Medicine and Health Sciences Commons^™

Risk Factors Associated With Opioid Use Among African American Faith-Based Populations, Kelsey Christensen Ma, Jannette Berkley-Patton Phd, Alexandria Bauer Phd, Carole Bowe Thompson, Tacia Burgin

Journal of Health Disparities Research and Practice

African Americans (AAs) in the Midwest are more likely to die from an opioid overdose compared to Whites, despite lower rates of use. Little is known about factors related to opioid use among AAs residing in the Midwest, particularly church-affiliated AAs. AAs have the highest rate of church attendance among all racial/ethnic groups, and the Black Church may be an appropriate setting for prevention efforts. The present study sought to better understand factors related to opioid use among Midwestern church-affiliated AAs to inform future faith-based interventions. This study examined predictors of opioid use (ever) using survey data from Taking It …

An Exploratory Study Of The Likelihood Of Adopting Genetic Counseling And Testing For Lynch Syndrome-Related Colorectal Cancer Among Primary Care Physicians In Florida, Vanessa B. Crowther, Sandra G. Suther, Jullet A. Weaver, Clement K. Gwede, Matthew Dutton, Dongming Cui, Ivette A. Lopez

Journal of Health Disparities Research and Practice

Genetic counseling and testing for inherited cancer syndromes have the potential to save lives and may be an avenue for addressing health care disparities among African Americans newly diagnosed with colorectal cancer (CRC); and their close relatives. African Americans are more likely to be diagnosed with CRC at younger ages (under age 50 years), and diagnosed at later stages when cancer is more aggressive and difficult to treat, which are factors associated with hereditary cancers such as Lynch syndrome-related CRC. Considering the benefits of genetic testing for hereditary cancer syndromes - risk stratification, preventive surveillance, targeted treatment, and subsequent reduction …

Black Drowning Deaths: An Introductory Analysis, Alena Gadberry, James Gadberry

International Journal of Aquatic Research and Education

Black children between the ages of 5 and 14 are 2.6 times more likely to drown than white children. A systematic exclusion from public pools and other forms of water activities over time has led to a lack of cultural capital involving aquatics among black families. Pierre Bourdieu has provided a theoretical foundation in which to understand this issue. The social fields created by generational socialization have made blacks feel like they have no place in the water. It will take a restructuring of the social institutions to set in motion the socialization (or a re-socialization) of new and more …

"Courage 2 Test": An Evaluation Of A Social Media Marketing Campaign To Increase Hiv Testing Among Young Black Men, Jamal T. Jones, Laura F. Salazar, Richard A. Crosby

Journal of Health Disparities Research and Practice

The purpose of this study was to evaluate a social media marketing (SMM) campaign designed to increase HIV testing among young Black men attending a public university in Atlanta, GA. “Courage 2 Test” was a three-month SMM campaign (launched from February 2017 to April 2017) that included targeted Facebook and Instagram advertisements to encourage HIV testing. Students completed an online survey via two cross-sectional samples (n=106 at baseline and n=98 post campaign). Campaign evaluation involved assessing the effects of campaign exposure and the pre/post-grouping variable on ever testing for HIV and testing for HIV in the previous six months via …

Diabetes Disparities In African Americans: A Cry For Help To Primary Care Providers, Pandora Goode

Journal of Health Disparities Research and Practice

Diabetes is a national public health problem. Low socioeconomic status influence access to quality care for African Americans with Diabetes who must rely on government assisted insurance or are uninsured. Inadequate access and poor quality care for African Americans contributes to increased morbidity and negative health outcomes. This manuscript will examine the existence of diabetes disparities in African Americans pertaining to the role of low socioeconomic status, access, and poor quality care, and suggest some practical strategies for reducing diabetes disparities in this population.

Analysis Of Hypertension Control Rates Among Participants In The Georgia Hypertension Management And Outreach Program, Sara Byers, Jean O'Connor, Kia Powell-Threets, Brittany Taylor, Kia Padgett, Melissa K. Hallow

Journal of the Georgia Public Health Association

Background: This study utilized health department electronic medical records retrospectively to evaluate hypertension control rates achieved by the Georgia Hypertension Management and Outreach Program (HMOP), an education, screening, and treatment control program that provides services, including blood pressure screening and assessment, referral to physicians, counseling, educational material, disease case management, and treatment.

