Medicine and Health Sciences Commons^™

African American Adults’ Experiences With The Health Care System: In Their Own Words, Keri A. Jupka, Nancy L. Weaver, Vetta L. Sanders-Thompson, Nicole M. Caito, Matthew W. Kreuter

Journal of Health Disparities Research and Practice

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and …

Examination Of Racial Disparities In Childhood Asthma Management Practices, Crystal N. Piper, Saundra Glover, Kieth Elder, Jong-Deuk Baek

Journal of Health Disparities Research and Practice

Objective: To analyze asthma management plan practices for children with asthma in the United States considering race and other demographic and person-level characteristics.

Methods: Univariate/Bivariate/Multivariate analysis was performed to examine asthma management plan physician recommendations among children in the United States utilizing secondary data analysis of the 2002 and 2003 National Health Interview Survey.

Results: The majority of the study participants reported not having an asthma management plan at (59.00%). In multivariate analysis using SAS callable SUDAAN, Whites were significantly more likely to have an asthma management plan (OR=1.66, p=.0031).

Conclusion: Findings from this study indicate that Black and Hispanic …

Pastors’ Influence On Research-Based Health Programs In Church Settings, Shirley M. Timmons

Journal of Health Disparities Research and Practice

Churches, in the United States, are recognized essential players in addressing our mounting health and social service needs. Yet, even though they implement a relatively large number of programs, few are research-based. Focus groups were conducted with pastors from 11 Baptist churches in a small Southeastern town to explore factors that influence the implementation of research-based health programs. Transcripts were coded for domains resulting in four themes: congregant needs, shared programming ethics, common understanding of programming processes, and care for the church and congregation. Pastors value research and seek church-based programs that enhance the health of congregants. Yet, future study …

Promoting Physical Activity In Low Income African Americans: Project Laps, Dorothy W. Pekmezi, Brooke L. Barbera, Jamie S. Bodenlos, Glenn N. Jones, Phillip J. Brantley

Journal of Health Disparities Research and Practice

Low income African Americans are at increased risk for physical inactivity and related chronic illnesses. Thus, effective interventions are needed to address these health disparities. The current study examined the efficacy of a home-based physical activity intervention among a low income African American sample with high rates of chronic illnesses (obesity, hypertension, diabetes, high cholesterol). Participants (n=214) were randomly assigned to either the home-based physical activity intervention (self-help print materials, five monthly newsletters, two telephone counseling sessions) or an attention control condition, which promoted healthy diet. Results indicated that the intervention did not produce significantly greater increases in physical activity …

Utilizing Community Resources To Reduce The Presence Of Type 2 Diabetes In Rural Youth, Antonia S. Mead, M. C. Nagy, Stephen Nagy

Journal of Health Disparities Research and Practice

The purpose of this study was to implement a program designed to promote diabetes prevention activities among preadolescents in a rural southern setting using a day camp intervention. Participants in the study were eleven youth from a rural Alabama county who participated in a week-long half-day camp administered by local and community volunteers. Change scores were used to compare pre- to post- to follow-up measures for camp participant responses. Program results consistently demonstrated that the day camp was theoretically sound and that program activities positively impacted behavioral antecedents. This study demonstrated the feasibility of conducting a diabetes prevention day camp …

Hepatitis C Diagnoses In An American Indian Primary Care Population, Hillary E. Norton, John T. Redd, Ralph T. Bryan

Journal of Health Disparities Research and Practice

BACKGROUND: Despite large disparities in the burden of chronic liver disease, data on hepatitis C virus (HCV) infection among American Indians (AIs) are lacking. We reviewed hepatitis C diagnoses in 35,712 AI/AN primary care patients.

MAIN FINDINGS: At least one HCV-associated ICD-9 code was recorded in 251 (1%) patients between October 1, 2001 and September 30, 2003. An HCV enzyme-linked immunoassay (HCVEIA) was sent in 209 (83.0%); 206/209 (99%) were positive. Confirmatory testing was performed in 144/206 (70%) HCV-EIA positive patients; HCV infection was confirmed in 144 (100%). In the 90/144 (63%) charts with risk factor documentation, injection drug use …

Tribally-Driven Participatory Research: State Of The Practice And Potential Strategies For The Future, Patricia Mariella, Eddie Brown, Michael Carter, Vanessa Verri

Journal of Health Disparities Research and Practice

This paper discusses current practice of research with and by American Indian tribal governments in the United States. It begins with a brief overview of Community-Based Participatory Research and compares and contrasts its principles and methods with what this paper terms Tribally-Driven Participatory Research. The paper analyzes current challenges and offers concepts for continuing to improve the effectiveness of Tribally-Driven Participatory Research.

