Factors associated with nicotine dependence among African American women cigarette smokers

Cigarette smoking contributes to disproportionate morbidity and mortality among African Americans. Purposes of the study were to describe smoking behavior and test a model of nicotine dependence among African American women. Participants (n = 187) smoked a low rate of high nicotine mentholated cigarettes and had a mean salivary cotinine of 402 ng/mL. The proposed model predicted 48% of variance in nicotine dependence with smoking to cope, number of cigarettes/day, positive outcome expectancies about smoking, and interest in quitting, as significant contributors. Suggested interventions include developing alternative coping skills, cognitive restructuring, and techniques focused on the precontemplation stage of smoking cessation. © 1993 John Wiley & Sons, Inc.     

Diabetes Risks and Health Literacy in Southern African American and Latino Women

Minority women experience health disparities, especially related to diabetes. The purpose of this article is to examine diabetes risk in minority women. A survey design was used to recruit 52 African Americans (AA) and 48 Latina women. Participants described their health, health behaviors, and health literacy. Blood pressure and body mass index were measured. AA women had more diabetes risks than Latinas, and older women had more risks than younger women. All of the women had low health literacy. Women with higher numbers of diabetes risks had lower health literacy. Findings can be used to develop diabetes prevention and education programs.     

Measurement adequacy of parenting and children's functional status in African American and Latino families

To examine the psychometric adequacy of two existing instruments, the Functional Status Questionnaire (FS IIR) and the Parent Behavior Checklist (PBC), in two ethnic minority groups. Age-specific items that were not relevant for children ages 1 to 5 were removed from the FS IIR and PBC. Measures were administered to 196 Latino and African American parents of children aged 1 to 5. Reliability, variability, item-convergence, and factor structure were examined. The results highlight common pitfalls in using existing measures in populations other than those on which they were originally developed. Both measures were modified resulting in all scales having low or acceptable reliability. Construct validity was supported for both the FS IIR and the PBC through confirmation of hypothesized relationships. In both ethnic groups, factor analyses supported the hypothesized factor solutions for the FS IIR and the PBC. Use of measures in minority groups requires researchers to be cognizant of the issues of psychometric adequacy in all groups. The psychometric properties of the FS IIR and the PBC were generally acceptable for Hispanics and African Americans, but each had some problems in at least one psychometric characteristic in one or both groups. Different factor loadings for some items for Hispanics and African Americans suggest different interpretation of items between the two cultural groups.     

Evidence-based practice: A theory-based tobacco dependence treatment at an adolescent health clinic

Tobacco is the leading cause of preventable death in the US. Most smokers report initiating smoking in adolescence when smoking is not perceived as a health risk. Assessment and education about the harm of tobacco use is critical to stemming the destructive behavior of smoking and avoiding lifelong addiction. This article describes a theory-based, nurse-run, adolescent-focused smoking assessment, education and intervention program. Results of the first 6 months of the program are described.     

Parental stress among African American parents and grandparents

The purpose of this study was to examine the relationships among parental stress, health (defined as level of systolic and diastolic blood pressure and body mass index), childcare characteristics, and social support. The study used a correlational research design and the setting was the metropolitan Detroit area. The sample consisted of 120 hypertensive African American parents and grandparents who reported caring for 1 to 9 children living in the household. Several variables (average diastolic blood pressure, number of children/grandchildren in home, child/grandchild is physically/mentally disabled, ability to decrease stress) were statistically significant predictors of parental stress. These results indicate that the multiple demands of parenting may become a barrier to making life-style changes for parents and grandparents diagnosed with hypertension. Nursing implications of the findings are discussed.     

The feasibility of a nurse-managed, peer-led tobacco cessation intervention among HIV-positive smokers.

