Medicine and Health Sciences Commons^™

Evaluating The Relationship And Outcomes Of Ischemic Stroke In Patients With Covid-19 While Also Reviewing Overall Incidence And Mortality Of Stroke In Vulnerable Populations In The Us, Jaime Dougherty

Rowan-Virtua Research Day

COVID-19 has affected the worldwide population since early 2020 and has remained a health issue. Among the various symptoms and outcomes people are encountering when infected with COVID-19, this virus has also been connected to severe vascular insults involving large vessel occlusions.

Current stroke statistics indicate a nearly twice as high risk of stroke in African Americans when compared to whites. This brings into question how social determinants of health are affecting COVID-19 and stroke incidence.

The purpose of this review is to investigate the relationship between COVID-19 and ischemic stroke while advocating for a more robust primary prevention approach …

A Longitudinal Analysis Of The Impact Of Child Custody Loss On Drug Use And Crime Among A Sample Of African American Mothers, Kathi L. H. Harp, Carrie B. Oser

Health Management and Policy Faculty Publications

This study examines the influence of child custody loss on drug use and crime among a sample of African American mothers. Two types of custody loss are examined: informal custody loss (child living apart from mother but courts not involved), and official loss (child removed from mother’s care by authorities).

Methods—Using data from 339 African American women, longitudinal random coefficient models analyzed the effects of each type of custody loss on subsequent drug use and crime.

Results—Results indicated that both informal and official custody loss predicted increased drug use, and informal loss predicted increased criminal involvement. Findings demonstrate …

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.

Acceptability Of Hiv Testing Sites Among Rural And Urban African Americans Who Use Cocaine, D. Keith Branham, Tyrone F. Borders, Katharine E. Stewart, Geoffrey M. Curran, Brenda M. Booth

Health Management and Policy Faculty Publications

African Americans (AAs) who use cocaine in the Southern region of the U.S. have a relatively high risk of HIV and need for HIV testing. Among this group, those residing in rural areas may have less favorable opinions about common HIV testing sites, which could inhibit HIV testing. We examined rural/urban variations in their acceptability of multiple HIV testing sites (private physician clinic, local health department, community health center, community HIV fair, hospital emergency department, blood plasma donation center, drug abuse treatment facility, and mobile van or community outreach worker). Results from partial proportional odds and logistic regression analyses indicate …

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 …

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 …

Black Is Decidedly Not Just Black: A Case Study On Hiv Among African-Born Populations Living In Massachusetts, Chioma Nnaji, Nzinga Metzger

Trotter Review

Black or African American is a racial category that includes the descendants of enslaved Africans as well as members of foreign-born black communities who migrated to the United States from places abroad, such as Africa, the Caribbean, and Latin America. Grouping native-born and foreign-born blacks into a single homogeneous racial category may make it easier to track disease and health outcomes; however, it masks the different cultural experiences, histories, languages, social and moral values, and expectations that influence health beliefs, attitudes, practices, and behaviors. It also ignores such factors as migration, which forces foreign-born populations to examine both their traditional …

Why African-American Women Are At Greater Risk For Pregnancy-Related Death, Margaret Harper, Elizabeth Dugan, Mark Espeland, Anibal Martinez-Borges, Cynthia Mcquellon

Elizabeth Dugan

PURPOSE: Our study aim was to identify factors that may contribute to the racial disparity in pregnancy-related mortality.

METHODS: We examined differences in severity of disease, comorbidities, and receipt of care among 608 (304 African-American and 304 white) consecutive patients of non-Hispanic ethnicity with one of three pregnancy-related morbidities (pregnancy-related hypertension, puerperal infection, and hemorrhage) from hospitals selected at random from a statewide region.

RESULTS: African-American women had more severe hypertension, lower hemoglobin concentrations preceding hemorrhage, more antepartum hospital admissions, and a higher rate of obesity. The rate of surgical intervention for hemorrhage was lower among African-Americans, although the severity …

Racial Disparity In Pregnancy-Related Mortality Following A Live Birth Outcome, Margaret Harper, Mark Espeland, Elizabeth Dugan, Robert Meyer, Kathy Lane, Sharon Williams

Elizabeth Dugan

PURPOSE: African-American women have a 2- to 4-fold increased risk of pregnancy-related death compared with Caucasian women. We conducted this study to determine if differences in a combination of socioeconomic and medical risk factors may explain this racial disparity in pregnancy-related death. METHODS: Pregnancy-related deaths of African-American (N=60) and Caucasian (N=47) women were identified from review of pregnancy-associated deaths (N=400) ascertained through cause of death on death certificates, electronic linkage of birth and death files, and review of the hospital discharge database for the State of North Carolina, during the period between 1992 and 1998. Controls (N=3404) were randomly selected …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Race And Colorectal Cancer Disparities: Health-Care Utilization Vs Different Cancer Susceptibilities, Adeyinka Laiyemo, Chyke Doubeni, Paul Pinsky, V. Doria-Rose, Robert Bresalier, Lois Lamerato, E. Crawford, Paul Kvale, Mona Fouad, Thomas Hickey, Thomas Riley, Joel Weissfeld, Robert Schoen, Pamela Marcus, Philip Prorok, Christine Berg

Chyke A. Doubeni

BACKGROUND: It is unclear whether the disproportionately higher incidence and mortality from colorectal cancer among blacks compared with whites reflect differences in health-care utilization or colorectal cancer susceptibility. METHODS: A total of 60, 572 non-Hispanic white and black participants in the ongoing Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial underwent trial-sponsored screening flexible sigmoidoscopy (FSG) without biopsy at baseline in 10 geographically dispersed centers from November 1993 to July 2001. Subjects with polyps or mass lesions detected by FSG were referred to their physicians for diagnostic workup, the cost of which was not covered by PLCO. The records …

Increased Racial Differences On Breast Cancer Care And Survival In America: Historical Evidence Consistent With A Health Insurance Hypothesis, 1975-2001, Kevin M. Gorey

Social Work Publications

PURPOSE: This study examined whether race/ethnicity had differential effects on breast cancer care and survival across age strata and cohorts within stages of disease.

METHODS: The Detroit Cancer Registry provided 25,997 breast cancer cases. African American and non-Hispanic white, older Medicare-eligible and younger non-eligible women were compared. Successive historical cohorts (1975-1980 and 1990-1995) were, respectively, followed until 1986 and 2001.

RESULTS: African American disadvantages on survival and treatments increased significantly, particularly among younger women who were much more likely to be uninsured. Within node positive disease all treatment disadvantages among younger African American women disappeared with socioeconomic adjustment.

CONCLUSIONS: Growth …