Medicine and Health Sciences Commons^™

Do Modifiable Cardiovascular Risk Factors Differ By Rural Classification In Women Who Enroll In A Weight Loss Intervention?, Dieu-My Tran, Carol H. Pullen, Lani M. Zimmerman Patricia, A. Hageman University Of Nebraska

Nursing Faculty Research

PURPOSE: If clinicians and researchers are aware of specific cardiovascular risks associated with women's rural status, whether it be large or small/isolated rural areas, it may help in developing more relevant rural resources. The purpose of this study was to examine whether there were differences in modifiable cardiovascular risk factors of overweight and obese rural women living in large or small/isolated rural areas. SAMPLE: This secondary analysis examined baseline cross-sectional data from the "Web-based Weight Loss and Weight Maintenance Intervention for Older Rural Women" clinical trial. Analysis included data from 299 rural Midwestern women, ages 40-69 years with a baseline …

Factors Associated With Intention To Receive Influenza And Tetanus, Diphtheria, And Acellular Pertussis (Tdap) Vaccines During Pregnancy: A Focus On Vaccine Hesitancy And Perceptions Of Disease Severity And Vaccine Safety, Allison T. Chamberlain, Katherine Seib, Kevin A. Ault, Walter A. Orenstein, Paula M. Frew, Fauzia Malik, Marielysse Cortés, Pat Cota, Ellen A. S. Whitney, Lisa C. Flowers, Ruth L. Berkelman, Saad B. Omer

Environmental & Global Health Faculty Research

BACKGROUND: Improving influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccine coverage among pregnant women is needed. PURPOSE: To assess factors associated with intention to receive influenza and/or Tdap vaccinations during pregnancy with a focus on perceptions of influenza and pertussis disease severity and influenza vaccine safety. METHODS: Participants were 325 pregnant women in Georgia recruited from December 2012 – April 2013 who had not yet received a 2012/2013 influenza vaccine or a Tdap vaccine while pregnant. Women completed a survey assessing influenza vaccination history, likelihood of receiving antenatal influenza and/or Tdap vaccines, and knowledge, attitudes and beliefs about influenza, …

Impact Of Hiv Testing And Counseling (Htc) Knowledge On Hiv Prevention Practices Among Traditional Birth Attendants In Nigeria, Alice Osuji, Jennifer R. Pharr, Uche Nwokoro, Anulika Ike, Christiana Ali, Ogheneaga Ejiro, John Osuyali, Michael Obiefune, Kevin Fiscella, Echezona E. Ezeanolue

Environmental & Global Health Faculty Research

Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess …

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 & Global Health Faculty Research

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 …

Unlv School Of Medicine Return On Investment To The State General Fund, Tripp Umbach, Lincy Institute

Lincy Institute Reports and Briefs

Economic activity in the State of Nevada’s economy from the spending of the UNLV School of Medicine will remain inside the state as well as fresh dollars that will flow inside the state because the medical school will generate general fund revenue through a wide variety of taxes. Tripp Umbach estimates that every fresh dollar in economic impact from the UNLV School of Medicine will generate 4.9% in state general fund revenue. As the UNLV School of Medicine matures, the Return on Investment (ROI) to the State of Nevada’s economy will grow.

Recognizing The Influence Of Social Determinants On Hiv Risk Behaviors And The Need For Structural Interventions To Prevent Hiv In Women, Arlene Edwards

Journal of Health Disparities Research and Practice

The design and implementation of structural interventions may provide for simultaneous and longitudinal responses to prevention needs in multiple contexts as defined by social determinants, thus varied opportunities exist to respond to the HIV prevention needs of women. According to the CDC, in 2010, the rate of new HIV infections among black women was 20 times that of white women, and the rate among Hispanic/Latino women was 4 times the rate of white women. Additionally, 86% of HIV infections in women were attributed to heterosexual contact and 14% to injection drug use (CDC, 2012). These numbers are reflected outside the …

Common Threads: An Integrated Hiv Prevention And Vocational Development Intervention For African American Women Living With Hiv/Aids, Liza Marie Conyers, Yung-Chen Chiu, Aisha Shamburger-Rousseau, Vanessa Johnson, Mark Misrok

