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.

Timing is everything: methodologic issues locating and recruiting medically underserved women for abnormal mammography follow-up research

PubMed Central

Fair, Alecia Malin; Wujcik, Debra; Lin, Jin-Mann S.; Egan, Kathleen M.; Grau, Ana M.; Zheng, Wei

2008-01-01

Objectives Recruiting underserved women in breast cancer research studies remains a significant challenge. We present our experience attempting to locate and recruit minority and medically underserved women identified in a Nashville, Tennessee public hospital for a mammography follow-up study. Study Design The study design was a retrospective hospital based case-control study. Methods We identified 227 women (88 African American, 65 Caucasian, 36 other minority, 38 race undocumented in the medical record) who had undergone screening mammography and received an abnormal result during 2003–2004. Of the 227 women identified, 159 women were successfully located with implementation of a tracking protocol and more rigorous attempts to locate the women using online directory assistance and public record search engines. Women eligible for the study were invited to participate in a telephone research survey. Study completion was defined as fully finishing the telephone survey. Results An average of 4.6 telephone calls (range 1–19) and 2.7 months (range 1–490 days) were required to reach the 159 women contacted. Within three contact attempts, more cases were located than controls (61% cases vs. 49% controls, p=0.03). African-American women cases were four times likely to be recruited than African-American controls, (OR, 4.07; 95% CI, 1.59–10.30) (p=0.003). After three months of effort, we located 67% of African-American women, 63% of Caucasian women, and 56% of other minorities. Ultimately, after a maximum of 12 attempts to contact women, 77% of African-American women and 71% of Caucasian women were eventually found. Of these, 59% of African-American women, 69% Caucasian women, and 50% other minorities were located and completed the study survey for an overall response rate of 59%, 71%, and 47% respectively. Conclusions Data collection and study recruitment efforts were more challenging in racial and ethnic minorities. Continuing attempts to contact women may increase minority group study participation but does not guarantee retention or study completion. PMID:18289943

Acceptance of a community-based navigator program for cancer control among urban African Americans.

PubMed

Halbert, Chanita Hughes; Briggs, Vanessa; Bowman, Marjorie; Bryant, Brenda; Bryant, Debbie Chatman; Delmoor, Ernestine; Ferguson, Monica; Ford, Marvella E; Johnson, Jerry C; Purnell, Joseph; Rogers, Rodney; Weathers, Benita

2014-02-01

Patient navigation is now a standard component of cancer care in many oncology facilities, but a fundamental question for navigator programs, especially in medically underserved populations, is whether or not individuals will use this service. In this study, we evaluated acceptance of a community-based navigator program for cancer control and identified factors having significant independent associations with navigation acceptance in an urban sample of African Americans. Participants were African American men and women ages 50-75 who were residents in an urban metropolitan city who were referred for navigation. Of 240 participants, 76% completed navigation. Age and perceived risk of developing cancer had a significant independent association with navigation acceptance. Participants who believed that they were at high risk for developing cancer had a lower likelihood of completing navigation compared with those who believed that they had a low risk for developing this disease. The likelihood of completing navigation increased with increases in age. None of the socioeconomic factors or health care variables had a significant association with navigation acceptance. There are few barriers to using community-based navigation for cancer control among urban African Americans. Continued efforts are needed to develop and implement community-based programs for cancer control that are easy to use and address the needs of medically underserved populations.

Acceptance of a community-based navigator program for cancer control among urban African Americans

PubMed Central

Halbert, Chanita Hughes; Briggs, Vanessa; Bowman, Marjorie; Bryant, Brenda; Bryant, Debbie Chatman; Delmoor, Ernestine; Ferguson, Monica; Ford, Marvella E.; Johnson, Jerry C.; Purnell, Joseph; Rogers, Rodney; Weathers, Benita

2014-01-01

Patient navigation is now a standard component of cancer care in many oncology facilities, but a fundamental question for navigator programs, especially in medically underserved populations, is whether or not individuals will use this service. In this study, we evaluated acceptance of a community-based navigator program for cancer control and identified factors having significant independent associations with navigation acceptance in an urban sample of African Americans. Participants were African American men and women ages 50–75 who were residents in an urban metropolitan city who were referred for navigation. Of 240 participants, 76% completed navigation. Age and perceived risk of developing cancer had a significant independent association with navigation acceptance. Participants who believed that they were at high risk for developing cancer had a lower likelihood of completing navigation compared with those who believed that they had a low risk for developing this disease. The likelihood of completing navigation increased with increases in age. None of the socioeconomic factors or health care variables had a significant association with navigation acceptance. There are few barriers to using community-based navigation for cancer control among urban African Americans. Continued efforts are needed to develop and implement community-based programs for cancer control that are easy to use and address the needs of medically underserved populations. PMID:24173501

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

Assessing the moderating effects of anxiety sensitivity on antisocial behavior among urban African American youth.

PubMed

Nebbitt, Von Eugene; Lombe, Margaret; Williams, James Herbert

2008-02-01

African American adolescents are a vulnerable population, overrepresented in the juvenile justice system and underserved by mental health providers. Consequently, a disproportionate number of African American youth in the juvenile justice system have diagnosable mental health problems. This study investigates whether, among African American adolescents, the effects of attitude towards deviance, self-efficacy, and exposure to delinquent peers on antisocial behavior are moderated by anxiety sensitivity. A sample of 238 African American adolescents ages 13-19 from 3 public housing developments participated in this study. Results indicated that 40% of the adolescents reported no involvement in antisocial behaviors. Gender, anxiety sensitivity, and attitudes towards deviance were significant correlates of antisocial behavior. Interaction effects indicate that the relative impact of attitudes towards deviance and exposure to delinquent peers on antisocial behaviors is contingent upon adolescents' level of anxiety sensitivity. Implications for practice and future research are discussed.

Grantee Spotlight: Elisa Rodriguez, Ph.D., M.S.

Cancer.gov

Dr. Elisa M. Rodriguez tests the feasibility of community-based participatory research approaches to engaging Hispanics, African Americans, and the medically underserved in the Buffalo, NY area in biospecimen donation for cancer research.

Exploring the financial impact of breast cancer for African American medically underserved women: a qualitative study.

PubMed

Darby, Kathleen; Davis, Cindy; Likes, Wendy; Bell, John

2009-08-01

In addition to the physical suffering experienced by cancer survivors, there are considerable financial hardships and access barriers to quality health care. The current study explored the financial burden of breast cancer on African American medically underserved women. Four focus groups were conducted in three major cities across Tennessee. Research participants (N=36) were recruited by the staff of cancer support and treatment programs in the area. Findings revealed that participants' lack of insurance or inadequate insurance resulted in missed, delayed, or fewer treatment opportunities. The financial burden of cancer was not limited to the acute treatment phase. The women in the current study reported extreme economic hardship resulting from this disease into long-term survivorship. This exploratory study confirms the importance of providing care across the continuum to address the complex needs of low-income cancer survivors.

Calmer Life: A Hybrid Effectiveness-implementation Trial for Late-life Anxiety Conducted in Low-income, Mental Health-Underserved Communities.

PubMed

Shrestha, Srijana; Wilson, Nancy; Kunik, Mark E; Wagener, Paula; Amspoker, Amber B; Barrera, Terri; Freshour, Jessica; Kraus-Schuman, Cynthia; Bavineau, Jane; Turner, Maria; Stanley, Melinda A

2017-05-01

Anxiety is common among older adults and is associated with multiple negative outcomes. Late-life anxiety is usually unrecognized by providers and undertreated, although evidence supports the effectiveness of psychosocial treatment. Access to mental health care is especially poor among African American seniors. New treatment models are needed to expand the reach of mental health care to minority elders. Our article outlines a study designed to test the effectiveness and implementation potential of Calmer Life (CL), a community-based, person-centered, flexible and culturally tailored intervention for late-life anxiety and worry, offered in low-income, mental health-underserved and predominantly African American communities. CL is skills-based, but also includes resource counseling and an option to integrate religion/spirituality. The study population includes individuals 50 years of age and older who are experiencing high levels of worry. The program was developed in the context of a community-academic partnership with organizations that provide services for seniors in underserved communities, and it trains nontraditional community providers to deliver the intervention. Study progress to date, challenges, and lessons learned are discussed. Data collection is ongoing, and study findings will be available in late 2017. CL will offer valuable information to help expand the reach of anxiety treatment among minority seniors living in underserved neighborhoods.

Explaining and improving breast cancer information acquisition among African American women in the Deep South.

PubMed

Anderson-Lewis, Charkarra; Ross, Levi; Johnson, Jarrett; Hastrup, Janice L; Green, B Lee; Kohler, Connie L

2012-06-01

A major challenge facing contemporary cancer educators is how to optimize the dissemination of breast cancer prevention and control information to African American women in the Deep South who are believed to be cancer free. The purpose of this research was to provide insight into the breast cancer information-acquisition experiences of African American women in Alabama and Mississippi and to make recommendations on ways to better reach members of this high-risk, underserved population. Focus group methodology was used in a repeated, cross-sectional research design with 64 African American women, 35 years old or older who lived in one of four urban or rural counties in Alabama and Mississippi. Axial-coded themes emerged around sources of cancer information, patterns of information acquisition, characteristics of preferred sources, and characteristics of least-preferred sources. It is important to invest in lay health educators to optimize the dissemination of breast cancer information to African American women who are believed to be cancer free in the Deep South.

Use of mental health services by Asian Americans.

PubMed

Barreto, Rose M; Segal, Steven P

2005-06-01

This study explored the use of mental health services by Asian Americans and other ethnic populations (N=104,773) in California. The authors used linear regression analyses to assess the role of ethnicity and diagnosis in predicting six-month use of services. East Asians used more services than Southeast Asians, Filipinos, other Asians, Caucasians, African Americans, Latinos, and Native Americans, even when severity of illness was taken into account. The findings suggest that aggregating Asian subpopulations into a single group in services research is no longer appropriate. Attention needs to be placed on the needs of Southeast Asians and other Asians, whose service use patterns approximate those of the traditionally most underserved groups, African Americans and Latinos.

Explaining and Improving Breast Cancer Information Acquisition among African American Women in the Deep South

PubMed Central

Anderson-Lewis, Charkarra; Ross, Levi; Johnson, Jarrett; Hastrup, Janice L.; Green, B. Lee; Kohler, Connie L.

2012-01-01

Objectives A major challenge facing contemporary cancer educators is how to optimize the dissemination of breast cancer prevention and control information to African American women in the Deep South who are believed to be cancer free. The purpose of this research was to provide insight into the breast cancer information-acquisition experiences of African American women in Alabama and Mississippi and to make recommendations on ways to better reach members of this high-risk, underserved population. Methods Focus group methodology was used in a repeated, cross-sectional research design with 64 African American women, 35 years old or older who lived in one of four urban or rural counties in Alabama and Mississippi. Results Axial-coded themes emerged around sources of cancer information, patterns of information acquisition, characteristics of preferred sources, and characteristics of least-preferred sources. Conclusions It is important to invest in lay health educators to optimize the dissemination of breast cancer information to African American women who are believed to be cancer free in the Deep South. PMID:22665151

Uneven Youth Resistance across Uneven School Contexts

ERIC Educational Resources Information Center

Hidalgo, Nicole

2011-01-01

This postcard compares youth resistance across classroom contexts. It draws from a two-year ethnography of the East Oakland Step to College (Step) program, which prepared underserved African-American and Latina/o youth to enroll in four-year universities, while nurturing students' sensibilities to fight for social justice. Students were highly…

Developing a Community-Academic Partnership to Improve Recognition and Treatment of Depression in Underserved African American and White Elders

PubMed Central

Dobransky-Fasiska, Deborah; Brown, Charlotte; Pincus, Harold A.; Nowalk, Mary P.; Wieland, Melissa; Parker, Lisa S.; Cruz, Mario; McMurray, Michelle L.; Mulsant, Benoit; Reynolds, Charles F.

2011-01-01

Objective Reducing mental health disparities among underserved populations, particularly African American elders, is an important public health priority. The authors describe the process and challenges of developing a community/academic research partnership to address these disparities. Methods The authors are using a Community-Based Participatory Research approach to gain access to underserved populations in need of depression treatment. The authors identify six stages: 1) Collaborating to Secure Funding; 2) Building a Communications Platform and Research Infrastructure; 3) Fostering Enduring Relationships; 4) Assessing Needs/Educating about Research Process; 5) Initiating Specific Collaborative Projects (meeting mutual needs/interests); and 6) Maintaining a Sustainable and Productive Partnership. Data from a needs assessment developed collaboratively by researchers and community agencies facilitated agreement on mutual research goals, while strengthening the partnership. Results A community/academic-based partnership with a solid research infrastructure has been established and maintained for 3 years. Using the results of a needs assessment, the working partnership prioritized and launched several projects. Through interviews and questionnaires, community partners identified best practices for researchers working in the community. Future research and interventional projects have been developed, including plans for sustainability that will eventually shift more responsibility from the academic institution to the community agencies. Conclusions To reach underserved populations by developing and implementing models of more effective mental health treatment, it is vital to engage community agencies offering services to this population. A successful partnership requires “cultural humility,” collaborative efforts, and the development of flexible protocols to accommodate diverse communities. PMID:20104053

Racial/Ethnic, socioeconomic, and geographic disparities of cervical cancer advanced-stage diagnosis in Texas.

PubMed

Zhan, F Benjamin; Lin, Yan

2014-01-01

Advanced-stage diagnosis is among the primary causes of mortality among cervical cancer patients. With the wide use of Pap smear screening, cervical cancer advanced-stage diagnosis rates have decreased. However, disparities of advanced-stage diagnosis persist among different population groups. A challenging task in cervical cancer disparity reduction is to identify where underserved population groups are. Based on cervical cancer incidence data between 1995 and 2008, this study investigated advanced-stage cervical cancer disparities in Texas from three social domains: Race/ethnicity, socioeconomic status (SES), and geographic location. Effects of individual and contextual factors, including age, tumor grade, race/ethnicity, as well as contextual SES, spatial access to health care, sociocultural factors, percentage of African Americans, and insurance expenditures, on these disparities were examined using multilevel logistic regressions. Significant variations by race/ethnicity and SES were found in cervical cancer advanced-stage diagnosis. We also found a decline in racial/ethnic disparities of advanced cervical cancer diagnosis rate from 1995 to 2008. However, the progress was slower among African Americans than Hispanics. Geographic disparities could be explained by age, race/ethnicity, SES, and the percentage of African Americans in a census tract. Our findings have important implications for developing effective cervical cancer screening and control programs. We identified the location of underserved populations who need the most assistance with cervical cancer screening. Cervical cancer intervention programs should target Hispanics and African Americans, as well as individuals from communities with lower SES in geographic areas where higher advanced-stage diagnosis rates were identified in this study. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Ethnicity as a moderator of how parents' attitudes and perceived stigma influence intentions to seek child mental health services.

PubMed

Turner, Erlanger A; Jensen-Doss, Amanda; Heffer, Robert W

2015-10-01

Research has identified several variables that affect utilization of mental health services. However, more could be explored regarding ethnic differences among parents seeking help for their children. In our study, 238 caregivers were recruited from the southern United States to examine ethnic differences in intentions to access child mental health services with the Parental Attitudes Toward Psychological Services Inventory (Turner, 2012) as the primary measure. Group comparisons indicated that African-American parents reported less positive attitudes and more stigma than European-American or Hispanic-American parents. Moderation analyses found (a) attitudes were associated with a higher level of parental help-seeking intention among European Americans, but not among African Americans or Hispanic Americans and (b) stigma was associated with a lower parent-reported likelihood of help-seeking for Hispanic Americans, but not for European Americans or African Americans. Ethnicity deferentially impacts attitudes and stigma associated with seeking mental health services. Public education efforts to increase service use should be tailored toward under-served groups to be more effective. (c) 2015 APA, all rights reserved).

Socioeconomic status, parenting, and externalizing problems in African American single-mother homes: A person-oriented approach.

PubMed

Anton, Margaret T; Jones, Deborah J; Youngstrom, Eric A

2015-06-01

African American youth, particularly those from single-mother homes, are overrepresented in statistics on externalizing problems. The family is a central context in which to understand externalizing problems; however, reliance on variable-oriented approaches to the study of parenting, which originate from work with intact, middle-income, European American families, may obscure important information regarding variability in parenting styles among African American single mothers, and in turn, variability in youth outcomes as well. The current study demonstrated that within African American single-mother families: (a) a person-, rather than variable-, oriented approach to measuring parenting style may further elucidate variability; (b) socioeconomic status may provide 1 context within which to understanding variability in parenting style; and (c) 1 marker of socioeconomic status, income, and parenting style may each explain variability in youth externalizing problems; however, the interaction between income and parenting style was not significant. Findings have potential implications for better understanding the specific contexts in which externalizing problems may be most likely to occur within this at-risk and underserved group. (c) 2015 APA, all rights reserved).

Socioeconomic Status, Parenting, and Externalizing Problems in African American Single-Mother Homes: A Person-Oriented Approach

PubMed Central

Anton, Margaret T.; Jones, Deborah J.; Youngstrom, Eric A.

2016-01-01

African American youth, particularly those from single-mother homes, are overrepresented in statistics on externalizing problems. The family is a central context in which to understand externalizing problems; however, reliance on variable-oriented approaches to the study of parenting, which originate from work with intact, middle-income, European American families, may obscure important information regarding variability in parenting styles among African American single mothers, and in turn, variability in youth outcomes as well. The current study demonstrated that within African American single-mother families: (a) a person-, rather than variable-, oriented approach to measuring parenting style may further elucidate variability; (b) socioeconomic status may provide 1 context within which to understanding variability in parenting style; and (c) 1 marker of socioeconomic status, income, and parenting style may each explain variability in youth externalizing problems; however, the interaction between income and parenting style was not significant. Findings have potential implications for better understanding the specific contexts in which externalizing problems may be most likely to occur within this at-risk and underserved group. PMID:26053349

African American community breast health education: a pilot project.

PubMed

Robertson, Ethel M; Franklin, Anett Wakefield; Flores, AnnMarie; Wherry, Shari; Buford, Juanita

2006-01-01

This paper reports the results of a project designed to examine the effectiveness of a Train the Trainer breast health education and screening program for African American, elderly and underserved women residing in the greater Nashville area. The project aimed to identify a cadre of women from the community willing to serve as leaders advocated and peer breast health educators. Data collected from the community leaders and the women from the local community during the course of the project suggest that the Train the Trainer model was well suited to provide education, support and breast cancer resource referral to women residing within this rural Tennessee community.

From mothers to daughters: transgenerational food and diet communication in an underserved group.

PubMed

Wilson, Diane Baer; Musham, Catherine; McLellan, Mary S

2004-01-01

Studies show that young girls are highly influenced by their mothers' attitudes toward food and body image. To investigate the nature of the information about food that mothers transfer to their daughters, the researchers used focus groups comprising African American women. Results suggest that when educators work with low-income African American women, they should be cognizant of overeating from the perspectives of early food scarcity, reverence for the mother's authoritative role in the family and respect for cultural differences in body size norms. In addition, nutrition educators should counsel young mothers to understand the impact of their eating habits on their daughters.

Factors associated with female provider preference among African American women, and implications for breast cancer screening.

PubMed

Casciotti, Dana M; Klassen, Ann C

2011-07-01

Globally, breast cancer incidence is increasing. Early detection remains important for addressing disparities, including among U.S. minorities. Seeing a female physician increases screening, but the effects of unmet provider gender preference among underserved populations remain unexplored. Among 576 urban African American women age 45-93, we examined predictors of gender preference and how met and unmet preference influenced screening. We conclude that provider gender is a "double-edged sword." We saw a female provider screening benefit, but also that gender preference was associated with past disadvantage and attitudes inconsistent with health maintenance. Provider gender preference merits further consideration in women's health research.

Satisfaction with Life and Psychosocial Factors among Underserved Minorities with Type 2 Diabetes

ERIC Educational Resources Information Center

Phelps, Kenneth W.; Hodgson, Jennifer L.; Lamson, Angela L.; Swanson, Melvin S.; White, Mark B.

2012-01-01

The objective of this study was to examine the association between biomedical markers of disease management and psychosocial constructs, while also assessing the correlates and predictors of variability for satisfaction with life (SWL) among African American and Hispanic participants with type 2 diabetes. Data were collected from 142 participants…

Challenges and Considerations Related to Studying Dementia in Blacks/African Americans.

PubMed

Ighodaro, Eseosa T; Nelson, Peter T; Kukull, Walter A; Schmitt, Frederick A; Abner, Erin L; Caban-Holt, Allison; Bardach, Shoshana H; Hord, Derrick C; Glover, Crystal M; Jicha, Gregory A; Van Eldik, Linda J; Byrd, Alexander X; Fernander, Anita

2017-01-01

Blacks/African Americans have been reported to be ∼2-4 times more likely to develop clinical Alzheimer's disease (AD) compared to Whites. Unfortunately, study design challenges (e.g., recruitment bias), racism, mistrust of healthcare providers and biomedical researchers, confounders related to socioeconomic status, and other sources of bias are often ignored when interpreting differences in human subjects categorized by race. Failure to account for these factors can lead to misinterpretation of results, reification of race as biology, discrimination, and missed or delayed diagnoses. Here we provide a selected historical background, discuss challenges, present opportunities, and suggest considerations for studying health outcomes among racial/ethnic groups. We encourage neuroscientists to consider shifting away from using biologic determination to interpret data, and work instead toward a paradigm of incorporating both biological and socio-environmental factors known to affect health outcomes with the goal of understanding and improving dementia treatments for Blacks/African Americans and other underserved populations.

What precipitates depression in African-American cancer patients? Triggers and stressors.

PubMed

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

2012-12-01

This study examined general and cancer-related stressors of depression that are unique to African-American cancer patients. The study used cohort design and mixed methods. Seventy-four breast and prostate cancer survivors including 34 depressed and 23 non-depressed African-Americans and 17 depressed whites were interviewed. Qualitative data analysis identified themes. The thematic codes were converted to a SPSS data set numerically. The Fisher's exact test was performed to examine group differences in the experience of stress. Significantly more depressed African-Americans experienced a dramatic reaction to a cancer diagnosis (p = 0.03) or had concerns about functional decline (p = 0.01), arguments with relatives or friends (p = 0.02), and unemployment status (p = 0.03) than did non-depressed African-Americans, who reacted to the cancer diagnosis as a matter of reality (p = 0.02). Significantly more depressed African-Americans talked about feeling shocked by a cancer diagnosis (p = 0.04) and being unable to do things that they used to do (p = 0.02) than did depressed whites. Qualitative analysis shed light on the extent of such group differences. Distress from the initial cancer diagnosis and functional decline were likely to have triggered or worsened depression in African-American cancer patients. This study highlighted racial differences in this aspect. It is critical to screen African-American cancer patients for depression at two critical junctures: immediately after the disclosure of a cancer diagnosis and at the onset of functional decline. This will enhance the chance of prompt diagnosis and treatment of depression in this underserved population.

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD).

PubMed

Lumpkins, Crystal Y; Saint Onge, Jarron M

2017-02-04

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups ( n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health.

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD)

PubMed Central

Lumpkins, Crystal Y.; Saint Onge, Jarron M.

2017-01-01

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health. PMID:28165368

Strategies to Improve HIV Testing in African Americans.

PubMed

Kenya, Sonjia; Okoro, Ikenna; Wallace, Kiera; Carrasquillo, Olveen; Prado, Guillermo

2015-01-01

Only 17% of Miami-Dade County residents are African American, yet this population accounts for 59% of the county's HIV-related mortality. The Centers for Disease Control and Prevention recommend annual testing for persons at increased risk for HIV, but 40% of African Americans have never been tested. OraQuick® (OraSure Technologies, Inc., Bethlehem, PA), the first US Food and Drug Administration-approved home-based HIV rapid test (HBHRT), has the potential to increase testing rates; however, there are concerns about HBHRT in vulnerable populations. We conducted focus groups in an underserved Miami neighborhood to obtain community input regarding HBHRT as a potential mechanism to increase HIV testing in African Americans. We queried HIV knowledge, attitudes toward research, and preferred intervention methods. Several HIV misconceptions were identified, and participants expressed support for HIV research and introducing HBHRT into the community by culturally appropriate individuals trained to provide support. We concluded that community health workers paired with HBHRT were a promising strategy to increase HIV testing in this population. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Recruiting and Retaining Primary Care Physicians in Urban Underserved Communities: The Importance of Having a Mission to Serve

PubMed Central

Ryan, Gery; Ramey, Robin; Nunez, Felix L.; Beltran, Robert; Splawn, Robert G.; Brown, Arleen F.

2010-01-01

Objectives. We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. Methods. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods. Results. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area. Conclusions. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work–life balance. PMID:20935263

Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve.

PubMed

Odom Walker, Kara; Ryan, Gery; Ramey, Robin; Nunez, Felix L; Beltran, Robert; Splawn, Robert G; Brown, Arleen F

2010-11-01

We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work-life balance.

Reflections on Multiculturalism, Social Justice, and Empowerment Groups for Academic Success: A Critical Discourse for Contemporary Schools

ERIC Educational Resources Information Center

Bemak, Fred

2005-01-01

Writing the article entitled "Empowerment Groups for Academic Success: An Innovative Approach to Prevent High School Failure for At-Risk, Urban African American Girls," Fred Bemak anticipated that there would be mixed reactions, given the unique and non traditional approach to working with a difficult and typically underserved population. The…

Weight Status as a Moderator of the Relationship Between Motivation, Emotional Social Support, and Physical Activity in Underserved Adolescents

PubMed Central

Wilson, Dawn K.; Lawman, Hannah G.; Van Horn, M. Lee

2013-01-01

Objective This study examined weight status as a moderator of the relationship between motivation (controlled, autonomous, regulatory), emotional social support (parents, peers) and moderate-to-vigorous physical activity (MVPA) in underserved adolescents (ethnic minority, low-income). Methods Participants from the Active by Choice Today Trial (n = 1,416; 54% girls, 73% African American, 52% overweight/obese) completed baseline measures, including height and weight, psychosocial surveys, and 7-day accelerometry estimates. Weight status was defined by body mass index z-score (zBMI). Results Weight status moderated the effects of controlled, autonomous, and regulatory motivation on MVPA, such that these variables were more strongly associated with MVPA in adolescents with lower versus higher zBMI scores. Conclusions A better understanding of why motivation is not related to MVPA in underserved youth with a higher weight status is needed. Future pediatric obesity treatment in underserved youth may need to move beyond motivation into environmental factors associated with long-term behavior change. PMID:23378172

Weight status as a moderator of the relationship between motivation, emotional social support, and physical activity in underserved adolescents.

PubMed

St George, Sara M; Wilson, Dawn K; Lawman, Hannah G; Van Horn, M Lee

2013-05-01

This study examined weight status as a moderator of the relationship between motivation (controlled, autonomous, regulatory), emotional social support (parents, peers) and moderate-to-vigorous physical activity (MVPA) in underserved adolescents (ethnic minority, low-income). Participants from the Active by Choice Today Trial (n = 1,416; 54% girls, 73% African American, 52% overweight/obese) completed baseline measures, including height and weight, psychosocial surveys, and 7-day accelerometry estimates. Weight status was defined by body mass index z-score (zBMI). Weight status moderated the effects of controlled, autonomous, and regulatory motivation on MVPA, such that these variables were more strongly associated with MVPA in adolescents with lower versus higher zBMI scores. A better understanding of why motivation is not related to MVPA in underserved youth with a higher weight status is needed. Future pediatric obesity treatment in underserved youth may need to move beyond motivation into environmental factors associated with long-term behavior change.

Disparities in barriers to follow-up care between African American and White breast cancer survivors.

PubMed

Palmer, Nynikka R A; Weaver, Kathryn E; Hauser, Sally P; Lawrence, Julia A; Talton, Jennifer; Case, L Douglas; Geiger, Ann M

2015-11-01

Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009-2011, 6-24 months post-treatment (N = 203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62 %. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28 vs. 51.6 %, p = 0.01), other health care costs (21.3 vs. 45.2 %, p = 0.01), anxiety/worry (29.4 vs. 51.6 %, p = 0.02), and transportation (4.4 vs. 16.1 %, p = 0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (odds ratio (OR) = 3.3, 95 % confidence interval (CI) = 1.1-10.1). Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors.

Disparities in Barriers to Follow-up Care between African American and White Breast Cancer Survivors

PubMed Central

Palmer, Nynikka R. A.; Weaver, Kathryn E.; Hauser, Sally P.; Lawrence, Julia A.; Talton, Jennifer; Case, L. Douglas; Geiger, Ann M.

2015-01-01

Purpose Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. Methods We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009–2011, 6–24 months post-treatment (N=203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. Results Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62%. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28% vs. 51.6%, p=0.01), other healthcare costs (21.3% vs. 45.2%, p=0.01), anxiety/worry (29.4% vs. 51.6%, p=0.02), and transportation (4.4% vs. 16.1%, p=0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (OR=3.3, 95%CI=1.1–10.1). Conclusions Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors. PMID:25821145

Improving cardiovascular health of underserved populations in the community with Life's Simple 7.

PubMed

Murphy, Marcia Pencak; Coke, Lola; Staffileno, Beth A; Robinson, Janis D; Tillotson, Robin

2015-11-01

The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Life's Simple 7 and My Life Check (MLC) tools. Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. NPs are prepared to target community-based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success. ©2015 American Association of Nurse Practitioners.

Conducting Research With Community Groups.

PubMed

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2015-10-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. Although several barriers to conducting research with community groups exist, community-based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This article presents case studies that demonstrate how CBPR principles guided the development of (a) a healthy body weight program for urban, underserved African American women; (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women; and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research-intensive academic environments. © The Author(s) 2015.

Conducting Research with Community Groups

PubMed Central

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2016-01-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. While several barriers to conducting research with community groups exist, community based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This manuscript presents case studies that demonstrate how CBPR principles guided the development of: (a) a healthy body weight program for urban, underserved African-American women, (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women, and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research intensive academic environments. PMID:25724557

Formative process evaluation for implementing a social marketing intervention to increase walking among African Americans in the Positive Action for Today's Health trial.

PubMed

Coulon, Sandra M; Wilson, Dawn K; Griffin, Sarah; St George, Sara M; Alia, Kassandra A; Trumpeter, Nevelyn N; Wandersman, Abraham K; Forthofer, Melinda; Robinson, Shamika; Gadson, Barney

2012-12-01

Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today's Health trial. We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months. Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating. Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities.

Challenges and Considerations Related to Studying Dementia in Blacks/African Americans

PubMed Central

Ighodaro, Eseosa T.; Nelson, Peter T.; Kukull, Walter A.; Schmitt, Frederick A.; Abner, Erin L.; Caban-Holt, Allison; Bardach, Shoshana H.; Hord, Derrick C.; Glover, Crystal M.; Jicha, Gregory A.; Van Eldik, Linda J.; Byrd, Alexander X.; Fernander, Anita

2018-01-01

Blacks/African Americans have been reported to be ~2–4 times more likely to develop clinical Alzheimer’s disease (AD) compared to Whites. Unfortunately, study design challenges (e.g., recruitment bias), racism, mistrust of healthcare providers and biomedical researchers, confounders related to socioeconomic status, and other sources of bias are often ignored when interpreting differences in human subjects categorized by race. Failure to account for these factors can lead to misinterpretation of results, reification of race as biology, discrimination, and missed or delayed diagnoses. Here we provide a selected historical background, discuss challenges, present opportunities, and suggest considerations for studying health outcomes among racial/ethnic groups. We encourage neuroscientists to consider shifting away from using biologic determination to interpret data, and work instead toward a paradigm of incorporating both biological and socio-environmental factors known to affect health outcomes with the goal of understanding and improving dementia treatments for Blacks/African Americans and other underserved populations. PMID:28731440

Casting a Wider Net: Engaging Community Health Worker Clients and Their Families in Cancer Prevention

PubMed Central

Roman, Lee Anne; Zambrana, Ruth Enid; Ford, Sabrina; Meghea, Cristian

2016-01-01

Engaging family members in an intervention to prevent breast and cervical cancer can be a way to reach underserved women; however, little is known about whether family member recruitment reaches at-risk women. This study reports the kin relationship and risk characteristics of family members who chose to participate in the Kin KeeperSM cancer prevention intervention, delivered by community health workers (CHWs) via existing community programs. African American, Latina, and Arab family members reported risk factors for inadequate screening, including comorbid health conditions and inadequate breast or cervical cancer literacy. CHW programs can be leveraged to reach underserved families with cancer preventive interventions. PMID:27634780

Misperceptions of medicaid ineligibility persist among African American caregivers of Alzheimer's dementia care recipients.

PubMed

Kingsberry, Sheridan Quarless; Mindler, Philinda

2012-06-01

African American caregivers of the elderly, including those who care for patients with Alzheimer's and other forms of dementia, remain underserved by Medicaid Assistance Programs. The purpose of this exploratory study was to ascertain to what degree participants in an Alzheimer's Association program that primarily targeted African Americans applied for and received Medicaid assistance, in particular for adult day care, in-home care, and respite care. Secondary data from the Delaware Regional Office of the Alzheimer's Association's 2006 Caregiver Survey of 38 caregivers were reviewed using descriptive, chi-square, and logistic regression analysis. Results indicate that 20 caregivers applied for Medicaid services, 12 of whom were approved. However, 18 caregivers did not apply for Medicaid mainly because they perceived that they would not qualify for benefits, without investigating their eligibility. Clearly more education is needed in African American communities about the eligibility requirements and benefits of Medicaid Assistance Programs because services such as adult day care, in-home care, and respite care have been shown to reduce some of the burden, stress, and strain associated with caring for elderly patients with Alzheimer's dementia. However, a multisystem approach should be used in the outreach and education processes. Finally, the Medicaid application process should be streamlined to make it less cumbersome. More financial and support services are needed by African American caregivers of Alzheimer's care recipients.

Culturally Diverse and Underserved Populations of Gifted Students in the United States and in Taiwan: Equitable Access to Gifted Education

ERIC Educational Resources Information Center

Ho, Ya-Ting

2014-01-01

There is a continuing increase in the African American and Hispanic student populations in public schools. The students who are invited to gifted programs are overwhelmingly White. This is the situation in schools in the United States and also in Taiwan. Misunderstanding or unawareness of culture difference among educators might contribute to…

Effectiveness of Interventions for Breast Cancer Screening in African American Women: A Meta-Analysis.

PubMed

Copeland, Valire Carr; Kim, Yoo Jung; Eack, Shaun M

2017-11-21

The purpose of this study was to report the results of a meta-analysis conducted on the effects of clinical trials in breast cancer screening for African American women between 1997 and 2017. Articles published in English and in the United States, between January 1997 and March 2017, were eligible for inclusion if they (1) conducted psychosocial, behavioral, or educational interventions designed to increase screening mammography rates in predominantly African American women of all ages; (2) utilized a randomized, controlled trial (RCT) design; and (3) reported quantitative screening rates following the intervention. Randomized clinical trials on breast cancer screening in African American women, published between January 1997 and March 2017, were selected from database searches. Data collected included effect size of screening versus comparison interventions, intervention characteristics, and a number of study characteristics to explore potential moderators. Search results yielded 327 articles, of which 14 met inclusion criteria and were included in analyses. Findings indicated that screening interventions for African American women were significantly more likely to result in mammography than control (OR = 1.56 [95 percent CI = 1.27-1.93], p < .0001). Although no patient or study characteristics significantly moderated screening efficacy, the most effective interventions were those specifically tailored to meet the perceived risk of African American women. Screening interventions are at least minimally effective for promoting mammography among African American women, but research in this area is limited to a small number of studies. More research is needed to enhance the efficacy of existing interventions and reduce the high morbidity and mortality rate of this underserved population. © Health Research and Educational Trust.

Molecular Analysis of Colorectal Tumors within a Diverse Patient Cohort at a Single Institution

PubMed Central

Sylvester, Brooke E.; Huo, Dezheng; Khramtsov, Andrey; Zhang, Jing; Smalling, Rana V.; Olugbile, Sope; Polite, Blase N.; Olopade, Olufunmilayo I.

2012-01-01

Purpose African American colorectal cancer (CRC) patients have worse survival outcomes than Caucasian patients. To determine if differences exist in the molecular mechanisms driving CRC between African Americans and Caucasians, we characterized patient tumors from a single institution by assessing genetic alterations involved in CRC progression and response to treatment. Experimental Design We retrospectively examined 448 African Americans and Caucasians diagnosed with CRC at The University of Chicago Medical Center between 1992 and 2002. Microsatellite instability (MSI) status was determined by genotyping the BAT25, BAT26, BAT40, D5S346, and BAX loci. Mutations in KRAS codons 12 and 13 and BRAF codon 600 were identified by direct sequencing. MSI and detected mutations were correlated with clinicopathological features. Results Overall, no difference existed in MSI or BRAF mutation frequencies between African Americans and Caucasians. However, African Americans with microsatellite stable (MSS)/MSI-low (MSI-L) tumors had a higher proportion of KRAS mutations than Caucasians (34% v. 23%, p=0.048) that was isolated to proximal colon cancers and primarily driven by mutations in codon 13. There was no racial/ethnic difference in receipt of chemotherapy, but African Americans with MSS/MSI-L tumors had a 73% increased risk of death over Caucasians that could not be explained by known prognostic factors. Conclusions The significantly higher risk of death among African Americans with MSS/MSI-L tumors may be related to differences in the distribution of factors influencing response to standard therapies. These data underscore the need for further research into the molecular mechanisms driving CRC progression in underserved and understudied populations. PMID:22114137

The role of motivation in understanding social contextual influences on physical activity in underserved adolescents in the ACT Trial: a cross-sectional study.

PubMed

Lawman, Hannah G; Wilson, Dawn K; Van Horn, M Lee; Zarrett, Nicole

2012-12-01

Previous research has shown that social contextual factors are important in understanding physical activity (PA) behavior, although little is known about how these factors may relate to PA, especially in underserved adolescents (low income, minorities). This study examined how motivation may differentially mediate the relationship of two social contextual variables (i.e., peer and parent social support) and moderate-to-vigorous PA (MVPA). Baseline data (n = 1421 sixth graders, 54% female, 72% African American) from the Active by Choice Today (ACT) trial in underserved adolescents were analyzed. Motivation was examined as a mediator of the relationships between peer social support, parent social support, and MVPA (measured by 7-day accelerometer estimates). Motivation and peer but not parent support were significantly related to MVPA overall. Significant mediation effects were found indicating motivation partially mediated the relation between peer social support and MVPA and to a lesser degree parent support and MVPA. These findings provide support for the importance of social contextual influences, especially peer social support, on underserved adolescents' PA and motivation for PA.

Self-Efficacy and Social Support as Mediators Between Culturally Specific Dance and Lifestyle Physical Activity

PubMed Central

Murrock, Carolyn J.; Madigan, Elizabeth

2013-01-01

Culturally specific dance has the potential to generate health benefits but is seldom used even among studies advocating culturally specific interventions. This study examined the components of self-efficacy and social support as mediators between culturally specific dance and lifestyle physical activity in African American women (N = 126). An experimental design compared intervention and control groups for mediating effects of self-efficacy and social support on lifestyle physical activity. Findings indicated that only outcome expectations and social support from friends mediated effects. Culturally specific dance is a first step in encouraging African American women to become more physically active and improve health outcomes. The implications are that culturally specific dance programs can improve health outcomes by including members of underserved populations. PMID:18763475

Self-efficacy and social support as mediators between culturally specific dance and lifestyle physical activity.

PubMed

Murrock, Carolyn J; Madigan, Elizabeth

2008-01-01

Culturally specific dance has the potential to generate health benefits but is seldom used even among studies advocating culturally specific interventions. This study examined the components of self-efficacy and social support as mediators between culturally specific dance and lifestyle physical activity in African American women (N = 126). An experimental design compared intervention and control groups for mediating effects of self-efficacy and social support on lifestyle physical activity. Findings indicated that only outcome expectations and social support from friends mediated effects. Culturally specific dance is a first step in encouraging African American women to become more physically active and improve health outcomes. The implications are that culturally specific dance programs can improve health outcomes by including members of underserved populations.

Formative Process Evaluation for Implementing a Social Marketing Intervention to Increase Walking Among African Americans in the Positive Action for Today’s Health Trial

PubMed Central

Wilson, Dawn K.; Griffin, Sarah; St. George, Sara M.; Alia, Kassandra A.; Trumpeter, Nevelyn N.; Wandersman, Abraham K.; Forthofer, Melinda; Robinson, Shamika; Gadson, Barney

2012-01-01

Objectives. Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today’s Health trial. Methods: We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months. Results: Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating. Conclusions: Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities. PMID:23078486

Urban African-American Men Speak Out on Sexual Partner Concurrency

PubMed Central

Carey, Michael P.; Senn, Theresa E.; Seward, Derek X.; Vanable, Peter A.

2008-01-01

Sexual partner concurrency, which fuels the spread of HIV, has been hypothesized as a cause of higher rates of HIV among low-income, urban African-Americans. Despite this hypothesis, little is known about the phenomenology of partner concurrency. To address this gap in the literature, we recruited 20 urban African-American men from a public STD clinic to elicit their ideas about partner concurrency. Five themes emerged during focus group discussions. First, there was a general consensus that it is normative to have more than one sexual partner. Second, men agreed it is acceptable for men to have concurrent partners, but disagreed about whether it was acceptable for women. Third, although men provided many reasons for concurrent partnerships, the most common reasons were that (a) multiple partners fulfill different needs, and (b) it is in a man’s nature to have multiple partners. Fourth, men described some (but not all) of the negative consequences of having concurrent partners. Finally, men articulated spoken and unspoken rules that govern concurrent partnerships. These findings increase knowledge about urban, African-American men’s attitudes toward concurrent partnerships, and can help to improve the efficacy of sexual risk-reduction interventions for this group of underserved men and their partners. PMID:18483847

Designing an Intervention for Women with Systemic Lupus Erythematosus from Medically Underserved Areas to Improve Care: A Qualitative Study

PubMed Central

Feldman, Candace H; Bermas, Bonnie L; Zibit, Melanie; Fraser, Patricia; Todd, Derrick J; Fortin, Paul R; Massarotti, Elena; Costenbader, Karen H

2013-01-01

Objective Systemic lupus erythematosus (lupus) disproportionately affects women, racial/ethnic minorities and low-income populations. We held focus groups for women from medically underserved communities to discuss interventions to improve care. Methods From our Lupus Registry, we invited 282 women, > 18 years, residing in urban, medically underserved areas. Hospital-based clinics and support groups also recruited participants. Women were randomly assigned to 3 focus groups. 75-minute sessions were recorded, transcribed and coded thematically using interpretative phenomenologic analysis and single counting methods. We categorized interventions by benefits, limitations, target populations and implementation questions. Results 29 women with lupus participated in 3 focus groups, (n=9, 9, 11). 80% were African American and 83% were from medically underserved zip codes. Themes included the desire for lupus education, isolation at the time of diagnosis, emotional and physical barriers to care, and the need for assistance navigating the healthcare system. 20 of 29 participants (69%) favored a peer support intervention; 17 (59%) also supported a lupus health passport. Newly diagnosed women were optimal intervention targets. Improvements in quality of life and mental health were proposed outcome measures. Conclusion Women with lupus from medically underserved areas have unique needs best addressed with an intervention designed through collaboration between community members and researchers. PMID:23087258

Navigating the digital divide: A systematic review of eHealth literacy in underserved populations in the United States.

PubMed

Chesser, Amy; Burke, Anne; Reyes, Jared; Rohrberg, Tessa

2016-01-01

eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.

Biopsychosocial Challenges and Needs of Young African American Women with Triple-Negative Breast Cancer.

PubMed

Bollinger, Sarah

2018-05-01

Triple-negative breast cancer (TNBC) is a subtype of breast cancer known to have poorer prognoses and lower survival rates compared with other types of breast cancer. In addition, TNBC is overrepresented in premenopausal African American women. Using grounded theory as the qualitative methodological approach, the present article elucidates unique biopsychosocial challenges and needs of young African American women with TNBC. A study group of six women with TNBC and a comparison group of six women with estrogen receptor-positive breast cancer were interviewed longitudinally over three time points throughout the cancer treatment trajectory. Major themes that were unique to the study group of women with TNBC include (a) longer, more aggressive treatment trajectories; (b) more difficult struggles with feminine identity; (c) the presence of fertility and parenting issues; (d) higher burdens of care; (e) barriers to separation and individuation as a maturation milestone; and (f) feeling out of place compared with peers. These themes provide a foundation to inform how social workers care for this underserved group of women.

Perceptions of financial payment for research participation among African-American drug users in HIV studies.

PubMed

Slomka, Jacquelyn; McCurdy, Sheryl; Ratliff, Eric A; Timpson, Sandra; Williams, Mark L

2007-10-01

Financial compensation for participating in research is controversial, especially when participants are recruited from economically disadvantaged and/or marginalized populations such as drug users. Little is known about these participants' own views regarding payment for research participation. The objective of the study was to elicit underserved minority drug users' views about monetary payments for participating in research. Semi-structured in-depth interview study of motivations for and perceptions of participation in research was used. Thirty-seven adult, economically disadvantaged African-American crack cocaine smokers were the participants of the study. Participants were recruited from among those taking part in three HIV prevention studies. Interviews were conducted at one of 2 research field offices located in underserved minority neighborhoods in Houston, Texas. Interviews lasting 30-45 min were recorded, transcribed, coded, and analyzed for categories and themes using both conventional and directed qualitative content analysis. This report addresses themes under the broad category of financial motivations for participating in research. Participants viewed monetary payment for research as essential to attract participation and desirable to provide optional income. Payment for research participation was perceived as one potential income source among others. Participants considered self-determination a prerogative for themselves and others. They rejected the notion of payment for participation as encouraging drug use or as inducing risk taking. Research regulators should consider participants' views of their desires and capacity for autonomous decisions about financial compensation for research rather than assume participants' diminished capacity due to poverty and/or drug use. Payment for research participation appears to be part of the "informal economy" that has been observed in underserved communities.

Adapting evidence-based strategies to increase physical activity among African Americans, Hispanics, Hmong, and Native Hawaiians: a social marketing approach.

PubMed

Van Duyn, Mary Ann S; McCrae, Tarsha; Wingrove, Barbara K; Henderson, Kimberly M; Boyd, Jamie K; Kagawa-Singer, Marjorie; Ramirez, Amelie G; Scarinci-Searles, Isabel; Wolff, Lisa S; Penalosa, Tricia L; Maibach, Edward W

2007-10-01

Using a social marketing approach, we studied how best to adapt proven, evidence-based strategies to increase physical activity for use with underserved racial or ethnic groups. We conducted focus groups with low-income Hispanic women in Texas, Hmong parents and their children in California, low-income African American women and men in the Mississippi Delta, and Native Hawaiian college students in Hawaii. We also interviewed key leaders of these communities. Topics of discussion were participants' perceptions about 1) the benefits of engaging in physical activity, 2) the proposed evidence-based strategies for increasing each community's level of physical activity, and 3) the benefits and barriers to following the proposed interventions for increasing physical activity. A total of 292 individuals participated in the study. All groups considered that being physically active was part of their culture, and participants found culturally relevant suggestions for physical activities appealing. Overwhelmingly, strategies that aimed to create or improve social support and increase access to physical activity venues received the most positive feedback from all groups. Barriers to physical activity were not culturally specific; they are common to all underserved people (lack of time, transportation, access, neighborhood safety, or economic resources). Results indicate that evidence-based strategies to increase physical activity need to be adapted for cultural relevance for each racial or ethnic group. Our research shows that members of four underserved populations are likely to respond to strategies that increase social support for physical activity and improve access to venues where they can be physically active. Further research is needed to test how to implement such strategies in ways that are embraced by community members.

Tailoring cancer education and support programs for low-income, primarily African American cancer survivors.

PubMed

Martin, Michelle Y; Pollack, Lori A; Evans, Mary B; Smith, Judith Lee; Kratt, Polly; Prayor-Patterson, Heather; Watson, Christopher D; Dignan, Mark; Cheney, Lydia C; Pisu, Maria; Liwo, Amandiy; Hullett, Sandral

2011-01-01

to identify the information and stress-management topics of most interest to low-income, predominantly African American cancer survivors. descriptive, cross sectional. outpatient oncology clinic in a public hospital in Birmingham, Alabama. 25 patients with cancer; 12 were men, 22 were African Americans, and 16 had a 12th-grade education or less. patients ranked potential topics to be included in an educational curriculum. quantitative rankings of information and stress-management priorities. learning about cancer, understanding cancer treatments, relieving cancer pain, and keeping well in mind and body were the most highly ranked topics among those offered within the American Cancer Society's I Can Cope curriculum, which also included supportive topics such as mobilizing social support. The preferred stress-management topics were humor therapy, music therapy, meditation, and relaxation; lower-ranked topics included pet therapy and art as therapy. cancer survivors appear most interested in topics specific to their illness and treatment versus supportive topics. Stress management also received high rankings. nurses have a key role in providing patient education and support. Tailoring education programs may better target specific needs and improve the quality of cancer care of underserved patients.

The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach.

PubMed

Yeary, Karen Hye-cheon Kim; Cornell, Carol E; Prewitt, Elaine; Bursac, Zoran; Tilford, J Mick; Turner, Jerome; Eddings, Kenya; Love, ShaRhonda; Whittington, Emily; Harris, Kimberly

2015-01-01

The positive effects of weight loss on obesity-related risk factors diminish unless weight loss is maintained. Yet little work has focused on the translation of evidence-based weight loss interventions with the aim of sustaining weight loss in underserved populations. Using a community-based participatory approach (CBPR) that engages the strong faith-based social infrastructure characteristic of rural African American communities is a promising way to sustain weight loss in African Americans, who bear a disproportionate burden of the obesity epidemic. Led by a collaborative community-academic partnership, The WORD aims to change dietary and physical activity behaviors to produce and maintain weight loss in rural, African American adults of faith. The WORD is a randomized controlled trial with 450 participants nested within 30 churches. All churches will receive a 16-session core weight loss intervention. Half of the churches will be randomized to receive an additional 12-session maintenance component. The WORD is a cultural adaptation of the Diabetes Prevention Program, whereby small groups will be led by trained church members. Participants will be assessed at baseline, 6, 12, and 18 months. A detailed cost-effectiveness and process evaluation will be included. The WORD aims to sustain weight loss in rural African Americans. The utilization of a CBPR approach and the engagement of the faith-based social infrastructure of African American communities will maximize the intervention's sustainability. Unique aspects of this trial include the focus on weight loss maintenance and the use of a faith-based CBPR approach in translating evidence-based obesity interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

The Role of Motivation in Understanding Social Contextual Influences on Physical Activity in Underserved Adolescents in the ACT Trial: A Cross-Sectional Study

PubMed Central

Wilson, Dawn K.; Van Horn, M. Lee; Zarrett, Nicole

2012-01-01

Abstract Background Previous research has shown that social contextual factors are important in understanding physical activity (PA) behavior, although little is known about how these factors may relate to PA, especially in underserved adolescents (low income, minorities). This study examined how motivation may differentially mediate the relationship of two social contextual variables (i.e., peer and parent social support) and moderate-to-vigorous PA (MVPA). Methods Baseline data (n=1421 sixth graders, 54% female, 72% African American) from the Active by Choice Today (ACT) trial in underserved adolescents were analyzed. Motivation was examined as a mediator of the relationships between peer social support, parent social support, and MVPA (measured by 7-day accelerometer estimates). Results Motivation and peer but not parent support were significantly related to MVPA overall. Significant mediation effects were found indicating motivation partially mediated the relation between peer social support and MVPA and to a lesser degree parent support and MVPA. Conclusions These findings provide support for the importance of social contextual influences, especially peer social support, on underserved adolescents' PA and motivation for PA. PMID:23181920

Faith Among Low-Income, African American/Black Men Treated for Prostate Cancer

PubMed Central

Maliski, Sally L.; Connor, RN Sarah E.; Williams, Lindsay; Litwin, Mark S.

2014-01-01

Background Understanding how low-income, uninsured African American/black men use faith to cope with prostate cancer provides a foundation for the design of culturally appropriate interventions to assist underserved men cope with the disease and its treatment. Previous studies have shown spirituality to be a factor related to health and quality of life, but the process by which faith, as a promoter of action, supports coping merits exploration. Objective Our purpose was to describe the use of faith by low-income, uninsured African American/black men in coping with prostate cancer and its treatment and adverse effects. Methods We analyzed data from a qualitative study that used in-depth individual interviews involving 18 African American men ranging in ages from 53 to 81 years. Our analysis used grounded theory techniques. Results Faith was used by African American men to overcome fear and shock engendered by their initial perceptions of cancer. Faith was placed in God, health care providers, self, and family. Men came to see their prostate cancer experience a new beginning that was achieved through purposeful acceptance or resignation. Conclusions Faith was a motivator of and source for action. Faith empowered men to be active participants in their treatment and incorporate treatment outcomes into their lives meaningfully. Implication By understanding faith as a source of empowerment for active participation in care, oncology nurses can use men's faith to facilitate reframing of cancer perceptions and to acknowledge the role of men's higher being as part of the team. Studies are needed to determine if this model is relevant across various beliefs and cultures. PMID:20555257

A question of trust: user-centered design requirements for an informatics intervention to promote the sexual health of African-American youth.

PubMed

Veinot, Tiffany C; Campbell, Terrance R; Kruger, Daniel J; Grodzinski, Alison

2013-01-01

We investigated the user requirements of African-American youth (aged 14-24 years) to inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections (STI). We conducted 10 focus groups with 75 African-American youth from a city with high HIV/STI prevalence. Data analyses involved coding using qualitative content analysis procedures and memo writing. Unexpectedly, the majority of participants' design recommendations concerned trust. Youth expressed distrust towards people and groups, which was amplified within the context of information technology-mediated interactions about HIV/STI. Participants expressed distrust in the reliability of condoms and the accuracy of HIV tests. They questioned the benevolence of many institutions, and some rejected authoritative HIV/STI information. Therefore, reputational information, including rumor, influenced HIV/STI-related decision making. Participants' design requirements also focused on trust-related concerns. Accordingly, we developed a novel trust-centered design framework to guide intervention design. Current approaches to online trust for health informatics do not consider group-level trusting patterns. Yet, trust was the central intervention-relevant issue among African-American youth, suggesting an important focus for culturally informed design. Our design framework incorporates: intervention objectives (eg, network embeddedness, participation); functional specifications (eg, decision support, collective action, credible question and answer services); and interaction design (eg, member control, offline network linkages, optional anonymity). Trust is a critical focus for HIV/STI informatics interventions for young African Americans. Our design framework offers practical, culturally relevant, and systematic guidance to designers to reach this underserved group better.