Methods: Hypertension control rates after at least 6 months of study participation were determined for patients participating in the program for at least 6 months between 2010 and 2014, and for African American and uninsured subgroups.

Results: The overall hypertension control rate was 61.1%, above the 2012 national …

Knowledge And Beliefs About Cancer In African American Population, Rabindra P. Gautam Dhs, Deven Shah Phd, Eric Matthews Phd

Journal of Health Disparities Research and Practice

Cancer is the second most common cause of death in the United States, taking the lives of one in four Americans each year (American Cancer Society [ACS], 2015). A total of 1,658,370 new cancer cases and 589,430 deaths from cancer were projected to occur in the United States in 2015 (ACS, 2015). In 2013, approximately 176,630 new cancer cases and 64,880 deaths from cancer were projected to occur in African American communities. The majority of diagnoses were cancers of the prostate, lung, colon, rectum, breast, and colorectal region (ACS, 2013). For most cancers, African Americans have the highest death rate, …

Social Networks As Predictors Of Colorectal Cancer Screening In African Americans, Ernest Alema-Mensah, Selina A. Smith, Mechelle Claridy, Victor Ede, Benjamin Ansa, Daniel S. Blumenthal

Journal of the Georgia Public Health Association

Background: Early detection can reduce colorectal cancer (CRC) mortality by 15%–33%, and screening is widely recommended for average-risk adults beginning at age 50 years. Colorectal cancer mortality rates are higher in African Americans than in whites, while screening rates are somewhat lower. Individual social networks can reduce emotional and/or logistical barriers to healthpromoting but distasteful procedures such as CRC screening. The aim of this study was to examine social network interactions, and their impact on CRC screening among African Americans. We hypothesized a positive association between social network index (SNI) scores and CRC screening.

Methods: In a community intervention trial …

Sociocultural Risk Factors For Elevated Perceived Stress Among African American Smokers, Monica Webb Hooper, Noella A. Dietz, Joseph C. Wilson

Journal of Health Disparities Research and Practice

Introduction: African Americans experience unique stressors that may inhibit smoking cessation and enhance relapse rates. Few studies, however, have focused on risk factors for perceived stress among treatment seekers. Because African Americans are less likely to quit compared to the larger community, understanding factors associated with perceived stress among smokers has the potential to improve intervention outcomes. This study examined psychosocial and cultural correlates of stress in a sample of African American participants in a randomized controlled trial.

Methods: At baseline, participants reported demographic factors and completed assessments of smoking history, alcohol use, friend and household smoking, weight concerns, acculturation, …

Identifying Outcomes And Gaps Impacting Tobacco Control And Prevention In African American Communities, Leah M. Ranney, Hannah M. Baker, Delmonte Jefferson, Adam O. Goldstein

Journal of Health Disparities Research and Practice

Great racial disparities exist in smoking and related health outcomes in the United States. African American (AA) smokers start smoking later and smoke less than white smokers but are less likely to quit. In 2008, the CDC’s Office on Smoking and Health funded the National African American Tobacco Prevention Network (NAATPN) to focus tobacco control leadership, expertise and promotion in the AA community. In 2012, NAATPN sought to determine significant outcomes of tobacco control efforts impacting Black and AA communities by conducting a qualitative document search and series of interviews with experts in the field. Thirteen identified outcomes were categorized …

Feasibility Of A Community-Based Sickle Cell Trait Testing And Counseling Program, Ashley Housten, Regina Abel, Terianne Lindsey, Allison King

Journal of Health Disparities Research and Practice

Background: Sickle cell trait (SCT) screening is required at birth in the United States; however, adults rarely know their SCT status prior to having children.

Purpose: Assess feasibility of a community-based SCT education and testing intervention.

Methods: Participants were recruited from eight community sites to complete an educational program and offered a hemoglobin analysis. A genetic counselor met individually with participants to discuss lab results.

Results: Between July 14, 2010 and May 31, 2012, 637 participants completed the educational program. Five hundred seventy (89.5%) provided a blood sample, and 61 (10.9%) had SCT or other hemoglobinopathies. The genetic counselor met …

Determinants Of Adherence To Nutrition- Related Cancer Prevention Guidelines Among African American Breast Cancer Survivors, Lindsey A. Ramirez, Yunmi Chung, Wonsuk Yoo, Brittney Fontenot, Benjamin E. Ansa, Mary S. Whitehead, Selina A. Smith

Journal of the Georgia Public Health Association

Background: Mortality rate for breast cancer is higher among African American (AA) women than for women of other racial/ethnic groups. Obesity, also higher among AA women, may increase the risk of breast cancer development and recurrence. Lifestyle factors such as healthy nutrition can reduce the rate of obesity and breast cancer. This study examined the determinants of adherence to nutrition-related cancer prevention guidelines among AA breast cancer survivors.

