Medicine and Health Sciences Commons^™

Dna Methylation Signatures Of Chronic Low-Grade Inflammation Are Associated With Complex Diseases, Symen Ligthart, Carola Marzi, Stella Aslibekyan, Michael M. Mendelson, Karen N. Conneely, Toshiko Tanaka, Elena Colicino, Lindsay L. Waite, Roby Joehanes, Weihua Guan, Jennifer A. Brody, Cathy Elks, Riccardo Marioni, Min A. Jhun, Golareh Agha, Jan Bressler, Cavin K. Ward-Caviness, Brian H. Chen, Tianxiao Huan, Kelly Bakulski, Elias L. Salfati, Whi-Empc Investigators, Giovanni Fiorito, Charge Epigenetics Of Coronary Heart Disease, Simone Wahl, Katharina Schramm, Jin Sha, Dena G. Hernandez, Allan C. Just, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

Results: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10^–7) in the discovery panel …

Correlates Of Sexual-Risk Behaviors Among Young Black Msm: Implications For Clinic-Based Counseling Programs, Richard A. Crosby, Leandro Mena, Janelle M. Ricks

Health, Behavior & Society Faculty Publications

This study applied an 8-item index of recent sexual-risk behaviors to young Black men who have sex with men (YBMSM) and evaluated the distribution for normality. The distribution was tested for associations with possible antecedents of sexual risk. YBMSM (N = 600), aged 16–29 years, were recruited from a sexually transmitted infection clinic, located in the southern US. Men completed an extensive audio computer-assisted self-interview. Thirteen possible antecedents of sexual risk, as assessed by the index, were selected for analyses. The 8-item index formed a normal distribution with a mean of 4.77 (SD = 1.77). In adjusted analyses, not …

Circumcision Status Is Not Associated With Condom Use And Prevalence Of Sexually Transmitted Infections Among Young Black Msm, Richard A. Crosby, Cynthia A. Graham, Leandro Mena, William L. Yarber, Stephanie A. Sanders, Robin R. Milhausen, Angelica Geter

Health, Behavior & Society Faculty Publications

This study investigated whether intact young Black MSM differed from their circumcised counterparts regarding condom use behaviors and perceptions and HIV/Chlamydia/gonorrhea. Young Black MSM completed a self-interview, including a pictorial item assessing circumcision status and measures of condom use. Twenty-seven percent of 388 participants reported not being circumcised. With one exception, no associations tested approached significance. The mean frequency of unprotected insertive anal sex for circumcised men was about twice as high compared to those intact (P = .04). Intact young Black MSM did not differ from circumcised men relative to prevalence of STIs (including HIV) or condom use behaviors …

Racial Differences In Renal Replacement Therapy Initiation Among Children With A Nonglomerular Cause Of Chronic Kidney Disease., Derek K. Ng, Marva Moxey-Mims, Bradley A. Warady, Susan L. Furth, Alvaro Muñoz

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: African American (AA) adults with chronic kidney disease (CKD) have a faster progression to end-stage renal disease and are less likely to receive a kidney transplant. It is unclear whether AA children experience renal replacement therapy (RRT) for end-stage renal disease sooner than non-AA children after accounting for socioeconomic status (SES).

METHODS: Among children with nonglomerular CKD in the Chronic Kidney Disease in Children study, we investigated time to RRT (i.e., first dialysis or transplant) after CKD onset using parametric survival models and accounted for SES differences by inverse probability weights.

RESULTS: Of 110 AA and 493 non-AA children …

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 …

Determinants Of Adherence To Nutrition- Related Cancer Prevention Guidelines Among African American Breast Cancer Survivors, Lindsey A. Ramirez, Yunmi Chung, Wonsuk Yoo, Brittney Fontenot, Benjamin E. Ansa, Mary S. Whitehead, Selina A. Smith

Journal of the Georgia Public Health Association

Background: Mortality rate for breast cancer is higher among African American (AA) women than for women of other racial/ethnic groups. Obesity, also higher among AA women, may increase the risk of breast cancer development and recurrence. Lifestyle factors such as healthy nutrition can reduce the rate of obesity and breast cancer. This study examined the determinants of adherence to nutrition-related cancer prevention guidelines among AA breast cancer survivors.

