Medicine and Health Sciences Commons^™

Personalized Nutrition As A Key Contributor To Improving Radiation Response In Breast Cancer, Anuradha A. Shastri, Joseph Lombardo, Samantha C Okere, Stephanie Higgins, Brittany C Smith, Tiziana Deangelis, Ajay Palagani, Kamryn Hines, Daniel A. Monti, Stella Volpe, Edith P. Mitchell, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Understanding metabolic and immune regulation inherent to patient populations is key to improving the radiation response for our patients. To date, radiation therapy regimens are prescribed based on tumor type and stage. Patient populations who are noted to have a poor response to radiation such as those of African American descent, those who have obesity or metabolic syndrome, or senior adult oncology patients, should be considered for concurrent therapies with radiation that will improve response. Here, we explore these populations of breast cancer patients, who frequently display radiation resistance and increased mortality rates, and identify the molecular underpinnings that are, …

Examining The Healthcare Journeys Of African American Individuals With Type 2 Diabetes Amid Covid-19, Lei Edmerson

Honors Theses

The overall purpose of this study is to explore the pandemic experience of African American’s with Type 2 Diabetes. This study was done to highlight a specific group of people who live with a chronic illness and the steps they took to ensure their safety during a pandemic. The COVID- 19 pandemic had been shown to adversely and disproportionately impact minorities and those with diabetes in regards to mortality rates. This study aims to bring light to the stories of those dealing with more than just the pandemic. It wanted to explore how they made it thus far, and if …

The Psychosocial Experiences Of African American Sexual And Gender Minority Caregivers Of People With Dementia, Lakeva Harris

Doctoral Dissertations

Over 50 million people in the United States provide unpaid care to a family member or friend. One-third of these caregivers (16 million) provide care to someone with Alzheimer’s disease and related dementias (ADRD). Of these caregivers, more than 20% state caregiving has led to a decline in their health. African American caregivers are less likely to report being in very good or better health than their white caregiving peers. Similarly, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) caregivers are more likely to report fair or poor health than their heterosexual, cisgender peers. The overlap of these minoritized identities may …

Language Variation In The Writing Of African American Students: 6 Factors Predicting Reading Achievement, Lisa Fitton Ph.D., Lakeisha Johnson, Carla Wood, Christopher Schatschneider, Sara A. Hart

Faculty Publications

Purpose

This study aims to examine the predictive relation between measures obtained from African American students' written narrative language samples and reading achievement, as measured by standardized academic assessments.

Method

Written language samples were elicited from 207 African American students in Grades 1–8. The samples were examined for morphosyntactic variations from standardized written Generalized American English (GAE). These variations were categorized as either (a) specific to African American English (AAE) or (b) neutral across AAE and standardized written GAE (i.e., considered ungrammatical both in AAE and in standardized written GAE). Structural equation modeling was employed to then examine the predictive …

Detection Of Breast Cancer In African American Women Using Walk-In Mammography, Munachi Nwosu

Dissertations

Abstract

Problem: Breast cancer is a life-threatening condition, in which the prognosis could potentially worsen with a delay in the detection and commencement of treatment. Scheduling patients for mammograms continues to allow for long wait times that exist in screening mammography. Lower rates of participation in scheduled screening mammograms contributes to the increased rate of advanced breast cancer diagnosis that exit in African American women and threatens their health outcomes. The purpose of this project was to implement walk-in mammography to increase participation for early breast cancer detection.

Methods: An observational descriptive design with a retrospective chart review. A PDSA …

A Theory-Based Analysis Of Covid-19 Vaccine Hesitancy Among African Americans In The United States: A Recent Evidence, Manoj Sharma, Kavita Batra, Ravi Batra

Environmental & Occupational Health Faculty Publications

African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch’s t test, and Pearson’s correlation tests were utilized …

Racial And Socioeconomic Disparities Influencing Obesity Amongst Middle-Aged Women, Morgan Woods

