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Sample records for african-american patients compared

  1. Lower prevalence of intraventricular block in African-American patients compared with Caucasian patients: an electrocardiographic study II.

    PubMed Central

    Upshaw, Charles B.

    2003-01-01

    BACKGROUND: Electrocardiographic (ECG) differences occur between African-American and white persons. METHODS: Intraventricular conduction abnormalities of ECGs of 2,123 African-American and white hospital patients ages 20-99 years were studied in a consecutive manner. RESULTS: Intraventricular conduction abnormalities develop later in life and are less common in African-American patients, compared with white patients. The prevalence of conduction abnormalities increases with advancing age in both races. Left- and right ventricular conduction abnormalities begin to rise at age 50 for white patients but begin to rise at age 70 for African-American patients. The prevalence of left ventricular conduction abnormalities peaks in the ninth decade of life in both races but declines in both races in the tenth decade of life. The prevalence of right ventricular conduction abnormalities gradually increases and peaks in the tenth decade of life in both races. CONCLUSIONS: The prevalence of intraventricular block is significantly less in African-American patients, compared with white patients--occurring in 8.6% of African-American patients and in 15.2% of white patients. The prevalence of intraventricular block is lowest in African-American women at 6.5% and highest in white men at 16.8%. PMID:14527049

  2. African American ESRD patients have a high pre-dialysis prevalence of kidney stones compared to NHANES III.

    PubMed

    Stankus, Nicole; Hammes, Mary; Gillen, Daniel; Worcester, Elaine

    2007-04-01

    If nephrolithiasis (NL) promotes progression to end stage renal disease (ESRD), requiring renal replacement therapy, one might expect a higher prevalence of pre-ESRD stones among ESRD versus non-ESRD subjects. We compared the prevalence of pre-ESRD stones in an African-American (AA) hemodialysis (HD) population to the estimated stone prevalence in a nationally representative cohort of AA persons as obtained by the Third National Health and Nutrition Survey (NHANES III). Face-to-face questionnaires were administered to a sample of 300 AA HD patients undergoing dialysis therapy at the University of Chicago to determine pre-ESRD NL prevalence. All data on pre-ESRD stone prevalence was confirmed by documented medical history, radiology and laboratory findings, where available. Prevalence of pre-ESRD NL in AA HD patients was 8.3% versus 2.8% in the age, race and sex adjusted NHANES III population (P < 0.001). After adjustment for age and sex, it was estimated that the prevalence of pre-ESRD kidney stones among AA HD patients is significantly higher than the prevalence of kidney stones found in the general AA population.

  3. African-American Students' Expectations about Counseling: A Comparative Investigation.

    ERIC Educational Resources Information Center

    Kemp, Arthur D.

    1994-01-01

    Compared African American college students' counseling expectations at two universities with different racial majorities. The type of university attended exerted the most powerful effect on counseling expectations of subjects. Counseling professionals must help African American students fully understand issues such as confidentiality, privacy, and…

  4. Factors influencing medical information seeking among African American cancer patients.

    PubMed

    Matthews, Alicia K; Sellergren, Sarah A; Manfredi, Clara; Williams, Maryann

    2002-01-01

    Qualitative research methods were used to explore factors that may affect medical information seeking, treatment engagement, and emotional adjustment among African American cancer patients. Focus group findings suggest that an array of cultural and socioeconomic factors plays important roles in the behavior of African American cancer patients. Participants described a number of important barriers and facilitators of medical information seeking and treatment participation. Factors linked to the health care-related behaviors and adjustment of African American cancer patients included limited knowledge and misinformation about cancer, mistrust of the medical community, concerns about privacy, lack of insurance, religious beliefs, and emotional issues such as fear and stigma associated with seeking emotional support. Recommendations are made that may assist mental and physical health providers in improving patient information and mental and physical health outcomes of African American cancer patients.

  5. Depression in African-American patients with kidney disease.

    PubMed Central

    Kimmel, Paul L.; Patel, Somir S.; Peterson, Rolf A.

    2002-01-01

    There are few data on the epidemiology, consequences and treatment of depression in African-American patients with kidney disease in the US, even though such patients disproportionately bear the burden of this illness. This paper reviews data on the diagnosis and pathogenesis of depression and its consequences in patients with and without kidney disease, in addition to work on the epidemiology of depression in the African-American population and in the US End-stage Renal Disease (ESRD) program. African Americans are thought to have similar susceptibility to the development of depression as other populations in the US, but diminished access to care for this group of patients may be associated with differential outcomes. Data are presented from longitudinal studies of psychosocial outcomes in a population comprising primarily African-American patients with ESRD, and is reviewed the treatment of depression in patients with and without kidney disease. There are few studies of the management of depression that focus on minority populations. The authors agree with recommendations that treatment trials should include minority patients, patients with medical comorbidities, and the elderly, and assess function and quality of life as outcomes. The relationships between age, marital status and satisfaction, ethnicity, and perception of quality of life and depressive affect level and diagnosis of depression, and medical outcomes have not been determined in ESRD patients, or in African-American patients with ESRD. There are few studies of drugs for the treatment of depression in ESRD patients, and only one small randomized controlled trial. These have shown that therapy with selective serotonin reuptake inhibitors appears to be a safe treatment option for patients with ESRD. The long-term effectiveness of therapy, and its association with clinically important outcomes such as perception of quality of life, compliance, and survival have not been evaluated in ESRD patients. Also

  6. Physicians' cultural competency as perceived by African American patients.

    PubMed

    Michalopoulou, Georgia; Falzarano, Pamela; Arfken, Cynthia; Rosenberg, David

    2009-09-01

    The purpose of the study was to determine the association between African American patients' perceptions of physician cultural competency and patient satisfaction with the visit, independent of other factors, including physician and patient race concordance. African American participants were surveyed at urban clinics. Cultural competency (Perceived Cultural Competency scale) was based on the 3-factor model that includes patients' perception of (1) physicians' cultural knowledge, (2) physicians' cultural awareness, and (3) physicians' cultural skill. The results confirmed that patients' perceptions of physician cultural competency are independently associated with satisfaction with the visit. These results further validate use of the Perceived Cultural Competency scale as a tool to measure patients' perceptions of physicians' cultural competency.

  7. B cells from African American lupus patients exhibit an activated phenotype

    PubMed Central

    Menard, Laurence C.; Habte, Sium; Gonsiorek, Waldemar; Lee, Deborah; Banas, Dana; Holloway, Deborah A.; Cunningham, Mark; Stetsko, Dawn; Casano, Francesca; Kansal, Selena; Davis, Patricia M.; Carman, Julie; Zhang, Clarence K.; Abidi, Ferva; Furie, Richard; Nadler, Steven G.; Suchard, Suzanne J.

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease driven by both innate and adaptive immune cells. African Americans tend to present with more severe disease at an earlier age compared with patients of European ancestry. In order to better understand the immunological differences between African American and European American patients, we analyzed the frequencies of B cell subsets and the expression of B cell activation markers from a total of 68 SLE patients and 69 normal healthy volunteers. We found that B cells expressing the activation markers CD86, CD80, PD1, and CD40L, as well as CD19+CD27–IgD– double-negative B cells, were enriched in African American patients vs. patients of European ancestry. In addition to increased expression of CD40L, surface levels of CD40 on B cells were lower, suggesting the engagement of the CD40 pathway. In vitro experiments confirmed that CD40L expressed by B cells could lead to CD40 activation and internalization on adjacent B cells. To conclude, these results indicate that, compared with European American patients, African American SLE patients present with a particularly active B cell component, possibly via the activation of the CD40/CD40L pathway. These data may help guide the development of novel therapies.

  8. B cells from African American lupus patients exhibit an activated phenotype

    PubMed Central

    Menard, Laurence C.; Habte, Sium; Gonsiorek, Waldemar; Lee, Deborah; Banas, Dana; Holloway, Deborah A.; Cunningham, Mark; Stetsko, Dawn; Casano, Francesca; Kansal, Selena; Davis, Patricia M.; Carman, Julie; Zhang, Clarence K.; Abidi, Ferva; Furie, Richard; Nadler, Steven G.; Suchard, Suzanne J.

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease driven by both innate and adaptive immune cells. African Americans tend to present with more severe disease at an earlier age compared with patients of European ancestry. In order to better understand the immunological differences between African American and European American patients, we analyzed the frequencies of B cell subsets and the expression of B cell activation markers from a total of 68 SLE patients and 69 normal healthy volunteers. We found that B cells expressing the activation markers CD86, CD80, PD1, and CD40L, as well as CD19+CD27–IgD– double-negative B cells, were enriched in African American patients vs. patients of European ancestry. In addition to increased expression of CD40L, surface levels of CD40 on B cells were lower, suggesting the engagement of the CD40 pathway. In vitro experiments confirmed that CD40L expressed by B cells could lead to CD40 activation and internalization on adjacent B cells. To conclude, these results indicate that, compared with European American patients, African American SLE patients present with a particularly active B cell component, possibly via the activation of the CD40/CD40L pathway. These data may help guide the development of novel therapies. PMID:27699274

  9. Psoriasis and psoriatic arthritis in African-American patients--the need to measure disease burden.

    PubMed

    Kerr, Gail S; Qaiyumi, Seema; Richards, John; Vahabzadeh-Monshie, Hashem; Kindred, Chesahna; Whelton, Sean; Constantinescu, Florina

    2015-10-01

    Gaps in knowledge exist regarding the clinical characteristics of psoriatic disease in ethnic minority patients. We evaluated validated clinical disease measures of psoriasis and psoriatic arthritis in African-American and Caucasian patients. Adult outpatients with confirmed diagnoses of psoriasis and psoriatic arthritis and seen at four urban academic institutions were eligible for evaluation. Validated patient and physician-reported disease outcome parameters, quality of life measures of psoriasis and psoriatic arthritis, and frequencies of systemic immunosuppressive therapies and patient comorbidities were documented. Psoriatic arthritis was less frequent in African-Americans compared to Caucasians (30 vs. 64.5 %, respectively, p < 0.001); however, African-Americans had more severe skin involvement [Psoriasis Area and Severity Index 8.4 (10.0) vs. Caucasians 5.5 (6.4), p = 0.06], with greater psychological impact and impaired quality of life. Use of biologic therapies was greater in Caucasian patients (46.2 vs. 13.3 % in African-Americans, p < 0.0001); yet, only one in four patients of the study cohort achieved minimal disease activity. Comorbidity was not associated with frequency of immunosuppressive drug use. In order to achieve a target of low disease activity and to reduce ethnic disparities in the care of psoriatic disease, the routine application of measures of disease status is needed.

  10. Comparing knowledge of colorectal and prostate cancer among African American and Hispanic men.

    PubMed

    Powe, Barbara D; Cooper, Dexter L; Harmond, Lokie; Ross, Louie; Mercado, Flavia E; Faulkenberry, Rachel

    2009-01-01

    African American and Hispanic men are less likely to participate in prostate and colorectal cancer screening and have poorer outcomes from these diseases. Guided by the Patient/Provider/System Theoretical Model for Cancer Screening, this study compares the relationships among knowledge of prostate and colorectal cancer, perceptions of cancer fatalism, common sources of cancer information, and awareness of cancer resources screening between African American (n = 72) and Hispanic (n = 47) men who attend federally qualified health centers and a hospital-based primary care clinic in a southern state. African American men were older, had higher levels of education, and were more knowledgeable about cancer than Hispanic men were. However, Hispanic men were more fatalistic about cancer. Most men in both groups were more likely to get cancer information from the television and/or radio, with few accessing the Internet for this information. The men were not aware of many of the leading cancer-related organizations and programs. Nurses continue to play a critical role in patient education and enhancing screening rates. These findings suggest that culturally and educationally appropriate intervention strategies are needed to enhance knowledge and that the television/radio may be an effective medium for delivering these strategies.

  11. PKCα and ERβ Are Associated with Triple-Negative Breast Cancers in African American and Caucasian Patients

    PubMed Central

    Tonetti, Debra A.; Gao, Weihua; Escarzaga, Diana; Walters, Kelly; Szafran, April; Coon, John S.

    2012-01-01

    Although the incidence of breast cancer in the United States is higher in Caucasian women compared with African American women, African-American patients have more aggressive disease as characterized by a higher percentage of triple-negative breast cancers (TNBCs), high-grade tumors, and a higher mortality rate. PKCα is a biomarker associated with endocrine resistance and poor prognosis and ERβ is emerging as a protective biomarker. Immunohistochemical analysis of ERβ and PKCα expression was performed on 198 formalin-fixed paraffin-embedded primary infiltrating ductal carcinomas from 105 African-American and 93 Caucasian patients. PKCα is positively correlated with TNBC in patients of both races and with high tumor grade in African-American patients. Patients with TNBC express less nuclear ERβ compared with all other subtypes. We find no difference in frequency or intensity of PKCα or ERβ expression between African-American and Caucasian patients. PKCα and ERβ are discussed as potential therapeutic targets for the treatment of patients with TNBC. PMID:22500240

  12. Adequacy and survival of autogenous arteriovenous fistula in African American hemodialysis patients.

    PubMed

    Obialo, Chamberlain I; Tagoe, Albert T; Martin, Phyllis C; Asche-Crowe, Pearl E

    2003-01-01

    In African American hemodialysis patients, the prevalence of autogenous arteriovenous fistula (AVF) use is lower yet AVF complications are higher. However, the adequacy and survival rates of AVF in African American patients have not been clarified. These rates were evaluated in this study. A prospective surveillance of AVF was conducted at the Morehouse School of Medicine affiliated dialysis units. A database was generated to adequately document the dates of AVF creation, cannulation, and failure; anatomic fistula sites; and demographic and pertinent clinical information. A total of 167 AVF were created in 140 African American patients between 1997 and 2001. The mean age of the patients was 56 +/- 14 (21-83) years, and the mean duration of follow-up was 40 +/- 3 (1-200) weeks. Only 92 of 167 (55%) AVF were adequate for cannulation; 12% (20 of 167) failed to mature and 33% (55 of 167) developed early failure. Unassisted primary patency rates at 6 and 12 months were 85% and 61%, respectively. Both fistula adequacy and survival were greater in younger (aged < 65 years), male patients and in nondiabetic patients, but the differences were not significant. Logistic regression analysis showed that advanced age (> or = 65 years), female gender, and diabetic state did not significantly alter AVF adequacy. However, the presence of peripheral vascular disease adversely affected AVF adequacy [Odds Ratio 0.4 (confidence interval 0.2-1.0), p = 0.048]. The adequacy and survival rates of AVF in African Americans are comparable with those reported in other populations. Fistula adequacy and survival appear to be independent of ethnicity but dependent on individual comorbid conditions and the integrity of the vasculature. Discriminant AVF site selection and adequate preoperative assessment of the vasculature remain crucial to AVF survival.

  13. Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?

    PubMed

    Akinboboye, Olakunle

    2015-01-01

    Atrial fibrillation (AF) is a very common cardiac arrhythmia, and its prevalence is increasing along with aging in the developed world. This review discusses racial differences in the epidemiology and treatment of AF between African-American and Caucasian patients. Additionally, the effect of race on warfarin and novel oral anticoagulant use is discussed, as well as the role that physicians and patients play in achieving optimal treatment outcomes. Despite having a lower prevalence of AF compared with Caucasians, African-Americans suffer disproportionately from stroke and its sequelae. The possible reasons for this paradox include poorer access to health care, lower health literacy, and a higher prevalence of other stroke-risk factors among African-Americans. Consequently, it is important for providers to evaluate the effects of race, health literacy, access to health care, and cultural barriers on the use of anticoagulation in the management of AF. Warfarin-dose requirements vary across racial groups, with African-American patients requiring a higher dose than Caucasians to maintain a therapeutic international normalized ratio; the novel oral anticoagulants (dabigatran, rivaroxaban, and apixaban) seem to differ in this regard, although data are currently limited. Minority racial groups are not proportionally represented in either real-world studies or clinical trials, but as more information becomes available and other social issues are addressed, the treatment disparities between African-American and Caucasian patients should decrease. PMID:26056467

  14. Adherence to Analgesics for Cancer Pain: A Comparative Study of African Americans and Whites Using an Electronic Monitoring Device.

    PubMed

    Meghani, Salimah H; Thompson, Aleda M L; Chittams, Jesse; Bruner, Deborah W; Riegel, Barbara

    2015-09-01

    Despite well-documented disparities in cancer pain outcomes among African Americans, surprisingly little research exists on adherence to analgesia for cancer pain in this group. We compared analgesic adherence for cancer-related pain over a 3-month period between African Americans and whites using the Medication Event Monitoring System (MEMS). Patients (N = 207) were recruited from outpatient medical oncology clinics of an academic medical center in Philadelphia (≥18 years of age, diagnosed with solid tumors or multiple myeloma, with cancer-related pain, and at least 1 prescription of oral around-the-clock analgesic). African Americans reported significantly greater cancer pain (P < .001), were less likely than whites to have a prescription of long-acting opioids (P < .001), and were more likely to have a negative Pain Management Index (P < .001). There were considerable differences between African Americans and whites in the overall MEMS dose adherence, ie, percentage of the total number of prescribed doses that were taken (53% vs 74%, P < .001). On subanalysis, analgesic adherence rates for African Americans ranged from 34% (for weak opioids) to 63% (for long-acting opioids). Unique predictors of analgesic adherence varied by race; income levels, analgesic side effects, and fear of distracting providers predicted analgesic adherence for African Americans but not for whites. Perspective: Despite evidence of disparities in cancer pain outcomes among African Americans, surprisingly little research exists on African Americans' adherence to analgesia for cancer pain. This prospective study uses objective measures to compare adherence to prescribed pain medications between African American and white patients with cancer pain.

  15. Attitudes toward cancer and implications for mental health outcome in African-American cancer patients.

    PubMed

    Zhang, Amy Y; Gary, Faye; Zhu, Hui

    2015-03-01

    This study examined African-American cancer patients’ attitudes toward cancer and their relationship with long-term mental health outcomes. Using mixed methods, 74 breast and prostate cancer patients including 34 depressed and 23 nondepressed African-Americans and 17 depressed Whites were interviewed. The interviews were audiotaped and transcribed. Qualitative data analysis identified themes that were coded. The codes were entered into SPSS software. Fisher’s exact test was performed to examine group differences in the identified themes. Nondepressed African-Americans more frequently reported cancer as an adaptive experience (p = 0.047) and less frequently as a struggle (p = 0.012) than the depressed African-Americans and Whites. Groups did not significantly differ in the belief that cancer has no cure (p = 0.763), but depressed African-Americans more frequently reported unwillingness to share a cancer diagnosis with family or friends than depressed Whites (p = 0.50). African-Americans’ adaptive attitudes to cancer exhibit a pragmatist approach and a worldview shaped by their lived experience. Participants’ narratives were examined to illuminate the meanings of these findings. Adaptive attitudes to cancer are associated with better long-term mental health outcomes, and conversely, unpreparedness and inability to cope are associated with a higher risk of depression among African-American cancer patients. Education about cancer and supports for treatment navigation are important measures for improving the long-term mental health of African-Americans living with cancer.

  16. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients.

    PubMed

    LaVeist, T A; Nickerson, K J; Bowie, J V

    2000-01-01

    The authors examine determinants of satisfaction with medical care among 1,784 (781 African American and 1,003 white) cardiac patients. Patient satisfaction was modeled as a function of predisposing factors (gender, age, medical mistrust, and perception of racism) and enabling factors (medical insurance). African Americans reported less satisfaction with care. Although both black and white patients tended not to endorse the existence of racism in the medical care system, African American patients were more likely to perceive racism. African American patients were significantly more likely to report mistrust. Multivariate analysis found that the perception of racism and mistrust of the medical care system led to less satisfaction with care. When perceived racism and medical mistrust were controlled, race was no longer a significant predictor of satisfaction.

  17. Pitfalls in communication with Hispanic and African-American patients: do translators help or harm?

    PubMed Central

    Brooks, T. R.

    1992-01-01

    The Martin Luther King County General Hospital, Los Angeles, California, provides services for an equal number of Hispanics (most are recent immigrants from Mexico) and African Americans who have lived in the community since before the Watts riot in 1965. The hospital is staffed by a large percentage of foreign-trained doctors and other personnel who speak some English, but suffer from a lack of understanding of the Hispanic as well as the African-American patients. Very few trained interpreters are provided for the Spanish-speaking population, and no interpreters are provided for African Americans. A 100-question survey on common African-American expressions was conducted in the Department of Family Medicine, as well as an opinion poll to determine if adequate understanding existed between patients and providers. The data revealed that native African-American providers understood significantly more African-American expressions than foreign, white, and Hispanic providers. The opinion poll also revealed inadequate translation of medical complaints from patients through interpreters. In addition, the poll found that diagnoses and instructions were not adequately related to the patients. Furthermore, it was felt that trained interpreters should be provided for all patients who presented communication problems. PMID:1460681

  18. Pitfalls in communication with Hispanic and African-American patients: do translators help or harm?

    PubMed

    Brooks, T R

    1992-11-01

    The Martin Luther King County General Hospital, Los Angeles, California, provides services for an equal number of Hispanics (most are recent immigrants from Mexico) and African Americans who have lived in the community since before the Watts riot in 1965. The hospital is staffed by a large percentage of foreign-trained doctors and other personnel who speak some English, but suffer from a lack of understanding of the Hispanic as well as the African-American patients. Very few trained interpreters are provided for the Spanish-speaking population, and no interpreters are provided for African Americans. A 100-question survey on common African-American expressions was conducted in the Department of Family Medicine, as well as an opinion poll to determine if adequate understanding existed between patients and providers. The data revealed that native African-American providers understood significantly more African-American expressions than foreign, white, and Hispanic providers. The opinion poll also revealed inadequate translation of medical complaints from patients through interpreters. In addition, the poll found that diagnoses and instructions were not adequately related to the patients. Furthermore, it was felt that trained interpreters should be provided for all patients who presented communication problems.

  19. Do African American Patients Treated with Radical Cystectomy for Bladder Cancer have Worse Overall Survival? Accounting for Pathologic Staging and Patient Demographics Beyond Race Makes a Difference

    PubMed Central

    Kaye, Deborah R.; Canner, Joseph K.; Kates, Max; Schoenberg, Mark P.; Bivalacqua, Trinity J.

    2016-01-01

    Background: It is estimated that 74,000 men and women in the United States will be diagnosed with bladder cancer and 16,000 will die from the disease in 2015. The incidence of bladder cancer in Caucasian males is double that of African American males, but African American men and women have worse survival. Although factors contributing to this disparity have been analyzed, there is still great uncertainty as to why this disparity exists. Objective: To evaluate whether the disparities in bladder cancer survival after radical cystectomy for transitional cell carcinoma (TCC) of the bladder amongst African American (AA) and Caucasian patients is attributable to patient demographics, year of diagnosis, and/or tumor characteristics. Methods: Using Surveillance, Epidemiology, and End Results Program (SEER) data from 1973–2011, African American and Caucasian patients treated with a radical cystectomy for TCC of the bladder were identified. Primary outcomes were all-cause and cancer-specific mortality. Differences in survival between African Americans and Caucasian patients were assessed using chi-square tests for categorical variables and Student’s t-tests for continuous variables. Cox proportional hazards regression was used to measure the hazard ratio for African Americans compared to Caucasians for all-cause and cancer-specific mortality. In addition, coarsened matching techniques within narrow ranges, were used to match African American and Caucasian patients on the basis of age, sex, and cancer stage. Following matching, differences in all-cause and cancer-specific mortality were again assessed using a stratified Cox proportional hazards model, using the matching strata for the regression strata. Results: The study cohort consisted of 21,406 African American and Caucasian patients treated with radical cystectomy for bladder urothelial cancer, with 6.2% being African American and 73.9% male. African American patients had worse all-cause and cancer

  20. Predictors of plasma cell disorders among African American patients: a community practice perspective.

    PubMed

    Tun, Nay Min; Joseph, Gardith; Soe, Aye Min; Ford, Jean G

    2014-06-01

    African Americans have two- to three-fold higher incidence of multiple myeloma and MGUS compared to other ethnic groups in the USA. Some physicians often perform diagnostic evaluations for plasma cell disorders (PCD) in African American patients on the basis of hematological abnormalities (thrombocytopenia, leucopenia, etc.) even in the absence of traditional triggers such as anemia, renal impairment, hypercalcemia, hyperglobulinemia, and lytic bone disease. Whether these nontraditional triggers have any significant association with PCD in African American population is not known. In addition, whether this approach could detect more asymptomatic PCD than black population prevalence is questionable. Moreover, the association between traditional triggers and PCD particularly in blacks has not been clearly delineated. Hence, we have carried out a retrospective study in an attempt to answer these questions. Two hundred fifty-four patients were eligible. Multiple myeloma workup based on parameters other than traditional triggers did not detect more asymptomatic PCD than what is expected of black population prevalence (p = 0.19). Of traditional triggers, the finding of only anemia or hyperglobulinemia seemed to be nonspecific in black population (p = 0.17 and 0.85, respectively). However, the presence of serum creatinine >2 mg/dL or corrected serum calcium >10.5 mg/dL or a combination of traditional triggers appeared to be strongly predictive of PCD (odds ratio of 6.9, 4.2, and 3, respectively). The number of trigger variables was positively correlated with the likelihood of PCD (p < 0.001). Light-chain-only PCD, renal disease, and abnormal free light chain ratio seemed to be higher in black patients than their white counterparts.

  1. Frequency of nonalcoholic fatty liver disease and degree of hepatic steatosis in African-American patients.

    PubMed Central

    Giday, Samuel A.; Ashiny, Zelalem; Naab, Tammy; Smoot, Duane; Banks, Alpha

    2006-01-01

    BACKGROUND: This retrospective study evaluates the degree and distribution of hepatic steatosis in predominantly African-American patients who had liver biopsies over a period of five years in our institution. METHOD: A search in the pathology registry of Howard University Hospital was performed for the presence of fat in liver biopsies. Each biopsy was assessed. RESULTS: Of the 320 liver biopsies that were reviewed, 61 were found to have steatosis. Fifty-six of the 61 patients were African-American. The mean body mass index in those African-American patients was found to be 30. Grade-1 steatosis was found in 16 patients, grade 2 in 22 patients, grade 3 in 14 patients and nine patients had grade-4 steatosis. Four patients fulfilled the criteria for the diagnosis of nonalcoholic fatty liver disease (NAFLD). All four patients had simple steatosis without any inflammation. The frequency of NAFLD in our study population was found to be <2%. Nonalcoholic steatohepatitis was not found in any of our study population. Dyslipidemia was found in all four patients with steatosis. CONCLUSION: NAFLD has a low prevalence in African-American patients. Nonalcoholic steatohepatitis was not found in any of the African-American patients seen at our institution. PMID:17052050

  2. Comparing the validity of 2 physical activity questionnaire formats in African-American and Hispanic women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to compare the validity of 2 physical activity questionnaire formats—one that lists activities (Checklist questionnaire) and one that assesses overall activities (Global questionnaire) by domain. Two questionnaire formats were validated among 260 African-American and Hi...

  3. A Study Comparing the Academic Achievement of African American Male Students Enrolled in Two Types of Nontraditional High Schools

    ERIC Educational Resources Information Center

    Rutledge, Anthony B.

    2010-01-01

    This study examined the relationship of the achievement of African American male students enrolled in an early college high school to those enrolled in a performing arts high school. The Georgia High School Graduation Test (GHSGT) scores of the 11th-grade African American male students from an early college high school were compared to the GHSGT…

  4. Comorbid illnesses and chest radiographic severity in African-American sarcoidosis patients.

    PubMed

    Westney, Gloria E; Habib, Sadia; Quarshie, Alexander

    2007-01-01

    Sarcoidosis disease expression differs along racial/ethnic lines and black race has been cited as a poor prognostic factor. Besides genetic, healthcare, and socioeconomic factors, comorbid illnesses may influence sarcoidosis disease expression. We set out to investigate the association between comorbid illnesses and chest radiographic severity in a population of African-American sarcoidosis patients. The study was designed as a retrospective database analysis. The hospital and outpatient databases of the Grady Health System were searched to capture adult patients between November 1999 and December 2003 with the ICD-9 codes of 135 or 519.8, along with all associated secondary and tertiary diagnostic codes. Patient electronic pathology and radiographic reports were reviewed for tissue biopsies showing noncaseating granulomas and for chest radiographic Scadding stage. A total of 165 African-American patients were identified (64% female, 43 +/- 10 years old). Ninety percent (149/165) had comorbid illnesses. The most frequent chronic comorbid illnesses were hypertension (39%), diabetes mellitus (19%), anemia (19%), asthma (15%), gastroesophageal reflux disease (15%), depression (13%), and heart failure (10%). Females had increased frequency and clustering of chronic illnesses. Chest radiographic stages were more severe in patients with anemia, depression, and those less than 40 years old. Males, within each chronic illnesses category, had more severe CXR stages compared to females; however, significance was not achieved. We concluded that most adult patients with sarcoidosis have comorbid illnesses and these, in addition to gender differences, may influence sarcoidosis disease expression. Screening for comorbid illnesses should be an important aspect of sarcoidosis patient management.

  5. Patient trust in physicians and shared decision-making among African-Americans with diabetes.

    PubMed

    Peek, Monica E; Gorawara-Bhat, Rita; Quinn, Michael T; Odoms-Young, Angela; Wilson, Shannon C; Chin, Marshall H

    2013-01-01

    This study explores patient trust in physicians and its relationship to shared decision-making (SDM) among African-Americans with diabetes (types 1 and 2). We conducted a series of focus groups (n = 27) and in-depth interviews (n = 24). Topic guides were developed utilizing theoretical constructs. Each interview was audiotaped and transcribed verbatim. Each transcript was independently coded by two randomly assigned members of the research team; codes and themes were identified in an iterative fashion utilizing Atlas.ti software. The mean age of study participants was 62 years and 85% were female. We found that (1) race as a social construct has the potential to influence key domains of patient trust (interpersonal/relationship aspects and medical skills/technical competence), (2) the relationship between patient trust and shared decision-making is bidirectional in nature, and (3) enhancing patient trust may potentially increase or decrease SDM among African-Americans with diabetes. Mistrust of physicians among African-Americans with diabetes may partially be addressed through (1) patient education efforts, (2) physician training in interpersonal skills and cultural competence, and (3) physician efforts to engage patients in SDM. To help enhance patient outcomes among African-Americans with diabetes, physicians might consider incorporating strategies to simultaneously engender their patients' trust and encourage shared decision-making.

  6. Sebaceous carcinoma on the abdomen in an African-American male patient

    PubMed Central

    Moon, Talitha C.; Cassler, Nicole M.; Lackey, Jeffrey N.

    2015-01-01

    Sebaceous carcinoma is a rare, aggressive cutaneous tumor most commonly involving the head and neck, especially the periorbital area. It has been associated with Muir–Torre syndrome, human papillomavirus infection, and radiotherapy. This case report describes an unusual clinical presentation of a large sebaceous carcinoma on the abdomen of an African-American male patient who was successfully treated with Mohs micrographic surgery. The case is reported due to the unusual location of the lesion on the abdomen and the rare occurrence of this tumor type in an African-American male. PMID:26904445

  7. Differences in Risk Factors for Suicidality between African American and White Patients Vulnerable to Suicide

    ERIC Educational Resources Information Center

    Vanderwerker, Lauren C.; Chen, Joyce H; Charpentier, Peter; Paulk, Mary Elizabeth; Michalski, Marion; Prigerson, Holly G.

    2007-01-01

    Risk factors for suicidal ideation and attempts have been shown to differ between African Americans and Whites across the lifespan. In the present study, risk factors for suicidality were examined separately by race/ethnicity in a population of 131 older adult patients considered vulnerable to suicide due to substance abuse and/or medical frailty.…

  8. Factor VIII gene variants and inhibitor risk in African American hemophilia A patients.

    PubMed

    Gunasekera, Devi; Ettinger, Ruth A; Nakaya Fletcher, Shelley; James, Eddie A; Liu, Maochang; Barrett, John C; Withycombe, Janice; Matthews, Dana C; Epstein, Melinda S; Hughes, Richard J; Pratt, Kathleen P

    2015-08-13

    African American hemophilia A (HA) patients experience a higher incidence of neutralizing anti-factor VIII (FVIII) antibodies ("inhibitors") vis-à-vis white patients. Nonsynonymous single-nucleotide polymorphisms (ns-SNPs) in the F8 gene encoding FVIII-H484, FVIII-E1241, and FVIII-V2238 are more prevalent in African Americans. This study tested the hypothesis that immune responses to these sites provoke inhibitors. Blood samples were obtained from 174 African American and 198 white HA subjects and their F8 gene sequences determined. Major histocompatibility complex class II binding and T-cell recognition of polymorphic sequences were evaluated using quantitative binding assays and HLA-DRB1 tetramers. Peptides corresponding to 4 common ns-SNPs showed limited binding to 11 HLA-DRB1 proteins. CD4 T cells from 22 subjects treated with FVIII products having sequences at residues FVIII-484, 1241, and 2238 differing from those of putative proteins encoded by their F8 genes did not show high-avidity tetramer binding, whereas positive-control staining of tetanus-specific CD4 T cells was routinely successful. African Americans with an intron-22 inversion mutation showed a 2-3 times-higher inhibitor incidence than whites with the same mutation (odds ratio = 2.3 [1.1-5.0, P = .04]), but this did not correlate with any of the ns-SNPs. We conclude that immune responses to "sequence-mismatched" FVIII products are unlikely to contribute appreciably to the inhibitor incidence in African Americans.

  9. Rhinoplasty in the African American Patient: Anatomic Considerations and Technical Pearls.

    PubMed

    Peng, Grace Lee; Nassif, Paul S

    2016-01-01

    There are several anatomic considerations as well as variations in patients of African heritage. The goal of improvement in aesthetics and functionality must be in balance with racial preservation. Preoperative counseling must discuss patient expectations and surgical limitations based on patients' skin and cartilage. Dorsal augmentation, increased tip projection, and rotation are often needed. Understanding the thick, sebaceous skin often seen in African Americans assists in postoperative management of swelling. PMID:26616712

  10. Rhinoplasty in the African American Patient: Anatomic Considerations and Technical Pearls.

    PubMed

    Peng, Grace Lee; Nassif, Paul S

    2016-01-01

    There are several anatomic considerations as well as variations in patients of African heritage. The goal of improvement in aesthetics and functionality must be in balance with racial preservation. Preoperative counseling must discuss patient expectations and surgical limitations based on patients' skin and cartilage. Dorsal augmentation, increased tip projection, and rotation are often needed. Understanding the thick, sebaceous skin often seen in African Americans assists in postoperative management of swelling.

  11. Comparing the Experiential and Psychosocial Dimensions of Chronic Pain in African Americans and Caucasians: Findings from a National Community Sample

    PubMed Central

    Ruehlman, Linda S.; Karoly, Paul; Newton, Craig

    2005-01-01

    Objectives To ascertain whether non-Hispanic African American and Caucasian chronic pain sufferers differ or converge in their self-reports of pain experience and pain adjustment. Research Design A telephone survey of U.S. English-speaking adults selected via random-digit dialing procedures and constrained to locate persons with chronic pain within selected gender by age groupings. Subjects A national sample of 2,407 participants contained a total of 214 non-Hispanic African Americans. A sample of 214 non-Hispanic Caucasians was randomly selected from the larger set of 1,935 Caucasian participants to serve as a comparison group for the present study. Measures Participants provided responses to interviewer questions that assessed pain experience (severity, interference, and emotional burden) and psychosocial outcomes (coping, attitudes and beliefs, catastrophizing, social support and hindrance, pain’s interference with daily life activities, treatment status, and medication taking). Results Although African American and Caucasian adults with chronic pain did not differ significantly in pain severity, interference, emotional burden, or current treatment status, multivariate analyses revealed differences in several domains of psychosocial functioning. Compared to Caucasians, African Americans reported greater pain-related interference with daily living, deficiencies in coping, and counterproductive attitudes and beliefs. African Americans also reported greater impatience and insensitivity from the most important person in their lives. Conclusions Psychosocial dimensions of chronic pain differed between community-residing African American and Caucasian adults surveyed as part of a national sample. PMID:15669950

  12. The Epworth Score in African American Populations

    PubMed Central

    Hayes, Amanda L.; Spilsbury, James C.; Patel, Sanjay R.

    2009-01-01

    Introduction: African Americans have elevated scores on the Epworth Sleepiness Scale (ESS) compared to whites. The reason for this difference is not clear. Methods: Responses to the ESS were assessed in 687 patients (52.3% African American) referred to a hospital-based sleep clinic. Differences in total ESS score and the scores on individual Epworth questions were compared in African Americans and whites. Findings were validated in an independent sleep apnea research cohort of 712 subjects (57.3% African Americans). Results: African Americans in the clinic-based population had a higher mean ESS score than whites (11.4 ± 0.3 vs. 9.8 ± 0.3, p < 0.0001). This difference persisted after adjusting for sleepiness risk factors. In adjusted analyses including responses to the other ESS questions, African Americans scored significantly greater on 3 of the 8 ESS component questions: questions 2-“Watching TV,” 6-“Sitting and talking to someone,” and 7-“Sitting quietly after lunch without alcohol.” In the validation cohort, African Americans also had a higher mean ESS score (9.1 ± 0.3, vs. 8.2 ± 0.3, p = 0.04). In addition they had significantly elevated scores on questions 6 and 7 (p = 0.0002, p = 0.012 respectively) even after adjusting for responses to the other Epworth questions. Conclusions: African Americans have greater sleepiness than whites as assessed by the ESS; this is independent of sleepiness risk factors. The difference appears due primarily to differences in responses to questions 6 and 7 of the ESS questions suggesting a difference in the interpretation of these 2 questions. Citation: Hayes AL; Spilsbury JC; Patel SR. The Epworth score in African American populations. J Clin Sleep Med 2009;5(4):344-348. PMID:19968012

  13. Cultural perceptions in cancer care among African-American and Caucasian patients.

    PubMed Central

    Matsuyama, Robin K.; Grange, Christina; Lyckholm, Laurie J.; Utsey, Shawn O.; Smith, Thomas J.

    2007-01-01

    PURPOSE: This exploratory study examined perceptions and beliefs of African Americans and Caucasians related to cancer care. Understanding belief systems and cultures optimizes cancer treatment and care delivery to ethnic minority individuals. PATIENTS AND METHODS: Focus groups were conducted with 39 African-American and Caucasian cancer patients. Data analysis included whole group analysis with a team of five researchers. RESULTS: Regardless of ethnicity, cancer patients share many of the same emotions and experiences, and want complete information and quality care. Differences were also apparent. African-American participants were more likely to report increased religious behaviors, believe that healthcare providers demonstrate care with simple actions and provision of practical assistance, and use church and community information sources. Caucasian participants were more likely to report spiritual but not overtly religious changes, and depend on healthcare providers for information. CONCLUSION: Understanding how culture colors perceptions, communication and information requirements is critical to providing effective care to ethnically diverse cancer patients. Findings have implications for professionals understanding ways patients seek information, the role of spirituality and religion in care, and ways healthcare providers demonstrate care. PMID:17987914

  14. Treatment Outcomes of African American Buprenorphine Patients by Parole and Probation Status.

    PubMed

    Mitchell, Shannon Gwin; Gryczynski, Jan; Kelly, Sharon M; O'Grady, Kevin E; Jaffe, Jerome H; Olsen, Yngvild K; Schwartz, Robert P

    2014-01-01

    This secondary analysis compared outcomes of African-American adults newly-admitted to buprenorphine treatment who were on parole and probation to patients who were not under criminal justice supervision. Buprenorphine patients (N=300) were randomly assigned to receive either Intensive Outpatient Treatment (IOP) or Standard Outpatient Treatment (OP) treatment and were assessed at baseline, 3- and 6-months. There were no differences between groups in treatment retention. Among probationers/parolees, IOP was associated with lower 3-month treatment retention compared to OP, but among participants not on probation/parole the relationship was reversed (p=.004). Both conditions showed significant declines in heroin and cocaine use, illegal activity, and in meeting DSM-IV criteria for opioid and cocaine dependence. Probationers/parolees reported lower frequency of illegal activities at 3-months compared to non-probationers/parolees (p=.007). Buprenorphine treatment should be made more widely available to individuals on parole/probation as they respond as well to treatment as patients not supervised by the criminal justice system.

  15. Retinal Damage and Vision Loss in African-American Multiple Sclerosis Patients

    PubMed Central

    Kimbrough, Dorlan J.; Sotirchos, Elias S.; Wilson, James A.; Al-Louzi, Omar; Conger, Amy; Conger, Darrel; Frohman, Teresa C.; Saidha, Shiv; Green, Ari J.; Frohman, Elliot M.; Balcer, Laura J.; Calabresi, Peter A.

    2014-01-01

    Objective To determine whether African-American (AA) multiple sclerosis (MS) patients exhibit more retinal damage and visual impairment compared to Caucasian-American (CA) MS patients. Methods 687 MS patients (81 AA) and 110 healthy control (HC) subjects (14 AA) were recruited at three academic hospitals between 2008 and 2012. Using mixed effects regression models, we compared high and low contrast visual acuity (HCVA and LCVA) and high-definition spectral-domain optical coherence tomography (Cirrus-OCT) measures of retinal architecture between MS patients of self-identified AA and CA ancestry. Results In HC, baseline peripapillary retinal nerve fiber layer thickness (RNFL) was 6.1 μm greater in AA (p = 0.047), while ganglion cell / inner plexiform layer (GCIP) thickness did not differ by race. In MS patients, baseline RNFL did not differ by race, and GCIP was 3.98 μm thinner in AA (p = 0.004). AA had faster RNFL and GCIP thinning rates compared to CA (p = 0.004 and p= 0.046, respectively). AA MS patients had lower baseline HCVA (p = 0.02) and worse LCVA per year of disease duration (p= 0.039). Among patients with an acute optic neuritis (AON) history, AA had greater loss of HCVA than CA patients (p = 0.012). Interpretation This multicenter investigation provides objective evidence that AA MS patients exhibit accelerated retinal damage compared to CA MS patients. Self-identified AA ancestry is associated with worse MS-related visual disability, particularly in the context of an AON history, suggesting a more aggressive inflammatory disease course among AA MS patients or a subpopulation therein. PMID:25382184

  16. Barriers to Clinical Trial Participation: Comparing Perceptions and Knowledge of African American and White South Carolinians.

    PubMed

    Kim, Sei-Hill; Tanner, Andrea; Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline

    2015-01-01

    Analyzing data from a survey of African American and White residents in South Carolina, this study attempts to understand how to better promote clinical trial participation specifically within the African American population. To explore why participation is lower in the African American population, the authors examined two sets of potential barriers: structural/procedural (limited accessibility, lack of awareness, doctors not discussing clinical trial options, lack of health insurance) and cognitive/psychological (lack of subjective and factual knowledge, misperceptions, distrust, fear, perceived risk). Findings revealed that African Americans were significantly less willing than Whites to participate in a clinical trial. African Americans also had lower subjective and factual knowledge about clinical trials and perceived greater risk involved in participating in a clinical trial. The authors found that lack of subjective knowledge and perceived risk were significant predictors of African Americans' willingness to participate in a clinical trial. Implications of the findings are discussed in detail. PMID:26042496

  17. Patients' cultural beliefs in patient-provider communication with African American women and Latinas diagnosed with breast cancer.

    PubMed

    Mott-Coles, Susan

    2014-08-01

    African American women and Latinas often experience suboptimal breast cancer care. This article describes providers' self-rated skills in communication practices when working with African American women and Latinas diagnosed with breast cancer. Current literature reveals how providers are lacking in the ability to communicate with these patients and often fail to incorporate cultural beliefs into breast cancer care and treatment. This poor communication and failure to acknowledge cultural beliefs can be correlated with poor patient outcomes. In a study of providers' perceptions of how they address the cultural beliefs of African American women and Latinas diagnosed with breast cancer, interviews with physicians, inpatient nurses, cancer clinic nurses, mammography technicians, and ultrasound technicians showed that they used the same approach for all patients, regardless of race, ethnicity, or culture but felt they practiced culturally sensitive care. Increased and improved cultural competence education is recommended for providers at all levels as a first step toward increasing culturally competent communications.

  18. Profile of diabetic ketoacidosis in a predominantly African American urban patient population.

    PubMed

    Seyoum, Berhane; Berhanu, Paulos

    2007-01-01

    The occurrence of diabetic ketoacidosis (DKA), a serious but largely preventable acute complication of diabetes mellitus, has been declining in recent years. However, empiric observations indicate that DKA continues to have a major effect on ethnic minority patients in inner-city settings. In this study, we conducted a retrospective analysis of five-year hospital admission data for DKA at a single inner-city hospital that serves a largely uninsured adult African American population. A computer-assisted search of the International Classification of Diseases, Ninth Revision, Clinical Modification codes for DKA revealed 847 admissions for confirmed DKA in 630 patients. Of these, 592 (94%) were African Americans, 22 (3.5%) were Whites, and 16 (2.5%) were Hispanics. The mean age was 43.4 +/- .4 years. Five hundred seventy-one (90.6%) of the patients had type 1 diabetes, and 59 (9.4%) had type 2 diabetes. One hundred forty-five patients (23%) were newly diagnosed with diabetes. Ninety-four (14.9%) of the patients had multiple admissions, ranging from 2 to 23 admissions per patient during the five-year period, while the remaining 391 (62.1%) patients were single admissions. Half of the patients (52%) did not have health insurance. Major precipitating factors for DKA included discontinuation of insulin, infection, and other medical illness in 501 (59.1%), 136 (16.1%), and 30 (3.5%) of the admissions, respectively. In conclusion, these data demonstrate that DKA continues to have a major effect in urban African American patients with diabetes. Therefore, multiple targeted interventions are needed in this population to improve diabetes care and thereby decrease the frequency of DKA.

  19. Trio Student Support Services: A Comparative Study of African American Students at Three Texas Universities

    ERIC Educational Resources Information Center

    Powell, Hattie Marie

    2013-01-01

    Although access to postsecondary education for ethnic minorities has increased since desegregation in 1954, the college completion rates for these groups have not, particularly for African Americans. For this reason, it is important to continue to examine strategies that contribute to increases in completion rates for African Americans. The…

  20. An Empirical Examination of Inter-Ethnic Stereotypes: Comparing Asian American and African American Employees.

    ERIC Educational Resources Information Center

    Gilbert, Jackie; Carr-Ruffino, Norma; Ivancevich, John M.; Lownes-Jackson, Millicent

    2003-01-01

    Undergraduates (n=127) read career histories (including photographs) of fictitious employees in a 2x2x2 design depicting job type (engineer/human resources), ethnicity (Asian or African American), and gender, with the same qualifications and performance information. African-American males were rated most negatively on work characteristics;…

  1. Molecular phenotypes in triple negative breast cancer from African American patients suggest targets for therapy.

    PubMed

    Lindner, Robert; Sullivan, Catherine; Offor, Onyinye; Lezon-Geyda, Kimberly; Halligan, Kyle; Fischbach, Neal; Shah, Mansi; Bossuyt, Veerle; Schulz, Vincent; Tuck, David P; Harris, Lyndsay N

    2013-01-01

    Triple negative breast cancer (TNBC) is characterized by high proliferation, poor differentiation and a poor prognosis due to high rates of recurrence. Despite lower overall incidence African American (AA) patients suffer from higher breast cancer mortality in part due to the higher proportion of TNBC cases among AA patients compared to European Americans (EA). It was recently shown that the clinical heterogeneity of TNBC is reflected by distinct transcriptional programs with distinct drug response profiles in preclinical models. In this study, gene expression profiling and immunohistochemistry were used to elucidate potential differences between TNBC tumors of EA and AA patients on a molecular level. In a retrospective cohort of 136 TNBC patients, a major transcriptional signature of proliferation was found to be significantly upregulated in samples of AA ethnicity. Furthermore, transcriptional profiles of AA tumors showed differential activation of insulin-like growth factor 1 (IGF1) and a signature of BRCA1 deficiency in this cohort. Using signatures derived from the meta-analysis of TNBC gene expression carried out by Lehmann et al., tumors from AA patients were more likely of basal-like subtypes whereas transcriptional features of many EA samples corresponded to mesenchymal-like or luminal androgen receptor driven subtypes. These results were validated in The Cancer Genome Atlas mRNA and protein expression data, again showing enrichment of a basal-like phenotype in AA tumors and mesenchymal subtypes in EA tumors. In addition, increased expression of VEGF-activated genes together with elevated microvessel area determined by the AQUA method suggest that AA patients exhibit higher tumor vascularization. This study confirms the existence of distinct transcriptional programs in triple negative breast cancer in two separate cohorts and that these programs differ by racial group. Differences in TNBC subtypes and levels of tumor angiogenesis in AA versus EA patients

  2. Identifying Barriers to Colonoscopy Screening for Nonadherent African American Participants in a Patient Navigation Intervention

    ERIC Educational Resources Information Center

    Sly, Jamilia R.; Edwards, Tiffany; Shelton, Rachel C.; Jandorf, Lina

    2013-01-01

    African Americans have a higher rate of colorectal cancer (CRC) mortality than other racial/ethnic groups. This disparity is alarming given that CRC is largely preventable through the use of endoscopy (screening colonoscopy or sigmoidoscopy), yet rates of CRC screening among African Americans is suboptimal. Only 48.9% of African Americans are…

  3. Engaging African-American Veterans in Mental Health Care: Patients' Perspectives.

    PubMed

    Eliacin, Johanne; Rollins, Angela L; Burgess, Diana J; Salyers, Michelle P; Matthias, Marianne S

    2016-04-01

    Despite growing interest in patient engagement, the concept remains poorly defined. Moreover, patients' perspectives on engagement are lacking, particularly those of minority patients. A better understanding of patients' views and what influences their engagement in health services will facilitate better patient education and implementation practices to enhance patient participation in health care. This article addresses patients' perspectives of facilitators and barriers to engagement in outpatient mental health services. Forty-nine African-American veterans with mental illness receiving routine medication management visits were interviewed. Qualitative data analysis was guided by a constructivist grounded theory approach. Participants identified several barriers and facilitators to engagement in mental health services, including patient as well as provider-related factors. Results emphasize the role of providers in facilitating sustained involvement of patients in their own care. Based on the findings, the authors offer a preliminary framework for patient engagement that encompasses patient and provider factors. PMID:26894316

  4. Culturally competent approaches to assessing ADHD in African American adults and overcoming cultural issues with patients and families.

    PubMed

    Waite, Roberta

    2015-03-01

    To better diagnose and treat African American patients with ADHD, clinicians should consider the mental health field from a cultural and historical perspective. This perspective can aid clinicians in assessing patients' culturally informed resistance or ambivalence toward ADHD treatment and in adopting strategies for communicating with patients about their diagnosis and treatment. Clinicians must learn to recognize and manage their own biases as well as their patients' biases. Using a culturally competent approach is critical to assessing ADHD in African American adults and overcoming cultural issues with patients and their families.

  5. Culturally competent approaches to assessing ADHD in African American adults and overcoming cultural issues with patients and families.

    PubMed

    Waite, Roberta

    2015-03-01

    To better diagnose and treat African American patients with ADHD, clinicians should consider the mental health field from a cultural and historical perspective. This perspective can aid clinicians in assessing patients' culturally informed resistance or ambivalence toward ADHD treatment and in adopting strategies for communicating with patients about their diagnosis and treatment. Clinicians must learn to recognize and manage their own biases as well as their patients' biases. Using a culturally competent approach is critical to assessing ADHD in African American adults and overcoming cultural issues with patients and their families. PMID:25830467

  6. Defensive Localism in White and Black: A Comparative History of European-American and African-American Youth Gangs.

    ERIC Educational Resources Information Center

    Adamson, Christopher

    2000-01-01

    Compares European American and African American youth gangs in four historical periods (seaboard, immigrant, racially changing, and hypersegregated cities), showing that differences can be traced to race-specific effects of labor, housing, and consumer markets, government policies, local politics, and organized crime on their communities.…

  7. Correlates of African American and Latino parents' messages to children about ethnicity and race: a comparative study of racial socialization.

    PubMed

    Hughes, Diane

    2003-03-01

    Recently, social scientists have become increasingly interested in the nature of communications from parents to children regarding ethnicity and race. Termed racial socialization, race-related messages to children may have important consequences for children's identity development and well-being. This study examined the frequency and correlates of two dimensions of racial socialization-messages about ethnic pride, history, and heritage (Cultural Socialization) and messages about discrimination and racial bias (Preparation for Bias)--among 273 urban African American, Puerto Rican, and Dominican parents. Parents reported more frequent Cultural Socialization than Preparation for Bias. There were no significant ethnic group differences in the frequency of Cultural Socialization. However, African American parents reported more frequent Preparation for Bias than did Dominican parents who, in turn, reported more frequent messages of this sort than did Puerto Rican parents Ethnic identity was a stronger predictor of Cultural Socialization among Puerto Rican and Dominican parents than among their African American counterparts. In contrast, perceived discrimination experiences was a stronger predictor of Preparation for Bias among African American and Dominican parents than among Puerto Rican parents. Finally, race-related phenomenon accounted for more variance in both Cultural Socialization and Preparation for Bias among parents reporting on their behaviors with children 10-17 years old as compared to parents reporting on their behaviors with children 6-9 years old. PMID:12741687

  8. Patient-Centered Community Diabetes Education Program Improves Glycemic Control in African-American Patients with Poorly Controlled Type 2 Diabetes: Importance of Point of Care Metabolic Measurements.

