Chronic Health Illnesses as Predictors of Mild Cognitive Impairment Among African American Older Adults

Approximately 5.5 million individuals are diagnosed with Alzheimer's disease (AD) dementia, a number which includes those with mild cognitive impairment and asymptomatic individuals with biomarkers of AD. There is a higher incidence of mild cognitive impairment (MCI) in African American populations as compared to White populations, even when controlling for sociodemographic factors. The existing body of ethnically/racially targeted research on MCI has been limited by few studies with the ability to generalize to African American communities. This study sought to examine whether medical conditions which occur at a higher rate in African American individuals increase the hazard of subsequent MCI development.A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was employed to examine the associations between health conditions (congestive heart failure, traumatic brain injury, diabetes, hypertension, hypercholesterolemia, B12 deficiency, thyroid disease) and their relationship to MCI. The analytic sample included 2847 participants with 9872 observations. Binary logistic generalized estimating equation modeling was used to examine repeated measures over the course of 1–11 observations. Education was associated with MCI development, specifically those with some college or college graduates (p < 0.001) and more than college (p = 0.002). Female sex was associated with development of MCI (p < 0.001). African Americans with traumatic brain injury (TBI) were more likely to develop MCI (p < 0.001) compared to those with no reports of a TBI. Inactive thyroid conditions decreased the risk of MCI development (p = 0.005) compared to those without thyroid disease.Though vascular factors are often attributed to higher mortality and neurodegeneration in African Americans, congestive heart failure, diabetes, high cholesterol, hypertension, diabetes, nor seizures were associated with an increased risk of MCI development. Findings from this study provide formative data to develop targeted interventions for subsets of the African American community, including those with higher educational levels, those with TBI, and those with a history of thyroid disease. While it may not be possible to prevent MCI development, it is possible to modify lifestyle behaviors contributing to these health conditions, such as falls that are often experienced by older adults. Practitioners can increase awareness, knowledge, and resources relevant to clients.     

The Buffering Effects of Active Coping on the Relationship Between SES and Cortisol Among African American Young Adults

Abstract

Cortisol levels have consistently been related to socioeconomic status (SES). Possible moderators for this relationship are coping styles that are known to moderate relationships between cardiovascular factors and SES. The authors examined whether coping style moderated a relationship between resting Cortisol levels and various measures of SES in a sample of urban, African American young adults. Those scoring low on coping style had high Cortisol levels if they were currently students or unemployed. This effect, however, differed for men and women. The authors suggest that coping style may play an adaptive role regarding salivary Cortisol measures in young adults when they are students or unemployed. Active coping may help protect against stress among young African American adults.     

Reducing Substance Use Among African American Adolescents: Effectiveness of School-Based Health Centers

This paper explores the impact of school-based heath centers (SBHCs) on the substance use behaviors of low-income, inner-city African American adolescents. Researchers surveyed 2,114 9th- and 11th-grade students from seven inner-city public high schools (three with SBHCs and four without SBHCs). Of the initial 2,114 students, 598 SBHC students and 598 non-SBHC students were successfully matched using ethnicity, grade, gender, and propensity scores. The results of separate grade x gender x SBHC ANOVAs indicated significant grade x SBHC interactions (i.e., such that substance use decreased in SBHC schools while increasing in non-SBHC schools) for cigarettes (p = .05) and marijuana (p < .001), but not for alcohol. These findings show that the SBHC intervention model is promising toward the prevention and reduction of substance use among high-risk African American adolescents and highlight the importance of accessible, holistic, and culturally appropriate health care.     

Stress and Quitting Among African American Smokers

This study examined the relationship between stress and the likelihood of quitting among 300 urban African American smokers enrolled in the placebo arm of a controlled randomized trial assessing the efficacy of bupropion for smoking cessation. Participants were predominantly female, middle-aged, and of lower income. Participants received 7 weeks of placebo treatment and counseling as well as a self-help guide. Quit status and stress, measured with the Perceived Stress Scale and an adapted Hassles Index, were assessed at baseline, end of treatment, and 6 month follow-up. Results indicated that although baseline stress did not predict quitting at later visits, higher concurrent stress levels were associated with not being abstinent. Furthermore, changes (reductions) in perceived stress from baseline also predicted abstinence at the end of treatment. Results suggest that methods to help African Americans cope with stress as they attempt to quit smoking may prevent relapse to smoking.     