Journal of Health Disparities Research and Practice

Current policies and initiatives call for the integration of social determinants of health into HIV/AIDS prevention and care interventions. According to the World Health Organization’s Commission on Social Determinants of Health, the lower a person’s socioeconomic status, the worse the health outcomes. One way to alleviate poverty among African American women with HIV/AIDS is to help foster their vocational development and economic empowerment. The National HIV/AIDS Strategy Implementation Plan specifically directs federal agencies to find ways to integrate people living with HIV/AIDS into broader employment initiatives. The purpose of this manuscript is to examine medical, psychosocial, financial/legal and vocational social …

A Comparison Of Sexual Health And Sexual Pressure Among Young African American And Caucasian Women, Ann Gakumo

Journal of Health Disparities Research and Practice

Introduction. Condom self-efficacy, positive attitudes toward condom use, condom negotiation skills, HIV knowledge, and self-esteem have been associated with decreased HIV risk behavior among young women, but few studies have examined racial disparities that may exist in these social health indicators. Moreover, sexual pressure (inclusive of both coercive and non-coercive pressures to engage in unwanted or unprotected sex) has been understudied in women of different racial groups.

Study Purpose. The purpose of this study was to compare racial similarities and disparities in indicators of sexual health and sexual pressure in an urban sample of young African American and Caucasian women …

Project Thanks: A Socio-Ecological Framework For An Intervention Involving Hiv Positive African American Women With Comorbidities, Meena Mahadevan, Ndidiamaka Amutah, Lauren Juliette Ramos, Emily Rose Raines, Jerome King, Jodyann Mcintosh, Constance Leverett

Journal of Health Disparities Research and Practice

HIV-positive individuals are living longer today as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases such as diabetes, and hypertension. These conditions result in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished African American women may represent an especially high-risk group due to disparities in health care, racial discrimination, and limited resources. This article describes an intervention that is based on the conceptual framework of the socio-ecological model. Project THANKS uses a community-based participatory, and empowerment building approach to target the unique personal, social, and environmental needs of …

Sexual Decision Making In The Absence Of Choice: The African American Female Dating Experience., Michele Peake Andrasik, Hong V. Nguyen, William H. George, Kelly F. Kajumulo

Journal of Health Disparities Research and Practice

Although links between low mate availability and increased HIV and STI risk for African American women have been documented in the literature, we know little about the impact of limited mate choices on the quality of relationships between Black men and women and how these relationship dynamics impact risk for young Black women. We conducted a qualitative study with African American female young adults (N=12) to explore the perceived impact of structural forces on African American female young adults’ dating and sexual behavior. Participants reported (1) perceptions of Black men as untrustworthy and manipulative, (2) the limited and often negative …

Lessons Learned: Exploratory Study Of A Hiv/Aids Prevention Intervention For African American Women Who Have Experienced Intimate Partner Violence, Michele A. Rountree

Journal of Health Disparities Research and Practice

Given the prevalence and co-occurring nature of HIV and intimate partner violence among African American women there is a need for a risk reduction intervention. This study explored the results from an exploratory study of an HIV/AIDS prevention intervention for African-American women who have experienced intimate partner violence. The emphasis of this study is to identify lessons learned to guide future research.

Recruitment for the feasibility study was done in two waves over a period of three months. During the first wave, 22 participants were recruited for the intervention group, and in the second wave, 25 participants were in the …

Is Race A Factor In Disparate Health Problems Associated With Violence Against Women?, Gabriel M. Garcia, Marny Rivera

Journal of Health Disparities Research and Practice

Research studies examining the health correlates of violence against women have consistently demonstrated associations between violence and poor health outcomes, but have not examined a disparate impact on racial minorities. Alaska Victimization Survey data (2010) was used to examine whether a disparate relationship between victimization and health problems exists for minority women relative to White women. The Alaska Victimization Survey (AVS) is a cross-sectional survey designed to provide baseline estimates of intimate partner and sexual violence for Alaskan women. Logistic regression was used to assess the odds of experiencing various health problems given race and exposure to violence status while …

