Background This study describes the development of a social marketing campaign for increasing walking in a low income, high crime community as part of the Positive Action for Today’s Health (PATH) trial. Methods Focus groups were conducted with 52 African American adults (ages 18 to 65 yrs), from two underserved communities to develop themes for a social marketing campaign to promote walking. Participants responded to questions concerning social marketing principles related to product, price, place, promotion, and positioning for increasing neighbourhood walking. Results Focus group data informed the development of the campaign objectives that were derived from the “5 Ps” to promote physical and mental health, social connectedness, safety, and confidence in walking regularly. Focus group themes indicated that physical and mental health benefits of walking were important motivators. Walking for social reasons was also important for overcoming barriers to walking. Police support from trusted officers while walking was also essential to promoting safety for walking. Print materials were developed by the steering committee, with a 12-month calendar and door hangers delivered to residents’ homes to invite them to walk. Pride Stride walks empowered community walkers to serve as peer leaders for special walking events to engage new walkers. Conclusions Essential elements for developing culturally tailored social marketing interventions for promoting walking in underserved communities are outlined for future researchers. PMID:23497164
Wilson, Dawn K; St George, Sara M; Trumpeter, Nevelyn N; Coulon, Sandra M; Griffin, Sarah F; Wandersman, Abe; Forthofer, Melinda; Gadson, Barney; Brown, Porschia V
This study describes the development of a social marketing campaign for increasing walking in a low income, high crime community as part of the Positive Action for Today's Health (PATH) trial. Focus groups were conducted with 52 African American adults (ages 18 to 65 yrs), from two underserved communities to develop themes for a social marketing campaign to promote walking. Participants responded to questions concerning social marketing principles related to product, price, place, promotion, and positioning for increasing neighbourhood walking. Focus group data informed the development of the campaign objectives that were derived from the "5 Ps" to promote physical and mental health, social connectedness, safety, and confidence in walking regularly. Focus group themes indicated that physical and mental health benefits of walking were important motivators. Walking for social reasons was also important for overcoming barriers to walking. Police support from trusted officers while walking was also essential to promoting safety for walking. Print materials were developed by the steering committee, with a 12-month calendar and door hangers delivered to residents' homes to invite them to walk. Pride Stride walks empowered community walkers to serve as peer leaders for special walking events to engage new walkers. Essential elements for developing culturally tailored social marketing interventions for promoting walking in underserved communities are outlined for future researchers.
Lynch, Elizabeth B.; Holmes, Shane
Objective: Describe lay food group categories of low-income African American women and assess the overlap of lay food groups and MyPyramid food groups. Design: A convenience sample of African American mothers from a low-income Chicago neighborhood performed a card-sorting task in which they grouped familiar food items into food groups. Setting:…
Palta, Priya; Page, G; Piferi, R L; Gill, J M; Hayat, M J; Connolly, A B; Szanton, S L
Hypertension affects a large proportion of urban African-American older adults.While there have been great strides in drug development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction (MBSR)has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years old and residents of a low-income senior residence. All participants were African-American, and one was male.Twenty participants were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention. A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure measurements, controlling for age,education, smoking status, and anti-hypertensive medication use. Effect sizes were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention and the outcome variable, blood pressure. Attendance remained 980%in all 8 weeks of both the intervention and the control groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this value was statistically significant(p=0.020). The average diastolic blood pressure decreased in the
Beech, Bettina M.; Scarinci, Isabel C.
Qualitatively examined sociocultural factors associated with smoking attitudes and practices among low-income, African American young adults smokers and nonsmokers. Focus group data indicated that specific contextual and familial factors contributed to smoking initiation, maintenance, and cessation (e.g., strong parental discipline, limited…
Kuczmarski, Marie Fanelli; Mason, Marc A; Allegro, Deanne; Zonderman, Alan B; Evans, Michele K
C-reactive protein (CRP), an inflammatory biomarker, is influenced by many factors, including socioeconomic position, genetics, and diet. The inverse association between diet and CRP is biologically feasible because micronutrients with antioxidative properties may enable the body to manage the balance between production and accumulation of reactive species that cause oxidative stress. To determine the quality of the diet consumed by urban, low-income African-American and white adults aged 30 to 64 years, and association of diet quality with CRP. Data from a cross-sectional study were used to evaluate diet quality assessed by mean adequacy ratio (MAR). Two 24-hour recalls were collected by trained interviewers using the US Department of Agriculture automated multiple pass method. The sample consisted of Healthy Aging in Neighborhoods of Diversity across the Life Span baseline study participants, 2004-2009, who completed both recalls (n=2,017). MAR equaled the average of the ratio of intakes to Recommended Dietary Allowance for 15 vitamins and minerals. CRP levels were assessed by the nephelometric method utilizing latex particles coated with CRP monoclonal antibodies. Linear ordinary least square regression and generalized linear models were performed to determine the association of MAR (independent variable) with CRP (dependent variable) while adjusting for potential confounders. MAR scores ranged from 74.3 to 82.2. Intakes of magnesium and vitamins A, C, and E were the most inadequate compared with Estimated Average Requirements. CRP levels were significantly associated with MAR, dual-energy x-ray absorptiometry-measured body fat, and hypertension. A 10% increase in MAR was associated with a 4% decrease in CRP. The MAR was independently and significantly inversely associated with CRP, suggesting diet is associated with the regulation of inflammation. Interventions to assist people make better food choices may not only improve diet quality but also their health
Bruce, Marino A.; Beech, Bettina M.; Edwards, Christopher L.; Sims, Mario; Scarinci, Isabel; Whitfield, Keith E.; Gilbert, Keon; Crook, Errol D.
Obesity is a biological risk factor or comorbidity that has not received much attention from scientists studying hypertension among African American men. The purpose of this study was to examine the relationship between weight status and high blood pressure among African American men with few economic resources. The authors used surveillance data collected from low-income adults attending community- and faith-based primary care clinics in West Tennessee to estimate pooled and group-specific regression models of high blood pressure. The results from group-specific logistic regression models indicate that the factors associated with hypertension varied considerably by weight status. This study provides a glimpse into the complex relationship between weight status and high blood pressure status among African American men. Additional research is needed to identify mechanisms through which excess weight affects the development and progression of high blood pressure. PMID:20937738
Goodman, S H; Cooley, E L; Sewell, D R; Leavitt, N
Depressed, schizophrenic, and well low-income, African-American women were studied in an effort to extend previous hypotheses of the association between depression and the two personality constructs of low self-esteem and externality to this population. Subjects were 113 low income African-American women including 26 who had been diagnosed as depressed, 54 diagnosed as schizophrenic, and 33 well women. Locus of control was measured with the Adult Nowicki-Strickland Internal-External Control Scale (Nowicki & Duke, 1974). Self-esteem was measured with the Rosenberg Self-Esteem Scale (Rosenberg, 1965). Contrary to predictions, a diagnosis of schizophrenia, but not depression, was associated with more external locus of control. For self-esteem, severity of disturbance, rather than diagnosis, seemed to be of primary importance. Also, lower self-esteem scores were correlated significantly with higher levels of externality for both depressed and schizophrenic women but not for well controls. The present study indicates that self-esteem and locus of control are related to depression differently in low socio-economic status (SES) African-American women than in previously studied middle SES depressed whites. The findings emphasize the need for more normative studies to clarify the complex relations among SES, race, emotional disturbance, self-esteem, and locus of control.
Coulon, S M; Wilson, D K
Socioeconomic disadvantage has been linked to elevated blood pressure (BP), and the purpose of this study was to assess whether interpersonal social supports buffer these adverse relations in African-American adults. In three communities matched demographically, a subsample of participants (N = 204) of the Positive Action for Today's Health trial provided measures of perceived social support, annual household income, and BP. Multiple regression analyses with cross-product interactions were conducted using follow-up data. The sample had a mean age of 52.8 years (SD = 15.1), and was predominantly female (66 %) with a high body mass index (M = 33.5, SD = 14.7). Results indicated an inverse relation between social support and diastolic BP (B = -.178, p = .005), and also an interaction with income (p = .046), such that higher social support related to lower diastolic BP in the lowest-income individuals (B = -1.05). The same direct (B = -.141, p = .025) and interacting (B = -1.42, p = .040) social support effects were present for systolic BP, however the omnibus model for systolic BP was not significant, F(6, 196) = 1.80, p = .09. The hypothesized buffering effect of social support on the adverse relation of income to BP was partially supported in at-risk African-American adults. Future prevention efforts for reducing the impact of socioeconomic stress on BP may aim to increase perceptions of social support.
Boyd, Rhonda C; Waanders, Christine
Maternal depression has a deleterious impact on child psychological outcomes, including depression symptoms. However, there is limited research on the protective factors for these children and even less for African Americans. The purpose of the study is to examine the effects of positive parenting skills on child depression and the potential protective effects of social skills and kinship support among African American children whose mothers are depressed and low-income. African American moth...
Estacion, Angela; Cherlin, Andrew
This article investigates levels of generalized distrust of men among low-income non-Hispanic African American, Mexican, Puerto Rican, Dominican and non-Hispanic White women in a three-city survey. The results reveal substantial variation. Hispanics' overall levels of distrust are found to be higher than levels for either African Americans or…
Gaylord-Harden, Noni K.; Cunningham, Jamila A.; Holmbeck, Grayson N.; Grant, Kathryn E.
Objective: The purpose of the current study was to demonstrate the replicable nature of statistical suppressor effects in coping research through 2 examples with African American adolescents from low-income communities. Method: Participants in the 1st example included 497 African American adolescents (mean age = 12.61 years, SD = 0.99; 57% female)…
Voisin, Dexter R; Kim, Dong Ha
This study explored the association between neighborhood conditions and behavioral health among African American youth. Cross-sectional data were collected from 683 African American youth from low-income communities. Measures for demographics, neighborhood conditions (i.e. broken windows index), mental health, delinquency, substance use, and sexual risk behaviors were assessed. Major findings indicated that participants who reported poorer neighborhood conditions compared to those who lived in better living conditions were more likely to report higher rates of mental health problems, delinquency, substance use, and unsafe sexual behaviors. Environmental factors need to be considered when addressing the behavioral health of low-income African American youth.
Sarah S Cohen
Full Text Available Increased sedentary behavior and lack of physical activity are associated with increased risk for many chronic diseases. Differences in leisure-time physical activity between African American and white adults have been suggested to partially explain racial disparities in chronic disease outcomes, but expanding the definition of physical activity to include household and occupational activities may reduce or even eliminate racial differences in total physical activity. The objective of this study was to describe patterns of active and sedentary behaviors in black and white adults and to examine these behaviors across demographic measures. Sedentary and physically active behaviors were obtained from a validated physical activity questionnaire in 23,021 black men, 9,899 white men, 32,214 black women, and 15,425 white women (age 40-79 at enrollment into the Southern Community Cohort Study. Descriptive statistics for sedentary time; light, moderate, and vigorous household/occupational activity; sports/exercise; total activity; and meeting current physical activity recommendations via sports/exercise were examined for each race-sex group. Adjusted means were calculated using multiple linear regression models across demographic measures. Study participants spent approximately 60% of waking time in sedentary behaviors. Blacks reported more television viewing time than whites (45 minutes for females, 15 minutes for males, but when sitting time was expressed as a proportion of overall awake time, minimal racial differences were found. Patterns of light, moderate, and vigorous household/occupational activity were similar in all race/sex groups. 2008 Physical Activity Guidelines for Americans were followed by 16% of women and 25% of men independent of race. Overall, black and white men and women in this study spent the majority of their daily time in sedentary behaviors and less than one-fourth followed current guidelines for physical activity. These
Zvara, Bharathi J.; Mills-Koonce, W. Roger; Heilbron, Nicole; Clincy, Amanda; Cox, Martha J.
The present study extends the spillover and crossover hypotheses to more carefully model the potential interdependence between parent-parent interaction quality and parent-child interaction quality in family systems. Using propensity score matching, the present study attempted to isolate family processes that are unique across African American and…
Spears, Claire Adams; Houchins, Sean C; Bamatter, Wendy P; Barrueco, Sandra; Hoover, Diana Stewart; Perskaudas, Rokas
Individuals with low socioeconomic status (SES) and members of racial/ethnic minority groups often experience profound disparities in mental health and physical well-being. Mindfulness-based interventions show promise for improving mood and health behaviors in higher-SES and non-Latino White populations. However, research is needed to explore what types of adaptations, if any, are needed to best support underserved populations. This study used qualitative methods to gain information about a) perceptions of mindfulness, b) experiences with meditation, c) barriers to practicing mindfulness, and d) recommendations for tailoring mindfulness-based interventions in a low-income, primarily African American treatment-seeking sample. Eight focus groups were conducted with 32 adults (16 men and 16 women) currently receiving services at a community mental health center. Most participants (91%) were African American. Focus group data were transcribed and analyzed using NVivo 10. A team of coders reviewed the transcripts to identify salient themes. Relevant themes included beliefs that mindfulness practice might improve mental health (e.g., managing stress and anger more effectively) and physical health (e.g., improving sleep and chronic pain, promoting healthier behaviors). Participants also discussed ways in which mindfulness might be consistent with, and even enhance, their religious and spiritual practices. Results could be helpful in tailoring mindfulness-based treatments to optimize feasibility and effectiveness for low-SES adults receiving mental health services.
Full Text Available A healthy diet, as defined by the US Dietary Guidelines for Americans (DGA, has been associated with lower morbidity and mortality from major chronic diseases in studies conducted in predominantly non-Hispanic white individuals. It is unknown whether this association can be extrapolated to African-Americans and low-income populations.We examined the associations of adherence to the DGA with total and cause-specific mortality in the Southern Community Cohort Study, a prospective study that recruited 84,735 American adults, aged 40-79 y, from 12 southeastern US states during 2002-2009, mostly through community health centers that serve low-income populations. The present analysis included 50,434 African-Americans, 24,054 white individuals, and 3,084 individuals of other racial/ethnic groups, among whom 42,759 participants had an annual household income less than US$15,000. Usual dietary intakes were assessed using a validated food frequency questionnaire at baseline. Adherence to the DGA was measured by the Healthy Eating Index (HEI, 2010 and 2005 editions (HEI-2010 and HEI-2005, respectively. During a mean follow-up of 6.2 y, 6,906 deaths were identified, including 2,244 from cardiovascular disease, 1,794 from cancer, and 2,550 from other diseases. A higher HEI-2010 score was associated with lower risks of disease death, with adjusted hazard ratios (HRs of 0.80 (95% CI, 0.73-0.86 for all-disease mortality, 0.81 (95% CI, 0.70-0.94 for cardiovascular disease mortality, 0.81 (95% CI, 0.69-0.95 for cancer mortality, and 0.77 (95% CI, 0.67-0.88 for other disease mortality, when comparing the highest quintile with the lowest (all p-values for trend 0.50. Several component scores in the HEI-2010, including whole grains, dairy, seafood and plant proteins, and ratio of unsaturated to saturated fatty acids, showed significant inverse associations with total mortality. HEI-2005 score was also associated with lower disease mortality, with a HR of 0.86 (95
Yeager, Katherine A; Sterk, Claire E; Quest, Tammie E; DiIorio, Colleen; Vena, Catherine; Bauer-Wu, Susan
African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life. The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do. A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management. Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience. This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms. As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.
Ispa, J.M.; Halgunseth, L.C.
Qualitative interviews conducted over the course of 5 years with nine young low-income African American mothers were analyzed in order to gain understanding of their perspectives on corporal punishment. All used corporal punishment with their children. Results pertain to the vocabulary mothers used to describe corporal punishment (pop, tap, whup,…
Mccreary, Linda L.; Dancy, Barbara L.
Family functioning is influenced by socio-economic status, culture, family structure, and developmental stage, and is assessed primarily using instruments developed for middle-income European American two-parent families. These instruments may not validly assess low-income African American single-parent families. This qualitative study was…
Papas, Mia A.; Hurley, Kristen M.; Quigg, Anna M.; Oberlander, Sarah E.; Black, Maureen M.
Objective: To examine the relationship between maternal and toddler dietary variety. Design: Longitudinal; maternal and toddler dietary data were collected at 13 months; anthropometry was collected at 13 and 24 months. Setting: Data were collected in homes. Participants: 109 primiparous, low-income, African American adolescent mothers and…
The purpose of this study was to examine the relationship between media influence and ethnic identity among low-income African American and White adolescent girls. According to the U.S. Census (2008), 98% of Americans have a television in their home. Prior research suggests that low-income African American adolescents are exposed to more media…
Luke, Sabrina; Salihu, Hamisu M; Alio, Amina P; Mbah, Alfred K; Jeffers, Dee; Berry, Estrellita Lo; Mishkit, Vanessa R
Data on risk factors for major antenatal depression among African American women are scant. In this study, we seek to determine the prevalence and risk factors for major antenatal depression among low-income African American women receiving prenatal services through the Central Hillsborough Healthy Start (CHHS). Women were screened using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff of > or =13 as positive for risk of major antenatal depression. In total, 546 African American women were included in the analysis. We used logistic regression to identify risk factors for major antenatal depression. The prevalence of depressive symptomatology consistent with major antenatal depression was 25%. Maternal age was identified as the main risk factor for major antenatal depression. The association between maternal age and risk for major antenatal depression was biphasic, with a linear trend component lasting until age 30, at which point the slope changed markedly tracing a more pronounced likelihood for major depression with advancing age. Women aged > or =30 were about 5 times as likely to suffer from symptoms of major antenatal depression as teen mothers (OR = 4.62, 95% CI 2.23-9.95). The risk for major antenatal depression increases about 5-fold among low-income African American women from age 30 as compared to teen mothers. The results are consistent with the weathering effect resulting from years of cumulative stress burden due to socioeconomic marginalization and discrimination. Older African American mothers may benefit from routine antenatal depression screening for early diagnosis and intervention.
Veronnie Faye Jones
Full Text Available Background: Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. Objective: The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. Methods: This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overweight or obese (BMI > 85 and their parents. An expert panel provided insights in developing culturally appropriate intervention strategies. Results: Child and parent focus group analysis revealed eleven barriers and no definitive facilitators for healthy eating and lifestyles. Parents reported confusion regarding what constitutes nutritional eating, varying needs of family members in terms of issues with weight, and difficulty in engaging the family in appropriate and safe physical activities; to name a few themes. Community experts independently suggested that nutritional information is confusing and, often, contradictory. Additionally, they recommended simple messaging and practical interventions such as helping with shopping lists, meal planning, and identifying simple and inexpensive physical activities.Conclusions: Childhood obesity in the context of low-resource families is a complex problem with no simple solutions. Culturally sensitive and family-informed interventions are needed to support low-income African American families in dealing with childhood obesity.
Jones, Veronnie Faye; Rowland, Michael L; Young, Linda; Atwood, Katherine; Thompson, Kirsten; Sterrett, Emma; Honaker, Sarah Morsbach; Williams, Joel E; Johnson, Knowlton; Davis, Deborah Winders
Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overweight or obese (BMI ≥ 85) and their parents. An expert panel provided insights in developing culturally appropriate intervention strategies. Child and parent focus group analysis revealed 11 barriers and no definitive facilitators for healthy eating and lifestyles. Parents reported confusion regarding what constitutes nutritional eating, varying needs of family members in terms of issues with weight, and difficulty in engaging the family in appropriate and safe physical activities; to name a few themes. Community experts independently suggested that nutritional information is confusing and, often, contradictory. Additionally, they recommended simple messaging and practical interventions such as helping with shopping lists, meal planning, and identifying simple and inexpensive physical activities. Childhood obesity in the context of low-resource families is a complex problem with no simple solutions. Culturally sensitive and family informed interventions are needed to support low-income African American families in dealing with childhood obesity.
Herring, Sharon J; Henry, Tasmia Q; Klotz, Alicia A; Foster, Gary D; Whitaker, Robert C
A rising number of low-income African-American mothers gain more weight in pregnancy than is recommended, placing them at risk for poor maternal and fetal health outcomes. Little is known about the perceptions of mothers in this population that may influence excessive gestational weight gain. In 2010-2011, we conducted 4 focus groups with 31 low-income, pregnant African-Americans in Philadelphia. Two readers independently coded the focus group transcripts to identify recurrent themes. We identified 9 themes around perceptions that encouraged or discouraged high gestational weight gain. Mothers attributed high weight gain to eating more in pregnancy, which was the result of being hungrier and the belief that consuming more calories while pregnant was essential for babies' health. Family members, especially participants own mothers, strongly reinforced the need to "eat for two" to make a healthy baby. Mothers and their families recognized the link between poor fetal outcomes and low weight gains but not higher gains, and thus, most had a greater pre-occupation with too little food intake and weight gain rather than too much. Having physical symptoms from overeating and weight retention after previous pregnancies were factors that discouraged higher gains. Overall, low-income African-American mothers had more perceptions encouraging high gestational weight gain than discouraging it. Interventions to prevent excessive weight gain need to be sensitive to these perceptions. Messages that link guideline recommended weight gain to optimal infant outcomes and mothers' physical symptoms may be most effective for weight control.
Johnson, Michael; Mills, Terry L; Deleon, Jessica M; Hartzema, Abraham G; Haddad, Judella
Research evidence points to the existence of racial-ethnic disparities in both access to and quality of mental health services for African Americans with panic disorder. Current panic disorder evaluation and treatment paradigms are not responsive to the needs of many African Americans. The primary individual, social, and health-care system factors that limit African Americans' access to care and response to treatment are not well understood. Low-income African American women with panic disorder participated in a series of focus-group sessions designed to elicit (1) their perspectives regarding access and treatment barriers and (2) their recommendations for designing a culturally consistent panic treatment program. Fear of confiding to others about panic symptoms, fear of social stigma, and lack of information about panic disorder were major individual barriers. Within their social networks, stigmatizing attitudes toward mental illness and the mentally ill, discouragement about the use of psychiatric medication, and perceptions that symptoms were the result of personal or spiritual weakness had all interfered with the participants' treatment seeking efforts and contributed to a common experience of severe social isolation. None of the focus-group members had developed fully effective therapeutic relationships with either medical or mental health providers. They described an unmet need for more interactive and culturally authentic relationships with treatment providers. Although the focus-group sessions were not intended to be therapeutic, the women reported that participation in the meetings had been an emotionally powerful and beneficial experience. They expressed a strong preference for the utilization of female-only, panic disorder peer-support groups as an initial step in the treatment/recovery process. Peer-support groups for low-income African American women with panic disorder could address many of the identified access and treatment barriers.
.... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...
The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...
.... The purpose of the current study was to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...
.... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...
Marotta, Phillip L.; Voisin, Dexter R.
Objective Mounting literature suggests that parental monitoring, risky peer norms, and future orientation correlate with illicit drug use and delinquency. However, few studies have investigated these constructs simultaneously in a single statistical model with low income African American youth. This study examined parental monitoring, peer norms and future orientation as primary pathways to drug use and delinquent behaviors in a large sample of African American urban adolescents. Methods A path model tested direct paths from peer norms, parental monitoring, and future orientation to drug use and delinquency outcomes after adjusting for potential confounders such as age, socioeconomic, and sexual orientation in a sample of 541 African American youth. Results Greater scores on measures of risky peer norms were associated with heightened risk of delinquency with an effect size that was twice in magnitude compared to the protective effects of future orientation. Regarding substance use, greater perceived risky peer norms correlated with the increased likelihood of substance use with a standardized effect size 3.33 times in magnitude compared to the protective effects of parental monitoring. Conclusions Findings from this study suggest that interventions targeting risky peer norms among adolescent African American youth may correlate with a greater impact on reductions in substance use and delinquency than exclusively targeting parental monitoring or future orientation. PMID:28974824
West-Olatunji, Cirecie; Sanders, Tiffany; Mehta, Sejal; Behar-Horenstein, Linda
Research investigating the relationship between parenting and academic achievement has provided conflicting results, particularly for low-income, culturally-diverse parents. Using resilience theory, the researchers conducted a case study with five low-income African American mothers. Findings suggest that educators can benefit from partnering with…
Wilson, Helen W.; Woods, Briana A.; Emerson, Erin; Donenberg, Geri R.
Objective This study examined the relationship between violence exposure and sexual risk-taking among low-income, urban African American (AA) adolescent girls, considering overlap among different types and characteristics of violence. Methods AA adolescent girls were originally recruited from outpatient mental health clinics serving urban, mostly low-SES communities in Chicago, IL as part of a two-year longitudinal investigation of HIV-risk behavior. A subsequent follow-up was completed to assess lifetime history of trauma and violence exposure. The current study (N=177) included violence exposure and sexual risk behavior reported at the most recent interview (ages 14-22). Multiple regression was used to examine combined and unique contributions of different types, ages, settings, and perpetrators or victims of violence to variance in sexual risk. Results More extensive violence exposure and cumulative exposure to different kinds of violence were associated with overall unsafe sex, more partners, and inconsistent condom use. The most significant unique predictors, accounting for overlap among different forms of violence, were physical victimization, adolescent exposure, neighborhood violence, and violence involving dating partners. Conclusions These findings put sexual risk in the context of broad traumatic experiences but also suggest that the type and characteristics of violence exposure matter in terms of sexual health outcomes. Violence exposure should be addressed in efforts to reduce STIs among low-income, urban African American girls. PMID:24563808
Porter, Lauren; Shriver, Lenka H; Ramsay, Samantha
Objectives Health disparities are prevalent in the U.S., with low-income African American children suffering from high rates of obesity and related conditions. Better understanding of parental attitudes and barriers related to healthy eating and obesity risk is needed to suggest more effective intervention foci for this at-risk population. Methods African American caregivers of 3-5 year old children were recruited for focus groups and a questionnaire completion from two Head Start programs in a southeastern state of the U.S. The Social Cognitive Theory was utilized to develop a focus group guide. Focus group recordings were transcribed verbatim and analyzed using the comparative content analysis. Results Eight focus groups (all participants were mothers) yielded the following main themes: (1) general nutrition knowledge but common misconceptions about foods/beverages; (2) beliefs that meals have to include meat and starch and be home-cooked to be healthy; (3) desire to feed children better than their own parents; (4) lack of family support and child pickiness perceived as the greatest barriers to healthy eating; (5) awareness of family history of diseases; and (6) low concern about children's current diet and weight status. Over 25 % of mothers underestimated their child weight status. Conclusions Our findings highlight the importance of understanding maternal perspectives related to food, eating, and weight among low-income African American mothers of preschoolers. Nutrition educators should be aware of misconceptions and recognize that mothers might not perceive diet quality in early childhood as having strong impact on the child's future health and/or obesity risks.
Ramos-Marcuse, Fatima; Oberlander, Sarah E; Papas, Mia A; McNary, Scot W; Hurley, Kristen M; Black, Maureen M
Maternal depressive symptomatology is an important public health issue with negative consequences for both mothers and infants. This study examined prevalence and patterns of depressive symptoms among 181 urban, low-income, first-time, African American adolescent mothers recruited from urban hospitals following delivery. Follow-up evaluations were conducted at 6 (N=148; 82%) and 24 (N=147; 81%) month home visits. Depressive symptoms were measured with Beck Depression Inventory (BDI). Half of mothers (49%) had BDI scores >9 at baseline, with significant correlations between BDI scores across all visits (r=0.28-0.50). Depressive symptom trajectories analyzed using group-based trajectory modeling revealed three trajectories of depressive symptoms: Low (41%), Medium (45%), and High (14%). The high depressive symptom group reported lower self-esteem, more negative life events, and lower parenting satisfaction than the low and moderate depressive symptoms groups. Depressive symptoms were self-reported and not verified with a clinical interview. Findings are limited to urban, low-income, African American adolescent mothers and may not be generalizable to other populations. The high prevalence and relative stability of depressive symptoms through 2years of parenting suggest the need for early identification and treatment of maternal depressive symptoms. Brief screening for maternal depressive symptoms conducted during pediatric well-child visits is a feasible and effective method for identifying mothers with depressive symptoms, however, screening measures can not differentiate between high and low levels of depressive symptoms. Brief intervention may be an effective treatment for mothers with mild symptoms of depression; mothers with moderate to severe symptoms may require more intensive intervention. Copyright 2009 Elsevier B.V. All rights reserved.
Jarrett, Robin L; Hamilton, Megan-Brette; Coba-Rodriguez, Sarai
The development of emergent literacy skills are important for the development of later literacy competencies and affect school readiness. Quantitative researchers document race- and social class-based disparities in emergent literacy competence between low-income African American and middle-income White children. Some researchers suggest that deficits in parenting practices account for limited literacy skills among low-income African American children. A small body of qualitative research on low-income African American families finds that despite economic challenges, some African American families were actively engaged in promoting child literacy development. Using qualitative interviews that emphasize family strengths, we add to this small body of research to highlight positive family practices obscured in many quantitative analyses that concentrate on family shortcomings. Specifically, we examine in-home literacy practices and child literacy development with a sample of low-income African American mothers (families) of preschoolers. Key findings include identification of various literacy activities promoting child literacy development and inclusion of multiple family members assisting in literacy activities. These findings add to substantive discussions of emergent literacy and resilience. Insights from the qualitative interviews also provide culturally-sensitive recommendations to childhood educators and speech-language pathologists (SLP) who work with low-income African American families and children. Reader should recognize that (1) there is not a 'right' phenotype and therefore not a right form of environmental input and (2) that context matters (at both the level of the cell and the individual organism). Copyright © 2015 Elsevier Inc. All rights reserved.
Bell, Carl C; Chimata, Radhika
This study examined the point prevalence of neurodevelopmental disorders among predominantly low-income, African-American psychiatric patients at Jackson Park Hospital's Family Medicine Clinic on Chicago's South Side. Using active case ascertainment methodology, the authors assessed the records of 611 psychiatric patients visiting the clinic between May 23, 2013, and January 14, 2014, to identify those with DSM-5 neurodevelopmental disorders. A total of 297 patients (49%) met criteria for a neurodevelopmental disorder during childhood. Moreover, 237 (39%) had clinical profiles consistent with neurobehavioral disorder associated with prenatal alcohol exposure, and 53 (9%) had other neurodevelopmental disorders. The authors disagreed on the specific type of neurodevelopmental disorder of seven (1% of 611) of the 297 patients with neurodevelopmental disorders. A high prevalence of neurodevelopmental disorders was found among low-income predominantly African-American psychiatric patients on Chicago's South Side. If replicated, these findings should bring about substantial changes in medical practice with African-American patients.
Harper, Erin; Kruger, Ann Cale; Hamilton, Chela; Meyers, Joel; Truscott, Stephen D.; Varjas, Kris
School-based mental health practitioners are positioned to address low-income urban African American girls' mental health needs through culturally responsive services. Despite the importance of culturally reflective practice, it is understudied. We asked school-based mental health practitioners (N = 7) to reflect on barriers and facilitators to…
Berlin, Lisa J.; Ispa, Jean M.; Fine, Mark A.; Malone, Patrick S.; Brooks-Gunn, Jeanne; Brady-Smith, Christy; Ayoub, Catherine; Bai, Yu
This study examined the prevalence, predictors, and outcomes of spanking and verbal punishment in 2,573 low-income White, African American, and Mexican American toddlers at ages 1, 2, and 3. Both spanking and verbal punishment varied by maternal race/ethnicity. Child fussiness at age 1 predicted spanking and verbal punishment at all 3 ages.…
Leone, Janel M.
This study examined risk of suicidal behavior among low-income, African American women (N = 369) in three types of male intimate relationships--intimate terrorism (IT) (i.e., physical violence used within a general pattern of coercive control), situational couple violence (SCV; i.e., episodic physical violence that is not part of a general pattern…
Meaney, Karen S.; Hart, Melanie A.; Griffin, L. Kent
Fun & Fit is a program designed to create positive physical activity experiences and to promote healthy lifestyle choices among overweight children from low-income African American and Hispanic American families. The program is a collaborative project between Texas Tech University and the Lubbock Independent School District funded through a…
Coolahan, Kathleen; McWayne, Christine; Fantuzzo, John; Grim, Suzanne
Examined the construct and concurrent validity of the Parenting Behavior Questionnaire-Head Start (PBQ-HS) with low-income African-American families with preschoolers, and whether parenting styles differed by caregiver characteristics. Derived Active-Responsive, Active-Restrictive, and Passive-Permissive parenting dimensions; the last differed…
Examined play interactions of 33 low-income African American fathers with their preschool-age children in relation to the fathers' psychological characteristics, love for the child's mother, employment status, education, and coresidence with the child. The fathers' self-esteem was the best predictor of play interactions. Coresidence with the child…
Groth, Susan W; Morrison-Beedy, Dianne
This research was conducted to gain insight into how low-income, pregnant, African American women viewed physical activity and approached nutrition during pregnancy. Three focus groups with a total of 26 women were conducted utilizing open-ended questions related to physical activity and diet during pregnancy. Content analysis was used to analyze the verbatim transcripts. Groups were compared and contrasted at the within-group and between-group levels to identify themes. Two themes that related to physical activity during pregnancy were identified: 1) fatigue and low energy dictate activity and 2) motivation to exercise is not there. Three themes were identified that related to diet: 1) despite best intentions, appetite, taste, and cravings drive eating behavior; 2) I'll decide for myself what to eat; and 3) eating out is a way of life. Women reported that being physically active and improving their diets was not easy. Women indicated that their levels of physical activity had decreased since becoming pregnant. Attempts at improving their diets were undermined by frequenting fast food restaurants and cravings for highly dense, palatable foods. Women ceded to the physical aspects of pregnancy, often choosing to ignore the advice of others. A combination of low levels of physical activity and calorie-dense diets increased the risk of excessive gestational weight gain in this sample of women, consequently increasing the risk for weight retention after pregnancy. Health care providers can promote healthy eating and physical activity by building on women's being "in tune with and listening to" their bodies. They can query women about their beliefs regarding physical activity and diet and offer information to ensure understanding of what contributes to healthy pregnancy outcomes. Intervention can focus on factors such as cravings and what tastes good, suggesting ways to manage pregnancy effects within a healthy diet. © 2013 by the American College of Nurse-Midwives.
Full Text Available The purposes of this descriptive study were to (1 describe nutrition knowledge, attitudes, beliefs (KAB, and self-efficacy among low-income African American and Hispanic women; (2 identify the associations these variables have on diet quality and weight status; (3 identify barriers to healthy eating. Data from three separate studies were combined and analyzed. The total sample included African Americans ( and Hispanics (. Descriptive statistics and bivariate analyses were used to identify associations between KAB and body mass index (BMI and diet quality. The majority of African Americans had good knowledge in nutrition while Hispanics had fair knowledge. Attitudes toward eating a healthy diet were significantly associated with high fiber intake among African Americans and low fat consumption among Hispanics. A computed KAB score showed no significant relation to individuals' weight status or diet quality. However, attitudes and beliefs about healthy foods strongly correlated with participants' weight or diet consumption among Hispanics. The most common barrier to consuming a healthy diet reported by both groups was the cost of healthy foods. It is therefore recommended to address these variables when addressing obesity and poor dietary intake among low-income minority groups.
Fisher, Jennifer O; Arreola, Angeles; Birch, Leann L; Rolls, Barbara J
Portion size influences children's energy intakes at meals, but effects on daily intake are unknown. Effects of large portions on daily energy intake were tested in 5-y-old Hispanic and African American children from low-income families. Maternal food intake data were collected to evaluate familial susceptibility to portion size. A within-subjects experimental design with reference and large portion sizes was used in a study of 59 low-income Hispanic and African American preschool-aged children and their mothers. The portion size of 3 entrées (lunch, dinner, and breakfast) and an afternoon snack served during a 24-h period were of a reference size in one condition and doubled in the other condition. Portion sizes of other foods and beverages did not vary across conditions. Weighed food intake, anthropometric measures, and self-reported data were obtained. Doubling the portion size of several entrées and a snack served during a 24-h period increased energy intake from those foods by 23% (180 kcal) among children (P kcal) among mothers (P daily intakes among Hispanic and African American children.
Hoyt, DaVina J.
It is often that during their academic pursuits, to become successful, low-income African-American women must learn to navigate an upstream current through higher education, where the established order in the academy is based on Western European values that often conflict with African-American values (Harper, Patton & Wooden, 2009; Phinney,…
Barbosa, Cecilia E; Masho, Saba W; Carlyle, Kellie E; Mosavel, Maghboeba
Positive deviant individuals practice beneficial behaviors in spite of having qualities characterizing them as high risk for unhealthy behaviors. This study aimed to identify and understand factors distinguishing low-income African American women who breastfeed the longest (positive deviants) from those who breastfeed for a shorter duration or do not breastfeed. Seven mini-focus groups on infant-feeding attitudes and experiences were conducted with 25 low-income African American women, grouped by infant-feeding practice. Positive deviants, who had breastfed for 4 months or more, were compared with formula-feeding participants who had only formula fed their babies and short-term breastfeeding participants who had breastfed for 3 months or less. Positive deviant women had more schooling, higher income, breastfeeding intention, positive breastfeeding and unfavorable formula-feeding attitudes, higher self-efficacy, positive hospital and Special Supplemental Nutrition Program for Women, Infants, and Children experiences, more exclusive breastfeeding, and greater comfort breastfeeding in public. Short-term breastfeeding women varied in breastfeeding intention and self-efficacy, seemed to receive insufficient professional breastfeeding support, and supplemented breastfeeding with formula. Some showed ambivalence, concern with unhealthy behaviors, and discomfort with breastfeeding in public. Formula-feeding women intended to formula feed, feared breastfeeding, thought their behaviors were incompatible with breastfeeding, were comfortable with and found formula convenient, and received strong support to formula feed. Tapping into the strengths of positive deviants; tailoring interventions to levels of general and breastfeeding self-efficacy; increasing social, institutional, and community supports; and removing inappropriate formula promotion may offer promising strategies to increase breastfeeding among low-income African American women.
Qi, Cathy H.; Kaiser, Ann P.; Marley, Scott C.; Milan, Stephanie
The purposes of the study were to determine (a) the ability of two spontaneous language measures, mean length of utterance in morphemes (MLU-m) and number of different words (NDW), to identify African American preschool children at low and high levels of language ability; (b) whether child chronological age was related to the performance of either…
Voisin, Dexter R.; Harty, Justin; Kim, Dong Ha; Elsaesser, Caitlin; Takahashi, Lois M.
Background: African American youth in urban centers often reside in poorly resourced communities and face structural disadvantage, which can result in higher rates of poor behavioral health factors such as mental health problems, juvenile justice system involvement, substance use, risky sex and lower school engagement. While parental monitoring…
Mills, Monique T
This study investigated classroom differences in the narrative performance of school-age African American English (AAE)-speaking children in gifted and general education classrooms. Forty-three children, Grades 2-5, each generated fictional narratives in response to the book Frog, Where Are You? (Mayer, 1969). Differences in performance on traditional narrative measures (total number of communication units [C-units], number of different words, and mean length of utterance in words) and on AAE production (dialect density measure) between children in gifted and general education classrooms were examined. There were no classroom-based differences in total number of C-units, number of different words, and mean length of utterance in words. Children in gifted education classrooms produced narratives with lower dialect density than did children in general educated classrooms. Direct logistic regression assessed whether narrative dialect density measure scores offered additional information about giftedness beyond scores on the Peabody Picture Vocabulary Test-Fourth Edition (Dunn & Dunn, 2007), a standard measure of language ability. Results indicated that a model with only Peabody Picture Vocabulary Test-Fourth Edition scores best discriminated children in the 2 classrooms. African American children across gifted and general education classrooms produce fictional narratives of similar length, lexical diversity, and syntax complexity. However, African American children in gifted education classrooms may produce lower rates of AAE and perform better on standard measures of vocabulary than those in general education classrooms.
Purpose This study investigated classroom differences in the narrative performance of school-age African American English (AAE)-speaking children in gifted and general education classrooms. Method Forty-three children, Grades 2–5, each generated fictional narratives in response to the book Frog, Where Are You? (Mayer, 1969). Differences in performance on traditional narrative measures (total number of communication units [C-units], number of different words, and mean length of utterance in words) and on AAE production (dialect density measure) between children in gifted and general education classrooms were examined. Results There were no classroom-based differences in total number of C-units, number of different words, and mean length of utterance in words. Children in gifted education classrooms produced narratives with lower dialect density than did children in general educated classrooms. Direct logistic regression assessed whether narrative dialect density measure scores offered additional information about giftedness beyond scores on the Peabody Picture Vocabulary Test–Fourth Edition (Dunn & Dunn, 2007), a standard measure of language ability. Results indicated that a model with only Peabody Picture Vocabulary Test–Fourth Edition scores best discriminated children in the 2 classrooms. Conclusion African American children across gifted and general education classrooms produce fictional narratives of similar length, lexical diversity, and syntax complexity. However, African American children in gifted education classrooms may produce lower rates of AAE and perform better on standard measures of vocabulary than those in general education classrooms. PMID:25409770
Reese, L E; Vera, E M; Thompson, K; Reyes, R
Conducted a qualitative investigation to identify the perceptions of risk factors for violence in a sample of inner-city African American youth. Using ethnographic analyses, themes emerging from these data included concerns about the reciprocity between drugs and violence, familial quality of life issues, gender differences in the experience of violence and risk for violence, community safety concerns, and fears about managing peer relationships specific to violence. These data are interpreted relative to the risk factors the violence prevention literature has identified among youth residing in urban environments. Findings are discussed in terms of their potential contribution to generating hypotheses for the development of theory and effective violence prevention practice.
Taylor, Ronald D; Budescu, Mia
Association of mothers' emotional adjustment and negative kin relations with distressed interpersonal relations was examined. Among 115 low-income African American mothers, relationship of depressive symptoms, self-esteem, and demanding kin relations with psychological control and stressful interpersonal relations was assessed. Depressive symptoms and demanding kin relations were positively associated with mothers' use of psychological control in parenting. Interaction of self-esteem with demanding kin relations revealed that self-esteem was negatively associated with psychological control for mothers with high-demanding kin relations but not for mothers with low-demanding kin relations. Mothers' depressive symptoms and demanding kin relations were positively associated with their stressful interpersonal relations. Findings were discussed in terms of the need for research on the beneficial and detrimental aspects of families' social network.
Koblinsky, S A; Morgan, K M; Anderson, E A
The child-rearing practices of homeless and low-income housed mothers of preschool children in Head Start were compared. Overall, homeless mothers provided less learning and academic stimulation, less variety in social and cultural experiences, less warmth and affection, and a less positive physical environment for their children than did housed mothers. Mothers in both living arrangements provided more language stimulation to daughters than to sons. Implications of the findings for working with homeless families are discussed.
Deborah Winders Davis
Full Text Available Objective: Parenting anticipatory guidance is one way to promote optimal child health and development and minimize disparities between children from lower socio-economic status families and their higher income peers. However, low rates of attendance at and completion of parenting programs has been demonstrated. Understanding barriers to participation has important implications. The Obstacles to Engagement Scale (OES has been used in some populations, but it has not been evaluated for use with low-income African American samples. The aim of the current study is to evaluate the factor structure of the OES with a sample of low-income, African American parents.Method: Parents or legal guardians with children aged 3-8 years completed a survey in the waiting room of a primary care pediatric academic practice in an urban location in the southern United States of America (N = 114. Almost 87% had < 12th grade education and 93% of the children received Medicaid services. The OES was one measure from a larger study and only participants with complete data on the OES were included in the exploratory factor analysis (EFA.Results: The EFA did not support the previous 4-factor solution (intervention demands, personal or family stressors or obstacles, relevance of or trust in intervention, and time and scheduling demands. Instead, a 3-factor statistical solution emerged, but not all items held together conceptually.Conclusions: The current study supports the necessity for evaluating study instruments for use with specific populations. Larger samples are needed to disentangle the effects of educational and poverty status from race and ethnicity and to develop and validate instruments that are appropriate for the study population.
Wilson, Helen W; Samuelson, Sarah L; Staudenmeyer, Anna H; Widom, Cathy Spatz
The current study examined patterns of psychopathology, drug and alcohol use, and sexual behavior associated with childhood abuse and neglect in a high-risk sample of low-income African American girls seeking mental health treatment. Participants (N=177) were African American girls recruited from mental health clinics serving low-income communities in Chicago, IL and followed over six waves of data collection (T1-T6) reflecting early (mean age 14) to late (mean age 17) adolescence. Child abuse and neglect history was determined from adolescent and caregiver reports. Latent curve modeling examined patterns of internalizing and externalizing psychopathology, drug and alcohol use, sexual experience, and risky sexual behavior reported by girls and associations with reported child abuse and neglect. Overall, these trajectories indicated a decrease in internalizing and externalizing symptoms, stability of drug and alcohol use, and an increase in sexual experience and risky sexual behaviors over time. Child abuse and neglect was associated with increased internalizing symptoms and sexual experience at baseline and with externalizing symptoms and risky sexual behavior both at baseline and the final point. Child abuse and neglect was not significantly associated with alcohol or drug use. This study adds to the literature on the long-term consequences of child abuse and neglect by demonstrating patterns of psychopathology and risky behavior that persist over time in a high-risk group of girls with self or parent reported histories of abuse and neglect. Interventions that address externalizing problems and health risk behaviors may be of particular importance for this population. Copyright © 2015. Published by Elsevier Ltd.
Bentley, M; Gavin, L; Black, M M; Teti, L
The early introduction of non-milk foods among African-American infants has been well documented. Several studies report the addition of semi-solids as early as 1-2 weeks of age. This study investigated, through ethnographic, repeat indepth interviews with teen mothers and grandmothers of infants, the determinants of such feeding practices and the inter-generational factors involved in infant feeding decision-making. Nineteen adolescent mothers were recruited from Baltimore City WIC programs. The teen mothers were interviewed in their homes during four separate visits and the grandmothers at least twice. Ethnographic field guides focused on questions about what, why and how infants were fed and on the 'ethnotheories' of parenting and infant care in this population. All interviews were taped and transcripts were analyzed using text retrieval software. Results confirmed that it is the cultural norm to feed cereal in the bottle and to feed other semi-solid foods within the first month of life. Most grandmothers played the dominant role in deciding what the infant should eat and the timing of the introduction of solids. This pattern occurred both because grandmothers had extensive physical access to their grandchildren and because teen mothers were dependent upon grandmothers. The use of qualitative research methods, with an ecological, multi-generational focus, provides a rich description of the context within which infant feeding decisions are made.
Vedovato, Gabriela M; Surkan, Pamela J; Jones-Smith, Jessica; Steeves, Elizabeth Anderson; Han, Eunkyung; Trude, Angela Cb; Kharmats, Anna Y; Gittelsohn, Joel
To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviours among low-income African-American families. Cross-sectional survey of participants in the baseline evaluation of the B'More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socio-economic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programmes, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. Fourteen low-income, predominantly African-American neighbourhoods in Baltimore City, MD, USA. Two hundred and ninety-eight adult caregiver-child (10-14 years old) dyads. Of households, 41·6 % had some level of food insecurity and 12·4 % experienced some level of hunger. Food-insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obesity) among adults and children (82·8 % and 37·9 % among food insecure without hunger, 89·2 % and 45·9 % among food insecure with hunger, respectively), although there were no significant differences by food security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. In this setting, obesity and food insecurity are major problems. For many food-insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption.
Full Text Available Introduction: Youth from low-income, urban backgrounds face significant challenges to maintaining a positive developmental trajectory. Dangerous neighborhoods and stressed relationships are common in these settings and threaten adaptation by weakening the natural assets that undergird resilience. African American girls in these contexts face specific, multiple risks, including gender stereotyping, violence, and sexual exploitation. The commercial sexual exploitation of children (CSEC is a multibillion-dollar industry victimizing over 1 million children around the globe.1 The typical victim in 1 city in the southeastern United States is an African American girl 12-14 years old. There has been little research investigating the characteristics of girls placed at risk for CSEC and even less research on the personal perspectives of these girls. Methods: Over 3 school terms we provided preventive intervention groups for 36 African American middle school girls who were placed at risk because they lived in neighborhoods with high rates of interpersonal violence and CSEC. Two group leaders and a process recorder took detailed notes on each group session. Our focus on group conversations over a period of weeks increased the probability of recording spontaneous, open comments by the children and is a promising method with this population. The data were analyzed qualitatively and resulted in an account of the girls’ own views of the environmental challenges and personal experiences that may influence their development.Results: The girls’ language during the group sessions contained 4 themes: difficulty forming trusting relationships, frequent peer aggression, familiarity with adult prostitution, and sexuality as a commodity.Conclusion: Our research shows how girls placed at risk for CSEC view their own lives. These children described violence and sexual exploitation and cited limited supports to protect them from these risks. Understanding the
Jarrett, Robin L.; Coba-Rodriguez, Sarai
Researchers have examined the impact of family on child literacy among low-income African American families and preschoolers considered to be at risk for not being ready for kindergarten. Quantitative studies identify family-parental variables associated with poorer literacy outcomes, whereas qualitative studies detail family practices that…
Lyons, Heather Z.
The already limited vocational prospects of low-income African Americans in New Orleans were further devastated by Hurricane Katrina in 2005. The 2010 Deepwater Horizon oil spill added to the devastation, highlighting the continued vulnerability of New Orleanians seeking employment. As a result, opportunities persist for vocational practitioners…
Dutton, Mary Ann; Bermudez, Diana; Matas, Armely; Majid, Haseeb; Myers, Neely L.
In this article, we consider the use of Mindfulness-Based Stress Reduction (MBSR; Kabat-Zinn, 1991) as a community-based intervention for posttraumatic stress disorder (PTSD) among low-income, predominantly African American women with a history of intimate partner violence (IPV). The results of a pilot randomized clinical trial (RCT) of MBSR as an…
Horodynski, Mildred A; Stommel, Manfred; Brophy-Herb, Holly E; Weatherspoon, Lorraine
To examine maternal demographic characteristics and depressive symptoms as predictors of TV viewing during mealtimes, and to investigate how mealtime TV viewing predicts mothers' and toddlers' food consumption. A prospective, cross-sectional survey design was employed with 199 African American and 200 Caucasian, low-income, mother-toddler dyads enrolled in eight Early Head Start programs in a Midwestern state. Mothers completed the Toddler-Parent Mealtime Behavior Questionnaire to assess toddler mealtime behavior. Data were analyzed using a three-step multiple regression: (a) step one was to determine what characteristics predicted family TV viewing during mealtime; (b) step two was to determine whether TV viewing during mealtime predicted maternal food consumption, and (c) step three was to determine whether TV viewing during mealtime predicted toddler food consumption. Direct and indirect effects of TV watching were explored via path models. Maternal race, education, and depressive symptoms predicted 8% of the variance in TV viewing during mealtime (P < or = 0.001). African American mothers and mothers who had fewer years of schooling and exhibited more depressive symptoms tended to watch more TV during mealtime. More TV viewing during mealtime predicted mothers' intake of 'more' unhealthy foods. Mothers' food consumption was the single best predictor of toddlers' food consumption, while TV viewing during mealtime had an indirect effect through mothers' TV viewing. TV viewing practices affect mothers' food consumption and mealtime behaviors; this, in turn, impacts toddlers' food consumption. Practical interventions are needed to positively influence the nutritional habits of lower-income mothers. Reducing mothers' "unhealthy" food consumption while watching TV may offer one effective strategy.