    PubMed

    Gaillard, Trudy; Amponsah, Grace; Osei, Kwame

    2015-07-01

    African-Americans with type 2 diabetes (T2DM) have higher morbidity and mortality partly attributed to poor glucose control and lack of formal diabetes self-management education and support (DSMES) programs compared to Whites. Therefore, the objective of this study was to compare the clinical and metabolic parameters during DSMES vs. standard care in African-Americans with T2DM attending primary care inner city clinics. We recruited 124 African-American patients with T2DM, randomized into Group 1-DSMES (n = 58) and Group 2-standard care group (n = 38) for 6 months. Body weight, blood pressure, random blood sugars and point-of-care (POC) hemoglobin A1C (A1C) and lipids/lipoproteins were measured at 0, 3, and 6 months. At 6 months, Group 1 had significant reduction in A1C (8.2 ± 1.4% vs. 7.5 ± 1.5%, p = 0.02) and random glucose (190.4 ± 77.6 vs. 160.6 ± 59.8 mg/dl, p = 0.03). However, there were no changes in body weight, blood pressure, or lipids/lipoprotein levels. We found no significant changes in the clinical/metabolic parameters in Group 2. We concluded that DSMES, supplemented with POC testing, was associated with significant improvements in glycemic control without changes in body weight, blood pressure, or lipids/lipoproteins. We recommend the inclusion of DSMES with POC testing in managing African-American patients with T2DM attending inner city primary care clinics.

  9. Patient-Centered mHealth Living Donor Transplant Education Program for African Americans: Development and Analysis

    PubMed Central

    Sieverdes, John Christopher; Nemeth, Lynne S; Magwood, Gayenell S; Baliga, Prabhakar K; Chavin, Kenneth D; Brunner-Jackson, Brenda; Patel, Sachin K; Ruggiero, Kenneth J

    2015-01-01

    Background There is a critical need to expand the pool of available kidneys for African Americans who are on the transplant wait-list due to the disproportionally lower availability of deceased donor kidneys compared with other races/ethnic groups. Encouraging living donation is one method to fill this need. Incorporating mHealth strategies may be a way to deliver educational and supportive services to African American transplant-eligible patients and improve reach to those living in remote areas or unable to attend traditional group-session-based programs. Before program development, it is essential to perform formative research with target populations to determine acceptability and cultivate a patient-centered and culturally relevant approach to be used for program development. Objective The objectives of this study were to investigate African American kidney transplant recipients’ and kidney donors’/potential donors’ attitudes and perceptions toward mobile technology and its viability in an mHealth program aimed at educating patients about the process of living kidney donation. Methods Using frameworks from the technology acceptance model and self-determination theory, 9 focus groups (n=57) were administered to African Americans at a southeastern medical center, which included deceased/living donor kidney recipients and living donors/potential donors. After a demonstration of a tablet-based video education session and explanation of a group-based videoconferencing session, focus groups examined members’ perceptions about how educational messages should be presented on topics pertaining to the process of living kidney donation and the transplantation. Questionnaires were administered on technology use and perceptions of the potential program communication platform. Transcripts were coded and themes were examined using NVivo 10 software. Results Qualitative findings found 5 major themes common among all participants. These included the following: (1

  10. Social Network and Health Outcomes among African American Cardiac Rehabilitation Patients

    PubMed Central

    Tkatch, Rifky; Artinian, Nancy T.; Abrams, Judith; Mahn, Jennifer R.; Franks, Melissa M.; Keteyian, Steven J.; Franklin, Barry; Pienta, Amy; Schwartz, Steven

    2010-01-01

    Objective To test the hypotheses that the number of close social network members and health-related support provided by social network members is predictive of coping efficacy and health behaviors. Methods Cross-sectional data were collected from 115 African Americans enrolled in cardiac rehabilitation. Measures included Social Convoy Model, SF-36, Social Interaction Questionnaire, the Patient Self-Efficacy Questionnaire and an investigator developed assessment of health behaviors. Results Bivariate relationships were found between the number of inner network members and coping efficacy (r=.19, p<.05) health behaviors (r=.18, p<.06) and between health related support and coping efficacy (r=.22, p.05) and health behaviors (r=.28, p<.001). Regression analyses support the hypotheses that close network members predicted better coping efficacy (β=.18, p<.05) and health behaviors (β=.19, p<.05). Health-related support also predicted coping efficacy (β=.23, p<.05) and health behaviors (β=.30, p<.01). Conclusion African Americans with larger inner networks have more health support, better health behaviors and higher coping efficacy. The number of close social network members and related health support promote health through health behaviors and coping efficacy. PMID:20674978

  11. A decade of experience with renal transplantation in African-Americans.

    PubMed

    Foster, Clarence E; Philosophe, Benjamin; Schweitzer, Eugene J; Colonna, John O; Farney, Alan C; Jarrell, Bruce; Anderson, Leslie; Bartlett, Stephen T

    2002-12-01

    OBJECTIVE To evaluate the strategies instituted by the authors' center to decrease the time to transplantation and increase the rate of transplantation for African-Americans, consisting of a formal education program concerning the benefits of living organ donation that is oriented to minorities; a laparoscopic living donation program; use of hepatitis C-positive donors in documented positive recipients; and encouraging vaccination for hepatitis B, allowing the use of hepatitis B core Ab-positive donors. SUMMARY BACKGROUND DATA The national shortage of suitable kidney donor organs has disproportional and adverse effects on African-Americans for several reasons. Type II diabetes mellitus and hypertension, major etiologic factors for end-stage renal disease, are more prevalent in African-Americans than in the general population. Once kidney failure has developed, African-Americans are disadvantaged for the following reasons: this patient cohort has longer median waiting times on the renal transplant list; African-Americans have higher rates of acute rejection, which affects long-term allograft survival; and once they are transplanted, the long-term graft survival rates are lower in this population than in other groups. METHODS From March 1990 to November 2001 the authors' center performed 2,167 renal transplants; 944 were in African-Americans (663 primary cadaver renal transplants and 253 primary Living donor renal transplants). The retransplants consisted of 83 cadaver transplants and 17 living donor transplants. Outcome measures of this retrospective analysis included median waiting time, graft and patient survival rates, and the rate of living donation in African-Americans and comparable non-African-Americans. Where applicable, data are compared to United Network for Organ Sharing national statistics. Statistical analysis employed appropriate SPSS applications. RESULTS One- and 5-year patient survival rates for living donor kidneys were 97.1% and 91.3% for non-African-Americans

  12. Obesity and African Americans

    MedlinePlus

    ... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... ss6304.pdf [PDF | 3.38MB] HEALTH IMPACT OF OBESITY More than 80 percent of people with type ...

  13. The Chicago Parent Program: Comparing 1-Year Outcomes for African American and Latino Parents of Young Children

    PubMed Central

    Breitenstein, Susan M.; Gross, Deborah; Fogg, Louis; Ridge, Alison; Garvey, Christine; Julion, Wrenetha; Tucker, Sharon

    2012-01-01

    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

  14. Intimate partner violence and mental health symptoms in African American female ED patients#

    PubMed Central

    Houry, Debra; Kemball, Robin; Rhodes, Karin V.; Kaslow, Nadine J.

    2006-01-01

    Background Intimate partner violence (IPV) victims often seek care in the ED, whether for an injury from abuse or other sequelae such as mental health symptoms. Objectives The objective of the study was to assess whether depressive symptoms, posttraumatic stress disorder (PTSD), and suicidality were associated with physical, sexual, or emotional IPV in African American female ED patients and to determine if experiencing multiple types of abuse was associated with increased mental health symptoms. Methods All eligible African American female patients were approached in the ED waiting room during study periods. Patients participated in the screening process via a computer kiosk. Questions regarding IPV and mental health symptoms were asked using validated tools. Results In this prospective cohort, 569 participated and 36% of those in a relationship in the past year (n = 461) disclosed that there were victims of IPV in the past year. In the past year, 22% experienced recent physical abuse, 9% recent sexual abuse, and 32% recent emotional abuse. A Pearson correlation was conducted and showed that all mental health symptoms were positively correlated with each type of IPV and each type of mental health symptom category. Mental health symptoms increased significantly with amount of abuse: depression (odds ratio [OR], 5.9 for 3 types of abuse), PTSD (OR, 9.4 for 3), and suicidality (OR, 17.5 for 3). Conclusions Emotional, sexual, and physical IPV were significantly associated with mental health symptoms. Each type of abuse was independently associated with depression, suicidality, and PTSD. Experiencing more than 1 type of abuse was also correlated with increased mental health symptoms. PMID:16787803

  15. Macro- and micronutrients in patients with congestive heart failure, particularly African-Americans.

    PubMed

    Newman, Kevin P; Bhattacharya, Syamal K; Munir, Ahmad; Davis, Richard C; Soberman, Judith E; Ramanathan, Kodangudi B

    2007-01-01

    Not all patients with heart failure, defined as a reduced ejection fraction, will have an activation of the RAAS, salt and water retention, or the congestive heart failure (CHF) syndrome. Beyond this cardiorenal perspective, CHF is accompanied by a systemic illness that includes oxidative stress, a proinflammatory phenotype, and a wasting of soft tissues and bone. A dyshomeostasis of calcium, magnesium, zinc, selenium, and vitamin D contribute to the appearance of oxidative stress and to compromised endogenous defenses that combat it. A propensity for hypovitaminosis D, given that melanin is a natural sunscreen, and for secondary hyperparathyroidism in African-Americans make them more susceptible to these systemic manifestations of CHF-a situation which is further threatened by the calcium and magnesium wasting that accompanies the secondary aldosteronism of CHF and the use of loop diuretics. PMID:18078025

  16. The management of hypertension in African Americans.

    PubMed

    Ferdinand, Keith C; Armani, Annemarie M

    2007-06-01

    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.

  17. Comparative Effectiveness of a Faith-Based HIV Intervention for African American Women: Importance of Enhancing Religious Social Capital

    PubMed Central

    Robinson, LaShun R.; Braxton, Nikia D.; Er, Deja L.; Conner, Anita C.; Renfro, Tiffaney L.; Rubtsova, Anna A.; Hardin, James W.; DiClemente, Ralph J.

    2013-01-01

    Objectives. We assessed the effectiveness of P4 for Women, a faith-based HIV intervention. Methods. We used a 2-arm comparative effectiveness trial involving 134 African American women aged 18 to 34 years to compare the effectiveness of the Centers for Disease Control and Prevention–defined evidence-based Sisters Informing Sisters about Topics on AIDS (SISTA) HIV intervention with P4 for Women, an adapted faith-based version of SISTA. Participants were recruited from a large black church in Atlanta, Georgia, and completed assessments at baseline and follow-up. Results. Both SISTA and P4 for Women had statistically significant effects on this study’s primary outcome—consistent condom use in the past 90 days—as well as other sexual behaviors. However, P4 for Women also had statistically significant effects on the number of weeks women were abstinent, on all psychosocial mediators, and most noteworthy, on all measures of religious social capital. Results were achieved by enhancing structural social capital through ministry participation, religious values and norms, linking trust and by reducing negative religious coping. High intervention attendance may indicate the feasibility of conducting faith-based HIV prevention research for African American women. Conclusions. P4 for Women enhanced abstinence and safer sex practices as well as religious social capital, and was more acceptable than SISTA. Such efforts may assist faith leaders in responding to the HIV epidemic in African American women. PMID:24134367

  18. Challenges in making therapeutic lifestyle changes among hypercholesterolemic African-American patients and their physicians.

    PubMed Central

    Dailey, Rhonda; Schwartz, Kendra L.; Binienda, Juliann; Moorman, Jessica; Neale, Anne Victoria

    2006-01-01

    OBJECTIVE: We explored challenges faced by hypercholesterolemic African-American primary care patients and their physicians regarding therapeutic lifestyle changes (TLC) and provide patient-influenced recommendations to physicians. METHODS: In this qualitative study, 23 urban family medicine patients and their physicians (N=12) participated in separate focus groups, where they were asked semistructured, open-ended questions about knowledge and barriers to lifestyle treatment of high cholesterol. RESULTS: During the focus groups, barriers mentioned by physicians were: lack of time for TLC counseling, inadequate knowledge about counseling patients, and patient readiness and responsibility to change. Patient-revealed barriers included difficulty adhering to a diet/exercise regimen and a lack of knowledge about high cholesterol. Patients who were successful with adopting a healthy lifestyle identified personal experiences or those of family and friends as motivating. CONCLUSION: Physicians desire training and resources to better help patients adopt diet and exercise regimens specific to their general and health literacy and their access to healthy foods, along with their readiness to change. Patients desire that physicians tailor their TLC advice to be specific to their context and they want help from physicians in setting realistic goals. Such a patient-centered counseling approach may improve adherence to lifestyle guidelines and, thus, clinical outcomes. PMID:17225831

  19. Relationships between Psychosocial-Spiritual Well-Being and End-of-Life Preferences and Values in African-American Dialysis Patients

    PubMed Central

    Hanson, Laura C.

    2010-01-01

    The purpose of the study was to examine whether psychosocial and spiritual well-being is associated with African-American dialysis patients' end-of-life treatment preferences and acceptance of potential outcomes of life sustaining treatment. Fifty-one African Americans with end stage renal disease (ESRD) completed a socio-demographic questionnaire and interview with measures of symptom distress, health-related quality of life, psychosocial and spiritual well-being, and preferences and values related to life sustaining treatment choices. The subjects were stratified by end-of-life treatment preferences and by acceptance of life sustaining treatment outcomes and compared for psychosocial and spiritual well-being as well as socio-demographic and clinical characteristics. Individuals who desired continued use of life sustaining treatment in terminal illness or advanced dementia had significantly lower spiritual well-being (p = .012). Individuals who valued four potential outcomes of life sustaining treatment as unacceptable showed a more positive, adaptive well-being score in the spiritual dimension compared to the group who valued at least one outcome as acceptable (p = .028). Religious involvement and importance of spirituality were not associated with end-of-life treatment preferences and acceptance of treatment outcomes. African Americans with ESRD expressed varied levels of psychosocial and spiritual well-being, and this characteristic was associated with life sustaining treatment preferences. In future research, the assessment of spirituality should not be limited to its intensity or degree but extended to other dimensions. PMID:19356896

  20. Health numeracy: perspectives about using numbers in health management from African American patients receiving dialysis.

    PubMed

    Wright Nunes, Julie A; Osborn, Chandra Y; Ikizler, T Alp; Cavanaugh, Kerri L

    2015-04-01

    Health numeracy is linked to important clinical outcomes. Kidney disease management relies heavily on patient numeracy skills across the continuum of kidney disease care. Little data are available eliciting stakeholder perspectives from patients receiving dialysis about the construct of health numeracy. Using focus groups, we asked patients receiving hemodialysis open-ended questions to identify facilitators and barriers to their understanding, interpretation, and application of numeric information in kidney care. Transcripts were analyzed using content analysis. Twelve patients participated with a mean (standard deviation) age of 56 (12) years. All were African American, 50% were women, and 83% had an annual income <$20,000/year. Although patients felt numbers were critical to every aspect in life, they noted several barriers to understanding, interpreting and applying quantitative information specifically to manage their health. Low patient self-efficacy related to health numeracy and limited patient-provider communication about quantitatively based feedback, were emphasized as key barriers. Through focus groups of key patient stakeholders we identified important modifiable barriers to effective kidney care. Additional research is needed to develop tools that support numeracy-sensitive education and communication interventions in dialysis. PMID:25358522

  1. Colorectal Cancer in African Americans: An Update

    PubMed Central

    Williams, Renee; White, Pascale; Nieto, Jose; Vieira, Dorice; Francois, Fritz; Hamilton, Frank

    2016-01-01

    This review is an update to the American College of Gastroenterology (ACG) Committee on Minority Affairs and Cultural Diversity's paper on colorectal cancer (CRC) in African Americans published in 2005. Over the past 10 years, the incidence and mortality rates of CRC in the United States has steadily declined. However, reductions have been strikingly much slower among African Americans who continue to have the highest rate of mortality and lowest survival when compared with all other racial groups. The reasons for the health disparities are multifactorial and encompass physician and patient barriers. Patient factors that contribute to disparities include poor knowledge of benefits of CRC screening, limited access to health care, insurance status along with fear and anxiety. Physician factors include lack of knowledge of screening guidelines along with disparate recommendations for screening. Earlier screening has been recommended as an effective strategy to decrease observed disparities; currently the ACG and American Society of Gastrointestinal Endoscopists recommend CRC screening in African Americans to begin at age 45. Despite the decline in CRC deaths in all racial and ethnic groups, there still exists a significant burden of CRC in African Americans, thus other strategies including educational outreach for health care providers and patients and the utilization of patient navigation systems emphasizing the importance of screening are necessary. These strategies have been piloted in both local communities and Statewide resulting in notable significant decreases in observed disparities. PMID:27467183

  2. Colorectal Cancer in African Americans: An Update.

    PubMed

    Williams, Renee; White, Pascale; Nieto, Jose; Vieira, Dorice; Francois, Fritz; Hamilton, Frank

    2016-01-01

    This review is an update to the American College of Gastroenterology (ACG) Committee on Minority Affairs and Cultural Diversity's paper on colorectal cancer (CRC) in African Americans published in 2005. Over the past 10 years, the incidence and mortality rates of CRC in the United States has steadily declined. However, reductions have been strikingly much slower among African Americans who continue to have the highest rate of mortality and lowest survival when compared with all other racial groups. The reasons for the health disparities are multifactorial and encompass physician and patient barriers. Patient factors that contribute to disparities include poor knowledge of benefits of CRC screening, limited access to health care, insurance status along with fear and anxiety. Physician factors include lack of knowledge of screening guidelines along with disparate recommendations for screening. Earlier screening has been recommended as an effective strategy to decrease observed disparities; currently the ACG and American Society of Gastrointestinal Endoscopists recommend CRC screening in African Americans to begin at age 45. Despite the decline in CRC deaths in all racial and ethnic groups, there still exists a significant burden of CRC in African Americans, thus other strategies including educational outreach for health care providers and patients and the utilization of patient navigation systems emphasizing the importance of screening are necessary. These strategies have been piloted in both local communities and Statewide resulting in notable significant decreases in observed disparities. PMID:27467183

  3. Genetic Risk Factors for Type 2 Diabetes with Pharmacologic Intervention in African-American Patients with Schizophrenia or Schizoaffective Disorder

    PubMed Central

    MR, Irvin; HW, Wiener; RP, Perry; RM, Savage; CP, Go R

    2009-01-01

    An increased prevalence of type 2 diabetes (T2D) in schizophrenia (SCZ) patients has been observed. Exposure to antipsychotics (APs) has been shown to induce metabolic dysregulation in some patients but not all treated patients. We hypothesized important candidate genes for T2D may increase risk for T2D in African-American patients with SCZ or schizoaffective disorder. The PAARTNERS study comprises African-American families with at least one proband with SCZ or schizoaffective disorder. The current study of PAARTNERS SCZ and schizoaffective disorder cases (N=820) examined single nucleotide polymorphisms (SNPs) within select T2D candidate genes including transcription factor like 7 (TCF7L2), calpain 10 (CAPN10), and ectoenzyme nucleotide pyrophosphate phosphodiesterase 1 (ENNP1) for association with prevalent T2D. We report association of TCF7L2 (rs7903146) with T2D under both an additive and recessive model for the risk allele T. Specifically, the odds ratio (OR) for having T2D was 1.4 (p=0.03) under an additive model and 2.4 (p=0.004) under a recessive model. We also report a marginally significant TCF7L2 by AP treatment interaction that should be investigated in future studies. CAPN10 (rs3792267) was marginally associated with T2D with OR=1.5 (p=0.08) when considering the model GG vs. AG/AA with risk allele G. ENPP1 (rs1044498) was not associated with T2D. We conclude TCF7L2, a risk factor for T2D in the general population, is also a risk factor for T2D in African-American patients with SCZ or schizoaffective disorder. Research is needed to determine if T2D associated polymorphisms are of interest in the pharmacogenetics and future treatment choices of antipsychotics in African-American patients. PMID:19643578

  4. Review: Heart failure with preserved ejection fraction in African Americans.

    PubMed

    Shah, Sachil

    2012-01-01

    Heart failure (HF) affects 5,700 000 people in the United States, with heart failure with preserved ejection fraction (HFPEF) being responsible for between 30%-50% of acute admissions. Epidemiological studies and HF registries have found HFPEF patients to be older, hypertensive and to have a history of atrial fibrillation. These findings, however, may not be fully applicable to African Americans, as they have been poorly studied making up only a minority of the test subjects. This review article is intended to discuss the pathophysiology and epidemiology of HFPEF within African Americans, highlight the differences compared to Caucasian populations and review current treatment guidelines. Studies looking at African Americans in particular have shown them to be younger, female and have worse diastolic dysfunction compared to Caucasian populations. African Americans also have been shown to have a worse mortality outcome especially in patients without coronary artery disease. The treatment of HFPEF is primarily symptomatic with no survival benefit seen in randomized controlled trials. Mechanisms postulated for the worse prognosis in African Americans with HFPEF include: greater incidence of hypertension and diastolic dysfunction, undefined race-driven genetic predispositions or relative resistance to medications that treat HF in general. The biological predispositions may also be compounded by inequality of healthcare access; something still felt to exist today. Prospective studies and randomized controlled trials need to be conducted with particular emphasis on African American populations to fully elucidate this disease and to formulate race specific treatment outcomes for the future.

  5. Identification of novel mutations by exome sequencing in African American colorectal cancer patients

    PubMed Central

    Ashktorab, Hassan; Daremipouran, Mohammad; Devaney, Joe; Varma, Sudhir; Rahi, Hamed; Lee, Edward; Shokrani, Babak; Schwartz, Russell; Nickerson, Mike; Brim, Hassan

    2015-01-01

    Background To identify genome wide single nucleotide variants (SNVs) and mutations in African Americans (AAs) with colorectal cancer (CRC). There is a need of such studies in AAs since they display a higher incidence of aggressive CRC tumors. Methods We performed whole exome sequencing (WES) on DNA from 12 normal–tumor pairs of AA CRC patients’ tissues. Data analysis was carried out using GATK (Genome Analysis Tool Kit). Normative population databases (e.g. 1000 Genomes SNP database, dbSNP, and HapMap) were used for comparison. Variants were annotated using Annova and validated by Sanger sequencing. Results We identified somatic mutations in genes that are known targets in CRC such as APC, BRAF, KRAS, and PIK3CA. We detected novel alterations in the WNT pathway gene, APC, within its exon 15 of which mutations are highly associated with CRC. Conclusions This first WES from AA CRC patients provides insight into the identification of novel somatic mutations in APC. Our data suggest an association between specific mutations in the WNT signaling pathway and increased risk of CRC. The analysis of the pathogenicity of these novel variants might help understand the aggressive nature of CRC in AAs. PMID:25250560

  6. Variant hemoglobin phenotypes may account for differential erythropoiesis-stimulating agent dosing in African-American hemodialysis patients.

    PubMed

    Derebail, Vimal K; Nachman, Patrick H; Key, Nigel S; Ansede, Heather; Falk, Ronald J; Rosamond, Wayne D; Kshirsagar, Abhijit V

    2011-11-01

    African-American patients with end-stage renal disease have historically lower hemoglobin concentrations and higher requirements of erythropoiesis-stimulating agent (ESA). While disparities in health-care access may partially explain these findings, the role of variant hemoglobin, such as sickle trait, has not been investigated. To clarify this, we evaluated 154 African-American patients receiving in-center hemodialysis with available hemoglobin phenotyping. The primary exposure was any abnormal hemoglobin variant and the primary outcome of higher-dose ESA was defined as a dose of 6500 or more units per treatment. Logistic regression assessed the association between variant hemoglobin and higher-dose ESA. Covariates included age, gender, diabetes, iron parameters, intravenous iron dose, parathyroid hormone, albumin, phosphorus, body mass index, vascular access type, hospitalization/missed treatments, smoking status, alcohol abuse, and gastrointestinal bleeding. Of 33 patients with variant hemoglobin, 24 had HbAS and 9 had HbAC. Univariate odds of higher-dose ESA among those with hemoglobin variants were twice that of those with the normal HbAA phenotype (odds ratio 2.05). In multivariate models, the likelihood of higher-dose ESA had an odds ratio of 3.31 and the nature of this relationship did not change in Poisson regression or sensitivity analyses. Hence, our findings may explain, in part, the difference in ESA dosing between Caucasians and African-Americans with end-stage renal disease but await further study.

  7. Hair care practices in African American women.

    PubMed

    Quinn, Chemene R; Quinn, Timothy M; Kelly, A Paul

    2003-10-01

    Hair care in African American women is wrought with historical and cultural issues. Dermatologists need to improve their understanding of hair and scalp disorders in their African American patient population by being informed about the styling methods commonly used by and for these patients. The styling habits described in this article are intended to encompass the hairstyles adapted by a wide range of African American women with varying hair textures.

  8. Adherence to Varenicline Among African American Smokers: An Exploratory Analysis Comparing Plasma Concentration, Pill Count, and Self-report

    PubMed Central

    Berg, Carla J.; Cox, Lisa Sanderson; Nazir, Niaman; Benowitz, Neal L.; Yu, Lisa; Yturralde, Olivia; Jacob, Peyton; Choi, Won S.; Ahluwalia, Jasjit S.; Nollen, Nicole L.

    2012-01-01

    Introduction: Measuring adherence to smoking cessation pharmacotherapy is important to evaluating its effectiveness. Blood levels are considered the most accurate measure of adherence but are invasive and costly. Pill counts and self-report are more practical, but little is known about their relationship to blood levels. This study compared the validity of pill count and self-report against plasma varenicline concentration for measuring pharmacotherapy adherence. Methods: Data were obtained from a randomized pilot study of varenicline for smoking cessation among African American smokers. Adherence was measured on Day 12 via plasma varenicline concentration, pill count, 3-day recall, and a visual analogue scale (VAS; adherence was represented on a line with two extremes “no pills” and “all pills”). Results: The sample consisted of 55 African American moderate to heavy smokers (average 16.8 cigarettes/day, SD = 5.6) and 63.6% were female. Significant correlations (p < .05) were found between plasma varenicline concentration and pill count (r = .56), 3-day recall (r = .46), and VAS (r = .29). Using plasma varenicline concentration of 2.0 ng/ml as the cutpoint for adherence, pill count demonstrated the largest area under the receiver operating characteristic curve (AUC = 0.85, p = .01) and had 88% sensitivity (95% CI = 75.0–95.0) and 80% specificity (95% CI = 30.0–99.0) for detecting adherence. Conclusions: Of 3 commonly used adherence measures, pill count was the most valid for identifying adherence in this sample of African American smokers. Pill count has been used across other health domains and could be incorporated into treatment to identify nonadherence, which, in turn, could maximize smoking cessation pharmacotherapy use and improve abstinence rates. PMID:22367976

  9. Relation of Serum Fetuin-A Levels to Coronary Artery Calcium in African-American Patients on Chronic Hemodialysis

    PubMed Central

    Zheng, Sijie; de las Fuentes, Lisa; Bierhals, Andrew; Ash-Bernal, Rachel; Spence, Karen; Slatopolsky, Eduardo; Davila-Roman, Victor G.; Delmez, James

    2008-01-01

    Vascular calcium deposition in end-stage renal disease occurs commonly, however its relationship to cardiovascular risk factors and fetuin-A levels in African-Americans is not known. Compliant African-American HD patients (n=17) agreed to undergo a 64-slice multidetector computed tomography for the assessment of coronary artery calcium score (CACS). The relationship between traditional cardiovascular risk factors (i.e., age, gender, dialysis vintage, history of diabetes, means of the previous 3 years of the weekly pre-dialysis blood pressure and hemoglobin, means of monthly values of calcium, phosphorus, alkaline phosphatase, uric acid and albumin, and means of quarterly measures of parathyroid hormone and lipids), and fetuin-A levels and CACS was explored by univariate analyses. Serum phosphorus levels over the previous 3 years were well controlled. The CACS range was 0-3,877 Agatston units (mean: 996; median :196). Among the tested variables, only fetuin-A was significantly and inversely associated with CACS (standardized β = -0.64 [95% confidence limits [CL]: -18.09, -3.62], p=0.006). There was no association between age and fetuin-A level (standardized β = -0.02 [95%CL: -0.10, 0.23]). In conclusion, African-American patients on long-term HD and with good phosphorus control exhibit a strong inverse correlation between fetuin-A levels and CACS which is independent of age. PMID:19101228

  10. Differential gene expression between African American and European American colorectal cancer patients.

    PubMed

    Jovov, Biljana; Araujo-Perez, Felix; Sigel, Carlie S; Stratford, Jeran K; McCoy, Amber N; Yeh, Jen Jen; Keku, Temitope

    2012-01-01

    The incidence and mortality of colorectal cancer (CRC) is higher in African Americans (AAs) than other ethnic groups in the U. S., but reasons for the disparities are unknown. We performed gene expression profiling of sporadic CRCs from AAs vs. European Americans (EAs) to assess the contribution to CRC disparities. We evaluated the gene expression of 43 AA and 43 EA CRC tumors matched by stage and 40 matching normal colorectal tissues using the Agilent human whole genome 4x44K cDNA arrays. Gene and pathway analyses were performed using Significance Analysis of Microarrays (SAM), Ten-fold cross validation, and Ingenuity Pathway Analysis (IPA). SAM revealed that 95 genes were differentially expressed between AA and EA patients at a false discovery rate of ≤5%. Using IPA we determined that most prominent disease and pathway associations of differentially expressed genes were related to inflammation and immune response. Ten-fold cross validation demonstrated that following 10 genes can predict ethnicity with an accuracy of 94%: CRYBB2, PSPH, ADAL, VSIG10L, C17orf81, ANKRD36B, ZNF835, ARHGAP6, TRNT1 and WDR8. Expression of these 10 genes was validated by qRT-PCR in an independent test set of 28 patients (10 AA, 18 EA). Our results are the first to implicate differential gene expression in CRC racial disparities and indicate prominent difference in CRC inflammation between AA and EA patients. Differences in susceptibility to inflammation support the existence of distinct tumor microenvironments in these two patient populations.

  11. Hepatitis C in African Americans.

    PubMed

    Saab, Sammy; Jackson, Christian; Nieto, Jose; Francois, Fritz

    2014-10-01

    The care of hepatitis C virus (HCV) in African Americans represents an opportunity to address a major health disparity in medicine. In all facets of HCV infection, African Americans are inexplicably affected, including in the prevalence of the virus, which is higher among them compared with most of the racial and ethnic groups. Ironically, although fibrosis rates may be slow, hepatocellular carcinoma and mortality rates appear to be higher among African Americans. Sustained viral response (SVR) rates have historically significantly trailed behind Caucasians. The reasons for this gap in SVR are related to both viral and host factors. Moreover, low enrollment rates in clinical trials hamper the study of the efficacy of anti-viral therapy. Nevertheless, the gap in SVR between African Americans and Caucasians may be narrowing with the use of direct-acting agents. Gastroenterologists, hepatologists, primary care physicians, and other health-care providers need to address modifiable risk factors that affect the natural history, as well as treatment outcomes, for HCV among African Americans. Efforts need to be made to improve awareness among health-care providers to address the differences in screening and referral patterns for African Americans.

  12. Chromosome 22q11.2 deletion syndrome in African-American patients: a diagnostic challenge.

    PubMed

    Veerapandiyan, Aravindhan; Abdul-Rahman, Omar A; Adam, Margaret P; Lyons, Michael J; Manning, Melanie; Coleman, Karlene; Kobrynski, Lisa; Taneja, Deeksha; Schoch, Kelly; Zimmerman, Holly H; Shashi, Vandana

    2011-09-01

    Chromosome 22q11.2 deletion syndrome (22q11DS) is associated with numerous and variable clinical manifestations including conotruncal heart abnormalities, palatal anomalies, hypoparathyroidism, immune deficiency, and cognitive deficits. The clinical suspicion of this syndrome is often heightened by the presence of characteristic facial features. A previous report highlighted the under-diagnosis of this condition in African Americans, thought to be related to a paucity of typical facial features. We ascertained the largest cohort (n = 50) of African-American individuals with 22q11DS reported thus far, across five genetics centers in the United States and report on their facial and other phenotypic features. About 3/4 of our cohort has at least one dysmorphic facial feature. Auricular abnormalities, especially small ears, are the most common dysmorphic facial feature followed by nasal and ocular abnormalities. Skeletal findings are seen in about 2/3 of our cohort, higher than the typical frequency reported in 22q11DS. Cardiac anomalies, developmental delay, and palatal abnormalities are seen at a lower frequency in our cohort. Thus, it is evident that the features traditionally associated with 22q11DS are difficult to recognize in African-American individuals with this syndrome, due to both altered frequencies of major anomalies and a non-classic facial appearance. Therefore, a high index of suspicion is needed to recognize 22q11DS in African-American individuals. PMID:21834039

  13. Does compliance with radiation therapy differ in African-American patients with early-stage breast cancer?

    PubMed

    Sharma, Charu; Harris, Lyndsay; Haffty, Bruce G; Yang, Qifeng; Moran, Meena S

    2010-01-01

    The worse outcomes in African-American (AA) breast cancer patients have been attributed to a variety of factors, including compliance/variations with treatment. We evaluated a large cohort of AA patients treated with breast conservation therapy (BCT) in an effort to determine if compliance with radiation or if choice of chemotherapy regimen could be a contributing factor for the worse outcomes reported in AA patients. Our two cohorts consisted of 221 AA and 2170 white patients treated with BCT. Chart reviews were conducted to document dates of treatment, treatment breaks, dose delivered, and chemotherapy delivered. The data were analyzed to detect differences between the two cohorts. The median radiation dose delivered (including cone-down) was 64 Gy in both cohorts (p = 0.9910). The median number of treatment days was: AA, 45 (range 21-71 days) versus white, 45 (range 14-90 days; p = 0.8465). The chemotherapy regimens administered were: adriamycin/cytoxan (17% AA versus 19% white, respectively), adriamycin/cytoxan/taxol (13% versus 5%), cytoxan/methotrexate/5-FU (53% versus 59%), cytoxan/methotrexate/5-FU/vincristine (0% versus 3%), cytoxan/adriamycin/5-FU (12% versus 11%), high dose/transplant (0% versus 1%), and other (4% versus 5%), p = 0.113. Our large institutional series suggests that compliance with radiation therapy, once patients are seen in consultation and simulated, does not differ significantly between AA and white patients. In our large cancer center environment, AA patients referred for radiation therapy appear to receive the same radiation doses in a comparable time frame to white patients. Further exploration of compliance for adjuvant chemotherapy regimens in AA patients is warranted.

  14. Refining the association of MHC with multiple sclerosis in African Americans.

    PubMed

    McElroy, Joseph P; Cree, Bruce A C; Caillier, Stacy J; Gregersen, Peter K; Herbert, Joseph; Khan, Omar A; Freudenberg, Jan; Lee, Annette; Bridges, S Louis; Hauser, Stephen L; Oksenberg, Jorge R; Gourraud, Pierre-Antoine

    2010-08-01

    Multiple sclerosis (MS) is a common demyelinating disease of the central nervous system mediated by autoimmune and neurodegenerative pathogenic mechanisms. Multiple genes account for its moderate heritability, but the only genetic region shown to have a large replicable effect on MS susceptibility is the major histocompatibility complex (MHC). Strong linkage disequilibrium (LD) across the MHC has made it difficult to fully characterize individual genetic contributions of this region to MS risk in previous studies. African Americans are at a lower risk for MS when compared with northern Europeans and Americans of European descent, but greater haplotypic diversity and distinct patterns of LD suggest that this population may be particularly informative for fine-mapping efforts. To examine the role of the MHC in African American MS, a case-control association study was performed with 499 African American MS patients and 750 African American controls that were genotyped for 6040 MHC region single nucleotide polymorphisms (SNPs). A replication data set consisting of 451 African American patients and 718 African American controls was genotyped for selected SNPs. Two MHC class II SNPs, rs2647040 and rs3135021, were significant in the replication cohort and partially tagged DRB1*15 alleles. Surprisingly, in comparison to similar studies of individuals of European descent, the MHC seems to play a smaller role in MS susceptibility in African Americans, consistent with pervasive genetic heterogeneity across ancestral groups, and may explain the difference in MS susceptibility between African Americans and individuals of European descent.

  15. Refining the association of MHC with multiple sclerosis in African Americans

    PubMed Central

    McElroy, Joseph P.; Cree, Bruce A. C.; Caillier, Stacy J.; Gregersen, Peter K.; Herbert, Joseph; Khan, Omar A.; Freudenberg, Jan; Lee, Annette; Bridges, S. Louis; Hauser, Stephen L.; Oksenberg, Jorge R.; Gourraud, Pierre-Antoine

    2010-01-01

    Multiple sclerosis (MS) is a common demyelinating disease of the central nervous system mediated by autoimmune and neurodegenerative pathogenic mechanisms. Multiple genes account for its moderate heritability, but the only genetic region shown to have a large replicable effect on MS susceptibility is the major histocompatibility complex (MHC). Strong linkage disequilibrium (LD) across the MHC has made it difficult to fully characterize individual genetic contributions of this region to MS risk in previous studies. African Americans are at a lower risk for MS when compared with northern Europeans and Americans of European descent, but greater haplotypic diversity and distinct patterns of LD suggest that this population may be particularly informative for fine-mapping efforts. To examine the role of the MHC in African American MS, a case–control association study was performed with 499 African American MS patients and 750 African American controls that were genotyped for 6040 MHC region single nucleotide polymorphisms (SNPs). A replication data set consisting of 451 African American patients and 718 African American controls was genotyped for selected SNPs. Two MHC class II SNPs, rs2647040 and rs3135021, were significant in the replication cohort and partially tagged DRB1*15 alleles. Surprisingly, in comparison to similar studies of individuals of European descent, the MHC seems to play a smaller role in MS susceptibility in African Americans, consistent with pervasive genetic heterogeneity across ancestral groups, and may explain the difference in MS susceptibility between African Americans and individuals of European descent. PMID:20466734

  16. High-Achieving, Low Socioeconomic Status African-American Males: A Comparative Perspective of Students at Three Urban High Schools

    ERIC Educational Resources Information Center

    Randle, James P.

    2012-01-01

    A recent study by the Council of the Great City Schools reports that "the nation's young African-American males are in a state of crisis" and describes the situation as "a national catastrophe" (Lewis, Simon, Uzzell, Horwitz, & Casserly, 2010; Herbert, 2010). The report indicates that African-American males still lag…

  17. Choledocholithiasis in African American and Hispanic patients: a comparison between painless presentation and classical biliary pain with regards to clinical manifestations and outcomes.

    PubMed

    Akhtar, Abbasi J; Akhtar, Aslam A; Padda, Manmeet S

    2014-06-01

    Choledocholithiasis (CDL) usually presents with biliary pain. Painless CDL is also known to occur, especially in the elderly. The purpose of this study is to determine whether the mode of presentation (painful vs. painless) influences the clinical course and outcomes of CDL in African American and Hispanic patients. Ten years of admission and discharge records (January 1998-December 2007) were reviewed retrospectively, yielding 527 community hospital patients, aged 23-97 years, with the final diagnosis of CDL. Patients with painless presentation had higher odds of having comorbidities compared to patients presenting with pain. However, patients who presented with biliary pain were predominantly younger (mean age 34 years), and 59% were Hispanic females (p = 0.001). In our study painless CDL was associated with higher morbidity and mortality.

  18. A Comparative Study of Parental Involvement and Its Effect on African-American Male and Overall Student Achievement at Single Gender and Coeducational Middle Schools

    ERIC Educational Resources Information Center

    Nellums, Michael W.

    2011-01-01

    The purpose of this study was to determine if Parental Involvement influenced academic performance at single gender and co-educational schools. This study also compared African American male academic achievement with all students enrolled in two single gender, and one coeducational, middle school programs. Although all three schools reflected a…

  19. Heart failure in African Americans: disparities can be overcome.

    PubMed

    Sharma, Alok; Colvin-Adams, Monica; Yancy, Clyde W

    2014-05-01

    African Americans are disproportionately affected by heart failure, with a high prevalence at an early age. Hypertension, diabetes, obesity, and chronic kidney disease are all common in African Americans and all predispose to heart failure. Neurohormonal imbalances, endothelial dysfunction, genetic polymorphisms, and socioeconomic factors also contribute. In general, the same evidence-based treatment guidelines that apply to white patients with heart failure also apply to African Americans. However, the combination of hydralazine and isosorbide dinitrate is advised specifically for African Americans.

  20. Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-Hispanic whites. The Insulin Resistance Atherosclerosis Study.

    PubMed

    Haffner, S M; D'Agostino, R; Saad, M F; Rewers, M; Mykkänen, L; Selby, J; Howard, G; Savage, P J; Hamman, R F; Wagenknecht, L E

    1996-06-01

    The etiology of NIDDM is still controversial, with both insulin resistance and decreased insulin secretion postulated as potential important factors. African-Americans and Hispanics have a two- to threefold excess risk of developing NIDDM compared with non-Hispanic whites. Yet little is known concerning the prevalence of insulin resistance and secretion defects in minorities, especially in African-Americans in population-based studies. Fasting and 2-h post-glucose load glucose and insulin levels, insulin-mediated glucose disposal (insulin sensitivity index) (S(I)), glucose effectiveness (S(G)), and first-phase insulin response (acute insulin response [AIR]) were determined in nondiabetic African-Americans (n= 288), Hispanics (n= 363), and non-Hispanic whites (n= 435) as part of the Insulin Resistance Atherosclerosis Study. Subjects received a standard 2-h oral glucose tolerance test on the first day and an insulin-modified frequently sampled intravenous glucose tolerance test on the second day. African-Americans and Hispanics were more obese than non-Hispanic whites. Both African-Americans and Hispanics had higher fasting and 2-h insulin concentrations and AIR but lower S(I) than non-Hispanic whites. No ethnic difference was observed in S(G). After further adjustments for obesity, body fat distribution, and behavioral factors, African-Americans continued to have higher fasting and 2-h insulin levels and AIR, but lower S(I) than non-Hispanic whites. In contrast, after adjustment for these covariates, no significant ethnic differences in S(I) or fasting insulin levels were observed between Hispanics and non-Hispanic whites. Hispanics continued to have higher 2-h insulin levels and AIRs than those in non-Hispanic whites. In this report, the association between S(I) and upper body adiposity (waist-to-hip, ratio) was similar in each ethnic group. Both nondiabetic African-Americans and Hispanics have increased insulin resistance and higher AIR than nondiabetic non

  1. Identification of common cystic fibrosis mutations in African-Americans with cystic fibrosis increases the detection rate to 75%.

    PubMed Central

    Macek, M; Mackova, A; Hamosh, A; Hilman, B C; Selden, R F; Lucotte, G; Friedman, K J; Knowles, M R; Rosenstein, B J; Cutting, G R

    1997-01-01

    Cystic fibrosis (CF)--an autosomal recessive disorder caused by mutations in CF transmembrane conductance regulator (CFTR) and characterized by abnormal chloride conduction across epithelial membranes, leading to chronic lung and exocrine pancreatic disease--is less common in African-Americans than in Caucasians. No large-scale studies of mutation identification and screening in African-American CF patients have been reported, to date. In this study, the entire coding and flanking intronic sequence of the CFTR gene was analyzed by denaturing gradient-gel electrophoresis and sequencing in an index group of 82 African-American CF chromosomes to identify mutations. One novel mutation, 3120+1G-->A, occurred with a frequency of 12.3% and was also detected in a native African patient. To establish frequencies, an additional group of 66 African-American CF chromosomes were screened for mutations identified in two or more African-American patients. Screening for 16 "common Caucasian" mutations identified 52% of CF alleles in African-Americans, while screening for 8 "common African" mutations accounted for an additional 23%. The combined detection rate of 75% was comparable to the sensitivity of mutation analysis in Caucasian CF patients. These results indicate that African-Americans have their own set of "common" CF mutations that originate from the native African population. Inclusion of these "common" mutations substantially improves CF mutation detection rates in African-Americans. PMID:9150159

  2. 16 Extraordinary African Americans.

    ERIC Educational Resources Information Center

    Lobb, Nancy

    This collection for children tells the stories of 16 African Americans who helped make America what it is today. African Americans can take pride in the heritage of these contributors to society. Biographies are given for the following: (1) Sojourner Truth, preacher and abolitionist; (2) Frederick Douglass, abolitionist; (3) Harriet Tubman, leader…

  3. Understanding African American Males

    ERIC Educational Resources Information Center

    Bell, Edward Earl

    2010-01-01

    The purpose of this study was to assess the socialization skills, self-esteem, and academic readiness of African American males in a school environment. Discussions with students and the School Perceptions Questionnaire provided data for this investigation. The intended targets for this investigation were African American students; however, there…

  4. Diabetes in African Americans

    PubMed Central

    Marshall, M

    2005-01-01

    African Americans have a high risk for type 2 diabetes. Genetic traits, the prevalence of obesity, and insulin resistance all contribute to the risk of diabetes in the African American community. African Americans have a high rate of diabetic complications, because of poor glycaemic control and racial disparities in health care in the USA. African Americans with diabetes may have an atypical presentation that simulates type 1 diabetes, but then their subsequent clinical course is typical of type 2 diabetes. Culturally sensitive strategies, structured disease management protocols, and the assistance of nurses, diabetic educators, and other health care professionals are effective in improving the outcome of diabetes in the African American community. PMID:16344294

  5. Low-income African American women's beliefs regarding exercise during pregnancy.

    PubMed

    Krans, Elizabeth E; Chang, Judy C

    2012-08-01

    Exercise may decrease the incidence of obesity and obesity related complications during pregnancy including gestational diabetes and preeclampsia. African American women are at higher risk for obesity and physical inactivity during pregnancy when compared to other patient groups. The purpose of this qualitative study was to describe in detail the unique beliefs and perspectives regarding exercise during pregnancy of African American women. A series of 6 focus groups discussions with pregnant African American women were audio-recorded and transcribed verbatim. Focus group transcripts were qualitatively analyzed for major themes and independently coded for beliefs regarding exercise during pregnancy. A total of 34 pregnant, African American women participated in 6 focus group discussions. The majority of women were single (94%), had only a high school education (67%), received Medicaid (100%) and had a mean BMI of 33 kg/m(2). Three major themes emerged regarding our subjects' beliefs about exercise during pregnancy: (1) women had a broad definition of what types of activities constituted exercise, (2) women believed exercise was generally beneficial during pregnancy and (3) women believed certain types of activities or movements could cause problems with pregnancy. African American women overwhelmingly believe that exercise positively impacts pregnancy. A lack of knowledge concerning the benefits of exercise during pregnancy was not found to be a major contributor to inactivity in African American women. However, health care providers should be aware of cultural myths that prevent many African American women from performing certain activities during pregnancy.

  6. Patient- and Family-Centered Care as an approach to reducing disparities in asthma outcomes in urban African American children: A review of the literature

    PubMed Central

    Harper, Felicity W. K.; Eggly, Susan; Crider, Beverly; Kobayashi, Hitomi; Meert, Kathleen L.; Ball, Allison; Penner, Louis A.; Gray, Herman; Albrecht, Terrance L.

    2016-01-01

    Background Patient- and family-centered care (PFCC) has the potential to address disparities in access and quality of healthcare for African American pediatric asthma patients by accommodating and responding to the individual needs of patients and families. Study Objectives To identify and evaluate research on the impact of family–provider interventions that reflect elements of PFCC on reducing disparities in the provision, access, quality, and use of healthcare services for African American pediatric asthma patients. Methods Electronic searches were conducted using PubMed, CINAHL, and Psyclnfo databases. Inclusion criteria were peer-reviewed, English-language articles on family–provider interventions that (a) reflected one or more elements of PFCC and (b) addressed healthcare disparities in urban African American pediatric asthma patients (≤18years). Results Thirteen interventions or programs were identified and reviewed. Designs included randomized clinical trials, controlled clinical trials, pre-and post-interventions, and program evaluations. Conclusions Few interventions were identified as explicitly providing PFCC in d pediatric asthma context, possibly because of a Iack of consensus on what constitutes PFCC in practice. Some studies have demonstrated that PFCC improves satisfaction and communication during clinical interactions. More empirical research is needed to understand whether PFCC interventions reduce care disparities and improve the provision, access, and quality of asthma healthcare for urban African American children. Electronic databases used PubMed, CINAHL, and Psyclnfo PMID:27269485

  7. Major depressive disorder in the African American population: meeting the challenges of stigma, misdiagnosis, and treatment disparities.

    PubMed

    Bailey, Rahn Kennedy; Blackmon, Holly L; Stevens, Francis L

    2009-11-01

    This article examines major depressive disorder (MDD) in the African American population. As prevalence rates and severity of depression in African Americans are investigated, the findings indicate many blacks are underdiagnosed. Further, African Americans seem to have more severe episodes of depression compared to Caucasians. Explanations for this difference are that African Americans with MDD often present with somatic symptoms, leading physicians to miss a MDD diagnosis. Depression is often stigmatized in the African American population, seen as a "personal weakness." Educating the community about depression and educating physicians to make cultural competent diagnoses are necessary. Treatment disparities emerge as African Americans are more likely uninsured, and many are nonresponsive to traditional pharmacological interventions for depression. African American and other ethnic groups differ in the way they metabolize selective serotonin reuptake inhibitors, leading physicians to have less of an understanding of how to treat the African American patients. The lack of minorities in research trials limits the number of effective medication to treat this population of patients.

  8. Evaluation of Conceptual Framework for Recruitment of African American Patients With Breast Cancer

    PubMed Central

    Heiney, Sue P.; Adams, Swann Arp; Wells, Linda M.; Johnson, Hiluv

    2010-01-01

    Purpose/Objectives To describe the Heiney-Adams Recruitment Framework (H-ARF); to delineate a recruitment plan for a randomized, behavioral trial (RBT) based on H-ARF; and to provide evaluation data on its implementation. Data Sources All data for this investigation originated from a recruitment database created for an RBT designed to test the effectiveness of a therapeutic group convened via teleconference for African American women with breast cancer. Data Synthesis Major H-ARF concepts include social marketing and relationship building. The majority of social marketing strategies yielded 100% participant recruitment. Greater absolute numbers were recruited via Health Insurance Portability and Accountability Act waivers. Using H-ARF yielded a high recruitment rate (66%). Conclusions Application of H-ARF led to successful recruitment in an RBT. The findings highlight three areas that researchers should consider when devising recruitment plans: absolute numbers versus recruitment rate, cost, and efficiency with institutional review board–approved access to protected health information. Implications for Nursing H-ARF may be applied to any clinical or population-based research setting because it provides direction for researchers to develop a recruitment plan based on the target audience and cultural attributes that may hinder or help recruitment. PMID:20439201

  9. The Comparative Influence of Individual, Peer Tutoring, and Communal Learning Contexts on the Recall of African American Children.

    ERIC Educational Resources Information Center

    Dill, Ebony M.; Boykin, A. Wade

    2000-01-01

    Examined the effect of communal learning, peer tutoring, and individual learning on the text recall of African American fifth graders. Students completed surveys assessing their preference for communal beliefs and behaviors, participated in groups, and recalled text. Communal learning group students recalled the most text. Communal beliefs…

  10. A Comparative Analysis of Child Welfare Services through the Eyes of African American, Caucasian, and Latino Parents

    ERIC Educational Resources Information Center

    Ayon, Cecilia; Lee, Cheryl D.

    2005-01-01

    Objective: The purpose of this study was to find if differences exist among 88 African American, Caucasian, and Latino families who received child welfare services. Method: A secondary data analysis of cross-sectional survey data employing standardized measures was used for this study. Family preservation (FP) services were received by 49…

  11. The Comparative Effects of Function-Based versus Nonfunction-Based Interventions on the Social Behavior of African American Students

    ERIC Educational Resources Information Center

    Mustian, April Leigh

    2010-01-01

    Disproportionality has been a persistent problem in special education for decades. Despite mandates outlined in the Individuals with Disabilities Education Improvement Act (IDEA, 2004), African American students continue to be disproportionately represented in the Emotional Disturbance (ED) category in special education (e.g., Skiba,…

  12. Comparing Gifted and Nongifted African American and Euro-American Students on Cognitive and Academic Variables Using Local Norms

    ERIC Educational Resources Information Center

    Jordan, Kelli R.; Bain, Sherry K.; McCallum, R. Steve; Mee Bell, Sherry

    2012-01-01

    A total of 47 gifted and nongifted African American and Euro-American elementary students were rated by their teachers on a multidimensional instrument developed to minimize language considerations and to rely on local norms (Universal Multiple Abilities Scales [UMAS; McCallum & Bracken, 2012a]). Results from two factorial MANOVAs revealed no…

  13. African American Health

    MedlinePlus

    ... specific health concerns. Differences in the health of groups can result from Genetics Environmental factors Access to care Cultural factors On this page, you'll find links to health issues that affect African Americans.

  14. Physician Posture at the Bedside: A Study of African-American and Hispanic Patient Preferences at a Teaching Hospital.