Dramatic Plays As A Tool To Educate Young African-American Females About Hiv/Aids, Jonathan N. Livingston, James Merryweather, Jessica Mohabir, Che' Smith, Nina Smith, Jacqueline Madry, Travis Knight, Dorothy M. Singleton, Seronda A. Robinson, Lisa Cothran, Dwayne Brandon, Alexis L. Slay, Camille Brown

Journal of Health Disparities Research and Practice

Rates of HIV/AIDS transmission have increased substantially, particularly among young African American women. According to the Centers for Disease Control and Prevention (CDC), HIV/AIDS is the number one killer for African American women aged 25 to 34. Given that many of these young women are contracting the disease in their late teens and early twenties, there is a need to develop interventions that directly address the needs of this group. The current study sought to assess the effectiveness of theater in increasing knowledge of HIV/AIDS and the likelihood of healthier sexual behavior and choices among 219 young African American women …

Editors' Notes-Women Of Color Sexual Health Across The Lifespan, Marya Shegog, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

No abstract provided.

Parental Discussions About Sexual Risk With African American Sons: The Role Of Religiosity., Wadiya A. Udell, Geri R. Donenberg

Journal of Health Disparities Research and Practice

The current study investigated the relationship between parental religiosity (i.e., parent church attendance), and frequency of parent-youth communication about sexual risk (i.e., discussion about sex, and discussion about condom use) with African American boys. Participants were 65 parents of African American boys between the ages of 11 and 17 years. Results indicated no relationship between age and parent-son discussion about sexual risk. However, parental religiosity was negatively associated with frequency of communication with sons about sex and condom use. Parents who attended church more frequently reported fewer discussions about sex and condom use than parents who attended church less frequently. …

Condom Use Among Young African American Men: Implications For Planning Interventions, Adedeji S. Adefuye, Stephen B. Kennedy, Shakirudeen Amuwo, Sherry Nolan, Judith V. Sayad

Journal of Health Disparities Research and Practice

Condom Use among Young African American Men: Implications for Planning Interventions

Sexually transmitted diseases, including HIV, continue to present significant public health problems affecting young people in the United States, especially African Americans. While African Americans make up about 12% of the U.S. population, in 2010 they accounted for 44% of new HIV infections in 2010 and 48% of all persons living with AIDS in 2007. The 2010 data shows that of these new cases, 38% occurred among African American males ages 13-24 years old.

Correct condom use remains a challenge in this population and efforts to increase condom use …

The Role Of Relationship And Other Factors Associated With Condom Use Intention Among Young American Indian Men Ages 18 To 24 Years Old, Rebecca Dick, Elizabeth Rink, Kris Fourstar

Journal of Health Disparities Research and Practice

The purpose of this study was to investigate the heterosexual relationship factors that were associated with condom use intention for STI prevention in a purposive sample of American Indian men. The sample was drawn from the Fort Peck Reservations in northeastern Montana. The sample size included 122 American Indian men ages 18 to 24. The theory of planned behavior and interdependence theory provided the theoretical basis for the study. Seventy- seven percent of the young men reported being in a steady relationship with 60.3% agreeing that they were committed to maintaining their relationship with their current partner. Relationship duration and …

Do Masculinity And Perceived Condom Barriers Predict Heterosexual Hiv Risk Behaviors Among Black Substance Abusing Men?, A, Kathleen Burlew, Jerika Wilson, Latrice Montgomery, Bridgette Peteet, Candace Johnson, Mary Hatch-Maillette

Journal of Health Disparities Research and Practice

Although HIV prevention during substance abuse treatment is ideal, existing HIV risk-reduction interventions are less effective among Black and other ethnic minority substance abusers. The Sexual Health Model (SHM) and the Person, Extended Family and Neighborhood-3 model (PEN-3) both highlight the importance of increasing our understanding of the relationship of sociocultural factors to sexual-decision making as a step towards developing more HIV prevention interventions for ethnic minorities. However, few studies examine sociocultural factors in the sexual decision-making process of Black substance abusing men. This secondary analysis of data collected in an evaluation of Real Men Are Safe (REMAS), a HIV …

