Community-Based Research Commons^™

Cancer Awareness In Alternative Settings: Lessons Learned And Evaluation Of The Barbershop Men’S Health Project, Cheryl L. Holt, Theresa A. Wynn, Katrina Debnam, Mark S. Litaker, Sanford Jeames, Yu-Mei Schoenberger, Penny Southward, Virgil Simons

Journal of Health Disparities Research and Practice

Prostate and colorectal cancer are two of the leading causes of cancer deaths among African American men. This study describes lessons learned from the development, implementation and evaluation of a culturally appropriate, barbershop-based intervention to improve prostate and colorectal cancer screening awareness among African American men. Working with an Advisory Panel of shop owners, barbers, and cancer survivors, local barbers were recruited and trained as Community Health Advisors to educate, motivate, and assist their clients in becoming more knowledgeable about prostate and colorectal cancer. Survey results reveal increases in prostate and colorectal cancer knowledge and self-reported screening among participants. Lessons …

Physical Activity Effects On Depressive Symptoms In Black Adults, Elisa R. Torres, Carolyn M. Sampselle, Kimberlee A. Gretebeck, David L. Ronis, Harold W. Neighbors

Journal of Health Disparities Research and Practice

Objectives: Randomized trials found physical activity (PA) effective in decreasing depressive symptoms. Few studies included Black participants. The purpose of this systematic literature review was to determine the effects of PA on depressive symptoms in Black adults. Methods: Articles were abstracted by conducting a computer and hand search of eligible studies. Results: Eight of 13 studies found a significant inverse relationship between PA and depressive symptoms in Black adults. Sources for the heterogeneity were explored. Conclusion: Future studies should include representative samples of Black adults, incorporate a theory which considers multiple levels of influence, account for genetic factors in the …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel Rickles, Silvia Dominguez, Hortensia Amaro

Journal of Health Disparities Research and Practice

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans’ perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006.

Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Preventable Asthma Episodes Among Urban/Rural Children And Adolescents: A Comparative Study, Saundra Glover, Crystal N. Piper, Edith Williams, Kevin Bennett, Winifred Thompson, Lucy Annang, Shaniece Charlemagne, Rahnuma Hassan

Journal of Health Disparities Research and Practice

Context: Asthma is a chronic respiratory illness that is increasing in prevalence among children in the United States. A limited number of studies have examined the relationship between rurality and the prevalence of asthma in minority children, and those studies found mixed results. The aim of this study is to examine urban/rural locality and its impact on asthma episodes and preventable emergency department visits, and to provide quantitative evidence concerning the relationship between patient characteristics and geographic location. Methods: This is a retrospective study and secondary data analysis of the 2000 National Health Interview Survey. Parametric testing using Univariate/Bivariate/Multivariate analysis …

Colorectal Cancer Screening Behaviors Among American Indians In The Midwest, Christine M. Daley, Niaman Nazir, K. A. Greiner, Aimee S. James, Won S. Choi

Journal of Health Disparities Research and Practice

Colorectal cancer is the second most diagnosed cancer among American Indians and is also the second leading cause of cancer death. We used a community-based participatory approach to conduct a mixed methods study to examine colorectal cancer screening behaviors. Here we report on the screening behaviors of our focus group participants (n=153). There were significant gender differences in the colorectal cancer screening rates for FOBT and colonoscopy. Although over 80% of participants reported having health insurance, only 35% of males over 50 years old and 57% of females reported ever having a colonoscopy. More research is needed to identify the …

Determinants Of Depressive Symptoms Among Women On Public Assistance In Louisiana, Theresa C. Davidson, Joachim Singelmann

Journal of Health Disparities Research and Practice

Depression can be a significant barrier in the welfare-to-work transition of poor women. Fortunately, support from social networks can lessen symptoms and facilitate entry into the workplace. Inconsistency in the literature concerning the effects of social networks on the poor suggests further research is needed. Thus, we examine the level and determinants of depressive symptoms among participants in the Temporary Assistance to Needy Families program. Having a good job, being in good health, married, and black, and living in rural areas inhibit symptoms of depression. Remaining on TANF and having several children increases symptom levels. Those who report that they …

Social Capital And Violence Across Racial And Ethnic Samples Of Adolescents, Darlene R. Haff, Kevin M. Fitzpatrick, H. H. Floyd

Journal of Health Disparities Research and Practice

Using a national sample of adolescents, results of this study demonstrate the important role family and school social capital plays in protecting both White and selected non- White students against violent outcomes. For example, parent-child relationship was associated with reduced violence for Black and White adolescents but not for Hispanics. School affiliation was significant in models for Hispanic and White adolescents but not in models for Black students. Sports participation was associated with greater violence among Hispanics and Whites, but not Blacks. Interestingly, club participation was significant for Whites, but, like sports, it was associated with greater violence. Parental monitoring …

