Objective: The purpose of this scoping review is two-fold: to assess the literature that quantitatively measures outcomes of mentorship programs designed to support research-focused junior faculty and to identify mentoring strategies that promote diversity within academic medicine mentoring programs. Methods: Studies were identified by searching Medline using MESH terms for mentoring and academic medicine. Eligibility criteria included studies focused on junior faculty in research-focused positions, receiving mentorship, in an academic medical center in the USA, with outcomes collected to measure career success (career trajectory, career satisfaction, quality of life, research productivity, leadership positions). Data were abstracted using a standardized data collection form, and best practices were summarized. Results: Search terms resulted in 1,842 articles for title and abstract review, with 27 manuscripts meeting inclusion criteria. Two studies focused specifically on women, and four studies focused on junior faculty from racial/ethnic backgrounds underrepresented in medicine. From the initial search, few studies were designed to specifically increase diversity or capture outcomes relevant to promotion within academic medicine. Of those which did, most studies captured the impact on research productivity and career satisfaction. Traditional one-on-one mentorship, structured peer mentorship facilitated by a senior mentor, and peer mentorship in combination with one-on-one mentorship were found to be effective strategies to facilitate research productivity. Conclusion: Efforts are needed at the mentee, mentor, and institutional level to provide mentorship to diverse junior faculty on research competencies and career trajectory, create a sense of belonging, and connect junior faculty with institutional resources to support career success.

Racial/ethnic and sex concordance between patients and providers has been suggested as an important consideration in improving satisfaction and increasing health equity. We aimed to guide local efforts by understanding the relationship between satisfaction with care and patient–provider racial/ethnic and sex concordance within our academic medical center’s primary care clinic. Methods: Satisfaction data for encounters from August 2016 to August 2019 were matched to data from the medical record for patient demographics and comorbidities. Data on 33 providers were also obtained, and racial/ethnic and sex concordance between patients and providers was determined for each of the 3672 unique encounters. The primary outcome was top-box scoring on the CGCAHPS overall satisfaction scale (0–8 vs. 9–10). Generalized mixed-effects logistic regression, including provider- and patient-level factors as fixed effects and a random intercept effect for providers, were used to determine whether concordance had an independent relationship with satisfaction. Results: 89.0% of the NHW-concordant pairs and 90.4% of the Minority Race/Ethnicity-concordant pairs indicated satisfaction, while 90.1% of the male-concordant and 85.1% of the female-concordant pairs indicated satisfaction. When fully adjusted, the female-concordant (OR = 0.58, 95% CI 0.35–0.94) and male-discordant (OR = 0.68, 95% CI 0.51–0.91) pairs reported significantly lower top-box satisfaction compared to the male-concordant pairs. Significant differences did not exist in racial/ethnic concordance. Conclusions: In this sample, differences in sex concordance were noted; however, patient- and provider-level factors may be more influential in driving patient satisfaction than race/ethnicity in this health system.

Evidence for dietary habits among the Kuna Indians of Panama outside of cacao consumption is limited. Global trends suggest an uptake in processed foods conferring risk for chronic disease. This paper aims to provide information on dietary habits and investigate sociodemographic correlates of diet for the indigenous population living off the coast of Panama. This sample included 211 Kuna Indians ages 18 years or older living within the island communities of Ustupu and Ogobsucum. Cross-sectional data was collected using a paper-based survey to assess dietary patterns. Categories of food included: fruits, vegetables, cacao, fish, sodas, fried, junk, and fast foods. Univariate analyses were used to describe demographic variables, followed by chi-squared tests to understand individual correlates of food types. About 85% reported eating fast food at least weekly, 47% reported eating fried food daily, and 11% reported eating junk food daily. Forty-three percent of the sample population reported eating fish daily. Those with poor incomes reported more fish consumption than any other income group (51%, p = 0.02). After adjusting for all covariates, those in higher income categories were less likely to eat fruits, cacao, and fish daily, but were also less likely to eat fast food weekly and junk food daily. Elderly populations (age 60–90 OR = 12.17, 95%CI 2.00, 73.84), women (OR = 3.43, 95%CI 1.23, 9.56), and those with primary education (OR = 4.83, 95%CI 1.01, 23.0) were also more likely to eat fast food weekly. This is the first dietary survey study of the Kuna that focuses on food groups outside of cacao. Results suggest the community could benefit from efforts to increase cultivation of fruits and vegetables and reduce the percentage of energy consumption contributed by fast food, fried food, and junk food. N/A

To determine the prevalence of hypertension and investigate sociodemographic correlates in an indigenous Kuna community living on the San Blas islands of Panama. Data was collected from adults using a paper-based survey using a cross sectional study design. Blood pressure was measured, and hypertension defined at two cut-points: 130/80 mmHg and 140/90 mmHg. Individuals with undiagnosed hypertension had a blood pressure measurement that indicated hypertension, however, the individual had not been told by a doctor they had hypertension. Whereas individuals with diagnosed hypertension had been told by a healthcare provider that they had hypertension. Univariate tests compared diagnosed and undiagnosed hypertension by sociodemographic categories and logistic regression models tested individual correlates adjusting for all sociodemographic factors. Two hundred and eleven adult indigenous Kuna participated in the study. Overall prevalence of hypertension was 6.2% (95%CI:3.32–10.30) as defined by 140/90 mmHg, and 16.6% (95%CI:11.83–22.31) as defined by 130/80 mmHg. Hypertension was significantly higher in men (31.6, 95% CI:19.90–45.24, compared to 11.0, 95% CI:6.56–17.09). Individuals with low income were 3 times more likely to be hypertensive (OR = 3.13, 95% CI:1.02–9.60) and 3.5 times more likely to have undiagnosed hypertension (OR = 3.42, 95% CI:1.01–11.52); while those with moderate income were 6 times more likely to be hypertensive (OR = 7.37, 95% CI:1.76–30.90) compared to those who were poor. The prevalence of diagnosed and undiagnosed hypertension is higher in men and those with higher income. Investigating these factors remains vitally important in helping improve the health of the Kuna through targeted interventions to address chronic disease.

Background: Globally, the prevalence of diabetes is increasing, especially in low- and middle-income countries (LMICs), including those in the sub-Saharan African region. However, the independent socioeconomic correlates of glycemic control as measured by hemoglobin A1C have yet to be identified. Therefore, the aim of this analysis was to understand the independent correlates of glycemic control in South Africa. Methods: Data from the 2016 South Africa Demographic and Health Survey on adults with diabetes were used for this analysis. The dependent variable, glycemic control, was defined using hemoglobin A1c (HbA1c). Independent variables included: age, gender, ethnicity, marital status, region, urban/rural residence, ability to read, education, insurance, wealth, occupation, and employment in the last year. Analysis of variance was used to test for differences in mean HbA1c for each category of all independent variables, and a fully adjusted linear regression model was used to identify independent correlates of glycemic control (HbA1c). Results: Among the 772 people included in this analysis, there were significant differences in mean HbA1c by age (p < 0.001), ethnicity (p < 0.001), place of residence (p = 0.024), wealth index (p = 0.001), and employment in the last year (p = 0.008). Independent correlates of HbA1c included age, ethnicity, and wealth index. Conclusions: This study used data from a large diverse population with a high prevalence of diabetes in sub-Saharan Africa and provides new evidence on the correlates of glycemic control and potential targets for interventions designed to lower HbA1c and improve diabetes-related health outcomes of adults in South Africa.