O'Donnell, Philip; Richards, Maryse; Pearce, Steven; Romero, Edna
Juvenile delinquency is an ongoing social problem particularly among low-income urban youth who are regularly exposed to numerous risk factors. Although much research has been conducted in this area, the most at-risk youth have been largely neglected. This study examines the role of peer deviance in mediating the influence of adult monitoring on…
Leonard, Tammy; Shuval, Kerem; de Oliveira, Angela; Skinner, Celette Sugg; Eckel, Catherine; Murdoch, James C.
Purpose To examine the relationship between physical activity stages of change and preferences for financial risk and time. Design A cross-sectional, community-based study. Setting A low-income, urban, African American neighborhood. Subjects 169 adults Measures Self-reported physical activity stages of change—precontemplation to maintenance, objectively measured BMI and waist circumference, and economic preferences for time and risk measured via incentivized economic experiments. Analysis Multivariable ordered logistic regression models were used to examine the association between physical activity stages of change and economic preferences while controlling for demographic characteristics of the individuals. Results Individuals who are more tolerant of financial risks (OR=1.31, pfinancial risk tolerance or 1 unit increase in the time preference measure, respectively. Conclusions Greater tolerance of financial risk and more patient time preferences among this low-income ethnic minority population are associated with a more advanced physical activity stage. Further exploration is clearly warranted in larger and more representative samples. PMID:23448410
Leonard, Tammy; Shuval, Kerem; de Oliveira, Angela; Skinner, Celette Sugg; Eckel, Catherine; Murdoch, James C
To examine the relationship between physical activity stages of change and preferences for financial risk and time. A cross-sectional, community-based study. A low-income, urban, African-American neighborhood. One hundred sixty-nine adults. Self-reported physical activity stages of change-precontemplation to maintenance, objectively measured body mass index and waist circumference, and economic preferences for time and risk measured via incentivized economic experiments. Multivariable ordered logistic regression models were used to examine the association between physical activity stages of change and economic preferences while controlling for demographic characteristics of the individuals. Individuals who are more tolerant of financial risks (odds ratio [OR] = 1.31, p < .05) and whose time preferences indicate more patience (OR = 1.68, p < .01) are more likely to be in a more advanced physical activity stage (e.g., from preparation to action). The likelihood of being in the maintenance stage increases by 5.6 and 10.9 percentage points for each one-unit increase in financial risk tolerance or one-unit increase in the time preference measure, respectively. Greater tolerance of financial risk and more patient time preferences among this low-income ethnic minority population are associated with a more advanced physical activity stage. Further exploration is clearly warranted in larger and more representative samples.
Wang, Youfa; Li, Ji; Caballero, Benjamin
Objectives To examine the association and predictors of dietary intake resemblance between urban low-income African American adolescents and their mothers. Methods Detailed dietary data collected from 121 child-parent pairs in Chicago in Fall 2003 were used. The association was assessed using correlation coefficients, kappa, and percentage of agreement, and logistic regression models. Results Overall, the association was weak as indicated by correlations and other measures. None of the mother-son correlations for nutrients and food groups were greater than 0.20. Mother-daughter pairs had stronger correlations (0.26 for energy and 0.30 for fat). The association was stronger in normal weight- than overweight or obese mothers. Logistic models showed that mother being a current smoker, giving child more pocket money, and allowing child to eat or purchase snacks without parental permission or presence predicted a higher probability of resemblance in undesirable eating patterns, such as high-energy, high-fat, and high-snack intakes (p<0.05). Conclusions Mother-child diet association was generally weak, and varied considerably across groups and intake variables in this homogenous population. Some maternal characteristics seem to affect the association. PMID:19103323
Sattler, Melissa; Hopkins, Laura; Anderson Steeves, Elizabeth; Cristello, Angelica; Mccloskey, Morgan; Gittelsohn, Joel; Hurley, Kristen
This study explores food preparation behaviors, including types of food prepared, methods of preparation, and frequency of preparation of low-income urban African American youth ages 9-15 in Baltimore City (n = 289) and analyzes a potential association to diet quality as measured through Healthy Eating Index 2010 (HEI) scores. Overall, the youth prepared their own food 6.7 ± 0.33 times per week without significant differences between age groups or genders as measured through pairwise comparison of means. Cereal, noodles, and sandwiches were amongst the foods prepared most frequently. Linear regression analysis found youth food preparation frequency was not significantly associated with total HEI (p = 0.59), sodium (p = 0.58), empty calories (p = 0.96), or dairy scores (p = 0.12). Younger age was associated with higher total HEI scores (p = 0.012) and higher dairy scores (p = 0.01) and female gender was associated with higher total HEI scores (p = 0.03), higher sodium scores (p = 0.03), and lower dairy scores (p = 0.008).
Reyes, Naomi R; Klotz, Alicia A; Herring, Sharon J
Poor diet quality is common among low-income, overweight, African-American mothers, placing them at high risk for adverse pregnancy outcomes. We sought to better understand the contextual factors that may influence low-income African-American mothers' diet quality during pregnancy. In 2011, we conducted semi-structured interviews with 21 overweight/obese, pregnant African Americans in Philadelphia, PA, all of whom received Medicaid and were eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children. Two readers independently coded the interview transcripts to identify recurrent themes. We identified 10 themes around motivators and barriers to healthy eating in pregnancy. Mothers believed that consuming healthy foods, like fruits and vegetables, would lead to healthy babies and limit the physical discomforts of pregnancy. However, more often than not, mothers chose foods that were high in fats and sugars because of taste, cost, and convenience. In addition, mothers had several misconceptions about the definition of healthy (eg, "juice is good for baby"), which led to overconsumption. Many mothers feared they might "starve" their babies if they did not get enough to eat, promoting persistent snacking and larger portions. Living in multigenerational households and sharing resources also limited the mothers' control over food choices and made consuming healthy foods especially difficult. Despite the good intentions of low-income African-American mothers to improve diet quality during pregnancy, multiple factors worked together as barriers to healthy eating. Interventions that emphasize tasty and affordable healthy food substitutes, address misconceptions, and counsel mothers about true energy needs in pregnancy may improve low-income, African-American, overweight/obese mothers' diet quality. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Bean, Kristen F; Sidora-Arcoleo, Kimberly
African American students are overrepresented in special education. Ecological systems theory, social cognitive theory, and a literature review demonstrate that children's environments, particularly school, and self-efficacy impact the educational outcomes of African American children. Interventions have aimed to improve children's environmental resources and efficacy. The aim of this study was to assess the impact of environment, efficacy beliefs, and the Nurse-Family Partnership intervention on the educational achievements of African American children in special education. A secondary data analysis of 126 African American children in special education found that self-efficacy and the number of hours spent in special education were associated with their academic achievement.
Shimpi, Priya M.; Fedewa, Alicia; Hans, Sydney
The relation of social and linguistic input measures to early vocabulary development was examined in 30 low-income African American mother-infant pairs. Observations were conducted when the child was 0 years, 1 month (0;1), 0;4, 0;8, 1;0, 1;6, and 2;0. Maternal input was coded for word types and tokens, contingent responsiveness, and…
Vedovato, Gabriela M.; Surkan, Pamela J.; Jones-Smith, Jessica; Steeves, Elizabeth Anderson; Han, Eunkyung; Trude, Angela C.B.; Kharmats, Anna Y.; Gittelsohn, Joel
Objective To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviors among low-income African-American (AA) families. Design Cross-sectional survey of participants in the baseline evaluation of the B’More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socioeconomic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programs, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. Setting Fourteen low-income, predominantly AA neighborhoods in Baltimore City. Subjects 298 adult caregiver-child (10–14 years old) dyads. Results 41.6% of households had some level of food insecurity, and 12.4% experienced some level of hunger. Food insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obese) among adults and children (82.8% and 37.9% food insecure without hunger; 89.2% and 45.9% with hunger, respectively), although there were no significant differences by security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. Conclusions In this setting, obesity and food insecurity are major problems. For many food insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption. PMID:26441159
.... During Year 02, we conducted technical analyses of completed Phase 1 interviews that were obtained from African American women who were eligible to receive, but who chose to decline, free screening mammograms...
Maliski, Sally L; Litwin, Mark S
.... Preliminary common categories between the Latino and African American men included erectile dysfunction and incontinence were the price that had to be paid to cure cancer, trusting God as a means...
Maliski, Sally L; Litwin, Mark S
.... Preliminary common categories between the Latino and African American men included erectile dysfunction and incontinence were the price that had to be paid to cure cancer, trusting God as a means...
Roy, Kevin M; Dyson, Omari
In this analysis, we explore how low-income African American fathers build understandings of successful manhood in the context of community-based responsible fatherhood programs. Drawing on life history interviews with 75 men in Illinois and Indiana, we explore men's attempts to fulfill normative expectations of fatherhood while living in communities with limited resources. We examine the efforts of community-based fatherhood programs to shape alternative African American masculinities through facilitation of personal turning points and "breaks with the past," use of social support and institutional interventions, and the reframing of provision as a priority of successful fatherhood. We refer to Connell's hegemonic masculinity framework (Connell in Masculinities, Polity Press, Cambridge, 1995) and discuss how both men and programs borrow from hegemonic and street masculinities to develop alternative approaches to paternal involvement for marginalized men.
Golden, Annis G
This study was undertaken in partnership with a publicly funded reproductive healthcare organization to better understand barriers to utilization of its services as perceived by low income African American women in its community and how those barriers might be managed. The study uses a place-based, ecological perspective to theorize privacy challenges across different levels of the communication ecology. Analysis of participant observation, interviews, and focus group data identified three key public-private problematics in African American women's experience of reproductive healthcare seeking in a smaller urban setting: a public-private problematic of organizational identity, of organizational regions, and of organizational members. Potential strategies are identified for managing these problematics by the organization and community members. Copyright © 2014. Published by Elsevier Ltd.
Taylor, Ronald D
Association of demanding kin relations and family routine with adolescents' psychological distress and school achievement was assessed among 200 low-income, African American mothers and adolescents. Demanding kin relations were significantly associated with adolescents' psychological distress. Family routine was significantly related to adolescents' school achievement. Demanding kin relations were negatively associated with school achievement for adolescents from families low in routine, but unrelated to achievement for adolescents in families high in routine. Additional research is needed on poor families and their social networks. © 2015 The Author. Journal of Research on Adolescence © 2015 Society for Research on Adolescence.
Curenton, Stephanie M.; Wilson, Melvin N.
This study examined low-income African American and European American preschoolers' socioemotional causal attributions. Results indicate that younger preschoolers, particularly young African Americans, may need help articulating emotions. Adults can support children's emotional reasoning through scaffolding. (Author)
... Data > Minority Population Profiles > Black/African American > Immunizations Immunizations and African Americans African American adults are less ... 19 to 35 months had comparable rates of immunization. African American women are as likely to have ...
Murray, Kantahyanee W.; Haynie, Denise L.; Howard, Donna E.; Cheng, Tina L.; Simons-Morton, Bruce
This research examined the relation between early adolescent aggression and parenting practices in an urban, predominately African American sample. Sixth graders (N = 209) completed questionnaires about their overt and relational aggressive behaviors and perceptions of caregivers' parenting practices. Findings indicated that moderate levels of…
Full Text Available 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 underserved African Americans and Latinos. Methods. Ten focus groups were conducted with African American (=43 and Latino participants (=44 in both English and Spanish and analyzed for key themes. Results. Both groups perceived increased and immediate access to multiple medical opinions and reduced wait time as relative advantages of telemedicine. However, African Americans expressed more concerns than Latinos about confidentiality, privacy, and the physical absence of the specialist. This difference may reflect lower levels of trust in new health care innovations among African Americans resulting from a legacy of past abuses in the US medical system as compared to immigrant Latinos who do not have this particular historical backdrop. Conclusions. These findings have implications for important issues such as adoption of telemedicine, patient satisfaction, doctor-patient interactions, and the development and tailoring of strategies targeted to each of these populations for the introduction, marketing, and implementation of telemedicine.
Wells, Anjanette A; Shon, En-Jung; McGowan, Kelly; James, Aimee
Although information-motivation-behavioral skills (IMB) adherence model has been successfully used in many illness domains and with other populations, it has not been used in understanding mammogram screening among low-income African-American women. Thus, a qualitative examination is needed to theoretically and collectively understand the barriers to screening, given the disparities in breast cancer mortality rates among this population. Semi-structured telephone interviews were conducted with 28 low-income uninsured and underinsured African-American women, 40 to 70 years, who had not had a mammogram within the past 12 months. Women were recruited from 21 hair and nail salons and Laundromats within the five North St. Louis city zip codes with the highest breast cancer mortality rates. Transcripts were analyzed and rooted in grounded theory. This study found that the individual relevancy of information, behavioral skills-both procedural and systematic-and motivation seemed to affect screening adherence; (the results suggest the importance of reordering traditional IMB components into the following sequential order: information, behavioral skills, and motivation (IBM)). Future analyses should include a larger, more representative sample of unscreened women, in which quantitative statistical analyses could be conducted to assist in strengthening assertions about information, behavioral skills, and motivational aspects and their relationship to screening.
Pempek, Tiffany A; Calvert, Sandra L
To examine how advergames, which are online computer games developed to market a product, affect consumption of healthier and less healthy snacks by low-income African American children. Cross-sectional, between-subjects examination of an advergame in which children were rewarded for having their computer character consume healthier or less healthy foods and beverages. Children were randomly assigned to 1 of the following 3 conditions: (1) the healthier advergame condition, (2) the less healthy advergame condition, or (3) the control condition. Urban public elementary schools. Thirty low-income, African American children aged 9 to 10 years. Main Exposure Children in the treatment conditions played a less healthy or a healthier version of an advergame 2 times before choosing and eating a snack and completing the experimental measures. Children in the control group chose and ate a snack before playing the game and completing the measures. The number of healthier snack items children selected and ate and how much children liked the game. Children who played the healthier version of the advergame selected and ate significantly more healthy snacks than did those who played the less healthy version. Children reported liking the advergame. Findings suggest that concerns about online advergames that market unhealthy foods are justified. However, advergames may also be used to promote healthier foods and beverages. This kind of social marketing approach could tip the scales toward the selection of higher-quality snacks, thereby helping to curb the obesity epidemic.
Goldman, Samantha E.; Glover, Carrie A.; Lloyd, Blair P.; Barton, Erin E.; Mello, Maria P.
Low-income, minority families are underrepresented in the literature on parent training for school-aged children with autism spectrum disorder (ASD). Although the use of visual supports, such as visual schedules, is considered to be an evidence-based practice for children with ASD in school, it is not known whether this strategy is effective for…
Cheney, Marshall K.; Mansker, Jacqueline
Background: African Americans have one of the lowest smoking rates as teens yet have one of the highest smoking rates as adults. Approximately 40% of African Americans who have ever smoked started smoking between the ages of 18 and 21. Purpose: This study aimed to identify why African American young adults began smoking in young adulthood and what…
Dempster, Robert; Davis, Deborah Winders; Faye Jones, V; Keating, Adam; Wildman, Beth
Significant numbers of children have diagnosable mental health problems, but only a small proportion of them receive appropriate services. Stigma has been associated with help-seeking for adult mental health problems and for Caucasian parents. The current study aims to understand factors, including stigma, associated with African American parents' help-seeking behavior related to perceived child behavior problems. Participants were a community sample of African American parents and/or legal guardians of children ages 3-8 years recruited from an urban primary care setting (N = 101). Variables included child behavior, stigma (self, friends/family, and public), object of stigma (parent or child), obstacles for engagement, intention to attend parenting classes, and demographics. Self-stigma was the strongest predictor of help-seeking among African American parents. The impact of self-stigma on parents' ratings of the likelihood of attending parenting classes increased when parents considered a situation in which their child's behavior was concerning to them. Findings support the need to consider parent stigma in the design of care models to ensure that children receive needed preventative and treatment services for behavioral/mental health problems in African American families.
Murray, Kantahyanee W; Haynie, Denise L; Howard, Donna E; Cheng, Tina L; Simons-Morton, Bruce
This research examined the relation between early adolescent aggression and parenting practices in an urban, predominately African American sample. Sixth graders (N = 209) completed questionnaires about their overt and relational aggressive behaviors and perceptions of caregivers' parenting practices. Findings indicated that moderate levels of parental expectations for peaceful solutions at Time 1 were associated with a lower likelihood of overt aggression at Time 2. Furthermore, findings suggest that when caregivers' support and knowledge of adolescents' whereabouts were relatively low or when caregivers' exerted high psychological control, moderate levels of parental expectations for peaceful solutions protected early adolescents against engagement in both overt and relational aggression. The implications of the findings for schools and other youth violence prevention settings are discussed.
Heidelberger, Lindsay; Smith, Chery
Objectives Pediatric obesity is complicated by many factors including psychological issues, such as body dissatisfaction. Body image assessment tools are used with children to measure their acceptance of their body shape or image. Limited research has been conducted with African American and American Indian children to understand their opinions on assessment tools created. This study investigated: (a) children's perception about body image and (b) differences between two body image instruments among low-income, multi-ethnic children. Methods This study uses mixed methodology including focus groups (qualitative) and body image assessment instruments (quantitative). Fifty-one children participated (25 girls, 26 boys); 53% of children identified as African American and 47% as American Indian. The average age was 10.4 years. Open coding methods were used by identify themes from focus group data. SPSS was used for quantitative analysis. Results Children preferred the Figure Rating Scale (FRS/silhouette) instrument over the Children's Body Image Scale (CBIS/photo) because their body parts and facial features were more detailed. Children formed their body image perception with influence from their parents and the media. Children verbalized that they have experienced negative consequences related to poor body image including disordered eating habits, depression, and bullying. Healthy weight children are also aware of weight-related bullying that obese and overweight children face. Conclusions for Practice Children prefer that the images on a body image assessment tool have detailed facial features and are clothed. Further research into body image assessment tools for use with African American and American Indian children is needed.
Lehrer, H Matthew; Dubois, Susan K; Maslowsky, Julie; Laudenslager, Mark L; Steinhardt, Mary A
African Americans have higher diabetes prevalence compared to Whites. They also have elevated cortisol levels - indicating possible HPA axis dysregulation - which may raise blood glucose as part of the biological response to physiological and psychosocial stress. Little is known about chronic cortisol levels in African Americans, and even less about the role of chronically elevated cortisol in type 2 diabetes development in this racial group. We used analysis of cortisol in hair to examine associations of long-term (∼3months) cortisol levels with glycated hemoglobin (HbA1c) in a group of African American adults. In exploratory analyses, we also studied the relationship of hair dehydroepiandrosterone (DHEA) with HbA1c. Participants were 61 community-dwelling African American adults (85% female; mean age 54.30 years). The first 3cm of scalp-near hair were analyzed for cortisol and DHEA concentration using enzyme-linked immunoassay analysis. Glycated hemoglobin was assessed, and regression analyses predicting HbA1c from hair cortisol and DHEA were performed in the full sample and in a subsample of participants (n=20) meeting the National Institute of Diabetes and Digestive Kidney Disease (NIDDK) criteria for type 2 diabetes (HbA1c≥6.5%). In the full sample, HbA1c increased with hair cortisol level (β=0.22, p=0.04, f(2)=0.10), independent of age, sex, chronic health conditions, diabetes medication use, exercise, and depressive symptoms. In the subsample of participants with an HbA1c≥6.5%, hair cortisol was also positively related to HbA1c (β=0.45, p=0.04, f(2)=0.32), independent of diabetes medication use. Glycated hemoglobin was unrelated to hair DHEA in both the full sample and HbA1c≥6.5% subsample. Long-term HPA axis dysregulation in the form of elevated hair cortisol is associated with elevated HbA1c in African American adults. Copyright © 2016 Elsevier Ltd. All rights reserved.
Thompson, Amanda L; Adair, Linda S; Bentley, Margaret E
The prevalence of overweight among infants and toddlers has increased dramatically in the past three decades, highlighting the importance of identifying factors contributing to early excess weight gain, particularly in high-risk groups. Parental feeding styles and the attitudes and behaviors that characterize parental approaches to maintaining or modifying children's eating behavior are an important behavioral component shaping early obesity risk. Using longitudinal data from the Infant Care and Risk of Obesity Study, a cohort study of 217 African-American mother-infant pairs with feeding styles, dietary recalls, and anthropometry collected from 3 to 18 months of infant age, we examined the relationship between feeding styles, infant diet, and weight-for-age and sum of skinfolds. Longitudinal mixed models indicated that higher pressuring and indulgent feeding style scores were positively associated with greater infant energy intake, reduced odds of breastfeeding, and higher levels of age-inappropriate feeding of liquids and solids, whereas restrictive feeding styles were associated with lower energy intake, higher odds of breastfeeding, and reduced odds of inappropriate feeding. Pressuring and restriction were also oppositely related to infant size with pressuring associated with lower infant weight-for-age and restriction with higher weight-for-age and sum of skinfolds. Infant size also predicted maternal feeding styles in subsequent visits indicating that the relationship between size and feeding styles is likely bidirectional. Our results suggest that the degree to which parents are pressuring or restrictive during feeding shapes the early feeding environment and, consequently, may be an important environmental factor in the development of obesity. Copyright © 2012 The Obesity Society.
... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...
Harris, Charlie L; Strayhorn, Gregory; Moore, Sandra; Goldman, Brian; Martin, Michelle Y
Obese African American women under-appraise their body mass index (BMI) classification and report fewer weight loss attempts than women who accurately appraise their weight status. This cross-sectional study examined whether physician-informed weight status could predict weight self-perception and weight self-regulation strategies in obese women. A convenience sample of 118 low-income women completed a survey assessing demographic characteristics, comorbidities, weight self-perception, and weight self-regulation strategies. BMI was calculated during nurse triage. Binary logistic regression models were performed to test hypotheses. The odds of obese accurate appraisers having been informed about their weight status were six times greater than those of under-appraisers. The odds of those using an "approach" self-regulation strategy having been physician-informed were four times greater compared with those using an "avoidance" strategy. Physicians are uniquely positioned to influence accurate weight self-perception and adaptive weight self-regulation strategies in underserved women, reducing their risk for obesity-related morbidity.
Rowles, Joanna; Duan, Changming
Racial discrimination has negatively affected African Americans in the United States for centuries and produced one of the most publicly recognized histories of social oppression. Extensive research has shown the deleterious effects of racism on African American people and clearly demonstrated that perceived racism and discrimination may…
Hunter, Lora Rose; Schmidt, Norman B.
In this review, the extant literature concerning anxiety psychopathology in African American adults is summarized to develop a testable, explanatory framework with implications for future research. The model was designed to account for purported lower rates of anxiety disorders in African Americans compared to European Americans, along with other…
Mason, Marc A; Fanelli Kuczmarski, Marie; Allegro, Deanne; Zonderman, Alan B; Evans, Michele K
Analysing dietary data to capture how individuals typically consume foods is dependent on the coding variables used. Individual foods consumed simultaneously, like coffee with milk, are given codes to identify these combinations. Our literature review revealed a lack of discussion about using combination codes in analysis. The present study identified foods consumed at mealtimes and by race when combination codes were or were not utilized. Duplicate analysis methods were performed on separate data sets. The original data set consisted of all foods reported; each food was coded as if it was consumed individually. The revised data set was derived from the original data set by first isolating coded foods consumed as individual items from those foods consumed simultaneously and assigning a code to designate a combination. Foods assigned a combination code, like pancakes with syrup, were aggregated and associated with a food group, defined by the major food component (i.e. pancakes), and then appended to the isolated coded foods. Healthy Aging in Neighborhoods of Diversity across the Life Span study. African-American and White adults with two dietary recalls (n 2177). Differences existed in lists of foods most frequently consumed by mealtime and race when comparing results based on original and revised data sets. African Americans reported consumption of sausage/luncheon meat and poultry, while ready-to-eat cereals and cakes/doughnuts/pastries were reported by Whites on recalls. Use of combination codes provided more accurate representation of how foods were consumed by populations. This information is beneficial when creating interventions and exploring diet-health relationships.
Trude, Angela Cristina Bizzotto; Kharmats, Anna Yevgenyevna; Hurley, Kristen Marie; Anderson Steeves, Elizabeth; Talegawkar, Sameera A; Gittelsohn, Joel
Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD. Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10-14 y) dyads participating in the baseline evaluation of the B'More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income. On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth's healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06-1.41, ORvegetable 1.31; 1.15-1.51 and ORfiber 1.46; 1.23-1.74, Self-efficacy: ORfruit 1.07; 1.03-1.12, ORvegetable 1.04; 1.01-1.09, ORfiber 1.10; 1.04-1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable
Angela Cristina Bizzotto Trude
Full Text Available Abstract Background Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA youth in Baltimore, MD. Methods Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10–14 y dyads participating in the baseline evaluation of the B’More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake controlling for youth age, sex, BMI percentile, total calorie intake and household income. Results On average, youth consumed 1.5 ± 1.1 (M ± SD servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth’s healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06–1.41, ORvegetable 1.31; 1.15–1.51 and ORfiber 1.46; 1.23–1.74, Self-efficacy: ORfruit 1.07; 1.03–1.12, ORvegetable 1.04; 1.01–1.09, ORfiber 1.10; 1.04–1.16. Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9. In addition, youth shopping more
Coulon, Sandra M; Wilson, Dawn K; Alia, Kassandra A; Van Horn, M Lee
African-American adults experience the highest rates of elevated blood pressure (BP), and this disparity may be linked to socioeconomic and neighborhood-related disadvantage. Based on a bioecological stress-buffering framework, relations of poverty and neighborhood environmental perceptions with BP were assessed using multilevel regression in at-risk African-American adults. This cross-sectional study used baseline data that were collected in 2008 as part of the Positive Action for Today's Health (PATH) trial (N = 409), a community-based intervention to increase walking in low-income, high-crime neighborhoods. BP and perceived neighborhood crime and satisfaction were investigated as individual-level indicators of health and neighborhood environment. Census block groups (N = 22) served as geographic proxies for neighborhoods, and poverty was obtained using 2010 U.S. Census data, to characterize the neighborhood-level socioeconomic environment. There were no individual-level direct associations. Significant cross-product interactions demonstrated that with higher perceived crime, high satisfaction was associated with lower systolic (γ = 3.34) and diastolic (γ = -1.37) BP, but low satisfaction was associated with higher systolic (γ = 15.12) and diastolic (γ = 7.57) BP. Neighborhood-level poverty was associated with diastolic (γ = 11.48, SE = 4.08, P = 0.008) and systolic BP (γ = 12.79, SE = 6.33, P = 0.052). Variance in BP across block groups was low (intraclass correlation coefficients = 0.002-0.014) and there were no significant random effects. Results supported hypotheses, with greater neighborhood satisfaction linked to lower systolic and diastolic BP when perceived crime was high. Neighborhood poverty was also linked to higher systolic and diastolic BP. Prevention efforts should further investigate whether attending to issues of poverty and related neighborhood perceptions reduces high BP in at-risk African-American communities. © Published by Oxford
J. Camille Hall
Full Text Available For many African Americans, the extended family has been the source of strength, resilience, and survival. Although changes in African American families, like changes in all families in the United States that have diluted the importance of kinship ties, many African Americans continue to place a high value on extended family members. Children of Africans and communities of African descent traditionally interact with multiple caregivers, consisting of kin, and fictive kin.Utilizing both attachment theory and risk and resilience literature, this paper discusses ways to better understand the resilient nature of African American families and how multiple attachment relationships assist at-risk African American children, specifically adult children of alcoholics (ACOAs.
Wanda Lott Collins
Full Text Available Using an individual’s last name indicates respect and contributes to positive interaction with African American clients and adults of African descent. This paper discusses the importance of using social titles as a proper form of address during, and sometimes after, the initial professional relationship. Two case vignettes will highlight potential difficulties that non-African American practitioners may experience when using first names with African Americans within the professional realm. The vignettes include a scenario for a supervisor and a client.
Windsor, Liliane Cambraia; Dunlap, Eloise; Armour, Marilyn
Drawing on standpoint and intersectionality theories, this study explores the degree to which interactions among New York State’s Rockefeller Drug Laws, educational and welfare policies have contributed to the maintenance of a culture of surveillance in which the lives of impoverished African Americans are overseen and influenced by oppressive policies and governmental institutions. Qualitative secondary analysis of longitudinal ethnographic data was conducted. Findings demonstrate multiple disadvantages that impoverished African American families struggling with substance use and/or sale experience. These disadvantages accumulated intergenerationally, in a snowball effect making it difficult for participants to maintain stable lives. Findings explored the tension between participants’ experiences with oppression and the multiple ways they either assimilated or resisted their oppression. New sensitive policies informed by standpoint, intersectionality, and Afrocentric perspectives must be developed to increase the availability of meaningful employment and strengthening impoverished African American communities. PMID:23216440
Windsor, Liliane Cambraia; Dunlap, Eloise; Armour, Marilyn
Drawing on standpoint and intersectionality theories, this study explores the degree to which interactions among New York State's Rockefeller Drug Laws and educational and welfare policies have contributed to the maintenance of a culture of surveillance in which the lives of impoverished African Americans are overseen and influenced by oppressive policies and governmental institutions. Qualitative secondary analysis of longitudinal ethnographic data was conducted. Findings demonstrate multiple disadvantages that impoverished African American families struggling with substance use or sale experience. These disadvantages accumulated intergenerationally, in a snowball effect, making it difficult for participants to maintain stable lives. Findings explored the tension between participants' lived experiences and the multiple ways they either assimilated or resisted their oppression. New sensitive policies informed by standpoint, intersectionality, and Afrocentric perspectives must be developed to increase the availability of meaningful employment and strengthening impoverished African American communities.
Bragg, Marie A; Tucker, Carolyn M; Kaye, Lily B; Desmond, Frederic
Obesity rates are rising in the United States, especially among low-income and racial/ethnic minority individuals. Exploring motivators and barriers relative to engaging in physical activity is imperative. The purpose of this study was to identify motivators and barriers relative to engagement in physical activity as reported by culturally diverse low-income adolescents and adults. A total of 91 adolescent (11 to 15 years of age) and adult (18 years of age or older) participants who self-identified as African American, Hispanic, or non-Hispanic White engaged in age group-, race/ethnicity-, and gender-concordant focus groups. Qualitative data analysis indicated that the motivators and barriers most commonly identified among the adolescent and adult focus groups were: social influence; time and priorities; physical environment; fun and enjoyment; inherently physical activities; weight concerns; fatigue, physical discomfort and current fitness level; and immediate positive feelings. Findings were generally similar across age group, gender and race/ethnicity. Age group-specific, gender-specific and race/ethnicity-specific motivators and barriers were related to how commonly the motivators and barriers were identified among each group. Implications for increasing physical activity among low-income culturally diverse adolescents and adults are discussed.
Sterrett, Emma M.; Jones, Deborah J.; Kincaid, Carlye
African American youth from single mother homes are at greater risk for internalizing and externalizing problems relative to their peers from two-parent homes. Although the predominance of psychosocial research on these youth has focused on maternal parenting and mother-child relationship quality, far less attention has been devoted to the quality…
Chapman, L Kevin; Petrie, Jenny M; Richards, Allyn
Empirical literature pertaining to anxiety in African Americans has been relatively sparse. More recent studies indicate that the construct of social fear is different in African Americans than in non-Hispanic Whites. Although some of these studies have examined factor structure utilizing self-report measures of anxiety in African American samples, none to date have examined the clinical utility of these measures in predicting anxiety diagnoses, particularly social phobia. A total of sixty-five African American adults from the community completed the Fear Survey Schedule-Second Edition (FSS-II), Social Anxiety Interaction Scale (SIAS), Social Phobia Scale (SPS), and Albany Panic and Phobia Questionnaire (APPQ). The Anxiety Disorder Interview Schedule-Fourth Edition (ADIS-IV) was administered to all participants to specify differential diagnoses of anxiety and related disorders. Twenty-three African American adults were diagnosed with social phobia leaving 42 diagnostic controls. Results suggest that the social anxiety factors were highly predictive of a social phobia diagnosis (AUC=.84 to .90; CI .73-.98, p<.01) and sensitivity and specificity rates revealed optimal cutoff scores for each measure. The optimal cutoff scores reveal the clinical utility of the social fear factor from these measures in screening for social phobia in African Americans. Future direction and implications are discussed. Psychinfo, PubMed, Medline. © 2015 National Medical Association. Published by Elsevier Inc. All rights reserved.
Bradley, Rebekah; Schwartz, Ann C; Kaslow, Nadine J
There is a dearth of research on risk/protective factors for posttraumatic stress disorder (PTSD) among low-income African American women with a history of intimate partner violence (IPV), presenting for suicidal behavior or routine medical care in a large, urban hospital. We examined self-esteem, social support, and religious coping as mediators between experiences of child maltreatment (CM) and IPV and symptoms of PTSD in a sample (N = 134) of low-income African American women. Instruments used included the Index of Spouse Abuse, the Childhood Trauma Questionnaire, the Taylor Self-Esteem Inventory, the Multidimensional Profile of Social Support, the Brief Religious Coping Activities Scale, and the Davidson Trauma Scale. Both CM and IPV related positively to PTSD symptoms. Risk and resilience individual difference factors accounted for 18% of the variance in PTSD symptoms over and above IPV and CM, with self-esteem and negative religious coping making unique contributions. Both variables mediated the abuse-PTSD symptom link. In addition, we tested an alternate model in which PTSD symptoms mediated the relationship between abuse and both self-esteem and negative religious coping.
Fish, Caitlin A; Brown, Jonisha R; Quandt, Sara A
Minority families often reside in neighborhoods with few supermarkets or alternative healthy food options (e.g., farmers markets, community gardens), making fresh produce difficult to obtain. This qualitative study identified factors influencing fruit and vegetable shopping and use of alternative healthy food options. Forty-eight minority women with children completed interviews regarding food shopping habits and use of and attitudes toward alternative healthy food options. Interviews were subjected to thematic analysis. Produce shopping was motivated by costs and family preferences. For African American women, poor cooking skills restricted the variety of fruits and vegetables purchased. Latinas were receptive to alternative healthy food options, but did not use them because these sources were inconvenient. African American women were not receptive to them. Improving cooking skills and perceptions of acceptable foods may be as important as increased access to promote greater consumption of fruits and vegetables.
Speck, Aimee L; Hess, Michael; Baptist, Alan P
Health disparities are seen in many chronic conditions including asthma. Young African American adults represent a population at high risk for poor asthma outcomes due to both their minority status and the difficult transition from adolescence to adulthood. Recruitment and retention has been challenging in this demographic stratum, and traditional asthma education is often not feasible. The objective of this study was to develop and assess the feasibility of an electronic asthma self-management program for young African American adults. A total of 44 African American adults (age 18-30 years) with uncontrolled persistent asthma were enrolled in an asthma self-management program. The 6-week Breathe Michigan program (predicated on the social cognitive theory) was tailored specifically to the concerns and preferences of young African American adults. The entire program was completed electronically, without any specialized human support. At 2 weeks and 3 months after program completion, participants were contacted for follow-up. A total of 89% of enrolled subjects completed the 6-week intervention, and 77% were available for evaluation at 3 months. All subjects completing the 2-week postprogram survey reported that the program was helpful, and 97% would recommend it to others. Asthma control as measured by the Asthma Control Test improved from 16.1 to 19.3 (P young African American adults. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Windsor, Liliane Cambraia; Dunlap, Eloise; Armour, Marilyn
Drawing on standpoint and intersectionality theories, this study explores the degree to which interactions among New York State’s Rockefeller Drug Laws, educational and welfare policies have contributed to the maintenance of a culture of surveillance in which the lives of impoverished African Americans are overseen and influenced by oppressive policies and governmental institutions. Qualitative secondary analysis of longitudinal ethnographic data was conducted. Findings demonstrate multiple d...
Lee, Young-Shin; Kim, Hee-Gerl; Moreno, Kim
The purpose of this study was to identify the prevalence of xerostomia and related factors among low-income older adults in South Korea. A cross-sectional, population-based study. Using data from the Home Healthcare Service Project, a population-based interview survey with home healthcare service, a total of 9,840 adults 65 years of age and older were assessed for the presence of xerostomia in association with aspects of health lifestyles, chronic disease, oral conditions, and oral function. Overall, 40% of participants reported experiencing xerostomia. Multivariate regression analysis indicated xerostomia was more likely to be reported by women having symptoms of gingival bleeding/pain, having difficulty swallowing liquid or chewing solid food, and having multiple chronic diseases. Interestingly, older adults who live alone and drink alcohol (two or more times per week) reported fewer problems with xerostomia. Increased focus on the detrimental health consequences of xerostomia would make treatment a higher priority. Improved assessment of at-risk populations, particularly among the elderly, could lead to earlier preventative interventions, lessening the negative impact on quality of life. Health professionals along with the general public need increased knowledge about the detrimental effects of xerostomia on overall health. There is a need for earlier assessment and treatment to facilitate optimal health promotion and disease prevention. © 2015 Sigma Theta Tau International.
Full Text Available The relationship between residential segregation and overweight/obesity among African-American adults remains unclear. Elucidating that relationship is relevant to efforts to prevent and to reduce racial disparities in obesity. This article provides a critical review of the 11 empirical studies of segregation and overweight/obesity among African-American adults. Results revealed that most studies did not use a valid measure of segregation, many did not use a valid measure of overweight/obesity, and many did not control for neighborhood poverty. Only four (36% of the studies used valid measures of both segregation and overweight/obesity and also controlled for area-poverty. Those four studies suggest that segregation contributes to overweight and obesity among African-American adults, but that conclusion cannot be drawn with any certainty in light of the considerable methodological problems in this area of research. Suggestions for improving research on this topic are provided.
Taylor, Teletia R; Van Kirk, Kendra; Tapscott, Denia; Bernard, Monet; Llano, Juliana; Mellman, Thomas A
African-Americans have been found to experience increased rates of post-traumatic stress disorder (PTSD), obesity, and flatter diurnal cortisol slopes compared to other demographic groups. Further exploration, however, is needed to understand how PTSD impacts diurnal cortisol activity in obese African-American women. The purpose of the current study is to examine the relationship between salivary cortisol levels and PTSD in a sample of obese young adult African-American women and to examine how depression and insomnia influence the relationship. Thirty-four young adult African-American women (mean age = 24.0 years; mean BMI = 37.4 kg/m(2), 6/34 of the sample had a score of 40 or above on the PTSD Checklist (PCL) representing clinically significant PTSD) filled out questionnaires assessing PTSD, lifetime exposure to traumatic events, insomnia severity, and depression. A home-based assessment of salivary cortisol was provided upon awakening at 30 min and 1, 3, 6, and 12 h. There was a significant interaction between PTSD status and diurnal cortisol activity (p cortisol levels at awakening (p cortisol was attenuated by co-varying for depression and insomnia (p > 0.05). PTSD, influenced by depression and insomnia symptoms, has an impact on diurnal cortisol activity in obese young adult African-American women.
Affuso, Olivia; Cox, Tiffany L; Durant, Nefertiti H; Allison, David B
More than 60% of African American adults do not meet recommendations for moderate physical activity. We sought to discover the extent to which health attitudes and beliefs are associated with leisure-time physical activity in this population. Cross-sectional study. African American adults were asked about their health attitudes and beliefs during a national survey. Participants were 807 African American men and women aged 18 years and older. Random-digit dialing was employed, sampling telephone numbers by geographical region, area code, and population size. Participants were asked six health belief questions on the importance of exercise and body weight in health. Logistic regression was used to determine which of these factors were associated with physical activity participation. The percent of respondents participating in some form of physical activity during the past month was 87.1% in men and 82.9% in women. Factors associated with previous month physical activity in men were perceived personal importance of exercise (P importance of exercise (P important to exercise or be physically active for health predicts physical activity participation in both African American men and women. Creating a sense of importance of physical activity to relieve stress and foster good health may stimulate physical activity participation in African American adults.
Stewart, Jennifer M
To assess the barriers and facilitators to using African American churches as sites for implementation of evidence-based HIV interventions among young African American women. Mixed methods cross-sectional design. African American churches in Philadelphia, PA. 142 African American pastors, church leaders, and young adult women ages 18 to 25. Mixed methods convergent parallel design. The majority of young adult women reported engaging in high-risk HIV-related behaviors. Although church leaders reported willingness to implement HIV risk-reduction interventions, they were unsure of how to initiate this process. Key facilitators to the implementation of evidence-based interventions included the perception of the leadership and church members that HIV interventions were needed and that the church was a promising venue for them. A primary barrier to implementation in this setting is the perception that discussions of sexuality should be private. Implementation of evidence-based HIV interventions for young adult African American women in church settings is feasible and needed. Building a level of comfort in discussing matters of sexuality and adapting existing evidence-based interventions to meet the needs of young women in church settings is a viable approach for successful implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Connolly Amy B
Full Text Available Abstract Background Mindfulness-based stress reduction (MBSR programs are becoming increasingly common, but have not been studied in low income minority older populations. We sought to understand which parts of MBSR were most important to practicing MBSR members of this population, and to understand whether they apply their training to daily challenges. Methods We conducted three focus groups with 13 current members of an MBSR program. Participants were African American women over the age of 60 in a low-income housing residence. We tape recorded each session and subsequently used inductive content analysis to identify primary themes. Results and discussion Analysis of the focus group responses revealed three primary themes stress management, applying mindfulness, and the social support of the group meditation. The stressors they cited using MBSR with included growing older with physical pain, medical tests, financial strain, and having grandchildren with significant mental, physical, financial or legal hardships. We found that participants particularly used their MBSR training for coping with medical procedures, and managing both depression and anger. Conclusion A reflective stationary intervention delivered in-residence could be an ideal mechanism to decrease stress in low-income older adult's lives and improve their health.
Holland, Megan M.; DeLuca, Stefanie
Increasing numbers of low-income and minority youth are now pursuing shorter-duration sub-baccalaureate credentials at for-profit trade and technical schools. However, many students drop out of these schools, leaving with large debts and few job prospects. Despite these dismal outcomes, we know very little about students' experiences in for-profit…
Bengle, Rebecca; Sinnett, Stephanie; Johnson, Tommy; Johnson, Mary Ann; Brown, Arvine; Lee, Jung Sun
Low-income older adults are at increased risk of cutting back on basic needs, including food and medication. This study examined the relationship between food insecurity and cost-related medication non-adherence (CRN) in low-income Georgian older adults. The study sample includes new Older Americans Act Nutrition Program participants and waitlisted people assessed by a self-administered mail survey (N = 1000, mean age 75.0 + so - 9.1 years, 68.4% women, 25.8% African American). About 49.7% of participants were food insecure, while 44.4% reported practicing CRN. Those who were food insecure and/or who practiced CRN were more likely to be African American, low-income, younger, less educated, and to report poorer self-reported health status. Food insecure participants were 2.9 (95% CI 2.2, 4.0) times more likely to practice CRN behaviors than their counterparts after controlling for potential confounders. Improving food security is important inorder to promote adherence to recommended prescription regimens.
Acton Ronald T
Full Text Available Abstract Background Results of previous autopsy studies indicate that increased hepatic iron stores or hepatic iron overload is common in African Americans dying in hospitals, but there are no reports of hepatic iron content in other cohorts of African Americans. Methods We investigated the prevalence of heavy liver iron deposition in African American adults. Using established histochemical criteria, we graded Perls' acid ferrocyanide-reactive iron in the hepatocytes and Kupffer cells of 341 consecutive African American adults who were autopsied in the coroner/medical examiner office. Heavy staining was defined as grade 3 or 4 hepatocyte iron or grade 3 Kupffer cell iron. Results There were 254 men and 85 women (mean age ± 1 SD: 44 ± 13 y vs. 48 ± 14 y, respectively; p = 0.0255; gender was unstated or unknown in two subjects. Approximately one-third of subjects died of natural causes. Heavy staining was observed in 10.2% of men and 4.7% of women. 23 subjects had heavy hepatocyte staining only, six had heavy Kupffer cell staining only, and one had a mixed pattern of heavy staining. 15 subjects had histories of chronic alcoholism; three had heavy staining confined to hepatocytes. We analyzed the relationships of three continuous variables (age at death in years, hepatocyte iron grade, Kupffer cell iron grade and two categorical variables (sex, cause of death (natural and non-natural causes in all 341 subjects using a correlation matrix with Bonferroni correction. This revealed two positive correlations: hepatocyte with Kupffer cell iron grades (p Conclusions The present results confirm and extend previous observations that heavy liver iron staining is relatively common in African Americans. The pertinence of these observations to genetic and acquired causes of iron overload in African Americans is discussed.
Drayton, Brendaly; Prins, Esther
Although the national graduation rate for African American males is only 47% (Schott Foundation for Public Education, 2010), few studies have explored their experiences in adult basic and literacy education (ABEL) programs. This study draws on prior research to explore the relationship between literacy and identity and its potential for…
Roldós, María Isabel
The purpose of this study was to investigate the longitudinal effect of marijuana and heavy alcohol use on the productivity status of nonmetropolitan African American young adults. This analysis was based on secondary data from the Family and Community Health Study. For alcohol, the study evaluated the effects on productivity status for…
Green, Kerry M.; Ensminger, Margaret E.
The authors examined the effects of heavy adolescent marijuana use on employment, marriage, and family formation and tested both dropping out of high school and adult marijuana use as potential mediators of these associations among a community sample of African Americans followed longitudinally from age 6 to age 32-33. They used propensity …
Kennedy, Sara M; Patel, Roshni P; Cheh, Paul; Hsia, Jason; Rolle, Italia V
African American youth use marijuana at similar rates and tobacco at lower rates compared with white youth; however, in adulthood, tobacco use is similar. Tobacco and marijuana use are closely associated; differing initiation patterns may contribute to observed racial differences in tobacco prevalence by age. Therefore, it is important to assess tobacco and marijuana initiation patterns by race. Data were obtained from 56,555 adults aged 18-25 who completed the 2005-2012 National Survey on Drug Use and Health. The analysis was restricted to those who reported ever use of marijuana and combustible tobacco (cigarettes and/or cigars). Three mutually exclusive categories of initiation patterns were evaluated: use of marijuana before tobacco; marijuana and tobacco at the same age; and tobacco before marijuana. Multivariable regression models were used to assess changes over time and compare these outcomes by race while controlling for sociodemographics, risk perceptions, and current substance use. In 2005, 26.6% of African American and 14.3% of white young adults used marijuana before tobacco, compared with 41.5% of African American and 24.0% of white young adults in 2012 (P young adults had greater odds of using marijuana before tobacco (AOR = 1.79; 95% CI: 1.67, 1.91) compared with whites. African American young adults were more likely than whites to use marijuana before tobacco and both groups were increasingly likely to use marijuana before tobacco over time. A greater understanding of how marijuana initiation interacts with tobacco initiation could inform more effective tobacco and marijuana use prevention efforts. Among ever users of combustible tobacco and marijuana, greater proportions of African American young adults used marijuana before tobacco or at the same age than their white counterparts. Moreover, both African Americans and whites were more likely to use marijuana before tobacco in 2012 compared with 2005. Tobacco control policy may benefit from a
Flórez, Karen R; Richardson, Andrea S; Ghosh-Dastidar, Madhumita Bonnie; Troxel, Wendy; DeSantis, Amy; Colabianchi, Natalie; Dubowitz, Tamara
Social support and social networks can elucidate important structural and functional aspects of social relationships that are associated with health-promoting behaviors, including Physical Activity (PA) and weight. A growing number of studies have investigated the relationship between social support, social networks, PA and obesity specifically among African Americans; however, the evidence is mixed and many studies focus exclusively on African American women. Most studies have also focused on either functional or structural aspects of social relationships (but not both) and few have objectively measured moderate-to-vigorous physical activity (MVPA) and body mass index (BMI). Cross-sectional surveys of adult African American men and women living in two low-income predominantly African American neighborhoods in Pittsburgh, PA (N = 799) measured numerous structural features as well as functional aspects of social relationships. Specifically, structural features included social isolation, and social network size and diversity. Functional aspects included perceptions of social support for physical activity from the social network in general as well as from family and friends specifically. Height, weight, and PA were objectively measured. From these, we derived Body Mass Index (BMI) and moderate-to-vigorous physical activity (MVPA). All regression models were stratified by gender, and included age, income, education, employment, marital status, physical limitations, and a neighborhood indicator. Greater social isolation was a significant predictor of lower BMI among men only. Among women only, social isolation was significantly associated with increased MVPA whereas, network diversity was significantly associated with reduced MVPA. Future research would benefit from in-depth qualitative investigations to understand how social networks may act to influence different types of physical activity among African Americans, as well as understand how they can be possible levers
Bentley L Gibson
Full Text Available Implicit intergroup bias emerges early in development, are typically pro-ingroup, and remain stable across the lifespan. Such findings have been interpreted in terms of an automatic ingroup bias similar to what is observed with minimal groups paradigms. These studies are typically conducted with groups of high cultural standing (e.g., Caucasians in North America and Europe. Research conducted among culturally lower status groups (e.g., African-Americans, Latino-Americans reveals a notable absence of an implicit ingroup bias. Understanding the environmental factors that contribute to the absence of an implicit ingroup bias among people from culturally lower status groups is critical for advancing theories of implicit intergroup cognition. The present study aimed to elucidate the factors that shape racial group bias among African-American children and young adults by examining their relationship with age, school composition (predominantly Black schools or racially mixed schools, parental racial attitudes and socialization messages among African-American children (N = 86 and young adults (N = 130. Age, school-type and parents' racial socialization messages were all found to be related to the strength of pro-Black (ingroup bias. We also found that relationships between implicit and explicit bias and frequency of parents' racial socialization messages depended on the type of school participants attended. Our results highlight the importance of considering environmental factors in shaping the magnitude and direction of implicit and explicit race bias among African-Americans rather than treating them as a monolithic group.
Gothe, Neha P; Kendall, Bradley J
According to the Centers for Disease Control and Prevention, less than 11% of adults more than the age of 65 meet the 2008 Physical Activity Guidelines for Americans. Among minority populations, only 5% of non-Hispanic Black older adults met the guidelines. Given our limited understanding of psychosocial and environmental factors that affect physical activity participation in these groups, the purpose of our focus groups was to investigate barriers, motivators, and preferences of physical activity for community-dwelling African American older adults. Three focus groups were conducted with female African American older adults ( N = 20). Questions posed to each focus group targeted motivations and barriers toward physical activity as well as their preferences for physical activity. The motivations included perceived health benefits of physical activity, social support, and enjoyment associated with engagement in physical activity. Prominent barriers included time and physical limitations, peer pressure and family responsibilities, and weather and poor neighborhood conditions. Group activities involving a dance component and novel exercises such as tai-chi or yoga were preferred choices. These findings should be taken into consideration when designing and implementing research or community physical activity programs for female African American older adults.