Developing a Training Program in Breast Cancer Research to Decrease the Disparity of Morbidity and Mortality in Underserved/Minority Women

DTIC Science & Technology

2006-10-01

eHealth Promotion Training Institute. As a result of the training, they submitted a grant and received funding from the UNCFSP/NLM-HBCU Access...increase breast cancer screening among African American women eHealth Training Institute, Center for Collaborative Research. June...2006 Received funding and completed 40 hours of the eHealth Promotion Training Institute sponsored by the Center for Excellence in eHealth Promotion

Qualitative developmental research among low income African American adults to inform a social marketing campaign for walking.

PubMed

Wilson, Dawn K; St George, Sara M; Trumpeter, Nevelyn N; Coulon, Sandra M; Griffin, Sarah F; Wandersman, Abe; Forthofer, Melinda; Gadson, Barney; Brown, Porschia V

2013-03-05

This study describes the development of a social marketing campaign for increasing walking in a low income, high crime community as part of the Positive Action for Today's Health (PATH) trial. Focus groups were conducted with 52 African American adults (ages 18 to 65 yrs), from two underserved communities to develop themes for a social marketing campaign to promote walking. Participants responded to questions concerning social marketing principles related to product, price, place, promotion, and positioning for increasing neighbourhood walking. Focus group data informed the development of the campaign objectives that were derived from the "5 Ps" to promote physical and mental health, social connectedness, safety, and confidence in walking regularly. Focus group themes indicated that physical and mental health benefits of walking were important motivators. Walking for social reasons was also important for overcoming barriers to walking. Police support from trusted officers while walking was also essential to promoting safety for walking. Print materials were developed by the steering committee, with a 12-month calendar and door hangers delivered to residents' homes to invite them to walk. Pride Stride walks empowered community walkers to serve as peer leaders for special walking events to engage new walkers. Essential elements for developing culturally tailored social marketing interventions for promoting walking in underserved communities are outlined for future researchers.

Qualitative developmental research among low income African American adults to inform a social marketing campaign for walking

PubMed Central

2013-01-01

Background This study describes the development of a social marketing campaign for increasing walking in a low income, high crime community as part of the Positive Action for Today’s Health (PATH) trial. Methods Focus groups were conducted with 52 African American adults (ages 18 to 65 yrs), from two underserved communities to develop themes for a social marketing campaign to promote walking. Participants responded to questions concerning social marketing principles related to product, price, place, promotion, and positioning for increasing neighbourhood walking. Results Focus group data informed the development of the campaign objectives that were derived from the “5 Ps” to promote physical and mental health, social connectedness, safety, and confidence in walking regularly. Focus group themes indicated that physical and mental health benefits of walking were important motivators. Walking for social reasons was also important for overcoming barriers to walking. Police support from trusted officers while walking was also essential to promoting safety for walking. Print materials were developed by the steering committee, with a 12-month calendar and door hangers delivered to residents’ homes to invite them to walk. Pride Stride walks empowered community walkers to serve as peer leaders for special walking events to engage new walkers. Conclusions Essential elements for developing culturally tailored social marketing interventions for promoting walking in underserved communities are outlined for future researchers. PMID:23497164

Health Volunteerism and Improved Cancer Health for Latina and African American Women and Their Social Networks: Potential Mechanisms.

PubMed

Molina, Yamile; McKell, Marnyce S; Mendoza, Norma; Barbour, Lynda; Berrios, Nerida M; Murray, Kate; Ferrans, Carol Estwing

2018-02-01

Health volunteerism has been associated with positive health outcomes for volunteers and the communities they serve. This work suggests that there may be an added value to providing underserved populations with information and skills to be agents of change. The current study is a first step toward testing this hypothesis. The purpose is to identify how volunteerism may result in improved cancer health among Latina and African American women volunteers. A purposive sample of 40 Latina and African American female adults who had participated in cancer volunteerism in the past 5 years was recruited by community advocates and flyers distributed throughout community venues in San Diego, CA. This qualitative study included semi-structured focus groups. Participants indicated that volunteerism not only improved their health but also the health of their family and friends. Such perceptions aligned with the high rates of self-report lifetime cancer screening rates among age-eligible patients (e.g., 83-93 % breast; 90-93 % cervical; 79-92 % colorectal). Identified mechanisms included exposure to evidence-based information, health-protective social norms and support, and pressure to be a healthy role model. Our findings suggest that train-the-trainer and volunteer-driven interventions may have unintended health-protective effects for participating staff, especially Latina and African American women.

Stimulating cancer screening among Latinas and African-American women. A community case study.

PubMed

Yancey, A K; Walden, L

1994-01-01

Recent studies have attributed underutilization of early cancer detection programs among the disadvantaged to knowledge deficits and myths, lack of belief in cancer susceptibility (denial), and such attitudinal barriers as fear and embarrassment. Video modalities have been demonstrated to be effective in increasing knowledge and promoting health-protective behavior in low-income people of color. Waiting rooms of public health clinic facilities in large urban areas provide a captive audience of predominantly African Americans and Latinos with a preference for obtaining health information from audiovisual media. The development of a culturally sensitive, cost-effective documentary format is described. An experience of rapid acceleration in demand for Pap smears in an underserved Latino community of East Los Angeles following the showing of one of these videos is chronicled as a spontaneous and informal evaluation of this approach to health education/promotion video production.

Stress, stress reduction and hypercholesterolemia in African Americans: a review.

PubMed

Calderon, R; Schneider, R H; Alexander, C N; Myers, H F; Nidich, S I; Haney, C

1999-01-01

Psychological stress may directly contribute to the disproportionately high rates of coronary heart disease morbidity and mortality and its etiologic risk factors in African Americans. Specifically, acute and chronic stress have been shown to raise serum lipids and are associated with clinical coronary events. The mechanisms by which stress contributes to alterations in lipid levels are not fully known, but various pathways (ie, hormonal, dietary, etc) have been implicated. Traditional methods for reducing blood serum lipids include diet, drugs or both. These methods have been criticized because of issues of compliance, side effects, and cost. Because of these limitations, nondrug behavioral methods are recommended by the National Cholesterol Education Program as the first line of prevention and treatment for hypercholesterolemia and other risk factors. Research shows that CHD morbidity and mortality and major risk factors may be modifiable by behavioral intervention. Specifically, the Transcendental Meditation technique, an effective antidote to stress, reduces levels of major CHD risk factors including hypercholesterolemia, as well as blood pressure and smoking. Using an effective stress reduction approach for prevention and treatment of CHD and its risk factors in African Americans may prove to be a valuable asset for this underserved population.

Toward the Elimination of Colorectal Cancer Disparities Among African Americans.

PubMed

Coughlin, Steven S; Blumenthal, Daniel S; Seay, Shirley Jordan; Smith, Selina A

2016-12-01

In the USA, race and socioeconomic status are well-known factors associated with colorectal cancer incidence and mortality rates. These are higher among blacks than whites and other racial/ethnic groups. In this article, we review opportunities to address disparities in colorectal cancer incidence, mortality, and survivorship among African Americans. First, we summarize the primary prevention of colorectal cancer and recent advances in the early detection of the disease and disparities in screening. Then, we consider black-white disparities in colorectal cancer treatment and survival including factors that may contribute to such disparities and the important roles played by cultural competency, patient trust in one's physician, and health literacy in addressing colorectal cancer disparities, including the need for studies involving the use of colorectal cancer patient navigators who are culturally competent. To reduce these disparities, intervention efforts should focus on providing high-quality screening and treatment for colorectal cancer and on educating African Americans about the value of diet, weight control, screening, and treatment. Organized approaches for delivering colorectal cancer screening should be accompanied by programs and policies that provide access to diagnostic follow-up and treatment for underserved populations.

Toward the Elimination of Colorectal Cancer Disparities Among African Americans

PubMed Central

Blumenthal, Daniel S.; Seay, Shirley Jordan; Smith, Selina A.

2015-01-01

Background In the USA, race and socioeconomic status are well-known factors associated with colorectal cancer incidence and mortality rates. These are higher among blacks than whites and other racial/ethnic groups. Methods In this article, we review opportunities to address disparities in colorectal cancer incidence, mortality, and survivorship among African Americans. Results First, we summarize the primary prevention of colorectal cancer and recent advances in the early detection of the disease and disparities in screening. Then, we consider black-white disparities in colorectal cancer treatment and survival including factors that may contribute to such disparities and the important roles played by cultural competency, patient trust in one’s physician, and health literacy in addressing colorectal cancer disparities, including the need for studies involving the use of colorectal cancer patient navigators who are culturally competent. Conclusion To reduce these disparities, intervention efforts should focus on providing high-quality screening and treatment for colorectal cancer and on educating African Americans about the value of diet, weight control, screening, and treatment. Organized approaches for delivering colorectal cancer screening should be accompanied by programs and policies that provide access to diagnostic follow-up and treatment for underserved populations. PMID:27294749

Developing a Training Program in Breast Cancer Research to Decrease the Disparity of Morbidity and Mortality in Underserved/Minority Women

DTIC Science & Technology

2005-10-01

fingers and the ability of elderly minority women to detect breast tumor size? Research Model Function "* Range of Motion0. AblttoD ec Age S~Cormobidity...Future" National conference to end health disparities, Sept. 27-29 WS, NC Factors Affecting Breast Cancer Screening Adherence in Older African American...designated Historically Black College and University (HBCU) is committed to resolving some of the economic, social and health problems in the community in

Effects of dance on depression, physical function, and disability in underserved adults.

PubMed

Murrock, Carolyn J; Graor, Christine Heifner

2014-07-01

This study documented the feasibility and immediate effects of a dance intervention two times per week for 12 weeks on depression, physical function, and disability in older, underserved adults. The one-group, pretest-posttest study had a convenience sample of 40 participants recruited from a federally subsidized apartment complex located in an economically depressed, inner-city neighborhood. Depression, physical function, and disability were measured at baseline and 12 weeks. Average age was 63 years (SD = 7.9), 92% were female, and 75% were African American. At baseline, participants reported increased depression (M = 20.0, SD = 12.4), decreased physical function (M = 56.6, SD = 10.9), and increased disability limitations (M = 65.7, SD = 14.9). At posttest, paired t tests showed that the dance intervention significantly decreased depression, t = 6.11, p < .001, and disability, t = -2.70, p = .014, and significantly increased physical function, t = -2.74, p = .013. The results indicate that the 12-week dance intervention may be an effective adjunct therapy to improve depression, disability, and physical function in underserved adults.

Prioritizing multiple health behavior change research topics: expert opinions in behavior change science.

PubMed

Amato, Katie; Park, Eunhee; Nigg, Claudio R

2016-06-01

Multiple health behavior change (MHBC) approaches are understudied. The purpose of this study is to provide strategic MHBC research direction. This cross-sectional study contacted participants through the Society of Behavioral Medicine email listservs and rated the importance of 24 MHBC research topics (1 = not at all important, 5 = extremely important) separately for general and underserved populations. Participants (n = 76) were 79 % female; 76 % White, 10 % Asian, 8 % African American, 5 % Hispanic, and 1 % Native Hawaiian/Pacific Islander. Top MHBC research priorities were predictors of behavior change and the sustainability, long-term effects, and dissemination/translation of interventions for both populations. Recruitment and retention of participants (t(68) = 2.17, p = 0.000), multi-behavioral indices (t(68) = 3.54, p = 0.001), and measurement burden (t(67) = 5.04, p = 0.001) were important for the underserved. Results identified the same top research priorities across populations. For the underserved, research should emphasize recruitment, retention, and measurement burden.

Relationship of body mass index and psychosocial factors on physical activity in underserved adolescent boys and girls.

PubMed

Kitzman-Ulrich, Heather; Wilson, Dawn K; Van Horn, M Lee; Lawman, Hannah G

2010-09-01

Previous research indicates that body mass index (BMI) and sex are important factors in understanding physical activity (PA) levels. The present study examined the influence of BMI on psychosocial variables (self-efficacy, social support) and PA in underserved (ethnic minority, low income) boys in comparison with girls. Participants (N = 669; 56% girls; 74% African American) were recruited from the "Active by Choice Today" trial. BMI ʐ score was calculated from objectively collected height and weight data, and PA was assessed with 7-day accelerometry estimates. Self-report questionnaires were used to measure self-efficacy and social support (family, peers) for PA. A 3-way interaction between BMI z score, sex, and family support on PA was shown such that family support was positively associated with PA in normal-weight but not overweight or obese boys, and was not associated with PA in girls. Self-efficacy had the largest effect size related to PA in comparison with the other psychosocial variables studied. Self-efficacy was found to be an important variable related to PA in underserved youth. Future studies should evaluate possible barriers to PA in girls, and overweight youth, to provide more effective family support strategies for underserved adolescents' PA. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Internet and mobile technology use among urban African American parents: survey study of a clinical population.

PubMed

Mitchell, Stephanie J; Godoy, Leandra; Shabazz, Kanya; Horn, Ivor B

2014-01-13

There is considerable potential for mobile technologies to empower pediatric patients and families by improving their communication with health professionals. National surveys suggest minority parents frequently communicate via mobile technology, but it is uncertain how amenable they are to receiving health care information in this format. Although the low cost and far reach characteristics of mobile health (mHealth) technology makes it advantageous for communication with minority parents, data on acceptance are needed. The objective of the study was to determine utilization of mobile and Internet technology by African American parents in an urban, underserved population, and to assess their interest in receiving health information via text messaging or other technologies (eg, social media and the Internet). A survey was administered to parents of children aged 1-12 years covered by public insurance receiving care at 3 pediatric primary care centers in Washington, DC. The African American sample (N=302) was composed of primarily single (75.8%, 229/302) mothers. Almost half had more than a high school education (47.7%, 144/302) and incomes above US $25,000 per year (43.0%, 130/302). Most (97.0%, 293/302) reported owning a cell phone, of which 91.1% (275/302) used it to text and 78.5% (237/302) used it to access the Internet. Most had service plans with unlimited text and data, but 26.5% (80/302) experienced service interruptions in the previous year. Home Internet access was more prevalent among those with higher income (86.2%, 112/130), but it was still relatively pervasive among lower income families (66.9%, 83/124). In adjusted logistic regression models, African American mothers with income greater than US $25,000 annually were 4 times as likely to own a tablet computer than their lower income counterparts. Of the participants, 80.8% (244/302) used social networking, primarily Facebook, and 74.2% (224/302) were interested in joining a social networking group about a health topic concerning their child. Although relatively few African American mothers (17.9%, 54/302) shared health information via texting, there was strong interest in receiving health information via mobile phones (87.4%, 264/302). There was no significant difference in Internet/mobile device use or interest in using these outlets to send/receive information about their children's health between parents of healthy children and parents of children with chronic health conditions. Urban African American parents are active users of the Internet and mobile technology for social interactions, but they are less likely to use it for accessing or communicating health information. However, most parents expressed an interest in receiving health information or utilizing social networking to learn more about health topics. Mobile technology and social networks may be an underutilized method of providing health information to underserved minority populations.

Internet and Mobile Technology Use Among Urban African American Parents: Survey Study of a Clinical Population

PubMed Central

Godoy, Leandra; Shabazz, Kanya

2014-01-01

Background There is considerable potential for mobile technologies to empower pediatric patients and families by improving their communication with health professionals. National surveys suggest minority parents frequently communicate via mobile technology, but it is uncertain how amenable they are to receiving health care information in this format. Although the low cost and far reach characteristics of mobile health (mHealth) technology makes it advantageous for communication with minority parents, data on acceptance are needed. Objective The objective of the study was to determine utilization of mobile and Internet technology by African American parents in an urban, underserved population, and to assess their interest in receiving health information via text messaging or other technologies (eg, social media and the Internet). Methods A survey was administered to parents of children aged 1-12 years covered by public insurance receiving care at 3 pediatric primary care centers in Washington, DC. Results The African American sample (N=302) was composed of primarily single (75.8%, 229/302) mothers. Almost half had more than a high school education (47.7%, 144/302) and incomes above US $25,000 per year (43.0%, 130/302). Most (97.0%, 293/302) reported owning a cell phone, of which 91.1% (275/302) used it to text and 78.5% (237/302) used it to access the Internet. Most had service plans with unlimited text and data, but 26.5% (80/302) experienced service interruptions in the previous year. Home Internet access was more prevalent among those with higher income (86.2%, 112/130), but it was still relatively pervasive among lower income families (66.9%, 83/124). In adjusted logistic regression models, African American mothers with income greater than US $25,000 annually were 4 times as likely to own a tablet computer than their lower income counterparts. Of the participants, 80.8% (244/302) used social networking, primarily Facebook, and 74.2% (224/302) were interested in joining a social networking group about a health topic concerning their child. Although relatively few African American mothers (17.9%, 54/302) shared health information via texting, there was strong interest in receiving health information via mobile phones (87.4%, 264/302). There was no significant difference in Internet/mobile device use or interest in using these outlets to send/receive information about their children’s health between parents of healthy children and parents of children with chronic health conditions. Conclusions Urban African American parents are active users of the Internet and mobile technology for social interactions, but they are less likely to use it for accessing or communicating health information. However, most parents expressed an interest in receiving health information or utilizing social networking to learn more about health topics. Mobile technology and social networks may be an underutilized method of providing health information to underserved minority populations. PMID:24418967

Computer and internet use among urban African Americans with type 2 diabetes.

PubMed

Jackson, Chandra L; Batts-Turner, Marian L; Falb, Matthew D; Yeh, Hsin-Chieh; Brancati, Frederick L; Gary, Tiffany L

2005-12-01

Previous studies have identified a "digital divide" between African Americans and whites, with African Americans having substantially lower rates of Internet use. However, use of the Internet to access health information has not been sufficiently evaluated in this population. Therefore, we conducted a telephone survey to determine the prevalence of computer and Internet use among 457 African American adults with type 2 diabetes. Participants were 78% female, with a mean age of 57 +/- 11 years, and about one-third had a yearly income % $7,500. Forty percent of the participants reported having a computer at home and 46% reported knowing how to use a computer. Most participants (58%) reported that they had, at some point, used a computer, and of those, 40% reported that they used the computer to find health information. In a stratified analysis, participants with lower education levels (

A question of trust: user-centered design requirements for an informatics intervention to promote the sexual health of African-American youth

PubMed Central

Veinot, Tiffany C; Campbell, Terrance R; Kruger, Daniel J; Grodzinski, Alison

2013-01-01

Objective We investigated the user requirements of African-American youth (aged 14–24 years) to inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections (STI). Materials and Methods We conducted 10 focus groups with 75 African-American youth from a city with high HIV/STI prevalence. Data analyses involved coding using qualitative content analysis procedures and memo writing. Results Unexpectedly, the majority of participants’ design recommendations concerned trust. Youth expressed distrust towards people and groups, which was amplified within the context of information technology-mediated interactions about HIV/STI. Participants expressed distrust in the reliability of condoms and the accuracy of HIV tests. They questioned the benevolence of many institutions, and some rejected authoritative HIV/STI information. Therefore, reputational information, including rumor, influenced HIV/STI-related decision making. Participants’ design requirements also focused on trust-related concerns. Accordingly, we developed a novel trust-centered design framework to guide intervention design. Discussion Current approaches to online trust for health informatics do not consider group-level trusting patterns. Yet, trust was the central intervention-relevant issue among African-American youth, suggesting an important focus for culturally informed design. Our design framework incorporates: intervention objectives (eg, network embeddedness, participation); functional specifications (eg, decision support, collective action, credible question and answer services); and interaction design (eg, member control, offline network linkages, optional anonymity). Conclusions Trust is a critical focus for HIV/STI informatics interventions for young African Americans. Our design framework offers practical, culturally relevant, and systematic guidance to designers to reach this underserved group better. PMID:23512830

Awareness of Human Papillomavirus Vaccine Among Adolescent African American Males Who Have Sex with Males: a Pilot Study.

PubMed

Onyeabor, Onyekachi S; Martin, Nicolle; Orish, Verner N; Sanyaolu, Adekunle O; Iriemenam, Nnaemeka C

2015-09-01

African American adolescent males who have sex with males (MSMs) have a high prevalence of sexually transmitted diseases (STDs) that has been directly linked to lack of access to primary care providers and reluctance to disclose their sexuality. The human papillomavirus (HPV) is the most common STD with more than 40 different serotypes and can lead to anal/genital warts as well as oral and genital cancers. The HPV vaccine if taken prior to an adolescent becoming sexually active serves a prophylactic function. The HPV vaccine is approved by the Food and Drug Administration (FDA) for girls and boys; however, HPV vaccination rates among adolescents within different minority and underserved communities have been disappointing even though these groups are disproportionately infected with the HPV virus and certain male-specific cancers. Little is known about the uptake of the vaccine among African American MSMs and thus the aim of this study. This qualitative study is based on the health belief model and assessed participants' level of awareness of HPV, the HPV vaccine, and HPV-related illnesses among 24 African American male adolescents between 16 and 18 years old who self identify as MSMs. As part of a larger study, two focus groups were conducted for African American MSMs. Participants failed to understand their potential risk for HPV given the higher rates of STD infection experienced by MSMs. They expressed very little knowledge of the HPV vaccine and are also not aware of the complications of HPV virus infection. However, they were very eager to know more about the virus and the vaccine. This study demonstrates the need for the development of health communication intervention and more research targeting African American MSMs and also the need for policy change towards making the HPV vaccine routine for males especially adolescents at no cost.

Considering the Role of Stress in Populations of High-Risk, Underserved Community Networks Program Centers.

PubMed

Hébert, James R; Braun, Kathryn L; Kaholokula, Joseph Keawe'aimoku; Armstead, Cheryl A; Burch, James B; Thompson, Beti

2015-01-01

Cancer disparities are associated with a broad range of sociocultural determinants of health that operate in community contexts. High-risk populations may be more vulnerable to social and environmental factors that lead to chronic stress. Theoretical and empirical research indicates that exposure to contextual and sociocultural stress alters biological systems, thereby influencing cancer risk, progression, and, ultimately, mortality. We sought to describe contextual pathways through which stress likely increases cancer risk in high-risk, underserved populations. This review presents a description of the link between contextual stressors and disease risk disparities within underserved communities, with a focus on 1) stress as a proximal link between biological processes, such as cytokine responses, inflammation, and cancer and 2) stress as a distal link to cancer through biobehavioral risk factors such as poor diet, physical inactivity, circadian rhythm or sleep disruption, and substance abuse. These concepts are illustrated through application to populations served by three National Cancer Institute-funded Community Networks Program Centers (CNPCs): African Americans in the Deep South (the South Carolina Cancer Disparities Community Network [SCCDCN]), Native Hawaiians ('Imi Hale-Native Hawaiian Cancer Network), and Latinos in the Lower Yakima Valley of Washington State (The Center for Hispanic Health Promotion: Reducing Cancer Disparities). Stress experienced by the underserved communities represented in the CNPCs is marked by social, biological, and behavioral pathways that increase cancer risk. A case is presented to increase research on sociocultural determinants of health, stress, and cancer risk among racial/ethnic minorities in underserved communities.

"For the good of the patient," survey of the physicians of the National Medical Association regarding perceptions of DTC advertising, Part II, 2006.

PubMed Central

Morris, Albert W.; Gadson, Sandra L.; Burroughs, Valentine

2007-01-01

BACKGROUND: Since the advent of direct-to-consumer (DTC) advertising in the 1980s, there have been numerous studies and surveys on the topic, addressing issues as varied as its impact on patient understanding of health conditions to its repercussions for drug spending. However, until 2001, there was a dearth of research on DTC advertising's impact on minority populations, specifically the African-American community. The National Medical Association (NMA) remedied that in 2001 by undertaking a landmark study that gauged African-American physicians' perceptions of DTC advertising, its impact on the doctor-patient relationship and, perhaps most importantly, its role in educating underserved populations about critical health issues and potential treatments. In 2006, the NMA decided to once again poll its members on this critical issue to gauge not only current perceptions but how the community's understanding of DTC advertising has changed since 2001. RESULTS: The 2006 survey revealed several clear trends: NMA physicians are more positive toward DTC advertising now than they were in 2001; African-American physicians see DTC advertising as providing substantial educational benefits; physicians believe that DTC advertising helps rather than hurts the doctor-patient relationship; and African-American physicians see the benefits of DTC advertising outweighing its drawbacks. It must be noted that NMA physicians also had clear concerns about DTC advertising that point to potential areas of improvement for pharmaceutical companies. PMID:17393955

"For the good of the patient," survey of the physicians of the National Medical Association regarding perceptions of DTC advertising, Part II, 2006.

PubMed

Morris, Albert W; Gadson, Sandra L; Burroughs, Valentine

2007-03-01

Since the advent of direct-to-consumer (DTC) advertising in the 1980s, there have been numerous studies and surveys on the topic, addressing issues as varied as its impact on patient understanding of health conditions to its repercussions for drug spending. However, until 2001, there was a dearth of research on DTC advertising's impact on minority populations, specifically the African-American community. The National Medical Association (NMA) remedied that in 2001 by undertaking a landmark study that gauged African-American physicians' perceptions of DTC advertising, its impact on the doctor-patient relationship and, perhaps most importantly, its role in educating underserved populations about critical health issues and potential treatments. In 2006, the NMA decided to once again poll its members on this critical issue to gauge not only current perceptions but how the community's understanding of DTC advertising has changed since 2001. The 2006 survey revealed several clear trends: NMA physicians are more positive toward DTC advertising now than they were in 2001; African-American physicians see DTC advertising as providing substantial educational benefits; physicians believe that DTC advertising helps rather than hurts the doctor-patient relationship; and African-American physicians see the benefits of DTC advertising outweighing its drawbacks. It must be noted that NMA physicians also had clear concerns about DTC advertising that point to potential areas of improvement for pharmaceutical companies.

Holding up the oral health safety net: the role of National Health Service Corps alumni dentists in North Carolina.

PubMed

Bhatavadekar, Neel B; Rozier, R Gary; Konrad, Thomas R

2011-06-01

  Access to oral health care among low income populations is a growing problem. The National Health Service Corps (NHSC) might increase the supply of dentists motivated to provide services for this population.   To determine if North Carolina dentists who began a service obligation with the NHSC in 1990-1999 continued to provide care for underserved populations and if they differ from non-NHSC alumni primary care dentists who started practice in the state during that same period.   All 19 NHSC alumni and 50 comparison dentists were surveyed by mail. NHSC alumni also responded to selected items in a telephone follow-up interview. The two groups were compared using difference of means tests and multivariate contingency tables.   National Health Service Corps alumni were more likely to be African-American (38%vs. 10%), work in safety net practices (84%vs. 23%), and see more publicly insured patients (60%vs. 19%) than comparison dentists. Yet their job satisfaction was comparable to non-NHSC alumni dentists. Analyses suggested that current practice in safety net settings is affected by dentists' race, altruistic motivations and previous NHSC participation. CONCLUSION AND POLICY IMPLICATION:  Targeted recruitment of African-American dentists and others wanting to work in underserved communities could amplify the effectiveness of the financial incentive of NHSC loan repayment and induce dentists to remain in 'safety net' settings. © 2011 FDI World Dental Federation.

State-of-the-science of patient navigation as a strategy for enhancing minority clinical trial accrual.

PubMed

Ghebre, Rahel G; Jones, Lovell A; Wenzel, Jennifer A; Martin, Michelle Y; Durant, Raegan W; Ford, Jean G

2014-04-01

Patient navigation programs are emerging that aim to address disparities in clinical trial participation among medically underserved populations, including racial/ethnic minorities. However, there is a lack of consensus on the role of patient navigators within the clinical trial process as well as outcome measures to evaluate program effectiveness. A review of the literature was conducted of PubMed, Medline, CINHAL, and other sources to identify qualitative and quantitative studies on patient navigation in clinical trials. The search yielded 212 studies, of which only 12 were eligible for this review. The eligible studies reported on the development of programs for patient navigation in cancer clinical trials, including training and implementation among African Americans, American Indians, and Native Hawaiians. A low rate of clinical trial refusal (range, 4%-6%) was reported among patients enrolled in patient navigation programs. However, few studies reported on the efficacy of patient navigation in increasing clinical treatment trial enrollment. Outcome measures are proposed to assist in developing and evaluating the efficacy and/or effectiveness of patient navigation programs that aim to increase participation in cancer clinical trials. Future research is needed to evaluate the efficacy of patient navigators in addressing barriers to clinical trial participation and increasing enrollment among medically underserved cancer patients. © 2014 American Cancer Society.

Evaluation of the Effectiveness of a Problem-Solving Intervention Addressing Barriers to Cardiovascular Disease Prevention Behaviors in 3 Underserved Populations: Colorado, North Carolina, West Virginia, 2009

PubMed Central

Bryant, Lucinda L.; Leary, Janie M.; Vu, Maihan B.; Hill-Briggs, Felicia; Samuel-Hodge, Carmen D.; McMilin, Colleen R.; Keyserling, Thomas C.

2014-01-01

Introduction In low-income and underserved populations, financial hardship and multiple competing roles and responsibilities lead to difficulties in lifestyle change for cardiovascular disease (CVD) prevention. To improve CVD prevention behaviors, we adapted, pilot-tested, and evaluated a problem-solving intervention designed to address barriers to lifestyle change. Methods The sample consisted of 81 participants from 3 underserved populations, including 28 Hispanic or non-Hispanic white women in a western community (site 1), 31 African-American women in a semirural southern community (site 2), and 22 adults in an Appalachian community (site 3). Incorporating focus group findings, we assessed a standardized intervention involving 6-to-8 week group sessions devoted to problem-solving in the fall of 2009. Results Most sessions were attended by 76.5% of participants, demonstrating participant adoption and engagement. The intervention resulted in significant improvement in problem-solving skills (P < .001) and perceived stress (P < .05). Diet, physical activity, and weight remained stable, although 72% of individuals reported maintenance or increase in daily fruit and vegetable intake, and 67% reported maintenance or increase in daily physical activity. Conclusion Study results suggest the intervention was acceptable to rural, underserved populations and effective in training them in problem-solving skills and stress management for CVD risk reduction. PMID:24602586

Clinician-Patient Communication about Physical Activity in an Underserved Population

PubMed Central

Carroll, Jennifer K.; Fiscella, Kevin; Meldrum, Sean C.; Williams, Geoffrey C.; Sciamanna, Christopher N.; Jean-Pierre, Pascal; Morrow, Gary R.; Epstein, Ronald M.

2010-01-01

Introduction The 5A (Ask, Advise, Agree, Assist, Arrange) model, used to promote patient behavior changes in primary care, can also be applied to physical activity. Our goal was to assess primary care physicians’ use of the 5As in discussions about physical activity with underserved populations. Methods We analyzed 51 audiorecorded, transcribed office visits on randomly selected patient care days and post-visit patient surveys with adults in two community health centers in Rochester, New York. Results The patient sample was 51% African American, predominantly female (70%), with the majority having a high school level education or less (66%) and an annual household income less than $39,000 (57%). Physical activity was discussed during 19 of the 51 visits, which included 16 (84%) visits with "Ask", ten (53%) with “Advise”, four (21%) with "Agree", five (26%) with "Assist", and 0 with "Arrange" statements. Most discussions of physical activity contained several Ask or Advise statements, but few Agree, Assist, or Arrange statements. Conclusion Communication about physical activity that included Agree, Arrange, and Assist statements of the 5As was infrequent. Health promotion interventions in underserved populations should target these steps and prompt patients to initiate communication to improve physical activity. PMID:18343859

Considering the Role of Stress in Populations of High-Risk, Underserved Community Networks Program Centers

PubMed Central

Hébert, James R.; Braun, Kathryn L.; Kaholokula, Joseph Keawe‘aimoku; Armstead, Cheryl A.; Burch, James B.; Thompson, Beti

2015-01-01

Background Cancer disparities are associated with a broad range of sociocultural determinants of health that operate in community contexts. High-risk populations may be more vulnerable to social and environmental factors that lead to chronic stress. Theoretical and empirical research indicates that exposure to contextual and sociocultural stress alters biological systems, thereby influencing cancer risk, progression, and, ultimately, mortality. Objective We sought to describe contextual pathways through which stress likely increases cancer risk in high-risk, underserved populations. Methods This review presents a description of the link between contextual stressors and disease risk disparities within underserved communities, with a focus on 1) stress as a proximal link between biological processes, such as cytokine responses, inflammation, and cancer and 2) stress as a distal link to cancer through biobehavioral risk factors such as poor diet, physical inactivity, circadian rhythm or sleep disruption, and substance abuse. These concepts are illustrated through application to populations served by three National Cancer Institute-funded Community Networks Program Centers (CNPCs): African Americans in the Deep South (the South Carolina Cancer Disparities Community Network [SCCDCN]), Native Hawaiians (‘Imi Hale—Native Hawaiian Cancer Network), and Latinos in the Lower Yakima Valley of Washington State (The Center for Hispanic Health Promotion: Reducing Cancer Disparities). Conclusions Stress experienced by the underserved communities represented in the CNPCs is marked by social, biological, and behavioral pathways that increase cancer risk. A case is presented to increase research on sociocultural determinants of health, stress, and cancer risk among racial/ethnic minorities in underserved communities. PMID:26213406

Imputational Modeling of Spatial Context and Social Environmental Predictors of Walking in an Underserved Community: The PATH Trial

PubMed Central

Ellerbe, Caitlyn; Lawson, Andrew B.; Alia, Kassandra A.; Meyers, Duncan C.; Coulon, Sandra M.; Lawman, Hannah G.

2013-01-01

Background This study examined imputational modeling effects of spatial proximity and social factors of walking in African American adults. Purpose Models were compared that examined relationships between household proximity to a walking trail and social factors in determining walking status. Methods Participants (N=133; 66% female; mean age=55 yrs) were recruited to a police-supported walking and social marketing intervention. Bayesian modeling was used to identify predictors of walking at 12 months. Results Sensitivity analysis using different imputation approaches, and spatial contextual effects, were compared. All the imputation methods showed social life and income were significant predictors of walking, however, the complete data approach was the best model indicating Age (1.04, 95% OR: 1.00, 1.08), Social Life (0.83, 95% OR: 0.69, 0.98) and Income > $10,000 (0.10, 95% OR: 0.01, 0.97) were all predictors of walking. Conclusions The complete data approach was the best model of predictors of walking in African Americans. PMID:23481250

Imputational modeling of spatial context and social environmental predictors of walking in an underserved community: the PATH trial.

PubMed

Wilson, Dawn K; Ellerbe, Caitlyn; Lawson, Andrew B; Alia, Kassandra A; Meyers, Duncan C; Coulon, Sandra M; Lawman, Hannah G

2013-03-01

This study examined imputational modeling effects of spatial proximity and social factors of walking in African American adults. Models were compared that examined relationships between household proximity to a walking trail and social factors in determining walking status. Participants (N=133; 66% female; mean age=55 years) were recruited to a police-supported walking and social marketing intervention. Bayesian modeling was used to identify predictors of walking at 12 months. Sensitivity analysis using different imputation approaches, and spatial contextual effects, were compared. All the imputation methods showed social life and income were significant predictors of walking, however, the complete data approach was the best model indicating Age (1.04, 95% OR: 1.00, 1.08), Social Life (0.83, 95% OR: 0.69, 0.98) and Income <$10,000 (0.10, 95% OR: 0.01, 0.97) were all predictors of walking. The complete data approach was the best model of predictors of walking in African Americans. Copyright © 2012 Elsevier Ltd. All rights reserved.

Streaming weekly soap opera video episodes to smartphones in a randomized controlled trial to reduce HIV risk in young urban African American/black women.

PubMed

Jones, Rachel; Lacroix, Lorraine J

2012-07-01

Love, Sex, and Choices is a 12-episode soap opera video series created as an intervention to reduce HIV sex risk. The effect on women's HIV risk behavior was evaluated in a randomized controlled trial in 238 high risk, predominately African American young adult women in the urban Northeast. To facilitate on-demand access and privacy, the episodes were streamed to study-provided smartphones. Here, we discuss the development of a mobile platform to deliver the 12-weekly video episodes or weekly HIV risk reduction written messages to smartphones, including; the technical requirements, development, and evaluation. Popularity of the smartphone and use of the Internet for multimedia offer a new channel to address health disparities in traditionally underserved populations. This is the first study to report on streaming a serialized video-based intervention to a smartphone. The approach described here may provide useful insights in assessing advantages and disadvantages of smartphones to implement a video-based intervention.

Urban-rural differences in excess mortality among high-poverty populations: evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health.

PubMed

Geronimus, Arline T; Colen, Cynthia G; Shochet, Tara; Ingber, Lori Barer; James, Sherman A

2006-08-01

Black youth residing in high-poverty areas have dramatically lower probabilities of surviving to age 65 if they are urban than if they are rural. Chronic disease deaths contribute heavily. We begin to probe the reasons using the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). We compare HHS and PCS respondents on chronic disease rates, health behaviors, social support, employment, indicators of health care access, and health insurance. Chronic disease profiles do not favor Pitt County. Smoking uptake is similar across samples, but PCS respondents are more likely to quit. Indicators of access to health care and private health insurance are more favorable in Pitt County. Findings suggest rural mortality is averted through secondary or tertiary prevention, not primary. Macroeconomic and health system changes of the past 20 years may have left poor urban Blacks as medically underserved as poor rural Blacks.

Perceived Physician-informed Weight Status Predicts Accurate Weight Self-Perception and Weight Self-Regulation in Low-income, African American Women.

PubMed

Harris, Charlie L; Strayhorn, Gregory; Moore, Sandra; Goldman, Brian; Martin, Michelle Y

2016-01-01

Obese African American women under-appraise their body mass index (BMI) classification and report fewer weight loss attempts than women who accurately appraise their weight status. This cross-sectional study examined whether physician-informed weight status could predict weight self-perception and weight self-regulation strategies in obese women. A convenience sample of 118 low-income women completed a survey assessing demographic characteristics, comorbidities, weight self-perception, and weight self-regulation strategies. BMI was calculated during nurse triage. Binary logistic regression models were performed to test hypotheses. The odds of obese accurate appraisers having been informed about their weight status were six times greater than those of under-appraisers. The odds of those using an "approach" self-regulation strategy having been physician-informed were four times greater compared with those using an "avoidance" strategy. Physicians are uniquely positioned to influence accurate weight self-perception and adaptive weight self-regulation strategies in underserved women, reducing their risk for obesity-related morbidity.

Retired African American female urban middle school science teachers' beliefs and practices

NASA Astrophysics Data System (ADS)

Whitney, Frances M.

The purpose of this paper is to give a voice to a dedicated group of professionals who unselfishly labored twenty-five plus years educating the children of America's poorest taxpaying citizens. These retired African American female urban middle school science teachers (RAAFUMSST) explain the experiences that gave them the fortitude to stay in the urban school system until their retirement. The goal is to give you a glimpse into the distractions, challenges, and victories the teachers encountered as they strove to teach science in an overcrowded, underserviced, and depressed urban school district of a major city. Most times sacrificing self for service, the participants of this study held fast to their beliefs that all of America's children, regardless of their parents' socioeconomic status, deserve a quality education. It is through individual interviews that the five retired science teachers of this project share their reflections on the events and circumstances that altered their labor of love. Critical Race Theory (CRT) serves as the theoretical frame for this study.

Using Religious Songs as an Integrative and Complementary Therapy for the Management of Psychological Symptoms Among African American Cancer Survivors.

PubMed

Hamilton, Jill B; Worthy, Valarie C; Kurtz, Melissa J; Cudjoe, Joycelyn; Johnstone, Peter A

Acupuncture, acupressure, yoga, meditation, cognitive-behavioral techniques, and, to a lesser extent, music are among those integrative and complementary therapies with known beneficial effects on psychological symptoms. However, noticeably absent from this research is the use of religious song as a type of integrative and complementary therapy. The aim of this study was to explore how religious songs were used to alleviate psychological symptoms associated with a cancer diagnosis among a sample of older African American cancer survivors. Thirty-one older African American cancer survivors residing in the Southeastern US participated in a qualitative descriptive study involving criterion sampling, open-ended semistructured interviews, and qualitative content analysis. Participants used religious songs in response to feeling depressed, low, or sad; feeling weak and seeking strength to endure treatment; and feeling worried, anxious, or fearful. Religious songs were also a source of support and hope. Types of religious songs included instructive, thanksgiving and praise, memory of forefathers, communication with God, and life after death. Religious songs appear to be an important form of religious expression in this population and used to manage psychological symptoms. Integrative and complementary oncology therapy has generally focused on yoga, meditation, acupuncture, and cognitive-behavioral techniques. However, religious songs are an important strategy used among older African American cancer patients. Religious songs can be readily integrated into cancer care. The incorporation of religious songs into spiritually based support groups and other integrative and complementary therapies might enhance health outcomes among this medically underserved cancer population.

Moderating effects of race in clinical trial participation and outcomes among marijuana-dependent young adults.

PubMed

Montgomery, LaTrice; Petry, Nancy M; Carroll, Kathleen M

2012-12-01

Few studies have examined clinical trial participation rates and treatment outcomes among underserved young adults who are dependent on marijuana, the most commonly abused illicit drug. The present study was a secondary analysis of a trial of court-referred marijuana-dependent young adults (ages 18-25) randomized to one of four treatment conditions: Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT), MET/CBT+Contingency Management (CM), Drug Counseling (DC) or DC+CM. African American (N=81) participants were compared to White (N=31) participants with respect to rates of participation in phases of treatment and substance use outcomes. In addition, the interaction of race and treatment condition was examined to ascertain if the interventions yielded different effects based on race. Among those who started treatment, African American young adults were significantly less likely to complete the treatment and posttreatment phases of the clinical trial than their White counterparts. Irrespective of treatment type, substance use outcomes (i.e., percentage of marijuana-negative specimens and longest duration of continuous abstinence) did not vary by race. However, there was a significant interaction effect between treatment type and race; African American young adults did not benefit differentially from any specific type of treatment, but CM was effective in reducing proportion of marijuana positive samples among White young adults. Findings suggest that clinical trial treatment and posttreatment completion rates vary by race in this population, as does response to specific treatment types. More treatment research focusing specifically on African American marijuana-dependent young adults is warranted. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Internet and computer access and use for health information in an underserved community.

PubMed

Kind, Terry; Huang, Zhihuan J; Farr, Deeonna; Pomerantz, Karyn L

2005-01-01

The "digital divide" is the gap between those with access to information tools such as the Internet and those without access. The gap has been described by income, education, age, and race. Little information exists on computer and Internet access and use for health information by parents, particularly among populations of low income and low education level. To describe computer and Internet access and use, including health information retrieval, among low-income, urban, African American caregivers (parents). Cross-sectional survey administered in pediatric waiting rooms of urban community-based health centers in a low-income area. Caregivers of pediatric outpatients. Access to computers, Internet access, and use of Internet for health information. In 2003, among 260 African Americans who completed surveys, 58% had a computer and 41% had home Internet access. Fifty-two percent had used the Internet for finding health information. Ninety-three percent agreed or strongly agreed that there is useful health information on the Internet. Ninety-two percent agreed or strongly agreed that they would want to talk with a medical professional about health information on the Internet. Sixty-five percent of respondents had no additional schooling after high school. Annual household income was

The need to modify physical activity messages to better speak to older African American women: a pilot study.

PubMed

Sebastião, Emerson; Chodzko-Zajko, Wojtek; Schwingel, Andiara

2015-09-25

Combating the physical inactivity crisis and improving health and quality of life is a challenge and a public health priority, especially in underserved populations. A key role of public health consists of informing, educating, and empowering individuals and communities about health issues. Researchers have found that mass communication messages often have limited effectiveness in reaching and impacting the health of underserved populations. The present pilot study was designed to explore perceptions of older African American women (AAW) in response to widely disseminated public information pertaining to physical activity (PA) and aging. A total of 10 older AAW aged 60 years and over participated in this study. Participants were evenly assigned in one of the 2 focus groups (i.e. active, n = 5; and inactive, n = 5) based on their PA level. The focus group approach was employed to gather information about widely available public information materials related to PA that target the adult and older adult population. The three guides used were: (1) Exercise and Physical Activity: Your Everyday Guide; (2) The Physical Activity Guidelines for Older Adults; and (3) Be Active Your Way: A Guide for Adults. NVIVO 10 software was used to help in the qualitative data analysis. Descriptive thematic analysis was employed in identifying, analyzing and reporting patterns/themes within the data. Older AAW in the present study identified some shortcomings in current public health materials. Participants from both focus groups raised concerns regarding language and the types of activities used as examples in the materials. After analysis, two themes emerged: "We may have trouble in reading it" and "It does not reflect us". Participants' evaluation was found to be similar between the active and inactive focus groups. Older AAW's perceptions of the materials suggest that materials intended to educate and motivate the general public towards PA need to be modified to better speak to older African American women, especially to those who are sedentary and have difficulty in building PA into their daily lives.

The impact of a lifestyle change program on the mental health of obese under-served African American women.

PubMed

Groh, Carla J; Urbancic, Joan C

2015-04-01

Obesity is a critical social and health issue, adversely impacting life expectancy, quality of life, and mental health. Minorities are disproportionately impacted by obesity with African Americans experiencing the highest prevalence among minority groups. The aim of this study was to determine if a lifestyle program that integrated chair exercises, nutrition and educational counseling, and scripture readings would help under-served obese African American women make lifestyle changes that would positively impact their quality of life, especially mental health. A repeated measures intervention study was conducted (24-weeks). Weeks 1-12 involved meeting twice a week for a total of 4h with participants engaged in chair exercises, educational counseling, and scripture readings. During weeks 13-24, the participants were "on their own" but were encouraged to exercise and eat healthy. Focus groups were held at 12 and 24-weeks. Participants were recruited from a nurse managed center and a primary care clinic for the uninsured. Mental health data were collected at baseline, 12, and 24-weeks. The Medical Outcomes Study Short Form Version 2 (SF-36v2) was used to measure changes in mental health. Higher scores indicate better perceived health status. Group scores less than 47 indicate impaired functioning. 55 women had complete data for all three data collection points, with a mean age of 50 and a mean BMI of 41.2. Repeated ANOVAs detected significant differences on the mental component summary of the SF-36v2: this score improved from baseline (M=44.1) to 12-weeks (M=50.7) but decreased at 24-weeks (M=47.9) (p=.000). The four domains (vitality, social functioning, role emotional, mental health) were also significantly different over the three data collection points. The findings have significant implications for psychiatric nurses in terms of education, clinical practice, and future research. The study contributed to the participants' mental health through the various group activities including scripture readings, socialization with "like minded" women and structured exercises. These findings offer psychiatric nurses additional tools for effective care. Copyright © 2014 Elsevier Inc. All rights reserved.

The impact of racism on the delivery of health care and mental health services.

PubMed

Hollar, M C

2001-01-01

This article presents research findings useful in formulating a Best Practices Model for the delivery of mental health services to underserved minority populations. Aspects of the role of racism in health care delivery and public health planning are explored. An argument is made for inclusion of the legacy of the slavery experience and the history of racism in America in understanding the current health care crisis in the African-American population. The development of an outline in APA DSM IV for the use of cultural formulations in psychiatric diagnosis is discussed.

A Preliminary Test of a Student-Centered Intervention on Increasing Physical Activity in Underserved Adolescents

PubMed Central

Wilson, Dawn K.; Evans, Alexandra E.; Williams, Joel; Mixon, Gary; Sirard, John R.; Pate, Russell

2008-01-01

Background Previous studies have shown that choice and self-initiated behavior change are important for increasing intrinsic motivation and physical activity (PA), however, little of this research has focused on underserved adolescents. Purpose This study examined the effects of a 4-week student-centered intervention on increasing PA in underserved adolescents. Methods Twenty-eight students in the intervention school were matched (on race, percentage on free or reduced-price lunch program, gender, and age) with 20 students from another school who served as the comparison group (30 girls, 18 boys; ages 10–12 years; 83% African American; 83% on free or reduced-price lunch). The student-centered intervention was consistent with self-determination (motivation) theory and social cognitive theory in that it emphasized increasing intrinsic motivation and behavioral skills for PA. Intervention adolescents took ownership in selecting a variety of PA activities in which to participate, and they generated coping strategies for making effective PA behavior changes. Results Intervention participants showed greater increases in accelerometer estimates of time spent in moderate PA, moderate-to-vigorous PA, and vigorous PA from baseline to Week 4 of the intervention than the comparison group. Intervention participants also showed greater increases in PA motivation and positive self-concept for PA than comparison adolescents. Conclusions This study provides preliminary evidence that increasing adolescent involvement and choice of activities may be important in developing future PA interventions for underserved adolescents. PMID:16173908

Efficacy of a DVD-Based Smoking Cessation Intervention for African Americans

PubMed Central

Baker, Elizabeth A.; Robinson, Robert G.

2014-01-01

Introduction: Previous research suggests that African American smokers may have improved outcomes if interventions are culturally specific. However, few interventions sufficiently address the unique needs of this population in a format with large reach potential. The purpose of this study was to test the efficacy of a newly developed digital video disc (DVD)-based cessation intervention targeting African Americans. Methods: In a 2-arm randomized trial, smokers (N = 140) were randomly assigned to view either the new Pathways to Freedom (PTF) DVD or a standard control DVD. Participants were assessed at baseline, immediately postviewing the DVD, and at a 1-month follow-up. The primary outcomes were feasibility and process variables, including intervention evaluations, readiness to quit, and risk perceptions, and smoking-related behavior changes were examined as secondary outcomes. Results: Findings demonstrated the hypothesized positive effects of the PTF DVD compared with the control DVD on content evaluations, risk perceptions, and readiness to quit at follow-up. Conclusions: We found initial evidence for the efficacy of the PTF DVD as a stand-alone intervention. Future research will test the efficacy of the DVD for smoking cessation in a larger randomized trial. The ultimate goal of this research is to validate a new intervention for an underserved community of smokers that can be used in multiple settings, such as community health clinics, primary care, quitlines, cessation clinics, and seminars/workshops. PMID:24838844

Perceptions of Mindfulness in a Low-income, Primarily African American Treatment-Seeking Sample.

PubMed

Spears, Claire Adams; Houchins, Sean C; Bamatter, Wendy P; Barrueco, Sandra; Hoover, Diana Stewart; Perskaudas, Rokas

2017-12-01

Individuals with low socioeconomic status (SES) and members of racial/ethnic minority groups often experience profound disparities in mental health and physical well-being. Mindfulness-based interventions show promise for improving mood and health behaviors in higher-SES and non-Latino White populations. However, research is needed to explore what types of adaptations, if any, are needed to best support underserved populations. This study used qualitative methods to gain information about a) perceptions of mindfulness, b) experiences with meditation, c) barriers to practicing mindfulness, and d) recommendations for tailoring mindfulness-based interventions in a low-income, primarily African American treatment-seeking sample. Eight focus groups were conducted with 32 adults (16 men and 16 women) currently receiving services at a community mental health center. Most participants (91%) were African American. Focus group data were transcribed and analyzed using NVivo 10. A team of coders reviewed the transcripts to identify salient themes. Relevant themes included beliefs that mindfulness practice might improve mental health (e.g., managing stress and anger more effectively) and physical health (e.g., improving sleep and chronic pain, promoting healthier behaviors). Participants also discussed ways in which mindfulness might be consistent with, and even enhance, their religious and spiritual practices. Results could be helpful in tailoring mindfulness-based treatments to optimize feasibility and effectiveness for low-SES adults receiving mental health services.

The Health Sciences and Technology Academy: an educational pipeline to address health care disparities in West Virginia.

PubMed

McKendall, Sherron Benson; Kasten, Kasandra; Hanks, Sara; Chester, Ann

2014-01-01

Health and educational disparities are national issues in the United States. Research has shown that health care professionals from underserved backgrounds are more likely than others to work in underserved areas. The Association of American Medical Colleges' Project 3000 by 2000, to increase the number of underrepresented minorities in medical schools, spurred the West Virginia School of Medicine to start the Health Sciences and Technology Academy (HSTA) in 1994 with the goal of supporting interested underrepresented high school students in pursuing college and health professions careers. The program was based on three beliefs: (1) if underrepresented high school students have potential and the desire to pursue a health professions career and are given the support, they can reach their goals, including obtaining a health professions degree; (2) underserved high school students are able to predict their own success if given the right resources; and (3) community engagement would be key to the program's success.In this Perspective, the authors describe the HSTA and its framework and philosophy, including the underlying theories and pedagogy from research in the fields of education and the behavioral/social sciences. They then offer evidence of the program's success, specifically for African American students, including graduates' high college-going rate and overwhelming intention to choose a health professions major. Finally, the authors describe the benefits of the HSTA's community partnerships, including providing mentors to students, adding legislative language providing tuition waivers and a budgetary line item devoted to the program, and securing program funding from outside sources.

Promoting change through political consciousness: a South African speech-language pathology response to the World Report on Disability.

PubMed

Kathard, Harsha; Pillay, Mershen

2013-02-01

In the context of the World Report on Disability, Wylie, McAllister, Davidson, and Marshall (2013) question how speech-language pathologists (SLPs) change practices to benefit under-served people with communication disability. This commentary provides a South African response premised on Political Consciousness. In South Africa, a grossly unequal society, the under-served population is not only those with communication disability but also include those who are at a communication disadvantage due to disabling conditions. As a consequence of the combined effects of a severe shortage of SLPs as well as maldistribution in service provision, the under-served are mainly poor Black South Africans who are the majority population. Political Consciousness allows one to examine how selected forces at the macro-level, meso-level, and micro-level may enable or limit services to the under-served majority. At a macro-level, this study appraises policies and actions advancing and impeding service delivery. At the meso-level it is argued that hegemonic professional knowledge is limiting and an equity-driven population-based approach is advocated. At a micro-level, the Relationship of Labouring Affinities is offered as a conceptual tool for critical engagement. In conclusion, it is suggested that the speech-language pathology profession must collectively become political actors at all levels to effect change.

