Crawford Paul, Maxey Randall, Dacosta Keith
American Kidney Fund, African-American Outreach Project, Northwestern University, and Neomedica Dialysis Units, Chicago, Illinois 60805, USA.
J Natl Med Assoc. 2002 Aug;94(8 Suppl):63S-71S.
For a variety of reasons, end-stage renal disease disproportionately affects minority populations. Factors such as socioeconomic status, cultural differences, and genetic variations, are all involved. In addition, there are often real and perceived barriers for these patient groups in fully accessing the healthcare system. Thus, there is a real need for the development of specific outreach programs that target these high-risk communities. In developing such programs, it is important to realize that there is not a homogeneous 'ethnic community', but rather, like any large demographic grouping, a diverse population. These differing communities will all have different requirements and needs and, thus, outreach programs need to be wide-ranging and adapted for individual, local communities, to ensure that all target audiences are reached. The core aims for these outreach programs must be raising disease awareness and education among minority patients. To achieve this goal, a wide range of organizations need to be actively involved, including national and--importantly--local, community-based patient organizations, and hospital management corporations, as well as local radio and television companies to advertise the outreach initiatives. However, any outreach campaign will need to be combined with policy changes and further research into kidney disease among minority groups if real improvements in outcomes are to be achieved.
由于多种原因,终末期肾病对少数族裔人群的影响尤为严重。社会经济地位、文化差异和基因变异等因素都与之相关。此外,这些患者群体在全面接入医疗体系方面往往存在实际的和认知上的障碍。因此,确实需要制定针对这些高风险社区的特定外展项目。在制定此类项目时,必须认识到不存在同质化的“族裔社区”,相反,如同任何大型人口群体一样,是一个多样化的群体。这些不同的社区都有不同的要求和需求,因此,外展项目需要广泛且针对各个当地社区进行调整,以确保覆盖所有目标受众。这些外展项目的核心目标必须是提高少数族裔患者对疾病的认识并开展相关教育。为实现这一目标,需要众多组织积极参与,包括国家层面的,以及重要的地方社区患者组织、医院管理公司,还有当地的广播和电视公司来宣传外展活动。然而,如果要真正改善治疗效果,任何外展活动都需要与政策变革以及对少数族裔群体肾病的进一步研究相结合。