Health Status Among Urban African American Women: Associations Among Well-Being, Perceived Stress, and Demographic Factors

The purpose of this study was to evaluate the associations among health status, well-being, and perceived stress in a sample of urban African American women. African American women (n = 128) (Mean +/- SD, 49.3 +/- 10.5) from Baltimore, Maryland, enrolled in a church-based physical activity randomized trial were included in the analysis. Health status was assessed from the SF-36. Well-being, perceived stress, and demographics were also determined from self-report. Results indicated that the sample reported favorable health status, well-being, and stress levels compared to mean levels reported in the literature. Spearman rank-order correlations indicated that perceived stress score negatively correlated with most health status dimensions and well-being in the present, past, and future. Multiple regression analyses, adjusting for potential demographic confounders, indicated that higher perceived stress was associated with lower health status and well-being. If these results are confirmed in prospective investigations, they suggest that interventions designed to reduce stress may impact health status and future morbidity and mortality.     

Social Support Factors as Moderators of Community Violence Exposure Among Inner-City African American Young Adolescents

Using both surveys and the experience sampling method (ESM), community violence exposure, social support factors, and depressive and anxiety symptoms were assessed longitudinally among inner-city African American adolescents. Moderator models were tested to determine protective factors for youth exposed to community violence. Several social support factors emerged as protective–stabilizing forces for witnesses of violence both cross-sectionally and longitudinally, including maternal closeness, time spent with family, social support, and daily support (ESM). Contrary to hypotheses, several social support factors demonstrated a promotive–reactive effect such that, in conditions of high victimization, they failed to protect youth from developing symptoms. Effects did not differ by outcome or sex, though sex differences in findings emerged. Protective-stabilizing effects occurred more for witnessing violence, whereas promotive–reactive patterns occurred more for victimization. Results affirm social support factors as protective from the adverse effects of violence exposure, but they also suggest that some factors typically conceived as contributing to resilience might at times fail to protect youth in conditions of extreme risk.     

Advancing Uterine Cancer Survivorship Among African American Women

Background

Few studies have examined health behavior interventions for African American women who are uterine cancer survivors. Black-white differences in uterine cancer survival suggest that there are unmet needs among these survivors.

Characterizing Mobility Limitations Among Older African American Men

This study represents an effort to contribute to the limited body of research on biopsychosocial contextual factors that influence or contribute to mobility limitations for older African American men. Specifically, we were interested in examining associations between socio-demographic, physical and emotional health experiences with mobility limitations. A secondary analysis of 1666 older African American men was performed to investigate socio-demographic, mental and physical health correlates to a specific measures of mobility limitation. In the final model, difficulty with self-care, severe pain interference, and problems with usual activities were most strongly associated with mobility limitations. Men who were married were significantly less likely to experience mobility limitations. Findings highlighted the relationship between mobility limitations and difficulty performing activities of daily living. Additional research should examine the impact of poor emotional health and the buffering effects of marriage on mobility for older African American men, a population at high risk of experiencing disparate health outcomes.     

Relationship of Stereotypic Beliefs About Physicians to Health Care-Relevant Behaviors and Cognitions Among African American Women

A great deal of basic social psychological research has demonstrated that stereotypes affect judgments, behaviors, and decisions with respect to individual group members. However, almost no research has applied social psychological theories of stereotypes to understanding health behavior. The purpose of the present study was to examine the relationship between stereotypic beliefs about physicians and health care-relevant behaviors and cognitions. Fifty-nine African American women were recruited from community venues to complete self-report, anonymous questionnaires measuring beliefs about physicians and health care utilization, satisfaction, and intentions. Participants who perceived physicians positively overall, and as competent and warm, reported greater health care utilization and higher satisfaction with their current health care, controlling for perceived general health status. These results suggest that interpersonal social cognitive expectancies play a role in health care-related behaviors and cognitions.     