Sexual Hiv Risk Among Male Parolees And Their Female Partners: The Relate Project, Megan Comfort, Olga Grinstead Reznick, Samantha E. Dilworth, Diane Binson, Lynae Darbes, Torsten B. Neilands

Journal of Health Disparities Research and Practice

Background: The massively disproportionate impact of America’s prison boom on communities of color has raised questions about how incarceration may affect health disparities, including disparities in HIV. Primary partners are an important source of influence on sexual health. In this paper, we investigate sexual HIV risk among male-female couples following a man’s release from prison.

Methods: We draw upon data from the Relate Project, a novel cross-sectional survey of recently released men and their female partners in Oakland and San Francisco, California (N=344). Inferential analyses use the actor-partner model to explore actor and partner effects on sexual HIV risk outcomes. …

Perceptions Of Hiv Risk And Explanations Of Sexual Risk Behavior Offered By Heterosexual Black Male Barbershop Patrons In Brooklyn, Ny, Tonya N. Taylor, Michael A. Joseph, Kirk D. Henny, Angelo R. Pinto, Francis Agbetor, Brignel Camilien, Kim M. Williams, Ruth C. Browne, Marilyn White, Yolene Gousse, Humberto Brown, Raekiela D. Taylor, Tracey E. Wilson

Journal of Health Disparities Research and Practice

Objective: To describe HIV risk factors among adult heterosexual Black men recruited from four barbershops located in high HIV seroprevalent neighborhoods of Brooklyn, NY.

Methods: Data on HIV-risk related behaviors and other characteristics were collected from barbershop clients. All participants (n=60) completed brief risk assessments; and a subset (n=22) also completed focus groups and/or individual interviews.

Results: Of the subset of 22 men, 68% were US born, 59% had been in jail/prison, 32% were unemployed; and during the 3 months before the interviews, 68% reported at least two partners and 45% reported unprotected vaginal or anal sex with …

Editors' Notes: Men Of Color Sexual Health Across The Lifespan, Marya Shegog, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

No abstract provided.

Environmental Disparities Present A Challenge For Diabetes Prevention And Management Efforts In Dallas County, Theresa Mendoza, Sushma Sharma, Pamela Daughty, Crystee Cooper, Carol Young, Larry Tubb, Kristin Jenkins, Community Health Collaborative Of North Texas (Chc)

Journal of Health Disparities Research and Practice

The State of Texas is home to nearly 2 million men, women and children with diabetes, over half a million of which reside in the Dallas-Fort Worth (DFW) region. Recognizing the rising need to identify the disparities in implementing the diabetes prevention and management efforts and adopting the healthy life style in high diabetes prevalence areas in Dallas County, we explored the potential of Geographic Information System (GIS) methodology to analyze the data at zip code level from Dallas-Fort Worth Hospital Council (DFWHC) Research Foundation’s data registry. The objectives of this research were to identify the zip codes with the …

Predictors Of Readiness To Quit Among A Diverse Sample Of Sexual Minority Male Smokers, Alicia Kaye Matthews, Anna Hotton, Frances Aranda, Lisa Kuhns, Joseph G.L. Lee, Natalie Ross

Journal of Health Disparities Research and Practice

ABSTRACT

Introduction: Readiness to quit smoking - a pattern of attitudes, intentions, and behaviors that reflect a likelihood of engaging in cessation activities—is a useful heuristic for understanding smoking disparities based on sexual orientation. This study examined demographic, tobacco-use patterns, psychosocial and cognitive factors associated with readiness to quit among gay and bisexual male smokers.