Randomized Trial of a Family-based, Automated, Conversational Obesity Treatment Program for Underserved Populations

PubMed Central

Wright, J. A.; Phillips, B.D.; Watson, B.L.; Newby, P.K.; Norman, G. J.; Adams, W.G.

2013-01-01

Objective To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care and delivered using interactive voice technology (IVR) to families from underserved populations. Design and Methods Fifty parent-child dyads (child 9–12 yrs, BMI >95th percentile) were recruited from a pediatric primary care clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidenced-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3 mo follow-up. Results Forty-three dyads completed the study. IVR parents ate 1 cup more fruit than WLC (p < .05). No other groups differences were found. Children classified as high users of the IVR decreased weight, BMI and BMI z-score compared to low users (p<.05). Mean number of calls for parents and children were 9.1 (5.2 SD) and 9.0 (5.7 SD), respectively. Of those who made calls, >75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. Conclusion An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations. PMID:23512915

Using ICT for Education and Sustainable Development among the Underserved in Africa

ERIC Educational Resources Information Center

Kwapong, Olivia A. T. Frimpong

2009-01-01

The potential of ICT for education and sustainable development cannot be underestimated. Using cases from some African countries and data from deprived regions in Ghana, this paper discusses the opportunities and challenges in ICT for education and sustainable development in underserved areas in Africa. Much as infrastructural development,…

The Black dentist workforce in the United States.

PubMed

Mertz, Elizabeth; Calvo, Jean; Wides, Cynthia; Gates, Paul

2017-03-01

The purpose of this paper is to describe the Black dentist workforce, the practice patterns of providers, and their contributions to oral health care for minority and underserved patients. A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 32.6 percent response rate for self-reported Black dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile of Black dentists. National comparisons are provided from published data. Among all Black dentists (weighted n = 6,254), 76.6 percent self-identify as African-American, 13.2 percent as African, and 10.3 percent as Afro-Caribbean. The largest share of Black dentists are male, married, heterosexual, born in the United States and raised in a medium to large city. One third of Black dentists were the first in their family to graduate from college. Black dentists report higher average educational debt than all dental students, with graduates from International Dentist Programs having the greatest debt. Traditional practices (i.e., private practices) dominate, with 67.1 percent of Black dentists starting out in this setting and 73.5 percent currently in the setting. Black dentists care for a disproportionate share of Black patients, with an average patient mix that is 44.9 percent Black. Two in five Black dentists reported their patient pool is made up of more than 50 percent Black patients. The underrepresentation for Black dentists is extraordinary, and the Black dentists that are in practice are shouldering a disproportionate share of dental care for minority and underserved communities. © 2016 American Association of Public Health Dentistry.

Lack of Comprehension of Common Prostate Cancer Terms in an Underserved Population

PubMed Central

Kilbridge, Kerry L.; Fraser, Gertrude; Krahn, Murray; Nelson, Elizabeth M.; Conaway, Mark; Bashore, Randall; Wolf, Andrew; Barry, Michael J.; Gong, Debra A.; Nease, Robert F.; Connors, Alfred F.

2009-01-01

Purpose To assess the comprehension of common medical terms used in prostate cancer in patient education materials to obtain informed consent, and to measure outcomes after prostate cancer treatment. We address this issue among underserved, African-American men because of the increased cancer incidence and mortality observed in this population. Patients and Methods We reviewed patient education materials and prostate-specific quality-of-life instruments to identify technical terms describing sexual, urinary, and bowel function. Understanding of these terms was assessed in face-to-face interviews of 105, mostly African-American men, age ≥ 40, from two low-income clinics. Comprehension was evaluated using semiqualitative methods coded by two independent investigators. Demographics were collected and literacy was measured. Results Fewer than 50% of patients understood the terms “erection” or “impotent.” Only 5% of patients understood the term “incontinence” and 25% understood the term “bowel habits.” More patients recognized word roots than related terms or compound words (eg, “rectum” v “rectal urgency,” “intercourse” v “vaginal intercourse”). Comprehension of terms from all domains was statistically significantly correlated with reading level (P < .001). Median literacy level was fourth to sixth grade. Prostate cancer knowledge was poor. Many patients had difficulty locating key anatomic structures. Conclusion Limited comprehension of prostate cancer terms and low literacy create barriers to obtaining informed consent for treatment and to measuring prostate cancer outcomes accurately in our study population. In addition, the level of prostate cancer knowledge was poor. These results highlight the need for prostate cancer education efforts and outcomes measurements that consider literacy and use nonmedical language. PMID:19307512

Results of a Culturally Adapted Internet-Enhanced Physical Activity Pilot Intervention for Overweight and Obese Young Adult African American Women.

PubMed

Joseph, Rodney P; Pekmezi, Dori; Dutton, Gareth R; Cherrington, Andrea L; Kim, Young-Il; Allison, Jeroan J; Durant, Nefertiti H

2016-03-01

This study evaluated a culturally relevant, social cognitive theory-based, Internet-enhanced physical activity (PA) pilot intervention developed for overweight/obese African American (AA) female college students. Using a 3-month, single group, pretest-posttest design, participants accessed a culturally relevant PA promotion website and engaged in four moderate-intensity PA sessions each week. Study completers (n = 25, mean age = 21.9 years) reported a decrease in sedentary screen time (p < .0001); however, no changes in moderate-to-vigorous PA were reported (p = .150). A significant increase in self-regulation for PA (p < .0001) and marginally significant increases in social support (p = .052) and outcome expectations (p = .057) for PA were observed. No changes in body mass index (p = .162), PA enjoyment (p = .151), or exercise self-efficacy (p = .086) were reported. Findings of this exploratory study show some preliminary support for Internet-enhanced approaches to promote PA among overweight/obese AA women. Future studies with larger samples are needed to further explore culturally relevant Internet-enhanced PA programs in this underserved population. © The Author(s) 2014.

Racial differences in the mental health needs and service utilization of youth in the juvenile justice system.

PubMed

Rawal, Purva; Romansky, Jill; Jenuwine, Michael; Lyons, John S

2004-01-01

Mental health placement rates by the juvenile justice system differ by race. However, it is unknown whether mental health needs differ by race. This study attempted to investigate potential differences in mental health needs and service utilization among Caucasian, African American, and Hispanic juvenile justice involved youth. A stratified random sample of 473 youth petitioned, adjudicated, and incarcerated from 1995-1996 was examined using a standard chart review protocol and the Childhood Severity of Psychiatric Illness measure for mental health needs. Significant and unique mental health needs were demonstrated for all racial groups. African American youth demonstrated the greatest level of needs. Minority status indicated significantly lower rates of mental health service utilization. Minority youth in the juvenile justice system are most at risk for underserved mental health needs. Based on the current data, it can be inferred that the first contact with the state's child and adolescent serving system, which includes the juvenile justice and mental health sectors, appears to be through the juvenile justice sector for many minority youth with delinquency problems.

State-of-the-Science of Patient Navigation as a Strategy for Enhancing Minority Clinical Trial Accrual

PubMed Central

Ghebre, Rahel G.; Jones, Lovell A.; Wenzel, Jennifer; Martin, Michelle Y.; Durant, Raegan; Ford, Jean G.

2014-01-01

Background Patient navigation programs are emerging, that aim to address disparities in clinical trial participation among medically underserved populations, including racial/ethnic minorities. However, there is a lack of consensus on the role of patient navigators within the clinical trial process, as well as outcome measures to evaluate program effectiveness. Methods A review of the literature was conducted of PubMed, Medline, CINHAL, and other sources to identify qualitative and quantitative studies on patient navigation in clinical trials. The search yielded 212 studies, of which only 12 were eligible for this review. Results The eligible studies reported on development of programs for patient navigation in cancer clinical trials, including training and implementation among African American, American Indian and Native Hawaiians. Low clinical trial refusal, 4% to 6%, was reported among patients enrolled in patient navigation program. However, few studies reported on the efficacy of patient navigation on increasing clinical treatment trial enrollment. Conclusion Outcome measures are proposed to assist in developing and evaluating the efficacy and/or effectiveness of patient navigation programs that aim to increase participation in cancer clinical trials. Future research is needed to evaluate the efficacy of patient navigators in addressing barriers to clinical trial participation and increasing enrollment among medically underserved cancer patients. PMID:24643650

Racial and Ethnic Disparities in Cardiovascular Disease: An Assessment of Obstetrician-Gynecologists' Knowledge, Attitudes, and Practice Patterns.

PubMed

Jones, Katherine M; Carter, Michele M; Schulkin, Jay

2015-06-01

African American and Hispanic women are disproportionately affected by cardiovascular disease (CVD) and its many risk factors. Obstetrician-gynecologists (OB/GYNs) play an integral role in well-woman care and have a unique opportunity to provide CVD counseling and screening to these at-risk and underserved groups. To assess whether OB/GYN race/ethnicity and OB/GYN practices with increasing minority patient populations predicted differences in OB/GYNs' knowledge, attitudes, and practice patterns relevant to racial/ethnic disparities in CVD. This study also sought to determine provider and patient-related barriers to CVD care. A questionnaire on CVD was mailed to 273 members of The American College of Obstetricians and Gynecologists in March-July 2013. African American and Hispanic OB/GYNs and OB/GYN practices with increasing minority patient populations were more knowledgeable of CVD disparities. These OB/GYNs reported greater concern for minority women's CVD risk relative to White OB/GYNs. Overall, OB/GYNs appear less knowledgeable and concerned with Hispanics' increased CVD risk relative to African Americans'. The most commonly reported provider and patient-related barriers to CVD care were time constraints, patient nonadherence to treatment recommendations, and inadequate training. It is likely that minority OB/GYNs and those with practices with increasing minority patient populations have greater exposure to women at risk for CVD. Dissemination of educational information regarding Hispanic women's CVD risk profile may improve OB/GYN knowledge, counseling, and screening. Increased training in CVD and multicultural competency during medical school and residency should help OB/GYNs overcome what they report as primary barriers to CVD care.

Engaging Health Systems to Increase Colorectal Cancer Screening: Community–Clinical Outreach in Underserved Areas of Wisconsin

PubMed Central

Weeth-Feinstein, Lauren; Conlon, Amy; Scott, Sheryl

2013-01-01

Background Colorectal cancer is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related death in Wisconsin. Incidence and mortality rates for colorectal cancer vary by age, race/ethnicity, geography, and socioeconomic status. From 2010 through 2012, the Wisconsin Comprehensive Cancer Control Program awarded grants to 5 regional health systems for the purpose of planning and implementing events to increase colorectal cancer screening rates in underserved communities. Community Context Grantees were chosen for their ability to engage community partners in reaching underserved groups including African American, Hispanic/Latino, Hmong, rural, and uninsured populations in their service areas. Methods Grantees identified target populations for proposed screening events, designated institutional planning teams, engaged appropriate local partner organizations, and created plans for follow-up. All grantees implemented 1 or more colorectal cancer screening events within 6 months of receiving their awards. Events were conducted in 2 phases. Outcomes Participating health systems organized 36 screening events and distributed 633 individual test kits; 506 kits were returned, of which 57 (9%) tested positive for colorectal abnormalities. Of attendees who received screening, 63% were uninsured or underinsured, 55% had no previous screening, 46% were of a racial/ethnic minority group, 22% had a family history of cancer, and 13% were rural residents. This project strengthened partnerships between health systems and local organizations. Interpretation An effective strategy for improving colorectal cancer screening rates, particularly among underserved populations, is to award health systems grants for implementing community-based screening events in conjunction with community partners. PMID:24262024

The broader the base, the taller the tower: including underserved minority students in the quest to explore the great beyond

NASA Astrophysics Data System (ADS)

Wilson-Comer, M.; Lindsey, R.; Banks, F.

The Saturday Academy for Space Science SASS a National Aeronautical and Space Administration NASA outreach program implemented at Chicago State University on the south side of Chicago brought space scientists into contact with underserved high school students The program included instruction in astronomy physics chemistry and mathematics Hands-on construction of telescopes allowed the students to gain insights into the development of tools needed for scientific investigation For thirty six Saturdays each year for three years African American Latino American and Asian American high school students took leadership roles in developing and carrying out space science research As a result of the program over one hundred students participated in overnight observations at the Yerkes Observatory In addition six students went to space camp at the NASA space center in Huntsville Alabama and twelve students took advantage of the space science program at the University of Illinois Urbana Champaign A number of the students who participated in the SASS program are currently graduating from high school and many of those are seeking college studies in various science disciplines Equally important was the degree of parent participation Parents of the students were intensely involved with the program they volunteered to chaperone field trips participated in meetings prepared snacks for students and staff and assisted students in projects and experiments Parents gained insights into the advantages of studying science and the demands on

Spiritually based intervention to increase colorectal cancer screening among African Americans: screening and theory-based outcomes from a randomized trial.

PubMed

Holt, Cheryl L; Litaker, Mark S; Scarinci, Isabel C; Debnam, Katrina J; McDavid, Chastity; McNeal, Sandre F; Eloubeidi, Mohamad A; Crowther, Martha; Bolland, John; Martin, Michelle Y

2013-08-01

Colorectal cancer screening has clear benefits in terms of mortality reduction; however, it is still underutilized and especially among medically underserved populations, including African Americans, who also suffer a disproportionate colorectal cancer burden. This study consisted of a theory-driven (health belief model) spiritually based intervention aimed at increasing screening among African Americans through a community health advisor-led educational series in 16 churches. Using a randomized design, churches were assigned to receive either the spiritually based intervention or a nonspiritual comparison, which was the same in every way except that it did not contain spiritual/religious content and themes. Trained and certified peer community health advisors in each church led a series of two group educational sessions on colorectal cancer and screening. Study enrollees completed a baseline, 1-month, and 12-month follow-up survey at their churches. The interventions had significant pre-post impact on awareness of all four screening modalities, and self-report receipt of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. There were no significant study group differences in study outcomes, with the exception of fecal occult blood test utilization, whereas those in the nonspiritual intervention reported significantly greater pre-post change. Both of these community-engaged, theory-driven, culturally relevant approaches to increasing colorectal cancer awareness and screening appeared to have an impact on study outcomes. Although adding spiritual/religious themes to the intervention was appealing to the audience, it may not result in increased intervention efficacy.

The interaction of perceived risk and benefits and the relationship to predicting mammography adherence in African American women.

PubMed

Fair, Alecia Malin; Monahan, Patrick O; Russell, Kathleen; Zhao, Qianqian; Champion, Victoria L

2012-01-01

To test the interaction of perceived risk and benefits and how they impact stage of mammography readiness and adherence. Cross-sectional study. Community gathering centers and healthcare clinics across Indiana. 299 African American women who had not had a mammogram in more than 18 months. In-person interviews were used to collect data on sociodemographics, health belief variables, and stage of readiness to undertake mammography screening. Four categories were created to measure the combined magnitude of high or low levels of perceived risk and benefit, with health belief variables linked to modified mammography screening behavior. Perceived risks and benefits, stage of readiness, and mammography adherence. The lowest rate of mammography adherence was in women with a high perceived risk and low perceived benefit toward mammography adherence (26%). The highest rate of adherence was in women with a high perceived benefit and low perceived risk (46%). Differences in mammography adherence were statistically significant between the groups (p = 0.009). The interaction of high perceived risk and low perceived benefits impacted readiness to undergo screening mammography. Reducing disparities in breast cancer diagnosis and survival requires timely and efficient mammography adherence. African American medically underserved women with high perceived risk and low perceived benefits exhibited a reluctance to move forward with mammography adherence. Interventions are needed to increase the perception of mammography benefit and to subsequently reduce breast cancer mortality rates in that population.

African American perspectives: A qualitative study of an informal science enrichment program

NASA Astrophysics Data System (ADS)

Simpson, Jamila Rashida

The purposes of this study were to determine what program characteristics African American parents consider when they enroll their children into an informal science education enrichment program, the parents' evaluation of a program called Jordan Academy in which they enrolled their children, and the alignment of the parents' perspectives with Black Cultural Ethos (BCE). BCE refers to nine dimensions posited by Wade Boykin, a psychologist, as comprising African American culture. Participants were parents of students that attended Jordan Academy, an informal science enrichment program designed for third through sixth grade students from underserved populations. Qualitative methodologies were utilized to perform a thorough assessment of parents' perspectives. Data sources included classroom observations, student surveys, academy curriculum, photos and video-taped class sessions. Data included teachers and parents' responses to semi-structured, audio recorded interviews and students' written responses to open-ended items on the program's evaluation instrument. The data were analyzed for themes and the findings compared to Black Cultural Ethos. Findings revealed that the participants believed that informal science education offered their children opportunities not realized in the formal school setting - a means of impacting their children holistically. The parents expressed the academic, cultural, and personal development of their children in their characterizations of the ideal informal science education experience and in their evaluations of Jordan Academy. Overall, the parents' views emphasized the BCE values of harmony, affect, verve, movement, orality and communalism. The study has important implications for practices within and research on informal science education.

Simple CPR: A randomized, controlled trial of video self-instructional cardiopulmonary resuscitation training in an African American church congregation.

PubMed

Todd, K H; Heron, S L; Thompson, M; Dennis, R; O'Connor, J; Kellermann, A L

1999-12-01

Despite the proven efficacy of cardiopulmonary resuscitation (CPR), only a small fraction of the population knows how to perform it. As a result, rates of bystander CPR and rates of survival from cardiac arrest are low. Bystander CPR is particularly uncommon in the African American community. Successful development of a simplified approach to CPR training could boost rates of bystander CPR and save lives. We conducted the following randomized, controlled study to determine whether video self-instruction (VSI) in CPR results in comparable or better performance than traditional CPR training. This randomized, controlled trial was conducted among congregational volunteers in an African American church in Atlanta, GA. Subjects were randomly assigned to receive either 34 minutes of VSI or the 4-hour American Heart Association "Heartsaver" CPR course. Two months after training, blinded observers used explicit criteria to assess CPR performance in a simulated cardiac arrest setting. A recording manikin was used to measure ventilation and chest compression characteristics. Participants also completed a written test of CPR-related knowledge and attitudes. VSI trainees displayed a comparable level of performance to that achieved by traditional trainees. Observers scored 40% of VSI trainees competent or better in performing CPR, compared with only 16% of traditional trainees (absolute difference 24%, 95% confidence interval 8% to 40%). Data from the recording manikin confirmed these observations. VSI trainees and traditional trainees achieved comparable scores on tests of CPR-related knowledge and attitudes. Thirty-four minutes of VSI can produce CPR of comparable quality to that achieved by traditional training methods. VSI provides a simple, quick, consistent, and inexpensive alternative to traditional CPR instruction, and may be used to extend CPR training to historically underserved populations.

Adherence to cancer prevention guidelines and cancer risk in low-income and African American populations

PubMed Central

Andersen, Shaneda Warren; Blot, William J; Shu, Xiao-Ou; Sonderman, Jennifer S; Steinwandel, Mark D; Hargreaves, Margaret K; Zheng, Wei

2016-01-01

Background The American Cancer Society (ACS) publishes behavioral guidelines for cancer prevention, including standards on body weight, physical activity, nutrition, alcohol, and tobacco use. The impact of these guidelines has been rarely studied in low-income and African American populations. Methods The study included 61,098 racially diverse, mainly low-income adults who participated in the Southern Community Cohort Study and were followed for a median of 6 years. Cox models were used to estimate hazard ratios (HRs) for cancer incidence associated with behaviors and with an ACS physical activity/nutrition 0-to-4 compliance score indicating the number of body weight, physical activity, healthy eating, and alcohol guidelines met. Results During the study period, 2,240 incident cancers were identified. Significantly lower cancer incidence was found among never smokers and non/moderate alcohol drinkers, but not among those meeting guidelines for obesity, physical activity, and diet. The ACS compliance score was inversely associated with cancer risk among the 25,509 participants without baseline chronic disease. HRs for cancer incidence among those without baseline chronic diseases and who met one, two, three, or four guidelines vs. zero guideline were 0.93 (95% confidence interval: 0.71–1.21), 0.85 (0.65–1.12), 0.70 (0.51–0.97), and 0.55 (0.31–0.99), respectively. Associations were consistent in analyses stratified by sex, race, household income, and smoking status. Conclusions Meeting the ACS smoking and body weight/physical activity/dietary/alcohol guidelines for cancer prevention is associated with reductions in cancer incidence in low-income and African American populations. Impact This study provides strong evidence supporting lifestyle modification to lower cancer incidence in these underserved populations. PMID:26965499

Learning from experience: three community health population-based outreach projects for graduate and undergraduate students.

PubMed

D'Lugoff, Marion Isaacs; McCarter, Jeanne

2005-01-01

Three outreach activities by a school of nursing, in partnership with community agencies, provided learning experiences in primary and secondary preventive health care for graduate and undergraduate nursing students while addressing health needs in the community. The activities included administration of immunizations to a newly arrived Somali Bantu refugee population, targeted screening of an African-American population at risk for diabetic retinopathy, and general health screening for an underserved Hispanic immigrant population. These activities lend insight and depth to a community health curriculum by allowing students to provide needed services while engaging with culturally diverse clients of varying socioeconomic status. Learner objectives, resources, processes and outcomes are provided for each example.

American Dental Association White Paper Targets Dental Care for the Underserved

ERIC Educational Resources Information Center

Berthold, Mark

2005-01-01

Reaffirming its leadership role toward better oral health for all Americans, the ADA has produced a white paper that also challenges policy-makers and the US to improve access to dental services. The white paper, "State and Community Models for Improving Access to Dental Care for the Underserved," was presented October 1 to the House of…

HOME-BASED BLOOD PRESSURE INTERVENTIONS FOR AFRICAN AMERICANS

PubMed Central

Feldman, Penny H.; McDonald, Margaret V.; Mongoven, Jennifer M.; Peng, Timothy R.; Gerber, Linda M.; Pezzin, Liliana E.

2009-01-01

Background Efforts to increase blood pressure (BP) control rates in African Americans, a traditionally underserved, high risk population must address both provider practice and patient adherence issues. The Home-Based BP Intervention for African Americans study is a three-arm randomized controlled trial designed to test two strategies to improve HTN management and outcomes in a decentralized service setting serving a vulnerable and complex home care population. The primary study outcomes are systolic BP, diastolic BP, and BP control; secondary outcomes are nurse adherence to HTN management recommendations, and patient adherence to medication, healthy diet and other self-management strategies. Methods and Results Nurses (N=312) in a nonprofit Medicare-certified home health agency are randomized along with their eligible hypertensive patients (N=845). The two interventions being tested are: (i) a “basic” intervention delivering key evidence-based reminders to home care nurses and patients while the patient is receiving traditional post-acute home health care; and (ii) an “augmented” intervention that includes that same as the basic intervention, plus transition to an ongoing HTN Home Support Program that extends support for 12 months. Outcomes are measured at 3 and 12 months post baseline interview. The interventions will be assessed relative to usual care and to each other. Conclusions Systems change to improve BP management and outcomes in home health will not easily occur without new intervention models and rigorous evaluation of their impact. Results from this trial will provide important information on potential strategies to improve BP control in a low income, chronically ill patient population. PMID:20031844

The significance of recruiting underrepresented minorities in medicine: an examination of the need for effective approaches used in admissions by higher education institutions.

PubMed

Figueroa, Obed

2014-01-01

The purpose of this paper is to examine the significance of recruiting underrepresented minorities in medicine (URM). This would include African Americans, Hispanics, and Native Americans. The research findings support the belief that URMs, upon graduating, are more likely to become practitioners in underserved communities, thereby becoming a resource that prompts us to find effective ways to help increase their college enrollments statewide. This paper analyzes the recruitment challenges for institutions, followed by a review of creative and effective approaches used by organizations and universities. The results have shown positive outcomes averaging a 50% increase in minority enrollments and retention. In other areas, such as cognitive development, modest gains were achieved in programs that were shorter in duration. The results nevertheless indicated steps in the right direction inspiring further program developments.

The significance of recruiting underrepresented minorities in medicine: an examination of the need for effective approaches used in admissions by higher education institutions

PubMed Central

Figueroa, Obed

2014-01-01

The purpose of this paper is to examine the significance of recruiting underrepresented minorities in medicine (URM). This would include African Americans, Hispanics, and Native Americans. The research findings support the belief that URMs, upon graduating, are more likely to become practitioners in underserved communities, thereby becoming a resource that prompts us to find effective ways to help increase their college enrollments statewide. This paper analyzes the recruitment challenges for institutions, followed by a review of creative and effective approaches used by organizations and universities. The results have shown positive outcomes averaging a 50% increase in minority enrollments and retention. In other areas, such as cognitive development, modest gains were achieved in programs that were shorter in duration. The results nevertheless indicated steps in the right direction inspiring further program developments. PMID:25192970

A community intervention: AMBER: Arab American breast cancer education and referral program.

PubMed

Ayash, Claudia; Axelrod, Deborah; Nejmeh-Khoury, Sana; Aziz, Arwa; Yusr, Afrah; Gany, Francesca M

2011-12-01

Although the number of Arab Americans is growing in the United States, there is very little data available on this population's cancer incidence and screening practices. Moreover, there are few interventions addressing their unique needs. This study aims to determine effective strategies for increasing breast cancer screening in at-risk underserved Arab American women. AMBER utilizes a community based participatory approach to conduct formative research and program interventions, including culturally appropriate Arabic language breast cancer education, screening coordination, and cultural competency training for healthcare professionals in New York City. In 2 years, 597 women were educated, 189 underserved women were identified as being in need of assistance, 68 were screened, one new case of breast cancer was detected, and four active cases in need of follow-up reconnected with care. The AMBER model is an important intervention for breast cancer screening and care in the underserved Arab American community.

Mammographic Breast Density in a Cohort of Medically Underserved Women

DTIC Science & Technology

2015-12-01

Health Center, a public facility serving medically indigent and underserved women. Dietary and total ( dietary plus supplements ) vitamin D and calcium...Cancer Study Questionnaire [18] were used to categorize dietary intake and supplement use of vitamin D and calcium into tertiles. The Harvard African...Byrne C, Evers KA, Daly MB. Dietary intake and breast density in high- risk women: a cross-sectional study. Breast Cancer Res 2007;9:R72. [4] Yaghjyan L

Disparities in access to emergency general surgery care in the United States.

PubMed

Khubchandani, Jasmine A; Shen, Connie; Ayturk, Didem; Kiefe, Catarina I; Santry, Heena P

2018-02-01

As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room." Internet search and direct contact confirmed emergency general surgery services that covered the emergency room 7 days a week, 24 hours a day. Geographic and population-level emergency general surgery access was derived from Geographic Information Systems and US Census. Of the 6,356 hospitals in the 2013 American Hospital Association database, only 2,811 were emergency general surgery hospitals. Counties with greater percentages of black, Hispanic, uninsured, and low-education individuals and rural counties disproportionately lacked access to emergency general surgery care. For example, counties above the 75th percentile of African American population (10.2%) had >80% odds of not having an emergency general surgery hospital compared with counties below the 25th percentile of African American population (0.6%). Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities. Policy initiatives need to increase emergency general surgery capacity nationwide. Copyright © 2017 Elsevier Inc. All rights reserved.

A community-integrated home based depression intervention for older African Americans: descripton of the Beat the Blues randomized trial and intervention costs

PubMed Central

2012-01-01

Background Primary care is the principle setting for depression treatment; yet many older African Americans in the United States fail to report depressive symptoms or receive the recommended standard of care. Older African Americans are at high risk for depression due to elevated rates of chronic illness, disability and socioeconomic distress. There is an urgent need to develop and test new depression treatments that resonate with minority populations that are hard-to-reach and underserved and to evaluate their cost and cost-effectiveness. Methods/Design Beat the Blues (BTB) is a single-blind parallel randomized trial to assess efficacy of a non-pharmacological intervention to reduce depressive symptoms and improve quality of life in 208 African Americans 55+ years old. It involves a collaboration with a senior center whose care management staff screen for depressive symptoms (telephone or in-person) using the Patient Health Questionnaire (PHQ-9). Individuals screened positive (PHQ-9 ≥ 5) on two separate occasions over 2 weeks are referred to local mental health resources and BTB. Interested and eligible participants who consent receive a baseline home interview and then are randomly assigned to receive BTB immediately or 4 months later (wait-list control). All participants are interviewed at 4 (main study endpoint) and 8 months at home by assessors masked to study assignment. Licensed senior center social workers trained in BTB meet with participants at home for up to 10 sessions over 4 months to assess care needs, make referrals/linkages, provide depression education, instruct in stress reduction techniques, and use behavioral activation to identify goals and steps to achieve them. Key outcomes include reduced depressive symptoms (primary), reduced anxiety and functional disability, improved quality of life, and enhanced depression knowledge and behavioral activation (secondary). Fidelity is enhanced through procedure manuals and staff training and monitored by face-to-face supervision and review of taped sessions. Cost and cost effectiveness is being evaluated. Discussion BTB is designed to bridge gaps in mental health service access and treatments for older African Americans. Treatment components are tailored to specific care needs, depression knowledge, preference for stress reduction techniques, and personal activity goals. Total costs are $584.64/4 months; or $146.16 per participant/per month. Trial Registration ClinicalTrials.gov #NCT00511680 PMID:22325065

Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) for adults at risk for glaucoma: study rationale and design.

PubMed

Owsley, Cynthia; Rhodes, Lindsay A; McGwin, Gerald; Mennemeyer, Stephen T; Bregantini, Mary; Patel, Nita; Wiley, Demond M; LaRussa, Frank; Box, Dan; Saaddine, Jinan; Crews, John E; Girkin, Christopher A

2015-11-18

Primary open angle glaucoma is a chronic, progressive eye disease that is the leading cause of blindness among African Americans. Glaucoma progresses more rapidly and appears about 10 years earlier in African Americans as compared to whites. African Americans are also less likely to receive comprehensive eye care when glaucoma could be detected before irreversible blindness. Screening and follow-up protocols for managing glaucoma recommended by eye-care professional organizations are often not followed by primary eye-care providers, both ophthalmologists and optometrists. There is a pressing need to improve both the accessibility and quality of glaucoma care for African Americans. Telemedicine may be an effective solution for improving management and diagnosis of glaucoma because it depends on ocular imaging and tests that can be electronically transmitted to remote reading centers where tertiary care specialists can examine the results. We describe the Eye Care Quality and Accessibility Improvement in the Community project (EQUALITY), set to evaluate a teleglaucoma program deployed in retail-based primary eye care practices serving communities with a large percentage of African Americans. We conducted an observational, 1-year prospective study based in two Walmart Vision Centers in Alabama staffed by primary care optometrists. EQUALITY focuses on new or existing adult patients who are at-risk for glaucoma or already diagnosed with glaucoma. Patients receive dilated comprehensive examinations and diagnostic testing for glaucoma, followed by the optometrist's diagnosis and a preliminary management plan. Results are transmitted to a glaucoma reading center where ophthalmologists who completed fellowship training in glaucoma review results and provide feedback to the optometrist, who manages the care of the patient. Patients also receive eye health education about glaucoma and comprehensive eye care. Research questions include diagnostic and management agreement between providers, the impact of eye health education on patients' knowledge and adherence to follow-up and medication, patient satisfaction, program cost-effectiveness, and EQUALITY's impact on Walmart pharmacy prescription rates. As eye-care delivery systems in the US strive to improve quality while reducing costs, telemedicine programs including teleglaucoma initiatives such as EQUALITY could contribute toward reaching this goal, particularly among underserved populations at-risk for chronic blinding diseases.

The Black Dentist Workforce in the United States

PubMed Central

Mertz, Elizabeth; Calvo, Jean; Wides, Cynthia; Gates, Paul

2017-01-01

Objectives The purpose of this paper is to describe the Black dentist workforce, the practice patterns of providers, and their contributions to oral health care for minority and underserved patients. Methods A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 32.6% response rate for self-reported Black dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile of Black dentists. National comparisons are provided from published data. Results Among all Black dentists (weighted n=6,254), 76.6% self-identify as African-American, 13.2% as African, and 10.3% as Afro-Caribbean. The largest share of Black dentists are male, married, heterosexual, born in the U.S. and raised in a medium to large city. One third of Black dentists were the first in their family to graduate from college. Black dentists report higher average educational debt than all dental students, graduates from International Dentist Programs having the greatest debt. Traditional practices (i.e., private practices) dominate, with 67.1% of Black dentists starting out in this setting and 73.5% currently in the setting. Black dentists care for a disproportionate share of Black patients, with an average patient mix that is 44.9% Black. Two in five Black dentists reported their patient pool is made up of more than 50% Black patients. Conclusions The underrepresentation for Black dentists is extraordinary, and the Black dentists that are in practice are shouldering a disproportionate share of dental care for minority and underserved communities. PMID:27966789

Science, Engineering, Mathematics and Aerospace Academy

NASA Technical Reports Server (NTRS)

1997-01-01

This is an annual report on the Science, Engineering, Mathematics, and Aerospace Academy (SEMAA), which is run as a collaborative effort of NASA Lewis Research Center, and Cuyahgoga Community College. The purpose of SEMA is to increase the percentage of African Americans, and Hispanics in the fields of science and technology. The SEMAA program reaches from kindergarden, to grade 12, involving the family of under-served minorities in the education of the children. The year being reported (i.e., 1996-1997) saw considerable achievement. The program served over 1,939 students, and 120 parents were involved in various seminars. The report goes on to review the program and its implementation for each grade level. It also summarizes the participation, by gender and ethnicity.

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings.

PubMed

Kent, Shia T; McClure, Leslie A; Zaitchik, Ben F; Gohlke, Julia M

2013-06-10

Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban-rural status. Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991-2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse birth outcomes elsewhere may not be reaching isolated rural areas.

Exploring Disparities and Variability in Perceptions and Self-Reported Colorectal Cancer Screening Among Three Ethnic Subgroups of U.S. Blacks

PubMed Central

Gwede, Clement K.; William, Claire M.; Thomas, Kamilah B.; Tarver, Will L.; Quinn, Gwendolyn P.; Vadaparampil, Susan T.; Kim, Jongphil; Lee, Ji-Hyun; Meade, Cathy D.

2010-01-01

Purpose/Objectives To explore perceptions of colorectal cancer (CRC) and self-reported CRC screening behaviors among ethnic subgroups of U.S. blacks. Design Descriptive, cross-sectional, exploratory, developmental pilot. Setting Medically underserved areas in Hillsborough County, FL. Sample 62 men and women aged 50 years or older. Ethnic subgroup distribution included 22 African American, 20 English-speaking Caribbean-born, and 20 Haitian-born respondents. Methods Community-based participatory research methods were used to conduct face-to-face individual interviews in the community. Main Research Variables Ethnic subgroup, health access, perceptions of CRC (e.g., awareness of screening tests, perceived risk, perceived barriers to screening), healthcare provider recommendation, and self-reported CRC screening. Findings Awareness of CRC screening tests, risk perception, healthcare provider recommendation, and self-reported use of screening were low across all subgroups. However, only 55% of Haitian-born participants had heard about the fecal occult blood test compared to 84% for English-speaking Caribbean-born participants and 91% for African Americans. Similarly, only 15% of Haitian-born respondents had had a colonoscopy compared to 50% for the English-speaking Caribbean and African American subgroups. Conclusions This exploratory, developmental pilot study identified lack of awareness, low risk perception, and distinct barriers to screening. The findings support the need for a larger community-based study to elucidate and address disparities among subgroups. Implications for Nursing Nurses play a major role in reducing cancer health disparities through research, education, and quality care. Recognition of the cultural diversity of the U.S. black population can help nurses address health disparities and contribute to the health of the community. PMID:20797950

Barriers to Physical Activity Among African American Women: An Integrative Review of the Literature.

PubMed

Joseph, Rodney P; Ainsworth, Barbara E; Keller, Colleen; Dodgson, Joan E

2015-01-01

A key aspect for researchers to consider when developing culturally appropriate physical activity (PA) interventions for African American (AA) women are the specific barriers AA women face that limit their participation in PA. Identification and critical examination of these barriers is the first step in developing comprehensive culturally relevant approaches to promote PA and help resolve PA-related health disparities in this underserved population. We conducted a systematic integrative literature review to identify barriers to PA among AA women. Five electronic databases were searched, and forty-two studies (twenty-seven qualitative, fourteen quantitative, one mixed method) published since 1990 (range 1998-2013) in English language journals met inclusion criteria for review. Barriers were classified as intrapersonal, interpersonal, or environment/community according to their respective level of influence within our social ecological framework. Intrapersonal barriers included lack of time, knowledge, and motivation; physical appearance concerns; health concerns; monetary cost of exercise facilities; and tiredness/fatigue. Interpersonal barriers included family/caregiving responsibilities; lack of social support; and lack of a PA partner. Environmental barriers included safety concerns; lack of facilities; weather concerns; lack of sidewalks; and lack of physically active AA role models. Results provide key leverage points for researchers to consider when developing culturally relevant PA interventions for AA women.

Assessing the fidelity of the Kin KeeperSM prevention intervention in African American, Latina and Arab women.

PubMed

Ford, Sabrina; Meghea, Cristian; Estes, Tamika; Hamade, Hiam; Lockett, Murlisa; Williams, Karen Patricia

2014-02-01

We evaluated a randomized controlled treatment, utilizing Community Health Workers (CHW) to deliver breast and cervical cancer education intervention to African American, Latina, and Arab women in Detroit and Dearborn, Michigan. The main objectives of the study are to: (1) examine fidelity and consistency of treatment delivery and (2) assess qualitative elements of the intervention. We surveyed 305 women who received the intervention and 16 CHWs Survey included questions regarding the treatment integrity, treatment received, and training provided. Surveys included both quantitative and questions. The intervention group (n = 305) was made up of 48% Black, 11% Latina, and 41% Arab women. Almost all (≥ 90%) women agreed that they received the treatment in the way that it was intended. Sixteen CHWs responded affirmatively as well. Both participants and CHWs indicated that the program was mutually rewarding, indicating that there was "cross fertilization and cross benefit" of working with each other. These benefits served to endorse and confirm that CHWs are a very important mechanism in increasing health literacy in the community and referring underserved individuals to health providers. Second, with strong treatment fidelity the Kin Keeper(SM) program and has the potential to be replicated for a number of diseases in a variety of venues especially for those facing health disparities.

Lessons Learned Recruiting Minority Participants for Research in Urban Community Health Centers.

PubMed

Fam, Elizabeth; Ferrante, Jeanne M

2018-02-01

To help understand and mitigate health disparities, it is important to conduct research with underserved and underrepresented minority populations under real world settings. There is a gap in the literature detailing real-time research staff experience, particularly in their own words, while conducting in-person patient recruitment in urban community health centers. This paper describes challenges faced at the clinic, staff, and patient levels, our lessons learned, and strategies implemented by research staff while recruiting predominantly low-income African-American women for an interviewer-administered survey study in four urban Federally Qualified Health Centers in New Jersey. Using a series of immersion-crystallization cycles, fieldnotes and research reflections written by recruiters, along with notes from team meetings during the study, were qualitatively analyzed. Clinic level barriers included: physical layout of clinic, very low or high patient census, limited private space, and long wait times for patients. Staff level barriers included: unengaged staff, overburdened staff, and provider and staff turnover. Patient level barriers included: disinterested patients, patient mistrust and concerns over confidentiality, no-shows or lack of patient time, and language barrier. We describe strategies used to overcome these barriers and provide recommendations for in-person recruitment of underserved populations into research studies. To help mitigate health disparities, disseminating recruiters' experiences, challenges, and effective strategies used will allow other researchers to build upon these experience in order to increase recruitment success of underserved and underrepresented minority populations into research studies. Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.

Complementary and Alternative Medicine Use in Minority and Medically Underserved Oncology Patients: Assessment and Implications.

PubMed

Jones, Desiree; Cohen, Lorenzo; Rieber, Alyssa G; Urbauer, Diana; Fellman, Bryan; Fisch, Michael J; Nazario, Arlene

2018-06-01

Complementary and alternative medicine (CAM) use in minority and medically underserved oncology patients is not well documented. We assessed knowledge and utilization of CAM in a sample of these patients receiving treatment at an urban community hospital. Patients with cancer were interviewed using an electronic application that depicted specific CAM therapies. Patients were questioned on their knowledge and utilization of therapies, deterrents to use, and interest in using these therapies if they were made available. Patients (n = 165) reported a high awareness and use of CAM therapies. CAM use was highest for prayer (85%), relaxation (54%), special diet (29%), meditation (19%), and massage (18%). Patients' interest in using CAM was high for nearly all therapies. Lack of adequate knowledge and cost of use were reported as deterrents to use. Female patients reported higher use of aromatherapy relative to males (37.1% vs 19.4%, P = .02); those with higher education reported greater use of relaxation (60.8% vs 28.6%, P = .02); non-Hispanics reported higher use of relaxation relative to Hispanics (63.5% vs 44.2%, P = .03), and African American patients reported higher use of relaxation relative to White patients (69.2% vs 50%, P = .03). CAM use in minority and medically underserved cancer patients is common, but not professionally guided; thus, concerns remain regarding its safe use. Our data underscore the importance of patient-physician dialogue regarding CAM use in this patient population, and interest in access to the medically guided integration of evidence-based CAM therapies.

Dentist shortage: an analysis of dentists, practices, and populations in the underserved areas.

PubMed

Voinea-Griffin, Andreea; Solomon, Eric S

2016-09-01

The objectives of this study are to identify and describe the characteristics of dental underserved geographic areas. Understanding these characteristics is an important step in addressing access to dental care barriers. Dental underserved areas were identified from the Health Resources and Services Administration (HRSA) database and converted to census tracts for analysis. Characteristics of dental underserved geographic areas were compared with areas not designated as underserved. Dental practices included in the Dun & Bradstreet Business information database were geocoded and analyzed according to the underserved designation of their location and census demographic data. Thus, the relationships between dental underserved status, practice, and population characteristics were evaluated. Dental underserved areas are more likely to comprise individuals with lower socio-economic status (income and education levels), higher levels of underrepresented population groups, and have lower population densities than non-underserved areas. The populations living in dental underserved areas are more likely to experience geographic, financial, and educational barriers to dental care. The study identifies the geographic and financial barriers to dental care access. These findings suggest that the likelihood of a market-driven solution to dental underserved geographic areas is low and support public sector interventions to improve the status quo. © 2016 American Association of Public Health Dentistry.

Ethical Considerations for Conducting Health Disparities Research in Community Health Centers: A Social-Ecological Perspective

PubMed Central

Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

2013-01-01

Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings. PMID:24134347

Understanding and Effectively Addressing Breast Cancer in African American Women: Unpacking the Social Context

PubMed Central

Williams, David R.; Mohammed, Selina A.; Shields, Alexandra E.

2017-01-01

Black women have higher incidence of breast cancer before the age of 40, more severe disease at all ages, and elevated mortality risk compared to white women. There is limited understanding of the contribution of social factors to these patterns. Elucidating the role of the social determinants of health in breast cancer disparities requires greater attention to how risk factors for breast cancer unfold over the lifecourse, and the complex ways that socioeconomic status and racism shape exposure to psychosocial, physical, chemical and other individual and community-level assaults that increase the risk of breast cancer. Research that takes seriously the social context in which Black women live is also needed to maximize the opportunities to prevent breast cancer among this underserved group. PMID:26930024

Ethical considerations for conducting health disparities research in community health centers: a social-ecological perspective.

PubMed

Boutin-Foster, Carla; Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

2013-12-01

Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings.

Religious competence as cultural competence

PubMed Central

2012-01-01

Definitions of cultural competence often refer to the need to be aware and attentive to the religious and spiritual needs and orientations of patients. However, the institution of psychiatry maintains an ambivalent attitude to the incorporation of religion and spirituality into psychiatric practice. This is despite the fact that many patients, especially those from underserved and underprivileged minority backgrounds, are devotedly religious and find much solace and support in their religiosity. I use the case of mental health of African Americans as an extended example to support the argument that psychiatric services must become more closely attuned to religious matters. I suggest ways in which this can be achieved. Attention to religion can aid in the development of culturally competent and accessible services, which in turn, may increase engagement and service satisfaction among religious populations. PMID:22421686

Preconception Health Behaviors of Low-Income Women.

PubMed

Ayoola, Adejoke B; Sneller, Krista; Ebeye, Tega D; Dykstra, Megan Jongekrijg; Ellens, Victoria L; Lee, HaEun Grace; Zandee, Gail L

2016-01-01

Preconception behaviors have a significant impact on birth outcomes, particularly among low-income minority groups, and women with unplanned pregnancies. This study examined women's perceived health status and behaviors such as drinking, smoking, exercise, and use of multivitamins and folic acid. This was a descriptive study based on a convenience sample of women living in urban underserved neighborhoods. Univariate and bivariate analyses were conducted using STATA 13. The sample consisted of 123 women ages 18 to 51 years (mean = 30.57); 51.22% were Hispanic, 36.59% African American, and 12.2% Caucasian. Over 70% had a household income of less than $20,000, 57.72% had no health insurance in the last year, and 58.54% were not married. These women were below the Healthy People 2020 goals for drinking, smoking, and multivitamin use, especially those who were planning to get pregnant in the next 6 months or not sure of their pregnancy planning status. There were no significant differences on any of the preconception health behavior variables based on pregnancy intention. Nurses and healthcare providers should emphasize importance of practicing healthy behaviors during the preconception period among low-income ethnic minority women specifically those living in urban medically underserved areas who are unsure of their pregnancy planning status or are at risk of unintended pregnancy.

Acceptability of the Talking Touchscreen for Health Literacy Assessment

PubMed Central

Yost, Kathleen J.; Webster, Kimberly; Baker, David W.; Jacobs, Elizabeth A.; Anderson, Andy; Hahn, Elizabeth A.

2012-01-01

Self-administration of a multimedia health literacy measure in clinic settings is a novel concept. Demonstrated ease of use and acceptability will help predicate the future value of this strategy. We previously demonstrated the acceptability of a “Talking Touchscreen” for health status assessment. For this study, we adapted the touchscreen for self-administration of a new health literacy measure. Primary care patients (n=610) in clinics for underserved populations completed health status and health literacy questions on the Talking Touchscreen and participated in an interview. Participants were 51% female, 10% age 60+, 67% African American, 18% without a high school education, and 14% who had never used a computer. The majority (93%) had no difficulty using the touchscreen, including those who were computer-naïve (87%). Most rated the screen design as very good or excellent (72%), including computer-naïve patients (71%) and older patients (75%). Acceptability of the touchscreen did not differ by health literacy level. The Talking Touchscreen was easy to use and acceptable for self-administration of a new health literacy measure. Self-administration should reduce staff burden and costs, interview bias, and feelings of embarrassment by those with lower literacy. Tools like the Talking Touchscreen may increase exposure of underserved populations to new technologies. PMID:20845195

Infectious and Non-infectious Etiologies of Cardiovascular Disease in Human Immunodeficiency Virus Infection.

PubMed

Chastain, Daniel B; King, Travis S; Stover, Kayla R

2016-01-01

Increasing rates of HIV have been observed in women, African Americans, and Hispanics, particularly those residing in rural areas of the United States. Although cardiovascular (CV) complications in patients infected with human immunodeficiency virus (HIV) have significantly decreased following the introduction of antiretroviral therapy on a global scale, in many rural areas, residents face geographic, social, and cultural barriers that result in decreased access to care. Despite the advancements to combat the disease, many patients in these medically underserved areas are not linked to care, and fewer than half achieve viral suppression. Databases were systematically searched for peer-reviewed publications reporting infectious and non-infectious etiologies of cardiovascular disease in HIV-infected patients. Relevant articles cited in the retrieved publications were also reviewed for inclusion. A variety of outcomes studies and literature reviews were included in the analysis. Relevant literature discussed the manifestations, diagnosis, treatment, and outcomes of infectious and non-infectious etiologies of cardiovascular disease in HIV-infected patients. In these medically underserved areas, it is vital that clinicians are knowledgeable in the manifestations, diagnosis, and treatment of CV complications in patients with untreated HIV. This review summarizes the epidemiology and causes of CV complications associated with untreated HIV and provide recommendations for management of these complications.

The Quick Peek Program: A Model for Developmental Screening within Underserved Communities

ERIC Educational Resources Information Center

Harris, Jill; Norton, Amy

2016-01-01

Developmental screening of young children is important in all populations, especially underserved communities with known health care disparities. The American Academy of Pediatrics created guidelines and a toolkit for pediatricians to conduct developmental surveillance and screening, yet these guidelines are not uniformly implemented within…

Access to Digital Communication Technology and Perceptions of Telemedicine for Patient Education among American Indian Patients with Diabetes.

PubMed

Mathieson, Kathleen; Leafman, Joan S; Horton, Mark B

2017-01-01

Health care access for medically underserved patients managing chronic conditions is challenging. While telemedicine can support patient education and engagement, the "digital divide" may be particularly problematic among the medically underserved. This study evaluated physical access to digital devices, use of e-mail and social media tools, and perceptions of telemedicine among American Indian (AI) patients with diabetes mellitus (DM). Survey data were collected from AI patients with DM during teleophthalmology exams. Eighty-eight percent of patients had access to digital device(s), 70% used e-mail, and 56% used social media. Younger age and greater education were positively associated with e-mail and social media use (p < .05). Most (60%) considered telemedicine an excellent medium for health-related patient education. American Indian patients with DM had access enabling patient education via telemedicine. Future work should examine patient technology preferences and effectiveness of technology-based education in improving outcomes among medically underserved populations.

Defining an integrative approach for health promotion and disease prevention: A population health equity framework

PubMed Central

Trinh-Shevrin, Chau; Nadkarni, Smiti; Park, Rebecca; Islam, Nadia; Kwon, Simona C.

2015-01-01

Background Eliminating health disparities in racial ethnic minority and underserved populations requires a paradigm shift from disease-focused biomedical approaches to a health equity framework that aims to achieve optimal health for all by targeting social and structural determinants of health. Methods We describe the concepts and parallel approaches that underpin an integrative population health equity framework. Using a case study approach we present the experience of the NYU Center for the Study of Asian American Health (CSAAH) in applying the framework to guide its work. Results This framework is central to CSAAH’s efforts moving towards a population health equity vision for Asian Americans. Discussion Advancing the health of underserved populations requires community engagement and an understanding of the multilevel contextual factors that influence health. Applying an integrative framework has allowed us to advance health equity for Asian American communities and may serve as a useful framework for other underserved populations. PMID:25981095

A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients.

PubMed

Cooper, Lisa A; Roter, Debra L; Carson, Kathryn A; Bone, Lee R; Larson, Susan M; Miller, Edgar R; Barr, Michael S; Levine, David M

2011-11-01

African Americans and persons with low socioeconomic status (SES) are disproportionately affected by hypertension and receive less patient-centered care than less vulnerable patient populations. Moreover, continuing medical education (CME) and patient-activation interventions have infrequently been directed to improve the processes of care for these populations. To compare the effectiveness of patient-centered interventions targeting patients and physicians with the effectiveness of minimal interventions for underserved groups. Randomized controlled trial conducted from January 2002 through August 2005, with patient follow-up at 3 and 12 months, in 14 urban, community-based practices in Baltimore, Maryland. Forty-one primary care physicians and 279 hypertension patients. Physician communication skills training and patient coaching by community health workers. Physician communication behaviors; patient ratings of physicians' participatory decision-making (PDM), patient involvement in care (PIC), reported adherence to medications; systolic and diastolic blood pressure (BP) and BP control. Visits of trained versus control group physicians demonstrated more positive communication change scores from baseline (-0.52 vs. -0.82, p = 0.04). At 12 months, the patient+physician intensive group compared to the minimal intervention group showed significantly greater improvements in patient report of physicians' PDM (β = +6.20 vs. -5.24, p = 0.03) and PIC dimensions related to doctor facilitation (β = +0.22 vs. -0.17, p = 0.03) and information exchange (β = +0.32 vs. -0.22, p = 0.005). Improvements in patient adherence and BP control did not differ across groups for the overall patient sample. However, among patients with uncontrolled hypertension at baseline, non-significant reductions in systolic BP were observed among patients in all intervention groups-the patient+physician intensive (-13.2 mmHg), physician intensive/patient minimal (-10.6 mmHg), and the patient intensive/physician minimal (-16.8 mmHg), compared to the patient+physician minimal group (-2.0 mmHg). Interventions that enhance physicians' communication skills and activate patients to participate in their care positively affect patient-centered communication, patient perceptions of engagement in care, and may improve systolic BP among urban African-American and low SES patients with uncontrolled hypertension.

Reducing Cancer Health Disparities through Community Engagement: Working with Faith-Based Organizations (Project CHURCH)

Cancer.gov

Lorna H. McNeill, PhD, MPH, is Chair and Associate Professor in the Department of Health Disparities at the University of Texas MD Anderson Cancer Center. Dr. McNeill's research is on the elimination of cancer-related health disparities in minority populations. Her research has particular emphasis on understanding the influence of social contextual determinants of cancer in minorities, with a special focus of the role of physical activity as a key preventive behavior and obesity as a major cancer determinant. Her research takes place in minority and underserved communities such as public housing developments, black churches, community-based clinics and low-income neighborhoods-communities with excess cancer death rates. She has been continuously funded, receiving grants from various funding agencies (i.e., National Institutes of Health, Robert Wood Johnson Foundation, etc.), to better understand and design innovative solutions to address obesity in racial/ethnic minority communities. Dr. McNeill is PI of several community-based studies, primarily working with African American churches. One is a called Project CHURCH, an academic-faith-based partnership established to: 1) identify underlying reasons for health disparities in cancer and cancer risk factors (e.g., screening, diet) among AAs using a cohort study (N=2400), 2) engage AAs as partners in the research process, and 3) to ultimately eliminate disparities among AAs. In 2014 Dr. McNeill furthered her partnership through the Faith, Health, and Family (FHF) Collaborative. The goals of FHF are to enhance the Project CHURCH partnership to address family obesity in African Americans, strengthen the partnership by developing a larger coalition of organizations and stakeholders to address the problem, assess church and community interest in family obesity and develop an agenda to address obesity in faith settings. To date we have 50 churches as members. Dr. McNeill is also director of the Center for Community-Engaged Translational Research (CCETR) at MD Anderson. CCETR works with MD Anderson faculty to develop collaborations with underserved communities with a focus on conducting high-quality, relevant cancer prevention research.

