Nancy R Kressin
Biographic Data
| ID | 762472 |
|---|---|
| NAME | Nancy R Kressin |
| GIVEN NAMES | Nancy R |
| FAMILY NAME | Kressin |
| SIGNATURE | KRESSIN N R |
| AFFILIATIONS | Boston University |
| ORCID | 0000-0003-2767-4286 |
| VERIFIED | Yes |
| TOTAL WORKS | 40 |
| TOTAL CITATIONS | 79 |
| AUTHOR COUNT | 40 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1996 |
| LATEST PUBLICATION YEAR | 2023 |
| H-INDEX | 5 |
Women's Reactions to Breast Density Information Vary by Sociodemographic Characteristics
Diabetes Control During Massachusetts Insurance Reform
The Influence of Health Insurance Stability on Racial/Ethnic Differences in Diabetes Control and Management
Stable insurance coverage was associated with improved DM outcomes for all racial / ethnic groups, but did not eliminate racial ethnic disparities
Racial/Ethnic Differences in 30-Day Mortality for Heart Failure and Pneumonia in the Veterans Health Administration Using Claims-based, Clinical, and Social Risk-adjustment Variables
BACKGROUND: Prior studies have identified lower mortality in Black Veterans compared with White Veterans after hospitalization for common medical conditions, but these studies adjusted for comorbid conditions identified in administrative claims. OBJECTIVES: The objectives of this study were to compare mortality for non-Hispanic White (hereafter, "White"), non-Hispanic Black (hereafter, "Black"), and Hispanic Veterans hospitalized for heart failur…
Beyond Medication Adherence
Results suggest that when clinicians must choose a dimension on which to intervene, focusing on beliefs would be the most fruitful approach to effecting change in BP control
Racial Differences in Insurance Stability After Health Insurance Reform
BACKGROUND: One of the potential benefits of insurance reform is greater stability of insurance and reduced coverage disparities by race and ethnicity. OBJECTIVES: We examined the temporal trends in insurance coverage by racial/ethnic group before and after Massachusetts Insurance Reform by abstracting records across 2 urban safety net hospital systems. RESEARCH DESIGN: We examined adjusted odds of being uninsured and incident rate ratios of gain…
Implementing an EHR-based Screening and Referral System to Address Social Determinants of Health in Primary Care
BACKGROUND: Social determinants affect health, yet there are few systematic clinical strategies in primary care that leverage electronic health record (EHR) automation to facilitate screening for social needs and resource referrals. An EHR-based social determinants of health (SDOH) screening and referral model, adapted from the WE CARE model for pediatrics, was implemented in urban adult primary care. OBJECTIVES: This study aimed to: (1) understa…
Is 30-Day Posthospitalization Mortality Lower Among Racial/Ethnic Minorities
BACKGROUND: Multiple studies have reported that risk-adjusted rates of 30-day mortality after hospitalization for an acute condition are lower among blacks compared with whites. OBJECTIVE: To examine if previously reported lower mortality for minorities, relative to whites, is accounted for by adjustment for do-not-resuscitate status, potentially unconfirmed admission diagnosis, and differential risk of hospitalization. RESEARCH DESIGN: Using inp…
Perceived discrimination, racial identity, and health behaviors among black primary-care patients who use drugs
Blacks who use drugs are at heightened risk for health problems. Discrimination experiences may contribute to these risks by influencing health behaviors. This study examined associations between discrimination, racial identity, and health behaviors (alcohol use, cigarette smoking, low physical activity, and unprotected [condomless] sex) in a sample of 203 Black primary-care patients who reported current drug use. Logistic regression analyses did…
A Brief, Multifaceted, Generic Intervention to Improve Blood Pressure Control and Reduce Disparities Had Little Effect
More substantial or racial/ethnically tailored interventions are needed
Massachusetts Health Reform’s Effect on Hospitals’ Racial Mix of Patients and on Patients’ Use of Safety-net Hospitals
Following MA health reform, the safety-net remains an important component of the health care system
Dental Care in an Equal Access System Valuing Equity
BACKGROUND: Racial disparities in dental care have previously been shown in the Veterans Health Administration (VA)-a controlled access setting valuing equitable, high-quality care. OBJECTIVES: The aim of this study is to examine current disparities in dental care by focusing on the receipt of root canal therapy (RCT) versus tooth extraction. RESEARCH DESIGN: This is a retrospective analysis of data contained in the VA's electronic health records…
