April 2021 Learning Network Resources

Trust in Healthcare

  • Quinn SC, et alt. Addressing Vaccine Hesitancy in BIPOC Communities — Toward Trustworthiness, Partnership, and Reciprocity. NEJM. March 2021
    “A primary path toward trust and confidence is relationship building. In too many situations and circumstances, BIPOC communities are asked to ‘help us solve the problems in your community.’ Long-standing and reciprocal relationships between medical and research institutions and BIPOC communities are largely nonexistent. The relationships that do exist are generally short-lived, often enduring only as long as grant funding lasts. For health care and public health institutions to build a reputation of trustworthiness, partnerships rooted in bidirectional communication, capacity building, and reciprocity are required.”
  • Beach MC, et alt. Testimonial Injustice: Linguistic Bias in the Medical Records of Black Patients and Women. Journal of General Internal Medicine. March 2021
    “Black patients may be subject to systematic bias in physicians’ perceptions of their credibility, a form of testimonial injustice. This is another potential mechanism for racial disparities in healthcare quality that should be further investigated and addressed.”
  • Pollard MS, et alt. Decline in Trust in the Centers for Disease Control and Prevention During the COVID-19 Pandemic. RAND Corporation. March 2021
    “As part of a nationally representative RAND American Life Panel (ALP) survey fielded in early May 2020 that assessed how Americans are coping with COVID-19, we asked more than 2,000 individuals to report their levels of trust in a variety of federal institutions, including the CDC, the United States Postal Service (USPS), and the Federal Emergency Management Agency (FEMA). In October 2020, we resurveyed a random sample of 1,892 of the original respondents and asked them to report their levels of trust again. In this report, we compare individual-level changes in trust in the CDC, USPS, and FEMA between May and October 2020. Responses are weighted to match a range of population distributions in the Current Population Survey and voting behavior.”
  •  Carolla B, et alt. Are Health Centers Facilitating Equitable Access to COVID-19 Vaccinations? Kaiser Family Foundation. March 2021
    “These early data show that health centers appear to be reaching people of color at a higher rate than overall vaccination efforts. While vaccinations at health centers represent a relatively small share of total vaccinations administered nationally to date, further ramping up health centers’ involvement in vaccination efforts at the federal, state, and local levels will likely be a meaningful step in reaching people of color and advancing equity on a larger scale.” 
  • Tharakan S, et alt. The impact of the globalization of cancer clinical trials on the enrollment of Black patients. American Cancer Society. March 2021
    “The globalization of cancer clinical trials is associated with a widening racial enrollment disparity gap in the United States. The impact of global trials on domestic clinical trial generalizability warrants further consideration from a regulatory and policy standpoint.”
  • Bleich SN, et alt. Addressing Racial Discrimination in US Health Care Today. JAMA Health Forum. March 2021
    “From the public statements and initial actions of the Biden administration, it is clear that addressing racial discrimination will be a high policy priority. This comes alongside a growing national awareness of the seriousness of this problem by leadership groups in health care and medicine. This article addresses 2 central issues related to racial discrimination in health care: the extent of reported discrimination in various health care settings among Black and Latinx households and recommended policies to hold health care institutions accountable for addressing racial discrimination.” 
  • Bogart LM, et alt. What Contributes to COVID-19 Vaccine Hesitancy in Black Communities, and How Can It Be Addressed? RAND Corporation. March 2021
    “Recent polls show that Black Americans are less willing than Americans of other races or ethnicities to be vaccinated for COVID-19. These lower vaccination rates among Black Americans would further widen COVID-19 inequities in diagnosis, hospitalization, and mortality. A main driver of hesitancy among Black Americans is thought to be general mistrust of health care systems and providers. Such mistrust has arisen in Black communities as an understandable, rational, and self-protective reaction to history, knowledge, and continuous and repeated discrimination, racism, and harmful experiences toward Black Americans by the health care system, health care providers, and the U.S. government.”   

Blogs, Issue Briefs, Opinion Pieces and More…

  • Hyun D, et alt. Many hospitalized Covid-19 patients are given antibiotics. That’s a problem. STAT. March 2021.
    “As the Covid-19 pandemic continues into its second year, public health experts are increasingly concerned that the response to this global crisis may be accelerating another one: the development and persistence of the antibiotic-resistant bacteria known as superbugs. Why? All antibiotic use hastens the emergence of resistance. And although antibiotics aren’t used to treat Covid-19, which is a viral illness, they’re often prescribed to Covid-19 patients who are at risk for bacterial infection.”
  •  Khullar D, et alt. Imagining a World Without Low-Value Services: Progress, Barriers, and the Path Forward. AJMC. March 2021
    “Low-value services are a major problem in the US health care system. We believe that the coronavirus disease 2019 pandemic’s unprecedented impact on the health system, and society writ large, offers an opportunity to reshape the conversation and incentives around low-value services. This article explores current barriers to and opportunities for accelerating progress toward high-value care delivery.”
  •  Brownlee SM, et alt. Better understanding the downsides of low value healthcare could reduce harm. BMJ. March 2021
    “Today, efforts to quantify and tackle gaps in patient safety have expanded far beyond anaesthesia. A distinct discipline with its own emerging scientific framework, patient safety has been declared ‘one of the most important components of healthcare delivery’ by the World Health Organization. Yet there is one area of healthcare that remains sorely in need of similar data on harm and an equally sustained worldwide effort to reduce it. That area is overuse of low value healthcare services.”
  •  For Cancer Screening, COVID-19 Pandemic Creates Obstacles, Opportunities. National Cancer Institute. March 2021
    “The pandemic may lead to other potential innovations in cancer screening. Some physicians are already using video conferencing tools to educate people about screening tests, while others are discussing ways to focus screening resources on those most at risk of developing cancer.” 