Methods: AA breast cancer survivors (n=240) were recruited from a breast cancer support group to complete a lifestyle assessment tool for this cross-sectional study. Chi-square test and ordinal logistic regression analysis were …

Recurrent Violent Injury: Magnitude, Risk Factors, And Opportunities For Intervention From A Statewide Analysis., Elinore Kaufman, Kristin L. Rising, Md, Ms, Douglas J. Wiebe, David J. Ebler, Marie L. Crandall, M. Kit Delgado

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Although preventing recurrent violent injury is an important component of a public health approach to interpersonal violence and a common focus of violence intervention programs, the true incidence of recurrent violent injury is unknown. Prior studies have reported recurrence rates from 0.8% to 44%, and risk factors for recurrence are not well established.

METHODS: We used a statewide, all-payer database to perform a retrospective cohort study of emergency department visits for injury due to interpersonal violence in Florida, following up patients injured in 2010 for recurrence through 2012. We assessed risk factors for recurrence with multivariable logistic regression and …

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, …

Local Efforts Toward Addressing Health Disparities In Dekalb County, Georgia, April Hermstad, Erikka Gilliam, Sedessie Spivey, Zipatly Mendoza

Journal of the Georgia Public Health Association

Background: In underserved African American communities throughout DeKalb County, the DeKalb County Board of Health (DCBOH) is implementing community-based initiatives using policy, systems, and environmental improvement approaches to reduce racial and ethnic health disparities by increasing opportunities for nutrition and physical activity.

Methods: The initiatives are being implemented in priority census tracts where the population is at least 40% African American, 30% live below federal poverty level, and 25% did not graduate from high school. Communications promote awareness of the programs, and evaluation activities document processes and outcomes.

Results: To date, implementation of five interventions has affected approximately 276,000 DeKalb …

Engaging African Americans In Developing An Intervention To Reduce Breast Cancer Recurrence: A Brief Report, Selina A. Smith, Mary S. Whitehead, Joyce Q. Sheats, Brittney Fontenot, Ernest Alema-Mensah, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: To develop a culturally appropriate lifestyle intervention, involvement of its intended users is needed.

Methods: Members of an African American (AA) breast cancer support group participated in two 4-hour guided discussions, which were audiotaped, transcribed, and analyzed to guide the content.

Results: The support group collaborated with researchers to develop 24 experiential nutrition education sessions using a social cognitive framework and incorporating self-regulation skills (goal-setting, self-monitoring, problem-solving, stimulus control) and social support to enhance self-efficacy for changes in dietary intake.

Conclusions: Community engagement fostered autonomy, built collaboration, and enhanced the capacity of AA breast cancer survivors to participate in …

Social Support And Intimate Partnerships In African American Women With Breast Cancer, Tess Thompson

Arts & Sciences Electronic Theses and Dissertations

This mixed methods study investigated social support in African American breast cancer patients in one Midwestern metropolitan area. The study includes a quantitative analysis of social support in 227 African American breast cancer patients participating in a quality of life study, as well as a qualitative component involving a subsample of 15 married participants. In the larger sample, growth curve models were used to assess factors contributing to initial levels of perceived social support and change in social support over time. Interviews with women in the qualitative study allowed an in-depth exploration of how breast cancer affected womens relationships with …

African American Female Offender's Use Of Alternative And Traditional Health Services After Re-Entry: Examining The Behavioral Model For Vulnerable Populations, Carrie B. Oser, Amanda M. Bunting, Erin L. Pullen, Danelle Stevens-Watkins

Sociology Faculty Publications

This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women's use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number …

Assessing Cultural Competence In A Mental Health Outpatient Facility., Alexis N. Keen Crook