Application Of A Re-Aim Framework To Assess The Impact Of The Southwest American Indian Collaborative Network, Michelle Chino, Carolee Dodge Francis

Journal of Health Disparities Research and Practice

In response to a Request for Proposals from the National Cancer Institute (NCI), the Inter Tribal Council of Arizona (ITCA) along with health care partners from the Phoenix Indian medical Center (PIMC) and academic partners from the Arizona Cancer Center (ACC) at the University of Arizona (UA), and the University of Nevada Las Vegas (UNLV) established a Community Network Program entitled the Southwest American Indian Collaborative Network (SAICN). The ultimate goal of the SAICN project was to “eliminate cancer health disparities by closing the gap between the health needs of the community and cancer prevention and control made possible by …

A Su Salud En Acción: Replicating A Model To Increase Utilization Of Cancer Screening Among Low Income Latinas, Amelie G. Ramirez Drph, Patricia Chalela, Lucina Suarez, Kipling J. Gallion

Journal of Health Disparities Research and Practice

Latinas suffer longstanding disparities in breast cancer survival and cervical cancer incidence and mortality compared to non-Hispanic white women. This study assessed the feasibility of replicating the theory-based A Su Salud En Acción communication model to impact cancer screening behaviors in two at-need Nevada clinics. The intervention significantly increased the number of mammograms and Pap smears among Latinas. Mammograms and Pap smear rates increased by 58.7‰ and 51.8‰ respectively in the pilot site (95% CI 40.1-49.1 and 47.1-56.5 respectively) and by 33.7‰ and 7.5‰ respectively (95% CI 15.6-51.9 and 4.3-10.6) in the replication site, among women ages 50-64.

This study …

Participant Recruitment Of African American College Students At An Historically Black College And University (Hbcu): Challenges And Strategies For Health-Related Research, Cecile N. Yancu, Anna K. Lee, Daphne D. Witherspoon, Correll D. Mcrae

Journal of Health Disparities Research and Practice

Lack of research participation among African Americans is problematic for population relevant health disparity research. The purpose of this paper is to identify and describe challenges and strategies in recruitment of African American college students for health related research being conducted at a small Historically Black College or University (HBCU). Upon completion of a recruitment and retention literature review, study investigators constructed and tested a culturally-specific, direct-appeal protocol to recruit participants. Major barriers to recruitment of African American college students included discrete sources of distrust, lack of understanding of the research process, and logistical concerns. Implementation of a culturally-specific, direct …

Walking Increases Among African American Adults Following A Community-Based Physical Activity Intervention: Racial And Ethnic Approaches To Community Health, 2002–2005, I. W. Miles, J. Kruger, Y. Liao, S. A. Carlson, J. E. Fulton

Journal of Health Disparities Research and Practice

Racial and Ethnic Approaches to Community Health (REACH) 2010, a communitybased program, is a cornerstone of CDC’s efforts to eliminate racial and ethnic health disparities. Six African American REACH sites implemented walking interventions as part of their plans to decrease health disparities. We evaluated changes in walking using annual evaluation assessments (2002–2005) from the REACH 2010 Risk Factor Survey. Walking was classified 3 ways: (1) any walking (≥ 10 minutes per week); (2) regular walking (≥ 30 minutes each day, ≥ 5 days per week); and (3) median minutes of walking per week. Any walking increased from 68.3% in 2002 …

Self-Stigma, Stress, And Smoking Among African American And American Indian Female Smokers: An Exploratory Qualitative Study, Diana Burgess, Rachel Widome, Michelle Van Ryn, Sean Phelan, Steven Fu

Journal of Health Disparities Research and Practice

Research suggests that negative emotions and difficulty coping with stressful events might impede women’s ability to quit smoking. This study uses qualitative methods to explore interrelationships between smoking behavior and negative emotions among a sample of racial/ethnic minority female smokers with the aims of theory-building and hypothesis generation. Data were derived from a larger study involving sixteen focus groups with current and former smokers from ethnic minority communities. The present study consisted of three focus groups of female African American and American Indian smokers (N = 16). Data was analyzed following standard methods for in vivo coding of qualitative data. …

Breast Cancer Screening Practices Among American Indians And Alaska Natives In The Midwest, Christine M. Daley, Melissa Filippi, Aimee S. James, Sarah Brokenleg, Stacy Braiuca, K. A. Greiner, Won S. Choi

Journal of Health Disparities Research and Practice

American Indian and Alaska Native (AI/AN) women currently have some of the highest mortality rates from breast cancer for any racial/ethnic group in the United States and some of the lowest screening rates. However, current data are not available for regional differences in screening, which can result in dramatically different stage at diagnosis and mortality. We conducted surveys with 120 focus group participants in a needs assessment of mammography among AI/AN in the greater Kansas City metropolitan area and parts of Northeast Kansas. We found that among women under age 40, for whom recommended screenings include only annual clinical breast …

Poverty And Mortality Disparities In Central Appalachia: Mountaintop Mining And Environmental Justice, Michael Hendryx

Journal of Health Disparities Research and Practice

Objectives. This study investigated the associations between poverty rates, Appalachian mountaintop coal mining, and age-adjusted total mortality rates to determine if persons exposed to this form of mining experience greater poverty and higher death rates compared to other types of mining or other areas of Appalachia.

