evidence for an interaction between numeracy and aural language among women suggesting that higher skills in one area (e.g., aural language) may compensate for difficulties in another resulting in an equally low risk of CHD.ConclusionsResults of this study not only provide important insight into the independent and interactive effects of literacy skills on risk of CHD, they also highlight the need for the development of easy-to use assessments of the oral exchange in the health care setting and the need to better understand which literacy skills are most important for a given health outcome.