Talking Glossary Of Genomics Terminology: A Genomics Education Module For American Indian Communities, Jill Peters, Pauline Davies, Naomi Lane, Kathryn Coe

Journal of Health Disparities Research and Practice

This paper describes the development of an audio visual genomics glossary that was designed as an education tool for American Indian communities. This “Talking Glossary of Genomics Terminology” is a multimedia DVD that was modeled on the “Talking Glossary of Genetics,” which was developed by the National Human Genome Research Institute (NHGRI). The NHGRI Glossary was modified and expanded with content designed to increase awareness among American Indians about cancer, genomics, and personalized medicine. Partners on the project include the Inter Tribal Council of Arizona, Inc., Phoenix Indian Medical Center, Arizona Cancer Center at the University of Arizona, the Translational …

Beyond The It Magic Bullet: Hiv Prevention Education And Public Policy, Fay C. Payton

Journal of Health Disparities Research and Practice

Analytic applications are vital in the assessments of public health and surveillance as these applications can drive resource allocation, community assessment and public policy. Using a dataset of nearly 90,000 patient hospital encounters, the number of instances with an ICD code of HIV and co-morbidities was identified. Blacks accounted for 75 percent of HIV hospital encounters in the dataset. While business analytic applications informed this study of cross-tabulations and interaction effects among race, age and gender, there appears to be a significant relationship among HIV diagnoses and substance abuse. Payer data is informed by the Healthcare Cost and Utilization Project …

Health Disparities In Kidney Transplantation: An Equity Analysis, Shirley A. Wells

Journal of Health Disparities Research and Practice

The growing incidence of end stage renal disease along with advances of the past 40 years that have improved the success rate of kidney transplantation have created an unprecedented demand for kidney transplant. Yet, certain racial and ethnic groups and women consistently have longer waiting times and lower rates of transplantation which makes a review of the kidney procurement and transplantation system in view of its equity imperative. Reasons given for these disparities have varied from cultural attitudes and beliefs on the part of patients and health care providers, socioeconomic status, rates of organ donation, and geographic location. The equity …

A Review Of Smoking Among Rural African Americans: Recommendations For Research And Cessation Interventions, Susan Hedgecock, Anita Fernander

Journal of Health Disparities Research and Practice

Objective: The purpose of this review is to synthesize the available literature on smoking among rural African Americans.

Methods: Using search terms “rural” “African American” “Black” and “smoking” 19 relevant articles were identified in the Medline data base. Findings gleaned from the 19 articles are presented in four categories: a) smoking prevalence, b) smoking behavior and patterns, c) smoking cessation interventions and quitting, and d) smoking-related outcomes.

Results: There may be gender differences, a pattern of late onset of smoking, and a preference for mentholated brands among rural African American smokers. There is no evidence that rural African Americans are …

The Context Of Sexual Risk Among African-American Female College Students, Lucy Annang, Shacara D. Johnson, Malaika A. Pepper-Washington

Journal of Health Disparities Research and Practice

Objective: To assess the sexually transmitted infection (STI) awareness, sexual risk behaviors, and related contextual factors of African-American female college students.

Participants: Eighty-nine African-American first year female students attending a majority public four-year college in the southern U.S. participated in the study in Spring, 2006.

Methods: Participants completed an anonymous self-administered paper-and-pencil survey and received a $15 cash incentive.

Results: Participants were highly knowledgeable and aware about STIs and their consequences. While this awareness translated into low levels of risk for many, still others engaged in behaviors and maintained beliefs that could potentially put them at high risk for contracting …

Differential Effects Of Race And Poverty On Ambulatory Care Sensitive Conditions, Farrukh B. Hakeem, Daniel L. Howard, Timothy S. Carey, Yhenneko J. Taylor

Journal of Health Disparities Research and Practice

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in …

Recruitment Of African Americans For Obsessive Compulsive Disorder Treatment Research, Georgia Michalopoulou, Pamela Falzarano, David Rosenberg

Journal of Health Disparities Research and Practice

A systematic review of recruitment approaches was conducted as a step towards creating a culturally sensitive approach to enhance participation of African Americans into our Obsessive Compulsive Disorder (OCD) treatment research. From this review, a recruitment plan providing a collaborative partnership between the African American community and the clinical investigators was adopted. We sought to increase participation in OCD research by developing culturally sensitive educational materials, implementing strategies such as recruiter ethnic match, encouraging individuals to participate by a pastor, and providing education in the community that attempted to decrease stigmatization of mental illness and target cultural suspicion of institutional …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith Williams, Carlos Crespo, Joan Dorn