Petrilla, Cassandra; Cheney, Marshall K
African American young adults have higher rates of smoking and chronic disease than Whites. Understanding the association between chronic disease and smoking beliefs and behaviors could improve cessation strategies for young adult smokers. African American young adult smokers aged 18-29 years (n = 243) were administered surveys assessing smoking beliefs and behaviors. Participants indicated if they had physician-diagnosed asthma, diabetes, and/or hypertension. Responses were analyzed using logistic regression, comparing responses of those diagnosed with a chronic disease to those without that disease. Smokers with asthma were 2.20 times more likely to acknowledge smoking negatively affected their health yet were no more likely to make a quit attempt than those without asthma. Diabetic smokers were 4.10 times more likely than those without to have made a quit attempt, yet were 3.24 times more likely to disagree that they were in control of their smoking. Hypertensive smokers were more likely to be heavier smokers and were 3.12 times more likely to disagree that they would stop smoking if they knew it affected the health of others than those without hypertension. Smokers with chronic disease were less likely to be influenced to quit by their physician than smokers without. African American young adult smokers with a chronic disease often diverge from smokers without that chronic disease in smoking beliefs and behaviors. These may influence how young adults respond to cessation messages and programs.
Neha P. Gothe PhD
Full Text Available According to the Centers for Disease Control and Prevention, less than 11% of adults more than the age of 65 meet the 2008 Physical Activity Guidelines for Americans. Among minority populations, only 5% of non-Hispanic Black older adults met the guidelines. Given our limited understanding of psychosocial and environmental factors that affect physical activity participation in these groups, the purpose of our focus groups was to investigate barriers, motivators, and preferences of physical activity for community-dwelling African American older adults. Three focus groups were conducted with female African American older adults ( N = 20. Questions posed to each focus group targeted motivations and barriers toward physical activity as well as their preferences for physical activity. The motivations included perceived health benefits of physical activity, social support, and enjoyment associated with engagement in physical activity. Prominent barriers included time and physical limitations, peer pressure and family responsibilities, and weather and poor neighborhood conditions. Group activities involving a dance component and novel exercises such as tai-chi or yoga were preferred choices. These findings should be taken into consideration when designing and implementing research or community physical activity programs for female African American older adults.
Bibeau, Wendy S; Saksvig, Brit I; Gittelsohn, Joel; Williams, Sonja; Jones, Lindsey; Young, Deborah Rohm
Obesity disproportionately affects African American adolescents, particularly girls. While ethnically targeted marketing of unhealthful food products contributes to this disparity, it is not known how African Americans perceive the food marketing environment in their communities. Qualitative methods, specifically photovoice and group discussions, were used to understand perceptions of African American adults and teen girls regarding targeted food marketing to adolescent girls. An advisory committee of four students, two faculty, and two parents was formed, who recruited peers to photograph their environments and participate in group discussions to answer "what influences teen girls to eat what they do." Seven adults and nine teens (all female) participated in the study. Discussions were transcribed, coded, and analyzed with ATLAS.ti to identify common and disparate themes among participants. Results indicated that adults and teens perceived the type of food products, availability of foods, and price to influence the girls' choices. The girls spoke about products that were highly convenient and tasty as being particularly attractive. The adults reported that advertisements and insufficient nutrition education were also influencers. The teens discussed that the places in which food products were available influenced their choices. Results suggest that the marketing of highly available, convenient food at low prices sell products to teen girls. Future work is needed to better understand the consumer's perspective on the food and beverage marketing strategies used. Copyright © 2011 Elsevier Ltd. All rights reserved.
Broaddus, Michelle R; Dickson-Gomez, Julia
African American young adults are at high risk of HIV infection during their lifetimes, and the male condom remains the best method of prevention. Efforts to increase condom use should address the barrier of condom negotiation. We conducted a thematic analysis of qualitative, semistructured interviews with African American young adults to examine their use of text messaging for requesting human immunodeficiency virus (HIV) or sexually transmitted infection (STI) testing and condom use within the larger context of general sexual communication using text messages. Text messaging gave participants a level of comfort and disinhibition to discuss sexual topics and negotiate sexual safety. Benefits of text messages included ease of communication, privacy, and increased ability to express condom desires. Difficulties reflected the potential relationship implications of suggesting HIV/STI testing and condom use. Condom negotiation strategies using text messages also mirrored those found to be used in face-to-face communication.
Haire-Joshu, Debra; Kreuter, Matthew K; Holt, Cheryl; Steger-May, Karen
This exploratory study examined how estimates of one's fruit and vegetable intake in childhood are related to 3 current dietary behaviors among African American women: intake of fruits and vegetables, exposure to and preference for fruits and vegetables, and preference for trying new foods. Baseline data from a randomized dietary intervention trial. Ten urban public health centers in St. Louis, Missouri. 1227 African American women. A 33-item fruit and vegetable food frequency questionnaire, items measuring estimates of childhood fruit and vegetable intake, adult fruit and vegetable intake, exposure to and preference for fruit and vegetable, and preference for trying new foods. Linear regression evaluated the association between predictors and continuous measures; logistic regression determined the association between predictors and categorical measures. Estimates of one's vegetable intake as a child were significantly related to exposure and preference for both fruits and vegetables, trying of new foods, and intake of both fruits and vegetables in adulthood. Estimates of eating fruit as a child were not significantly associated with these adult dietary behaviors. Developmental influences on adult dietary patterns may be stronger for vegetables than fruits among African American women. Additional emphasis is needed regarding exposure to and preference for vegetable intake in childhood.
... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...
Charles R. Rogers, Ph.D., CHES
Full Text Available Racial disparities in health among African American men in the United States are extensive. In contrast to their White counterparts, African American men have more illnesses and die younger. African American men have colorectal cancer (CRC incidence and mortality rates 25% and 50% higher, respectively, than White men. Due to CRC’s younger age at presentation and high incidence among African American men, CRC screening is warranted at the age of 45 rather than 50, but little is known about younger African American men’s views of CRC screening. Employing survey design, the purpose of the study was to describe the male role norms, knowledge, attitudes, perceived subjective norms, and perceived barriers associated with screening for CRC among a non-random sample of 157 young adult African American men (ages 19-45. Sixty-seven percent of the study sample received a passing knowledge score (85% or better, yet no significant differences were found among the three educational levels (i.e., low, medium, high. More negative attitudes towards CRC screening correlated with the participants’ strong perceptions of barriers, but no extremely negative or positive male role norms and perceived subjective norms were found. The factors significantly associated with attitudes were family history of cancer (unsure, work status, and perceived barriers. Findings from this study provide a solid basis for developing structured health education interventions that address the salient factors shaping young adult African American men's view of CRC and early detection screening behaviors.
Van Dyke, Miriam E; Vaccarino, Viola; Dunbar, Sandra B; Pemu, Priscilla; Gibbons, Gary H; Quyyumi, Arshed A; Lewis, Tené T
We examined the association between socioeconomic status (SES) discrimination and C-reactive protein (CRP) in a biracial cohort of middle-aged adults using an intersectionality framework. Participants were 401 African-American and White adults from a population-based cohort in the Southeastern United States. SES discrimination was self-reported with a modified Experiences of Discrimination Scale, and CRP levels were assayed from blood samples. Linear regression analyses were used to examine the associations among SES discrimination, race, education, and CRP after controlling for age, gender, racial and gender discrimination, financial and general stress, body mass index, smoking, sleep quality, and depressive symptoms. Intersectional effects were tested using race×SES discrimination, education×SES discrimination and race×education×SES discrimination interactions. Adjusting for sociodemographics, racial discrimination, gender discrimination, and all relevant two-way interaction terms, we observed a significant race×education×SES discrimination interaction (p=0.019). In adjusted models stratified by race and education, SES discrimination was associated with elevated CRP among higher educated African-Americans (β=0.29, p=0.018), but not lower educated African-Americans (β=-0.13, p=0.32); or lower educated (β=-0.02, p=0.92) or higher educated (β=-0.01, p=0.90) Whites. Findings support the relevance of SES discrimination as an important discriminatory stressor for CRP specifically among higher educated African-Americans. Copyright © 2017 Elsevier Ltd. All rights reserved.
Wang, Youfa; Li, Ji; Caballero, Benjamin
To examine the association and predictors of dietary intake resemblance between urban low-income African-American adolescents and their mothers. Detailed dietary data collected from 121 child-parent pairs in Chicago during fall 2003 were used. The association was assessed using correlation coefficients, kappa, and percentage of agreement, as well as logistic regression models. Overall, the association was weak as indicated by correlations and other measures. None of the mother-son correlations for nutrients and food groups were greater than 0.20. Mother-daughter pairs had stronger correlations (0.26 for energy and 0.30 for fat). The association was stronger in normal-weight mothers than in mothers with overweight or obesity. Logistic models showed that mother being a current smoker, giving child more pocket money, and allowing child to eat or purchase snacks without parental permission or presence predicted a higher probability of resemblance in undesirable eating patterns, such as high-energy, high-fat, and high-snack intakes (P<0.05). Mother-child diet association was generally weak, and varied considerably across groups and intake variables in this homogenous population. Some maternal characteristics seem to affect the association.
Vaughn, Michael G; Salas-Wright, Christopher P; White, Norman A; Kremer, Kristen P
We know that poor sleep can have important implications for a variety of health outcomes and some evidence suggests a link between sleep and aggressive behavior. However, few studies have looked at this relationship among African-Americans in the United States. Data from the National Survey of American Life (NSAL) and the NSAL Adult Re-Interview were used to examine associations between sleep duration and self-reported quality of sleep on reactive aggression among African American and Caribbean Black respondents between the ages of 18 and 65 (n = 2499). Controlling for an array of sociodemographic and psychiatric factors, sleep was found to be significantly associated with reactive aggression. Specifically, individuals who reported sleeping on average less than 5 h per night were nearly three times more likely to report losing their temper and engaging in a physical fight (AOR = 3.13, 95% CI = 1.22-8.02). Moreover, individuals who reported being "very dissatisfied" with their sleep were more than two times more likely to report losing their temper and engaging in physical fights (AOR = 3.32, 95% CI = 1.50-7.33). Persons reporting everyday discrimination and problems managing stress were more likely to sleep poorly. The present study is among the first to document an association between poor sleep and reactive violence among African-Americans. Findings suggest that reducing discrimination may lead to improved sleep and subsequently reduce forms of reactive violence. Copyright © 2015 Elsevier Ltd. All rights reserved.
Hovick, Shelly R; Yamasaki, Jill S; Burton-Chase, Allison M; Peterson, Susan K
This qualitative study examined patterns of communication regarding family health history among older African American adults. The authors conducted 5 focus groups and 6 semi-structured interviews with African Americans aged 60 years and older (N = 28). The authors identified 4 distinct patterns of family health history communication: noncommunication, open communication, selective communication (communication restricted to certain people or topics), and one-way communication (communication not reciprocated by younger family members). In general, participants favored open family health history communication, often resulting from desires to change patterns of noncommunication in previous generations regarding personal and family health history. Some participants indicated that they were selective about what and with whom they shared health information in order to protect their privacy and not worry others. Others described family health history communication as one-way or unreciprocated by younger family members who appeared uninterested or unwilling to share personal and family health information. The communication patterns that the authors identified are consistent with communication privacy management theory and with findings from studies focused on genetic testing results for hereditary conditions, suggesting that individuals are consistent in their communication of health and genetic risk information. Findings may guide the development of health message strategies for African Americans to increase family health history communication.
Fuller-Rowell, Thomas E; Curtis, David S; Doan, Stacey N; Coe, Christopher L
The current study examined the prospective effects of educational attainment on proinflammatory physiology among African American and white adults. Participants were 1192 African Americans and 1487 whites who participated in Year 5 (mean [standard deviation] age = 30 [3.5] years), and Year 20 (mean [standard deviation] age = 45 [3.5]) of an ongoing longitudinal study. Initial analyses focused on age-related changes in fibrinogen across racial groups, and parallel analyses for C-reactive protein and interleukin-6 assessed at Year 20. Models then estimated the effects of educational attainment on changes in inflammation for African Americans and whites before and after controlling for four blocks of covariates: a) early life adversity, b) health and health behaviors at baseline, c) employment and financial measures at baseline and follow-up, and d) psychosocial stresses in adulthood. African Americans had larger increases in fibrinogen over time than whites (B = 24.93, standard error = 3.24, p educational attainment were weaker for African Americans than for whites (B = 10.11, standard error = 3.29, p = .002), and only 8% of this difference was explained by covariates. Analyses for C-reactive protein and interleukin-6 yielded consistent results. The effects of educational attainment on inflammation levels were stronger for white than for African American participants. Why African Americans do not show the same health benefits with educational attainment is an important question for health disparities research.
Full Text Available The transition to adulthood is a developmental period marked by increased stress, especially among African Americans. In addition to stress related to emerging adulthood, neighborhood fear may contribute to depressive symptoms for African Americans. We examined gender differences in longitudinal associations between changes in perceived neighborhood fear, parental support, and depressive symptoms among African American youth who were in transition to adulthood. Five hundred and thirteen African American youths (235 males and 278 females were included in the study. An increase in perceived neighborhood fear was associated with an increase in depressive symptoms, and change in perceived maternal support was predictive of depressive symptoms among males, but not females. The findings suggest that policies and programs should help parents provide support to young adult children who live in violent neighborhoods as a strategy to prevent depressive symptoms during emerging adulthood.
Newton Robert L
Full Text Available Abstract Background This study investigated the number of pedometer assessment occasions required to establish habitual physical activity in African American adults. Methods African American adults (mean age 59.9 ± 0.60 years; 59 % female enrolled in the Diet and Physical Activity Substudy of the Jackson Heart Study wore Yamax pedometers during 3-day monitoring periods, assessed on two to three distinct occasions, each separated by approximately one month. The stability of pedometer measured PA was described as differences in mean steps/day across time, as intraclass correlation coefficients (ICC by sex, age, and body mass index (BMI category, and as percent of participants changing steps/day quartiles across time. Results Valid data were obtained for 270 participants on either two or three different assessment occasions. Mean steps/day were not significantly different across assessment occasions (p values > 0.456. The overall ICCs for steps/day assessed on either two or three occasions were 0.57 and 0.76, respectively. In addition, 85 % (two assessment occasions and 76 % (three assessment occasions of all participants remained in the same steps/day quartile or changed one quartile over time. Conclusion The current study shows that an overall mean steps/day estimate based on a 3-day monitoring period did not differ significantly over 4 – 6 months. The findings were robust to differences in sex, age, and BMI categories. A single 3-day monitoring period is sufficient to capture habitual physical activity in African American adults.
This podcast features Kenny Mendoza-Herrera, a former graduate student at the National Institute of Public Health of Mexico and one of the winners of PCD's 2017 Student Research Paper Contest. Kenny answers questions about his winning research and what impact his study has on the prevention of diabetic blindness and public health, particularly for Mexican adults.
This podcast features Kenny Mendoza-Herrera, a former graduate student at the National Institute of Public Health of Mexico and one of the winners of PCDâs 2017 Student Research Paper Contest. Kenny answers questions about his winning research and what impact his study has on the prevention of diabetic blindness and public health, particularly for Mexican adults. Created: 10/9/2017 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 10/9/2017.
Kogan, Steven M; Lei, Man-Kit; Grange, Christina R; Simons, Ronald L; Brody, Gene H; Gibbons, Frederick X; Chen, Yi-Fu
Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10-22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths' exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults' romantic relationships.
Williams, Monnica T; Duque, Gerardo; Wetterneck, Chad T; Chapman, L Kevin; DeLapp, Ryan C T
Prior research has found that a strong positive ethnic identity is a protective factor against anxiety and depression in African Americans. In this study, ethnic identity is examined in a geographically representative sample of African American young adults (n = 242), using the Multigroup Ethnic Identity Measure (MEIM) (Phinney in J Adolescent Res 7:156-76, 15). The two-factor structure of the measure (Roberts et al. in J Early Adolescence 19:301-22, 1) was analyzed using a structural equation model and displayed an acceptable fit only when multiple error terms were correlated. A multigroup confirmatory factor analysis revealed measurement equivalence of the two-factor structure between African Americans from Southern and non-Southern regions of the USA. We found that significantly higher levels of ethnic identity were present among African American in the South compared to other regions, and region significantly predicted total ethnic identity scores in a linear regression, even when controlling for gender, age, urbanicity, and years of education. Furthermore, among African Americans, living in the South was significantly correlated with less help-seeking for diagnosed depression, anxiety, and/or obsessive-compulsive disorder, where help-seeking was defined as obtaining a diagnosis by a professional. The role of ethnic identity and social support are discussed in the context of African American mental health.
Porcerelli, John H; Hurrell, Kristen; Cogan, Rosemary; Jeffries, Keturah; Markova, Tsveti
This study assessed the relationship between psychopathology with the Personality Assessment Screener (PAS) and childhood physical and sexual abuse and adult physical and sexual partner violence in a primary care sample of 98 urban-dwelling African American women. Patients completed the PAS, the Childhood Trauma Questionnaire, and the Conflict Tactics Scale. The PAS total score significantly correlated with all measures of childhood and adult abuse. Stepwise regression analyses revealed that PAS element scores of Suicidal Thinking and Hostile Control significantly predicted a history of childhood physical abuse; Suicidal Thinking, Hostile Control, and Acting Out significantly predicted a history of childhood sexual abuse; Suicidal Thinking, Negative Affect, and Alienation significantly predicted current adult partner physical violence; and Psychotic Features, Alcohol Problems, and Anger Control significantly predicted current adult sexual partner violence. The PAS appears to be a useful measure for fast-paced primary care settings for identifying patients who need a more thorough assessment for abuse. © The Author(s) 2015.
Akinyemiju, Tomi; Do, Anh N; Patki, Amit; Aslibekyan, Stella; Zhi, Degui; Hidalgo, Bertha; Tiwari, Hemant K; Absher, Devin; Geng, Xin; Arnett, Donna K; Irvin, Marguerite R
The high prevalence of obesity among US adults has resulted in significant increases in associated metabolic disorders such as diabetes, dyslipidemia, and high blood pressure. Together, these disorders constitute metabolic syndrome, a clinically defined condition highly prevalent among African-Americans. Identifying epigenetic alterations associated with metabolic syndrome may provide additional information regarding etiology beyond current evidence from genome-wide association studies. Data on metabolic syndrome and DNA methylation was assessed on 614 African-Americans from the Hypertension Genetic Epidemiology Network (HyperGEN) study. Metabolic syndrome was defined using the joint harmonized criteria, and DNA methylation was assessed using the Illumina HumanMethylation450K Bead Chip assay on DNA extracted from buffy coat. Linear mixed effects regression models were used to examine the association between CpG methylation at > 450,000 CpG sites and metabolic syndrome adjusted for study covariates. Replication using DNA from a separate sample of 69 African-Americans, as well as meta-analysis combining both cohorts, was conducted. Two differentially methylated CpG sites in the IGF2BP1 gene on chromosome 17 (cg06638433; p value = 3.10 × 10 - 7 ) and the ABCG1 gene on chromosome 21 (cg06500161; p value = 2.60 × 10 - 8 ) were identified. Results for the ABCG1 gene remained statistically significant in the replication dataset and meta-analysis. Metabolic syndrome was consistently associated with increased methylation in the ABCG1 gene in the discovery and replication datasets, a gene that encodes a protein in the ATP-binding cassette transporter family and is involved in intra- and extra-cellular signaling and lipid transport.
Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Silverman, Kenneth
Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training…
Craig, Holly K.; Grogger, Jeffrey T.
Purpose In this study, the authors examined the influences of selected social (gender, employment status, educational achievement level) and style variables (race of examiner, interview topic) on the production of African American English (AAE) by adults. Method Participants were 50 African American men and women, ages 20–30 years. The authors used Rapid and Anonymous Survey (RAS) methods to collect responses to questions on informal situational and formal message-oriented topics in a short interview with an unacquainted interlocutor. Results Results revealed strong systematic effects for academic achievement, but not gender or employment status. Most features were used less frequently by participants with higher educational levels, but sharp declines in the usage of 5 specific features distinguished the participants differing in educational achievement. Strong systematic style effects were found for the 2 types of questions, but not race of addressee. The features that were most commonly used across participants—copula absence, variable subject–verb agreement, and appositive pronouns—were also the features that showed the greatest style shifting. Conclusions The findings lay a foundation with mature speakers for rate-based and feature inventory methods recently shown to be informative for the study of child AAE and demonstrate the benefits of the RAS. PMID:22361105
Franck, Karen; Vineyard, Michelle; Olson, Ann; Peterson, Ashley
Experiential cooking classes for low-income adults can help improve healthy nutrition behaviors. However, nutrition educators and Extension professionals can face challenges in successful implementation of these programs such as difficulties recruiting and retaining participants. Drawing upon lessons learned from a cooking intervention with…
Schaffer, Brigid Ann
This phenomenological study explored the perceptions and expectations of low income adults regarding financial literacy to discover ways to increase attendance in financial literacy programs designs for this cohort. The study utilized interviews with closed-ended questions to establish the participants' backgrounds, then opened-ended questions to…
Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian
Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.
Full Text Available Background: Although exercise participation has numerous benefits among young adults, socio-economically disadvantaged ethnic minorities tend to be less active than their White counterparts of higher SES. Instead of relying on logical positivism in exercise promotion, a phronetic (humanistic approach may better assist with understanding exercise behavior. Objective: The study purpose was to examine the exercise behavior and qualitatively distinct exercise values (e.g., activity and inactivity reasons among socio-economically disadvantaged African American young adults. Method: This was a phronetic, qualitative study among 14 African American young adults (Mage = 32.97 years old ±14.13, who attended General Educational Development classes in an inner-city learning center. An in-depth and dialogical interview process was conducted regarding exercise behavior, positive and negative exercise experiences, reasons for exercise participation or not, exercise behavior of participants’ peers and significant others, and neighborhood safety. Results: Only three men met the minimum aerobic exercise recommendations and their main activity was basketball. Three individuals were somewhat active, while the rest of the participants were inactive. Based on the phronetic, thematic analysis, two themes emerged. Exercise facilitators included enjoyment (from skill and fitness development in a playful setting, health improvement, weight loss and toned physique, and utilitarian purpose (i.e., karate to work for campus security. Exercise barriers included time constraints and other priorities (school, work, caretaking, injuries, accessibility and cost issues, safety issues (unsafe neighborhoods, personality (lack of motivation and self-discipline, and undesirable results on appearance and performance. Conclusion: Exercise promoters should emphasize: a playful, culturally meaningful, and socially supported activities to increase fitness, skill development, and
Kelso, T M; Abou-Shala, N; Heilker, G M; Arheart, K L; Portner, T S; Self, T H
To determine if a comprehensive long-term management program, emphasizing inhaled corticosteroids and patient education, would improve outcomes in adult African-American asthmatics a nonrandomized control trial with a 2-year intervention was performed in a university-based clinic. Inclusion criteria consisted of (> or = 5) emergency department (ED) visits or hospitalizations (> or = 2) during the previous 2 years. Intervention patients were volunteers; a comparable control group was identified via chart review at hospitals within the same area and time period as the intervention patients. Individualized doses of beclomethasone with a spacer, inhaled albuterol "as needed," and crisis prednisone were the primary therapies. Environmental control, peak flow monitoring, and a partnership with the patient were emphasized. Detailed patient education was an integral part of management. Control patients received usual care from local physicians. ED visits and hospitalizations for 2 years before and 2 years during the intervention period were compared. Quality of life (QOL) measurements were made at baseline and every 6 months in the intervention group. Study group (n = 21) had a significant reduction in ED visits (2.3 +/- 0.2 pre-intervention versus 0.6 +/- 0.2 post-intervention; P = 0.0001). Control group (n = 18) did not have a significant change in ED visits during the 2-year post-intervention period (2.6 +/- 0.2 pre-intervention versus 2.0 +/- 0.2 post-intervention; P = 0.11). Both groups had significant reductions in hospitalizations, but the study group had a greater reduction. Sixty-two percent of study patients had complete elimination of ED visits and hospitalizations, whereas no control patients had total elimination of the need for institutional acute care. QOL in the study patients revealed significant improvements for most parameters. A comprehensive long-term management program emphasizing inhaled corticosteroids combined with other state-of-the-art management
Tyson, Sheryl Y
This qualitative study explored perspectives of emerging adult African American women on the development of mature love relationships. Inductive analysis of focus group interviews, conducted with a purposive sample of 31 African American women, yielded themes related to relationship goals and characteristics, and interpersonal and societal challenges to finding the right partner and developing a mature love relationship. Core categories that emerged from analysis of the discussions were (1) age and relationship goal differences within the emerging adult group, (2) mature love relationship goals and characteristics, (3) interpersonal obstacles to finding the right partner, and (4) societal obstacles to finding the right partner. Two approaches-black womanist/feminist thought (Collins, 2000 ; Walker, 1983 ) and relationship maturity theory (Paul & White, 1990 )-were then combined to explain the influence of historic and contemporary interpersonal and societal factors on developmental and ethnic issues that challenge positive gender identity formation, hasten intimacy maturity, and hinder the development of mature love relationships among emerging adult African American women. For these women, premature responsibility, especially early caregiver burden, was related to the early development of intimacy capacity and the desire for a mature love relationship, to be protected, and to have someone to help carry the load. Interracial dating, negative stereotypic images of African American women, and even positive images of enduring black love relationships posed difficult challenges to positive identity formation and intimacy maturity. A primary challenge was to counteract negative stereotypic images, so that they could develop their own self-identities as women and as relationship partners.
Kohon, Jacklyn; Carder, Paula
This study focused on meanings of health, housing, independence and aging among low-income adults age 55 and older who live in, or are on a waiting list for, publicly subsidized rental housing. The purpose was to learn how low-income older adults perceive their independence and health, and how their place of residence contributes to these perceptions, as well as related perceptions of self. Qualitative data were collected using in-person narrative interviews with 45 individuals and a second photo elicitation interview with 31 of these persons. Themes describe how disrupted identities influence subjective thoughts about the aging process, housing, health, and finances, the process of clinicalization, and place identities. These findings highlight the relationship between housing status, dignity, and shifting identities as older adults experience the aging process in a low-income context. This study expands the current scholarship on the relationship between environment and aging as well as our understanding of poverty among older persons. These topics are relevant for new policies and programs to support the aging in place of older persons in subsidized housing. Understanding the life worlds of those who live in or have applied to this form of housing will be instrumental in developing such strategies. Copyright © 2014 Elsevier Inc. All rights reserved.
Schensul, Jean J; Radda, Kim; Coman, Emil; Vazquez, Elsie
In this paper we describe a successful multi-level participatory intervention grounded in principles of individual and group empowerment, and guided by social construction theory. The intervention addressed known and persistent inequities in influenza vaccination among African American and Latino older adults, and associated infections, hospitalizations and mortality. It was designed to increase resident ability to make informed decisions about vaccination, and to build internal and external infrastructure to support sustainability over time. The intervention brought a group of social scientists, vaccine researchers, geriatricians, public health nurses, elder services providers and advocates together with senior housing management and activist African American and Latino residents living in public senior housing in a small east coast city. Two buildings of equal size and similar ethnic composition were randomized as intervention and control buildings. Pre and post intervention surveys were conducted in both buildings, measuring knowledge, attitudes and peer norms. Processes and outcomes were documented at four levels: Influenza Strategic Alliance (macro and exo levels), building management (meso level), building resident committee (meso level) and individual residents. The Influenza Strategic Alliance (I.S.A.) provided ongoing resources, information and vaccine; the building management provided economic and other in-kind resources and supported residents to continue flu clinics in the building. The V.I.P. Resident Committee conducted flu campaigns with flu clinics in English and Spanish. The vaccination rate in the intervention building at post test exceeded the study goal of 70% and showed a significant improvement over the control building. The intervention achieved desired outcomes at all four levels and resulted in a significant increase in influenza vaccination, and improvements in pro-vaccination knowledge, beliefs, and understanding of health consequences.
Simons, Leslie Gordon; Simons, Ronald L; Landor, Antoinette M; Bryant, Chalandra M; Beach, Steven R H
It is well known that a high-quality relationship with a romantic partner is related to a variety of positive outcomes associated with health and well-being. Establishing such relationships is an important developmental task for young adults, and past research indicates that there is a link between experiences in the family of origin and the success of later intimate relationships. It has been suggested that this association can be explained by the acquisition of social competencies (e.g., emotions, schemas, traits) that are acquired during childhood in the family of origin and, in turn, influence interaction with adult romantic partners. The current study builds on this foundation by identifying particular competencies expected to explain the association between childhood exposure to supportive and harsh parenting and later patterns of interaction with romantic partners. Specifically, we examine anger management, attachment style, hostile attribution bias, and self-control as potential mediators using prospective, longitudinal data from a sample of 345 African American young adults. Results from structural equation modeling indicate that each of the mediators in our study accounts for a significant portion of the effect of parenting on the quality of adult romantic relationships, although the constructs linking parenting to warm interactions with romantic partners are somewhat different from those that link parenting to hostile interactions with romantic partners. Even after accounting for the effect of the mediators, there is still a direct effect of parenting on both warm/loving and hostile/aggressive interactions with romantic partner. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Simons, Leslie Gordon; Simons, Ronald L.; Landor, Antoinette M.; Bryant, Chalandra M.; Beach, Steven R.H.
It is well known that a high quality relationship with a romantic partner is related to a variety of positive outcomes associated with health and well-being. Establishing such relationships is an important developmental task for young adults and past research indicates that there is a link between experiences in the family of origin and the success of later intimate relationships. It has been suggested that this association can be explained by the acquisition of social competencies (e.g., emotions, schemas, traits) that are acquired during childhood in the family of origin and, in turn, influence interaction with adult romantic partners. The current study builds on this foundation by identifying particular competencies expected to explain the association between childhood exposure to supportive and harsh parenting and later patterns of interaction with romantic partners. Specifically, we examine anger management, attachment style, hostile attribution bias, and self-control as potential mediators using prospective, longitudinal data from a sample of 345 African American young adults. Results from structural equation modeling indicate that each of the mediators in our study accounts for a significant portion of the effect of parenting on the quality of adult romantic relationships although the constructs linking parenting to warm interactions with romantic partners are somewhat different from those that link parenting to hostile interactions with romantic partners. Even after accounting for the effect of the mediators, there is still a direct effect of parenting on both warm/loving and hostile/aggressive interactions with romantic partner. Implications for theory and practice are discussed. PMID:24730381
Lucas, Rudolf; Parikh, Samip J.; Sridhar, Supriya; Guo, De-Huang; Bhagatwala, Jigar; Dong, Yutong; Caldwell, Ruth; Mellor, Andrew; Caldwell, William; Zhu, Haidong; Dong, Yanbin
Approximately 5–10% of subjects with prediabetes become diabetic every year. Inflammation is involved in the development of obesity-related type 2 diabetes (T2D). However, to date, the relationship between inflammation and prediabetes, defined by hemoglobin A1c (HbA1c) ≥ 5.7 and prediabetes. A total of 21 otherwise healthy, overweight/obese, young adult African American females with prediabetes, together with 20 matched overweight/obese controls, were selected for this study. Plasma cytokines were assessed by multiplex cytokine profiling. Plasma concentrations of interleukin (IL)-5, IL-6, IL-7, tumor necrosis factor-α (TNF-α), and granulocyte-monocyte colony-stimulating factor (GM-CSF) were significantly higher in the prediabetic group, as compared to the control group (all p prediabetic group, but failed to reach statistical significances. Upon merging both groups, HbA1c was found to be positively correlated with IFN- γ, IL-1β, IL-2, IL-5, IL-7, IL-8, TNF-α and GM-CSF. This study demonstrates elevated levels of various pro-inflammatory cytokines in overweight/obese young subjects with prediabetes, which place them at higher risk of developing T2D and cardiovascular diseases. Our data also call for further investigations in animal models and population cohorts to establish the roles of a variety of pro-inflammatory cytokines in the early development of obesity-related T2D. PMID:23769592
Coe, William H; Redmond, Leslie; Parisi, Jeanine M; Bowie, Janice V; Liu, Elizabeth Y; Ng, Tin Yee; Onyuka, Alberta M A; Cort, Marcia; Cheskin, Lawrence J
African American adults achieve smaller amounts of weight loss than their white counterparts when exposed to the same intervention and are more likely to regain weight during long-term follow-up. To identify perceived motivators, barriers, and facilitators to weight loss and behavior change among African American adults. Two focus groups were conducted between April and May 2015 at an urban community health center in Baltimore City, Maryland. A total of 13 participants took part in the discussions. Eligible participants were obese (BMI 30+) African American adults aged 21-70 who had at least one obesity-related comorbidity. Discussion questions were designed to identify the personal, social, and environmental factors that influence weight loss and behavior change among urban minority populations. Statements were first classified as a motivator, barrier, or facilitator, then divided further as a personal, social, or environmental factor influencing weight loss and behavior change. Among the findings, several novel motivators (reducing or eliminating medication, improving physical intimacy) and barriers (personal transportation, lack of access to scales) emerged that were not previously characterized in the existing literature. This study was intended to provide preliminary evidence that may be used to guide the development of innovative and culturally relevant weight-loss interventions in the future. Results are applicable to similar urban minority populations. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.
Seth, Puja; Murray, Colleen C; Braxton, Nikia D; DiClemente, Ralph J
Substance use is prevalent among African American men living in urban communities. The impact of substance use on the social, psychological, and physical health of African American men has important public health implications for families, communities, and society. Given the adverse consequences of alcohol and drug abuse within communities of color, this study evaluated the relationship between city stress, alcohol consumption, and drug use among African American men. Eighty heterosexual, African American men, 18 to 29 years old, completed psychosocial risk assessments that assessed substance use and city stress. Multiple logistic regression analyses, controlling for age, indicated that participants reporting high levels of urban stress, relative to low levels of urban stress, were more likely to report a history of marijuana use (AOR = 5.19, p = .05), history of ecstasy and/or GHB use (AOR = 3.34, p = .04), having family/friends expressing strong concerns about their illicit drug use (AOR = 4.06, p = .02), and being unable to remember what happened the night before due to drinking (AOR = 4.98, p = .01). African American men living within the confines of a stressful urban environment are at increased risk for exposure to and utilization of illicit substances. Culturally competent public health interventions for substance use/abuse should address psychological factors, such as stress and neighborhood violence.
Lincoln, Karen D; Lloyd, Donald A; Nguyen, Ann W
A common mechanism underlying premature morbidity may be accelerated biological aging as reflected by salivary telomere length (STL). This study examined the extent to which social relationships, both positive and negative, can be protective or confer risk relative to biological aging. Data from the Health and Retirement Study and multiple regression were used to examine cross-sectional associations between STL, self-reported social support, and negative interaction (e.g., conflict, criticism) with family in a nationally representative sample of African American and non-Hispanic White middle-aged and older adults (N = 4,080). Social support from family was associated with shorter STL. Negative interaction with family had no main effect on STL but interactions characterized by high social support and more frequent negative interactions were associated with longer STL. Negative interaction with family was negatively associated with STL for African Americans and Whites but the magnitude of the effect was greater for African Americans. Study findings highlight the role of social relationships in physiological deterioration among middle-aged and older adults and identify a potential mechanism whereby race is linked to accelerated biological aging. Findings highlight the importance of considering positive and negative aspects of social relationships to understand the consequences of social connections for cellular aging in diverse populations. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
Pang, Raina D; Bello, Mariel S; Liautaud, Madalyn M; Weinberger, Andrea H; Leventhal, Adam M
Prior studies have found heightened negative affect following tobacco abstinence in women compared to men. However, experimental work addressing whether these findings generalize across racial groups is scarce. The current study investigated whether race (Non-Hispanic White vs. Non-Hispanic African American) moderated gender differences in abstinence-induced negative affect and smoking behavior. Data were collected from 2010 to 2017 from two separate laboratory studies investigating experimentally manipulated tobacco abstinence. Following a baseline session, adult daily smokers (10 cigarettes per day; women: n=297, 83.8% Non-Hispanic African American; men: n=492, 86.2% Non-Hispanic African American) attended two counterbalanced lab sessions (16 hours abstinent vs. non-abstinent) and completed self-report measures of negative affect followed by a laboratory analogue smoking reinstatement task. We found a gender race interaction for several negative affect states and composite negative affect (ßs=-.12 to -.16, psNon-Hispanic White women compared to Non-Hispanic White men exhibited greater abstinence-induced increases in anger, anxiety, and composite negative affect (ßs=-.20 to -.29, psNon-Hispanic African American smokers (ßs=.00 to -.04, ps>.05). These findings suggest that negative affect during acute tobacco abstinence may be a clinically important and intervenable factor that can inform cessation interventions specifically for Non-Hispanic White women smokers. Further empirical exploration of mechanisms underlying interactions of gender and race in tobacco addiction may benefit smoking cessation efforts in Non-Hispanic African American women smokers. The current study contributes to a scant body of research examining the intersectional influence of race and gender on abstinence-induced negative affect-a central, motivationally prepotent feature of tobacco withdrawal. Using a laboratory-based design to experimentally manipulate abstinence, we provide evidence
Smith, Katherine Clegg; Bone, Lee; Clay, Eric A; Owings, Kerry; Thames, Sean; Stillman, Frances
Young adults are generally overlooked in tobacco control initiatives, even though they are critical to sustained success. African American young adults who are not in higher education or working are particularly vulnerable to harmful tobacco use, given high smoking rates and limited access to cessation services. Guided by community-based participatory research (CBPR) principles, we sought to identify program and community-level strategies to reduce tobacco use among African American young adults in Baltimore. We describe the challenges and opportunities for integrating effective tobacco control into community-based education and job training programs for unemployed young adults. As part of a longstanding community-research partnership in Baltimore, we conducted fourteen semistructured key informant interviews with leaders from city government and education and job training programs for young adults. The research design, data collection, analysis, and dissemination all included dialogue between and active contribution by both research and community partners. Interview data were structured into opportunities (mindset for change and desire for bonds with a trusted adult), challenges (culture of fatalism, tobacco as a stress reliever, and culture of tobacco use among young adults), and possible tobacco control solutions (tobacco education designed with and for program staff and participants and integration of tobacco issues into holistic program goals and policies). The emergent themes enhance our understanding of how tobacco is situated in the lives of unemployed young adults and the potential for building sustainable, community-based public health solutions.
African Americans report a greater number of modifiable risk factors, such as overweight/obesity, physical inactivity and poor dietary habits, putting them at increased risk of developing and dying from chronic diseases. These risk factors are also associated with poorer health-related quality of li...
Burton, Wanda Martin; White, Ashley N.; Knowlden, Adam P.
Background: African Americans have the highest age-adjusted rates of obesity at 48.1%. High rates of obesity contribute to the disproportionate share of chronic health conditions. In order to reduce these high rates and achieve health equity, intervention programs must address racial health disparities in culturally meaningful ways. Methods: The…
... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... youthonline . [Accessed 08/18/2017] HEALTH IMPACT OF OBESITY People who are overweight are more likely to ...
Painter, Julia E.; Wingood, Gina M.; DiClemente, Ralph J.; DePadilla, Lara M.; Simpson-Robinson, LaShun
African-American women are disproportionately affected by STIs including HIV. The Theory of Gender and Power (TGP) posits that economic exposures, including educational attainment, place women at increased risk for STIs/HIV. This study examined the association between educational attainment and vulnerability to STIs/HIV, as well as potential TGP-driven mediators of this association, among African-American women. Baseline data were assessed from an STI/HIV prevention intervention for African-American women (N=848) aged 18–29 recruited from three Kaiser Permanente Centers in Atlanta, GA. Data collection included 1) a survey of demographic, psychosocial, and behavioral measures and 2) self-collected, laboratory-confirmed vaginal swabs for STIs (trichomoniasis, chlamydia, gonorrhea, and human papillomavirus). Multiple regression analyses and multivariate mediation analyses were used to examine the association between educational attainment with a laboratory-confirmed STI and potential TGP mediators. Controlling for age and receipt of public assistance, the odds of an STI diagnosis were 73% lower among participants with a college degree or greater compared to participants who had not completed high school. There were also significant associations between educational attainment and multiple TGP mediators from the Sexual Division of Power and the Structure of Cathexis. TGP constructs did not mediate the association between educational attainment and laboratory-confirmed STI. The current study suggests that graduating from college may lead to a beneficial reduction in vulnerability to STIs/HIV among African-American women. Findings from this study support expanding structural level interventions, emphasizing both high-school and college graduation, as a means of reducing vulnerability to STIs/HIV among African-American women. PMID:22555218
MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Bruzzese, Jean-Marie; Wang, Bo; Brody, Aaron
Racial and ethnic minority youth have poorer asthma status than white youth, even after controlling for socioeconomic variables. Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity. The clinical consequences of poor asthma management include increased illness complications, excessive functional morbidity, and fatal asthma attacks. There are significant limitations in research on interventions to improve asthma management in racial minority populations, particularly minority adolescents and young adults, although illness management tends to deteriorate after adolescence during emerging adulthood, the unique developmental period beyond adolescence but before adulthood. The objective of the pilot study was to test the feasibility, acceptability, and signals of efficacy of an intervention targeting adherence to controller medication in African American youth (ages 18-29) with asthma. All elements of the protocol were piloted in a National Heart, Lung, and Blood Institute (NHLBI)-funded pilot study (1R34HL107664 MacDonell). Results suggested feasibility and acceptability of the protocol as well as proof of concept. We are now ready to test the intervention in a larger randomized clinical trial. The proposed study will include 192 African American emerging adults with moderate to severe persistent asthma and low controller medication adherence recruited from clinic, emergency department, and community settings. Half of the sample will be randomized to receive a multicomponent technology-based intervention targeting adherence to daily controller medication. The multicomponent technology-based intervention consists of 2 components: (1) 2 sessions of computer-delivered motivational interviewing targeting medication adherence and (2) individualized text messaging focused on medication adherence between the sessions. Text messages will be individualized based on ecological momentary assessment. The remaining participants will
Neuenschwander, Lauren M.; Abbott, Angela; Mobley, Amy R.
Objective: The main objective of this study was to investigate access and use of technologies such as the Internet among Indiana's low-income population. The secondary objective was to determine whether access and use of computers significantly differed by age, race, and/or education level. Methods: Data were collected from low-income adult…
Mance, Gishawn A; Mendelson, Tamar; Byrd, Benjamin; Jones, Jahon; Tandon, Darius
Adapting mental health interventions to heighten their cultural and contextual appropriateness may be critical for engaging ethnic/racial groups that have been traditionally excluded or marginalized. Community-based participatory research (CBPR) is a collaborative research approach that highlights unique strengths and expertise of those involved. Although intervention adaptations have garnered much attention there is little previous work specifically describing the adaptation process of mental health interventions using CBPR. This article summarizes the use of a CBPR approach to adapt a mental health intervention for urban adolescents and young adults disconnected from school and work, a population at elevated risk for poor mental health owing to the presence of numerous chronic stressors. We describe the process undertaken to modify the content and delivery format of an evidence-based intervention. Unique challenges of working with urban African American adolescents and young adults in a job training program are highlighted. By incorporating principles of co-learning and shared responsibility, this partnership was able to achieve positive outcomes. Our experience suggests that a CBPR approach can be used effectively to adapt a mental health intervention in collaboration with African American adolescents and emerging adults in a job training program.
Sobel, Rina M; Paasche-Orlow, Michael K; Waite, Katherine R; Rittner, Sarah S; Wilson, Elizabeth A H; Wolf, Michael S
Asthma 1-2-3 is a newly-developed low-literacy multimedia education tool designed to promote asthma self-care concepts among African American adults. An expert panel (n = 10) informed content development for the tool. The video script and storyboard imagery were shown to 30 African Americans recruited from the American Lung Association, whose reactions and comments guided further revisions. The final version was pilot tested in three diverse community settings in Chicago to determine the efficacy of Asthma 1-2-3 at improving patient understanding of asthma and its symptoms. In all, 130 adults participated in the pilot test. Knowledge scores significantly improved from pretest to posttest following presentation of the developed tool for subjects across all literacy levels (Pretest: Mean = 4.2 [SD = 1.6]; Posttest: M = 6.8 [SD = 2.0], P < 0.001). Symptom pathophysiology concepts were the least understood. Individuals with low literacy had less total knowledge score gains compared to those with marginal and adequate literacy (1.8, 2.6, and 3.2 respectively; P = 0.002). The multimedia tool significantly improved understanding of asthma. Individuals with limited literacy may require additional instruction, repeated viewing, or added tangible cues (i.e. supplementary print materials) to support knowledge retention. In general, feedback from the target population was particularly helpful in the development of the tool and its initial evaluation, and should be considered as a necessary step in the creation of other patient education materials.
Samuel-Hodge, Carmen D.; Holder-Cooper, Judith C.; Gizlice, Ziya; Davis, Gwendolyn; Steele, Sonia P.; Keyserling, Thomas C.; Kumanyika, Shiriki K.; Brantley, Phillip J.; Svetkey, Laura P.
Objective To develop and test a family-centered behavioral weight loss intervention for African American adults with type 2 diabetes. Methods In this randomized trial, dyads consisting of African American adult with overweight or obesity and type 2 diabetes (index participant) paired with a family partner with overweight or obesity, but not diagnosed with diabetes, were assigned in a 2:1 ratio to a 20-week special intervention (SI) or delayed intervention (DI) control group. The primary outcome was weight loss among index participants at 20 weeks follow-up. Results One hundred-eight participants (54 dyads – 36 (SI) and 18 (DI) dyads) were enrolled: 81% females; mean age, 51 years; mean weight,103 kg; and mean BMI, 37 kg/m2. At post-intervention, 96 participants (89%) returned for follow-up measures. Among index participants, mean difference in weight loss between groups was −5.0 kg, pfamily interactions, and dietary, physical activity, and diabetes self-care behaviors. SI family partners also had significant weight loss (−3.9 kg (SI) vs. −1.0 kg (DI) p=0.02). Conclusions A family-centered, behavioral weight loss intervention led to clinically significant short-term weight loss among family dyads. PMID:27911049
Hernandez, Daphne C; Reesor, Layton; Murillo, Rosenda
Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults. The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults. Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight. Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506). Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates. In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models. Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and
Waldersen, Brian W; Wolff, Jennifer L; Roberts, Laken; Bridges, Allysin E; Gitlin, Laura N; Szanton, Sarah L
To describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community. Secondary analysis. Participants' homes. Older adults (N=226) with disability who participated in the Community Aging in Place, Advancing Better Living for Elders trial. A 5-month, home-based, person-directed, structured program delivered by an interprofessional team: occupational therapist, registered nurse, and handyman. Process of occupational therapist goal setting and attainment at the final occupational therapist visit. Participants identified 728 functional goals (mean of 3.2 goals per participant), most commonly related to transferring (22.0%; n=160 goals), changing or maintaining body position (21.4%; n=156 goals), and stair climbing (13.0%; n=95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stair climbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, sex, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared with those without pain (adjusted odds ratio, 0.38; 95% confidence interval, 0.17-0.86). When participant readiness to change score increases by 1 point on the 4-point scale, goal attainment was 62% more likely (adjusted odds ratio, 1.62; 95% confidence interval, 1.14-2.29). Home-based collaborative goal setting between older adults and occupational therapists is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Marcela de Freitas Ferreira
Full Text Available This study aimed to assess whether physical intimate partner violence affects the nutritional status of adult women with different levels of body mass index (BMI. This was a population-based cross-sectional study with 625 women selected through complex multistage cluster sampling. Information on physical intimate partner violence was obtained with the Revised Conflict Tactics Scales, and nutritional status was measured as BMI (kg/m2. A quantile regression model was used to assess the effect of physical intimate partner violence at all percentiles of BMI distribution. Physical intimate partner violence occurred in 27.6% of the women (95%CI: 20.0; 35.2. Mean BMI was 27.9kg/m2 (95%CI: 27.1; 28.7. The results showed that physical intimate partner violence was negatively associated with BMI between the 25th and 85th percentiles, corresponding to 22.9 and 31.2kg/m2. The findings support previous studies indicating that physical intimate partner violence can reduce BMI in low-income women.
Physical access to jobs has long been identified as a barrier to employment and earnings, with prior : research identifying the spatial mismatch between suburban entry-level jobs and low-income workers. : However, existing transportation resear...
Gault, Barbara; Reichlin, Lindsey; Román, Stephanie
This report examines how efforts to understand and improve college affordability can be informed by the experiences and circumstances of low-income adults, students of color, and students with dependent children. The report discusses how the time and financial demands associated with financial independence, parenthood, and work affect a student's…
Jensen, Jakob D; King, Andy J; Guntzviller, Lisa M; Davis, LaShara A
To assess whether literacy, numeracy, and optimism are related to low-income adults' satisfaction with their healthcare provider's communication skills. Low-income adults (N=131) were recruited from seven counties in Indiana through University extension programs. To achieve research triangulation, participants were surveyed and interviewed about their communication satisfaction with health providers. Survey data revealed that four variables significantly predicted satisfaction: age, race, literacy, and optimism. Low-income adults in the current study were more critical of their healthcare provider's communication skills if they were younger, White, functionally literate, and pessimistic. Follow-up interviews confirmed this pattern and suggested it was a byproduct of patient activism. In low-income populations, communication satisfaction may be lower for groups that are traditionally active in doctor-patient interactions (e.g., younger patients, patients with higher literacy skills). Healthcare providers should be aware that older, non-White, optimistic, and literacy deficient patients report greater communication satisfaction than their younger, White, pessimistic, and functionally literate peers. Both groups may be coping with their situation, the former by withdrawing and the latter by actively pushing for a higher standard of care. Healthcare providers should continue to seek out ways to facilitate dialogue with these underserved groups. 2009 Elsevier Ireland Ltd. All rights reserved.
Hall Brown, Tyish; Mellman, Thomas A
African Americans residing in stressful urban environments have high rates of insomnia and short sleep duration, both of which are associated with adverse health outcomes. However, limited data exist that explore factors influencing inadequate sleep in this high-risk population. This study sought to evaluate the contributions of demographics, trauma, posttraumatic stress disorder (PTSD) symptoms, sleep fears, and neighborhood stress to both insomnia and short sleep in urban African American young adults. Data were analyzed from self-report measures completed by 378 participants 18-35 years of age. PTSD symptom severity and sleep fears were independently associated with insomnia severity, and sleep fears was associated with sleep duration. Results have implications for preventative health intervention strategies for urban African American young adults.
Mills, Terry L; Alea, Nicole L; Cheong, Josepha A
Depression among older adults is a major public health concern in the U.S. Yet, time and again this condition goes undiagnosed, or attributed to other causes. Despite being treatable, few individuals older than age 65 are treated for this disorder. Using a community sample of 404 African-American and Caucasian older adults, the aim of this study was to identify the sources of racial group variance in self-reports of depressive symptoms. Descriptive and multivariate analyses reveal no racial/ethnic differences in the mean level of depressive symptoms, but differences in the correlates of self-reported depression, as well as differences in the distribution of individual indicators of depressive symptoms.