    PubMed

    Gupta, Arjun; Madhavapeddi, Sai; Das, Avash; Harris, Samar; Naina, Harris

    2015-01-01

    The physician-patient interaction is central to any clinical encounter. Although the technical components of the interaction are conveyed by verbal communication, the nonverbal cues are instrumental in setting up the physician-patient relationship and carrying it forward. Often, patient preferences in terms of non-verbal communication cues depend on the ethnicity of the patient. In this article, we present a study of Hispanic and African-American patients regarding their preference of physician posture. Together, these groups represent almost one third of the U.S. population. In our study, a majority of patients preferred their physicians to be seated during the medical interview. Although these results were similar across cultural groups, subtle differences were observed in patient preference regarding other nonverbal communication methods by physicians. It is important for physicians to be aware of these differences. Including course-work that highlights cultural sensitivities in the medical school curriculum is a good way to create awareness among the next generation of physicians. PMID:26856020

  15. Racial differences in allogeneic hematopoietic cell transplantation outcomes among African Americans and whites.

    PubMed

    Hamilton, B K; Rybicki, L; Sekeres, M; Kalaycio, M; Hanna, R; Sobecks, R; Dean, R; Duong, H; Hill, B T; Bolwell, B; Copelan, E

    2015-06-01

    The impact of race on outcome has been identified in a number of cancers, with African Americans having poorer survival compared with whites. We conducted a study to investigate the association of race with allogeneic hematopoietic cell transplant (HCT) outcomes. We identified 789 patients (58 African Americans and 731 whites) who underwent allogeneic HCT for hematologic disorders. There were no significant differences between African Americans and white patients in gender, performance status or comorbidity score. However, African Americans were younger than whites (median 40 years versus 47 years, P=0.003) and were more likely to be in remission at HCT (74% versus 57%, P=0.011), to have an HLA-mismatched donor (36% versus 14%, P<0.001), to have positive donor or recipient CMV serostatus (90% versus 69%, P<0.001) and to have received a cord blood transplant (21% versus 6%, P<0.001). In univariate analysis, African Americans had worse overall survival (OS) (HR 1.41, P=0.026) compared with whites, with no significant differences in acute or chronic GvHD, non-CMV infection or relapse. However, after adjusting for several transplant and disease-related factors in multivariate analysis, the OS difference between African Americans and whites became nonsignificant (HR 1.27, P=0.18). These results suggest that race in and of itself does not lead to worse survival post HCT.

  16. Comparison of baseline characteristics and one-year outcomes between African-Americans and Caucasians undergoing percutaneous coronary intervention.

    PubMed

    Leborgne, Laurent; Cheneau, Edouard; Wolfram, Roswitha; Pinnow, Ellen E; Canos, Daniel A; Pichard, Augusto D; Suddath, William O; Satler, Lowell F; Lindsay, Joseph; Waksman, Ron

    2004-02-15

    The objectives of this study were to determine whether there are race-based differences in baseline characteristics and in short- or long-term outcomes after percutaneous coronary intervention (PCI). African-Americans have a higher incidence of coronary artery disease but are less likely to undergo coronary revascularization than Caucasians. Little is known about the profiles and outcomes of African-Americans who undergo PCI. Consecutive series of 1,268 African-Americans and 10,561 Caucasians with symptomatic coronary artery disease who underwent PCI between January 1994 and June 2001 were analyzed. Patients hospitalized for acute myocardial infarction were excluded. African-Americans were older, were more likely to be women, and had more co-morbid baseline conditions compared with Caucasians. Preprocedure lesion characteristics were similar with regard to vessel size, length, and complexity. The rate of clinical success did not differ between the groups. African-Americans experienced more in-hospital combined events of death and Q-wave myocardial infarction (p = 0.03). After propensity score adjustment, African-American race was not an independent predictor for in-hospital events. At 1 year, African-Americans had a slightly lower rate of target lesion revascularization and a 50% higher rate of death (9.8% vs. 6.4%, p <0.001), with a relative risk of 1.52 (95% confidence interval 1.22 to 1.89). In multivariate analysis, African-American race remained a significant predictor of increased 1-year mortality (hazard ratio 1.35, 95% confidence interval 1.06 to 1.71, p = 0.01). African-Americans undergoing angioplasty have more co-morbid baseline conditions than Caucasians. Despite similar clinical success, 1-year outcomes are impaired in African-Americans.

  17. Absence of bias in clinician ratings of everyday functioning among African American, Hispanic and Caucasian patients with schizophrenia.

    PubMed

    Sabbag, Samir; Prestia, Davide; Robertson, Belinda; Ruiz, Pedro; Durand, Dante; Strassnig, Martin; Harvey, Philip D

    2015-09-30

    A substantial research literature implicates potential racial/ethnic bias in the diagnosis of schizophrenia and in clinical ratings of psychosis. There is no similar information regarding bias effects on ratings of everyday functioning. Our aims were to determine if Caucasian raters vary in their ratings of the everyday functioning of schizophrenia patients of different ethnicities, to find out which factors determine accurate self-report of everyday functioning in different ethnic groups, and to know if depression has similar effects on the way people of different ethnicities self-report their current functionality. We analyzed data on 295 patients with schizophrenia who provided their self-report of their everyday functioning and also had a Caucasian clinician rating their functionality. Three racial/ethnic groups (African American (AA), Hispanic and Caucasian) were studied and analyzed on the basis of neurocognition, functional capacity, depression and real-world functional outcomes. No differences based on racial/ethnic status in clinician assessments of patients' functionality were found. Differences between racial groups were found in personal and maternal levels of education. Severity of depression was significantly correlated with accuracy of self-assessment of functioning in Caucasians, but not in AAs. Higher scores on neurocognition and functional capacity scales correlated with reduced overestimation of functioning in AAs, but not in Hispanics. This data might indicate that measurement of everyday functionality is less subject to rater bias than measurement of symptoms of schizophrenia. PMID:26160197

  18. Patient–Physician Communication in the Primary Care Visits of African Americans and Whites with Depression

    PubMed Central

    Ghods, Bri K.; Roter, Debra L.; Ford, Daniel E.; Larson, Susan; Arbelaez, Jose J.

    2008-01-01

    Background Little research investigates the role of patient–physician communication in understanding racial disparities in depression treatment. Objective The objective of this study was to compare patient–physician communication patterns for African-American and white patients who have high levels of depressive symptoms. Design, Setting, and Participants This is a cross-sectional study of primary care visits of 108 adult patients (46 white, 62 African American) who had depressive symptoms measured by the Medical Outcomes Study–Short Form (SF-12) Mental Component Summary Score and were receiving care from one of 54 physicians in urban community-based practices. Main Outcomes Communication behaviors, obtained from coding of audiotapes, and physician perceptions of patients’ physical and emotional health status and stress levels were measured by post-visit surveys. Results African-American patients had fewer years of education and reported poorer physical health than whites. There were no racial differences in the level of depressive symptoms. Depression communication occurred in only 34% of visits. The average number of depression-related statements was much lower in the visits of African-American than white patients (10.8 vs. 38.4 statements, p = .02). African-American patients also experienced visits with less rapport building (20.7 vs. 29.7 statements, p = .009). Physicians rated a higher percentage of African-American than white patients as being in poor or fair physical health (69% vs. 40%, p = .006), and even in visits where depression communication occurred, a lower percentage of African-American than white patients were considered by their physicians to have significant emotional distress (67% vs. 93%, p = .07). Conclusions This study reveals racial disparities in communication among primary care patients with high levels of depressive symptoms. Physician communication skills training programs that emphasize recognition and rapport

  19. African Americans show increased risk for pressure ulcers: a retrospective analysis of acute care hospitals in America.

    PubMed

    Fogerty, Mary; Guy, Jeffrey; Barbul, Adrian; Nanney, Lillian B; Abumrad, Naji N

    2009-01-01

    In an earlier study, we reported a significantly increased risk of pressure ulcer hospital discharge diagnoses in African Americans, higher age groups, and those with certain medical conditions. The objectives of the present study were to: (a) investigate the demographics associated with a higher odds ratio (OR) in African Americans and (b) determine whether African Americans have different rates of medical risk factors. The 2003 Nationwide Inpatient Sample database was queried. Patients with pressure ulcers were identified by discharge diagnoses using ICD-9 codes 707.0-707.09. Discharge diagnosis was examined using the agency for healthcare research and quality clinical classifications software (CCS). The present study used identified CCS discharge diagnoses present in at least 5% of all patients, with an OR>2. African Americans exhibited a higher incidence of an OR>2 for 28 identified CCS risk factors for pressure ulcers. The pressure ulcer diagnoses tended to occur at younger ages in African Americans. No significant differences were noted in African Americans with pressure ulcers when a subanalysis was conducted by zip code income quartile, region of the country, or teaching status of the hospital. Hospitalized African Americans exhibit an age-dependent, higher prevalence of pressure ulcers compared with Caucasians. Socioeconomic factors tracked within the Nationwide Inpatient Sample do not provide an explanation for this phenomenon.

  20. APOL1 renal-risk genotypes associate with longer hemodialysis survival in prevalent nondiabetic African American patients with end-stage renal disease.

    PubMed

    Ma, Lijun; Langefeld, Carl D; Comeau, Mary E; Bonomo, Jason A; Rocco, Michael V; Burkart, John M; Divers, Jasmin; Palmer, Nicholette D; Hicks, Pamela J; Bowden, Donald W; Lea, Janice P; Krisher, Jenna O; Clay, Margo J; Freedman, Barry I

    2016-08-01

    Relative to European Americans, evidence supports that African Americans with end-stage renal disease (ESRD) survive longer on dialysis. Renal-risk variants in the apolipoprotein L1 gene (APOL1), associated with nondiabetic nephropathy and less subclinical atherosclerosis, may contribute to dialysis outcomes. Here, APOL1 renal-risk variants were assessed for association with dialytic survival in 450 diabetic and 275 nondiabetic African American hemodialysis patients from Wake Forest and Emory School of Medicine outpatient facilities. Outcomes were provided by the ESRD Network 6-Southeastern Kidney Council Standardized Information Management System. Dates of death, receipt of a kidney transplant, and loss to follow-up were recorded. Outcomes were censored at the date of transplantation or through 1 July 2015. Multivariable Cox proportional hazards models were computed separately in patients with nondiabetic and diabetic ESRD, adjusting for the covariates age, gender, comorbidities, ancestry, and presence of an arteriovenous fistula or graft at dialysis initiation. In nondiabetic ESRD, patients with 2 (vs. 0/1) APOL1 renal-risk variants had significantly longer dialysis survival (hazard ratio 0.57), a pattern not observed in patients with diabetes-associated ESRD (hazard ratio 1.29). Thus, 2 APOL1 renal-risk variants are associated with longer dialysis survival in African Americans without diabetes, potentially relating to presence of renal-limited disease or less atherosclerosis. PMID:27157696

  1. African-Americans and Alzheimer's

    MedlinePlus

    ... 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 ...

  2. End-stage renal disease and African American race are independent predictors of mild liver fibrosis in patients with chronic hepatitis C infection.

    PubMed

    Aslinia, F M; Wasan, S K; Mindikoglu, A L; Adeyemo, O A; Philosophe, B; Drachenberg, C; Howell, C D

    2012-05-01

    Recipients of haemodialysis for end-stage renal disease (ESRD) have a higher prevalence of hepatitis C virus (HCV) infection relative to the general US population. However, the natural course of HCV infection in patients with renal failure, including African Americans (AAs) and Caucasian Americans (CAs), is not well known. We compared the degree of liver inflammation and fibrosis in AA and CA patients with HCV infection, with and without ESRD. This was a cross-sectional study of 156 HCV patients with ESRD (130 AAs and 26 CAs) with a liver biopsy between 1992 and 2005. The control group consisted of 138 patients (50 AAs; 88 CAs) with HCV infections and a serum creatinine <1.5 mg/dL with a liver biopsy between 1995 and 1998. Specimens were graded for inflammation and fibrosis using Knodell histological activity index. Compared to patients without renal impairment, HCV patients with renal failure were older and more likely to be AA. Patients with renal impairment had lower mean serum transaminases, a higher mean serum alkaline phosphatase levels (all P < 0.0001) and less hepatic necro-inflammation (Knodell histological activity index -I, II and III; P < 0.05) and fibrosis (Knodell histological activity index -IV; P < 0.0001). There were no racial differences in serum liver chemistry and histology scores among patients with renal failure. In a multivariate analysis, younger age, ESRD, AA race and a lower serum alkaline phosphatase were associated with lower odds for advanced liver fibrosis. Thus, HCV patients with ESRD had a lower degree of hepatic inflammation and fibrosis compared to those without renal disease, independent of race.

  3. The Other African Americans.

    ERIC Educational Resources Information Center

    Matory, J. Lorand

    Black North America is ethnically and culturally diverse. It contains many groups who do not call themselves or have not always called themselves "Negro,""Black,""African-American," and so forth, such as Louisiana Creoles of color and many of the Indian tribes east of the Mississippi. There are also numerous North American ethnic groups of African…

  4. Educating African American Males

    ERIC Educational Resources Information Center

    Bell, Edward E.

    2010-01-01

    Background: Schools across America spend money, invest in programs, and sponsor workshops, offer teacher incentives, raise accountability standards, and even evoke the name of Obama in efforts to raise the academic achievement of African American males. Incarceration and college retention rates point to a dismal plight for many African American…

  5. Perspectives of African-American women on infant mortality.

    PubMed

    Barnes, Glenna L

    2008-01-01

    Twice as many African-American infants die each year when compared to White infants. This study explores the lived experiences of African-American women to identify factors related to this racial gap in infant mortality. Thirteen African-American women from two Virginia towns participated in either a focus group or in-depth interviews. Content and interpretive analysis revealed several themes. Participants indicated that the experiences of stress and racism are constant factors in African-American women's lives and are inseparable from their pregnancy experiences. Participants noted the importance of social support and the health care provider-client relationship for positive pregnancy outcomes.

  6. Contribution of Genome-Wide HCV Genetic Differences to Outcome of Interferon-Based Therapy in Caucasian American and African American Patients

    PubMed Central

    Donlin, Maureen J.; Cannon, Nathan A.; Aurora, Rajeev; Li, Jia; Wahed, Abdus S.; Di Bisceglie, Adrian M.; Tavis, John E.

    2010-01-01

    Background Hepatitis C virus (HCV) has six major genotypes, and patients infected with genotype 1 respond less well to interferon-based therapy than other genotypes. African American patients respond to interferon α-based therapy at about half the rate of Caucasian Americans. The effect of HCV's genetic variation on treatment outcome in both racial groups is poorly understood. Methodology We determined the near full-length pre-therapy consensus sequences from 94 patients infected with HCV genotype 1a or 1b undergoing treatment with peginterferon α-2a and ribavirin through the Virahep-C study. The sequences were stratified by genotype, race and treatment outcome to identify HCV genetic differences associated with treatment efficacy. Principal Findings HCV sequences from patients who achieved sustained viral response were more diverse than sequences from non-responders. These inter-patient diversity differences were found primarily in the NS5A gene in genotype 1a and in core and NS2 in genotype 1b. These differences could not be explained by host selection pressures. Genotype 1b but not 1a African American patients had viral genetic differences that correlated with treatment outcome. Conclusions & Significance Higher inter-patient viral genetic diversity correlated with successful treatment, implying that there are HCV genotype 1 strains with intrinsic differences in sensitivity to therapy. Core, NS3 and NS5A have interferon-suppressive activities detectable through in vitro assays, and hence these activities also appear to function in human patients. Both preferential infection with relatively resistant HCV variants and host-specific factors appear to contribute to the unusually poor response to therapy in African American patients. PMID:20140258

  7. Gastrointestinal Symptoms among African Americans Undergoing Hemodialysis.

    PubMed

    Daniels, Glenda; Robinson, Janie R; Walker, Charles; Pennings, Jacquelyn S; Anderson, Staci T

    2015-01-01

    The incidence of end stage renal disease is more than three times higher in African Americans. Treatment regimens contribute to gastrointestinal (GI) complaints. This study's purpose was to examine the incidence of GI symptoms in African-American patients undergoing hemodialysis. Younger participants were more likely to report mild indigestion, while older participants reported severe indigestion or none at all. Females were more likely to report gastrointestinal symptoms. Commonly reported co-morbidities included hypertension, diabetes, and heart disease. Time on hemodialysis ranged from 1 to 279 months. Those who had been on hemodialysis the longest were more likely to report acid reflux, stomach rumbling and mild diarrhea. This study provides a foundation for early identification of GI symptoms in African-Americans patients undergoing hemodialysis.

  8. Disparities in Osteoporosis Screening Between At-Risk African-American and White Women

    PubMed Central

    Miller, Redonda G; Ashar, Bimal H; Cohen, Jennifer; Camp, Melissa; Coombs, Carmen; Johnson, Elizabeth; Schneyer, Christine R

    2005-01-01

    Background Despite a lower prevalence of osteoporosis in African-American women, they remain at risk and experience a greater mortality than white women after sustaining a hip fracture. Lack of recognition of risk factors may occur in African-American women, raising the possibility that disparities in screening practices may exist. Objective To determine whether there is a difference in physician screening for osteoporosis in postmenopausal, at-risk African-American and white women. Methods We conducted a retrospective chart review at an urban academic hospital and a suburban community hospital. Subjects included 205 African-American and white women, age ≥65 years and weight ≤127 pounds, who were seen in Internal Medicine clinics. The main outcome was dual-energy x-ray absorptiometry (DXA) scan referral. We investigated physician and patient factors associated with referral. Secondary outcomes included evidence of discussion of osteoporosis and prescription of medications to prevent osteoporosis. Results Significantly fewer African-American than white women were referred for a DXA scan (OR 0.39%, 95% confidence interval (CI): 0.22 to 0.68). Physicians were also less likely to mention consideration of osteoporosis in medical records (0.27, 0.15 to 0.48) and to recommend calcium and vitamin D supplementation for this population (0.21, 0.11 to 0.37). If referred, African-American women had comparable DXA completion rates when compared with white women. No physician characteristics were significantly associated with DXA referral patterns. Conclusions Our study found a significant disparity in the recommendation for osteoporosis screening for African-American versus white women of similar risk, as well as evidence of disparate osteoporosis prevention and treatment, confirming results of other studies. Future educational and research initiatives should target this inequality. PMID:16117754

  9. Multiple sclerosis susceptibility alleles in African Americans

    PubMed Central

    Johnson, Britt A.; Wang, Joanne; Taylor, Elise M.; Caillier, Stacy J.; Herbert, Joseph; Khan, Omar A.; Cross, Anne H.; De Jager, Philip L.; Gourraud, Pierre-Antoine F.; Cree, Bruce C.A.; Hauser, Stephen L.; Oksenberg, Jorge R.

    2009-01-01

    Multiple sclerosis (MS) is an autoimmune demyelinating disease characterized by complex genetics and multifaceted gene-environment interactions. Compared to whites, African Americans have a lower risk for developing MS, but African Americans with MS have a greater risk of disability. These differences between African Americans and whites may represent differences in genetic susceptibility and/or environmental factors. SNPs from 12 candidate genes have recently been identified and validated with MS risk in white populations. We performed a replication study using 918 cases and 656 unrelated controls to test whether these candidate genes are also associated with MS risk in African Americans. CD6, CLEC16a, EVI5, GPC5, and TYK2 contained SNPs that are associated with MS risk in the African American dataset. EVI5 showed the strongest association outside the MHC (rs10735781, OR = 1.233, 95% CI = 1.06–1.43, P value = 0.006). In addition, RGS1 appears to affect age of onset whereas TNFRSF1A appears to be associated with disease progression. None of the tested variants showed results that were statistically in-consistent with the effects established in whites. The results are consistent with shared disease genetic mechanisms among individuals of European and African ancestry. PMID:19865102

  10. Pharmacogenetic-guided Warfarin Dosing Algorithm in African-Americans.

    PubMed

    Alzubiedi, Sameh; Saleh, Mohammad I

    2016-01-01

    We aim to develop warfarin dosing algorithm for African-Americans. We explored demographic, clinical, and genetic data from a previously collected cohort of 163 African-American patients with a stable warfarin dose. We explored 2 approaches to develop the algorithm: multiple linear regression and artificial neural network (ANN). The clinical significance of the 2 dosing algorithms was evaluated by calculating the percentage of patients whose predicted dose of warfarin was within 20% of the actual dose. Linear regression model and ANN model predicted the ideal dose in 52% and 48% of the patients, respectively. The mean absolute error using linear regression model was estimated to be 10.8 mg compared with 10.9 mg using ANN. Linear regression and ANN models identified several predictors of warfarin dose including age, weight, CYP2C9 genotype *1/*1, VKORC1 genotype, rs12777823 genotype, rs2108622 genotype, congestive heart failure, and amiodarone use. In conclusion, we developed a warfarin dosing algorithm for African-Americans. The proposed dosing algorithm has the potential to recommend warfarin doses that are close to the appropriate doses. The use of more sophisticated ANN approach did not result in improved predictive performance of the dosing algorithm except for patients of a dose of ≥49 mg/wk.

  11. Pharmacogenetic-guided Warfarin Dosing Algorithm in African-Americans.

    PubMed

    Alzubiedi, Sameh; Saleh, Mohammad I

    2016-01-01

    We aim to develop warfarin dosing algorithm for African-Americans. We explored demographic, clinical, and genetic data from a previously collected cohort of 163 African-American patients with a stable warfarin dose. We explored 2 approaches to develop the algorithm: multiple linear regression and artificial neural network (ANN). The clinical significance of the 2 dosing algorithms was evaluated by calculating the percentage of patients whose predicted dose of warfarin was within 20% of the actual dose. Linear regression model and ANN model predicted the ideal dose in 52% and 48% of the patients, respectively. The mean absolute error using linear regression model was estimated to be 10.8 mg compared with 10.9 mg using ANN. Linear regression and ANN models identified several predictors of warfarin dose including age, weight, CYP2C9 genotype *1/*1, VKORC1 genotype, rs12777823 genotype, rs2108622 genotype, congestive heart failure, and amiodarone use. In conclusion, we developed a warfarin dosing algorithm for African-Americans. The proposed dosing algorithm has the potential to recommend warfarin doses that are close to the appropriate doses. The use of more sophisticated ANN approach did not result in improved predictive performance of the dosing algorithm except for patients of a dose of ≥49 mg/wk. PMID:26355760

  12. African Americans' Access to Vocational Rehabilitation Services after Antidiscrimination Legislation

    ERIC Educational Resources Information Center

    Mwachofi, Ari K.

    2008-01-01

    The purpose of this study was to determine changes in African Americans' access to occasional rehabilitation (VR) services subsequent to landmark legislative and judicial antidiscrimination provisions of the mid-20th century. This study compared African American VR access before the antidiscrimination legislation in 1937 and after the legislation…

  13. Asthma Management Disparities: A Photovoice Investigation with African American Youth

    ERIC Educational Resources Information Center

    Evans-Agnew, Robin

    2016-01-01

    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…

  14. The Perceptions of Standardized Tests, Academic Self-Efficacy, and Academic Performance of African American Graduate Students: a Correlational and Comparative Analysis

    ERIC Educational Resources Information Center

    Marrah, Arleezah K.

    2012-01-01

    The academic performance of African American students continues to be a concern for educators, researchers, and most importantly their community. This issue is particularly prevalent in the standardized test scores of African American students where they score on average one or more standard deviations below their Caucasian and Asian American…

  15. African American Male Achievement: Using a Tenet of Critical Theory to Explain the African American Male Achievement Disparity

    ERIC Educational Resources Information Center

    Palmer, Robert T.; Maramba, Dina C.

    2011-01-01

    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…

  16. Comparison of survival and clinicopathologic features in colorectal cancer among African American, Caucasian, and Chinese patients treated in the United States: Results from the surveillance epidemiology and end results (SEER) database.

    PubMed

    Lin, Junzhong; Qiu, Miaozhen; Xu, Ruihua; Dobs, Adrian Sandra

    2015-10-20

    African American patients of colorectal cancer (CRC) were found to have a worse prognosis than Caucasians, but it has not been fully understood about the survival difference among Chinese and these two races above. In this study, we used the Surveillance, Epidemiology and End Results database to analyze the survival difference among these three race/ethnicities in the United States. Adenocarcinoma patients of colorectal cancer with a race/ethnicity of Caucasian, Chinese and African American were enrolled for study. Patients were excluded if they had more than one primary cancer but the CRC was not the first one, had unknown cause of death or unknown survival months. The 5-year cause specific survival (CSS) was our primary endpoint. Totally, there were 585,670 eligible patients for analysis. Chinese patients had the best and African American patients had the worst 5-year CSS (66.7% vs 55.9%), P < 0.001. The 5-year CSS for Caucasian patients was 62.9%. Race/ethnicity was an independent prognostic factor in the multivariate analysis, P < 0.001. The comparison of clinicopathologic factors among these three race/ethnicities showed that the insurance coverage rate, income, percentage that completing high school and percentage of urban residence was lowest in the African American patients. Chinese patients had the highest percentage of married, while African American patients ranked lowest. More African American patients were diagnosed as stage IV and had high percentage of signet ring cell and mucinous adenocarcinoma. It is likely that biological differences as well as socioeconomic status both contribute to the survival disparity among the different race/ethnicities.

  17. Comparison of survival and clinicopathologic features in colorectal cancer among African American, Caucasian, and Chinese patients treated in the United States: Results from the surveillance epidemiology and end results (SEER) database.

    PubMed

    Lin, Junzhong; Qiu, Miaozhen; Xu, Ruihua; Dobs, Adrian Sandra

    2015-10-20

    African American patients of colorectal cancer (CRC) were found to have a worse prognosis than Caucasians, but it has not been fully understood about the survival difference among Chinese and these two races above. In this study, we used the Surveillance, Epidemiology and End Results database to analyze the survival difference among these three race/ethnicities in the United States. Adenocarcinoma patients of colorectal cancer with a race/ethnicity of Caucasian, Chinese and African American were enrolled for study. Patients were excluded if they had more than one primary cancer but the CRC was not the first one, had unknown cause of death or unknown survival months. The 5-year cause specific survival (CSS) was our primary endpoint. Totally, there were 585,670 eligible patients for analysis. Chinese patients had the best and African American patients had the worst 5-year CSS (66.7% vs 55.9%), P < 0.001. The 5-year CSS for Caucasian patients was 62.9%. Race/ethnicity was an independent prognostic factor in the multivariate analysis, P < 0.001. The comparison of clinicopathologic factors among these three race/ethnicities showed that the insurance coverage rate, income, percentage that completing high school and percentage of urban residence was lowest in the African American patients. Chinese patients had the highest percentage of married, while African American patients ranked lowest. More African American patients were diagnosed as stage IV and had high percentage of signet ring cell and mucinous adenocarcinoma. It is likely that biological differences as well as socioeconomic status both contribute to the survival disparity among the different race/ethnicities. PMID:26375551

  18. Delayed Parkinson's Disease Diagnosis among African-Americans: The Role of Reporting of Disability

    PubMed Central

    Dahodwala, Nabila; Karlawish, Jason; Siderowf, Andrew; Duda, John E.; Mandell, David S.

    2011-01-01

    Background/Aims Racial differences in the observed prevalence of Parkinson's disease (PD) may be due to delayed diagnosis among African-Americans. We sought to compare the stage at which African-American and white PD patients present for healthcare, and determine whether perception of disability accounts for racial differences. Methods Using records of veterans with newly diagnosed PD at the Philadelphia Veterans Affairs Medical Center, we calculated differences in reporting of symptoms as the difference in z-scores on the Unified Parkinson Disease Rating Scale part 2 (disability) and part 3 (motor impairment). Ordinal logistic regression was used to determine predictors of stage at diagnosis. Results African-American (n = 16) and white (n = 58) veterans with a mean age of 70.1 years were identified. African-Americans presented at a later PD stage than whites (median Hoehn + Yahr stage 2.5 vs. 2.0, p = 0.02) and were more likely to under-report disability relative to motor impairment (81 vs. 40%, p < 0.01). Multivariate analysis showed that under-reporting of disability accounted for much of the effect of race on stage of diagnosis. Conclusions Under-reporting of disability among African-Americans may account for later stages of PD diagnosis than whites. This study begins to explain the mechanisms underlying observed racial disparities in PD. PMID:21508648

  19. Race, Class, Gender and Community College Persistence among African American Women

    ERIC Educational Resources Information Center

    Walpole, MaryBeth; Chambers, Crystal Renee; Goss, Kathryn

    2014-01-01

    This inquiry is an exploration of the educational trajectories of African American women community college students. We compare the persistence of African American women to African American men and to all women college students using the 1996/2001 Beginning Postsecondary Students Longitudinal Survey and the 1993/2003 Baccalaureate and Beyond…

  20. A Case Study of the Development of African American Women Executives

    ERIC Educational Resources Information Center

    Brooks Greaux, Lisa

    2010-01-01

    Even in an era when the country elected an African American man as President of the United States, there is still a paucity of African American women executives within Fortune 500 companies. Although more African American women have joined the ranks of corporate management over the last two decades, the numbers, when compared to those of White…

  1. Can l-Cysteine and Vitamin D Rescue Vitamin D and Vitamin D Binding Protein Levels in Blood Plasma of African American Type 2 Diabetic Patients?

    PubMed Central

    Kahlon, Gunjan; Bass, Pat; Levine, Steven N.; Warden, Cassandra

    2015-01-01

    Abstract Aims: Vitamin D (VD) deficiency has become a worldwide epidemic, particularly affecting African Americans (AA). VD deficiency has been implicated in the excessive rate of complications associated with diabetes in AA. Blood levels of VD binding protein (VDBP) and glutathione (GSH) are lower in AA compared with those in Caucasians. This study tested the hypothesis that lower GSH levels are linked to VDBP and VD deficiency in AA-type 2 diabetic (AA-T2D) patients. Blood was analyzed from T2D and nondiabetic subjects (N). Experiments examining GSH deficiency and l-cysteine (LC) supplementation were performed using THP-1 monocytes. Results: Plasma levels of LC, GSH, VDBP, and VD were significantly lower in AA-T2D compared with age-matched AA-N or Caucasian-T2D. Lower levels of LC and GSH showed a significant positive correlation with lower VDBP and VD levels in AA-T2D. GSH deficiency investigated using an antisense approach depleted VDBP/vitamin D receptor (VDR); LC supplementation caused significant upregulation of GSH and of VDBP/VDR, while supplementation with VD+LC caused a significantly greater GSH and VDBP/VDR upregulation compared with that of VD alone in monocytes. Innovation and Conclusion: The reported observations suggest that VD deficiency may be linked to GSH and LC status and lead to a novel hypothesis that supplementation with LC in combination with VD will be effective in increasing VD levels and reducing health disparities in AA. Antioxid. Redox Signal. 23, 688–693. PMID:25816831

  2. Hospitalizations for cardiovascular disease in African Americans and whites with HIV/AIDS.

    PubMed

    Oramasionwu, Christine U; Morse, Gene D; Lawson, Kenneth A; Brown, Carolyn M; Koeller, Jim M; Frei, Christopher R

    2013-06-01

    Therapeutic advances have resulted in an epidemiological shift in the predominant causes of hospitalization for patients with HIV/AIDS. An emerging cause for hospitalization in this patient population is cardiovascular disease (CVD); however, data are limited regarding how this shift affects different racial groups. The objective of this observational, retrospective study was to evaluate the association between race and hospitalization for CVD in African Americans and whites with HIV/AIDS and to compare the types of CVD-related hospitalizations between African Americans and whites with HIV/AIDS. Approximately 1.5 million hospital discharges from the US National Hospital Discharge Surveys for the years of 1996 to 2008 were identified. After controlling for potential confounders, the odds of CVD-related hospitalization in patients with HIV/AIDS were 45% higher for African Americans than whites (odds ratio [OR]=1.45, 95% CI, 1.39-1.51). Other covariates that were associated with increased odds of hospitalization for CVD included chronic kidney disease (OR=1.43, 95% CI, 1.36-1.51), age≥50 years (OR=3.22, 95% CI, 2.94-3.54), region in the Southern United States (OR=1.17, 95% CI, 1.11-1.23), and Medicare insurance coverage (OR=1.71, 95% CI, 1.60-1.83). Male sex was not significantly associated with the study outcome (OR=0.99, 95% CI, 0.96-1.02). Compared to whites with HIV/AIDS, African Americans with HIV/AIDS had more hospitalizations for heart failure and hypertension, but fewer hospitalizations for stroke and coronary heart disease. In conclusion, African Americans with HIV/AIDS have increased odds of CVD-related hospitalization as compared to whites with HIV/AIDS. Furthermore, the most common types of CVD-related hospitalizations differ significantly in African Americans and whites.

  3. Discrimination, Mastery, and Depressive Symptoms Among African American Men

    PubMed Central

    Watkins, Daphne C.; Hudson, Darrell L.; Caldwell, Cleopatra Howard; Siefert, Kristine; Jackson, James S.

    2013-01-01

    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 related to depressive symptoms for men ages 35 to 54 and mastery was found to be protective against depressive symptoms for all men. Compared to African American men in the young and late adult groups, discrimination remained a statistically significant predictor of depressive symptoms for men in the middle group once mastery was included. Implications Findings demonstrate the distinct differences in the influence of discrimination on depressive symptoms among adult African American males and the need for future research that explores the correlates of mental health across age groups. Implications for social work research and practice with African American men are discussed. PMID:24436576

  4. Perceived needs of African-American caregivers of elders with dementia.

    PubMed

    Lampley-Dallas, V T; Mold, J W; Flori, D E

    2001-02-01

    To assess the perceived needs of African-American caregivers and their expectations of the health care system, perceived level of success and satisfaction in meeting their needs, and their level of distress, we convened two focus groups at a local church in Oklahoma City, OK to discuss three questions. Responses were qualitatively analyzed for common themes. The groups comprised 13 African-American caregivers of demented elders. All participants completed a demographic form, the Zarit Burden Interview, and the Depression Scale. We found that African-American caregivers are frustrated with health care and service providers. The main differences of this group compared with other caregivers were their perceptions of racism and the absence of an available local support group. This information can serve to guide future studies in developing ways to increase caregiver satisfaction, decrease caregiver stress, and increase patient quality of life for this subgroup of caregivers.

  5. Prevalence of Stuttering in African American Preschoolers

    ERIC Educational Resources Information Center

    Proctor, Adele; Yairi, Ehud; Duff, Melissa C.; Zhang, Jie

    2008-01-01

    Purpose: In this study, the authors sought to determine the prevalence of stuttering in African American (AA) 2- to 5-year-olds as compared with same-age European Americans (EAs). Method: A total of 3,164 children participated: 2,223 AAs and 941 EAs. Data were collected using a 3-pronged approach that included investigators' individual…

  6. Home Remedy Use Among African American and White Older Adults.

    PubMed

    Quandt, Sara A; Sandberg, Joanne C; Grzywacz, Joseph G; Altizer, Kathryn P; Arcury, Thomas A

    2015-06-01

    Home remedy use is an often overlooked component of health self-management, with a rich tradition, particularly among African Americans and others who have experienced limited access to medical care or discrimination by the health care system. Home remedies can potentially interfere with biomedical treatments. This study documented the use of home remedies among older rural adults, and compared use by ethnicity (African American and white) and gender. A purposeful sample of 62 community-dwelling adults ages 65+ from rural North Carolina was selected. Each completed an in-depth interview, which probed current use of home remedies, including food and non-food remedies, and the symptoms or conditions for use. Systematic, computer-assisted analysis was used to identify usage patterns. Five food and five non-food remedies were used by a large proportion of older adults. African American elders reported greater use than white elders; women reported more use for a greater number of symptoms than men. Non-food remedies included long-available, over-the-counter remedies (e.g., Epsom salts) for which "offlabel" uses were reported. Use focused on alleviating common digestive, respiratory, skin, and musculoskeletal symptoms. Some were used for chronic conditions in lieu of prescription medications. Home remedy use continues to be a common feature of the health self-management of older adults, particularly among African Americans, though at lower levels than previously reported. While some use is likely helpful or benign, other use has the potential to interfere with medical management of disease. Health care providers should be aware of the use of remedies by their patients. PMID:26543255

  7. Home Remedy Use Among African American and White Older Adults

    PubMed Central

    Quandt, Sara A.; Sandberg, Joanne C.; Grzywacz, Joseph G.; Altizer, Kathryn P.; Arcury, Thomas A.

    2015-01-01

    Home remedy use is an often overlooked component of health self-management, with a rich tradition, particularly among African Americans and others who have experienced limited access to medical care or discrimination by the health care system. Home remedies can potentially interfere with biomedical treatments. This study documented the use of home remedies among older rural adults, and compared use by ethnicity (African American and white) and gender. A purposeful sample of 62 community-dwelling adults ages 65+ from rural North Carolina was selected. Each completed an in-depth interview, which probed current use of home remedies, including food and non-food remedies, and the symptoms or conditions for use. Systematic, computer-assisted analysis was used to identify usage patterns. Five food and five non-food remedies were used by a large proportion of older adults. African American elders reported greater use than white elders; women reported more use for a greater number of symptoms than men. Non-food remedies included long-available, over-the-counter remedies (e.g., Epsom salts) for which “off-label” uses were reported. Use focused on alleviating common digestive, respiratory, skin, and musculoskeletal symptoms. Some were used for chronic conditions in lieu of prescription medications. Home remedy use continues to be a common feature of the health self-management of older adults, particularly among African Americans, though at lower levels than previously reported. While some use is likely helpful or benign, other use has the potential to interfere with medical management of disease. Health care providers should be aware of the use of remedies by their patients. PMID:26543255

  8. African American Administrators and Staff

    ERIC Educational Resources Information Center

    Wright, Dianne; Taylor, Janice D.; Burrell, Charlotte; Stewart, Gregory

    2006-01-01

    This article explores the issues of African American participation in the administrative ranks of the academy. The authors find that African Americans tend to hold positions that are marginal in academic organizations, lacking power and influence, and that not much has changed over recent decades. Forces influencing this condition are explored,…

  9. African-American Children's Literature.

    ERIC Educational Resources Information Center

    Kline, Lucinda

    This paper examines the history of African American children's literature, the present-day status of it, and ventures predictions about its future. The paper also considers the historic and social factors of the debate about whether an author who is not African American can write a book that will/should be accepted in this category of children's…

  10. African-American Sacred Music.

    ERIC Educational Resources Information Center

    Bailey, A. Peter

    1991-01-01

    The history of African-American sacred music is traced from the time of slavery to the present interest in gospel music. The religious music of African Americans is geared toward liberation themes. It is important that this music does not dilute its power through cross-over with other music forms. (SLD)

  11. Trauma exposure, posttraumatic stress disorder and depression in an African-American primary care population.

    PubMed Central

    Alim, Tanya N.; Graves, Elaine; Mellman, Thomas A.; Aigbogun, Notalelomwan; Gray, Ekwenzi; Lawson, William; Charney, Dennis S.

    2006-01-01

    OBJECTIVE: Trauma exposure is high in African Americans who live in stressful urban environments. Posttraumatic stress disorder (PTSD) and depression are common outcomes of trauma exposure and are understudied in African Americans. African Americans are more likely to seek treatment for psychiatric disorders in a primary care setting. Our study evaluated trauma exposure, PTSD and major depression in African Americans attending primary care offices. METHOD: Six-hundred-seventeen patients (96% African Americans) were surveyed for trauma exposure in the waiting rooms of four primary care offices. Those patients reporting significant traumatic events were invited to a research interview. Of the 403 patients with trauma exposure, 279 participated. RESULTS: Of the 617 participants, 65% reported > or = 1 clearly traumatic event. The most common exposures were transportation accidents (42%), sudden unexpected death of a loved one (39%), physical assault (30%), assault with a weapon (29%) and sexual assault (25%). Lifetime prevalence of PTSD and a major depressive episode (MDE) among those with trauma exposure (n=279) was 51% and 35%, respectively. The percent of lifetime PTSD cases (n=142) with comorbid MDE was 46%. Lifetime PTSD and MDE in the trauma-exposed population were approximately twice as common in females than males, whereas current PTSD rates were similar. CONCLUSIONS: Our rate of PTSD (approximately 33% of those screened) exceeds estimates for the general population. Rates of MDE comorbid with PTSD were comparable to other studies. These findings suggest the importance of screening African Americans for PTSD, in addition to depression, in the primary care setting. PMID:17052054

  12. Mistrust, misperceptions, and miscommunication: A qualitative study of preferences about kidney transplantation among African-Americans

    PubMed Central

    Wachterman, Melissa W.; McCarthy, Ellen P.; Marcantonio, Edward R.; Ersek, Mary

    2015-01-01

    Background Kidney transplantation rates in the United States are lower among African-Americans than among Whites. Well-documented racial disparities in access to transplantation explain some, but not all, of these differences. Prior survey-based research suggests that African-American dialysis patients are less likely than Whites to desire transplantation, but little research has focused on an in-depth exploration of preferences about kidney transplantation among African-Americans. Thus, the purpose of the study was to explore preferences, and compare patients’ expectations about transplantation with actual status on the transplant list. Methods We conducted semi-structured interviews with sixteen African-Americans receiving chronic hemodialysis. We analyzed the interviews using the constant comparative method of qualitative analysis. We also reviewed the dialysis center's transplant list. Results Four dominant themes emerged: 1) Varied desire for transplant; 2) Concerns about donor source; 3) Barriers to transplantation; 4) Lack of communication with nephrologists and transplant team. A thread of mistrust about equity in the transplantation process flowed through themes 2-4. In 7/16 cases, patients’ understanding of their transplant listing status was discordant with their actual status. Conclusions Our study suggests that many African-Americans on hemodialysis are interested in kidney transplantation, but that interest is often tempered by concerns about transplantation, including misconceptions about the risks to recipients and donors. Mistrust about equity in the organ allocation process also contributed to ambivalence. The discordance between patients’ perceptions of listing status and actual status suggests communication gaps between African-American hemodialysis patients and physicians. Clinicians should avoid interpreting ambivalence about transplantation as lack of interest. PMID:25769556

  13. Cancer statistics for African Americans.

    PubMed

    Ghafoor, Asma; Jemal, Ahmedin; Cokkinides, Vilma; Cardinez, Cheryll; Murray, Taylor; Samuels, Alicia; Thun, Michael J

    2002-01-01

    The American Cancer Society provides estimates on the number of new cancer cases and deaths, and compiles health statistics on African Americans in a biennial publication, Cancer Facts and Figures for African Americans. The compiled statistics include cancer incidence, mortality, survival, and lifestyle behaviors using the most recent data on incidence and survival from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program, mortality data from the National Center for Health Statistics (NCHS), and behavioral information from the Behavior Risk Factor Surveillance System (BRFSS), Youth Risk Behavior Surveillance System (YRBSS), and National Health Interview Survey (NHIS). It is estimated that 132,700 new cases of cancer and 63,100 deaths will occur among African Americans in the year 2003. Although African Americans have experienced higher incidence and mortality rates of cancer than whites for many years, incidence rates have declined by 2.7 percent per year in African-American males since 1992, while stabilizing in African-American females. During the same period, death rates declined by 2.1 percent and 0.4 percent per year among African-American males and females, respectively. The decrease in both incidence and death rates from cancer among African-American males was the largest of any racial or ethnic group. Nonetheless, African Americans still carry the highest cancer burden among US racial and ethnic groups. Most cancers detectable by screening are diagnosed at a later stage and survival rates are lower within each stage of disease in African Americans than in whites. The extent to which these disparities reflect unequal access to health care versus other factors is an active area of research.

  14. Coping and distress among women under treatment for early stage breast cancer: comparing African Americans, Hispanics and non-Hispanic Whites.

    PubMed

    Culver, Jenifer L; Arena, Patricia L; Antoni, Michael H; Carver, Charles S

    2002-01-01

    This study examined coping and distress in African American (n=8), Hispanic (n=53), and non-Hispanic White (n=70) women with early stage breast cancer. The participants were studied prospectively across a year beginning at the time of surgery. African American women reported the lowest levels of distress (particularly before surgery) and depression symptoms. Hispanic women reported the highest levels of self-distraction as a coping response, non-Hispanic Whites reported the highest use of humor. Hispanics reported the highest levels of venting, African Americans reported the lowest levels. African American and Hispanic women reported more religious coping than non-Hispanic Whites. The data also provided evidence of a maladaptive spiral of distress and avoidant coping over time. Although some ethnic differences were identified, findings also point to a great many similarities across groups. PMID:12476431

  15. Attention-deficit/hyperactivity disorder in African American youth.

    PubMed

    Bailey, Rahn K; Ali, Shahid; Jabeen, Shagufta; Akpudo, Hilary; Avenido, Jaymie U; Bailey, Theresa; Lyons, Jessica; Whitehead, Amelia A

    2010-10-01

    This article examines attention-deficit/hyperactivity disorder (ADHD) in African American youth. Tackling the myths and misinformation surrounding ADHD in the African American community can be one of the most difficult issues in mental illness circles. There is a lot of conflicting information about how African Americans are diagnosed, examined, and treated. This article clarifies some of the misconceptions and offers some comprehensibility to the issue of ADHD in African American youth. The incidence of ADHD is probably similar in African Americans and Caucasians. However, fewer African Americans are diagnosed with and treated for ADHD. That reality flies in the face of some perceptions in many African American communities. Reasons for this disparity have not been fully clarified and are most likely complex and numerous. Some barriers to treatment are driven by the beliefs of patients and their families, while others are the result of limitations in the health care system. Patient-driven obstacles to care include inadequate knowledge of symptoms, treatment, and consequences of untreated ADHD and fear of overdiagnosis and misdiagnosis. System-driven limitations include a lack of culturally competent health care providers, stereotyping or biases, and failure of clinicians to evaluate the child in multiple settings before diagnosis. PMID:20697849

  16. African American Race is an Independent Risk Factor in Survival from Initially Diagnosed Localized Breast Cancer

    PubMed Central

    Wieder, Robert; Shafiq, Basit; Adam, Nabil

    2016-01-01

    BACKGROUND: African American race negatively impacts survival from localized breast cancer but co-variable factors confound the impact. METHODS: Data sets were analyzed from the Surveillance, Epidemiology and End Results (SEER) directories from 1973 to 2011 consisting of patients with designated diagnosis of breast adenocarcinoma, race as White or Caucasian, Black or African American, Asian, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, age, stage I, II or III, grade 1, 2 or 3, estrogen receptor or progesterone receptor positive or negative, marital status as single, married, separated, divorced or widowed and laterality as right or left. The Cox Proportional Hazards Regression model was used to determine hazard ratios for survival. Chi square test was applied to determine the interdependence of variables found significant in the multivariable Cox Proportional Hazards Regression analysis. Cells with stratified data of patients with identical characteristics except African American or Caucasian race were compared. RESULTS: Age, stage, grade, ER and PR status and marital status significantly co-varied with race and with each other. Stratifications by single co-variables demonstrated worse hazard ratios for survival for African Americans. Stratification by three and four co-variables demonstrated worse hazard ratios for survival for African Americans in most subgroupings with sufficient numbers of values. Differences in some subgroupings containing poor prognostic co-variables did not reach significance, suggesting that race effects may be partly overcome by additional poor prognostic indicators. CONCLUSIONS: African American race is a poor prognostic indicator for survival from breast cancer independent of 6 associated co-variables with prognostic significance.

  17. African American Race is an Independent Risk Factor in Survival from Initially Diagnosed Localized Breast Cancer

    PubMed Central

    Wieder, Robert; Shafiq, Basit; Adam, Nabil

    2016-01-01

    BACKGROUND: African American race negatively impacts survival from localized breast cancer but co-variable factors confound the impact. METHODS: Data sets were analyzed from the Surveillance, Epidemiology and End Results (SEER) directories from 1973 to 2011 consisting of patients with designated diagnosis of breast adenocarcinoma, race as White or Caucasian, Black or African American, Asian, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, age, stage I, II or III, grade 1, 2 or 3, estrogen receptor or progesterone receptor positive or negative, marital status as single, married, separated, divorced or widowed and laterality as right or left. The Cox Proportional Hazards Regression model was used to determine hazard ratios for survival. Chi square test was applied to determine the interdependence of variables found significant in the multivariable Cox Proportional Hazards Regression analysis. Cells with stratified data of patients with identical characteristics except African American or Caucasian race were compared. RESULTS: Age, stage, grade, ER and PR status and marital status significantly co-varied with race and with each other. Stratifications by single co-variables demonstrated worse hazard ratios for survival for African Americans. Stratification by three and four co-variables demonstrated worse hazard ratios for survival for African Americans in most subgroupings with sufficient numbers of values. Differences in some subgroupings containing poor prognostic co-variables did not reach significance, suggesting that race effects may be partly overcome by additional poor prognostic indicators. CONCLUSIONS: African American race is a poor prognostic indicator for survival from breast cancer independent of 6 associated co-variables with prognostic significance. PMID:27698895

  18. Training African-American residents in the 20th century.

    PubMed

    Green-McKenzie, Judith

    2004-03-01

    needed not only to serve minority populations but also to serve as mentors and role models for prospective and current students. The first African-American resident to graduate from the Bellevue Residency Program did indeed treat the underserved, as Dr. Vincent founded the Vincent Sanatorium, dedicated to treating African-American patients, and training African-American nurses and doctors. Over the course of the 20th century, Bellevue Hospital has trained increasing numbers of African-American physicians. It is hoped that, like their predecessor, Dr. Vincent, they will provide care to underserved communities and to the community as a whole, as well as serve as role models for generations to come. PMID:15040520

  19. An African-American family with dystonia.

    PubMed

    Puschmann, Andreas; Xiao, Jianfeng; Bastian, Robert W; Searcy, Jill A; LeDoux, Mark S; Wszolek, Zbigniew K

    2011-08-01

    The genetic cause of late-onset focal and segmental dystonia remains unknown in most individuals. Recently, mutations in Thanatos-associated protein domain containing, apoptosis associated protein 1 (THAP1) have been described in DYT6 dystonia and associated with some cases of familial and sporadic late-onset dystonia in Caucasians. We are not aware of any previous descriptions of familial dystonia in African-Americans or reports of THAP1 mutations in African-Americans. Herein, we characterize an African-American (AA) kindred with late-onset primary dystonia, clinically and genetically. The clinical phenotype included cervical, laryngeal and hand-forearm dystonia. Symptoms were severe and disabling for several family members, whereas others only displayed mild signs. There were no accompanying motor or cognitive signs. In this kindred, age of onset ranged from 45 to 50 years and onset was frequently sudden, with symptoms developing within weeks or months. DYT1 was excluded as the cause of dystonia in this kindred. The entire genomic region of THAP1, including non-coding regions, was sequenced. We identified 13 sequence variants in THAP1, although none co-segregated with dystonia. A novel THAP1 variant (c.-237-3G>T/A) was found in 3/84 AA dystonia patient alleles and 3/212 AA control alleles, but not in 5870 Caucasian alleles. In summary, although previously unreported, familial primary dystonia does occur in African-Americans. Genetic analysis of the entire genomic region of THAP1 revealed a novel variant that was specific for African-Americans. Therefore, genetic testing for dystonia and future studies of candidate genes must take genetic background into consideration. PMID:21601506

  20. An African-American Family with Dystonia

    PubMed Central

    Puschmann, Andreas; Xiao, Jianfeng; Bastian, Robert W.; Searcy, Jill A.; LeDoux, Mark S.; Wszolek, Zbigniew K.

    2011-01-01

    The genetic cause of late-onset focal and segmental dystonia remains unknown in most individuals. Recently, mutations in Thanatos-associated protein domain containing, apoptosis associated protein 1 (THAP1) have been described in DYT6 dystonia and associated with some cases of familial and sporadic late-onset dystonia in Caucasians. We are not aware of any previous descriptions of familial dystonia in African Americans or reports of THAP1 mutations in African Americans. Herein, we characterize an African-American (AA) kindred with late-onset primary dystonia, clinically and genetically. The clinical phenotype included cervical, laryngeal and hand-forearm dystonia. Symptoms were severe and disabling for several family members, whereas others only displayed mild signs. There were no accompanying motor or cognitive signs. In this kindred, age of onset ranged from 45 to 50 years and onset was frequently sudden, with symptoms developing within weeks or months. DYT1 was excluded as the cause of dystonia in this kindred. The entire genomic region of THAP1, including non-coding regions, was sequenced. We identified 13 sequence variants in THAP1, although none co-segregated with dystonia. A novel THAP1 variant (c.-237-3G>T/A) was found in 3/84 AA dystonia patient alleles and 3/212 AA control alleles, but not in 5,870 Caucasian alleles. In summary, although previously unreported, familial primary dystonia does occur in African Americans. Genetic analysis of the entire genomic region of THAP1 revealed a novel variant that was specific for African Americans. Therefore, genetic testing for dystonia and future studies of candidate genes must take genetic background into consideration. PMID:21601506

  1. Psychological adjustment among African American breast cancer patients: one-year follow-up results of a randomized psychoeducational group intervention.

    PubMed

    Taylor, Kathryn L; Lamdan, Ruth M; Siegel, Jamie E; Shelby, Rebecca; Moran-Klimi, Karen; Hrywna, Mary

    2003-05-01

    The effectiveness of support group interventions for cancer patients has been established among White patients but has been virtually unstudied among minority patients. The current study represents the 1st randomized support group intervention targeted to African American women with breast cancer. Participants (N = 73) with nonmetastatic breast cancer were randomly assigned to an 8-week group intervention or an assessment-only control condition At 12 months, the intervention resulted in improved mood as well as improved general and cancer-specific psychological functioning among women with greater baseline distress or lower income. Subsequent research is needed to address effective methods of enrolling and following women with fewer psychosocial and financial resources, as they were the most likely to benefit from this particular intervention.

  2. The Great Migration and African-American Genomic Diversity

    PubMed Central

    Barakatt, Maxime; Gignoux, Christopher R.; Errington, Jacob; Blot, William J.; Bustamante, Carlos D.; Kenny, Eimear E.; Williams, Scott M.; Aldrich, Melinda C.; Gravel, Simon

    2016-01-01

    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. PMID:27232753

  3. The Great Migration and African-American Genomic Diversity.

    PubMed

    Baharian, Soheil; Barakatt, Maxime; Gignoux, Christopher R; Shringarpure, Suyash; Errington, Jacob; Blot, William J; Bustamante, Carlos D; Kenny, Eimear E; Williams, Scott M; Aldrich, Melinda C; Gravel, Simon

    2016-05-01

    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. PMID:27232753

  4. The Great Migration and African-American Genomic Diversity.

    PubMed

    Baharian, Soheil; Barakatt, Maxime; Gignoux, Christopher R; Shringarpure, Suyash; Errington, Jacob; Blot, William J; Bustamante, Carlos D; Kenny, Eimear E; Williams, Scott M; Aldrich, Melinda C; Gravel, Simon

    2016-05-01

    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.