心理干预对冠心病患者自测健康的影响

目的探讨心理干预对冠心病患者自测健康的影响。方法将120例住院冠心病患者随机等分为干预组和对照组,对照组只给予心内科常规治疗,干预组在给予心内科常规治疗的基础上进行心理干预,使用自测健康量表(SRHMS)分别于心理干预前后对两组患者进行评定。结果对干预组和对照组再次使用自测健康量表(SRHMS)进行评定,干预组在自测健康的3个维度(生理健康上t=2.772,P0.01,心理健康上t=7.779,P0.001,社会健康上t=6.403,P0.001)和总体心理健康得分上(t=7.035,P0.001)差值都显著高于对照组。结论在心内科常规治疗的基础上,对冠心病患者进行综合心理干预,能够有效改善患者的健康水平。     

Role of Social Factors in Glycemic Control Among African American Children and Adolescents with Type 1 Diabetes

Objective

With the rising incidence of Type 1 diabetes (T1DM), it is important to recognize deficiencies in care and areas of improvement to provide better access to resources and education for T1DM patients. The objective of this study was to recognize social factors and compliance barriers affecting glycated hemoglobin (A1c) level in T1D patients among the minority population.

Context Matters: Examining Perceived Health and Fitness Outcomes of Physical Activity Participation Among South Korean Adults and Youth

Purpose

To examine associations between physical activity contexts and health and fitness perceptions among Korean adults and youth.

Method

Data were from the Korean Survey on Citizens’ Sports Participation in 2015. Korean youth (N?=?832; M_age?=?14.7) and adults (N?=?6719; M_age?=?41.3) were included in the hierarchical logistic and linear regressions. Youth physical activity was examined in school-based (i.e., school-based and after-school/Saturday school sports) and out of school (i.e., organized sports) settings. Adults who met the World Health Organization (WHO) physical activity guidelines or not, and participated in structured (e.g., sport) and unstructured (e.g., walking) physical activity were compared. The outcome variables were self-reported health and fitness. Gender interactions between physical activity and all outcomes were examined for the adult sample only.

Results

No associations existed between physical activity and perceived health or fitness among youth. Adults who met the WHO guidelines, or participated in structured physical activity showed higher odds of reporting good health. Unstructured physical activity was associated with lower odds of reporting good health. Positive perceptions of fitness were more likely to be reported by males who met physical activity guidelines compared to females.

Conclusions

For youth, the potential benefit of physical activity, regardless of contexts, may be more apparent for psychological health than perceived physical health, and school should be used as a venue to promote physical activity. For adults, structured physical activity and achieving the WHO physical activity guidelines may be suggested for perceptions of overall health.

     

Sleep Deprivation and Chronic Health Conditions Among Sexual Minority Adults

Objectives: To examine associations between sleep duration and health outcomes among distinct groups of sexual minority adults. Methods: Using data from the 2014 Behavioral Risk Factor Surveillance System, we compared sleep duration (very short: ≤ 5 hr; short: 6 hr; normal: 7–8 hr; and long: ≥ 9 hr per day) between cisgender straight adults and distinct groups of sexual minorities. We further examined associations between sleep duration and 10 chronic health conditions among sexual minorities. Results: Of 146,893 respondents, 142,507 (96.2%) were cisgender straight, and 4,386 (3.8%) were lesbian, gay, bisexual, transgender (LGBT). Overall, 17.3% of LGBT respondents reported very short sleep per day, compared with 12.2% for cisgender straight respondents (p < 0.0001). Among LGBT populations, the prevalence of very short sleep varied significantly among distinct groups, ranging from 13.2% among transgender female to male adults to 35.5% among transgender gender nonconforming adults. Very short sleep was further associated with increased odds of having stroke (aOR = 4.1, 95% CI [2.2–7.6]), heart attack (aOR = 3.0, CI [1.6–5.8]), coronary heart disease (aOR = 3.1, 95% CI [1.5–6.2]), asthma (aOR = 1.7, 95% CI [1.1–2.4]), chronic obstructive pulmonary disease (aOR = 2.5, CI [1.5–4.0]), arthritis (aOR = 2.1, CI [1.4–3.0]), and cancer (aOR = 1.8, 95% CI [1.0–3.2]) among sexual minorities. Disparities in the prevalence of stroke, heart attack, coronary health disease, COPD, diabetes, obesity, arthritis, and cancer were found among LGBT populations. Conclusions: Sexual minorities have a higher prevalence of sleep deprivation as compared with their straight counterparts. Sleep deprivation varies by sexual identity and gender. Very short sleep duration is associated with some chronic health conditions among LGBT populations. Promotion of sleep health education and routine medical assessment of sleep disorders are critically needed for sexual minority adults.