Methods. Mortality rates, poverty rates, Appalachian designation and mining activity were examined for counties in Kentucky, Tennessee, Virginia and West Virginia (N=403). Linear least squares models tested for annual group differences from 2000-2007 in total and child poverty, and total mortality, based on mining type and Appalachian location. Nested linear models accounting for state-level …

Value Of Community Partnership For Understanding Stress And Coping In Rural Yup’Ik Communities: The Canhr Study, Inna D. Rivkin, Ellen Lopez, Tonie M. Quaintance, Joseph Trimble, Scarlett Hopkins, Candace Fleming, Eliza Orr, Gerald V. Mohatt

Journal of Health Disparities Research and Practice

Stress and trauma can compromise physical and mental health. Rural Alaska Native communities have voiced concern about stressful and traumatic events and their effects on health. The goal of the Yup’ik Experiences of Stress and Coping Project is to develop an in-depth understanding of experiences of stress and ways of coping in Yup’ik communities. The long-range goal is to use project findings to develop and implement a community-informed and culturally grounded intervention to reduce stress and promote physical and mental health in rural Alaska Native communities. This paper introduces a long-standing partnership between the Yukon-Kuskokwim Regional Health Corporation, rural communities …

Health Effects Associated With Foreclosure: A Secondary Analysis Of Hospital Discharge Data, Nancy Menzel, Sheniz Moonie, Melva V. Thompson-Robinson

Nursing Faculty Research

Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods. We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between …

Immigration And Ethnic Diversity In Nevada, Thomas Wright, John P. Tuman, Maryam T. Stevenson

Social Health of Nevada Reports

In a few decades, non-Hispanic whites will constitute a bare majority in the United States. If current demographic trends continue, the Hispanic population will double or even triple in size by 2050, the Asian population will double, and the African-American population will grow at a faster pace than non-Hispanic whites, which are actually expected to begin declining by 2025. These developments promise to bring profound changes in the country’s ethnic and racial landscape.

Health Effects Associated With Foreclosure: A Secondary Analysis Of Hospital Discharge Data, Nancy N. Menzel, Sheniz Moonie, Melva Thompson-Robinson

Environmental & Global Health Faculty Research

Objectives: The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose.

Methods: We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed.

Results: Most conditions did not demonstrate a statistical change between 2005 and …

High School Graduation And Dropout Rates In Nevada, Tiffany G. Tyler, Sandra D. Owens

Social Health of Nevada Reports

The causes and consequences of high school dropout rates are multifaceted and of great importance to society, and that is why this problem has been the subject of close scrutiny by educators, researchers, administrators, politicians and laypersons. Experts do not always agree on the nature of this social problem, but they have pinpointed its economic and social costs, identified key risk factors, and outlined most promising policy options for improving high school graduation rates in our society.

Crime And Delinquency In Nevada, Brooke M. Wagner, Andrew L. Spivak, Stephanie L. Kent, Deborah Koetzle

Social Health of Nevada Reports

Crime and justice system have received much attention from American scholars and politicians in the last than 50 years, with issues in adult criminality, delinquency, and penology emerging at the center stage of criminological inquiry. While scholarly literature now includes many studies focused on different regions and cities, there are no large-scale empirical examinations of crime and delinquency in Nevada. One exception is the Social Health of Nevada report issued in 2006 by University of Nevada, Las Vegas (UNLV) Center for Democratic Culture (CDC).

Teen Sexuality And Pregnancy In Nevada, Tiffany G. Tyler, Marie A. Wakefield, Sandra D. Owens, Lori Smith

Social Health of Nevada Reports

The proliferation of sexually explicit materials has been the hallmark of North American culture for decades. The arrival of the Internet made access to such materials all the easier, and not only for adults but also for teenagers who learn at ever-early age that romantic relations are exciting and sexual encounters are a welcome part of life. When such exposure to sensual images is not accompanied by appropriate sex education, the consequences could be dire for teenagers and society alike.