Allen, Rebecca S; Phillips, Laura L; Pekmezi, Dorothy; Crowther, Martha R; Prentice-Dunn, Steven
Using protection motivation theory, we examined racial differences in intent to complete a living will, rational problem solving (e.g., information seeking), and maladaptive coping responses (i.e., wishful thinking) to a health crisis. Sixty healthy, older adults without living wills responded to written vignettes, including information about living wills as an effective coping mechanism to avoid a health crisis. Use of adaptive coping responses predicted intent to execute a living will. A significant race-by-threat interaction predicted use of rational problem solving, with Caucasians more likely to seek information in response to perceived threat in comparison with African Americans. A significant race-by-adaptive-coping interaction predicted maladaptive coping, indicating that Caucasians were more variable in their maladaptive responses. The effectiveness of health care messages regarding living wills for older adults may be enhanced by focusing on racial differences in response to perceived health threat and perceived adaptive coping information.
Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Silverman, Kenneth
Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training program for low-income, unemployed adults. Participants worked on typing and keypad programs for 7 months. Participants randomly assigned to Group A (n = 23) earned hourly and productivity pay on the typing program (productivity pay), but earned only equalized hourly pay on the keypad program (hourly pay). Group B (n = 19) participants had the opposite contingencies. Participants worked more on, advanced further on, and preferred their productivity pay program. These results show that monetary incentives can increase performance in a job-skills training program, and indicate that payment in adult education programs should be delivered contingent on performance in the training program instead of simply on attendance. © Society for the Experimental Analysis of Behavior.
Le, Huynh-Nhu; Hipolito, Maria Mananita S; Lambert, Sharon; Terrell-Hamilton, Flora; Rai, Narayan; McLean, Charlee; Kapetanovic, Suad; Nwulia, Evaristus
Major depressive disorder (MDD) is highly prevalent among HIV-infected (HIV+) individuals, and is associated with non-adherence to antiretroviral therapy (ART), and accelerated disease progression. MDD is underdiagnosed and undertreated among low-income African Americans, who are disproportionately impacted by the HIV epidemic. To improve detection and treatment of depression among African Americans living with HIV/AIDS, it is important to understand culturally and contextually relevant aspects of MDD and attitudes about mental health treatment. A focus group session was conducted with seven providers and staff at a primary care center that serves a largely African-American community heavily impacted by the HIV epidemic in Washington, DC. Data were analyzed using an inductive approach to distill prominent themes, perspectives, and experiences among participating providers. Five themes emerged to characterize the lived experiences of HIV+ African-American patients: (a) Changes in perceptions of HIV over time; (b) HIV is comorbid with mental illness, particularly depression and substance abuse; (c) Stigma is associated with both HIV and depression; (d) Existing mental health services vary and are insufficient and (e) Suggestions for optimal treatment for comorbid HIV and depression. This study reflects the views of providers from one clinic in this community. Substantial economic disadvantage, pervasive childhood adversity, limited education and limited resources jointly put members of this community at risk for acquisition of HIV and for development of depression and addictions. These contextual factors provide an important reminder that any patient-level depression identification or intervention in this community will have to be mindful of such circumstances.
Tucker, Jalie A.; Cheong, JeeWon; Chandler, Susan D.
Natural health information sources used by African-American emerging adults were investigated to identify sources associated with high and low substance-related risk. Participants (110 males, 234 females; M age = 18.9 years) were recruited using respondent-driven sampling, and structured interviews assessed substance use, sources of health…
Brody, Gene H; Yu, Tianyi; Chen, Yi-fu; Kogan, Steven M; Smith, Karen
This report addresses the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk. African American youths (M age, pretest = 17.7 years) were assigned randomly to the AIM (n = 174) or control (n = 173) group. Past 3-month alcohol use, past 6-month substance use problems, risk taking, and susceptibility cognitions were assessed at pretest and at 6.4, 16.6, and 27.5 months after pretest. Pretest assessments of parent-child conflict, affiliations with substance-using companions, and perceived racial discrimination were used to construct a contextual risk factor index. A protective stabilizing hypothesis was supported; the long-term efficacy of AIM in preventing escalation of alcohol use and substance use problems was greater for youths with higher pretest contextual risk scores. Consistent with a mediation-moderation hypothesis, AIM-induced reductions over time in risk taking and susceptibility cognitions were responsible for the AIM × contextual risk prevention effects on alcohol use and substance use problems. Training in developmentally appropriate protective parenting processes and self-regulatory skills during the transition from adolescence to emerging adulthood for rural African Americans may contribute to a self-sustaining decreased interest in alcohol use and a lower likelihood of developing substance use problems. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Research involving adolescent and young African American (AA) females has demonstrated that they face uncontrollable obstacles which can interfere with the negotiation of safer sexual behaviors. If these obstacles are perceived as uncontrollable, then these females may be at risk for the development of Learned Helplessness (LH). As the LH model predicts, if these obstacles are believed not to be in their control, it may lead to deficits in motivational or cognitive decision-making, deficits that could certainly influence their sexual risk taking behaviors. Therefore, the primary objective for this pilot study was to trial the Learned Helplessness Scale (LHS) to examine the perceptions of LH in this population. A convenience sample of 50 adolescent and young AA females between the ages of 16 and 21 were recruited from two clinics in Southeast Michigan. Scores on the LHS ranged from 20 to 57, with a mean score of 39.1 (standard deviation = 10.49). The higher range of scores in the sample demonstrates a continuum of LH among the participants in the study.
Torres, Elisa R
Few studies have examined differences in disability and comorbity among major depressive disorder (MDD), dysthymia, and double depression in African-Americans (AA). A secondary analysis was performed on AA in the National Survey of American Life. Interviews occurred 2001-2003. A four stage national area probability sampling was performed. DSM-IV-TR diagnoses were obtained with a modified version of the World Health Organization's expanded version of the Composite International Diagnostic Interview. Disability was measured by interview with the World Health Organization's Disability Assessment Schedule II. Compared to non-depressed AA, AA endorsing MDD (t=19.0, p=0.0001) and double depression (t=18.7, p=0.0001) reported more global disability; AA endorsing MDD (t=8.5, p=0.0063) reported more disability in the getting around domain; AA endorsing MDD (t=19.1, p=0.0001) and double depression (t=12.1, p=0.0014) reported more disability in the life activities domain. AA who endorsed double depression reported similar disability and comorbidities with AA who endorsed MDD. Few AA endorsed dysthymia. This was a cross-sectional study subject to recall bias. The NSAL did not measure minor depression. The current study supports the idea of deleting distinct chronic subtypes of depression and consolidating them into a single category termed chronic depression. © 2013 Elsevier B.V. All rights reserved.
Kogan, Steven M.; Lei, Man-Kit; Grange, Christina R.; Simons, Ronald L.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yi-fu
Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research,…
Jensen, Jakob D; King, Andy J; Davis, LaShara A; Guntzviller, Lisa M
To examine whether low-income adults' utilization of Internet technology is predicted or mediated by health literacy, health numeracy, and computer assistance. Low-income adults (N = 131) from the midwestern United States were surveyed about their technology access and use. Individuals with low health literacy skills were less likely to use Internet technology (e.g., email, search engines, and online health information seeking), and those with low health numeracy skills were less likely to have access to Internet technology (e.g., computers and cell phones). Consistent with past research, males, older participants, and those with less education were less likely to search for health information online. The relationship between age and online health information seeking was mediated by participant literacy. The present study suggests that significant advances in technology access and use could be sparked by developing technology interfaces that are accessible to individuals with limited literacy skills.
Sparks, Martha A.; Radnitz, Cynthia L.
Objective: To examine both unique and interactive effects of parent restrictive feeding and child disinhibited eating behavior on child body mass index (BMI) in low-income Latino and African American preschoolers. Methods: The sample included 229 parent-child pairs, the majority of whom were low-income and Latino (57%) or African American (25%).…
Molina, Kristine M.; James, Drexler
Emerging research suggests that both perceptions of discrimination and internalized racism (i.e., endorsement of negative stereotypes of one’s racial group) are associated with poor mental health. Yet, no studies to date have examined their effects on mental health with racial/ethnic minorities in the US in a single study. The present study examined: (a) the direct effects of everyday discrimination and internalized racism on risk of DSM-IV criteria of past-year major depressive disorder (MDD); (b) the interactive effects of everyday discrimination and internalized racism on risk of past-year MDD; and (c) the indirect effect of everyday discrimination on risk of past-year MDD via internalized racism. Further, we examined whether these associations differed by ethnic group membership. We utilized nationally representative data of Afro-Caribbean (N = 1,418) and African American (N = 3,570) adults from the National Survey of American Life. Results revealed that experiencing discrimination was associated with increased odds of past-year MDD among the total sample. Moreover, for Afro-Caribbeans, but not African Americans, internalized racism was associated with decreased odds of meeting criteria for past-year MDD. We did not find an interaction effect for everyday discrimination by internalized racism, nor an indirect effect of discrimination on risk of past-year MDD through internalized racism. Collectively, our findings suggest a need to investigate other potential mechanisms by which discrimination impacts mental health, and examine further the underlying factors of internalized racism as a potential self-protective strategy. Lastly, our findings point to the need for research that draws attention to the heterogeneity within the U.S. Black population. PMID:28405176
Walker, Rheeda L; Salami, Temilola K; Carter, Sierra E; Flowers, Kelci
Suicide is a public health problem for African Americans who are young and of working age. The purpose of this study was to examine mediated and moderated effects of perceived racism on suicide ideation in a community sample of 236 African American men and women. Measures of suicide ideation, depression symptoms, intrinsic/extrinsic religiosity, and perceived racism were administered. Perceived racial discrimination was directly and indirectly associated with suicide ideation. For participants who reported low levels of extrinsic religiosity, the mediated effect of perceived racism (via depression symptoms) was significant. These findings provide some insight into suicide vulnerability for specific subgroups of African Americans. © 2014 The American Association of Suicidology.
Walsh, Jennifer L; Senn, Theresa E; Carey, Michael P
Although there are established relationships between physical and mental health, few studies have explored the relationship between health behaviors and mental health over time. To explore rates of health-compromising behaviors (HCBs) and the longitudinal relationship between HCBs and depression, anxiety, and stress, five waves of data were collected over 1 year from 482 patients at an urban public health clinic (47 % female, 68 % African-American, M age = 28). Smoking (61 %), binge drinking (52 %), illegal drug use (53 %), unprotected sex with non-primary partners (55 %), and fast food consumption (71 %) were common, while consumption of fruits or vegetables (30 %) and breakfast (17 %) were rare. Cross-lagged models identified within-time associations between HCBs and depression/anxiety and stress. Additionally, depression/anxiety and stress predicted later HCBs, but HCBs did not predict later mental health. Results suggest that targeting mental health may be important to promoting improvements across multiple health behaviors.
The Adult-Adolescent Parenting Inventory (AAPI) is a 32-item inventory widely used to identify adolescents and adults at risk for inadequate parenting behaviors. It includes four subscales representing the most frequent patterns associated with abusive parenting: (a) Inappropriate Expectations; (b) Lack of Empathy; (c) Parental Value of Corporal Punishment; and (d) Parent-Child Role Reversal. Although it has been used in a variety of samples, the psychometric properties of the AAPI have not been examined in low-income single mothers. The purposes of this study were to: (a) examine the reliability and validity of the Adult-Adolescent Parenting Inventory (AAPI) in a sample of 206 low-income single mothers; (b) assess the mother's risk for inadequate parenting by comparing their AAPI subscale scores with normative subscale scores on the AAPI; (c) assess the construct validity of the AAPI by testing the hypothesis that mothers with lower AAPI scores have a higher level of depressive symptoms and lower self-esteem in comparison to mothers with higher AAPI scores; and (d) determine whether the 4-factor structure proposed by Bavolek (1984) could be replicated. AAPI scores indicated these mothers were at high risk for child abuse when compared with normative data for parents with no known history of abuse. Higher risk for abusive parenting was associated with a higher level of depressive symptoms, less education, and unemployment. The subscales, Inappropriate Expectations and Parental Value of Corporal Punishment demonstrated poor internal consistency with Cronbach's alphas of .40 and .54, respectively. Hypothesis testing supported the construct validity of the AAPI. Bavolek's 4-factor structure was not supported. A 19-item modified version of the AAPI with three dimensions was identified. This modified version of the AAPI may provide a more efficacious tool for use with low-income single mothers.
Beach, Steven R H; Lei, Man Kit; Ong, Mei Ling; Brody, Gene H; Dogan, Meeshanthini V; Philibert, Robert A
Smoking has been shown to have a large, reliable, and rapid effect on demethylation of AHRR, particularly at cg05575921, suggesting that methylation may be used as an index of cigarette consumption. Because the availability of methyl donors may also influence the degree of demethylation in response to smoking, factors that affect the activity of methylene tetrahydrofolate reductase (MTHFR), a key regulator of methyl group availability, may be of interest. In the current investigation, we examined the extent to which individual differences in methylation of MTHFR moderated the association between smoking and demethylation at cg05575921 as well as at other loci on AHRR associated with a main effect of smoking. Using a discovery sample (AIM, N = 293), and a confirmatory sample (SHAPE, N = 368) of young adult African Americans, degree of methylation of loci in the first exon of MTHFR was associated with amplification of the association between smoking and AHRR demethylation at cg05575921. However, genetic variation at a commonly studied MTHFR variant, C677T, did not influence cg05575921 methylation. The significant interaction between MTHFR methylation and the smoking-induced response at cg05575921 suggests a role for individual differences in methyl cycle regulation in understanding the effects of cigarette consumption on genome wide DNA methylation. © 2017 Wiley Periodicals, Inc.
Full Text Available Diet quality may be a unique target for preventing and managing obesity-related osteoarthritis (OA. Using the Healthy Eating Index-2010 (HEI-2010, this study examined the nutrient intake and diet quality of 400 urban overweight and obese primarily African American older adults with self-reported lower extremity OA. Associations between sociodemographic and health-related factors and diet quality were explored. Participants (mean age 67.8 years, SD 5.9 were included. Habitual dietary intake was assessed using a food frequency questionnaire (FFQ. Nutrient intake and diet quality were calculated from the FFQ. Results indicated that diet quality needs improvement (HEI-2010: 66.3 (SD 10.5. Age, body mass index, employment (multivariable model only, and OA severity (bivariate model only were significant predictors of HEI-2010 total score in linear models. Mean intakes for fiber, calcium, and vitamin D were below recommendations, while percentage of calories as total fat exceeded recommendations. These findings can inform future dietary intervention trials and public health messaging for a sub-population at a high risk for obesity-related OA.
Sommers, Benjamin D; Maylone, Bethany; Nguyen, Kevin H; Blendon, Robert J; Epstein, Arnold M
States are taking variable approaches to the Affordable Care Act (ACA) Medicaid expansion, Marketplace design, enrollment outreach, and application assistance. We surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, which expanded Medicaid, created a successful state Marketplace, and supported outreach efforts; Arkansas, which enacted the private option and a federal-state partnership Marketplace, but with legislative limitations on outreach; and Texas, which did not expand Medicaid and passed restrictions on navigators. We found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions. Application assistance from navigators and others was the strongest predictor of enrollment, while Latino applicants were less likely than others to successfully enroll. Twice as many respondents felt that the ACA had helped them as hurt them (although the majority reported no direct impact), and advertising was strongly associated with perceptions of the law. State policy choices appeared to have had major impacts on enrollment experiences among low-income adults and their perceptions of the ACA. Project HOPE—The People-to-People Health Foundation, Inc.
African American Suicide Fact Sheet Based on 2012 Data (2014) Overview • In 2012, 2,357 African Americans completed suicide in the U.S. Of these, 1,908 (80. ... rate of 9.23 per 100,000). The suicide rate for females was 1.99 per 100, ...
Keen, Larry; Turner, Arlener D.; Callender, Clive; Campbell, Alfonso
It is unknown how lifetime marijuana use affects different proinflammatory cytokines. The purpose of the current study is to explore potential differential effects of lifetime marijuana use on interleukin-1 alpha (IL-1α) and tumor necrosis factor (TNF) in a community based sample. Participants included 168 African American adults (51% female, median age= 47 years). Upon study entry, blood was drawn and the participants completed questions regarding illicit drug use history whose answers were ...
Mulry, Claire M; Papetti, Christina; De Martinis, Julian; Ravinsky, Mark
Community participation is integral to wellness. This study examined the outcomes of Let's Go, a program designed to facilitate community participation of urban-dwelling, low-income older adults. Fifty-two older adults participated in a mixed-methods, single-group pretest-posttest study. The Impact on Participation and Autonomy Questionnaire, participant surveys, and semistructured interviews were used to evaluate self-reported participation in community-based occupations, confidence, isolation, frequency of community trips, autonomy outdoors, and satisfaction with social life and relationships. Significant improvement was found in participation, confidence, frequency of community trips, autonomy outdoors, and satisfaction with social life and relationships at 4 wk and 6 mo. Qualitative themes were decreased isolation, importance of peer and community support, increased knowledge of mobility options, and a shift from fear to confidence. Community mobility programming can facilitate the participation of marginalized older adults in community-based occupations. Copyright © 2017 by the American Occupational Therapy Association, Inc.
Schenke, Katerina; Nguyen, Tutrang; Watts, Tyler W; Sarama, Julie H; Clements, Douglas H
We examined whether African American students differentially responded to dimensions of the observed classroom-learning environment compared with non-African American students. Further, we examined whether these dimensions of the classroom mediated treatment effects of a preschool mathematics intervention targeted at students from low-income families. Three observed dimensions of the classroom (teacher expectations and developmental appropriateness; teacher confidence and enthusiasm; and support for mathematical discourse) were evaluated in a sample of 1,238 preschool students in 101 classrooms. Using multigroup multilevel mediation where African American students were compared to non-African American students, we found that teachers in the intervention condition had higher ratings on the observed dimensions of the classroom compared with teachers in the control condition. Further, ratings on teacher expectations and developmental appropriateness had larger associations with the achievement of African American students than for non-African Americans. Findings suggest that students within the same classroom may react differently to that learning environment and that classroom learning environments could be structured in ways that are beneficial for students who need the most support.
Wade, Jeannette M
Previous research has demonstrated that frequent consumption of fast food is linked to obesity and that trends in both are disparate across race and sex categories. Contextualizing race- and sex-related factors that structure fast food consumption in emerging adulthood is a much-needed contribution to social research. Specifically, this study uses the "doing difference" framework, to examine the frequency of fast food consumption in a sample of White and African American (18-25 years old). According to the framework, social inequalities are reproduced through dramaturgical performances of race, class, and gender. Results of this suggest that feminine gender orientation and education serve as protective factors, while African American race and male sex serve as risk factors. African American women emerged as especially high risk given their higher prevalence of traditionally masculine traits.
Simons, Leslie Gordon; Simons, Ronald L.; Landor, Antoinette M.; Bryant, Chalandra M.; Beach, Steven R.H.
It is well known that a high quality relationship with a romantic partner is related to a variety of positive outcomes associated with health and well-being. Establishing such relationships is an important developmental task for young adults and past research indicates that there is a link between experiences in the family of origin and the success of later intimate relationships. It has been suggested that this association can be explained by the acquisition of social competencies (e.g., emo...
Chudyk, Anna M; McKay, Heather A; Winters, Meghan; Sims-Gould, Joanie; Ashe, Maureen C
Walking, and in particular, outdoor walking, is the most common form of physical activity for older adults. To date, no study investigated the association between the neighborhood built environment and physical activity habits of older adults of low SES. Thus, our overarching aim was to examine the association between the neighborhood built environment and the spectrum of physical activity and walking for transportation in older adults of low socioeconomic status. Cross-sectional data were from the Walk the Talk Study, collected in 2012. Participants (n = 161, mean age = 74 years) were in receipt of a rental subsidy for low income individuals and resided in neighbourhoods across Metro Vancouver, Canada. We used the Street Smart Walk Score to objectively characterize the built environment main effect (walkability), accelerometry for objective physical activity, and the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure walking for transportation. We used regression analyses to examine associations of objectively measured physical activity [total volume, light intensity and moderate intensity physical activity (MVPA)] and self-reported walking for transportation (any, frequency, duration) with walkability. We adjusted analyses for person- and environment-level factors associated with older adult physical activity. Neighbourhood walkability was not associated with physical activity volume or intensity and self-reported walking for transportation, with one exception. Each 10-point increase in Street Smart Walk Score was associated with a 45% greater odds of any walking for transportation (compared with none; OR = 1.45, 95% confidence interval = 1.18, 1.78). Sociodemographic, physical function and attitudinal factors were significant predictors of physical activity across our models. The lack of associations between most of the explored outcomes may be due to the complexity of the relation between the person and
Kolmodin MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Lam, Phebe; Secord, Elizabeth
To conduct a randomized controlled pilot of a multicomponent, technology-based intervention promoting adherence to controller medication in African-American emerging adults with asthma. The intervention consisted of two computer-delivered sessions based on motivational interviewing combined with text messaged reminders between sessions. Participants (N = 49) were 18-29 years old, African-American, with persistent asthma requiring controller medication. Participants had to report poor medication adherence and asthma control. Youth were randomized to receive the intervention or an attention control. Data were collected through computer-delivered self-report questionnaires at baseline, 1, and 3 months. Ecological Momentary Assessment via two-way text messaging was also used to collect "real-time" data on medication use and asthma control. The intervention was feasible and acceptable to the target population, as evidenced by high retention rates and satisfaction scores. Changes in study outcomes from pre- to postintervention favored the intervention, particularly for decrease in asthma symptoms, t (42) = 2.22, p < .05 (Cohen's d = .071). Results suggest that the intervention is feasible and effective. However, findings are preliminary and should be replicated with a larger sample and more sophisticated data analyses. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Guy, Gery P; Adams, E Kathleen; Atherly, Adam
The Patient Protection and Affordable Care Act (ACA) will substantially increase public health insurance eligibility and alter the costs of insurance coverage. Using Current Population Survey (CPS) data from the period 2000-2008, we examine the effects of public and private health insurance premiums on the insurance status of low-income childless adults, a population substantially affected by the ACA. Results show higher public premiums to be associated with a decrease in the probability of having public insurance and an increase in the probability of being uninsured, while increased private premiums decrease the probability of having private insurance. Eligibility for premium assistance programs and increased subsidy levels are associated with lower rates of uninsurance. The magnitudes of the effects are quite modest and provide important implications for insurance expansions for childless adults under the ACA.
Pooler, Jennifer A; Morgan, Ruth E; Wong, Karen; Wilkin, Margaret K; Blitstein, Jonathan L
Determine the impact of Cooking Matters for Adults (CM) on food resource management (FRM) skills and self-confidence 6 months after course completion. Quasi-experimental design with nonequivalent comparison group and 6-month follow-up. Cooking Matters for Adults programs in CA, CO, ME, MA, MI, and OR. Participants in CM attending classes in April to July, 2016 (n = 332); comparison group (n = 336). Cooking Matters for Adults educated low-income adults to shop for and prepare healthy meals economically using hands-on meal preparation, facilitated discussion, and an interactive grocery store tour. Classes met for 2 hours, once a week for 6 weeks. Food resource management practices; FRM self-confidence (ie, in shopping for and preparing healthy foods on a budget); worrying that food might run out. Pearson's chi-square test and t tests identified measures associated with outcomes of interest and between-group differences. Repeated-measures linear mixed models with fixed and random effects were used to examine differences in outcomes between participants in CM and nonequivalent comparison group and to estimate the treatment effect of the program at 3 and 6 months after course completion. Six months after course completion, CM participants demonstrated improvements in all outcome measures of interest: Use of FRM practices improved (P = .002) as did FRM confidence (P < .001). Participants also worried less that food would run out before they had money to buy more (P = .03). This study demonstrated a positive impact of including FRM skills and confidence building in a nutrition education program, the effects of which could be seen for 6 months after participation in the program. Equipping low-income families with FRM skills allowed them to access healthier foods even during times of hardship. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.
Mizell, C. Andre
Examines factors over the life course that affect levels of depression in Black men using samples of 892 African-American and 1,454 White men from the National Longitudinal Survey of Youth. Parental educational attainment is a significant negative predictor of depression. Its role and that of other identified predictors of depression are…
Lemacks, Jennifer; Wells, Brittny A; Ilich, Jasminka Z; Ralston, Penny A
The incidence of preventable chronic diseases is disproportionally high among African Americans and could be reduced through diet and physical activity interventions. Our objective was to systematically review the literature on clinical outcomes of diet and physical activity interventions conducted among adult African American populations in the United States. We used the Preferred Reporting Items for Systematic Review and Meta Analysis construct in our review. We searched Medline (PubMed and Ovid), Cochrane, and DARE databases and restricted our search to articles published in English from January 2000 through December 2011. We included studies of educational interventions with clinically relevant outcomes and excluded studies that dealt with nonadult populations or populations with pre-existing catabolic or other complicated disorders, that did not focus on African Americans, that provided no quantitative baseline or follow-up data, or that included no diet or physical activity education or intervention. We report retention and attendance rates, study setting, program sustainability, behavior theory, and education components. Nineteen studies were eligible for closer analysis. These studies described interventions for improving diet or physical activity as indicators of health promotion and disease prevention and that reported significant improvement in clinical outcomes. Our review suggests that nutrition and physical activity educational interventions can be successful in improving clinically relevant outcomes among African Americans in the United States. Further research is needed to study the cost and sustainability of lifestyle interventions. Further studies should also include serum biochemical parameters to substantiate more specifically the effect of interventions on preventing chronic disease and reducing its incidence and prevalence.
... Us Donate In This Section African Americans and Glaucoma email Send this article to a friend by ... and eventually, in developing more effective treatments. Does glaucoma treatment differ? Although treatment varies for all individuals, ...
Mehta, Sejal; West-Olatunji, Cirecie; Sanders, Tiffany; Goodman, Rachael
The purpose of this paper is to provide a strength-based discussion of the relationship between parenting values of low-income African Americans and the academic performance of their school-aged children. Using resilience theory as a framework (Seccombe, 2002), the authors suggest that African American parents in low-resourced communities have…
Uzogara, Ekeoma E.; Lee, Hedwig; Abdou, Cleopatra M.; Jackson, James S.
This study investigated perceptions of skin tone discrimination among adult African American men. Research suggests that through negative African American stereotypes, out-group members (Whites) perceive light-skinned African Americans favorably and dark-skinned African Americans unfavorably. However, it is unclear how treatment by in-group members (other African Americans) uniquely affects men. Using data from the 1995 Detroit Area Study and the 2003 National Survey of America...
Schmidt, Tanja; Kerr, Jacqueline; Kestens, Yan
Daily mobility, defined as the ability to move oneself within one's neighborhood and regions beyond, is an important construct, which affects people as they age. Having a feasible and valid measure of daily mobility is essential to understand how it affects older adults' everyday life. Given......, of which 23 wore the GPS device. Remembering to wear and charge the GPS was difficult for 48% participants, whereas remembering street names and drawing routes in VERITAS was difficult for two. Both the GPS and VERITAS were able to measure 10 out of the 13 identified components of mobility; however...
Xun, Pengcheng; Bujnowski, Deborah; Liu, Kiang; Steve Morris, J.; Guo, Zhongqin; He, Ka
Background: Data on selenium (Se) levels in American young adults, especially in African Americans, are lacking. Objective: This study presented toenail Se distributions in American young adults of both genders, including both Caucasians and African Americans; and explored potential predictors of toenail Se levels. Data and methods: Data from the Coronary Artery Risk Development in Young Adults study among 4252 American young adults, aged 20-32 in 1987 was used to examine toenail Se levels by instrumental neutron-activation analysis. The distribution of Se levels was described and multivariable linear regression was used to examine potential modifiers of toenail Se concentration within ethnicity-gender subgroups. Results: The geometric mean of toenail Se in this cohort was 0.844 μg/g (95% CI, 0.840-0.849 μg/g) and the median was 0.837 μg/g (95% CI, 0.833-0.844 μg/g). Median levels from lowest to highest quintile were 0.691, 0.774, 0.838, 0.913 and 1.037 μg/g. Se levels varied geographically, and were generally in accordance with its concentrations in local soil. Males, African Americans, current smokers, heavy drinkers and less educated participants were more likely to have low Se levels. Conclusion: This study suggests that toenail Se levels vary geographically depending on soil Se concentrations. In addition to gender, ethnicity and education level, smoking status and alcohol consumption are two important indicators of Se status since they are modifiable lifestyle factors. Findings from this study might aid public health professionals in identifying people at relatively high or low Se levels, so that chronic disease prevention efforts can be directed toward these subgroups. - Research highlights: → Average of toenail Se levels in this cohort was 0.844 μg/g (95% CI, 0.840-0.849 μg/g). → Toenail Se levels vary geographically depending on soil Se concentrations. → Males, African Americans and less educated participants have low Se levels. → Smoking
Kaiboriboon, Kitti; Schiltz, Nicholas K.; Bakaki, Paul M.; Lhatoo, Samden D.; Koroukian, Siran M.
SUMMARY Objective To examine mortality and causes of death (COD) in socioeconomically disadvantaged persons with epilepsy (PWE) in the US. Methods We performed a retrospective open cohort analysis using Ohio Medicaid claims data between 1992 and 2008 to assess mortality and COD in 68,785 adult Medicaid beneficiaries with epilepsy. Case fatality (CF), mortality rates (MRs), standardized mortality ratios (SMRs), and years of potential life lost (YPLL) were calculated. The SMRs were estimated to compare risk of death in PWE with that in the general Medicaid population with and without disabilities. Proportionate mortality ratios (PMRs), YPLLs, and SMRs for specific COD were also obtained. Results There were 12,630 deaths in PWE. CF was 18.4%, the age-race-sex adjusted MR was 18.6/1,000 person-years (95% CI, 18.3–18.9). The SMR was 1.8 (95% CI, 1.8 – 1.9) when compared to the general Medicaid population, and was 1.4 (95% CI, 1.3–1.6) when compared to those with disabilities. The average YPLL was 16.9 years (range, 1–47 years). Both epilepsy and comorbid conditions significantly contributed to premature mortality in PWE. Cardiovascular diseases, cancer, and unintentional injuries were the most common COD and account for a large proportion of YPLL. Deaths from epilepsy-related causes occurred in about 10% of the cases. Significance Socioeconomically deprived PWE, especially young adults, experience high mortality and die 17 years prematurely. The high mortality in Medicaid beneficiaries with epilepsy affirms that comorbid conditions and epilepsy play a crucial role in premature death. Management of comorbid conditions is, at a minimum, as important as epilepsy management, and therefore deserves more attention from physicians, particularly those who care for Medicaid individuals with epilepsy. PMID:25244361
James, Aimee S.; Daley, Christine M.; Greiner, K. Allen
Objectives: To explore knowledge and attitudes about colorectal cancer (CRC) screening among African American patients age 45 and older at a community health center serving low-income and uninsured patients. Methods: We conducted 7 focus groups and 17 additional semistructured interviews. Sessions were audio-recorded, transcribed, and analyzed…
Pagones, Rachel; Lee, Janet L; Hurst, Samantha
Multimorbidity is common, but often poorly managed, among the rapidly growing population of older adults. The existing guidelines followed by physicians frequently lead to polypharmacy and a complex treatment burden. The objective of this study was to explore what benefits are perceived by older adults with multimorbidity as a result of long-term, regular acupuncture treatment. A qualitative design with inductive thematic analysis of semistructured interviews. Participants were recruited from a no-cost, college-affiliated acupuncture clinic for low-income older adults in an urban, racially/ethnically diverse neighborhood in southern California. Fifteen patients aged 60 years and older suffering from at least two chronic conditions. Five themes were identified: (1) mind-body effects, (2) the enhanced therapeutic alliance, (3) what they liked best, (4) the conventional healthcare system, and (5) importance of regular schedule. A notable mind-body effect, reported by a substantial number of participants, was medication reduction. Participants also cited changes in mood, energy, and well-being as important benefits. In addition, they voiced widespread dissatisfaction with conventional healthcare. Keeping up regular treatments as a way to deal with new complaints and encourage a healthier lifestyle was seen an important aspect of care at the clinic. This cohort of older adults with multimorbidity valued acupuncture as a way to reduce medication as well as a means to maintain physical and mental health. In addition, they developed a strong trust in the clinic's ability to support the totality of their health as individuals, which they contrasted to the specialized and impersonal approach of the conventional medical clinic.
Best Al M
Full Text Available Abstract Background Since African-Americans have twice the prevalence of cytomegalovirus (CMV infections as age-matched Caucasians we sought to determine the ages and possible sources of infection of African-American children. Methods Subjects were 157 African-American healthy children and adolescents and their 113 household adults in Richmond VA. Families completed a questionnaire, provided saliva for antibody testing, and adolescents were interviewed regarding sexual activity. Results Regardless of age CMV seropositivity was not associated with gender, breast feeding, health insurance, sexual activity, or household income, education, or size. In the final regression model, prior CMV infection in adults was over two-fold higher than in children (chi-square = 18.8, p Conclusion We observed that African-American children had CMV seroprevalence rates by age 20 years at less than one-half of that of their adult mothers and caregivers. Sibling-to-sibling transmission was a likely source of CMV infections for the children. The next generation of African-American women may be highly susceptible to a primary CMV infection during pregnancy and may benefit from a CMV vaccine.
... Share Plus on Google Plus African-Americans and Alzheimer's alz.org | IHaveAlz Introduction 10 Warning Signs Brain ... African-Americans are at a higher risk for Alzheimer's disease. Many Americans dismiss the warning signs of ...
... have insurance or can’t afford treatment, your community may have publicly-funded mental health centers or programs that charge you according to ... how he found healing in an African American community. Other Resources ... Institute of Mental Health Phone Number: 301-443-4513 Toll Free Number: ...
Jackson, Linda A.; von Eye, Alexander; Biocca, Frank; Barbatsis, Gretchen; Zhao, Yong; Fitzgerald, Hiram E.
HomeNetToo is a longitudinal field study designed to examine home Internet use by low-income families in the United States. Participants were 140 children, mostly African American, whose Internet use was continuously and automatically recorded for one year. This article focuses on relationships between children's main computer activities, academic…
Full Text Available Researchers have documented culturally specific family literacy practices in which low-income families engage, which are often a function of the context in which the family is currently embedded. These practices are well documented in ethnographic literature. Although this evidence exists, its utility is limited due to small sample sizes and lack of quantitative documentation on their contribution to children’s language and literacy development. This study attempted to quantify those culturally specific family literacy practices. 51 low-income African-American mother-child dyads participated. The contribution of multiple literacy practices was examined in relation to child language and literacy outcomes. Most low-income African-American families engaged in multiple literacy practices. Recommended areas for future research directions are discussed.
Beck, Dano W; Lalota, Marlene; Metsch, Lisa R; Cardenas, Gabriel A; Forrest, David W; Lieb, Spencer; Liberti, Thomas M
Misconceptions about HIV transmission and prevention may inhibit individuals' accurate assessment of their level of risk. We used venue-based sampling to conduct a cross-sectional study of heterosexually active adults (N = 1,221) within areas exhibiting high poverty and HIV/AIDS rates in Miami-Dade and Broward counties in 2007. Two logistic regression analyses identified correlates of holding inaccurate beliefs about HIV transmission and prevention. Belief in incorrect HIV prevention methods (27.2%) and modes of transmission (38.5%) was common. Having at least one incorrect prevention belief was associated with being Hispanic compared to white (non-Hispanic), being depressed, and not knowing one's HIV status. Having at least one incorrect transmission belief was associated with being younger, heavy alcohol use, being depressed, not having seen a physician in the past 12 months, and not knowing one's HIV status. Among low-income heterosexuals, HIV prevention and transmission myths are widespread. Debunking them could have HIV prevention value.
Tandon, S Darius; Latimore, Amanda D; Clay, Eric; Mitchell, Lois; Tucker, Margaret; Sonenstein, Freya L
Recent estimates indicate that 6.5 million adolescents and young adults in the United States are neither in school nor working. These youth have significant mental health concerns that require intervention. To determine whether a mental health intervention, integrated into an employment training program that serves adolescents and young adults disconnected from school and work, can reduce depressive symptoms and improve engaged coping strategies. A quasi-experimental study was conducted; 512 adolescents and young adults newly enrolling in one employment training program site were intervention participants, while 270 youth from a second program site were enrolled as controls. Participants were aged 16 to 23 years and not in foster care. Study recruitment took place from September 1, 2008, to May 31, 2011, with follow-up data collection occurring for 12 months after recruitment. Propensity score matching adjusted for observed baseline differences between the intervention and control groups. Depressive symptoms measured on a Center for Epidemiologic Studies Depression Scale (CES-D) and engaged coping strategies. The mean age of participants was 19 years, 93.7% were African American, and 49.4% were male. Six- and 12-month follow-up rates were 61.0% (n = 477) and 56.8% (n = 444), respectively. Males in the intervention group with high baseline depressive symptoms exhibited a statistically significant decrease in depressive symptoms at 12 months (5.64-point reduction in CES-D score; 95% CI, -10.30 to -0.96; P = .02) compared with similar males in the control group. A dosage effect was observed at 12 months after the intervention, whereby males with greater intervention exposure showed greater improvement in depressive symptoms compared with similar males with lower intervention doses (effect on mean change in CES-D score, -3.37; 95% CI, -6.72 to -0.09; P = .049). Males and females in the intervention group were more likely than participants in the control group to
Broaddus, Michelle; Dickson-Gomez, Julia
Qualitative and quantitative research was used to create the Uses of Texting in Sexual Relationships scale. At-risk, predominantly African American emerging adults participated in qualitative interviews (N = 20) and quantitative surveys (N = 110) about their uses of text messaging within romantic and sexual relationships. Exploratory factor analysis of items generated from interviews resulted in four subscales: Sexting, Relationship Maintenance, Relationship Development, and Texting for Sexual Safety. Exploratory analyses indicated associations of Sexting with more instances of condomless sex, and Texting for Sexual Safety with fewer instances of condomless sex, which was moderated by relationship power. Further research on the connections between text messaging in relationships and sexual behavior among high-risk and minority young adults is warranted, and intervention efforts to decrease sexual risks need to incorporate these avenues of sexual communication. PMID:27710089
Broaddus, Michelle; Dickson-Gomez, Julia
Qualitative and quantitative research was used to create the Uses of Texting in Sexual Relationships scale. At-risk, predominantly African American emerging adults participated in qualitative interviews (N = 20) and quantitative surveys (N = 110) about their uses of text messaging within romantic and sexual relationships. Exploratory factor analysis of items generated from interviews resulted in four subscales: Sexting, Relationship Maintenance, Relationship Development, and Texting for Sexual Safety. Exploratory analyses indicated associations of Sexting with more instances of condomless sex, and Texting for Sexual Safety with fewer instances of condomless sex, which was moderated by relationship power. Further research on the connections between text messaging in relationships and sexual behavior among high-risk and minority young adults is warranted, and intervention efforts to decrease sexual risks need to incorporate these avenues of sexual communication.
Olivo, Robert E; Davenport, Clemontina A; Diamantidis, Clarissa J; Bhavsar, Nrupen A; Tyson, Crystal C; Hall, Rasheeda; Bidulescu, Aurelian; Young, Bessie; Mwasongwe, Stanford E; Pendergast, Jane; Boulware, L Ebony; Scialla, Julia J
African Americans are at high risk for chronic kidney disease (CKD). Obesity may increase the risk for CKD by exacerbating features of the metabolic syndrome and promoting glomerular hyperfiltration. Whether other factors also affecting these pathways may amplify or mitigate obesity-CKD associations has not been investigated. We studied interactions between obesity and these candidate factors in 2043 African Americans without baseline kidney disease enrolled in the Jackson Heart Study. We quantified obesity as body mass index (BMI), sex-normalized waist circumference and visceral adipose volume measured by abdominal computed tomography at an interim study visit. Interactions were hypothesized with (i) metabolic risk factors (dietary quality and physical activity, both quantified by concordance with American Heart Association guidelines) and (ii) factors exacerbating or mitigating hyperfiltration (dietary protein intake, APOL1 risk status and use of renin-angiotensin system blocking medications). Using multivariable regression, we evaluated associations between obesity measures and incident CKD over the follow-up period, as well as interactions with metabolic and hyperfiltration factors. Assessed after a median of 8 years (range 6-11 years), baseline BMI and waist circumference were not associated with incident CKD. Higher visceral adipose volume was independently associated with incident CKD (P = 0.008) in a nonlinear fashion, but this effect was limited to those with lower dietary quality (P = 0.001; P-interaction = 0.04). In additional interaction models, higher waist circumference was associated with greater risk of incident CKD among those with the low-risk APOL1 genotype (P = 0.04) but not those with a high-risk genotype (P-interaction = 0.02). Other proposed factors did not modify obesity-CKD associations. Higher risks associated with metabolically active visceral adipose volume and interactions with dietary quality suggest
Jung, Seung Eun; Shin, Yeon Ho; Kim, Sunyoung; Hermann, Janice; Bice, Crystal
Identify underlying salient behavioral, normative, and control beliefs about fruit and vegetable (F&V) consumption among limited-income older adults. The Theory of Planned Behavior (TPB) was used as the framework for conducting semistructured individual interviews in 2016. Two congregate meal sites in the city of Tuscaloosa, AL. A total of 25 low-income older adults aged ≥60 years. Behavioral, normative, and control beliefs about F&V intake. All interviews were audiotaped and transcribed verbatim. Data were analyzed using a hybrid inductive and deductive content analysis approach. The elicitation interviews identified salient behavioral, normative, and control beliefs about F&V intake among low-income older adults. These results can be used to develop nutrition education programs aimed at improving economically vulnerable older adults' F&V intake. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Elmasry, Hoda; Webb Hooper, Monica; Niaura, Raymond S; Hamilton, Alison B; Milburn, Norweeta G
Background Recent evidence suggests that sexualized text communication (“sexting”) is associated with substance use and sexual risk behaviors among young adults, yet little is known about this relationship among young adult African American gay and bisexual men, a population disproportionately impacted by HIV in the United States. Rapid advances in mobile phone technology indicate a clear need for research using mobile health (mHealth) methods such as ecological momentary assessment (EMA) to serve as a viable counterpart to retrospective evaluation methods by using real-time data collection to assess sexting and substance use among this population. Objective The objective of this pilot study was to (1) describe the EMA study design and protocol, (2) characterize the study population, and (3) assess the feasibility of a random prompt text message-based thrice-daily EMA over 14 days, as a means of prospectively studying sexting, marijuana, and alcohol use among a sample of young adult African American gay and bisexual men ages 21 to 25. Methods Participants were recruited through flyers and snowball sampling during spring and summer 2015 at a community-based HIV/AIDS prevention, care, and support organization in Washington, DC. Eligible participants were enrolled in a one-time in-person study visit that consisted of informed written consent to participate in the study, a self-administered survey, a semi-structured interview, and enrollment and training in EMA data collection. Commencing the day after the study visit, a random prompt survey was texted to participants on their personal mobile phones 3 times a day over a 14-day data collection period assessing mood, texts sent, texts received, sexts sent, sexts received, marijuana want, marijuana use, and alcohol use. Results EMA feasibility was tested with 25 self-identified African American gay (n=16) and bisexual (n=9) men (mean age of 23.48 years, SD 1.5). Each random prompt survey had 8 questions with responses
Sweeney, Allison M; Wilson, Dawn K; Lee Van Horn, M
Engaging in regular physical activity (PA) as an older adult has been associated with numerous physical and mental health benefits. The aim of this study is to directly compare how individual-level cognitive factors (self-efficacy for PA, self-determined motivation for PA, self-concept for PA) and neighborhood perceptions of the social factors (neighborhood satisfaction, neighborhood social life) impact moderate-to-vigorous physical activity (MVPA) longitudinally among older African American adults. Data were analyzed from a sub-set of older African American adults (N = 224, M age = 63.23 years, SD = 8.74, 63.23% female, M Body Mass Index = 32.01, SD = 7.52) enrolled in the Positive Action for Today's Health trial. MVPA was assessed using 7-day accelerometry-estimates and psychosocial data (self-efficacy for PA, self-determined motivation for PA, self-concept for PA, neighborhood satisfaction, neighborhood social life) were collected at baseline, 12-, 18-, and 24-months. Multilevel growth modeling was used to examine within- and between-person effects of individual-level cognitive and social environmental factors on MVPA. At the between-person level, self-concept (b = 0.872, SE = 0.239, p self-concept (b = 0.294, SE = 0.145, p = 0.043) and neighborhood social life (b = 0.270, SE = 0.113, p = 0.017) were associated with increased MVPA. These results suggest that people with a higher average self-concept for PA and a more positive social life engaged in greater average MVPA. Additionally, changes in perceptions of one's neighborhood social life and one's self-concept for PA were associated with greater MVPA over 2 years. These factors may be particularly relevant for future interventions targeting long-term change and maintenance of MVPA in older African Americans. ClinicalTrials.Gov # NCT01025726 registered 1 December 2009.
Roberts, Megan E; Colby, Suzanne M; Lu, Bo; Ferketich, Amy K
Compared to the majority of non-Hispanic white ("white") cigarette smokers, many African American smokers demonstrate a later age of initiation. The goal of the present study was to examine African American late-onset smoking (ie, regular smoking beginning at age 18 or later) and determine whether late-onset (vs. early-onset) smoking is protective in terms of quit rates and health outcomes. We used data from the National Survey of Midlife Development in the United States (MIDUS) because the wide age range of participants (20-75 at baseline) allowed the examination of smoking cessation and mortality incidence across the lifespan. Consistent with previous research, results indicated a later average age of smoking onset among African Americans, compared to whites. Disentangling effects of race from age-of-onset, we found that the cessation rate among late-onset African American smokers was 33%, whereas rates for early-onset African American smokers and early- and late-onset white smokers ranged from 52% to 57%. Finally, results showed that among white, low-socioeconomic status (SES) smokers, the hazard rate for mortality was greater among early- versus late-onset smokers; in contrast, among African American smokers (both low- and high-SES) hazard rates for mortality did not significantly differ among early- versus late-onset smokers. Although late (vs. early) smoking onset may be protective for whites, the present results suggest that late-onset may not be similarly protective for African Americans. Tobacco programs and regulatory policies focused on prevention should expand their perspective to include later ages of initiation, in order to avoid widening tobacco-related health disparities. This study indicates that late-onset smoking is not only the norm among African American adult smokers, but that late- versus early-onset smoking (ie, delaying onset) does not appear to afford any benefits for African Americans in terms of cessation or mortality. These results
McNeal, Gloria J
The purpose of this investigation, using case study methodology, was to explore the end of life issues and to give meaning to the biopsychosocial experiences of the study participant, an adult African American female patient diagnosed with Cystic Fibrosis. Two theoretical frameworks were used to guide the investigation of the study: Kubler-Ross Model of the Stages of Dying and the Conceptual Framework for Palliative Care Practice. Data analysis included review of medical records and patient journals, interviews, observations and clinical assessment. The findings indicated that end of life issues can be articulated within the context of a palliative care framework and that the biopsychosocial experiences of the dying person acquire meaning when situated within life history, ethical values and metaphysical belief systems.
Hodgson, Eric J.; Collier, Charlene; Hayes, Laura; Curry, Leslie; Fraenkel, Liana
Background Significant racial disparities exist in the US unplanned pregnancy rate. We conducted a qualitative study using the theory of planned behavior as a framework to describe how low-income, African-American women approach family planning. Study Design Structured focus groups were held with adult, low-income, non-pregnant, African-American women in Connecticut. Data were collected using a standardized discussion guide, and audio-taped and transcribed. Four, independent researchers coded the transcripts using the constant comparative method. Codes were organized into over-arching themes. Results Contraceptive knowledge was limited with formal education often occurring after sexual debut. Attitudes about contraception were overtly negative with method effectiveness being judged by the experience of side effects. Family and friends strongly influence contraceptive decisions while male partners are primarily seen as a barrier. Contraceptive pills are perceived as readily accessible although compliance is considered a barrier. Conclusions Contraception education should occur before sexual debut, should involve trusted family and community members, and should positively frame issues in terms of achieving life goals. PMID:23177266
Bragg, Marie A.; Tucker, Carolyn M.; Kaye, Lily B.; Desmond, Frederic
Background: Obesity rates are rising in the United States, especially among low-income and racial/ethnic minority individuals. Exploring motivators and barriers relative to engaging in physical activity is imperative. Purpose: The purpose of this study was to identify motivators and barriers relative to engagement in physical activity as reported…
People of Color Rising up and Speaking out: Oppression and Knowledge Production. Proceedings for the Annual African American & Latino/a American Adult Education Research Symposium (11th, Chicago, Illinois, April 6, 2002).
Garth, Phyllis Ham, Ed.
This document contains 14 papers from an annual symposium on research in adult education for African Americans and Latin Americans. Representative papers include the following: "Congressman Adam Clayton Powell Jr., Keeping the Faith and Representing the Race--From the Pulpit to Politics" (Roudell Kirkwood); "Religious Education and…
Sanders, Kay E.; Deihl, Amy; Kyler, Amy
This paper presents a qualitative analysis concerning child care practices by six African American directors of subsidized child care centers located in a low-income, racial ethnic minority area of Los Angeles, California. These programs are traditionally African American programs that experienced an influx of Latino immigrant enrollment. Using…
This program was designed to provide Acquired Immune Deficiency Syndrome (AIDS) prevention education for African-American women of child bearing age at a child care center which serves low income high risk families. The primary goal was to reduce the risk of African-American women at the child care center for contracting the Human Immunodeficiency…
Hoehn, Jessica L.; Riekert, Kristin A.; Borrelli, Belinda; Rand, Cynthia S.; Eakin, Michelle N.
Objective: To identify barriers and motivators for reducing secondhand smoke exposure (SHSe) for families of African-American, low-income, urban children. Method: Audiotaped intervention sessions of 52 African-American caregivers of Head Start children who reported being a smoker and/or had at least one smoker in the home were randomly sampled…
Otto-Salaj, Laura L.; Reed, Barbara; Brondino, Michael J.; Gore-Felton, Cheryl; Kelly, Jeffrey A.; Stevenson, L. Yvonne
Little research has been performed on how people respond to different strategies to negotiate condom use in sexual situations, and whether certain strategies tend to be perceived as more or less effective in condom use negotiation. This study examined gender differences and preferences in the use of and response to six different styles of condom use negotiation with a hypothetical sexual partner of the opposite gender. Participants were 51 heterosexually-active African-American men and women between the ages of 18 and 35, attending an inner-city community center. Study participants completed a semi-structured qualitative interview in which they were presented with six negotiation strategies —coercive, reward, legitimate, expert, referent, and informational--based on Raven’s 1992 Power/Interaction Model of Interpersonal Influence. Results showed that women participants responded best to referent, reward, and legitimate strategies, and worst to informational tactics. Men participants responded best to reward strategies, and worst to coercion to use condoms. Further, responses given by a subset of both women—and, to a greater extent, men--indicated that use of negotiation tactics involving coercion to use condoms may result in negative or angry reactions. Finally, response to strategies may vary with the value of the relationship as viewed by the target of negotiation. Implications for HIV prevention programs and media campaigns are discussed. PMID:18569536
Model, S; Fisher, G
In this research we use 1990 PUMS data to compare the propensity for unions between African Americans and native whites with the propensity for unions between British West Indians and native whites. In addition, we distinguish women and men. Descriptive statistics indicate that West Indians, with the exception of men who arrived as adults, are more likely than African Americans to have white partners. After the introduction of controls for several correlates of intermarriage, however, West Indian men of any generation have lower exogamy rates than African American men, while exogamy rates are higher among West Indian women who arrived as children or who were born in the United States than among African American women. Thus we find no consistent evidence of greater exogamy for British West Indians than for African Americans.