  5. Increasing the adjustment success of the disabled African American.

    PubMed

    Miller, S D

    1993-01-01

    Adjustment to a physically disabling condition is a challenge for any patient who confronts a future of severe impairment and limited mobility. The emotional trauma is usually devastating at least until the initial shock of the disability dissipates. For the disabled African-American patient, the physical and psychic pain are compounded by personal and social factors not experienced in similar intensity by other disabled patients. A conceptual framework for better understanding the nature of the forces that impinge on the ability of the disabled African-American patient to adjust and an understanding of the impact of multi-level systems on the life of the disabled African-American is provided. The influence of racism, be it intentional or unintentional, is explained as it relates to the services and the attitudes of health care systems. The family as a significant and vital system is discussed as the major contributor to the successful adjustment of African-American disabled persons.

  6. Active surveillance of prostate cancer in African American men.

    PubMed

    Silberstein, Jonathan L; Feibus, Allison H; Maddox, Michael M; Abdel-Mageed, Asim B; Moparty, Krishnarao; Thomas, Raju; Sartor, Oliver

    2014-12-01

    Active surveillance (AS) is a treatment strategy for prostate cancer (PCa) whereby patients diagnosed with PCa undergo ongoing characterization of their disease with the intent of avoiding radical treatment. Previously, AS has been demonstrated to be a reasonable option for men with low-risk PCa, but existing cohorts largely consist of Caucasian Americans. Because African Americans have a greater incidence, more aggressive, and potentially more lethal PCa than Caucasian Americans, it is unclear if AS is appropriate for African Americans. We performed a review of the available literature on AS with a focus on African Americans.

  7. Atrial fibrillation among African Americans, Hispanics and Caucasians: clinical features and outcomes from the AFFIRM trial.

    PubMed Central

    Bush, David; Martin, Lisa W.; Leman, Robert; Chandler, Mary; Haywood, L. Julian

    2006-01-01

    The Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study concluded that rate control with anticoagulation was equivalent overall to rhythm control with cardioversion for long-term survival and that anticoagulation reduced the risk of stroke. We compared baseline and follow-up data for three ethnic groups: Caucasians (n=3,599), African Americans (n=265) and Hispanics (n=132). Caucasians were older and more likely male, African Americans were more likely female and hypertensive, and Hispanics had higher prevalence of cardiomyopathy. Survival was better for rate control than rhythm control in Caucasians, equivalent in African Americans and better for rhythm control in Hispanics. Outcomes may be influenced by differential baseline characteristics, but low numbers of African Americans and Hispanics warrant caution in data interpretation. BACKGROUND: The AFFIRM study compared a rate-control strategy to a rhythm-control strategy for the treatment of atrial fibrillation (AF) in patients at high risk for stroke or death. It concluded that the rhythm-control strategy offered no survival advantage, and it also confirmed the value of anticoagulation to prevent complications of AF. Data have not previously been available for specific racial ethnic populations. METHODS: We compared baseline and follow-up data for the patients randomized to rate-control versus rhythm-control in three population groups-Caucasian, African-American and Hispanic. RESULTS: Among 4,060 total patients, 3,599 were Caucasian, 265 were African-American and 132 were Hispanic. At baseline, Caucasians were older and had a higher percentage of males, normal ejection fractions, AF as their only cardiac diagnosis, a prior antiarrhythmic drug failure and less congestive heart failure. African Americans were more likely to be female, had more hypertension and qualified for the study with a first episode of AF, compared to Caucasians. Hispanics had more cardiomyopathy at baseline than

  8. Prevalence and Severity of Symptoms in a Sample of African Americans and White Participants.

    PubMed

    Taneja, Indu; So, Suzanna; Stewart, Julian M; Evans, Meredyth; Jason, Leonard A

    2015-01-01

    According to the Centers for Disease Control and Prevention (2013), African Americans have a substantially greater prevalence of a range of health conditions when compared to other racial or ethnic groups. Many of these conditions have been attributed to the historical and contemporary social and economic disparities faced by the African American community. While many health conditions occur at a higher rate in African Americans, it is unclear whether there are specific symptom clusters that may also be more prevalent in African Americans as a result of these disparities. Potential differences in symptomology have not been thoroughly examined between African Americans and White populations. The current study compares the prevalence and pain severity of symptoms among a sample of African Americans and White participants. Significant differences in symptom prevalence were found in disturbed sleep and reproductive areas. African Americans also experience more pain due to symptoms related to orthostatic intolerance. Implications of this finding are discussed.

  9. Prevalence and Severity of Symptoms in a Sample of African Americans and White Participants

    PubMed Central

    Taneja, Indu; So, Suzanna; Stewart, Julian M.; Evans, Meredyth; Jason, Leonard A.

    2016-01-01

    According to the Centers for Disease Control and Prevention (2013), African Americans have a substantially greater prevalence of a range of health conditions when compared to other racial or ethnic groups. Many of these conditions have been attributed to the historical and contemporary social and economic disparities faced by the African American community. While many health conditions occur at a higher rate in African Americans, it is unclear whether there are specific symptom clusters that may also be more prevalent in African Americans as a result of these disparities. Potential differences in symptomology have not been thoroughly examined between African Americans and White populations. The current study compares the prevalence and pain severity of symptoms among a sample of African Americans and White participants. Significant differences in symptom prevalence were found in disturbed sleep and reproductive areas. African Americans also experience more pain due to symptoms related to orthostatic intolerance. Implications of this finding are discussed. PMID:26245010

  10. ENVE: a novel computational framework characterizes copy-number mutational landscapes in colorectal cancers from African American patients.

    PubMed

    Varadan, Vinay; Singh, Salendra; Nosrati, Arman; Ravi, Lakshmeswari; Lutterbaugh, James; Barnholtz-Sloan, Jill S; Markowitz, Sanford D; Willis, Joseph E; Guda, Kishore

    2015-01-01

    Reliable detection of somatic copy-number alterations (sCNAs) in tumors using whole-exome sequencing (WES) remains challenging owing to technical (inherent noise) and sample-associated variability in WES data. We present a novel computational framework, ENVE, which models inherent noise in any WES dataset, enabling robust detection of sCNAs across WES platforms. ENVE achieved high concordance with orthogonal sCNA assessments across two colorectal cancer (CRC) WES datasets, and consistently outperformed a best-in-class algorithm, Control-FREEC. We subsequently used ENVE to characterize global sCNA landscapes in African American CRCs, identifying genomic aberrations potentially associated with CRC pathogenesis in this population. ENVE is downloadable at https://github.com/ENVE-Tools/ENVE. PMID:26269717

  11. Randomized Controlled Trial of SPIRIT: An Effective Approach to Preparing African-American Dialysis Patients and Families for End of Life

    PubMed Central

    Song, Mi-Kyung; Ward, Sandra E.; Denne, Helen; Happ, Mary Beth; Piraino, Beth; Donovan, Heidi S.; Shields, Anne-Marie; Connolly, Mary C.

    2009-01-01

    This randomized controlled trial tested an intervention, Sharing Patients’ Illness Representations to Increase Trust (SPIRIT), designed to enhance communication regarding end-of-life care between African Americans with end-stage renal disease (ESRD) and their chosen surrogate decision makers (N = 58 dyads). We used surveys and semi-structured interviews to determine the feasibility, acceptability, and preliminary effects of SPIRIT on patient and surrogate outcomes at 1 week and 3 months post-intervention. We also evaluated patients’ deaths and surrogates’ end-of-life decision making to assess surrogates’ perceptions of benefits and limitations of the SPIRIT while facing end-of-life decisions. We found that SPIRIT promoted communication between patients and their surrogates and was effective and well received by the participants. PMID:19205027

  12. Successfully Educating Our African-American Students

    ERIC Educational Resources Information Center

    Moncree-Moffett, Kareem

    2013-01-01

    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…

  13. The Relationship between Pain, Disability, and Sex in African Americans.

    PubMed

    Walker, Janiece L; Thorpe, Roland J; Harrison, Tracie C; Baker, Tamara A; Cary, Michael; Szanton, Sarah L; Allaire, Jason C; Whitfield, Keith E

    2016-10-01

    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.

  14. African Americans and HIV/AIDS: cultural concerns.

    PubMed

    Jordan, Wilbert C; Vaughn, Anita C; Hood, Rodney G

    2004-10-01

    AIDS is a disease that has had a disproportionate effect on African Americans. While there has been significant progress in the treatment of people with HIV infection, there are obstacles to the optimal treatment of African Americans, such as distrust of the medical system, cultural differences between patients and providers, and institutional racism. To optimize treatment of African Americans with HIV/AIDS, health care providers must learn more about cultural issues that impact treatment. The goals of treatment for African Americans with HIV infection are the same as those for all patients: maintain durable suppression of HIV replication, prevent resistance, support optimal immune system function, extend AIDS-free survival time, maximize adherence to antiretroviral regimens, and improve quality of life.

  15. Provider perceptions of key barriers to providing state-of-the-art clinical care for HIV-infected African-American patients.

    PubMed Central

    Lee-Ougo, Wilhelmena; Boekeloo, Bradley O.; Thompson, Estina E.; Funnyé, Alen S.; Jackson, Rudolph E.; ShuTangyie, Gerard; McNeil, J. I.

    2003-01-01

    U.S. AIDS rates have declined among same population groups; however, African-Americans and other ethnic minorities have experienced the least amount of decline. As a result medical and public health authorities are tasked with developing strategies to help eliminate the disparity in HIV/AIDS incidence rate and clinical outcomes. Thus, in 1999, the National Minority AIDS Education and Training Center (NMAETC) was developed to facilitate training, clinical consultation and technical assistance to clinicians that provide care to HIV-infected minority patients. Its initial activities were designed solely to increase providers' clinical capacity to use state-of-art anti-retroviral therapies to treat and manage the disease. However, through focused discussions with target providers and a survey of medical care service sites, the NMAETC confirms that provider' training and assistance needs extend into non-medical domains. PMID:12656428

  16. Contribution of substance abuse and HIV infection to psychiatric distress in an inner-city African-American population.

    PubMed Central

    Nnadi, C. U.; Better, W.; Tate, K.; Herning, R. I.; Cadet, Jean Lud

    2002-01-01

    We used Symptom Checklist 90-Revised (SCL90-R) to investigate psychiatric symptom severity in African-American drug-abusing individuals. Three hundred and seventeen African-American volunteers (52 control subjects; 265 drug users) were recruited, 19.2% of whom were HIV-positive. The impact of drug of choice or HIV status on mental distress was assessed. Symptomatic HIV-positive participants were excluded. The intake SCL90-R, Addiction Severity Index, and demographic data were subjected to regression analyses. Drug-abusing African Americans reported increased global distress, a finding that remained robust after we adjusted for HIV status, gender, age, and education. Drug of choice had no influence on the severity of global mental distress in our sample. Asymptomatic HIV-positive African Americans who abused drugs reported more distress than the HIV-negative drug users. Levels of global distress were similar in the HIV-negative and the HIV-positive controls. Subscales of the SCL90-R showed more symptom severity among drug-using, compared with nonusing, African Americans. Except for paranoia, anxiety, and obsessive-compulsive subscales, other symptom dimensions were significantly elevated in HIV-positive, compared with HIV-negative, drug abusers. When taken together, these findings suggest that drug abuse can exacerbate the severity of mental distress in HIV-positive patients. Treatment of these patients may be more successful if both sets of needs are addressed with matched interventions. PMID:12069213

  17. A smaller magnitude of exercise-induced hypoalgesia in African Americans compared to non-Hispanic Whites: A potential influence of physical activity.

    PubMed

    Umeda, Masataka; Kempka, Laura E; Greenlee, Brennan T; Weatherby, Amy C

    2016-01-01

    This study compared exercise-induced hypoalgesia (EIH) between African Americans (AAs, n=16) and non-Hispanic Whites (NHWs, n=16), and examined the potential influence of physical activity (PA) on the racial/ethnic difference in EIH. The PA levels were quantified using a questionnaire, and intensity of electrical stimulus to produce moderate pain was individually determined. Participants squeezed a hand dynamometer at 25% of their maximal strength for three minutes, followed by a three-minute post-exercise rest. Numeric ratings to electrical stimulus at the pre-determined intensity were recorded every one minute during and after exercise. Compared to NHWs, AAs reported less lifestyle PA. Both AAs and NHWs showed EIH, but AAs exhibited a smaller magnitude of EIH than NHWs. However, this difference in EIH disappeared after controlling for the lifestyle PA levels. The results suggest that AAs exhibit less efficient pain modulation than NHWs, and AAs' reduced PA could potentially explain the observed difference in EIH. PMID:26607443

  18. Barriers to using palliative care: insight into African American culture.

    PubMed

    Drisdom, Sheronda

    2013-08-01

    As the hospice care setting becomes more racially and ethnically diverse, attending to the different conditions and needs of various groups is essential to providing optimal care. African Americans make up only a small percentage of hospice users in the United States. This article highlights barriers associated with the underenrollment of African Americans into hospice and palliative care programs. A thorough analysis of the literature was conducted to define hospice and palliative care and assess circumstances that impact the use of hospice services by African Americans. Many African Americans are not choosing hospice care because of cultural issues or knowledge deficits, whether through lack of communication or low literacy. Healthcare providers can begin by familiarizing themselves with hospice organizations and developing and putting into practice strategies to communicate with and educate patients and families about hospice care in a culturally sensitive manner. PMID:23899976

  19. Mental health, family function and obesity in African-American women.

    PubMed Central

    Davis, Esa M.; Rovi, Sue; Johnson, Mark S.

    2005-01-01

    CONTEXT: African-American women are disproportionately affected by obesity and its related diseases. How psychological and psychosocial factors that affect this population differ across weight categories remains poorly understood. PURPOSE: To determine whether poor mental health and family functioning are associated with obesity in African-American women. METHODS: African-American women patients aged 21-65 years were interviewed at three primary care centers. Four well-established assessment tools were used to measure general mental and physical health status, family functioning, depressive symptoms and anxiety levels. Demographics, health behaviors and family and personal histories of overweight were assessed. RESULTS: Among 113 patients, after controlling for age and parity, obese women had significantly higher anxiety levels, poorer perception of their physical health, more often were overweight as a child, had overweight parents or siblings and experienced more psychosocial problems in their family growing up, compared to overweight and normal weight women. CONCLUSIONS: The observed findings of poor mental health, perception of physical health and family function in obese African-American women support a need for clinical attention and further study. PMID:15868768

  20. Outcomes in African Americans and Hispanics with lupus nephritis.

    PubMed

    Contreras, G; Lenz, O; Pardo, V; Borja, E; Cely, C; Iqbal, K; Nahar, N; de La Cuesta, C; Hurtado, A; Fornoni, A; Beltran-Garcia, L; Asif, A; Young, L; Diego, J; Zachariah, M; Smith-Norwood, B

    2006-05-01

    Poor outcomes have been reported in African Americans and Hispanics compared to Caucasians with lupus nephritis. The purpose of this retrospective analysis was to identify independent predictors of outcomes in African Americans and Hispanics with lupus nephritis. In total, 93 African Americans, 100 Hispanics, and 20 Caucasians with a mean age of 28 +/- 13 years and an annual household income of 32.9 +/- 17.3 (in 1000 US dollars) were studied. World Health Organization (WHO) lupus nephritis classes II, III, IV, and V were seen in 9, 13, 52, and 26%, respectively. Important baseline differences were higher mean arterial pressure (MAP) in African Americans compared to Hispanics and Caucasians (107 +/- 19, 102 +/- 15, and 99 +/- 13 mmHg, P < 0.05), and higher serum creatinine (1.66 +/- 1.3, 1.25 +/- 1.0, and 1.31 +/- 1.0 mg/dl, P < 0.025). African Americans had lower hematocrit compared to Hispanics and Caucasians (29 +/- 5, and 31 +/- 6, and 32 +/- 7%, P < 0.05), and lower annual household income (30.8 +/- 14.9, 33.1 +/- 15.9, and 42.2 +/- 29.3 in 1000 US dollars; P < 0.05). Lower prevalence of WHO class IV was seen in Caucasians (30%) compared to Hispanics (57%, P = 0.03) and African Americans (51%, P = 0.09). Development of doubling creatinine or end-stage renal disease was higher in African Americans and Hispanics than in Caucasians (31, 18, and 10%; P < 0.05), as was the development of renal events or death (34, 20, and 10%; P < 0.025). Our results suggest that both biological factors indicating an aggressive disease and low household income are common in African Americans and Hispanics with lupus nephritis, and outcomes in these groups are worse than in Caucasians.

  1. Risk of injury in African American hospital workers.

    PubMed

    Simpson, C L; Severson, R K

    2000-10-01

    Very few data exist that describe the risk of injury in African American health care workers, who are highly represented in health care occupations. The present study examined the risk for work-related injury in African American hospital workers. Hospital Occupational Health Service medical records and a hospital human resource database were used to compare risk of injury between African American and white workers after adjusting for gender, age, physical demand of the job, and total hours worked. Risk of work-related injury was 2.3 times higher in African Americans. This difference was not explained by the other independent variables. Differences in injury reporting, intra-job workload, psychosocial factors, and organizational factors are all potential explanations for racial disparity in occupational injury. More research is needed to clarify these findings. PMID:11039167

  2. Telephone Surveys Underestimate Cigarette Smoking among African-Americans

    PubMed Central

    Landrine, Hope; Corral, Irma; Simms, Denise Adams; Roesch, Scott C.; Pichon, Latrice C.; Ake, Diane; Villodas, Feion

    2013-01-01

    Background: This study tested the hypothesis that data from random digit-dial telephone surveys underestimate the prevalence of cigarette smoking among African-American adults. Method: A novel, community-sampling method was used to obtain a statewide, random sample of N = 2118 California (CA) African-American/Black adults, surveyed door-to-door. This Black community sample was compared to the Blacks in the CA Health Interview Survey (N = 2315), a statewide, random digit-dial telephone survey conducted simultaneously. Results: Smoking prevalence was significantly higher among community (33%) than among telephone survey (19%) Blacks, even after controlling for sample differences in demographics. Conclusion: Telephone surveys underestimate smoking among African-Americans and probably underestimate other health risk behaviors as well. Alternative methods are needed to obtain accurate data on African-American health behaviors and on the magnitude of racial disparities in them. PMID:24350205

  3. ELDERLY MEXICANS HAVE LESS MUSCLE AND GREATER TOTAL AND TRUNCAL FAT COMPARED TO AFRICAN-AMERICANS AND CAUCASIANS WITH THE SAME BMI

    PubMed Central

    ALEMAN-MATEO, H.; LEE, S.Y.; JAVED, F.; THORNTON, J.; HEYMSFIELD, S.B.; PIERSON, R.N.; PI-SUNYER, F.X.; WANG, Z.M.; WANG, J.; GALLAGHER, D.

    2010-01-01

    Background How body composition, specifically skeletal muscle mass, compares in Mexican elderly to other ethnic groups has not previously been reported. We tested the hypothesis that older adults from Northwest Mexico (Mex) would have similar total appendicular skeletal muscle (TASM) compared with New York dwelling Caucasians (Cauc) and African-Americans (AA). Methods Two hundred and eighty nine Mex (135 males and 154 females), 166 AA (36 males and 130 females) and 229 Cauc (64 males and 165 females), aged 60–98 years were assessed. Total and regional fat and lean tissues were measured by whole-body dual energy X-ray absorptiometry where TASM is the sum of arm and leg bone-free and fat-free lean tissue. Differences in TASM were tested by ANCOVA, with age, height, and body mass index (BMI) as covariates. Results TASM adjusted for ethnicity, age, height and BMI, were 22.6 ± 0.2 kg and 17.8 ± 0.1 kg for males and females, respectively (p<0.001). Among males with similar age, height, and BMI, Mex had less TASM compared with AA and Cauc (p<0.001). Total body fat and truncal fat were higher (p< 0.001) and FFM lower (p<0.001) in Mex compared to both AA and Cauc males after adjusting for age and BMI. Among females, Mex had higher total and truncal fat (p<0.001) after adjusting for age and BMI, and significantly lower TASM (p<0.001) after adjusting for age, height, and BMI compared to AA and Cauc females. Conclusions Elderly Mex have a different body composition compared with AA and Cauc of a similar BMI and age. Mex have significantly less TASM with greater total and truncal fat. In the long-term, Mex elderly may be at greater risk for sarcopenic obesity compared to other ethnic groups. PMID:19924354

  4. Changing psychiatric perception of African-Americans with affective disorders.

    PubMed

    Jarvis, G Eric

    2012-12-01

    This article explored the origins and implications of the underdiagnosis of affective disorders in African-Americans. MEDLINE and old collections were searched using relevant key words. Reference lists from the articles that were gathered from this procedure were reviewed. The historical record indicated that the psychiatric perception of African-Americans with affective disorders changed significantly during the last 200 years. In the antebellum period, the mental disorders of slaves mostly went unnoticed. By the early 20th century, African-Americans were reported to have high rates of manic-depressive disorder compared with whites. By the mid-century, rates of manic-depressive disorder in African-Americans plummeted, whereas depression remained virtually nonexistent. In recent decades, diagnosed depression and bipolar disorder, whether in clinical or research settings, were inexplicably low in African-Americans compared with whites. Given these findings, American psychiatry needs to appraise the deep-seated effects of historical stereotypes on the diagnosis and treatment of African-Americans.

  5. A Comparative Analysis Regarding Factors Related to 13- to 18-Year-Old African American Male Adolescents in Special Education and the Justice System

    ERIC Educational Resources Information Center

    Phipps, Jonathan Lanier

    2013-01-01

    This study was focused on the identification of selected risk factors seemingly present among African American male adolescents 13 to 18 years old who were participants in special education programs at their schools. Many of these male adolescents were also found to participate in the juvenile justice system under what was characterized as…

  6. Factors Predictive of the Range of Occupations Considered by African American Juniors and Seniors in High School

    ERIC Educational Resources Information Center

    Lease, Suzanne H.

    2006-01-01

    This study assesses factors predictive of the range of possible occupations considered by 166 African American high school students. There are no differences in the number of African American representative occupations (those in which 13.5% or more employees were African American) considered compared to nonrepresentative occupations (those with…

  7. A community-based collaborative approach to improve breast cancer screening in underserved African American women.

    PubMed

    Karcher, Rachel; Fitzpatrick, Dawn C; Leonard, Dawn J; Weber, Scott

    2014-09-01

    Although African American women in the United States have a lower incidence of breast cancer compared with white women, those younger than 40 years actually have a higher incidence rate; additionally, African American women are more likely to die from breast cancer at every age compared with white women. Racial disparities in breast cancer mortality rates are especially significant in Maryland, which ranks fifth in the nation for breast cancer mortality, and in Baltimore City, which has the second highest annual death rate for African American women in Maryland. To address this disparity in care, Med-IQ, an accredited provider of CME, collaborated with Sisters Network Baltimore Metropolitan, Affiliate Chapter of Sisters Network® Inc., the only national African American breast cancer survivorship organization, to sponsor their community-based educational outreach initiative. The collaborative mission was to engage at-risk African American women, their families, local organizations, healthcare professionals, and clinics, with the goals of increasing awareness, addressing fears that affect timely care and diagnosis, and encouraging women to obtain regular mammograms. Intervention strategies included (1) a "Survivor Stories" video, (2) patient outreach consisting of neighborhood walks and an educational luncheon, and (3) a community outreach utilizing direct mailings to local businesses, community groups, and healthcare professionals. Trusted and well-known community resources were presented as mediums to promote the initiative, yielding achievement of broader and more effective outcomes. As a result of this patient-friendly initiative, two (2) of the women who sought screening were diagnosed with breast cancer and underwent treatment.

  8. Neuropsychological screening tests in African Americans.

    PubMed Central

    Lampley-Dallas, V. T.

    2001-01-01

    Neuropsychological tests are instruments used to diagnose a variety of cognitive conditions. This article will review a few of the brief scales commonly used in screening for dementia. It will also discuss the properties of and problems with some of the brief scales that are commonly used to screen African Americans for dementia, highlighting the various biases. The Mini-Mental State Examination (MMSE) is the most widely known and utilized cognitive impairment instrument in the United States. Whether or not it is biased to race after adjusting the scores for educational attainment remains controversial. The Blessed Information-Memory-Concentration Test (BIMC), Blessed Orientation-Memory-Concentration Test (BOMC), Short Portable Mental Status Questionnaire (SPMSQ), and Neurobehavioral Cognitive Status Examination (NCSE) are other screening tests used to diagnose dementia. Some of these tests have been found to misclassify many more African Americans as demented compared to the proportion of whites that are misclassified. The Cambridge Cognitive Examination (CAMCOG) is the only brief neuropsychological scale designed to actually diagnose early dementia, but it is not known if it is biased for African Americans. PMID:11560287

  9. Assessment of antioxidant nutrient intake of a population of southern US African-American and Caucasian women of various ages when compared to dietary reference intakes.

    PubMed

    Lewis, S M; Mayhugh, M A; Freni, S C; Thorn, B; Cardoso, S; Buffington, C; Jairaj, K; Feuers, R J

    2003-01-01

    Antioxidant nutrient intervention strategies to ameliorate negative health factors are of notable research interest. Central to the thesis that antioxidant nutrients improve biological defense systems and provide health benefits is an accurate indication of daily antioxidant nutrient intake. Little information is available concerning these nutrient intakes among non-affluent women of the southern U.S. This study examines the 24-h intake of vitamins: A, E, C, -carotene, a-tocopherol, riboflavin, and minerals: zinc, selenium, copper, manganese, iron, and molybdenum among 259 Caucasian (CA) and African-American (AA) women from small urban communities. Women were non-pregnant females, 19-93 y of age. Statistical comparisons of nutrient intake were made by least squares means within age groups. Intakes were compared to various Dietary Reference Intakes including Recommended Daily Allowance (RDA) and Estimated Average Requirement (EAR) values as established by the U.S. National Research Council. Numerous dietary deficiencies in important antioxidant nutrients associated with metabolic antioxidant systems were identified. Few race-related differences were detected. Intake of vitamin A was generally within recommended levels while vitamin E intake was below the EAR. The vitamin precursors, -carotene and a-tocopherol, were significantly (P<0.05) below customary intakes at all ages. More than 60% of this population reported dietary copper, zinc, and selenium intakes below recommended levels. A lack of race differences for most nutrient intakes suggests similar socioeconomic or endogeneous regional factors. All women in this population reported dietary intakes of antioxidant vitamins and minerals below recommended values, conditions that could contribute to subsequent health risks unless nutrient-dense food choices and antioxidant supplementation are considered in their overall nutritional support. PMID:12679833

  10. Comparing Perceived and Test-Based Knowledge of Cancer Risk and Prevention among Hispanic and African Americans: An Example of Community Participatory Research

    PubMed Central

    Jones, Loretta; Bazargan, Mohsen; Lucas-Wright, Anna; Vadgama, Jaydutt V.; Vargas, Roberto; Smith, James; Otoukesh, Salman; Maxwell, Annette E.

    2013-01-01

    Background Most theoretical formulations acknowledge that knowledge and awareness of cancer screening and prevention recommendations significantly influence health behaviors. This study compares perceived knowledge of cancer prevention and screening with test-based knowledge in a community sample. We also examine demographic variables and self-reported cancer screening and prevention behaviors as correlates of both knowledge scores, and consider whether cancer related knowledge can be accurately assessed using just a few, simple questions in a short and easy-to-complete survey. Methods We used a community-partnered participatory research approach to develop our study aims and a survey. The study sample was composed of 180 predominantly African American and Hispanic community individuals who participated in a full-day cancer prevention and screening promotion conference in South Los Angeles, California, on July 2011. Participants completed a self-administered survey in English or Spanish at the beginning of the conference. Results Our data indicate that perceived and test-based knowledge scores are only moderately correlated. Perceived knowledge score shows a stronger association with demographic characteristics and other cancer related variables than the test-based score. Thirteen out of twenty variables that are examined in our study showed a statistically significant correlation with the perceived knowledge score, however, only four variables demonstrated a statistically significant correlation with the test-based knowledge score. Conclusion Perceived knowledge of cancer prevention and screening was assessed with fewer items than test-based knowledge. Thus, using this assessment could potentially reduce respondent burden. However, our data demonstrate that perceived and test-based knowledge are separate constructs. PMID:23530303

  11. Heart failure in African Americans.

    PubMed

    Yancy, Clyde W

    2005-10-10

    The demographics of the United States are changing, and in the next few decades there will no longer be a racial/ethnic majority population. Increased awareness of cardiovascular disease (CVD) in special populations is warranted as these populations increase. Heart failure carries a substantial burden on those affected, particularly African Americans, who have a disproportionate burden of heart disease. Current treatments for heart failure include angiotensin-converting enzyme inhibitors, beta-blockers, angiotensin II-receptor antagonists, and vasodilating agents. This review discusses the unique characteristics of CVD in African Americans and addresses the need for targeted treatments to reduce the excess burden found in this population.

  12. An Examination of Cross-Racial Comparability of Mother-Child Interaction among African American and Anglo American Families.

    ERIC Educational Resources Information Center

    Whiteside-Mansell, Leanne; Bradley, Robert H.; Little, Todd D.; Corwyn, Robert Flynn; Spiker, Donna

    2001-01-01

    Study examined the cross-racial comparability of maternal quality of assistance and supportive presence coded from a video protocol using data from the Infant Health and Development Program for low birth weight, premature 30-month-olds and their mothers. Comparisons across groups indicated similar variances and correlation between child and…

  13. African American Males. A Critical Link in the African American Family.

    ERIC Educational Resources Information Center

    Jones, Dionne J., Ed.

    African Americans are experiencing extreme stress in the United States, and African-American males appear to suffer the most. The chapters in this volume examine some of the issues confronting African-American men today. They include: (1) "Introduction" (Dionne J. Jones); (2) "Reaffirming Young African American Males: Mentoring and Community…

  14. Transthyretin Ile 122: Gene frequency and risk of cardiac amyloidosis in African Americans

    SciTech Connect

    Buxbaum, J. |; Pastore, R.; Yaghoubian, R.

    1994-09-01

    Point mutations in the protein transthyretin (TTR) cause familial amyloidosis involving mainly the heart and peripheral nerves. To determine the TTR Ile 122 gene frequency in African Americans, the allele encoding TTR Ile 122 was identified by PCR-Primer Introduced Restriction Analysis of TTR exon 4 and FokI digestion on 1659 control DNA samples from 1659 African Americans: 64 were heterozygous and one homozygous (allele frequency .02). To determine the risk to gene carriers of developing cardiac amyloidosis, immunohistochemical and genetic studies were performed on amyloid-containing samples identified among 52,370 autopsy samples examined over 32 years. In autopsy samples from patients over age 60, isolated cardiac amyloidosis was more common in African Americans (1.6%) than in White Americans (.40%), suggesting a genetic risk factor. All 29 samples from African Americans were immunohistochemically TTR-positive, and 5 were heterozygous for the TTR Ile 122 allele (17%), as compared with 5/108 heterozygotes (4.6%) among age-matched (over age 60) African American controls without amyloidosis from the same autopsy study (one-tailed P value < .03). Among the 29 amyloid-positive samples were 16 with 1+ or 2+ deposition and 13 with 3+ or 4+ deposition. All 5 TTR Ile 122 heterozygotes had 3+ or 4+ deposition. None of 15 samples from White Americans with cardiac amyloidosis was TTR Ile 122-positive. Extrapolating from the 5/29 samples from which we were able to obtain genetic data, we estimate that 9/54 samples containing cardiac amyloid were TTR Ile 122 heterozygotes. We conclude that heterozygosity for TTR Ile 122 is associated with a greater frequency (relative risk 5.8) and greater severity of cardiac amyloid deposition than in non-carriers of the TTR Ile 122 gene. Of over 40 TTR point mutations associated with amyloidosis described to date, TTR Ile 122 appears to be the most common worldwide and to have the lowest penetrance in causing disease.

  15. The African American Image in American Cinema.

    ERIC Educational Resources Information Center

    Bourne, St. Clair

    1990-01-01

    Political conditions have influenced the screen images of U.S. cinema, and the images of African Americans have reflected prevailing social stereotypes. The history of African-American representation in films is traced, and it is noted that the tendency to portray African Americans stereotypically has not changed. (SLD)

  16. Freedom Road: Adult Education of African Americans.

    ERIC Educational Resources Information Center

    Peterson, Elizabeth A., Ed.

    This book contains six chapters by various authors about the history of African Americans' contributions and participation in adult education. The book reports on how some African American leaders saw the connection between education and the eventual freedom or uplift of the African American people. Following a foreword (Phyllis M. Cunningham) and…

  17. Engaging African Americans in Smoking Cessation Programs

    ERIC Educational Resources Information Center

    Wallen, Jacqueline; Randolph, Suzanne; Carter-Pokras, Olivia; Feldman, Robert; Kanamori-Nishimura, Mariano

    2014-01-01

    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,…

  18. Complex Syntax Production of African American Preschoolers.

    ERIC Educational Resources Information Center

    Jackson, Sandra C.; Roberts, Joanne E.

    2001-01-01

    This study examined changes in the complex syntax production of 85 African American preschoolers and the role of child (gender, age, African American English) and family (home environment) factors. Age, gender, and home environment effects were found for the amount of complex language used. African American English was not related to amount of…

  19. African-American youth: essential prevention strategies for every pediatrician.

    PubMed

    Murray-Garcia, J

    1995-07-01

    National statistics of morbidity and mortality warrant our urgent attention to the issue of effective prevention strategies among African-Americans. Implicit, explicit, and often internalized messages of inferior value, negative expectations, and expendability remain a part of everyday life for African-American youth. This sociopolitical disenfranchisement has a direct impact on their health and development and on our ability to provide effective preventive and therapeutic intervention. Pediatricians enjoy a deserved perception of expertise in those areas that bear directly on the healthy physical and psychosocial development of all children. We have not heretofore optimally exploited this perceived and real expertise in prevention efforts among African-American children. We ourselves are in need of reeducation. We need to first shatter the insidious conceptual barriers of our own impotence as well as the perceived impotence of African-American patients in our collective abilities to inspire and affect change. On a patient-by-patient basis, among our regional pediatric communities and in the public policy arena, we can be involved in the process that restores to our African-American patients a sense of full citizenship and potential within our society. Without adoption of this process of sociopolitical reenfranchisement, our best-intended efforts at prevention in this community will always tragically fall short of their full and critically needed potential.

  20. Classic African American Children's Literature

    ERIC Educational Resources Information Center

    McNair, Jonda C.

    2010-01-01

    The purpose of this article is to assert that there are classic African American children's books and to identify a sampling of them. The author presents multiple definitions of the term classic based on the responses of children's literature experts and relevant scholarship. Next, the manner in which data were collected and analyzed in regard to…

  1. Wellness among African American Counselors

    ERIC Educational Resources Information Center

    Day-Vines, Norma L.; Holcomb-McCoy, Cheryl

    2007-01-01

    Although there are various definitions of wellness, few conceptual definitions have addressed the contextual dimensions of wellness relative to African American counselors. The authors present an overview of generic models of wellness, discuss factors that both inhibit and promote wellness, offer some culture-specific models of wellness, and…

  2. African American Men in College

    ERIC Educational Resources Information Center

    Cuyjet, Michael J., Ed.

    2006-01-01

    This book is a much-needed resource that includes examples of real-world programs and activities to enhance academic success in the college environment for African American men. The examples are collected from a variety of institutions across the country. With contributions from leading practitioners and scholars in the field, this book explores…

  3. The Diabetic Health of African American Grandmothers Raising their Grandchildren

    PubMed Central

    Carthron, Dana L.; Busam, Maria Rivera

    2016-01-01

    PURPOSE The purpose of this study is to compare the health of primary caregiving African American grandmothers with diabetes with African American women with diabetes who were not primary caregivers. DESIGN Using a comparative, descriptive, cross-sectional design, 34 African American primary caregiving grandmothers were compared with 34 non-caregiving women with diabetes mellitus; women aged 55–75 years were recruited for this study throughout the central Arkansas. METHODS To measure the overall health, data on blood pressure, body mass index measurements, HbA1c levels, total cholesterol, and urine protein and creatinine levels were collected from all the participants. RESULTS Statistically significant differences between the caregivers and non-caregivers groups in systolic pressure (t = −3.42, P = 0.001) and diastolic pressure (t = −3.790, P = 0.000) and urine protein (W = 294.00, P = 0.000) were noted. Additionally, a clinically significant difference in HbA1c was noted between groups. CONCLUSION Differences in systolic and diastolic pressures, urine protein, and clinically significant differences in HbA1c suggest that African American primary caregiving grandmothers with diabetes mellitus may have more difficulty in maintaining their diabetic health than non-caregiving African American women. PMID:27398044

  4. Major depressive disorder in the African American population.

    PubMed

    Bailey, Rahn K; Patel, Milapkumar; Barker, Narviar C; Ali, Shahid; Jabeen, Shagufta

    2011-07-01

    Depression is a common mental disorder that presents with depressed mood. It can become chronic or recurrent and lead to substantial impairment in an individual's ability to function. At this level, it is identified as major depressive disorder (MDD). Depression and MDD occur across all racial and ethnic groups. Although many depressed patients are treated in primary care, depression in these settings has been underdetected and undertreated. African Americans, especially, who suffer from depression are frequently underdiagnosed and inadequately managed in primary care due to patient, physician, and treatment setting factors. Patient factors include being poor, uninsured, restrictive insurance policies, biological-genetic vulnerability, nonresponsiveness to traditional pharmacological interventions, and stigma (i.e., attitudes and perceptions of mental illness). Physician factors include diagnosis and assessment, physician characteristics, physician bias, and culture; and treatment setting factors include systemic variables such as lack of or poor access to health care, racism, environment, and patient management. African Americans are less likely to receive proper diagnosis and treatment, more likely to have depression for long periods of time, and more likely to suffer greater disability from depression. Understanding patient, physician, and treatment setting factors as contributing barriers that impede effective diagnosis and treatment of depression and MDD in African Americans is critical to effective patient management and discovery. Greater African American participation in clinical research trials also is needed to effectively improve, diagnose, and treat depression in African Americans. This article examines depression among African Americans in the context of gender, culture, and psychosocial determinants, and their engagement in clinical trials.

  5. Perceptions of Support Among Older African American Cancer Survivors

    PubMed Central

    Hamilton, Jill B.; Moore, Charles E.; Powe, Barbara D.; Agarwal, Mansi; Martin, Pamela

    2010-01-01

    Purpose/Objectives To explore the perceived social support needs among older adult African American cancer survivors. Research Approach Qualitative design using grounded theory techniques. Setting Outpatient oncology clinics in the southeastern United States. Participants Focus groups with 22 older adult African American cancer survivors. Methodologic Approach Purposeful sampling technique was used to identify focus group participants. In-depth interviews were conducted and participants were interviewed until informational redundancy was achieved. Main Research Variables Social support needs of older adult African American patients with cancer. Findings Social support was influenced by (a) symptoms and treatment side effects, (b) perceptions of stigma and fears expressed by family and friends, (c) cultural beliefs about cancer, and (d) desires to lessen any burden or disruption to the lives of family and friends. Survivors navigated within and outside of their networks to get their social support needs met. In some instances, survivors socially withdrew from traditional sources of support for fear of being ostracized. Survivors also described feeling hurt, alone, and socially isolated when completely abandoned by friends. Conclusions The support from family, friends, and fellow church members is important to positive outcomes among older African American cancer survivors. However, misconceptions, fears, and negative cultural beliefs persist within the African American community and negatively influence the social support available to this population. Interpretations Early identification of the factors that influence social support can facilitate strategies to improve outcomes and decrease health disparities among this population. PMID:20591808

  6. Screening for Depression in African American Churches

    PubMed Central

    Hankerson, Sidney H.; Lee, Young A; Brawley, David K.; Braswell, Kenneth; Wickramaratne, Priya J.; Weissman, Myrna M.

    2015-01-01

    Introduction Substantial racial/ethnic disparities exist in the identification and management of major depression.1 Faith-Based Health Promotion interventions reduce disparities in health screenings for numerous medical conditions.2 However, the feasibility of systematically screening for depression in faith-based settings has not been investigated. The purpose of this study was to assess the feasibility of using a validated instrument to screen for depression in African American churches. Methods Participants were recruited between October and November 2012 at three predominantly African American churches in New York City. A participatory research approach was used to determine screening days. The Patient Health Questionnaire-9 (PHQ-9) was administered to 122 participants. Positive depression screen was defined as a PHQ-9 score ≥10. Descriptive statistics were used to report sample characteristics, prevalence of participants who screened positive, and history of help seeking. Logistic regression analyses were conducted to determine the association of positive depression screen and sociodemographic characteristics. Initial analyses were conducted in 2013, with additional analyses in 2014. Results The prevalence estimate for positive depression screen was 19.7%. More men (22.5%) screened positive than women (17.7%). Total household income was inversely related to positive depression screen. A similar percentage of respondents had previously sought help from primary care providers as from clergy. Conclusions It was feasible to screen for depression with the PHQ-9 in African American churches. The prevalence of positive depression screen was high, especially among black men. Churches may be an important setting in which to identify depressive symptoms in this underserved population. PMID:26232907

  7. Improving prediction of outcomes in African Americans with normal stress echocardiograms using a risk scoring system.

    PubMed

    Sutter, David A; Thomaides, Athanasios; Hornsby, Kyle; Mahenthiran, Jothiharan; Feigenbaum, Harvey; Sawada, Stephen G

    2013-06-01

    Cardiovascular mortality is high in African Americans, and those with normal results on stress echocardiography remain at increased risk. The aim of this study was to develop a risk scoring system to improve the prediction of cardiovascular events in African Americans with normal results on stress echocardiography. Clinical data and rest echocardiographic measurements were obtained in 548 consecutive African Americans with normal results on rest and stress echocardiography and ejection fractions ≥50%. Patients were followed for myocardial infarction and death for 3 years. Predictors of cardiovascular events were determined with Cox regression, and hazard ratios were used to determine the number of points in the risk score attributed to each independent predictor. During follow-up of 3 years, 47 patients (8.6%) had events. Five variables-age (≥45 years in men, ≥55 years in women), history of coronary disease, history of smoking, left ventricular hypertrophy, and exercise intolerance (<7 METs in men, <5 METs in women, or need for dobutamine stress)-were independent predictors of events. A risk score was derived for each patient (ranging from 0 to 8 risk points). The area under the curve for the risk score was 0.82 with the optimum cut-off risk score of 6. Among patients with risk scores ≥6, 30% had events, compared with 3% with risk score <6 (p <0.001). In conclusion, African Americans with normal results on stress echocardiography remain at significant risk for cardiovascular events. A risk score can be derived from clinical and echocardiographic variables, which can accurately distinguish high- and low-risk patients.

  8. African American women's breast memories, cancer beliefs, and screening behaviors.

    PubMed

    Thomas, Eileen C

    2004-01-01

    African American women experience higher breast cancer mortality and lower survival rates compared with white women of comparable age and cancer stage. The literature is lacking in studies that address the influence of past events on current health behaviors among women of diverse cultural groups. This qualitative exploratory study used participant narratives to examine associations between women's memories and feelings concerning their breasts and current breast cancer screening behaviors. Twelve professional African American women, aged 42 to 64 years, shared stories about memories and feelings regarding their breasts. Codes grouped together with related patterns and recurrences revealed categories that encompassed the language and culture of the participants. The categories identified were Seasons of Breast Awareness, Womanhood, Self-Portraits, Breast Cancer and Cancer Beliefs, Breast Cancer Screening Experiences, and Participants' Advice for Change. These categories provide direction for further exploration of barriers to health promotion practices among African American women and women in general.

  9. Fatalistic Beliefs about Cancer Prevention among Older African American Men

    PubMed Central

    Manning, Mark; Shires, Deirdre; Chapman, Robert A.; Burnett, Janice

    2014-01-01

    Objectives Evidence suggests that minority groups are more likely to exhibit fatalistic beliefs about cancer prevention (FBCP); defined as confusion, pessimism, and helplessness about one’s ability to prevent cancer. This study examines socioeconomic and psychosocial predictors of FBCP among older African American men. Methods African American men (N=1,666) enrolled in Medicare and participating in a longitudinal study on patient navigation were surveyed. Measures included three FBCP constructs, demographic items, and physical and mental health variables. Binary logistic regression was performed. Results The average participant was 73.6 years old; 76.5% felt helpless, 44.2% were confused, and 40.7% were pessimistic about the ability to prevent cancer. As education increased, so did all three FBCP. Being downhearted was predictive of confused and helpless beliefs. Discussion It is critical for health practitioners to understand how psychosocial and economic challenges influence beliefs that may impede cancer prevention efforts for older African American men. PMID:25651585

  10. Knowledge and Attitudes about Colon Cancer Screening among African Americans

    ERIC Educational Resources Information Center

    James, Aimee S.; Daley, Christine M.; Greiner, K. Allen

    2011-01-01

    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…

  11. Connections: Examining African American Teachers' Religious Identities and Teacher Identities

    ERIC Educational Resources Information Center

    Whitfield, Victoria Michelle

    2013-01-01

    This study compares the pedagogical practices of African American Sunday school teachers and their secondary English/Language Arts pedagogical practices. The major purpose of this study is to determine if there is a connection between African American Sunday school teachers' pedagogical practices and their pedagogical practices within the…

  12. The Importance of Visibility: Students' and Teachers' Criteria for Selecting African American Literature

    ERIC Educational Resources Information Center

    Gray, Erika Swarts

    2009-01-01

    Previous research has demonstrated that African American children do not always relate to the literature available in their classrooms. The study examined fifth-grade students' responses to African American literature to determine the criteria students use to select books. Students' selection criteria were then compared with teachers' selection…

  13. Effects of Schools Attuned on Special Education Referrals for African American Boys

    ERIC Educational Resources Information Center

    Rodriguez, Andrea B.

    2010-01-01

    This study compared the number of special education referrals for African American boys before and after the implementation of the training program, "Schools Attuned". The purpose of the research was to ascertain if the number of special education referrals for African American boys generated in schools with teachers trained in "Schools Attuned"…

  14. Motivations for Sex among Low-Income African American Young Women

    ERIC Educational Resources Information Center

    Deardorff, Julianna; Suleiman, Ahna Ballonoff; Dal Santo, Teresa S.; Flythe, Michelle; Gurdin, J. Barry; Eyre, Stephen L.

    2013-01-01

    African American young women exhibit higher risk for sexually transmitted infections, including HIV/AIDS, compared with European American women, and this is particularly true for African American women living in low-income contexts. We used rigorous qualitative methods, that is, domain analysis, including free listing ("n" = 20),…

  15. Moving beyond the Margins: An Exploration of Low Performing African American Male College Students

    ERIC Educational Resources Information Center

    Jackson, Ronald C.

    2011-01-01

    Data have shown that African American male college students are being outperformed. Compared to all other populations by ethnicity and gender, African American males most often fare the worst in terms of persistence, performance, and completion. The impetus of this study was to explore the motivation of those that have low academic performance and…

  16. Recruiting Secondary Mathematics Teachers: Characteristics That Add Up for African American Students

    ERIC Educational Resources Information Center

    Ragland, Tamra C.; Harkness, Shelly Sheats

    2014-01-01

    In this article, the authors provide portraits of three mathematics teachers: one European American man, one African American man, and one Middle Eastern woman. All three taught in secondary schools with predominantly African American student populations. Semi-structured interviews and observations were conducted to create a comparative case study…

  17. Reexaming the Development of African American English: Evidence from Isolated Communities.

    ERIC Educational Resources Information Center

    Wolfram, Walt

    2003-01-01

    Examines several longstanding, isolated biracial sociolinguistic situations in the coastal and Appalachian regions of North Carolina: a core community of African Americans and two case studies of isolated speakers. Compares diagnostic phonological and morphosyntactic variables for speakers representing different generations of African American and…

  18. African Americans and Mathematics Outcomes on National Assessment of Educational Progress: Parental and Individual Influences

    ERIC Educational Resources Information Center

    Noble, Richard, III; Morton, Crystal Hill

    2013-01-01

    This study investigated within group differences between African American female and male students who participated in the 2009 National Assessment of Educational Progress mathematics assessment. Using results from participating states, we compare average scale scores of African American students based on home regulatory environment and interest…

  19. Increasing Prosocial Behavior and Academic Achievement among Adolescent African American Males

    ERIC Educational Resources Information Center

    Martin, Don; Martin, Magy; Gibson, Suzanne Semivan; Wilkins, Jonathan

    2007-01-01

    African American adolescents disproportionately perform poorly compared to peers in both behavioral and academic aspects of their educational experience. In this study, African American male students participated in an after-school program involving tutoring, group counseling, and various enrichment activities. All students were assessed regarding…

  20. Physical Activities and Sedentary Pursuits in African American and Caucasian Girls

    ERIC Educational Resources Information Center

    Dowda, Marsha; Pate, Russell R.; Felton, Gwen M.; Saunders, Ruth; Ward, Dianne S.; Dishman, Rod K.; Trost, Stewart G.

    2004-01-01

    The purposes of this study were to describe and compare the specific physical activity choices and sedentary pursuits of African American and Caucasian American girls. Participants were 1,124 African American and 1,068 Caucasian American eighth-grade students from 31 middle schools. The 3-Day Physical Activity Recall (3DPAR) was used to measure…

  1. A Village without Borders: Umoja Programs Level the Playing Field for African-American Students

    ERIC Educational Resources Information Center

    Beebe, Anthony; Burgess, Terrence; Carroll, Constance; Charlens, Erin

    2009-01-01

    The San Diego Community College District (SDCCD) has implemented programs designed to help African-American students overcome the psychological and cultural obstacles to successful participation in formal learning environments. African-American students suffer low achievement rates in higher education compared with all racial or ethnic groups.…

  2. Health Behaviors and Breast Cancer: Experiences of Urban African American Women

    ERIC Educational Resources Information Center

    Stolley, Melinda R.; Sharp, Lisa K.; Wells, Anita M.; Simon, Nolanna; Schiffer, Linda

    2006-01-01

    Breast-cancer survival rates are lower among African American women compared to White women. Obesity may contribute to this disparity. More than 77% of African American women are overweight or obese. Adopting health behaviors that promote a healthy weight status may be beneficial because obesity increases risk for recurrence. Studies among White…

  3. Anxiety Psychopathology in African American Adults: Literature Review and Development of an Empirically Informed Sociocultural Model

    ERIC Educational Resources Information Center

    Hunter, Lora Rose; Schmidt, Norman B.

    2010-01-01

    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…

  4. HIV/AIDS stigma and religiosity among African American women.

    PubMed

    Muturi, Nancy; An, Soontae

    2010-06-01

    African American women are disproportionately affected by HIV/AIDS compared with other ethnicities, accounting for two-thirds (67%) of all women diagnosed with HIV. Despite their increased risk of HIV infection, few studies have been conducted to understand culture-specific factors leading to their vulnerability. Given the central role of religious organizations in African American communities, this study explored whether and to what extent religiosity plays a role in stigma toward HIV/AIDS. Results of hierarchical regression showed that after controlling for key factors, religiosity was a significant factor predicting the level of religious stigma. Those with high religiosity displayed significantly higher stigma, associating HIV/AIDS with a curse or punishment from God. Verbatim responses to an open-ended question also revealed seemingly ingrained prejudice against HIV/AIDS from a religious perspective. The findings point to the important role of faith-based organizations (FBOs) in addressing HIV/AIDS issues within African American communities.

  5. How Do Low-Income Urban African Americans and Latinos Feel about Telemedicine? A Diffusion of Innovation Analysis

    PubMed Central

    George, Sheba; Hamilton, Alison; Baker, Richard S.

    2012-01-01

    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 (n = 43) and Latino participants (n = 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. PMID:22997511

  6. How Do Low-Income Urban African Americans and Latinos Feel about Telemedicine? A Diffusion of Innovation Analysis.

    PubMed

    George, Sheba; Hamilton, Alison; Baker, Richard S

    2012-01-01

    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 (n = 43) and Latino participants (n = 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.

  7. Hot Spot Mutation in TP53 (R248Q) Causes Oncogenic Gain-of-Function Phenotypes in a Breast Cancer Cell Line Derived from an African American patient.

    PubMed

    Shtraizent, Nataly; Matsui, Hiroshi; Polotskaia, Alla; Bargonetti, Jill

    2016-01-01

    African American (AA) breast cancer patients often have triple negative breast cancer (TNBC) that contains mutations in the TP53 gene. The point mutations at amino acid residues R273 and R248 both result in oncogenic gain-of-function (GOF) phenotypes. Expression of mutant p53 (mtp53) R273H associates with increased cell elasticity, survival under serum deprivation conditions, and increased Poly (ADP ribose) polymerase 1 (PARP1) on the chromatin in the AA-derived TNBC breast cancer cell line MDA-MB-468. We hypothesized that GOF mtp53 R248Q expression could stimulate a similar phenotype in the AA-derived TNBC cell line HCC70. To test this hypothesis we depleted the R248Q protein in the HCC70 cell line using shRNA-mediated knockdown. Using impedance-based real-time analysis we correlated the expression of mtp53 R248Q with increased cell deformability. We also documented that depletion of mtp53 R248Q increased PARP1 in the cytoplasm and decreased PARP1 on the chromatin. We conclude that in the AA-derived TNBC HCC70 cells mtp53 R248Q expression results in a causative tumor associated phenotype. This study supports using the biological markers of high expression of mtp53 R273H or R248Q as additional diagnostics for TNBC resistant subtypes often found in the AA community. Each mtp53 protein must be considered separately and this work adds R248Q to the increasing list of p53 mutations that can be used for diagnostics and drug targeting. Here we report that when R248Q mtp53 proteins are expressed in TNBC, then targeting the gain-of-function pathways may improve treatment efficacy.