The purpose of this pilot study was to examine the effectiveness of an 8-week, nurse-managed, peer-led smoking cessation intervention among HIV-positive smokers. The intervention was based on the Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline and was delivered by an ex-smoker who was HIV positive and had been trained by an advanced practice nurse to deliver cessation counseling. Eight male HIV-positive smokers were assigned to the intervention group and received (a) 21 mg nicotine patch therapy for 6 weeks, (b) weekly face-to-face or telephone counseling, and (c) skills training that included substitute strategies for dealing with not smoking. Those participants assigned to the control group received written self-help materials for smoking cessation. Abstinence rates at end of intervention and 8 months were compared between groups. At end of treatment, 62.5% of intervention group participants were biochemically confirmed as abstinent from smoking compared with 0% in the control group. Eight-month abstinence rates were 50% among the intervention group compared with 0% in the control group.     

Parental competence among African American adolescent mothers and grandmothers

This study describes the influence of grandmothers on parental competence among urban African American adolescent mothers, using a model adapted from Belsky's (1984) Determinants of Parenting Process Model. The sample included 53 pairs of urban African American mothers (age 16.4 +/- 1.2 years) and their mothers (age 39.2 +/- 4.3 years). All adolescents were enrolled in school, co-resided with mothers, and had infants ages 4 to 8 months. Survey instruments measured personal resources, perception of infant temperament, and contextual sources of support and stress. The outcome measure for adolescent mothers was perceived parental competence. Multiple regression analyses indicated adolescent mothers' self-esteem and mastery explained 41% of the variance and grandmothers' self-esteem explained 42% of the variance in adolescent mothers' parental competence. A combined regression equation demonstrated that adolescent mothers' mastery and grandmothers' self-esteem accounted for 65% of the variance in adolescent mothers' parental competence.     

Recruiting African American smokers into intervention research: Relationships between recruitment strategies and participant characteristics

The purposes of this study were to (a) to describe an 8-month recruitment campaign to enroll African American smokers (N = 249) into a randomized controlled trial and (b) examine characteristics of participants recruited through proactive (face-to-face), reactive (television, radio, or newspaper ads inviting participants), and combination (both reactive and proactive) approaches. Reactive recruitment was most successful (43%), followed by proactive (31%), and combination (26%) recruitment. Compared to proactive recruitment, reactive recruitment was associated with lower nicotine dependence, and greater readiness to quit, processes of change engagement, and acculturation. Combination recruitment was associated with lower nicotine dependence and greater readiness to quit. The differences according to recruitment strategy could be used to tailor recruitment strategies for African American smokers.     

Spirituality among African American cancer survivors: having a personal relationship with God

African American breast and prostate cancer survivors describe their personal relationship with God as very real, close, and intimate. During their cancer trajectory, God was there with them, healing, protecting, and in control of their lives. Participants believed that God provided types of support not available from family members or friends. In return, these participants dedicated their lives to God through service in their churches or through helping others. Findings can help healthcare professionals and others in clinical practice to understand the reliance that many African American cancer survivors have on their spirituality. These findings also suggest that many African Americans perceive their survival from cancer as a gift from God. Therefore, for them, finding a way to give back is an important component of their spirituality.     

Balance, mobility, and falls among elderly African American women

OBJECTIVE: To compare balance, mobility, recent falls, and injuries among elderly African American and white women. DESIGN: This was a nonexperimental study. Participants, who were older than 65 yr of age, able to walk at least 30 ft, not residing in a nursing home, and with no acute medical problems, were recruited from 17 senior citizens' community centers. RESULTS: Compared with white women (n=180), African American women (n = 118) took fewer medications, had greater body mass indexes, had less muscle strength, and had more medical conditions and neurologic abnormalities. Additionally, these women were less active and had poorer performances on an obstacle course. The two groups had a similar histories of falls and injuries. For both groups, activity level and neurologic findings were predictors of obstacle course performance. For white women, muscle strength was an additional predictor of obstacle course performance. An additional predictor for African American women was range of motion. CONCLUSION: The poorer balance and mobility of African American women compared with white women may have consequences such as their functional dependence, resulting in their greater use of hospitals and formal and informal health services.