Cheref, Soumia; Talavera, David; Walker, Rheeda L
Suicide is a leading cause of death for vulnerable ethnic minority emerging adults in the United States (Web-based injury statistics query and reporting system [WISQARS], 2015). Perceived discrimination (Journal of Youth and Adolescence, 40, 2011, 1465) and anxiety symptoms (Asian American Journal of Psychology, 1, 2010, 18) are two predictors that are theoretically and conceptually related, but have yet to be examined in a simultaneous model for suicide ideation. Existing theory and research suggest that these variables activate similar pathways (American Behavioral Scientist, 51, 2007, 551). This study sought to address this gap in the literature by examining the simultaneous relationship between perceived discrimination and anxiety symptoms as predictors of suicide ideation. The moderating effect of anxiety symptoms on the relationship between perceived discrimination and suicide ideation was examined in a multiethnic sample of emerging adults. Results indicated that anxiety symptoms moderated the perceived discrimination-suicide ideation relationship for Hispanic emerging adults, but not for their Asian American and African American counterparts. Furthermore, ethnic identity has been shown to mitigate suicide risk in the face of other stressors (Cultural Diversity and Ethnic Minority Psychology, 14, 2008, 75). Ethnic identity emerged as a protective factor for Hispanic emerging adults by further interacting with perceived discrimination and anxiety symptoms to negatively predict suicide ideation. The implications of these findings are discussed. © 2018 The American Association of Suicidology.
Stephens, T; Braithwaite, R L; Taylor, S E
Currently little attention has been directed, with the exception of peer education efforts, to constructively develop new and innovative ways to promote HIV/AIDS primary prevention among African American (AA) adolescents and young adults. With this in mind, the aim of this conceptual effort is to present a HIV/AIDS preventive counseling protocol developed for use with AA young adults that makes use of hip-hop music, a form of music popularized by young AAs. The author contend that an increased understanding of the relationships that many AA young adults have with hip-hop music may be used by disease prevention personnel to educate these populations about protective factors for HIV. Making use of hip-hop music is one strategy for integrating counseling in prevention and health maintenance. The overall implications of using hip-hop music in health promotion are unlimited. First, this method makes use of cultural relevant materials to address the educational and health needs of the target community. Second, it is grounded in an approach that serves to stimulate cooperative learning based on peer developed content. Moreover, the use of this medium can be applied to other health promotion activities such as violence/harm reduction and substance abuse prevention, upon reviews of songs for appropriate content. The authors contend that such an approach holds heuristic value in dealing with HIV/AIDS prevention among AA young adults. Additional testing of the intervention is warranted in the refinement of this innovative intervention.
Adrian Garcia Mosqueira MA
Full Text Available The Affordable Care Act (ACA expanded Medicaid eligibility to adults with incomes under 138% of the federal poverty level, leading to substantial reductions in uninsured rates among low-income adults. Despite large gains in coverage, studies suggest that Latinos may be less likely than other racial/ethnic groups to apply and enroll in health insurance, and they remain the group with the highest uninsured rate in the United States. We explore two potential factors related to racial/ethnic differences in ACA enrollment—awareness of the law and receipt of application assistance such as navigator services. Using a survey of nearly 3000 low-income U.S. citizens (aged 19-64 in 3 states in late 2014, we find that Latinos had significantly lower levels of awareness of the ACA relative to other groups, even after adjusting for demographic covariates. Higher education was the strongest positive predictor of ACA awareness. In contrast, Latinos were much more likely to receive assistance from navigators or social workers when applying, relative to other racial/ethnic groups. Taken together, these results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations, two groups that are overrepresented in the Latino population, to close existing disparities in coverage.
Tauriac, Jesse J.; Scruggs, Natoschia
Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…
Lemacks, Jennifer L; James, Robert E; Abbott, Laurie; Choi, Hwanseok; Parker, Ashley; Bryant, Ashley; Ralston, Penny A; Rigsby, Annither Gilner; Gilner, Patricia
Churches are effective community partners and settings to address weight management among African Americans. There is limited information on the use of churches to reach young adult populations and church collaborations with primary care clinics. The Church Bridge Project represents a community-academic partnership that presents the recruitment process of a church-based weight management intervention and describes baseline data of participants recruited from churches and primary care providers. We also discuss research contributions, challenges and limitations, study applicability, and practice implications from an academic and community perspective. Church leaders were involved in the entire research process. The theory-driven intervention included 12 diabetes prevention program-adapted education and motivational interviewing (MI)-guided sessions. Participants were recruited through primary care providers and church leaders. Demographics, medical and weight history, stage of change for weight loss, social support, and self-efficacy for diet and physical activity, weight, and girth circumferences were measured. Baseline descriptive data were analyzed. Of 64 potential participants, 42 (65.6%) were enrolled in the study and 16 (25.0%) completed baseline data collection. No participants were recruited through primary care providers. Recruited participants were similar to the target population except for being all obese and mostly female. The mean ± SD age of participants was 34.31 ± 8.86 years with most reporting having more than a high school education (n = 14 [87.5%]), individual yearly income of less than $59,000 (n = 12 [75.0%]), and been married or living with a partner (n = 9 [56.3%]). Most reported a history of hypertension and an immediate family history of diabetes and hypertension. Most participants were classified as class III obesity. Young adults and primary care providers are difficult to engage in church-based interventions. Church leaders were
Smiley, Sabrina L; Elmasry, Hoda; Webb Hooper, Monica; Niaura, Raymond S; Hamilton, Alison B; Milburn, Norweeta G
Recent evidence suggests that sexualized text communication ("sexting") is associated with substance use and sexual risk behaviors among young adults, yet little is known about this relationship among young adult African American gay and bisexual men, a population disproportionately impacted by HIV in the United States. Rapid advances in mobile phone technology indicate a clear need for research using mobile health (mHealth) methods such as ecological momentary assessment (EMA) to serve as a viable counterpart to retrospective evaluation methods by using real-time data collection to assess sexting and substance use among this population. The objective of this pilot study was to (1) describe the EMA study design and protocol, (2) characterize the study population, and (3) assess the feasibility of a random prompt text message-based thrice-daily EMA over 14 days, as a means of prospectively studying sexting, marijuana, and alcohol use among a sample of young adult African American gay and bisexual men ages 21 to 25. Participants were recruited through flyers and snowball sampling during spring and summer 2015 at a community-based HIV/AIDS prevention, care, and support organization in Washington, DC. Eligible participants were enrolled in a one-time in-person study visit that consisted of informed written consent to participate in the study, a self-administered survey, a semi-structured interview, and enrollment and training in EMA data collection. Commencing the day after the study visit, a random prompt survey was texted to participants on their personal mobile phones 3 times a day over a 14-day data collection period assessing mood, texts sent, texts received, sexts sent, sexts received, marijuana want, marijuana use, and alcohol use. EMA feasibility was tested with 25 self-identified African American gay (n=16) and bisexual (n=9) men (mean age of 23.48 years, SD 1.5). Each random prompt survey had 8 questions with responses including yes/no and Likert scale
Sullivan, Samaah M; Brashear, Meghan M; Broyles, Stephanie T; Rung, Ariane L
To examine possible associations between perceived neighborhood environments and obesity among a U.S. nationally representative sample of Afro-Caribbean, African American, and Non-Hispanic white adults. Data was used from the 2001-2003 National Survey of American Life (NSAL). All measures including neighborhood characteristics, height, and weight were self-reported. Multivariate logistic regression was used to compute odds ratios (ORs) of obesity (body mass index (BMI) ≥ 30 kg/m(2)) based on perceived neighborhood physical and social characteristics. The odds of obesity were significantly lower for adults who reported involvement in clubs, associations, or help groups (odds ratio (OR): 0.62; 95% confidence interval (CI): 0.44, 0.85) and perceived that they had a park, playground, or open space in their neighborhood (odds ratio (OR): 0.68; 95% confidence interval (CI): 0.47, 0.98). These associations remained significant after adjusting for leisure-time physical activity. Race/ethnicity appeared to modify the association between involvement in clubs, associations, or help groups and obesity. Providing parks, playgrounds, or open space or increasing the perception of those amenities may assist in the prevention of obesity, especially in ethnically diverse neighborhoods in the United States. More research is needed to investigate how perceptions of the neighborhood environment influence obesity and whether perceptions of the neighborhood environment differ between individuals within the same neighborhoods. Copyright © 2014 Elsevier Inc. All rights reserved.
Bergdall, Anna R; Kraft, Joan Marie; Andes, Karen; Carter, Marion; Hatfield-Timajchy, Kendra; Hock-Long, Linda
Communication technology is a central feature of young people's lives, but its role in romantic and sexual relationships has not been thoroughly examined. This article describes how young adults use communication technology for partnering across relationship stages (formation, maintenance, and dissolution) and types (serious/casual), and proposes implications of usage in relationships. This study analyzed qualitative data from a five-week, prospective, coital diary method with related debriefing interviews (N = 70) of African American and Puerto Rican men and women aged 18 to 25 years in Hartford and Philadelphia. Cell phones, including calls, text messaging, and mobile Internet, were the most common forms of communication technology used for partnering goals. Participants reported using cell phones to pursue partnering goals across all relationship stages, including formation (meeting, screening, and getting to know new partners), maintaining existing relationships, and breaking up. Cell phone uses depended on the type of relationship (serious/casual) and the participants' intentions and desires. Results indicated that cell phones are an important element of communication among young adults in romantic and sexual relationships. Specific features of cell phone communication shape the process and context of partnering. Future research should explore emerging communication technologies and implications for psychosocial development, dating violence, and sexual behavior.
Woda, Aimee; Haglund, Kristin; Belknap, Ruth Ann; Sebern, Margaret
African Americans have a higher risk of developing heart failure (HF) than persons from other ethnic groups. Once diagnosed, they have lower rates of HF self-care and poorer health outcomes. Promoting engagement in HF self-care is amenable to change and represents an important way to improve the health of African Americans with HF. This study used a community-based participatory action research methodology called photovoice to explore the practice of HF self-care among low-income, urban, community dwelling African Americans. Using the photovoice methodology, themes emerged regarding self-care management and self-care maintenance.
López, Ivette A; Boston, Patricia Q; Dutton, Matthew; Jones, Chauneva Glenn; Mitchell, M Miaisha; Vilme, Helene
To explore causal explanations of obesity among African-American women of diverse weight across the life spectrum. In-depth interviews were conducted with adult African-American women of healthy weight (N = 10), overweight (N = 10), and obese weight (N = 20) to evaluate the relationship between causal explanations of obesity and weight. Generally overlooked dimensions of health definitions were discovered. Differences in weight definitions were detected between women of different weights. Terminology, symptoms, and solutions to obesity were detected between the women of different weights and public health recommendations. Identified causal discrepancies will help bridge the disconnection between public health recommendations and African-American women's perceptions with tailored interventions.
Cleveland, Michael J; Turrisi, Rob; Gibbons, Frederick X; Gerrard, Meg; Marzell, Miesha
We examined how mothers' protective parenting and alcohol use influenced changes in offspring's heavy drinking among a sample of African American youth. The conceptual model also tested indirect effects of mothers' behaviors, through changes in the youths' social images (i.e., prototypes) of heavy drinkers, derived from the prototype willingness (PW) model. Participants were 686 emerging adults (55% female) from the Family and Community Health Study (FACHS), an ongoing prospective study of African American families. Three waves of FACHS data were used as follows: T3 during 10th grade (M age = 16.3 years), T4 shortly after high school (M age = 19.4 years), and T5 3 years later (M age = 22.1 years). Mothers' self-reports of protective parenting and alcohol use were assessed at T4. Two separate path models tested the study hypotheses. The first model specified direct and indirect effects of mothers' protective parenting and alcohol use. The second model added interaction terms between the protective parenting behaviors and mothers' alcohol use. The analyses were first conducted using the full sample and then repeated separately for female and male participants. Maternal alcohol use had a positive and direct effect on offspring's alcohol use. Mothers' endorsement of alcohol-related rules inhibited normative increases in the favorability of the offspring's social image of heavy drinkers (prototype) while her warmth was positively related to these increases. Maternal alcohol use amplified the positive association between mothers' warmth and the daughters' increased drinking. For sons, maternal alcohol use increased the positive association between alcohol-related rules and increased prototype favorability. Results indicated clear gender differences in how mothers' behaviors influence her offspring's alcohol use during the transition to emerging adulthood. Interventions that target culturally specific risk and protective factors within the family environment are
Siriwardhana, Dhammika D; Hardoon, Sarah; Rait, Greta; Weerasinghe, Manuj C; Walters, Kate R
To systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs. Systematic review and meta-analysis. PROSPERO registration number is CRD42016036083. MEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017. Low-income and middle-income countries. Community-dwelling older adults aged ≥60 years. We screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I 2 =99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I 2 =97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years. The prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries. CRD42016036083. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Sterling, K; Fryer, C; Pagano, I; Jones, D; Fagan, P
Flavour additives in cigarettes and little cigars and cigarillos (LCCs), which influence smokers' risk perceptions, may reinforce dual flavoured tobacco use. We examined the association among mentholated cigarette use, risk perceptions for flavour additives in LCCs and flavoured LCC smoking behaviour. Data from a national probability sample of 964 young and middle-aged adult current cigarette smokers were analysed. Multinomial logistic regression models examined the relationship among mentholated cigarette smoking, risk perceptions and current flavoured LCC use for the analytic sample and gender and race/ethnicity. Daily menthol cigarette smokers, compared to occasional, non-menthol smokers, had increased odds of flavoured LCC smoking (OR=1.75, 95% CI 1.02 to 2.98). This relationship was found for males, blacks/African-Americans and Hispanics/Latinos (psmokers, specifically those from vulnerable populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Hanson, Karla L; Kolodinsky, Jane; Wang, Weiwei; Morgan, Emily H; Pitts, Stephanie B Jilcott; Ammerman, Alice S; Sitaker, Marilyn; Seguin, Rebecca A
This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2-12 y in a summer CO-CSA were surveyed online twice: August 2015 ( n = 41) and February 2016 ( n = 23). FVI was measured by the National Cancer Institute's (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to United States (US) recommendations and averages, and across seasons, were tested with non-parametric tests and paired t -tests ( p < 0.05). Both adults and children in the CO-CSA had higher FVI than the US averages, and more often met recommendations for vegetables. Some summer fruits and vegetables were more often eaten when locally in-season. The CO-CSA model warrants further examination as an avenue for improving vegetable consumption among adults and children in low-income households. However, causality between CO-CSA participation and FVI cannot be inferred, as CO-CSA participants may be positive deviants with respect to FVI. A multi-state randomized controlled trial is currently underway to evaluate impacts of CO-CSAs on FVI and related outcomes.
Lamis, Dorian A; Wilson, Christina K; Shahane, Amit A; Kaslow, Nadine J
Although there is an association between experiencing childhood emotional abuse and feeling hopeless as an adult, it is critical to understand the factors that may be protective in this relationship. The goal of this study was to determine if two protective factors, namely spiritual well-being, including both religious and existential well-being, and positive self-esteem, served to mediate the association between childhood emotional abuse and adult hopelessness. The sample for this investigation was low-income African American women suicide attempters who were abused by a partner in the prior year (N=121). A path analysis revealed that in this sample, the childhood emotional abuse-hopelessness link was mediated by existential well-being and positive self-esteem, as well as by the two-mediator path of emotional abuse on existential well-being on self-esteem on hopelessness. Results suggested that existential well-being may be a more salient protective factor for hopelessness than religious well-being among abused, suicidal African American women who experienced childhood emotional abuse. Findings highlight the value of culturally relevant strategies for enhancing existential well-being and self-esteem in this at-risk population to reduce their vulnerability to feelings of hopelessness. Copyright © 2013 Elsevier Ltd. All rights reserved.
Choi, Jihea; Choi, Jung A
The purpose of the current study was to investigate the relationships among leisure competence, level of leisure activity, and life satisfaction in low-income older adults in rural South Korea. A sample of 137 older adults answered the study questionnaire, and significant differences in leisure competence were noted depending on age, religion, and perceived health status as well as level of leisure activity based on perceived health status and type of leisure activities. There were also notable differences in life satisfaction regarding religion and perceived health status, and a correlation among leisure competence, level of leisure activity, and life satisfaction; the influencing power of leisure competence and level of leisure activity on life satisfaction was 47%. The findings suggest that enhancement of older adults' leisure competence may increase participation in leisure activities. [Res Gerontol Nurs. 2017; 10(2):67-75.]. Copyright 2017, SLACK Incorporated.
Smith, Lindsey P; Ng, Shu Wen; Popkin, Barry M
We examined the effects of state-level unemployment rates during the recession of 2008 on patterns of home food preparation and away-from-home (AFH) eating among low-income and minority populations. We analyzed pooled cross-sectional data on 118 635 adults aged 18 years or older who took part in the American Time Use Study. Multinomial logistic regression models stratified by gender were used to evaluate the associations between state-level unemployment, poverty, race/ethnicity, and time spent cooking, and log binomial regression was used to assess respondents' AFH consumption patterns. High state-level unemployment was associated with only trivial increases in respondents' cooking patterns and virtually no change in their AFH eating patterns. Low-income and racial/ethnic minority groups were not disproportionately affected by the recession. Even during a major economic downturn, US adults are resistant to food-related behavior change. More work is needed to understand whether this reluctance to change is attributable to time limits, lack of knowledge or skill related to food preparation, or lack of access to fresh produce and raw ingredients.
Nollen, Nicole L; Cox, Lisa Sanderson; Yu, Qing; Ellerbeck, Edward F; Scheuermann, Taneisha S; Benowitz, Neal L; Tyndale, Rachel F; Mayo, Matthew S; Ahluwalia, Jasjit S
African-Americans smoke fewer cigarettes per day than Whites but experience greater smoking attributable morbidity and mortality. African-American-White differences may also exist in cessation but rigorously designed studies have not been conducted to empirically answer this question. Quit2Live is, to our knowledge, the first head-to-head trial designed with the primary aim of examining African-American-White disparities in quitting smoking. Secondary aims are to identify mechanisms that mediate and/or moderate the relationship between race and quitting. The study is ongoing. Study aims are accomplished through a 5-year prospective cohort intervention study designed to recruit equal numbers of African-Americans (n=224) and Whites (n=224) stratified on age (White disparities in quitting smoking exist but, more importantly, will examine mechanisms underlying the difference. Attention to proximal, modifiable mechanisms (e.g., adherence, response to treatment, depression, stress) maximizes Quit2Live's potential to inform practice. Findings will provide an empirically-derived approach that will guide researchers and clinicians in identifying specific factors to address to improve cessation outcomes and reduce tobacco-related morbidity and mortality in African-American and White smokers. ClinicalTrials.gov: NCT01836276. Copyright © 2015 Elsevier Inc. All rights reserved.
The purpose of this empirical study was to explore the lived experiences of African American retired female teachers who have prior experience with educating urban African American students in public schools. Also explored are the experiences of active African American female teachers of urban African American students and comparisons are…
DiNitto, Diana M
Background Internet technology can provide a diverse array of online resources for low-income disabled and homebound older adults to manage their health and mental health problems and maintain social connections. Despite many previous studies of older adults’ Internet use, none focused on these most vulnerable older adults. Objective This study examined Internet use patterns, reasons for discontinued use, eHealth literacy, and attitudes toward computer/Internet use among low-income homebound individuals aged 60 and older in comparison to their younger counterparts—homebound adults under age 60. Methods Face-to-face or telephone surveys were conducted with 980 recipients of home-delivered meals in central Texas (78% were age 60 years and older and 22% under age 60). The eHealth Literacy Scale (eHEALS) and the efficacy and interest subscales of the Attitudes Toward Computer/Internet Questionnaire (ATC/IQ) were used to measure the respective constructs. Age groups were compared with chi-square tests and t tests. Correlates of Internet use were analyzed with multinomial logistic regression, and correlates of eHEALS and ATC/IQ scores were analyzed with OLS regression models. Results Only 34% of the under-60 group and 17% of the 60 years and older group currently used the Internet, and 35% and 16% of the respective group members reported discontinuing Internet use due to cost and disability. In addition to being older, never users were more likely to be black (OR 4.41; 95% CI 2.82-6.91, PInternet every day or every few days, and their eHEALS scores were negatively associated with age and positively associated with frequency of use. Among the 60 and older group, a depression diagnosis was also negatively associated with eHEALS scores. ATC/IQ efficacy among never users of all ages and among older adults was positively associated with living alone, income, and the number of medical conditions and inversely associated with age, Hispanic ethnicity, and Spanish as the
Areán, Patricia A; Raue, Patrick J; McCulloch, Charles; Kanellopoulos, Dora; Seirup, Joanna K; Banerjee, Samprit; Kiosses, Dimitris N; Dwyer, Eleanor; Alexopoulos, George S
To test the following hypotheses: (1) Clinical case management integrated with problem-solving therapy (CM-PST) is more effective than clinical case management alone (CM) in improving functional outcomes in disabled, impoverished patients and (2) improvement in depression, self-efficacy, and problem-solving skills mediates improvement of disability. Using a randomized controlled trial with a parallel design, 271 individuals were screened and 171 were randomized to 12 weekly sessions of either CM or CM-PST at 1:1 ratio. Raters were blind to patients' assignments. Participants were at least age 60 years with major depression, had at least one disability, were eligible for home-based meals services, and had income no more than 30% of their counties' median. The WHO Disability Assessment Scale was used. Both interventions resulted in improved functioning by 12 weeks (t = 4.28, df = 554, p = 0.001), which was maintained until 24 weeks. Contrary to hypothesis, CM was noninferior to CM-PST (one-sided p = 0.0003, t = -3.5, df = 558). Change in disability was not affected by baseline depression severity, cognitive function, or number of unmet social service needs. Improvements in self efficacy (t = -2.45, df = 672, p = 0.021), problem-solving skill (t = -2.44, df = 546, p = 0.015), and depression symptoms (t = 2.25, df = 672, p = .025) by week 9 predicted improvement in function across groups by week 12. CM is noninferior to CM-PST for late-life depression in low-income populations. The effect of these interventions occur early, with benefits in functional status maintained as long as 24 weeks after treatment initiation (clinicaltrials.gov; NCT00540865). Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Demerath, Ellen W; Lutsey, Pam L; Monda, Keri L; Linda Kao, Wen Hong; Bressler, Jan; Pankow, James S; North, Kari E; Folsom, Aaron R
Physical inactivity accentuates the association of variants in the FTO locus with obesity-related traits but evidence is largely lacking in non-European populations. Here we tested the hypothesis that physical activity (PA) modifies the association of the FTO single-nucleotide polymorphism (SNP) rs9939609 with adiposity traits in 2,656 African Americans (AA) (1,626 women and 1,030 men) and 9,867 European Americans (EA) (5,286 women and 4,581 men) aged 45-66 years in the Atherosclerosis Risk in Communities (ARIC) study. Individuals in the lowest quintile of the sport activity index of the Baecke questionnaire were categorized as low PA. Baseline BMI, waist circumference (WC), and skinfold measures were dependent variables in regression models testing the additive effect of the SNP, low PA, and their interaction, adjusting for age, alcohol use, cigarette use, educational attainment, and percent European ancestry in AA adults, stratified by sex and race/ethnicity. rs9939609 was associated with adiposity in all groups other than AA women. The SNP × PA interaction was significant in AA men (P ≤ 0.002 for all traits) and EA men (P ≤ 0.04 for all traits). For each additional copy of the A (risk) allele, WC in AA men was higher in those with low PA (β(lowPA): 5.1 cm, 95% confidence interval (CI): 2.6-7.5) than high PA (β(highPA): 0.7 cm, 95% CI: -0.4 to 1.9); P (interaction) = 0.002). The interaction effect was not observed in EA or AA women. FTO SNP × PA interactions on adiposity were observed for AA as well as EA men. Differences by sex require further examination.
Fanelli Kuczmarski, Marie; Cotugna, Nancy; Pohlig, Ryan T; Beydoun, May A; Adams, Erica L; Evans, Michele K; Zonderman, Alan B
Stress affects health-related quality of life through several pathways, including physiological processes and health behaviors. There is always a relationship between stress (the stimulus) and coping (the response). The relationship between snacking and snackers' diet quality and stress coping is a topic overlooked in research. The study was primarily designed to determine whether energy provided by snacks and diet quality were associated with coping behaviors to manage stress. We analyzed a baseline cohort of the Healthy Aging in Neighborhoods of Diversity across the Life Span study (2004 to 2009). The sample was composed of 2,177 socioeconomically diverse African-American and white adults who resided in Baltimore, MD. Energy from snacks was calculated from 2 days of 24-hour dietary recalls collected using the US Department of Agriculture's Automated Multiple Pass Method. Snack occasions were self-reported as distinct eating occasions. Diet quality was evaluated by the Healthy Eating Index-2010. Multiple regression analyses were used to determine whether coping factors were associated with either energy provided by snacks or Healthy Eating Index-2010, adjusting for age, sex, race, socioeconomic status, education, literacy, and perceived stress. Coping was measured by the Brief COPE Inventory with instrument variables categorized into three factors: problem-focused coping, emotion-focused coping, and use of support. Perceived stress was measured with the 4-item Perceived Stress Scale. Adjusting for perceived stress and selected demographic characteristics, emotion-focused coping strategies were associated with greater energy intakes from snacks (P=0.020), and use of coping strategies involving support was positively associated with better diet quality (P=0.009). Energy contributed by snacks and diet quality were affected by the strategy that an individual used to cope with stress. The findings suggest that health professionals working with individuals seeking
Greer, Tawanda M.; Laseter, Adrian; Asiamah, David
The present study tested gender as a moderator of the relationship between race-related stress and mental health symptoms among African American adults. Because African American women are exposed to stressors associated with race and gender, we hypothesized that African American women would have higher levels of race-related stress and more severe…
Gfroerer, Joe; Kuramoto, S. Janet; Ali, Mir; Woodward, Albert M.; Teich, Judith
Objectives. We designed this study to examine differences in receipt of mental health treatment between low-income uninsured nonelderly adults with serious mental illness (SMI) who were eligible for Medicaid under the Affordable Care Act (ACA) and their existing Medicaid counterparts. Assessing these differences might estimate the impact of the Medicaid expansion efforts under the ACA on receipt of mental health treatment among uninsured nonelderly adults with SMI. Methods. We examined data from 2000 persons aged 18 to 64 years who participated in the 2008 to 2013 National Survey on Drug Use and Health, had income below 138% of the federal poverty level, met SMI criteria, and either were uninsured (n = 1000) or had Medicaid-only coverage (n = 1000). We defined SMI according to the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act. We used descriptive analyses and logistic regression modeling. Results. In the 28 states currently expanding Medicaid, the model-adjusted prevalence (MAP) of receiving mental health treatment among Medicaid-only enrollees with SMI (MAP = 71.3%; 95% confidence interval [CI] = 65.74%, 76.29%) was 30.1% greater than their uninsured counterparts (MAP = 54.8%; 95% CI = 48.16%, 61.33%). In the United States, the MAP of receiving mental health treatment among Medicaid-only enrollees with SMI (MAP = 70.4%; 95% CI = 65.67%, 74.70%) was 35.9% higher than their uninsured counterparts (MAP = 51.8%; 95% CI = 46.98%, 56.65%). Conclusions. Estimated increases in receipt of mental health treatment because of enrolling in Medicaid among low-income uninsured adults with SMI might help inform planning and implementation efforts for the Medicaid expansion under the ACA. PMID:25790424
Davis, Lindsey T; Weiss, Nicole H; Tull, Matthew T; Gratz, Kim L
Few studies have examined correlates of deliberate self-harm (DSH) among African-Americans. Moreover, most research on the correlates of DSH in general has focused on risk factors rather than protective factors. This study examined differences in perceived social support, religiosity (both spirituality and church attendance) and overall life satisfaction between African-Americans with and without a history of DSH, as well as the moderating roles of gender and sexual orientation in these relations. Participants were 244 African-American university students who completed questionnaires. Participants with (vs. without) DSH reported significantly lower levels of social support. Additionally, rates of DSH were significantly higher among participants who attended church irregularly versus regularly or rarely/never. However, the association between DSH and church attendance was significant only for women (vs. men) and LGBQ (vs. heterosexual) women. Further, gender moderated the relation between DSH and social support from both significant others and friends, with self-harming women (but not men) reporting less support than their non-DSH counterparts. Findings add to the literature on DSH among African-Americans, highlighting both social support and church attendance (depending on regularity) as potential protective factors within this population.
Barton, Allen W; Beach, Steven R H; Lavner, Justin A; Bryant, Chalandra M; Kogan, Steven M; Brody, Gene H
Enhancing communication as a means of promoting relationship quality has been increasingly questioned, particularly for couples at elevated sociodemographic risk. In response, the current study investigated communication change as a mechanism accounting for changes in relationship satisfaction and confidence among 344 rural, predominantly low-income African American couples with an early adolescent child who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program. Approximately 9 months after baseline assessment, intent-to-treat analyses indicated ProSAAF couples demonstrated improved communication, satisfaction, and confidence compared with couples in the control condition. Improvements in communication mediated ProSAAF effects on relationship satisfaction and confidence; conversely, neither satisfaction nor confidence mediated intervention effects on changes in communication. These results underscore the short-term efficacy of a communication-focused, culturally sensitive prevention program and suggest that communication is a possible mechanism of change in relationship quality among low-income African American couples.
Hammack, Phillip L.; Robinson, W. LaVome; Crawford, Isiaah; Li, Susan T.
We examined the role of family stress as a mediator of the relationship between poverty and depressed mood among 1,704 low-income, inner-city African-American adolescents. Nearly half of participants (47%) reported clinically significant levels of depressive symptoms. Being female, reporting higher levels of family stress, and scoring higher on a…
Williams, Joseph M.; Bryan, Julia
This qualitative multicase research study identified the home, school, and community factors and processes that contributed to the academic success of 8 urban, African American high school graduates from low-income, single-parent families. Ten main themes emerged: school-related parenting practices, personal stories of hardship, positive…
Adelabu, Detris Honora
This study examined the relationship of academic achievement to time perspective (future, present) and school membership (belonging, acceptance, rejection) among 232 low-income, urban African American adolescents. Findings indicated positive, significant relationships among academic achievement, future time perspective, school belonging, and…
Adelabu, Detris Honora
This study examines the relationship of academic achievement to future time perspective (FTP), hope, and ethnic identity among low-income, rural and urban African American adolescents ( N = 661). Findings indicate that adolescents who are oriented toward the future, determined to reach their goals (hope), and interested in and have a strong sense…
The use of mobile technologies has been proposed for increasing access and designing innovative educational activities. Unfortunately, there is limited data on the current uses of cellular phones amongst low-income African American youth. In particular, there is little known about how this population may design on the rapidly adapting technology,…
Webb, Jenny; Morris, Melanie Hall; Thomas, Sandra P; Combs-Orme, Terri
The purpose of this descriptive qualitative study was to gain understanding of perceptions of low-income pregnant women and mothers about parenting. Participants were 65 low-income, primarily African American, women in their 20s and 30s who were recruited from a faith-based social service center in Memphis, Tennessee. Interviews were conducted by nursing, social work, and psychology students. The existential phenomenological method was used to analyze verbatim responses of participants to vignettes depicting parenting behaviors of hypothetical mothers. Five global themes were identified: (a) Focus on baby's development: "Because I'm the Mother, I'm the First Teacher"; (b) Focus on baby's safety/security: "The Baby Could Be Hurt"; (c) Focus on conveying love: "She Just Wants the Baby to Feel Her Love"; (d) Focus on learning the rules of good childcare: "It's Important to Know the Do's and Don'ts"; and (e) Focus on doing it differently (better) than parents did: "When You Know Better, You Do Better." Findings suggest that these mothers care deeply about providing a better life for their children than the life they have had. They desire to learn about being the best parents they can be. As nurses, we can help to provide educational opportunities for mothers through a variety of evidence-based interventions delivered across the childbearing years.
Whitfield, Keith E.; Wiggins, Sebrina A.
Examined the influence of educational desegregation on cognitive performance. Data from African American adults who had attended desegregated (DS) versus segregated (SS) schools indicated that DS adults had significantly higher mean cognitive scores than SS adults. After controlling for age, gender, years of education, and years in desegregated…
Reisine, S; Schensul, J J; Goldblatt, R; Radda, K; Foster-Bey, C; Acosta-Glynn, C; Miron-Carcamo, L; Ioannidou, E
This paper describes the results of a bi-level intervention, using a cognitive-behavioral theoretical approach, to improve the oral hygiene of older adults and the disabled in community-based low income senior housing. The bi-level pilot intervention consisted of an on-site tailored adapted motivational interviewing (AMI) session and two oral health fairs, supported by a resident campaign committee, to change community norms. All materials were available in English and Spanish. Participants completed a survey consisting of 12 domains that provided the basis for tailoring the AMI and shaping the campaigns. The domains were activities of daily living (ADLs), access to oral health information, oral hygiene status, dental knowledge, hygiene behaviors, importance of oral hygiene, self-efficacy/locus of control, diet, intentions, self-management worries/fears, perceived risk and dry mouth. Each participant received clinical assessments consisting of full-mouth plaque score (PS) and gingival index (GI) before the intervention and at three months. Twenty-seven residents with at least one tooth completed all phases of the study. The mean number of domains requiring attention was 4.5 (SD 1.6) with a range of one to seven. Mean baseline PS was 83% (SD 16%) which improved significantly to 58% (SD 31%); mean baseline GI was 1.15 (SD 0.61) and improved significantly to 0.49 (SD 0.46). This pilot study supports the feasibility and acceptability of a tailored oral hygiene intervention among older and disabled adults living in low income senior housing. Although a small sample, the study demonstrated significant improvements in both plaque and gingival scores three months after the bi-level intervention.
McDaniel, Tyler C; Wilson, Dawn K; Coulon, Sandra M; Hand, Gregory A; Siceloff, E Rebekah
African Americans have the highest rate of obesity in the United States relative to other ethnic minority groups. Bioecological factors including neighborhood social and physical environmental variables may be important predictors of weight-related measures specifically body mass index (BMI) in African American adults. Baseline data from the Positive Action for Today's Health (PATH) trial were collected from 417 African American adults. Overall a multiple regression model for BMI was significant, showing positive associations with average daily moderate-to-vigorous physical activity (MVPA) (B =-.21, Psocial interaction (B =-.13, Psocial interaction was associated with healthier BMI, highlighting it as a potential critical factor for future interventions in underserved, African American communities.
Parham, Groesbeck P; Scarinci, Isabel C
Low-income African Americans who live in rural areas of the Deep South are particularly vulnerable to diseases associated with unhealthy energy imbalance. The Centers for Disease Control and Prevention (CDC) has suggested various physical activity strategies to achieve healthy energy balance. Our objective was to conduct formal, open-ended discussions with low-income African Americans in the Mississippi Delta to determine 1) their dietary habits and physical activity levels, 2) their attitudes toward CDC's suggested physical activity strategies, and 3) their suggestions on how to achieve CDC's strategies within their own environment. A qualitative method (focus groups) was used to conduct the study during 2005. Prestudy meetings were held with African American lay health workers to formulate a focus group topic guide, establish inclusion criteria for focus group participants, select meeting sites and times, and determine group segmentation guidelines. Focus groups were divided into two phases. All discussions and focus group meetings were held in community centers within African American neighborhoods in the Mississippi Delta and were led by trained African American moderators. Phase I focus groups identified the following themes: overeating, low self-esteem, low income, lack of physical exercise, unhealthy methods of food preparation, a poor working definition of healthy energy balance, and superficial knowledge of strategies for achieving healthy energy balance. Phase 2 focus groups identified a preference for social support-based strategies for increasing physical activity levels. Energy balance strategies targeting low-income, rural African Americans in the Deep South may be more effective if they emphasize social interaction at the community and family levels and incorporate the concept of community volunteerism.
Mersky, Joshua P; Janczewski, Colleen E; Nitkowski, Jenna C
It is well established that exposure to a greater number of adverse childhood experiences (ACEs) increases the risk of poor physical and mental health outcomes. Given the predictive validity of ACE scores and other cumulative risk metrics, a similar measurement approach may advance the study of risk in adulthood. We examined the prevalence and interrelations of 10 adverse adult experiences, including household events such as intimate partner violence and extrafamilial events such as crime victimization. We also tested the relation between cumulative adult adversity and later mental health problems, and we examined whether adult adversity mediates the link between childhood adversity and mental health. Data were collected from 501 women in the Families and Children Thriving Study, a longitudinal investigation of low-income families that received home visiting services in Wisconsin. We conducted correlation analyses to assess interrelations among study measures along with multivariate analyses to test the effects of childhood and adult adversity on three outcomes: depression, anxiety, and posttraumatic stress disorder (PTSD). We then fit a structural equation model to test whether the effects of childhood adversity on mental health are mediated by adult adversity. Over 80% of participants endorsed at least one adverse adult experience. Adult adversities correlated with each other and with the mental health outcomes. Controlling for ACEs and model covariates, adult adversity scores were positively associated with depression, anxiety, and PTSD scores. Path analyses revealed that the ACE-mental health connection was mediated by adult adversity. Our findings indicate that mental health problems may be better understood by accounting for processes through which early adversity leads to later adversity. Pending replication, this line of research has the potential to improve the identification of populations that are at risk of poor health outcomes. Copyright © 2018
Choi, Namkee G; Dinitto, Diana M
Internet technology can provide a diverse array of online resources for low-income disabled and homebound older adults to manage their health and mental health problems and maintain social connections. Despite many previous studies of older adults' Internet use, none focused on these most vulnerable older adults. This study examined Internet use patterns, reasons for discontinued use, eHealth literacy, and attitudes toward computer/Internet use among low-income homebound individuals aged 60 and older in comparison to their younger counterparts-homebound adults under age 60. Face-to-face or telephone surveys were conducted with 980 recipients of home-delivered meals in central Texas (78% were age 60 years and older and 22% under age 60). The eHealth Literacy Scale (eHEALS) and the efficacy and interest subscales of the Attitudes Toward Computer/Internet Questionnaire (ATC/IQ) were used to measure the respective constructs. Age groups were compared with chi-square tests and t tests. Correlates of Internet use were analyzed with multinomial logistic regression, and correlates of eHEALS and ATC/IQ scores were analyzed with OLS regression models. Only 34% of the under-60 group and 17% of the 60 years and older group currently used the Internet, and 35% and 16% of the respective group members reported discontinuing Internet use due to cost and disability. In addition to being older, never users were more likely to be black (OR 4.41; 95% CI 2.82-6.91, Pincomes (OR 0.36; 95% CI 0.27-0.49, Pincomes. Among both age groups, approximately three-fourths of the current users used the Internet every day or every few days, and their eHEALS scores were negatively associated with age and positively associated with frequency of use. Among the 60 and older group, a depression diagnosis was also negatively associated with eHEALS scores. ATC/IQ efficacy among never users of all ages and among older adults was positively associated with living alone, income, and the number of medical
Maria Cecília Sobral
Full Text Available At affluent markets, the literature on product development management tells us to aggregate value and technology, to differentiate products and to launch fast. And at the low-income markets? This exploratory research defines a popular product, characterizes and measures their markets in Brazil, and identifies innovation strategies for them. The results suggest that the effective strategic orientation differs from affluent markets. It includes: to enhance the auto service component; to identify and service the key functionalities to the targeted public; to standardize products and increase the production scale; to extend the product life cycle; to use convenient distribution and marketing channels; to build product images that have appeal in the popular market; to offer longer financing horizons with befittingly lower installments. Data came from market researches and general demographic census. General media published stories were used to identify companies and their strategies. And a few case studies allowed the authors a deeper exploration of the relevant themes.
Keith, Judith B.; And Others
Examined sexual activity and contraception among urban, low-income African-American adolescent female clients who were not sexually active (n=50), sexually active/noncontracepting (n=20), or sexually active/contracepting (n=72). Not sexually active group was younger, more career motivated, had father at home, was more influenced by family values,…
Coley, Rebekah Levine; Lombardi, Caitlin McPherran
This study assessed whether previous findings linking early maternal employment to lower cognitive and behavioral skills among middle-class and White children generalized to other groups. Using a representative sample of urban, low-income, predominantly African American and Hispanic families ("n" = 444), ordinary least squares regression…
Ghazarian, Sharon R.; Roche, Kathleen M.
The current study examined the role of engaged parenting in explaining longitudinal associations between maternal perceptions of social network support and whether youth engage in delinquent behaviors during the transition into adolescence. The sample included 432 low-income, African American and Latino youth (49% female) and their mothers…
Whiteside-Mansell, Leanne; Bradley, Robert H.; McKelvey, Lorraine
We examined the impact of parenting behaviors on preschool children's social development in low-income families from three cultural groups: European American (n = 286), African American (n = 399), and Hispanic American (n = 164) using Spanish as the primary language in the home. Observed parenting behaviors of stimulation, responsivity, and…
Lucchetti, Giancarlo; Lucchetti, Alessandra L G; Peres, Mario F Prieto
The use of religious behaviors to alleviate the consequences of stressful life circumstances is a frequent strategy employed by pain sufferers. Specifically in the field of headache research, to date, few studies have assessed spiritual and religious beliefs. The objective of this article is to investigate the relation between religiousness (organizational, non-organizational and intrinsic) and headache disorders in a representative sample of adults living in a low-income community. This was a cross-sectional, population-based study. In 2005, we conducted door-to-door interviews with 439 people, aged more than 18 years, randomly selected from a low-income community in Brazil. Four regression models were created to explain the relationships between religious involvement and headache, controlling for demographics, depression/anxiety and alcohol use and smoking. Of the 439 households contacted, at least one member from 383 (87.2%) households participated. We interviewed more women (74.4%) and more subjects aged 18-39 years. The mean age was 41.7 (SD 8.5) years. Bivariate analysis shows that high religious attendance, non-organizational religiousness and intrinsic religiousness were associated with presence of headache and presence of migraine. After the logistic regression models, only high non-organizational religiousness remained associated with presence of headache (odds ratio (OR): 1.22 (1.01-1.49)). All other religious variables were unrelated to the presence of headache and its types. There is a modest relationship between high non-organizational religiousness and presence of headache. Headache sufferers may use coping strategies such as private religious behaviors to try to overcome suffering. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Engel, L; Chudyk, A M; Ashe, M C; McKay, H A; Whitehurst, D G T; Bryan, S
The built environment and social cohesion are increasingly recognized as being associated with older adults' quality of life (QoL). However, limited research in this area still exists and the relationship has remained unexplored in the area of Metro Vancouver, Canada. This study examined the association between the built environment and social cohesion with QoL of 160 community-dwelling older adults (aged ≥ 65 years) on low income from Metro Vancouver. Cross-sectional data acquired from the Walk the Talk (WTT) study were used. Health-related QoL (HRQoL) and capability wellbeing were assessed using the EQ-5D-5L and the ICECAP-O, respectively. Measures of the environment comprised the NEWS-A (perceived built environment measure), the Street Smart Walk Score (objective built environment measure), and the SC-5PT (a measure of social cohesion). The primary analysis consists of Tobit regression models to explore the associations between environmental features and HRQoL as well as capability wellbeing. Key findings indicate that after adjusting for covariates, older adults' capability wellbeing was associated with street connectivity and social cohesion, while no statistically significant associations were found between environmental factors and HRQoL. Our results should be considered as hypothesis-generating and need confirmation in a larger longitudinal study. Copyright © 2016 Elsevier Ltd. All rights reserved.
ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? African Americans in the U.S. have a higher prevalence of high blood pressure (HBP) than ...
This 60 second public service announcement is based on the May 2017 CDC Vital Signs report. The life expectancy of African Americans has improved, but it's still an average of four years less than whites. Learn what can be done so all Americans can have the opportunity to pursue a healthy lifestyle.
Feinberg, A; Lopez, P M; Wyka, K; Islam, N; Seidl, L; Drackett, E; Mata, A; Pinzon, J; Baker, M R; Lopez, J; Trinh-Shevrin, C; Shelley, D; Bailey, Z; Maybank, K A; Thorpe, L E
To guide targeted cessation and prevention programming, this study assessed smoking prevalence and described sociodemographic, health, and healthcare use characteristics of adult smokers in public housing. Self-reported data were analyzed from a random sample of 1664 residents aged 35 and older in ten New York City public housing developments in East/Central Harlem. Smoking prevalence was 20.8%. Weighted log-binomial models identified to be having Medicaid, not having a personal doctor, and using health clinics for routine care were positively associated with smoking. Smokers without a personal doctor were less likely to receive provider quit advice. While most smokers in these public housing developments had health insurance, a personal doctor, and received provider cessation advice in the last year (72.4%), persistently high smoking rates suggest that such cessation advice may be insufficient. Efforts to eliminate differences in tobacco use should consider place-based smoking cessation interventions that extend cessation support beyond clinical settings.
Barker, Gary; Loewenstein, Irene
Qualitative research with 127 low-income young men and women, aged 14 to 30, in Rio de Janeiro found rigid gender roles with males displaying widespread "machista" attitudes (an exaggerated deep structure of masculinity) and acceptance of violence against women that was greater in low-income urban areas. Implications for working with…
McDougall, Graham J.; Holston, Ezra C.; Wilke, Pat
A total of 218 adults with an average age of seventy-eight years participated in a study of memory performance in community elders. A computer-generated random zip code list of adults ≥70 years of age was purchased and a four-phase telephone-screening plan was adopted. During the second year, the sampling plan had to be changed, with a convenience-sampling plan being adopted to recruit adequate numbers of African-American subjects. Fifty-seven percent of the African-American subjects (N = 55)...
Blow, Frederic C; Walton, Maureen A; Bohnert, Amy S B; Ignacio, Rosalinda V; Chermack, Stephen; Cunningham, Rebecca M; Booth, Brenda M; Ilgen, Mark; Barry, Kristen L
To examine efficacy of drug brief interventions (BIs) among adults presenting to a low-income urban emergency department (ED). Randomized controlled trial on drug use outcomes at 3, 6 and 12 months. Participants were assigned to (1) computer-delivered BI (Computer BI), (2) therapist-delivered, computer-guided BI (Therapist BI) or (3) enhanced usual care (EUC-ED) for drug-using adults. Participants were re-randomized after the 3-month assessment to either adapted motivational enhancement therapy (AMET) booster or enhanced usual care booster (EUC-B). Patients recruited from low-income urban emergency departments (ED) in Flint, Michigan, USA. A total of 780 ED patients reporting recent drug use, 44% males, mean age = 31 years. Computer BI consisted of an interactive program guided by a virtual health counselor. Therapist BI included computer guidance. The EUC-ED conditions included review of community health and HIV prevention resources. The BIs and boosters were based on motivational interviewing, focusing on reduction of drug use and HIV risk behaviors. Primary outcome was past 90 days using drugs at 6 and 12 months and secondary outcomes were weighted drug-days and days of marijuana use. Percentage changes in mean days used any drug from baseline to 12 months were: Computer BI + EUC-B: -10.9%, P = 0.0844; Therapist BI + EUC-B: -26.7%, P = 0.0041, for EUC-ED + EUC-B: -20.9, P = 0.0011. In adjusted analyses, there was no significant interaction between ED intervention and booster AMET for primary and secondary outcomes. Compared with EUC-ED, Therapist BI reduced number of days using any drug [95% confidence interval (CI) = -0.41, -0.07, P = 0.0422] and weighted drug-days (95% CI = -0.41, -0.08, P = 0.0283). Both Therapist and Computer BI had significantly fewer number of days using marijuana compared to EUC-ED (Therapist BI: 95% CI = -0.42, -0.06, P = 0.0104, Computer BI: 95% CI = -0.34, -0.01, P = 0.0406). Booster effects were not
Zvolensky, Michael J; Paulus, Daniel J; Bakhshaie, Jafar; Garza, Monica; Manning, Kara; Lemaire, Chad; Reitzel, Lorraine R; Smith, Lia J; Ochoa-Perez, Melissa
One social determinant of health construct that is reliably related to health disparities among the Latino population is subjective social status, reflecting subjective ratings of social standing. Yet, little research has explored factors that may undergird variability in subjective social status among this population or in general. Accordingly, the present investigation examined one possible etiological model wherein age moderates the relation between individual differences in anxiety sensitivity (fear of the negative consequences of stress sensations) and subjective social status among a Latino primary care sample. Participants included Spanish-speaking Latino adults (n = 394; 86.5% female; average age = 39.0 years). Results demonstrated an interaction between the anxiety sensitivity and age for subjective social status among the Latino sample. Inspection of the form of the significant interaction indicated that the association between anxiety sensitivity and subjective social status was evident among older, but not younger, persons. The current findings suggest that decreasing anxiety sensitivity, especially among older Latinos, may be one possible viable therapeutic approach to change subjective social status in order to help offset health disparities among this group.
