Race and Ethnicity Commons^™

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith Williams, Carlos Crespo, Joan Dorn

Journal of Health Disparities Research and Practice

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Race/Ethnicity As A Risk Factor Of Mother To Child Transmission Among Hiv Infected Mothers, Wei Yang, Fares Qeadan, Mona L. Brown, Michelle Chino, Scott Hall, Mary Guinan

Journal of Health Disparities Research and Practice

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were …

A Human Capital Approach To Reduce Health Disparities, Saundra Glover, Sudha Xirasagar, Yunho Jeon, Keith Elder, Crystal N. Piper, Harris Pastides

Journal of Health Disparities Research and Practice

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research.

Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), …

Multiple Peer Group Self-Identification And Adolescent Tobacco Use, C. Anderson Johnson, Juliana L. Fuqua, Peggy E. Gallaher, Jennifer B. Unger, Dennis R. Trinidad, Steve Sussman, Enrique Ortega

CGU Faculty Publications and Research

Associations between peer group self-identification and smoking were examined among 2,698 ethnically diverse middle school students in Los Angeles who self-identified with groups such as Rockers, Skaters, and Gamers. The sample was 47.1% male, 54.7% Latino, 25.4% Asian, 10.8% White, 9.1% Other ethnicity, and 59.3% children of immigrant parents. Multiple group self identification was common: 84% identified with two or more groups and 65% identified with three or more groups. Logistic regression analyses indicated that as students endorsed more high risk groups, the greater their risk of tobacco use. A classification tree analysis identified risk groups based on interactions among …

Perceptions Of Barriers That Inhibit African American Women And Adolescent Girls From Participation In Physical Activity, Sonya Daniels Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study examined the barriers to leisure time physical activity for African American women and their adolescent daughters. Six mother-daughter dyads were interviewed who have access to physical activity opportunity. Three of the dyads participated in a follow-up focus group. A qualitative research design that utilized a grounded theory approach identified two themes for the women and two themes for the girls. Themes for the women include influence of culture and low physical activity IQ. Sub-themes of influence of culture are (a) hair and (b) body image. Sub-themes of low physical activity IQ are (a) mommy guilt, (b) perception of …

Research Brief: Technology And Health Education: An Exploratory Study Of Older Chinese Immigrants, Jenny H. Tsai, Vicky Taylor, Shin-Ping Tu

Journal of Health Disparities Research and Practice

Technology advances, especially in the Internet, provide new tools to deliver health education to limited English proficient immigrants. This paper presents the findings of a qualitative descriptive study of older limited English proficient Chinese immigrants’ perspectives regarding computer-based health education. The sample consisted of 33 foreign-born Chinese recruited in Seattle, Washington. Data were generated through six focus groups and an 18-item demographic questionnaire. The analyses revealed that the majority was not skillful in computer use and Internet browsing, and the Internet was not a common health information source. Nevertheless, participants were supportive of having computer-based health information designed for Chinese …

Preliminary Evaluation Of The Incharge Program Among Older African Americans In Rural Alabama, Cynthia Owsley, Gerald Mcgwin Jr., June Weston, Beth T. Stalvey, Karen Searcey, Christopher A. Girkin

Journal of Health Disparities Research and Practice

Objective: Blindness rates among older African Americans are two times higher than for older whites. Our purpose was to understand attitudes about eye care and perceived barriers to care among older African Americans living in rural Alabama and to determine whether an educational program reduced perceived barriers to care. InCHARGE, an eye health education program for older African Americans, promotes eye disease prevention by conveying the personal benefits of annual dilated comprehensive eye care and by teaching strategies to minimize barriers to eye care.

Design and Participants: InCHARGE was presented in five senior centers to 111 individuals. Using a questionnaire …

Obesity Prevalence, Weight-Related Beliefs And Behaviors Among Low-Income Ethnically Diverse National Job Corps Students, Jamie S. Bodenlos, Milagros C. Rosal, Diane Blake, Celeste Lemay, Diane Elfenbein

Journal of Health Disparities Research and Practice

The obesity rates of Job Corps students, a predominantly ethnic minority and low income group of youth, are unknown. The purpose of this project was to examine obesity rates among these youth as well as their weight-related perceptions and behavior. First, medical charts (N=641) of all Job Corps students (ages 16-25) who were enrolled in the program in the past year were examined for height and weight. In the second phase of the study, 344 Job Corp students were recruited and information on weight perceptions, knowledge of obesity consequences, and weight loss behavior were examined. Almost half of the participants …

The Significance Of A K-12 Diabetes-Based Science Education Program For Tribal Populations: Evaluating Cognitive Learning, Cultural Context, And Attitudinal Components, Carolee D. Francis, Doug Coulson, Bonnie Kalberer, Lemyra Debruyn, William Freeman, Janet Belcourt

Journal of Health Disparities Research and Practice

Preventing and reducing the onset of type 2 diabetes among American Indian/Alaska Native youth requires ground-breaking strategies to affect knowledge, attitudes, and cognitive decision-making skills. In an unparalleled endeavor to address the growing epidemic of type 2 diabetes in tribal communities, a K-12 Diabetes Education in Tribal Schools (DETS) curriculum was created by eight tribal colleges and three federal agencies. This article highlights the results of the implementation phase, the final evaluation step in acquiring and measuring student knowledge and attitude gains through pre-post standardized assessment.