Development of a theater-based nutrition and physical activity intervention for low-income, urban, African American adolescents.

PubMed

Jackson, Caree J; Mullis, Rebecca M; Hughes, Marilyn

2010-01-01

Childhood overweight is disproportionately worse in minority and low-income populations. Theater is a promising and effective tool for delivering health education to these underserved populations, but no known studies have examined the use of theater to promote both nutrition and physical activity to minority youth. To develop an interactive, theater-based intervention that conveys health messages to low-income, urban, African Americans and engages them in learning ways to adopt a healthy lifestyle. Community partners worked to develop a theater-based nutrition and physical activity intervention. A focus group provided urban adolescents' thoughts about their desires for the intervention. Based on input from all community partners, the group created a theater-based intervention. Researchers used a quasi-experimental (pre-/posttest) design with a community-based participatory research (CBPR) approach. Participants learned health messages through theater, dance, and music and gave feedback on the program sessions and materials. The program ended with a dinner theater performance showcasing information that students learned during the intervention. Participants received six theater-based health lessons. Learning objectives for each health education session were achieved. Each participant contributed to and performed in the final performance. All program participants were highly satisfied with the theater-based method of learning health messages. A community-academic partnership succeeded in developing a theater-based nutrition and physical activity intervention that satisfied participating adolescents.

Assessing the fidelity of the Kin KeeperSM prevention intervention in African American, Latina and Arab women

PubMed Central

Ford, Sabrina; Meghea, Cristian; Estes, Tamika; Hamade, Hiam; Lockett, Murlisa; Williams, Karen Patricia

2014-01-01

Background: We evaluated a randomized controlled treatment, utilizing Community Health Workers (CHW) to deliver breast and cervical cancer education intervention to African American, Latina, and Arab women in Detroit and Dearborn, Michigan. The main objectives of the study are to: (1) examine fidelity and consistency of treatment delivery and (2) assess qualitative elements of the intervention. Methods: We surveyed 305 women who received the intervention and 16 CHWs Survey included questions regarding the treatment integrity, treatment received, and training provided. Surveys included both quantitative and questions. Results: The intervention group (n = 305) was made up of 48% Black, 11% Latina, and 41% Arab women. Almost all (≥ 90%) women agreed that they received the treatment in the way that it was intended. Sixteen CHWs responded affirmatively as well. Conclusions: Both participants and CHWs indicated that the program was mutually rewarding, indicating that there was “cross fertilization and cross benefit” of working with each other. These benefits served to endorse and confirm that CHWs are a very important mechanism in increasing health literacy in the community and referring underserved individuals to health providers. Second, with strong treatment fidelity the Kin KeeperSM program and has the potential to be replicated for a number of diseases in a variety of venues especially for those facing health disparities. PMID:24122323

Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

PubMed

Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

2002-01-01

Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings

PubMed Central

2013-01-01

Background Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban–rural status. Methods Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Results Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991–2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Conclusions Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse birth outcomes elsewhere may not be reaching isolated rural areas. PMID:23759062

Promoting Health and Behavioral Health Equity in California.

PubMed

Mishra, Meenoo; Lupi, Monica Valdes; Miller, Wm Jahmal; Nolfo, Tamu

2016-01-01

Behavioral health disparities are not usually considered part of the same system of health disparities. However, the California Department of Public Health focused its health equity strategies on reducing behavioral health disparities through its California Statewide Plan to Promote Health and Mental Health Equity. This statewide plan was developed through a community-wide stakeholder engagement and outreach process. In addition, the California Reducing Disparities Project is a prevention and early intervention effort to reduce mental health disparities in underserved populations. This strategic plan represents the voice of several racial/ethnic communities, such as African American, Asian and Pacific Islander, Latino, Native American, as well as lesbian, gay, bisexual, transgender, and queer and questioning communities in California, through 5 strategic planning workgroups. The workgroups were composed of a broad range of stakeholders, including community leaders, mental health care providers, consumer and family members, individuals with lived experience, and academia. This case example highlights the various efforts of California's Office of Health Equity in eliminating behavioral health disparities and promoting mental health equity, as well as discusses the unique statutory and regulatory role of the Office of Health Equity's deputy director.

Survivorship Care Plan Information Needs: Perspectives of Safety-Net Breast Cancer Patients.

PubMed

Burke, Nancy J; Napoles, Tessa M; Banks, Priscilla J; Orenstein, Fern S; Luce, Judith A; Joseph, Galen

2016-01-01

Despite the Institute of Medicine's (IOM) 2005 recommendation, few care organizations have instituted standard survivorship care plans (SCPs). Low health literacy and low English proficiency are important factors to consider in SCP development. Our study aimed to identify information needs and survivorship care plan preferences of low literacy, multi-lingual patients to support the transition from oncology to primary care and ongoing learning in survivorship. We conducted focus groups in five languages with African American, Latina, Russian, Filipina, White, and Chinese medically underserved breast cancer patients. Topics explored included the transition to primary care, access to information, knowledge of treatment history, and perspectives on SCPs. Analysis of focus group data identified three themes: 1) the need for information and education on the transition between "active treatment" and "survivorship"; 2) information needed (and often not obtained) from providers; and 3) perspectives on SCP content and delivery. Our data point to the need to develop a process as well as written information for medically underserved breast cancer patients. An SCP document will not replace direct communication with providers about treatment, symptom management and transition, a communication that is missing in participating safety-net patients' experiences of cancer care. Women turned to peer support and community-based organizations in the absence of information from providers. "Clear and effective" communication of survivorship care for safety-net patients requires dedicated staff trained to address wide-ranging information needs and uncertainties.

The interaction of perceived risk and benefits and its relationship to predicting mammography adherence in African-American women

PubMed Central

Fair, Alecia Malin; Monahan, Patrick O.; Russell, Kathleen; Zhao, Qianqian; Champion, Victoria L.

2013-01-01

PURPOSE/OBJECTIVES To test the interaction of perceived risk and benefits on stage of mammography readiness and adherence. DESIGN Cross-sectional study SETTING Community gathering places and health care clinics across a Midwestern state. SAMPLE 299 African-American women who had not had a mammogram in ≥ 18 months. METHODS In-person interviews were used to collect data on sociodemographics, health belief variables and stage of readiness to undertake mammography screening. Four categories were created to measure the combined magnitude of high/low levels of perceived risk and benefit with health belief variables linked to modifying mammography screening behavior. MAIN RESEARCH VARIABLES Perceived risks and benefits, stage of readiness, mammography adherence. FINDINGS The lowest rate of mammography adherence was in women with a high perceived risk and low benefit towards mammography adherence (25.6) compared to women with a high perceived benefit and low risk towards mammography adherence (46.0). Differences in mammography adherence were statistically significant between these groups p=(0.009). CONCLUSIONS The interaction of high perceived risk and low benefits additively effected readiness to undertake screening mammography. IMPLICATIONS FOR NURSING Reducing disparities in breast cancer diagnosis and survival requires timely and efficient mammography adherence. Minority, medically underserved women with perceived high risk and low benefits exhibit immobilization to move forward with mammography adherence when they experience higher perceived risk. Further interventions to increase the perception of benefit of mammography are recommended to reduce breast cancer mortality. PMID:22201655

The Role of Structural Barriers in Risky Sexual Behavior, Victimization and Readiness to Change HIV/STI-Related Risk Behavior Among Transgender Women.

PubMed

Raiford, Jerris L; Hall, Grace J; Taylor, Raekiela D; Bimbi, David S; Parsons, Jeffrey T

2016-10-01

This study examines the role of structural barriers experienced by a community-based sample of 63 HIV-positive and negative transgender women that may elevate HIV infection and transmission risks. Separate hierarchical linear multiple regression analyses tested the association between structural barriers (e.g., unemployment, lack of food, shelter) and condomless anal sex acts, abuse, and readiness to change risk behavior, while controlling for other related factors. Among this primarily Hispanic and African-American sample, HIV-positive and negative transgender women experienced a similar number of structural barriers and experiencing structural barriers was significantly associated with an increased number of condomless anal sex acts (p = .002), victimization (p = .000) and a decreased readiness to change HIV-related risk behavior (p = .014). Structural-level interventions are needed to address this elevated risk among this underserved and hard-to-reach population.

Primary care professional's perspectives on treatment decision making for depression with African Americans and Latinos in primary care practice.

PubMed

Patel, Sapana R; Schnall, Rebecca; Little, Virna; Lewis-Fernández, Roberto; Pincus, Harold Alan

2014-12-01

Increasing interest has been shown in shared decision making (SDM) to improve mental health care communication between underserved immigrant minorities and their providers. Nonetheless, very little is known about this process. The following is a qualitative study of fifteen primary care providers at two Federally Qualified Health Centers in New York and their experience during depression treatment decision making. Respondents described a process characterized in between shared and paternalistic models of treatment decision making. Barriers to SDM included discordant models of illness, stigma, varying role expectations and decision readiness. Respondents reported strategies used to overcome barriers including understanding illness perceptions and the role of the community in the treatment process, dispelling stigma using cultural terms, orienting patients to treatment and remaining available regarding the treatment decision. Findings from this study have implications for planning SDM interventions to guide primary care providers through treatment engagement for depression.

Impact of the University of California, Los Angeles/Charles R. Drew University Medical Education Program on medical students' intentions to practice in underserved areas.

PubMed

Ko, Michelle; Edelstein, Ronald A; Heslin, Kevin C; Rajagopalan, Shobita; Wilkerson, Luann; Colburn, Lois; Grumbach, Kevin

2005-09-01

To estimate the impact of a U.S. inner-city medical education program on medical school graduates' intentions to practice in underserved communities. The authors conducted an analysis of secondary data on 1,088 medical students who graduated from either the joint University of California, Los Angeles/Charles R. Drew University Medical Education Program (UCLA/Drew) or the UCLA School of Medicine between 1996 and 2002. Intention to practice in underserved communities was measured using students' responses to questionnaires administered at matriculation and graduation for program improvement by the Association of American Medical Colleges. Multivariate logistic regression analysis was used to compare the odds of intending to practice in underserved communities among UCLA/Drew students with those of their counterparts in the UCLA School of Medicine. Compared with students in the UCLA School of Medicine, UCLA/Drew students had greater adjusted odds of reporting intention to work in underserved communities at graduation, greater odds of maintaining or increasing such intentions between matriculation and graduation, and lower odds of decreased intention to work in underserved communities between matriculation and graduation. Training in the UCLA/Drew program was independently associated with intention to practice medicine in underserved communities, suggesting that a medical education program can have a positive effect on students' goals to practice in underserved areas.

Honoring the Ways of American Indian Women: A Group Therapy Intervention

ERIC Educational Resources Information Center

McWhirter, Paula T.; Robbins, Rockey; Vaughn, Karen; Youngbull, Natalie; Burks, Derek; Willmon-Haque, Sadie; Schuetz, Suzan; Brandes, Joyce A.; Nael, Andrea Zainab Omidy

2010-01-01

A culturally grounded group intervention for a typically underserved population of urban American Indian women is described. The intervention is designed to increase interpersonal connection, improve inter-tribal acceptance and trust, and enhance psychological well being of marginalized urban American Indian women. Topics used to structure the…

Study protocol for a comparative effectiveness trial of two parent training programs in a fee-for-service mental health clinic: can we improve mental health services to low-income families?

PubMed

Gross, Deborah A; Belcher, Harolyn M E; Ofonedu, Mirian E; Breitenstein, Susan; Frick, Kevin D; Chakra, Budhathoki

2014-03-01

Untreated behavioral and mental health problems beginning in early childhood are costly problems affecting the long-term health and wellbeing of children, their families, and society. Although parent training (PT) programs have been demonstrated to be a cost-effective intervention modality for treating childhood behavior problems, they have been less effective for children from low-income and underserved racial and ethnic populations. The purpose of this randomized trial is to compare the effectiveness, cost, and social validity of two manualized evidence-based PT programs that were developed and tested on different populations and employ different delivery models: (1) The Chicago Parent Program (CPP), a group-based program developed in collaboration with a community advisory board of African-American and Latino parents; and (2) Parent-Child Interaction Therapy (PCIT), an individualized parent-child coaching model considered to be 'the gold standard' for parents of children with externalizing behavior problems. This trial uses an experimental design with randomization of parents seeking behavioral treatment for their 2- to 5-year-old children at a mental health clinic in Baltimore, MD (80% African-American or multi-racial; 97% receiving Medicaid). Using block randomization procedures, 262 parents are randomized to CPP or PCIT. Clinicians (n=13) employed in the mental health clinic and trained in CPP or PCIT are also recruited to participate. Primary outcomes of interest are reductions in child behavior problems, improvements in parenting, perceived value of the interventions from the perspective of parents and clinicians, and cost. Parent distress and family social risk are assessed as modifiers of treatment effectiveness. We hypothesize that CPP will be at least as effective as PCIT for reducing child behavior problems and improving parenting but the programs will differ on cost and their social validity as perceived by parents and clinicians. This is the first study to compare the effectiveness of a PT program originally designed with and for parents from underserved racial and ethnic populations (CPP) against a well-established program considered to be the 'the gold standard' (PCIT) with a high-risk population of parents. Challenges related to conducting a randomized trial in a fee-for-service mental health clinic serving urban, low-income families are discussed. NCT01517867.

Study protocol for a comparative effectiveness trial of two parent training programs in a fee-for-service mental health clinic: can we improve mental health services to low-income families?

PubMed Central

2014-01-01

Background Untreated behavioral and mental health problems beginning in early childhood are costly problems affecting the long-term health and wellbeing of children, their families, and society. Although parent training (PT) programs have been demonstrated to be a cost-effective intervention modality for treating childhood behavior problems, they have been less effective for children from low-income and underserved racial and ethnic populations. The purpose of this randomized trial is to compare the effectiveness, cost, and social validity of two manualized evidence-based PT programs that were developed and tested on different populations and employ different delivery models: (1) The Chicago Parent Program (CPP), a group-based program developed in collaboration with a community advisory board of African-American and Latino parents; and (2) Parent-Child Interaction Therapy (PCIT), an individualized parent-child coaching model considered to be ‘the gold standard’ for parents of children with externalizing behavior problems. Methods This trial uses an experimental design with randomization of parents seeking behavioral treatment for their 2- to 5-year-old children at a mental health clinic in Baltimore, MD (80% African-American or multi-racial; 97% receiving Medicaid). Using block randomization procedures, 262 parents are randomized to CPP or PCIT. Clinicians (n = 13) employed in the mental health clinic and trained in CPP or PCIT are also recruited to participate. Primary outcomes of interest are reductions in child behavior problems, improvements in parenting, perceived value of the interventions from the perspective of parents and clinicians, and cost. Parent distress and family social risk are assessed as modifiers of treatment effectiveness. We hypothesize that CPP will be at least as effective as PCIT for reducing child behavior problems and improving parenting but the programs will differ on cost and their social validity as perceived by parents and clinicians. Discussion This is the first study to compare the effectiveness of a PT program originally designed with and for parents from underserved racial and ethnic populations (CPP) against a well-established program considered to be the ‘the gold standard’ (PCIT) with a high-risk population of parents. Challenges related to conducting a randomized trial in a fee-for-service mental health clinic serving urban, low-income families are discussed. Trial registration NCT01517867 PMID:24581245

Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: a randomized control trial study protocol.

PubMed

Gleason-Comstock, Julie; Streater, Alicia; Ager, Joel; Goodman, Allen; Brody, Aaron; Kivell, Laura; Paranjpe, Aniruddha; Vickers, Jasmine; Mango, LynnMarie; Dawood, Rachelle; Levy, Phillip

2015-12-21

Persistently elevated blood pressure (BP) is a leading risk factor for cardiovascular disease development, making effective hypertension management an issue of considerable public health importance. Hypertension is particularly prominent among African Americans, who have higher disease prevalence and consistently lower BP control than Whites and Hispanics. Emergency departments (ED) have limited resources for chronic disease management, especially for under-served patients dependent upon the ED for primary care, and are not equipped to conduct follow-up. Kiosk-based patient education has been found to be effective in primary care settings, but little research has been done on the effectiveness of interactive patient education modules as ED enhanced discharge for an under-served urban minority population. Achieving Blood Pressure Control Through Enhanced Discharge (AchieveBP) is a behavioral RCT patient education intervention for patients with a history of hypertension who have uncontrolled BP at ED discharge. The project will recruit up to 200 eligible participants at the ED, primarily African-American, who will be asked to return to a nearby clinical research center for seven, thirty and ninety day visits, with a 180 day follow-up. Consenting participants will be randomized to either an attention-control or kiosk-based interactive patient education intervention. To control for potential medication effects, all participants will be prescribed similar, evidenced-based anti-hypertensive regimens and have their prescription filled onsite at the ED and during visits to the clinic. The primary target endpoint will be success in achieving BP control assessed at 180 days follow-up post-ED discharge. The secondary aim will be to assess the relationship between patient activation and self-care management. The AchieveBP trial will determine whether using interactive patient education delivered through health information technology as ED enhanced discharge with subsequent education sessions at a clinic is an effective strategy for achieving short-term patient management of BP. The project is innovative in that it uses the ED as an initial point of service for kiosk-based health education designed to increase BP self-management. It is anticipated findings from this translational research could also be used as a resource for patient education and follow-up with hypertensive patients in primary care settings. ClinicalTrials.gov. NCT02069015. Registered February 19, 2014.

Access and Financial Aid: How American-Indian Students Pay for College

ERIC Educational Resources Information Center

Tierney, William G.; Sallee, Margaret W.; Venegas, Kristan M.

2007-01-01

American Indians are among the most underrepresented and underserved groups in higher education. Fifty-one out of every 100 American Indians graduate from high school. Of these 1, only 7 percent will enroll in college and ultimately earn a bachelor's degree within six years. Some American-Indian students fail to complete their studies for…

A day of immersive physiology experiments increases knowledge and excitement towards physiology and scientific careers in Native American students.

PubMed

Becker, Bryan K; Schiller, Alicia M; Zucker, Irving H; Eager, Eric A; Bronner, Liliana P; Godfrey, Maurice

2017-03-01

Underserved minority groups are disproportionately absent from the pursuit of careers in science, technology, engineering, and mathematics (STEM) fields. One such underserved population, Native Americans, are particularly underrepresented in STEM fields. Although recent advocacy and outreach designed toward increasing minority involvement in health care-related occupations have been mostly successful, little is known about the efficacy of outreach programs in increasing minority enthusiasm toward careers in traditional scientific professions. Furthermore, very little is known about outreach among Native American schools toward increasing involvement in STEM. We collaborated with tribal middle and high schools in South Dakota and Nebraska through a National Institutes of Health Science Education Partnership Award to hold a day-long physiology, activity-based event to increase both understanding of physiology and enthusiasm to scientific careers. We recruited volunteer biomedical scientists and trainees from the University of Nebraska Medical Center, Nebraska Wesleyan University, and University of South Dakota. To evaluate the effectiveness of the day of activities, 224 of the ~275-300 participating students completed both a pre- and postevent evaluation assessment. We observed increases in both students self-perceived knowledge of physiology and enthusiasm toward scientific career opportunities after the day of outreach activities. We conclude that activity-based learning opportunities in underserved populations are effective in increasing both knowledge of science and interest in scientific careers. Copyright © 2017 the American Physiological Society.

Local innovation for improving primary care cardiology in resource-limited African settings: an insight on the Cardio Pad(®) project in Cameroon.

PubMed

Noubiap, Jean Jacques N; Jingi, Ahmadou M; Kengne, André Pascal

2014-10-01

Cardiovascular disease (CVD) is an emerging threat to the health of populations in Africa. With the inadequate health infrastructures, understaffed and underfunded health systems, African countries are ill-prepared to cope with the increasing demand for care for CVD, particularly for populations in remote and underserved rural areas, where 60% of the population currently reside. Task shifting and telehealth have been suggested as strategies to overcome the current health workforce shortage in African countries, and to increase access to prevention and curative services for emerging CVD. However, strategies for promoting their incorporation into the existing health systems, have yet to be developed. The Cardio Pad(®) initiative (originating from Cameroon) seeks to provide appropriate solutions to improve the application of telemedicine for CVD prevention and control in remote African settings. The Cardio Pad(®) is a tele-cardiology device which provides a number of advantages in terms of cost, ease of use, autonomy and reduced technology requirements. It is a fully touch screen medical device which enables cardiac tests such as electrocardiograms (ECG) to be performed in remote underserved areas (rural areas for instance), while the test results are transferred wirelessly via mobile phone connection, to specialist physicians who can interpret them and provide assistance with case management. While most of the current telemedicine clinical services on the African continent receive most expertise from developed countries, the Cardio Pad(®), a local invention by a 26-year-old Cameroon-trained engineer demonstrates how much innovative solutions to combat CVD and other health issues could and should be developed locally in Africa.

Managing the space between visits: a randomized trial of disease management for diabetes in a community health center.

PubMed

Anderson, Daren R; Christison-Lagay, Joan; Villagra, Victor; Liu, Haibei; Dziura, James

2010-10-01

Diabetes outcomes are worse for underserved patients from certain ethnic/racial minority populations. Telephonic disease management is a cost-effective strategy to deliver self-management services and possibly improve diabetes outcomes for such patients. We conducted a trial to test the effectiveness of a supplemental telephonic disease management program compared to usual care alone for patients with diabetes cared for in a community health center. Randomized controlled trial. All patients had type 2 diabetes, and the majority was Hispanic or African American. Most were urban-dwelling with low socioeconomic status, and nearly all had Medicaid or were uninsured. Clinical measures included glycemic control, blood pressure, lipid levels, and body mass index. Validated surveys were used to measure dietary habits and physical activity. A total of 146 patients were randomized to the intervention and 149 to the control group. Depressive symptoms were highly prevalent in both groups. Using an intention to treat analysis, there were no significant differences in the primary outcome (HbA1c) between the intervention and control groups at 12 months. There were also no significant differences for secondary clinical or behavioral outcome measures including BMI, systolic or diastolic blood pressure, LDL cholesterol, smoking, or intake of fruits and vegetables, or physical activity. A clinic-based telephonic disease management support for underserved patients with diabetes did not improve clinical or behavioral outcomes at 1 year as compared to patients receiving usual care alone.

ACCISS study rationale and design: activating collaborative cancer information service support for cervical cancer screening.

PubMed

Cofta-Woerpel, Ludmila; Randhawa, Veenu; McFadden, H Gene; Fought, Angela; Bullard, Emily; Spring, Bonnie

2009-12-02

High-quality cancer information resources are available but underutilized by the public. Despite greater awareness of the National Cancer Institute's Cancer Information Service among low-income African Americans and Hispanics compared with Caucasians, actual Cancer Information Service usage is lower than expected, paralleling excess cancer-related morbidity and mortality for these subgroups. The proposed research examines how to connect the Cancer Information Service to low-income African-American and Hispanic women and their health care providers. The study will examine whether targeted physician mailing to women scheduled for colposcopy to follow up an abnormal Pap test can increase calls to the Cancer Information Service, enhance appropriate medical follow-up, and improve satisfaction with provider-patient communication. The study will be conducted in two clinics in ethnically diverse low-income communities in Chicago. During the formative phase, patients and providers will provide input regarding materials planned for use in the experimental phase of the study. The experimental phase will use a two-group prospective randomized controlled trial design. African American and Hispanic women with an abnormal Pap test will be randomized to Usual Care (routine colposcopy reminder letter) or Intervention (reminder plus provider recommendation to call the Cancer Information Service and sample questions to ask). Primary outcomes will be: 1) calls to the Cancer Information Service; 2) timely medical follow-up, operationalized by whether the patient keeps her colposcopy appointment within six months of the abnormal Pap; and 3) patient satisfaction with provider-patient communication at follow-up. The study examines the effectiveness of a feasible, sustainable, and culturally sensitive strategy to increase awareness and use of the Cancer Information Service among an underserved population. The goal of linking a public service (the Cancer Information Service) with real-life settings of practice (the clinics), and considering input from patients, providers, and Cancer Information Service staff, is to ensure that the intervention, if proven effective, can be incorporated into existing care systems and sustained. The approach to study design and planning is aimed at bridging the gap between research and practice/service. NCT00873288.

Expanding oral care opportunities: direct access care provided by dental hygienists in the United States.

PubMed

Naughton, Doreen K

2014-06-01

Dental hygienists expand access to oral care in the United States. Many Americans have access to oral health care in traditional dental offices however millions of Americans have unmet dental needs. For decades dental hygienists have provided opportunities for un-served and under-served Americans to receive preventive services in a variety of alternate delivery sites, and referral to licensed dentists for dental care needs. Publications, state practice acts, state public health departments, the American Dental Hygienists' Association, and personal interviews of dental hygiene practitioners were accessed for information and statistical data. Dental hygienists in 36 states can legally provide direct access care. Dental hygienists are providing preventive services in a variety of settings to previously un-served and under-served Americans, with referral to dentists for dental needs. Dental hygienists have provided direct access to care in the United States for decades. The exact number of direct access providers in the United States is unknown. Limited research and anecdotal information demonstrate that direct access care has facilitated alternate entry points into the oral health systems for thousands of previously un-served and underserved Americans. Older adults, persons with special needs, children in schools, pregnant women, minority populations, rural populations, and others have benefited from the availability of many services provided by direct access dental hygienists. Legislatures and private groups are becoming increasingly aware of the impact that direct access has made on the delivery of oral health care. Many factors continue to drive the growth of direct access care. Additional research is needed to accumulate qualitative and quantitative outcome data related to direct access care provided by dental hygienists and other mid level providers of oral health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Reducing safety risk among underserved caregivers with an Alzheimer's home safety program.

PubMed

Levy-Storms, Lené; Cherry, Debra L; Lee, Linda J; Wolf, Sheldon M

2017-09-01

Older adults living with Alzheimer's disease (AD) experience more of the types of accidents and injuries prevalent among older adults. Relatively few studies specifically on safety risks have included older adults of color and tested interventions. This pilot study tested the feasibility and evaluability of educating Hispanic and African American caregivers of patients living with AD about reducing safety risks in their homes. This outpatient memory clinic-based intervention study included a pre-/post-test survey design with two nonequivalent groups and predominately serves Hispanic and African Americans. Of 60 eligible caregivers, 67% participated in a tailored, safety training class with an optional follow-up call. The results indicate a reduction in some safety risks compared to baseline and/or a no intervention group, respectively, including leaving patients at home alone part-time (p < .01 and p < .01), getting lost (p < .05 and p < .05), going outdoors alone less often (p < .05 and p < .01), and giving themselves medicine (p < .05 and p < .01). At post-test, 47 clinically significant instances occurred, in which caregivers who participated in the intervention self-reported patients living with AD to be 'completely safe' in one or more of the safety risk items compared to 8 instances among those who did not. This pilot pre/post design with non-equivalent groups study needs refinement in a future randomized control trial. Despite limitations, this pilot study demonstrates the first feasible and evaluable intervention with both statistically and clinically significant results that suggest potential for reducing safety risks among at-risk minority patients living with AD in future research.

Strategies Used and Challenges Faced by a Breast Cancer Patient Navigator in an Urban Underserved Community

PubMed Central

Ferrante, Jeanne M.; Wu, Justine; Dicicco-Bloom, Barbara

2013-01-01

Patient navigation has been widely implemented by cancer care programs across the United States. While activities of navigators have been described elsewhere, little has been documented regarding specific strategies used or challenges experienced by navigators from their own perspectives. We describe the experience of an African American patient navigator who promoted breast cancer screening and facilitated diagnosis and treatment among inner-city mostly African American women in Newark, New Jersey. We conducted qualitative analysis of journal notes, log data, and in-depth interviews with the patient navigator. Strategies used by the patient navigator to develop trust and rapport included: (1) “meet patients where they are” (outreach is best performed in locations women frequent, such as hair salons); (2) being accessible (must be flexible and available by phone or in person to meet patient’s needs); and (3) “bring it down, sista” (must have “street credibility” in dress and language). Key challenges included experiencing threats to safety, setting boundaries, and facing and overcoming burnout. The patient navigator responded to these obstacles by creating new community linkages and resources and reaching out for emotional support from her mother and supervisor. Areas that need to be addressed further for future patient navigator programs include promoting safety in potentially dangerous neighborhoods and helping navigators set boundaries and avoid burnout. Further research into experiences of patient navigators in different settings is needed to build upon this preliminary data, and to consider character traits and attributes best suited for a patient navigator, as well as the support needed for this new health care worker. PMID:22046850

Nourishing Our Understanding of Role Modeling to Improve Support and Health (NOURISH): design and methods.

PubMed

Mazzeo, Suzanne E; Kelly, Nichole R; Stern, Marilyn; Gow, Rachel W; Serdar, Kasey; Evans, Ronald K; Jones, Resa M; Bulik, Cynthia M

2012-05-01

Pediatric overweight is associated with numerous physical and psychological health risks, and overweight children are at significant risk for obesity in adulthood. African-American children are at particularly high risk for obesity and related health complications. However, this racial group has traditionally had limited access to obesity treatment and relatively few studies have included sufficient numbers of lower-SES, African American participants. Further, although parental involvement in treatment for pediatric overweight has been found to be beneficial, few studies have examined the efficacy of offering treatment exclusively to parents, a potentially cost-effective approach which could benefit the entire family. This pilot project will evaluate the efficacy of an intensive parenting intervention, (NOURISH; Nourishing Our Understanding of Role modeling to Improve Support and Health), targeting racially diverse parents of overweight children (ages 6-11). NOURISH addresses several urgent research priorities by targeting the underserved and addressing the significant disparity in obesity treatment services. Parents meeting study criteria (having a child between the ages of 6 and 11 with a BMI ≥ the 85th percentile) will be offered participation in the randomized trial comparing NOURISH with a control group. We hypothesize that children whose parents participate in NOURISH will manifest greater decreases in BMI, and greater improvements in dietary intake, and quality of life compared to children whose parents do not participate. This study is designed explicitly to gather preliminary feasibility, acceptability, and effectiveness data to inform a subsequent larger randomized controlled trial. Copyright © 2012 Elsevier Inc. All rights reserved.

Combining community participatory research with a randomized clinical trial: the Protecting the Hood Against Tobacco (PHAT) smoking cessation study.

PubMed

Froelicher, Erika Sivarajan; Doolan, Daniel; Yerger, Valerie B; McGruder, Carol O; Malone, Ruth E

2010-01-01

This article describes the process and results of a smoking cessation intervention randomized clinical trial (RCT) that was conducted as a community-based participatory research project. This RCT tested whether outcomes are improved by adding social justice and tobacco industry targeting messages to a smoking cessation program conducted among African American adults within a low-income community in San Francisco, California. This study provides lessons for future similar research projects that focus on urban low-income populations. Participants were randomly allocated to receive a smoking-cessation program (control group [CG]) or CG care plus tobacco industry and media (IAM) messages. Primary interventions were behavioral. At intake, participants reporting severe withdrawal or smoking > or = 25 cigarettes daily were offered free nicotine replacement therapy. Baseline data were from an in-person interview. Outcome measures included self-reported smoking status; validation of quitting was by salivary cotinine assays. Of 87 participants providing baseline data, 31% (27) did not join the RCT. Proportions quitting in the CG and IAM group were 11.5% and 13.6% at 6 months and 5.3% and 15.8% at 12 months, respectively. African Americans in underserved inner-city neighborhoods can be recruited into RCTs with community participatory approaches. Differences between the CG and IAM in proportions who quit were 2.1% and 10.5% at 6 and 12 months, respectively. More than 3 years with adequate funding, high staffing ratios, and intense outreach and follow-up schedules are needed to achieve recruitment and study goals. 2010 Elsevier Inc. All rights reserved.

Some African American Males' Perspectives on the Black Woman.

ERIC Educational Resources Information Center

Burrow, Rufus, Jr.

1992-01-01

Presents views of Frederick Douglass, W. E. B. Du Bois, Malcolm X, and James Hal Cone (African-American male leaders) toward African-American women in the United States. Discusses the role of African-American men in addressing and eradicating sexism in African-American churches and the African-American community. (SLD)

The excess burden of breast carcinoma in minority and medically underserved communities: application, research, and redressing institutional racism.

PubMed

Shinagawa, S M

2000-03-01

In 1998, the American Cancer Society, the National Cancer Institute, and the Centers for Disease Control and Prevention reported an overall downward trend in cancer incidence and mortality between 1990 and 1995 for all cancers combined. Many minority and medically underserved populations, however, did not share equally in these improvements. A review of surveillance and other reports and recent literature on disparities in cancer incidence and mortality in minority and medically underserved communities was conducted 1) to ascertain the extent to which these communities bear an excess cancer burden, and 2) to explore the macrosocietal and microinstitutional barriers to equitable benefits in cancer health care delivery. Tragic disparities in cancer incidence and mortality in minority and medically underserved communities continue to be inadequately addressed. Overall improvements in U.S. cancer incidence and mortality rates are not shared equally by all segments of our society. While numerous individual and cultural barriers to optimal cancer control and care exist in minority and medically underserved communities, a major factor precluding these populations from sharing equally in advances in cancer research is prevailing societal and institutional racism. Immediate and equitable application of existing cancer control interventions and quality treatment options will significantly decrease cancer incidence and mortality. Enhanced surveillance efforts and a greater investment in targeted cancer research in those communities with the greatest disparities must be employed immediately if we are to achieve the goal of the president of the United States of eliminating racial and ethnic disparities in cancer and other diseases by 2010. Unless we acknowledge and redress institutionalized racism, the miscarriage of health justice will be perpetuated while celebrated advances in cancer research leading to declining incidence and mortality rates continue to evade our nation's minority and medically underserved communities. Copyright 2000 American Cancer Society.

Mechanisms of Vowel Variation in African American English.

PubMed

Holt, Yolanda Feimster

2018-02-15

This research explored mechanisms of vowel variation in African American English by comparing 2 geographically distant groups of African American and White American English speakers for participation in the African American Shift and the Southern Vowel Shift. Thirty-two male (African American: n = 16, White American controls: n = 16) lifelong residents of cities in eastern and western North Carolina produced heed,hid,heyd,head,had,hod,hawed,whod,hood,hoed,hide,howed,hoyd, and heard 3 times each in random order. Formant frequency, duration, and acoustic analyses were completed for the vowels /i, ɪ, e, ɛ, æ, ɑ, ɔ, u, ʊ, o, aɪ, aʊ, oɪ, ɝ/ produced in the listed words. African American English speakers show vowel variation. In the west, the African American English speakers are participating in the Southern Vowel Shift and hod fronting of the African American Shift. In the east, neither the African American English speakers nor their White peers are participating in the Southern Vowel Shift. The African American English speakers show limited participation in the African American Shift. The results provide evidence of regional and socio-ethnic variation in African American English in North Carolina.

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…

Adaptation of Consultation Planning for Native American and Latina Women with Breast Cancer

ERIC Educational Resources Information Center

Belkora, Jeffrey; Franklin, Lauren; O'Donnell, Sara; Ohnemus, Julie; Stacey, Dawn

2009-01-01

Context: Resource centers in rural, underserved areas are implementing Consultation Planning (CP) to help women with breast cancer create a question list before a doctor visit. Purpose: To identify changes needed for acceptable delivery of CP to rural Native Americans and Latinas. Methods: We interviewed and surveyed 27 Native American and Latino…

Mechanisms of Vowel Variation in African American English

ERIC Educational Resources Information Center

Holt, Yolanda Feimster

2018-01-01

Purpose: This research explored mechanisms of vowel variation in African American English by comparing 2 geographically distant groups of African American and White American English speakers for participation in the African American Shift and the Southern Vowel Shift. Method: Thirty-two male (African American: n = 16, White American controls: n =…

Defense.gov Special Report: African-American History Month 2014

Science.gov Websites

Department of Defense Submit Search African-American History Month: Civil Rights in America - February 2014 Proclamation African-American Firsts in U.S. Naval History DEOMI 2014 African American/Black History Month Poster African-American History at National Museum of the U.S. Air Force African-Americans and the U.S

Pharmacogenetic research in partnership with American Indian and Alaska Native communities

PubMed Central

Woodahl, Erica L; Lesko, Lawrence J; Hopkins, Scarlett; Robinson, Renee F; Thummel, Kenneth E; Burke, Wylie

2014-01-01

Pharmacogenetics is a subset of personalized medicine that applies knowledge about genetic variation in gene–drug pairs to help guide optimal dosing. There is a lack of data, however, about pharmacogenetic variation in underserved populations. One strategy for increasing participation of underserved populations in pharmacogenetic research is to include communities in the research process. We have established academic–community partnerships with American Indian and Alaska Native people living in Alaska and Montana to study pharmacogenetics. Key features of the partnership include community oversight of the project, research objectives that address community health priorities, and bidirectional learning that builds capacity in both the community and the research team. Engaging the community as coresearchers can help build trust to advance pharmacogenetic research objectives. PMID:25141898

Views of Low-Income Women of Color at Increased Risk for Breast Cancer.

PubMed

E Anderson, Emily; Tejada, Silvia; B Warnecke, Richard; Hoskins, Kent

2018-01-01

Individual risk assessment (IRA) for breast cancer may increase adherence to risk-appropriate screening and prevention measures. However, knowledge gaps exist regarding how best to communicate IRA results and support women at increased risk in future health care decisions, in part because patients conceptualize and make meaning of risk differently from the medical community. Better understanding the views of low-income women of color identified as being at increased risk for breast cancer can inform efforts to conduct IRA in an ethical and respectful manner. We conducted in-depth interviews with 13 low-income African American and Latina women who receive care at a federally qualified health center (FQHC) and had recently learned of their increased risk for breast cancer. These interviews explored their experience of the IRA process, their interpretation of what being at increased risk means, and their reactions to provider recommendations. Eight key themes were identified. We conclude with recommendations for the implementation of IRA for breast cancer in underserved primary care settings.

Tuskegee University Experience Challenges Conventional Wisdom: Is Integrative Bioethics Practice the New Ethics for the Public's Health?

PubMed Central

Sodeke, Stephen Olufemi

2013-01-01

The Tuskegee University National Center for Bioethics in Research and Health Care was established in 1999 in partial response to the Presidential Apology for the United States Public Health Service's Study of Untreated Syphilis in the Negro Male conducted in Macon County, Alabama, from 1932 to 1972. The Center's mission of promoting equity and justice in health and health care for African Americans and other underserved populations employs an integrative bioethics approach informed by moral vision. Etymological and historical analyses are used to delineate the meaning and evolution of bioethics and to provide a basis for Tuskegee's integrative bioethics niche. Unlike mainstream bioethics, integrative bioethics practice is holistic in orientation, and more robust for understanding the epistemic realities of minority life, health disparities, and population health. The conclusion is that integrative bioethics is relevant to the survival of all people, not just a privileged few; it could be the new ethics for the public's health. PMID:23124497

Tuskegee University experience challenges conventional wisdom: is integrative bioethics practice the new ethics for the public's health?

PubMed

Sodeke, Stephen Olufemi

2012-11-01

The Tuskegee University National Center for Bioethics in Research and Health Care was established in 1999 in partial response to the Presidential Apology for the United States Public Health Service's Study of Untreated Syphilis in the Negro Male conducted in Macon County, Alabama, from 1932 to 1972. The Center's mission of promoting equity and justice in health and health care for African Americans and other underserved populations employs an integrative bioethics approach informed by moral vision. Etymological and historical analyses are used to delineate the meaning and evolution of bioethics and to provide a basis for Tuskegee's integrative bioethics niche. Unlike mainstream bioethics, integrative bioethics practice is holistic in orientation, and more robust for understanding the epistemic realities of minority life, health disparities, and population health. The conclusion is that integrative bioethics is relevant to the survival of all people, not just a privileged few; it could be the new ethics for the public's health.

Utility of Respondent Driven Sampling to Reach Disadvantaged Emerging Adults for Assessment of Substance Use, Weight, and Sexual Behaviors.

PubMed

Tucker, Jalie A; Simpson, Cathy A; Chandler, Susan D; Borch, Casey A; Davies, Susan L; Kerbawy, Shatomi J; Lewis, Terri H; Crawford, M Scott; Cheong, JeeWon; Michael, Max

2016-01-01

Emerging adulthood often entails heightened risk-taking with potential life-long consequences, and research on risk behaviors is needed to guide prevention programming, particularly in under-served and difficult to reach populations. This study evaluated the utility of Respondent Driven Sampling (RDS), a peer-driven methodology that corrects limitations of snowball sampling, to reach at-risk African American emerging adults from disadvantaged urban communities. Initial "seed" participants from the target group recruited peers, who then recruited their peers in an iterative process (110 males, 234 females; M age = 18.86 years). Structured field interviews assessed common health risk factors, including substance use, overweight/obesity, and sexual behaviors. Established gender-and age-related associations with risk factors were replicated, and sample risk profiles and prevalence estimates compared favorably with matched samples from representative U.S. national surveys. Findings supported the use of RDS as a sampling method and grassroots platform for research and prevention with community-dwelling risk groups.

Effects of parenting style and parent-related weight and diet on adolescent weight status.

PubMed

Alia, Kassandra A; Wilson, Dawn K; St George, Sara M; Schneider, Elizabeth; Kitzman-Ulrich, Heather

2013-04-01

This study examined the interaction between parental limit setting of sedentary behaviors and health factors (weight status, physical activity [PA], fruit and vegetable [FV] intake) on standardized body mass index (zBMI) in African American adolescents. Data were from 67 parent-adolescent dyads. Parental limit setting, PA and FV intake were assessed via self-report, and objective height and weight measurements were collected. Regressions examined the interaction between parental limit setting and BMI, PA, FV intake on adolescent zBMI. The model for parent BMI and FV intake accounted for 31% of the variance in adolescent zBMI. A significant interaction for parent BMI by limit setting showed that as parental BMI increased, higher (vs. lower) limit setting was associated with lower adolescent zBMI. Higher parent FV consumption was associated with lower adolescent zBMI. Future interventions should integrate parent limit setting and target parent fruit and vegetable intake for obesity prevention in underserved adolescents.

Culturally Grounded Prevention for Minority Youth Populations: A Systematic Review of the Literature

PubMed Central

Lauricella, Michela; Valdez, Jessica K.; Okamoto, Scott K.; Helm, Susana; Zaremba, Colleen

2016-01-01

Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern U.S. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the “ground up.” This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs. PMID:26733384

Culturally Grounded Prevention for Minority Youth Populations: A Systematic Review of the Literature.

PubMed

Lauricella, Michela; Valdez, Jessica K; Okamoto, Scott K; Helm, Susana; Zaremba, Colleen

2016-02-01

Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican-American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern US. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the "ground up." This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs.

Curriculum Recommendations of the AACP-PSSC Task Force on Caring for the Underserved

PubMed Central

Roche, Victoria F.; Assemi, Mitra; Conry, John M.; Shane-McWhorter, Laura; Sorensen, Todd D.

2008-01-01

A task force was convened by the American Association of Colleges of Pharmacy (AACP) and the Pharmaceutical Services Support Center (PSSC) and charged with the development of a curriculum framework to guide pharmacy programs in educating students on caring for the underserved. Utilizing a literature-based model, the task force constructed a framework that delineated evidence-based practice, clinical prevention and health promotion, health systems and policy, and community aspects of practice. Specific learning outcomes tailored to underserved populations were crafted and linked to resources readily available to the academy. The AACP-PSSC curriculum framework was shared with the academy in 2007. Schools and Colleges are urged to share experiences with implementation so that the impact of the tool can be evaluated. The task force recommends that the AACP Institutional Research Advisory Committee be involved in gathering assessment data. Implementation of the curriculum framework can help the academy fulfill the professional mandate to proactively provide the highest quality care to all, including underserved populations. PMID:18698398

School Psychologists Working with Native American Youth: Training, Competence, and Needs

ERIC Educational Resources Information Center

Robinson-Zanartu, Carol; Butler-Byrd, Nola; Cook-Morales, Valerie; Dauphinais, Paul; Charley, Elvina; Bonner, Mike

2011-01-01

Despite growing emphases on multicultural competence, Native American youth remain tremendously underserved by schools: low achievement, high dropout rates, and over-identification for special education persist. The authors analyzed responses of 403 school psychologists to a national survey regarding their competence gained in training, in current…

Libraries Online!: Microsoft Partnering with American Library Association (ALA).

ERIC Educational Resources Information Center

Machovec, George S., Ed.

1995-01-01

Describes Libraries Online, a pilot project created by Microsoft and the American Library Association to develop ways to provide access to information technologies to underserved populations. Presents the nine public libraries that will receive cash grants, staff training, computer hardware and software, and technical support to help support local…

Church and spirituality in the lives of the African American community.

PubMed

Giger, Joyce Newman; Appel, Susan J; Davidhizar, Ruth; Davis, Claudia

2008-10-01

The African American church is held in the highest esteem by most African Americans. Although the influence of the African American church has been underestimated by physicians and nurses, it could be pivotal in optimizing health status among African Americans. Because of this influence, health care practitioners, including nurses, are now recognizing the important role that the African American church plays in improving the health status of individuals in the African American community. This article illuminates the health and health care concerns of the African American community by considering the traditional lack of equal access for this population and the role that the church can play in not only offering church-based health care services but also improving the health status of church congregations. Future roles of the African American church for improved health status are also suggested.

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…

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…

Is No Child Left Behind "Wise Schooling" for African American Male Students?

ERIC Educational Resources Information Center

McMillian, M. Monique

2004-01-01

To improve achievement among African American students, education professionals must pay special attention to African American male achievement and reframe the academic achievement gap as a treatment gap. Engagement studies suggest that African American students, and African American boys in particular, are susceptible to academic disengagement.…

Exploring the Link between Self-Construal and Distress among African American and Asian American College Students

ERIC Educational Resources Information Center

Christopher, Michael S.; Skillman, Gemma D.

2009-01-01

The authors investigated ethnicity, self-construal, and distress among African American and Asian American college students. African American students expressed more salient independent self-construals, whereas Asian American students expressed more salient interdependent self-construals. As hypothesized, among African American participants,…

Intimate Partner Violence among West African Immigrants

PubMed Central

AKINSULURE-SMITH, ADEYINKA M.; CHU, TRACY; KEATLEY, EVA; RASMUSSEN, ANDREW

2013-01-01

Although the number of African immigrants arriving to the United States has increased significantly, there has been little investigation regarding their experiences of intimate partner violence or coping strategies. This study used focus groups and individual interviews to explore intimate partner violence among 32 heterosexual West African immigrants. Results suggest that although cultural expectations influence their coping strategies, West African–born men and women face different realities, with women reporting multiple instances of abuse and a sense of frustration with the existing options for assistance. Although participants discussed multilevel support structures within the immediate West African community to address intimate partner violence, all of these options maintained a gender hierarchy, leaving women dissatisfied. Challenges and barriers to partner violence resolution and coping strategies are identified. Results are examined in terms of their implications for addressing the needs of this underserved population. Implications for future research and services are discussed and highlighted. PMID:23730146

76 FR 3633 - Consumer Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

..., and outreach to underserved populations such as Native Americans and persons living in rural areas... technologies (e.g., availability of broadband, digital television, cable, satellite, low power FM, and the...

African American Culture and Heritage in Higher Education Research and Practice.

ERIC Educational Resources Information Center

Freeman, Kassie, Ed.

Fifteen papers examine the cultural context and history of African Americans in higher education research and practice. Papers are grouped in three parts: African American culture in higher education research; African American higher education research issues and paradigms; and African American culture and higher education policy and practice.…

Defense.gov Special Report: African-American History Month

Science.gov Websites

Department of Defense Submit Search African-American History Month: At the Crossroads of Freedom and Equality Links Air Force African-American History Month Special Report Naval History and Heritage Command , African American Navy Experience 2013 African American/Black History Month Tri-signed Letter Presidential

Comparison of Infant Sleep Practices in African-American and US Hispanic Families: Implications for Sleep-Related Infant Death.

PubMed

Mathews, Anita A; Joyner, Brandi L; Oden, Rosalind P; Alamo, Ines; Moon, Rachel Y

2015-06-01

African-American and Hispanic families share similar socioeconomic profiles. Hispanic rates of sleep-related infant death are four times lower than African-American rates. We conducted a cross-sectional, multi-modal (surveys, qualitative interviews) study to compare infant care practices that impact risk for sleep-related infant death in African-American and Hispanic families. We surveyed 422 African-American and 90 Hispanic mothers. Eighty-three African-American and six Hispanic mothers participated in qualitative interviews. African-American infants were more likely to be placed prone (p < 0.001), share the bed with the parent (p < 0.001), and to be exposed to smoke (p < 0.001). Hispanic women were more likely to breastfeed (p < .001), while African-American women were more knowledgeable about SIDS. Qualitative interviews indicate that, although African-American and Hispanic parents had similar concerns, behaviors differed. Although the rationale for infant care decisions was similar for African-American and Hispanic families, practices differed. This may help to explain the racial/ethnic disparity seen in sleep-related infant deaths.

Mexican-American children's perspectives: neighborhood characteristics and physical activity in Texas-Mexico border colonias.

PubMed

Mier, Nelda; Lee, Chanam; Smith, Matthew Lee; Wang, Xiaohui; Irizarry, David; Avila-Rodriguez, Elias H; Trevino, Laura; Ory, Marcia G

2013-10-01

The qualitative study described in this article investigated perceptions about environmental factors influencing physical activity (PA) among children from underserved neighborhoods known as colonias in the U.S.-Mexico border. Ten focus groups were conducted with 67 Mexican-American colonia children ages 8 to 13 living in one of the poorest border counties in the U.S. Analyses indicated that PA among children was influenced by neighborhood characteristics, including litter, speeding cars, unleashed dogs, and dark streets. The children also underlined intrapersonal and social environmental factors. Findings may inform policy makers and public health professionals about ways to promote PA among underserved children through urban planning and programs focusing on PA-supportive infrastructure, neighborhood safety, and family- and home-based physical activities.

Ethnicity-related variation in breast cancer risk factors.

PubMed

Bernstein, Leslie; Teal, Cayla R; Joslyn, Sue; Wilson, Jerome

2003-01-01

A variety of factors are predictors of breast cancer risk. However, the studies conducted to establish these risk factors have rarely included African American women. The few studies with sufficient numbers of African-American women suggest that risk factors for breast cancer among African-American women are similar to those of white women. Although risk factors may be similar for African-American and white women, differences in the prevalence of risk factors may explain the differences in patterns of incidence. The authors reviewed the epidemiologic studies of breast cancer among African-American women and identified resources with information regarding the prevalence of risk factors among African American and white women. Considerable variation exists in the studies of breast cancer risk factors among African American women. Because few studies have included sufficient numbers of African-American women, no firm conclusions can be drawn regarding whether risk estimates for African American women differ from those of white women. Estimates of the prevalence of breast cancer risk factors indicate that African American and white women differ in terms of their ages at menarche, menstrual cycle patterns, birth rates, lactation histories, patterns of oral contraceptive use, levels of obesity, frequency of menopausal hormone use, physical activity patterns, and alcohol intake. The risk factor profile of African-American women appears to differ from that of white women. This may explain in part, the higher incidence rates for African Americans before age 45 years and the lower incidence rates at older ages. Discussions of these data at a workshop highlighted the need for future research on breast cancer risk among African Americans. This research should acknowledge the heterogeneous heritage, cultural beliefs, and cultural knowledge of African-American women. Studies conducted in collaboration with the African-American community of women and with the breast cancer advocacy community can benefit from assistance in the design of questionnaires and recruitment of participants.

Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association.

PubMed

Carnethon, Mercedes R; Pu, Jia; Howard, George; Albert, Michelle A; Anderson, Cheryl A M; Bertoni, Alain G; Mujahid, Mahasin S; Palaniappan, Latha; Taylor, Herman A; Willis, Monte; Yancy, Clyde W

2017-11-21

Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines. © 2017 American Heart Association, Inc.

Engaging African American Faith-Based Organizations in Adolescent HIV Prevention.

PubMed

Woods-Jaeger, Briana A; Carlson, Mamie; Taggart, Tamara; Riggins, Linda; Lightfoot, Alexandra F; Jackson, Melvin R

2015-08-01

To reduce current HIV disparities among African American youth, it is imperative to find effective ways to extend the reach of evidence-based HIV prevention. One promising community resource to support this effort is faith-based organizations (FBOs), a credible and respected resource in the African American community. This paper describes the experiences, perceptions, and challenges that African American FBOs and faith leaders face in engaging in adolescent HIV prevention and highlights facilitators and barriers to implementing HIV prevention in African American FBOs. The findings suggest that African American FBOs and faith-based leaders are uniquely positioned to be instrumental resources in reducing African American youth HIV disparities.

Mitochondrial DNA (mtDNA) haplotypes reveal maternal population genetic affinities of Sea Island Gullah-speaking African Americans.

PubMed

McLean, David C; Spruill, Ida; Argyropoulos, George; Page, Grier P; Shriver, Mark D; Garvey, W Timothy

2005-08-01

To better understand the population substructure of African Americans living in coastal South Carolina, we used restriction site polymorphisms and an insertion/deletion in mitochondrial DNA (mtDNA) to construct seven-position haplotypes across 1,395 individuals from Sierra Leone, Africa, from U.S. European Americans, and from the New World African-derived populations of Jamaica, Gullah-speaking African Americans of the South Carolina Sea Islands (Gullahs), African Americans living in Charleston, South Carolina, and West Coast African Americans. Analyses showed a high degree of similarity within the New World African-derived populations, where haplotype frequencies and diversities were similar. Phi-statistics indicated that very little genetic differentiation has occurred within New World African-derived populations, but that there has been significant differentiation of these populations from Sierra Leoneans. Genetic distance estimates indicated a close relationship of Gullahs and Jamaicans with Sierra Leoneans, while African Americans living in Charleston and the West Coast were progressively more distantly related to the Sierra Leoneans. We observed low maternal European American admixture in the Jamaican and Gullah samples (m = 0.020 and 0.064, respectively) that increased sharply in a clinal pattern from Charleston African Americans to West Coast African Americans (m = 0.099 and 0.205, respectively). The appreciably reduced maternal European American admixture noted in the Gullah indicates that the Gullah may be uniquely situated to allow genetic epidemiology studies of complex diseases in African Americans with low European American admixture. (c) 2004 Wiley-Liss, Inc.