  8. Hot Spot Mutation in TP53 (R248Q) Causes Oncogenic Gain-of-Function Phenotypes in a Breast Cancer Cell Line Derived from an African American patient

    PubMed Central

    Shtraizent, Nataly; Matsui, Hiroshi; Polotskaia, Alla; Bargonetti, Jill

    2015-01-01

    African American (AA) breast cancer patients often have triple negative breast cancer (TNBC) that contains mutations in the TP53 gene. The point mutations at amino acid residues R273 and R248 both result in oncogenic gain-of-function (GOF) phenotypes. Expression of mutant p53 (mtp53) R273H associates with increased cell elasticity, survival under serum deprivation conditions, and increased Poly (ADP ribose) polymerase 1 (PARP1) on the chromatin in the AA-derived TNBC breast cancer cell line MDA-MB-468. We hypothesized that GOF mtp53 R248Q expression could stimulate a similar phenotype in the AA-derived TNBC cell line HCC70. To test this hypothesis we depleted the R248Q protein in the HCC70 cell line using shRNA-mediated knockdown. Using impedance-based real-time analysis we correlated the expression of mtp53 R248Q with increased cell deformability. We also documented that depletion of mtp53 R248Q increased PARP1 in the cytoplasm and decreased PARP1 on the chromatin. We conclude that in the AA-derived TNBC HCC70 cells mtp53 R248Q expression results in a causative tumor associated phenotype. This study supports using the biological markers of high expression of mtp53 R273H or R248Q as additional diagnostics for TNBC resistant subtypes often found in the AA community. Each mtp53 protein must be considered separately and this work adds R248Q to the increasing list of p53 mutations that can be used for diagnostics and drug targeting. Here we report that when R248Q mtp53 proteins are expressed in TNBC, then targeting the gain-of-function pathways may improve treatment efficacy. PMID:26703669

  9. Quality of care in African-American patients admitted for congestive heart failure at a university teaching hospital.

    PubMed

    Ilksoy, Nurcan; Moore, Renee H; Easley, Kirk; Jacobson, Terry A

    2006-03-01

    Previous studies have shown that the quality of congestive heart failure (CHF) treatment for hospitalized patients varies. The goal of this study was to evaluate the compliance of physicians at a large, inner-city teaching hospital with current evidence-based guidelines. A retrospective review of the medical records of 104 patients admitted with CHF was conducted. Quality-of-care indicators were assessed, including the use of echocardiograms, the administration of angiotensin-converting enzyme (ACE) inhibitors and beta blockers to appropriate patients, and lifestyle and medication counseling at discharge. The assessment of left ventricular (LV) function was documented in 96.1% of patients (n = 100). A total of 65 patients (92.8%) with systolic dysfunction were considered to be ideal candidates for ACE inhibitor therapy. Of these 65 patients, 58 (89.2%) were discharged on ACE inhibitors. Of 41 patients with LV systolic dysfunction who were considered to be ideal candidates for beta-blocker therapy, only 10 (24.4%) were discharged on beta-blocker therapy. Of all patients with CHF, 50% received discharge counseling on medication compliance, 48% received counseling on a low-salt diet, and only 9% were told to monitor daily weight. This study shows that in a major academic teaching hospital, there is a need for improvement in the use of beta-blocker therapy as well as greater emphasis on patient education strategies regarding diet, medication adherence, and monitoring daily weight. PMID:16490439

  10. Obesity, body fat distribution, and blood pressure in Nigerian and African-American men and women.

    PubMed Central

    Adams-Campbell, L. L.; Wing, R.; Ukoli, F. A.; Janney, C. A.; Nwankwo, M. U.

    1994-01-01

    This article describes a study that assesses body fat distribution patterns in Nigerian and African-American males and females and determines the association between body fat distribution patterns and blood pressure in young adults of differing geographical and ethnic backgrounds. The study population was comprised of 275 African Americans (92 males and 183 females) and 282 Nigerians (219 males and 63 females). The mean ages for the African-American males and females were 18.7 and 18.9 years, respectively, compared with 21 and 19.2 years for the Nigerian males and females. African Americans were more likely to be obese and overweight compared with their Nigerian counterparts. However, there were no significant differences between the two ethnic groups within gender for body fat distribution patterns based on waist-to-hip ratio. Despite being leaner, the Nigerians had higher diastolic blood pressures than the African Americans. There were no significant associations observed between blood pressure and waist-to-hip ratio for either the Nigerian or the African-American males or females, and body mass index was associated consistently with blood pressure only among the African Americans. These findings suggest that body mass index, a general indicator of obesity, is a better correlate of blood pressure than the waist-to-hip ratio among African Americans. PMID:8151724

  11. Treatment of heart failure in African Americans--a call to action.

    PubMed

    Mitchell, Judith E; Ferdinand, Keith C; Watson, Karol E; Wenger, Nanette K; Watkins, Laurence O; Flack, John M; Gavin, James R; Reed, James W; Saunders, Elijah; Wright, Jackson T

    2011-02-01

    Advances in heart failure treatment have not necessarily translated into equity in improved outcomes for African Americans. Heart failure in African Americans is characterized by a higher prevalence, especially at younger ages; more-adverse course with more frequent hospitalizations; and higher mortality rates compared to the general population. Despite this distinct disease profile, African Americans are remarkably underrepresented in large heart failure trials. This paper reviews the unique course of heart failure in African Americans and discusses treatment in the context of clinical trial evidence. African Americans with heart failure may respond differently to some standard therapies compared to whites, but low levels of enrollment of AAs in large clinical trials preclude valid conclusions in certain cases. An important exception is the African American Heart Failure Trial (AHeFT), a well-designed, prospective, randomized, placebo-controlled, double-blind study, that added a combination of fixed-dose isosorbide dinitrate/hydralazine (ISDN/ HYD) to standard therapy and showed a 43% improvement in survival and a 33% reduction in first hospitalizations. Despite compelling evidence from AHeFT, post hoc secondary analyses, and recommendations from current practice guidelines, ISDN/HYD remains underutilized in African Americans with heart failure. In this paper, we put forth a call to action for racial equity in clinical research and treatment in African Americans with heart failure.

  12. Suicidal Behaviors in the African American Community

    PubMed Central

    Crosby, Alex; Molock, Sherry Davis

    2006-01-01

    This article reviews the risk and protective factors associated with suicidal thoughts and behaviors in the African American community. The authors provide a brief review of the history of suicide research in African American communities and critique some of the paradigms and underlying assumptions that have made it difficult to address the problem of suicidal behaviors in the African American community. The article also summarizes the articles that are presented in this special edition of the Journal of Black Psychology on suicidality in the African American community. PMID:17047727

  13. Usability Testing the "Personal Patient Profile-Prostate" in a Sample of African American and Hispanic Men.

    PubMed

    Wolpin, Seth; Halpenny, Barbara; Sorrentino, Erica; Stewart, Mark; McReynolds, Justin; Cvitkovic, Ivan; Chang, Peter; Berry, Donna

    2016-07-01

    Shared treatment decision making in a cancer setting requires a patient's understanding of the potential benefits and risks of each treatment option. Graphical display of risk information is one approach to improving understanding. Little is known about how patients engage with infographics in the context of health education materials and whether interactions vary with health literacy levels. We conducted an observational study, using an eye tracker device, of how men with newly diagnosed localized prostate cancer visually engaged with an on-screen infographic depicting risk information in the Personal Patient Profile-Prostate. Health literacy was measured with the Short Assessment of Health Literacy-English. Gaze patterns on an exemplar screens containing infographics about survival were analyzed and explored with respect to sociodemographic and health literacy data. Acceptability of Personal Patient Profile-Prostate was measured with the Acceptability E-scale. Twenty-six English-speaking men participated, and eye tracking data were collected for 12 men on the exemplar page of risk information that we analyzed. We found preliminary evidence of visual scanning and of participants with lower literacy focusing sooner on infographics versus text. Acceptability for Personal Patient Profile-Prostate was high. These findings suggest that infographics may be of higher relative value to participants with low health literacy. Eye trackers may provide valuable information on how people visually engage with infographics and may inform development of health education materials, although care must be taken to minimize data loss.

  14. African American Preschoolers' Language, Emergent Literacy Skills, and Use of African American English: A Complex Relation

    ERIC Educational Resources Information Center

    Connor, Carol McDonald; Craig, Holly K.

    2006-01-01

    Purpose: This study examined the relation between African American preschoolers' use of African American English (AAE) and their language and emergent literacy skills in an effort to better understand the perplexing and persistent difficulties many African American children experience learning to read proficiently. Method: African American…

  15. African American Therapists Working with African American Families: An Exploration of the Strengths Perspective in Treatment

    ERIC Educational Resources Information Center

    Bell-Tolliver, Laverne; Burgess, Ruby; Brock, Linda J.

    2009-01-01

    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…

  16. Inclusion of African Americans in genetic studies: what is the barrier?

    PubMed

    Hartz, Sarah M; Johnson, Eric O; Saccone, Nancy L; Hatsukami, Dorothy; Breslau, Naomi; Bierut, Laura J

    2011-08-01

    To facilitate an increase in the amount of data on minority subjects collected for genetic databases, the authors attempted to clarify barriers to African-American participation in genetic studies. They randomly sampled 78,072 subjects from the community (Missouri Family Registry, 2002-2007). Of these, 28,658 participated in a telephone screening interview, 3,179 were eligible to participate in the genetic study, and 1,919 participated in the genetic study. Response rates were examined in relation to the proportion of subjects in the area who were African-American according to US Census 2000 zip code demographic data. Compared with zip codes with fewer than 5% African Americans (average = 2% African-American), zip codes with at least 60% African Americans (average = 87% African-American) had higher proportions of subjects with an incorrect address or telephone number but lower proportions of subjects who did not answer the telephone and subjects who refused the telephone interview (P < 0.0001). Based on reported race from the telephone screening, 71% of eligible African Americans and 57% of eligible European Americans participated in the genetic study (P < 0.0001). The results of this study suggest that increasing the number of African Americans in genetic databases may be achieved by increasing efforts to locate and contact them.

  17. Disparities in outcomes for African American and Latino subjects in the Flexible Initial Retrovirus Suppressive Therapies (FIRST) trial.

    PubMed

    Giordano, Thomas P; Bartsch, Glenn; Zhang, Yafeng; Tedaldi, Ellen; Absalon, Judith; Mannheimer, Sharon; Thomas, Avis; MacArthur, Rodger D

    2010-05-01

    To benefit maximally from antiretroviral therapy, patients with HIV infection must enter care before their disease is advanced and adhere to care. We sought to determine if and where on this continuum of care racial/ethnic disparities were evident. Data from the Flexible Initial Retrovirus Suppressive Therapies (FIRST) trial, which evaluated three strategies for initial HIV therapy, were compared for White, African American, and Latino subjects. Outcomes included progression of disease and death, HIV viral suppression, and change in CD4(+) cell count. Multivariate Cox proportional hazard models adjusted for known predictors of survival. There were 1357 subjects, including 368 non-Latino white, 751 non-Latino African American, and 238 Latino subjects. At baseline, the two latter groups were more likely to have had AIDS and had lower CD4(+) cell counts than white subjects. In follow-up, African American subjects had lower self-reported adherence to therapy, lower CD4(+) cell count increases, and lower odds of viral suppression. African American and Latino subjects had unadjusted hazard ratios of progression of disease or death of 1.57 (1.17, 2.10; p = 0.0025) and 1.57 (1.09, 2.26; p = 0.02), respectively. Adjusting for baseline differences and differences in adherence, CD4(+) cell count change, and viral suppression accounted for the disparities in outcomes. Opportunities to reduce disparities in outcomes for African American and Latino patients exist along the continuum of HIV care. Efforts to promote access to HIV testing and care and to improve adherence have the potential to reduce racial/ethnic disparities in outcomes of patients with HIV infection.

  18. Enhancing knowledge of colorectal cancer among African Americans: why are we waiting until age 50?

    PubMed

    Powe, Barbara D; Finnie, Ramona; Ko, Jean

    2006-01-01

    Because of low rates of colorectal cancer screening among African Americans, it may be beneficial to begin educating persons about this disease before age 50. Using the Patient/Provider/System Theoretical Model for cancer screening, this study compared knowledge of colorectal cancer, sources of information, and awareness of programs among participants of age 20-29, 30-49, and 50-75 years. The majority (n = 354) were women and African American (mean age = 37 years, mean education = 12th grade). Younger participants tended to know less about the disease, but there were few differences in knowledge between the two older groups. Persons in the 40-49-year age group were more likely to be familiar with the role diet plays in the risk of colorectal cancer. Participants associated the need for screening with the presence of symptoms. Television and radio were listed as the most frequent source of information about cancer. The Internet was the least used. The majority were not familiar with selected national programs and services focused on increasing awareness of cancer. Findings suggest that colorectal cancer-related information should be targeted toward this population before age 50, using multiple sources such as TV/radio, providers, magazines, and cancer-related organizations. An estimated 104,950 colon and 40,340 rectal cancer cases will be diagnosed in 2005 with an estimated 56,290 deaths from the disease (American Cancer Society [ACS], 2005). Despite a stabilization of colorectal cancer (CRC) incidence rates since the 1980s, African American males and females have higher incidence and mortality rates associated with this disease compared to Whites. The 5-year survival rate for CRC among African Americans improved to 54% during the years 1995-2000, but lagged well behind the 64% survival rate for Whites during the same time period. Screening and early detection of CRC followed by effective treatment is crucial to reducing these mortality rates.

  19. Take up the caregiver's burden: stories of care for urban African American elders with dementia.

    PubMed

    Fox, K; Hinton, W L; Levkoff, S

    1999-12-01

    This pilot study uses an anthropological gaze to analyze transcripts of extended in-home interviews among a set of ten caregivers of African-American elders with dementia. How are race and ethnicity made to matter in the recognition of, the meaning-making around and the responses to dementing illness among a sample of African-American caregivers? The essay contrasts prevailing cultural representations of African-American caregiver burden with caregiver interview data. What we find is that current constructs which consistently demonstrate "lesser burden" among African-American caregivers compared with Whites may not adequately capture these caregivers' experiences. Interpretations of experiences, meanings of "burden" and the logic of symptoms in the illness narratives generated by these African-American caregivers of elders with dementia require attention to the embodiment of large scale sociopolitical and historical forces like residential, educational and occupational segregation, institutional racism, and economic exploitation over the life course.

  20. Take up the caregiver's burden: stories of care for urban African American elders with dementia.

    PubMed

    Fox, K; Hinton, W L; Levkoff, S

    1999-12-01

    This pilot study uses an anthropological gaze to analyze transcripts of extended in-home interviews among a set of ten caregivers of African-American elders with dementia. How are race and ethnicity made to matter in the recognition of, the meaning-making around and the responses to dementing illness among a sample of African-American caregivers? The essay contrasts prevailing cultural representations of African-American caregiver burden with caregiver interview data. What we find is that current constructs which consistently demonstrate "lesser burden" among African-American caregivers compared with Whites may not adequately capture these caregivers' experiences. Interpretations of experiences, meanings of "burden" and the logic of symptoms in the illness narratives generated by these African-American caregivers of elders with dementia require attention to the embodiment of large scale sociopolitical and historical forces like residential, educational and occupational segregation, institutional racism, and economic exploitation over the life course. PMID:10647946

  1. A review of genetics, arterial stiffness, and blood pressure in African Americans.

    PubMed

    Hall, Jennifer L; Duprez, Daniel A; Barac, Ana; Rich, Stephen S

    2012-06-01

    The prevalence of hypertension in African Americans in the USA is among the highest in the world and increasing. The identification of genes and pathways regulating blood pressure in African Americans has been challenging. An early predictor of hypertension is arterial stiffness. The prevalence of arterial stiffness is significantly higher in African Americans compared to Caucasians. Approximately 20 % of the variance in arterial stiffness is estimated to be heritable. Identifying genes and biological pathways regulating arterial stiffness may provide insight into the genetics underlying the increased risk of hypertension in African Americans. This paper reviews the genetic findings to date in the area of arterial stiffness and blood pressure in African Americans with an emphasis on the current limitations and new efforts to move the field forward.

  2. Perceived value in food selection when dining out: comparison of African Americans and Euro-Americans.

    PubMed

    Vinci, Debra M; Philipp, Steven F

    2007-06-01

    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.

  3. Disordered eating in African American and Caucasian women: the role of ethnic identity.

    PubMed

    Shuttlesworth, Mary E; Zotter, Deanne

    2011-01-01

    The influential roles of culture and ethnic identity are frequently cited in developing disordered eating and body dissatisfaction, constituting both protective and risk factors. For African American women, strongly identifying with African American cultural beauty ideals may protect against disordered eating to lose weight, but may actually increase risk in development of disordered eating directed at weight gain, such as binge eating. This study compares African American and Caucasian women on disordered eating measures, positing that African American women show greater risk for binge eating due to the impact of ethnic identity on body dissatisfaction. Findings indicate low levels of ethnic identity represent a risk factor for African American women, increasing the likelihood of showing greater binge eating and bulimic pathology. In Caucasian women, high levels of ethnic identity constitute a risk factor, leading to higher levels of both binge eating and global eating pathology. Implications for prevention and treatment are discussed. PMID:22073427

  4. An assessment of home remedy use by African Americans.

    PubMed Central

    Boyd, E. L.; Taylor, S. D.; Shimp, L. A.; Semler, C. R.

    2000-01-01

    This analysis represents the first national look at family and individual use of home remedies by African Americans. The purpose is to examine home remedy usage by African-American individuals and their families and assess the relationship between sociodemographic characteristics and home remedy usage for African-American families and African-American individuals. Using logistic regression, a secondary analysis of the National Survey on Black Americans (NSBA) data (N = 2107) was conducted to examine factors associated with home remedy use. Multivariate analysis indicated that parent's education, importance of religion, living with a grandparent, and living in a rural area were associated with families' use of home remedies. Age, gender, living with a grandparent, education, and geographic region were associated with individual home remedy use. The results of this research may provide insight to health care practitioners in their challenge of appropriately integrating self-care practices (i.e., home remedy use) and the use of the formal health care system among the patients that utilize both "scientific" and "folk" medical systems. When possible, treatment plans should be adapted to consider patients' demographics, health beliefs, and self-care practices. Health care providers should encourage patient and family involvement and dialogue regarding therapeutic approaches. As more information becomes available, health care practitioners will be better able to ascertain the possible health consequences of concurrent usage of home remedies and prescription drug therapies. PMID:10946530

  5. Colorectal cancer screening in African Americans: practice patterns in the United States. Are we doing enough?

    PubMed Central

    Waghray, Abhijeet; Jain, Alok; Waghray, Nisheet

    2016-01-01

    Background: Colorectal cancer (CRC) is a common form of malignancy and a leading cause of death in the United States. Screening decreases CRC incidence and mortality. African Americans are at an increased risk of developing CRC, and recommendations are to initiate screening at the age of 45. This study aims to assess the rate of screening for colorectal cancer in African Americans between the ages of 45–49. Methods: African Americans between the ages of 45–49 were identified in the Explorys national database. Patients who completed a colonoscopy, sigmoidoscopy or fecal occult blood test were identified and stratified by sex and insurance status. A P value < 0.05 was considered significant. Results: A total of 181 200 African Americans were identified as eligible for screening. Only 31 480 patients (17.4%) received at least one screening procedure for CRC. The majority of patients (66.7%) were screened via colonoscopy. African American females were more likely to complete a screening test (17.8% vs 16.7%; P < 0.01). The majority of patients (66.0%) who completed a screening test had private insurance. Conclusion: Race, gender and barriers to medical care contribute to disparities in CRC screening rates. Among African Americans, CRC screening remains suboptimal. Tailored public health initiatives, medical record alerts and improved communication between providers and patients are fundamental to addressing issues that impact poor adherence to CRC screening in African Americans. PMID:27071411

  6. An African ancestry-specific allele of CTLA4 confers protection against rheumatoid arthritis in African Americans.

    PubMed

    Kelley, James M; Hughes, Laura B; Faggard, Jeffrey D; Danila, Maria I; Crawford, Monica H; Edberg, Yuanqing; Padilla, Miguel A; Tiwari, Hemant K; Westfall, Andrew O; Alarcón, Graciela S; Conn, Doyt L; Jonas, Beth L; Callahan, Leigh F; Smith, Edwin A; Brasington, Richard D; Allison, David B; Kimberly, Robert P; Moreland, Larry W; Edberg, Jeffrey C; Bridges, S Louis

    2009-03-01

    Cytotoxic T-lymphocyte associated protein 4 (CTLA4) is a negative regulator of T-cell proliferation. Polymorphisms in CTLA4 have been inconsistently associated with susceptibility to rheumatoid arthritis (RA) in populations of European ancestry but have not been examined in African Americans. The prevalence of RA in most populations of European and Asian ancestry is approximately 1.0%; RA is purportedly less common in black Africans, with little known about its prevalence in African Americans. We sought to determine if CTLA4 polymorphisms are associated with RA in African Americans. We performed a 2-stage analysis of 12 haplotype tagging single nucleotide polymorphisms (SNPs) across CTLA4 in a total of 505 African American RA patients and 712 African American controls using Illumina and TaqMan platforms. The minor allele (G) of the rs231778 SNP was 0.054 in RA patients, compared to 0.209 in controls (4.462 x 10(-26), Fisher's exact). The presence of the G allele was associated with a substantially reduced odds ratio (OR) of having RA (AG+GG genotypes vs. AA genotype, OR 0.19, 95% CI: 0.13-0.26, p = 2.4 x 10(-28), Fisher's exact), suggesting a protective effect. This SNP is polymorphic in the African population (minor allele frequency [MAF] 0.09 in the Yoruba population), but is very rare in other groups (MAF = 0.002 in 530 Caucasians genotyped for this study). Markers associated with RA in populations of European ancestry (rs3087243 [+60C/T] and rs231775 [+49A/G]) were not replicated in African Americans. We found no confounding of association for rs231778 after stratifying for the HLA-DRB1 shared epitope, presence of anti-cyclic citrullinated peptide antibody, or degree of admixture from the European population. An African ancestry-specific genetic variant of CTLA4 appears to be associated with protection from RA in African Americans. This finding may explain, in part, the relatively low prevalence of RA in black African populations.

  7. Allostatic Load and Health Status of African Americans and Whites

    ERIC Educational Resources Information Center

    Deuster, Patricia A.; Kim-Dorner, Su Jong; Remaley, Alan T.; Poth, Merrily

    2011-01-01

    Objectives: To compare health risks in 84 healthy African American and 45 white men and women after calculating allostatic load (AL) from biologic, psychosocial, and behavioral measures. Methods: Participants (18-45 years) ranging in weight from normal to obese and without hypertension or diabetes. Fitness, body fat, CRP, mood, social support,…

  8. Fostering Healthy Lifestyles in the African American Population

    ERIC Educational Resources Information Center

    Murimi, Mary; Chrisman, Matthew S.; McAllister, Tiffany; McDonald, Olevia D.

    2015-01-01

    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…

  9. Hispanic versus African American Girls: Body Image, Nutrition, and Puberty

    ERIC Educational Resources Information Center

    Talpade, Medha

    2008-01-01

    Public health research has been dominated by the biomedical model, which does not appear to be appropriate for studying public health variables across different populations. For example, when comparing the Hispanic American (HA) and African American (AA) population in the U.S., there are similarities on several demographic and public health…

  10. Vital Signs: The State of African Americans in Higher Education.

    ERIC Educational Resources Information Center

    Cross, Theodore L.; And Others

    1994-01-01

    Presents a statistical record of the progress of African Americans in institutions of higher education in the United States. Statistics include trends in black enrollment, library resources in historically black colleges, leading foundation grants, blacks in business schools, and comparative analysis of Asian Americans and blacks in higher…

  11. Strategies for Preventing Disproportionate Exclusions of African American Students

    ERIC Educational Resources Information Center

    Tobin, Tary J.; Vincent, Claudia G.

    2011-01-01

    The authors studied changes in disproportionate exclusion of African American students, compared with their White peers, in relation to implementation of Schoolwide Positive Behavior Support using data from 46 schools. They measured (a) exclusion through suspension and expulsion data collected with the Schoolwide Information System; (b) Schoolwide…

  12. The African American Student Network: An Intervention for Retention

    ERIC Educational Resources Information Center

    Grier-Reed, Tabitha; Arcinue, Ferdinand; Inman, Evetta

    2016-01-01

    Comparing retention rates for 91 Black women and 56 Black men who participated in the African American Student Network with 68 women and 36 men who were randomly selected from the population of Black undergraduates at a Midwestern university, we included an analysis of covariance to control for ACT score and first-term grade point average. Results…

  13. Characterizing the learning styles and testing the science-related attitudes of African American middle school students: Implications for the underrepresentation of African Americans in the sciences

    NASA Astrophysics Data System (ADS)

    Perine, Donald Ray

    African Americans, Hispanics, Native Americans and women are underrepresented among the population of scientists and science teachers in the United States. Specifically, the shortage of African Americans teaching math and science at all levels of the educational process and going into the many science-related fields is manifested throughout the entire educational and career structure of our society. This shortage exists when compared to the total population of African Americans in this country, the population of African American students, and to society's demand for more math and science teachers and professionals of all races. One suggestion to address this problem is to update curricular and instructional programs to accommodate the learning styles of African Americans from elementary to graduate school. There is little in the published literature to help us understand the learning styles of African American middle school students and how they compare to African American adults who pursue science careers. There is also little published data to help inform us about the relationship between learning styles of African American middle school students and their attitudes toward science. The author used a learning styles inventory instrument to identify the learning style preferences of the African American students and adults. The preferences identified describe how African American students and African American adult science professionals prefer to function, learn, concentrate, and perform in their educational and work activities in the areas of: (a) immediate environment, (b) emotionality, (c) sociological needs, and (d) physical needs. The learning style preferences for the students and adults were not significantly different in key areas of preference. A Test of Science-Related Attitudes (TOSRA) was used to measure seven distinct science-related attitudes of the middle school students. A comparison of the profile of the mean scores for the students in this study

  14. Improving African American Achievement in Geometry Honors

    ERIC Educational Resources Information Center

    Mims, Adrian B.

    2010-01-01

    This case study evaluated the significance of implementing an enrichment mathematics course during the summer to rising African American ninth graders entitled, "Geometry Honors Preview." In the past, 60 to 70 percent of African American students in this school district had withdrawn from Geometry Honors by the second academic quarter. This study…

  15. Cancer and the African American Experience

    Cancer.gov

    The first plenary of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans explores the many factors that lead to inequalities in cancer care outcomes for African Americans.

  16. African American Undergraduates and the Academic Library

    ERIC Educational Resources Information Center

    Whitmire, Ethelene

    2006-01-01

    This study examines the academic library experiences of African American undergraduates attending a research university in the Midwest. Data collection techniques included questionnaires and ethnographic observations. The results indicated that African American undergraduates are using the academic library primarily to read and to study with their…

  17. Smoking Cessation in African-Americans.

    ERIC Educational Resources Information Center

    Ahluwalia, Jasjit S.

    1996-01-01

    Because the smoking behavior of African Americans differs considerably from that of other groups, researchers examined differences between African Americans who did and did not use the nicotine patch as an adjunct to counseling and education for smoking cessation. Results indicated the nicotine patch significantly improved six-month cessation…

  18. African American Teaching and the Matriarchal Performance.

    ERIC Educational Resources Information Center

    Jeffries, Rhonda Baynes

    This paper discusses the role of matriarchs in African-American culture, explaining that traditionally, African-American matriarchs arise from a combination of African norms and American social positions that naturally forces them to assume leadership conditions. The roles these women assume are a response to the desire to survive in a society…

  19. The African American Woman. Runta (Truth).

    ERIC Educational Resources Information Center

    Jackson, Monica L.; Watson, Betty Collier, Ed.

    1989-01-01

    The African American woman has commanded widespread public attention, but popular misconceptions of her socioeconomic role and status differ sharply from her actual situation. The following basic characteristics of the contemporary African American woman, drawn from census figures, are outlined: (1) demographically, females comprise a majority of…

  20. A Mirror Image African American Student Reflections

    ERIC Educational Resources Information Center

    Cannon Dawson, Candice

    2012-01-01

    This dissertation is a narrative inquiry research project that focuses on the collegiate experiences of African American students at both historically black colleges and universities (HBCUs) and predominantly white institutions (PWIs). I look at how African American college students who engage in race or culturally specific activities, the degree…

  1. African American Art: A Los Angeles Legacy.

    ERIC Educational Resources Information Center

    Walker, Harriet

    This curriculum unit focuses on the importance of Los Angeles (California) as a center for African American art and shows how African American artists have developed their own styles and how critics and collectors have encouraged them. The unit consists of four lessons, each of which can stand alone or be used in conjunction with the others. It…

  2. Heart Truth for African American Women

    MedlinePlus

    THE HEART TRUTH ® FOR AFRICAN AMERICAN WOMEN: AN ACTION PLAN When you hear the term “heart disease,” what’s your first reaction? Like many women, you may ... in four women dies of heart disease. For African American women, the risk of heart disease is especially ...

  3. Hidden Education among African Americans during Slavery

    ERIC Educational Resources Information Center

    Gundaker, Grey

    2007-01-01

    Background/Context: Historical studies examine aspects of African American education in and out of school in detail (Woodson 1915, 1933, Bullock 1970, Anderson 1988, Morris 1982, Rachal 1986, Rose 1964, Webber 1978, Williams 2005). Scholars of African American literacy have noted ways that education intersects other arenas such as religion and…

  4. African American Teachers and Culturally Relevant Pedagogy.

    ERIC Educational Resources Information Center

    Foster, Michele

    An overview is presented of research on African American teachers, addressing the large body of literature written by policy analysts, first-person narratives, and the sociological and anthropological literature. Policy research has identified the small number of African American teachers and has studied some reasons for this shortage and some of…

  5. Reading Comprehension among African American Graduate Students

    ERIC Educational Resources Information Center

    Onwuegbuzie, Anthony J.; Mayes, Eric; Arthur, Leslie; Johnson, Joseph; Robinson, Veronica; Ashe, Shante; Elbedour, Salman; Collins, Kathleen M. T.

    2004-01-01

    A study was conducted to examine the reading comprehension performance of African American graduate students. The result showed that though the African American sample attained statistically significantly higher levels of reading comprehension than a normative sample of undergraduate students, they achieved lower levels of reading comprehension…

  6. Lessons learned in developing a culturally adapted intervention for African-American families coping with parental cancer.

    PubMed

    Davey, Maureen P; Kissil, Karni; Lynch, Laura; Harmon, La-Rhonda; Hodgson, Nancy

    2012-12-01

    Prior clinical research supports the effectiveness of cancer support groups for cancer patients and their families, yet African-American families continue to be underrepresented in cancer support groups and in cancer clinical research studies. In order to fill this gap, we developed and evaluated a culturally adapted family support group for African-American families coping with parental cancer. We encountered unexpected challenges in overcoming barriers to recruitment, partnering with oncology providers, and building trust with the African-American community and African-American families coping with parental cancer. We describe actions taken during the two phases of this study and lessons learned along the way about recruiting and engaging African-American families in cancer support group studies, partnering with oncology providers, networking with the African-American community, and the importance of demonstrating cultural sensitivity to overcome the understandable historical legacy of mistrust.

  7. African Americans and the medical establishment.

    PubMed

    Smith, C

    1999-09-01

    The African American community's response to the AIDS epidemic has reflected the profound mistrust of the medical establishment which many African Americans feel. Among African Americans, the belief that the epidemic originated in a genocidal plot is widespread. It is thought that organized medicine has been significantly involved in this plot. If we look at African Americans' historical relationship to the medical establishment from the era of slavery to the recent past, the suspicious attitudes which make such beliefs possible can be seen as an intelligible response to a new disease which disproportionately affects African Americans. Successful medical and public health responses to the epidemic have depended and will continue to depend upon overcoming the historical legacy of suspicion and gaining the trust of the community.

  8. Primary care for young African American men.

    PubMed

    Rich, J A

    2001-01-01

    Young African American men in the inner city have higher rates of mortality and morbidity from potentially preventable causes than other American men of the same age. They suffer disproportionately high rates of preventable illness from violence, sexually transmitted diseases, and HIV infection. These young men present with problems related to sexual concerns, mental health issues, substance abuse, and violence. They also report substantial risk-taking behaviors, including unprotected sex, substance use, and weapon carrying, as well as exposure to violence. Access to and use of preventive primary care services has been limited for these patients in the past because of financial barriers and competing social issues. Racism and historical oppression have created barriers of mistrust for young men of color. Factors that contribute to their adverse health status, as well as ways to address these problems, are discussed.

  9. Health seeking behaviors of African Americans: implications for health administration.

    PubMed

    Hewins-Maroney, Barbara; Schumaker, Alice; Williams, Ethel

    2005-01-01

    Disparities in health care and good health between African Americans and other populations while established in the literature are traditionally based on socioeconomic measures of race, income, age, and education (Bailey, 2000; Lillie-Blanton, Brodie, Rowland, Altman and McIntosh, 2000; Ren and Amick, 1996; Watson, 2001; Weinick, Zuvekas, and Cohen, 2000). This study broadens the scope by exploring how sociocultural (poverty, racism, prejudice, and discrimination) and psychosocial factors (perceived health status, the lack of personal efficacy in contributing to decisions about health care. feelings of helplessness, and the lack of trust in the health care providers) relate to health-seeking behaviors of African Americans (Bailey, 1991; Ren and Amick, 1996, Watson, 2001). Interviews were conducted with 111 African American adult patients at a community health center, focusing on health-seeking behaviors, and sociocultural and psychosocial factors. Results suggest that when these negative factors are removed, the health seeking behaviors of African Americans closely mirror the behaviors of the majority population. Subjects did not view themselves in poorer health, fail to seek medical attention when needed, or distrust their primary health care providers. In general, fears associated with health care were attributed to illness rather than health care providers, although a weak linkage was found between patient self-esteem and fear or dislike of future treatment by physicians (adj R2= .362, S.E. =15, F=21, sig. <.001). The study highlights the need for further study in two areas: cultural competency of health care providers, especially those from Asia and Africa who are often assigned to community health centers, and the impact of an accessible community health center on the health seeking behaviors and health status of predominately African American communities.

  10. Perspectives of African Americans on Lung Cancer: A Qualitative Analysis

    PubMed Central

    Waldman, Laura Tesler; Browning, Emily; Gagne, Joshua; Emmons, Karen

    2015-01-01

    Background. Disparities in incidence and mortality for lung cancer in African Americans are well documented; however, the extent to which disparities reflect differences in patient perceptions of tobacco and lung cancer treatment is unclear. The objective of this study was to explore African Americans’ knowledge of lung cancer, perceived risk, interest in smoking cessation, attitudes toward lung cancer treatment, and lung cancer diagnosis and treatment experiences. Patients and Methods. The cohort comprised 32 African-American current and former smokers without a cancer diagnosis who participated in focus groups and 10 African Americans with lung cancer who participated in in-depth interviews. Transcripts were analyzed using a modified grounded theory approach. Results. Participants without a cancer diagnosis were aware of the link between smoking and lung cancer, the common symptoms of the disease, and its poor prognosis. They desired specific, personalized smoking-cessation information. If diagnosed, the majority reported, they would seek medical care. Most believed that insurance and socioeconomic factors were more likely to affect treatment access than racial discrimination. Participants with a cancer diagnosis were also aware of the relationship between smoking and lung cancer. They felt their treatment plans were appropriate and trusted their physicians. Most did not believe that race affected their care. Conclusion. This qualitative study suggests that African-American smokers are aware of the relationship between smoking and lung cancer and are interested in smoking-cessation treatment. These data also indicate that lung cancer disparities are unlikely to be associated with differential willingness to receive care but that African Americans may perceive financial and insurance barriers to lung cancer treatment. PMID:25795634

  11. African Americans with memory loss: findings from a community clinic in Lexington, Kentucky.

    PubMed

    Danner, Deborah D; Smith, Charles D; Jessa, Peace; Hudson, JoAnna

    2008-09-01

    Kentucky's African-American Dementia Outreach Partnership (AADOP) has shown that African-American patients seek dementia care if a clinic is conveniently located and families are educated about the distinction between normal aging and signs of disease. The early identification of dementia allows African Americans access to pharmaceutic treatments that work best early in the course of the disease and provides the opportunity for the patient to plan future care. In the AADOP model, a conveniently located clinic and access to the patient's home were first steps in achieving equality of care. The trust that was built in the community through collaboration with African-American churches has allowed patients and their families to receive help with memory problems and to feel comfortable in seeking help for other medical problems. Maintaining this involvement and responsiveness to the community over the long term is the next challenge for the program.

  12. Differentiating Central Centrifugal Cicatricial Alopecia and Androgenetic Alopecia in African American Men

    PubMed Central

    Davis, Erica C.; Reid, Sophia D.; Sperling, Leonard C.

    2012-01-01

    Central centrifugal cicatricial alopecia is a scarring alopecia that is predominantly seen in African American women, but occurs less frequently in men. The authors present three cases of African American men with biopsy-proven central centrifugal cicatricial alopecia and detail the clinical presentation, histological findings, and treatment regimens. Central centrifugal cicatricial alopecia should be considered in the differential diagnosis when evaluating male patients with vertex hair loss accompanied by scalp symptoms. Physicians should maintain a high index of suspicion in African American men with the appropriate clinical picture and confirm the diagnosis by scalp biopsy. Prompt and appropriate treatment can help halt or slow disease progression. PMID:22768355

  13. I too, am America: a review of research on systemic lupus erythematosus in African-Americans.

    PubMed

    Williams, Edith M; Bruner, Larisa; Adkins, Alyssa; Vrana, Caroline; Logan, Ayaba; Kamen, Diane; Oates, James C

    2016-01-01

    Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African-Americans experience the disease more severely than other racial-ethnic groups. Relevant literature for the years 2000 to August 2015 were obtained from systematic searches of PubMed, Scopus, and the EBSCOHost platform that includes MEDLINE, CINAHL, etc. to evaluate research focused on SLE in African-Americans. Thirty-six of the 1502 articles were classified according to their level of evidence. The systematic review of the literature reported a wide range of adverse outcomes in African-American SLE patients and risk factors observed in other mono and multi-ethnic investigations. Studies limited to African-Americans with SLE identified novel methods for more precise ascertainment of risk and observed novel findings that hadn't been previously reported in African-Americans with SLE. Both environmental and genetic studies included in this review have highlighted unique African-American populations in an attempt to isolate risk attributable to African ancestry and observed increased genetic influence on overall disease in this cohort. The review also revealed emerging research in areas of quality of life, race-tailored interventions, and self-management. This review reemphasizes the importance of additional studies to better elucidate the natural history of SLE in African-Americans and optimize therapeutic strategies for those who are identified as being at high risk. PMID:27651918

  14. I too, am America: a review of research on systemic lupus erythematosus in African-Americans

    PubMed Central

    Williams, Edith M; Bruner, Larisa; Adkins, Alyssa; Vrana, Caroline; Logan, Ayaba; Kamen, Diane; Oates, James C

    2016-01-01

    Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African-Americans experience the disease more severely than other racial-ethnic groups. Relevant literature for the years 2000 to August 2015 were obtained from systematic searches of PubMed, Scopus, and the EBSCOHost platform that includes MEDLINE, CINAHL, etc. to evaluate research focused on SLE in African-Americans. Thirty-six of the 1502 articles were classified according to their level of evidence. The systematic review of the literature reported a wide range of adverse outcomes in African-American SLE patients and risk factors observed in other mono and multi-ethnic investigations. Studies limited to African-Americans with SLE identified novel methods for more precise ascertainment of risk and observed novel findings that hadn't been previously reported in African-Americans with SLE. Both environmental and genetic studies included in this review have highlighted unique African-American populations in an attempt to isolate risk attributable to African ancestry and observed increased genetic influence on overall disease in this cohort. The review also revealed emerging research in areas of quality of life, race-tailored interventions, and self-management. This review reemphasizes the importance of additional studies to better elucidate the natural history of SLE in African-Americans and optimize therapeutic strategies for those who are identified as being at high risk.

  15. I too, am America: a review of research on systemic lupus erythematosus in African-Americans

    PubMed Central

    Williams, Edith M; Bruner, Larisa; Adkins, Alyssa; Vrana, Caroline; Logan, Ayaba; Kamen, Diane; Oates, James C

    2016-01-01

    Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African-Americans experience the disease more severely than other racial-ethnic groups. Relevant literature for the years 2000 to August 2015 were obtained from systematic searches of PubMed, Scopus, and the EBSCOHost platform that includes MEDLINE, CINAHL, etc. to evaluate research focused on SLE in African-Americans. Thirty-six of the 1502 articles were classified according to their level of evidence. The systematic review of the literature reported a wide range of adverse outcomes in African-American SLE patients and risk factors observed in other mono and multi-ethnic investigations. Studies limited to African-Americans with SLE identified novel methods for more precise ascertainment of risk and observed novel findings that hadn't been previously reported in African-Americans with SLE. Both environmental and genetic studies included in this review have highlighted unique African-American populations in an attempt to isolate risk attributable to African ancestry and observed increased genetic influence on overall disease in this cohort. The review also revealed emerging research in areas of quality of life, race-tailored interventions, and self-management. This review reemphasizes the importance of additional studies to better elucidate the natural history of SLE in African-Americans and optimize therapeutic strategies for those who are identified as being at high risk. PMID:27651918

  16. Guidelines for management of high-risk African Americans with multiple cardiovascular risk factors: recommendations of an expert consensus panel.

    PubMed

    Williams, Richard Allen; Flack, John M; Gavin, James R; Schneider, Wendy R; Hennekens, Charles H

    2007-01-01

    African Americans have higher rates of cardiovascular disease (CVD) than do Caucasians, which contributes significantly to their reduced life expectancy. Most African American adults have at least one major risk factor for CVD. Nonetheless, African Americans are often underdiagnosed and undertreated, despite presenting to the healthcare system late in their course, often after a CVD event. Patients with multiple risk factors have a CVD risk far greater than the sum of their individual risks. Metabolic syndrome tends to be clustered to a greater degree in African American women. Aggressive management of African Americans is necessary. In this report, we provide guidelines for the management of high-risk African Americans. For each individual risk factor, we address existing data and guidelines in the general population, existing data in African Americans, and proposed guidelines for African Americans based on evidence or extrapolation. In particular, for elevated cholesterol and blood pressure, evidence is emerging that lower is better, so aggressive management strategies are necessary. For dyslipidemia, statins alone will generally reach the goal, but for hypertension, multiple drugs are usually necessary. We conclude that further research in African Americans is necessary to complete the totality of evidence.

  17. Racism: perceptions of distress among African Americans.

    PubMed

    Thompson, Vetta L Sanders

    2002-04-01

    Some scholars have suggested that stressful living conditions are a major source of mental disorder among African Americans (Krieger, 1999; Neighbors, 1990; Kessler & Neighbors, 1986). There has, however, been debate as to whether this higher level of distress is due to racism or the fact that African Americans are more often of lower socioeconomic status. Stressors that play a significant role in mental disorder might be expected to occur more frequently among African Americans than the general population. This paper attempts to provide empirical support for the notion that racism is a separate and unique source of stress for African Americans. Specifically, it was hypothesized that African Americans would report more experiences of (1) daily stress and (2) racism than other groups and (3) the impact of racial stress would be greater among African Americans. One hundred and fifty six participants completed the Daily Stress Inventory and the Experience of Discrimination questionnaire. Multivariate analysis of variance indicated that African Americans reported higher impact of discrimination scores than European Americans. There were no gender or ethnicity differences in daily stress or the number of racial incidents reported. The implications of the data are discussed.

  18. Parenting Needs of Urban, African American Fathers.

    PubMed

    Smith, Tyler K; Tandon, S Darius; Bair-Merritt, Megan H; Hanson, Janice L

    2015-07-01

    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.

  19. Conducting Precision Medicine Research with African Americans

    PubMed Central

    Halbert, Chanita Hughes; McDonald, Jasmine; Vadaparampil, Susan; Rice, LaShanta; Jefferson, Melanie

    2016-01-01

    Importance 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. Objective 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. Design, Setting, Participants Observational study conducted between October 2010 and February 2011 in a national sample of African Americans. Main Outcome Measure 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. Results 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). Conclusion and Relevance 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. PMID:27441706

  20. Substance abuse in African American women.

    PubMed

    Wingo, L K

    2001-01-01

    Substance abuse is a serious problem from which, regardless of sex or race, no one is immune. Each racial and gender group has specific etiological factors relating to the use of illicit drugs. Data regarding substance abuse in African American women has only recently begun to emerge in the literature. Issues such as socio-economic, racism, and sexism, place African American women at particular risk for substance abuse. Limited availability to treatment, a lack of appropriate treatment and poor social supports impact recovery and places these women at risk for relapse. This article provides an overview of the current literature regarding substance abuse, treatment and recovery in African American women.

  1. Misconceptions of depression in african americans.

    PubMed

    Sohail, Zohaib; Bailey, Rahn Kennedy; Richie, William D

    2014-01-01

    Major depression is a very common disabling disorder. Although the relationship between race and depression is complex, depression affects all races, all ethnic and geographic locations as well as all age groups. The prevalence of depression in African Americans is controversial, due to the paucity of research. The deficit in the knowledge and skills in treating depression in African Americans have not been adequately addressed so far. Inadequate and insufficient data on African Americans contributes to the problems of under diagnoses, misdiagnosis, and under treatment of depression. This article will highlight the existing problem of depression in Afro American with a focus on diagnostic and treatment issues.

  2. Assessing spirituality in mentally ill African Americans.

    PubMed

    Perdue, Bobbie; Johnson, Deanna; Singley, Doretha; Jackson, Cheylon

    2006-01-01

    The case scenario illustrates the advantage of using spirituality as a tool for recovery when working with mentally ill African American clients. Often spiritual and clinical perspectives are seen as contradictory. But for African Americans, these perspectives can be mutually reinforcing. Spirituality can serve as a resource of strength. It can provide emotional consolation, inspiration, guidance, and security. It can foster personal responsibility, identity, respect for ethical codes and community building. Mental Health professionals who use spirituality as a tool for recovery can expect to have better client outcomes when working with African Americans than those who do not.

  3. Less drinking, yet more problems: understanding African American drinking and related problems.

    PubMed

    Zapolski, Tamika C B; Pedersen, Sarah L; McCarthy, Denis M; Smith, Gregory T

    2014-01-01

    Researchers have found that, compared to European Americans, African Americans report later initiation of drinking, lower rates of use, and lower levels of use across almost all age groups. Nevertheless, African Americans also have higher levels of alcohol problems than European Americans. After reviewing current data regarding these trends, we provide a theory to understand this apparent paradox as well as to understand variability in risk among African Americans. Certain factors appear to operate as both protective factors against heavy use and risk factors for negative consequences from use. For example, African American culture is characterized by norms against heavy alcohol use or intoxication, which protects against heavy use but also provides within-group social disapproval when use does occur. African Americans are more likely to encounter legal problems from drinking than European Americans, even at the same levels of consumption, perhaps thus resulting in reduced consumption but more problems from consumption. There appears to be one particular group of African Americans, low-income African American men, who are at the highest risk for alcoholism and related problems. We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability). Further empirical research will be needed to test our theories and otherwise move this important field forward. A focus on within-group variation in drinking patterns and problems is necessary. We suggest several new avenues of inquiry. PMID:23477449

  4. Less drinking, yet more problems: understanding African American drinking and related problems.

    PubMed

    Zapolski, Tamika C B; Pedersen, Sarah L; McCarthy, Denis M; Smith, Gregory T

    2014-01-01

    Researchers have found that, compared to European Americans, African Americans report later initiation of drinking, lower rates of use, and lower levels of use across almost all age groups. Nevertheless, African Americans also have higher levels of alcohol problems than European Americans. After reviewing current data regarding these trends, we provide a theory to understand this apparent paradox as well as to understand variability in risk among African Americans. Certain factors appear to operate as both protective factors against heavy use and risk factors for negative consequences from use. For example, African American culture is characterized by norms against heavy alcohol use or intoxication, which protects against heavy use but also provides within-group social disapproval when use does occur. African Americans are more likely to encounter legal problems from drinking than European Americans, even at the same levels of consumption, perhaps thus resulting in reduced consumption but more problems from consumption. There appears to be one particular group of African Americans, low-income African American men, who are at the highest risk for alcoholism and related problems. We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability). Further empirical research will be needed to test our theories and otherwise move this important field forward. A focus on within-group variation in drinking patterns and problems is necessary. We suggest several new avenues of inquiry.

  5. Less Drinking, Yet More Problems: Understanding African American Drinking and Related Problems

    PubMed Central

    Zapolski, Tamika C. B.; Pedersen, Sarah L.; McCarthy, Denis M.; Smith, Gregory T.

    2013-01-01

    Researchers have found that, compared to European Americans, African Americans report later initiation of drinking, lower rates of use, and lower levels of use across almost all age groups. Nevertheless, African Americans also have higher levels of alcohol problems than European Americans. After reviewing current data regarding these trends, we provide a theory to understand this apparent paradox as well as to understand variability in risk among African Americans. Certain factors appear to operate as both protective factors against heavy use and risk factors for negative consequences from use. For example, African American culture is characterized by norms against heavy alcohol use or intoxication, which protects against heavy use but which also provides within group social disapproval when use does occur. African Americans are more likely to encounter legal problems from drinking than European Americans, even at the same levels of consumption, perhaps thus resulting in reduced consumption but more problems from consumption. There appears to be one particular group of African Americans, low-income African American men, who are at the highest risk for alcoholism and related problems. We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability). Further empirical research will be needed to test our theories and otherwise move this important field forward. A focus on within group variation in drinking patterns and problems is necessary. We suggest several new avenues of inquiry. PMID:23477449

  6. Fatigue Severity among African Americans: Gender and Age Interactions.

    ERIC Educational Resources Information Center

    Song, Sharon; Jason, Leonard A.; Taylor, Renee R.; Torres-Harding, Susan R.; Helgerson, Jena; Witter, Elizabeth

    2002-01-01

    Investigated the relationship between fatigue, age, and gender among African Americans, Caucasians, and Latinos. Survey results found significant age and gender interactions among African Americans and Caucasians. African American women and older African American men had the highest fatigue rates. There was no significant difference in levels of…

  7. Coming of Age: African American Male Rites-of-Passage.

    ERIC Educational Resources Information Center

    Hill, Paul, Jr.

    An overview is provided of issues confronting the African American male, along with a strategy to nurture a new generation of African American males. Chapters 1 and 2 focus on the social status and new demographics of the African American male and the external threats that are devastating to the African American male and the African American…

  8. The African-American History of Martha's Vineyard.

    ERIC Educational Resources Information Center

    Weintraub, Elaine

    1993-01-01

    Reports on research into African American history and experiences in Martha's Vineyard (Massachusetts). Examines primary sources and oral traditions of African American cultural and social history from 1703 to the present. Discusses African American sailors, race relations, and contributions by African American individuals to the community. (CFR)

  9. African American Women's Preparation for Childbirth From the Perspective of African American Health-Care Providers.

    PubMed

    Abbyad, Christine; Robertson, Trina Reed

    2011-01-01

    Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women's birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women's mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women's preparation for birthing.

  10. New paradigms for transcultural nursing: frameworks for studying African American women.

    PubMed

    Shambley-Ebron, Donna Z; Boyle, Joyceen S

    2004-01-01

    African American women continue to experience disparities in health status when compared to their European American counterparts, yet, often their unique perspectives are not presented in the nursing literature. This article will discuss various theoretical frameworks arising from Black women's thought and reality that can be used to enhance and expand transcultural nursing knowledge. Historical, sociocultural, and literary perspectives will be used to illuminate the realities of African American women's lives. Selected frameworks arising from these realities will be discussed that recognize the impact of race, class, and gender on the lives of African American women and have the potential to guide nursing research and practice. PMID:14768411

  11. A Randomized Controlled Trial of Positive-Affect Intervention and Medication Adherence in Hypertensive African Americans

    PubMed Central

    Ogedegbe, Gbenga O.; Boutin-Foster, Carla; Wells, Martin T.; Allegrante, John P.; Isen, Alice M.; Jobe, Jared B.; Charlson, Mary E.