Race/Ethnicity Identification
VA Boston Healthcare System †Health/Care Disparities Research Program ‡Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA The author declares no conflict of interest. Reprints: Nancy R. Kressin, PhD, Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Centre, 2nd Floor, Room 2090, Boston, MA 02118. E-mail…
Clinical Operations Variables are Associated With Blood Pressure Outcomes
BACKGROUND: Uncontrolled blood pressure (BP), among patients diagnosed and treated for the condition, remains an important clinical challenge; aspects of clinical operations could potentially be adjusted if they were associated with better outcomes. OBJECTIVES: To assess clinical operations factors' effects on normalization of uncontrolled BP. RESEARCH DESIGN: Observational cohort study. SUBJECTS: Patients diagnosed with hypertension from a large…
Child maltreatment and hypertension in young adulthood
Sexual abuse in early childhood is associated with hypertension in young women
Massachusetts Reform and Disparities in Inpatient Care Utilization
BACKGROUND: The 2006 Massachusetts health reform substantially decreased uninsurance rates. Yet, little is known about the reform's impact on actual health care utilization among poor and minority populations, particularly for receipt of inpatient surgical procedures that are commonly initiated by outpatient physician referral. METHODS: Using discharge data on Massachusetts hospitalizations for 21 months before and after health reform implementat…
Identifying the Tuskegee Syphilis Study
The two major implications of these findings for health disparity researchers are 1) that it is unlikely that detailed knowledge of the Tuskegee Syphilis Study has any current widespread influence on the willingness of minorities to participate in biomedical research, and 2) that caution should be applied before assuming that what community leaders 'know and are aware of' is equally 'well known' within their community constituencies
Prevalence of Early Childhood Caries Among Very Young Urban Boston Children Compared with US Children
Lower ECC prevalence among urban Boston children of immigrant parents compared with US children of immigrant parents may reflect changing immigrant composition in the United States since NHANES III or a different immigrant composition in the Boston area compared with the United States. This finding reinforces the need for further research of immigrants in order to understand cultural practices that may affect oral health. Finally, low ECC prevale…
Pediatric Clinicians Can Help Reduce Rates of Early Childhood Caries
OBJECTIVE: Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk. RESEARCH DESIGN: We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452). INTERVENTION: We provided communication skills training …
Perceived Racial Discrimination in Health Care
Perceived racial discrimination in health care was equally prevalent among veterans and nonveterans and among veterans who used the Veterans Affairs health care system and those who did not
Perceptions of Race/Ethnicity-Based Discrimination
Background . To assess discrimination in health care, reliable, valid, and comprehensive measures of racism/discrimination are needed. Objective . To review literature on measures of perceived race/ethnicity-based discrimination and evaluate their characteristics and usefulness in assessing discrimination from health care providers. Methods . Literature review of measures of perceived race/ethnicity-based discrimination (1966–2007), using MEDLINE…
Use of Patient Self‐Report Oral Health Outcome Measures in Assessment of Dental Treatment Outcomes
The measure was sensitive to differences within groups, with a small to borderline magnitude of change
Dental Treatment Improves Self‐Rated Oral Health in Homeless Veterans – A Brief Communication
There was significant improvement in homeless veterans'perceived oral health after receiving dental care
Awareness of the Tuskegee Syphilis Study and the US Presidential Apology and Their Influence on Minority Participation in Biomedical Research
Objectives. We compared the influence of awareness of the Tuskegee Syphilis Study and the presidential apology for that study on the willingness of Blacks, non-Hispanic Whites, and Hispanics to participate in biomedical research. Methods. The Tuskegee Legacy Project Questionnaire was administered to 1133 adults in 4 US cities. This 60-item questionnaire addressed issues related to the recruitment of minorities into biomedical studies. Results. Ad…