Electronic Theses and Dissertations

Cultural competence is a concept that has been thoroughly investigated in healthcare, but there is a dearth of literature and research on this topic as it pertains to mental health services. In healthcare, research has shown that a lack of cultural competence is directly linked to high levels of misdiagnoses, mistrust of healthcare and professionals, and overall poor health in minority populations. Using the Campinha-Bacote model for cultural competence in health care, I explore how cultural competence is defined and operationalized in an outpatient mental health facility. I hypothesize that, similar to research addressing cultural competency in healthcare systems, cultural …

Examining Multi-Session Brief Intervention For Substance Use In Primary Care: Research Methods Of A Randomized Controlled Trial., Jaclyn E Chambers, Adam C Brooks, Rachel Medvin, David S Metzger, Jennifer Lauby, Carolyn M Carpenedo, Kevin E Favor, Kimberly C Kirby

Faculty Scholarship for the College of Science & Mathematics

BACKGROUND: Brief interventions such as Screening, a single session of Brief Intervention, and Referral to Treatment (SBIRT) have shown mixed effectiveness in primary care. However, there are indications that multi-session brief interventions may demonstrate more consistently positive outcomes, and perhaps a more intensive approach would be of benefit in addressing substance use in primary care. This study compared the effectiveness of SBIRT with a single BI session (BI/RT) to a multi-session brief-treatment intervention (BI/RT+) in primary care. We also developed easy-to-use, evidence-based materials to assist clinicians in delivering these interventions.

METHODS/DESIGN: This study was conducted in three Federally Qualified Healthcare …

How Complicated Can It Be? The Link Between Apol1 Risk Variants And Lipoprotein Heterogeneity In Kidney And Cardiovascular Diseases., Chien-An A Hu, Patricio E Ray

Pediatrics Faculty Publications

The beginning of human apolipoprotein L1 study (gene: APOL1; protein: ApoL1) originated from the identification of circulating ApoL1 as an interacting protein of ApoA1 and a minor component of high-density lipoprotein subfraction 3 (HDL3) in 1997 [1]. In the past 18 years, ApoL1 has been investigated in the context of complex human diseases such as African sleeping sickness, schizophrenia, host innate immunity, cancer, hyperlipidemia, cardiovascular diseases, stroke and type 2 diabetes [2–10]. A major breakthrough, however, was the documentation of two haplotypes of APOL1, harboring three coding-sequence mutations as risk variants associated with non-diabetic …

Similarities And Differences In Sexual Risk Behaviors Between Young Black Msm Who Do And Do Not Have Sex With Females, Richard A. Crosby, Leandro Mena, Angelica Geter, Demarc Hickson

Health, Behavior & Society Faculty Publications

The objective of this study is to determine whether young Black MSM who also have sex with females report similar levels of sexual risk behaviors as those not having sex with females. YBMSM (N = 400) were recruited from an STI clinic, located in the Southern U.S. Men completed an audio-computer assisted self-interview and donated specimens for STI/HIV testing. Forty-three percent recently engaged in penile-vaginal sex. They were less likely to report having concurrent partners (P = .01), unprotected fellatio (P = .04), multiple partners as a bottom (P < .02), any unprotected anal sex as a bottom (P < .013), and any anal sex (P = .007). They were equally likely …

A Review Of Community-Based Participatory Research Studies To Promote Physical Activity Among African Americans, Steven S. Coughlin, Selina A. Smith

Journal of the Georgia Public Health Association

Background: As part of the planning process for new research, the literature on community-based participatory research (CBPR) approaches for promoting physical activity in African American communities was systematically reviewed.

Methods: Studies published through October 31, 2015 that employed CBPR methods were identified using PubMed and CINAHL databases and MeSH terms and keyword searches.

