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 …

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, …

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, …

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 …

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 …

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 …

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 …

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 …

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 …

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 …