Comparison of Patient-Based Oral Health Outcome Measures
Agreement Between Administrative Data and Patients’ Self-Reports of Race/Ethnicity
Objectives. We examined agreement of administrative data with self-reported race/ethnicity and identified correlates of agreement. Methods. We used Veterans Affairs administrative data and VA 1999 Large Health survey race/ethnicity data. Results. Relatively low rates of agreement (approximately 60%) between data sources were largely the result of administrative data from patients whose race/ethnicity was unknown, with least agreement for Native A…
Self-Reported vs Administrative Race/Ethnicity Data and Study Results
Concerns about administrative data on race/ethnicity have led some researchers to consider self-reported race/ethnicity as superior.1–5 However, few studies have examined the differential impact of the source of race/ethnicity data, that is, observed or selfreported, on study outcomes. We investigated whether differences in reporting of race/ethnicity led to different results with regard to the use of one therapeutic dental procedure, root canal …
Perceived Racial Discrimination in Health Care
Perceived racial discrimination in health care was equally prevalent among veterans and nonveterans and among veterans who used the Veterans Affairs health care system and those who did not
Awareness of the Tuskegee Syphilis Study and the US Presidential Apology and Their Influence on Minority Participation in Biomedical Research
Objectives. We compared the influence of awareness of the Tuskegee Syphilis Study and the presidential apology for that study on the willingness of Blacks, non-Hispanic Whites, and Hispanics to participate in biomedical research. Methods. The Tuskegee Legacy Project Questionnaire was administered to 1133 adults in 4 US cities. This 60-item questionnaire addressed issues related to the recruitment of minorities into biomedical studies. Results. Ad…
Intrapersonal Characteristics and the Timing of Divorce
Data from two longitudinal studies (Normative Aging Study and Terman Life Cycle Study) were used to investigate the intrapersonal predictors of earlier and later divorce. Initially married individuals were classified as having not divorced, divorced before 20 years of marriage, or divorced after 20 or more years of marriage. Individuals rated as more disagreeable (angry, vain/egotistical, lacking sympathy/tenderness) and more impulsive (lacking c…
Racial Differences in Cardiac Catheterization as a Function of Patients’ Beliefs
Objectives. We examined racial differences in cardiac catheterization rates and reviewed whether patients’ beliefs or other variables were associated with observed disparities. Methods. We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia. Results. There were few demographic differences between Whit…
Assessing Oral Health-Related Quality of Life
The contribution of oral health to health-related quality of life (HQOL) has seldom been examined. This study was designed to develop and validate a measure of oral health-related quality of life (OHQOL), examine relations between OHQOL and HQOL, and explore OHQOL's relation to problem-based dental care utilization in a sample of 1,242 older men, using data gathered by a mail survey. Factor analysis of eight oral health items revealed that three …
Comparing the Impact of Oral Disease in Two Populations of Older Adults
The GOHAI exhibits satisfactory psychometric properties in both samples of older men. Results suggest continued use of the GOHAI as an indicator of the impact of oral conditions on functioning and well-being in a variety of samples
Intrapersonal Characteristics and the Timing of Divorce
Data from two longitudinal studies (Normative Aging Study and Terman Life Cycle Study) were used to investigate the intrapersonal predictors of earlier and later divorce. Initially married individuals were classified as having not divorced, divorced before 20 years of marriage, or divorced after 20 or more years of marriage. Individuals rated as more disagreeable (angry, vain/egotistical, lacking sympathy/tenderness) and more impulsive (lacking c…
Negative Affectivity and Health-Related Quality of Life
OBJECTIVES: Although personality is known to influence patients' self-ratings of health, its effects on reports of health-related quality of life (HRQOL) have not been fully described. We examined the relationship between a dimension of personality called negative affectivity (NA; a general disposition to experience negative mood states) and HRQOL, controlling for age and common chronic physical and mental diseases. METHODS: We used data from 3 s…