Results: A total of 15 studies met the search criteria. One focused on CBPR and physical activity among African American school children and adolescents, 13 on adults, and one on both children and adults. Seven studies employed CBPR methods to promote physical activity in church settings. Eight …

Identification Of An Association Of Tnfaip3 Polymorphisms With Matrix Metalloproteinase Expression In Fibroblasts In An Integrative Study Of Systemic Sclerosis-Associated Genetic And Environmental Factors.*, Peng Wei, Yang Yang, Xinjian Guo, Nainan Hei, Syeling Lai, Shervin Assassi, Mengyuan Liu, Filemon Tan, Xiaodong Zhou

Faculty Publications

OBJECTIVE: Systemic sclerosis (SSc) is a fibrotic disease attributed to both genetic susceptibility and environmental factors. This study was undertaken to investigate the associations between SSc-associated genetic variants and the expression of extracellular matrix (ECM) genes in human fibroblasts stimulated with silica particles in time-course and dose-response experiments.

METHODS: A total of 200 fibroblast strains were examined for ECM gene expression after stimulation with silica particles. The fibroblasts were genetically profiled using Immunochip assays and then subjected to whole-genome genotype imputation. Associations of genotypes and gene expression were first analyzed in a Caucasian cohort and then validated in a meta-analysis …

Improving The Health Of African Americans In The Usa: An Overdue Opportunity For Social Justice, Allan S. Noonan, Hector Eduardo Velasco-Mondragon, Fernando A. Wagner

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Using a modified social ecological model, we conducted a review of the literature and nationwide statistics on African American health. We discuss the main social determinants of health and main health disparities, risk factors, the leading causes of morbidity and mortality, and access to health services for blacks in the USA. The mechanisms through which social determinants, including racism, exert their deleterious effects on black health are discussed at the macro and individual levels. Incarceration and mental health care issues are highlighted as priorities to be addressed. African Americans remain the least healthy ethnic group in the USA, a somber …

The Impact Of African-Centered Psychotherapy On Depressive Symptoms And Africentric Worldview In African Americans, Larae Tillis

Walden Dissertations and Doctoral Studies

Depression is a prominent issue in the African American community. However, there are significant gaps in the literature on the delivery and outcomes of culturally relevant mental health psychotherapy to African Americans. Cultural variables, such as worldview, have been noted to impact an individual's overall psychosocial functioning and have significant implications for mental health service delivery. The purpose of this study was to use archival data to analyze the impact of African-centered therapeutic services on depressive symptoms and on Africentric worldview among African Americans. Archival data on 38 African American adults, recorded from 2012-2015, were obtained from a community mental …

Examining Nurse Practitioners' Perceptions And Beliefs Regarding Hospice Referrals For African Americans, Karen Jackson Mcclary

Walden Dissertations and Doctoral Studies

Terminally ill patients often have difficult choices at the end-of-life, and electing to receive hospice services is one of them. Hospice has been linked to improved quality of life and death and is accessible to terminally ill patients. Despite the accessibility, African American patients often make the decision to forgo hospice services. The purpose of this descriptive study was to explore perceptions and beliefs of nurse practitioners (NPs) regarding the lack of utilization of hospice for African American patients and the feasibility of NPs for initial referral for terminally ill African American patients. The research questions addressed whether an NP's …

African Americans' Understanding Of The Provisions Of The Affordable Care Act, Ewang Theo Epie-Alobwede

Walden Dissertations and Doctoral Studies

African Americans as a group tend to have numerous health issues, and by the time they seek healthcare, the conditions often advance into more serious ailments. Researchers have shown that cultural distrust of the U.S. healthcare system coupled with some discriminatory practices has hindered African Americans seeking care and taking full advantage of the healthcare system. With the introduction of the Patient Protection and Affordable Care Act (ACA), there is some confusion about the application of the law, resulting in many intended beneficiaries misinterpreting it, and not accessing quality healthcare. This interpretive phenomenological study explored how African Americans in the …

Admixture Mapping Of Subclinical And Clinical Cardiovascular Disease Among African Americans, Aditi Shendre

