
Sheba GeorgeCharles R. Drew University of Medicine and Science | CDU
Sheba George
PhD
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62
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Introduction
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November 2013 - present
March 2005 - present
Publications
Publications (62)
Objective
To evaluate the effect of the transition from IMPACT, a disease-focused treatment program, to comprehensive health insurance under Medicaid through the Affordable Care Act (ACA) on general and prostate cancer-specific quality of life (QoL) on a cohort of previously uninsured low-income men. We hypothesize that general QoL would improve an...
Objective
Visual timelines of patient-reported outcomes (PRO) can help prostate cancer survivors manage longitudinal data, compare with population averages, and consider future trajectories. PRO visualizations are most effective when designed with deliberate consideration of users. Yet, graph literacy is often overlooked as a design constraint, par...
Medically and socially complex patients disproportionately face barriers to primary care, contributing to health inequities and higher health care costs. This study elicited perspectives on how community health workers (CHWs) act upon barriers to primary care in 5 patient (n = 25) and 3 CHW focus groups (n = 17). Participants described how CHWs act...
Introduction: Historically, CHW trainings have been developed to support community-based CHWs. When CHWs have been trained to engage with patients, typically such trainings have been for short term grant funded projects, focusing on a specific health intervention and not for long term, ongoing engagement of CHWs employed in clinical settings. To th...
Introduction
The recent increase in non-directed donors (NDDs) in the United States (U.S.) may help reduce the overwhelming number of patients on the waitlist. However, non-directed donation may be limiting its full potential. Out-of-pocket donation costs upward of $8,000 may be a barrier to potential donors with altruistic tendencies, but inadequa...
Amid increasing interest in improving the patient-centeredness of research, new forms of engagement are emerging that enable researchers to get input from community members on research goals, methods, and implementation. This input often includes stories, which are useful for understanding lived experiences of illness and encounters with health car...
Because of their shared backgrounds, community health workers' (CHWs) care of patients/program participants (PAPAs) is assumed to be acceptable, and often not evaluated empirically. Using PRISMA guidelines, we reviewed 9560 articles from 5 databases, selected 37 articles for full-text review, and developed a 5-dimensional depth analysis (focus, con...
Researcher perspectives on embedding community stakeholders in T1-T2 research: A potential new model for full-spectrum translational research – ADDENDUM - Sheba George, Stefanie D. Vassar, Keith Norris, Bernice Coleman, Cynthia Gonzalez, Mariko Ishimori, D’Ann Morris, Norma Mtume, Martin F. Shapiro, Anna Lucas-Wright, Arleen F. Brown
Effective community engagement in T 3 –T 4 research is widespread, however, similar stakeholder involvement is missing in T 1 –T 2 research. As part of an effort to embed community stakeholders in T 1 –T 2 research, an academic community partnered team conducted discussion groups with researchers to assess perspectives on (1) barriers/challenges to...
OBJECTIVES/SPECIFIC AIMS: Community stakeholder engagement along the translational spectrum of biomedical research has been identified as a potentially crucial factor for encouraging participation among underrepresented groups, improving research relevance, and adoption of evidence into practice. Although we have developed various methods to improv...
Safety-net patients' socioeconomic barriers interact with limited digital and health literacies to produce a "knowledge gap" that impacts the delivery of healthcare via telehealth technologies. Six focus groups (2 African- American and 4 Latino) were conducted with patients who received teleretinal screening in a U.S. urban safety-net setting. Focu...
Culture is essential for humans to exist. Yet surprisingly little attention has been paid to identifying how culture works or developing standards to guide the application of this concept in health research. This paper describes a multidisciplinary effort to find consensus on essential elements of a definition of culture to guide researchers in stu...
The internet has replaced physicians as primary health information source for cancer-survivors.It is important to uncover barriers/facilitators to cancer information seeking, particularly on-line.Asian Americans are the fastest growing U.S racial/ethnic minority, 2) cancer is the leading cause of r death and 3) cancer knowledge is low among them an...
Culture informs all human behavior; it allows us to exist as social animals. Yet no other variable
used in health research is as poorly defined or tested as is culture (Dressler, Oths, & Gravlee,
2005; Hruschka, 2009). There has been surprisingly little attention to identify how culture works or
to develop standards to guide the integration or appl...
This article investigated the complex interplay of choice, socioeconomic structural factors, and empowerment influencing engagement in sex work. The analysis was focused on pathways into and reasons for staying in sex work from in-depth qualitative interviews with participants (n = 37) recruited from the Durbar community-led structural intervention...
To assess the experienced or perceived barriers and facilitators to health research participation for major US racial/ethnic minority populations, we conducted a systematic review of qualitative and quantitative studies from a search on PubMed and Web of Science from January 2000 to December 2011.
With 44 articles included in the review, we found d...