Leisure Activities, Stress, and Health among Bereaved and Non-Bereaved Elderly Men
Few studies have examined the effect that a resource such as leisure activities might have on the relationship between stress and health among elderly men. Data from the Normative Aging Study (NAS) were used to examine whether specific groups of leisure activities (social, solitary, and mixed activities; activities performed either alone or with others) moderated the effect of stress on the health of elderly men and whether there were differences…
Is Depressive Symptomatology Associated with Worse Oral Functioning and Well‐being Among Older Adults
These findings further emphasize the importance of treating depression among older adults, and suggest that both dentists and physicians have a role in recognizing and referring patients for such treatment
Self-Reported vs Administrative Race/Ethnicity Data and Study Results
Concerns about administrative data on race/ethnicity have led some researchers to consider self-reported race/ethnicity as superior.1–5 However, few studies have examined the differential impact of the source of race/ethnicity data, that is, observed or selfreported, on study outcomes. We investigated whether differences in reporting of race/ethnicity led to different results with regard to the use of one therapeutic dental procedure, root canal …
Racial Differences in Health-Related Beliefs, Attitudes, and Experiences of VA Cardiac Patients
OBJECTIVES: To deternine whether there are racial differences in patients' health-related attitudes, beliefs, and experiences regarding invasive cardiac procedures, and to develop psychometrically and conceptually valid scales and single items to assess these dimensions. METHODS: A survey was designed and administered to 854 white and black patients with ischemic heart disease at five VA medical centers. Patients were queried about the domains pr…
Racial Differences in How Patients Perceive Physician Communication Regarding Cardiac Testing
OBJECTIVES: Recent studies documenting racial variation in the use of cardiac procedures highlight the need to understand if there are racial differences in processes of communication and decision making. Investigations of patients' perceptions of their interaction with providers regarding cardiac testing were conducted. METHODS: Four focus groups were convened with 13 patients who had undergone cardiac stress testing with positive results, strat…
Contribution of the Veterans Health Administration in Understanding Racial Disparities in Access and Utilization of Health Care
Oddone, Eugene Z. MD, MHSc; Petersen, Laura A. MD, MPH; Weinberger, Morris PhD; Freedman, Jay PhD; Kressin, Nancy R. PhD Author Information
Agreement Between Administrative Data and Patients’ Self-Reports of Race/Ethnicity
Objectives. We examined agreement of administrative data with self-reported race/ethnicity and identified correlates of agreement. Methods. We used Veterans Affairs administrative data and VA 1999 Large Health survey race/ethnicity data. Results. Relatively low rates of agreement (approximately 60%) between data sources were largely the result of administrative data from patients whose race/ethnicity was unknown, with least agreement for Native A…
Tooth Retention as an Indicator of Quality Dental Care
BACKGROUND: Retaining teeth improves oral health and quality of life. Thus, receipt of a root canal (vs. a tooth extraction) is a useful indicator of the quality of dental care. However, use of this quality measure without adjusting for the severity of oral disease could lead to spurious conclusions. OBJECTIVES: This paper describes the development of a dental severity adjustment methodology. RESEARCH DESIGN: Retrospective study. SUBJECTS: 54,423…
Gender Differences in Service Connection for PTSD
BACKGROUND: Mentally ill female veterans obtain a smaller proportion of their care from Department of Veterans Affairs (VA) facilities than mentally ill male veterans do, possibly because women are less likely than men to be service connected for psychiatric disabilities. "Service connected" veterans have documented, compensative conditions related to or aggravated by military service, and they receive priority for enrollment into the VA healthca…
Comparison of Patient-Based Oral Health Outcome Measures
Is Lipid-Lowering Therapy Underused by African Americans at High Risk of Coronary Heart Disease Within the VA Health Care System