Master of Science in Integrative Biology Theses

Many studies have examined the effects of racial and socioeconomic differences on health-related disparities involving obesity but, few have examined the mental and physical well-being intersection. Obesity is a disease that affects many Americans and has become an epidemic affecting the American population. Obesity, especially morbid obesity, is a risk factor for many other obesity-related diseases such as diabetes, cardiovascular diseases, hypertension, and more. Using the 2018 Healthcare Avoidance Study, differences were found between two racial groups, Caucasian and African-American women. Race was found as a significant factor for both level of physical activity and ideal body image perception

No Difference In Clinical Outcomes For African American And White Patients Hospitalized With Sars-Cov-2 Pneumonia In Louisville, Kentucky, Julio A. Ramirez, Stephen P. Furmanek, Thomas Chandler, Stephen S. Hanson, Dawn Balcom, Subathra Marimuthu, Sathya Krishnasamy, Jose Bordon, Rodrigo Cavallazzi, Amr Aboelnasr, Mahder A. Tella, William A. Mattingly, Ashley M. Wilde, Daisy Sangroula, Demetra Antimisiaris, Donghoon Chung, Guillermo Cabral, Gabino R Fernandez-Botran, Jiapeng Huang, Martin Gnoni, Ozan Akca, Paul Schulz, Phillip F. Bressoud, Priya Krishnan, Sally Suliman, William P. Mckinney, Bryan Moffett, Leslie A Wolf, Mark Burns, Alex Glynn, Ruth Carrico, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Introduction: Current literature indicates that African American individuals are at increased risk of becoming infected with the SARS-CoV-2 virus and suffer higher SARS-CoV-2-related mortality rates. However, there is a lack of consensus as to how the clinical outcomes of African American patients differ from those of other groups. The objective of this study was to define the clinical outcomes of African American and White hospitalized patients with SARS-CoV-2 community-acquired pneumonia (CAP) in Louisville, Kentucky.

Methods: This was a retrospective cohort study of hospitalized patients with SARS-CoV-2 CAP at eight hospitals in Louisville, Kentucky. Severity of CAP at time of hospitalization …

A Cost Effectiveness Analysis Of The Nutritious Eating With Soul Study, Mary Jones Wilson

Theses and Dissertations

PURPOSE Historically, African Americans (AA) have been underrepresented in nutritionrelated behavioral research despite their disproportionate higher risk of cardiovascular disease (CVD). The Nutritious Eating with Soul (NEW Soul) Study is one of the first of its kind to recruit an AA only study group to examine CVD prevention via a clinical trial to examine changes in CVD risk factors across two cohorts who are randomly assigned to a plant-based, soul food vegan diet or low-fat omnivorous (omni) diet. The purpose of cost effectiveness analysis (CEA) is to inform clinical and policy decisions and the costs of interventions that society is …

Attitudes Towards A Mindfulness-Based Intervention From African American Women Living With Hiv: A Qualitative Study, Slone Taylor, Shan Qiao Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction: Mindfulness-based interventions train participants to pay attention to their own emotions in the current moment without judging themselves. This study aims to assess the attitudes toward a mindfulness-based stress reduction intervention among African American women living with HIV. Methods: We collected qualitative data from three focus group discussions with 18 African American women living with HIV who were purposely recruited from the Palmetto Health-USC Immunology Center in South Carolina, United States. The participants discussed how they coped with stress, and then were given a presentation on mindfulness-based stress reduction and a sample mindfulness-based stress reduction mini workshop with follow-up …

The Impact Of Poverty And Neighborhood Characterstics On The Mental Health And Parent-Child Closeness In The Black Community: The Protective Role Of Black Cultural Strengths, Brandon Davis Hollie

Dissertations - ALL

Poverty and negative neighborhood characteristics can be detrimental to the mental health wellbeing of Black people. Yet, there is a lack of understanding of how, why, and for whom such factors impact the mental of the Black community. Using a sample of 1654 Black families from the Fragile Family and Child Wellbeing Study I investigated two models. First, I examined the path from poverty to depression, anxiety, and tested Black cultural strengths, religiosity and neighborhood cohesion as moderators. Second, I examined the path from poverty to parent-child closeness and tested Black cultural strengths, social ties and extended family as moderators. …