Lack of adequate consumer health information about clinical research contributes to health disparities among low health literate minority multicultural populations and requires appropriate methods for making information accessible. Enhancing understanding of health research can enable such minority multicultural consumers to make informed, active d...
Background/Significance: Because the internet has replaced physicians as the primary health information source for cancer-survivors, it is important to uncover barriers and facilitators, such as educational and cultural differences, that affect their ability to find accurate and timely cancer information, particularly on-line. While Asian Americans...
Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that...
Differential access to everyday technology and healthcare amongst safety net patients is associated with low technological and health literacies, respectively. These low rates of literacy produce a complex patient "knowledge gap" that influences the effectiveness of telehealth technologies. To understand this "knowledge gap", six focus groups (2 Af...
Introduction:
Screening guidelines for diabetic patients recommend yearly eye examinations to detect diabetic retinopathy and other forms of diabetic eye disease. However, annual screening rates for retinopathy in US urban safety net settings remain low.
Methods:
Using data gathered from a study of teleretinal screening in six urban safety net c...
Objective:
Teleretinal screening with nonmydriatic cameras has been presented as a means of increasing the number of patients assessed for diabetic retinopathy in urban safety net clinics. It has been hypothesized that automated nonmydriatic cameras may improve screening rates by reducing the learning curve for camera use. In this article, we exam...
Little research has examined differences in HIV stigma versus MSM stigma and the role of these stigmas in depression for HIV-positive Latino and African American men who have sex with men (MSM), subgroups disproportionately impacted by HIV in the US. MSM stigma, HIV stigma, depression, stress and social support were examined among HIV-positive Lati...
African American and Latino young men who have sex with men (YMSM) are at the forefront of the U.S. HIV epidemic. As members of the "cellular generation," these youth are very likely to use text messaging; yet, relatively little research has explored use of text messaging as a tool for sexual health promotion, particularly among racial ethnic minor...
We present GeoCEDRIC, an info button based extension to an existing chronic disease registry that uses the patient's residential and/or work address to extract clinically relevant information from the patient's local neighborhood environment and delivers it to the doctor or other health provider at the point of clinical care, in the form of a map a...
Background: Diabetic retinopathy is a leading cause of blindness in US adults, affecting over 5.3 million Americans. However, severe vision loss from diabetic retinopathy can be reduced up to 94% by timely treatment with laser photocoagulation. In Los Angeles County, patients in the safety net at high risk for sight-threatening retinopathy experien...
Although the literature on barriers and facilitators to racial and ethnic minority participation in clinical research has burgeoned over the past decade, most of this scholarship has focused on African Americans. There are fewer studies that include a spectrum of multicultural populations and a comparative understanding of the factors that enhance...
Studies of sexuality have increasingly shifted their attention towards understanding the social contexts that inform and organise sexual behaviour. Building on this work, we examine how substance use and sex are socially organised and meaningful activities for young African American and Latino gay and bisexual men who use substances with sex. Drawi...
Introduction. Telemedicine is promoted as a means to increase access to specialty medical care among the urban underserved, yet little is known about its acceptability among these populations. We used components of a diffusion of innovation conceptual framework to analyze preexperience perceptions about telemedicine to assess its appeal among urban...
Young adults report frequent use of texting to communicate with their friends; yet, relatively little research has explored the use of text messaging as a tool for sexual communication, particularly among Black and Latino young men who have sex with men (YMSM). It is important to understand how the development of new technologies such as text messa...
Community Partnered Participatory Research (CPPR) offers a research approach to identify and address barriers to Health Information Technology (HIT) use in underserved healthcare settings. CPPR is a form of community-based participatory research that advocates equal community and academic partnerships, an approach that is advanced as particularly s...
High rates of empowerment, HIV-related knowledge, and condom use among sex workers in Sonagachi, India have been attributed to a community-led intervention called the Sonagachi HIV/AIDS Intervention Program (SHIP). In this research we examined the crucial role of brothels in the success of the intervention. In-depth, semistructured interviews were...
Upon leaving the hospital, parents of high-risk infants experience a variety of challenges in providing care at home. In this work, we present results from a qualitative study to understand the role of social interaction and information-sharing surrounding high-risk infants among both home caregivers and health professionals. These results demonstr...
Telemedicine holds great promise for increased access to specialty care services for safety net clinic patients. However, the adoption of these technologies is not a seamless transition for clinicians working in resource-poor settings. Previous research has analyzed workflow issues that arise in primary care settings when adopting telehealth tools...
Diabetic retinopathy is a leading cause of blindness in US adults. This paper presents initial results of a teleretinal screening project for diabetic retinopathy involving six Los Angeles safety net clinics. A total of 1,943 patients have been screened for diabetic retinopathy by three ophthalmologist readers, with 416 receiving a recommendation f...