Obesity and African Americans

MedlinePlus

... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... youthonline . [Accessed 08/18/2017] HEALTH IMPACT OF OBESITY People who are overweight are more likely to ...

Cancer, Employment, and American Indians: A Participatory Action Research Pilot Study

ERIC Educational Resources Information Center

Johnson, Sharon R.; Finifrock, DeAnna; Marshall, Catherine A.; Jaakola, Julia; Setterquist, Janette; Burross, Heidi L.; Hodge, Felicia Schanche

2011-01-01

American Indian cancer survivors are an underserved and understudied group. In this pilot study we attempted to address, through participatory action research, missing information about those factors that serve to either facilitate employment or hinder it for adult cancer survivors. One task of the study was to develop and/or modify…

"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…

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…

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…

Investigating Instructional Practices of an African American Male Mathematics Teacher with Underachieving African American Male Students

ERIC Educational Resources Information Center

Muhammad, Rhonda K.

2012-01-01

This qualitative study examined the instructional practices of an experienced African American mathematics teacher to determine his perceived capabilities in augmenting academic proficiency for his African American male students. Provided in this descriptive case study are the lived experiences of an African American male teacher working to move…

Assessing the feasibility, acceptability, and potential effectiveness of a behavioral-automaticity focused lifestyle intervention for African Americans with metabolic syndrome: The Pick two to Stick to protocol.

PubMed

Fritz, Heather; Brody, Aaron; Levy, Philip

2017-09-01

Metabolic syndrome (MetS) significantly increases the risk of developing diabetes and cardiovascular disease. Being physically active and eating a healthy diet can reduce MetS risk factors. Too frequently, however, studies report that the effects of interventions targeting those factors are not maintained once interventions are withdrawn. A potential solution to the problem is targeting behavioral automaticity (habit-development) to aid in initiation and maintenance of health-behavior changes. The Pick two to Stick To (P2S2), is an 8-week, theory-based hybrid (face-to-face/telecoaching) habit focused lifestyle intervention designed to increase healthful physical activity and dietary behavioral automaticity. The purpose of this article is to describe the rationale and protocol for evaluating the P2S2 program's feasibility, acceptability and potential effectiveness. Using a prospective, non-comparative design, the P2S2 program will be implemented by trained occupational therapy 'coaches' to 40 African Americans aged 40 and above with MetS recruited from the emergency department. Semi-structured interviews with participants, bi-weekly research meetings with study staff, and observations of intervention delivery will provide data for a process evaluation. Estimates of effectiveness include weight, blood pressure, waist circumference, BMI, and behavioral automaticity measures that will be collected at baseline and week 20. The P2S2 program could facilitate the development of healthful dietary and physical activity habits in an underserved population. Whether interventions aimed at changing habits can feasibly influence this automaticity, particularly for high-risk, low resource communities where other barriers exist, is not known. This pilot study, therefore, will fill an important gap, providing insight to inform subsequent trials.

3 CFR 8476 - Proclamation 8476 of February 1, 2010. National African American History Month, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... African American History Month, 2010 8476 Proclamation 8476 Presidential Documents Proclamations Proclamation 8476 of February 1, 2010 Proc. 8476 National African American History Month, 2010By the President... the triumph of the American Dream. African American history is an essential thread of the American...

Treatment adherence and outcome in women with inflammatory breast cancer: does race matter?

PubMed

Andic, Fundagul; Godette, Karen; O'Regan, Ruth; Zelnak, Amelia; Liu, Tian; Rizzo, Monica; Gabram, Sheryl; Torres, Mylin

2011-12-15

The authors compared treatment adherence rates and outcome in Caucasian and African American patients with inflammatory breast cancer (IBC). The records of 55 (25 Caucasian and 30 African American) IBC patients treated with curative intent from 1995 to 2009 were reviewed. All patients received neoadjuvant doxorubicin (Adriamycin) and/or taxane-based chemotherapy, and mastectomy with or without radiotherapy. The median follow-up period for Caucasian and African American patients was similar (39.5 months and 36.1 months, respectively). There was no difference between races in median age, tumor size, grade, and receptor status at diagnosis. The number of patients who completed neoadjuvant chemotherapy, surgery, and radiotherapy did not differ by race (84% of Caucasians vs 86.7% of African Americans) nor did the median length of time to complete trimodality treatment (263 [range, 207-422] days for Caucasians vs 262 [range, 165-371] days for African Americans). There was a trend toward slightly higher pathological complete response rates in Caucasian than African American women (20% in Caucasians vs 6.7% in African Americans, P = .23). Despite slightly better response rates to neoadjuvant chemotherapy, Caucasian patients did not have higher 3-year local control rates (70% in Caucasians vs 64% in African Americans, P = .73). However, there was a trend toward higher 3-year overall survival in Caucasian versus African American patients (73% in Caucasians vs 55% in African Americans, P = .09) and higher distant metastasis-free survival (60% in Caucasians vs 40% in African Americans, P = .19). This study is among the largest to examine patients with IBC by race. Being Caucasian or African American did not appear to impact treatment adherence. However, African American patients tended to have poorer response to standard treatment and worse outcome than Caucasian patients. Copyright © 2011 American Cancer Society.

Mental Health and African Americans

MedlinePlus

... than Non-Hispanic whites. The death rate from suicide for African American men was more than four ... for African American women, in 2014. However, the suicide rate for African Americans is 70% lower than ...

Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial.

PubMed

Joseph, Rodney P; Keller, Colleen; Adams, Marc A; Ainsworth, Barbara E

2015-03-27

African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women. Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction. All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = -74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = -34 minutes/week) in comparison to PI participants (all P's < .05). No between group differences for accelerometer measured moderate-to-vigorous intensity physical activity were observed (P > .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P < .001) and social support from family for physical activity (P = .044). Satisfaction with the FI was also high: 100% reported physical activity-related knowledge gains and 100% would recommend the program to a friend. A culturally-relevant Facebook and text message delivered physical activity program was associated with several positive outcomes, including decreased sedentary behavior, increased light- and moderate-lifestyle intensity physical activity, enhanced psychosocial outcomes, and high participant satisfaction. Future studies with larger samples are warranted to further explore the efficacy of technology-based approaches to promote physical activity among African American women. ClinicalTrials.gov NCT02372565 . Registered 25 February 2015.

African American Women’s Preparation for Childbirth From the Perspective of African American Health-Care Providers

PubMed Central

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. PMID:22211059

Race and Residential Mobility: Individual Determinants and Structural Constraints.

ERIC Educational Resources Information Center

South, Scott J.; Deane, Glenn D.

1993-01-01

In 1979-80, residential mobility was lower among African Americans than non-African Americans after adjusting for differences in home ownership and sociodemographic characteristics. Both African-American and non-African-American mobility were influenced by life-cycle factors, housing characteristics, and metropolitan features, but African-American…

School and Peer Influences on the Academic Outcomes of African American Adolescents

PubMed Central

Estrada-Martinez, Lorena; Colin, Rosa J.; Jones, Brittni D.

2015-01-01

Little scholarship explores how adolescents’ beliefs about school and peers influence the academic outcomes of African American boys and girls. The sample included 612 African American boys (N=307, Mage=16.84) and girls (N=305, Mage=16.79). Latent class analysis (LCA) revealed unique patterns for African American boys and girls. Findings indicate that for African American boys, school attachment was protective, despite having peers who endorsed negative achievement values. Furthermore, socio-economic (SES) status was associated with higher grade point averages (GPA) for African American girls. Overall, these findings underscore the unique role of school, peer, and gendered experiences in lives of African American adolescents. PMID:26277404

The Influence of the African American Father on Level of Self-Efficacy, Career Achievement, and Aspirations of His African American Daughter

ERIC Educational Resources Information Center

Stewart, April E.

2014-01-01

The purpose of this correlational study was to investigate the influence of perceived and desired paternal involvement of the African American father on his African American daughter. The research problem is how father involvement may influence self-efficacy, career achievements, and aspirations of African American females. This study sought to…

Measuring Type 2 Diabetes Mellitus Knowledge and Perceptions of Risk in Middle-Class African Americans

ERIC Educational Resources Information Center

Spears, Erica C.; Guidry, Jeffrey J.; Harvey, Idethia S.

2018-01-01

There is a paucity in the literature examining the African American middle-class. Most studies of African Americans and Type 2 Diabetes Mellitus (T2DM) have concentrated on lower-SES individuals, or make no distinction between African Americans of varying socio-economic positions. Middle-class African Americans are vulnerable in ways often…

African American and European American Mothers’ Beliefs about Negative Emotions and Emotion Socialization Practices

PubMed Central

Nelson, Jackie A.; Leerkes, Esther M.; O’Brien, Marion; Calkins, Susan D.; Marcovitch, Stuart

2012-01-01

SYNOPSIS Objective Mothers’ beliefs about their children’s negative emotions and their emotion socialization practices were examined. Design Sixty-five African American and 137 European American mothers of 5-year-old children reported their beliefs and typical responses to children’s negative emotions, and mothers’ emotion teaching practices were observed. Results African American mothers reported that the display of negative emotions was less acceptable than European American mothers, and African American mothers of boys perceived the most negative social consequences for the display of negative emotions. African American mothers reported fewer supportive responses to children’s negative emotions than European Americans and more nonsupportive responses to children’s anger. African American mothers of boys also reported more nonsupportive responses to submissive negative emotions than African American mothers of girls. However, no differences were found by ethnicity or child gender in observed teaching about emotions. Group differences in mothers’ responses to negative emotions were explained, in part, by mothers’ beliefs about emotions. Conclusions Differences in beliefs and practices may reflect African American mothers’ efforts to protect their children from discrimination. PMID:22639552

Gender-Based Salary Differences in African American Senior Student Affairs Officers.

ERIC Educational Resources Information Center

Reason, Robert D.

2003-01-01

Study examined representation and salary differences related to gender for African American Senior Student Affairs Officers (SSAOs). Data from a national survey revealed gender and institutional size significantly affect mean SSAO salary for African American respondents. African American women SSAOs make significantly less than African American…

A Decade of Experience With Renal Transplantation in African-Americans

PubMed Central

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

2002-01-01

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 and 96.8% and 90.4% for African-Americans. One- and 5-year graft survival rates were 95.1% and 89.1% for non-African-Americans and 93.1% and 82.9% for African-Americans. One- and 4-year patient survival rates for cadaver donor kidneys were 91.4% and 78.7% for non-African-Americans and 92.4% and 80.2% for African-Americans. One- and 5-year graft survival rates for cadaver kidneys were 84.6% and 73.7% for non-African-Americans and 84.6% and 68.9% for African-Americans. One- and 5-year graft and patient survival rates were identical for recipients of hepatitis C virus-positive and anti-HBc positive donors, with the exception of a trend to late graft loss in the African-American hepatitis C virus group due to higher rates of noncompliance, an effect that disappears with censoring of graft loss from that cause. The cadaveric renal transplant median waiting time for non-African-Americans was 391 days compared to 734 days nationally; the waiting time for African-Americans was 647 days compared to 1,335 days nationally. When looking at all patients, living and cadaver donor, the median waiting times are 220 days for non-African-Americans and 462 days for African-Americans. Conclusions Programs specifically oriented to improve volunteerism in African-Americans have led to a marked improvement in overall waiting time and in rates of living donation in this patient group. The median waiting times to cadaveric renal transplantation were also significantly shorter in the authors’ center, especially for African-American patients, by taking advantage of the higher rates of hepatitis C infection and encouraging hepatitis B vaccination. These policies can markedly improve end-stage renal disease care for African-Americans by halving the overall waiting time while still achieving comparable graft and patient survival rates. PMID:12454518

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 and 96.8% and 90.4% for African-Americans. One- and 5-year graft survival rates were 95.1% and 89.1% for non-African-Americans and 93.1% and 82.9% for African-Americans. One- and 4-year patient survival rates for cadaver donor kidneys were 91.4% and 78.7% for non-African-Americans and 92.4% and 80.2% for African-Americans. One- and 5-year graft survival rates for cadaver kidneys were 84.6% and 73.7% for non-African-Americans and 84.6% and 68.9% for African-Americans. One- and 5-year graft and patient survival rates were identical for recipients of hepatitis C virus-positive and anti-HBc positive donors, with the exception of a trend to late graft loss in the African-American hepatitis C virus group due to higher rates of noncompliance, an effect that disappears with censoring of graft loss from that cause. The cadaveric renal transplant median waiting time for non-African-Americans was 391 days compared to 734 days nationally; the waiting time for African-Americans was 647 days compared to 1,335 days nationally. When looking at all patients, living and cadaver donor, the median waiting times are 220 days for non-African-Americans and 462 days for African-Americans. CONCLUSIONS Programs specifically oriented to improve volunteerism in African-Americans have led to a marked improvement in overall waiting time and in rates of living donation in this patient group. The median waiting times to cadaveric renal transplantation were also significantly shorter in the authors' center, especially for African-American patients, by taking advantage of the higher rates of hepatitis C infection and encouraging hepatitis B vaccination. These policies can markedly improve end-stage renal disease care for African-Americans by halving the overall waiting time while still achieving comparable graft and patient survival rates.

Combined Medication and CBT for Generalized Anxiety Disorder with African American Participants: Reliability and Validity of Assessments and Preliminary Outcomes

PubMed Central

Markell, Hannah M.; Newman, Michelle G.; Gallop, Robert; Gibbons, Mary Beth Connolly; Rickels, Karl; Crits-Christoph, Paul

2014-01-01

Using data from a study of combined cognitive behavioral therapy (CBT) and venlafaxine XR in the treatment of generalized anxiety disorder (GAD), the current article examines the reliability and convergent validity of scales, and preliminary outcomes, for African American compared to European American patients. Internal consistency and short-term stability coefficients for African Americans (n=42) were adequate and similar or higher compared to those found for European Americans (n=164) for standard scales used in GAD treatment research. Correlations among outcome measures among African Americans were in general not significantly different for African Americans compared to European Americans. A subset of patients with DSM-IV–diagnosed GAD (n = 24 African Americans; n = 52 European Americans) were randomly selected to be offered the option of adding 12 sessions of CBT to venlafaxine XR treatment. Of those offered CBT, 33.3% (n = 8) of the African Americans, and 32.6% (n = 17) of the European Americans accepted and attended at least one CBT treatment session. The outcomes for African Americans receiving combined treatment were not significantly different from European Americans receiving combined treatment on primary or secondary efficacy measures. PMID:24912462

Why We Must Continue to Investigate Menthol's Role in the African American Smoking Paradox.

PubMed

Alexander, Linda A; Trinidad, Dennis R; Sakuma, Kari-Lyn K; Pokhrel, Pallav; Herzog, Thaddeus A; Clanton, Mark S; Moolchan, Eric T; Fagan, Pebbles

2016-04-01

The disproportionate burden of tobacco use among African Americans is largely unexplained. The unexplained disparities, referred to as the African American smoking paradox, includes several phenomena. Despite their social disadvantage, African American youth have lower smoking prevalence rates, initiate smoking at older ages, and during adulthood, smoking rates are comparable to whites. Smoking frequency and intensity among African American youth and adults are lower compared to whites and American Indian and Alaska Natives, but tobacco-caused morbidity and mortality rates are disproportionately higher. Disease prediction models have not explained disease causal pathways in African Americans. It has been hypothesized that menthol cigarette smoking, which is disproportionately high among African Americans, may help to explain several components of the African American smoking paradox. This article provides an overview of the potential role that menthol plays in the African American smoking paradox. We also discuss the research needed to better understand this unresolved puzzle. We examined prior synthesis reports and reviewed the literature in PubMed on the menthol compound and menthol cigarette smoking in African Americans. The pharmacological and physiological effects of menthol and their interaction with biological and genetic factors may indirectly contribute to the disproportionate burden of cigarette use and diseases among African Americans. Future studies that examine taste sensitivity, the menthol compound, and their effects on smoking and chronic disease would provide valuable information on how to reduce the tobacco burden among African Americans. Our study highlights four counterintuitive observations related to the smoking risk profiles and chronic disease outcomes among African Americans. The extant literature provides strong evidence of their existence and shows that long-standing paradoxes have been largely unaffected by changes in the social environment. African Americans smoke menthols disproportionately, and menthol's role in the African American smoking paradox has not been thoroughly explored. We propose discrete hypotheses that will help to explain the phenomena and encourage researchers to empirically test menthol's role in smoking initiation, transitions to regular smoking and chronic disease outcomes in African Americans. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Disparity in the Persistence of High-Risk Human Papillomavirus Genotypes Between African American and European American Women of College Age

PubMed Central

Banister, Carolyn E.; Messersmith, Amy R.; Cai, Bo; Spiryda, Lisa B.; Glover, Saundra H.; Pirisi, Lucia; Creek, Kim E.

2015-01-01

Background. Cervical cancer incidence and mortality rates are higher in African Americans than in European Americans (white, non-Hispanic of European ancestry). The reasons for this disparity are not known. Methods. We recruited a population-based longitudinal cohort of 326 European American and 113 African American female college freshmen in Columbia, South Carolina, to compare clearance of high-risk human papillomavirus (HR-HPV) infection between ethnicities. HPV testing and typing from samples obtained for Papanicolaou testing occurred every 6 months. Results. African American participants had an increased risk of testing positive for HR-HPV, compared with European American participants, but the frequency of incident HPV infection was the same in African American and European American women. Thus, exposure to HPV could not explain the higher rate of HPV positivity among African American women. The time required for 50% of participants to clear HR-HPV infection was 601 days for African American women (n = 63) and 316 days for European American women (n = 178; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.08–2.53). African American women were more likely than European American women to have an abnormal result of a Papanicolaou test (OR, 1.58; 95% CI, 1.05–2.39). Conclusions. We propose that the longer time to clearance of HR-HPV among African American women leads to increased rates of abnormal results of Papanicolaou tests and contributes to the increased rates of cervical cancer observed in African American women. PMID:25028692

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…

Lung cancer disparities and African-Americans.

PubMed

Sin, Mo-Kyung

2017-07-01

African-Americans, as historically disadvantaged minorities, have more advanced stages of cancer when diagnosed, lower survival rates, and lower rates of accessing timely care than do Caucasians. Lung cancer incidence and mortality, in particular, are high among African-Americans. The U.S. Preventive Services Task Force recently released an evidence-based lung cancer screening technology called low-dose computerized tomography. High-risk African-Americans might benefit greatly from such screening but not many are aware of this technology. Public health nurses can play a key role in increasing awareness of the technology among African-American communities and encouraging qualified African-Americans to obtain screening. This study discusses issues with lung cancer and smoking among African-Americans, a recently released evidence-based lung cancer screening technology, and implications for public health nurses to enhance uptake of the new screening technology among high-risk African-Americans. © 2017 Wiley Periodicals, Inc.

Evaluating Academic Achievement of African-American Male Students in Relationship to African-American Male Teachers in Guilford County, North Carolina Public Schools

ERIC Educational Resources Information Center

Daniels, Byron L.

2010-01-01

The home and the public school classroom have been key environments in the African American community and have been instrumental in developing identity and encouraging academic progress. Despite this, the dropout rates of African American males in secondary grades have increased, while academic achievement scores of African American males in the…

An Investigation of African American Parents' Perception of School Leaders as It Relates to Parent Engagement and the African American Male Student

ERIC Educational Resources Information Center

Currie, Delvon Denise

2013-01-01

The purpose of this study was to investigate African American parents' perception of school leaders as it relates to parent engagement and the African American male student. Specifically, this study addressed African American parents' perceptions of the quality of their child's education and the quality of communication they received from their…

Expecting the Unexpected: a Comparative Study of African-American Women's Experiences in Science during the High School Years

NASA Astrophysics Data System (ADS)

Hanson, Sandra L.; Johnson, Elizabeth Palmer

Data from the National Educational Longitudinal Study (NELS) for the years 1988 to 1992 are used to explore the science experiences of young African-American women during the high school years. The comparison groups we use in trying to understand these experiences involve White women (for a race contrast) and African-American men (for a gender contrast). Within the context of a critical feminist perspective, it is argued that gender is constructed in a different way in White and African-American communities. Instead of expecting a disadvantage for young African-American women because of their gender and minority statuses, it is suggested that unique gender ideologies and work-family arrangements in the African-American community give these young women the resources and agency that allow them to compete with their White female counterparts and their African-American male counterparts in the science domain. Results from our analyses of the NELS data confirm these expectations. We find that on a majority of science measures, African-American women do as well as - and sometimes better than - White women and African-American men. For example, there are no differences between African-American women and men on attitudes toward science. And when compared with White women, African-American women tend to have more positive attitudes. When disadvantages appear for these young African-American women, they are more likely to be race effects then gender effects. The minimal gender effects in the science experiences of young African-Americans is in contrast to the more frequent male advantage in the White sample. A careful examination of family and individual resources shows that African-American families compensate for disadvantages on some resources (e.g., family socioeconomic status) by providing young women with an excess of other resources (e.g., unique gender ideologies, work expectations, and maternal expectations and involvement). And, unlike White parents, they sometimes provide more of these resources to their daughters than to their sons. Results do not support the popular notion that because minorities and women do less well in science African-American women will be especially disadvantaged in science. Implications of these findings are discussed.

African-American Academic Nurse Leader's Role in Persistence of African-American Baccalaureate Nursing Students

ERIC Educational Resources Information Center

Nelson, Kesha Marie

2017-01-01

African-American baccalaureate nursing students have a limited persistence to graduation. This constructivist grounded theory study was designed to generate a substantive theory, emerged from these data, that explained and provided insight the African-American academic nurse leader's role in the persistence to graduation of African-American…

African American Enrollment in Independent Schools, 1988-89. Research Notes on Education. No. 6.

ERIC Educational Resources Information Center

Institute for Independent Education, Inc., Washington, DC.

This report discusses the enrollment of African-American students in independent neighborhood schools across the country. Students in these schools constitute the second largest group of African-Americans outside the nation's public school systems. Over 52,000 African-American students are enrolled in independent schools. Data for African-American…

School Counseling for African American Adolescents: The Alfred Adler Approach

ERIC Educational Resources Information Center

Sapp, Marty

2010-01-01

This article discusses how Adlerian counseling can be used as a form of school counseling for African American adolescents. Moreover, school counseling for African American adolescents is discussed within the context of African American culture. Due to the strength-based nature of Adlerian approach, it can capitalize on African American…

Toward improved interpretation and theory building of African American male sexualities.

PubMed

Lewis, Linwood J; Kertzner, Robert M

2003-11-01

This paper examined five challenges to clear understanding of African American male sexualities: incorrect assumptions of African American homogeneity; an underemphasis on developmental change, the contexts and the meanings of sexual behaviors; and a lack of compelling theoretical grounding for African American sexualities. Critical elements for effective theorizing and research about African American sexualities (i.e. multiple levels of analysis, examination of phenomenological meaning of sexuality, measurement of dynamic/developmental change) were outlined and candidate theories within sexual science (social exchange theories, symbolic interactionism, sexual scripting theory) were analyzed in light of these elements. It is suggested that a re-orientation of sex research about African American men using these elements will result in improved understanding of African American sexualities in multiple contexts.

Psychological Misdiagnosis of African Americans.

ERIC Educational Resources Information Center

Garretson, Deborah J.

1993-01-01

Reviews historical and current problems with making accurate psychological diagnoses of African Americans. Suggests that misdiagnosis is strongly related to pathologization of African-American culture itself. Explores diagnostic process, stereotypes of African-American psychopathology, cultural differences in values and life stressors, and…

The association between global health training and underserved care: early findings from two longstanding tracks.

PubMed

Liaw, Winston; Bazemore, Andrew; Xierali, Imam; Walden, John; Diller, Phillip; Morikawa, Masahiro J

2013-04-01

Global health tracks (GHTs) improve knowledge and skills, but their impact on career plans is unclear. The objective of this analysis was to determine whether GHT participants are more likely to practice in underserved areas than nonparticipants. In this retrospective cohort study, using the 2009 American Medical Association Masterfile, we assessed the practice location of the 480 graduates from 1980--2008 of two family medicine residencies-Residency 1 and Residency 2. The outcomes of interest were the percentage of graduates in health professional shortage areas (HPSAs), medically underserved areas (MUAs), rural areas, areas of dense poverty, or any area of underservice. Thirty-seven percent of Residency 1 participants and 20% of nonparticipants practiced in HPSAs; 69% of Residency 2 participants and 55.5% of nonparticipants practiced in areas of dense poverty. All other combined and within-residency differences were not statistically significant. These findings neither confirm nor refute the results of prior surveys suggesting that global health training is associated with increased interest in underserved care. Studies involving more GHTs and complimentary methods are needed to more precisely elucidate the impact of this training.

Increasing community capacity to reduce tobacco-related health disparities in African American communities.

PubMed

Jones, Pamela R; Waters, Catherine M; Oka, Roberta K; McGhee, Eva M

2010-01-01

The purpose of this study was to understand the processes and interactions that African American tobacco control organizations use to engage African American communities in tobacco control efforts. The study used grounded theory methods to interpret participant's perspectives on tobacco control. The study sample consisted of African American tobacco control program directors from African American tobacco control organizations throughout the United States. Data collection involved 1 interview per participant using a semistructured interview at a location selected by the participant. Each interview lasted approximately 30-90 min. The results showed that organizations used specific strategies to involve African Americans in tobacco control. The tobacco control organizations built community capacity using 3 processes: developing relationships and partnerships, raising awareness, and creating collective power. Contextual, cultural processes, and historical references used by African American tobacco control organizations provide insight into how to engage African American communities in tobacco control efforts and achieve tobacco-related health parity. Public health professionals and nurses should be aware of these and other strategies that may increase the involvement of African American communities in tobacco control. © 2010 Wiley Periodicals, Inc.

Can Faith and Hospice Coexist: Is the African American Church the Key to Increased Hospice Utilization for African Americans?

PubMed

Townsend, Apollo; March, Alice L; Kimball, Jan

2017-01-01

African Americans are twice as likely as Caucasian Americans to choose aggressive hospital treatment when death is imminent. Repeat hospitalizations are traumatic for patients and drain patient and health system resources. Hospice care is a specialized alternative that vastly improves patient quality of life at end-of-life. This study was conducted to determine if hospices partnering with African American churches to disseminate hospice education materials could increase utilization of hospice services by African Americans. Members of two African American churches (N = 34) participated in focus group discussions to elicit beliefs about hospice care. Focus group transcripts were coded and comments were grouped according to theme. Six themes were identified. Lack of knowledge about hospice services and spiritual beliefs emerged as the top two contributing factors for underutilization of hospice services. Study findings support partnerships between hospices and African American churches to provide hospice education to the African American community. © The Author(s) 2015.

Clinical utility of the Rorschach with African Americans.

PubMed

Presley, G; Smith, C; Hilsenroth, M; Exner, J

2001-12-01

In this study we sought to identify Rorschach differences between African Americans and White Americans and to understand these differences within a social and cultural framework. Data from the Exner (1993) Comprehensive System normative sample (N = 700) was used to form a group of 44 African Americans and 44 White Americans matched for age, sex, education, and socioeconomic status. Twenty-three Rorschach variables were chosen a priori and group differences were analyzed. The only clinically significant difference found was that African Americans offered significantly less cooperative movement. This lower frequency of cooperative movement may suggest African Americans do not anticipate cooperative interactions with others as a routine event. This may reflect a shared feeling among African Americans that most members of our society are less likely to be sensitive to or responsive to their needs relative to others. However, the study demonstrates a striking similarity between the groups, supporting the clinical use of the Rorschach with African Americans.

Genetic Ancestry-Smoking Interactions and Lung Function in African Americans: A Cohort Study

PubMed Central

Colangelo, Laura A.; Williams, L. Keoki; Sen, Saunak; Kritchevsky, Stephen B.; Meibohm, Bernd; Galanter, Joshua; Hu, Donglei; Gignoux, Christopher R.; Liu, Yongmei; Harris, Tamara B.; Ziv, Elad; Zmuda, Joseph; Garcia, Melissa; Leak, Tennille S.; Foreman, Marilyn G.; Smith, Lewis J.; Fornage, Myriam; Liu, Kiang; Burchard, Esteban G.

2012-01-01

Background Smoking tobacco reduces lung function. African Americans have both lower lung function and decreased metabolism of tobacco smoke compared to European Americans. African ancestry is also associated with lower pulmonary function in African Americans. We aimed to determine whether African ancestry modifies the association between smoking and lung function and its rate of decline in African Americans. Methodology/Principal Findings We evaluated a prospective ongoing cohort of 1,281 African Americans participating in the Health, Aging, and Body Composition (Health ABC) Study initiated in 1997. We also examined an ongoing prospective cohort initiated in 1985 of 1,223 African Americans in the Coronary Artery Disease in Young Adults (CARDIA) Study. Pulmonary function and tobacco smoking exposure were measured at baseline and repeatedly over the follow-up period. Individual genetic ancestry proportions were estimated using ancestry informative markers selected to distinguish European and West African ancestry. African Americans with a high proportion of African ancestry had lower baseline forced expiratory volume in one second (FEV1) per pack-year of smoking (−5.7 ml FEV1/ smoking pack-year) compared with smokers with lower African ancestry (−4.6 ml in FEV1/ smoking pack-year) (interaction P value  = 0.17). Longitudinal analyses revealed a suggestive interaction between smoking, and African ancestry on the rate of FEV1 decline in Health ABC and independently replicated in CARDIA. Conclusions/Significance African American individuals with a high proportion of African ancestry are at greater risk for losing lung function while smoking. PMID:22737244

American Indian English Language Learners: Misunderstood and Under-Served

ERIC Educational Resources Information Center

Carjuzaa, Jioanna; Ruff, William G.

2016-01-01

English Language Learners (ELLs) represent the fastest growing segment of pre-K-12 students in the United States. Currently, Montana has the highest percentage of ELLs who are American Indian/Alaska Native. Although there is tremendous linguistic diversity among students, more than 80% of ELLs in the US speak Spanish as their first language. This…

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.

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.

A comparison of skin tone discrimination among African American men: 1995 and 2003

PubMed Central

Uzogara, Ekeoma E.; Lee, Hedwig; Abdou, Cleopatra M.; Jackson, James S.

2015-01-01

This study investigated perceptions of skin tone discrimination among adult African American men. Research suggests that through negative African American stereotypes, out-group members (Whites) perceive light-skinned African Americans favorably and dark-skinned African Americans unfavorably. However, it is unclear how treatment by in-group members (other African Americans) uniquely affects men. Using data from the 1995 Detroit Area Study and the 2003 National Survey of American Life, we investigated these relationships among African American men representing a wide range of socioeconomic groups. We found that African American men’s perceptions of out-group and in-group treatment, respectively, were similar across time. Light-skinned men perceived the least out-group discrimination while dark-skinned men perceived the most out-group discrimination. In appraisals of skin tone discrimination from in-group members, medium-skinned men perceived the least discrimination while both light- and dark-skinned men perceived more in-group discrimination. Additionally, men of lower social economic groups were more affected by skin tone bias than others. Future research should explore the influence of these out- and in-group experiences of skin tone discrimination on social and psychological functioning of African American men. PMID:25798076

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

Disparity in the persistence of high-risk human papillomavirus genotypes between African American and European American women of college age.

PubMed

Banister, Carolyn E; Messersmith, Amy R; Cai, Bo; Spiryda, Lisa B; Glover, Saundra H; Pirisi, Lucia; Creek, Kim E

2015-01-01

Cervical cancer incidence and mortality rates are higher in African Americans than in European Americans (white, non-Hispanic of European ancestry). The reasons for this disparity are not known. We recruited a population-based longitudinal cohort of 326 European American and 113 African American female college freshmen in Columbia, South Carolina, to compare clearance of high-risk human papillomavirus (HR-HPV) infection between ethnicities. HPV testing and typing from samples obtained for Papanicolaou testing occurred every 6 months. African American participants had an increased risk of testing positive for HR-HPV, compared with European American participants, but the frequency of incident HPV infection was the same in African American and European American women. Thus, exposure to HPV could not explain the higher rate of HPV positivity among African American women. The time required for 50% of participants to clear HR-HPV infection was 601 days for African American women (n = 63) and 316 days for European American women (n = 178; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.08-2.53). African American women were more likely than European American women to have an abnormal result of a Papanicolaou test (OR, 1.58; 95% CI, 1.05-2.39). We propose that the longer time to clearance of HR-HPV among African American women leads to increased rates of abnormal results of Papanicolaou tests and contributes to the increased rates of cervical cancer observed in African American women. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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…

Training African-American Parents for Success. An Afrocentric Parenting Guide.

ERIC Educational Resources Information Center

Hill, Marquita

Being an African-American parent in White America is an issue that becomes complicated simply by the difference in cultural values and traditions passed down to African-American families that are generally contradictory to contemporary White American culture. This guide addresses a number of issues for African-American parents in the following…

Feature Articles on African Americans in Sports Illustrated in the 1990s

ERIC Educational Resources Information Center

Angela Lumpkin

2009-01-01

This descriptive study examined whether the coverage of African Americans in the feature articles in Sports Illustrated during the 1990s was representative of their participation levels. Nearly half of the articles featured European Americans; about one-third featured African Americans. More African Americans were featured in basketball, boxing,…

Improved survival with HPV among African Americans with oropharyngeal cancer.

PubMed

Worsham, Maria J; Stephen, Josena K; Chen, Kang Mei; Mahan, Meredith; Schweitzer, Vanessa; Havard, Shaleta; Divine, George

2013-05-01

A major limitation of studies reporting a lower prevalence rate of human papilloma virus (HPV) in African American patients with oropharyngeal squamous cell cancer (OPSCC) than Caucasian Americans, with corresponding worse outcomes, was adequate representation of HPV-positive African American patients. This study examined survival outcomes in HPV-positive and HPV-negative African Americans with OPSCC. The study cohort of 121 patients with primary OPSCC had 42% African Americans. Variables of interest included age, race, gender, HPV status, stage, marital status, smoking, treatment, and date of diagnosis. Caucasian Americans are more likely to be HPV positive (OR = 3.28; P = 0.035), as are younger age (age < 50 OR = 7.14; P = 0.023 compared with age > 65) or being married (OR = 3.44; P = 0.016). HPV positivity and being unmarried were associated with being late stage (OR = 3.10; P = 0.047 and OR = 3.23; P = 0.038, respectively). HPV-negative patients had 2.7 times the risk of death as HPV-positive patients (P = 0.004). Overall, the HPV-race groups differed (log-rank P < 0.001), with significantly worse survival for HPV-negative African Americans versus (i) HPV-positive African Americans (HR = 3.44; P = 0.0012); (ii) HPV-positive Caucasian Americans (HR = 3.11; P = < 0.049); and (iii) HPV-negative Caucasian Americans (HR = 2.21; P = 0.049). HPV has a substantial impact on overall survival in African American patients with OPSCC. Among African American patients with OPSCC, HPV-positive patients had better survival than HPV negative. HPV-negative African Americans also did worse than both HPV-positive Caucasian Americans and HPV-negative Caucasian Americans. This study adds to the mounting evidence of HPV as a racially linked sexual behavior life style risk factor impacting survival outcomes for both African American and Caucasian American patients with OPSCC. ©2013 AACR.

Cultural in-group advantage: emotion recognition in African American and European American faces and voices.

PubMed

Wickline, Virginia B; Bailey, Wendy; Nowicki, Stephen

2009-03-01

The authors explored whether there were in-group advantages in emotion recognition of faces and voices by culture or geographic region. Participants were 72 African American students (33 men, 39 women), 102 European American students (30 men, 72 women), 30 African international students (16 men, 14 women), and 30 European international students (15 men, 15 women). The participants determined emotions in African American and European American faces and voices. Results showed an in-group advantage-sometimes by culture, less often by race-in recognizing facial and vocal emotional expressions. African international students were generally less accurate at interpreting American nonverbal stimuli than were European American, African American, and European international peers. Results suggest that, although partly universal, emotional expressions have subtle differences across cultures that persons must learn.

Dignifying Black Children's Lives.

ERIC Educational Resources Information Center

Hale, Janice E.

1992-01-01

Maintains that educators need to dignify the language and cognitive experiences of African-American children. Asserts that African-American culture emphasizes charismatic and stylistic uses of language. Teachers must understand African-American cultural styles if they are to create cultural continuity for African-American children who attend…

Predictors of activity level and retention among African American lay health advisors (LHAs) from The National Witness Project: Implications for the implementation and sustainability of community-based LHA programs from a longitudinal study.

PubMed

Shelton, Rachel C; Dunston, Sheba King; Leoce, Nicole; Jandorf, Lina; Thompson, Hayley S; Crookes, Danielle M; Erwin, Deborah O

2016-03-22

Lay health advisor (LHA) programs are increasingly being implemented in the USA and globally in the context of health promotion and disease prevention. LHAs are effective in addressing health disparities when used to reach medically underserved populations, with strong evidence among African American and Hispanic women. Despite their success and the evidence supporting implementation of LHA programs in community settings, there are tremendous barriers to sustaining LHA programs and little is understood about their implementation and sustainability in "real-world" settings. The purpose of this study was to (1) propose a conceptual framework to investigate factors at individual, social, and organizational levels that impact LHA activity and retention; and (2) use prospective data to investigate the individual, social, and organizational factors that predict activity level and retention among a community-based sample of African American LHAs participating in an effective, evidence-based LHA program (National Witness Project; NWP). Seventy-six LHAs were recruited from eight NWP sites across the USA. Baseline predictor data was collected from LHAs during a telephone questionnaire administered between 2010 and 2011. Outcome data on LHA participation and program activity levels were collected in the fall of 2012 from NWP program directors. Chi-square and ANOVA tests were used to identify differences between retained and completely inactive LHAs, and LHAs with high/moderate vs. low/no activity levels. Multivariable logistic regression models were conducted to identify variables that predicted LHA retention and activity levels. In multivariable models, LHAs based at sites with academic partnerships had increased odds of retention and high/moderate activity levels, even after adjusting for baseline LHA activity level. Higher religiosity among LHAs was associated with decreased odds of being highly/moderately active. LHA role clarity and self-efficacy were associated with retention and high/moderate activity in multivariable models unadjusted for baseline LHA activity level. Organizational and role-related factors are critical in influencing the retention and activity levels of LHAs. Developing and fostering partnerships with academic institutions will be important strategies to promote successful implementation and sustainability of LHA programs. Clarifying role expectations and building self-efficacy during LHA recruitment and training should be further explored to promote LHA retention and participation.

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.

Horizontal and vertical dimensions of individualism-collectivism: a comparison of African Americans and European Americans.

PubMed

Komarraju, Meera; Cokley, Kevin O

2008-10-01

The current study examined ethnic differences in horizontal and vertical dimensions of individualism and collectivism among 96 African American and 149 European American college students. Participants completed the 32-item Singelis et al. (1995) Individualism/Collectivism Scale. Multivariate analyses of variance results yielded a main effect for ethnicity, with African Americans being significantly higher on horizontal individualism and European Americans being higher on horizontal collectivism and vertical individualism. A moderated multiple regression analysis indicated that ethnicity significantly moderated the relationship between individualism and collectivism. Individualism and collectivism were significantly and positively associated among African Americans, but not associated among European Americans. In addition, collectivism was related to grade point average for African Americans but not for European Americans. Contrary to the prevailing view of individualism-collectivism being unipolar, orthogonal dimensions, results provide support for individualism-collectivism to be considered as unipolar, related dimensions for African Americans.

Help-Seeking Experiences and Attitudes among African American, Asian American, and European American College Students

ERIC Educational Resources Information Center

Masuda, Akihiko; Anderson, Page L.; Twohig, Michael P.; Feinstein, Amanda B.; Chou, Ying-Yi; Wendell, Johanna W.; Stormo, Analia R.

2009-01-01

The study examined African American, Asian American, and European American college students' previous direct and indirect experiences of seeking professional psychological services and related attitudes. Survey data were collected from 254 European American, 182 African American and 82 Asian American college students. Results revealed that fewer…

Investments in blood safety improve the availability of blood to underserved areas in a sub-Saharan African country

PubMed Central

Pitman, J. P.; Wilkinson, R.; Basavaraju, S. V.; von Finckenstein, B.; Sibinga, C. Smit; Marfin, A. A.; Postma, M. J.; Mataranyika, M.; Tobias, J.; Lowrance, D. W.

2015-01-01

Background and Objectives Since 2004, several African countries, including Namibia, have received assistance from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Gains have been documented in the safety and number of collected units in these countries, but the distribution of blood has not been described. Materials and Methods Nine years of data on blood requests and issues from Namibia were stratified by region to describe temporal and spatial changes in the number and type of blood components issued to Namibian healthcare facilities nationally. Results Between 2004 and 2007 (early years of PEPFAR support) and 2008–2011 (peak years of PEPFAR support), the average number of red cell units issued annually increased by 23.5% in seven densely populated but less-developed regions in northern Namibia; by 30% in two regions with urban centres; and by 35.1% in four sparsely populated rural regions. Conclusion Investments in blood safety and a policy decision to emphasize distribution of blood to underserved regions improved blood availability in remote rural areas and increased the proportion of units distributed as components. However, disparities persist in the distribution of blood between Namibia’s urban and rural regions. PMID:26478742

Understanding the Strengths of African American Families.

ERIC Educational Resources Information Center

Littlejohn-Blake, Sheila M.; Darling, Carol Anderson

1993-01-01

Focuses on strengths of African-American families and how they function, relevant conceptual approaches, and trends and issues in studying African-American families that can facilitate understanding. A shift from studying dysfunctional families to more positive aspects can help African-American families meet societal challenges. (SLD)

Discordant Voices in the Urban Community College.

ERIC Educational Resources Information Center

Weis, Lois

1992-01-01

Describes a one-year ethnographic study of the cultural conflicts evident at an urban community college, providing quotes from interviews that explain tensions between African-American and white students, between African-American students and African-American faculty, and between African-American men and women. (DMM)

Inclusion of African American Students in Mathematics Classrooms: Issues of Style, Curriculum, and Expectations.

ERIC Educational Resources Information Center

Rowser, Jacqueline Frazier; Koontz, Trish Yourst

1995-01-01

Attempts to help teachers reflect on classroom practices to encourage more participation in mathematics by all students, especially African Americans. Discusses learning styles of African Americans, culture-fair curriculum, and teacher expectations of African Americans. (14 references) (MKR)

DefenseLink Feature:

Science.gov Websites

Center, Wilberforce, Ohio. Celebrating African American History University Helps DoD Celebrate African -American History University Helps DoD Celebrate African-American History FAYETTEVILLE, N.C., Feb. 29, 2008 Carolina, hosted the Defense Department's 2008 African-American History Month outreach and observance

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,…

The Hidden Side of Zero Tolerance Policies: The African American Perspective

PubMed Central

Bell, Charles

2015-01-01

Several papers have documented the disproportionate representation of African Americans in school discipline and incarceration settings as a result of zero tolerance policies. In 2009, a federal study of the Chicago Public School system found African American boys represented 23 percent of the school age population, 44 percent of students who were suspended, and 61 percent of students who were expelled within the 2007 school year. Twenty years after the implementation of the Anti-Drug Abuse Acts of 1986 and 1988, studies show African Americans comprised a startling 74 percent of those incarcerated for drug offenses despite being only 15 percent of America’s drug users. Despite overwhelming evidence that suggests African Americans are adversely affected by zero tolerance policies, African American perceptions of zero tolerance policies remain relatively hidden in the literature. The current review seeks to explore a seemingly bidirectional process that involves how zero tolerance impacts African Americans and how African Americans perceive zero tolerance policies. PMID:25893006

Urban poverty and infant-health disparities among African Americans and whites in Milwaukee.

PubMed

Sims, Mario; Rainge, Yolanda

2002-06-01

This study examined neighborhood and infant health disparities between African-American and white mothers in Milwaukee, Wisconsin. Census-block data were used for 1990 and Vital Statistics data were used for 1992 through 1994. African-American mothers lived in less desirable, more segregated neighborhoods than white mothers did in 1990. African-American infant and neonatal mortality rates were twice those of whites (2.3 and 2.0, respectively), while African-American postneonatal mortality rates were three times that of whites (3.0). African-American low and very low birth weight rates were more than twice those of whites (2.5 and 2.6, respectively). All African-American mothers were nearly eight times as likely as all white mothers to have inadequate prenatal care, whereas poor African-American mothers were three times as likely to have inadequate prenatal care as were poor white mothers. Public health experts and practitioners may want to consider the communities of minority patients to devise interventions suitable for addressing health disparities.

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.

Leveraging community-academic partnerships to improve healthy food access in an urban, Kansas City, Kansas, community.

PubMed

Mabachi, Natabhona M; Kimminau, Kim S

2012-01-01

Americans can combat overweight (OW) and obesity by eating unprocessed, fresh foods. However, all Americans do not have equal access to these recommended foods. Low-income, minority, urban neighborhoods in particular often have limited access to healthy resources, although they are vulnerable to higher levels of OW and obesity. This project used community-based participatory research (CBPR) principles to investigate the food needs of residents and develop a business plan to improve access to healthy food options in an urban, Kansas City, Kansas, neighborhood. Partner community organizations were mobilized to conduct a Community Food Assessment survey. The surveys were accompanied by flyers that were part of the communication engagement strategy. Statistical analysis of the surveys was conducted. We engaged low-income, minority population (40% Latino, 30% African American) urban communities at the household level. Survey results provided in-depth information about residents' food needs and thoughts on how to improve food access. Results were reported to community members at a town hall style meeting. Developing a strategic plan to engage a community and develop trust is crucial to sustaining a partnership particularly when working with underserved communities. This project demonstrates that, if well managed, the benefits of academic and community partnerships outweigh the challenges thus such relationships should be encouraged and supported by communities, academic institutions, local and national government, and funders. A CBPR approach to understanding an urban community's food needs and opinions is important for comprehensive food access planning.

Defining Genomic Changes in Triple-Negative Breast Cancer in Women of African Descent

DTIC Science & Technology

2012-06-01

Triple negative breast cancer • Ethnic disparities • Breast cancer amongst African Americans and Africans • Gene expression profiling • Array... negative cases seen in both African and African - American breast cancer cases. Gene Expression Array Studies The 31 triple negative Kijabe... African - American Adjacent Normal Breast Tissue PI: Pegram &

Defining Genomic Changes in Triple Negative Breast Cancer in Women of African Descent

DTIC Science & Technology

2013-07-01

Triple negative breast cancer , Ethnic disparities, Breast cancer amongst African - Americans and Africans , Gene expression... Americans . Adjacent Normal AA Native African TN BC Tissue Figure 1. Gene Expression Pattern of Native African Triple Negative Breast Cancer ...and African - American Adjacent Normal Breast Tissue Genes PI: Pegram & Baumbach

Defining Genomic Changes in Triple-Negative Breast Cancer in Women of African Descent

DTIC Science & Technology

2012-06-01

African and African - American breast cancer cases. Gene Expression Array Studies The 31 triple negative Kijabe samples were... American Adjacent Normal Breast Tissue PI: Pegram & Baumbach Defining Genomic Changes in Triple Negative Breast Cancer in Women of African ...Tissues from African - American and East African Patients with Triple Negative Breast

Interracial and Intra-Racial Stereotypes and Constructive Memory in 7- and 9-Year-Old African-American Children

ERIC Educational Resources Information Center

Williams, Tangela L.; Davidson, Denise

2009-01-01

Across several measures, the interracial and intra-racial views of 7- and 9-year-old African-American children were examined. Overall, children showed more negative views toward other African-Americans, labeling pictures of African-American children with more negative adjectives than pictures of European-American children. Children displayed more…

Racial differences in predictors of college women's body image attitudes.

PubMed

Harris, S M

1994-01-01

African-American and Euro-American women from three predominantly Euro-American colleges in the southeast U.S. between 17 and 23 years of age completed instruments assessing body image attitudes, social competence, sex-role attitudes, racial identity, and a measure of family and personal characteristics. Analyses revealed race differences on all body image measures with the exception of appearance evaluation which was influenced by family income and race. Specifically, African-American women reported more satisfaction with and positive feelings towards their bodies and less dissatisfaction than Euro-American women. Unlike Euro-Americans, African-American women attached importance to fitness and health. The relationship between personal/physical factors and body image was stronger for African-American than Euro-American women. Additionally, personal/physical characteristics were the best model of appearance evaluation for African-American women, whereas personal/physical and sociodemographic factors best predicted this measure for Euro-American women. The results are discussed in relation to body image norms and standards of the African-American subculture and middle-class, Euro-American mainstream culture.

Violent Behaviors, Weapon Carrying, and Firearm Homicide Trends in African American Adolescents, 2001-2015.

PubMed

Khubchandani, Jagdish; Price, James H

2018-04-07

African American youths have the highest risk for firearm and other weapon related homicides. This study utilized the national Youth Risk Behavior Surveys from 2001 to 2015 to assess trends in violence related behaviors and weapon carrying of African American adolescents. Our analyses found statistically significant reductions in physical fighting and weapon carrying among African American male adolescents from 2007 to 2015. Planning suicide increased in both male and female African American adolescents since 2007. In addition, the number of firearm homicides increased in African American males. African American females and males had groups of items highly predictive of weapon carrying behaviors: alcohol, tobacco, and other drug use and violent risk behaviors. Both female and male students who made mostly A's or B's in school were significantly less likely to carry weapons in and out of school. Our findings indicate that firearm homicides have increased in African American adolescents, but weapon carrying in school going adolescents has significantly declined. School engagement and satisfactory school performance seems to have a significant protective effect on firearm homicides and violent behavior risks in African American adolescents.

Communication Development and Disorders in African American Children: Research, Assessment, and Intervention.

ERIC Educational Resources Information Center

Kamhi, Alan G., Ed.; And Others

The collection of papers on language development and African-American children includes: "The Challenges of Conducting Language Research with African American Children" (Holly K. Craig); "Issues in Recruiting African American Participants for Research" (Joyce L. Harris); "Issues in Assessing the Language Abilities of…

DefenseLink Special: African Americans in the Military

Science.gov Websites

Related Links * Timeline * 2007 Presidential Proclamation * White House: African American History History Month * African-Americans and the U.S. Navy * A Historic Context for the African-American Military UN Ambassador Young Praises Military's Inclusiveness * Life and History of the "Buffalo Soldiers

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…

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…

Lower kidney allograft survival in African-Americans compared to Hispanic-Americans with lupus.

PubMed

Gonzalez-Suarez, M L; Contreras, G

2017-10-01

Background and objective African-Americans and Hispanic-Americans with lupus are the two most common minority groups who receive kidney transplants in the USA. It is unknown if African-Americans and Hispanic-Americans with lupus have similar outcomes after kidney transplantation. In this study, we assessed whether African-Americans compared to Hispanic-Americans have worse kidney allograft survival after risk factors of rejection and other prognostic factors were matched between both groups. Methods Out of 1816 African-Americans and 901 Hispanic-Americans with lupus, who received kidney transplants between 1987 and 2006 and had complete records in the UNOS program, 478 pairs were matched in 16 baseline predictors and follow-up time employing a predicted probability of group membership. The primary outcome was kidney allograft survival. Main secondary outcomes were rejection, allograft failure attributed to rejection, and mortality. Results Matched pairs were predominantly women (81%) with the mean age of 36 years. 96% were on dialysis before transplantation. 89% of recipients received kidneys from deceased donors and 15.5% from expanded criteria donors. 12% of recipients had zero HLA mismatch. African-Americans compared to Hispanic-Americans had lower cumulative allograft survival during 12-year follow-up ( p < 0.001). African-Americans compared to Hispanic-Americans had higher rates of rejection (10.4 vs 6.73 events/100 patients-years; p = 0.0002) and allograft failure attributed to rejection (6.31 vs 3.99; p = 0.0023). However, African-Americans and Hispanic-Americans had similar mortality rates (2.71 vs 2.31; p = 0.4269). Conclusions African-Americans compared to Hispanic-Americans with lupus had lower kidney allograft survival when recognized risk factors of rejection were matched between groups.

Cultural variation in the social organization of problem solving among African American and European American siblings.

PubMed

Budak, Daniel; Chavajay, Pablo

2012-07-01

This study examined the social organization of a problem-solving task among 15 African American and 15 European American sibling pairs. The 30 sibling pairs between the ages of 6 and 12 were video recorded constructing a marble track together during a home visit. African American siblings were observed to collaborate more often than European American siblings who were more likely to divide up the labor and direct each other in constructing the marble track. In addition, older European American siblings made more proposals of step plans than older African American siblings. The findings provide insights into the cultural basis of the social organization of problem solving across African American and European American siblings.

Ophthalmic presentation of giant cell arteritis in African-Americans

PubMed Central

Garrity, S T; Pistilli, M; Vaphiades, M S; Richards, N Q; Subramanian, P S; Rosa, P R; Lam, B L; Osborne, B J; Liu, G T; Duncan, K E; Shin, R K; Volpe, N J; Shindler, K S; Lee, M S; Moster, M L; Tracey, E H; Cuprill-Nilson, S E; Tamhankar, M A

2017-01-01

Purpose To determine the differences in the presentation of ophthalmic giant cell arteritis between African-Americans and Caucasians. Methods This was a multicenter retrospective case series comparing African-American patients with ophthalmic GCA to a previously published Caucasian cohort. Neuro-ophthalmic centers across the United States were contacted to provide data on African-American patients with biopsy-proven ophthalmic giant cell arteritis. The differences between African-American and Caucasian patients with respect to multiple variables, including age, sex, systemic and ophthalmic signs and symptoms, ocular ischemic lesions, and laboratory results were studied. Results The Caucasian cohort was slightly older (mean=76.1 years) than the African-American cohort (mean=72.6 years, P=0.03), and there was no difference in sex distribution between the two cohorts. Headache, neck pain, and anemia were more frequent, while jaw claudication was less frequent in African-Americans (P<0.01, <0.001, 0.02, and 0.03 respectively). Acute vision loss was the most common presentation of giant cell arteritis in both groups, though it was less common in African-Americans (78 vs 98% of Caucasians, P<0.001). Eye pain was more common in African-Americans (28 vs 8% of Caucasians, P<0.01). Conclusions The presenting features of ophthalmic giant cell arteritis in African-Americans and Caucasians are not markedly different, although a few significant differences exist, including higher rates of headache, neck pain, anemia, and eye pain, and lower rates of jaw claudication and acute vision loss in African-Americans. Persons presenting with suspicious signs and symptoms should undergo evaluation for giant cell arteritis regardless of race. PMID:27636230

Outcomes in African Americans and whites after percutaneous coronary intervention.