Barriers, Control And Identity In Health Information Seeking Among African American Women, Jennifer R. Warren, Lynette Kvasny, Michael L. Hecht, Diana Burgess, Jasjit S. Ahluwalia, Kolawole S. Okuyemi

Journal of Health Disparities Research and Practice

Qualitative research methods were used to examine the role of racial, cultural, and socio-economic group (i.e., communal) identities on perceptions of barriers and control related to traditional and internet resources for seeking health information. Eighteen lower income, African American women participated in training workshops on using the internet for health, followed by two focus groups. Transcripts were analyzed using standardized coding methods. Results demonstrated that participants perceived the internet as a tool for seeking health information, which they believed would empower them within formal healthcare settings. Participants invoked racial, cultural, and socio-economic identities when discussing barriers to seeking health information …

Health Care Disparities For Persons With Limited English Proficiency: Relationships From The 2006 Medical Expenditure Panel Survey (Meps), Diane L. Smith

Journal of Health Disparities Research and Practice

Inadequate communication between patients with limited English proficiency (LEP) and providers can be associated with lower access to health care. The purpose of this research was to determine if there is a significant difference among those persons whose primary language is English and those with LEP in ability to access care and preventative screenings and perception of interaction with their physician. Chi square analysis was performed to determine if there was a significant relationship between primary language spoken and access to health care and patient-provider interaction. Data were obtained from the 2006 Medical Expenditure Panel Study. Results show that there …

Colorectal Cancer Brochure Development For African Americans, Kim L. Freeman, Lina Jandorf, Hayley Thompson, Katherine N. Duhamel

Journal of Health Disparities Research and Practice

Introduction: African Americans are more likely to die from colorectal cancer (CRC) than any other racial/ethnic group in the United States. Unfortunately, African Americans are also less likely to undergo screening for CRC than their White counterparts. Focus groups methodology was used to refine educational brochures designed to increase CRC screening among African Americans.

Methods: Two series of focus groups were completed, with a total of seven groups and 39 participants. Six different brochures (stage-matched and culturally sensitive) designed to promote CRC screening among African Americans were evaluated.

Results: All participants thought that the brochures motivated them …

Modeling Health Inequities Research In Context And The Minority Researcher’S Role, Ari Mwachofi, Ngure Wamwachofi

Journal of Health Disparities Research and Practice

Current health inequities research templates are flawed and self-defeating because they do not include historical inequalities as the central context that points to the root causes of health inequities. The context includes structural malformations which are products of the history of colonization and slavery that created racial separation and hierarchies which established Whites as the dominant group and non-Whites (minorities) as the subordinate group. Consequently it is difficult for mainstream researchers to capture the minorities’ core knowledge necessary for the creation of relevant and effective interventions for fundamental and sustainable improvement of their health. This paper proposes a health inequities …

Hiv/Sti Risk Factors Among African-American Students Attending Predominantly White Universities, Marya L. Shegog, Lisa Lindley, Melva Thompson-Robinson, David Simmons, Donna Richter

Journal of Health Disparities Research and Practice

Introduction: The majority of African American college students in the U.S. attend predominantly white institutions (PWIs). However, there is minimal research examining this population’s HIV/STI risk behaviors. The purpose of this investigation was to assess HIV/STI behavioral risk factors among African American college students (aged 18 – 24years) attending PWIs. (n = 2,568)

Methods: Backwards step-wise logistic regression analyses were conducted to determine factors associated with a positive HIV/STI diagnosis (past year) among sexually active African American college students who participated in the Spring, 2006 National College Health Assessment.

Findings: Nine factors were significantly associated with an HIV/STI diagnosis among …

Pap Test Follow-Up Pattern Among American Indian Women In Arizona, Merrill Eisenberg, Kathryn Coe, Charlton Wilson, Kathleen Evans, Elizabeth Brewer

Journal of Health Disparities Research and Practice

Objective: To quantify the loss to follow-up rate after abnormal Pap test results at the Phoenix Indian Medical Center, an Indian Health Service regional facility, and identify barriers to follow-up from the patients’ point of view.