Journal of Health Disparities Research and Practice

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Association Of Vitamin D Deficiency With Hypertension In Uninsured Women, Sreenivasa R. Chandana, Lakshmi P. Kocharla, Susan S. Harris, Radhika R. Kakarala

Journal of Health Disparities Research and Practice

Vitamin D deficiency is an epidemic in the United States. Uninsured women are at high risk due to a lower intake of vitamin D and limited sun exposure. We examined the association between vitamin D deficiency and hypertension in 96 uninsured women at a County Free Medical Clinic in urban Michigan. Questionnaires were used to obtain information about demographics, medical history including hypertension, and dietary habits. Measurements including blood pressure and serum 25(OH)D level were also collected. Prevalence of hypertension was higher in subjects with 25(OH)D less than 50nmol/l compared with others (85% vs. 27.3%, p = 0.014). For every …

Race/Ethnicity As A Risk Factor Of Mother To Child Transmission Among Hiv Infected Mothers, Wei Yang, Fares Qeadan, Mona L. Brown, Michelle Chino, Scott Hall, Mary Guinan

Journal of Health Disparities Research and Practice

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were …

A Human Capital Approach To Reduce Health Disparities, Saundra Glover, Sudha Xirasagar, Yunho Jeon, Keith Elder, Crystal N. Piper, Harris Pastides

Journal of Health Disparities Research and Practice

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research.

Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), …

Suicide Rates Among Young, Married Women In Nepal, Kirra L. Hughes

Capstone Collection

In 2009, a Maternal Mortality and Morbidity (MMM) report carried out in Nepal by the Family Health Division of the Department of Health Services accidently stumbled upon a surprising leading cause of death in Nepali women of reproductive age (15 - 49). The result: suicide. And the numbers are still on the rise. There have since been no comprehensive follow-up studies and none, to my knowledge, that are currently ongoing. This leaves an urgent need for research to be done on the causes of these suicides (Benson and Shakya, 2011; Bertolote et al, 2005; Pradhan et al, 2009).

Globally, there …

Individualism And Collectivism As Moderators Of Affect And Attributional Style In Predicting Life Satisfaction, Jo M. Holmquest

Graduate Theses

The present study examined the effect of person-level individualism and collectivism on attributional style and frequencies of positive and negative emotions as predictors of life satisfaction. Participants were 224 individuals (age range 18 to 78, M= 39.63, SD = 13.78; 73% women; 56% Filipinos) who answered an online survey. Results from regression analyses showed that attributional style is not a statistically significant predictor of life satisfaction. The analyses also showed that across all participants, and among those who did not score high in individualism and low in collectivism, the frequency of positive emotions, as compared to the frequency of negative …

Drug And Nondrug Alternatives To Altering Mood, Phuong N. Cardoza

Graduate Theses

This study examined the usage patterns of nondrug alternatives and obtained knowledge that will be beneficial to future drug abuse prevention and rehabilitation in college students. The purpose was to identify the specific nondrug/drug alternatives used to alter mood by non-Hispanic Whites and Hispanics. Analysis revealed that engaging in discussion with spouse/friends was used most frequently to alter mood. The overall distribution of drug alternatives and nondrug alternatives differed significantly from chance in 72 participants. Further pair-wise analyses found there were significant differences between five drug and nondrug alternatives endorsed by non-Hispanic Whites and Hispanics. In conclusion, it was found …

Multiple Peer Group Self-Identification And Adolescent Tobacco Use, C. Anderson Johnson, Juliana L. Fuqua, Peggy E. Gallaher, Jennifer B. Unger, Dennis R. Trinidad, Steve Sussman, Enrique Ortega

CGU Faculty Publications and Research

Associations between peer group self-identification and smoking were examined among 2,698 ethnically diverse middle school students in Los Angeles who self-identified with groups such as Rockers, Skaters, and Gamers. The sample was 47.1% male, 54.7% Latino, 25.4% Asian, 10.8% White, 9.1% Other ethnicity, and 59.3% children of immigrant parents. Multiple group self identification was common: 84% identified with two or more groups and 65% identified with three or more groups. Logistic regression analyses indicated that as students endorsed more high risk groups, the greater their risk of tobacco use. A classification tree analysis identified risk groups based on interactions among …

Sextrafficking Of Minors: How Many Juvenilesare Being Prostituted In The Us?, Michelle L. Stransky, David Finkelhor

Crimes Against Children Research Center

There have been many attempts to estimate the number of juveniles who are being prostituted (or trafficked) within the United States. These estimates range from 1,400 to 2.4 mil‐ lion, although most fall between 300,000 and 600,000. BUT PLEASE DO NOT CITE THESE NUMBERS. READ ON. A close look at these diverse estimates reveals that none are based on a strong scientific foundation. They are mostly educated guesses or extrapolations based on questionable assumptions. They do not have the substance of typically re‐ ported crime statistics, like the number of robberies or the number of child sexual abuse victims. The …

