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 …

Stress And Coping In Food-Insecure African Americans In Clark County, Nevada, Johanna Andrews

UNLV Theses, Dissertations, Professional Papers, and Capstones

African Americans have the highest rates of food insecurity than any other racial/ethnic group in the nation as a result of poverty, low household income, unemployment, food injustice, food mirages, and racial segregation. This consistent uncertainty in food access demonstrably results in poor mental health outcomes for food-insecure African Americans. Thus, the Transactional Model of Stress and Coping provides a theoretical framework to investigate how African Americans cope with food insecurity. The purpose of this study was to evaluate processes of coping with food insecurity and determine their impact on emotional well-being for African Americans in Clark County, Nevada. A …

Apol1 Ckd Risk Alleles In New Mexico African American And American Indian Populations: Racial Disparity, Chien-An A. Hu, Amelia Bierle, Matthew Shultz, Vallabh Shah

Journal of Health Disparities Research and Practice

Purpose/Background: Two haplotypes of human apolipoprotein L1 gene (gene: APOL1; protein: ApoL1) harboring three coding sequence mutations have been demonstrated as risk variants associated with non-diabetic chronic kidney diseases (CKD) in African Americans. The first one, termed G1, is a two non-synonymous SNP haplotype (rs73885319 (A>G; p.S342G) and rs60910145 (G>T; p.I384M). The second one, termed G2, is a two codon deletion haplotype rs71785313 (6-bp in frame deletion) These two coding-sequence variants have been discovered in CKD patients of African ancestry and linked to the pathogenesis of primary focal and segmental glomerulosclerosis (FSGS), hypertension-attributed kidney disease, and HIV-associated nephropathy …

Examining Race Differences In Blood Pressure Control Among People With Chronic Kidney Disease, Jayme Savoy, Roland J. Thorpe, Jr., Phd

Journal of Health Disparities Research and Practice

Of Chronic Kidney Disease (CKD) patients, 20% of them also have hypertension (HTN). African Americans (AA) are known to be more at risk of CKD development and poor HTN control compared to Whites, largely due to their higher prevalence of diabetes and HTN. While those health conditions are a known risk factor to CKD, it is less clear if there is a race difference in HTN control among CKD patients.

Using a combined 1999-2014 data set from The National Health and Nutrition Examination Survey (NHANES), we sought to determine if there is an association between race and HTN control among …

"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.

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, …

The Role Of Functional, Social, And Mobility Dynamics In Facilitating Older African Americans Participation In Clinical Research, Eve T. Shapiro, Jay T. Schamel, Kimberly A. Parker, Laura A. Randall, Paula M. Frew

Environmental & Occupational Health Faculty Publications

Purpose: Older African Americans experience disproportionately higher incidence of morbidity and mortality related to chronic and infectious diseases, yet are significantly underrepresented in clinical research compared to other racial and ethnic groups. This study aimed to understand the extent to which social support, transportation access, and physical impediments function as barriers or facilitators to clinical trial recruitment of older African Americans. Methods: Participants (N=221) were recruited from six African American churches in Atlanta and surveyed on various influences on clinical trial participation.

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 …

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, …

Results Of A Community Randomized Study Of A Faith-Based Education Program To Improve Clinical Trial Participation Among African Americans, Paula M. Frew, Jay T. Schamel, Kelli A. O'Connell, Laura A. Randall, Sahithi Boggavarapu

Environmental & Occupational Health Faculty Publications

This is a report of a cluster randomized clinical trial evaluating the effectiveness of a church-based educational intervention aimed at improving African Americans’ (AA) participation in clinical trials. Two hundred and twenty-one AA subjects ages ≥50 years from six predominantly AA churches were randomized to intervention or control condition. The intervention included three educational sessions about clinical trials and health disparities; control participants completed questionnaires. Primary endpoints of the study were differences in individual subjects' intentions to obtain clinical trial information and intention to join a clinical trial, as determined by 10 point scale items at baseline, three and six …

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 …

Delivering A “Dose Of Hope”: A Faith-Based Program To Increase Older African Americans’ Participation In Clinical Trials, Paula M. Frew, Saad B. Omer, Kimberly Parker, Marcus Bolton, Jay Schamel, Eve Shapiro, Lauren Owens, Diane Saint-Victor, Sahithi Boggavarapu, Nikia Braxton, Matthew Archibald, Ameeta S. Kalokhe, Takeia Horton, Christin M. Root, Vincent L. Fenimore, Aaron M. Anderson

Environmental & Occupational Health Faculty Publications

Background: Underrepresentation of older-age racial and ethnic minorities in clinical research is a significant barrier to health in the United States, as it impedes medical research advancement of effective preventive and therapeutic strategies. Objective: The objective of the study was to develop and test the feasibility of a community-developed faith-based intervention and evaluate its potential to increase the number of older African Americans in clinical research. Methods: Using a cluster-randomized design, we worked with six matched churches to enroll at least 210 persons. We provided those in the intervention group churches with three educational sessions on the role of clinical …

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 …

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 …

A Geospatial Analysis Of Cdc-Funded Hiv Prevention Programs For African Americans In The United States, G. A. Gilliam, Carol L. Hanchette, Kieran J. Fogarty, Deborah A. Gibbs

Journal of Health Disparities Research and Practice

Given the increase in HIV/AIDS infection rates among racial and ethnic minorities, particularly African Americans, this study was undertaken as part of a larger research effort to examine the distribution of HIV prevention services focusing on African American populations within the United States. Data were gathered via a national survey of community-based organizations (CBOs) funded by the Centers for Disease Control and Prevention (CDC). A geocoded national database was constructed to identify, locate, and map these HIV prevention programs. A total of 1,020 CBOs responded to the survey, yielding a response rate of 70.3%. These CBOs administered a total of …

Family Breast Cancer Education: A Model For African American Women, Frankie D. Powell, Edwin D. Bell, Jamilla Shepperson, Thomas Coaxum

Journal of Health Disparities Research and Practice

The purpose of this study, funded by the American Cancer Society, was to increase knowledge and understanding, i.e., the willingness and ability to discuss, of breast cancer in southern minority women and their families. A family model of health education guided the research questions. (a) To what extent will an action research intervention increase knowledge about the causes and treatment of breast cancer in minority women? (b) To what extent will an action research intervention increase willingness to talk with family members? The t-test analysis of a 67-item, self- administered survey indicated significant increases in knowledge of cancer and in …

Evaluating “Not In Mama's Kitchen” Second-Hand Smoke Campaign In Georgia, Jonathan B. Vangeest, Verna L. Welch

Journal of Health Disparities Research and Practice

In 2003-2005, the Association of Black Cardiologists, Inc. initiated the Not in Mama’s Kitchen (NIMK) second-hand smoke (SHS) prevention campaign in Georgia as part of their effort to reduce exposure to SHS in African American communities statewide. This initiative was evaluated using baseline data from pledge cards as well as data from a self-administered mail survey of 1,000 campaign participants. 14,770 Georgians participated in NIMK, signing pledges to make their homes and cars smoke free. Majorities of those surveyed followed through with their pledge, banning tobacco use in their homes (76.1%) and cars (80.2%). The program was cited by 65.4% …

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 …