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      Racial disparities in knowledge, attitudes and practices related to COVID-19 in the USA

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          Abstract

          Background

          Recent reports indicate racial disparities in the rates of infection and mortality from the 2019 novel coronavirus (coronavirus disease 2019 [COVID-19]). The aim of this study was to determine whether disparities exist in the levels of knowledge, attitudes and practices (KAPs) related to COVID-19.

          Methods

          We analyzed data from 1216 adults in the March 2020 Kaiser Family Foundation ‘Coronavirus Poll’ , to determine levels of KAPs across different groups. Univariate and multivariate regression analysis was used to identify predictors of KAPs.

          Results

          In contrast to White respondents, Non-White respondents were more likely to have low knowledge (58% versus 30%; P < 0.001) and low attitude scores (52% versus 27%; P < 0.001), but high practice scores (81% versus 59%; P < 0.001). By multivariate regression, White race (odds ratio [OR] 3.06; 95% confidence interval [CI]: 1.70–5.50), higher level of education (OR 1.80; 95% CI: 1.46–2.23) and higher income (OR 2.06; 95% CI: 1.58–2.70) were associated with high knowledge of COVID-19. Race, sex, education, income, health insurance status and political views were all associated with KAPs.

          Conclusions

          Racial and socioeconomic disparity exists in the levels of KAPs related to COVID-19. More work is needed to identify educational tools that tailor to specific racial and socioeconomic groups.

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          Most cited references10

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          Low health literacy associates with increased mortality in ESRD.

          Limited health literacy is common in the United States and associates with poor clinical outcomes. Little is known about the effect of health literacy in patients with advanced kidney disease. In this prospective cohort study we describe the prevalence of limited health literacy and examine its association with the risk for mortality in hemodialysis patients. We enrolled 480 incident chronic hemodialysis patients from 77 dialysis clinics between 2005 and 2007 and followed them until April 2008. Measured using the Rapid Estimate of Adult Literacy in Medicine, 32% of patients had limited (<9th grade reading level) and 68% had adequate health literacy (≥9th grade reading level). Limited health literacy was more likely in patients who were male and non-white and who had fewer years of education. Compared with adequate literacy, limited health literacy associated with a higher risk for death (HR 1.54; 95% CI 1.01 to 2.36) even after adjustment for age, sex, race, and diabetes. In summary, limited health literacy is common and associates with higher mortality in chronic hemodialysis patients. Addressing health literacy may improve survival for these patients.
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            Perceived barriers to care and attitudes towards shared decision-making among low socioeconomic status parents: role of health literacy.

            Although low parent health literacy (HL) has been linked to poor child health outcomes, it is not known whether differences in perceptions related to access to care and provider-parent partnership in care are potential contributing factors. We sought to assess whether parent HL is associated with differences in perceived barriers to care and attitudes regarding participatory decision-making with the provider.
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              Racial/ethnic disparities in knowledge about one's breast cancer characteristics.

              Understanding tumor characteristics is likely important, but little is known about breast cancer patients' knowledge of their own disease. The authors assessed women's knowledge about their tumor characteristics, whether racial/ethnic disparities in knowledge exist, and whether education and health literacy influence associations.
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                Author and article information

                Journal
                J Public Health (Oxf)
                J Public Health (Oxf)
                pubmed
                Journal of Public Health (Oxford, England)
                Oxford University Press
                1741-3842
                1741-3850
                03 June 2020
                : fdaa069
                Affiliations
                [1 ] Department of Health Research & Policy , Stanford University, Stanford, CA 94305, USA
                [2 ] Department of Surgery , Stanford University School of Medicine, Stanford, CA, USA
                [3 ] Department of Humanities and Sciences , Stanford University, Stanford, CA 94305, USA
                [4 ] Department of Medicine , Center for Health Policy and the Center for Primary Care and Outcomes Research , Stanford, CA 94305, USA
                Author notes
                Address correspondence to Wilson Alobuia, E-mail: walobuia@ 123456stanford.edu .
                Author information
                http://orcid.org/0000-0003-4360-0658
                Article
                fdaa069
                10.1093/pubmed/fdaa069
                7313911
                32490519
                8e63535a-1b8d-417e-8979-80cf79e6357b
                © The Author(s) 2020. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

                This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                : 4 May 2020
                : 5 May 2020
                : 6 May 2020
                Page count
                Pages: 9
                Categories
                AcademicSubjects/MED00860
                Original Article
                Custom metadata
                PAP

                Public health
                african-americans,covid-19,public health,race,socioeconomics factors
                Public health
                african-americans, covid-19, public health, race, socioeconomics factors

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