Designing An "Information-Experience" Using Creativity Science Theory And Tools, Stephanie Belhomme

Creativity and Change Leadership Graduate Student Master's Projects

An “information-experience” encapsulated by a technological/digital audio-visual tool presents data and potentially meaningful information to prompt actionable knowledge concerning: “unspoken creative process elements;” their profound impacts on both how well our “physiology of creativity” functions; but also on how well foundational creative thinking and behavioral prerequisites (energy, motivation, imagination, and ownership) are leveraged.

The product: 1) introduces the user to one component of the CPS (Creative Problem Solving) Facilitation Process - Exploring the Challenge; 2) features a content specific component which prompts exploration of the many correlations between societal, organizational / community, human physiological / behavioral data, and the direct …

Securing South Africa's Future Grandmothers Against Poverty And Aids As A Model For Social Development Change, Savannah Lynn Eck

Graduate Program in International Studies Theses & Dissertations

Focusing on the role of elder women in South Africa as a lens to understand the central connections among HIV/ AIDS, poverty and Human Security provides a distinct approach to analyze women's contributions to community development and social change. Drawing from the theories of Gender and Development and Human Security, this research aims to highlight HIV/ AIDS as a social and political security issue, while underscoring the vitality of the inclusion of women in the processes of peace building, reconciliation, education and social development. Furthermore, the influential role of elder women in South Africa will serve as a model in …

Perceptions Of Barriers That Inhibit African American Women And Adolescent Girls From Participation In Physical Activity, Sonya Daniels Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study examined the barriers to leisure time physical activity for African American women and their adolescent daughters. Six mother-daughter dyads were interviewed who have access to physical activity opportunity. Three of the dyads participated in a follow-up focus group. A qualitative research design that utilized a grounded theory approach identified two themes for the women and two themes for the girls. Themes for the women include influence of culture and low physical activity IQ. Sub-themes of influence of culture are (a) hair and (b) body image. Sub-themes of low physical activity IQ are (a) mommy guilt, (b) perception of …

School Age Children: The Effects Of Hunger, Dacia Bessler

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

Research Brief: Technology And Health Education: An Exploratory Study Of Older Chinese Immigrants, Jenny H. Tsai, Vicky Taylor, Shin-Ping Tu

Journal of Health Disparities Research and Practice

Technology advances, especially in the Internet, provide new tools to deliver health education to limited English proficient immigrants. This paper presents the findings of a qualitative descriptive study of older limited English proficient Chinese immigrants’ perspectives regarding computer-based health education. The sample consisted of 33 foreign-born Chinese recruited in Seattle, Washington. Data were generated through six focus groups and an 18-item demographic questionnaire. The analyses revealed that the majority was not skillful in computer use and Internet browsing, and the Internet was not a common health information source. Nevertheless, participants were supportive of having computer-based health information designed for Chinese …

Preliminary Evaluation Of The Incharge Program Among Older African Americans In Rural Alabama, Cynthia Owsley, Gerald Mcgwin Jr., June Weston, Beth T. Stalvey, Karen Searcey, Christopher A. Girkin

Journal of Health Disparities Research and Practice

Objective: Blindness rates among older African Americans are two times higher than for older whites. Our purpose was to understand attitudes about eye care and perceived barriers to care among older African Americans living in rural Alabama and to determine whether an educational program reduced perceived barriers to care. InCHARGE, an eye health education program for older African Americans, promotes eye disease prevention by conveying the personal benefits of annual dilated comprehensive eye care and by teaching strategies to minimize barriers to eye care.

Design and Participants: InCHARGE was presented in five senior centers to 111 individuals. Using a questionnaire …

Obesity Prevalence, Weight-Related Beliefs And Behaviors Among Low-Income Ethnically Diverse National Job Corps Students, Jamie S. Bodenlos, Milagros C. Rosal, Diane Blake, Celeste Lemay, Diane Elfenbein

Journal of Health Disparities Research and Practice

The obesity rates of Job Corps students, a predominantly ethnic minority and low income group of youth, are unknown. The purpose of this project was to examine obesity rates among these youth as well as their weight-related perceptions and behavior. First, medical charts (N=641) of all Job Corps students (ages 16-25) who were enrolled in the program in the past year were examined for height and weight. In the second phase of the study, 344 Job Corp students were recruited and information on weight perceptions, knowledge of obesity consequences, and weight loss behavior were examined. Almost half of the participants …