The Impact Of Poverty And Neighborhood Characterstics On The Mental Health And Parent-Child Closeness In The Black Community: The Protective Role Of Black Cultural Strengths, Brandon Davis Hollie

Dissertations - ALL

Poverty and negative neighborhood characteristics can be detrimental to the mental health wellbeing of Black people. Yet, there is a lack of understanding of how, why, and for whom such factors impact the mental of the Black community. Using a sample of 1654 Black families from the Fragile Family and Child Wellbeing Study I investigated two models. First, I examined the path from poverty to depression, anxiety, and tested Black cultural strengths, religiosity and neighborhood cohesion as moderators. Second, I examined the path from poverty to parent-child closeness and tested Black cultural strengths, social ties and extended family as moderators. …

Home And Neighborhood Physical Activity Location Availability Among African American Adolescent Girls Living In Low-Income, Urban Communities: Associations With Objectively Measured Physical Activity, Nicole O'Reilly

Social Work Faculty Publications and Presentations

Based on the ecological model of active living, the neighborhood environment may relate to individual physical activity (PA) behaviors. The purposes of this study were to (1) generate a replicable neighborhood-level physical activity location availability score (PALAS) from data variables associated with physical activity among adolescents and adults, and apply this score to Baltimore City, Maryland, and (2) determine if relationships exist between PA and PA location availability. Geographic information systems (GISs) were used to create the PALAS. Using linear regression models, we examined relations between objectively measured PA among low-income, urban, predominantly African American adolescent girls (n = …

Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji

Journal of Patient-Centered Research and Reviews

Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …

Evaluation Of A Clinic-Based Peer Navigation Program (Pnp) For African Americans Living With Hiv In South Carolina, Kimberly Butler Willis

Theses and Dissertations

Peer navigation programs have been identified as a potential motivator in care engagement and retention for patients living with HIV, although the data is inconsistent. HIV management requires important disease management considerations and innovative approaches for patient care. Medication advancements and technology have drastically improved care for most patients living with this chronic disease; yet African Americans contract, live with, and die because of HIV-related complications at disproportionately higher rates compared to their White peers.The purpose of this exploratory mixed-methods outcome evaluation is to: (1) determine if peer navigation is a viable intervention to improve three key HIV care metrics: …

A Faith-Based Approach To Promote African American Healthy Heart Behaviors, Gwendolyn Gaston

Electronic Theses and Dissertations

More than 100 million American people have some form of cardiovascular disease. African American life expectancy is 3.4 years shorter than that of Caucasians, with an estimated 32% difference in cardiovascular disease mortality between Caucasian and African American men and a 43% difference between Caucasian and African American women. The purpose of this project was to utilize a faith-based approach in developing a heart-healthy program for addressing health disparities in an African American Baptist Church. The program focused on improving cardiovascular health literacy and addressing modifiable risk factors. The results of this project revealed that African Americans need interventions to …

Effect Of Treatment For Hcv On The Development Of Hcc In A Predominately African American Medical Center Population, Bassem Farah, Yechiel Mor, Sarvani Surapaneni, Brian Rutledge, Hojun Lee, Hajra Khan, Anshu Wadehra, Neel Patel, Paul Naylor, Murray Ehrinpreis, Milton Mutchnick

Medical Student Research Symposium

Introduction

Direct Acting Antivirals (DAA) are effective in Hepatitis C (HCV) patients with cirrhosis, but viral elimination may occur in a setting where the HCC development pathway has already begun. Our objective was to determine whether achieving a sustained virologic response (SVR) prior to diagnosis of hepatocellular carcinoma (HCC) improved outcomes in our predominately African American population.

Methods

We reviewed the medical records of 96 HCV patients diagnosed with HCC between 2015 and 2019 Primary outcomes were defined as either alive, death/hospice, or transplant. Tumor size was measured as non-small (> 5cm or multiple tumors) or small (< 5cm). The study was approved by the WSU IRB and data analysis performed using the SAS-JMP statistical software.

