Research Outputs

Now showing 1 - 3 of 3

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Examining the relationships between experienced and anticipated stigma in health care settings, patient-provider race concordance, and trust in providers among women living with HIV
(Mary Ann Liebert Inc., 2021) Budhwani, Henna; Yigit, Ibrahim; Ofotokun, Igho; Konkle-Parker, Deborah J.; Cohen, Mardge H.; Wingood, Gina M; Metsch, Lisa R.; Adimora, Adaora A.; Taylor, Tonya N.; Wilson, Tracey E.; Weiser, Sheri D.; Kempf, Mirjam-Colette; Sosanya, Oluwakemi; Gange, Stephen; Kassaye, Seble; Turan, Janet M.; Department of Psychology; Turan, Bülent; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 219712
Stigma in health care settings can have negative consequences on women living with HIV, such as increasing the likelihood of missed visits and reducing trust in their clinical providers. Informed by prior stigma research and considering knowledge gaps related to the effect of patient-provider race concordance, we conducted this study to assess if patient-provider race concordance moderates the expected association between HIV-related stigma in health care settings and patients' trust in their providers. Moderation analyses were conducted using Women's Interagency HIV Study data (N = 931). We found significant main effects for patient-provider race concordance. Higher experienced stigma was associated with lower trust in providers in all patient-provider race combinations [White-White: B =-0.89, standard error (SE) = 0.14, p = 0.000, 95% confidence interval, CI (-1.161 to-0.624); Black patient-White provider: B =-0.19, SE = 0.06, p = 0.003, 95% CI (-0.309 to-0.062); and Black-Black: B =-0.30, SE = 0.14, p = 0.037, 95% CI (-0.575 to-0.017)]. Higher anticipated stigma was also associated with lower trust in providers [White-White: B =-0.42, SE = 0.07, p = 0.000, 95% CI (-0.552 to-0.289); Black patient-White provider: B =-0.17, SE = 0.03, p = 0.000, 95% CI (-0.232 to-0.106); and Black-Black: B =-0.18, SE = 0.06, p = 0.002, 95% CI (-0.293 to-0.066)]. Significant interaction effects indicated that the negative associations between experienced and anticipated HIV-related stigma and trust in providers were stronger for the White-White combination compared with the others. Thus, we found that significant relationships between HIV-related experienced and anticipated stigma in health care settings and trust in providers exist and that these associations vary across different patient-provider race combinations. Given that reduced trust in providers is associated with antiretroviral medication nonadherence and higher rates of missed clinical visits, interventions to address HIV-related stigma in health care settings may improve continuum of care outcomes.
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Oppression and internalized oppression as an emerging theme in accessing healthcare: findings from a qualitative study assessing first-language related barriers among the Kurds in Turkey
(BioMed Central Ltd, 2023) Bayram, Tevfik; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; Koç University Hospital; 172028
Background: Language has been well documented to be a key determinant of accessing healthcare. Most of the literature about language barrier in accessing healthcare is in the context of miscommunication. However, it is critical to consider the historical and political contexts and power dynamics underlying actions. The literature in this matter is short. In this paper we aimed to find out how first-language affects access to healthcare for people who do not speak the official language, with a particular focus on language oppression. Methods: We conducted this qualitative study based on patient-reported experiences of the Kurds in Turkey, which is a century-long oppressed population. We conducted 12 in-depth interviews (all ethnically Kurdish, non-Turkish speaking) in Şırnak, Turkey, in 2018–2019 using maximum variation strategy. We used Levesque’s ‘Patient-Centred Access to Healthcare’ framework which addresses individual and structural dimensions to access. Results: We found that Kurds who do not speak the official language face multiple first-language related barriers in accessing healthcare. Poor access to health information, poor patient-provider relationship, delay in seeking health care, dependence on others in accessing healthcare, low adherence to treatments, dissatisfaction with services, and inability to follow health rights were main issues. As an unusual outcome, we discovered that the barrier processes in accessing healthcare are particularly complicated in the context of oppression and its internalization. Internalized oppression, as we found in our study, impairs access to healthcare with creating a sense of reluctance to seek healthcare, and impairs their individual and collective agency to struggle for change. Conclusions: A human-rights-based top-down policy shift, and a bottom-up community empowerment approach is needed. At the system level, official recognition of oppressed populations, acknowledgement of the determinants of their health; and incorporating their language in official capacities (particularly education and healthcare) is crucial. Interventions should include raising awareness among relevant professions and stakeholders that internalized oppression is an issue in accessing healthcare to be considered. Given that internalized oppression can be in other forms than language or ethnicity, future research aimed at examining other aspects of access to healthcare should pay a special attention to internalized oppression.
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Yoğun bakımda çalışan hemşirelere yönelik geliştirilen radyasyon güvenliği programının değerlendirilmesi
(Koç University, 2019) Balsak, Habip; Beşer, Ayşe; 0000-0003-4039-7439; Koç University Graduate School of Health Sciences; 143490

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