Methods: AA breast cancer survivors (n=240) were recruited from a breast cancer support group to complete a lifestyle assessment tool for this cross-sectional study. Chi-square test and ordinal logistic regression analysis were …

Blood Pressure Control For African American Parents And Children: Feasibility And Initial Outcomes Of A Faith-Based Intervention Pilot Study, Penny A. Ralston Ph.D., Tammye Farmer M.S., Iris Young-Clark Ph.D., Catherine Coccia Ph.D., R.D.

Journal of Health Disparities Research and Practice

The overall purpose was to determine the feasibility and initial outcomes of a faith-based intervention to improve blood pressure (BP) control in African American (AA) parents/guardians and their children, using a pre/post without control group design. Sample included AA parents and children (n=17) from three churches in North Florida. Health behaviors (daily servings of fruits/vegetables [F/V], minutes of physical activity [PA]) and physical health (BMI, systolic BP and diastolic SB) were examined. Data were analyzed using descriptive statistics, paired t-tests, and correlations. Feasibility outcomes showed high attendance (91% children, 88% parents) and completion (100%) rates. F/V significantly increased at post-test …

Perceptions Of Renal Disease Risk Among African Americans: A Review Of The Literature, Casey L. Migliore, Julie Barroso, Allison Vorderstrasse

Journal of Health Disparities Research and Practice

African Americans are disproportionately at risk for renal disease, especially those with type 2 diabetes (McDonough et al., 2011). Despite this disease disparity, the literature lacks research on renal disease awareness and risk perceptions among African Americans with type 2 diabetes. Therefore, a literature review guided by the Common Sense Model was conducted to review and synthesize the literature on African Americans’ awareness of renal disease and existing risk perceptions, capturing sociocultural factors in the African American community that could influence the development of those risk perceptions. The literature identified an overall lack of knowledge about renal disease risk factors, …

Local Efforts Toward Addressing Health Disparities In Dekalb County, Georgia, April Hermstad, Erikka Gilliam, Sedessie Spivey, Zipatly Mendoza

Journal of the Georgia Public Health Association

Background: In underserved African American communities throughout DeKalb County, the DeKalb County Board of Health (DCBOH) is implementing community-based initiatives using policy, systems, and environmental improvement approaches to reduce racial and ethnic health disparities by increasing opportunities for nutrition and physical activity.

Methods: The initiatives are being implemented in priority census tracts where the population is at least 40% African American, 30% live below federal poverty level, and 25% did not graduate from high school. Communications promote awareness of the programs, and evaluation activities document processes and outcomes.

Results: To date, implementation of five interventions has affected approximately 276,000 DeKalb …

Engaging African Americans In Developing An Intervention To Reduce Breast Cancer Recurrence: A Brief Report, Selina A. Smith, Mary S. Whitehead, Joyce Q. Sheats, Brittney Fontenot, Ernest Alema-Mensah, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: To develop a culturally appropriate lifestyle intervention, involvement of its intended users is needed.

Methods: Members of an African American (AA) breast cancer support group participated in two 4-hour guided discussions, which were audiotaped, transcribed, and analyzed to guide the content.

Results: The support group collaborated with researchers to develop 24 experiential nutrition education sessions using a social cognitive framework and incorporating self-regulation skills (goal-setting, self-monitoring, problem-solving, stimulus control) and social support to enhance self-efficacy for changes in dietary intake.

Conclusions: Community engagement fostered autonomy, built collaboration, and enhanced the capacity of AA breast cancer survivors to participate in …

A Review Of Community-Based Participatory Research Studies To Promote Physical Activity Among African Americans, Steven S. Coughlin, Selina A. Smith

Journal of the Georgia Public Health Association

Background: As part of the planning process for new research, the literature on community-based participatory research (CBPR) approaches for promoting physical activity in African American communities was systematically reviewed.