Results

Of …

Pharmacogenomics And Ssris Appropriateness In Older Community Dwelling African Americans, Wint War Phyo, Lana Sargent, Elvin T. Price

Graduate Research Posters

Background: Depressive and anxiety disorders are among the most common illnesses experienced by older adults (age > 60). The selective serotonin reuptake inhibitors (SSRIs) are preferred class of antidepressants for these disorders due to their high efficacy and safety profiles among older adults. However, SSRIs are metabolized by highly polymorphic cytochrome P450 enzymes, specifically CYP2D6 and CYP2C19. This can lead to variable dose-response outcomes, especially among older African American population.

Objective: Analyze the frequency of CYP2D6 and CYP2C19 polymorphisms in African American older adults who are taking SSRIs and identify potential inappropriate use of SSRIs in these older adults using the …

Ambivalence Over Emotion Expression And The Effects Of Religious Coping In African American Christians, Anya Loraine Dobbs

Walden Dissertations and Doctoral Studies

African Americans are 10% more likely than non-Hispanic Whites to report having serious mental health issues from psychological stressors. Mental health concerns, such as depression and anxiety, that arise from psychological stressors, are more than likely to go untreated in African Americans. African Americans are more likely to turn to religion- their church, their pastors, and fellow parishioners to address these concerns. Religion and religious coping has influenced African Americans’ attitudes regarding help-seeking and mental health treatment, with the “Black Church” historically being a source of many things, including mental health care. Pargament’s theory of religious coping served as a …

Ambivalence Over Emotion Expression And The Effects Of Religious Coping In African American Christians, Anya Loraine Dobbs

Walden Dissertations and Doctoral Studies

African Americans are 10% more likely than non-Hispanic Whites to report having serious mental health issues from psychological stressors. Mental health concerns, such as depression and anxiety, that arise from psychological stressors, are more than likely to go untreated in African Americans. African Americans are more likely to turn to religion- their church, their pastors, and fellow parishioners to address these concerns. Religion and religious coping has influenced African Americans’ attitudes regarding help-seeking and mental health treatment, with the “Black Church” historically being a source of many things, including mental health care. Pargament’s theory of religious coping served as a …

Underrepresentation Of African American Male Nurses In Leadership Development, Moses Tucker

Walden Dissertations and Doctoral Studies

AbstractUnderrepresentation in nursing is a major concern for the African American community. Presently, racial, and ethnic minorities are underrepresented in the nursing workforce and other healthcare occupations. Having a more diverse workforce may help meet both current and future healthcare needs of the population being served. This quantitative study explored how African American male nurses are underrepresented in leadership in the Delaware Valley in Pennsylvania. Secondary data from the National Nursing Workforce Survey was used to obtain relevant data. The study highlighted how the movement into leadership for African American nurses is impeded by (a) a lack of mentors, (b) …

Understanding How Religious Practices Influence Self-Care In Black Churchgoers Diagnosed With Hypertension, Taquina C. Davis

Walden Dissertations and Doctoral Studies

Religion plays an essential role in managing health; however, there is limited research on religious practices among Black churchgoers diagnosed with hypertension. This research aims to understand how religious practices influence self-care in Black churchgoers diagnosed with hypertension. The sample consisted of 21 Black men and women, ages 29 to 70 years, with a clinical diagnosis of hypertension. Participants were recruited from two local, predominately Black churches in South Carolina and administered semistructured interviews to participants. A grounded theory design was used, and the data analysis consisted of constant comparison. Two core concepts were identified. One core concept identified was …

The Impact Of Midwifery On Infant And Maternal Outcomes Among Black Mothers, Joann Honoré

Walden Dissertations and Doctoral Studies

According to recent studies, disparities are prevalent in maternal and fetal outcomes between Black and White mothers in the United States. Researchers have established that using a midwife versus other healthcare practitioners can elicit positive maternal and fetal outcomes for Black mothers. However, no within-race research has been conducted exploring midwifery as an insulating factor against these disparities. The purpose of this quantitative retrospective cohort study was to explore the impact of midwifery on infant and maternal outcomes compared to outcomes associated with other prenatal care models/caregivers among Black mothers in California using secondary data. The ecological model was used …