Objectives. We examined whether racial differences exist in cholesterol monitoring, use of lipid-lowering agents, and achievement of guideline-recommended low-density lipoprotein (LDL) levels for secondary prevention of coronary heart disease. Methods. We reviewed charts for 1045 African American and White patients with coronary heart disease at 5 Veterans Affairs (VA) hospitals. Results. Lipid levels were obtained in 67.0% of patients. Whites an…
Racial Differences in Cardiac Catheterization as a Function of Patients’ Beliefs
Objectives. We examined racial differences in cardiac catheterization rates and reviewed whether patients’ beliefs or other variables were associated with observed disparities. Methods. We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia. Results. There were few demographic differences between Whit…
Perceptions of Race/Ethnicity-Based Discrimination
Background . To assess discrimination in health care, reliable, valid, and comprehensive measures of racism/discrimination are needed. Objective . To review literature on measures of perceived race/ethnicity-based discrimination and evaluate their characteristics and usefulness in assessing discrimination from health care providers. Methods . Literature review of measures of perceived race/ethnicity-based discrimination (1966–2007), using MEDLINE…
Use of Patient Self‐Report Oral Health Outcome Measures in Assessment of Dental Treatment Outcomes
The measure was sensitive to differences within groups, with a small to borderline magnitude of change
Dental Treatment Improves Self‐Rated Oral Health in Homeless Veterans – A Brief Communication
There was significant improvement in homeless veterans'perceived oral health after receiving dental care
Awareness of the Tuskegee Syphilis Study and the US Presidential Apology and Their Influence on Minority Participation in Biomedical Research
Objectives. We compared the influence of awareness of the Tuskegee Syphilis Study and the presidential apology for that study on the willingness of Blacks, non-Hispanic Whites, and Hispanics to participate in biomedical research. Methods. The Tuskegee Legacy Project Questionnaire was administered to 1133 adults in 4 US cities. This 60-item questionnaire addressed issues related to the recruitment of minorities into biomedical studies. Results. Ad…
Identifying the Tuskegee Syphilis Study
The two major implications of these findings for health disparity researchers are 1) that it is unlikely that detailed knowledge of the Tuskegee Syphilis Study has any current widespread influence on the willingness of minorities to participate in biomedical research, and 2) that caution should be applied before assuming that what community leaders 'know and are aware of' is equally 'well known' within their community constituencies
Prevalence of Early Childhood Caries Among Very Young Urban Boston Children Compared with US Children
Lower ECC prevalence among urban Boston children of immigrant parents compared with US children of immigrant parents may reflect changing immigrant composition in the United States since NHANES III or a different immigrant composition in the Boston area compared with the United States. This finding reinforces the need for further research of immigrants in order to understand cultural practices that may affect oral health. Finally, low ECC prevale…
Pediatric Clinicians Can Help Reduce Rates of Early Childhood Caries
OBJECTIVE: Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk. RESEARCH DESIGN: We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452). INTERVENTION: We provided communication skills training …
Perceived Racial Discrimination in Health Care
Perceived racial discrimination in health care was equally prevalent among veterans and nonveterans and among veterans who used the Veterans Affairs health care system and those who did not
Massachusetts Reform and Disparities in Inpatient Care Utilization
BACKGROUND: The 2006 Massachusetts health reform substantially decreased uninsurance rates. Yet, little is known about the reform's impact on actual health care utilization among poor and minority populations, particularly for receipt of inpatient surgical procedures that are commonly initiated by outpatient physician referral. METHODS: Using discharge data on Massachusetts hospitalizations for 21 months before and after health reform implementat…
Medicine (37 works) · Family medicine (18 works) · Gerontology (17 works) · Ethnic group (16 works) · Internal Medicine (16 works) · Psychology (15 works) · Demography (12 works) · Gerontology (12 works) · Health care (12 works) · Nursing (12 works)