Methods: Studies published through October 31, 2015 that employed CBPR methods were identified using PubMed and CINAHL databases and MeSH terms and keyword searches.

Results: A total of 15 studies met the search criteria. One focused on CBPR and physical activity among African American school children and adolescents, 13 on adults, and one on both children and adults. Seven studies employed CBPR methods to promote physical activity in church settings. Eight …

Sexual Health Education In Georgia: A Role For Reducing Sexually Transmitted Infections Among Adolescents, Madison L. Gates, Veronica Walker, Nancy C. Webb

Journal of the Georgia Public Health Association

Background: In Georgia, sexually transmitted infections (STIs) are a substantial health issue, particularly among young adults in vulnerable and minority populations. The United States Preventive Services Task Force recommends that sexually active adolescents and at-risk adults receive behavioral counseling and education in primary care settings, community organizations, departments of health, and schools.

Methods: The present approach used in Georgia for educating adolescents at high risk for STIs about these diseases was assessed. The data collected included standards for sexual health education, survey results from educators and students, and observations from a pilot study with adolescents detained by the juvenile justice …

Factors Associated With Colorectal Cancer Screening Among Younger African American Men: A Systematic Review, Charles R. Rogers, Patricia Goodson, Margaret Foster

Journal of Health Disparities Research and Practice

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men’s intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men’s screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies’ methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.

The Self-Reported Sexual Behaviors Of Single Older African Americans, Victoria Foster, Patricia C. Clark, Marcia M. Holstad

Journal of Health Disparities Research and Practice

Abstract

African Americans are disproportionally affected by HIV/AIDS, but little is known about the risky sexual behaviors of older African Americans. This cross-sectional, comparative study, investigated the self-reported sexual behaviors of sexually active older African Americans. The nonrandom sample (N = 78) included single African American men (59%) and women (41%), 50-74 years of age. Participants were recruited from various community sites, and data were collected with a standard sexual history questionnaire. Participants reported practicing risky behaviors such having unprotected oral, anal, and vaginal sex (96.5%), and having multiple sex partners (37.2%). There were several significant gender differences such …

Factors Associated With Belief In Conspiracies About Hiv/Aids Among Hiv-Positive African-American Patients, Andrew A. Zekeri, Youssouf Diabate

Professional Agricultural Workers Journal

Abstract

The purpose of this study is to examine factors associated with belief in conspiracies about HIV/AIDS among HIV-Positive African American patients. Survey data were collected from 256 African American patients living with HIV/AIDS attending two HIV clinics in Montgomery and Dothan, Alabama. The study used multiple regression analysis to examine how sociodemographic factors contribute to belief in conspiracies about HIV/AIDS. Education and age were significantly related to belief in conspiracies about HIV/AIDS among men and women. Beliefs in conspiracies about HIV/AIDS may be a barrier to HIV prevention among African Americans. Public health officials should work toward obtaining the …

Race And Sex Differences In Correlates Of Systolic Blood Pressure In Community-Dwelling Older Adults, Cassandra Ford Phd, Patricia Sawyer, Patricia Parmelee, Olivio J. Clay, Martha Crowther, Richard M. Allman

Journal of Health Disparities Research and Practice

Objectives: To describe correlates of measured systolic blood pressure (SBP) among community-dwelling older African American and White Medicare beneficiaries.

Methods: Participants completed an in-home assessment and factors significantly correlated with SBP were tested using multivariable models.

Results: Among the 958 participants (mean age= 75.3 [SD = 6.8]; 49% African American; 49% female; 52% rural) African Americans were more often diagnosed with hypertension, more likely on anti-hypertensives, and on more anti-hypertensive medications. SBP was 2.7 mmHg higher in African Americans than Whites (p=.03). SBP was higher in women than men. Multivariable models revealed differences in the factors associated with SBP by …

Strengthening Hiv Knowledge And Awareness Among Undergraduate Students At Historically Black Colleges And Universities, Ashley Murray, Monica J. Huang, Felicia Hardnett, Madeline Y. Sutton

Journal of Health Disparities Research and Practice

Objective: We describe baseline HIV knowledge among students at historically black colleges and universities (HBCUs) to inform and strengthen HIV education efforts at HBCUs.

Methods: We surveyed 1,230 African American HBCU students from 24 HBCUs; 1,051 responses (85.4 %) were analyzable.