Materials and Methods: Patient records were used to identify women who had abnormal Pap tests in 2002 and to document the status of their follow-up care. Women who had no clinical record of follow-up were contacted by telephone to arrange a follow-up appointment and to request participation in a structured qualitative interview to identify barriers to follow-up at the individual, family, community, and health …

Application Of The Pen-3 Model In A Diabetes Prevention Intervention, Joan E. Cowdery, Shandowyn Parker, Amy Thompson

Journal of Health Disparities Research and Practice

More effective strategies for addressing health issues in African American communities are needed. As part of a three year NIH funded Project Export grant, this community campus partnership used community-based participatory research principles and thePEN-3 Cultural Framework to develop a culturally specific, locally relevant intervention to prevent Diabetes among African-Americans. A comprehensive needs assessment which included 13 elicitation interviews, 3 focus groups, and 217 surveys resulted in identifying major themes including overall lack of knowledge regarding Diabetes,issues of denial and stigma, sense of inevitability, influence of family on perceptionsand behaviors, communication issues with health care providers, and lack of culturally …

Racial Differences In The Use Of Most Commonly Performed Medical Procedures In The United States, Syed S. Haque, Mohammad A. Faysel, Hafiz M. R. Khan

Journal of Health Disparities Research and Practice

Objective: This study investigates racial disparities in the use of commonly performed medical procedures in U.S. hospitals. Methods: To examine racial disparities, we calculated age-adjusted rate of procedures used by all Whites, Blacks, Hispanics, Asians or Pacific Islanders and Native Americans and calculated corresponding Relative Risks(RRs) of White vs. all other races based on procedure utilizations and insurance types using 20% random sample of Nationwide Inpatient Sample (NIS) data between 2001 and2003. Results: Whites were significantly more likely to receive 3 of the study procedures than Blacks, 3 of the procedures than Hispanics, 2 of the procedures than Asians or …

Racial Disparities In Cancer Screening Among Women With Chronic Joint Pain, Edith M. Williams, Laurene Tumiel-Berhalter, Christopher Purdy, Adrianne Ransom, Judith Anderson

Journal of Health Disparities Research and Practice

Chronic pain related disorders and breast and cervical cancer are more prevalent among African-American women compared with non-Hispanic White women. However, few studies address how racial differences in the context of comorbidity may compound these disparities. This study used secondary analysis of the National Health Interview Survey (NHIS) to assess racial differences in breast and cervical cancer screening and patient education among adult women with chronic joint pain conditions. Statistical analyses included chi-square and independent samples t-tests. African-American women compared with non-Hispanic White women were less likely to receive a pap smear or mammogram within the last two years and …

In Their Own Words: The Lived Experiences Of Unemployed African American Men, Kenlana R. Ferguson

Dissertations

Due to staggering unemployment rates, African American men's experience with work in the U.S. has historically received widespread attention in the media and social science literature. Terms such as black male unemployment crisis, puzzle, epidemic and catastrophe have been used to describe the unemployment woes of black. Attempts at explaining why African American men are experiencing such difficulty in the world of work has been undertaken across the disciplines, however much of this work has amounted to nothing more than acknowledgement that isolating independent factors as causes does not suffice and that a more interdisciplinary framework is needed if we …

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 …

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 …

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 …

Not Always Black And White: Racial Bias For Birth Disparities From Excluding Hispanic Identification, Barbara L. Wilson, Cristi Coursen, Matthew Butler

Journal of Health Disparities Research and Practice

Despite gains in prenatal care (PNC) usage and birth outcomes for minority women during the past few decades, observed disparities between non-Hispanic Whites, Blacks, and Hispanics persist. Using the National Center for Health Statistics’ (NCHS) natality files from 1981 through 1998, Alexander, Kogan, & Nabukera (2002) examined live births of U.S. residents by trimester in which PNC was initiated and the appropriateness of that care based on the Adequacy of Prenatal Care Utilization Index (APNCU) (Kotelchuck, 1994). They found racial disparities between White and Black women in both the trimester of PNC initiation and the number of PNC visits made. …

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 …

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. …

Asthma Management: An Ecosocial Framework For Disparity Research, Robin A. Evans-Agnew

Journal of Health Disparities Research and Practice

Background: Asthma management disparities (AMD) between African and White Americans are significant and alarming. Various determinants have been suggested by research frameworks that affect the unfair distribution of resources for asthma management to groups who are more or less advantaged socially. Ecosocial models organize determinants into individual/family, healthcare, community, and sociocultural levels. Multilevel interventions can affect AMD through simultaneous actions on different levels and pathways between determinants.

Objective: Provide a comprehensive summary of the known determinants of AMD.

Method: Peer reviewed research frameworks of AMD from 1998-2009 were retrieved from PubMed/ Web of Science databases using (“Socioeconomic Factors”[Mesh] OR (“Healthcare …

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 …