  • Maust DT, et alt. Prevalence of Central Nervous System-Active Polypharmacy Among Older Adults With Dementia in the US. JAMA. March 2021
    “In this cross-sectional analysis of Medicare claims data, 13.9% of older adults with dementia in 2018 filled prescriptions consistent with CNS-active polypharmacy. The lack of information on prescribing indications limits judgments about clinical appropriateness of medication combinations for individual patients.”
  •  Park S, et alt. Trends in Use of Low-Value Care in Traditional Fee-for-Service Medicare and Medicare Advantage. JAMA. March 2021
    “This cross-sectional study found that use of low-value care was similarly prevalent in MA and TM, suggesting that MA enrollment was not associated with decreased provision of low-value care compared with TM.”
  •  Soong C, et alt. Advise non-pharmacological therapy as first line treatment for chronic insomnia. BMJ. March 2021
    “Guidelines recommend non-pharmacological approaches, including cognitive behavioural therapy, as first line treatment for chronic insomnia in adults (box 1).12345 Yet, sedatives are commonly prescribed to treat insomnia.” 
  • Habib AR, et alt. Recommendations From Breast Cancer Centers for Frequent Screening Mammography in Younger Women May Do More Harm Than Good. JAMA Internal Medicine. March 2021
    “The most recent (2016) US Preventive Services Task Force (USPSTF) breast cancer screening recommendations for women with average risk advise biennial screening in women aged 50 to 74 years. Among younger women (aged 40-49 years), the estimates of reduced breast cancer mortality are smaller and have more uncertainty, and the rates of potential harm are higher. Thus, the USPSTF does not recommend routine screening but suggests individualization based on shared decision-making.”
  • Jonas DE, et alt. Screening for Lung Cancer With Low-Dose Computed Tomography Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. March 2021
    “Screening high-risk persons with LDCT can reduce lung cancer mortality but also causes false-positive results leading to unnecessary tests and invasive procedures, overdiagnosis, incidental findings, increases in distress, and, rarely, radiation-induced cancers. Most studies reviewed did not use current nodule evaluation protocols, which might reduce false-positive results and invasive procedures for false-positive results.”
  •  Maust DT, et alt. Prevalence of Central Nervous System–Active Polypharmacy Among Older Adults With Dementia in the US. JAMA. March 2021
    “In this cross-sectional analysis of Medicare claims data, 13.9% of older adults with dementia in 2018 filled prescriptions consistent with CNS-active polypharmacy. The lack of information on prescribing indications limits judgments about clinical appropriateness of medication combinations for individual patients.”
  •  Krist AH. Screening for Lung Cancer US Preventive Services Task Force Recommendation Statement. JAMA. March 2021
    “To update its 2013 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the accuracy of screening for lung cancer with low-dose computed tomography (LDCT) and on the benefits and harms of screening for lung cancer and commissioned a collaborative modeling study to provide information about the optimum age at which to begin and end screening, the optimal screening interval, and the relative benefits and harms of different screening strategies compared with modified versions of multivariate risk prediction models.”
  •  Bai F, et alt. Stroke Risk Factor Status and Use of Stroke Prevention Medications Among Hispanic/Latino Adults in HCHS/SOL. Stroke. March 2021
    “Hispanic/Latino adults in the United States have high prevalence and awareness of VRFs but low adherence to secondary stroke prevention strategies. Older adults, women, and uninsured people are vulnerable groups that may benefit from targeted interventions.”


  • Moloney S. NYC Health + Hospitals Adopt COVID-19 Care Recommendations of Board of Internal Medicine. Norwood News. March 2021
    “NYC Health + Hospitals announced on March 16, that it has adopted the American Board of Internal Medicine (ABIM) Foundation guidelines, system-wide, to further reduce the potential spread of COVID-19, and keep staff and patients safe during the pandemic. The COVID-19 ‘Choosing Wisely’ guidelines advise healthcare providers on eliminating unnecessary testing and treatment in an effort to reduce exposure to COVID-19. The guidelines also incorporate specific, evidence-based recommendations clinicians should consider to utilize limited resources wisely, such as blood transfusions.”
  •  Harris R. Antibiotic Use Ran High In Early Days Of COVID-19, Despite Viral Cause. NPR. March 2021
    “Doctors treating COVID-19 patients early in the pandemic often reached for antibiotics. But those drugs were not helpful in most cases, and overuse of antibiotics is a serious concern.”
  •  Davenport L. Swallowable Capsule-Camera Instead of Endoscopy for Use at Home. Medscape. March 2021
    “A miniature camera the size of a capsule that is swallowed and that then transmits images of the inside of the gut can reveal cancer and gastrointestinal diseases. The device, which will be studied in a trial conducted by the National Health Service (NHS) in England, is used by patients at home instead of having to visit a clinic for an endoscopy.”
  • Marchione M, et alt. Researchers study impact of pandemic cancer screening pause. Associated Press. March 2021
    “Millions of colonoscopies, mammograms, lung scans, Pap tests and other cancer screenings were suspended for several months last spring in the United States and elsewhere as COVID-19 swamped medical care. Now researchers are studying the impact, looking to see how many cancers were missed and whether tumors found since then are more advanced.”