Littlejohn-Blake, Sheila M.; Darling, Carol Anderson
Focuses on strengths of African-American families and how they function, relevant conceptual approaches, and trends and issues in studying African-American families that can facilitate understanding. A shift from studying dysfunctional families to more positive aspects can help African-American families meet societal challenges. (SLD)
Wallen, Jacqueline; Randolph, Suzanne; Carter-Pokras, Olivia; Feldman, Robert; Kanamori-Nishimura, Mariano
Background: African Americans are disproportionately exposed to and targeted by prosmoking advertisements, particularly menthol cigarette ads. Though African Americans begin smoking later than whites, they are less likely to quit smoking than whites. Purpose: This study was designed to explore African American smoking cessation attitudes,…
Strom Joni L
Full Text Available Abstract Background An estimated 1 in 3 American adults will have diabetes by the year 2050. Nationally, South Carolina ranks 10th in cases of diagnosed diabetes compared to other states. In adults, type 2 diabetes (T2DM accounts for approximately 90-95% of all diagnosed cases of diabetes. Clinically, provider and health system factors account for Methods We describe a four-year prospective, randomized clinical trial, which will test the effectiveness of technology-assisted case management in low income rural adults with T2DM. Two-hundred (200 male and female participants, 18 years of age or older and with an HbA1c ≥ 8%, will be randomized into one of two groups: (1 an intervention arm employing the innovative FORA system coupled with nurse case management or (2 a usual care group. Participants will be followed for 6-months to ascertain the effect of the interventions on glycemic control. Our primary hypothesis is that among indigent, rural adult patients with T2DM treated in FQHC's, participants randomized to the technology-assisted case management intervention will have significantly greater reduction in HbA1c at 6 months of follow-up compared to usual care. Discussion Results from this study will provide important insight into the effectiveness of technology-assisted case management intervention (TACM for optimizing diabetes care in indigent, rural adult patients with T2DM treated in FQHC's. Trial Registration National Institutes of Health Clinical Trials Registry (http://ClinicalTrials.gov identifier# NCT01373489
Lavner, Justin A; Barton, Allen W; Bryant, Chalandra M; Beach, Steven R H
Racial discrimination is a common stressor for African Americans, with negative consequences for mental and physical well-being. It is likely that these effects extend into the family, but little research has examined the association between racial discrimination and couple functioning. This study used dyadic data from 344 rural, predominantly low-income heterosexual African American couples with an early adolescent child to examine associations between self-reported racial discrimination, psychological and physical aggression, and relationship satisfaction and instability. Experiences of discrimination were common among men and women and were negatively associated with relationship functioning. Specifically, men reported higher levels of psychological aggression and relationship instability if they experienced higher levels of racial discrimination, and women reported higher levels of physical aggression if they experienced higher levels of racial discrimination. All results replicated when controlling for financial hardship, indicating unique effects for discrimination. Findings suggest that racial discrimination may be negatively associated with relationship functioning among African Americans and call for further research on the processes underlying these associations and their long-term consequences. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Ellis, Antonio L.; Hartlep, Nicholas D.
Stuttering places students at-risk for being stereotyped and experiencing identity difficulties in school. This study hoped to fill a lacuna in the literature on the educational experiences of African American male stutterers. Six African American adult males who stuttered and lived in Washington, DC; Maryland; and/or Virginia participated in this…
This 60 second public service announcement is based on the May 2017 CDC Vital Signs report. The life expectancy of African Americans has improved, but itâs still an average of four years less than whites. Learn what can be done so all Americans can have the opportunity to pursue a healthy lifestyle. Created: 5/2/2017 by Centers for Disease Control and Prevention (CDC). Date Released: 5/2/2017.
Mbulo, Lazarous; Kruger, Judy; Hsia, Jason; Yin, Shaoman; Salandy, Simone; Orlan, Elizabeth N; Agaku, Israel; Ribisl, Kurt M
There is little information on cigarette-purchasing behaviour among smokers globally. Understanding cigarette purchase and point-of-sale patterns can help guide the development and implementation of tobacco-control strategies in retail environments. The purpose of this study was to identify where adults in 19 countries last purchased cigarettes. Data were from 19 low-income and middle-income countries that conducted the Global Adult Tobacco Survey (GATS) during 2008-2012. GATS is a nationally representative household survey of adults aged 15 years or older using a standardised protocol to measure tobacco-related behaviours. Data were weighted to yield nationally representative estimates within each country and summarised by using descriptive statistics. Overall prevalence of current cigarette smoking ranged from 3.7% in Nigeria to 38.5% in the Russian Federation. Among current cigarette smokers, locations of last purchase were as follows: stores, from 14.6% in Argentina to 98.7% in Bangladesh (median=66.8%); street vendors, from 0% in Thailand to 35.7% in Vietnam (median=3.0%); kiosks, from 0.1% in Thailand to 77.3% in Argentina (median=16.1%); other locations, from 0.3% in China and Egypt to 57.5% in Brazil (median=2.6%). Cigarettes are purchased at various retail locations globally. However, stores and kiosks were the main cigarette purchase locations in 18 of the 19 countries assessed. Knowledge of where cigarette purchases occur could help guide interventions to reduce cigarette accessibility and use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Bhattacharya Shelley B
Full Text Available Abstract Background Completion of colorectal cancer (CRC screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT among a low-income, minority primary care population in an urban setting. Methods We recruited a convenience sample of adults over age 40 (n = 282 from a federally qualified community health center (70% African American. Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening. Results Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p Conclusion Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.
Murimi, Mary; Chrisman, Matthew S.; McAllister, Tiffany; McDonald, Olevia D.
Approximately 8.3% of the U.S. population (25.8 million people) is affected by type 2 diabetes. The burden of diabetes is disproportionately greater in the African American community. Compared with non-Hispanic Caucasian adults, the risk of diagnosed type 2 diabetes was 77% higher among non-Hispanic Blacks, who are 27% more likely to die of…
Nelson, Lyndsay A; Mulvaney, Shelagh A; Gebretsadik, Tebeb; Ho, Yun-Xian; Johnson, Kevin B; Osborn, Chandra Y
Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants' baseline characteristics and the probability of engaging with texts and calls. On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age (Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Campbell, Frances A.; Pungello, Elizabeth P.; Burchinal, Margaret; Kainz, Kirsten; Pan, Yi; Wasik, Barbara H.; Barbarin, Oscar A.; Sparling, Joseph J.; Ramey, Craig T.
Adult (age 30) educational, economic, and social-emotional adjustment outcomes were investigated for participants in the Abecedarian Project, a randomized controlled trial of early childhood education for children from low-income families. Of the original 111 infants enrolled (98% African American), 101 took part in the age 30 follow-up. Primary…
Ritchie, Lorrene D.; Raman, Aarthi; Sharma, Sushma; Fitch, Mark D.; Fleming, Sharon E.
Objective: To identify family and child nutrition and dietary attributes related to children's dietary intakes. Design: African American children (ages 8-11 years, n = 156), body mass index greater than 85th percentile, from urban, low-income neighborhoods. Baseline, cross-sectional data collected as part of an ongoing diabetes prevention…
Blackstock, Oni J.; Mba-Jonas, Adamma; Sacajiu, Galit M.
Disparities in the rates of unintended pregnancy have increased for low-income African American women as compared to other groups due, in part, to declining contraception use. Women obtain family planning information from diverse sources, which may ultimately influence contraceptive decision making. For this qualitative study, we conducted…
King, Vinetra L.; Mrug, Sylvie
Compared with other ethnic groups, African American adolescents are exposed to higher levels of family and community violence, which contribute to poorer academic achievement. This study examines whether emotion regulation moderates the effects of exposure to family and community violence on academic achievement among low-income African American…
Vinci, Debra M; Philipp, Steven F
This descriptive study compares African Americans' and Euro-Americans' perceived value of food selection pertaining to cost, portion size, and meal satisfaction when eating away from home. A stratified sample was drawn from a southern U.S. metropolitan area (N= 1,011; 486 African American, 525 Euro-American). Analysis showed no difference between African-American and Euro-American adults by sex or how often they dined out. These two groups significantly differed across years of education, age, and answering 14 of 18 rated statements on value perceptions. African-Americans' value perceptions were influenced more by lower cost foods and larger portion sizes than those of Euro-Americans. For meal satisfaction, African Americans were more likely to agree with statements that indicate preferring foods high in energy and low in essential micronutrient density. This study supports the need for more investigation.
LeCuyer, Elizabeth A; Christensen, Julie J; Kreher, Donna; Kearney, Margaret H; Kitzman, Harriet J
In this qualitative descriptive study, 30 young, unmarried, low-income African American mothers in Memphis, TN, were interviewed in 2011-2012 about their discipline strategies with their 12- to 19-month-old children. Using content analyses, their strategies were described and compared with those from a similar sample in 1992. Findings suggest both continuity and change during that 20-year period. More mothers in 2011-2012 described the use of distraction and time out, suggesting a wider variety of strategies than were used in 1992. These findings may help clinicians to better understand disciplinary methods in young low-income African American mothers such as these in Memphis. Approaching mothers in a respectful and culturally sensitive manner will help them focus on effective, developmentally appropriate strategies consistent with their own parenting goals. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Slaughter-Acey, Jaime C.; Caldwell, Cleopatra H.; Misra, Dawn P.
Background Racism has been hypothesized as a barrier to accessing healthcare. No quantitative study has directly assessed its influence on women's initiation of prenatal care (PNC). We examined the relationship between PNC entry and experiences of personal and group racism among low-income African American women. We also examined whether the use of denial of racism as coping mechanism was associated with a delay in accessing PNC. Methods Using a prospective/retrospective cohort design we collected data from 872 African American women (prenatally: n=484; postpartum: n=388). Multinomial logistic regression was used to assess the relationship between the overall denial of racism index and PNC initiation. Findings PNC entry was not significantly associated with personal experiences of racism (p=0.33); it was significantly associated with group experiences (pracism experienced by other AAs was a barrier to early PNC among low-income African American women. Delayed access to PNC may be rooted in the avoidance of racialized experiences among less empowered women when faced with discrimination. Our findings have important implication for the engagement of African American women into the PNC delivery system and the health care system postpartum. PMID:24041828
Gaydos, Laura M; Blake, Sarah C; Gazmararian, Julie A; Woodruff, Whitney; Thompson, Winifred W; Dalmida, Safiya George
The American Academy of Pediatrics recommends that children be placed in the supine position on firm bedding and not bed share with parents or other children. Health professionals increasingly understand that many African-American parents do not follow these recommendations, but little research exists on provider reactions to this non-compliance. This study was intended to better understand how low-income, African-American mothers understand and act upon safe sleep recommendations for newborns and how providers counsel these mothers. We conducted focus groups with 60 African-American, low-income, first-time mothers and telephone interviews with 20 providers serving these populations to explore provider counseling and patient decision making. The large majority of mothers reported understanding, but not following, the safe-sleeping recommendations. Key reasons for non-compliance included perceived safety, convenience, quality of infant sleep and conflicting information from family members. Mothers often take measures intended to mitigate risk associated with noncompliance, instead increasing SIDS risk. Providers recognize that many mothers are non-compliant and attribute non-compliance largely to cultural and familial influence. However, few provider attempts are made to mitigate SIDS risks from non-compliant behaviors. We suggest that counseling strategies should be adapted to: (1) provide greater detailed rationale for SIDS prevention recommendations; and (2) incorporate or acknowledge familial and cultural preferences. Ignoring the reasons for sleep decisions by African-American parents may perpetuate ongoing racial/ethnic disparities in SIDS.
Barrett, Katherine J; Wasser, Heather M; Thompson, Amanda L; Bentley, Margaret E
Infant feeding is a well-established topic of interest in obesity research, yet few studies have focused on contributions of nonmaternal caregivers (NMCs)-such as fathers, grandparents, and daycare providers-to infant feeding. Data from the Infant Care, Feeding and Risk of Obesity Project in North Carolina were used to investigate (a) which factors were associated with NMC feeding styles and (b) how NMCs' and mothers' feeding styles compared. Multivariate regression models utilizing random effects were used to analyse data from 108 NMCs who were identified by mothers as being heavily involved in infant feeding. Feeding styles were measured using the Infant Feeding Style Questionnaire. Several individual characteristics were important. Higher laissez faire-attention scores were reported by men and NMCs who lived in the same household as infant. Men reported higher indulgent-coax and indulgent-pamper scores. Perceptions of fussier infants, older infant age, and higher infant weight-for-length z-scores were also important. Mothers' and NMCs' feeding styles differed. Compared with mothers, grandparents reported lower laissez faire and indulgent-permissive scores. Fathers reported higher pressure-soothe and indulgent scores. Daycare providers reported higher restriction-diet quality and responsive satiety. Feeding styles were also predicted to change over time for all caregiver types. These findings highlight the importance of helping all caregivers develop skills that will promote optimal infant feeding outcomes. Given the paucity of research in this area, it is important to improve our understanding of what influences caregivers' feeding styles, especially among diverse populations, and how exposure to different feeding styles may shape children's obesity risk. © 2018 John Wiley & Sons Ltd.
Wang, Youfa; Jahns, Lisa; Tussing-Humphreys, Lisa; Xie, Bin; Rockett, Helaine; Liang, Huifang; Johnson, LuAnn
Studies have indicated that family meals may be a protective factor for childhood obesity; however, limited evidence is available in children with different racial, socioeconomic, and individual characteristics. The purpose of this study was to examine family meal frequency (FMF) as a protective factor for obesity in a US-based sample of non-Hispanic White, non-Hispanic Black, and Hispanic children aged 6 to 11, and to identify individual, familial, and socioeconomic factors that moderate thi...
Lowe, Sarah R.; Chan, Christian S.; Rhodes, Jean E.
Objective: In this study, we examined the influence of pre-disaster perceived social support on post-disaster psychological distress among survivors of Hurricane Katrina. Method: Participants (N = 386) were low-income mothers between 18 and 34 years of age at baseline (M = 26.4, SD = 4.43). The majority (84.8%) was African American; 10.4%…
The plight of African American males has become a problem of alarming proportions in the United States. This paper reports serious disadvantage and risk for this group in terms of education, employment, poverty levels, family disintegration, criminal status, health, and death rates. The paper contends that the crisis for African American males…
Wagner, Julie A; Abbott, Gina L; Heapy, Alicia; Yong, Lynne
This study of African Americans with diabetes investigated: (1) the relationship between depressive symptoms and glycemic control; (2) the relationship between depressive symptoms and long-term diabetes complications; (3) the relationship between depressive symptoms and medication usage; and (4) the effects of demographic and diabetes variables on these relationships. One-hundred twenty five African American diabetic adults who were attending health fairs reported demographic and medical history and provided blood samples for A1c assessment of glycemic control. They also completed the Centers for Epidemiological Studies Depression questionnaire, and the Diabetes Self-Care Inventory. After controlling for confounders, higher depressive symptoms were associated with higher A1c, more long-term diabetes complications, and more diabetes medications. Diabetes self-care did not fully account for these relationships. The relationship between depression and poor diabetes control exists in African Americans as it does in Whites. Providers are encouraged to attend to depression in their African American patients with diabetes.
Satia, Jessie A; Galanko, Joseph A
To describe associations of intrinsic and extrinsic motivations for dietary change with participant characteristics and current diet among African Americans. Cross-sectional survey of 658 African American adults in North Carolina provided information on intrinsic (self-image and health concerns) and extrinsic (social influence) motivation scales, participant characteristics, and diet. Most respondents considered it important to change their diet for health reasons; fewer were motivated by self-image or social influence. Motivation scales were significantly associated with demographic, behavioral, and psychosocial characteristics and fat, but not fruit/vegetable consumption, after adjustment for covariates (Pextrinsic motives may improve the effectiveness of dietary interventions in African Americans.
Shen, Huei-Wern; Pickard, Joseph G; Johnson, Sharon D
Research on the influence of volunteering on mental health outcomes has not placed enough focus on African American female caregivers who are at risk for adverse outcomes such as depression. This study addresses this gap by examining the mechanism through which volunteering might influence depressive symptoms using data collected from 521 African American female caregivers of older adults. Regression results indicate that although volunteering is inversely associated with depressive symptoms, self-esteem mediates this relationship. Findings suggest inclusion in volunteering for African American female caregivers may be relevant to promotion of their mental well-being.
Grant, Julia D; Agrawal, Arpana; Werner, Kimberly B; McCutcheon, Vivia V; Nelson, Elliot C; Madden, Pamela A F; Bucholz, Kathleen K; Heath, Andrew C; Sartor, Carolyn E
Childhood maltreatment is a known risk factor for cannabis initiation and problem use, but the extent to which this association is attributable to shared familial influences is unknown. We estimate the magnitude of associations between childhood maltreatment, timing of cannabis initiation, and cannabis-related problems, in European-American (EA) and African-American (AA) women, and parse the relative influence of additive genetic (A), shared environmental (C), and individual-specific environmental (E) factors on these constructs and their covariation. Data were from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a population-based study of female twins. Logistic regression analyses and twin modeling were used to test for associations, and estimate the relative contributions of genetic and environmental influences to childhood maltreatment and cannabis outcomes and their covariation. Maltreatment was significantly associated with increased likelihood of cannabis initiation before age 15 among EAs (OR=6.33) and AAs (OR=3.93), but with increased likelihood of later initiation among EAs only (OR=1.68). Maltreatment was associated with cannabis problems among both groups (EA OR=2.32; AA OR=2.03). Among EA women, the covariation between maltreatment and cannabis outcomes was primarily attributable to familial environment (rC=0.67-0.70); among AAs, only individual-specific environment contributed (rE=0.37-0.40). Childhood maltreatment is a major contributor to early initiation of cannabis as well as progression to cannabis problems in both AA and EA women. Distinctions by race/ethnicity are not in the relative contribution of genetic factors, but rather in the type of environmental influences that contribute to stages of cannabis involvement. Copyright © 2017 Elsevier B.V. All rights reserved.
Assari, Shervin; Lankarani, Maryam Moghani; Caldwell, Cleopatra Howard
Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES) are at an increased risk for having a major depressive episode (MDE). It is not known whether perceived discrimination (PD) explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL), 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status) were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI) was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.
Full Text Available Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES are at an increased risk for having a major depressive episode (MDE. It is not known whether perceived discrimination (PD explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL, 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.
Uhrig, Jennifer D.; Friedman, Allison; Poehlman, Jon; Scales, Monica; Forsythe, Ann
Objective: Current data on sexually transmitted disease (STD) among African Americans show significant racial/ethnic disparities. The purpose of this study was to explore knowledge, attitudes, beliefs, and behaviours related to STD risk, prevention, and testing among African American adults to help inform the development of a health communication…
Witherspoon, Dawn; Latta, Laura; Wang, Yan; Black, Maureen M.
Objective To examine how psychosocial factors vary by body weight and gender among African-American adolescents. Methods A community sample of 235 low-income, predominantly African-American adolescents completed measures of depression, self-esteem, body-esteem, and eating attitudes. Measured weight and height were converted to body mass index (kg/m2) age and gender-adjusted z-scores. Data were analyzed using 2-factor multivariate analysis of variance. Results Obese youths had significantly wo...
Sawyer, Brook E.; Cycyk, Lauren M.; Sandilos, Lia E.; Hammer, Carol S.
Given the need to enhance the academic language and early literacy skills of young children from low-income homes and the importance of the home literacy environment in supporting children's development, the purpose of this qualitative study was to better understand the home literacy environment of low-income African-American and Latino mothers of…
Full Text Available Obesity prevalence in United States (US adults exceeds 30% with highest prevalence being among blacks. Obesity is known to have significant effects on respiratory function and obese patients commonly report respiratory complaints requiring pulmonary function tests (PFTs. However, there is no large study showing the relationship between body mass index (BMI and PFTs in healthy African Americans (AA.To determine the effect of BMI on PFTs in AA patients who did not have evidence of underlying diseases of the respiratory system.We reviewed PFTs of 339 individuals sent for lung function testing who had normal spirometry and lung diffusion capacity for carbon monoxide (DLCO with wide range of BMI.Functional residual capacity (FRC and expiratory reserve volume (ERV decreased exponentially with increasing BMI, such that morbid obesity resulted in patients breathing near their residual volume (RV. However, the effects on the extremes of lung volumes, at total lung capacity (TLC and residual volume (RV were modest. There was a significant linear inverse relationship between BMI and DLCO, but the group means values remained within the normal ranges even for morbidly obese patients.We showed that BMI has significant effects on lung function in AA adults and the greatest effects were on FRC and ERV, which occurred at BMI values < 30 kg/m2. These physiological effects of weight gain should be considered when interpreting PFTs and their effects on respiratory symptoms even in the absence of disease and may also exaggerate existing lung diseases.
Gao, Liu; Bai, Lingling; Shi, Min; Ni, Jingxian; Lu, Hongyan; Wu, Yanan; Tu, Jun; Ning, Xianjia; Wang, Jinghua; Li, Yukun
Carotid intima-media thickness (CIMT) is an established predictor of cardiovascular disease and stroke. We aimed to identify the association between CIMT and blood glucose, as well as the risk factors associated with increased CIMT in a low-income Chinese population. Stroke-free and cardiovascular disease-free residents aged ≥45 years were recruited. B-mode ultrasonography was carried out to measure CIMT. There were 2,643 participants (71.0%) in the normal group, 549 (14.7%) in the impaired fasting glucose group and 533 (14.3%) in the diabetes mellitus group. The determinants of increased CIMT were older age; male sex; low education; hypertension; smoking; high levels of systolic blood pressure, fasting blood glucose and low-density lipoprotein cholesterol; and low levels of diastolic blood pressure, triglycerides and high-density lipoprotein cholesterol, after adjusting for covariates. Age and hypertension were the common risk factors for increased CIMT in all three groups. Furthermore, male sex, smoking and high low-density lipoprotein cholesterol level were positively associated with the mean CIMT in the normal group; high triglycerides levels were negatively associated with the mean CIMT in the impaired fasting glucose group; and alcohol consumption was an independent risk factor for mean CIMT in the diabetes mellitus group. Hypertension was the greatest risk factor for increased CIMT. These findings suggest that it is crucial to manage and control traditional risk factors in low-income populations in China in order to decelerate the recent dramatic increase in stroke incidence, and to reduce the burden of stroke. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Darko, Janice; Eggett, Dennis L.; Richards, Rickelle
Objective: To explore food shopping behaviors among low-income families over the course of the month. Design: Two researchers conducted 13 90-minute focus groups. Setting: Two community organizations serving low-income populations and a university campus. Participants: Low-income adults (n = 72) who were the primary household food shoppers and who…
Brooks Holliday, Stephanie; Dubowitz, Tamara; Haas, Ann; Ghosh-Dastidar, Bonnie; DeSantis, Amy; Troxel, Wendy M
Research has demonstrated the adverse impact that discrimination has on physical and mental health. However, few studies have examined the association between discrimination and symptoms of posttraumatic stress disorder (PTSD). There is evidence that African Americans experience higher rates of PTSD and are more likely to develop PTSD following trauma exposure than Whites, and discrimination may be one reason for this disparity. To examine the association between discrimination and PTSD among a cross-sectional sample largely comprising African American women, controlling for other psychosocial stressors (psychological distress, neighborhood safety, crime). A sample of 806 participants was recruited from two low-income predominantly African American neighborhoods. Participants completed self-report measures of PTSD symptoms, perceived discrimination, perceived safety, and psychological distress. Information on neighborhood crime was obtained through data requested from the city. Multivariate linear regression models were estimated to assess adjusted relationships between PTSD symptoms and discrimination. Discrimination was significantly associated with PTSD symptoms with a small effect size, controlling for relevant sociodemographic variables. This association remained consistent after controlling for psychological distress, perceived safety, and total neighborhood crime. There was no evidence of a gender by discrimination interaction. Participants who experienced any discrimination were significantly more likely to screen positive for PTSD. Discrimination may contribute to the disparate rates of PTSD experienced by African Americans. PTSD is associated with a range of negative consequences, including poorer physical health, mental health, and quality of life. These results suggest the importance of finding ways to promote resilience in this at-risk population.
Woods-Giscombé, Cheryl L.; Gaylord, Susan A.
African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, “buddy system,” etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. PMID:24442592
McBride, Chantee Earl
This study examines the life histories of three African American social studies teachers, focusing on the evolution and changes in their identities, perspectives, and attitudes related to their profession and instructional practice. In addition, the study addresses the significance of the teachers' racialized experiences as African Americans and…
McDonald, Jasmine A; Barg, Frances K; Weathers, Benita; Guerra, Carmen E; Troxel, Andrea B; Domchek, Susan; Bowen, Deborah; Shea, Judy A; Halbert, Chanita Hughes
Understanding genetic factors that contribute to racial differences in cancer outcomes may reduce racial disparities in cancer morbidity and mortality. Achieving this goal will be limited by low rates of African American participation in cancer genetics research. We conducted a qualitative study with African American adults (n = 91) to understand attitudes about participating in cancer genetics research and to identify factors that are considered when making a decision about participating in this type of research. Participants would consider the potential benefits to themselves, family members, and their community when making a decision to participate in cancer genetics research. However, concerns about exploitation, distrust of researchers, and investigators' motives were also important to participation decisions. Individuals would also consider who has access to their personal information and what would happen to these data. Side effects, logistical issues, and the potential to gain knowledge about health issues were also described as important factors in decision making. African Americans may consider a number of ethical, legal, and social issues when making a decision to participate in cancer genetics research. These issues should be addressed as part of recruitment efforts.
Robinson, W Lavome; Paxton, Keisha C; Jonen, Lynn P
Youth violence continues to present a serious public health challenge in the United States, particularly so for African American adolescent males. The present study utilized a multilevel approach to predict aggression within a community sample of low-income, urban African American adolescent males (n = 80). Participants' self-report data on normative beliefs about aggression, exposure to community violence, and depressive symptoms were used in multiple regression equations to predict (a) self-reported interpersonal aggression and (b) self-reported aggressive response style when angered. Results of this study indicate that all three of the independent variables contributed significantly to the prediction of interpersonal aggression and aggressive response style when angered. The findings are important for increasing our understanding of pathways to various types of youth aggression and guiding the development of evidence-based approaches to violence prevention among African American adolescent males.
Ayoola, Adejoke B; Sneller, Krista; Ebeye, Tega D; Dykstra, Megan Jongekrijg; Ellens, Victoria L; Lee, HaEun Grace; Zandee, Gail L
Preconception behaviors have a significant impact on birth outcomes, particularly among low-income minority groups, and women with unplanned pregnancies. This study examined women's perceived health status and behaviors such as drinking, smoking, exercise, and use of multivitamins and folic acid. This was a descriptive study based on a convenience sample of women living in urban underserved neighborhoods. Univariate and bivariate analyses were conducted using STATA 13. The sample consisted of 123 women ages 18 to 51 years (mean = 30.57); 51.22% were Hispanic, 36.59% African American, and 12.2% Caucasian. Over 70% had a household income of less than $20,000, 57.72% had no health insurance in the last year, and 58.54% were not married. These women were below the Healthy People 2020 goals for drinking, smoking, and multivitamin use, especially those who were planning to get pregnant in the next 6 months or not sure of their pregnancy planning status. There were no significant differences on any of the preconception health behavior variables based on pregnancy intention. Nurses and healthcare providers should emphasize importance of practicing healthy behaviors during the preconception period among low-income ethnic minority women specifically those living in urban medically underserved areas who are unsure of their pregnancy planning status or are at risk of unintended pregnancy.
Anna Maria Santiago
Full Text Available Using data from a natural experiment in Denver, we investigate whether the initiation of running away from home, aggressive or violent behavior, and marijuana use during adolescence are statistically related to the neighborhood contexts in which low-income Latino and African American youth were raised. Our analysis is based on retrospective child, caregiver, household, and neighborhood data for a sample of approximately 850 Latino and African American youth whose families were quasi-randomly assigned to public housing operated by the Denver (CO Housing Authority during part of their childhood. We used Cox PH models and accelerated failure time models to estimate ethnic differentials in the hazards and timing of initiation of these risky behaviors during adolescence. We found that multiple dimensions of neighborhood context—especially safety, ethnic and nativity composition, and socioeconomic status—strongly and robustly predicted initiation of running away, aggressive or violence behavior, and marijuana use during adolescence.
Senteio, Charles; Veinot, Tiffany
Adherence to treatment recommendations for chronic diseases is notoriously low across all patient populations. But African American patients, who are more likely to live in low-income neighborhoods and to have multiple chronic conditions, are even less likely to follow medical recommendations. Yet we know little about their contextually embedded, adherence-related experiences. We interviewed individuals (n = 37) with at least two of the following conditions: hypertension, diabetes, and chronic kidney disease. Using an "invisible work" theoretical framework, we outline the adherence work that arose in patients' common life circumstances. We found five types: constantly searching for better care, stretching medications, eating what I know, keeping myself alive, and trying to make it right. Adherence work was effortful, challenging, and addressed external contingencies present in high-poverty African American neighborhoods. This work was invisible within the health care system because participants lacked ongoing, trusting relationships with providers and rarely discussed challenges with them. © The Author(s) 2014.
Woda, Aimee; Belknap, Ruth Ann; Haglund, Kristin; Sebern, Margaret; Lawrence, Ashley
The purpose of this study was to understand the influences of heart failure (HF) self-care among low income, African Americans. Compared to all other racial groups, African Americans have the highest risk of developing HF, coupled with high mortality and morbidity rates. Using the photovoice method, participants related important lifestyle factors through photography. The participants and researcher met for reflection and discussion 2 h per week for six weeks. Four themes emerged: family support gives me the push I need, social interaction lifts me up, improving my mind to lift depression can improve my heart, and it is important but challenging to follow the HF diet. The findings from this study may assist policy makers, health care professionals, patients, and support systems in understanding the complexity of engaging in HF self-care. This understanding may lead to the development of appropriate patient-centered assessments and interventions. Copyright © 2015 Elsevier Inc. All rights reserved.
Sheely-Moore, Angela I.; Ceballos, Peggy L.
With the tendency of low-income African American and Latino children identified at-risk for school readiness and school success compared to their early-childhood counterparts, Head Start personnel are challenged to examine the role of family strengths in the promotion of academic success for these populations. This article provides a rationale for…
Backman, Desiree; Scruggs, Valarie; Atiedu, Akpene Ama; Bowie, Shene; Bye, Larry; Dennis, Angela; Hall, Melanie; Ossa, Alexandra; Wertlieb, Stacy; Foerster, Susan B.
Objective: Evaluate the effectiveness of the "Fruit, Vegetable, and Physical Activity Toolbox for Community Educators" ("Toolbox"), an intervention originally designed for Spanish- and English-speaking audiences, in changing knowledge, attitudes, and behavior among low-income African American women. Design: Quasi-experimental…
Lilly, Michelle M.; Graham-Bermann, Sandra A.
The present study uses a feminist theoretical framework to explore risk factors for the development of posttraumatic stress symptoms following intimate partner violence, with a community sample of 120 low-income European American and African American women. Hierarchical regression analyses were used to examine demographic, violence, and mental…
Keenan, Lisa A; Marshall, Linda L; Eve, Susan
Psychosocial vulnerabilities were added to a model of healthcare utilization. This extension was tested among low-income women with ethnicity addressed as a moderator. Structured interviews were conducted at 2 points in time, approximately 1 year apart. The constructs of psychosocial vulnerability, demographic predisposing, barriers, and illness were measured by multiple indicators to allow use of Structural Equation Modeling to analyze results. The models were tested separately for each ethnic group. Community office. African-American (N = 266), Euro-American (N = 200), and Mexican-American (N = 210) women were recruited from the Dallas Metropolitan area to participate in Project Health Outcomes of Women, a multi-year, multi-wave study. Face-to-face interviews were conducted with this sample. Participants had been in heterosexual relationships for at least 1 year, were between 20 and 49 years of age, and had incomes less than 200% of the national poverty level. Healthcare utilization, defined as physician visits and general healthcare visits. Illness mediated the effect of psychosocial vulnerability on healthcare utilization for African Americans and Euro-Americans. The model for Mexican Americans was the most complex. Psychosocial vulnerability on illness was partially mediated by barriers, which also directly affected utilization. Psychosocial vulnerabilities were significant utilization predictors for healthcare use for all low-income women in this study. The final models for the 2 minority groups, African Americans and Mexican Americans, were quite different. Hence, women of color should not be considered a homogeneous group in comparison to Euro-Americans.
Griffith, Derek M; Bergner, Erin M; Cornish, Emily K; McQueen, Chelsea M
Relatively little is known about what helps increase physical activity in African American men, and even less is known about promoting physical activity among Latino men. This systematic review aimed to address the key questions: (a) what is the state of the evidence on health-related behavior change interventions targeting physical activity among African American or Latino men? and (b) What factors facilitate physical activity for these men? For this review, nine electronic databases were searched to identify peer-reviewed articles published between 2011-2017 that reported interventions to promote physical activity among African American or Latino men. Following PRISMA guidelines, nine articles representing seven studies that met our criteria were identified: six published studies that provided data for African American men, and one published study provided data for Latino men. Consistent with previous reviews, more research is needed to better understand how gender can be incorporated in physical activity interventions for African American and Latino men. Future interventions should explore how being an adult male and a man of color shapes motivations, attitudes, and preferences to be physically active. Studies should consider how race and ethnicity intersect with notions of masculinity, manhood and Machismo to enhance the effectiveness of physical activity interventions for these populations. Despite the health benefits of physical activity, rates of these behaviors remain low among African American and Latino men. It is essential to determine how best to increase the motivation and salience for these men to overcome the obesogenic environments and contexts in which they often live.
Swift, Damon L.; Staiano, Amanda E.; Johannsen, Neil M.; Lavie, Carl J.; Earnest, Conrad P.; Katzmarzyk, Peter T.; Blair, Steven N.; Newton, Robert L.; Church, Timothy S.
Low cardiorespiratory fitness (CRF) is a well-established risk factor for all-cause and cardiovascular disease mortality. African Americans have higher rates of cardiovascular disease compared to their Caucasian counterparts. However, the extent to which lower CRF levels contribute to the excess risk in African Americans has not been fully explored. The purpose of this review is to: 1) explore the literature evaluating the relationship between CRF and mortality specifically in African American populations; and 2) critically evaluate the studies which have compared CRF between African American and Caucasians in epidemiological studies and clinical trials. We have further discussed several potential mechanisms that may contribute to the observation of lower CRF levels in African American compared to Caucasian adults including potential racial differences in physical activity levels, muscle fiber type distribution, and hemoglobin levels. If lower CRF is generally present in African Americans compared to Caucasians, and is of a clinically meaningful difference, this may represent an important public health concern. PMID:23982718
Vaterlaus, J Mitchell; Skogrand, Linda; Chaney, Cassandra; Gahagan, Kassandra
The current exploratory study utilized a family strengths framework to identify marital expectations in 39 strong African American heterosexual marriages. Couples reflected on their marital expectations over their 10 or more years of marriage. Three themes emerged through qualitative analysis and the participants' own words were used in the presentation of the themes. African Americans indicated that there was growth in marital expectations over time, with marital expectations often beginning with unrealistic expectations that grew into more realistic expectations as their marriages progressed. Participants also indicated that core expectations in strong African American marriages included open communication, congruent values, and positive treatment of spouse. Finally, participants explained there is an "I" in marriage as they discussed the importance of autonomy within their marital relationships. Results are discussed in association with existing research and theory. © 2016 Family Process Institute.
Hoehn, Jessica L; Riekert, Kristin A; Borrelli, Belinda; Rand, Cynthia S; Eakin, Michelle N
To identify barriers and motivators for reducing secondhand smoke exposure (SHSe) for families of African-American, low-income, urban children. Audiotaped intervention sessions of 52 African-American caregivers of Head Start children who reported being a smoker and/or had at least one smoker in the home were randomly sampled from a larger trial examining the effectiveness of a motivational-interviewing intervention in reducing child's SHSe. Counseling sessions were qualitatively coded to identify barriers and motivators to implementing a home smoking ban or quitting smoking. African-American families identified several themes that were either or both barriers and motivators for SHSe reduction, including: asking others not to smoke, other family living in the home, neighborhood safety, absence of childcare, cost/availability of cessation tools, physician support and prevention of health problems. Urban, low-income African-American families face numerous barriers to reducing SHSe. Families were able to identify many motivators for reducing SHSe, suggesting an awareness of the importance for SHSe reduction but uncertainty in their confidence to change behaviors. Counseling should include tailoring to be most effective in supporting health behavior change. Greater emphasis on motivators is needed, such as low-cost/free cessation tools, engagement from physicians and greater involvement of extended family members. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: email@example.com.
Black, Helen K
This article emerged from pilot research exploring experiences of war and suffering among African American veterans who served in World War II, Korean War, and Vietnam War. Men's experiences as soldiers reflected both racism and the social change that occurred in the Unites States while they served. We used techniques of narrative elicitation, conducting qualitative, ethnographic interviews with each of five veterans in his home. Interviews focused on unique and shared experiences as an African American man and a soldier. Three important themes emerged: (a) Expectations related to War--Although men viewed service to country as an expected part of life, they also expected equal treatment in war, which did not occur; (b) Suffering as an African American--Informants interpreted experiences of suffering in war as related to the lower status of African American servicemen; and (c) Perception of present identity--Each man was honed by the sum of his experiences, including those of combat, racism, and postwar opportunities and obstacles. From 40 to 70 years after the wars were fought, there are few scholarly narrative studies on African American veterans, despite the fact that Korean War Veterans are entering old-old age and few World War II Veterans are alive. The value of pilot research that offers narratives of unheard voices is significant; larger studies can interview more African American veterans to advance knowledge that might soon be lost. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Ferdinand, Keith C; Armani, Annemarie M
The prevalence of hypertension in blacks in the United States is among the highest in the world. Compared with whites, blacks develop hypertension at an earlier age, their average blood pressures are much higher and they experience worse disease severity. Consequently, blacks have a 1.3 times greater rate of nonfatal stroke, 1.8 times greater rate of fatal stroke, 1.5 times greater rate of heart disease death, 4.2 times greater rate of end-stage kidney disease, and a 50% higher frequency of heart failure; overall, mortality due to hypertension and its consequences is 4 to 5 times more likely in African Americans than in whites. The increased prevalence of hypertension and excessive target organ damage is due to a combination of genetic and, most likely, environmental factors. There are no clinical trial data at present to suggest that lower-than-usual BP targets should be set for high-risk demographic groups such as African Americans. The primary means of prevention and early treatment of hypertension in African Americans will be the appropriate use of lifestyle modification. The International Society of Hypertension in Blacks guidelines realize that most patients will require combination therapy, many of them first-line, to reach appropriate BP goals. Although certain classes and combinations of antihypertensive agents have been well-established to be effective, the choice of drugs for combination therapy in African American patients may be different. Within the African American group, the responsiveness to monotherapy with ACE inhibitors, angiotensin receptor blockers, and beta blockers may be less than the responsiveness to diuretics and calcium channel blockers, but these differences are corrected when diuretics are added to the neurohormonal antagonists. Of note, African American patients with systolic BP >15 mm Hg or a diastolic BP >10 mm Hg above goal should be treated with first-line combination therapy.
DeSantis, Carol; Naishadham, Deepa; Jemal, Ahmedin
In this article, the American Cancer Society estimates the number of new cancer cases and deaths for African Americans and compiles the most recent data on cancer incidence, mortality, survival, and screening prevalence based upon incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. It is estimated that 176,620 new cases of cancer and 64,880 deaths will occur among African Americans in 2013. From 2000 to 2009, the overall cancer death rate among males declined faster among African Americans than whites (2.4% vs 1.7% per year), but among females, the rate of decline was similar (1.5% vs 1.4% per year, respectively). The decrease in cancer death rates among African American males was the largest of any racial or ethnic group. The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of nearly 200,000 deaths from cancer among African Americans. Five-year relative survival is lower for African Americans than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Overall, progress in reducing cancer death rates has been made, although more can and should be done to accelerate this progress through ensuring equitable access to cancer prevention, early detection, and state-of-the-art treatments. Copyright © 2013 American Cancer Society, Inc.
Wang, Xiaoling; Pan, Yue; Zhu, Haidong; Hao, Guang; Huang, Yisong; Barnes, Vernon; Shi, Huidong; Snieder, Harold; Pankow, James; North, Kari; Grove, Megan; Guan, Weihua; Demerath, Ellen; Dong, Yanbin; Su, Shaoyong
Background: We conducted an epigenome-wide association study (EWAS) on obesity in healthy youth and young adults and further examined to what extent identified signals influenced gene expression and were independent of cell type composition and obesity-related cardio-metabolic risk factors.
Peters Ronald J
Full Text Available Abstract Background African-American women are disproportionately affected by HIV, accounting for 60% of all cases among women in the United States. Although their race is not a precursor for HIV, the socioeconomic and cultural disparities associated with being African American may increase their risk of infection. Prior research has shown that interventions designed to reduce HIV infection among African-American women must address the life demands and social problems they encounter. The present study used a qualitative exploratory design to elicit information about strategies to prevent HIV transmission among young, low-income African-American women. Methods Twenty five low income African American women, ages 18–29, participated in five focus groups of five women each conducted at a housing project in Houston, Texas, a large demographically diverse metropolitan area that is regarded as one of the HIV/AIDS epicenters in the United States. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The participants revealed that they had most frequently placed themselves at risk for HIV infection through drugs and drinking and they also reported drug and alcohol use as important barriers to practicing safer sex. The women also reported that the need for money and having sex for money to buy food or drugs had placed them at risk for HIV transmission. About one-third of the participants stated that a barrier to their practicing safe sex was their belief that there was no risk based on their being in a monogamous relationship and feeling no need to use protection, but later learning that their mate was unfaithful. Other reasons given were lack of concern, being unprepared, partner's refusal to use a condom, and lack of money to buy condoms. Finally, the women stated that they were motivated to practice safe sex because of fear of contracting sexually transmitted diseases and HIV, desire not to become pregnant, and
Sato, Priscila M.; Steeves, Elizabeth A.; Carnell, Susan; Cheskin, Lawrence J.; Trude, Angela C.; Shipley, Cara; Mejía Ruiz, M. J.; Gittelsohn, Joel
B'More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers…
Gillum, Richard F; Dodd, Kristen D
This book review analyzes the complex and profound impact active religious participation has on relationships and family outcomes among African Americans and Latinos. In Soul Mates, Wilcox and Wolfinger discuss the legacy of slavery and Jim Crow laws and the resulting devastating effects on African American and Latino families despite their high religious involvement. The authors make the case that many African American men are unlikely candidates for marriage or stable relationships due to trends of family instability driven by the declining income-power of working-class men as well as entry of more women into the labor force, government penalties for low-income couples, revolt against traditional values, increased access to birth control and abortion, and the persistence of discrimination and incarceration of minority men. The authors examine data from six national surveys as well as additional data from interviews, focus groups, ethnographic field work, and an extensive literature review. Wilcox and Wolfinger find evidence that when African American couples actively participate in Christian churches, the men are more likely to adhere to a "code of decency" which decreases street behaviors, such as binge drinking, having multiple sex partners, and having multi-partner fertility, which are known to inhibit family stability. This book will be helpful for health providers who would like to better understand and serve their African American and Latino patients. The findings suggest that health care providers can promote a healthy emotional environment for families by encouraging minority men to renew or maintain church involvement. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.
Fouquier, Katherine Ferrell
This article reviews the current state of knowledge of the theory of maternal role attainment (MRA) and its relevance in describing African American motherhood. EBSCOhost Research Databases that included PubMed, CINAHL plus, MEDLINE, PsycINFO, SCOPUS, and Web of Science were searched for journal articles that examined maternal identity and MRA. Keyword searches included maternal identity, maternal role attainment, becoming a mother, prenatal attachment, maternal-fetal attachment, and maternal-infant attachment. Inclusion criteria for this review were published journal articles of studies conducted in the United States, with a clear delineation of the theoretical framework of MRA. Journal articles that measured MRA among women with depression or medically fragile infants were excluded. Two hundred and twelve studies were reviewed; 25 studies, published between 1975 and 2007, met the inclusion criteria. Nine articles described the theory of MRA, 11 articles measured variables thought to influence MRA, and 6 articles described maternal-fetal attachment, a construct of MRA. Studies were reviewed, categorized, and analyzed to determine current knowledge of how the theory of MRA describes African American motherhood. Categories included studies describing the theoretical framework of maternal identity and MRA, studies measuring key variables thought to impact MRA, and studies measuring maternal-fetal attachment and maternal-infant attachment. The studies were limited by homogenous samples of upper-middle-class white women and low-income, single, African American adolescents. Study results of MRA cannot be generalized to African American women. Further research is essential to identify attributes influencing MRA, specifically among larger samples of African American women with demographics similar to that of the white populations that have been included in studies thus far. © 2013 by the American College of Nurse-Midwives.
Pedraza, Otto; Clark, Joy Humphreys; O'Bryant, Sid E; Smith, Glenn E; Ivnik, Robert J; Graff-Radford, Neill R; Willis, Floyd B; Petersen, Ronald C; Lucas, John A
To investigate whether demographic (age and education) adjustments for the Mini-Mental State Examination (MMSE) attenuate mean score discrepancies between African-American and Caucasian adults and whether demographically adjusted MMSE scores improve the diagnostic classification accuracy of dementia in African-American adults over unadjusted MMSE scores. Cross-sectional study. Community-dwelling adults participating in the Mayo Clinic Alzheimer's Disease Patient Registry and Alzheimer's Disease Research Center. Three thousand two hundred fifty-four adults (2,819 Caucasian, 435 African American) aged 60 and older. MMSE score at study entry. African-American adults had significantly lower unadjusted MMSE scores (23.0 ± 7.4) than Caucasian adults (25.3 ± 5.4). This discrepancy persisted despite adjustment of MMSE scores for age and years of education using established regression weights or newly derived weights. Controlling for dementia severity at baseline and adjusting MMSE scores for age and quality of education attenuated this discrepancy. In African-American adults, an age- and education-adjusted MMSE cut score of 23/24 provided optimal dementia classification accuracy, but this represented only a modest improvement over an unadjusted MMSE cut score of 22/23. The posterior probability of dementia in African-American adults is presented for various unadjusted MMSE cut scores and prevalence rates of dementia. Age, dementia severity at study entry, and quality of educational experience are important explanatory factors in understanding the existing discrepancies in MMSE performance between Caucasian and African-American adults. These findings support the use of unadjusted MMSE scores when screening older African Americans for dementia, with an unadjusted MMSE cut score of 22/23 yielding optimal classification accuracy. © 2012, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.
... Syndicated Content Website Feedback HIV Among African American Gay and Bisexual Men Recommend on Facebook Tweet Share Compartir Black/African American a gay, bisexual, and other men who have sex with ...
Green, Lisa J.
How do children acquire African American English? How do they develop the specific language patterns of their communities? Drawing on spontaneous speech samples and data from structured elicitation tasks, this book explains the developmental trends in the children's language. It examines topics such as the development of tense/aspect marking,…
Zulu, Itibari M.
Examines and describes 30 African-American centered quotation and motivational books, all but one of which were published between 1993 and 1997. The books articulate a diversity of genres and themes. Annotations are divided into: (1) general quotation; (2) daily words and meditation/motivation sources; (3) religion and theology; and (4)…
This podcast is based on the May 2017 CDC Vital Signs report. The life expectancy of African Americans has improved, but it's still an average of four years less than whites. Learn what can be done so all Americans can have the opportunity to pursue a healthy lifestyle.
Cunningham, Michael; Swanson, Dena Phillips
The purpose of this article was to examine factors within the school context that facilitates educational resilience among African American high school students. The authors expected academic self-esteem to be positively associated with future expectations (academic and general). They expected perceptions of school-based social support to have…
Knowles, Debora; Bryant, Rhonda M.
Given their tremendous professional responsibilities, professional counselors face daunting challenges to remaining healthy and avoiding role stress and overload. This article explores the intersection of race, gender, wellness, and spirituality in the self-care of African American women counselors. The authors give particular attention to…
King, G; Polednak, A P; Bendel, R
The impact of geographic region and metropolitan residence on smoking prevalence among African Americans has not been adequately examined. This study analyzed 5 years of data from the National Health Interview Survey (1990-1994) on current smoking and regional variation among 16,738 African Americans. Results. Respondents in the West had the lowest unadjusted smoking prevalence rates and Midwest residents had the highest. Current smoking was lower among African Americans living in non-central cities than in central cities even after adjusting for several sociodemographic covariates. Multivariate logistic regression analysis revealed that black women in the South were significantly less likely to be smokers compared with any other gender/region group. These findings suggest the significance of gender and regional factors such as the social history of migration, social stress and racism, exposure to tobacco advertisement, variations in cultural influences, community structures, and coping strategies in under standing African American smoking behavior. Copyright 1999 American Health Foundation and Academic Press.
The purpose of this study was to examine communication/reasoning, behavioral control, and trust as predictors of resourcefulness among African American children during middle childhood (6-12 years of age). Mothers who practice promotive socialization strategies are more likely to rear children who are socially competent and well adjusted. Multiple…
Coleman, M Nicole; Butler, Ebony O; Long, Amanda M; Fisher, Felicia D
Hip-hop media and Black-oriented reality television are powerful mechanisms for conveying and promoting stereotypes of Black women. Black women's sexuality is frequently presented as highly-salient in each medium. However, little is known about the impact of those images on Black women's sexuality and identity. The current study uses focus-group methodology to engage young adult Black in critical discussion of two predominant sexual scripts found in hip-hop music and Black-oriented reality television - the Freak and the Gold Digger. Analyses revealed shared and distinct aspects of each sexual script represented in both media and the impact of those scripts on participants' experiences. Implications for future research are discussed.
In theorizing how we should pedagogically approach African American literature, especially in courses for undergraduates, I argue that we have to move away from questions of what was or even what is African American literature and, instead, find ways to teach African American literature in both its historical contexts--artistic and political--and…
Smith, Eva C.
African American educational leadership has long been part of American education and African American activism to resist oppression. However, the field of educational leadership has rarely included the contributions of African American leaders, particularly women leaders, into mainstream leadership theory and practices. This omission is difficult…
in Military and Business Tuskegee Airman Shares History Soldier's Life Provides Example for West Department of Defense Submit Search During National African-American History Month, we celebrate the rich In honor of African-American History Month, Fred Moore, the first African-American Tomb Guard
This article discusses how Adlerian counseling can be used as a form of school counseling for African American adolescents. Moreover, school counseling for African American adolescents is discussed within the context of African American culture. Due to the strength-based nature of Adlerian approach, it can capitalize on African American…
Pittman, Chavella T.
This study was an examination of how African American faculty discussed their coping with racially stressful classrooms. Despite aims for racial equality in higher education, the classroom has been a significant site of racial stressors for African American facility. Analysis of interviews with 16 (8 women, 8 men) African American faculty at a…
Carnevale, Anthony P.; Fasules, Megan L.; Porter, Andrea; Landis-Santos Jennifer
Access to college for African Americans has increased, but African Americans are highly concentrated in lower-paying majors. The college major, which has critical economic consequences throughout life, reflects personal choices but also reflects the fact that African-American students are concentrated in open-access four-year institutions that…
Battle, Juan; Lemelle, Anthony J., Jr.
Used data from the 1993 National Black Politics Study to examine the way gender worked in explaining African American attitudes toward gay men. Results indicated that African American females expressed more positive attitudes toward homosexual men than did African American males, and of the variables examined (including age, church attendance,…
Williams, Monnica T; Proetto, Dante; Casiano, Delane; Franklin, Martin E
Obsessive-compulsive disorder (OCD) is a leading cause of disability worldwide, however for reasons that are poorly understood ethnic minority groups are not well represented in clinical research studies. Thus, although African Americans experience equivalent rates of OCD according to epidemiological surveys, the generalizability of findings from clinical trials remains unknown. Research designed to improve identification, assessment and treatment of OCD is an important public health priority. The purpose of this study is to report outreach methods used to recruit African American adults for participation in an OCD research study. A variety of methods were employed, including radio advertisements, public transportation advertising, community outreach, and online advertising. A total of 83 African American adult participants were recruited over a 9.5 month period at the University of Pennsylvania in Philadelphia, and given comprehensive psychiatric assessments. African Americans with OCD symptoms were reliably identified and assessed, for a total of 75 with lifetime OCD (4 past and 71 current diagnoses). There was variability in the success and cost effectiveness of study recruitment methods. Radio ads were the most expensive means of recruitment, newspaper ads accounted for the largest number of eligible participants, and no cost methods such as Craig's List and word of mouth were also effective. The authors conclude that, with focused efforts, there are many effective methods for recruiting African Americans with OCD. Guidelines for recruitment are discussed, with a focus on cultural considerations. Copyright © 2011 Elsevier Inc. All rights reserved.