All ETDs from UAB

The purpose of this dissertation is to evaluate the association of local European ancestry (LEA) with subclinical and clinical cardiovascular (CV) disease (CVD) among African Americans in three prospective cohorts from the United States. CVD burden is higher among African Americans compared to other racial/ethnic groups and prevention efforts have led to the evaluation of subclinical measures of CVD such as carotid artery intima-media thickness (CIMT), and risk factors including the underlying genetic component of the disease. Admixed populations such as African Americans may have increased risk of disease as a result of the increased prevalence of a disease among …

Communicating Social Support: Understanding Complexities Of Breastfeeding Communication Among African American Mothers, Nicole Rachael Peritore

Theses and Dissertations--Communication

Breast milk is the best choice for meeting the nutritional needs for an infant whenever possible. Despite the knowledge that this nutritional choice is the best choice for an infant, data demonstrates that there is a sharp decline in the rates of breastfeeding mothers. Among African Americans, breastfeeding rates are significantly lower than the national averages. Despite many of the applications of social support in communication research, there is a gap in knowledge on the social support systems in the context of breastfeeding, especially for African Americans. With the social ecological model as a framework, social support theory provides understanding …

Cognitive Health And African American Elders Study: Knowledge, Attitudes And Practices, Shelytia Cocroft

Wayne State University Dissertations

A substantial body of literature suggests that cognitive impairment disproportionately affects African Americans. To date, research has uncovered disturbing racial disparities associated with the prevalence of cognitive impairment and dementia and found prevalence rates of Alzheimer’s disease (AD) to be higher among African Americans (Potter et al., 2009). Furthermore, a 2002 report from the Alzheimer’s Association described AD in the African American community as an “emerging public health crisis”. This dissertation examined the impact of socioeconomic status (SES) on knowledge, attitudes, and practices (KAP) associated with the promotion of cognitive health among a sample of 120 African American women aged …

Hypertension And African Americans: A Retrospective Review Of Provider Education On Lifestyle Counseling And Medication Management, Danielle Bundrent

DNP Projects

Purpose: The purpose of this study was to evaluate current provider practice of the management of hypertension among African Americans in a primary care clinic in Louisville, KY. Specific aims of the study were to: 1) assess provider adherence to the JNC 8 guidelines related to African Americans with hypertension and, 2) assess provider adherence to hypertension lifestyle education and counseling.

Methods: This descriptive study used a retrospective chart review to evaluate provider management of hypertension. Medical records of African American men and women in a primary care practice in Louisville, KY were reviewed. A random sample of 100 charts, …

Biological And Psychosocial Risk Factors Of Stroke In African Americans Enrolled In The Jackson Heart Study (Jhs), Sasikiran Nunna

Electronic Theses and Dissertations

Objectives: the objective of this study is to estimate the impact of biological, psychosocial and other risk factors on stroke in African Americans enrolled in the JHS and determine the population attributable risk of risk factors. Methods: this study used a nested case control design. Cases were patients with stroke during the follow up period. Corresponding controls were selected from subjects who are alive at that time period and who are at risk of stroke by matching on the person-years spent in the cohort. Odds ratios (OR) and population attributable risks (PAR) were calculated to understand the association of risk …

Serum Vitamin D And C-Reactive Protein: Predictors Of Glucose Control In African-Americans With Type 2 Diabetes?, Mary Luree Garvin-Surpris

All ETDs from UAB

Introduction African-Americans experience more years of life lost as a result of complications from type 2 diabetes mellitus (T2DM) than any other racial or ethnic group. Evidence suggests that serum 25(OH)D (serum vitamin D), generally low in African-Americans, may play a role in glucose control. In addition, elevated levels of chronic low-grade inflammation, measured by C-reactive protein (CRP), may also relate to glucose control. The purposes of this study were to determine whether serum 25(OH)D and CRP are independent predictors of glucose control in adult African-Americans with T2DM, after controlling for other factors associated with glucose control, and to examine …