    2015-01-01

    Background Poor adherence explains poor blood pressure (BP) control; however African Americans suffer worse hypertension-related outcomes. Methods This randomized controlled trial evaluated whether a patient education intervention enhanced with positive-affect induction and self-affirmation (PA) was more effective than patient education (PE) alone in improving medication adherence and BP reduction among 256 hypertensive African Americans followed up in 2 primary care practices. Patients in both groups received a culturally tailored hypertension self-management workbook, a behavioral contract, and bimonthly telephone calls designed to help them overcome barriers to medication adherence. Also, patients in the PA group received small gifts and bimonthly telephone calls to help them incorporate positive thoughts into their daily routine and foster self-affirmation. The main outcome measures were medication adherence (assessed with electronic pill monitors) and within-patient change in BP from baseline to 12 months. Results The baseline characteristics were similar in both groups: the mean BP was 137/82 mm Hg; 36% of the patients had diabetes; 11% had stroke; and 3% had chronic kidney disease. Based on the intention-to-treat principle, medication adherence at 12 months was higher in the PA group than in the PE group (42% vs 36%, respectively; P =.049). The within-group reduction in systolic BP (2.14 mm Hg vs 2.18 mm Hg; P =.98) and diastolic BP (−1.59 mm Hg vs −0.78 mm Hg; P=.45) for the PA group and PE group, respectively, was not significant. Conclusions A PE intervention enhanced with PA led to significantly higher medication adherence compared with PE alone in hypertensive African Americans. Future studies should assess the cost-effectiveness of integrating such interventions into primary care. Trial Registration clinicaltrials.gov Identifier: NCT00227175 PMID:22269592

  12. Cognition and Health in African American Men

    PubMed Central

    Sims, Regina C.; Thorpe, Roland J.; Gamaldo, Alyssa A.; Aiken-Morgan, Adrienne T.; Hill, LaBarron K.; Allaire, Jason C.; Whitfield, Keith E.

    2015-01-01

    Objective Despite high rates of poor health outcomes, little attention has been focused on associations between prominent health factors and cognitive function in African American men, exclusively. The objective was to examine relationships between cardiovascular and pulmonary health, and cognitive function in African American men. Method Data from 257 men were pooled from two studies of African American aging. The mean age of participants was 58.15 and mean educational attainment was 11.78 years. Participants provided self-reported health and demographic information, completed cognitive measures, and had their blood pressure and peak expiratory flow assessed. Results After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures. Discussion Results suggest that lung function is important to consider when examining cognitive function in African American men. Understanding the role of health in cognition and implications for quality of life in this population will be critical as life expectancies increase. PMID:25053802

  13. Health Conditions Common in African American Women

    MedlinePlus

    ... health. Return to top Health conditions common in African-American women Asthma Breast cancer Cancer Cervical cancer Diabetes Glaucoma and cataracts Heart disease High blood pressure High cholesterol HIV/AIDS Infant death Kidney disease Lupus Mental health ...

  14. African-Americans and Heart Disease, Stroke

    MedlinePlus

    ... more about African-Americans and stroke at our Power To End Stroke website This content was last reviewed July 2015. ... Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  15. Mellonee Burnim on African American Music.

    ERIC Educational Resources Information Center

    Campbell, Patricia Shehan

    1995-01-01

    Describes the role and influence of Mellonee Burnim on U.S. music education. Discusses the origins and impact of African American gospel music. Includes a list of selected resources and two lesson plans featuring gospel music. (CFR)

  16. Adapting hypertension self-management interventions to enhance their sustained effectiveness among urban African Americans.

    PubMed

    Ameling, Jessica M; Ephraim, Patti L; Bone, Lee R; Levine, David M; Roter, Debra L; Wolff, Jennifer L; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L; Noronha, Gary J; Fagan, Peter J; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette; Cooper, Lisa A; Aboumatar, Hanan J; Albert, Michael C; Flynn, Sarah J; Boulware, L Ebony

    2014-01-01

    African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions' cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial.

  17. Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

    PubMed Central

    Duraimani, Shanthi; Schneider, Robert H.; Randall, Otelio S.; Nidich, Sanford I.; Xu, Shichen; Ketete, Muluemebet; Rainforth, Maxwell A.; Gaylord-King, Carolyn; Salerno, John W.; Fagan, John

    2015-01-01

    Background African Americans suffer from disproportionately high rates of hypertension and cardiovascular disease. Psychosocial stress, lifestyle and telomere dysfunction contribute to the pathogenesis of hypertension and cardiovascular disease. This study evaluated effects of stress reduction and lifestyle modification on blood pressure, telomerase gene expression and lifestyle factors in African Americans. Methods Forty-eight African American men and women with stage I hypertension who participated in a larger randomized controlled trial volunteered for this substudy. These subjects participated in either stress reduction with the Transcendental Meditation technique and a basic health education course (SR) or an extensive health education program (EHE) for 16 weeks. Primary outcomes were telomerase gene expression (hTERT and hTR) and clinic blood pressure. Secondary outcomes included lifestyle-related factors. Data were analyzed for within-group and between-group changes. Results Both groups showed increases in the two measures of telomerase gene expression, hTR mRNA levels (SR: p< 0.001; EHE: p< 0.001) and hTERT mRNA levels (SR: p = 0.055; EHE: p< 0.002). However, no statistically significant between-group changes were observed. Both groups showed reductions in systolic BP. Adjusted changes were SR = -5.7 mm Hg, p< 0.01; EHE = -9.0 mm Hg, p < 0.001 with no statistically significant difference between group difference. There was a significant reduction in diastolic BP in the EHE group (-5.3 mm Hg, p< 0.001) but not in SR (-1.2 mm Hg, p = 0.42); the between-group difference was significant (p = 0.04). The EHE group showed a greater number of changes in lifestyle behaviors. Conclusion In this pilot trial, both stress reduction (Transcendental Meditation technique plus health education) and extensive health education groups demonstrated increased telomerase gene expression and reduced BP. The association between increased telomerase gene expression and reduced BP

  18. Obesity and Pulmonary Function in African Americans

    PubMed Central

    Mehari, Alem; Afreen, Samina; Ngwa, Julius; Setse, Rosanna; Thomas, Alicia N.; Poddar, Vishal; Davis, Wayne; Polk, Octavius D.; Hassan, Sheik; Thomas, Alvin V.

    2015-01-01

    Background 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). Objective To determine the effect of BMI on PFTs in AA patients who did not have evidence of underlying diseases of the respiratory system. Methods 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. Results 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. Conclusions 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. PMID:26488406

  19. The Effect of Poverty on the Achievement of Urban African American Male Students Successfully Completing High School

    ERIC Educational Resources Information Center

    Welch, Amy L.

    2013-01-01

    The purpose of this study was to determine the impact of poverty on the achievement of African American male high school students attending the same large Midwest urban school district. Cumulative grade point average (GPA) at the tenth grade level were compared to the level of poverty provided through census data of African American male tenth…

  20. Comparison of African American and Afro-Caribbean Older Adults' Self-Reported Health Status, Function, and Substance Use

    ERIC Educational Resources Information Center

    Keane, Florence; Tappen, Ruth M.; Williams, Christine L.; Rosselli, Monica

    2009-01-01

    African American and Afro-Caribbean elders differ in regard to ethnic group membership, place of birth, and years of residence in the United States. In this study, the authors compare self-rated health status, function, and reports of substance use in these two groups. Fifty low-income African American and fifty low-income Afro-Caribbean adults…

  1. Body Size and Social Self-Image among Adolescent African American Girls: The Moderating Influence of Family Racial Socialization

    ERIC Educational Resources Information Center

    Granberg, Ellen M.; Simons, Leslie Gordon; Simons, Ronald L.

    2009-01-01

    Social psychologists have amassed a large body of work demonstrating that overweight African American adolescent girls have generally positive self-images, particularly when compared with overweight females from other racial and ethnic groups. Some scholars have proposed that elements of African American social experience may contribute to the…

  2. Brother, Will You Lend a Hand? Perceptions of Undergraduate African American Male Proteges' Formal Mentoring Journey

    ERIC Educational Resources Information Center

    Mason, John Leonard, Jr.

    2012-01-01

    African American males fail to graduate from colleges and universities as compared to any other demographic. The impact of this non-completion failure continues to touch the African American family structure, community stability, economic reduction at all levels, and an increasing situational hopelessness. The literature surrounding the struggles…

  3. Weight loss maintenance in African-American women: a systematic review of the behavioral lifestyle intervention literature

    Technology Transfer Automated Retrieval System (TEKTRAN)

    African-American women are disproportionally burdened by obesity. Results from behavioral weight loss interventions report that African-American women lose less weight compared to other subgroups but, show improvement in their cardiometabolic risk profile. Unfortunately, the health benefits are not ...

  4. When It Comes to Explaining: A Preliminary Investigation of the Expository Language Skills of African American School-Age Children

    ERIC Educational Resources Information Center

    Koonce, Nicole M.

    2015-01-01

    This research investigated the expository language of school-age speakers of African American English. Specifically, the study describes the language productivity, syntax, and pragmatic features present in expository language samples produced by African American children and compares their performance with White children in the extant literature.…

  5. African-American perceptions of health disparities: a qualitative analysis.

    PubMed

    Hatzfeld, Jennifer J; Cody-Connor, Crystal; Whitaker, Von Best; Gaston-Johansson, Fannie

    2008-07-01

    Health disparities, particularly in African-Americans, have been identified in a variety of settings. A secondary qualitative analysis of focus group data sought to describe African-American's perceptions of health disparities. Using an interpretive descriptive approach, three main levels of interaction within the health-care setting were identified that contained barriers to receiving the best possible care. The issue of finances was the major barrier that involved the insurance company, while racism, attitude, setting, and waiting were the major obstacles involved in the interaction in the health-care facility. The barriers present during the interaction with a personal provider were racism, a language barrier, and being rushed. Additionally, five ideals for patient-provider interaction were identified, as well as three approaches that the participants used to address the barriers within the health-care setting. A broad framework was developed incorporating these major themes.

  6. Teaching African American Youth: Learning from the Lives of Three African American Social Studies Teachers

    ERIC Educational Resources Information Center

    McBride, Chantee Earl

    2010-01-01

    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…

  7. Perceptions of African American and European American Teachers on the Education of African American Boys

    ERIC Educational Resources Information Center

    Bacon, Ellen; Banks, Joy; Young, Kathryn; Jackson, Francesina R.

    2007-01-01

    The authors interviewed 27 teachers (16 African American and 11 European American) on instructional factors contributing to overidentification of behavior problems in African American boys. Interviews focused on teachers' perspectives of effective teachers, teacher-student relationships, and communication styles. Analysis of the interviews showed…

  8. African American Pastors' Beliefs and Actions Regarding Childhood Incest in the African American Community

    ERIC Educational Resources Information Center

    Wells, Tesia Denis

    2012-01-01

    This quantitative study sought to explore African American pastors' beliefs and actions regarding childhood incest in the African American community and their decisions to inform the proper authorities. This exploratory study was developed in order to draw both public and academic attention to the understudied phenomenon of childhood incest…

  9. Research with African Americans: Lessons Learned about Recruiting African American Women

    ERIC Educational Resources Information Center

    Coker, Angela D.; Huang, Hsin-Hsin; Kashubeck-West, Susan

    2009-01-01

    The authors briefly explore literature related to recruiting African American research participants, reflect on their experiences conducting body image research with a sample of African American college women in an earlier study (S. Kashubeck-West et al., 2008), and discuss some methodological and cultural challenges that they encountered during…

  10. Infant mortality differences between whites and African Americans: the effect of maternal education.

    PubMed Central

    Din-Dzietham, R; Hertz-Picciotto, I

    1998-01-01

    OBJECTIVES: Despite decreasing infant mortality in North Carolina, the gap between African Americans and Whites persists. This study examined how racial differences in infant mortality vary by maternal education. METHODS: Data came from Linked Birth and Infant Death files for 1988 through 1993. Multiple logistic regression models adjusted for confounders. RESULTS: Infant mortality risk ratios comparing African Americans and Whites increased with higher levels of maternal education. Education beyond high school reduced risk of infant mortality by 20% among Whites but had little effect among African Americans. CONCLUSIONS: Higher education magnifies racial differences in infant mortality on a multiplicative scale. Possible reasons include greater stress, fewer economic resources, and poorer quality of prenatal care among African Americans. PMID:9551012

  11. Stress, stress reduction, and hypertension in African Americans: an updated review.

    PubMed

    Barnes, V; Schneider, R; Alexander, C; Staggers, F

    1997-07-01

    This is a comprehensive and integrative review of multiple factors underlying the greater prevalence of hypertension in African Americans compared with whites. Evidence linking stress with hypertension and cardiovascular disease in African Americans is reviewed. A survey of mechanisms of hypertension in African Americans and existing behavioral strategies for the treatment of hypertension is presented. Given that the excess of hypertension may be mediated in part by behavioral factors operating through biological mechanisms, a case is presented for behavioral stress reduction measures. This review of stress reduction techniques especially the Transcendental Mediation program for the treatment of hypertension in African Americans highlights current issues facing the field. New information is provided to help direct future nonpharmacological research and practice in hypertension to prevent morbidity and premature mortality in this underserved population.

  12. African American Women's Reports of Racism during Hurricane Katrina: Variation by Interviewer Race.

    PubMed

    Lowe, Sarah R; Lustig, Kara; Marrow, Helen B

    2011-01-01

    This study investigated the effects of interviewer race on low-income African American female hurricane survivors' reports of racism during Hurricane Katrina and its aftermath (N = 41). Respondents were asked directly about the role of racism during the storm and evacuation by one of three interviewers (two White females and one African American female). Contrary to expectations, respondents were not significantly more likely to agree that racism played a role during the hurricane and its aftermath when with an African American interviewer compared to a White interviewer. However, when speaking to the White interviewers versus the African American interviewer, respondents were significantly more likely to use qualifying and contradictory statements and to make references to other races also being victims of the hurricane.

  13. Anxiety psychopathology in African American adults: literature review and development of an empirically informed sociocultural model.

    PubMed

    Hunter, Lora Rose; Schmidt, Norman B

    2010-03-01

    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 ethnoracial differences reported in the literature. Three specific beliefs or attitudes related to the sociocultural experience of African Americans are identified: awareness of racism, stigma of mental illness, and salience of physical illnesses. In our model, we propose that these psychological processes influence interpretations and behaviors relevant to the expression of nonpathological anxiety as well as features of diagnosable anxiety conditions. Moreover, differences in these processes may explain the differential assessed rates of anxiety disorders in African Americans. The model is discussed in the context of existing models of anxiety etiology. Specific follow-up research is also suggested, along with implications for clinical assessment, diagnosis, and treatment.

  14. Stress, stress reduction, and hypertension in African Americans: an updated review.

    PubMed Central

    Barnes, V.; Schneider, R.; Alexander, C.; Staggers, F.

    1997-01-01

    This is a comprehensive and integrative review of multiple factors underlying the greater prevalence of hypertension in African Americans compared with whites. Evidence linking stress with hypertension and cardiovascular disease in African Americans is reviewed. A survey of mechanisms of hypertension in African Americans and existing behavioral strategies for the treatment of hypertension is presented. Given that the excess of hypertension may be mediated in part by behavioral factors operating through biological mechanisms, a case is presented for behavioral stress reduction measures. This review of stress reduction techniques especially the Transcendental Mediation program for the treatment of hypertension in African Americans highlights current issues facing the field. New information is provided to help direct future nonpharmacological research and practice in hypertension to prevent morbidity and premature mortality in this underserved population. PMID:9220696

  15. Culturally Grounded Stress Reduction and Suicide Prevention for African American Adolescents

    PubMed Central

    Robinson, W. LaVome; Case, Mary H.; Whipple, Christopher R.; Gooden, Adia S.; Lopez-Tamayo, Roberto; Lambert, Sharon F.; Jason, Leonard A.

    2016-01-01

    Suicide is an often-overlooked manifestation of violence among African American youth that has become more prevalent in the last two decades. This article reports on the process used to culturally adapt a cognitive-behavioral coping with stress prevention intervention for African American adolescents. We implemented this adapted school-based suicide prevention intervention with 758 African American 9th, 10th and 11th grade students at four high schools in a large Midwestern city. The findings presented are preliminary. The adolescents in this sample endorsed high levels of suicide risk, with females endorsing significantly more suicide risk than males. Those receiving the prevention intervention evidenced an 86% relative suicide risk reduction, compared to the standard care control participants. The presented model of adaptation and resulting culturally-grounded suicide prevention intervention significantly reduced suicide risk among African American adolescents. Clinical, research and policy implications are discussed. PMID:27517094

  16. Novel Risk Factors for Type 2 Diabetes in African-Americans.

    PubMed

    Chatterjee, Ranee; Maruthur, Nisa M; Edelman, David

    2015-12-01

    In the USA, compared to whites, African-Americans are disproportionately impacted by the diabetes epidemic. Traditional diabetes risk factors, such as obesity, are more common among African-Americans, but these traditional risk factors do not explain all of the disparity in diabetes risk. Recent research has identified novel environmental, lifestyle, physiologic, and genetic risk factors for diabetes, some of which appear to impact African-Americans more than whites. This manuscript reviews the recent literature to highlight some of these novel risk factors that may be contributing to the racial disparity in diabetes risk. Further study is needed of the modifiable risk factors for development of interventions to reduce the risk of diabetes in African-Americans, as well as other high-risk populations.

  17. Knowledge is (not) power: healthy eating and physical activity for African-American women.

    PubMed

    Barnett, Tracey Marie; Praetorius, Regina T

    2015-01-01

    African-American women are more likely to be overweight or obese as compared to other ethnic groups. The purpose of this Qualitative Interpretive Meta-Synthesis (QIMS) was to explore the experiences that African-American women encounter when trying to eat healthily and maintain physical activity to inform practice and research. The QIMS included studies from various disciplines to understand the experiences of African-American women with eating healthily and being physically active. Five themes were identified: family; structured support; translating knowledge into behavior modifications; barriers to physical activity; and God is my healer. These themes enhance understanding of what African-American women know, their support system(s), and how cultural barriers impact nutrition and physical activity.

  18. Knowledge is (not) power: healthy eating and physical activity for African-American women.

    PubMed

    Barnett, Tracey Marie; Praetorius, Regina T

    2015-01-01

    African-American women are more likely to be overweight or obese as compared to other ethnic groups. The purpose of this Qualitative Interpretive Meta-Synthesis (QIMS) was to explore the experiences that African-American women encounter when trying to eat healthily and maintain physical activity to inform practice and research. The QIMS included studies from various disciplines to understand the experiences of African-American women with eating healthily and being physically active. Five themes were identified: family; structured support; translating knowledge into behavior modifications; barriers to physical activity; and God is my healer. These themes enhance understanding of what African-American women know, their support system(s), and how cultural barriers impact nutrition and physical activity. PMID:25905767

  19. An integrative review of interventions to reduce peripheral arterial disease risk factors in African Americans.

    PubMed

    Eastridge, Diana K

    2009-06-01

    The purpose of this integrative review is to describe and assess randomized controlled trials of interventions to reduce peripheral arterial disease (PAD) risk factors among African Americans, given the high morbidity and mortality associated with PAD and the poorer outcomes in African Americans with PAD. The reviewed studies include non-pharmacological interventions aimed at the reduction of hemoglobin A1c, blood pressure and lipids in African-American patients with the causal PAD risk factors of diabetes, hypertension and hyperlipidemia. Database searches identified 21 studies that met the inclusion criteria for the review. These studies included interventions utilizing four different strategies: education/enhanced care, diet, physical activity and meditation. Though between-group differences were seen in a minority of the studies, changes within groups was demonstrated more frequently. Overall, the interventions with the education/enhanced care focus had the greatest effects. The review highlighted the need for additional research involving younger patients, the need for enrolling more African-American males in these types of interventional studies and the need to increase recruiting among African Americans who do not have primary healthcare. Given the limited knowledge about PAD and associated risk factors, African Americans' efforts to increase knowledge about PAD risk factors and risk reduction aimed at these factors is extremely important in an aging American population.

  20. Overcoming challenges in the diagnosis and treatment of attention-deficit/hyperactivity disorder in African Americans.

    PubMed Central

    Bailey, Rahn K.; Owens, Dion L.

    2005-01-01

    The incidence of ADHD appears to be similar in African Americans and white populations. However, fewer African-American than white children are diagnosed and treated for ADHD. Reasons for this disparity have not been fully elucidated; causes are most likely complex. Whereas certain barriers to treatment are driven by patients and their families, others are due to limitations in the healthcare system. Patient-driven obstacles to care include inadequate knowledge regarding the symptoms, treatment and consequences of untreated ADHD and fear of overdiagnosis and misdiagnosis. A survey conducted to explore cultural differences between African-American and white respondents found that African Americans were more likely than whites to be unfamiliar with ADHD. In addition, African Americans felt that they were diagnosed with ADHD more often than whites and that teachers blamed ADHD for learning or behavior problems more often in African Americans. Health system barriers include a lack of culturally competent healthcare providers, stereotyping/biases and failure of the clinician to evaluate the child in multiple settings before diagnosis. Strategies to overcome these challenges include increased dissemination of ADHD information through community events; improved training of clinicians in cultural competence; and open communication among parents, clinicians and school personnel. PMID:16350600

  1. An integrative review of interventions to reduce peripheral arterial disease risk factors in African Americans.

    PubMed

    Eastridge, Diana K

    2009-06-01

    The purpose of this integrative review is to describe and assess randomized controlled trials of interventions to reduce peripheral arterial disease (PAD) risk factors among African Americans, given the high morbidity and mortality associated with PAD and the poorer outcomes in African Americans with PAD. The reviewed studies include non-pharmacological interventions aimed at the reduction of hemoglobin A1c, blood pressure and lipids in African-American patients with the causal PAD risk factors of diabetes, hypertension and hyperlipidemia. Database searches identified 21 studies that met the inclusion criteria for the review. These studies included interventions utilizing four different strategies: education/enhanced care, diet, physical activity and meditation. Though between-group differences were seen in a minority of the studies, changes within groups was demonstrated more frequently. Overall, the interventions with the education/enhanced care focus had the greatest effects. The review highlighted the need for additional research involving younger patients, the need for enrolling more African-American males in these types of interventional studies and the need to increase recruiting among African Americans who do not have primary healthcare. Given the limited knowledge about PAD and associated risk factors, African Americans' efforts to increase knowledge about PAD risk factors and risk reduction aimed at these factors is extremely important in an aging American population. PMID:19486853

  2. African American Participation in Oncology Clinical Trials--Focus on Prostate Cancer: Implications, Barriers, and Potential Solutions.

    PubMed

    Ahaghotu, Chiledum; Tyler, Robert; Sartor, Oliver

    2016-04-01

    In the United States, the incidence and mortality rates of many cancers, especially prostate cancer, are disproportionately high among African American men compared with Caucasian men. Recently, mortality rates for prostate cancer have declined more rapidly in African American versus Caucasian men, but prostate cancer is still the most common cancer and the second leading cause of cancer deaths in African American men in the United States. Compared with Caucasian men, prostate cancer occurs at younger ages, has a higher stage at diagnosis, and is more likely to progress after definitive treatments in African American men. Reasons for racial discrepancies in cancer are multifactorial and potentially include socioeconomic, cultural, nutritional, and biologic elements. In addition to improving access to novel therapies, clinical trial participation is essential to adequately establish the risks and benefits of treatments in African American populations. Considering the disproportionately high mortality rates noted in these groups, our understanding of the natural history and responses to therapies is limited. This review will explore African American underrepresentation in clinical trials with a focus on prostate cancer, and potentially effective strategies to engage African American communities in prostate cancer research. Solutions targeting physicians, investigators, the community, and health care systems are identified. Improvement of African American participation in prostate cancer clinical trials will benefit all stakeholders. PMID:26786562

  3. Fear of Neighborhood Violence During Adolescence Predicts Development of Obesity a Decade Later: Gender Differences Among African Americans

    PubMed Central

    Assari, Shervin; Moghani Lankarani, Maryam; Caldwell, Cleopatra Howard; Zimmerman, Marc A

    2016-01-01

    Background African American youth are more likely than other racial and ethnic groups to be obese. African American youth are also more likely to live in disadvantaged neighborhoods which increase their victimization, observation, and fear of violence. Objectives This study tested if victimization, observation, and fear of violence in the neighborhood during adolescence predict trajectory of body mass index (BMI) in the 3rd decade of life in African Americans. Patients and Methods Data came from an 18-year community-based cohort. We used multi-group latent growth curve modeling for data analysis, considering neighborhood violence at age 15 (i.e. victimization, observation, and fear) as predictors, and the linear slope for the average change in BMI from age 21 to 32 as the outcome, with age and socioeconomic status (i.e. intact family and parental employment) as covariates. Results Fear of neighborhood violence at age 15 was predictive of an increase in BMI from age 21 to 32 among female but not male African Americans. Victimization and observation of violence at age 15 did not predict BMI change from age 21 to 32 among female or male African Americans. Conclusions Fear of neighborhood violence is a contributing factor to increased risk of obesity for female African American youth who live in disadvantaged areas. This finding has implications for prevention of obesity among African American women who are at highest risk for obesity in the United States. Initiatives that enhance neighborhood safety are critical strategies for obesity prevention among African American women.

  4. Academic Growth Trajectories and Family Relationships among African American Youth

    PubMed Central

    Dotterer, Aryn M.; Lowe, Katie; McHale, Susan M.

    2016-01-01

    This study explored trajectories of African American youths’ academic functioning and assessed whether changes in parent-adolescent relationships were associated with changes in youths’ academic functioning. The data were drawn from a three-year longitudinal study of gender socialization and development in two-parent African American families and included 197 families. Findings revealed gender differences in achievement trajectories and indicated that boys not only had lower levels of academic achievement compared to girls, but also experienced steeper declines in school self-esteem during adolescence. Changes in parent-adolescent relationship quality were linked to changes in academic functioning: Increases in conflict were related to decreases in GPA, school bonding, and school self-esteem and increases in warmth were related to increases in school bonding and school self-esteem. PMID:27122959

  5. The role of the African-American physician in reducing traffic-related injury and death among African Americans: consensus report of the National Medical Association.

    PubMed Central

    Daniels, Fernando; Moore, Wayne; Conti, Christopher; Norville Perez, Lucille C.; Gaines, Beverly M.; Hood, Rodney G.; Swain, Ian J. J.; Williams, Rudolph; Burgess, Chaka T.

    2002-01-01

    , its physician members, their patients, and their communities. CONSENSUS PROCESS: A literature review, driven by research instruments from numerous organizations included reports and materials from the National Highway Traffic Safety Administration (NHTSA), American Academy of Pediatrics, National Committee for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention (CDC), Mothers Against Drunk Driving (MADD), and the National SAFE KIDS Campaign. Both the Meharry Medical College report, Achieving a Credible Health and Safety Approach to Increasing Seat Belt Use Among African-Americans, and the U.S. Department of Transportation's Blue Ribbon Panel to Increase Seat Belt Use Among African Americans: A Report to the Nation, provided substantial background for the panel. More than 60 pieces of traffic safety literature have been examined to date. Based on the literature review, a short list of the most relevant issues affecting African Americans and traffic safety was devised. It includes: The disproportionately high rate of traffic-related injury and death among African Americans. The cost in health, monetary costs and other associated costs of traffic safety accidents and injuries. The number of traffic-related injuries and deaths that could be prevented if more African Americans observed good traffic safety practices. Barriers to practicing good traffic safety habits among African Americans. Failure of laws and public information campaigns to influence improved traffic safety practices among African Americans sufficient to reduce disparities in traffic-related injury and death. In July 2001, NMA convened a consensus panel of experts in St. Thomas, U.S. Virgin Islands, to review a briefing document summarizing the most salient traffic safety issues among African Americans. The panel elaborated on key issues, including existing policy and standards for the use of child restraint devices to secure infants and toddlers, existing data regarding

  6. Is there a color line in death? An examination of end-of-life care in the African American community.

    PubMed

    Hazin, Ribhi; Giles, Cheryl A

    2011-07-01

    Although the goals of end-of-life care and hospice are to mitigate suffering and improve quality of life for patients with terminal illnesses, they remain underutilized by a significant number of African Americans. While sociocultural issues play a role in the underutilization of these resources among African Americans, other confounding factors affect the ability of African Americans to adequately access quality care at the end of life. Here, the authors examine the various barriers preventing increased use of hospice care and palliative therapy among African Americans. A particular focus of this examination will revolve around suggestions for increasing the use of end-of-life care among African Americans in the future.

  7. Illness beliefs in African Americans with hypertension.

    PubMed

    Pickett, Stephanie; Allen, Wilfred; Franklin, Mary; Peters, Rosalind M

    2014-02-01

    Guided by Leventhal's common sense model of illness representations, this study examined the relationship between hypertension beliefs and self-care behaviors necessary for blood pressure (BP) control in a sample of 111 community-dwelling African Americans with hypertension. Participants completed the revised Illness Perception Questionnaire, BP Self-Care Scale, and a demographic data sheet, and had BP measured. Analyses revealed that beliefs about the causes of hypertension differed by gender and educational level. Stress-related causal attributions accounted for 34.7% of the variance in hypertension beliefs. Participants who believed stress or external factors caused hypertension were less likely to engage in healthy self-care behaviors (e.g., keeping doctor visits, eating low-salt, low-fat diets). Results suggest that patients who are nonadherent with hypertension self-care recommendations may hold hypertension beliefs that are not consistent with the medically endorsed views of this disease. To more effectively treat and control BP, providers should assess patients' hypertension beliefs.

  8. Which African American Mothers Disclose Psychosocial Issues to their Pediatric Providers?

    PubMed Central

    Godoy, Leandra; Mitchell, Stephanie J.; Shabazz, Kanya; Wissow, Larry S.; Horn, Ivor B.

    2014-01-01

    Objective To determine if parent’s self-efficacy in communicating with their child’s pediatrician is associated with African American mothers’ disclosure of psychosocial concerns during pediatric primary care visits. Methods Self-identified African American mothers (N = 231) of children 2–5 years were recruited from eight urban pediatric primary care practices in the Washington, DC metropolitan area. Visits were audio-recorded and parents completed phone surveys within 24 hours. Maternal disclosure of psychosocial issues and self-efficacy in communicating with their child’s provider were measured using the Roter Interactional Analysis System (RIAS) and the Perceived Efficacy in Patient-Physician Interactions (PEPPI) respectively. Results Thirty-two percent of mothers disclosed psychosocial issues. Mothers who disclosed were more likely to report maximum levels of self-efficacy in communicating with their child’s provider compared to those who did not disclose (50% vs. 35%; p = .02). During visits in which mothers disclosed psychosocial issues, providers were observed to provide more psychosocial information (M = 1.52 vs. 1.08 utterances per minute, p = 0.002) and ask fewer medical questions (M = 1.76 vs. 1.99 utterances per minute, p = 0.05) than during visits in which mothers did not disclose. The association between self-efficacy and disclosure was significant among low-income mothers (OR = 5.62, p < .01), but not higher-income mothers. Conclusions Findings suggest that efforts to increase parental self-efficacy in communicating with their child’s pediatrician may increase parents’ likelihood of disclosing psychosocial concerns. Such efforts may enhance rates of identifying and addressing psychosocial issues, particularly among lower-income African American patients. PMID:24976350

  9. Mineral metabolites and CKD progression in African Americans.

    PubMed

    Scialla, Julia J; Astor, Brad C; Isakova, Tamara; Xie, Huiliang; Appel, Lawrence J; Wolf, Myles

    2013-01-01

    CKD progresses more rapidly to ESRD among African Americans compared with Caucasians. Disordered mineral metabolism is more severe among African Americans with CKD, which might partially explain the accelerated progression of their kidney disease. Here, using data from the African American Study of Kidney Disease and Hypertension, we evaluated longitudinal changes in serum levels of fibroblast growth factor-23 (FGF23), parathyroid hormone (PTH), phosphate, and 25-hydroxyvitamin D in a subset of 420 participants followed for a median of 4 years. We also examined the association of baseline levels of mineral metabolites with risk for ESRD or death in 809 participants. FGF23, PTH, and phosphate levels rose over time; participants with faster rates of decline in measured GFR had the greatest increases in these parameters (P<0.01 for each). Higher baseline levels of FGF23, PTH, and phosphate each associated with increased risk for ESRD or death independent of GFR. FGF23 exhibited a dose-response relationship with outcomes (HR=1.30 per doubling, 95% CI=1.15-1.47; HR=2.24 for highest compared with lowest quartile, 95% CI=1.39-3.60), whereas PTH and phosphate showed nonlinear relationships. Vitamin D insufficiency (<30 ng/ml) was present in 95% of participants, but lower levels did not independently associate with outcomes. Using death-censored ESRD as the outcome produced qualitatively similar results. In conclusion, abnormalities of mineral metabolism worsen with progressive CKD and associate with higher risk for ESRD among African Americans with hypertensive nephrosclerosis.

  10. Implicit Stereotyping and Medical Decisions: Unconscious Stereotype Activation in Practitioners' Thoughts About African Americans

    PubMed Central

    Stone, Jeff; Childs, Amanda

    2012-01-01

    Objectives. We investigated whether stereotypes unconsciously influence the thinking and behavior of physicians, as they have been shown to do in other professional settings, such as among law enforcement personnel and teachers. Methods. We conducted 2 studies to examine whether stereotypes are implicitly activated in physicians. Study 1 assessed what diseases and treatments doctors associate with African Americans. Study 2 presented these (and control terms) to doctors as part of a computerized task. Subliminal images of African American and White men appeared prior to each word, and reaction times to words were recorded. Results. When primed with an African American face, doctors reacted more quickly for stereotypical diseases, indicating an implicit association of certain diseases with African Americans. These comprised not only diseases African Americans are genetically predisposed to, but also conditions and social behaviors with no biological association (e.g., obesity, drug abuse). Conclusions. We found implicit stereotyping among physicians; faces they never consciously saw altered performance. This suggests that diagnoses and treatment of African American patients may be biased, even in the absence of the practitioner's intent or awareness. PMID:22420815

  11. Breast Cancer Screening Use by African Americans and Whites in an HMO

    PubMed Central

    Reisch, Lisa M; Barton, Mary B; Fletcher, Suzanne W; Kreuter, William; Elmore, Joann G

    2000-01-01

    OBJECTIVE To examine racial differences in breast cancer screening in an HMO that provides screening at no cost. DESIGN Retrospective cohort study of breast cancer screening among African-American and white women. Breast cancer screening information was extracted from computerized medical records. SETTING A large HMO in New England. PATIENTS/PARTICIPANTS White and African-American women (N =2,072) enrolled for at least 10 years in the HMO. MAIN RESULTS Primary care clinicians documented recommending a screening mammogram significantly more often for African Americans than whites (70% vs 64%; P <.001). During the 10-year period, on average, white women obtained more mammograms (4.49 vs 3.93; P <.0001) and clinical breast examinations (5.35 vs 4.92; P <.01) than African-American women. However, a woman's race was no longer a statistically significant predictor of breast cancer screening after adjustment for differences in age, estimated household income, estrogen use, and body mass index (adjusted number of mammograms, 4.47 vs 4.25, P =.17; and adjusted number of clinical breast examinations, 5.35 vs 5.31, P =.87). CONCLUSIONS In this HMO, African-American and white women obtained breast cancer screening at similar rates. Comparisons with national data showed much higher screening rates in this HMO for both white and African-American women. PMID:10759997

  12. Relationships among obesity, inflammation, and insulin resistance in African Americans and West Africans.

    PubMed

    Doumatey, Ayo P; Lashley, Kerrie S; Huang, Hanxia; Zhou, Jie; Chen, Guanjie; Amoah, Albert; Agyenim-Boateng, Kofi; Oli, Johnnie; Fasanmade, Olufemi; Adebamowo, Clement A; Adeyemo, Adebowale A; Rotimi, Charles N

    2010-03-01

    Several research studies in different populations indicate that inflammation may be the link between obesity and insulin resistance (IR). However, this relationship has not been adequately explored among African Americans, an ethnic group with disproportionately high rates of obesity and IR. In this study, we conducted a comparative study of the relationship among adiposity, inflammation, and IR in African Americans and West Africans, the ancestral source population for African Americans. The associations between obesity markers (BMI and waist-to-hip ratio (WHR)), inflammatory markers (high-sensitivity C-reactive protein (hsCRP), haptoglobin, interleukin (IL)-6, and tumor necrosis factor (TNF)-alpha), and IR (homeostasis model assessment of insulin resistance (HOMA(IR))) were evaluated in 247 West Africans and 315 African Americans. In average, African Americans were heavier than the West Africans (by an average of 1.6 BMI units for women and 3 BMI units for men). Plasma hsCRP, haptoglobin, and IL-6 (but not TNF-alpha level) were higher in African Americans than in West Africans. In both populations, BMI was associated with markers of inflammation and with HOMA(IR), and these associations remained significant after adjusting for sex and age. However, the pattern of associations between measured inflammatory markers and IR was different between the two groups. In West Africans, hsCRP was the only inflammatory marker associated with IR. In contrast, hsCRP, haptoglobin, and IL-6 were all associated with IR in African Americans. Interestingly, none of the associations between markers of inflammation and IR remained significant after adjusting for BMI. This finding suggests that in African Americans, the relationship between inflammatory markers and IR is mediated by adiposity.

  13. Stroke in HIV-infected African Americans: a retrospective cohort study.

    PubMed

    Thakur, Kiran T; Lyons, Jennifer L; Smith, Bryan R; Shinohara, Russell T; Mateen, Farrah J

    2016-02-01

    The risk of having a first stroke is nearly twice as high among African Americans compared to Caucasians. HIV/AIDS is an independent risk factor for stroke. Our study aimed to report the risk factors and short-term clinical outcomes of African Americans with HIV infection and new-onset stroke admitted at the Johns Hopkins Hospitals (2000-2012). Multivariate linear regression was used to examine the association between potential predictors and odds of an unfavorable outcome, defined as a higher modified Rankin Scale (mRS) score on hospital discharge. African Americans comprised 105/125 (84%) of HIV-infected new-onset stroke inpatients (median age 50 years; 69% men; median CD4 140/mL; ischemic 77%; 39% taking highly active antiretroviral therapy). Vascular risk factors were common: hypertension (67%), cigarette smoking (66%), dyslipidemia (42%), hepatitis C (48%), intravenous drug abuse (32%), and prior myocardial infarction (29%). Prior aspirin and statin use were uncommon (18%, 9%). Unfavorable outcome (mRS score 4-6, n = 22 of 90 available records) was noted in 24% of patients, including seven in-hospital deaths. On multivariate analyses, higher CD4 count on hospital admission was associated with a lower mRS (-0.2 mRS points per 1 unit increase in CD4, 95% CI (-0.3, 0), p = 0.03). Intracerebral hemorrhage was also associated with a lower mRS (1.0 points lower, 95% CI (0.2, 1.8) compared to ischemic stroke, p = 0.01) after adjustment for other potential predictors. This underscores the importance of HIV infection on functional stroke outcomes beyond its recognized influence on stroke risk. PMID:26155903

  14. Solo status and self-construal: being distinctive influences racial self-construal and performance apprehension in African American women.

    PubMed

    Sekaquaptewa, Denise; Waldman, Andrew; Thompson, Mischa

    2007-10-01

    A preliminary study and main experiment tested the hypothesis that racial solo status (being the only member of one's race in a group) increases racial self-construal among African Americans. The preliminary study showed that African American men and women reported greater collectivist (i.e., group-based) over individualist self-construal under solo compared to nonsolo status, whereas Whites did not. The main experiment showed that the increased collectivism among African American solo women appears to be strongly reflected in racial identity becoming a salient aspect of self-construal. African American participants were also more likely than Whites to perceive that their anticipated performance would be generalized to their race, to feel like representatives of their race, and to show greater performance apprehension (indirectly evidenced by increased self-handicapping) when in racial solo status. The implications of solo status for African Americans in evaluative situations (such as academic testing sessions) are discussed.

  15. Evaluation of Health Disparity in Bacterial Vaginosis and the Implications for HIV-1 Acquisition in African American Women.

    PubMed

    Alcendor, Donald J

    2016-08-01

    There is a health disparity for both bacterial vaginosis (BV) and human immunodeficiency virus type 1 (HIV-1) infection in African American women that may be linked. The evidence that BV predisposes women to higher risk for HIV infection is well documented. The underlying mechanisms to support the epidemiological connections will require further investigations. This review explores the risk factors for BV disease with implications for HIV-1 acquisition in the context of race as a potential driver of the 20-fold increase in HIV-1 acquisition for African American women compared to white women. Specifically, it explores (i) disparities for BV in African American women, (ii) racial disparity for HIV-1 acquisition in African American women, (iii) common factors associated with BV and HIV acquisition in African American women, and (iv) potential mechanisms of the enhancement of HIV-1 transmission by BV.

  16. Microevolution of African American dental morphology.

    PubMed

    Edgar, Heather J H

    2007-04-01

    The African American (AA) gene pool is primarily the result of gene flow between two biologically disparate groups: West Africans (WA) and Americans of western European descent (EA). This research utilizes characteristics of dental morphology to trace genetic relationships among WA, western Europeans (EU), AA, and European Americans. Dental morphological traits are useful for this purpose because they are heritable, do not remodel during life (although they can be lost to wear or pathology), and can be compared equally among samples from past and present populations. The results of this research provide new information about human microevolution through time and space in a biocultural setting. The mean measure of divergence is used to analyze dental morphological data from 1,265 individuals in 25 samples grouped by ancestry and time. Three hypotheses associated with admixture in AA are tested. When compared with known history, results from dental morphological data are equivocal in documenting admixture in AA. Dental morphological traits do appear to reflect admixture in AA. However, changes in trait frequencies do not closely correspond with important cultural events and trends such as the institutionalized racism of the Civil War and Jim Crow era. Results are mixed concerning whether AA with greater admixture were more likely to take part in the Great Migration to southern urban centers and to the North.

  17. Strategic Planning for Recruitment and Retention of Older African Americans in Health Promotion Research Programs.

    PubMed

    Dreer, Laura E; Weston, June; Owsley, Cynthia

    2014-01-01

    The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this community-based project. We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE© was designed to promote eye disease prevention by conveying the personal benefits of annual, dilated, comprehensive eye care and teaching strategies to minimize barriers to regular eye care. The InCHARGE© program or a social contact control program was delivered at 20 senior centers in predominately African American urban and rural communities. From pooled data across three studies, 380 African Americans completed a questionnaire about knowledge and attitudes/beliefs about eye disease and eye care before the program and by telephone at either 3 or 6 months after the presentation. The project consisted of 4 phases and a total of 10 strategic objectives for recruitment as well as retention of older African Americans that were implemented in a systematic fashion. Overall, retention rates for follow-up at either 3 or 6 months were 75% and 66% respectively. African Americans from rural areas were more likely to be lost to follow-up compared to those from urban areas. We discuss the benefits of utilizing a strategic plan that serves to address problems with underrepresentation of minorities in clinical research.

  18. Strategic Planning for Recruitment and Retention of Older African Americans in Health Promotion Research Programs

    PubMed Central

    Dreer, Laura E.; Weston, June; Owsley, Cynthia

    2014-01-01

    The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this community-based project. We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE© was designed to promote eye disease prevention by conveying the personal benefits of annual, dilated, comprehensive eye care and teaching strategies to minimize barriers to regular eye care. The InCHARGE© program or a social contact control program was delivered at 20 senior centers in predominately African American urban and rural communities. From pooled data across three studies, 380 African Americans completed a questionnaire about knowledge and attitudes/beliefs about eye disease and eye care before the program and by telephone at either 3 or 6 months after the presentation. The project consisted of 4 phases and a total of 10 strategic objectives for recruitment as well as retention of older African Americans that were implemented in a systematic fashion. Overall, retention rates for follow-up at either 3 or 6 months were 75% and 66% respectively. African Americans from rural areas were more likely to be lost to follow-up compared to those from urban areas. We discuss the benefits of utilizing a strategic plan that serves to address problems with underrepresentation of minorities in clinical research. PMID:25346876

  19. The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans

    PubMed Central

    Woods-Giscombé, Cheryl L.; Gaylord, Susan A.

    2014-01-01

    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

  20. Mental health screening of African American adolescents and facilitated access to care.

    PubMed

    Husky, Mathilde M; Kanter, Deborah A; McGuire, Leslie; Olfson, Mark

    2012-02-01

    This study retrospectively reviews de-identified records from school-based mental health screening in a predominantly African American community. We compare participation rates, screening results, referrals to services and access to care of white and African American adolescents. Among those offered screening, 20.1% of white students (n = 297), and 28.8% of African American students (n = 499) were screened (χ(2) = 32.47, df = 1, P < .001). African American students (45.1%) were significantly more likely than white students (33.0%), (AOR = 1.59; P = .003) to be identified as being at risk. In both racial groups, most youth accessed the school-based services (89.02%, 95% CI 82.25-95.79) and community services (86.57%, 95% CI 78.41-94.73) to which they were referred. The groups did not differ in the odds of accessing community-based services (AOR = .58; P = .49). African American students were, however, more likely than white students to access school-based services (AOR = 10.08; P = .022). The findings support the effectiveness of screening in school settings in predominantly African American communities.

  1. Design of the Lifestyle Improvement through Food and Exercise (LIFE) study: a randomized controlled trial of self-management of type 2 diabetes among African American patients from safety net health centers.

    PubMed

    Lynch, Elizabeth B; Liebman, Rebecca; Ventrelle, Jennifer; Keim, Kathryn; Appelhans, Bradley M; Avery, Elizabeth F; Tahsin, Bettina; Li, Hong; Shapera, Merle; Fogelfeld, Leon

    2014-11-01

    The Lifestyle Improvement through Food and Exercise (LIFE) study is a community-based randomized-controlled trial to measure the effectiveness of a lifestyle intervention to improve glycemic control among African Americans with type 2 diabetes attending safety net clinics. The study enrolled African American adults with a diagnosis of type 2 diabetes and HbA1c ≥ 7.0 who had attended specific safety net community clinics in the prior year. 210 patients will be enrolled and randomized to either the LIFE intervention or a standard of care control group, which consists of two dietitian-led diabetes self-management classes. The LIFE intervention was delivered in 28 group sessions over 12 months and focused on improving diet through dietitian-led culturally-tailored nutrition education, increasing physical activity through self-monitoring using an accelerometer, increasing ability to manage blood sugar through modifications to lifestyle, and providing social support for behavior change. In addition to the group sessions, peer supporters made regular telephone calls to participants to monitor progress toward behavioral goals and provide social support. The 12-month intervention phase was followed by a six-month maintenance phase consisting of two group sessions. The primary outcome of the study is change in A1C from baseline to 12 months, and an additional follow-up will occur at 18 months. The hypothesis of the study is that the participants in the LIFE intervention will show a greater improvement in glycemic control over 12 months than participants in the control group.

  2. Child Maltreatment and Delinquency Onset Among African American Adolescent Males

    PubMed Central

    Williams, James Herbert; Van Dorn, Richard A.; Bright, Charlotte Lyn; Jonson-Reid, Melissa; Nebbitt, Von E.

    2013-01-01

    Child welfare and criminology research have increasingly sought to better understand factors that increase the likelihood that abused and neglected children will become involved in the juvenile justice system. However, few studies have addressed this relationship among African American male adolescents. The current study examines the relationship between child maltreatment (i.e., neglect, physical abuse, sexual abuse, and other/mixed abuse) and the likelihood of a delinquency petition using a sample of African American males (N = 2,335) born before 1990. Multivariable logistic regression models compared those with a delinquency-based juvenile justice petition to those without. Results indicate that African American males with a history of neglect, physical abuse, or other/mixed abuse were more likely to be involved in the juvenile justice system than those without any child maltreatment. Additionally, multiple maltreatment reports, a prior history of mental health treatment, victimization, and having a parent who did not complete high school also increased the likelihood of a delinquency petition. Implications for intervention and prevention are discussed. PMID:23730121

  3. Child Maltreatment and Delinquency Onset Among African American Adolescent Males.

    PubMed

    Williams, James Herbert; Van Dorn, Richard A; Bright, Charlotte Lyn; Jonson-Reid, Melissa; Nebbitt, Von E

    2010-05-01

    Child welfare and criminology research have increasingly sought to better understand factors that increase the likelihood that abused and neglected children will become involved in the juvenile justice system. However, few studies have addressed this relationship among African American male adolescents. The current study examines the relationship between child maltreatment (i.e., neglect, physical abuse, sexual abuse, and other/mixed abuse) and the likelihood of a delinquency petition using a sample of African American males (N = 2,335) born before 1990. Multivariable logistic regression models compared those with a delinquency-based juvenile justice petition to those without. Results indicate that African American males with a history of neglect, physical abuse, or other/mixed abuse were more likely to be involved in the juvenile justice system than those without any child maltreatment. Additionally, multiple maltreatment reports, a prior history of mental health treatment, victimization, and having a parent who did not complete high school also increased the likelihood of a delinquency petition. Implications for intervention and prevention are discussed.

  4. HIV/AIDS stigma and religiosity among African American women.

    PubMed

    Muturi, Nancy; An, Soontae

    2010-06-01

    African American women are disproportionately affected by HIV/AIDS compared with other ethnicities, accounting for two-thirds (67%) of all women diagnosed with HIV. Despite their increased risk of HIV infection, few studies have been conducted to understand culture-specific factors leading to their vulnerability. Given the central role of religious organizations in African American communities, this study explored whether and to what extent religiosity plays a role in stigma toward HIV/AIDS. Results of hierarchical regression showed that after controlling for key factors, religiosity was a significant factor predicting the level of religious stigma. Those with high religiosity displayed significantly higher stigma, associating HIV/AIDS with a curse or punishment from God. Verbatim responses to an open-ended question also revealed seemingly ingrained prejudice against HIV/AIDS from a religious perspective. The findings point to the important role of faith-based organizations (FBOs) in addressing HIV/AIDS issues within African American communities. PMID:20574877

  5. Charting the Ancestry of African Americans

    PubMed Central

    Salas, Antonio; Carracedo, Ángel; Richards, Martin; Macaulay, Vincent

    2005-01-01

    The Atlantic slave trade promoted by West European empires (15th–19th centuries) forcibly moved at least 11 million people from Africa, including about one-third from west-central Africa, to European and American destinations. The mitochondrial DNA (mtDNA) genome has retained an imprint of this process, but previous analyses lacked west-central African data. Here, we make use of an African database of 4,860 mtDNAs, which include 948 mtDNA sequences from west-central Africa and a further 154 from the southwest, and compare these for the first time with a publicly available database of 1,148 African Americans from the United States that contains 1,053 mtDNAs of sub-Saharan ancestry. We show that >55% of the U.S. lineages have a West African ancestry, with <41% coming from west-central or southwestern Africa. These results are remarkably similar to the most up-to-date analyses of the historical record. PMID:16175514

  6. Cancer statistics for African Americans, 2013.

    PubMed

    DeSantis, Carol; Naishadham, Deepa; Jemal, Ahmedin

    2013-05-01

    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.

  7. Discussing Cancer: Communication with African Americans

    PubMed Central

    Caito, Nikki; Hood, Sula; Thompson, Vetta L. Sanders

    2015-01-01

    Regular screening for colorectal cancer (CRC) facilitates earlier detection, lowers mortality, and may reduce incidence through detection and removal of pre-cancerous polyps. Optimizing health professional delivery of CRC screening information and recommendations can assist in reducing CRC disparity in the African American community. This paper presents qualitative data on African Americans’ attitudes about health professional CRC communications based on the analysis of focus groups (N=79). Using a social-ecological framework, colorectal cancer and professional communication themes are examined to offer four general and nine cancer specific theoretically based and culturally appropriate strategies for improving health professional cancer communication with African Americans. PMID:25050658

  8. Health parties for African American study recruitment.

    PubMed

    Sadler, Georgia Robins; York, Crystal; Madlensky, Lisa; Gibson, Kathi; Wasserman, Linda; Rosenthal, Eric; Barbier, Leslie; Newman, Vicky A; Tso, Cindy

    2006-01-01

    Innovative strategies are needed to increase minorities' research participation. Using existing social networks within the African American community, "home health parties" were tested as a way to recruit African American women to a breast cancer control study. Parties included social, educational, and recruitment components. All women attending health parties consented, completed a survey, and received the study's preliminary breast cancer risk assessment. There were no differences in rates of participation for subsequent study components between women recruited via parties versus other methods. Health parties are viable recruitment strategies, reduce barriers to participation, provide a supportive environment, and are relatively inexpensive. PMID:17020516

  9. What about African Americans and High Blood Pressure?

    MedlinePlus

    ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? The prevalence of high blood pressure in African Americans is among the highest in ...

  10. Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression.

    PubMed

    Adams, A; Vail, L; Buckingham, C D; Kidd, J; Weich, S; Roter, D

    2014-09-01

    This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries

  11. Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression.

    PubMed

    Adams, A; Vail, L; Buckingham, C D; Kidd, J; Weich, S; Roter, D

    2014-09-01

    This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries

  12. Cultural factors in preventive care: African-Americans.

    PubMed

    Witt, Deborah; Brawer, Rickie; Plumb, James

    2002-09-01

    In summary, the implications for healthcare practitioners in caring for African American patients in a culturally sensitive manner include: Gaining trust, and understanding the historical distrust of the health care system Understanding and employing the kinship web in decisions regarding screening and treatment Involving the church in developing and delivering prevention and care messages Asking patients about the meaning of words or phrases Asking patients about the use of alternative medicines and herbs Tailoring messages about prevention to depictions of real life situations Paying attention to body language and other nonverbal communication. PMID:12529892

  13. Filaggrin gene mutations in African Americans with both ichthyosis vulgaris and atopic dermatitis.

    PubMed

    Polcari, Ingrid; Becker, Lauren; Stein, Sarah L; Smith, Marilyn S; Paller, Amy S

    2014-01-01

    Atopic dermatitis (AD) and ichthyosis vulgaris (IV) are two common disorders of epidermal homeostasis resulting in dry skin. The profilaggrin gene, located on chromosome 1q22, encodes a keratin filament aggregating protein (filaggrin) that is essential to forming the epidermal barrier and maintaining hydration. Null mutations in filaggrin have been found to underlie IV and are common in patients with AD, but the minority of African Americans with AD or IV show these mutations in filaggrin. We have selectively studied African Americans with both AD and IV to maximize the possibility of finding filaggrin null mutations in this population. DNA was collected using buccal swabs from 18 African American children with both AD and IV and 17 African American controls without either of these diseases. Purified genomic DNA was amplified using polymerase chain reaction from three regions of the filaggrin gene, exon 3, including R501X, 2282del4, E2554X, R2447X, 1249insG, R826X, 2767insT, and E2422X. Of the African American children with both AD and IV, 22.2% were heterozygous for filaggrin null mutations. Out of the control group, one carried a null mutation and was later discovered to have a history of asthma. Null mutations found in this population included R501X (n = 1), 2282del4 (n = 2), and R826X (n = 2, including the control patient). Our data demonstrate a prevalence of filaggrin mutations in the African American population that exceeds previously published data, although the overall prevalence is still lower than in other populations. It is likely that factors other than known FLG mutations are involved in African American patients.