Methods: A cross-sectional survey was conducted as part of a larger Tobacco Elimination and Control Collaboration (Q-TECC) initiative in the lesbian, gay, bisexual, and transgender (LGBT) community. Readiness to quit was measured by a composite score created from four variables (motivation to quit, importance of …

Health Disparities Among Racial And Ethnic Minority Firefighters, Walker Sc Poston, Christopher K. Haddock, Sara A. Jahnke, Nattinee Jitnarin, Rena Sue Day, I David Daniels

Journal of Health Disparities Research and Practice

ABSTRACT

Background: Racial/ethnic minorities are substantially underrepresented in the fire service and this situation is unique when compared to similarly mentally and physically demanding and hazardous occupations such as the military and law enforcement. There is little systematic research to provide greater clarity about this significant disparity. The purpose of this study is to examine physical and behavioral health issues of racial/ethnic minority firefighters when compared to their white, non-Hispanic counterparts and potentially identify areas for future research that might assist in improving their substantial underrepresentation.

Materials and Methods: We report the results of a secondary analysis of data combining …

Inequalities In Infertility Service Utilization: A Comparison Of Latina And Caucasian Women With Impaired Fecundity Who Seek And Do Not Seek Care, Amy Sudhinaraset, Deyu Pan, Carolyn Alexander, Omid Khorram

Journal of Health Disparities Research and Practice

Purpose: To compare racial differences in accessing infertility services, and to characterize socioeconomic, cultural and social factors that influence the propensity to seek care.

Materials and Methods: Using data from the 2002 and 2006-2010 rounds of the National Survey of Family Growth, bivariate analyses and multiple logistic regressions were performed to determine the associations between individual patient characteristics and health seeking practices, stratified by ethnicity.

Results: Factors that were significantly associated with seeking infertility services included Latina ethnicity, age, country of birth, more than high school education, being born in the United States, placing importance on religion, >200% federal poverty …

Cultural Competence: New Conceptual Insights Into Its Limits And Potential For Addressing Health Disparities, Shireen S. Rajaram, Susan Bockrath

Journal of Health Disparities Research and Practice

The increasing interest in the role of racism and racialization in health disparities, calls for exploring new paradigms in addressing and eliminating health disparities related to race/ethnicity. Cultural competence is conceptualized as one of the keys ways to address racial/ethnic disparities in public health and healthcare. However, for cultural competence to fulfill this role, it requires a critical understanding of the underlying socio-political and economic processes of power, privilege and institutional racism that create, support and maintain existing health disparities. This paper outlines how the concept of cultural competence can be made more robust, by incorporating concepts such as Public …

Environmental And Health Disparities In Appalachian Ohio: Perceptions And Realities, Michele Morrone, Natalie A. Kruse, Amy E. Chadwick

Journal of Health Disparities Research and Practice

Background. Appalachia is a region of the United States that faces significant environmental and health disparities. Understanding these disparities and the social determinants that contribute to them will help public health practitioners make better decisions. The purpose of this research is two-fold. First, through secondary data analysis, we document environmental and health disparities as well as demographic and economic conditions that may contribute to these disparities between Appalachian and non-Appalachian Ohio. Second, we examine perceptions of environmental health practitioners about the differences in environmental conditions between Appalachian and non-Appalachian Ohio.

Methods. We gathered secondary data about economics, health, and the …

Evaluation Of The Community Child Health Research Network (Cchn) Community-Academic Partnership, Rhonda Belue, Peter Schafer, Bowen Chung, Maxine Vance, Robin Lanzi, Patricia O'Campo, Child And Community Health Network (Cchn)

Journal of Health Disparities Research and Practice

Background: The Community Child Health Network (CCHN) is a research collaborative network of five communities in the U.S. formed to study maternal and child health disparities, via a community-based participatory research study design. CCHN studies how community, family, and individual level influences interact with biological processes to affect maternal stress, resilience, and allostatic load; ultimately, the study evaluates whether such factors result in health disparities in pregnancy outcomes and infant and early childhood mortality and morbidity. The purpose of this paper is to assess the community-based participatory research (CBPR) process that governs the CCHN and offer lessons from our experiences. …

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 …

Connecting Gender, Race, Class, And Immigration Status To Disease Management, Marie-Anne S. Rosemberg Phd, Mn, Rn, Jenny Hsin-Chun Tsai Phd, Arnp, Pmhcns-Bc

Journal of Health Disparities Research and Practice

Objective: Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual’s life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management.

Methods: This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited (N = 31) and …