PubMed

Chen, Michael S; Bhatt, Deepak L; Chew, Derek P; Moliterno, David J; Ellis, Stephen G; Topol, Eric J

2005-09-01

We aimed to determine whether African Americans and whites have different outcomes after percutaneous coronary intervention (PCI). We prospectively selected 8832 patients (707 African Americans) for long-term follow-up after PCI at our institution from 1992 to 2002. The primary outcome studied was death or myocardial infarction at 1 year. Propensity adjustment was performed to account for baseline differences between African Americans and whites. African Americans had higher rates of diabetes and less prior revascularization. Percutaneous coronary interventions in African Americans were more often urgent. Stent use was similar. Procedural success rates were similar, as were periprocedural and 30-day composite rates of death or myocardial infarction. In 1-year unadjusted outcomes, African Americans had a higher rate of death or myocardial infarction (18.0% vs 14.5%; hazard ratio (HR) = 1.25; 95% confidence interval (CI): 1.04 to 1.50; P = 0.017), but the difference was no longer significant after propensity adjustment (HR = 1.18; 95% CI: 0.98 to 1.43, P = 0.087). African Americans had a higher risk for periprocedural bleeding that persisted after propensity adjustment (adjusted odds ratio = 1.45; 95% CI: 1.14 to 1.84, P = 0.002). After PCI, African Americans have similar short-term rates of death or myocardial infarction when compared with whites but have a nonsignificant trend toward worse long-term outcomes. Our findings, when interpreted in the context of reportedly lower revascularization rates among African Americans, suggest that continued efforts to optimize the appropriate use of coronary revascularization among African Americans are warranted.

The Tuskegee Study of Untreated Syphilis and public perceptions of biomedical research: a focus group study.

PubMed

Bates, Benjamin R; Harris, Tina M

2004-08-01

African Americans are less likely than European Americans to participate in biomedical research. Researchers often attribute nonparticipation to the "Tuskegee effect." Using critical qualitative analysis of focus group data, we examined the public's use of the Tuskegee Study of Untreated Syphilis (TSUS) to discuss biomedical research. Our participants articulated three primary themes in relation to TSUS: 1) that TSUS made them suspicious about biomedical research; 2) that other values had to weigh against concerns about TSUS; and 3) that African Americans could take steps to resolve their concerns about TSUS. African Americans were more likely to discuss TSUS than were European Americans. African Americans did not use TSUS to express simple fear. African Americans suggested issues other than TSUS that influence the decision to participate in research. African Americans indicated specific reforms that would increase participation in research. We discuss how a better understanding of African Americans' use of TSUS can enhance research participation and allay concerns about "another Tuskegee."

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…

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…

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.…

The Education of African-Americans.

ERIC Educational Resources Information Center

Willie, Charles V., Ed.; And Others

The 17 papers in this volume are products of a study group on the education of African Americans that was part of a national project, "The Assessment of the Status of African-Americans." The volume takes a comprehensive look at the education of African Americans, specifically early childhood through postsecondary education, and relevant…

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…

Who Will Teach African American Youth?

ERIC Educational Resources Information Center

Gill, Wali

Disparities between Whites and African Americans exist in many areas in U.S. society. These disparities are exacerbated by social ills, including the Persian Gulf conflict. Positive change on the part of African American educators is required to combat these problems. The following four postulates for teaching African American youth are provided:…

Mentoring and Professional Identity Development for African American Female Doctoral Students: An Exploratory Study

ERIC Educational Resources Information Center

Curry, Nettavia Doreen

2011-01-01

This dissertation examines the impact mentoring relationships, between African American women doctoral students and faculty members, has on the students' professional identity development. Of particular interest is an examination of whether matched mentoring relationships between African American women doctoral students and African American female…

The HBCU Experience: Liberating or Not?

ERIC Educational Resources Information Center

Kennedy, Joy L.

2012-01-01

While African American women routinely outnumber African American men on the historically Black college and university (HBCU) campus, the African American woman's voice is usually relegated to the margins within social and academic frameworks. The author seeks to gain a deeper understanding of the actual liberation of African American women on…

Emotional and Behavioral Functioning of Offspring of African American Mothers with Depression

ERIC Educational Resources Information Center

Boyd, Rhonda C.; Diamond, Guy S.; Ten Have, Thomas R.

2011-01-01

Extensive research demonstrates the negative impact of maternal depression on their offspring. Unfortunately, few studies have been explored in African American families. This study examined emotional and behavioral functioning among children of African American mothers with depression. African American mothers (n = 63), with a past year diagnosis…

Early Head Start and African American Families: Impacts and Mechanisms of Child Outcomes

ERIC Educational Resources Information Center

Harden, Brenda Jones; Sandstrom, Heather; Chazan-Cohen, Rachel

2012-01-01

Persistent disparities exist between African American children and their European American counterparts across developmental domains. Early childhood intervention may serve to promote more positive outcomes among African American children. The current study examined whether and how the Early Head Start (EHS) program benefited African American…

Aspects of the Student Engagement of African American Men in Community College

ERIC Educational Resources Information Center

Romney, Paulette B.

2012-01-01

High attrition rates of African American college students' is a continuing concern of higher education administrators. This is particularly true of African American men attending community college. African American men consistently experience low levels of scholastic achievement as a result of entering college underprepared, with academic deficits…

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…

Teachers' Attitudes toward African American Vernacular English: A Quantitative Correlational Study

ERIC Educational Resources Information Center

Daily, Danny L., Jr.

2017-01-01

African Americans students, who use African American Vernacular English (AAVE) in the academic setting, receive negative misconceptions by English educators. Negative teacher attitudes might cause African American students to lack commitment to learning. The purpose of this quantitative correlational study was to examine whether English teachers…

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…

African Americans: College Majors and Earnings. Fact Sheet

ERIC Educational Resources Information Center

Carnevale, Anthony P.; Fasules, Megan L.; Porter, Andrea; Landis-Santos Jennifer

2016-01-01

Access to college for African Americans has increased, but African Americans are highly concentrated in lower-paying majors. The college major, which has critical economic consequences throughout life, reflects personal choices but also reflects the fact that African-American students are concentrated in open-access four-year institutions that…

Links Between Remembered Childhood Emotion Socialization and Adult Adjustment: Similarities and Differences Between European American and African American Women

PubMed Central

Leerkes, Esther M.; Supple, Andrew J.; Su, Jinni; Cavanaugh, Alyson M.

2017-01-01

The purpose of this paper was to examine whether recollections of mothers’ emotion socialization practices during childhood are linked to adult emotional well-being as indexed by depression, trait anger, and cardiac vagal tone, and whether these effects vary for African American and European American women. Participants included 251 women (128 European American; 123 African American) who ranged in age from 18 to 44 years (M = 25 years). Multigroup confirmatory factor analyses indicated strong measurement and factor invariance across African American and European American participants. Remembered non-supportive emotion socialization was linked with elevated depressive symptoms for European American women, but not African American women and with elevated trait anger for both groups. Remembered supportive emotion socialization was linked with higher resting vagal tone for both groups. The results provide some support for the view that non-supportive emotion socialization may be more detrimental for European Americans than African Americans. PMID:29527083

Perceptions of Climate and Student-Faculty Interactions amongst African American Persisters in a Business Program at a Predominantly-White Institution

ERIC Educational Resources Information Center

Allen, Monica E.

2017-01-01

While representation of African American students in freshmen enrollment has improved, degree attainment of African Americans and other minority groups continue to lag behind the White and Asian American populations. Compounding the issue of lower attainment is the issue of degree major. African American students are highly concentrated in…

Exceptional but Not an Exception: Understanding How African American Women Make Their Way

ERIC Educational Resources Information Center

White, Ebony E.

2017-01-01

Success in the US has been defined in White American terms (Katz 1985; Mangino, 2014), which may not reflect the values of African American women. The goal of this study was to provide practitioners (e.g., counselors, educators, researchers) with a perspective of African American women from their standpoint. African American women who were raised…

Genetic Heterogeneity in Colorectal Cancer Associations in Americans of African vs. European Descent

PubMed Central

Kupfer, Sonia S.; Anderson, Jeffrey R.; Hooker, Stanley; Skol, Andrew; Kittles, Rick A.; Keku, Temitope O.; Sandler, Robert S.; Ellis, Nathan A.

2013-01-01

Background & Aims Genome-wide association studies of colorectal cancer (CRC) have identified risk variants in 10 genomic regions. None of these studies included African Americans, who have the highest incidence and mortality from CRC in the US. For the 10 genomic regions, we performed an association study of Americans of African and European descent. Methods We genotyped 22 single nucleotide polymorphisms (SNPs) in DNA samples from 1194 patients with CRC (795 African Americans and 399 European Americans) and 1352 controls (985 African Americans and 367 European Americans). At chromosome 8q24.21 region 3, we analyzed 6 SNPs from 1000 African American cases and 1393 controls. Association testing was done using multivariate logistic regression controlling for ancestry, age, and sex. Results Sizes and directions of association for all SNPs tested in European Americans were consistent with previously published studies, but for 9 of 22 SNPs tested in African Americans, they were of an opposite direction. Among African Americans, the SNP rs6983267 at 8q24.21 was not associated with CRC (odds ratio [OR]=1.18; P=0.12); instead, the 8q24.21 SNP rs7014346 (OR=1.15; p=0.03) was associated with CRC in this population. At 15q13.3, rs10318 was associated with CRC in both populations. At 10p14, the opposite allele of rs10795668 was associated with CRC in African Americans (OR=1.35; P=0.04). At 11q23.1, rs3802842 was significantly associated with rectal cancer risk only among African Americans (OR 1.34; P=0.01); this observation was made in previous studies. Among European Americans, SNPs at 8q24.21, 11q23.1, and 16q22.1 were associated with CRC, in agreement with previous reports. Conclusion There is genetic heterogeneity in CRC associations in Americans of African vs. European descent. PMID:20659471

Race, Serum Potassium, and Associations With ESRD and Mortality.

PubMed

Chen, Yan; Sang, Yingying; Ballew, Shoshana H; Tin, Adrienne; Chang, Alex R; Matsushita, Kunihiro; Coresh, Josef; Kalantar-Zadeh, Kamyar; Molnar, Miklos Z; Grams, Morgan E

2017-08-01

Recent studies suggest that potassium levels may differ by race. The basis for these differences and whether associations between potassium levels and adverse outcomes differ by race are unknown. Observational study. Associations between race and potassium level and the interaction of race and potassium level with outcomes were investigated in the Racial and Cardiovascular Risk Anomalies in Chronic Kidney Disease (RCAV) Study, a cohort of US veterans (N=2,662,462). Associations between African ancestry and potassium level were investigated in African Americans in the Atherosclerosis Risk in Communities (ARIC) Study (N=3,450). Race (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis. Potassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis. The RCAV cohort was 18% African American (N=470,985). Potassium levels on average were 0.162mmol/L lower in African Americans compared with non-African Americans, with differences persisting after adjustment for demographics, comorbid conditions, and potassium-altering medication use. In the ARIC Study, higher African ancestry was related to lower potassium levels (-0.027mmol/L per each 10% African ancestry). In both race groups, higher and lower potassium levels were associated with mortality. Compared to potassium level of 4.2mmol/L, mortality risk associated with lower potassium levels was lower in African Americans versus non-African Americans, whereas mortality risk associated with higher levels was slightly greater. Risk relationships between potassium and end-stage renal disease were weaker, with no difference by race. No data for potassium intake. African Americans had slightly lower serum potassium levels than non-African Americans. Consistent associations between potassium levels and percent African ancestry may suggest a genetic component to these differences. Higher and lower serum potassium levels were associated with mortality in both racial groups. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Involving American Indians and medically underserved rural populations in cancer clinical trials.

PubMed

Guadagnolo, B Ashleigh; Petereit, Daniel G; Helbig, Petra; Koop, David; Kussman, Patricia; Fox Dunn, Emily; Patnaik, Asha

2009-12-01

To assess cancer clinical trial recruitment and reasons for nonaccrual among a rural, medically underserved population served by a community-based cancer care center. We prospectively tracked clinical trial enrollment incidence among all new patients presenting at the Rapid City Regional Cancer Care Institute. Evaluating physicians completed questionnaires for each patient regarding clinical trial enrollment status and primary reasons for nonenrollment. Patients who identified as American Indian were referred to a program where patients were assisted in navigating the medical system by trained, culturally competent staff. Between September 2006 and January 2008, 891 new cancer patients were evaluated. Seventy-eight patients (9%; 95% confidence intervals, 7-11%) were enrolled on a clinical treatment trial. For 73% (95% confidence intervals, 69-75%) of patients (646 of 891) lack of relevant protocol availability or protocol inclusion criteria restrictiveness was the reason for nonenrollment. Only 45 (5%; 95% confidence intervals, 4-7%) patients refused enrollment on a trial. Of the 78 enrolled on a trial, 6 (8%; 95% confidence intervals, 3-16%) were American Indian. Three additional American Indian patients were enrolled under a nontreatment cancer control trial, bringing the total percentage enrolled of the 94 American Indians who presented to the clinic to 10% (95% confidence intervals, 5-17%). Eligibility rates were unable to be calculated and cross validation of the number in the cohort via registries or ICD-9 codes was not performed. Clinical trial participation in this medically underserved population was low overall, but approximately 3-fold higher than reported national accrual rates. Lack of availability of protocols for common cancer sites as well as stringent protocol inclusion criteria were the primary obstacles to clinical trial enrollment. Targeted interventions using a Patient Navigation program were used to engage AI patients and may have resulted in higher clinical trial enrollment among this racial/ethnic group.

Involving American Indians and medically underserved rural populations in cancer clinical trials

PubMed Central

Guadagnolo, B Ashleigh; Petereit, Daniel G; Helbig, Petra; Koop, David; Kussman, Patricia; Dunn, Emily Fox; Patnaik, Asha

2010-01-01

Purpose To assess cancer clinical trial recruitment and reasons for nonaccrual among a rural, medically underserved population served by a community-based cancer care center. Methods We prospectively tracked clinical trial enrollment incidence among all new patients presenting at the Rapid City Regional Cancer Care Institute. Evaluating physicians completed questionnaires for each patient regarding clinical trial enrollment status and primary reasons for nonenrollment. Patients who identified as American Indian were referred to a program where patients were assisted in navigating the medical system by trained, culturally competent staff. Results Between September 2006 and January 2008, 891 new cancer patients were evaluated. Seventy-eight patients (9%; 95% confidence intervals, 7–11%) were enrolled on a clinical treatment trial. For 73% (95% confidence intervals, 69–75%) of patients (646 of 891) lack of relevant protocol availability or protocol inclusion criteria restrictiveness was the reason for nonenrollment. Only 45 (5%; 95% confidence intervals, 4–7%) patients refused enrollment on a trial. Of the 78 enrolled on a trial, 6 (8%; 95% confidence intervals, 3–16%) were American Indian. Three additional American Indian patients were enrolled under a nontreatment cancer control trial, bringing the total percentage enrolled of the 94 American Indians who presented to the clinic to 10% (95% confidence intervals, 5–17%). Limitations Eligibility rates were unable to be calculated and cross validation of the number in the cohort via registries or ICD-9 codes was not performed. Conclusion Clinical trial participation in this medically underserved population was low overall, but approximately 3-fold higher than reported national accrual rates. Lack of availability of protocols for common cancer sites as well as stringent protocol inclusion criteria were the primary obstacles to clinical trial enrollment. Targeted interventions using a Patient Navigation program were used to engage AI patients and may have resulted in higher clinical trial enrollment among this racial/ethnic group. PMID:19933720

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 to a national norm, comprised of students of all races, showed no significant differences. The attitudes that African American middle school students have toward science are influenced by science professionals (role models), their parents, and their teachers. This correlates directly with the high preference for Parent Motivated and Teacher Motivated learning style preferences.

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 ...

Differences in the Manifest Dream Content of Anglo-American, Mexican-American, and African-American College Women.

ERIC Educational Resources Information Center

Kane, Connie M.

1994-01-01

Compares African Americans' manifest dream content with dreams of Anglo-American and Mexican American peers. Some dream elements that were examined included emotions, environmental press, achievement outcomes, and social interactions. Comparisons indicate that African Americans perceive themselves more strongly as victims of their fate rather than…

Tuskegee as Sacred Rhetoric: Focal Point for the Emergent Field of African American Religion and Health.

PubMed

Laws, Terri

2018-02-01

Scholars in African American religion engage the Tuskegee Syphilis Study as the focal point of the African American experience in institutional medicine. Seeking a way forward from this history and its intentional evil, the author proposes to position Tuskegee as a form of Lynch's culturally contextual sacred rhetoric to make use of its metaphoric value in the emerging field of African American religion and health. In this broader meaning-making frame, Tuskegee serves as a reminder that African American religious sensibility has long been an agential resource that counters abuse of the Black body. It also acknowledges the complex decisions facing African American clinical trial participants.

African American and Black Caribbean Feelings of Closeness to Africans

PubMed Central

Thornton, Michael C.; Taylor, Robert Joseph; Chatters, Linda M.; Forsythe-Brown, Ivy

2016-01-01

African American and Black Caribbean relations dominate research on interactions across black ethnic divides. Using National Survey of American Life data, we explore a different aspect of black interethnic attitudes: how close these groups feel toward Africans. African Americans and Black Caribbeans were largely similar in their feelings of closeness to Africans. For Black Caribbeans, younger and male respondents, those reporting higher levels of financial strain, living in the northeast and persons who immigrated to the United States at least 11 years ago, report feeling especially close to Africans. Being male was the only significant correlate among African Americans. The findings are discussed in relation to how race, ethnicity and national origin shape personal identities within the U.S. and their significance for intergroup perceptions. These broader issues warrant further consideration in light of assertions that race as a defining feature of American life and intergroup relations is obsolete. PMID:28943747

Liver transplantation outcomes among Caucasians, Asian Americans, and African Americans with hepatitis B.

PubMed

Bzowej, Natalie; Han, Steven; Degertekin, Bulent; Keeffe, Emmet B; Emre, Sukru; Brown, Robert; Reddy, Rajender; Lok, Anna S

2009-09-01

Several previous studies found that Asians transplanted for hepatitis B virus (HBV) infection had worse post-transplant outcomes than Caucasians. Data on post-transplant outcomes of African Americans and waitlist outcomes of Asian Americans and African Americans with hepatitis B are scant. The aim of this study was to compare waitlist and post-transplant outcomes among Asian Americans, African Americans, and Caucasians who had HBV-related liver disease. Data from a retrospective-prospective study on liver transplantation for HBV infection were analyzed. A total of 274 patients (116 Caucasians, 135 Asians, and 23 African Americans) from 15 centers in the United States were enrolled. African Americans were younger and more Asian Americans had hepatocellular carcinoma (HCC) at the time of liver transplant listing. The probability of undergoing transplantation and the probability of survival on the waitlist were comparable in the 3 racial groups. Of the 170 patients transplanted, 19 died during a median follow-up of 31 months. The probability of post-transplant survival at 5 years was 94% for African Americans, 85% for Asian Americans, and 89% for Caucasians (P = 0.93). HCC recurrence was the only predictor of post-transplant survival, and recurrence rates were similar in the 3 racial groups. Caucasians had a higher rate of HBV recurrence: 4-year recurrence was 19% versus 7% and 6% for Asian Americans and African Americans, respectively (P = 0.043). In conclusion, we found similar waitlist and post-transplant outcomes among Caucasians, Asian Americans, and African Americans with hepatitis B. Our finding of a higher rate of HBV recurrence among Caucasians needs to be validated in other studies. (c) 2009 AASLD.

Undiagnosed depression and its correlates in a predominantly immigrant Hispanic neurology clinic.

PubMed

Sahai-Srivastava, Soma; Zheng, Ling

2011-10-01

Previous studies have reported a high incidence of depression in neurology clinics, however areas where there are predominantly underserved immigrants have not been studied. Retrospective cohort study in an academic outpatient neurology clinic in Los Angeles, California. Newly referred patients (N=318) were assessed consecutively for depression using a PHQ-9 questionnaire, accompanied by review of the assessment of the depressive disorder. The patient cohort consisted of 190 females (59%) and 130 males (41%), primarily of Hispanic descent (72%), with 8% Asian 11% white, and 5% African-American. Sixty-eight percent (68%) had depression, with 40% exhibiting moderate to severe depression. Patients who had moderate to severe depression (based on PHQ-9) were more likely to be unemployed (75.2% vs. 60.7%, p=0.008), dependent on government income (29.5% vs. 20.4%, p=0.06), and have headache or pain as the reason for referral (42.4% vs. 28.5%, p=0.03). Severity of depression also significantly correlated with current treatment by psychiatrist, current antidepressant use, and less independent living. Patients with moderate to severe depression were more likely to have made ER visits in the last 12 months (0.9 vs. 0.7, p=0.01) and were taking more medications (3.3 vs. 2.5, p=0.03), compared to patient with mild or no depression. The presence of moderate to severe depression significantly correlated with socioeconomic status, use of emergency room, and presence of headache/pain. Neurology clinics with predominantly underserved immigrant patients have a disproportionate amount of depression, which may be related to socioeconomic factors resulting in overutilization of scarce healthcare resources. Copyright © 2011 Elsevier B.V. All rights reserved.

Self-care and mothering in African American women with HIV/AIDS.

PubMed

Shambley-Ebron, Donna Z; Boyle, Joyceen S

2006-02-01

African American women are the most rapidly growing group of people in the United States diagnosed with HIV/AIDS. The purpose of this study was to explore experiences of self-care and mothering among African American women with HIV/AIDS. It is important to recognize how culture affects illness management, childrearing, and daily living to design culturally appropriate nursing interventions for African American women. Critical ethnography was used to study 10 African American mothers from the rural Southeast who were HIV positive and mothered children who were HIV positive. Domains derived from the research were disabling relationships, strong mothering, and redefining self-care. The cultural theme was creating a life of meaning. African American mothers with HIV/AIDS in the rural Southeast used culturally specific self-care and mothering strategies reflective of cultural traditions. This study acknowledges strengths of African American women and generates theory that will enhance nursing care to this population.

Practice recommendations for pain assessment by self-report with African American older adults.

PubMed

Booker, Staja Star; Pasero, Chris; Herr, Keela A

2015-01-01

Despite decades of education and clinical practice guidelines underscoring disparities in pain management, pain continues to be inadequately managed in older African American adults as a result of patient, provider, and systems factors. Critical factors influencing pain assessment in older African American adults has not been extensively examined, contributing to a lack of data to inform health care providers' knowledge on culturally-responsive pain assessment in older African Americans. Assessing pain in older African Americans is unique because differences in language, cultural beliefs, and practices moderate how they report and express pain. This paper presents an overview of patient-provider factors that affect pain assessment in older African Americans with a focus on this population's unique cultural beliefs and practices. Recommendations for best practices for performance of a culturally-responsive pain assessment with older African Americans are provided. Copyright © 2015 Elsevier Inc. All rights reserved.

Biogeographic Ancestry, Self-Identified Race, and Admixture-Phenotype Associations in the Heart SCORE Study

PubMed Central

Halder, Indrani; Kip, Kevin E.; Mulukutla, Suresh R.; Aiyer, Aryan N.; Marroquin, Oscar C.; Huggins, Gordon S.; Reis, Steven E.

2012-01-01

Large epidemiologic studies examining differences in cardiovascular disease (CVD) risk factor profiles between European Americans and African Americans have exclusively used self-identified race (SIR) to classify individuals. Recent genetic epidemiology studies of some CVD risk factors have suggested that biogeographic ancestry (BGA) may be a better predictor of CVD risk than SIR. This hypothesis was investigated in 464 African Americans and 771 European Americans enrolled in the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) Study in March and April 2010. Individual West African and European BGA were ascertained by means of a panel of 1,595 genetic ancestry informative markers. Individual BGA varied significantly among African Americans and to a lesser extent among European Americans. In the total cohort, BGA was not found to be a better predictor of CVD risk factors than SIR. Both measures predicted differences in the presence of the metabolic syndrome, waist circumference, triglycerides, body mass index, very low density lipoprotein cholesterol, lipoprotein A, and systolic and diastolic blood pressure between European Americans and African Americans. These results suggest that for most nongenetic cardiovascular epidemiology studies, SIR is sufficient for predicting CVD risk factor differences between European Americans and African Americans. However, higher body mass index and diastolic blood pressure were significantly associated with West African BGA among African Americans, suggesting that BGA should be considered in genetic cardiovascular epidemiology studies carried out among African Americans. PMID:22771727

A Phenomenological Study: African-American Males in the Educational Profession

ERIC Educational Resources Information Center

Williams, Kristopher

2012-01-01

This phenomenological research study explored the perceptions and lived experiences of African-American male teachers related to the underrepresentation of African-American males in the teaching profession. The study was guided by four research questions. The data was collected from 15 African-American male teachers at the elementary school level,…

Pedagogies of Experience: A Case of the African American Male Teacher

ERIC Educational Resources Information Center

Brown, Anthony L.

2011-01-01

Numerous scholars have illustrated how African American teachers' past experiences provide them a philosophical vision committed to teaching for social and educational change for African American students. This article draws from this body of work by looking at the diverse ways five African American male teachers used their past experiences to…

Performance of African American Preschool and Kindergarten Students on the Expressive Vocabulary Test

ERIC Educational Resources Information Center

Thomas-Tate, Shurita; Washington, Julie; Craig, Holly; Packard, Mary

2006-01-01

Purpose: To examine the validity of the Expressive Vocabulary Test (EVT; K. Williams, 1997) for assessing the expressive vocabulary skills of African American students. Method/Results: One hundred sixty-five African American preschool and kindergarten students were administered the EVT. The mean EVT score for these African American students was…

Retaining African Americans in Higher Education: Challenging Paradigms for Retaining Students, Faculty and Administrators.

ERIC Educational Resources Information Center

Jones, Lee, Ed.

This collection discusses some of the issues surrounding the retention of African Americans in higher education, and it challenges traditional paradigms for retaining African American students, administrators, and faculty at predominantly White colleges. The chapters of part 1, "Retaining African-American Students," are: (1) "Creating an Affirming…

Exploring How African American Faculty Cope with Classroom Racial Stressors

ERIC Educational Resources Information Center

Pittman, Chavella T.

2010-01-01

This study was an examination of how African American faculty discussed their coping with racially stressful classrooms. Despite aims for racial equality in higher education, the classroom has been a significant site of racial stressors for African American facility. Analysis of interviews with 16 (8 women, 8 men) African American faculty at a…

African American and Latino Men's Recommendations for an Improved Campus Environment

ERIC Educational Resources Information Center

Cerezo, Alison; Lyda, James; Enriquez, Alma; Beristianos, Matthew; Connor, Michael

2015-01-01

The purpose of this study was to share findings from semistructured qualitative interviews with 9 African American and 12 Latino men about their ideas on how university personnel could better support their needs. Stressing the need for African American men to learn self-reliance to counter microaggressions, African American participants offered…

Defense.gov Special Report: African American History Month

Science.gov Websites

Department of Defense Submit Search During National African-American History Month, we celebrate the rich In honor of African-American History Month, Fred Moore, the first African-American Tomb Guard history a year later. Story Longest Serving Airman Also Longest in DOD The Air Force's longest serving

Positionality of African Americans and a Theoretical Accommodation of It: Rethinking Science Education Research

ERIC Educational Resources Information Center

Parsons, Eileen R. Carlton

2008-01-01

This essay addresses a call for research involving African Americans to interpret data from the historical, contemporary, and cultural experiences of African Americans. The essay argues for a science education research approach that explicitly considers the positionality of African Americans in the United States. This positionality involves the…

Young African American Male-Male Relationships: Experiences, Expectations, and Condom Use

ERIC Educational Resources Information Center

Taggart, Tamara; Ellen, Jonathan; Arrington-Sanders, Renata

2017-01-01

HIV disproportionately impacts young African American men who have sex with men (MSM). In this study, we sought to understand how previous relationship experiences and expectations for romantic relationships influence condom use among young African American MSM. Twenty African American MSM aged 16 to 24 years completed a semi-structured interview…

Black Lives Matter: Teaching African American Literature and the Struggle

ERIC Educational Resources Information Center

Gross, Jeffrey

2016-01-01

In theorizing how we should pedagogically approach African American literature, especially in courses for undergraduates, I argue that we have to move away from questions of what was or even what is African American literature and, instead, find ways to teach African American literature in both its historical contexts--artistic and political--and…

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…

'Rise 'n' Shine: Catholic Education and the African-American Community.

ERIC Educational Resources Information Center

Chineworth, Mary Alice, Ed.

African-Americans have been present in Catholic schools since their beginnings in the United States. The six essays in this book examine Catholic education from the perspective of the African-American Catholic. The essays underscore the continued challenge for continuing Catholic schools in the African-American community. They include: (1) an…

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…

African-American Males' Health Perceptions and Knowledge

ERIC Educational Resources Information Center

McNeal, CoSandra; Perkins, Isaac; Lyons, Shenia

2006-01-01

Research on African American men's health is limited. Perception and knowledge of health may have a significant effect on health seeking behavior and self care. This study was designed to examine factors that may influence health perception and knowledge among African American males. This is a cross-sectional study of 343 African American males…

African American Single Mothers Raising Sons: Implications for Family Therapy

ERIC Educational Resources Information Center

Gantt, Ann L.; Greif, Geoffrey L.

2009-01-01

Being raised by a single mother is one factor that has been suggested as contributing to the plight of African American males. Yet few studies have focused specifically on African American single mothers' experiences with raising sons. This qualitative study explored the following questions: (1) What are the experiences of African American single…

Predictors and Correlates of Academic Performance among Urban African American Adolescents

ERIC Educational Resources Information Center

Nebbitt, Von E.; Lombe, Margaret; LaPoint, Velma; Bryant, Dawn

2009-01-01

The academic performance of urban African American students continues to be a major concern. Academic achievement has been the main avenue to upward social mobility for African Americans. This study assesses the effect of attitudes, behavior, peers, and family on the academic performance of African American students living in urban public housing…

The All White World of Children's Books & African American Children's Literature.

ERIC Educational Resources Information Center

Osa, Osayimwense, Ed.

The essays in this collection explore African American children's literature and the view it provides of the African American community. Of particular interest is the relationship between African American folktales and those of subSaharan Africa. The following essays are included: (1) "The All-White World of Children's Books" (Nancy…

Addressing Reading Underachievement in African American Boys through a Multi-Contextual Approach

ERIC Educational Resources Information Center

Husband, Terry

2012-01-01

Much has been written about reading disparities between African American males and other student groups. Interestingly, the majority of this scholarship focuses on African American males at preadolescent states of development and beyond. To date, relatively little has been documented relative to improving reading outcomes in African American males…

Kinship Care: The African American Response to Family Preservation.

ERIC Educational Resources Information Center

Scannapieco, Maria; Jackson, Sondra

1996-01-01

Discusses increased kinship care as a resilient response by the African American community. Strengths and resilience of the African American family can be attributed in part to a strong kinship network. In this manner, the African American community is preserving the family. Concludes this community needs support through imaginative social work…

Increasing Reading Engagement in African American Boys

ERIC Educational Resources Information Center

Husband, Terry

2014-01-01

Much has been written concerning the challenges many teachers face in engaging African American males in reading practices. While much of this extant scholarship focuses on African American males at the pre-adolescent stage of development and beyond, little has been written regarding increasing reading engagement in African American boys in P-5…

Depression over the adult life course for African American men: toward a framework for research and practice.

PubMed

Watkins, Daphne C

2012-05-01

Rarely are within-group differences among African American men explored in the context of mental health and well-being. Though current conceptual and empirical studies on depression among African American men exists, these studies do not offer a framework that considers how this disorder manifests over the adult life course for African American men. The purpose of this article is to examine the use of an adult life course perspective in understanding the complexity of depression for African American men. The proposed framework underscores six social determinants of depression (socioeconomic status, stressors, racial and masculine identity, kinship and social support, self-esteem and mastery, and access to quality health care) to initiate dialogue about the risk and protective factors that initiate, prolong, and exacerbate depression for African American men. The framework presented here is meant to stimulate discussion about the social determinants that influence depression for African American men to and through adulthood. Implications for the utility and applicability of the framework for researchers and health professionals who work with African American men are discussed.

The African American Women and Mass Media campaign: a CDC breast cancer screening project.

PubMed

Hall, Ingrid J; Rim, Sun Hee; Johnson-Turbes, C Ashani; Vanderpool, Robin; Kamalu, Ngozi N

2012-11-01

For decades, black radio has reached African American communities with relevant, culturally appropriate information, and it continues to be an ideal communication channel to use for contemporary health promotion. In an effort to combat excess breast cancer mortality rates and help eliminate cancer disparities among low-income African American women, the Centers for Disease Control and Prevention's (CDC) Division of Cancer Prevention and Control designed, implemented, and evaluated the African American Women and Mass Media (AAMM) pilot campaign. The AAMM campaign uses black radio, radio stations with broad African American listenership, as a platform for targeted, culturally competent health promotion and outreach to low-income, African American women. The AAMM campaign uses radio advertisements and print materials disseminated in predominantly African American neighborhoods to promote awareness of breast cancer, early detection, and the CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Evaluation of the AAMM campaign found that the campaign successfully reached its target audience of low-income, African American women and increased women's awareness of breast cancer screening services through the Breast and Cervical Cancer Program in Savannah and Macon, Georgia.

Depression Over the Adult Life Course for African American Men: Toward a Framework for Research and Practice

PubMed Central

Watkins, Daphne C.

2014-01-01

Rarely are within-group differences among African American men explored in the context of mental health and well-being. Though current conceptual and empirical studies on depression among African American men exists, these studies do not offer a framework that considers how this disorder manifests over the adult life course for African American men. The purpose of this article is to examine the use of an adult life course perspective in understanding the complexity of depression for African American men. The proposed framework underscores six social determinants of depression (socioeconomic status, stressors, racial and masculine identity, kinship and social support, self-esteem and mastery, and access to quality health care) to initiate dialogue about the risk and protective factors that initiate, prolong, and exacerbate depression for African American men. The framework presented here is meant to stimulate discussion about the social determinants that influence depression for African American men to and through adulthood. Implications for the utility and applicability of the framework for researchers and health professionals who work with African American men are discussed. PMID:22105067

Differential effects of the classroom on African American and non-African American's mathematics achievement.

PubMed

Schenke, Katerina; Nguyen, Tutrang; Watts, Tyler W; Sarama, Julie H; Clements, Douglas H

2017-08-01

We examined whether African American students differentially responded to dimensions of the observed classroom-learning environment compared with non-African American students. Further, we examined whether these dimensions of the classroom mediated treatment effects of a preschool mathematics intervention targeted at students from low-income families. Three observed dimensions of the classroom (teacher expectations and developmental appropriateness; teacher confidence and enthusiasm; and support for mathematical discourse) were evaluated in a sample of 1,238 preschool students in 101 classrooms. Using multigroup multilevel mediation where African American students were compared to non-African American students, we found that teachers in the intervention condition had higher ratings on the observed dimensions of the classroom compared with teachers in the control condition. Further, ratings on teacher expectations and developmental appropriateness had larger associations with the achievement of African American students than for non-African Americans. Findings suggest that students within the same classroom may react differently to that learning environment and that classroom learning environments could be structured in ways that are beneficial for students who need the most support.

A CLINICAL AND SEROLOGIC COMPARISON OF AFRICAN-AMERICAN AND CAUCASIAN PATIENTS WITH SYSTEMIC SCLEROSIS

PubMed Central

Steen, Virginia; Domsic, Robyn T.; Lucas, Mary; Fertig, Noreen; Medsger, Thomas A.

2013-01-01

Objective Epidemiology studies suggest that Systemic Sclerosis is more common, occurs at a younger age and is more severe in African-Americans than Caucasians. However, the scleroderma autoantibody profile is very different between these two ethnic subgroups. This study examines the demographic and disease features, frequency and severity of internal organ system involvement and survival in African-American and Caucasian SSc patients with particular attention to their serum autoantibody profiles. Methods Demographic, clinical, autoantibody, natural history of organ involvement and survival were studied in consecutive African-American and Caucasian patients seen between 1972 and 2007 as part of the Pittsburgh Scleroderma Database. The Medsger Disease Severity Scale was used to determine severe disease. Results African-American patients were more likely to have anti topoisomerase, anti U1RNP and U3 RNP auto-antibodies. Comparing African-American and Caucasians with these antibodies, African-American patients with anti topoisomerase antibody had more frequent and more severe pulmonary fibrosis than Caucasians and an associated decreased survival. Pulmonary fibrosis was also more severe in the U1 RNP patients but was not associated with a difference in survival between African Americans and Caucasians. Anti U3 RNP was associated with more severe gastrointestinal involvement in African-American’s compared to Caucasians. Conclusions African Americans with systemic sclerosis have more severe disease complications than Caucasians both because of the type of autoantibody they have and because they have more severe interstitial lung disease even within the antibody subset. Early aggressive intervention in all African Americans with interstitial lung disease should be a priority. PMID:22576620

Cradle to third life: An autobiography of an African-American science educator

NASA Astrophysics Data System (ADS)

Caruthers-Jackson, Sarah

This inquiry used reflective autobiographical research to reveal my beliefs, values, and practices of science teaching by using participatory action research with two students of my science tutoring organization. Also, I conducted an ethnographic inquiry using African-American teachers to understand how my early schooling experiences influenced my beliefs, values, and science practices. I collected data for this inquiry from three African-American teachers through interview-conversation that were videotaped and audiotaped. In addition, I audiotaped two African-American students' tutoring practices along with students' and researcher's journals. The findings indicate that African-American teachers during the school years 1942-1954 used families, churches, and communities to secure teaching resources to provide equal education for their African-American students who received limited resources from the board of education. Also indicated was how African-American teachers instilled in their African-American students a level of motivation that remained with some African-American students for their future endeavors. This researcher's beliefs/values similar to those of her segregated teachers emerged from this action research. Researcher's additional beliefs/values arose out of emerging technologies in teaching science. However, I, as the researcher, believe that the origin of my beliefs/values occurred during those segregated, public school experiences at Monitor Schools during the school years 1942-1954.

Impact of Supplemental Site Grants to Increase African-American Accrual for SELECT

PubMed Central

Cook, Elise D.; Arnold, Kathryn B.; Hermos, John A.; McCaskill-Stevens, Worta; Moody-Thomas, Sarah; Probstfield, Jeffrey L.; Hamilton, Sandra J.; Campbell, Russell D.; Anderson, Karen B.; Minasian, Lori M.

2014-01-01

Background Low rates of minority recruitment in prevention studies may reduce the generalizability of study results to minority populations, including African Americans. High African American accrual to prevention studies requires additional resources and focused efforts. Objective To analyze the impact of Minority Recruitment Enhancement Grants (MREGs) on African American recruitment to the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Results Fifteen of 427 SELECT sites received MREGs after they demonstrated early success in minority recruitment. After receiving the grants, the average monthly rate of African American recruitment at these sites increased from 27.2% to 31.5%, and total average monthly recruitment also increased. Sites that did not receive grants, including sites that did not apply, increased average monthly African American recruitment from 11.0% to 14.6% but declined in total average monthly recruitment. Conclusions and Implications Sites who received MREGs modestly increased both the proportion of African American recruits and total recruits. These results are tempered by the high cost of the intervention, the relatively low number of SELECT sites that applied for the grants and the administrative delays in implementation. Nevertheless, targeted grants may be a useful multi-site intervention to increase African American accrual for a prevention study where adequate African American recruitment is essential. PMID:20156960

Pathways to health: a cluster randomized trial of nicotine gum and motivational interviewing for smoking cessation in low-income housing.

PubMed

Okuyemi, Kolawole S; James, Aimee S; Mayo, Matthew S; Nollen, Nicole; Catley, Delwyn; Choi, Won S; Ahluwalia, Jasjit S

2007-02-01

Despite high smoking rates among those living in poverty, few cessation studies are conducted in these populations. This cluster-randomized trial tested nicotine gum plus motivational interviewing (MI) for smoking cessation in 20 low-income housing developments (HDs). Intervention participants (10 HDs, n = 66) received educational materials, 8 weeks of 4 mg nicotine gum, and 5 MI sessions on quitting smoking. Comparison participants (10 HDs, n = 107) received 5 MI sessions and educational materials addressing fruit and vegetable consumption. Participants had a mean age of 46.3 years and were predominantly female (70%) and African American (83%). Biochemically-verified 7-day abstinence rates at 8 weeks were 6.1% and 5.6% in the intervention and comparison arms, respectively (p = ns); and at 26 weeks were 7.6% and 9.3%, respectively (p = ns). Results suggest that nicotine gum plus MI were not effective for smoking cessation in low-income housing. Programs are needed to enhance the effectiveness of pharmacotherapy and counseling in underserved populations.

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development.

PubMed

Joseph, Rodney P; Keller, Colleen; Affuso, Olivia; Ainsworth, Barbara E

2017-06-01

African-American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e., 57 % are obese, 49 % have cardiovascular disease). The marked health disparities among African-American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring physical activity programs to address the sociocultural norms, values, beliefs, and behaviors of African-American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African-American women and to present a conceptual framework to guide intervention development. Development of the framework was based on our previous physical activity research with African-American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African-American culture, and key determinants of physical activity engagement among African-American women. Three key concepts are discussed in the conceptual framework: (1) Developmental milestones and life stage transitions of African-American women; (2) Historical, social, and cultural influences associated with physical activity engagement; and (3) Intervention delivery strategies. Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African-American women.

Designing Culturally Relevant Physical Activity Programs for African American Women: A Framework for Intervention Development

PubMed Central

Keller, Colleen; Affuso, Oliva; Ainsworth, Barbara E.

2016-01-01

Background African American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e. 57% are obese, 49% have cardiovascular disease) The marked health disparities among African American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring PA programs to address the sociocultural norms, values, beliefs, and behaviors of African American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African American women and to present a conceptual framework to guide intervention development. Methods Development of the framework was based on our previous physical activity research with African American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African American culture, and key determinants of physical activity engagement among African American women. Results Three key concepts are discussed in the conceptual framework: 1) Developmental milestones and life stage transitions of African American women, 2) Historical, social and cultural influences associated with physical activity engagement, and 3) Intervention delivery strategies. Discussion Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African American women. PMID:27178447

African-American teen smokers: issues to consider for cessation treatment.

PubMed Central

Moolchan, E. T.; Berlin, I.; Robinson, M. L.; Cadet, J. L.

2000-01-01

Previous reports have indicated ethnic differences in both tobacco-related morbidity and treatment outcome for smoking cessation among adults. We assessed smoking-related characteristics in African-American and non-African American teenagers applying to a cessation trial. 115 teens (15.9 +/- 1.8 years, 68% females, 27% African-American) responded via telephone to media ads. Self-reported sociodemographic, medical and smoking-related data were obtained to determine pre-eligibility for a full intake screen prior to trial participation. Compared to non-African American, African American teen applicants were older (16.4 +/- 1.7 years versus 15.6 +/- 1.6; p = 0.015), had lower Fagerström Test for Nicotine Dependence (FTND) scores (5.3 +/- 2.3 versus 6.1 +/- 1.8; p = 0.018, ANOVA controlling for age) and smoked fewer cigarettes on the weekend (27 +/- 16 versus 38 +/- 17; p = 0.001). African American teens reported similar duration of smoking (3.3 +/- 1.4 versus 3.1 +/- 1.5 years) and time elapsed between first cigarette ever smoked and daily smoking (0.7 +/- 0.9 versus 0.6 +/- 0.7 years). African American and non-African American teens had similar motivation to quit scores and frequency of reported health problems (e.g., asthma, psychiatric conditions). These data suggest that cessation treatment programs designed for African American youth should include lower Fagerstrom-defined levels, and possibly other criteria for tobacco dependence. These observations also highlight the importance of ethnocultural issues in treatment research programs. PMID:11202758

Racial Disparities in Hepatitis C Treatment Eligibility.

PubMed

Sims, Omar; Pollio, David; Hong, Barry; North, Carol

2017-01-01

Hepatitis C (HCV) is more prevalent in African Americans than in any other racial group in the United States. However, African Americans are more likely to be deemed ineligible for HCV treatment than non-African Americans. There has been limited research into the origins of racial disparities in HCV treatment eligibility. The purpose of this study was to compare medical and non-medical characteristics commonly assessed in clinical practice that could potentially contribute to HCV treatment ineligibility disparities between African American and non-African American patients. Patients with confirmed HCV RNA considering treatment (n = 309) were recruited from university-affiliated and VA liver and infectious disease clinics. African Americans and non-African Americans did not differ in prevalence of lifetime and current psychiatric disorders and risky behaviors, and HCV knowledge. HCV clinical characteristics were similar between both groups in terms of HCV exposure history, number of months aware of HCV diagnosis, stage of fibrosis, and HCV virologic levels. African Americans did have higher proportions of diabetes, renal disease, and bleeding ulcer. No clinical evidence was found to indicate that African Americans should be more often deemed ineligible for HCV treatment than other racial groups. Diabetes and renal disease do not fully explain the HCV treatment ineligibility racial disparity, because HCV patients with these conditions are priority patients for HCV treatment because of their greater risk for cirrhosis, steatosis, and hepatocellular carcinoma. The findings suggest that an underlying contributor to the HCV treatment eligibility disparity disfavoring African Americans could be racial discrimination.

Barriers to treatment and culturally endorsed coping strategies among depressed African-American older adults

PubMed Central

Conner, Kyaien O.; Copeland, Valire Carr; Grote, Nancy K.; Rosen, Daniel; Albert, Steve; McMurray, Michelle L.; Reynolds, Charles F.; Brown, Charlotte; Koeske, Gary

2011-01-01

Objective Older adults are particularly vulnerable to the effects of depression, however, they are less likely to seek and engage in mental health treatment. African-American older adults are even less likely than their White counterparts to seek and engage in mental health treatment. This qualitative study examined the experience of being depressed among African-American elders and their perceptions of barriers confronted when contemplating seeking mental health services. In addition, we examined how coping strategies are utilized by African-American elders who choose not to seek professional mental health services. Method A total of 37 interviews were conducted with African-American elders endorsing at least mild symptoms of depression. Interviews were audiotaped and subsequently transcribed. Content analysis was utilized to analyze the qualitative data. Results Thematic analysis of the interviews with African-American older adults is presented within three areas: (1) Beliefs about Depression Among Older African-Americans: (2) Barriers to Seeking Treatment for Older African-Americans: and (3) Cultural Coping Strategies for Depressed African-American Older Adults. Conclusion Older African-Americans in this study identified a number of experiences living in the Black community that impacted their treatment seeking attitudes and behaviors. which led to identification and utilization of more culturally endorsed coping strategies to deal with their depression. Findings from this study provide a greater understanding of the stigma associated with having a mental illness and its influence on attitudes toward mental health services. PMID:21069603

A Phenomenological Investigation on the Role of Mentoring in the Academic Development of African American Male Secondary Students

NASA Astrophysics Data System (ADS)

Inge, Jillian

The purpose of this phenomenological study was to examine how the construct of mentoring by African American males can support the academic development of African American male students. Since African American male students perform significantly lower in academic subjects than their counterparts of other ethnicities, there is an exigent need for change in this area. Built upon the conceptual framework of communal interactions and identity, the inquiry questioned the experiences of mentors for African American male secondary students, and their perceptions of the influence of a mentoring relationship when the mentor and mentee are of similar backgrounds. Participants in this study were 7 African American males who had mentored or were currently mentoring African American male students. Data, obtained through semi structured interviews and focus group interviews, were coded for themes that reflected the experiences of mentors in mentoring African American males. Mentors in this study reported that students with whom they share similar backgrounds and experiences were better able to relate to them than those who had dissimilar backgrounds and experiences. In addition, mentors reported their mentees were more likely to envision themselves in professional areas beyond their perceived cultural norm when they routinely interact with successful African American males from various fields; thus, it was important for mentors to provide opportunities for students to interact with professionals. Contributions to social change will emerge as African American male mentors understand and employ their roles as a fundamental component in the academic development of African American male secondary students and thus empower this population of students to achieve academic success and to serve in a capacity that nurtures their immediate surroundings.

Disparities in the Population Distribution of African American and Non-Hispanic White Smokers Along the Quitting Continuum.

PubMed

Trinidad, Dennis R; Xie, Bin; Fagan, Pebbles; Pulvers, Kim; Romero, Devan R; Blanco, Lyzette; Sakuma, Kari-Lyn K

2015-12-01

To examine disparities and changes over time in the population-level distribution of smokers along a cigarette quitting continuum among African American smokers compared with non-Hispanic Whites. Secondary data analyses of the 1999, 2002, 2005, and 2008 California Tobacco Surveys (CTS). The CTS are large, random-digit-dialed, population-based surveys designed to assess changes in tobacco use in California. The number of survey respondents ranged from n = 6,744 to n = 12,876 across CTS years. Current smoking behavior (daily or nondaily smoking), number of cigarettes smoked per day, intention to quit in the next 6 months, length of most recent quit attempt among current smokers, and total length of time quit among former smokers were assessed and used to recreate the quitting continuum model. While current smoking rates were significantly higher among African Americans compared with non-Hispanic Whites across all years, cigarette consumption rates were lower among African Americans in all years. There were significant increases in the proportion of former smokers who had been quit for at least 12 months from 1999 (African Americans, 26.8% ± 5.5%; non-Hispanic Whites, 36.8% ± 1.6%) to 2008 (African Americans, 43.6% ± 4.1%; non-Hispanic Whites, 57.4% ± 2.9%). The proportion of African American former smokers in each CTS year was significantly lower than that of non-Hispanic Whites. Despite positive progression along the quitting continuum for both African American and non-Hispanic White smokers, the overall distribution was less favorable for African Americans. The lower smoking consumption levels among African Americans, combined with the lower rates of successful smoking cessation, suggest that cigarette addiction and the quitting process may be different for African American smokers. © 2015 Society for Public Health Education.

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.

Associations Between Cigarette Print Advertising and Smoking Initiation Among African Americans.

PubMed

Trinidad, Dennis R; Blanco, Lyzette; Emery, Sherry L; Fagan, Pebbles; White, Martha M; Reed, Mark B

2017-06-01

The objective of this study was to examine changes in the annual number of cigarette advertisements in magazines with a predominantly African-American audience following the broadcast ban on tobacco, and whether fluctuations in cigarette print advertising targeting African Americans during the late-1970s until the mid-1980s were associated with declines in smoking initiation. We tabulated the annual number of cigarette advertisements from magazines with large African-American readerships (Ebony, Essence, and Jet) from 1960 to 1990. Advertisements were coded depending on whether they featured African-American models. We calculated the incidence rate of regular smoking initiation from 1975 to 1990 for African-American 14-25 years old using data from the 1992-1993, 1995-1996, 1998-1999, and 2001-2002 Tobacco Use Supplements of the Current Population Survey. We examined whether trends in smoking initiation coincided with trends in cigarette advertising practices among African Americans. The annual aggregated number of printed cigarette advertisements in Ebony, Essence, and Jet magazines increased at least five-fold starting in 1971, following the broadcast ban on cigarette advertising. A decrease in the percentage of ads by Brown & Williamson that showed African-American models was positively correlated (r = 0.30) with declines in the incidence rate of smoking initiation among African Americans from the late-1970s to the mid-1980s. The tobacco industry adapted quickly following the broadcast ban on cigarettes by increasing print advertising in African-American magazines. However, changes in print advertising practices by were associated with declines in smoking initiation among African Americans from the late-1970s to mid-1980s.

What are Hospice Providers in the Carolinas Doing to Reach African Americans in Their Service Area?

PubMed Central

Payne, Richard; Kuchibhatla, Maragatha N.

2016-01-01

Abstract Background: Experts and national organizations recommend that hospices work to increase service to African Americans, a group historically underrepresented in hospice. Objective: The study objective was to describe strategies among hospices in North and South Carolina to increase service to African Americans and identify hospice characteristics associated with these efforts. Methods: The study was a cross-sectional survey using investigator-developed scales to measure frequency of community education/outreach, directed marketing, efforts to recruit African American staff, cultural sensitivity training, and goals to increase service to African Americans. We used nonparametric Wilcoxon tests to compare mean scale scores by sample characteristics. Results: Of 118 eligible hospices, 79 (67%) completed the survey. Over 80% were at least somewhat concerned about the low proportion of African Americans they served, and 78.5% had set goals to increase service to African Americans. Most were engaged in community education/outreach, with 92.4% reporting outreach to churches, 76.0% to social services organizations, 40.5% to businesses, 35.4% to civic groups, and over half to health care providers; 48.0% reported directed marketing via newspaper and 40.5% via radio. The vast majority reported efforts to recruit African American staff, most often registered nurses (63.75%). Nearly 90% offered cultural sensitivity training to staff. The frequency of strategies to increase service to African Americans did not vary by hospice characteristics, such as profit status, size, or vertical integration, but was greater among hospices that had set goals to increase service to African Americans. Conclusions: Many hospices are engaged in efforts to increase service to African Americans. Future research should determine which strategies are most effective. PMID:26840854

What are Hospice Providers in the Carolinas Doing to Reach African Americans in Their Service Area?