Results: Although general HIV knowledge was high among respondents (95% of students correctly responded that having sex without a condom constituted unsafe sex), knowledge deficits were noted (only 25% of students reported that multiple sex partners is a form of unsafe sex, while 25% of students reported that withdrawal of the penis before ejaculation reduced HIV …

Black Is Decidedly Not Just Black: A Case Study On Hiv Among African-Born Populations Living In Massachusetts, Chioma Nnaji, Nzinga Metzger

Trotter Review

Black or African American is a racial category that includes the descendants of enslaved Africans as well as members of foreign-born black communities who migrated to the United States from places abroad, such as Africa, the Caribbean, and Latin America. Grouping native-born and foreign-born blacks into a single homogeneous racial category may make it easier to track disease and health outcomes; however, it masks the different cultural experiences, histories, languages, social and moral values, and expectations that influence health beliefs, attitudes, practices, and behaviors. It also ignores such factors as migration, which forces foreign-born populations to examine both their traditional …

Strategic Planning For Recruitment And Retention Of Older African Americans In Health Promotion Research Programs, Laura Dreer, Cynthia Owsley, June Weston

Journal of Health Disparities Research and Practice

The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this project.

We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE was designed to promote eye disease prevention by conveying the personal benefits of annual dilated comprehensive eye care and teaching strategies to minimize barriers to eye care. The InCHARGEÓ program or a social contact control program was delivered at 20 senior centers in …

Healthcare Access And Health Outcomes In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

In a publication from the Robert Woods Johnson Foundation, it was recognized that a person’s zip code was a more important predictor of health than their genetic code. Where we live influences not only our access to health care, but other health indicators as well. Clark County has a low primary care physician to population ratio compared to other counties in Nevada and in the US. Clark County also has highest rates of uninsured in the Mountain West and among the highest in the nation.

Southern Nevada fared worse than other Mountain West Metropolitan areas in health indicators and preventative …

Health Disparities In Colorectal Cancer Screening In United States: Race/Ethnicity Or Shifting Paradigms?, Adina Williams, Kirk Dabney, Holmes Laurens Jr

Journal of Health Disparities Research and Practice

Background: Colorectal cancer (CRC) remains the third leading cause of cancer death in the United States. The incidence, mortality, and screening vary by race/ethnicity, with African Americans and Hispanics being disproportionately represented. Early detection through screening prolongs survival and decreases mortality. CRC screening (CRCS) varies by race/ethnicity, with lower prevalence rates observed among minorities, but the factors associated with such disparities remain to be fully understood. The current study aimed to examine the ethnic/racial disparities in the prevalence of CRCS, and the explanatory factors therein in a large sample of U.S. residents, using the National Health Interview Survey, 2003. …

Racial Disparities In Pain Management In Primary Care, Miriam Ezenwa

Journal of Health Disparities Research and Practice

This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African …

Equal Care, Unequal Outcomes: Experiences Of A Reach 2010 Community, Diane Neal, Barbara Carlson, Carolyn Jenkins, Gayenell Magwood

Journal of Health Disparities Research and Practice

Diabetes is growing in prevalence and costs. Guidelines for care have been available since 1983, yet diabetes care and outcomes remain less than ideal. CDC’s Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) identified diabetes in African Americans as a priority for action. This article documents the activities, interventions, and current progress of the REACH 2010 diabetes coalition formed in Charleston and Georgetown counties, South Carolina, in reducing health care disparities and describes next steps for improving outcomes. The Chronic Care Model guided many of the implementation activities, and chart audits were used to document outcomes. Ambulatory care …

Elevated Depressive Symptoms In A Community Sample Of African-Americans And Whites, Robert J. Jagers, Fernando A. Wagner, Pamela E. Scott-Johnson, Yan Wang, Dorothy C. Browne

Journal of Health Disparities Research and Practice

This study examined demographic and psychosocial correlates of elevated depressive symptoms among African-Americans and Whites from comparable socioeconomic and neighborhood backgrounds. 851 African-Americans and 597 Whites from adjacent census tracts were interviewed using previously validated indicators of depressive symptoms, social support, religious practices and various demographic characteristics. More Whites than African-Americans reported elevated depressive symptoms and the groups also differed on several demographic variables and psychosocial variables. Employment, marital status and age were salient demographic covariates for African Americans, while income was for Whites. For both groups, social support and church attendance were inversely associated with depressive symptoms. Prayer was …