Moneta, Maria Victoria; Garin, Noe; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Chatterji, Somnath; Leonardi, Matilde; Sainio, Päivi; Galas, Aleksander; Haro, Josep Maria
Objective The association between obesity and disability may differ between high-income and low-income/middle-income countries but there are no studies comparing this association between these settings. The aim of the study was to assess this association in nine countries using nationally-representative data from the Collaborative Research on Ageing in Europe (COURAGE) study and the WHO's Study on global AGEing and Adult Health (SAGE). Design Population-based cross-sectional study Setting The survey was conducted in China, Finland, Ghana, India, Mexico, Poland, Russia, South Africa and Spain between 2007 and 2012. Participants 42 116 individuals 50 years and older. The institutionalised and those with limited cognition were excluded. Primary outcome measure Disability was defined as severe or extreme difficulty in conducting at least one of six types of basic activities of daily living (ADL). Results The mean body mass index (BMI) ranged from 20.4 kg/m2 in India to 30.7 kg/m2 in South Africa. Compared to normal BMI (18.5–24.9 kg/m2), BMI≥35 kg/m2 was associated with significantly higher odds for ADL disability in Finland (OR 4.64), Poland (OR 2.77), South Africa (OR 2.19) and Spain (OR 2.42). Interaction analysis showed that obese individuals in high-income countries were more likely to have ADL limitations than those in low-income or middle-income countries. Conclusions The higher odds for disability among obese individuals in high-income countries may imply longer life lived with disability due to factors such as the decline in cardiovascular disease mortality. In South Africa, this may have been due to the exceptionally high prevalence of class III obesity. These findings underscore the importance of obesity prevention to reduce the disability burden among older adults. PMID:25838510
Schmidt, Tanja; Kerr, Jacqueline; Kestens, Yan; Schipperijn, Jasper
Daily mobility, defined as the ability to move oneself within one's neighborhood and regions beyond, is an important construct, which affects people as they age. Having a feasible and valid measure of daily mobility is essential to understand how it affects older adults' everyday life. Given the limitations of existing measures, new tools may be needed. The purpose of the study is to assess the feasibility and practicality of using the map-based questionnaire system VERITAS and GPS devices to measure daily mobility in older adults living in a deprived neighborhood in Denmark. Older adults were recruited from two senior housing areas, completed an interview using VERITAS and wore a GPS for 7 days. Feasibility of both methods was assessed by looking at practicalities, recruitment and compliance, and ability to measure daily mobility.Thirty-four older adults completed the VERITAS questionnaire, of which 23 wore the GPS device. Remembering to wear and charge the GPS was difficult for 48% participants, whereas remembering street names and drawing routes in VERITAS was difficult for two. Both the GPS and VERITAS were able to measure 10 out of the 13 identified components of mobility; however, VERITAS seemed more qualified at measuring daily mobility for this target population. The feasibility of assessing mobility may vary by specific context and study population being investigated. Wearable technology like a GPS may not be acceptable to low socioeconomic older adults, whereas interview led self-reported measurements like VERITAS might be more suitable for a low socioeconomic elderly population.
Over one-third of all adults in the United States are obese and African Americans represent over 49.5% of these cases. Young adults with some college education show the most rapid increase in the prevalence of overweight and obesity, with African Americans leading among all groups. The purpose of this paper is to consider why students gain weight in college and if racial and ethnic differences exist in the context of weight gain. Both physical environment and psychological factors affect the college students' weight-related behaviors. College students experience significant increases in their weight and African Americans are disproportionately affected. However, the role of race and ethnicity is under-examined. Future research should explore racial and ethnic differences in weight gain in college students.
Terryl J. Hartman
Full Text Available The goal of this research was to assess patterns of beverage consumption and the contribution of total beverages and classes of beverages to overall energy intake and weight status. We conducted an analysis in a community-based study of 280 low-income overweight and obese African American women residing in the rural South. Participants provided baseline data including demographic characteristics, weight and two 24-h food and beverage dietary recalls. Mean energy intake from beverages was approximately 273 ± 192 kcal/day or 18.3% of total energy intake. The most commonly reported beverage was plain water, consumed by 88.2% of participants, followed closely by sweetened beverages (soft drinks, fruit drinks, sweetened teas, sweetened coffees and sweetened/flavored waters consumed by 78.9% of participants. In multiple regression analyses total energy and percent energy from beverages and specific categories of beverages were not significantly associated with current body mass index (BMI. It is widely accepted that negative energy balance may lead to future weight loss. Thus, reducing consumption of beverages that contribute energy but not important nutrients (e.g., sugar sweetened beverages could be an effective strategy for promoting future weight loss in this population.
Melinda C Aldrich
Full Text Available BACKGROUND: Smoking tobacco reduces lung function. African Americans have both lower lung function and decreased metabolism of tobacco smoke compared to European Americans. African ancestry is also associated with lower pulmonary function in African Americans. We aimed to determine whether African ancestry modifies the association between smoking and lung function and its rate of decline in African Americans. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated a prospective ongoing cohort of 1,281 African Americans participating in the Health, Aging, and Body Composition (Health ABC Study initiated in 1997. We also examined an ongoing prospective cohort initiated in 1985 of 1,223 African Americans in the Coronary Artery Disease in Young Adults (CARDIA Study. Pulmonary function and tobacco smoking exposure were measured at baseline and repeatedly over the follow-up period. Individual genetic ancestry proportions were estimated using ancestry informative markers selected to distinguish European and West African ancestry. African Americans with a high proportion of African ancestry had lower baseline forced expiratory volume in one second (FEV₁ per pack-year of smoking (-5.7 ml FEV₁/ smoking pack-year compared with smokers with lower African ancestry (-4.6 ml in FEV₁/ smoking pack-year (interaction P value = 0.17. Longitudinal analyses revealed a suggestive interaction between smoking, and African ancestry on the rate of FEV(1 decline in Health ABC and independently replicated in CARDIA. CONCLUSIONS/SIGNIFICANCE: African American individuals with a high proportion of African ancestry are at greater risk for losing lung function while smoking.
Part 1 provides evidence, drawing on Statistics Canada reports, that Canadians without a high-school certificate are most at-risk of unemployment, low earnings, and poverty. Young adults are especially hard hit, with significantly higher unemployment rates and lower average earnings than high-school graduates. Part 2 cites research that shows the…
Goldberg, Abbie E.; Smith, JuliAnna Z.
Despite increases in transracial adoption, African American children remain the least likely to be adopted. No research has examined the factors that predict prospective adopters' willingness to adopt an African American child. This study used multilevel modeling to examine predictors of willingness to adopt an African American child in a sample…
Brown, Anthony L.
Drawing from ethnographic data, this paper explores how African American male teachers working with African American male students performed their pedagogy. This paper highlights how teachers' understanding of African American males social and educational needs shaped their pedagogical performance. Interestingly however, teachers' performance was…
Effectiveness of a Tai Chi intervention for improving functional fitness and general health among ethnically diverse older adults with self-reported arthritis living in low-income neighborhoods: a cohort study.
Dogra, Shilpa; Shah, Suhayb; Patel, Meghavi; Tamim, Hala
Tai Chi (TC) is a form of low to moderate physical activity that has been shown to significantly impact health and functional fitness among older adults; the impact of TC on the health and functional fitness of older adults with arthritis is not well understood. The purpose of this study was to assess the effectiveness of a 16-week TC intervention for improving functional fitness and self-reported general health among older adults with arthritis who were born outside Canada and were residing in low-income neighborhoods. A 16-week intervention was conducted among older adults residing in 1 of 2 specified low-income neighborhoods in Canada. The analysis was limited to those who self-reported having arthritis (n = 102). Participants were encouraged to attend 2 moderate-intensity TC sessions per week for a total of 120 minutes. Functional fitness and health were assessed at baseline and at 16 weeks. Average attendance was 1.1 sessions per week. Functional fitness assessment results indicated that right-hand grip strength (25.6 ± 8.2 to 26.7 ± 7.8 kg), left-hand grip strength (24.9 ± 7.3 to 26.8 ± 7.1 kg), 30-second arm curl (15.6 ± 5.0 to 18.6 ± 5.7 repetitions/30 s), Timed Up-and-Go (7.4 ± 2.6 to 6.9 ± 2.6 s), and 30-second chair stand (12.0 ± 3.9 to 15.4 ± 5.8 s) improved significantly (P health (61.5 ± 20.9 to 66.0 ± 20.4; P = 0.03), vitality (61.5 ± 18.9 to 67.5 ± 20.2; P = 0.008), and mental health (74.3 ± 16.5 to 78.5 ± 17.7; P = 0.04) also improved significantly over the intervention period. Improvements in physical health and physical function scores were clinically meaningful. Participating in TC for 16 weeks led to significant improvements in functional fitness and components of physical and mental health among older adults with self-reported arthritis. Tai Chi seems to be a valuable mode of physical activity for this population.
Felton, Teena M; Nickols-Richardson, Sharon M; Serrano, Elena; Hosig, Kathy W
African-American professionals are underrepresented in the profession of dietetics. This preliminary qualitative study identified African-American students' perceptions of their majors, future professions, and the dietetics major/profession to understand why they did or did not enter dietetics. It was hypothesized that dietetics students chose dietetics primarily for altruistic reasons, whereas students in other fields of study did not choose dietetics due to lack of awareness of dietetics. To learn students' views, African-American college students engaged in elicitation interviews or focus group discussions. Twenty-eight women and 12 men participated. Phenomenologic analysis identified common themes and meanings: African-American students selected their majors for a variety of reasons, including desire to help people, interest in the field, recommendation from an adult, and family influence. African-American students in fields of study other than dietetics believed that the dietetics major was not selected due to lack of awareness about dietetics. Both dietetics students and students in other fields of study perceived versatility, ability to work with/help people, and to have an influence as positive qualities about their future professions. Advanced degree and training requirements, lack of diversity, and low salary were identified as negative qualities about future professions. African-American students in fields of study other than dietetics had not been exposed to the dietetics major, careers, and profession. Recruitment efforts should begin early to increase the number of African-American students in dietetics.
Kennedy, Bernice Roberts; Jenkins, Chalice C
African American women, including adolescents and adults, are disproportionately affected by the transmission of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). HIV/AID is a health disparity issue for African American females in comparison to other ethnic groups. According to data acquired from 33 states in 2005, 64% of women who have HIV/ AIDS are African American women. It is estimated that during 2001-2004, 61% of African Americans under the age of 25 had been living with HIV/AIDS. This article is an analytical review of the literature emphasizing sexual assertiveness of African American women and the gap that exists in research literature on this population. The multifaceted model of HIV risk posits that an interpersonal predictor of risky sexual behavior is sexual assertiveness. The critical themes extracted from a review of the literature reveal the following: (a) sexual assertiveness is related to HIV risk in women, (b) sexual assertiveness and sexual communication are related, and (c) women with low sexual assertiveness are at increased risk of HIV As a result of this comprehensive literature, future research studies need to use models in validating sexual assertiveness interventions in reducing the risk of HIV/AIDS in African American women. HIV/AIDs prevention interventions or future studies need to target reducing the risk factors of HIV/AIDS of African Americans focusing on gender and culture-specific strategies.
Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kostanjsek, Nenad; Kowal, Paul; Officer, Alana; Chatterji, Somnath
Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.
Johnson, Angela; Kirk, Rosalind; Rosenblum, Katherine Lisa
Abstract The goals of this article are to provide a review of key interventions and strategies that impact initiation and duration of breastfeeding with particular focus on low-income African American mothers' maternal psychological vulnerabilities during the early postpartum period using a social ecological perspective as a guiding framework. Although modest gains have been achieved in breastfeeding initiation rates in the United States, a projected gap remains between infant feeding practices and national Healthy People breastfeeding goals set for 2020, particularly among African Americans. These disparities raise concerns that socially disadvantaged mothers and babies may be at increased risk for poor postnatal outcomes because of poorer mental health and increased vulnerability to chronic health conditions. Breastfeeding can be a protective factor, strengthening the relationship between mother and baby and increasing infant health and resilience. Evidence suggests that no single intervention can sufficiently address the multiple breastfeeding barriers faced by mothers. Effective intervention strategies require a multilevel approach. A social ecological perspective highlights that individual knowledge, behavior, and attitudes are shaped by interactions between the individual woman, her friends and family, and her wider historical, social, political, economic, institutional, and community contexts, and therefore effective breastfeeding interventions must reflect all these aspects. Current breastfeeding interventions are disjointed and inadequately meet all African American women's social and psychological breastfeeding needs. Poor outcomes indicate a need for an integrative approach to address the complexity of interrelated breastfeeding barriers mothers' experience across layers of the social ecological system. PMID:25423601
Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D.; Blackmon, Brittane; Bryant, Rachel J.; Siegelman, Asher E.; Kaslow, Nadine J.
Background This study examined 1) the relative efficacy of a culturally-sensitive empowerment group intervention (Nia) aimed at increasing three protective factors—self-esteem, hopefulness, and effectiveness of obtaining resources—versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and 2) the impact of participants’ readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the two conditions. Methods The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Results Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants that were “less ready to change” (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Conclusion Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally-informed intervention. PMID:25403027
Williams, Monnica T; Jahn, Matthew E
Obsessive-compulsive disorder (OCD) is a serious condition that remains understudied in ethnoracial minority populations. The presence of OCD and the individual, familial, and cultural factors that influence this condition can interfere with healthy development and cause lifelong disability. To date, there has not been a single published research article focused on OCD in African American youth. Ethnic and racial minorities with OCD are underrepresented or altogether absent from treatment centers and research studies, although evidence suggests that OCD may be particularly persistent in these populations. This article reviews risk factors, protective factors, and barriers to treatment in African American children and adolescents with OCD. This review conceptualizes cultural differences in symptomology, low income, reduced access to care, racism, and mental health stigma, as risk factors. Also discussed are the roles of family factors in the development and maintenance of the disorder, including family accommodations, conflictual family communication, and parenting styles. Potential protective factors are also examined, including a positive ethnic identity, social support, present-centered time orientation, and religious communities. Implications of findings are discussed. There is an urgent need for research to understand the needs of African American children and adolescents with OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Beckjord, Ellen Burke; Klassen, Ann C
Improving mammography initiation and maintenance among African American women has been suggested as a strategy for reducing breast cancer mortality in this population. We examined cultural values in relation to self-reported breast cancer screening among 572 low-income, urban, African American women. Cultural values examined included time orientation, family authority, employment aspirations, value of past vs modern life, and reliance on medical professionals. Also, implications for continued development of culturally tailored health interventions and opportunities for the consideration of cultural values in health communication are discussed. Bivariate analyses showed that more traditional values were associated with worse screening histories and lower intentions for future screening. In multivariate analyses, two interactions were observed between cultural values and age: for younger women, more traditional values were associated with lower odds of having ever received a mammogram, and for older women, more traditional values were associated with lower odds of intentions to receive a mammogram in the next 2 years. This study adds to the evidence that cultural constructs, such as values, are associated with secondary prevention of breast cancer and supports the consideration of cultural constructs as important in increasing mammography and reducing breast cancer disparities for African American women.
Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D; Blackmon, Brittane; Bryant, Rachel J; Siegelman, Asher E; Kaslow, Nadine J
This study examined (a) the relative efficacy of a culturally sensitive empowerment group intervention (Nia) aimed at increasing 3 protective factors-self-esteem, hopefulness, and effectiveness of obtaining resources-versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and (b) the impact of participants' readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the 2 conditions. The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants who were "less ready to change" (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally informed intervention. (c) 2015 APA, all rights reserved).
Stewart, Jennifer M; Thompson, Keitra; Rogers, Christopher
The US National HIV AIDS strategy promotes the use of faith communities to lessen the burden of HIV in African American communities. One specific strategy presented is the use of these non-traditional venues for HIV testing and co-location of services. African American churches can be at the forefront of this endeavour through the provision of HIV testing and linkage to care. However, there are few interventions to promote the churches' involvement in both HIV testing and linkage to care. We conducted 4 focus groups (n = 39 participants), 4 interviews and 116 surveys in a mixed-methods study to examine the feasibility of a church-based HIV testing and linkage to care intervention in Philadelphia, PA, USA. Our objectives were to examine: (1) available assets, (2) challenges and barriers and (3) needs associated with church-based HIV testing and linkage to care. Analyses revealed several factors of importance, including the role of the church as an access point for testing in low-income neighbourhoods, challenges in openly discussing the relationship between sexuality and HIV, and buy-in among church leadership. These findings can support intervention development and necessitate situating African American church-based HIV testing and linkage to care interventions within a multi-level framework.
Gittelsohn, Joel; Trude, Angela C; Poirier, Lisa; Ross, Alexandra; Ruggiero, Cara; Schwendler, Teresa; Anderson Steeves, Elizabeth
The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community intervention. The B'more Healthy Communities for Kids (BHCK) intervention worked at the wholesaler ( n = 3), corner store ( n = 50), carryout ( n = 30), recreation center ( n = 28), household ( n = 365) levels to improve availability, purchasing, and consumption of healthier foods and beverages (low-sugar, low-fat) in low-income food desert predominantly African American zones in the city of Baltimore (MD, USA), ultimately intending to lead to decreased weight gain in children (not reported in this manuscript). For this paper, we focus on more proximal impacts on the food environment, and measure change in stocking, sales and purchase of promoted foods at the different levels of the food system in 14 intervention neighborhoods, as compared to 14 comparison neighborhoods. Sales of promoted products increased in wholesalers. Stocking of these products improved in corner stores, but not in carryouts, and we did not find any change in total sales. Children more exposed to the intervention increased their frequency of purchase of promoted products, although improvement was not seen for adult caregivers. A multilevel food environment intervention in a low-income urban setting improved aspects of the food system, leading to increased healthy food purchasing behavior in children.
Full Text Available The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment multicomponent (interventions occurring at the same level community intervention. The B’more Healthy Communities for Kids (BHCK intervention worked at the wholesaler (n = 3, corner store (n = 50, carryout (n = 30, recreation center (n = 28, household (n = 365 levels to improve availability, purchasing, and consumption of healthier foods and beverages (low-sugar, low-fat in low-income food desert predominantly African American zones in the city of Baltimore (MD, USA, ultimately intending to lead to decreased weight gain in children (not reported in this manuscript. For this paper, we focus on more proximal impacts on the food environment, and measure change in stocking, sales and purchase of promoted foods at the different levels of the food system in 14 intervention neighborhoods, as compared to 14 comparison neighborhoods. Sales of promoted products increased in wholesalers. Stocking of these products improved in corner stores, but not in carryouts, and we did not find any change in total sales. Children more exposed to the intervention increased their frequency of purchase of promoted products, although improvement was not seen for adult caregivers. A multilevel food environment intervention in a low-income urban setting improved aspects of the food system, leading to increased healthy food purchasing behavior in children.
Shurtz, Mary Ann; LeFlore, Ann Becker
This module, one of six on teaching consumer matters to low-income adults, discusses banking skills. Topics include banking services (savings accounts, safety deposit boxes, Christmas clubs, loans, etc.), checking accounts (deposits, checkwriting, check registers, opening an account), how to use the check register (cancelled checks, deposits),…
Holt, Yolanda Feimster
This research explored mechanisms of vowel variation in African American English by comparing 2 geographically distant groups of African American and White American English speakers for participation in the African American Shift and the Southern Vowel Shift. Thirty-two male (African American: n = 16, White American controls: n = 16) lifelong residents of cities in eastern and western North Carolina produced heed,hid,heyd,head,had,hod,hawed,whod,hood,hoed,hide,howed,hoyd, and heard 3 times each in random order. Formant frequency, duration, and acoustic analyses were completed for the vowels /i, ɪ, e, ɛ, æ, ɑ, ɔ, u, ʊ, o, aɪ, aʊ, oɪ, ɝ/ produced in the listed words. African American English speakers show vowel variation. In the west, the African American English speakers are participating in the Southern Vowel Shift and hod fronting of the African American Shift. In the east, neither the African American English speakers nor their White peers are participating in the Southern Vowel Shift. The African American English speakers show limited participation in the African American Shift. The results provide evidence of regional and socio-ethnic variation in African American English in North Carolina.
Murry, Velma McBride; Berkel, Cady; Chen, Yi-fu; Brody, Gene H.; Gibbons, Frederick X.; Gerrard, Meg
AIDS is the leading killer of African Americans between the ages of 25 and 44, many of whom became infected when they were teenagers or young adults. The disparity in HIV infection rate among African Americans youth residing in rural Southern regions of the United States suggests that there is an urgent need to identify ways to promote early…
Gibbs, J T
African-American suicide rates have traditionally been lower than White rates despite a legacy of racial discrimination, persistent poverty, social isolation, and lack of community resources. This paper focuses on four issues: (1) patterns and trends of Black suicide across the lifespan; (2) risk and protective factors in subgroups of Blacks; (3) the influence of cultural factors on suicide patterns of Blacks; and (4) implications of these patterns for prevention and early intervention of suicidal behavior among African Americans. Risk factors for Black suicide include: male sex, early adulthood, substance abuse, psychiatric disorders, family or interpersonal conflict, antisocial behavior, and homosexuality. Protective factors that mitigate the risks of suicide include religiosity, older age, southern residence, and social support. Implications for preventive policies and programs are discussed to counter the recent trend of rising suicide rates among adolescents and very elderly Blacks.
Amankwaa, Linda Clark
The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included.
Full Text Available Environmental stressors, such as perceived discrimination (PD, are linked to Binge Eating Disorder (BED. The current study investigated the association between PD and BED among African Americans, and the variation in such an association based on gender. Data of the National Survey of American Life (NSAL, 2001–2003, with a nationally-representative sample of African American adults, were used (n = 3516. The independent variable in the study was PD. The dependent variable was BED, measured using the Composite International Diagnostic Interview (CIDI. Socio-demographics (age, education, employment, and marital status were covariates, and gender was the moderator variable. Survey logistic regressions with and without gender × PD interaction terms were used for data analysis. In the pooled sample, PD was associated with higher odds of BED, net of socio-demographic factors. Models also showed a significant gender × PD interaction term suggesting a stronger association between PD and BED for women, compared to men. Gender specific models showed an association between PD and BED among female, but not male, African Americans. Although a link may exist between PD and BED among African Americans, the magnitude of this association depends on gender, with a stronger association among females than males. This finding is in line with the literature that has shown gender-specific consequences of environmental stress for African Americans.
Gonzalez, Michelle; Jones, Deborah; Parent, Justin
African American youth from single-mother homes continue to be overrepresented in statistics on risk behavior and delinquency, a trend that many be attributed to father-absence, socioeconomic disadvantage, and compromises in parenting more typical of single than two-parent families. Yet, this risk-focused perspective ignores a long-standing strength of the African American community, the involvement and potential protective impact of extended family members in childrearing. This study describes the experiences of 95 African American single mothers and their nonmarital coparents who participated in a study of African American single-mother families with an 11-16-year-old child. Specifically, the study examines: (a) the extent to which nonmarital coparents are involved in childrearing; (b) the relative levels of risk (i.e., depression, mother-coparent conflict) and protective (i.e., parenting) associated with maternal and coparent involvement; and (c) how similarly and/or differently coparent and mother variables operate with regard to youth externalizing problems. Findings reveal that a range of family members and other adults actively participate in childrearing in African American single-mother families, coparents do not differ from mothers on certain study variables (i.e., depression and mother-coparent conflict) but do for others (parenting), and coparent involvement is associated with youth adjustment in ways that are similar to our more established understanding of maternal involvement. The potential clinical implications of the findings are discussed and future research directions are highlighted. © 2014 FPI, Inc.
Marotta, Phillip L; Voisin, Dexter R
The following study assessed whether future orientation mediated the effects of peer norms and parental monitoring on delinquency and substance use among 549 African American adolescents. Structural equation modeling computed direct and indirect (meditational) relationships between parental monitoring and peer norms through future orientation. Parental monitoring significantly correlated with lower delinquency through future orientation ( B = -.05, standard deviation = .01, p Future orientation mediated more than quarter (27.70%) of the total effect of parental monitoring on delinquency. Overall findings underscore the importance of strengthening resilience factors for African American youth, especially those who live in low-income communities.
Klinnert, Mary D.; Holsey, Chanda Nicole; McQuaid, Elizabeth L.
Objective To examine the reliability and validity of the Family Asthma Management System Scale for low-income African-American children with poor asthma control and caregivers under stress. The FAMSS assesses eight aspects of asthma management from a family systems perspective. Methods Forty-three children, ages 8–13, and caregivers were interviewed with the FAMSS; caregivers completed measures of primary care quality, family functioning, parenting stress, and psychological distress. Children rated their relatedness with the caregiver, and demonstrated inhaler technique. Medical records were reviewed for dates of outpatient visits for asthma. Results The FAMSS demonstrated good internal consistency. Higher scores were associated with adequate inhaler technique, recent outpatient care, less parenting stress and better family functioning. Higher scores on the Collaborative Relationship with Provider subscale were associated with greater perceived primary care quality. Conclusions The FAMSS demonstrated relevant associations with asthma management criteria and family functioning for a low-income, African-American sample. PMID:19776230
Hill, Gina Jarman; Arnett, Dennis B; Mauk, Eileen
Provide a better understanding of the process used by low-income pregnant/postpartum women when deciding whether to breast-feed or not. Pregnant/postpartum women admitted to an obstetrics floor completed a survey to determine breast-feeding intention (n=88). Subjects were primarily Hispanic and African American women. Beliefs and referent other were related positively to attitude and subjective norm, respectively. Subjective norm was related positively to intention to breast-feed. Breast-feeding knowledge was low. Others' opinions clearly influence feeding intentions among this population of low-income women. Inclusion of these significant others, family, and friends within the breast-feeding education process is warranted.
Brim, Hassan; Ashktorab, Hassan
Genome-wide studies are increasingly becoming a must, especially for complex diseases such as cancer where multiple genes and diverse molecular mechanisms are known to be involved in genes’ function alteration. In this review, we report our latest genomic and epigenomic findings in African-American colorectal cancer patients. This population suffers a higher burden of the disease and most investigators in this field are looking for the underlying genetic and epigenetic targets that might be r...
Sims, Regina C.; Whitfield, Keith E.; Ayotte, Brian J.; Gamaldo, Alyssa A.; Edwards, Christopher L.; Allaire, Jason C.
The current analysis examined (a) if measures of psychological well-being predict subjective memory, and (b) if subjective memory is consistent with actual memory. Five hundred seventy-nine older African Americans from the Baltimore Study of Black Aging completed measures assessing subjective memory, depressive symptomatology, perceived stress, locus of control, and verbal and working memory. Higher levels of perceived stress and greater externalized locus of control predicted poorer subjecti...
Perera, Minoli A; Cavallari, Larisa H; Limdi, Nita A; Gamazon, Eric R; Konkashbaev, Anuar; Daneshjou, Roxana; Pluzhnikov, Anna; Crawford, Dana C; Wang, Jelai; Liu, Nianjun; Tatonetti, Nicholas; Bourgeois, Stephane; Takahashi, Harumi; Bradford, Yukiko; Burkley, Benjamin M
Summary BackgroundVKORC1 and CYP2C9 are important contributors to warfarin dose variability, but explain less variability for individuals of African descent than for those of European or Asian descent. We aimed to identify additional variants contributing to warfarin dose requirements in African Americans. MethodsWe did a genome-wide association study of discovery and replication cohorts. Samples from African-American adults (aged ≥18 years) who were taking a stable maintenance dose of warfar...
Murrock, Carolyn J; Gary, Faye
This secondary analysis tested the reliability and validity of the Self-Efficacy for Exercise (SEE) and the Outcome Expectations for Exercise (OEE) scales in 126 community dwelling, middle aged African American women. Social Cognitive Theory postulates self-efficacy is behavior age, gender and culture specific. Therefore, it is important to determine ifself-efficacy scales developed and tested in older Caucasian female adults are reliable and valid in middle aged, minority women. Cronbach's alpha and construct validity using hypothesis testing and confirmatory factor analysis supported the reliability and validity of the SEE and OEE scales in community dwelling, middle aged African American women.
Saleh, Lena D; van den Berg, Jacob J; Chambers, Christopher S; Operario, Don
Previous research has suggested a need to understand the social-psychological factors contributing to HIV risk among African American men who have sex with men (MSM). We conducted individual in-depth interviews with 34 adult African American MSM to examine their personal experiences about: (i) sources of social support, (ii) psychological responses to the presence or absence of social support and (iii) influences of social support on sexual behaviours. The majority of participants described limited positive encouragement and lack of emotional support from family, as well as few meaningful personal relationships. Feelings of isolation and mistrust about personal relationships led many participants to avoid emotional intimacy and seek physical intimacy through sexual encounters. Findings highlight a need for multilevel interventions that enhance social support networks and address the social-psychological, emotional and interpersonal factors that contribute to HIV risk among African American MSM.
Brooke C. Schneider
Full Text Available An older adult's ability to perform physical tasks is predictive of disability onset and is associated with declines in cognition. Risk factors for physical performance declines among African Americans, a group with the highest rates of disability, remain understudied. This study sought to identify demographic, health, and cognitive factors associated with lower-extremity physical performance in a sample of 106 African American women ages 56 to 91. After controlling for global cognitive functioning (Mini Mental State Exam, physical performance was associated with executive functioning (Stroop Color/Word, but not visuospatial construction (WASI Block Design or processing speed (Trail Making Test, Part A. Executive functioning remained associated with physical performance after entry of demographic variables, exercise, depression, disease burden, and body mass index (BMI. Age, and BMI were also significant in this model. Executive functioning, age and BMI are associated with lower-extremity physical performance among older African American women.
Sims, Regina C.; Madhere, Serge; Gordon, Shalanda; Clark, Elijah; Abayomi, Kobi A.; Callender, Clive O.; Campbell, Alfonso L.
Background Individuals at greater risk for cardiovascular disease (CVD) display poorer cognitive functioning across various cognitive domains. This finding is particularly prevalent among older adults; however, few studies examine these relationships among younger adults or among African Americans. Purpose The objective was to examine the relationships among 2 cardiovascular risk factors, elevated blood pressure and elevated triglycerides, and verbal learning in a community-based sample of African Americans. Methods Measurements of blood pressure and triglycerides were obtained in 121 African-American adults and compared to performance on 3 domains of the California Verbal Learning Test-II (CVLT-II). Results Blood pressure was not related to CVLT-II performance. Triglyceride levels were inversely related to CVLT-II performance. Higher triglyceride levels were associated with poorer immediate, short delay and long delay recall. Conclusions Consistent with studies involving older participants, the current investigation shows that in a nonelderly sample of African Americans, triglyceride levels may be related to cognitive functioning. Because early detection and intervention of vascular-related cognitive impairment may have a salutary effect, future studies should include younger adults to highlight the impact of cardiovascular risk on cognition. PMID:18942281
Allen, Richard L.; Bagozzi, Richard P.
Examined the structure of African American belief systems (racial attitudes and self-esteem) and its relationship to wellbeing, other group attachments, and system orientations across different age and generation groups. Interview data from three age-groupings of adults demonstrated substantial similarity across age cohorts in understanding of…
In the last few years, there has been a growing problem with the prevalence of being overweight. This is becoming an accepted lifestyle in the African American community, and has begun to impact not just adults, but also adolescents and young children. There are problems associated with being overweight or obese that could have lifetime…
The decision to participate in visual arts studies in college and visual arts professions in adult life is the product of multiple factors, including the influences of family, community, peer group, mass culture, and K-12 schooling. Recognizing African American underrepresentation in visual arts studies and professions, this article explores how…
Arriola, Kimberly; Robinson, Dana H.; Thompson, Nancy J.; Perryman, Jennie P.
This study sought to evaluate the effectiveness of "Project ACTS: About Choices in Transplantation and Sharing," which was developed to increase readiness for organ and tissue donation among African American adults. Nine churches (N = 425 participants) were randomly assigned to receive donation education materials currently available to consumers…
Barr, Ashley B.; Simons, Ronald L.
Using Family and Community Health Study data consisting of 168 unmarried, primarily African American couples, the current study sought to understand the dyadic interplay among school, work, and partner-specific marriage expectations in early adulthood. Drawing on the economic prospects, adult transitions, and work-family literatures, the authors…
Brown, Danice L.; Segrist, Daniel
The present study examined the relative influence of aspects of internalized racism on the career aspirations of a sample of African American adults. Participants (N = 315), ranging in age from 18 to 62 years, completed measures of internalized racism and career aspirations online. A hierarchical multiple regression analysis was conducted to…
Bell-Tolliver, LaVerne; Burgess, Ruby; Brock, Linda J
With the exception of Hill's (1971, 1999) work, historically much of the literature on African American families has focused more on pathology than strengths. This study used interviews with 30 African American psychotherapists, self-identified as employing a strengths perspective with African American families, to investigate which strengths they identified in the families and how they use those strengths in therapy. Themes emerging from data analysis confirmed the continued importance of the five strengths Hill noted. In addition, two new strengths were identified by the participants: a willingness of a greater number of families to seek therapy, and the importance of family structure. Strategies used in engaging the families in therapy and practice implications for family therapists are discussed.
Lissouba, Pascale; Taljaard, Dirk; Rech, Dino; Doyle, Sean; Shabangu, Daniel; Nhlapo, Cynthia; Otchere-Darko, Josephine; Mashigo, Thabo; Matson, Caitlin; Lewis, David; Billy, Scott; Auvert, Bertran
World Health Organization (WHO)/Joint United Nations Programme on AIDS (UNAIDS) has recommended adult male circumcision (AMC) for the prevention of heterosexually acquired HIV infection in men from communities where HIV is hyperendemic and AMC prevalence is low. The objective of this study was to investigate the feasibility of the roll-out of medicalized AMC according to UNAIDS/WHO operational guidelines in a targeted African setting. The ANRS 12126 "Bophelo Pele" project was implemented in 2008 in the township of Orange Farm (South Africa). It became functional in 5 mo once local and ethical authorizations were obtained. Project activities involved community mobilization and outreach, as well as communication approaches aimed at both men and women incorporating broader HIV prevention strategies and promoting sexual health. Free medicalized AMC was offered to male residents aged 15 y and over at the project's main center, which had been designed for low-income settings. Through the establishment of an innovative surgical organization, up to 150 AMCs under local anesthesia, with sterilized circumcision disposable kits and electrocautery, could be performed per day by three task-sharing teams of one medical circumciser and five nurses. Community support for the project was high. As of November 2009, 14,011 men had been circumcised, averaging 740 per month in the past 12 mo, and 27.5% of project participants agreed to be tested for HIV. The rate of adverse events, none of which resulted in permanent damage or death, was 1.8%. Most of the men surveyed (92%) rated the services provided positively. An estimated 39.1% of adult uncircumcised male residents have undergone surgery and uptake is steadily increasing. This study demonstrates that a quality AMC roll-out adapted to African low-income settings is feasible and can be implemented quickly and safely according to international guidelines. The project can be a model for the scale-up of comprehensive AMC services, which
Full Text Available BACKGROUND: World Health Organization (WHO/Joint United Nations Programme on AIDS (UNAIDS has recommended adult male circumcision (AMC for the prevention of heterosexually acquired HIV infection in men from communities where HIV is hyperendemic and AMC prevalence is low. The objective of this study was to investigate the feasibility of the roll-out of medicalized AMC according to UNAIDS/WHO operational guidelines in a targeted African setting. METHODS AND FINDINGS: The ANRS 12126 "Bophelo Pele" project was implemented in 2008 in the township of Orange Farm (South Africa. It became functional in 5 mo once local and ethical authorizations were obtained. Project activities involved community mobilization and outreach, as well as communication approaches aimed at both men and women incorporating broader HIV prevention strategies and promoting sexual health. Free medicalized AMC was offered to male residents aged 15 y and over at the project's main center, which had been designed for low-income settings. Through the establishment of an innovative surgical organization, up to 150 AMCs under local anesthesia, with sterilized circumcision disposable kits and electrocautery, could be performed per day by three task-sharing teams of one medical circumciser and five nurses. Community support for the project was high. As of November 2009, 14,011 men had been circumcised, averaging 740 per month in the past 12 mo, and 27.5% of project participants agreed to be tested for HIV. The rate of adverse events, none of which resulted in permanent damage or death, was 1.8%. Most of the men surveyed (92% rated the services provided positively. An estimated 39.1% of adult uncircumcised male residents have undergone surgery and uptake is steadily increasing. CONCLUSION: This study demonstrates that a quality AMC roll-out adapted to African low-income settings is feasible and can be implemented quickly and safely according to international guidelines. The project can be
Krupski, Tracey L; Fink, Arlene; Kwan, Lorna; Maliski, Sally; Connor, Sarah E; Clerkin, Barbara; Litwin, Mark S
The objective was to describe health-related quality-of-life (HRQOL) in low-income men with prostate cancer. Subjects were drawn from a statewide public assistance prostate cancer program. Telephone and mail surveys included the RAND 12-item Health Survey and UCLA Prostate Cancer Index Short Form and were compared with normative age-matched men without cancer from the general population reported on in the literature. Of 286 eligible men, 233 (81%) agreed to participate and completed the necessary items. The sample consisted of 51% Hispanics, 23% non-Hispanic whites, and 17% African Americans. The low-income men had worse scores in every domain of prostate-specific and general HRQOL than had the age-matched general population controls. The degree of disparity indicated substantial clinical differences in almost every domain of physical and emotional functioning between the sample group and the control group. Linear regression modeling determined that among the low-income men, Hispanic race, and income level were predictive of worse physical functioning, whereas only comorbidities predicted mental health. Low-income patients with prostate cancer appear to have quality-of-life profiles that are meaningfully worse than age-matched men from the general population without cancer reported on in the literature.
Presley, G; Smith, C; Hilsenroth, M; Exner, J
In this study we sought to identify Rorschach differences between African Americans and White Americans and to understand these differences within a social and cultural framework. Data from the Exner (1993) Comprehensive System normative sample (N = 700) was used to form a group of 44 African Americans and 44 White Americans matched for age, sex, education, and socioeconomic status. Twenty-three Rorschach variables were chosen a priori and group differences were analyzed. The only clinically significant difference found was that African Americans offered significantly less cooperative movement. This lower frequency of cooperative movement may suggest African Americans do not anticipate cooperative interactions with others as a routine event. This may reflect a shared feeling among African Americans that most members of our society are less likely to be sensitive to or responsive to their needs relative to others. However, the study demonstrates a striking similarity between the groups, supporting the clinical use of the Rorschach with African Americans.
Sellers, R M; Kuperminc, G P; Damas, A
The present study provides a descriptive analysis of four areas of African American women student athletes' college life experiences: academic performance; alienation and abuse; perceived social advantage as the result of athletics; and life satisfaction. Multivariate comparisons were made between the four areas of college life experiences of 154 African American women student athletes and 793 White women student athletes, 250 African American women nonathletes, and 628 African American men student athletes from a national sample of 39 NCAA Division I universities. Overall, African American women student athletes are performing adequately academically, integrating socially within the university, perceiving some social advantage as the result of being athletes, and are fairly satisfied with their life. Their experiences seem most consistent with African American women nonathletes. Results are discussed in the context of potential policy recommendations as well as the need for more research on this particular population.
The term ‘black music’ has long been a cause for contention. What do we mean by music being ‘black’, or more specifically in the case of this chapter, African American? The music industry has typically marketed products via the categorization of specific genres: for example, jazz, blues, soul, funk and rap. These generic types are often classified as ‘black music’. Philip Tagg vehemently debates the suitability of such an essentializing label, as he correctly argues that aesthetic practice is...
Anthony, Jean Spann; Morris, Edith; Collins, Charles W; Watson, Albert; Williams, Jennifer E; Ferguson, Bʼnai; Ruhlman, Deborah L
Many African Americans (AAs) use clergy as their primary source of help for depression, with few being referred to mental health providers. This study used face-to-face workshops to train AA clergy to recognize the symptoms and levels of severity of depression. A pretest/posttest format was used to test knowledge (N = 42) about depression symptoms. Results showed that the participation improved the clergy's ability to recognize depression symptoms. Faith community nurses can develop workshops for clergy to improve recognition and treatment of depression.
U.S. Department of Health & Human Services — Cancer Outcomes in Low-Income Elders, Is There An Advantage to Being on Medicaid Because of reduced financial barriers, dual Medicare-Medicaid enrollment of...
Clothed in her traditional African garb, Michelle Amos, mistress of ceremonies, welcomes the audience on Feb. 3 at the kick-off of African-American History Month. The theme for this year's observation is 'Heritage and Horizons: The African-American Legacy and the Challenges of the 21st Century.' February is designated each year as a time to celebrate the achievements and contributions of African Americans to Kennedy Space Center, NASA and the nation.
Full Text Available Since the law has been crucial in defining and delineating the dimensions of African American experience both in slavery and in freedom, the encounter with the American legal system and its representatives has left a strong imprint on African American cultural and literary memory and expression. The article sketches out a few aspects and features which characterize the reflection of law and race in African American culture and literature.
SNPs from the African American breast cancer scan to COGs , a European collaborative study which is has designed a SNP array with that will be genotyped...Award Number: W81XWH-08-1-0383 TITLE: A Genome-wide Breast Cancer Scan in African Americans PRINCIPAL INVESTIGATOR: Christopher A...SUBTITLE A Genome-wide Breast Cancer Scan in African Americans 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-08-1-0383 5c. PROGRAM
Willie, Charles V., Ed.; Garibaldi, Antoine M., Ed.; Reed, Wornie L., Ed.
In 1987 a project was undertaken to assess the status of African Americans in the United States in the topical areas to be addressed by the National Research Council's Study Committee on the Status of Black Americans: education, employment, income and occupations, political participation and the administration of justice, social and cultural…
Albdour, Maha; Krouse, Helene J
Bullying among African American adolescents. This article reviews the current literature on bullying and victimization among African American adolescents. It highlights bullying and violence disparity among African American adolescents, associated risk and protective factors, and effects of bullying on adolescent health. Twenty-three English language peer-reviewed articles from CINAHL, Pubmed, and Psyc-INFO databases. African American adolescents have higher rates of bullying and victimization compared to other adolescent populations. This review found strong associations among bullying involvement, substance abuse, and family factors. Bullying also had a significant impact on adolescent health, particularly psychological symptoms and school performance. © 2014 Wiley Periodicals, Inc.
Payton, Erica; Thompson, Amy; Price, James H; Sheu, Jiunn-Jye; Dake, Joseph A
Firearm mortality is the leading cause of death for young African American males, however, few studies have focused on racial/ethnic minority populations and firearm violence. The National Black Caucus of State Legislators advocates for legislation that promotes the health of African Americans. Thus, the purpose of this study was to collect baseline data on African American legislators' perceptions regarding firearm violence in the African American community. A cross-sectional study of African American legislators (n = 612) was conducted to investigate the research questions. Of the 612 questionnaires mailed, 12 were not deliverable, and 170 were returned (28%). Utilizing a three wave mailing process, African American legislators were invited to participate in the study. The majority (88%) of respondents perceived firearm violence to be very serious among African Americans. Few (10%) legislators perceived that addressing legislative issues would be an effective strategy in reducing firearm violence among African Americans. The majority (72%) of legislators perceived the most effective strategy to reducing firearm violence in the African American community should focus on addressing societal issues (e.g. crime and poverty). After adjusting for the number of perceived barriers, the number of perceived benefits was a significant predictor of legislators' perceived effectiveness of firearm violence prevention legislation for 8 of the 24 potential firearm violence prevention legislative bills.
Kwate, Naa Oyo A; Meyer, Ilan H
Recent theoretical and empirical studies of the social determinants of health inequities have shown that economic deprivation, multiple levels of racism, and neighborhood context limit African American health chances and that African Americans' poor health status is predicated on unequal opportunity to achieve the American Dream. President Obama's election has been touted as a demonstration of American meritocracy-the belief that all may obtain the American Dream-and has instilled hope in African Americans. However, we argue that in the context of racism and other barriers to success, meritocratic ideology may act as a negative health determinant for African Americans.
Breitenstein, Susan M.; Gross, Deborah; Fogg, Louis; Ridge, Alison; Garvey, Christine; Julion, Wrenetha; Tucker, Sharon
Data were merged from two prevention randomized trials testing 1-year outcomes of a parenting skills program, the Chicago Parent Program (CPP), and comparing its effects for African-American (n=291) versus Latino (n=213) parents and their preschool children. Compared to controls, intervention parents had improved self-efficacy, used less corporal punishment and more consistent discipline, and demonstrated more positive parenting. Intervention children had greater reductions in behavior problems based on parent-report, teacher-report, and observation. Although improvements from CPP were evident for parents in both racial/ethnic groups, Latino parents reported greater improvements in their children’s behavior and in parenting self-efficacy but exhibited greater decreases in praise. Findings support the efficacy of the CPP for African American and Latino parents and young children from low-income urban communities. PMID:22622598
Koblinsky, Sally A; Kuvalanka, Katherine A; Randolph, Suzanne M
This study examined the role of parenting, family routines, family conflict, and maternal depression in predicting the social skills and behavior problems of low-income African American preschoolers. A sample of 184 African American mothers of Head Start children completed participant and child measures in a structured interview. Results of regression analyses revealed that mothers who utilized more positive parenting practices and engaged in more family routines had children who displayed higher levels of total prosocial skills. Positive parenting and lower levels of maternal depressive symptoms were predictive of fewer externalizing and internalizing child behavior problems. Lower family conflict was linked with fewer externalizing problems. Implications of the study for future research and intervention are discussed. (c) 2007 APA, all rights reserved
Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A
In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood.
Cicchetti, Dante; Rogosch, Fred A.
Genetic moderation of the effects of child maltreatment on depression and internalizing symptoms was investigated in a sample of low-income maltreated and nonmaltreated African-American children (N = 1,096). Lifetime child maltreatment experiences were independently coded from Child Protective Services records and maternal report. Child depression and internalizing problems were assessed in the context of a summer research camp by self-report (Children’s Depression Inventory, CDI) and adult counselor-report (Teacher Report Form, TRF). DNA was obtained from buccal cell or saliva samples and genotyped for polymorphisms of the following genes: 5-HTTLPR, BDNF, NET, and CRHR1. ANCOVAs with age and gender as covariates were conducted, with maltreatment status and respective polymorphism as main effects and their GxE interactions. Maltreatment consistently was associated with higher CDI and TRF symptoms. Results for child self-report symptoms indicated a GxE interaction for BDNF and maltreatment. Additionally, BDNF and tri-allelic 5-HTTLPR interacted with child maltreatment in a GxGxE interaction. Analyses for counselor-report of child anxiety/depression symptoms on the TRF indicated moderation of child maltreatment effects by tri-allelic 5-HTTLPR. These effects were elaborated based on variation in developmental timing of maltreatment experiences. NET was found to further moderate the GxE interaction of 5-HTTLPR and maltreatment status revealing a GxGxE interaction. This GxGxE was extended by consideration of variation in maltreatment subtype experiences. Finally, GxGxE effects were observed for the co-action of BDNF and the CRHR1 haplotype. The findings illustrate the variable influence of specific genotypes in GxE interactions based on variation in maltreatment experiences and the importance of a multi-genic approach for understanding influences on depression and internalizing symptoms among African-American children. PMID:25422957
Rigg, Khary K
Despite the growing popularity of MDMA (ecstasy/molly) among African Americans, their motives for using the drug are still largely unknown. The purpose of this study was to identify and describe the most salient motivations for using MDMA among this understudied population. In-depth interviews (n = 15) were conducted with a sample of African American young adults in Southwest Florida between August 2014 and November 2015. The primary motivations for using MDMA included: (1) altering the effects of marijuana and alcohol; (2) lasting longer sexually; (3) enhancing sexual pleasure; and (4) facilitating "freaky" sexual experiences. This is the first study to directly examine MDMA motivations specifically among African American drug users, and findings shed light on why some African Americans use MDMA. A better understanding of why African Americans use this drug should help to inform prevention and harm-reduction efforts. Study findings show the need for health messages that include the potential consequences of mixing MDMA with other drugs, and engaging in high-risk sexual behaviors after taking MDMA. These data contrast with motivations (e.g., introspection, self-enlightenment, getting into the music) commonly reported among groups of largely White MDMA users, suggesting that interventions tailored specifically for African American users are needed.
K. B. Holden
Full Text Available Gaining greater understanding about the various psychosocial, socio-cultural, and environmental factors that may influence experiences of depression among African American women (AAW helps elucidate how this mental illness impacts the lives of this population. Sixty-three adult AAW comprised the study’s convenience sample. Specifically, focus group cohorts inclusive of women from an academic institution, a primary healthcare clinic, and an urban community setting were conducted. Results indicated six (6 dominant common themes as issues that may increase risk for depression among diverse AAW. Similarities and differences about perspectives that contributed to depression were delineated among the three cohorts of AAW. These results are important for mental/behavioral health researchers, practitioners, and public health professionals that are engaged in the design and implementation of culturally centered and gender-specific prevention and intervention strategies targeted to AAW at risk for depression.
Wade, Roy; Shea, Judy A; Rubin, David; Wood, Joanne
Current assessments of adverse childhood experiences (ACEs) may not adequately encompass the breadth of adversity to which low-income urban children are exposed. The purpose of this study was to identify and characterize the range of adverse childhood experiences faced by young adults who grew up in a low-income urban area. Focus groups were conducted with young adults who grew up in low-income Philadelphia neighborhoods. Using the nominal group technique, participants generated a list of adverse childhood experiences and then identified the 5 most stressful experiences on the group list. The most stressful experiences identified by participants were grouped into a ranked list of domains and subdomains. Participants identified a range of experiences, grouped into 10 domains: family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, child welfare/juvenile justice, and media/technology. Included in these domains were many but not all of the experiences from the initial ACEs studies; parental divorce/separation and mental illness were absent. Additional experiences not included in the initial ACEs but endorsed by our participants included single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination. Gathering youth perspectives on childhood adversity broadens our understanding of the experience of stress and trauma in childhood. Future work is needed to determine the significance of this broader set of adverse experiences in predisposing children to poor health outcomes as adults. Copyright © 2014 by the American Academy of Pediatrics.
.... Both Phase I and 2 work and analyses have been completed. Phase I involved case intensive elicitation interviews of a population data base of over 600 women who were offered but declined participation in free screening mammogram through the Breast...