PubMed

Johnson, Kimberly S; Payne, Richard; Kuchibhatla, Maragatha N

2016-02-01

Experts and national organizations recommend that hospices work to increase service to African Americans, a group historically underrepresented in hospice. The study objective was to describe strategies among hospices in North and South Carolina to increase service to African Americans and identify hospice characteristics associated with these efforts. The study was a cross-sectional survey using investigator-developed scales to measure frequency of community education/outreach, directed marketing, efforts to recruit African American staff, cultural sensitivity training, and goals to increase service to African Americans. We used nonparametric Wilcoxon tests to compare mean scale scores by sample characteristics. Of 118 eligible hospices, 79 (67%) completed the survey. Over 80% were at least somewhat concerned about the low proportion of African Americans they served, and 78.5% had set goals to increase service to African Americans. Most were engaged in community education/outreach, with 92.4% reporting outreach to churches, 76.0% to social services organizations, 40.5% to businesses, 35.4% to civic groups, and over half to health care providers; 48.0% reported directed marketing via newspaper and 40.5% via radio. The vast majority reported efforts to recruit African American staff, most often registered nurses (63.75%). Nearly 90% offered cultural sensitivity training to staff. The frequency of strategies to increase service to African Americans did not vary by hospice characteristics, such as profit status, size, or vertical integration, but was greater among hospices that had set goals to increase service to African Americans. Many hospices are engaged in efforts to increase service to African Americans. Future research should determine which strategies are most effective.

Association between African American race and outcomes in patients with nonmetastatic triple-negative breast cancer: a retrospective analysis by using results from the Georgia Cancer Specialist Database.

PubMed

Christiansen, Neal; Chen, Lei; Gilmore, James; Pechar, David; Szabo, Stephen

2012-08-01

The objective of this study was to evaluate, in a real-world context, the impact of race on disease recurrence and survival in patients with nonmetastatic triple-negative breast cancer (TNBC) treated with adjuvant chemotherapy. The study selected patients from the 2003-2008 Georgia Cancer Specialist Database with stage I-III confirmed TNBC who had received adjuvant chemotherapy. These patients were followed-up from initial diagnosis to death, cancer recurrence, or loss to follow-up. The primary outcome was disease-free survival (DFS). Kaplan-Meier curves compared DFS and recurrence between African American and non-African American groups. The impact of African American status was examined further through multivariate Cox models by adjusting for age, comorbidity, body mass index (BMI), smoking status, initial TNBC stage, surgery, and radiation therapy. Among 209 patients with TNBC, 89 (42.6%) were African American. The 2 groups (African American vs. non-African American) were similar in mean age at diagnosis (53.2 vs. 54.4 years; P =.487) and with surgery and radiation rates (98.9% vs. 100%; P = .244; 68.5% vs. 62.5%; P = .365, respectively). Compared with non-African Americans, African American patients had a higher BMI (30.4 vs. 28.6 kg/m(2); P = .0477) and were less likely to be diagnosed at stage I (31.5% vs. 51.7%; P = .0107). The African American patients had a lower 5-year DFS rate (45.2% vs. 79.7%; P = .0005) and a higher 5-year recurrence rate (42.5% vs. 7.0%; P = .0005) compared with the non-African American patients. Among patients with TNBC treated with adjuvant chemotherapy, African American race was associated with a worse outcome irrespective of later stage at presentation or higher BMI. Copyright © 2012 Elsevier Inc. All rights reserved.

Perceived stress following race-based discrimination at work is associated with hypertension in African-Americans. The metro Atlanta heart disease study, 1999-2001.

PubMed

Din-Dzietham, Rebecca; Nembhard, Wendy N; Collins, Rakale; Davis, Sharon K

2004-02-01

There is increasing evidence of an association between stress related to job strain and hypertension. However little data exist on stress from racism and race-based discrimination at work (RBDW). The objective of this study was to investigate whether blood pressure (BP) outcomes are positively associated with stressful racism towards African-Americans from non-African-Americans as well as RBDW from other African-Americans. The metro Atlanta heart disease study was a population-based study which included 356 African-American men and women, aged >/=21 years, residing in metropolitan Atlanta, Georgia during 1999-2001. Perceived stress was self-reported by 197 participants for racism from non-African-Americans and 95 for RBDW from other African-Americans. Sitting systolic (SBP) and diastolic (DBP) BP were taken at a clinic visit and was the average of the last two of three BP measures. Hypertension was self-reported as physician-diagnosed high BP on 2 or more visits. Logistic and least-squares linear regression models were fit accordingly and separately for each type of stress, adjusting for age, gender, body mass index, and coping abilities. The likelihood of hypertension significantly increased with higher levels of perceived stress following racism from non-African-Americans, but not from RBDW from other African-Americans; adjusted odd ratios (95% CI) were 1.4 (1.0, 1.9) and 1.2 (0.8, 1.5) per unit increment of stress. The adjusted magnitude of SBP and DBP increase between low and very high level of stress, conversely, was greater when RBDW originated from African-Americans than racism from non-African-Americans. Stressful racism and RBDW encounters are associated with increased SBP and DBP and increased likelihood of hypertension in African-Americans. Future studies with a larger sample size are warranted to further explore these findings for mechanistic understanding and occupational policy consideration regarding stress risk reduction.

Family matters: Familial support and science identity formation for African American female STEM majors

NASA Astrophysics Data System (ADS)

Parker, Ashley Dawn

This research seeks to understand the experiences of African American female undergraduates in STEM. It investigates how familial factors and science identity formation characteristics influence persistence in STEM while considering the duality of African American women's status in society. This phenomenological study was designed using critical race feminism as the theoretical framework to answer the following questions: 1) What role does family play in the experiences of African American women undergraduate STEM majors who attended two universities in the UNC system? 2) What factors impact the formation of science identity for African American women undergraduate STEM majors who attended two universities in the UNC system? Purposive sampling was used to select the participants for this study. The researcher conducted in-depth interviews with 10 African American female undergraduate STEM major from a predominantly White and a historically Black institution with the state of North Carolina public university system. Findings suggest that African American families and science identity formation influence the STEM experiences of the African American females interviewed in this study. The following five themes emerged from the findings: (1) independence, (2) support, (3) pressure to succeed, (4) adaptations, and (5) race and gender. This study contributes to the literature on African American female students in STEM higher education. The findings of this study produced knowledge regarding policies and practices that can lead to greater academic success and persistence of African American females in higher education in general, and STEM majors in particular. Colleges and universities may benefit from the findings of this study in a way that allows them to develop and sustain programs and policies that attend to the particular concerns and needs of African American women on their campuses. Finally, this research informs both current and future African American female STEM students so that they might benefit from the knowledge of the experiences of others in STEM-related fields. As a result, other African American female students might be enlightened by these stories and have the confidence to pursue a STEM degree of their own.

The African Americanization of menthol cigarette use in the United States.

PubMed

Gardiner, Phillip S

2004-02-01

Today, over 70% of African American smokers prefer menthol cigarettes, compared with 30% of White smokers. This unique social phenomenon was principally occasioned by the tobacco industry's masterful manipulation of the burgeoning Black, urban, segregated, consumer market in the 1960s. Through the use of television and other advertising media, coupled with culturally tailored images and messages, the tobacco industry "African Americanized" menthol cigarettes. The tobacco industry successfully positioned mentholated products, especially Kool, as young, hip, new, and healthy. During the time that menthols were gaining a large market share in the African American community, the tobacco industry donated funds to African American organizations hoping to blunt the attack on their products. Many of the findings in this article are drawn from the tobacco industry documents disclosed following the Master Settlement Agreement in 1998. After a short review of the origins and growth of menthols, this article examines some key social factors that, when considered together, led to disproportionate use of mentholated cigarettes by African Americans compared with other Americans. Unfortunately, the long-term impact of the industry's practice in this community may be partly responsible for the disproportionately high tobacco-related disease and mortality among African Americans generally and African American males particularly.

Pigmentation in African American skin decreases with skin aging.

PubMed

Chien, Anna L; Suh, Jean; Cesar, Sabrina Sisto Alessi; Fischer, Alexander H; Cheng, Nancy; Poon, Flora; Rainer, Barbara; Leung, Sherry; Martin, Jo; Okoye, Ginette A; Kang, Sewon

2016-10-01

Tristimulus colorimetry, which uses the Commission Internationale de l'Eclairage L*a*b* model to quantify color, has previously been used to analyze pigmentation and erythema in human skin; however, colorimetry of African American skin is not well characterized. We sought to analyze skin color patterns in African Americans and compare them with those of Caucasians. Colorimetry readings of the sun-protected buttock and sun-exposed back of forearm were taken from 40 Caucasian and 43 African American participants from March 2011 through August 2015. African American participants also completed a lifestyle questionnaire. Correlation coefficients, paired t tests, and multivariable linear regression analyses were used for statistical comparisons. Forearm skin was lighter in African Americans ages 65 years and older versus 18 to 30 years (P = .02) but darker in Caucasians ages 65 years or older versus 18 to 30 years (P = .03). In African Americans ages 18 to 30 years, the buttock was darker than the forearm (P < .001), whereas in Caucasians the buttock was lighter than the forearm (P < .001). A lighter forearm than buttock was correlated with supplement use, smoking (ages 18-30 years), and less recreational sun exposure (ages ≥65 years) in African Americans. Our study was limited by the sample size and focal geographic source. Pigmentation patterns regarding sun-protected and sun-exposed areas in African Americans may differ from that of Caucasians, suggesting that other factors may contribute to skin pigmentation in African Americans. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Annotated Selected Bibliography & Index for Teaching African-American Learners: Culturally Responsive Pedagogy Project.

ERIC Educational Resources Information Center

Hilliard, Asa G.

This annotated bibliography and index presents nearly 2,000 references that are substantially unique to African or African American teaching and learning. Designed to support teacher education, the bibliography features references that were chosen if they were culturally relevant, recognized the African or African American experience, and drew…

The Teacher-Student Interactions and Academic Achievement of African American and African Immigrant Males

ERIC Educational Resources Information Center

Hussein, Hassen

2017-01-01

This quantitative survey questionnaires study compared the teacher-student interactions (TSI) and academic achievement of African-American and African immigrant undergraduate males. The academic achievement gap between different population groups provided the impetus for the study. While African Americans have been described as under-achievers in…

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.

APOL1 Genotype, Kidney and Cardiovascular Disease, and Death in Older Adults.

PubMed

Mukamal, Kenneth J; Tremaglio, Joseph; Friedman, David J; Ix, Joachim H; Kuller, Lewis H; Tracy, Russell P; Pollak, Martin R

2016-02-01

We sought to evaluate the cardiovascular impact of coding variants in the apolipoprotein L1 gene APOL1 that protect against trypanosome infection but have been associated with kidney disease among African Americans. As part of the Cardiovascular Health Study, a population-based cohort of Americans aged ≥65 years, we genotyped APOL1 polymorphisms rs73885319 and rs71785153 and examined kidney function, subclinical atherosclerosis, and incident cardiovascular disease and death over 13 years of follow-up among 91 African Americans with 2 risk alleles, 707 other African Americans, and 4964 white participants. The high-risk genotype with 2 risk alleles was associated with 2-fold higher levels of albuminuria and lower ankle-brachial indices but similar carotid intima-media thickness among African Americans. Median survival among high-risk African Americans was 9.9 years (95% confidence interval [CI], 8.7-11.9), compared with 13.6 years (95% CI, 12.5-14.3) among other African Americans and 13.3 years (95% CI, 13.0-13.6) among whites (P=0.03). The high-risk genotype was also associated with increased risk for incident myocardial infarction (adjusted hazard ratio 1.8; 95% CI, 1.1-3.0) and mortality (adjusted hazard ratio 1.3; 95% CI 1.0-1.7). Albuminuria and risk for myocardial infarction and mortality were nearly identical between African Americans with 0 to 1 risk alleles and whites. APOL1 genotype is associated with albuminuria, subclinical atherosclerosis, incident myocardial infarction, and mortality in older African Americans. African Americans without 2 risk alleles do not differ significantly in risk of myocardial infarction or mortality from whites. APOL1 trypanolytic variants may account for a substantial proportion of the excess risk of chronic disease in African Americans. © 2015 American Heart Association, Inc.

Mentors' Perceptions of a University-School Partnership through a Student African American Mentoring Initiative

ERIC Educational Resources Information Center

Gilman, Amanda

2014-01-01

The participants in this study were 10 African American male college mentors at Indiana State University who participated in the Indiana State University Student African American Male Mentor Program, one school counselor, and two members of the Student African American Brotherhood administration. The study examined potential benefits to mentors,…

The African American Women's Summit: A Student Affairs Professional Development Program

ERIC Educational Resources Information Center

West, Nicole M.

2017-01-01

The African American Women's Summit (AAWS) is a professional development program in the United States created by and for African American women in student affairs. This article reviews the evolution and structure of the AAWS. A discussion, grounded in Black feminist thought, is included relative to the impact of the AAWS on African American women…

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 within…

The Influence of Racism and Sexism in the Career Development of African American Women.

ERIC Educational Resources Information Center

Evans, Kathy M.; Herr, Edwin L.

1991-01-01

Combined effects of racism and sexism in the workplace subject African-American woman to more discrimination than either Black men or White women. Examines racism and sexism in employment practices and in the career development and aspirations of African-American women. Identifies coping system of African-American women who avoid career fields in…

Missed Education: An Examination of Educational Outcomes for African-American Males

ERIC Educational Resources Information Center

Greene, Mark Brandon

2013-01-01

The purpose of this body of work was to examine barriers that lead to high school non-completion for African-American males and to propose strategies to better support this group. Specifically, it examined how African-American male high school graduates vary from African-American male non-graduates. Across personal and environmental factors, this…

The potential of black radio to disseminate health messages and reduce disparities.

PubMed

Hall, Ingrid J; Johnson-Turbes, C Ashani; Williams, Kymber N

2010-07-01

Radio stations that target African American audiences ("black radio") reach a national African American audience daily, making black radio an ideal medium for health promotion and disparities reduction in the African American community. Black radio can be used to communicate public health messages and to recruit African Americans into public health research.

"Mom Made Me Do It": The Role of Family in African Americans' Decisions to Enroll in Doctoral Education

ERIC Educational Resources Information Center

McCallum, Carmen M.

2016-01-01

Large disparities exist among African Americans and other cultural groups in doctoral degree enrollment and degree attainment. To address this concern, scholars have focused on why African Americans do not pursue doctoral degrees. Although informative, this deficit perspective does not explain the factors that encourage African Americans to enroll…

African-American Stories and Literary Responses: Does a Child's Ethnicity Affect the Focus of a Response?

ERIC Educational Resources Information Center

Altieri, Jennifer L.

1993-01-01

Examines the written responses of Hispanic, African-American and Caucasian elementary students after listening to various African-American stories to see whether engagement with text is related to student's ethnicity. Finds that students were equally capable of engagement in the African-American stories regardless of their ethnicity. (RS)

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…

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…

Conceptualizing the African American Mathematics Teacher as a Key Figure in the African American Education Historical Narrative

ERIC Educational Resources Information Center

Clark, Lawrence M.; Jones Frank, Toya; Davis, Julius

2013-01-01

Background/Context: Historians and researchers have documented and explored the work and role of African American teachers in the U.S. educational system, yet there has been limited attention to the specific work, role, and experiences of African American mathematics teachers. To meaningfully and responsibly conceptualize the role of African…

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…

Crossing Over: Narratives of Successful Border Crossings of African American Teachers during Desegregation

ERIC Educational Resources Information Center

Tompkins, Renarta

2010-01-01

This study examines the narratives of three African American teachers who participated in an early desegregation plan that transferred selected African American teachers into all-White schools in the late 1960s and early 1970s. While many of these teachers experienced rejection in their new schools, the three African American teachers in this…

Cultural Orientation as a Protective Factor against Tobacco and Marijuana Smoking for African American Young Women

ERIC Educational Resources Information Center

Nasim, Aashir; Corona, Rosalie; Belgrave, Faye; Utsey, Shawn O.; Fallah, Niloofar

2007-01-01

The present study examined cultural orientation as a protective factor against tobacco and marijuana smoking for African American young women (ages 18 to 25). African American college students (N = 145) from a predominantly White university were administered subscales from the African American Acculturation Scale-Revised (AAAS-R); the shortened…

Unequal Burden of Disease, Unequal Participation in Clinical Trials: Solutions from African American and Latino Community Members

ERIC Educational Resources Information Center

Ford, Marvella E.; Siminoff, Laura A.; Pickelsimer, Elisabeth; Mainous, Arch G.; Smith, Daniel W.; Diaz, Vanessa A.; Soderstrom, Lea H.; Jefferson, Melanie S.; Tilley, Barbara C.

2013-01-01

African Americans and Latinos are underrepresented in clinical trials. The purpose of this study was to elicit solutions to participation barriers from African Americans and Latinos. Fifty-seven adults (32 African Americans, 25 Latinos) ages 50 years and older participated. The Institute of Medicine's "Unequal Treatment" conceptual framework was…

Social and Cultural Factors Influence African American Men's Medical Help Seeking

ERIC Educational Resources Information Center

Griffith, Derek M.; Allen, Julie Ober; Gunter, Katie

2011-01-01

Objective: To examine the factors that influenced African American men's medical help seeking. Method: Thematic analysis of 14 focus groups with 105 older, urban African American men. Results: African American men described normative expectations that they did not go to the doctor and that they were afraid to go, with little explanation. When they…

African-American Male Student Perceptions about Factors Related to Why Black Boys Drop out of Secondary School

ERIC Educational Resources Information Center

Edwards, Anntwanique DeVonne

2012-01-01

African-American males are overwhelmingly represented in the nation's dropout rates. Dropping out of school has serious social and economic consequences for our society. The dropout rate is overwhelmingly represented by African-American male students, but limited attention is given to student voice. This study examines African-American male…

The Meaning of African American College Women's Experiences Attending a Predominantly White Institution: A Phenomenological Study

ERIC Educational Resources Information Center

Hannon, Christine R.; Woodside, Marianne; Pollard, Brittany L.; Roman, Jorge

2016-01-01

Because both race and gender are important to the development of African American women, student affairs professionals need to understand the unique experiences of African American women within the context of the college environment. In this phenomenological study, we examined African American women's lived experiences as college students at a…

Teachers' and Parents' Perceptions of Special Education Referral for African American Students

ERIC Educational Resources Information Center

Smith-McClelland, Darlene

2017-01-01

Patterns of representation of African Americans in K-12 special education programs vary across the United States. A school district in Arizona has a 13% African American population, yet the African American special education representation is 17%. The purpose of this grounded theory study was to generate an understanding of the processes related…

A Tale of Two Classes: The Black Poor and the Black Middle Class.

ERIC Educational Resources Information Center

Lewin, Arthur

1991-01-01

To understand the African-American family, the African-American poor and middle class must be investigated. Extra costs mean that it is much harder for African Americans to reach the middle class. Ways to improve the economic status of African-American families and to increase the middle class are discussed. (SLD)

Connecting Social Disorganization Theory to African-American Outcomes to Explain the Achievement Gap

ERIC Educational Resources Information Center

Madyun, Na'im H.

2011-01-01

African-American student achievement outcomes have been and continue to be a critical concern for education researchers. Much of the framing of African-American student outcomes centers on what is known as achievement gaps that exist between African-American and White students. Unfortunately, these gaps have remained roughly the same since the…

Bidirectional Influence between African American Mothers' and Children's Racial Centrality from Elementary through High School

ERIC Educational Resources Information Center

Hoffman, Adam J.; Kurtz-Costes, Beth; Rowley, Stephanie J.; Adams, Elizabeth A.

2017-01-01

For many African Americans, racial identity is an important aspect of their individual identity. We explored developmental change and stability of individual differences in the racial centrality of African American youths and their mothers as well as the relation between maternal and child racial centrality across time. African American youths (N…

African-American Mentoring Program (AAMP): Addressing the Cracks in the Graduate Education Pipeline

ERIC Educational Resources Information Center

Green, Tonika Duren; Ammah, Beverly Booker; Butler-Byrd, Nola; Brandon, Regina; McIntosh, Angela

2017-01-01

In this conceptual article, we focus on mentoring as a strategy to mend the cracks in the education pipeline for African American graduate students. Our article highlights the African American Mentoring Program (AAMP) model and examines the unique methods it uses to support the retention and graduation of African American graduate students from a…

African American Educators' Ideas and Practices for Increasing High School Graduation Rates, 1920-1940

ERIC Educational Resources Information Center

Juergensen, Miyoshi B.

2015-01-01

This study explores African American educators' ideas about school completion in the 1920s and 1930s as a way to begin to understand their contributions to the historical discourse on school completion. Using publications from African American professional teaching organizations, the author elevates and examines how African American educators both…

The Impact of Ethnic Identity Stage Development on the Intercultural Sensitivity of African-American Students during Study Abroad

ERIC Educational Resources Information Center

Dinani, Thandiwe T.

2016-01-01

African-American students represent 12% of the 14 million students enrolled in higher education institutions (National Center for Education Statistics, 2013). However, African-American students participate in study-abroad programs at a much lower percentage; African-American students represent 5% of the total number of students who study abroad…

School Programs for African American Males. ERIC CUE Digest No. 72.

ERIC Educational Resources Information Center

Ascher, Carol

New educational programs are attempting to meet the needs of male African American students. The new programs vary widely in approach, scope, content, and targeted age group. However, they all focus on helping African American male youth develop productive behaviors and values by bringing them into contact with African American male adults. The…

Resiliency in Physics: The Lived Experiences of African-American Women Who Completed Doctoral Physics Programs

ERIC Educational Resources Information Center

Burnette, Samara Fleming

2013-01-01

Currently, little is known about African-American women with doctoral degrees in physics. This study examined the lived experiences of African-American women who completed doctoral programs in physics. Due to factors of race and gender, African-American women automatically enter a double-bind in science, technology, engineering, and mathematics…

"The Brown Face of Hope": Reading Engagement and African American Boys

ERIC Educational Resources Information Center

Meier, Terry

2015-01-01

African American children's literature has a potentially powerful role to play in increasing reading engagement for African American boys. Unfortunately, this body of literature is not always used effectively in schools. Many teachers use African American books as an add-on to pre-exisiting curriculum rather than fully exploring the topics,…

A multilevel understanding of HIV/AIDS disease burden among African American women.

PubMed

Brawner, Bridgette M

2014-01-01

Disproportionate HIV/AIDS rates among African American women have been examined extensively, primarily from an individual-centered focus. Beyond individual behaviors, factors such as the hyperincarceration of African American men and geographically concentrated disadvantage may better explain inequitable disease burden. In this article I propose a conceptual model of individual, social, and structural factors that influence HIV transmission among African American women. The model can be used to develop comprehensive assessments and guide prevention programs in African American communities. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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.

Experiences of African American and Caucasian women who survive urban residential fires.

PubMed

Jepson, C; Pickett, M; Keane, A; Tax, A; McCorkle, R

1996-01-01

This study examined differences in socioeconomic characteristics, traumatic experiences suffered, and psychological distress in African American and Caucasian women 3 months after urban residential fires. Distress was measured by the Brief Symptom Inventory (BSI). The sample included 310 women (224 African Americans and 86 Caucasians). The African American women had lower levels of education and income than the Caucasian women, and were more likely to be unmarried. Injury and deaths of loved ones were similar in the two groups; African American women reported greater loss of possessions, less insurance coverage, and less displacement than Caucasian women. African American and Caucasian women scored similarly on the BSI. Scores on the BSI for both groups were higher than the norms reported in the literature.

Race and Ethnic Differences in Religious Involvement: African Americans, Caribbean Blacks and Non-Hispanic Whites

PubMed Central

Chatters, Linda M.; Taylor, Robert Joseph; Bullard, Kai McKeever; Jackson, James S.

2010-01-01

This study examined differences in religious participation and spirituality among African Americans, Caribbean Blacks (Black Caribbeans) and non-Hispanic Whites. Data are taken from the National Survey of American Life, a nationally representative study of African Americans, Black Caribbeans and non-Hispanic Whites. Selected measures of organizational, nonorganizational and subjective religious participation were examined. African American and Caribbean Blacks were largely similar in their reports of religious involvement; both groups generally indicated higher levels of religious participation than non-Hispanic Whites. African Americans were more likely than Black Caribbeans to be official members of their places of worship, engage in activities (choirs, church clubs) at their place of worship and request prayer from others. Black Caribbeans reported reading religious materials more frequently than African Americans. The discussion notes the importance of examining ethnic differences within the black American population of the United States. PMID:20975850

Genetic African Ancestry and Markers of Mineral Metabolism in CKD.

PubMed

Gutiérrez, Orlando M; Parsa, Afshin; Isakova, Tamara; Scialla, Julia J; Chen, Jing; Flack, John M; Nessel, Lisa C; Gupta, Jayanta; Bellovich, Keith A; Steigerwalt, Susan; Sondheimer, James H; Wright, Jackson T; Feldman, Harold I; Kusek, John W; Lash, James P; Wolf, Myles

2016-04-07

Disorders of mineral metabolism are more common in African Americans with CKD than in European Americans with CKD. Previous studies have focused on the differences in mineral metabolism by self-reported race, making it difficult to delineate the importance of environmental compared with biologic factors. In a cross-sectional analysis of 3013 participants of the Chronic Renal Insufficiency Cohort study with complete data, we compared markers of mineral metabolism (phosphorus, calcium, alkaline phosphatase, parathyroid hormone, fibroblast growth factor 23, and urine calcium and phosphorus excretion) in European Americans versus African Americans and separately, across quartiles of genetic African ancestry in African Americans (n=1490). Compared with European Americans, African Americans had higher blood concentrations of phosphorus, alkaline phosphatase, fibroblast growth factor 23, and parathyroid hormone, lower 24-hour urinary excretion of calcium and phosphorus, and lower urinary fractional excretion of calcium and phosphorus at baseline (P<0.001 for all). Among African Americans, a higher percentage of African ancestry was associated with lower 24-hour urinary excretion of phosphorus (Ptrend<0.01) in unadjusted analyses. In linear regression models adjusted for socio-demographic characteristics, kidney function, serum phosphorus, and dietary phosphorus intake, higher percentage of African ancestry was significantly associated with lower 24-hour urinary phosphorus excretion (each 10% higher African ancestry was associated with 39.6 mg lower 24-hour urinary phosphorus, P<0.001) and fractional excretion of phosphorus (each 10% higher African ancestry was associated with an absolute 1.1% lower fractional excretion of phosphorus, P=0.01). A higher percentage of African ancestry was independently associated with lower 24-hour urinary phosphorus excretion and lower fractional excretion of phosphorus among African Americans with CKD. These findings suggest that genetic variability might contribute to racial differences in urinary phosphorus excretion in CKD. Copyright © 2016 by the American Society of Nephrology.

Perceived Discrimination, Coping, and Quality of Life for African-American and Caucasian Persons with Cancer

PubMed Central

Merluzzi, Thomas V.; Philip, Errol J.; Zhang, Zhiyong; Sullivan, Courtney

2016-01-01

In racial disparities research, perceived discrimination is a proposed risk factor for unfavorable health outcomes. In a proposed “threshold-constraint” theory, discrimination intensity may exceed a threshold and require coping strategies, but social constraint limits coping options for African Americans, who may react to perceived racial discrimination with disengagement, because active strategies are not viable under this social constraint. Caucasian Americans may experience less discrimination and lower social constraint, and thus may use more active coping strategies. 213 African Americans and 121 Caucasian Americans with cancer participated by completing measures of mistreatment, coping, and quality of life. African Americans reported more mistreatment than Caucasian Americans (p< 001) and attributed mistreatment more to race/ethnicity (p < .001). In the mistreatment-quality of life relationship, disengagement was a significant mediator for Caucasians (B = −.39;CI .13–.83) and African Americans (B = −.20;CI .07–.43). Agentic coping was a significant mediator only for Caucasians (B = −.48;CI .18–.81). Discrimination may exceed threshold more often for African Americans than for Caucasians and social constraint may exert greater limits for African Americans. Results suggest that perceived discrimination affects quality of life for African Americans with cancer because their coping options to counter mistreatment, which is racially based, are limited. This process may also affect treatment, recovery, and survivorship. PMID:25090144

Perceived discrimination, coping, and quality of life for African-American and Caucasian persons with cancer.

PubMed

Merluzzi, Thomas V; Philip, Errol J; Zhang, Zhiyong; Sullivan, Courtney

2015-07-01

In racial disparities research, perceived discrimination is a proposed risk factor for unfavorable health outcomes. In a proposed "threshold-constraint" theory, discrimination intensity may exceed a threshold and require coping strategies, but social constraint limits coping options for African Americans, who may react to perceived racial discrimination with disengagement, because active strategies are not viable under this social constraint. Caucasian Americans may experience less discrimination and lower social constraint, and may use more active coping strategies. There were 213 African Americans and 121 Caucasian Americans with cancer who participated by completing measures of mistreatment, coping, and quality of life. African Americans reported more mistreatment than Caucasian Americans (p < 001) and attributed mistreatment more to race or ethnicity (p < .001). In the mistreatment-quality of life relationship, disengagement was a significant mediator for Caucasians (B = -.39; CI .13-.83) and African Americans (B = -.20; CI .07-.43). Agentic coping was a significant mediator only for Caucasians (B = -.48; CI .18-.81). Discrimination may exceed threshold more often for African Americans than for Caucasians and social constraint may exert greater limits for African Americans. Results suggest that perceived discrimination affects quality of life for African Americans with cancer because their coping options to counter mistreatment, which is racially based, are limited. This process may also affect treatment, recovery, and survivorship. (c) 2015 APA, all rights reserved).

Online Health Information and Low-Literacy African Americans

PubMed Central

Birru, Mehret S

2004-01-01

African Americans with low incomes and low literacy levels disproportionately suffer poor health outcomes from many preventable diseases. Low functional literacy and low health literacy impede millions of Americans from successfully accessing health information. These problems are compounded for African Americans by cultural insensitivity in health materials. The Internet could become a useful tool for providing accessible health information to low-literacy and low-income African Americans. Optimal health Web sites should include text written at low reading levels and appropriate cultural references. More research is needed to determine how African Americans with low literacy skills access, evaluate, prioritize, and value health information on the Internet. PMID:15471752

Effect of Genetic African Ancestry on eGFR and Kidney Disease

PubMed Central

Nadkarni, Girish N.; Belbin, Gillian; Lotay, Vaneet; Wyatt, Christina; Gottesman, Omri; Bottinger, Erwin P.; Kenny, Eimear E.; Peter, Inga

2015-01-01

Self-reported ancestry, genetically determined ancestry, and APOL1 polymorphisms are associated with variation in kidney function and related disease risk, but the relative importance of these factors remains unclear. We estimated the global proportion of African ancestry for 9048 individuals at Mount Sinai Medical Center in Manhattan (3189 African Americans, 1721 European Americans, and 4138 Hispanic/Latino Americans by self-report) using genome-wide genotype data. CKD-EPI eGFR and genotypes of three APOL1 coding variants were available. In admixed African Americans and Hispanic/Latino Americans, serum creatinine values increased as African ancestry increased (per 10% increase in African ancestry, creatinine values increased 1% in African Americans and 0.9% in Hispanic/Latino Americans; P≤1x10−7). eGFR was likewise significantly associated with African genetic ancestry in both populations. In contrast, APOL1 risk haplotypes were significantly associated with CKD, eGFR<45 ml/min per 1.73 m2, and ESRD, with effects increasing with worsening disease states and the contribution of genetic African ancestry decreasing in parallel. Using genetic ancestry in the eGFR equation to reclassify patients as black on the basis of ≥50% African ancestry resulted in higher eGFR for 14.7% of Hispanic/Latino Americans and lower eGFR for 4.1% of African Americans, affecting CKD staging in 4.3% and 1% of participants, respectively. Reclassified individuals had electrolyte values consistent with their newly assigned CKD stage. In summary, proportion of African ancestry was significantly associated with normal-range creatinine and eGFR, whereas APOL1 risk haplotypes drove the associations with CKD. Recalculation of eGFR on the basis of genetic ancestry affected CKD staging and warrants additional investigation. PMID:25349204

Underserved: A Case Study of ROTC in New York City. A Report of the AEI Program on American Citizenship

ERIC Educational Resources Information Center

Miller, Cheryl

2011-01-01

The military-civilian disconnect has been a source of increasing concern over the last few decades. National security leaders--including the commander in chief, President Barack Obama--have warned that many Americans are unaware of the military's sacrifices and its growing sense of isolation from wider society. In remarks at Duke University in…

Strategies for Recruitment of Healthy Premenopausal Women into the African American Nutrition for Life (A NULIFE) Study

PubMed Central

Duello, Theresa M.; Miranda, Patricia Y.; Hodges, Kelly P.; Shelton, Andrea J.; Chukelu, Paul; Jones, Lovell A.

2010-01-01

Abstract Background Although African American women have an overall lower incidence of breast cancer, African American women <40 years of age are more likely than Caucasian women of all ages and postmenopausal African American women to be diagnosed with breast cancer and exhibit tumor characteristics associated with poorer survival. To begin to address this disparity, studies must be conducted to examine breast cancer preventive factors in this subpopulation of women. However, the strategies needed to recruit younger African American women have not been well defined. Methods In this study, we assessed methods used for recruiting and retaining healthy premenopausal African American women into the African American Nutrition for Life (A NULIFE) Study. The number of women contacted, enrolled, and retained by each recruitment strategy and the efficiency of individual strategies were calculated. Results Overall, recruitment through social networking was most effective in contacting large numbers of healthy premenopausal African American women. The worksite recruitment method was the most efficient recruitment strategy employed, with a ratio of 40%. The study participants (n = 164) were more likely to be ≥35 years of age and have completed some college. Additionally, the interpersonal relationships recruitment approach proved most efficient (33%) in retaining participants who completed the yearlong study. Conclusions The findings from this study add to the evolving research literature on minority recruitment strategies for research studies but specifically address effective recruitment of healthy young premenopausal African American women. The results demonstrate the need to use multiple recruitment strategies when recruiting this subgroup of African American women. PMID:20392156

African-American Men with Gleason Score 3+3=6 Prostate Cancer Produce Less Prostate Specific Antigen than Caucasian Men: A Potential Impact on Active Surveillance.

PubMed

Kryvenko, Oleksandr N; Balise, Raymond; Soodana Prakash, Nachiketh; Epstein, Jonathan I

2016-02-01

We assess the difference in prostate specific antigen production between African-American and Caucasian men with Gleason score 3+3=6 prostate cancer. We measured tumor volume in 414 consecutive radical prostatectomies from men with National Comprehensive Cancer Network(®) low risk prostate cancer (348 Caucasian, 66 African-American) who had Gleason score 3+3=6 disease at radical prostatectomy. We then compared clinical presentation, pathological findings, prostate specific antigen, prostate specific antigen density and prostate specific antigen mass (an absolute amount of prostate specific antigen in patient's circulation) between African-American and Caucasian men. The t-test and Wilcoxon rank sum were used for comparison of means. African-American and Caucasian men had similar clinical findings based on age, body mass index and prostate specific antigen. There were no statistically significant differences between the dominant tumor nodule volume and total tumor volume (mean 0.712 vs 0.665 cm(3), p=0.695) between African-American and Caucasian men. Prostates were heavier in African-American men (mean 55.4 vs 46.3 gm, p <0.03). Despite the significantly greater weight of benign prostate tissue contributing to prostate specific antigen in African-American men, prostate specific antigen mass was not different from that of Caucasian men (mean 0.55 vs 0.558 μg, p=0.95). Prostate specific antigen density was significantly less in African-American men due to larger prostates (mean 0.09 vs 0.105, p <0.02). African-American men with Gleason score 3+3=6 prostate cancer produce less prostate specific antigen than Caucasian men. African-American and Caucasian men had equal serum prostate specific antigen and prostate specific antigen mass despite significantly larger prostates in African-American men with all other parameters, particularly total tumor volume, being the same. This finding has practical implications in T1c cases diagnosed with prostate cancer due to prostate specific antigen screening. Lowering the prostate specific antigen density threshold in African-American men may account for this disparity, particularly in selecting patients for active surveillance programs. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

My Iowa Journey: The Life Story of the University of Iowa's First African American Professor. Singular Lives: The Iowa Series in North American Autobiography.

ERIC Educational Resources Information Center

Hubbard, Philip G.

This autobiography recounts the life story of an African American educator at the University of Iowa from 1965 to 1991, as its first African American professor and then as its first African American administrator. The book recounts his childhood and family relations, his student years at the university and his graduation as an electrical engineer,…

[Gene geography of Chile: regional distribution of American, European and African genetic contributions].

PubMed

Fuentes, Macarena; Pulgar, Iván; Gallo, Carla; Bortolini, María-Cátira; Canizales-Quinteros, Samuel; Bedoya, Gabriel; González-José, Rolando; Ruiz-Linares, Andrés; Rothhammer, Francisco

2014-03-01

The geographical distribution of genes plays a key role in genetic epidemiology. The Chilean population has three major stem groups (Native American, European and African). To estimate the regional rate of American, European and African admixture of the Chilean population. Forty single nucleotide polymorphisms (SNP´s) which exhibit substantially different frequencies between Amerindian populations (ancestry-informative markers or AIM´s), were genotyped in a sample of 923 Chilean participants to estimate individual genetic ancestry. The American, European and African individual average admixture estimates for the 15 Chilean Regions were relatively homogeneous and not statistically different. However, higher American components were found in northern and southern Chile and higher European components were found in central Chile. A negative correlation between African admixture and latitude was observed. On the average, American and European genetic contributions were similar and significantly higher than the African contribution. Weighted mean American, European and African genetic contributions of 44.34% ± 3 9%, 51.85% ± 5.44% and 3.81% ± 0.45%, were estimated. Fifty two percent of subjects harbor African genes. Individuals with Aymara and Mapuche surnames have an American admixture of 58.64% and 68.33%, respectively. Half of the Chilean population harbors African genes. Participants with Aymara and Mapuche surnames had a higher American genetic contribution than the general Chilean population. These results confirm the usefulness of surnames as a first approximation to determine genetic ancestry.

HIV/AIDS among African Americans: progress or progression?

PubMed

Smith, D K; Gwinn, M; Selik, R M; Miller, K S; Dean-Gaitor, H; Ma'at, P I; De Cock, K M; Gayle, H D

2000-06-16

To review data on the extent of HIV infection and associated risk behaviors, the occurrence of AIDS, and HIV-related mortality in African Americans and to suggest what can be done to reduce HIV exposure and infection in this population. Review of epidemiologic, published, multisite data on HIV infection in, and related behaviors of, African Americans. On every epidemiologic measure in common use, African Americans, compared with the four other federally recognized racial/ethnic groups, have the most severe epidemic. The trend data show continuing growth in the African American epidemic despite the availability of effective behavioral interventions and biomedical treatments. Few published intervention studies with African American populations have been adequately evaluated; nor have they focused proportionately on men who have sex with men, a group in the African American community with continuing high rates of infection. Rates of HIV transmission and disease among African Americans are high, disproportionate, and are not declining as significantly in response to effective interventions as they are among whites. Attention is urgently needed to increase our understanding of risk behaviors, social networks, and specific factors in the African American community that can be altered to reduce HIV infection. Macroenvironmental factors--poverty, social class, racism--need to be studied to suggest possible intervention components to reduce rates of HIV transmission and to increase the use of therapies that are more effectively slowing disease progression and lowering death rates among whites.

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. Published by Elsevier Inc.

Feasibility of Ecological Momentary Assessment of Daily Sexting and Substance Use Among Young Adult African American Gay and Bisexual Men: A Pilot Study

PubMed Central

Elmasry, Hoda; Webb Hooper, Monica; Niaura, Raymond S; Hamilton, Alison B; Milburn, Norweeta G

2017-01-01

Background Recent evidence suggests that sexualized text communication (“sexting”) is associated with substance use and sexual risk behaviors among young adults, yet little is known about this relationship among young adult African American gay and bisexual men, a population disproportionately impacted by HIV in the United States. Rapid advances in mobile phone technology indicate a clear need for research using mobile health (mHealth) methods such as ecological momentary assessment (EMA) to serve as a viable counterpart to retrospective evaluation methods by using real-time data collection to assess sexting and substance use among this population. Objective The objective of this pilot study was to (1) describe the EMA study design and protocol, (2) characterize the study population, and (3) assess the feasibility of a random prompt text message-based thrice-daily EMA over 14 days, as a means of prospectively studying sexting, marijuana, and alcohol use among a sample of young adult African American gay and bisexual men ages 21 to 25. Methods Participants were recruited through flyers and snowball sampling during spring and summer 2015 at a community-based HIV/AIDS prevention, care, and support organization in Washington, DC. Eligible participants were enrolled in a one-time in-person study visit that consisted of informed written consent to participate in the study, a self-administered survey, a semi-structured interview, and enrollment and training in EMA data collection. Commencing the day after the study visit, a random prompt survey was texted to participants on their personal mobile phones 3 times a day over a 14-day data collection period assessing mood, texts sent, texts received, sexts sent, sexts received, marijuana want, marijuana use, and alcohol use. Results EMA feasibility was tested with 25 self-identified African American gay (n=16) and bisexual (n=9) men (mean age of 23.48 years, SD 1.5). Each random prompt survey had 8 questions with responses including yes/no and Likert scale options. There were 104 total days of EMA observation, and the retention rate was 72% (18 out of 25 participants). Participants responded to the random prompt surveys with a 57.3% compliance rate providing a total of 544 completed surveys out of 949 surveys. The overall mean response time to complete a survey was 6.1 minutes. There were significant positive associations between EMA texts sent and received questions (ρ 0.84, P<.001) as well as sexts sent and received queries (ρ 0.72, P<.001). Conclusions The use of an EMA protocol has the potential to be a very useful research tool for understanding episodic behaviors such as sexting and substance use in this relatively understudied and underserved population, and has implications for practice. Additional research is needed on how to maximize survey compliance. PMID:28153816

Nonverbal behavior of vendors in customer-vendor interaction.

PubMed

Amsbary, J H; Powell, L

2007-04-01

Two research questions were posed on the homophily theory of customer-vendor interactions: (a) do vendors show any nonverbal preference for Euro-American or African-American customers?; (b) do vendors demonstrate any nonverbal preference for customers with which they share racial homophily? The results supported the homophily theory for Euro-American customers in that there were significant interaction effects by race in facial expression (F = 5.33, p < .05), amount of speaking (F = 6.76, p < .01), tone of voice (F = 7.62, p < .01), and touching (F = 4.57, p < .05). Vendor behavior varied when the customer was Euro-American, with Euro-American vendors smiling more frequently (M = 4.05) than African-American vendors (M = 3.69), speaking more frequently (M = 3.57) than African-American vendors (M = 3.09), using a more friendly tone of voice (M = 3.59, and engaging in more touching behaviors (M = 1.81) than African-American vendors (M = 1.48). There was no significant difference in the behavior of Euro-American and African-American vendors when the customer was African-American.

Caveolin-1 deficiency may predispose African Americans to systemic sclerosis-related interstitial lung disease.

PubMed

Reese, Charles; Perry, Beth; Heywood, Jonathan; Bonner, Michael; Visconti, Richard P; Lee, Rebecca; Hatfield, Corey M; Silver, Richard M; Hoffman, Stanley; Tourkina, Elena

2014-07-01

Interstitial lung disease (ILD) is the leading cause of death in patients with systemic sclerosis (SSc; scleroderma). Although SSc-related ILD is more common and severe in African Americans than in Caucasians, little is known about factors underlying this significant health disparity. The aim of this study was to examine the role that low expression of caveolin-1 might play in susceptibility to ILD among African Americans. Assays of monocyte migration toward stromal cell-derived factor 1 (SDF-1) were performed using monocytes from Caucasian and African American healthy donors and patients with SSc. For fibrocyte differentiation studies, total peripheral blood mononuclear cells were incubated on fibronectin-coated plates. Protein expression was evaluated by immunohistochemistry and Western blotting. Monocytes from healthy African American donors and those from patients with SSc had low caveolin-1 levels, enhanced migration toward the CXCR4 ligand SDF-1, and enhanced differentiation to fibrocytes. Enhanced migration and differentiation of monocytes from African Americans and patients with SSc appeared to be attributable to the lack of caveolin-1, because restoring caveolin-1 function using a caveolin-1 scaffolding domain peptide inhibited these processes. Although they differed from monocytes from Caucasians, monocytes from both African Americans and patients with SSc were not identical, because SSc monocytes showed major increases from baseline in ERK, JNK, p38, and Smad2/3 activation, while monocytes from African Americans showed only limited ERK activation and no activation of JNK, p38, or Smad2/3. In contrast, SDF-1 exposure caused no additional ERK activation in SSc monocytes but did cause significant additional activation in monocytes from African Americans. African Americans may be predisposed to SSc-related ILD due to low baseline caveolin-1 levels in their monocytes, potentially affecting signaling, migration, and fibrocyte differentiation. The monocytes of African Americans may lack caveolin-1 due to high levels of transforming growth factor β in their blood. Copyright © 2014 by the American College of Rheumatology.

Sister to Sister: Dynamics of Mentoring Relationships among African American Women in Leadership and Nonleadership Positions within Higher Education

ERIC Educational Resources Information Center

Stiff, MaNesha M.

2013-01-01

The purpose of this study was to identify the dynamics of mentoring relationships among African American women within the higher education profession. Utilizing a phenomenological research design, this researcher conducted in-depth interviews with 10 African American women who are mentors and/or mentees of an African American woman in the higher…

"Sisters of Nia": A Social Justice Advocacy Intervention for School Counselors in Their Work with Adolescent African American Females

ERIC Educational Resources Information Center

Grimes, Lee Edmondson; Haizlip, Breyan; Rogers, Tiffany; Brown, Kimberly D.

2013-01-01

Adolescent African American females face multiple obstacles that hinder their educational success. High school completion and college attendance rates remain lower for African American females than those for other racial and gender groups, while pregnancy rates for African American teens are higher. Group work holds promise for meeting the…

An Examination of African American Female College Presidents' Professional Ascendancy and Mentoring Experiences

ERIC Educational Resources Information Center

Smith-Ligon, Pamela

2011-01-01

There is a large disparity in the number of African American women leaders in higher education, specifically in the presidency. Much of the literature negates the experiences of the African American woman, often fusing their experiences with those of all women, or those of African American men, which often disregards the challenges and successes…

Breaking the Silence: The Black Church Addresses HIV.

ERIC Educational Resources Information Center

Swartz, Aimee

2002-01-01

AIDS is the leading cause of death among African Americans age 25-44 years. About half of all new U.S. HIV cases are African Americans, though African Americans make up only 13 percent of the population. Most U.S. children living with HIV are African American. There exists a strong pattern of resistance and denial of the disease in the African…

"Give a Brotha a Break!": The Experiences and Dilemmas of Middle-Class African American Male Students in White Suburban Schools

ERIC Educational Resources Information Center

Gordon, Beverly M.

2012-01-01

Background/Context: Today, in the era of the first African American president, approximately one third of all African Americans live in suburban communities, and their children are attending suburban schools. Although most research on the education of African American students, particularly males, focuses on their plight in urban schooling, what…

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…

The Discipline Gap: Teachers' Views on the Over-Representation of African American Students in the Discipline System

ERIC Educational Resources Information Center

Gregory, Anne; Mosely, Pharmicia M.

2004-01-01

While the achievement gap between African American students and white and Asian students is discussed widely in the media (e.g. Schemo, 2003), the gap in discipline between African Americans and these groups has gained much less attention. Few studies have explored teacher processes that affect the over-representation of African American students…

Urban Middle School African American Girls' Attitudes toward Physical Education and Out-of-School Physical Activity Levels

ERIC Educational Resources Information Center

Ramsey, Victor

2012-01-01

The purposes of this two-part study were (1) to investigate urban middle school African American girls' physical activity levels and their relationships to attitudes and, (2) to explore urban middle school African American girls' attitude toward physical education. A total of (N = 649) African American girls from 14 New York City middle schools…

"Fool Me Once, Shame on You; Fool Me Twice, Shame on Me": African American Students' Reclamation of Smartness as Resistance

ERIC Educational Resources Information Center

Twyman Hoff, Pamela

2016-01-01

In African American culture competing value systems shape the definition and value of smartness. This article will explore African American "sayins" as a tool to transmit the counter-hegemonic cultural value of smartness. "Sayins," a facet of the African American oral tradition, are drawn from the deep structures of African…

"A Tug of War for Our Minds:" African American High School Students' Perceptions of Their Academic Identities and College Aspirations

ERIC Educational Resources Information Center

Howard, Tyrone Caldwell

2003-01-01

The research examining African American high school students' perceptions of their academic identities has been limited. Yet, multitudes of other sources have contributed to the discussion on how to reverse the perennial underachievement of many African American students. This qualitative study attempts to provide a space for African American high…

A Qualitative Study of African-American Female Administrators in the Academy: Identification of Characteristics That Contribute to Their Advancement to Senior Level Positions of Authority

ERIC Educational Resources Information Center

Alexander-Lee, Mary Louise

2014-01-01

The qualitative study explored the (a) self-identity and individual experiences of five African American female higher education administrators, (b) educational and background preparedness of each African American female administrator, (c) individual support mechanisms of each African American female administrator, (i.e., mentoring, community and…

Relationship between Early Familial Influences and Personality Traits in Relation to Career Success Outcomes of African American Women

ERIC Educational Resources Information Center

Gardner, Keeba G.

2010-01-01

This study will examine the relationship between career success outcomes of African American women and early familial factors, as well as personality traits. Using a cross-sectional case-control design. the study will use participants who self-identified as African American with two African American parents. They will be randomly selected from a…

The Educational Status of African American Males in the 21st Century

ERIC Educational Resources Information Center

Garibaldi, Antoine M.

2007-01-01

This article assesses the educational attainment of African American males between the 1990s and early 2000s. Beginning with a summary of a 1987-88 study conducted by the author on African American males in the New Orleans Public Schools, national data are provided on the high school graduation rates of African American males and females, as well…

Reading, Interpreting, and Teaching African American History: Examining How African American History Influences the Curricular and Pedagogical Decisions of Preservice Teachers

ERIC Educational Resources Information Center

King, LaGarrett Jarriel

2012-01-01

African American history and how it is taught in classroom spaces have been a point of contention with activists, historians, and educators for decades. In it current form, African American history narratives often are ambiguous and truncated, leaving students with a disjointed construction about U.S. history. Additionally, the pedagogical…

Gender as a Moderator of the Relation between Race-Related Stress and Mental Health Symptoms for African Americans

ERIC Educational Resources Information Center

Greer, Tawanda M.; Laseter, Adrian; Asiamah, David

2009-01-01

The present study tested gender as a moderator of the relationship between race-related stress and mental health symptoms among African American adults. Because African American women are exposed to stressors associated with race and gender, we hypothesized that African American women would have higher levels of race-related stress and more severe…

Images of Male Friendships: An Investigation of How African American Undergraduate Men Develop Interpersonal Relationships with Other Men at a Predominantly White Institution

ERIC Educational Resources Information Center

McGowan, Brian Lamont

2013-01-01

African American men enter postsecondary institutions having been socialized to adopt stereotypical notions of masculinity. These traditional expectations of masculinity play a role in how African American men negotiate relationships with their male counterparts on the campus. African American men cultivate close relationships with other men to…

The Psychosocial Factors Contributing to the Underrepresentation of African American Males in Advanced High School Mathematics Courses

ERIC Educational Resources Information Center

Rowlett, Joel Everett

2013-01-01

This case study examined the beliefs of African American males on the psychosocial and pedagogical factors contributing to the underrepresentation of African American males in advanced high school math courses. Six 11th grade African American male juniors from a large, comprehensive, Southeastern high school served as individual cases. Within- and…

African American Young Adult Smoking Initiation: Identifying Intervention Points and Prevention Opportunities

ERIC Educational Resources Information Center

Cheney, Marshall K.; Mansker, Jacqueline

2014-01-01

Background: African Americans have one of the lowest smoking rates as teens yet have one of the highest smoking rates as adults. Approximately 40% of African Americans who have ever smoked started smoking between the ages of 18 and 21. Purpose: This study aimed to identify why African American young adults began smoking in young adulthood and what…

From 1960s Evans County Georgia to present-day Jackson, Mississippi: an exploration of the evolution of cardiovascular disease in African Americans.

PubMed

Crook, Errol D; Clark, Bobby L; Bradford, Shayna T J; Golden, Kimberly; Calvin, Rosie; Taylor, Herman A; Flack, John M

2003-06-01

Cardiovascular disease (CVD) is the No. 1 cause of mortality in the United States and it disproportionately affects African Americans. However, there are earlier reports that African Americans had significantly less CVD than whites. This racial discrepancy in CVD rates was noticed primarily for coronary heart disease (CHD). This issue was examined in the Evans County (Georgia) Cardiovascular Disease Study conducted in the 1960s. It showed that African American men had significantly lower rates of CHD than white men. Over the last couple of decades, the rates of CVD have been declining. However, the rate of decline of CVD in African Americans has not been equal to that seen in whites, such that African Americans now have a disproportionate share of CVD in the United States. In the 1990s, the Jackson Heart Study was designed to explore the reasons for the current racial discrepancy. This articles reviews the findings of the Evans County Study and explores various hypotheses for why CVD in African Americans has evolved from a disease from which African Americans may have been "protected" to one in which they shoulder a disproportionate burden.

The African American Women and Mass Media Campaign: A CDC Breast Cancer Screening Project

PubMed Central

Hall, Ingrid J.; Rim, Sun Hee; Johnson-Turbes, C. Ashani; Vanderpool, Robin; Kamalu, Ngozi N.

2015-01-01

For decades, black radio has reached African American communities with relevant, culturally appropriate information, and it continues to be an ideal communication channel to use for contemporary health promotion. In an effort to combat excess breast cancer mortality rates and help eliminate cancer disparities among low-income African American women, the Centers for Disease Control and Prevention’s (CDC) Division of Cancer Prevention and Control designed, implemented, and evaluated the African American Women and Mass Media (AAMM) pilot campaign. The AAMM campaign uses black radio, radio stations with broad African American listenership, as a platform for targeted, culturally competent health promotion and outreach to low-income, African American women. The AAMM campaign uses radio advertisements and print materials disseminated in predominantly African American neighborhoods to promote awareness of breast cancer, early detection, and the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Evaluation of the AAMM campaign found that the campaign successfully reached its target audience of low-income, African American women and increased women’s awareness of breast cancer screening services through the Breast and Cervical Cancer Program in Savannah and Macon, Georgia. PMID:23072329

Constructions of provider role identity among African American men: an exploratory study.

