Page 243 - Encyclopedia of Nursing Research

210 n HeAlTH DISpArITIeS: THeOreTIcAl AND MeTHODOlOGIcAl ApprOAcHeS

and innovative research to bring healthy tion, nurse researchers are contributing to
solutions to such a neighborhood. the elimination of health disparities by incor-
H The 2000 U.S. census Bureau forecasted porating the contexts of disparity in the theo-
a demographic transition to older age among retical frameworks that guide their research
U.S. born citizens and a mushrooming as well as the research methodologies they
growth of minority populations by the year select to address the complex health needs
2050. racial stereotyping in clinical interac- of marginalized and underserved groups.
tions and related sociocultural conditions, Using community-based participatory
such as language differences and poor health research and participatory action research
literacy, seriously undermine equitable health (pAr), qualitative methodologies, and fem-
care provision for minority populations inist and environmental frameworks, nurse
(laViest, 2005). A recent study confirms that researchers are investigating the root causes
health care providers perceived their care of health disparities (Butterfield & postma,
to racial or ethnic minorities as being less 2009; esperat, Feng, Owen, & Green, 2005;
than that provided for white clients (Blendon etowa, Bernard, Oyinsan, & clow, 2007; Kelly,
et al., 2008). Thus, increasing minority health 2009; Sullivan-Bolyai, Bova, & Harper, 2005;
care professionals to reflect the diversity of Walker, Sterling, Hoke, & Dearden, 2007).
the U.S. population is a strategy to improve As an example, Butterfield and postma
the nation’s health. Improved concordance (2009) developed the translational environ-
of minority providers and patients has mental research in rural areas (TerrA)
been associated with greater access to care, framework to investigate the environmen-
improved educational experiences, and bet- tal health risks affecting the rural poor. The
ter patient satisfaction among minority indi- TerrA framework locates environmental
viduals (Smedley, Butler, & Bristow, 2004). health risks within physical, economic, and
The landmark health legislation, called cultural contexts to develop family-level
the Affordable Care Act, passed in 2010 under interventions that positively influence rural
the direction of president Barack Obama, public health. Knowledge developed through
establishes a 5-year plan (2010–2015) to trans- the TerrA framework stopped the use of
form U.S. health care. The chief goals of the chat, a toxic material, in construction and
health care reform act emphasize affordable road projects.
insurance coverage to the uninsured, advance- The transformation for health frame-
ment of science and innovation to benefit work integrates Freire’s transformational
public health and health care provision, and framework with community-based par-
enhancement of the safety and well-being of ticipatory research to develop family-level
the American public through prevention and interventions for childhood obesity in latino
emergency response preparedness (DHHS, communities (esperat et al., 2005). The trans-
2009). continuing evaluation of health status formation for health interventions promotes
indicators for all segments of the population the development of “critical consciousness”
will help to guide the course for such a chal- or an individual’s deeper understanding
lenging undertaking. The impact of health of her realities. Interventions that encour-
care reform on health disparities will only be age critical consciousness have the greatest
clear over time, as evidenced by the ameliora- impact because participants achieve a trans-
tion of health status indicators and improved formational power that leads them to action
health performance measurements among that is initiated by them and for which they
those populations experiencing health dis- claim ownership.
parities today. Aside from using theoretical approaches
In addition to those trying to advance to guide research in health disparities, nurse
health policy through government legisla- researchers are engaging in refreshing