Abstract
Thoughtfully navigating indigenous -pharmacy partnerships: Successes, opportunities, and lessons learned
Laura Palombi, PharmD, MPH, MAT1 and Lucas Kosobuski2
(1)1110 Kirby Drive, 232 Life Science, Duluth, MN 55812, Duluth, MN, (2)1110 Kirby Drive, 232 Life Science, Duluth, MN
APHA 2023 Annual Meeting and Expo
This presentation will share considerations for thoughtful and responsible work with Indigenous communities, including the perspective of both an Indigenous person and a pharmacist faculty member. The presentation will include guidelines for establishing partnerships and proposing projects of interest, including obtaining Tribal Resolutions from Tribal Councils. Considerations for pharmacy practice, research, publishing, and the role of Tribal Sovereignty will be discussed in this session.
The presenters and their community partners have a strong track record of obtaining federal funding (HRSA, SAMHSA, USDA), state funding (Statewide Targeted Response to the Opioid Crisis, Statewide Opioid Response) and University grants to support substance use related-projects that benefit Indigenous communities, and are eager to support other partnerships that responsibly seek to support Indigenous communities. This presentation will share how Tribal Sovereignty and Traditional Indigenous practices can be harnessed to create innovative solutions to address pressing public health concerns.
Diversity and culture Ethics, professional and legal requirements Planning of health education strategies, interventions, and programs Public health or related research
Abstract
Community pharmacies as a potential oasis in maternity care deserts
Maria Duodu, PharmD Candidate and Natalie DiPietro Mager, PharmD, PhD, MPH
Ohio Northern University Raabe College of Pharmacy, Ada, OH
APHA 2023 Annual Meeting and Expo
Background: Maternity care deserts are a crucial public health issue, particularly in rural areas. In these areas, women's health services are scarce, resulting in health disparities. Previous studies have shown that women in rural areas are at higher risk of maternal mortality and morbidity, which is currently rising in the U.S. Community pharmacists are in a unique position to provide these services for women in areas that have healthcare professional shortages. The objective of this study is to determine whether community pharmacists in maternity care deserts in Ohio are aware of trends in maternal morbidity and mortality, provide maternal health services as recommended by the National Alliance of State Pharmacy Associations, screen for social determinants of health, and have interest to develop new services. Methods: An anonymous IRB-approved electronic survey assessing knowledge, practices, and intentions is sent to a sample of Ohio community pharmacists practicing in maternity care deserts and areas without this designation. Survey participants can receive a small gift card as an incentive. Data are analyzed using descriptive and non-parametric statistics to determine potential differences in responses based on demographic characteristics such as location of practice site. Results: Research in progress; data will be analyzed before the conference. Conclusion: The results of this research will give insight on Ohio community pharmacists' perceptions and practices to potentially bridge the gap and improve access to maternal health services to achieve health equity. Future studies will need to be done to examine the effectiveness of pharmacist-led maternal health care services.
Chronic disease management and prevention Clinical medicine applied in public health Diversity and culture Other professions or practice related to public health Provision of health care to the public Public health or related research
Abstract
Examining social inequities in pre-exposure prophylaxis adherence among a national sample of publicly insured patients
Natalie Crawford, PhD1, Qian Zhang2, Christina Chandra3, Daniel Alohan, MPH1, Xianyan Chen, PhD4, Daniel Hall, PhD4 and Henry Young, PhD4
(1)Emory University, Rollins School of Public Health, Atlanta, GA, (2)Athens, GA, (3)Rollins School of Public Health, Emory University, Atlanta, GA, (4)University of Georgia, Athens, GA
APHA 2023 Annual Meeting and Expo
Daily oral pre-exposure prophylaxis (PrEP) can prevent up to 99% of HIV infections. While early data show significant racial inequities in PrEP adherence, prior studies have small sample sizes, and it is unclear whether these inequities would persist if insurance coverage was not a barrier. We used nationally representative data from a publicly insured population using Merative (IBM MarketScan) Medicaid Database data (2017-2019) to examine PrEP adherence correlates. PrEP adherence was measured by the proportion of days covered (PDC), defined by the sum of the number of days covered on the medication divided by the follow-up days. Of the 9,284 adult patients prescribed PrEP, the median age was 44, most were male (57.7%), of Black (60.5%) followed by White (36.2%) race, and had a comprehensive (48.9%) versus HMO (39.1%) or combined comprehensive/HMO (12.0%) insurance plan. The median PDC was 65.75%, and only 39.7% of the sample had a PDC ⥠80%, the conventional threshold signifying adherence over 12 months. In age-adjusted models for adherence, significant two-way interactions were found between race and sex (p<0.001), and race and insurance plan type (p<0.05). The probability of being adherent to PrEP was the lowest for Black men compared to other race and sex groups. Black people in the combined comprehensive/HMO plan had the lowest adherence of any other racial group by insurance plan type. Significant improvement in PrEP adherence is needed to reduce HIV transmission. Social inequities by race, sex and health insurance type persist even in a publicly insured sample.
Clinical medicine applied in public health Epidemiology Social and behavioral sciences