The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager

Walden Dissertations and Doctoral Studies

Preventive health care screening plays an essential role in reducing chronic diseases and mortality rates; yet, even as health care access has increased, African American men’s utilization of preventive screenings remains low in rural areas. The purpose of this qualitative case study was to investigate why African American men are not utilizing preventive care services and ascertaining the impact that social determinants may have on their utilization of these services. The theoretical framework of this research study comprised the social-ecological modal and health belief model to investigate the barriers to preventive care utilization in the African American community. Twelve African …

Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo

Walden Dissertations and Doctoral Studies

Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …

Exploring Ethnic And New Orleans Cultural Influences On Health Behaviors Of African American Women, Keneitra Brown-Mayfield

Walden Dissertations and Doctoral Studies

In the United States (U.S.), African American women suffer disproportionately due to obesity and chronic diseases. Many studies have examined the culture of African Americans and its influence on their health behaviors in order to gain knowledge to inform obesity and chronic disease prevention interventions. However, a geographical segment of the U.S. African American population shares a unique culture that had yet to be studied. This qualitative study used in-depth interviews to understand the perceptions of overweight and obese African American women living in the Greater New Orleans region about their culture’s role in the prevalence of obesity and obesity-related …

African American Mothers’ Experience In The Neonatal Intensive Care Unit, Lauren Magruder

Walden Dissertations and Doctoral Studies

Black/African American (B/AA) mothers struggle disproportionately with problems related to childbirth. B/AA mothers have higher rates of premature births, infant death prior to age one, and death during childbirth. The purpose of this research was to add to present knowledge regarding B/AA mothers who have had a baby in the Neonatal Intensive Care Unit (NICU). Womanist theory was selected as a framework for the study because it focuses on the intersection of gender and race in relation to B/AA women. The experience of B/AA women in U.S. society is unique, in that it involves several pervasive stereotypes and controlling images. …

The Social Work Perspective Regarding The Underutilization Of Mental Health Services Among African American Families, Carissma Tempest Hughes

Walden Dissertations and Doctoral Studies

The underutilization of mental health services amongst African American families has been a long-standing concern in the African American community within large metropolitan cities in Texas. The metropolitan cities are Austin, Dallas/Fort Worth, Houston, San Antonio and McAllen. There remain experiences that impede families’ ability to engage in mental health services. These experiences involve the conflict between prayer and therapy, stigma, lack of awareness of local mental health services, and cultural competency. The purpose of this qualitative research study was to explore experiences of African American families and how those experiences affect mental health engagement, as well as how practicing …

The Lived Experiences Of African American Nurses In South Carolina Emergency Rooms, Debra A. Dixon

Walden Dissertations and Doctoral Studies

The underrepresentation of African American (AA) nurses in South Carolina (SC) emergency rooms (ERs) may affect quality patient care for AAs and all other patients in culturally diverse populations. This qualitative interpretive (hermeneutic) phenomenological study explored the lived experiences of AA nurses in several SC ERs concerning quality patient care in culturally diverse populations. Herzberg's two-factor theory and Maslow's hierarchy of needs theory framed the study. The research question investigated the lived experiences of AA ER nurses in SC ERs concerning quality patient care in culturally diverse populations. Interpretive phenomenology was used to gain insight from a sample of 17 …

Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield

Walden Dissertations and Doctoral Studies

Culturally competent care is widely accepted as a strategy to address healthcare disparities based on the perceptions of the individual provider, yet this approach lacks the voice of the African American (AA) communities intended to benefit from the strategy. Individuals in AA communities have been shown to suffer higher incidence of disease, disproportionately poorer health outcomes, and inequitable healthcare treatment. Framed by Leininger’s culture care theory, the purpose of this interpretive phenomenological study was to explore the lived cultural experiences of AA recipients of care when interacting with the healthcare system in an effort to contribute evidence to improve the …