Social support and stress have been poorly characterized for persons with HIV, particularly for racial/ethnic minorities. To address this gap, data on general and HIV-specific support and stress and social network characteristics were collected for 399 African American and Latino women and men who have sex with men (MSM) in Los Angeles County. Afri...
Limited research has examined the role that social support, stress, stigma and HIV disclosure play in retention in HIV care for African Americans and Latinos. Among 398 Latino and African American men who have sex with men (MSM) and women, the major predictor of retention in HIV care was disclosure of HIV status to more social network members (OR =...
Few data are available on factors contributing to sexual activity and condom use in custody settings, particularly among self-identified sexual minority prisoners. To address this gap, we undertook a study of sexual behavior and condom use of 101 randomly-selected men who have sex with men (MSM) and male-to-female transgender inmates in a segregate...
Based on eight focus group interviews with homeopathic practitioners in New Delhi and Pune, India, this study describes current HIV education/prevention practices of Indian homeopathic practitioners and qualitatively assesses the barriers and facilitators to integrating HIV prevention/education into homeopathic practice. We found that HIV/AIDS is i...
To meet the challenge of improving health care quality in urban, medically underserved areas of the US that have a predominance of chronic diseases such as diabetes, we have developed a new information system called CEDRIC for managing chronic diseases. CEDRIC was developed in collaboration with clinicians at an urban safety net clinic, using a com...
Background: Young African American and Latino MSM are at a disproportionately high risk of acquiring HIV. However, there is a dearth of information on the social contexts of substance use among YMSM. Methods: Using a modified time-space sampling methodology, 18- 24 year old YMSM were recruited throughout 2006 and 2007 at 18 Black and Latino Gay Pri...
The change in HIV from acute to chronic disease due to the introduction of HAART in the mid-1990s increased the importance of its successful management and imposed substantial lifestyle adjustments on HIV-positive people and their support networks. Few studies have examined the sources and types of social support and the areas of care relevant for...
This study explores perceptions about telemedicine among urban underserved African American and Latino populations. Telemedicine has been advanced as a vehicle to increase access to specialty care among the urban underserved, yet little is known about its acceptability among these populations. We conducted 10 focus groups with African American and...
The presence of street gangs has been hypothesized as influencing overall levels of violence in urban communities through a process of gun–drug diffusion and cross-type homicide. This effect is said to act independently of other known correlates of violence, i.e., neighborhood poverty. To test this hypothesis, we independently assessed the impact o...
Purpose: The low prevalence of HIV (about 11%) among sex workers in Calcutta is in sharp contrast to the 50 to 90% HIV prevalence among sex workers in Indian cities like Bombay, Delhi and Chennai. The proportion of sex workers in Calcutta reporting use of condoms rose from 3% in 1992 to 90% in 1999. The significantly low rate of HIV infection and h...
Background:
Since the liberalization of immigration in 1965, foreign educated nurses (FENs) have been increasingly recruited to meet the U.S. nursing shortage; 6% of new
U.S. nurses in 2000 were immigrants whereas 15% were immigrants in 2004. FENs are part of a critical source of labor for urban, safety net hospitals with a largely underserved,...
The significantly low rate of HIV infection and high rate of condom use among sex workers in Kolkata, India is partially attributable to a community-led structural intervention called the Sonagachi Project which mobilizes sex workers to engage in HIV education, formation of community-based organizations and advocacy around sex work issues. This res...
This study is designed to assess AIDS knowledge among Homeopathy educators and physicians in India, which has not been evaluated previously. India now has the largest number of HIV infected persons worldwide, with an estimated cumulative 5.1 million infections. Homeopathy is the dominant system among the nationally-recognized alternative or complem...
To evaluate the impact of exam-room computers on communication between clinicians and patients.
Longitudinal, qualitative study using videotapes of regularly scheduled visits from 3 points in time: 1 month before, 1 month after, and 7 months after introduction of computers into the exam room.
Primary care medical clinic in a large integrated delive...
With a subtle yet penetrating understanding of the intricate interplay of gender, race, and class, Sheba George examines an unusual immigration pattern to analyze what happens when women who migrate before men become the breadwinners in the family. Focusing on a group of female nurses who moved from India to the United States before their husbands,...
"At last world.com meets ethnography.eudora. This book shows how ethnography can have a global reach and a global relevance, its humanistic and direct methods actually made more not less relevant by recent developments in global culture and economy. Globalisation is not a singular, unilinear process, fatalistically unfolding towards inevitable ends...
In this paper, I examine the challenges faced by professional immigrant women and their families in terms of balancing the demands of work and home. I use the case of Indian Christian nurses from the state of Kerala who, starting in the late sixties, immigrated to the U.S. with their families. Because the nurses come first and are upwardly mobile w...
Thesis (Ph. D.)--University of California, Berkeley, 2001. Includes bibliographical references (leaves 186-298). Photocopy.