PubMed

Diemer, Matthew A

2002-02-01

This exploratory study examined the identity constructions of African American men using a qualitative research methodology. Seven African American men, ranging in age from 20 to 47 years and whose education levels ranged from a 1st-year university student to a PhD, were interviewed for this study. Central to how all of these men defined themselves was the breadwinner or provider role. Participants emphasized education as "insurance" against discrimination and an awareness of educational and occupational opportunities. For these participants, education was a means of ensuring opportunity, which afforded fulfillment of the provider role. This study supports the work of N. Cazenave (1979, 1981), who demonstrated the salience of the provider role among African American men. The implications of the provider role among African American men for research are also discussed. The data also suggested diversity within the African American male experience. As 1 participant described African American men. "We come like flowers, you know. Some in bouquets, and some wild." By providing constructions of identity that diverge from existing negative stereotypes of African American men, this study attempted to deconstruct those stereotypes. Finally, this study provided a voice to an underrepresented group in the research literature.

Minority donation in the United States: challenges and needs.

PubMed

Shaz, Beth H; Hillyer, Christopher D

2010-11-01

In the United States, blood donation rates of African-Americans are 25-50% of that of white individuals. As African-Americans make up an ever increasing and now substantial minority, and African-American recipients of blood transfusion, both specialized, such as sickle cell disease patients, and general hospitalized patients, have a better chance of receiving phenotype-matched or appropriate red blood cell units when there is a significant percentage of products in the inventory from African-American donors, it is important to understand the reason for the observed difference. Possible reasons for this discrepancy in donation rates include increased rates of donor deferral and ineligibility; increased barriers to donation, such as fear and distrust; and different marketing and education strategies. Thus, to increase the blood availability to African-American recipients, the reasons for these donation rate differences must be better understood and subsequently addressed through improved blood donor recruitment programs. The majority of African-American donor recruitment programs have focused on donating for sickle cell disease patients, particularly children, which have been of limited success. Significant improvements in African-American donor recruitment are needed to adequately meet the demand of African-American patients as well as the entire population.

European-American and African-American Mothers' Emotion Socialization Practices Relate Differently to Their Children's Academic and Social-Emotional Competence

ERIC Educational Resources Information Center

Nelson, Jackie A.; Leerkes, Esther M.; Perry, Nicole B.; O'Brien, Marion; Calkins, Susan D.; Marcovitch, Stuart

2013-01-01

The current study examines whether the relation between mothers' responses to their children's negative emotions and teachers' reports of children's academic performance and social-emotional competence are similar or different for European-American and African-American families. Two hundred mothers (137 European-American, 63 African-American)…

Most common single-nucleotide polymorphisms associated with rheumatoid arthritis in persons of European ancestry confer risk of rheumatoid arthritis in African Americans.

PubMed

Hughes, Laura B; Reynolds, Richard J; Brown, Elizabeth E; Kelley, James M; Thomson, Brian; Conn, Doyt L; Jonas, Beth L; Westfall, Andrew O; Padilla, Miguel A; Callahan, Leigh F; Smith, Edwin A; Brasington, Richard D; Edberg, Jeffrey C; Kimberly, Robert P; Moreland, Larry W; Plenge, Robert M; Bridges, S Louis

2010-12-01

Large-scale genetic association studies have identified >20 rheumatoid arthritis (RA) risk alleles among individuals of European ancestry. The influence of these risk alleles has not been comprehensively studied in African Americans. We therefore sought to examine whether these validated RA risk alleles are associated with RA risk in an African American population. Twenty-seven candidate single-nucleotide polymorphisms (SNPs) were genotyped in 556 autoantibody-positive African Americans with RA and 791 healthy African American control subjects. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for each SNP were compared with previously published ORs for RA patients of European ancestry. We then calculated a composite genetic risk score (GRS) for each individual based on the sum of all risk alleles. Overlap of the ORs and 95% CIs between the European and African American populations was observed for 24 of the 27 candidate SNPs. Conversely, 3 of the 27 SNPs (CCR6 rs3093023, TAGAP rs394581, and TNFAIP3 rs6920220) demonstrated ORs in the opposite direction from those reported for RA patients of European ancestry. The GRS analysis indicated a small but highly significant probability that African American patients relative to control subjects were enriched for the risk alleles validated in European RA patients (P = 0.00005). The majority of RA risk alleles previously validated for RA patients of European ancestry showed similar ORs in our population of African Americans with RA. Furthermore, the aggregate GRS supports the hypothesis that these SNPs are risk alleles for RA in the African American population. Future large-scale genetic studies are needed to validate these risk alleles and identify novel RA risk alleles in African Americans. Copyright © 2010 by the American College of Rheumatology.

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. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

A Multi-Institutional Prospective Trial Confirms Noninvasive Blood Test Maintains Predictive Value in African American Men.

PubMed

Punnen, Sanoj; Freedland, Stephen J; Polascik, Thomas J; Loeb, Stacy; Risk, Michael C; Savage, Stephen; Mathur, Sharad C; Uchio, Edward; Dong, Yan; Silberstein, Jonathan L

2018-06-01

The 4Kscore® test accurately detects aggressive prostate cancer and reduces unnecessary biopsies. However, its performance in African American men has been unknown. We assessed test performance in a cohort of men with a large African American representation. Men referred for prostate biopsy at 8 Veterans Affairs medical centers were prospectively enrolled in the study. All men underwent phlebotomy for 4Kscore test assessment prior to prostate biopsy. The primary outcome was the detection of Grade Group 2 or higher cancer on biopsy. We assessed the discrimination, calibration and clinical usefulness of 4Kscore to predict Grade Group 2 or higher prostate cancer and compared it to a base model consisting of age, digital rectal examination and prostate specific antigen. Additionally, we compared test performance in African American and nonAfrican American men. Of the 366 enrolled men 205 (56%) were African American and 131 (36%) had Grade Group 2 or higher prostate cancer. The 4Kscore test showed better discrimination (AUC 0.81 vs 0.74, p <0.01) and higher clinical usefulness on decision curve analysis than the base model. Test prediction closely approximated the observed risk of Grade Group 2 or higher prostate cancer. There was no difference in test performance in African American and nonAfrican American men (0.80 vs 0.84, p = 0.32), The test outperformed the base model in each group. The 4Kscore test accurately predicts aggressive prostate cancer for biopsy decision making in African American and nonAfrican American men. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A sociocultural stress and coping model for mental health outcomes among African American caregivers in Southern California.

PubMed

Knight, B G; Silverstein, M; McCallum, T J; Fox, L S

2000-05-01

A sociocultural stress and coping model to explain emotional distress among caregivers of family members who have dementia across ethnic and cultural groups is presented and explored in a sample of 41 African American and 128 non-African American caregivers. In this sample, African American caregivers reported lower levels of burden but equal levels of depression and anxiety. In the structural equation model, previous reports that African Americans' lower appraisal of caregiving as burdensome resulted in lower levels of emotional distress were confirmed. However, in this model, this pathway was counterbalanced by a tendency of African American caregivers to use emotion-focused coping and, therefore, increase emotional distress. African American caregivers were also younger and in poorer health, factors which tend to increase both burden and emotional distress outcomes. As suggested by the sociocultural stress and coping model, the influences of ethnic group variables on stress and coping processes are complex and multidirectional.

Low Cardiorespiratory Fitness in African Americans: A Health Disparity Risk Factor?

PubMed Central

Swift, Damon L.; Staiano, Amanda E.; Johannsen, Neil M.; Lavie, Carl J.; Earnest, Conrad P.; Katzmarzyk, Peter T.; Blair, Steven N.; Newton, Robert L.; Church, Timothy S.

2013-01-01

Low cardiorespiratory fitness (CRF) is a well-established risk factor for all-cause and cardiovascular disease mortality. African Americans have higher rates of cardiovascular disease compared to their Caucasian counterparts. However, the extent to which lower CRF levels contribute to the excess risk in African Americans has not been fully explored. The purpose of this review is to: 1) explore the literature evaluating the relationship between CRF and mortality specifically in African American populations; and 2) critically evaluate the studies which have compared CRF between African American and Caucasians in epidemiological studies and clinical trials. We have further discussed several potential mechanisms that may contribute to the observation of lower CRF levels in African American compared to Caucasian adults including potential racial differences in physical activity levels, muscle fiber type distribution, and hemoglobin levels. If lower CRF is generally present in African Americans compared to Caucasians, and is of a clinically meaningful difference, this may represent an important public health concern. PMID:23982718

Race, Gender, and Genetic Polymorphism Contribute to Variability in Acetaminophen Pharmacokinetics, Metabolism, and Protein-Adduct Concentrations in Healthy African-American and European-American Volunteers.

PubMed

Court, Michael H; Zhu, Zhaohui; Masse, Gina; Duan, Su X; James, Laura P; Harmatz, Jerold S; Greenblatt, David J

2017-09-01

Over 30 years ago, black Africans from Kenya and Ghana were shown to metabolize acetaminophen faster by glucuronidation and slower by oxidation compared with white Scottish Europeans. The objectives of this study were to determine whether similar differences exist between African-Americans and European-Americans, and to identify genetic polymorphisms that could explain these potential differences. Acetaminophen plasma pharmacokinetics and partial urinary metabolite clearances via glucuronidation, sulfation, and oxidation were determined in healthy African-Americans (18 men, 23 women) and European-Americans (34 men, 20 women) following a 1-g oral dose. There were no differences in acetaminophen total plasma, glucuronidation, or sulfation clearance values between African-Americans and European-Americans. However, median oxidation clearance was 37% lower in African-Americans versus European-Americans (0.57 versus 0.90 ml/min per kilogram; P = 0.0001). Although acetaminophen total or metabolite clearance values were not different between genders, shorter plasma half-life values (by 11-14%; P < 0.01) were observed for acetaminophen, acetaminophen glucuronide, and acetaminophen sulfate in women versus men. The UGT2B15*2 polymorphism was associated with variant-allele-number proportional reductions in acetaminophen total clearance (by 15-27%; P < 0.001) and glucuronidation partial clearance (by 23-48%; P < 0.001). UGT2B15 *2/*2 genotype subjects also showed higher acetaminophen protein-adduct concentrations than *1/*2 (by 42%; P = 0.003) and *1/*1 (by 41%; P = 0.003) individuals. Finally, CYP2E1 *1D/*1D genotype African-Americans had lower oxidation clearance than *1C/*1D (by 42%; P = 0.041) and *1C/*1C (by 44%; P = 0.048) African-Americans. Consequently, African-Americans oxidize acetaminophen more slowly than European-Americans, which may be partially explained by the CYP2E1*1D polymorphism. UGT2B15*2 influences acetaminophen pharmacokinetics in both African-Americans and European-Americans. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

Optimizing care for African-American HIV-positive patients.

PubMed

Smith, Kimberly Y; Brutus, Andre; Cathcart, Ronald; Gathe, Joseph; Johnson, William; Jordan, Wilbert; Kwakwa, Helena A; Nkwanyou, Joseph; Page, Carlos; Scott, Robert; Vaughn, Anita C; Virgil, Luther A; Williamson, Diana

2003-10-01

The African-American community has been disproportionately affected HIV/AIDS, as noted by higher reported rates of HIV infection, higher proportion of AIDS cases, and more deaths caused by complications of AIDS than whites and other ethnic groups. In addition, epidemiologic trends suggest that African Americans with HIV infection are more often diagnosed later in the course of HIV disease than whites. Numerous reasons account for this disparity, including the lack of perception of risk and knowledge about HIV transmission as well as a delays in HIV testing and diagnosis in the African-American community. Understanding the important considerations in the management of HIV infection in the African-American patient may create awareness among health care professionals and broaden the knowledge of HIV-infected patients within the African-American community.

The Relationship between Racial Identity and Perceived Significance of the Election of President Barack Obama among African American Mothers.

PubMed

Franco, Marisa; Smith-Bynum, Mia

2016-01-01

African American women's racial identity is a major determinant for how they interpret the world around them, yet there is little research examining how specific aspects of racial identity are linked with attitudes about an event that has been highly significant for African-Americans: the election of President Barack Obama. The current study examined the relationship between African American mothers' racial identity and their perceived significance of the election of President Barack Obama as an indicator of reduced systemic and actual racism for African Americans, using a sample of 110 African American mothers residing in a Northeastern metropolitan area. Results revealed that racial centrality and assimilation positively predicted perceived significance of President Obama's election for diminishing racism. Implications and future directions are discussed.

Tenancy and African American Marriage in the Postbellum South

PubMed Central

Bloome, Deirdre; Muller, Christopher

2015-01-01

The pervasiveness of tenancy in the postbellum South had countervailing effects on marriage between African Americans. Tenancy placed severe constraints on African American women’s ability to find independent agricultural work. Freedwomen confronted not only planters’ reluctance to contract directly with women but also whites’ refusal to sell land to African Americans. Marriage consequently became one of African American women’s few viable routes into the agricultural labor market. We find that the more counties relied on tenant farming, the more common was marriage among their youngest and oldest African American residents. However, many freedwomen resented their subordinate status within tenant marriages. Thus, we find that tenancy contributed to union dissolution as well as union formation among freedpeople. Microdata tracing individuals’ marital transitions are consistent with these county-level results. PMID:26223562

Tenancy and African American Marriage in the Postbellum South.

PubMed

Bloome, Deirdre; Muller, Christopher

2015-10-01

The pervasiveness of tenancy in the postbellum South had countervailing effects on marriage between African Americans. Tenancy placed severe constraints on African American women's ability to find independent agricultural work. Freedwomen confronted not only planters' reluctance to contract directly with women but also whites' refusal to sell land to African Americans. Marriage consequently became one of African American women's few viable routes into the agricultural labor market. We find that the more counties relied on tenant farming, the more common was marriage among their youngest and oldest African American residents. However, many freedwomen resented their subordinate status within tenant marriages. Thus, we find that tenancy contributed to union dissolution as well as union formation among freedpeople. Microdata tracing individuals' marital transitions are consistent with these county-level results.

Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT).

PubMed

Barrington, Wendy E; Schenk, Jeannette M; Etzioni, Ruth; Arnold, Kathryn B; Neuhouser, Marian L; Thompson, Ian M; Lucia, M Scott; Kristal, Alan R

2015-06-01

African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men. To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race. Prospective study of 3398 African American and 22,673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001-2011) with present analyses completed in 2014. Total, low-grade (Gleason score <7), and high-grade (Gleason score ≥7) prostate cancer incidence. With a median (interquartile range) follow-up of 5.6 (1.8) years, there were 270, 148, and 88 cases of total, low-, and high-grade prostate cancers among African American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI, <25 vs ≥35: hazard ratio [HR], 1.49 [95% CI, 0.95, 2.34]; P for trend = .03). Consequently, the risk associated with African American race increased from 28% (HR, 1.28 [95% CI, 0.91-1.80]) among men with BMI less than 25 to 103% (HR, 2.03 [95% CI, 1.38-2.98]) among African American men with BMI at least 35 (P for trend = .03). Body mass index was inversely associated with low-grade prostate cancer risk within non-Hispanic white men (BMI, <25 vs ≥35: HR, 0.80 [95% CI, 0.58-1.09]; P for trend = .02) but positively associated with risk within African American men (BMI, <25 vs ≥35: HR, 2.22 [95% CI, 1.17-4.21]; P for trend = .05). Body mass index was positively associated with risk of high-grade prostate cancer in both non-Hispanic white men (BMI, <25 vs ≥35: HR, 1.33 [95% CI, 0.90-1.97]; P for trend = .01) and African American men, although the increase may be larger within African American men, albeit the racial interaction was not statistically significant (BMI, <25 vs ≥35: HR, 1.81 [95% CI, 0.79-4.11]; P for trend = .02). Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men.

The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans: Implications for Reducing Stress-Related Health Disparities.

PubMed

Woods-Giscombé, Cheryl L; Gaylord, Susan A

2014-09-01

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. © The Author(s) 2014.

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

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.

Black versus Black: The Relationship among African, African American, and African Caribbean Persons.

ERIC Educational Resources Information Center

Jackson, Jennifer V.; Cothran, Mary E.

2003-01-01

Surveyed people of African descent regarding relationships among African, African-American, and African-Caribbean persons, focusing on contact and friendship, travel to countries of the diaspora, cross-cultural communication, thoughts and stereotypes, and education. Most respondents had contacts with the other groups, but groups had preconceived…

A preliminary study investigating the factors influencing STEM major selection by African American females

NASA Astrophysics Data System (ADS)

Ray, Tiffany Monique

The purpose of this study was to investigate the significant factors influencing STEM major selection by African American females. A quantitative research design with a qualitative component was employed. Ex post facto survey research was conducted utilizing an online questionnaire to collect data from participants. African American undergraduate females that had declared a major in STEM comprised the target population for the study. As a basis for comparison, a second data collection ensued. All non-African American undergraduate females majoring in STEM also received the survey instrument to determine if there was a significant difference between factors that influence STEM major selection between the two groups. The Social Cognitive Career Choice Model comprised the conceptual framework for this study. Frequencies and percentages illustrated the demographic characteristics of the sample, as well as the average influence levels of each of the items without regard for level of significance. The researcher conducted an independent samples t-test to compare the mean scores for undergraduate African American females majoring in STEM and non-African American females majoring in STEM on each influential factor on the survey instrument. The researcher coded responses to open-ended questions to generate themes and descriptions. The data showed that African American female respondents were very influenced by the following items: specific interest in the subject, type of work, availability of career opportunities after graduation, parent/guardian, precollege coursework in science, and introductory college courses. In addition, the majority of respondents were very influenced by each of the confidence factors. African American females were overwhelmingly not influenced by aptitude tests. African American females were more influenced than their non-African American female counterparts for the following factors: reputation of the university, college or department, high level of compensation in fields, religious leaders, precollege coursework in mathematics, confidence in mathematics ability, confidence in ability to be successful in mathematics in college, confidence in science ability, and confidence in ability to be successful in science in college. Non-African American females were more influenced than African American females by the precollege coursework in technology and the precollege STEM experience factors. Four themes emerged regarding the items that most influenced success in STEM for African American females: high level of compensation in the field, parents/legal guardians and family members, specific interest in the subject, and confidence in science and math ability. One theme emerged regarding the items that least influenced success in STEM majors for African American females: personal interactions with individuals excluding family members.

Utilizing a diabetic registry to manage diabetes in a low-income Asian American population.

PubMed

Seto, Winnie; Turner, Barbara S; Champagne, Mary T; Liu, Lynn

2012-08-01

Racial and income disparities persist in diabetes management in America. One third of African and Hispanic Americans with diabetes receive the recommended diabetes services (hemoglobin A1c [A1c] testing, retinal and foot examinations) shown to reduce diabetes complications and mortality, compared to half of whites with diabetes. National data for Asian Americans are limited, but studies suggest that those with language and cultural barriers have difficulty accessing health services. A diabetic registry has been shown to improve process and clinical outcomes in a population with diabetes. This study examined whether a community center that serves primarily low-income Asian American immigrants in Santa Clara County, California, could improve diabetes care and outcomes by implementing a diabetic registry. The registry was built using the Access 2007 software program. A total of 580 patients with diabetes were identified by reviewing charts, the appointment database, and reimbursement records from Medicaid, Medicare, and private insurance companies. Utilizing the registry, medical assistants contacted patients for follow-up appointments, and medical providers checked and tracked the patients' A1c results. Among the 431 patients who returned for treatment, the mean A1c was reduced from 7.27% to 6.97% over 8 months (P<0.001). Although 10.8% of the patients changed from controlled to uncontrolled diabetes post intervention, 32.6% of patients with uncontrolled diabetes converted to controlled diabetes (P<0.001). The diabetes control rate improved from 47% to 59% at the end of the study. This study demonstrated that a diabetic registry is an effective tool to manage an underserved population with diabetes, thereby reducing disparities in diabetes management.

African Americans and High Blood Pressure

MedlinePlus

ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? African Americans in the U.S. have a higher prevalence of high blood pressure (HBP) ...

African American Faculty Expressing Concerns: Breaking the Silence at Predominantly White Research Oriented Universities

ERIC Educational Resources Information Center

Ross, Henry H.; Edwards, Willie J.

2016-01-01

A Delphi method was used with a panel of 24 African American faculty employed at 43 predominantly white doctoral extensive universities to arrive at a group consensus on a list of concerns that African American faculty in general experienced or held. Using the Delphi method a panel of African American faculty initially worked from a list of eight…

Men of the Cloth: African-American Clergy's Knowledge and Experience in Providing Pastoral Care to African-American Elders with Late-Life Depression

ERIC Educational Resources Information Center

Stansbury, Kim L.

2011-01-01

African-American clergy's ability to recognize late-life depression and their capacity to provide support with this illness have been neglected in the literature. Using a mental health literacy framework, the purpose of this research was to explore African-American clergy's knowledge of and treatments for late-life depression. In-depth interviews…

A Mobile Device Based Intervention to Reduce the Influence of Smoking Cues Among African American Cigarette Smokers

DTIC Science & Technology

2015-03-04

lower rates of smoking cessation compared to Whites. African American smokers also live in communities that have a disproportionately high number of...Eye Tracker Screen Shots ................................................................... 139 Figure 6. Schematic Depiction of a PDA field...for African American smokers. African American smokers also live in communities that have a disproportionately high number of tobacco cues and

A Description and Analysis of the Perspectives on Leadership Effectiveness of African-American Student Leaders at the University of New Mexico. A Qualitative Research Study.

ERIC Educational Resources Information Center

Kustaa, Friedrich Freddy

This report concerns a qualitative study on African-American leadership effectiveness as perceived and defined by African-American student leaders at the University of New Mexico (Albuquerque). Six African-American student leaders (three males and three females) participated in-depth interviews. The interviews were audiorecorded and transcribed.…

Shooting for the Stars: A Case Study of the Mathematics Achievement and Career Attainment of an African American Male High School Student.

ERIC Educational Resources Information Center

Thompson, LaTasha R.; Lewis, Bradford F.

2005-01-01

The mathematics success of African American male adolescents has been given limited attention. Most often, African American males are viewed in terms of their failure as opposed to their success. This tendency to focus almost exclusively on African American failure is a debilitating feature of extant literature and it constrains our understanding…

Sea Island Cascades: An Analysis of Principals' and Teachers' Perceptions of Factors Related to the Overrepresentation of African American Males Identified as Having an Emotional Disability

ERIC Educational Resources Information Center

Bryant, Jacinta Maria

2014-01-01

The issue of the overrepresentation of African Americans in special education is a persistent concern that has negatively impacted African American male students, their families, school districts, and the field of special education. School districts throughout the nation report a higher representation of African American males in special education…

The Attainment of a Science Degree by African American College Students at Arizona State University: An Investigation to Identify the Barriers and Affordances

ERIC Educational Resources Information Center

Boyce, Quintin

2012-01-01

Historically, African American students have been underrepresented in the fields of science, technology, engineering and mathematics (STEM). If African American students continue to be underrepresented in STEM fields, they will not have access to valuable and high-paying sectors of the economy. Despite the number of African Americans in these…

Prevalence of High-Risk Sexual Behaviors Among Monoracial and Multiracial Groups from a National Sample: Are Multiracial Young Adults at Greater Risk?

PubMed

Landor, Antoinette M; Halpern, Carolyn Tucker

2016-02-01

The present study compared the prevalence and variation in high-risk sexual behaviors among four monoracial (i.e., White, African American, Asian, Native American) and four multiracial (i.e., White/African American, White/Asian, White/Native American, African American/Native American) young adults using Wave IV data (2008-2009) from the National Longitudinal Study of Adolescent to Adult Health (N = 9724). Findings indicated differences in the sexual behavior of monoracial and multiracial young adults, but directions of differences varied depending on the monoracial group used as the referent and gender. Among males, White/African Americans had higher risk than Whites; White/Native Americans had higher risk than Native Americans. Otherwise, multiracial groups had lower risk or did not differ from the single-race groups. Among females, White/Native Americans had higher risk than Whites; White/African Americans had higher risk than African Americans. Other comparisons showed no differences or had lower risk among multiracial groups. Variations in high-risk sexual behaviors underscore the need for health research to disaggregate multiracial groups to better understand health behaviors and outcomes in the context of experiences associated with a multiracial background, and to improve prevention strategies.

African American or Female: How Do We Identify Ourselves?

ERIC Educational Resources Information Center

Bowman, Sharon L.; And Others

African American female college students attending either a predominantly African American or predominantly White coed institution were surveyed about their racial identity levels, sex role attitude levels, and perceptions of racism and sexism in a school-related vignette. There were 95 participants from the predominantly African American…

Teaching African-American Children.

ERIC Educational Resources Information Center

Horton, Harold

1994-01-01

Examines the historical blighting of African-American slaves' minds, which stripped them of their African culture. Examines the effect on African-American children, as well as other children of color. Offers suggestions for coping with the problems of modern schools in terms of respecting and teaching these children that the system is the problem,…

Caveolin-1 Deficiency May Predispose African Americans to Systemic Sclerosis–Related Interstitial Lung Disease

PubMed Central

Reese, Charles; Perry, Beth; Heywood, Jonathan; Bonner, Michael; Visconti, Richard P.; Lee, Rebecca; Hatfield, Corey M.; Silver, Richard M.; Hoffman, Stanley; Tourkina, Elena

2014-01-01

Objective Interstitial lung disease (ILD) is the leading cause of death in patients with systemic sclerosis (SSc; scleroderma). Although SSc-related ILD is more common and severe in African Americans than in Caucasians, little is known about factors underlying this significant health disparity. The aim of this study was to examine the role that low expression of caveolin-1 might play in susceptibility to ILD among African Americans. Methods Assays of monocyte migration toward stromal cell–derived factor 1 (SDF-1) were performed using monocytes from Caucasian and African American healthy donors and patients with SSc. For fibrocyte differentiation studies, total peripheral blood mono-nuclear cells were incubated on fibronectin-coated plates. Protein expression was evaluated by immuno-histochemistry and Western blotting. Results Monocytes from healthy African American donors and those from patients with SSc had low caveolin-1 levels, enhanced migration toward the CXCR4 ligand SDF-1, and enhanced differentiation to fibrocytes. Enhanced migration and differentiation of monocytes from African Americans and patients with SSc appeared to be attributable to the lack of caveolin-1, because restoring caveolin-1 function using a caveolin-1 scaffolding domain peptide inhibited these processes. Although they differed from monocytes from Caucasians, monocytes from both African Americans and patients with SSc were not identical, because SSc monocytes showed major increases from baseline in ERK, JNK, p38, and Smad2/3 activation, while monocytes from African Americans showed only limited ERK activation and no activation of JNK, p38, or Smad2/3. In contrast, SDF-1 exposure caused no additional ERK activation in SSc monocytes but did cause significant additional activation in monocytes from African Americans. Conclusion African Americans may be predisposed to SSc-related ILD due to low baseline caveolin-1 levels in their monocytes, potentially affecting signaling, migration, and fibrocyte differentiation. The monocytes of African Americans may lack caveolin-1 due to high levels of transforming growth factor β in their blood. PMID:24578173

Genetic African Ancestry and Markers of Mineral Metabolism in CKD

PubMed Central

Parsa, Afshin; Isakova, Tamara; Scialla, Julia J.; Chen, Jing; Flack, John M.; Nessel, Lisa C.; Gupta, Jayanta; Bellovich, Keith A.; Steigerwalt, Susan; Sondheimer, James H.; Wright, Jackson T.; Feldman, Harold I.; Kusek, John W.; Lash, James P.; Wolf, Myles

2016-01-01

Background and objectives Disorders of mineral metabolism are more common in African Americans with CKD than in European Americans with CKD. Previous studies have focused on the differences in mineral metabolism by self-reported race, making it difficult to delineate the importance of environmental compared with biologic factors. Design, setting, participants, & measurements In a cross-sectional analysis of 3013 participants of the Chronic Renal Insufficiency Cohort study with complete data, we compared markers of mineral metabolism (phosphorus, calcium, alkaline phosphatase, parathyroid hormone, fibroblast growth factor 23, and urine calcium and phosphorus excretion) in European Americans versus African Americans and separately, across quartiles of genetic African ancestry in African Americans (n=1490). Results Compared with European Americans, African Americans had higher blood concentrations of phosphorus, alkaline phosphatase, fibroblast growth factor 23, and parathyroid hormone, lower 24-hour urinary excretion of calcium and phosphorus, and lower urinary fractional excretion of calcium and phosphorus at baseline (P<0.001 for all). Among African Americans, a higher percentage of African ancestry was associated with lower 24-hour urinary excretion of phosphorus (Ptrend<0.01) in unadjusted analyses. In linear regression models adjusted for socio-demographic characteristics, kidney function, serum phosphorus, and dietary phosphorus intake, higher percentage of African ancestry was significantly associated with lower 24-hour urinary phosphorus excretion (each 10% higher African ancestry was associated with 39.6 mg lower 24-hour urinary phosphorus, P<0.001) and fractional excretion of phosphorus (each 10% higher African ancestry was associated with an absolute 1.1% lower fractional excretion of phosphorus, P=0.01). Conclusions A higher percentage of African ancestry was independently associated with lower 24-hour urinary phosphorus excretion and lower fractional excretion of phosphorus among African Americans with CKD. These findings suggest that genetic variability might contribute to racial differences in urinary phosphorus excretion in CKD. PMID:26912553

Breastfeeding associated with higher lung function in African American youths with asthma.

PubMed

Oh, Sam S; Du, Randal; Zeiger, Andrew M; McGarry, Meghan E; Hu, Donglei; Thakur, Neeta; Pino-Yanes, Maria; Galanter, Joshua M; Eng, Celeste; Nishimura, Katherine Keiko; Huntsman, Scott; Farber, Harold J; Meade, Kelley; Avila, Pedro; Serebrisky, Denise; Bibbins-Domingo, Kirsten; Lenoir, Michael A; Ford, Jean G; Brigino-Buenaventura, Emerita; Rodriguez-Cintron, William; Thyne, Shannon M; Sen, Saunak; Rodriguez-Santana, Jose R; Williams, Keoki; Kumar, Rajesh; Burchard, Esteban G

2017-10-01

In the United States, Puerto Ricans and African Americans have lower prevalence of breastfeeding and worse clinical outcomes for asthma compared with other racial/ethnic groups. We hypothesize that the history of breastfeeding is associated with increased forced expiratory volume in 1 second (FEV 1 ) % predicted and reduced asthma exacerbations in Latino and African American youths with asthma. As part of the Genes-environments & Admixture in Latino Americans (GALA II) Study and the Study of African Americans, asthma, Genes & Environments (SAGE II), we conducted case-only analyses in children and adolescents aged 8-21 years with asthma from four different racial/ethnic groups: African Americans (n = 426), Mexican Americans (n = 424), mixed/other Latinos (n = 255), and Puerto Ricans (n = 629). We investigated the association between any breastfeeding in infancy and FEV 1 % predicted using multivariable linear regression; Poisson regression was used to determine the association between breastfeeding and asthma exacerbations. Prevalence of breastfeeding was lower in African Americans (59.4%) and Puerto Ricans (54.9%) compared to Mexican Americans (76.2%) and mixed/other Latinos (66.9%; p < 0.001). After adjusting for covariates, breastfeeding was associated with a 3.58% point increase in FEV 1 % predicted (p = 0.01) and a 21% reduction in asthma exacerbations (p = 0.03) in African Americans only. Breastfeeding was associated with higher FEV 1 % predicted in asthma and reduced number of asthma exacerbations in African American youths, calling attention to continued support for breastfeeding.

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

An examination of acceptability of HPV vaccination among African American women and Latina immigrants.

PubMed

Scarinci, Isabel C; Garcés-Palacio, Isabel C; Partridge, Edward E

2007-10-01

This study examined the acceptability of preventive human papillomavirus (HPV) vaccination among Latina immigrants and African American women through eight focus groups (n = 55, 28 Latinas and 27 African Americans). Latinas were between 17 and 39 years old (x = 27.9) and African Americans between 19 and 39 (x = 24.3). Approximately 86% of Latinas and 7% of African Americans were married or living with a partner; 10.7% of Latinas and 53.8% of African Americans reported having health insurance; 60.7% of Latinas and 77.8% of African Americans had never heard about HPV. Following a brief presentation about cervical cancer and HPV, participants were questioned about the acceptability of a preventive HPV vaccine. Overall, both groups indicated that an HPV preventive vaccine would be acceptable. However, African Americans were more skeptical, citing concerns about effectiveness and side effects. Another African American concern was whether vaccinated women would perceive themselves as being protected from HPV, leading them to increased promiscuity or unprotected sex. African Americans' motivating factors for vaccine use included receiving education/information about the vaccine, affordable prices, good results in trials, and knowing others who had already gotten vaccinated. Latina immigrants, on the other hand, unanimously stated that they would get the vaccine. However, they believed that multiple credible sources of information (educational talks, doctor's office, television, churches, and other women) needed to promote the vaccine before the Latino community at large would accept it. These findings suggest that unique educational strategies need to be developed, based on the needs and perceptions of the targeted audience, in order to achieve wide-spread acceptability of this vaccine.

African-American esophageal squamous cell carcinoma expression profile reveals dysregulation of stress response and detox networks.

PubMed

Erkizan, Hayriye Verda; Johnson, Kory; Ghimbovschi, Svetlana; Karkera, Deepa; Trachiotis, Gregory; Adib, Houtan; Hoffman, Eric P; Wadleigh, Robert G

2017-06-19

Esophageal carcinoma is the third most common gastrointestinal malignancy worldwide and is largely unresponsive to therapy. African-Americans have an increased risk for esophageal squamous cell carcinoma (ESCC), the subtype that shows marked variation in geographic frequency. The molecular architecture of African-American ESCC is still poorly understood. It is unclear why African-American ESCC is more aggressive and the survival rate in these patients is worse than those of other ethnic groups. To begin to define genetic alterations that occur in African-American ESCC we conducted microarray expression profiling in pairs of esophageal squamous cell tumors and matched control tissues. We found significant dysregulation of genes encoding drug-metabolizing enzymes and stress response components of the NRF2- mediated oxidative damage pathway, potentially representing key genes in African-American esophageal squamous carcinogenesis. Loss of activity of drug metabolizing enzymes would confer increased sensitivity of esophageal cells to xenobiotics, such as alcohol and tobacco smoke, and may account for the high incidence and aggressiveness of ESCC in this ethnic group. To determine whether certain genes are uniquely altered in African-American ESCC we performed a meta-analysis of ESCC expression profiles in our African-American samples and those of several Asian samples. Down-regulation of TP53 pathway components represented the most common feature in ESCC of all ethnic groups. Importantly, this analysis revealed a potential distinctive molecular underpinning of African-American ESCC, that is, a widespread and prominent involvement of the NRF2 pathway. Taken together, these findings highlight the remarkable interplay of genetic and environmental factors in the pathogenesis of African-American ESCC.

Factors influencing enrollment of African Americans in the Look AHEAD trial.

PubMed

Mount, David L; Davis, Cralen; Kennedy, Betty; Raatz, Susan; Dotson, Kathy; Gary-Webb, Tiffany L; Thomas, Sheikilya; Johnson, Karen C; Espeland, Mark A

2012-02-01

Many factors have been identified that influence the recruitment of African Americans into clinical trials; however, the influence of eligibility criteria may not be widely appreciated. We used the experience from the Look AHEAD (Action for Health in Diabetes) trial screening process to examine the differential impact eligibility criteria had on the enrollment of African Americans compared to other volunteers. Look AHEAD is a large randomized clinical trial to examine whether assignment to an intensive lifestyle intervention designed to produce and maintain weight loss reduces the long-term risk of major cardiovascular events in adults with type 2 diabetes. Differences in the screening, eligibility, and enrollment rates between African Americans and members of other racial/ethnic groups were examined to identify possible reasons. Look AHEAD screened 28,735 individuals for enrollment, including 6226 (21.7%) who were self-identified African Americans. Of these volunteers, 12.9% of the African Americans compared to 19.3% of all other screenees ultimately enrolled (p < 0.001). African Americans no more often than others were lost to follow-up or refused to attend clinic visits to establish eligibility. Furthermore, the enrollment rates of individuals with histories of cardiovascular disease and diabetes therapy did not markedly differ between the ethnic groups. Higher prevalence of adverse levels of blood pressure, heart rate, HbA1c, and serum creatinine among African American screenees accounted for the greater proportions excluded (all p < 0.001). Compared to non-African Americans, African American were more often ineligible for the Look AHEAD trial due to comorbid conditions. Monitoring trial eligibility criteria for differential impact, and modifying them when appropriate, may ensure greater enrollment yields.

"If you do nothing about stress, the next thing you know, you're shattered": Perspectives on African American men's stress, coping and health from African American men and key women in their lives.

PubMed

Ellis, Katrina R; Griffith, Derek M; Allen, Julie Ober; Thorpe, Roland J; Bruce, Marino A

2015-08-01

Stress has been implicated as a key contributor to poor health outcomes; however, few studies have examined how African American men and women explicitly describe the relationships among stress, coping, and African American men's health. In this paper, we explore strategies men use to cope with stress, and beliefs about the consequences of stress for African American men's health behaviors, morbidity and mortality from the perspectives of African American men and women. A phenomenological analytic approach was used to examine focus group data collected from 154 African American men (18 focus groups) and 77 African American women (8 focus groups). Women's perspectives were captured because women often observe men under stress and can provide support to men during stressful times. Our findings indicate that African American men in this study responded to stress by engaging in often identified coping behaviors (i.e., consumption of calorie dense food, exercise, spiritually-related activities). Men in our study, however, did not always view their responses to stress as explicit coping mechanisms. There was also some discordance between men's and women's perceptions of men's coping behaviors as there were occasions where they seemed to interpret the same behavior differently (e.g., resting vs. avoidance). Men and women believed that stress helped to explain why African American men had worse health than other groups. They identified mental, physical and social consequences of stress. We conclude by detailing implications for conceptualizing and measuring coping and we outline key considerations for interventions and further research about stress, coping and health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Incidence of atrial fibrillation in whites and African-Americans: the Atherosclerosis Risk in Communities (ARIC) study.

PubMed

Alonso, Alvaro; Agarwal, Sunil K; Soliman, Elsayed Z; Ambrose, Marietta; Chamberlain, Alanna M; Prineas, Ronald J; Folsom, Aaron R

2009-07-01

To define the incidence and cumulative risk of atrial fibrillation (AF) in a population-based cohort of whites and African Americans. African-Americans reportedly have a lower risk of AF than whites despite their higher exposure to AF risk factors. However, precise estimates of AF incidence in African Americans have not been previously published. We studied the incidence of AF in the Atherosclerosis Risk in Communities (ARIC) study, which has followed up 15,792 men and women 45 to 65 years of age at baseline from 4 communities in the United States since 1987. Atrial fibrillation cases were identified from electrocardiograms conducted at baseline and 3 follow-up visits, and from hospitalizations and death certificates through the end of 2004. During follow-up, 1,085 new cases of AF were identified (196 in African Americans, 889 in whites). Crude incidence rates of AF were 6.7, 4.0, 3.9, and 3.0 per 1,000 persons per year in white men, white women, African-American men, and African-American women, respectively. Increasing age was exponentially associated with an elevated risk of AF. Compared to whites, African-Americans had a 41% (95% CI: 8%-62%) lower age- and sex-adjusted risk of being diagnosed with AF. The cumulative risk of AF at 80 years of age was 21% in white men, 17% in white women, and 11% in African-American men and women. In this population-based cohort, African Americans presented a lower risk of AF than whites. Still, the burden of AF among the former is substantial, with 1 in 9 receiving a diagnosis of AF before 80 years of age.

Retention and Attrition Among African Americans in the STAR*D Study: What Causes Research Volunteers to Stay or Stray?

PubMed Central

Murphy, Eleanor J; Kassem, Layla; Chemerinski, Anat; Rush, A. John; Laje, Gonzalo; McMahon, Francis J.

2013-01-01

Background High attrition rates among African-Americans (AA) volunteers are a persistent problem that makes clinical trials less representative and complicates estimation of treatment outcomes. Many studies contrast AA with other ethnic/racial groups, but few compare the AA volunteers who remain in treatment with those who leave. Here, in addition to comparing patterns of attrition between African Americans and whites, we identify predictors of overall and early attrition among African Americans. Method Sample comprised non-Hispanic African-American (n=673) and white (n=2,549) participants in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Chi-square tests were used to examine racial group differences in reasons for exit. Multivariate logistic regression was used to examine predictors of overall attrition, early attrition (by Level 2) and top reasons cited for attrition among African Americans. Results For both African-American and white dropouts, non-compliance reasons for attrition were most commonly cited during the earlier phases of the study while reasons related to efficacy and medication side effects were cited later in the study. Satisfaction with treatment strongly predicted overall attrition among African Americans independent of socioeconomic, clinical, medical or psychosocial factors. Early attrition among African American dropouts was associated with less psychiatric comorbidity, and higher perceived physical functioning but greater severity of clinician-rated depression. Conclusions The decision to drop out is a dynamic process that changes over the course of a clinical trial. Strategies aimed at retaining African Americans in such trials should emphasize engagement with treatment and patient satisfaction immediately following enrollment and after treatment initiation. PMID:23723044

Most Common SNPs Associated with Rheumatoid Arthritis in Subjects of European Ancestry Confer Risk of Rheumatoid Arthritis in African-Americans

PubMed Central

Hughes, Laura B.; Reynolds, Richard J.; Brown, Elizabeth E.; Kelley, James M.; Thomson, Brian; Conn, Doyt L.; Jonas, Beth L.; Westfall, Andrew O.; Padilla, Miguel A.; Callahan, Leigh F.; Smith, Edwin A.; Brasington, Richard D.; Edberg, Jeffrey C.; Kimberly, Robert P.; Moreland, Larry W.; Plenge, Robert M.; Bridges, S. Louis

2010-01-01

Objective Large-scale genetic association studies have identified over 20 rheumatoid arthritis (RA) risk alleles among individuals of European ancestry. The influence of these risk alleles has not been comprehensively studied in African-Americans. We therefore sought to examine whether these validated RA risk alleles are associated with RA in an African-American population. Methods 27 candidate SNPs were genotyped in 556 autoantibody-positive African-Americans with RA and 791 healthy African-American controls. Odds ratios (OR) and 95% confidence intervals (CI) for each SNP were compared to previously published ORs of RA patients of European ancestry. We then calculated a composite Genetic Risk Score (GRS) for each individual based on the sum of all risk alleles. Results There was overlap in the OR and 95% CI between the European and African-American populations in 24 of the 27 candidate SNPs. Conversely, 3 of the 27 SNPs (CCR6 rs3093023, TAGAP rs394581, TNFAIP3 rs6920220) demonstrated an OR in the opposite direction from those reported in RA patients of European ancestry. The GRS analysis indicated a small but highly significant probability that African-American cases were enriched for the European RA risk alleles relative to controls (p=0.00005). Conclusion The majority of RA risk alleles previously validated among European ancestry RA patients showed similar ORs in our population of African-Americans with RA. Furthermore, the aggregate GRS supports the hypothesis that these SNPs are risk alleles for RA in the African-American population. Future large-scale genetic studies are needed to validate these risk alleles and identify novel risk alleles for RA in African-Americans. PMID:21120996

Retention and attrition among African Americans in the STAR*D study: what causes research volunteers to stay or stray?

PubMed

Murphy, Eleanor J; Kassem, Layla; Chemerinski, Anat; Rush, A John; Laje, Gonzalo; McMahon, Francis J

2013-11-01

High attrition rates among African-Americans (AA) volunteers are a persistent problem that makes clinical trials less representative and complicates estimation of treatment outcomes. Many studies contrast AA with other ethnic/racial groups, but few compare the AA volunteers who remain in treatment with those who leave. Here, in addition to comparing patterns of attrition between African Americans and Whites, we identify predictors of overall and early attrition among African Americans. Sample comprised non-Hispanic African-American (n = 673) and White (n = 2,549) participants in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Chi-square tests were used to examine racial group differences in reasons for exit. Multivariate logistic regression was used to examine predictors of overall attrition, early attrition (by level 2) and top reasons cited for attrition among African Americans. Both African-American and White dropouts most commonly cited noncompliance reasons for attrition during the earlier phases of the study, while citing reasons related to efficacy and medication side effects later in the study. Satisfaction with treatment strongly predicted overall attrition among African Americans independent of socioeconomic, clinical, medical or psychosocial factors. Early attrition among African American dropouts was associated with less psychiatric comorbidity, and higher perceived physical functioning but greater severity of clinician-rated depression. Compliance, efficacy, and side effects are important factors that vary in relative importance during the course of a clinical trial. For African Americans in such trials, retention strategies should be broadened to emphasize patient engagement and satisfaction during the critical periods immediately following enrollment and treatment initiation. © 2013 Wiley Periodicals, Inc.

Racial Differences in Circulating Natriuretic Peptide Levels: The Atherosclerosis Risk in Communities Study

PubMed Central

Gupta, Deepak K; Claggett, Brian; Wells, Quinn; Cheng, Susan; Li, Man; Maruthur, Nisa; Selvin, Elizabeth; Coresh, Josef; Konety, Suma; Butler, Kenneth R; Mosley, Thomas; Boerwinkle, Eric; Hoogeveen, Ron; Ballantyne, Christie M; Solomon, Scott D

2015-01-01

Background Natriuretic peptides promote natriuresis, diuresis, and vasodilation. Experimental deficiency of natriuretic peptides leads to hypertension (HTN) and cardiac hypertrophy, conditions more common among African Americans. Hospital-based studies suggest that African Americans may have reduced circulating natriuretic peptides, as compared to Caucasians, but definitive data from community-based cohorts are lacking. Methods and Results We examined plasma N-terminal pro B-type natriuretic peptide (NTproBNP) levels according to race in 9137 Atherosclerosis Risk in Communities (ARIC) Study participants (22% African American) without prevalent cardiovascular disease at visit 4 (1996–1998). Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates. Among African Americans, percent European ancestry was determined from genetic ancestry informative markers and then examined in relation to NTproBNP levels in multivariable linear regression analysis. NTproBNP levels were significantly lower in African Americans (median, 43 pg/mL; interquartile range [IQR], 18, 88) than Caucasians (median, 68 pg/mL; IQR, 36, 124; P<0.0001). In multivariable models, adjusted log NTproBNP levels were 40% lower (95% confidence interval [CI], −43, −36) in African Americans, compared to Caucasians, which was consistent across subgroups of age, gender, HTN, diabetes, insulin resistance, and obesity. African-American race was also significantly associated with having nondetectable NTproBNP (adjusted OR, 5.74; 95% CI, 4.22, 7.80). In multivariable analyses in African Americans, a 10% increase in genetic European ancestry was associated with a 7% (95% CI, 1, 13) increase in adjusted log NTproBNP. Conclusions African Americans have lower levels of plasma NTproBNP than Caucasians, which may be partially owing to genetic variation. Low natriuretic peptide levels in African Americans may contribute to the greater risk for HTN and its sequalae in this population. PMID:25999400

Racial Difference in Cerebral Microbleed Burden among Ischemic Stroke Patients.

PubMed

Shahjouei, Shima; Tsivgoulis, Georgios; Singh, Mantinderpreet; McCormack, Michael; Noorbakhsh-Sabet, Nariman; Goyal, Nitin; Alexandrov, Anne W; Alexandrov, Andrei V; Zand, Ramin

2017-11-01

Data on the epidemiology of cerebral microbleeds (CMBs) among patients with ischemic stroke are limited. This study compared the number, associated factors, and topography of CMBs between African American and Caucasian ischemic stroke patients in the Mid-South United States. We evaluated consecutive ischemic stroke patients admitted to our tertiary stroke center, University of Tennessee Health Science Center, Memphis, Tennessee, in a two-year period. We analyzed T2*-weighted magnetic resonance images for the number, location, and topography of CMBs, as well as patients' demographic and clinical information. Among 760 ischemic stroke patients who were included (mean age was 62.1 ± 13.9 years, 51.4% men), 450 (59.2%) were African American. In comparison with Caucasians, African Americans were about five years younger (P = .000) and had a higher rate of hypertension (80.9% vs. 74.5%, P = .036). Similarly, African Americans had a higher prevalence of diabetes mellitus (P = .001). There was no significant difference between African-Americans and Caucasians in terms of CMBs presence and location. African Americans had a higher number of CMBs in comparison with Caucasians, but the difference was not significant. African Americans were more likely to have CMBs ≥5 (P = .047). Although African American stroke patients had a higher rate of large confluent white matter lesions, there was no significant racial difference regarding the rate and severity of deep white matter lesions. We did not observe any differences between African American and Caucasian patients with ischemic stroke patients regarding the presence, number, and location of CMBs. However, our results suggested that the prevalence of multiple CMBs (CMBs ≥5) might be higher among African American stroke patients. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Correlates of Spirituality among African Americans and Caribbean Blacks in the United States: Findings from the National Survey of American Life

PubMed Central

Taylor, Robert Joseph; Chatters, Linda M.; Jackson, James S.

2010-01-01

The present study examined differences in reports of spirituality among African Americans, Caribbean Blacks (Black Caribbeans), and non-Hispanic whites using data from the National Survey of American Life (NSAL). Bivariate analyses indicated that African Americans were most likely to endorse statements regarding the importance of spirituality in their lives (“How important is spirituality in your life?”) and self-assessments of spirituality (“How spiritual would you say you are?”), followed by Caribbean Blacks and non-Hispanic whites. Regression analyses indicated that African Americans and Caribbean Blacks had significantly higher levels of spirituality than did non-Hispanic whites. However, there were no significant differences in spirituality between African Americans and Caribbean Blacks. Separate regression analyses for African Americans and Caribbean Blacks indicated distinctive patterns of sociodemographic and denominational correlates of spiritual sentiments. Findings are discussed in relation to available survey and ethnographic data on self-assessments of spirituality. PMID:21031157

Genome-wide scan of 29,141 African Americans finds no evidence of directional selection since admixture.

PubMed

Bhatia, Gaurav; Tandon, Arti; Patterson, Nick; Aldrich, Melinda C; Ambrosone, Christine B; Amos, Christopher; Bandera, Elisa V; Berndt, Sonja I; Bernstein, Leslie; Blot, William J; Bock, Cathryn H; Caporaso, Neil; Casey, Graham; Deming, Sandra L; Diver, W Ryan; Gapstur, Susan M; Gillanders, Elizabeth M; Harris, Curtis C; Henderson, Brian E; Ingles, Sue A; Isaacs, William; De Jager, Phillip L; John, Esther M; Kittles, Rick A; Larkin, Emma; McNeill, Lorna H; Millikan, Robert C; Murphy, Adam; Neslund-Dudas, Christine; Nyante, Sarah; Press, Michael F; Rodriguez-Gil, Jorge L; Rybicki, Benjamin A; Schwartz, Ann G; Signorello, Lisa B; Spitz, Margaret; Strom, Sara S; Tucker, Margaret A; Wiencke, John K; Witte, John S; Wu, Xifeng; Yamamura, Yuko; Zanetti, Krista A; Zheng, Wei; Ziegler, Regina G; Chanock, Stephen J; Haiman, Christopher A; Reich, David; Price, Alkes L

2014-10-02

The extent of recent selection in admixed populations is currently an unresolved question. We scanned the genomes of 29,141 African Americans and failed to find any genome-wide-significant deviations in local ancestry, indicating no evidence of selection influencing ancestry after admixture. A recent analysis of data from 1,890 African Americans reported that there was evidence of selection in African Americans after their ancestors left Africa, both before and after admixture. Selection after admixture was reported on the basis of deviations in local ancestry, and selection before admixture was reported on the basis of allele-frequency differences between African Americans and African populations. The local-ancestry deviations reported by the previous study did not replicate in our very large sample, and we show that such deviations were expected purely by chance, given the number of hypotheses tested. We further show that the previous study's conclusion of selection in African Americans before admixture is also subject to doubt. This is because the FST statistics they used were inflated and because true signals of unusual allele-frequency differences between African Americans and African populations would be best explained by selection that occurred in Africa prior to migration to the Americas. Copyright © 2014 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

A rural African American faith community's solutions to depression disparities.

PubMed

Bryant, Keneshia; Haynes, Tiffany; Kim Yeary, Karen Hye-Cheon; Greer-Williams, Nancy; Hartwig, Mary

2014-01-01

The aim of this study was to explore how a rural African American faith community would address depression within their congregations and the community as a whole. A qualitative, interpretive descriptive methodology was used. The sample included 24 participants representing pastors, parishioners interested in health, and African American men who had experienced symptoms of depression in a community in the Arkansas Delta. The primary data sources for this qualitative research study were focus groups. Participants identified three key players in the rural African American faith community who can combat depression: the Church, the Pastor/Clergy, and the Layperson. The roles of each were identified and recommendations for each to address depression disparities in rural African Americans. The recommendations can be used to develop faith-based interventions for depression targeting the African American faith community. © 2013 Wiley Periodicals, Inc.

The Relationship between Racial Identity and Perceived Significance of the Election of President Barack Obama among African American Mothers

PubMed Central

Franco, Marisa; Smith-Bynum, Mia

2016-01-01

African American women’s racial identity is a major determinant for how they interpret the world around them, yet there is little research examining how specific aspects of racial identity are linked with attitudes about an event that has been highly significant for African-Americans: the election of President Barack Obama. The current study examined the relationship between African American mothers’ racial identity and their perceived significance of the election of President Barack Obama as an indicator of reduced systemic and actual racism for African Americans, using a sample of 110 African American mothers residing in a Northeastern metropolitan area. Results revealed that racial centrality and assimilation positively predicted perceived significance of President Obama’s election for diminishing racism. Implications and future directions are discussed. PMID:28163660