Addiction And Substance Abuse Among Nevada Youths, An-Pyng Sun, Chih-Hsiang Ho, Larry Ashley

Social Health of Nevada Reports

Adolescence is a critical stage for substance abuse initiation, as well as for substance abuse prevention, intervention, and treatment. This report presents tobacco product use, alcohol use, and illicit drug use rates of Nevada’s youths (aged 12-17) compared with youths nationwide as a whole. Most data were retrieved from the Substance Abuse and Mental Health Services Administration (SAMHSA), including the 2008--2009 National Survey on Drug Use and Health (NSDUH) data and Treatment Episode Data Set (TEDS), supplemented with the Centers for Disease Control and Prevention (CDC)’s 2009 Youth Risk Behavior Survey (YRBS) data. Substate data were taken from SAMHSA’s 2006-2008 …

Health Care Access And Insurance Availability In Nevada, Douglas L. Garner, Marie A. Wakefield, Tiffany G. Tyler, A. Dexter Samuels, Roger Cleveland

Social Health of Nevada Reports

The U.S. Department of Health and Human Services (2012) defines healthcare access as “the timely use of health services to achieve the best health outcomes.” The Department specifies that efficient health care access is contingent on several steps, including (1) entry into the healthcare system, (2) availability of needed services, and (3) accessibility of providers with whom individuals can establish relationships founded on mutual communication and trust.

Suicide Trends And Prevention In Nevada, Matt Wray, Tatiana Poladko, Misty Vaughan

Social Health of Nevada Reports

Suicide is a leading cause of death in the United States. In 2007, nearly 35,000 Americans took their own lives, a rate of 11.5 suicides per 100,000 (Xu et al. 2010). Among 15-24 year olds, suicide is the third leading cause of death and for those aged 25-34, it is the second leading cause (CDC WISQARS 2007).

Academic Achievement And School Resources, Tiffany G. Tyler, Douglas L. Garner, Marie A. Wakefield, Roger Cleveland, Sandra D. Owens

Social Health of Nevada Reports

This chapter examines the national and local trends in educational policy, focusing in particular on Nevada’s academic achievement, standardized test performance, available school resources, and unmet needs. The discussion begins with the concept of academic achievement and the ways it is measured. After that, we analyze the policies impacting academic achievement, most notably the No Child Left Behind (NCLB) Act. Next, we suggest the strategies to improve academic performance in the Nevada K12 System and make recommendations to increase parental involvement in education and encourage culturally competent policies of bringing together children, families, and schools. Finally, we discuss the resources …

Child Abuse And Neglect In Nevada, Ramona W. Denby

Social Health of Nevada Reports

Child maltreatment in Nevada reflects the general social, economic, and health conditions within the state and its local communities. This chapter starts with various definitions of child abuse and neglect, focusing on the approach adopted by Nevada legislators and comparing it to competing definitions. Next, this report examines child abuse and neglect rates in Nevada and tracks the progress the state has made towards achieving its goals related to child welfare outcomes, including child protection and safety, child permanency, and child well-being. After that, the discussion moves to the most promising child welfare intervention practices and approaches. Finally, the chapter …

Disease Prevalence And Behavioral Risk In Nevada, Shannon M. Monnat

Social Health of Nevada Reports

Throughout the last several years, people living in the United States have engaged in intense debates about health care reform, costs, and mandates. What is often missing from these debates is arguably the key issue in American health: What is making us sick in the first place?

Disability Rights And Services In Nevada, Janet S. Belcove-Shalin

Social Health of Nevada Reports

For ages, people with disabilities faced hardship and condescension from the general public. As recently as the 19th century, individuals with serious physical or mental issues were singled out for pity, shunned by society, and urged to accept their afflictions as God’s will. The government offered no assistance to the impaired, relying instead on almsgiving by religious institutions and philanthropic organizations.

Environment And Sustainability In Nevada, Mark J. Salvaggio, Robert Futrell

Social Health of Nevada Reports

When the inaugural Earth Day launched the first environmental decade in the U.S. more than forty years ago, protecting our air, water, land and other natural resources seemed a relatively straightforward task. Environmental polluters and exploiters would be brought to heel by tough laws. The U.S. and other industrialized nations responded to quality of life concerns associated with environmental degradation by adopting dozens of major environmental and resource policies and creating new institutions such as the U.S. Environmental Protection Agency to manage environmental programs. Following these national developments, states and local communities began systematic efforts to address environmental problems.

Prenatal Care And Infant Mortality In Nevada, Douglas L. Garner, Roger Cleveland, A. Dexter Samuels, Tiffany G. Tyler

Social Health of Nevada Reports

The U.S. outspends all other industrial countries on health care, and yet Americans hardly enjoy better health (Gorman 2010). An American baby born in 2006 can expect to live 78 years – two years less than a baby born across the Canadian border. The U.S. ranks 28th in infant mortality out of the 30 major industrial countries (Gorman 2010). A large part of the gap in infant mortality can be traced to high infant death rates in certain populations, particularly African-Americans who make up about 13% of the total population. In 2005, infant mortality for non-Hispanic blacks in the U.S. …