  14. Effective Coping Strategies Employed in African-American Relationships.

    ERIC Educational Resources Information Center

    Washington, Novella Channell

    Living in a society that is quick to label and condemn, has been, and continues to be a source of pain for African-Americans. However, society's microscope has for sometime had a one dimensional lens, particularly when examining the coping styles of African-American male-female relationships within the African-American family. There exists a great…

  15. Exposure of African-American Youth to Alcohol Advertising.

    ERIC Educational Resources Information Center

    2003

    The marketing of alcohol products in African-American communities has, on occasion, stirred national controversy and met with fierce resistance from African Americans and others. Despite occasional media and community spotlights on the marketing of alcohol products in the African-American community, there has been no systematic review of the…

  16. Seeing African Americans as Competent Parents: Implications for Family Counselors

    ERIC Educational Resources Information Center

    Adkison-Bradley, Carla

    2011-01-01

    One of the primary roles of parents is to guide and socialize children to make meaningful life choices. African American parents, in particular, have the additional tasks of preparing their children to thrive in an environment that has historically been hostile toward African Americans. Yet, many African American parents are often depicted as…

  17. African American Educational Leadership in the School Superintendency

    ERIC Educational Resources Information Center

    Smith, Eva C.

    2013-01-01

    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…

  18. Persistence among African American Males in the Honors College

    ERIC Educational Resources Information Center

    Anderson Goins, Johnell Roxann

    2014-01-01

    Retaining African American students, specifically African American males, is an issue that plagues the American higher education system. Research shows that African American male students are the lowest represented group in the gifted studies programs (Ford, 2010). Lockie and Burke (1999); Chen and DeJardins (2010) and Bell (2010a) found that…

  19. An Exploration of African American Students' Attitudes toward Online Learning

    ERIC Educational Resources Information Center

    Okwumabua, Theresa M.; Walker, Kristin M.; Hu, Xiangen; Watson, Andrea

    2011-01-01

    The current work presents exploratory research findings concerning African American students' attitudes toward online learning. The Online Tutoring Attitudes Scale (OTAS; Graff, 2003) was administered to 124 African American students in a positive youth development program. Findings suggest that African American students' attitudes toward…

  20. African-American Artists in Context: The Philadelphia Art Museum.

    ERIC Educational Resources Information Center

    Verdino-Sullivan, Carla Maria

    1992-01-01

    Reviews two exhibits of visual art at the Philadelphia (Pennsylvania) Art Museum, "Works by African-Americans," which showcases the contributions of nineteenth- and twentieth-century African-American artists; and "Pertaining to Philadelphia," acquisitions from the collection of Julius Bloch, an artist and mentor to many African American artists in…

  1. African American Acculturation and Black Racial Identity: A Preliminary Investigation.

    ERIC Educational Resources Information Center

    Pope-Davis, Donald B.; Liu, William M.; Ledesma-Jones, Shannon; Nevitt, Jonathan

    2000-01-01

    Examines the relationship between acculturation and racial identity among African Americans. One hundred eighty-seven African American students completed the Black Racial Identity Attitude Scale and the African American Acculturation Scale (AAAS). Acculturation was associated with three of the five AAAS subscales: Dissonance, Immersion, and…

  2. African American Males in Counseling: Who's Pulling the Trigger Now?

    ERIC Educational Resources Information Center

    Bethea-Whitfield, Patricia

    African American males face numerous challenges to their physical and psychological well-being. This project is a survey of the literature and trends relative to African American males from 1987 to the present. In reviewing the fifteen years since Parham and McDavis published their now famous article on African American men as an endangered…

  3. Registers in the Academic Writing of African American College Students

    ERIC Educational Resources Information Center

    Syrquin, Anna F.

    2006-01-01

    The study examines the development of the registers of academic writing by African American college-level students through style and grammar: indirection inherent in the oral culture of the African American community and the paratactic functions of "because." Discourse analysis of 74 samples of academic writing by 20 African American undergraduate…

  4. Representing African American Women in U.S. History Textbooks

    ERIC Educational Resources Information Center

    Schocker, Jessica B.; Woyshner, Christine

    2013-01-01

    This article addresses the dearth of African American women in high school U.S. history textbooks. The authors conducted a content analysis of the images in an African American history textbook and found that black women are underrepresented. Women are found in less than 15 percent of the images in the African American history text, while they…

  5. Perceptions of Domestic Violence: A Dialogue with African American Women

    ERIC Educational Resources Information Center

    Bent-Goodley, Tricia B.

    2004-01-01

    Although empirical research has accumulated over the past 20 years regarding African Americans and domestic violence, many questions remain about African American perceptions of domestic violence. This article explores African American women's perceptions about domestic violence through three focus groups held at a New York social services agency.…

  6. From Crisis to Empowerment: African American Women in Community Colleges

    ERIC Educational Resources Information Center

    Bates, Marcie Ann

    2012-01-01

    Social challenges tear at the fabric of the African American family, revealing complexities that identify a de facto leader, the African American woman. She exists in a chasm of overt circumstances which heavily influences her successes. The purpose of this study is to identify factors that motivated seven female African American community college…

  7. Help-Seeking Attitudes among African American College Students

    ERIC Educational Resources Information Center

    So, Dominicus W.; Gilbert, Stefanie; Romero, Sergio

    2005-01-01

    Traditionally, African American students display a low-rate of seeking mental health treatment. Issues such as mistrust of White therapists, attitudes toward mental health problems, and African American spirituality affect their help-seeking behavior. The present study examined a sample of 134 African American students at a Historically Black…

  8. Going to School: The African-American Experience.

    ERIC Educational Resources Information Center

    Lomotey, Kofi, Ed.

    This volume presents the views of a range of African-American educators on questions related to African-American academic achievement. The concern in this volume is with the persistent, pervasive, and disproportionate underachievement of African-American students. The book is divided into four parts. Part 1, "Problem Identification," comprises the…

  9. Parent Support and African American Adolescents' Career Self-Efficacy

    ERIC Educational Resources Information Center

    Alliman-Brissett, Annette E.; Turner, Sherri L.; Skovholt, Thomas M.

    2004-01-01

    Research has shown that African American adolescents are not being prepared to enter the workforce at the same rates as adolescents from other ethnic groups. While educational and career options were unavailable to African Americans in previous eras, today educational and career opportunities abound, yet many young African Americans are not in a…

  10. Oral Cancer in African Americans: Addressing Health Disparities

    ERIC Educational Resources Information Center

    Dodd, Virginia J.; Watson, Jennifer M.; Choi, Youjin; Tomar, Scott L.; Logan, Henrietta L.

    2008-01-01

    Objectives: To explore factors underlying African Americans' perceptions of oral cancer and the oral cancer exam. Study findings were used to guide development of oral cancer messages designed to increase oral cancer exams among African Americans. Methods: Focus groups were conducted to understand African Americans' attitudes and expectations…

  11. Perceptions of Discrimination and Achievement in African American Students.

    ERIC Educational Resources Information Center

    Rowley, Stephanie Johnson

    This study explored the processes that lead to relatively lower academic performance among African American students. It has been suggested that African American students perceive that, because of discrimination, education is less useful as a tool for upward mobility for African Americans than it is for members of other ethnic groups. The nature…

  12. Gender Differences in African American Attitudes toward Gay Males.

    ERIC Educational Resources Information Center

    Battle, Juan; Lemelle, Anthony J., Jr.

    2002-01-01

    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,…

  13. Dialect Leveling and /ai/ Monopthongization among African American Detroiters.

    ERIC Educational Resources Information Center

    Anderson, Bridget L.

    2002-01-01

    Presents evidence that Detroit African Americans are participating in a recent sound change that is typically associated with some White but not African American varieties in the American South. Reports a leveling pattern in which /ai/ monothongization has expanded to the salient pre-voiceless context in Detroit African American English (AAE).…

  14. Recruiting intergenerational African American males for biomedical research Studies: a major research challenge.

    PubMed

    Byrd, Goldie S; Edwards, Christopher L; Kelkar, Vinaya A; Phillips, Ruth G; Byrd, Jennifer R; Pim-Pong, Dora Som; Starks, Takiyah D; Taylor, Ashleigh L; Mckinley, Raechel E; Li, Yi-Ju; Pericak-Vance, Margaret

    2011-06-01

    The health and well-being of all individuals, independent of race, ethnicity, or gender, is a significant public health concern. Despite many improvements in the status of minority health, African American males continue to have the highest age-adjusted mortality rate of any race-sex group in the United States. Such disparities are accounted for by deaths from a number of diseases such as diabetes, human immunodeficiency virus (HIV), cancer, and cardiovascular disease, as well as by many historical and present social and cultural constructs that present as obstacles to better health outcomes. Distrust of the medical community, inadequate education, low socioeconomic status, social deprivation, and underutilized primary health care services all contribute to disproportionate health and health care outcomes among African Americans compared to their Caucasian counterparts. Results of clinical research on diseases that disproportionately affect African American males are often limited in their reliability due to common sampling errors existing in the majority of biomedical research studies and clinical trials. There are many reasons for underrepresentation of African American males in clinical trials, including their common recollection and interpretation of relevant historical of biomedical events where minorities were abused or exposed to racial discrimination or racist provocation. In addition, African American males continue to be less educated and more disenfranchised from the majority in society than Caucasian males and females and their African American female counterparts. As such, understanding their perceptions, even in early developmental years, about health and obstacles to involvement in research is important. In an effort to understand perspectives about their level of participation, motivation for participation, impact of education, and engagement in research, this study was designed to explore factors that impact their willingness to participate. Our

  15. HLA disease association and protection in HIV infection among African Americans and Caucasians.

    PubMed

    Cruse, J M; Brackin, M N; Lewis, R E; Meeks, W; Nolan, R; Brackin, B

    1991-01-01

    In a previous investigation, we demonstrated an increased progression of overt AIDS in the African American population compared to the Caucasian population as reflected by the significantly lower absolute number of CD4+ lymphocytes detected in the African American population in an earlier study. The present study elucidates some of the possible genetic factors which may contribute to disease association or protection against HIV infection. The HLA phenotypes expressed as A, B, C, DR and DQw antigens were revealed by the Amos-modified typing procedure. NIH scoring was utilized to designate positive cells taking up trypan blue. A test of proportion equivalent to the chi 2 approximation was used to compare the disease population (n = 62; 38 African Americans, 24 Caucasians) to race-matched normal heterosexual local controls (323 African Americans, 412 Caucasians). Significant p values were corrected for the number of HLA antigens tested. HLA markers associated with possible protection from infection for African Americans were Cw4 and DRw6, whereas Caucasians expressed none. Disease association markers present in the African American population were A31, B35, Cw6, Cw7, DR5, DR6, DRw11, DRw12, DQw6 and DQw7, whereas in the Caucasian population A28, Aw66, Aw48, Bw65, Bw70, Cw7, DRw10, DRw12, DQw6 and DQw7 were demonstrated. The highest phenotypic frequency for a disease association marker in the study was for HLA-DR5 (62.9%) in the HIV-infected African American population without Kaposi's sarcoma compared to a frequency of 28.9% for the regional control group (p = 0.0012). We conclude that genetic factors do have a role in HIV infection since only 50-60% of those exposed to the AIDS virus will become infected. PMID:1910527

  16. African American Biographies: A Collection Development Challenge.

    ERIC Educational Resources Information Center

    Woody, Donna

    2000-01-01

    Discusses the lack of African American biographies for elementary school libraries and reports the results of a study that surveyed publishers from the Children's Book Council. Examines book reviews, discusses the number of sports figures included, and considers problems with a lack of appropriate materials to support the curriculum. (LRW)

  17. Paranoid Ideation among Elderly African American Persons.

    ERIC Educational Resources Information Center

    Bazargan, Mohsen; Bazargan, Shahrzad; King, Lewis

    2001-01-01

    A cross sectional study involving 998 independently living elderly African Americans used the Brief Symptom Inventory to measure paranoid ideation and 14 independent variables including demographic characteristics, cognitive deficit, and depression. Paranoid ideation was found in 10% of the sample. Regression analysis revealed 6 of 14 independent…

  18. African American English: A Linguistic Introduction.

    ERIC Educational Resources Information Center

    Green, Lisa J.

    This introduction to African American English (AAE) looks at the grammar as a whole, describing patterns in sentence structure, sound system, word formation, and word use in AAE. The book uses linguistic description and data from conversation to explain that AAE is not a compilation of random deviations from mainstream English but rather a…

  19. African American Students' Attitudes toward Entrepreneurship Education.

    ERIC Educational Resources Information Center

    Ede, Fred O.; Panigrahi, Bhagaban; Calcich, Stephen E.

    1998-01-01

    A survey of 171 African-American students found that 72% came from nonentrepreneurial family backgrounds; only 24.5% intended to start their own businesses, there were no gender differences in entrepreneurship attitudes, and seniors and those from entrepreneurial backgrounds were more favorable toward entrepreneurship. (SK)

  20. Sun protection behaviors among African Americans.

    PubMed

    Hall, H I; Rogers, J D

    1999-01-01

    The anatomic distribution of some skin cancers suggests that sun exposure may be an etiologic factor for skin cancer among African Americans. Yet little is known about sun protection behaviors among African Americans. We analyzed data from the 1992 National Health Interview Survey (N = 1,583) to determine the prevalence of sun protection behaviors and sun sensitivity. About 6% of African Americans reported being extremely sensitive to the sun and severe sunburning, and 9% reported mild burns. Overall, 53% of respondents (47% of men and 57% of women) reported that they were very likely to wear protective clothing, seek shade, or use sunscreen lotion. Women were more likely than men to report seeking shade and using sunscreen. Sun protection behaviors were more frequently reported by those who sunburn more easily and were positively associated with age. Use of sunscreen was positively associated with income and education. Education about sun protection and early detection may help reduce the morbidity and mortality of skin cancer among African Americans.

  1. African American Women Counselors, Wellness, and Spirituality

    ERIC Educational Resources Information Center

    Knowles, Debora; Bryant, Rhonda M.

    2011-01-01

    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…

  2. African-American Males: Education or Incarceration.

    ERIC Educational Resources Information Center

    Green, Robert L.

    This paper analyzes the relationship between levels of educational attainment and outcomes for African American males, in particular the likelihood of conflict with the criminal justice system. The analysis begins with a look at society's belief system and political and economic forces, and argues that these have combined to promote failure among…

  3. African American Female Superintendents: Resilient School Leaders

    ERIC Educational Resources Information Center

    Johnson, Bernadeia H.

    2012-01-01

    Six African American female superintendents who had served as superintendents in at least 2 school districts were interviewed to understand ways in which they responded to barriers and adversity in their roles, with a particular emphasis on issues related to sexism and racism. Study participants shared that they work to engage the community and…

  4. Educational Resilience in African American Adolescents

    ERIC Educational Resources Information Center

    Cunningham, Michael; Swanson, Dena Phillips

    2010-01-01

    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…

  5. Legacy of a Pioneer African American Educator

    ERIC Educational Resources Information Center

    Cazers, Gunars; Curtner-Smith, Matthew

    2013-01-01

    Purpose: The purpose was to reconstruct the historical and legendary contribution of one exemplary African American physical education teacher educator who lived and worked in the Deep South prior to and immediately following the 1954 Brown v. Board of Education court case. The following questions guided data collection and analysis: To what…

  6. African American's Perceptions of Psychotherapy and Psychotherapists.

    ERIC Educational Resources Information Center

    Thompson, Vetta L. Sanders; Akbar, Maysa D.; Bazile, Anita

    The attitudes and beliefs about utilization of mental health services of 201 African Americans, 18 years and older, are explored. One hundred and thirty-four females and 66 males participated in mixed sex focus groups conducted in an urban, Midwestern city. Discussion probes addressed participant perceptions of psychotherapists and psychotherapy,…

  7. Violent Behaviors among African-American Adolescents.

    ERIC Educational Resources Information Center

    Garrett, Darhyl

    1995-01-01

    Explores the development of behaviors by using Erik Erikson's psychosocial developmental theory, with emphasis on adolescents. Examines factors, such as identity versus identity diffusion, that may be contributing to increasing acts of violence by African American adolescents. Other factors are examined that may contribute to increased violence.…

  8. 2000 African American History Month Celebration Luncheon

    NASA Technical Reports Server (NTRS)

    2000-01-01

    In the Early Space Exploration Conference Center at the KSC Visitor Complex, Dr. Julian M. Earls (left), deputy director for Operations, Glenn Research Center, receives a plaque from astronaut Joan Higginbotham (right) during the 2000 African American History Month Celebration Luncheon. Dr. Earls was guest speaker at the luncheon.

  9. African American Homeschooling Practices: Empirical Evidence

    ERIC Educational Resources Information Center

    Mazama, Ama

    2016-01-01

    Despite a significant increase in scholarly interest for homeschooling, some of its most critical aspects, such as instructional daily practices, remain grossly understudied. This essay thus seeks to fill that void by presenting empirical evidence regarding the homeschooling practices of a specific group, African Americans. Most specifically, the…

  10. 2000 African American History Month Celebration Luncheon

    NASA Technical Reports Server (NTRS)

    2000-01-01

    In the Early Space Exploration Conference Center at the KSC Visitor Complex, the planning committee for the 2000 African American History Month Celebration Luncheon gather in the lobby. At the far left is Mack McKinney, chief, Programs Resources Management, who was chairperson for the event.

  11. 2000 African American History Month Celebration Luncheon

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Mack McKinney (left), chief, Programs Resources Management, and Delores Abraham (right), with the Astronaut office, flank one of the posters decorating the Early Space Exploration Conference Center at the KSC Visitor Complex for the 2000 African American History Month Celebration Luncheon. McKinney is chairperson for the event.

  12. Marginality Theory and the African American Student.

    ERIC Educational Resources Information Center

    Grant, G. Kathleen; Breese, Jeffrey R.

    1997-01-01

    Reports on a study of African-American college students at a state university in the Midwest. The study examined the effects of marginality on their college experience and performance. Identifies six reactions to marginality and provides case study examples of each. Includes extensive references and verbatim comments from the students. (MJP)

  13. Depressive Symptoms in African-American Women.

    ERIC Educational Resources Information Center

    Reed, Michael K.; And Others

    1996-01-01

    Examined the prevalence of depressive symptoms in an African American female college student sample (n=78) using the Minnesota Multiphasic Personality Inventory (MMPI2) and the Beck Depression Inventory (BDI). MMPI-2 was a more conservative scale than BDI in identifying depressive symptom levels. Discusses stress inoculation methods to assist…

  14. Cultural Considerations When Caring for African Americans

    Cancer.gov

    The EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans is a free comprehensive multimedia curricula for health professionals caring for persons with cancer and their families.

  15. Promotive Parenting Practices among African American Mothers

    ERIC Educational Resources Information Center

    Williams-Wheeler, Meeshay

    2011-01-01

    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…

  16. African American College Women's Suicide Buffers.

    ERIC Educational Resources Information Center

    Marion, Michelle S.; Range, Lillian M.

    2003-01-01

    To examine the relationships buffers may have with suicide ideation, 300 African American female college students completed measures of suicide ideation and buffers. Three variables accounted for a significant and unique portion of the variance in suicide ideation: family support, a view that suicide is unacceptable, and a collaborative religious…

  17. Gout and African Americans: Reducing disparities.

    PubMed

    Kumar, Bharat; Lenert, Petar

    2016-09-01

    African Americans are more likely to suffer from gout and are less likely to receive optimal treatment for it. Physicians should be aware of risk factors for gout and professional guidelines for treating acute attacks and high uric acid levels, and should help develop strategies to reduce disparities in healthcare delivery. PMID:27618355

  18. Careers of African Americans in Academic Astronomy.

    ERIC Educational Resources Information Center

    Fikes, Robert Jr.

    2000-01-01

    Though traditionally the field of academic astronomy has belonged almost exclusively to whites, today several black scholars are beginning to make their mark in this scientific discipline. Profiles a group of contemporary African American scholars who are astronomers and astrophysicists, noting that there are at least four black graduate students…

  19. African Americans in Television: An Afrocentric Analysis.

    ERIC Educational Resources Information Center

    Tait, Alice A.; Perry, Robert L.

    1994-01-01

    Proposes that, historically and contemporarily, African Americans were and are severely underrepresented in the Eurocentric press, portrayed stereotypically, depicted in low-status occupational roles, and denied news or public affairs programs to adequately serve their informational needs. Theories on mass media's impact on society and individuals…

  20. Language and the African American Child

    ERIC Educational Resources Information Center

    Green, Lisa J.

    2011-01-01

    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,…

  1. "Brothers Gonna Work It Out:" Understanding the Pedagogic Performance of African American Male Teachers Working with African American Male Students

    ERIC Educational Resources Information Center

    Brown, Anthony L.

    2009-01-01

    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…

  2. Predicting Non-African American Lesbian and Heterosexual Preadoptive Couples' Openness to Adopting an African American Child

    ERIC Educational Resources Information Center

    Goldberg, Abbie E.; Smith, JuliAnna Z.

    2009-01-01

    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…

  3. A Call to Action to Raise Achievement for African American Students. Student Achievement Policy Brief #1: African American Students

    ERIC Educational Resources Information Center

    Kober, Nancy

    2010-01-01

    One out of every six public school students in the U.S. is African American. The achievement of African American students as a group will have a significant impact on the nation's economic strength and social well-being. This brief looks at the performance of African American students on state reading and mathematics tests and considers the policy…

  4. Sleep paralysis in African Americans with panic disorder.

    PubMed

    Paradis, Cheryl M; Friedman, Steven

    2005-03-01

    Studies have reported a wide range in lifetime prevalence of sleep paralysis (SP). This variation may stem from cultural factors, stressful life events and genetic differences in studied populations. We found that recurrent SP was more common among African-American participants, especially those with panic disorder. Recurrent SP was reported by 59% of African Americans with panic disorder, 7% of whites with panic disorder, 23% of African-American community volunteers and 6% of white community volunteers. Significantly more early life stressors were reported by African Americans than whites. Higher levels of psychosocial stressors, including poverty, racism and acculturation, may contribute to the higher rates of SP experienced by African Americans.

  5. Tuberculosis in African Americans: clinical characteristics and outcome.

    PubMed Central

    Funnyé, A. S.; Ganesan, K.; Yoshikawa, T. T.

    1998-01-01

    This study examined the clinical characteristics and outcome of pulmonary tuberculosis in African Americans hospitalized in a teaching hospital in south-central Los Angeles from May 1992 through April 1994. The charts of 41 African Americans with culture-positive Mycobacterium tuberculosis were reviewed. Predisposing factors for pulmonary tuberculosis were identified in nearly half of cases. Cough and fever were the most common symptoms. Seventy-six percent had positive acid-fast bacilli (AFB) smears. Nine patients were human immunodeficiency virus (HIV)-positive, and 6 of 9 HIV-positive patients had positive AFB smears whereas 17 of 19 HIV-negative patients had positive AFB smears. Radiographic changes were not significantly different between HIV-positive and HIV-negative patients. Drug resistance was identified in nine of 31 patients (29%). Eight of 41 patients (19.5%) died, with 2 being drug resistant. Human immunodeficiency virus infection was a major predisposing factor for tuberculosis, and no statistical differences were found in radiographic features or AFB smear positivity between HIV-positive and HIV-negative patients. Drug resistance and mortality were disproportionately high. These results indicate that HIV infection and drug resistance are major problems that predispose for tuberculosis infection and make its treatment difficult. PMID:9510620

  6. Perceptions of selected science careers by African American high school males

    NASA Astrophysics Data System (ADS)

    Ijames, Erika Denise

    Research indicates that internal and external factors such as role models, stereotypes, and pressures placed on African American males by their family and friends influence their perceptions of science careers (Assibey-Mensah, 1997; Hess & Leal, 1997; Jacobowitz, 1983; Maple & Stage, 1991; Thomas, 1989; Ware & Lee, 1988). The purpose of this research was to investigate the perceptions of African American high school males about selected science careers based on apparent internal and external factors. Two questions guided this research: (1) What are high school African American males' perceptions of science careers? (2) What influences high school African American males' perceptions of science careers? This research was based on a pilot study in which African American college males perceived a selection of science careers along racial and gender lines. The follow-up investigation was conducted at Rockriver High School in Acorn County, and the participants were three college-bound African American males. The decision to choose males was based on the concept of occupational niching along gender lines. In biology, niching is defined as the role of a particular species regarding space and reproduction, and its interactions with other factors. During the seven-week period of the students' senior year, they met with the researcher to discuss their perceptions of science careers. An ethnographic approach was used to allow a richer and thicker narrative to occur. Critical theory was used to describe and interpret the voices of the participants from a social perspective. The data collected were analyzed using a constant comparative analysis technique. The participants revealed role models, negative stereotypes, peer pressure, social pressures, and misconceptions as some of the factors that influenced their perceptions of science careers. Results of this research suggest that by dispelling the misconceptions, educators can positively influence the attitudes and perceptions of

  7. Systemic lupus erythematosus and vitamin D deficiency are associated with shorter telomere length among African Americans: a case-control study.

    PubMed

    Hoffecker, Brett M; Raffield, Laura M; Kamen, Diane L; Nowling, Tamara K

    2013-01-01

    Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that disproportionately affects African American females. The causes of SLE are unknown but postulated to be a combination of genetic predisposition and environmental triggers. Vitamin D deficiency is one of the possible environmental triggers. In this study we evaluated relationships between vitamin D status, cellular aging (telomere length) and anti-telomere antibodies among African American Gullah women with SLE. The study population included African American female SLE patients and unaffected controls from the Sea Island region of South Carolina. Serum 25-hydroxyvitamin D levels were measured using a nonchromatographic radioimmunoassay. Telomere length was measured in genomic DNA of peripheral blood mononuclear cells (PBMCs) by monochrome multiplex quantitative PCR. Anti-telomere antibody levels were measured by enzyme-linked immunosorbent assay (ELISA). Patients with SLE had significantly shorter telomeres and higher anti-telomere antibody titers compared to age- and gender-matched unaffected controls. There was a positive correlation between anti-telomere antibody levels and disease activity among patients and a significant correlation of shorter telomeres with lower 25-hydroxyvitamin D levels in both patients and controls. In follow-up examination of a subset of the patients, the patients who remained vitamin D deficient tended to have shorter telomeres than those patients whose 25-hydroxyvitamin D levels were repleted. Increasing 25-hydroxyvitamin D levels in African American patients with SLE may be beneficial in maintaining telomere length and preventing cellular aging. Moreover, anti-telomere antibody levels may be a promising biomarker of SLE status and disease activity.

  8. Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke.

    PubMed

    Brown, Candice M; Bushnell, Cheryl D; Samsa, Gregory P; Goldstein, Larry B; Colton, Carol A

    2015-12-01

    The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflammatory and thrombotic biomarkers in African-Americans at least 6 weeks post-stroke compared to control individuals. Cases were African-Americans with lacunar stroke (n = 30), and controls were age-matched African-Americans with no history of stroke or other major neurologic disease (n = 37). Blood was obtained >6 weeks post-stroke and was analyzed for inflammatory biomarkers. Freshly isolated peripheral blood mononuclear cells were stimulated with lipopolysaccharide (LPS) to assess immune responsiveness in a subset of cases (n = 5) and controls (n = 4). After adjustment for covariates, the pro-inflammatory biomarkers, soluble vascular cadherin adhesion molecule-1 (sVCAM-1) and thrombin anti-thrombin (TAT), were independently associated with lacunar stroke. Immune responsiveness to LPS challenge was abnormal in cases compared to controls. African-Americans with lacunar stroke had elevated blood levels of VCAM-1 and TAT and an abnormal response to acute immune challenge >6 weeks post-stroke, suggesting a chronically compromised systemic inflammatory response. PMID:26373290

  9. Assessing quality of care for African Americans with hypertension.

    PubMed

    Peters, Rosalind M; Benkert, Ramona; Dinardo, Ellen; Templin, Thomas

    2007-01-01

    African Americans bear a disproportionate burden of hypertension. A causal-modeling design, using Donabedian's Quality Framework, tested hypothesized relationships among structure, process, and outcome variables to assess quality of care provided to this population. Structural assessment revealed that administrative and staff organization affected patients' trust in their provider and satisfaction with their care. Interpersonal process factors of racism, cultural mistrust, and trust in providers had a significant effect on satisfaction, and perceived racism had a negative effect on blood pressure (BP). Poorer quality in technical processes of care was associated with higher BP. Findings support the utility of Donabedian's framework for assessing quality of care in a disease-specific population.

  10. Breast cancer and racial disparity between Caucasian and African American women, part 1 (BRCA-1).

    PubMed

    Tariq, Khurram; Latif, Naeem; Zaiden, Robert; Jasani, Nick; Rana, Fauzia

    2013-08-01

    Breast cancer is a commonly diagnosed malignancy and the second leading cause of cancer-related death among American women today. Despite the lower incidence of breast cancer among African American women, they are more likely to die from the disease each year than their white counterparts. We present a retrospective cohort study of the tumor registry data from electronic medical records of patients diagnosed with breast cancer at the University of Florida Health, Jacksonville from 2000 to 2005. A total of 907 patients were diagnosed with breast cancer; 445 patients with invasive breast cancer had complete medical records and were selected for this review. Much like previously published research, we found that African American patients presented with a more advanced stage and aggressive subtype of breast cancer than white patients, and were less likely to have health insurance. However, we have yet to determine if universal health care insurance can lead to improved health care access, better breast cancer awareness, and an enhanced attitude toward breast cancer screenings. Such factors would ultimately lead to an earlier diagnosis and better outcomes in both African American and white patients. We plan to investigate this critical issue in a follow-up study (BRCA-2; Breast Cancer and Racial Disparity Between Caucasian and African American Women, Part 2), which will begin a few years after the complete implementation of the universal health care law enacted by President Obama in 2010. The higher frequency of aggressive tumor subtypes in African American women warrants more attention. We suggest further research to determine whether decreasing the initial age for screening or increasing the frequency of mammograms in African American women would improve breast cancer outcomes. This study underscores the importance of identifying and preventing obstacles in routine breast cancer screening, as well as increasing breast cancer awareness.

  11. Comparison of Substance Use Typologies as Predictors of Sexual Risk Outcomes in African American Adolescent Females.

    PubMed

    Swartzendruber, Andrea; Sales, Jessica M; Brown, Jennifer L; DiClemente, Ralph J; Rose, Eve S

    2016-01-01

    African American female adolescents have a disproportionate risk of sexually transmitted infections (STIs) and other adverse sexual health outcomes. Both alcohol and marijuana use have been shown to predict sexual risk among young African American women. However, no studies have attempted to differentiate alcohol and marijuana typologies use as predictors of sexual risk outcomes exclusively among adolescents who use these substances. This study compared recent alcohol and/or marijuana use as predictors of sexual risk outcomes over 18 months among 182 African American female adolescents. African American females (14-20 years) completed interviews at baseline, 6-, 12-, and 18-months. At each assessment, pregnancy testing was conducted and self-collected vaginal swab specimens were assayed for Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae using DNA amplification. Logistic subject-specific random-intercept models compared sexual risk outcomes during follow-up among adolescents who reported recent use of alcohol only (AO), marijuana only (MO) or both substances (A + M) at the baseline assessment. Relative to baseline AO use, baseline MO use predicted condom non-use at last sex. Relative to AO use, A + M use predicted pregnancy. Relative to MO use, A + M use predicted pregnancy and acquisition of T. vaginalis and any STI. The results suggest that African American female adolescents who use A + M may represent a priority population for STI, HIV, and pregnancy prevention efforts. PMID:25929200

  12. Comparison of Substance Use Typologies as Predictors of Sexual Risk Outcomes in African American Adolescent Females.

    PubMed

    Swartzendruber, Andrea; Sales, Jessica M; Brown, Jennifer L; DiClemente, Ralph J; Rose, Eve S

    2016-01-01

    African American female adolescents have a disproportionate risk of sexually transmitted infections (STIs) and other adverse sexual health outcomes. Both alcohol and marijuana use have been shown to predict sexual risk among young African American women. However, no studies have attempted to differentiate alcohol and marijuana typologies use as predictors of sexual risk outcomes exclusively among adolescents who use these substances. This study compared recent alcohol and/or marijuana use as predictors of sexual risk outcomes over 18 months among 182 African American female adolescents. African American females (14-20 years) completed interviews at baseline, 6-, 12-, and 18-months. At each assessment, pregnancy testing was conducted and self-collected vaginal swab specimens were assayed for Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae using DNA amplification. Logistic subject-specific random-intercept models compared sexual risk outcomes during follow-up among adolescents who reported recent use of alcohol only (AO), marijuana only (MO) or both substances (A + M) at the baseline assessment. Relative to baseline AO use, baseline MO use predicted condom non-use at last sex. Relative to AO use, A + M use predicted pregnancy. Relative to MO use, A + M use predicted pregnancy and acquisition of T. vaginalis and any STI. The results suggest that African American female adolescents who use A + M may represent a priority population for STI, HIV, and pregnancy prevention efforts.

  13. Understanding "masculinity" and the challenges of managing type-2 diabetes among African-American men.

    PubMed Central

    Liburd, Leandris C.; Namageyo-Funa, Apophia; Jack, Leonard

    2007-01-01

    African-American men bear a greater burden of type-2 diabetes and its associated complications. The purpose of this analysis was to explore in greater depth themes that emerged in illness narratives of a small sample of African-American men living with type-2 diabetes. The primary theme that is the focus of this article is the lived experience of black manhood and masculinity and its intersection with the challenges of diabetes self-management. In-depth interviews with 16 African-American men who had established type-2 diabetes yielded thematic analyses of four questions: (1) What do you fear most about having diabetes? (2) In what ways have people in your life treated you differently after learning you have diabetes? (3) In what ways has knowing you have diabetes affected the way you see yourself? and (4) What are some reactions when you tell people you have diabetes? This preliminary study suggests that the requirements of diabetes self-management often run counter to the traditional sex roles and learned behaviors of African-American men, and this can contribute to nonadherence to medications and poor glycemic control. Gender identity is a key cultural factor that influences health-related behaviors, including how men with type-2 diabetes engage with the healthcare system and manage their diabetes. Understanding African-American men's gender identity is an important component of cultural competency for physicians and can be consequential in patient outcomes. PMID:17534013

  14. Informing cancer prevention strategies for African Americans: the relationship of African American acculturation to fruit, vegetable, and fat intake.

    PubMed

    Ard, Jamy D; Skinner, Celette Sugg; Chen, Chuhe; Aickin, Mikel; Svetkey, Laura P

    2005-06-01

    Acculturation has been associated with health-related behaviors in African Americans. We sought to determine if there is a relationship between acculturation and dietary intake in African Americans. African Americans in the PREMIER trial completed the African American Acculturation Scale (AAAS) and 2 nonconsecutive 24-h dietary recalls (n = 238). Analysis of variance (ANOVA) and canonical correlation were used to assess relationships between acculturation and dietary intakes. Canonical correlation (p = 0.05) showed that traditional African Americans had lower intakes of fruits/vegetables and milk/dairy with higher intakes of fats, meat, and nuts. This pattern was supported by differences in the ANOVA. African American acculturation is related to dietary intake. These findings have implications for the design of cancer-related public health messages targeted to African Americans. PMID:16015458

  15. Lifestyle management of cardiovascular risk factors in African American women.

    PubMed

    Brennen, Marlene; Williams, Christine L

    2013-01-01

    African American women have the highest prevalence of obesity in the nation when compared to Caucasian and Hispanic women. The purpose of this project was to evaluate the effect of nutrition education and counseling on weight loss, blood pressure, self- efficacy and perception of power. The project was a 12 week community-based lifestyle intervention program designed to provide counseling and education on increasing physical activity, dietary intake of fruits and vegetables while, decreasing dietary intake salt and fat. The results showed that the women, who engaged in all aspects of the program, were able to lose weight and lower their blood pressure.

  16. Caveats in the neuropsychological assessment of African Americans.

    PubMed Central

    Campbell, Alfonso L.; Ocampo, Carlota; DeShawn Rorie, Kashemi; Lewis, Sonya; Combs, Shawn; Ford-Booker, Phyllis; Briscoe, Juanita; Lewis-Jack, Ometha; Brown, Andrew; Wood, Don; Dennis, Gary; Weir, Roger; Hastings, Alicia

    2002-01-01

    This preliminary investigation examined the predictive accuracy of six neuropsychological tests in a population of non-brain-injured African Americans. False positives were unacceptably high on five of the neuropsychological tests administered. These pilot data raise important questions about the utility of neuropsychological test norms with groups dissimilar in sociocultural background to the normative population. These findings are examined in terms of the relative merits of the race-homogenous and race-comparative paradigms and underscore the importance of conducting normative studies that involve ethnic minority populations. PMID:12126285

  17. A New Audience Segmentation Tool for African Americans: The Black Identity Classification Scale

    PubMed Central

    DAVIS, RACHEL E.; ALEXANDER, GWEN; CALVI, JOSEPHINE; WIESE, CHERYL; GREENE, SARAH; NOWAK, MIKE; CROSS, WILLIAM E.; RESNICOW, KEN

    2011-01-01

    Many health communications target African Americans in an attempt to remediate race-based health disparities. Such materials often assume that African Americans are culturally homogeneous; however, research indicates that African Americans are heterogeneous in their attitudes, behaviors, and beliefs. The Black Identity Classification Scale (BICS) was designed as a telephone-administered tool to segment African American audiences into 16 ethnic identity types. The BICS was pretested using focus groups, telephone pretests, and a pilot study (n=306). The final scale was then administered to 625 Black adults participating in a dietary intervention study, where it generally demonstrated good internal consistency reliability. The construct validity of the BICS was also explored by comparing participants’ responses to culturally associated survey items. The distribution of the 16 BICS identity types in the intervention study is presented, as well as select characteristics for participants with core identity components. Although additional research is warranted, these findings suggest that the BICS has good psychometric properties and may be an effective tool for identifying African American audience segments. PMID:20677057

  18. The relationship between stress and weight-control behavior in African-American women.

    PubMed

    Walcott-McQuigg, J A

    1995-06-01

    Obesity is a problem for African-American women across all socioeconomic strata. Age-adjusted prevalence of overweight is 48.5% among African-American women compared with 21% among white women. An exploratory field was designed to examine selected psychosocial factors that influence the weight-control behavior of middle-income African-American women. A triangulation methodology was used in which both qualitative and quantitative data were collected. First, semistructured interviews were held with 36 African-American women between the ages of 25 and 75. Second, a Global Stress Scale was administered to measure perceived stress. Statistical analysis of the data revealed a positive correlation between body weight and stress in that women who were more overweight were experiencing more stress. Ethnographic analysis of the data showed that more than 50% of the women thought that stress negatively affected their weight-control behavior. Additionally, occupational stressors related to racism, sexism, and workload were major stressors for this group of women. Recognition of factors that influence weight-control health practices will enable health professionals to assist African-American women to manage their weight.

  19. Weight loss maintenance in African American women: a systematic review of the behavioral lifestyle intervention literature.

    PubMed

    Tussing-Humphreys, Lisa M; Fitzgibbon, Marian L; Kong, Angela; Odoms-Young, Angela

    2013-01-01

    We performed a systematic review of the behavioral lifestyle intervention trials conducted in the United States published between 1990 and 2011 that included a maintenance phase of at least six months, to identify intervention features that promote weight loss maintenance in African American women. Seventeen studies met the inclusion criteria. Generally, African American women lost less weight during the intensive weight loss phase and maintained a lower % of their weight loss compared to Caucasian women. The majority of studies failed to describe the specific strategies used in the delivery of the maintenance intervention, adherence to those strategies, and did not incorporate a maintenance phase process evaluation making it difficult to identify intervention characteristics associated with better weight loss maintenance. However, the inclusion of cultural adaptations, particularly in studies with a mixed ethnicity/race sample, resulted in less % weight regain for African American women. Studies with a formal maintenance intervention and weight management as the primary intervention focus reported more positive weight maintenance outcomes for African American women. Nonetheless, our results present both the difficulty in weight loss and maintenance experienced by African American women in behavioral lifestyle interventions.

  20. Motivations for sex among low-income African American young women.

    PubMed

    Deardorff, Julianna; Suleiman, Ahna Ballonoff; Dal Santo, Teresa S; Flythe, Michelle; Gurdin, J Barry; Eyre, Stephen L

    2013-12-01

    African American young women exhibit higher risk for sexually transmitted infections, including HIV/AIDS, compared with European American women, and this is particularly true for African American women living in low-income contexts. We used rigorous qualitative methods, that is, domain analysis, including free listing (n = 20), similarity assessment (n = 25), and focus groups (four groups), to elicit self-described motivations for sex among low-income African American young women (19-22 years). Analyses revealed six clusters: Love/Feelings, For Fun, Curiosity, Pressured, For Money, and For Material Things. Focus groups explored how African American women interpreted the clusters in light of condom use expectations. Participants expressed the importance of using condoms in risky situations, yet endorsed condom use during casual sexual encounters less than half the time. This study highlights the need for more effective intervention strategies to increase condom use expectations among low-income African American women, particularly in casual relationships where perceived risk is already high. PMID:23372029

  1. Stereotype or reality: another look at alcohol and drug use among African American children.

    PubMed Central

    Bass, L E; Kane-Williams, E

    1993-01-01

    The Center for Substance Abuse Prevention's Division of Communications Programs launched its Urban Youth Public Education Campaign in late 1990 to target African American youth in 14 cities with prevention messages about alcohol and other drugs. During the market research phase of the campaign, the Center sought to determine the extent inner city African American children are impacted by alcohol and other drugs and how widespread the use of these substances is among younger children. Is it rampant and universal, as some press accounts have it, or are the images portrayed by the news media, by popular movies, and by other communication outlets fueling harmful stereotypes? The campaign's market research consisted of in-depth reviews of the literature, of personal communications, conference proceedings, grant and contract reports, monographs, newspaper and magazine articles, and of national survey results, and the analysis of findings from focus groups conducted with 143 African American children living in several urban environments. Although information and conclusions gleaned from the market research revealed a longstanding trend of comparatively lower rates of alcohol and drug use by African American youth, also disclosed was a need for an expanded framework to address the problems of substance abuse within the African American community. An expanded framework acknowledges the dimension of substance use and abuse but also addresses three other dimensions--involvement, exposure, and victimization--that unfold as having major significance for this population of youth who live in urban, high-risk environments. PMID:8210277

  2. The Impact of Racism on the Sexual and Reproductive Health of African American Women.

    PubMed

    Prather, Cynthia; Fuller, Taleria R; Marshall, Khiya J; Jeffries, William L

    2016-07-01

    African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health.

  3. The relationship between stress and weight-control behavior in African-American women.

    PubMed Central

    Walcott-McQuigg, J. A.

    1995-01-01

    Obesity is a problem for African-American women across all socioeconomic strata. Age-adjusted prevalence of overweight is 48.5% among African-American women compared with 21% among white women. An exploratory field was designed to examine selected psychosocial factors that influence the weight-control behavior of middle-income African-American women. A triangulation methodology was used in which both qualitative and quantitative data were collected. First, semistructured interviews were held with 36 African-American women between the ages of 25 and 75. Second, a Global Stress Scale was administered to measure perceived stress. Statistical analysis of the data revealed a positive correlation between body weight and stress in that women who were more overweight were experiencing more stress. Ethnographic analysis of the data showed that more than 50% of the women thought that stress negatively affected their weight-control behavior. Additionally, occupational stressors related to racism, sexism, and workload were major stressors for this group of women. Recognition of factors that influence weight-control health practices will enable health professionals to assist African-American women to manage their weight. PMID:7595965

  4. The Impact of Racism on the Sexual and Reproductive Health of African American Women

    PubMed Central

    Prather, Cynthia; Fuller, Taleria R.; Marshall, Khiya J.; Jeffries, William L.

    2016-01-01

    African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women’s sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women’s sexual and reproductive health. PMID:27227533

  5. African American Women’s Limited Knowledge and Experiences with Genetic Counseling for Hereditary Breast Cancer

    PubMed Central

    Sheppard, Vanessa B.; Graves, Kristi D.; Christopher, Juleen; Hurtado-de-Mendoza, Alejandra; Talley, Costellia; Williams, Karen Patricia

    2014-01-01

    Genetic counseling and testing for hereditary breast cancer have the potential benefit of early detection and early interventions in African American women. However, African American women have low use of these services compared to White women. We conducted two focus groups with African American women diagnosed with breast cancer (affected group, n=13) and women with at least one first-degree relative with breast/ovarian cancer (unaffected group, n= 8). A content analysis approach was employed to analyze interview data. Breast cancer survivors had more knowledge about genetic counseling and testing than participants who were unaffected with cancer. However, knowledge about genetic counseling was limited in both groups. Barriers to pursuing genetic counseling and testing included poor understanding of the genetic counseling and testing process, fear of carrying the mutation, concerns about discrimination, and cost. Motivators to participate in genetic counseling and testing included desire to help family members, insurance coverage, and potential of benefiting the larger African American community. Education efforts are needed to increase genetic counseling and testing awareness in the African American community. PMID:24186304

  6. USE OF COMPLEMENTARY AND ALTERNATIVE THERAPIES BY RURAL AFRICAN AMERICANS WITH TYPE 2 DIABETES

    PubMed Central

    Jones, Randy A.; Utz, Sharon; Wenzel, Jennifer; Steeves, Richard; Hinton, Ivora; Andrews, Dana; Murphy, Alison; Oliver, Norman

    2013-01-01

    The prevalence of type 2 diabetes among non-Hispanic African American adults aged 20 years and older is 11.4%, compared to 8.4% non-Hispanic whites. Given the high rate of diabetes in this population, it is important to determine whether African Americans use complementary and alternative medicine (CAM), and if so, what kind. Such information is important to healthcare professionals who prescribe therapies and make self-care recommendations to those with diabetes. The use of CAM by African Americans with diabetes has not been well studied, however, particularly among those living in rural areas. This descriptive study was conducted in 2 rural communities in Central Virginia to explore the use of CAM therapies and the role of religion and spirituality in dealing with diabetes among adult African Americans with type 2 diabetes. Sixty-eight participants attended 1 of 8 focus group sessions in various community settings and described their use of alternative therapies. According to these sessions, the most common alternative therapies used are prayer, diet-based therapies, and natural products. The participants’ descriptions enhance our understanding of CAM use among rural African Americans with diabetes. PMID:17017753

  7. The Impact of Racism on the Sexual and Reproductive Health of African American Women.

    PubMed

    Prather, Cynthia; Fuller, Taleria R; Marshall, Khiya J; Jeffries, William L

    2016-07-01

    African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health. PMID:27227533

  8. African American women's limited knowledge and experiences with genetic counseling for hereditary breast cancer.

    PubMed

    Sheppard, Vanessa B; Graves, Kristi D; Christopher, Juleen; Hurtado-de-Mendoza, Alejandra; Talley, Costellia; Williams, Karen Patricia

    2014-06-01

    Genetic counseling and testing for hereditary breast cancer have the potential benefit of early detection and early interventions in African American women. However, African American women have low use of these services compared to White women. We conducted two focus groups with African American women diagnosed with breast cancer (affected group, n = 13) and women with at least one first-degree relative with breast/ovarian cancer (unaffected group, n = 8). A content analysis approach was employed to analyze interview data. Breast cancer survivors had more knowledge about genetic counseling and testing than participants who were unaffected with cancer. However, knowledge about genetic counseling was limited in both groups. Barriers to pursuing genetic counseling and testing included poor understanding of the genetic counseling and testing process, fear of carrying the mutation, concerns about discrimination, and cost. Motivators to participate in genetic counseling and testing included desire to help family members, insurance coverage, and potential of benefiting the larger African American community. Education efforts are needed to increase genetic counseling and testing awareness in the African American community.

  9. Fine-mapping and initial characterization of QT interval loci in African Americans.

    PubMed

    Avery, Christy L; Sethupathy, Praveen; Buyske, Steven; He, Qianchuan; Lin, Dan-Yu; Arking, Dan E; Carty, Cara L; Duggan, David; Fesinmeyer, Megan D; Hindorff, Lucia A; Jeff, Janina M; Klein, Liviu; Patton, Kristen K; Peters, Ulrike; Shohet, Ralph V; Sotoodehnia, Nona; Young, Alicia M; Kooperberg, Charles; Haiman, Christopher A; Mohlke, Karen L; Whitsel, Eric A; North, Kari E

    2012-01-01

    The QT interval (QT) is heritable and its prolongation is a risk factor for ventricular tachyarrhythmias and sudden death. Most genetic studies of QT have examined European ancestral populations; however, the increased genetic diversity in African Americans provides opportunities to narrow association signals and identify population-specific variants. We therefore evaluated 6,670 SNPs spanning eleven previously identified QT loci in 8,644 African American participants from two Population Architecture using Genomics and Epidemiology (PAGE) studies: the Atherosclerosis Risk in Communities study and Women's Health Initiative Clinical Trial. Of the fifteen known independent QT variants at the eleven previously identified loci, six were significantly associated with QT in African American populations (P≤1.20×10(-4)): ATP1B1, PLN1, KCNQ1, NDRG4, and two NOS1AP independent signals. We also identified three population-specific signals significantly associated with QT in African Americans (P≤1.37×10(-5)): one at NOS1AP and two at ATP1B1. Linkage disequilibrium (LD) patterns in African Americans assisted in narrowing the region likely to contain the functional variants for several loci. For example, African American LD patterns showed that 0 SNPs were in LD with NOS1AP signal rs12143842, compared with European LD patterns that indicated 87 SNPs, which spanned 114.2 Kb, were in LD with rs12143842. Finally, bioinformatic-based characterization of the nine African American signals pointed to functional candidates located exclusively within non-coding regions, including predicted binding sites for transcription factors such as TBX5, which has been implicated in cardiac structure and conductance. In this detailed evaluation of QT loci, we identified several African Americans SNPs that better define the association with QT and successfully narrowed intervals surrounding established loci. These results demonstrate that the same loci influence variation in QT across multiple

  10. The role of the family in psychosocial adaptation to physical disabilities for African Americans.

    PubMed Central

    Turner, W. L.; Alston, R. J.

    1994-01-01

    The psychosocial adjustment of patients who are experiencing physical disabilities is examined within the context of a family ecological approach. Historical and sociocultural characteristics of African-American families are delineated and explored in terms of their potentially positive impact on the adjustment process. Four family strengths are delineated: strong kinship bonds, strong religious orientation, family role flexibility, and strong education/work ethic. The authors demonstrate how these various assets interact reciprocally in the family lives of those individuals who are disabled. Contrary to the predominant deficit theories, a fresh asset-oriented approach is provided. A model of the family adjustment process of African-American clients with disabilities is presented, and some of the important strengths of the African-American family system are examined. Finally, a family strengths model is applied to the therapeutic process. PMID:7861470

  11. Age, gender and health among African Americans.

    PubMed

    Fitzpatrick, T R; Thanh, V T

    1997-01-01

    Public policy and epidemiological studies have not adequately addressed age and gender differences on important health dimensions among African Americans. The purpose of this study was to examine gender and health among five age groups of African Americans. A sample of 1,174 respondents age 24 to 85 was selected from the 1986 Americans' Changing Lives (ACL) Study. Regression analysis was performed using a hierarchical model to examine age and gender on five dimensions of health: functional health, chronic conditions, satisfaction with health, self-ratings of health, and activities of daily living (ADL) limitations controlling for age, education, income, and marital status among five age groups of African Americans. Results revealed that in the 24-39 age group, men had fewer chronic conditions and less ADL limitations, yet rated their health poorer than their female counterparts. In the 75 and over age group men had better functional health yet were less satisfied with their health than women. Control variables were significantly related to objective and subjective dimensions of health especially among the younger age groups. Overall, gender differences persist mainly among the youngest and oldest age groups despite variations in the above demographic variables. Implications for social work practice and future research are discussed.

  12. African American Culture and Hypertension Prevention

    PubMed Central

    Peters, Rosalind M.; Aroian, Karen J.; Flack, John M.