Background and Purpose: Racial and ethnic minority populations are disproportionally affected by obesity. Text messaging is a major feature of mobile phones and is popular because it allows people to receive information effectively, unobtrusively, and privately. However, the willingness to exercise and eat healthy to prevent obesity by receiving…
Threlfall, Jennifer M; Seay, Kristen D; Kohl, Patricia L
This qualitative study examines low-income African American fathers' perceptions of their parenting role and the strategies they employ to bring up children in poor urban neighborhoods. Focus groups and individual interviews were conducted with 36 fathers who had contact with their children at least twice a month. Men in the study expressed conventional views of their fathering roles as provider, nurturer, and teacher, but placed the most emphasis on "being there" for their children, as their financial circumstances limited other forms of involvement. Many fathers felt their circumstances to be exacerbated by a hostile child-support system. They desired to teach their children alternatives to the negative practices and values they saw in their urban neighborhoods and to have the skills to prosper in mainstream society. Overall, the findings suggest that many low-income urban fathers already desire to be responsible fathers but see themselves as limited by material and structural challenges. Services and policies that promote the economic stability of low-income fathers are recommended.
Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A
Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Eighty low-income mothers and their preschool children were videotaped at dinner in their homes. Mothers were chosen from a larger study to create a 2 X 2 X 2 design: maternal ethnicity (African American vs. Latina) by child gender by child weight status (healthy weight vs. overweight/obese). Observers coded videotapes for a range of maternal feeding strategies and other behaviors. Many mothers spent considerable time encouraging eating--often in spite of the child's insistence that he or she was finished. Mothers talked little about food characteristics, rarely referred to feelings of hunger and fullness, and made more attempts to enforce table manners than to teach eating skills. Latina mothers showed higher levels of teaching eating skills and encouraging their children to eat; African American mothers showed higher levels of enforcing table manners and getting children to clear their plates. Mothers of boys used more unelaborated commands and less questions/suggestions than mothers of girls. Finally, compared to mothers of overweight/obese children, mothers of healthy weight children showed higher levels of encouraging eating and lower levels of discouraging eating. Most of the mothers in this study did not engage in feeding practices that are consistent with current recommendations. They did this, despite the fact that they knew they were being observed. These results should be used to inform future research about the motivations behind mothers' feeding practices and the development of interventions by helping identify areas in greatest need of change.
Kogan, Steven M.; Lei, Man-Kit; Grange, Christina R.; Simons, Ronald L.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yifu
Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10–22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths’ exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults’ romantic relationships. PMID:23494451
Halasa, Katrina Bassam
The major purpose of this qualitative study was to examine the past in order to understand the complex phenomenon of students engaging in science (Newman, Ridenour, Newman, & DeMarco, 2003) specifically through the oral histories of six self-identified African American males enrolled in a high school Advanced Placement Biology class and the oral histories about events that followed during their post high school experiences. To elucidate an understanding of this phenomenon, this research explored the ecology of African American males' descriptions of their school science, their peer school science community, their lived experiences during and after graduation, and their meso-community (Bronfenbrenner, 1979). Many minority and low-income students are less likely to enroll in rigorous courses during high school (Education Trust, 2006). This study is of utmost importance because capturing the informants' oral histories may improve rigorous science education. Many African American male students are attending urban schools with an ever growing achievement gap among their White counterparts (Norman, Ault, Bentz, & Meskimen, 2001); therefore, they are disengaging in science. As a result, African American males are underrepresented in both science careers and achievements in science (Atwater, 2000; National Science Foundation, 1994). The six oral histories highlighted the ecological factors that affected African American males regarding (1) the impact of their relationship with their mothers, (2) the understanding of personal responsibility, (3) the notion of a scientist, (4) the issue of gender being more of an obstacle than race, (5) the understanding that education is valuable, (6) the interactions and influence of relationships with others on their decisions, (7) the development of integrity through the participation in sports, (8) the ecological neighborhood environment influences an image, (9) the enrollment of Advanced Placement Biology course helped the transition
Coley, Rebekah Levine; Lombardi, Caitlin McPherran
This study assessed whether previous findings linking early maternal employment to lower cognitive and behavioral skills among middle class and White children generalized to other groups. Using a representative sample of urban, low-income, predominantly African American and Hispanic families (n = 444), OLS regression and propensity score matching models assessed links between maternal employment in the two years after childbearing and children’s functioning at age 7. Children whose mothers were employed early, particularly in their first 8 months, showed enhanced socio-emotional functioning compared to peers whose mother remained nonemployed. Protective associations emerged for both part time and full time employment, and were driven by African American children, with neutral effects for Hispanics. Informal home-based child care also heightened positive links. PMID:22931466
Keyes, Angela W.; Smyke, Anna T.; Middleton, Melissa; Black, Corey L.
The legacy of slavery in the United States has impacted generations of African Americans, especially parents who must prepare their children to face the challenges associated with being a person of color in this country. The authors explore aspects of racism, White privilege, racial socialization, and African American parents' fears as they equip…
Broman, Clifford L.
Investigated the link between job-related stressors and family life among African Americans. Data from African Americans who participated in the America's Changing Lives survey indicated that job latitude positively affected marital harmony, and physical demands negatively affected marital harmony. Psychosocial demands, job bother, and chronic…
Moore-Thomas, Cheryl; Day-Vines, Norma L.
Religion and spirituality are deeply rooted in traditional African American culture. Data suggest that African American adolescents maintain higher baseline rates of religious activities and beliefs than their peers (Bachman, Johnston, & O'Malley, 2005; Smith, Faris, Denton, & Regnerus, 2003). Recognizing these data, this article examines…
Avent Harris, Janeé R.; Wong, Christine D.
African American undergraduate students face numerous challenges during college; however, they are less likely to seek help from college counseling services. Often, African Americans seek support from spiritual resources. In the current phenomenological study, participants shared in a focus group interview. Overall, participants seemed to value…
Fikes, Robert Jr.
A large number of black scholars have pursued advanced degrees in the German language, history, and culture. Describes the history of African American interest in the German language and culture, highlighting various black scholars who have studied German over the years. Presents data on African Americans in German graduate programs and examines…
Watkins, Daphne C.; Hudson, Darrell L.; Caldwell, Cleopatra Howard; Siefert, Kristine; Jackson, James S.
Purpose: This study examines the influence of discrimination and mastery on depressive symptoms for African American men at young (18-34), middle (35-54), and late (55+) adulthood. Method: Analyses are based on responses from 1,271 African American men from the National Survey of American Life (NSAL). Results: Discrimination was significantly…
Knox-Kazimierczuk, Francoise; Geller, Karly; Sellers, Sherrill; Taliaferro Baszile, Denise; Smith-Shockley, Meredith
Background: There are minimal studies focusing on African American women and obesity, and there are even fewer studies examining obesity through a critical race theoretical framework. African American obesity research has largely focused on individual and community interventions, which have not been sufficient to reverse the obesity epidemic.…
John Schelhas; Sarah Hitchner; Cassandra Johnson Gaither; Rory Fraser; Viniece Jennings; Amadou Diop
The Sustainable Forestry and African American Land Retention Program is a comprehensive effort to address theÂ long-standing problem of underparticipation of African Americans in forest management. We conducted rapidÂ appraisal baseline research for pilot projects in this program in three Southern states using a carefully selectedÂ purposive sample to enhance our...
Ervin, Kelly S.
Hypothesized that African American college students with higher racial self-esteem would be more open to diversity and multiculturalism than students with lower racial self-esteem. Surveys indicated that most students valued diversity-oriented courses, though most also believed that diversity courses were biased against African Americans. Students…
Disparities in asthma management are a burden on African American youth. The objective of this study is to describe and compare the discourses of asthma management disparities (AMDs) in African American adolescents in Seattle to existing youth-related asthma policies in Washington State. Adolescents participated in a three-session photovoice…
Hankerson, Sidney H; Weissman, Myrna M
African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans.
Lucas, Todd; Lumley, Mark A.; Flack, John M.; Wegner, Rhiana; Pierce, Jennifer; Goetz, Stefan
Objective According to worldview verification theory, inconsistencies between lived experiences and worldviews are psychologically threatening. These inconsistencies may be key determinants of stress processes that influence cardiovascular health disparities. This preliminary examination considers how experiencing injustice can affect perceived racism and biological stress reactivity among African Americans. Guided by worldview verification theory, it was hypothesized that responses to receiving an unfair outcome would be moderated by fairness of the accompanying decision process, and that this effect would further depend on the consistency of the decision process with preexisting justice beliefs. Method A sample of 118 healthy African American adults completed baseline measures of justice beliefs, followed by a laboratory-based social-evaluative stressor task. Two randomized fairness manipulations were implemented during the task: participants were given either high or low levels of distributive (outcome) and procedural (decision process) justice. Glucocorticoid (cortisol) and inflammatory (C-reactive protein) biological responses were measured in oral fluids, and attributions of racism were also measured. Results The hypothesized 3-way interaction was generally obtained. Among African Americans with a strong belief in justice, perceived racism, cortisol and C-reactive protein responses to low distributive justice were higher when procedural justice was low. Among African Americans with a weak belief in justice however, these responses were higher when a low level of distributive justice was coupled with high procedural justice. Conclusions Biological and psychological processes that contribute to cardiovascular health disparities are affected by consistency between individual-level and contextual justice factors. PMID:27018728
Mama, Scherezade K; Li, Yisheng; Basen-Engquist, Karen; Lee, Rebecca E; Thompson, Deborah; Wetter, David W; Nguyen, Nga T; Reitzel, Lorraine R; McNeill, Lorna H
Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans.
Scherezade K Mama
Full Text Available Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467 completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination, and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p < .001 and U.S. (p < .001 and low social support (p < .001 were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans.
Fritz, Heather; Cutchin, Malcolm P; Cummins, Emily R
Although evidence suggests that neighborhood conditions are related to stress and health, the processes connecting neighborhood conditions and stress for older minorities is little explored. The purpose of this analysis is to contribute new insights into this issue. We conducted a qualitative analysis as part of a larger mixed methods study of 100 African Americans aged 55 and older living in neighborhoods of varying quality in Detroit, Michigan. A subsample of (n = 20) older adults took photographs of bothersome aspects of their neighborhoods and participated in in-depth photo-elicitation interviews. Data were analyzed using a grounded theory approach. 'Loss of trust in the neighborhood' emerged as the core category to explain how older African Americans in our sample experienced neighborhood stressors in their daily lives. Loss of trust in physical, social, and institutional dimensions of the neighborhood contributed to the core category. The life course of neighborhoods and the trust placed in them appears to be intimately connected to the well-being of older African Americans. We therefore hypothesize that a fundamental pathway through which neighborhood stressors are experienced for older African Americans in U.S. 'Rust Belt' cities is the multifaceted loss of trust in the neighborhood.
Chen, RuiJun; Flores, Glenn; Shetgiri, Rashmi
Adolescent fighting affects 25% of youth, with the highest rates among African-Americans and Latinos but little is known about parental views on youth fighting. The purpose of this study was to examine African-American and Latino parents’ perspectives on adolescent fighting and methods to prevent fighting. We conducted four focus groups with parents of African-American and Latino urban adolescents. Focus groups were stratified by race/ethnicity and fighting status. Groups were audiotaped, transcribed, and analyzed by three independent coders using thematic content analysis. Seventy-six percent of the 17 participants were female. Latino parents condoned fighting only as a last resort, and taught children about consequences of fighting, emotional regulation, and non-violent conflict-resolution strategies. African-American parents endorsed teaching non-violent strategies, but expressed some doubts about their effectiveness. African-American parents also suggested corporal punishment, but acknowledged that this may not be an optimal long-term strategy. Positive role modeling and involvement by teachers and other adults were cited as having important roles in fighting prevention. Suggested interventions included teaching adolescents non-violent conflict-resolution skills, anger management, and alternatives to fighting. Parents recommended that violence prevention programs incorporate the experiences of former fighters and be tailored to community needs. Study findings suggest that youth violence-prevention programs may benefit from addressing parental attitudes towards fighting and parent-child communication about fighting, teaching adolescents non-violent conflict-resolution skills, and tailoring programs by race/ethnicity. Promoting positive modeling and involvement by teachers and other adults also may be beneficial. PMID:27186064
Chen, RuiJun; Flores, Glenn; Shetgiri, Rashmi
Adolescent fighting affects 25% of youth, with the highest rates among African-Americans and Latinos but little is known about parental views on youth fighting. The purpose of this study was to examine African-American and Latino parents' perspectives on adolescent fighting and methods to prevent fighting. We conducted four focus groups with parents of African-American and Latino urban adolescents. Focus groups were stratified by race/ethnicity and fighting status. Groups were audiotaped, transcribed, and analyzed by three independent coders using thematic content analysis. Seventy-six percent of the 17 participants were female. Latino parents condoned fighting only as a last resort, and taught children about consequences of fighting, emotional regulation, and non-violent conflict-resolution strategies. African-American parents endorsed teaching non-violent strategies, but expressed some doubts about their effectiveness. African-American parents also suggested corporal punishment, but acknowledged that this may not be an optimal long-term strategy. Positive role modeling and involvement by teachers and other adults were cited as having important roles in fighting prevention. Suggested interventions included teaching adolescents non-violent conflict-resolution skills, anger management, and alternatives to fighting. Parents recommended that violence prevention programs incorporate the experiences of former fighters and be tailored to community needs. Study findings suggest that youth violence-prevention programs may benefit from addressing parental attitudes towards fighting and parent-child communication about fighting, teaching adolescents non-violent conflict-resolution skills, and tailoring programs by race/ethnicity. Promoting positive modeling and involvement by teachers and other adults also may be beneficial.
Bryant, Keneshia; Haynes, Tiffany; Kim Yeary, Karen Hye-Cheon; Greer-Williams, Nancy; Hartwig, Mary
The aim of this study was to explore how a rural African American faith community would address depression within their congregations and the community as a whole. A qualitative, interpretive descriptive methodology was used. The sample included 24 participants representing pastors, parishioners interested in health, and African American men who had experienced symptoms of depression in a community in the Arkansas Delta. The primary data sources for this qualitative research study were focus groups. Participants identified three key players in the rural African American faith community who can combat depression: the Church, the Pastor/Clergy, and the Layperson. The roles of each were identified and recommendations for each to address depression disparities in rural African Americans. The recommendations can be used to develop faith-based interventions for depression targeting the African American faith community. © 2013 Wiley Periodicals, Inc.
Bloome, Deirdre; Muller, Christopher
The pervasiveness of tenancy in the postbellum South had countervailing effects on marriage between African Americans. Tenancy placed severe constraints on African American women's ability to find independent agricultural work. Freedwomen confronted not only planters' reluctance to contract directly with women but also whites' refusal to sell land to African Americans. Marriage consequently became one of African American women's few viable routes into the agricultural labor market. We find that the more counties relied on tenant farming, the more common was marriage among their youngest and oldest African American residents. However, many freedwomen resented their subordinate status within tenant marriages. Thus, we find that tenancy contributed to union dissolution as well as union formation among freedpeople. Microdata tracing individuals' marital transitions are consistent with these county-level results.
Full Text Available Abstract Background Effectiveness of combined physician and patient-level interventions for blood pressure (BP control in low-income, hypertensive African Americans with multiple co-morbid conditions remains largely untested in community-based primary care practices. Demographic, clinical, psychosocial, and behavioral characteristics of participants in the Counseling African American to Control Hypertension (CAATCH Trial are described. CAATCH evaluates the effectiveness of a multi-level, multi-component, evidence-based intervention compared with usual care (UC in improving BP control among poorly controlled hypertensive African Americans who receive primary care in Community Health Centers (CHCs. Methods Participants included 1,039 hypertensive African Americans receiving care in 30 CHCs in the New York Metropolitan area. Baseline data on participant demographic, clinical (e.g., BP, anti-hypertensive medications, psychosocial (e.g., depression, medication adherence, self-efficacy, and behavioral (e.g., exercise, diet characteristics were gathered through direct observation, chart review, and interview. Results The sample was primarily female (71.6%, middle-aged (mean age = 56.9 ± 12.1 years, high school educated (62.4%, low-income (72.4% reporting less than $20,000/year income, and received Medicaid (35.9% or Medicare (12.6%. Mean systolic and diastolic BP were 150.7 ± 16.7 mm Hg and 91.0 ± 10.6 mm Hg, respectively. Participants were prescribed an average of 2.5 ± 1.9 antihypertensive medications; 54.8% were on a diuretic; 33.8% were on a beta blocker; 41.9% were on calcium channel blockers; 64.8% were on angiotensin converting enzyme (ACE inhibitors/angiotensin receptor blockers (ARBs. One-quarter (25.6% of the sample had resistant hypertension; one-half (55.7% reported medication non-adherence. Most (79.7% reported one or more co-morbid medical conditions. The majority of the patients had a Charlson Co-morbidity score ≥ 2. Diabetes
Halbert, Chanita Hughes; McDonald, Jasmine; Vadaparampil, Susan; Rice, LaShanta; Jefferson, Melanie
Precision medicine is an approach to detecting, treating, and managing disease that is based on individual variation in genetic, environmental, and lifestyle factors. Precision medicine is expected to reduce health disparities, but this will be possible only if studies have adequate representation of racial minorities. It is critical to anticipate the rates at which individuals from diverse populations are likely to participate in precision medicine studies as research initiatives are being developed. We evaluated the likelihood of participating in a clinical study for precision medicine. Observational study conducted between October 2010 and February 2011 in a national sample of African Americans. Intentions to participate in a government sponsored study that involves providing a biospecimen and generates data that could be shared with other researchers to conduct future studies. One third of respondents would participate in a clinical study for precision medicine. Only gender had a significant independent association with participation intentions. Men had a 1.86 (95% CI = 1.11, 3.12, p = 0.02) increased likelihood of participating in a precision medicine study compared to women in the model that included overall barriers and facilitators. In the model with specific participation barriers, distrust was associated with a reduced likelihood of participating in the research described in the vignette (OR = 0.57, 95% CI = 0.34, 0.96, p = 0.04). African Americans may have low enrollment in PMI research. As PMI research is implemented, extensive efforts will be needed to ensure adequate representation. Additional research is needed to identify optimal ways of ethically describing precision medicine studies to ensure sufficient recruitment of racial minorities.
Smith, Tyler K; Tandon, S Darius; Bair-Merritt, Megan H; Hanson, Janice L
Fathers play a critical role in children's development; similarly, fatherhood positively affects men's health. Among the larger population of fathers relatively little is known about the parenting knowledge of urban, African American fathers. Focusing on urban, African American fathers, the objectives of this study were to (1) understand the primary sources from which fathers learn about parenting, (2) determine where and how fathers prefer to receive future parenting education, and (3) explore the information perceived as most valuable to fathers and how this compares with the recommended anticipatory guidance (Bright Futures-based) delivered during well visits. Five focus groups, with a total of 21 participants, were conducted with urban fathers at a community-based organization. Study eligibility included being more than 18 years old, English speaking, and having at least one child 0 to 5 years old. During the focus groups, fathers were asked where they received parenting information, how and where they preferred to receive parenting information, and what they thought about Bright Futures parenting guidelines. Fathers most commonly described receiving parenting information from their own relatives rather than from their child's health care provider. Most fathers preferred to learn parenting from a person rather than a technology-based source and expressed interest in learning more about parenting at community-based locations. Although fathers viewed health care providers' role as primarily teaching about physical health, they valued Bright Futures anticipatory guidance about parenting. Fathers valued learning about child rearing, health, and development. Augmenting physician counseling about Bright Futures with community-based parenting education may be beneficial for fathers. © The Author(s) 2014.
Palmer, Robert T.; Maramba, Dina C.
Although African Americans continue to demonstrate a desire for education, Black male enrollment and completion rates in higher education are dismal when compared to other ethnic groups. Researchers and scholars have noted various theories and philosophies responsible for the academic disengagement of African American men in higher education. This…
Nelson, Kesha Marie
African-American baccalaureate nursing students have a limited persistence to graduation. This constructivist grounded theory study was designed to generate a substantive theory, emerged from these data, that explained and provided insight the African-American academic nurse leader's role in the persistence to graduation of African-American…
Peek, Monica E; Lopez, Fanny Y; Williams, H Sharif; Xu, Lucy J; McNulty, Moira C; Acree, M Ellen; Schneider, John A
Enhancing patient-centered care and shared decision making (SDM) has become a national priority as a means of engaging patients in their care, improving treatment adherence, and enhancing health outcomes. Relatively little is known about the healthcare experiences or shared decision making among racial/ethnic minorities who also identify as being LGBT. The purpose of this paper is to understand how race, sexual orientation and gender identity can simultaneously influence SDM among African-American LGBT persons, and to propose a model of SDM between such patients and their healthcare providers. We reviewed key constructs necessary for understanding SDM among African-American LGBT persons, which guided our systematic literature review. Eligible studies for the review included English-language studies of adults (≥ 19 y/o) in North America, with a focus on LGBT persons who were African-American/black (i.e., > 50 % of the study population) or included sub-analyses by sexual orientation/gender identity and race. We searched PubMed, CINAHL, ProQuest Dissertations & Theses, PsycINFO, and Scopus databases using MESH terms and keywords related to shared decision making, communication quality (e.g., trust, bias), African-Americans, and LGBT persons. Additional references were identified by manual reviews of peer-reviewed journals' tables of contents and key papers' references. We identified 2298 abstracts, three of which met the inclusion criteria. Of the included studies, one was cross-sectional and two were qualitative; one study involved transgender women (91 % minorities, 65 % of whom were African-Americans), and two involved African-American men who have sex with men (MSM). All of the studies focused on HIV infection. Sexual orientation and gender identity were patient-reported factors that negatively impacted patient/provider relationships and SDM. Engaging in SDM helped some patients overcome normative beliefs about clinical encounters. In this paper, we present a
Mosavel, Maghboeba; Wilson Genderson, Maureen; Ports, Katie A; Carlyle, Kellie E
Mothers and daughters share a powerful and unique bond, which has potential for the dissemination of information on a variety of women's health issues, including the primary and secondary prevention of breast and cervical cancer. This study presents formative research from a long-term project examining the potential of mother-daughter communication in promoting cancer screening among African American women. Thirty-two mother-daughter pairs (N = 64) completed orally administered surveys regarding their cancer knowledge, beliefs and attitudes, and barriers to care. This study compares the attitudes and beliefs of low-income, urban, African American mothers and their adolescent daughters regarding cervical and breast cancer screening. Both mothers and daughters had fairly high levels of knowledge about breast and cervical cancer. In addition, there was a high concordance rate between mothers' and daughters' responses, suggesting a potential sharing of health knowledge between mother and daughter. These results have implications for selecting communication strategies to reduce health disparities, and support that the mother-daughter dyad could be a viable unit to disseminate targeted screening information. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Wiegand, Ryan E.; Hill, Elizabeth G.; Magruder, Kathryn M.; Slate, Elizabeth H.; Salinas, Carlos F.; London, Steven D.
Objective The aim of this study is to explore behavioral factors associated with toothache among African American adolescents living in rural South Carolina. Methods Using a self-administered questionnaire, data were collected on toothache experience in the past 12 months, oral hygiene behavior, dental care utilization, and cariogenic snack and non-diet soft drink consumption in a convenience sample of 156 African American adolescents aged 10-18 years old living in rural South Carolina. Univariable and multivariable logistic regression analyses were used to assess the associations between reported toothache experience and socio-demographic variables, oral health behavior, and snack consumption. Results Thirty-four percent of adolescents reported having toothache in the past 12 months. In univariable modeling, age, dental visit in the last two years, quantity and frequency of cariogenic snack consumption, and quantity of non-diet soft drink consumption were each significantly associated with experiencing toothache in the past 12 months (all p-values cariogenic snacks, and number of cans of non-diet soft drink consumed during the weekend significantly increased the odds of experiencing toothache in the past 12 months (all p-values ≤ 0.01). Conclusion Findings indicate age, frequent consumption of cariogenic snacks and number of cans of non-diet soft drinks are related to toothache in this group. Public policy implications related to selling cariogenic snacks and soft drink that targeting children and adolescents especially those from low income families are discussed. PMID:22085328
Hovick, Shelly R; Freimuth, Vicki S; Johnson-Turbes, Ashani; Chervin, Doryn D
We investigated the risk-information-processing behaviors of people living at or near the poverty line. Because significant gaps in health and communication exist among high- and low-income groups, increasing the information seeking and knowledge of poor individuals may help them better understand risks to their health and increase their engagement in health-protective behaviors. Most earlier studies assessed only a single health risk selected by the researcher, whereas we listed 10 health risks and allowed the respondents to identify the one that they worried about most but took little action to prevent. Using this risk, we tested one pathway inspired by the risk information seeking and processing model to examine predictors of information insufficiency and of systematic processing and extended this pathway to include health-protective action. A phone survey was conducted of African Americans and whites living in the southern United States with an annual income of ≤$35,000 (N= 431). The results supported the model pathway: worry partially mediated the relationship between perceived risk and information insufficiency, which, in turn, increased systematic processing. In addition, systematic processing increased health-protective action. Compared with whites and better educated respondents, African Americans and respondents with little education had significantly higher levels of information insufficiency but higher levels of systematic processing and health-protective action. That systematic processing and knowledge influenced health behavior suggests a potential strategy for reducing health disparities. © 2011 Society for Risk Analysis.
McMahon, Susan D; Felix, Erika D; Nagarajan, Thara
Although neighborhood stressors have a negative impact on youth, and social support can play a protective role, it is unclear what types and sources of social support may contribute to positive outcomes among at-risk youth. We examined the influences of neighborhood disadvantage and social support on global self-worth among low-income, urban African American youth, both concurrently and longitudinally. We examined social support from both a structural and functional perspective, and tested the main-effects and the stress-buffering models of social support. Participants included 82-130 youth, in 6th-8th grade, who completed self-report measures. Network support results suggest participants received emotional, tangible, and informational support most often from mothers and other female relatives, with friends, fathers, and teachers also playing important roles. Model testing accounted for neighborhood stressors and support from various sources, revealing support from close friends was associated with concurrent self-worth; whereas, parent support predicted self-worth longitudinally, above and beyond initial levels of self-worth. The findings provide evidence for the main-effects model of social support and not the stress-buffering model. Our findings illustrate the importance of extended family networks and the types of support that youth rely upon in African American impoverished communities, as well as how support contributes to global self-worth. Implications and suggestions for future research and intervention are discussed.
Qu, Haiyan; Shewchuk, Richard; Mannon, Roslyn B.; Gaston, Robert; Segev, Dorry L.; Mannon, Elinor C.; Martin, Michelle Y.
Background and objectives African Americans are disproportionately affected by ESRD, but few receive a living donor kidney transplant. Surveys assessing attitudes toward donation have shown that African Americans are less likely to express a willingness to donate their own organs. Studies aimed at understanding factors that may facilitate the willingness of African Americans to become organ donors are needed. Design, setting, participants, & measurements A novel formative research method was used (the nominal group technique) to identify and prioritize strategies for facilitating increases in organ donation among church-attending African Americans. Four nominal group technique panel interviews were convened (three community and one clergy). Each community panel represented a distinct local church; the clergy panel represented five distinct faith-based denominations. Before nominal group technique interviews, participants completed a questionnaire that assessed willingness to become a donor; 28 African-American adults (≥19 years old) participated in the study. Results In total, 66.7% of participants identified knowledge- or education-related strategies as most important strategies in facilitating willingness to become an organ donor, a view that was even more pronounced among clergy. Three of four nominal group technique panels rated a knowledge-based strategy as the most important and included strategies, such as information on donor involvement and donation-related risks; 29.6% of participants indicated that they disagreed with deceased donation, and 37% of participants disagreed with living donation. Community participants’ reservations about becoming an organ donor were similar for living (38.1%) and deceased (33.4%) donation; in contrast, clergy participants were more likely to express reservations about living donation (33.3% versus 16.7%). Conclusions These data indicate a greater opposition to living donation compared with donation after one’s death
Full Text Available Background: Patients with diabetes who contract influenza are at higher risk of complications, such as hospitalization and death. Patients with diabetes are three times more likely to die from influenza complications than those without diabetes. Racial disparities among patients with diabetes in preventive health services have not been extensively studied. Objective: To compare influenza vaccination rates among African Americans and Whites patients with diabetes and investigate factors that might have an impact on racial disparities in the receipt of influenza vaccinations. Methods: A secondary data analysis of 47,283 (unweighted patients with diabetes from the 2011 Behavioral Risk Factor Surveillance System survey (BRFSS (15,902,478 weighted was performed. The survey respondents were asked whether they received an influenza vaccination in the last twelve months. We used logistic regression to estimate the odds of receiving the influenza vaccine based on race. Results: The results indicated a significantly lower proportion of African Americans respondents (50% reported receiving the influenza vaccination in the last year when compared with Whites respondents (61%. Age, gender, education, health care coverage, health care cost, and employment status were found to significantly modify the effect of race on receiving the influenza vaccination. Conclusions: This study found a significant racial disparity in influenza vaccination rates in adults with diabetes with higher rates in Whites compared to African Americans individuals. The public health policies that target diabetes patients in general and specifically African Americans in the 65+ age group, women, and homemakers, may be necessary to diminish the racial disparity in influenza vaccination rates between African Americans and Whites diabetics.
Coley, Sheryl L; Mendes de Leon, Carlos F; Ward, Earlise C; Barnes, Lisa L; Skarupski, Kimberly A; Jacobs, Elizabeth A
Emerging data suggest that African-American women may fare worse than African-American men in health-related quality-of-life (HRQOL). Perceived discrimination is an important contributor to poor health overall among African Americans, but few studies examined the intersecting effects of perceived discrimination and gender in explaining HRQOL disparities. We investigated gender differences in HRQOL and tested whether perceived discrimination accounted for these differences. We examined data from the Chicago Health and Aging Project in which 5652 African-American adults aged 65 and older completed structured questionnaires about demographic and socioeconomic characteristics, HRQOL, perceived discrimination, and health-related variables. Logistic regression models were used to identify associations between perceived discrimination and gender differences in poor HRQOL outcomes (defined as 14+ unhealthy days in overall, physical, or mental health over the past 30 days) when controlling for the other variables. More women reported poor overall HRQOL than men (24 vs. 16% respectively). Higher perceived discrimination was significantly associated with worse overall HRQOL (OR 1.11; 95% CI 1.08, 1.15), with stronger effects for women in overall and mental HRQOL. These gender disparities remained significant until controlling for potentially confounding variables. Perceived discrimination did not account for gender differences in poor physical HRQOL. Perceived discrimination is associated with poor HRQOL in older African Americans, with this association appearing stronger in women than men for mental HRQOL. These findings warrant further investigation of effects of perceived discrimination in gender disparities in overall health, and such research can inform and guide efforts for reducing these disparities.
Schwartz, Alan; Peacock, Nadine; McRae, Kenya; Seymour, Rachel; Gilliam, Melissa
Half of all U.S. pregnancies are categorized as unintended at conception, but concerns persist that existing measures of pregnancy intention do not adequately reflect the complexities of reproductive desires and preferences. We explored new strategies for categorizing viewpoints toward future pregnancy focusing on young, low-income, African-American women, and assessed the stability of these viewpoints over time. For pregnancies that occurred during the study, we examined the utility of the newly derived categories for predicting retrospective measures of intendedness. Data were collected using Q-methodology, a technique for eliciting subjective viewpoints and identifying shared patterns among individuals. African-American women ages 15 to 25 and at risk for pregnancy were recruited at clinics serving low-income populations. The women sorted statements reflecting attitudes and preferences regarding future pregnancy into a distribution on a continuum from "least true for me" to "most true for me." We used by-person factor analysis to derive latent viewpoints. We identified six factors each reflecting a unique viewpoint about future pregnancy. These were a pregnancy seeking factor, one reflecting both ambivalence and low reproductive control, and four reflecting pregnancy avoidance, with distinctions around social support, reproductive control, and desired pregnancy timing. Distribution of factors differed by age group, as well as by retrospective categorization of pregnancy intention for those women who became pregnant during the study. Our categories provide a nuanced reflection of women's points of view about future pregnancies, and, with further validation, may prove useful for predicting or preventing contraceptive nonuse, undesired conceptions, and associated adverse outcomes. Copyright © 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Gough, Katherine V.; Langevang, Thilde; Namatovu, Rebecca
of entrepreneurship conducted in a low-income settlement, which combined participatory quantitative and qualitative approaches, highlighting the strengths and challenges of using participatory methods. The paper demonstrates how drawing on a range of participatory methods can contribute to creating more engaging...
Jenkins, Chalice C; Kennedy, Bernice Roberts
The transmission of HIV/AIDS among African American women through heterosexual sex is an epidemic. Critical themes extracted from the HIV/AIDS sexual assertiveness literature revealed that: (a) sexual assertiveness is related to HIV risk, (b) sexual assertiveness is related to communication, and (c) women with low sexual assertiveness are at risk for HIV. This descriptive study sought to answer the following research question: What do young adult college attending African American women self-report about asking information about their partner's sexual history? The multifaceted model of HIV risk is the theoretical framework which guided this descriptive study. A basic tenet of the multifaceted model of HIV risk is that there is no single predictor of women's HIV risk behavior. Results revealed that 104 young adult college attending African American women who volunteered to attend a one day HIV prevention training overall scored high on a Sexual Assertive Scale on subscales of Information Communication, Refusal, and Pregnancy/STD Prevention Subscale, and scored in the medium range on the Initiation Subscales. The Information Communication and Pregnancy/ STD Prevention Subscale received the highest scores. More research is needed targeting diverse African American females with different socioeconomic status, various locations, and educated to determine their sexual assertiveness with partners which are essential in developing specific programs for diverse groups of African American females.
Lowe, SR; Chan, CS; Rhodes, JE
Objective: In this study, we examined the influence of pre-disaster perceived social support on post-disaster psychological distress among survivors of Hurricane Katrina. Method: Participants (N = 386) were low-income mothers between 18 and 34 years of age at baseline (M = 26.4, SD = 4.43). The majority (84.8) was African American; 10.4 identified as Caucasian, 3.2 identified as Hispanic, and 1.8 identified as other. Participants were enrolled in an educational intervention study in 2004 and ...
Full Text Available We present a comprehensive assessment of genomic diversity in the African-American population by studying three genotyped cohorts comprising 3,726 African-Americans from across the United States that provide a representative description of the population across all US states and socioeconomic status. An estimated 82.1% of ancestors to African-Americans lived in Africa prior to the advent of transatlantic travel, 16.7% in Europe, and 1.2% in the Americas, with increased African ancestry in the southern United States compared to the North and West. Combining demographic models of ancestry and those of relatedness suggests that admixture occurred predominantly in the South prior to the Civil War and that ancestry-biased migration is responsible for regional differences in ancestry. We find that recent migrations also caused a strong increase in genetic relatedness among geographically distant African-Americans. Long-range relatedness among African-Americans and between African-Americans and European-Americans thus track north- and west-bound migration routes followed during the Great Migration of the twentieth century. By contrast, short-range relatedness patterns suggest comparable mobility of ∼15-16km per generation for African-Americans and European-Americans, as estimated using a novel analytical model of isolation-by-distance.
Walker, Janiece L; Thorpe, Roland J; Harrison, Tracie C; Baker, Tamara A; Cary, Michael; Szanton, Sarah L; Allaire, Jason C; Whitfield, Keith E
Older African Americans consistently report diminished capacities to perform activities of daily living (ADL) compared with other racial groups. The extent to which bodily pain is related to declining abilities to perform ADL/ADL disability in African Americans remains unclear, as does whether this relationship exists to the same degree in African American men and women. For nurses to provide optimal care for older African Americans, a better understanding of the relationship between bodily pain and ADL disability and how it may differ by sex is needed. The aim of this study was to examine whether pain, age, education, income, marital status and/or comorbid conditions were associated with ADL disabilities in older African American women and men. This was a cross-sectional descriptive study. The sample included 598 participants (446 women, 152 men) from the first wave of the Baltimore Study on Black Aging. African American women (odds ratio [OR] = 4.06; 95% confidence interval [CI] 2.63-6.26) and African American men (OR = 6.44; 95% CI = 2.84-14.57) who reported bodily pain had greater ADL disability than those who did not report bodily pain. Having two or more comorbid conditions also was significantly associated with ADL disability in African American women (OR = 3.95; 95% CI: 2.09-7.47). Further work is needed to understand pain differences between older African American women and men to develop interventions that can be tailored to meet the individual pain needs of both groups. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Nicholson, Robert A.; Kreuter, Matthew W.; Lapka, Christina; Wellborn, Rachel; Clark, Eddie M.; Sanders-Thompson, Vetta; Jacobsen, Heather M.; Casey, Chris
Little is known about how minority groups react to public information that highlights racial disparities in cancer. This double-blind randomized study compared emotional and behavioral reactions to four versions of the same colon cancer (CRC) information presented in mock news articles to a community sample of African-American adults (n = 300). Participants read one of four articles that varied in their framing and interpretation of race-specific CRC mortality data, emphasizing impact (CRC is...
Fall, Caroline H D; Sachdev, Harshpal Singh; Osmond, Clive; Restrepo-Mendez, Maria Clara; Victora, Cesar; Martorell, Reynaldo; Stein, Aryeh D; Sinha, Shikha; Tandon, Nikhil; Adair, Linda; Bas, Isabelita; Norris, Shane; Richter, Linda M
Both young and advanced maternal age is associated with adverse birth and child outcomes. Few studies have examined these associations in low-income and middle-income countries (LMICs) and none have studied adult outcomes in the offspring. We aimed to examine both child and adult outcomes in five LMICs. In this prospective study, we pooled data from COHORTS (Consortium for Health Orientated Research in Transitioning Societies)-a collaboration of five birth cohorts from LMICs (Brazil, Guatemala, India, the Philippines, and South Africa), in which mothers were recruited before or during pregnancy, and the children followed up to adulthood. We examined associations between maternal age and offspring birthweight, gestational age at birth, height-for-age and weight-for-height Z scores in childhood, attained schooling, and adult height, body composition (body-mass index, waist circumference, fat, and lean mass), and cardiometabolic risk factors (blood pressure and fasting plasma glucose concentration), along with binary variables derived from these. Analyses were unadjusted and adjusted for maternal socioeconomic status, height and parity, and breastfeeding duration. We obtained data for 22 188 mothers from the five cohorts, enrolment into which took place at various times between 1969 and 1989. Data for maternal age and at least one outcome were available for 19 403 offspring (87%). In unadjusted analyses, younger (≤19 years) and older (≥35 years) maternal age were associated with lower birthweight, gestational age, child nutritional status, and schooling. After adjustment, associations with younger maternal age remained for low birthweight (odds ratio [OR] 1·18 (95% CI 1·02-1·36)], preterm birth (1·26 [1·03-1·53]), 2-year stunting (1·46 [1·25-1·70]), and failure to complete secondary schooling (1·38 [1·18-1·62]) compared with mothers aged 20-24 years. After adjustment, older maternal age remained associated with increased risk of preterm birth (OR 1
Bohannon Sean B
Full Text Available Abstract Background Homozygosity or compound heterozygosity for coding region mutations of the hemojuvelin gene (HJV in whites is a cause of early age-of-onset iron overload (juvenile hemochromatosis, and of hemochromatosis phenotypes in some young or middle-aged adults. HJV coding region mutations have also been identified recently in African American primary iron overload and control subjects. Primary iron overload unexplained by typical hemochromatosis-associated HFE genotypes is common in white and black adults in Alabama, and HJV I222N and G320V were detected in a white Alabama juvenile hemochromatosis index patient. Thus, we estimated the frequency of the HJV missense mutations I222N and G320V in adult whites and African Americans from Alabama general population convenience samples. Methods We evaluated the genomic DNA of 241 Alabama white and 124 African American adults who reported no history of hemochromatosis or iron overload to detect HJV missense mutations I222N and G320V using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP technique. Analysis for HJV I222N was performed in 240 whites and 124 African Americans. Analysis for HJV G320V was performed in 241 whites and 118 African Americans. Results One of 240 white control subjects was heterozygous for HJV I222N; she was also heterozygous for HFE C282Y, but had normal serum iron measures and bone marrow iron stores. HJV I222N was not detected in 124 African American subjects. HJV G320V was not detected in 241 white or 118 African American subjects. Conclusions HJV I222N and G320V are probably uncommon causes or modifiers of primary iron overload in adult whites and African Americans in Alabama. Double heterozygosity for HJV I222N and HFE C282Y may not promote increased iron absorption.
Witherspoon, Dawn; Latta, Laura; Wang, Yan; Black, Maureen M
To examine how psychosocial factors vary by body weight and gender among African-American adolescents. A community sample of 235 low-income, predominantly African-American adolescents completed measures of depression, self-esteem, body-esteem, and eating attitudes. Measured weight and height were converted to body mass index (kg/m(2)) age and gender-adjusted z-scores. Data were analyzed using 2-factor multivariate analysis of variance. Obese youths had significantly worse scores on all psychosocial domains than normal weight youths, with no differences between overweight and normal weight youths. Obese youths had significantly worse scores than overweight youths on body-esteem and self-esteem. Female adolescents had significantly worse scores than males on depressed mood, body-esteem, and eating attitudes. Among a community sample of predominantly African-American adolescents, obesity, not overweight, was associated with poor psychosocial health. Findings suggest that overweight may be perceived as normative, and that weight-related programs consider adolescents' psychosocial functioning.
Coley, Rebekah Levine; Kull, Melissa A.; Carrano, Jennifer
This study assessed prospective, bidirectional associations between maternal endorsement of spanking and children’s internalizing and externalizing behavior problems in low-income urban African American and Hispanic (N = 592) families drawn from the Three City Study. Children in sample families were followed from early childhood through middle childhood with three sets of interviews and assessments at ages 3, 4, and 9 years. Cross-lagged path analyses tested longitudinal bidirectional associations between parental endorsement of spanking and children’s internalizing and externalizing problems, with multi-group comparisons employed to test group differences between race/ethnic groups. African American and Hispanic mothers showed similar endorsements of spanking. Results suggest that associations between spanking endorsement and child functioning were due primarily to parenting effects, with spanking predicting changes in children’s behaviors, rather than child evocative effects, with limited evidence of child behaviors predicting changes in parental spanking. Maternal spanking endorsement predicted short-term decreases in children’s internalizing problems in early childhood, but over the longer term spanking was associated with increased internalizing and externalizing problems for both African American and Hispanic children in middle childhood among economically disadvantaged families. PMID:24364363
McGee, Bernestine B; Richardson, Valerie; Johnson, Glenda; Johnson, Crystal
To explore the nutrition and physical activity perceptions of children for planning a healthy weight curriculum to address childhood obesity in African-American children living in the Lower Mississippi Delta (LMD). Six children's focus group sessions. Two Louisiana parishes in the LMD. Seventy 8- to 13-year-old African-American children, 46 (66%) females and 24 (44%) males, participated in the focus group sessions. Interview questions were based on personal and environmental determinants and content and strategies for a healthy lifestyle program for children. Focus group discussions were audio recorded and transcribed, observer recorded, and analyzed to identify recurring trends and patterns among focus groups. Content analysis consisted of coding focus group transcripts for recurrent themes and review of data by an independent reviewer to confirm the themes. Emerging themes were categorized as healthy lifestyle opinions within the social cognitive theory constructs of personal and environmental determinants and curriculum content. LMD youth recognized a healthy eating pattern and that overweight and obesity result from poor eating habits and physical inactivity. Children's food intake pattern did not reflect this understanding, suggesting a need for culturally tailoring an intervention to impact the poor food intake and physical inactivity in two low-income African-American Delta communities.
Cherlin, Andrew; Cross-Barnet, Caitlin; Burton, Linda M.; Garrett-Peters, Raymond
Using survey data on low-income mothers in Boston, Chicago, and San Antonio (n = 1,722) supplemented with ethnographic data, we test 3 propositions regarding mothers’ attitudes toward childbearing, marriage, and divorce. These are drawn from Edin & Kefalas (2005) but have also arisen in other recent studies. We find strong support for the proposition that childbearing outside of marriage carries little stigma, limited support for the proposition that women prefer to have children well before marrying, and almost no support for the proposition that women hesitate to marry because they fear divorce. We suggest that mothers’ attitudes and preferences in these 3 domains do not support the long delay between childbearing and marriage that has been noted in the literature. Throughout, we are able to study attitudes among several Hispanic groups as well as among African Americans and non-Hispanic Whites. PMID:19885381
Dennhardt, Ashley A; Murphy, James G
Although levels of heavy drinking and alcohol-related problems are high in college students, there is significant variability in the number and type of problems experienced, even among students who drink heavily. African American students drink less and experience fewer alcohol-related problems than European American students, but are still at risk, and little research has investigated the potentially unique patterns and predictors of problems among these students. Depression, distress tolerance, and delay discounting have been implicated in adult substance abuse and may be important predictors of alcohol problem severity among college students. We examined the relationship between these variables and alcohol-related problems among African American and European American students (N = 206; 53% female; 68% European American; 28% African American) who reported recent heavy drinking. In regression models that controlled for drinking level, depression, distress tolerance, and delay discounting were associated with alcohol problems among African American students, but only depression was associated with alcohol problems among European American students. These results suggest that negative affect is a key risk factor for alcohol problems among college student drinkers. For African American students, the inability to tolerate negative emotions and to organize their behavior around future outcomes may also be especially relevant risk factors.
Gonzalez, Michelle; Jones, Deborah J.; Parent, Justin
African American youth from single mother homes continue to be overrepresented in statistics on risk behavior and delinquency, a trend that many be attributed to father-absence, socioeconomic disadvantage, and compromises in parenting more typical of single than two-parent families. Yet, this risk-focused perspective ignores a long-standing strength of the African American community, the involvement and potential protective impact of extended family members in childrearing. This study describes the experiences of 95 African American single mothers and their non-marital coparents who participated in a study of African American single mother families with an 11 to 16 year old child. Specifically, the study examines: 1) the extent to which nonmarital coparents are involved in childrearing; 2) the relative levels of risk (i.e., depression, mother-coparent conflict) and protective (i.e., parenting) associated with maternal and coparent involvement; and 3) how similarly and/or differently coparent and mother variables operate with regard to youth externalizing problems. Findings reveal that a range of family members and other adults actively participate in childrearing in African American single mother families, coparents do not differ from mothers on certain study variables (i.e., depression and mother-coparent conflict) but do for others (parenting), and coparent involvement is associated with youth adjustment in ways that are similar to our more established understanding of maternal involvement. The potential clinical implications of the findings are discussed and future research directions are highlighted. PMID:24479612
Østergaard, Marianne Stubbe; Nantanda, Rebecca; Tumwine, James K
Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts...... of pneumonia and asthma/wheezing/bronchiolitis and examines whether asthma in under-5s may be confused with pneumonia. Over-diagnosing of bacterial pneumonia can be suspected from the limited association between clinical pneumonia and confirmatory test results such as chest x-ray and microbiological findings...... and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing...
Pieper, Barbara; Templin, Thomas N
Adequate nutrition has long been considered a critical component for wound healing, but literature regarding the relationship between nutrition and venous ulcer (VU) healing is limited. A person's nutrition is affected by the availability of food as well as his/her overall health. Food sufficiency and nutrition are important concerns in the care of persons of low income with injection-related VUs, which tend to be large and slow to heal. A cross-sectional pilot study was conducted to explore the relationship between food sufficiency/security and nutrition with regard to demographic, wound, quality-of-life, physical activity, falls, and fall risk variables. Nutrition was examined using 2 well-developed instruments that measure food sufficiency/security and assess nutrition--the United States Department of Agriculture's Adult Food Sufficiency Questionnaire (FSQ) and the Nestle Mini Nutritional Assessment (MNA). All participants (N = 31, 54% men, mean age 56.1 ± 3.6 years, all African American) were recruited from an outpatient clinic. All had injection-related VUs from a history of injecting illicit substances. In terms of food sufficiency/security, most participants (26, 84%) reported having enough food in the house, but 10 (32%) worried about running out of food. From 16% to 22.6% of participants expressed concern with food sufficiency/security in terms of cutting meal size, eating less, hunger, and weight loss. Food sufficiency/security was high for 19 (61.3%), but 12 (39%) had marginal or lower food sufficiency/security. MNA scores showed 16 participants (52%) were at risk of malnutrition or malnourished. Low food sufficiency/security was significantly (P nutrition assessment scores were significantly associated (P nutrition assessment are important to assess in low-income persons with injection-related VUs. A number of significant relationships of the FSQ and MNA to other variables was found but needs further investigation with a larger sample.
.... The objectives of this study are to develop a Culturally Tailored Genetic (CTGC) protocol for African American women and evaluate its impact on decision-making and satisfaction about BRCAl/2 testing, quality of life, and cancer control practices...
Anderson, Will; White, Vicki; Finney, Andrea
This paper presents findings from a study of low-income households in Great Britain which explored households’ strategies for coping both with limited financial resources in the winter months, when demand for domestic energy increases, and, in some cases, with cold homes. The study combined a national survey of 699 households with an income below 60 per cent of national median income with in-depth interviews with a subsample of 50 households. The primary strategy adopted by low-income households to cope with financial constraint was to reduce spending, including spending on essentials such as food and fuel, and thereby keep up with core financial commitments. While spending on food was usually reduced by cutting the range and quality of food purchased, spending on energy was usually reduced by cutting consumption. Sixty-three per cent of low-income households had cut their energy consumption in the previous winter and 47 per cent had experienced cold homes. Improvements to the thermal performance of homes reduced but did not eliminate the risk of going cold as any heating cost could be a burden to households on the lowest incomes. Householders’ attitudes were central to their coping strategies, with most expressing a determination to ‘get by’ come what may.
Frew, Paula M; Archibald, Matthew; Martinez, Nina; del Rio, Carlos; Mulligan, Mark J
The HIV/AIDS pandemic continues to challenge the African American community with disproportionate rates of infection, particularly among young women ages 25 to 34 years. Development of a preventive HIV vaccine may bring a substantial turning point in this health crisis. Engagement of the African American community is necessary to improve awareness of the effort and favorably influence attitudes and referent norms. The Theory of Reasoned Action (TRA) may be a useful framework for exploration of community engagement outcomes including future attendance, community mobilization, and study participation. Within the context of HIV vaccine outreach, we conducted a cross-sectional survey in early 2007 with 175 African-American adults (>/= 18 years). Confirmatory factor analysis and structural equation modeling were performed and the findings support the potential of the model in understanding behavioral intentions toward HIV vaccine research.
This research investigates how eight undergraduate African American women in science, math, and engineering (SME) majors accessed cultural capital and informal science learning opportunities from preschool to college. It uses the multiple case study methodological approach and cultural capital as the framework to better understand their opportunities to engage in free-choice science learning. The article demonstrates that African American women have access to cultural capital and informal sci...
Sanders Thompson, Vetta L.; Arnold, Lauren D.; Notaro, Sheri R.
This study describes attitudes and social and environmental factors that affect African American parents’ intent to vaccinate their daughters against human papillomavirus (HPV). Thirty African American parents of daughters aged nine to 17 years and no history of HPV infection completed semi-structured interviews. Interviews addressed factors that influenced intent to vaccinate, perception of community norms related to vaccination, vaccination scenarios involving place of vaccination, and vacc...