    2009-01-01

    A qualitative study was done to explore attitudes and beliefs of African Americans regarding hypertension-preventive self-care behaviors. Five focus groups, with 34 participants, were held using interview questions loosely based on the Theory of Planned Behavior (TPB). Analysis revealed themes broadly consistent with the TPB, and also identified an overarching theme labeled “circle of culture.” The circle is a metaphor for ties that bind individuals within the larger African American community, and provides boundaries for culturally acceptable behaviors. Three sub-themes were identified: one describes how health behaviors are “passed from generation to generation,” another reflects a sense of being “accountable” to others within the culture; and the third reflects negative views taken toward people who are “acting different,” moving outside the circle of culture. Findings provide an expanded perspective of the TPB by demonstrating the influence of culture and collective identify on attitude formation and health-related behaviors among African Americans. PMID:17056776

  13. Psychosocial correlates of medical mistrust among African American men.

    PubMed

    Hammond, Wizdom Powell

    2010-03-01

    The current study proposed and tested a conceptual model of medical mistrust in a sample of African American men (N = 216) recruited primarily from barbershops in the Midwest and Southeast regions of the United States. Potential psychosocial correlates were grouped into background factors, masculine role identity/socialization factors, recent healthcare experiences, recent socioenvironmental experiences (e.g., discrimination), and healthcare system outcome expectations (e.g., perceived racism in healthcare). Direct and mediated relationships were assessed. Results from the hierarchical regression analyses suggest that perceived racism in healthcare was the most powerful correlate of medical mistrust even after controlling for other factors. Direct effects were found for age, masculine role identity, recent patient-physician interaction quality, and discrimination experiences. Also, perceived racism in healthcare mediated the relationship between discrimination experiences and medical mistrust. These findings suggest that African American men's mistrust of healthcare organizations is related to personal characteristics, previous negative social/healthcare experiences, and expectations of disparate treatment on the basis of race. These findings also imply that aspects of masculine role identity shape the tone of patient-physician interactions in ways that impede trust building processes.

  14. Do Birds of a Feather Flock Together? The Variable Bases for African American, Asian American, and European American Adolescents' Selection of Similar Friends.

    ERIC Educational Resources Information Center

    Hamm, Jill V.

    2000-01-01

    Examined variability in adolescent-friend similarity in African American, Asian American, and European American adolescents. Found greatest similarity for substance use, modest for academic orientation, and low for ethnic identity. Found that compared with other groups, African Americans chose friends who were less similar in academic orientation…

  15. Examining the Use of the College Self-Efficacy Inventory to Establish a Retention Strategy for Incoming African American Freshmen Males

    ERIC Educational Resources Information Center

    Evans, Dauvell K.

    2013-01-01

    The purpose of this study was to apply the College Self-Efficacy Inventory (CSEI) to further analyze the situations surrounding African American males' retention rate. The research that has been conducted has consistently proven that African American males' retention is among the lowest compared to any other males or females of any other…

  16. Mayo's Older African Americans Normative Studies: WMS-R norms for African American elders.

    PubMed

    Lucas, John A; Ivnik, Robert J; Smith, Glenn E; Ferman, Tanis J; Willis, Floyd B; Petersen, Ronald C; Graff-Radford, Neill R

    2005-06-01

    Norms for African American elders on the Wechsler Memory Scale-Revised (WMS-R) were derived from a sample of 309 community-dwelling individuals participating in Mayo's Older African Americans Normative Studies (MOAANS). Normative estimates are provided for traditional WMS-R subtest scores and for supplemental procedures to evaluate forgetting rates and recognition memory. Tables are provided to convert raw WMS-R subtest and supplemental scores to age-corrected scaled scores. These may be further adjusted for years of education, if desired, by applying regression-based corrections. We anticipate that these data will enhance the diagnostic utility and clinical interpretation of WMS-R performance in older African Americans.

  17. Physical activities and sedentary pursuits in African American and Caucasian girls.

    PubMed

    Dowda, Marsha; Pate, Russell R; Felton, Gwen M; Saunders, Ruth; Ward, Dianne S; Dishman, Rod K; Trost, Stewart G

    2004-12-01

    The purposes of this study were to describe and compare the specific physical activity choices and sedentary pursuits of African American and Caucasian American girls. Participants were 1,124 African American and 1,068 Caucasian American eighth-grade students from 31 middle schools. The 3-Day Physical Activity Recall (3DPAR) was used to measure participation in physical activities and sedentary pursuits. The most frequently reported physical activities were walking, basketball, jogging or running, bicycling, and social dancing. Differences between groups were found in 11 physical activities and 3 sedentary pursuits. Participation rates were higher in African American girls (p < or = .001) for social dancing, basketball, watching television, and church attendance but lower in calisthenics, ballet and other dance, jogging or running, rollerblading, soccer, softball or baseball, using an exercise machine, swimming, and homework. Cultural differences of groups should be considered when planning interventions to promote physical activity.

  18. Regional, racial, and gender differences in colorectal cancer screening in middle-aged African-Americans and Whites.

    PubMed

    Wallace, Phyllis M; Suzuki, Rie

    2012-12-01

    African-Americans have higher incidence and mortality from colorectal cancer than non-African-Americans. Early detection with colorectal cancer (CRC) screening reduces untimely death because the test can detect abnormalities and precancerous polyps in the colon and rectum. However, African-Americans aged 50 and older continue to have low CRC screening adherence. A retrospective analysis was conducted on data from the 2010 National Health Interview Survey to examine trends in self-reported CRC screening by geographic region, race, and gender. African-Americans, particularly men, were less likely to have been screened for colon cancer compared to all races and genders in this study. Individuals in the south were more likely to receive CRC screening than other regions. Colon cancer education and interventions are needed among low-adherent groups to promote the benefits of early detection with CRC screening.

  19. Perceived racial/ethnic harassment and tobacco use among African American young adults.

    PubMed

    Bennett, Gary G; Wolin, Kathleen Yaus; Robinson, Elwood L; Fowler, Sherrye; Edwards, Christopher L

    2005-02-01

    We examined the association between perceived racial/ethnic harassment and tobacco use in 2129 African American college students in North Carolina. Age-adjusted and multivariate analyses evaluated the effect of harassment on daily and less-than-daily tobacco use. Harassed participants were twice as likely to use tobacco daily (odds ratio = 2.01; 95% confidence interval=1.94, 2.08) compared with those with no reported harassment experiences. Experiences of racial/ethnic harassment may contribute to tobacco use behaviors among some African American young adults.

  20. Family structure and psychosocial correlates among urban African-American adolescent males.

    PubMed

    Zimmerman, M A; Salem, D A; Maton, K I

    1995-12-01

    Substance use and delinquency, psychological well-being, and social support were compared across 5 family constellations among 254 urban African-American adolescent males. Single-mother, stepparent, both parents, mother with extended family, and extended family only households were studied. The only differences found were that youth living in single-mother households reported more parental support than other youth. Relationships with father and male role models were also studied and related to several psychosocial outcomes. The results challenge the assumptions that single African-American mothers are alone in providing support to their sons and that fathers' absence results in no significant relationship. PMID:8556888

  1. African American parents' behaviors and attitudes about substance use and abuse.

    PubMed

    Paschal, Angelia M; Lewis, Rhonda K; Sly, Jamilia

    2007-01-01

    Limited information exists about African American parents' substance use and attitudes, independent of how they relate to their children. This study examined whether the behaviors and attitudes of a sample of African American parents differed from the general population of adults. Results indicated their attitudes were relatively more conservative, and that alcohol and illicit drug use were lower. Cigarette and marijuana use were comparable. Correlations between attitudes and behaviors were found. Findings suggest that increased educational efforts are needed among parents, especially about cigarettes, marijuana, and the negative impact these attitudes and behaviors may have on their children.

  2. Higher postprandial serum ghrelin among African American females before puberty

    PubMed Central

    Ellis, Amy C.; Casazza, Krista; Chandler-Laney, Paula; Gower, Barbara A.

    2013-01-01

    Objective Recent reports suggest that ghrelin regulation may differ by ethnicity and age. This study was designed to examine circulating ghrelin among overweight African American females across different age groups. Methods Eleven overweight peri-pubertal girls, 17 overweight pubertal girls, and a control group of 18 overweight AA premenopausal women ingested a standard liquid meal following an overnight fast. Blood samples were obtained before the meal and for 4 hours post-challenge. Participants rated appetite by a visual analog scale. Results Peri-pubertal girls demonstrated higher postprandial ghrelin and lesser ghrelin suppression compared to adults (p<0.05), corresponding with greater desire to eat across the test period (p=0.017). Fasting ghrelin tended to be inversely related to fasting estradiol (r=−0.264, p=0.076). Conclusion Compared to overweight African American women, peri-pubertal girls had higher ghrelin as well as greater appetite after a standard meal. These results may suggest a dysregulation in ghrelin reflective of demands of growth. PMID:23155695

  3. Lift every voice: voices of African-American lesbian elders.

    PubMed

    Woody, Imani

    2015-01-01

    Old lesbians of African descent have experienced racism, heterosexism, homophobia, and ageism. This article explores the topics of aging, ageism, heterosexism, and minority stress among older African-American lesbians. The narratives and subsequent analysis offer significant contributions to the dialogue regarding Black aging lesbians in the aging and lesbian, gay, bisexual, and transgender (LGBT) communities generally and in the African-American and African-American lesbian communities specifically.

  4. Perspectives from the historic African American medical institutions.

    PubMed

    Epps, C H

    1999-05-01

    The historically African American medical schools have been at the center of medical education for African American physicians in the United States since the Howard University College of Medicine opened in 1868. Although there were more than a dozen African American medical schools established during the next few decades, as propriety or church affiliated schools, only two survived the Flexner Report in 1910. Howard University (1868) and Meharry (1876) survived and trained generations of African Americans. These two schools educated approximately 85% of all African American physicians whereas the majority medical schools educated 15% for more than half of the twentieth century. As the result of a series of lawsuits filed by the National Association for the Advancement of Colored People, civil rights legislation and affirmative action programs, the numbers of the schools that now admitted African Americans increased and the total numbers of African American medical students increased when discrimination was prohibited in 1966. The percentage of African American medical students attending predominantly white institutions increased by 25% in 1948, by 47% in 1968, by 61% in 1983 and to 84% in 1990. Two additional predominantly African American medical schools were established: the Charles R. Drew Medical School, Los Angeles (affiliated with the University of California, Los Angeles) in 1966, and Morehouse Medical School, Atlanta, which admitted its first class in 1978. Recent court decisions prohibiting schools from considering race as factor in admission and the end of affirmative action programs have resulted in a drop in total minority enrollment. The historically African American medical schools, that admitted approximately 15% of the African American medical students during the era of affirmative action programs, will see this percentage decrease as the majority institutions admit fewer African American medical students and minority students. In the United States

  5. KSC kicks off African-American History Month

    NASA Technical Reports Server (NTRS)

    2000-01-01

    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.

  6. KSC kicks off African-American History Month

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Michelle Amos, mistress of ceremonies for the kick-off of African-American History Month, works with the audience to assist them in the pronunciation of a few token words in native Swahili. 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.

  7. Spiritual Expressions of African Americans and Whites in Cancer Pain

    PubMed Central

    Buck, Harleah G.; Meghani, Salimah H.

    2014-01-01

    Background Spiritual practices are one way that individuals cope with cancer pain. Purpose Describe and contrast expressions and values about the use of spirituality for pain in African American (AA) and White (WH) oncology patients. Methods Six groups (3 AA; 3 WH; n=42; mean age 58) were conducted. Focus group and qualitative methodology with a cultural interpretive lens was utilized. The Model of Integrated Spirituality provided the conceptual framework for understanding the narratives. Findings AAs and WHs did not differ on demographics, pain status, or integrative therapies. Three spirituality themes emerged: 1) pain and distress as antecedents to the use of spirituality; 2) active and existential attributes of the use of spirituality; and 3) mobilization of internal and external resources as outcomes. There were commonalities between AAs and WHs but greater frequency of certain subthemes and keywords in AAs. Conclusions Future studies should examine whether differences in overt expressions translate into different types and levels of spiritual usage. Implications for Practice Clinicians should recognizing similar as well as different uses and descriptions of spirituality between African Americans and Whites. PMID:22024953

  8. African American women and breastfeeding: an integrative literature review.

    PubMed

    Spencer, Becky S; Grassley, Jane S

    2013-07-01

    The purpose of this article is to present a review of literature regarding factors that influence breastfeeding intentions, initiation, and duration in the African American population. Research related to health disparities experienced by African Americans in the United States, as well as research regarding the protective benefits of breastfeeding for those specific health disparities, are also presented. Community and institutional interventions and promotional campaigns aimed at increasing initiation and duration of breastfeeding in the African American population are discussed. Future research regarding African American women's breastfeeding experiences using Black feminist thought as a theoretical foundation is recommended.

  9. The myth of meritocracy and African American health.

    PubMed

    Kwate, Naa Oyo A; Meyer, Ilan H

    2010-10-01

    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.

  10. Critical social theory and the domination of African American Women.

    PubMed

    Davis, S P

    1995-01-01

    This historical reconstruction of the experiences of African American women in America from slavery to the present exposes the prevailing and enduring system of White male domination. From White men having control of their reproductive choices, to conspiracy to withhold the right to vote, African American women were victims of both sexism and racism. Later, as a result of the myth conceived by White sociologists of the super African American woman, further divisiveness became apparent in the African American home. As African American women took advantage of educational opportunities only to find that there was a dearth of similarly educated African American males to marry, increasing numbers of African American men were reported as parties to violent acts, drugs or illness. All of these variables are conjectured as impacting on the African American woman's experience. Lastly, data were presented depicting the increasing trend of African American women marrying White men, and the emergence of a more diverse workforce. It was concluded that economics serve as a catalyst for this change in human relations.

  11. African American legislators' perceptions of firearm violence prevention legislation.

    PubMed

    Payton, Erica; Thompson, Amy; Price, James H; Sheu, Jiunn-Jye; Dake, Joseph A

    2015-06-01

    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.

  12. Black and Blue: Depression and African American Men.

    PubMed

    Plowden, Keith O; Thompson Adams, Linda; Wiley, Dana

    2016-10-01

    Depression is a common mental disorder affecting individuals. Although many strides have been made in the area of depression, little is known about depression in special populations, especially African American men. African American men often differ in their presentation of depression and are often misdiagnosed. African American men are at greater risk for depression, but they are less likely to participate in mental health care. This article explores depression in African American by looking at environmental factors, sigma, role, and other unique to this populations, such as John Henryism. Interventions to encourage early screening and participation in care are also discussed.

  13. Novel recurrently mutated genes in African American colon cancers

    PubMed Central

    Guda, Kishore; Veigl, Martina L.; Varadan, Vinay; Nosrati, Arman; Ravi, Lakshmeswari; Lutterbaugh, James; Beard, Lydia; Willson, James K. V.; Sedwick, W. David; Wang, Zhenghe John; Molyneaux, Neil; Miron, Alexander; Adams, Mark D.; Elston, Robert C.; Markowitz, Sanford D.; Willis, Joseph E.

    2015-01-01

    We used whole-exome and targeted sequencing to characterize somatic mutations in 103 colorectal cancers (CRC) from African Americans, identifying 20 new genes as significantly mutated in CRC. Resequencing 129 Caucasian derived CRCs confirmed a 15-gene set as a preferential target for mutations in African American CRCs. Two predominant genes, ephrin type A receptor 6 (EPHA6) and folliculin (FLCN), with mutations exclusive to African American CRCs, are by genetic and biological criteria highly likely African American CRC driver genes. These previously unsuspected differences in the mutational landscapes of CRCs arising among individuals of different ethnicities have potential to impact on broader disparities in cancer behaviors. PMID:25583493

  14. Novel recurrently mutated genes in African American colon cancers.

    PubMed

    Guda, Kishore; Veigl, Martina L; Varadan, Vinay; Nosrati, Arman; Ravi, Lakshmeswari; Lutterbaugh, James; Beard, Lydia; Willson, James K V; Sedwick, W David; Wang, Zhenghe John; Molyneaux, Neil; Miron, Alexander; Adams, Mark D; Elston, Robert C; Markowitz, Sanford D; Willis, Joseph E

    2015-01-27

    We used whole-exome and targeted sequencing to characterize somatic mutations in 103 colorectal cancers (CRC) from African Americans, identifying 20 new genes as significantly mutated in CRC. Resequencing 129 Caucasian derived CRCs confirmed a 15-gene set as a preferential target for mutations in African American CRCs. Two predominant genes, ephrin type A receptor 6 (EPHA6) and folliculin (FLCN), with mutations exclusive to African American CRCs, are by genetic and biological criteria highly likely African American CRC driver genes. These previously unsuspected differences in the mutational landscapes of CRCs arising among individuals of different ethnicities have potential to impact on broader disparities in cancer behaviors. PMID:25583493

  15. Ending the epidemic of heterosexual HIV transmission among African Americans.

    PubMed

    Adimora, Adaora A; Schoenbach, Victor J; Floris-Moore, Michelle A

    2009-11-01

    This article examines factors responsible for the stark racial disparities in HIV infection in the U.S. and the now concentrated epidemic among African Americans. Sexual network patterns characterized by concurrency and mixing among different subpopulations, together with high rates of other sexually transmitted infections, facilitate dissemination of HIV among African Americans. The social and economic environment in which many African Americans live shapes sexual network patterns and increases personal infection risk almost independently of personal behavior. The African-American HIV epidemic constitutes a national crisis whose successful resolution will require modifying the social and economic systems, structures, and processes that facilitate HIV transmission in this population.

  16. Ending the Epidemic of Heterosexual HIV Transmission Among African Americans

    PubMed Central

    Adimora, Adaora A.; Schoenbach, Victor J.; Floris-Moore, Michelle A.

    2014-01-01

    This article examines factors responsible for the stark racial disparities in HIV infection in the U.S. and the now concentrated epidemic among African Americans. Sexual network patterns characterized by concurrency and mixing among different subpopulations, together with high rates of other sexually transmitted infections, facilitate dissemination of HIV among African Americans. The social and economic environment in which many African Americans live shapes sexual network patterns and increases personal infection risk almost independently of personal behavior. The African American HIV epidemic constitutes a national crisis whose successful resolution will require modifying the social and economic systems, structures, and processes that facilitate HIV transmission in this population. PMID:19840704

  17. HIV health crisis and African Americans: a cultural perspective.

    PubMed

    Plowden, K; Miller, J L; James, T

    2000-01-01

    While incidence of new HIV infections have decreased in the overall population, the numbers continue to rise in African-Americans creating a serious health emergency. Studies seem to imply that part of the rise is due to HIV beliefs and high risk behaviors among African Americans. Due to certain societal factors, African Americans appear to be at greater risk for contracting the virus. This article will examine these critical social factors and their impact on this current state of emergency in the African American community using Leininger's theory of Culture Care and Universality. Implications for health providers are also addressed. PMID:11760310

  18. The myth of meritocracy and African American health.

    PubMed

    Kwate, Naa Oyo A; Meyer, Ilan H

    2010-10-01

    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. PMID:20724679

  19. African American Literature, 1989-94: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Miller, R. Baxter; Butts, Tracy; Jones, Sharon

    1997-01-01

    Contains an annotated bibliography of African American literature (published between 1989 and 1994), including anthologies, fiction, poetry, drama, criticism, cultural studies, biography, interviews, and letters. (TB)

  20. The Myth of Meritocracy and African American Health

    PubMed Central

    Meyer, Ilan H.

    2010-01-01

    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. PMID:20724679

  1. Genetic bottlenecks, perceived racism, and hypertension risk among African Americans and first-generation African immigrants.

    PubMed

    Poston, W S; Pavlik, V N; Hyman, D J; Ogbonnaya, K; Hanis, C L; Haddock, C K; Hyder, M L; Foreyt, J P

    2001-05-01

    The complexity of factors influencing the development of hypertension (HTN) in African Americans has given rise to theories suggesting that genetic changes occurred due to selection pressures/genetic bottleneck effects (ie, constriction of existing genetic variability) over the course of the slave trade. Ninety-nine US-born and 86 African-born health professionals were compared in a cross-sectional survey examining genetic and psychosocial predictors of HTN. We examined the distributions of three genetic loci (G-protein, AGT-235, and ACE I/D) that have been associated with increased HTN risk. There were no significant differences between US-born African Americans and African-born immigrants in the studied genetic loci or biological variables (eg, plasma renin and angiotensin converting enzyme activity), except that the AGT-235 homozygous T genotype was somewhat more frequent among African-born participants than US-born African Americans. Only age, body mass index, and birthplace consistently demonstrated associations with HTN status. Thus, there was no evidence of a genetic bottleneck in the loci studied, ie, that US-born African Americans have different genotype distributions that increase their risk for HTN. In fact, some of the genotypic distributions evidenced lower frequencies of HTN-related alleles among US-born African Americans, providing evidence of European admixture. The consistent finding that birthplace (ie, US vs Africa) was associated with HTN, even though it was not always significant, suggests potential and unmeasured cultural, lifestyle, and environmental differences between African immigrants and US-born African Americans that are protective against HTN.

  2. Fear of Neighborhood Violence During Adolescence Predicts Development of Obesity a Decade Later: Gender Differences Among African Americans

    PubMed Central

    Assari, Shervin; Moghani Lankarani, Maryam; Caldwell, Cleopatra Howard; Zimmerman, Marc A

    2016-01-01

    Background African American youth are more likely than other racial and ethnic groups to be obese. African American youth are also more likely to live in disadvantaged neighborhoods which increase their victimization, observation, and fear of violence. Objectives This study tested if victimization, observation, and fear of violence in the neighborhood during adolescence predict trajectory of body mass index (BMI) in the 3rd decade of life in African Americans. Patients and Methods Data came from an 18-year community-based cohort. We used multi-group latent growth curve modeling for data analysis, considering neighborhood violence at age 15 (i.e. victimization, observation, and fear) as predictors, and the linear slope for the average change in BMI from age 21 to 32 as the outcome, with age and socioeconomic status (i.e. intact family and parental employment) as covariates. Results Fear of neighborhood violence at age 15 was predictive of an increase in BMI from age 21 to 32 among female but not male African Americans. Victimization and observation of violence at age 15 did not predict BMI change from age 21 to 32 among female or male African Americans. Conclusions Fear of neighborhood violence is a contributing factor to increased risk of obesity for female African American youth who live in disadvantaged areas. This finding has implications for prevention of obesity among African American women who are at highest risk for obesity in the United States. Initiatives that enhance neighborhood safety are critical strategies for obesity prevention among African American women. PMID:27679791

  3. Marriage and End-Stage Renal Disease: Implications for African Americans

    ERIC Educational Resources Information Center

    Shortridge, Emily F.; James, Cara V.

    2010-01-01

    African Americans are disproportionately represented among patients with end-stage renal disease (ESRD). ESRD is managed with a strict routine that might include regular dialysis as well as dietary, fluid intake, and other lifestyle changes. In a disease such as this, with such disruptive treatment modalities, marriage, specifically, and its ties…

  4. Attitudes and Beliefs of African Americans Toward Participation in Medical Research

    PubMed Central

    Corbie-Smith, Giselle; Thomas, Stephen B; Williams, Mark V; Moody-Ayers, Sandra

    1999-01-01

    OBJECTIVE To describe barriers to participation of African Americans in research. DESIGN Focus group interviews conducted in 1997. PATIENTS Thirty-three African-American adults presenting to an urban public hospital for outpatient medical care participated in one of five focus groups. MEASUREMENTS AND MAIN RESULTS African-American patients' attitudes toward medical research were measured. Mistrust of doctors, scientists, and the government was reported consistently by the participants. Many participants described concerns about the ethical conduct of clinicians and investigators when poor or minority patients are involved and cited examples of exploitation as supporting evidence for their mistrust of the medical establishment. While participants were clear about the violation of human rights in the Tuskegee Syphilis Study, all were misinformed of the historical facts of the study. Few participants understood the concept of informed consent. Participants saw signing the document as relinquishing their autonomy and as a legal protection for physicians. Despite these concerns, participants gave recommendations to improve minority participation in research. CONCLUSIONS African-American participants in this study described distrust of the medical community as a prominent barrier to participation in clinical research. Participants described real and perceived examples of exploitation to support their distrust of researchers. The goal of the consent process, to inform patients of risks and benefits so as to facilitate self-determination, was misinterpreted by these participants. Understanding the importance of interpersonal trust within the clinical relationship may prove to be a significant factor in enhancing participation in clinical trials. PMID:10491242

  5. Evaluating brief cognitive impairment screening instruments among African Americans.

    PubMed

    Kiddoe, Jared M; Whitfield, Keith E; Andel, Ross; Edwards, Christopher L

    2008-07-01

    This article compared and contrasted the Telephone Interview of Cognitive Status (TICS) to the racially-sensitive Short Portable Mental Status Questionnaire (SPMSQ). The empirical questions addressed was whether the TICS over-represented African American (AA) cognitive impairment (CI) relative to the SPMSQ, if there were age differences in CI prevalence between younger subjects (ages 50-64) and older ones (>64 years) and on accuracy to detect CI in individuals with higher levels of educations (> or =13 years) versus those with lower education levels (<13 years). A secondary data analysis was performed on 396 AA participants from the Carolina African American Twin Study on Aging (CAATSA). The SPMSQ measured CI prevalence at 10.3% and the TICS at 45.0%. Within the younger group, TICS and CI prevalence was 49.3 and 80% among the older group. Within the younger group SPMSQ and CI prevalence was 14.5 and 53.8% among the older group. Within the higher educated group, TICS and CI prevalence was 36.7 and 51.4% among the lower educated. Within the higher educated group, SPMSQ and CI prevalence was 7.7 and 14.5% among the lower educated. Findings are consistent with our hypotheses that the TICS would be a less accurate assessor of CI among AAs.

  6. Culturally specific interventions for African American smokers: an efficacy experiment.

    PubMed

    Webb, Monica S

    2009-09-01

    This pilot study sought to dismantle the efficacy of culturally specific print materials for smoking cessation. Two-hundred sixty-one African American smokers were randomized into 1 of 2 conditions: standard booklet or culturally specific booklet. The content and length of the interventions were identical yet varied in their degree of cultural specificity. Three-month follow-up assessments were completed by 70% (N = 183) of participants. Dependent variables included content evaluation, readiness to quit smoking, and actual behavior change. Evidence suggested that the culturally specific material was more effective at capturing attention, providing encouragement and gaining interest compared to standard materials; however, greater credibility was found for standard materials. In addition, greater readiness to quit and more 24-hour quit attempts were found in the standard condition. No differences were found in abstinence rates. In conclusion, culturally specific interventions may be preferred over standard approaches among African American smokers. Culturally specific approaches, however, may not result in greater behavior change. Implications for written interventions and cultural specificity are discussed. PMID:19806851

  7. C-reactive protein and cardiac vagal activity following resistance exercise training in young African-American and white men.

    PubMed

    Heffernan, Kevin S; Jae, Sae Young; Vieira, Victoria J; Iwamoto, Gary A; Wilund, Kenneth R; Woods, Jeffrey A; Fernhall, Bo

    2009-04-01

    African Americans have a greater prevalence of hypertension and diabetes compared with white Americans, and both autonomic dysregulation and inflammation have been implicated in the etiology of these disease states. The purpose of this study was to examine the cardiac autonomic and systemic inflammatory response to resistance training in young African-American and white men. Linear (time and frequency domain) and nonlinear (sample entropy) heart rate variability, baroreflex sensitivity, tonic and reflex vagal activity, and postexercise heart rate recovery were used to assess cardiac vagal modulation. C-reactive protein (CRP) and white blood cell count were used as inflammatory markers. Twenty two white and 19 African-American men completed 6 wk of resistance training followed by 4 wk of exercise detraining (Post 2). Sample entropy, tonic and reflex vagal activity, and heart rate recovery were increased in white and African-American men following resistance training (P < 0.05). Following detraining (Post 2), sample entropy, tonic and reflex vagal activity, and heart rate recovery returned to baseline values in white men but remained above baseline in African-American men. While there were no changes in white blood cell count or CRP in white men, these inflammatory markers decreased in African-American men following resistance training, with reductions being maintained following detraining (P < 0.05). In conclusion, resistance training improves cardiac autonomic function and reduces inflammation in African-American men, and these adaptations remained after the cessation of training. Resistance training may be an important lifestyle modification for improving cardiac autonomic health and reducing inflammation in young African-American men.

  8. Assessment of the Status of African-Americans. Volume III: The Education of African-Americans.

    ERIC Educational Resources Information Center

    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…

  9. Equipping African American Clergy to Recognize Depression.

    PubMed

    Anthony, Jean Spann; Morris, Edith; Collins, Charles W; Watson, Albert; Williams, Jennifer E; Ferguson, Bʼnai; Ruhlman, Deborah L

    2016-01-01

    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.

  10. Equipping African American Clergy to Recognize Depression.

    PubMed

    Anthony, Jean Spann; Morris, Edith; Collins, Charles W; Watson, Albert; Williams, Jennifer E; Ferguson, Bʼnai; Ruhlman, Deborah L

    2016-01-01

    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. PMID:27610907

  11. Recruitment and enrollment of African Americans and Caucasians in a health promotion trial for persons with serious mental illness.

    PubMed

    Siddiqui, Mona; Cooper, Lisa A; Appel, Lawrence J; Yu, Airong; Charleston, Jeanne; Gennusa, Joseph; Dickerson, Faith; Daumit, Gail L

    2015-01-01

    African Americans with serious mental illness (SMI) continue to experience inadequate representation in clinical trials. Persons with SMI, regardless of race, have an increased burden of all cardiovascular disease (CVD) risk factors including obesity, hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and tobacco smoking. Having SMI and being African American, however, is each associated with an increased risk of CVD mortality compared to the general population. There is a critical need, therefore, to adapt health promotion interventions for African Americans with SMI. We sought to examine overall recruitment into a randomized clinical trial of CVD prevention among persons with SMI, and to examine racial differences in interest, enrollment, and potential barriers to participation. Although similar levels of interest in participation were seen between African Americans and Caucasians in signing screening consent, 9.6% fewer African Americans enrolled due to inability to complete initial data collection. Further work is needed to better understand the nature of the barriers encountered by African Americans with SMI who otherwise may be interested in participating within clinical trials.

  12. From Description to Explanation: An Empirical Exploration of the African-American Pipeline Problem in STEM

    ERIC Educational Resources Information Center

    Brown, Bryan A.; Henderson, J. Bryan; Gray, Salina; Donovan, Brian; Sullivan, Shayna; Patterson, Alexis; Waggstaff, William

    2016-01-01

    We conducted a mixed-methods study of matriculation issues for African-Americans in the STEM pipeline. The project compares the experiences of students currently majoring in science (N?=?304) with the experiences of those who have succeeded in earning science degrees (N?=?307). Participants were surveyed about their pipeline experiences based on…

  13. Factors Influencing Elementary Teachers' Positioning of African American Girls as Science and Mathematics Learners

    ERIC Educational Resources Information Center

    Pringle, Rose M.; Brkich, Katie Milton; Adams, Thomasenia Lott; West-Olatunii, Cirecie; Archer-Banks, Diane A.

    2012-01-01

    Despite recent progress toward gender equity in science and mathematics education, the underachievement of low-income African American girls remains a challenge when compared with their white counterparts. Furthermore, the causes of this persistent underachievement have not been explored thoroughly. We have initiated a three-year longitudinal…

  14. Effects of a Math Intervention Program on Math Academic Performance among African American Students

    ERIC Educational Resources Information Center

    Johnson, Willie F., Jr.

    2013-01-01

    In the United States, an academic achievement gap has prevented many African American students from advancement and educational empowerment. Guided by Bandura's theoretical belief, which posits a relationship between social factors and an individual's perception, this non-experimental, causal comparative, control treatment group design study…

  15. From Access to Success: Identity Contingencies & African-American Pathways to Science

    ERIC Educational Resources Information Center

    Brown, Bryan A.; Henderson, J. Bryan; Gray, Salina; Donovan, Brian; Sullivan, Shayna

    2013-01-01

    We conducted a mixed-methodological study of matriculation issues for African-American students in science. The project compares the experiences of students currently majoring in science (N = 304) with the experiences of those who have succeeded in earning science degrees (N = 307). Using a 57-item Likert scale questionnaire, participants were…

  16. Resilience Post Tenure: The Experience of an African American Woman in a PWI

    ERIC Educational Resources Information Center

    Behar-Horenstein, Linda S.; West-Olatunji, Cirecie A.; Moore, Thomas E.; Houchen, Deidre F.; Roberts, Kellie W.

    2012-01-01

    The purpose of this study was: 1) to explore the pre-tenure experiences of an African American female faculty member in a counselor education program; and 2) to compare the themes that ascended from a precursor study to the current one. By using critical ethnography and case study format, this research gave voice to the participant by prompting…

  17. African American College Students and Stress: School Racial Composition, Self-Esteem and Social Support

    ERIC Educational Resources Information Center

    Negga, Feven; Applewhite, Sheldon; Livingston, Ivor

    2007-01-01

    College students are a very vulnerable group to experience stress, the latter of which is related to a variety of outcomes, such as health and academic performance. However, there is a dearth of research examining African American college students and stress. Further, fewer studies have compared stress for students attending predominately white…

  18. RECRUITING AND RETAINING AFRICAN-AMERICANS FOR AN EXPOSURE STUDY IN SOUTHEAST RALEIGH

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) recently completed a study of African-Americans' exposure to particulate matter (PM) in Southeast Raleigh. A primary goal was to compare PM levels measured at ambient and residential sites with those from personal exposure monitors...

  19. Demographics of African-American vs. European-Heritage Mothers of Newborns with Down Syndrome

    ERIC Educational Resources Information Center

    Hodapp, Robert M.; Urbano, Richard C.

    2008-01-01

    Although important for public health policy, ethnic/racial disparities have rarely been examined among families of young children with Down syndrome. This study compared 144 African-American mothers with 726 European-heritage mothers of newborns with Down syndrome using official birth records in one American state from 1990 through 2002; outcome…

  20. Student Perceptions of Teacher Characteristics on Math Achievement for Middle School African American Students

    ERIC Educational Resources Information Center

    Clayton, Otis, Jr.

    2013-01-01

    This causal-comparative research explored how African American students' perceptions of their math teachers affected their academic performance on the Math Tennessee Comprehensive Assessment Program (TCAP) Test during 2009-2010 academic year. When considering possible measures of teacher effectiveness in K-12 education, it can be argued that…

  1. Preliminary Information on Stuttering Characteristics Contrasted between African American and White Children.

    ERIC Educational Resources Information Center

    Olsen, Lisa Taylor; Steelman, Mary Lynn; Buffalo, M. D.; Montague, Jim

    1999-01-01

    This study compared verbal disfluency and accessory characteristics of 15 African-American and 15 White male stutterers (ages 8-12). Overall, no significant differences were found in verbal- or visual-disfluency behaviors on either reading or conversation tasks between the two groups. Also, no significant differences were found in attitudes toward…

  2. African American Male Student-Athletes: Career Maturity Differences at High School Level.

    ERIC Educational Resources Information Center

    Brown, Chris

    1999-01-01

    Investigates career maturity differences among 133 African American male high school student-athletes. Findings revealed no significant differences between student-athletes and their nonathlete peers on the career maturity attitude and competence variables. Findings further indicated that 94% of student-athletes as compared to 72% of nonathletes…

  3. African American College Students' Health Behaviors and Perceptions of Related Health Issues.

    ERIC Educational Resources Information Center

    Ford, Denyce S.; Goode, Carolyn R.

    1994-01-01

    A study of African American college students compared students' health-related behaviors with their perceptions of corresponding health issues. Students had low smoking rates but higher alcohol consumption. Most students did not practice good nutrition or daily physical activity. Over half managed stress well, and three-quarters were sexually…

  4. African American and Hispanic Student Engagement at Minority Serving and Predominantly White Institutions

    ERIC Educational Resources Information Center

    Nelson Laird, Thomas F.; Bridges, Brian K.; Morelon-Quainoo, Carla L.; Williams, Julie M.; Holmes, Michelle Salinas

    2007-01-01

    Although scholars have examined historically Black colleges and universities (HBCUs) in terms of their educational effectiveness for African American students compared to predominantly white institutions (PWIs), there is a lack of similar research on Hispanic students at Hispanic-serving institutions (HSIs) and PWIs. This study uses data from the…

  5. African American and European American College Students' Expectations for Self and for Future Partners.

    ERIC Educational Resources Information Center

    Ganong, Lawrence H.; And Others

    1996-01-01

    Examines self-expectations, expectations for future partners, and comparative expectations (self versus partner) held by college students. African Americans had higher self-expectations regarding future income, professional success, and educational achievement than European Americans. No differences emerged in expectations for future partners'…

  6. Passive Participle Marking by African American English-Speaking Children Reared in Poverty

    ERIC Educational Resources Information Center

    Pruitt, Sonja L.; Oetting, Janna B.; Hegarty, Michael

    2011-01-01

    Purpose: In this study, the authors examined the linguistic profile of African American English (AAE)-speaking children reared in poverty by focusing on their marking of passive participles and by comparing the results with the authors' previous study of homophonous forms of past tense (S. Pruitt & J. Oetting, 2009). Method: The data were from 45…

  7. Phonological Features Exhibited by Children Speaking African American English at Three Grade Levels

    ERIC Educational Resources Information Center

    Harris, Kandis L.; Moran, Michael J.

    2006-01-01

    This study compared phonological features of African American English speakers at 3 grade levels: preschool, elementary school, and middle school. The phonological features exhibited at all 3 grade levels were quite similar. The frequency of usage, determined by the percentage of speakers exhibiting the feature and by the mean number of…

  8. A Home-Based Intervention to Reduce Depressive Symptoms and Improve Quality of Life in Older African Americans

    PubMed Central

    Gitlin, Laura N.; Harris, Lynn Fields; McCoy, Megan C.; Chernett, Nancy L.; Pizzi, Laura T.; Jutkowitz, Eric; Hess, Edward; Hauck, Walter W.

    2014-01-01

    Background Effective care models for treating older African Americans with depressive symptoms are needed. Objective To determine whether a home-based intervention alleviates depressive symptoms and improves quality of life in older African Americans. Design Parallel, randomized trial stratified by recruitment site. Interviewers assessing outcomes were blinded to treatment assignment. (ClinicalTrials.gov: NCT00511680) Setting A senior center and participants’ homes from 2008 to 2010. Patients African Americans aged 55 years or older with depressive symptoms. Intervention A multicomponent, home-based intervention delivered by social workers or a wait-list control group that received the intervention at 4 months. Measurements Self-reported depression severity at 4 months (primary outcome) and depression knowledge, quality of life, behavioral activation, anxiety, function, and remission at 4 and 8 months. Results Of 208 participants (106 and 102 in the intervention and wait-list groups, respectively), 182 (89 and 93, respectively) completed 4 months and 160 (79 and 81, respectively) completed 8 months. At 4 months, participants in the intervention group showed reduced depression severity (difference in mean change in Patient Health Questionnaire-9 score from baseline, −2.9 [95% CI, −4.6 to −1.2]; difference in mean change in Center for Epidemiologic Studies Depression Scale score from baseline, −3.7 [CI, −5.4 to −2.1]); improved depression knowledge, quality of life, behavioral activation, and anxiety (P < 0.001); and improved function (P = 0.014) compared with wait-list participants. More intervention than wait-list participants entered remission at 4 months (43.8% vs. 26.9%). After treatment, control participants showed benefits similar in magnitude to those of participants in the initial intervention group. Those in the initial intervention group maintained benefits at 8 months. Limitation The study had a small sample, short duration, and differential

  9. African-American caregivers' breast health behavior.

    PubMed

    Inoue, Megumi; Pickard, Joseph G; Welch-Saleeby, Patricia; Johnson, Sharon

    2009-10-01

    This study utilizes a stress and coping framework which includes cognitive appraisal, personal and environmental resources, coping and stress to examine factors related to African-American caregivers' breast cancer screenings, including mammograms, clinical examinations and self-examinations. Using data from the Black Rural and Urban Caregivers Mental Health and Functioning Study, we performed separate logistic regressions for each type of breast cancer screening. Results reveal that having a regular doctor checkup (coping), care recipients having a cancer diagnosis (cognitive appraisal, and living in urban areas (environment resources) are associated with receiving a mammogram. Having greater income, having at least a high school degree (both personal resources) and having a regular doctor checkup (coping) are associated with receiving a clinical examination. Increased caregiver strain (stress), being 40 years old or older, social support (coping) and living in rural areas are associated with performing a self-examination. Targeting African-American caregivers, particularly in rural areas, for increased education on the importance of receiving breast cancer screenings is crucial to addressing health disparities. Making resources available, encouraging caregivers to get a clinical examination and a mammogram and directing public education toward caregivers are important points of intervention.

  10. Correlates of African American Men's Sexual Schemas

    PubMed Central

    Morales, Dawn A.; Coyne-Beasley, Tamera; St. Lawrence, Janet

    2013-01-01

    Sexual schemas are cognitive representations of oneself as a sexual being and aid in the processing of sexually relevant information. We examined the relationship between sociosexuality (attitudes about casual sex), masculine ideology (attitudes toward traditional men and male roles), and cultural centrality (strength of identity with racial group) as significant psychosocial and sociocultural predictors in shaping young, heterosexual African American men's sexual schemas. A community sample (n=133) of men in a southeastern city of the United States completed quantitative self-report measures examining their attitudes and behavior related to casual sex, beliefs about masculinity, racial and cultural identity, and self-views of various sexual aspects of themselves. Results indicated that masculine ideology and cultural centrality were both positively related to men's sexual schemas. Cultural centrality explained 12 % of the variance in level of sexual schema, and had the strongest correlation of the predictor variables with sexual schema (r=.36). The need for more attention to the bidirectional relationships between masculinity, racial/cultural identity, and sexual schemas in prevention, intervention, and public health efforts for African American men is discussed. PMID:24031118

  11. Physical activity participation in African American churches.

    PubMed

    Bopp, Melissa; Wilcox, Sara; Laken, Marilyn; McClorin, Lottie

    2009-01-01

    The potential benefit of physical activity (PA) programs delivered through churches is largely unexamined. This study examined availability of PA programs, interpersonal support for PA, and PA participation in African-American churches. Individuals from a random sample of 20 churches in South Carolina participated in a telephone survey (N = 571). Forty two percent of respondents reported PA programs at their churches. Walking programs (20%), aerobics (22%) or a combination of both (20%) were most common. Respondents who reported having these programs were more likely to meet PA recommendations than those who did not (p = 0.05). Larger churches were more likely to offer PA programs (p = 0.02) than small or medium sized churches. Only 24% of respondents had spoken with the health director at their church about participating in a PA program, and only 25% and 33% had ever spoken with another church member about a PA program or were encouraged to join a PA program, respectively. Individuals with more interpersonal support from other church members for PA were significantly more likely to meet PA recommendations (p = 0.01). This study indicates that program and interpersonal supports within African American churches may offer a venue for increasing PA among members.

  12. Social Support Structures and African-American Marriages.

    ERIC Educational Resources Information Center

    Curry-El, Judith A.; And Others

    An issue currently facing the African-American community is the incidence of divorce, which is presently at a higher rate than that of other groups. This study focused on the supportive networks of African-American couples utilizing a network analysis approach to examine the relationship between the networks, and marital satisfaction among the…

  13. "Workin' on the Railroad": African American Labor History

    ERIC Educational Resources Information Center

    Maher, Rebecca

    2004-01-01

    In the spring of 2003, the author worked with a team of eighth grade teachers at Asheville Middle School in North Carolina on a project that combined fine art, music, the history of the railroads, and the African American experience in the state and nation. In her classroom, students interviewed a retired train conductor, who was African American,…

  14. Retention of African American Faculty in Research Universities

    ERIC Educational Resources Information Center

    Awe, Clara

    2006-01-01

    Most literature on the American professorate provides a culture of evidence that suggests that the above account represents the typical experience endured by many African American faculty members and other faculty of color. African American faculty remain under-represented in predominantly White research universities. The number of African…

  15. Perceptions of Teacher Expectations by African American High School Students

    ERIC Educational Resources Information Center

    Pringle, Beverley E.; Lyons, James E.; Booker, Keonya C.

    2010-01-01

    African American high school students are performing behind their White classmates regardless of whether they are in majority or minority populations at school. Teacher expectations, among school-related factors that can impact the academic achievement of African American high school students, are the focus of this study. Interviews were conducted…

  16. Perceived Racism as a Predictor of Paranoia among African Americans

    ERIC Educational Resources Information Center

    Combs, Dennis R.; Penn, David L.; Cassisi, Jeffrey; Michael, Chris; Wood, Terry; Wanner, Jill; Adams, Scott

    2006-01-01

    Recent theoretical models suggest that perceived racism acts as a stressor for African Americans and may be associated with a variety of negative psychological consequences, notably paranoia. Paranoia among African Americans is believed to reflect the lower end of the paranoia continuum based on experiences with racism. Thus, it may be beneficial…

  17. Race, Culture, and the Education of African Americans

    ERIC Educational Resources Information Center

    Lynn, Marvin

    2006-01-01

    In this essay, Marvin Lynn explores a range of perspectives on African American education, with particular focus on three works: "Black American Students in an Affluent Suburb: A Study of Academic Disengagement," by social anthropologist John Ogbu; "African-Centered Pedagogy: Developing Schools of Achievement for African American Children," by…

  18. Conducting Children's Health Insurance Outreach in African American Communities.

    ERIC Educational Resources Information Center

    Patterson, Jacqueline

    In 1998, 19.7 percent of African American children were uninsured. Since a majority of African American children live in families with incomes below 200 percent of the federal poverty line, they are eligible for free or low-cost insurance coverage. This report presents strategies for facilitating the recruitment and enrollment of African American…

  19. Resiliency Instructional Tactics: African American Students with Learning Disabilities

    ERIC Educational Resources Information Center

    Jones, Vita L.

    2011-01-01

    Schools and classrooms, if well conceived, can serve as protective environments for the positive development of African American students with learning disabilities (LD) (Keogh & Weisner, 1993). Many African American students who lack resiliency often struggle with life's challenges and may be predisposed to negative outcomes in life, so the focus…

  20. The African American Family and AIDS: Counseling Issues and Strategies.

    ERIC Educational Resources Information Center

    Rowe, Patrick; Beamish, Patricia M.

    This document discusses the application of a systems approach for family counseling for African American families with a family member infected with Acquired Immune Deficiency Syndrome (AIDS). It begins by citing statistics that illustrate that there exists a disproportionate representation of cases of AIDS among African Americans. A discussion on…

  1. The Classroom and the Community: African American Youth Speak Out.

    ERIC Educational Resources Information Center

    Clardy, Pauline; Cole-Robinson, Cynthia; Jones, Terrence O'C.; Michie, Gregory

    In studying urban schools, researchers have identified several critical curriculum issues related to the miseducation and alienation of African American students. This paper looks at three such issues: the disconnection between the school curriculum and African American students' cultural backgrounds and environments (e.g., black dialect versus…

  2. African Americans Who Teach German Language and Culture.

    ERIC Educational Resources Information Center

    Fikes, Robert Jr.

    2001-01-01

    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…

  3. African American English: Implications for School Counseling Professionals

    ERIC Educational Resources Information Center

    Day-Vines, Norma L.; Barto, Heather H.; Booker, Beverly L.; Smith, Kim V.; Barna, Jennifer; Maiden, Brian S.; Zegley, Linda; Felder, Monique T.

    2009-01-01

    African American English (AAE) refers to the systematic, rule-governed linguistic patterns of found among African Americans. This article provides an overview of AAE. More specifically, the article enumerates the historical underpinnings associated with AAE, identifies a representative set of AAE characteristics, reviews relevant research, and…

  4. Spirituality and Academic Performance among African American College Students.

    ERIC Educational Resources Information Center

    Walker, Katrina L.; Dixon, Vicki

    2002-01-01

    Investigated spirituality and religious participation among African American and European American college students. Student surveys indicated that African Americans had higher levels of spiritual beliefs and religious participation than did European Americans. Correlation analysis indicated that spiritual beliefs and religious participation were…

  5. Race Consciousness. African-American Studies for the New Century.

    ERIC Educational Resources Information Center

    Fossett, Judith Jackson, Ed.; Tucker, Jeffrey A., Ed.

    This collection of essays represents new scholarship in African American studies, drawing lessons from the past and providing insights into current intellectual trends. Topics such as the culture of America as a culture of race, legacies of slavery and colonialism, crime and welfare politics, and African American cultural studies are addressed.…

  6. Higher Education and the Early Education of African American Ministers

    ERIC Educational Resources Information Center

    Cooks, Michael

    2010-01-01

    The education of African American ministers in the United States has been little researched. Numerous books address the profession of ministry and the education of Blacks in general, but most do not specifically address issues pertaining to the professional education of Black ministers. The majority of the hurdles African Americans faced were…

  7. 75 FR 6081 - National African American History Month, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... African American History Month, 2010 By the President of the United States of America A Proclamation In... slavery and oppression, the hope of progress, and the triumph of the American Dream. African American..., I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in...

  8. Perceived Racism and Encouragement among African American Adults

    ERIC Educational Resources Information Center

    Rowles, Joanna; Duan, Changming

    2012-01-01

    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…

  9. Boys into Men: Raising Our African American Teenage Sons.

    ERIC Educational Resources Information Center

    Boyd-Franklin, Nancy; Franklin, A. J.

    This guide to rearing African American boys offers simple and effective strategies for problem-solving, improving communication, and instilling a positive racial identity. The book draws on strong African American family values and cultural and spiritual strengths. The chapters are: (1) "You Must Act As If It Is Impossible To Fail: Challenges in…

  10. A Rationale for Creating African-American Immersion Schools.

    ERIC Educational Resources Information Center

    Holt, Kenneth C.

    1991-01-01

    The traditional U.S. classroom's milieu has distorted and refused to recognize the language and cultural richness of African-American students. Milwaukee's two immersion schools, Victor Berger Elementary School and Parkman Middle School, place the African-American students and their culture at the center of the educational process. Results have…

  11. African American History as Depicted in Recently Published Children's Books

    ERIC Educational Resources Information Center

    Lamme, Linda Leonard; Astengo, Be; Lowery, Ruth McCoy; Masla, Diane; Russo, Roseanne; Savage, Debbie; Shelton, Nancy Rankie

    2002-01-01

    Exciting stories about African Americans in recently published historical fiction books for children concern Pea Island Life-Station, a private school for African American girls, a biracial slave, a black woman who homesteads for land in 1889, and an orphan who travels on his own to Flint, Michigan, during the Depression. Much of this history…

  12. Clustering of Risk Behaviours among African American Adults

    ERIC Educational Resources Information Center

    Baruth, M.; Addy, C. L.; Wilcox, S.; Dowda, M.

    2012-01-01

    Objectives: Individuals may engage in more than one risk behaviour at any given time. The extent to which risk behaviours cluster among African American adults has been largely unexplored. This study examined the prevalence and clustering of three risk behaviours among African American church members: smoking; low moderate-to-vigorous intensity…

  13. The Guide for Choosing African American Parenting Curricula.

    ERIC Educational Resources Information Center

    Wingo, Robin R.; Mertensmeyer, Carol

    This guide is designed to help professionals working with African American parents to be better prepared to select culturally sensitive materials, to program more effectively, and to draw from the richness within the African American culture. The guide is one in a series of culturally specific guides produced as part of ParentLink's Review of…

  14. Enriching Inclusive Learning: African Americans in Historic Costume

    ERIC Educational Resources Information Center

    Ratute, Ashley; Marcketti, Sara B.

    2009-01-01

    Educating students to embrace diversity and value all people is a core value of educators in family and consumer sciences (FCS). For instructors in FCS, integrating the contributions of African Americans--particularly in textiles and clothing--can be an inclusive learning opportunity. The authors compiled resources on African Americans and…

  15. African American English: An Interview with Marcyliena Morgan.

    ERIC Educational Resources Information Center

    Rymes, Betsy

    1995-01-01

    Discusses an interview in which Marcyliena Morgan elaborates on the necessity to analyze both microlinguistic issues of grammar and phonology as well as larger issues of discourse pragmatics and language ideology. The interview touches on African American poetry, the convergence of African American and standard English, and oases and indirectness.…

  16. 20 African-Americans Your Students Should Meet

    ERIC Educational Resources Information Center

    Bardeen, Tara

    2008-01-01

    There is more to Black History Month than honoring Martin Luther King Jr. Black History Month is a time to honor the significant contributions of African-Americans throughout history. This article presents 20 super-achievers new generation of African-Americans heroes students should meet: (1) Kimberly Oliver; (2) John Lewis; (3) Rita Dove; (4)…

  17. Effective Education of African American Exceptional Learners: New Perspectives.

    ERIC Educational Resources Information Center

    Ford, Bridgie Alexis, Ed.; And Others

    This book presents 11 author-contributed papers covering the theory and practice of effective assessment and instruction of African American students with exceptionalities, including both disabilities and giftedness. Emphasis is on effective delivery of empowering services to African American youth and their families. The first seven papers have…

  18. Serving African American Children: Child Welfare Perspectives Series.

    ERIC Educational Resources Information Center

    Jackson, Sondra, Ed.; Brissett-Chapman, Sheryl, Ed.

    This collection brings together articles by African American authors who are committed to research, policies, and programs affecting African American children and families. The articles are grouped into sections on policy, research, and practice issues; clinical techniques and treatment models; and new perspectives in child welfare. The following…

  19. A Profile of Bereavement Supports in African American Church Congregations.

    ERIC Educational Resources Information Center

    Moore, Penelope J.; Hazell, LaVone V.; Honeyghan, Edna M.

    Bereavement educators, counselors, clergy, and other specialists have observed that African Americans tend to under-utilize end-of-life palliative care services and general bereavement resources. The literature suggests that involving clergy in outreach to the African American community may be a viable strategy for developing bereavement supports.…

  20. African American Homeschooling and the Question of Curricular Cultural Relevance

    ERIC Educational Resources Information Center

    Mazama, Ama; Lundy, Garvey

    2013-01-01

    Homeschooling, and academic interest in this phenomenon, have increased tremendously over the last decade. The surge of African American involvement in the homeschool movement has also become noticeable. However, there continues to be a general paucity of research on the motivations of African American parents that choose homeschooling. In order…