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.     

Pathogenic Mechanisms of Prediabetes in Obese vs. Very Obese African American Women: Implications for Diabetes Prevention

Background

The influence of obesity on the development of prediabetes among African American women (AAW) remains uncertain. Thus, we investigated whether the pathogenic mechanisms of prediabetes differ in obese (OB, BMI<35 kg/m²) and very obese (VOB, BMI>35 kg/m²) AAW.

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.     

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.     

Acculturation and Its Relationship to Smoking and Breast Self-Examination Frequency in African American Women

The concept of acculturation has been used to understand differences in health behaviors between and within a variety of racial and ethnic immigrant groups. Few studies, however, have examined the potential impact of acculturation on health behaviors among African Americans. The present study has two goals: 1) to reconfirm relations between acculturation and cigarette smoking; 2) to investigate the impact of acculturation on another type of health behavior, cancer screening and specifically breast self-examination (BSE). African American women (N = 66) attending an inner-city cancer-screening clinic completed study questionnaires. Results reconfirmed psychometric properties of the African American Acculturation Scale (AAAS); replicated the negative association between acculturation and lifetime smoking status; and found relations between acculturation and womens adherence to BSE frequency guidelines. Findings from this study raise the possibility that specific aspects of acculturation may better explain specific health behaviors.The present study was done as part of a dissertation submitted by the first author to The City University of New York     

The Role of African American Folk Beliefs in the Modern Therapeutic Process

In response to a need for more cultural competency in indigenous practices, this article examines folk beliefs and healing practices in African American culture from theoretical, clinical, and practical perspectives. Four empirically derived culture-specific factors—spirituality, ritual, power of words, and dreams—are presented as themes often embedded in African American clients' narratives. A clinical case example illustrates the use of narrative therapy as an approach in therapy with a depressed client who subscribes to a folk belief system. Finally, interview questions and suggestions are given concerning how to better incorporate African American folk beliefs and healing practices in counseling and psychotherapy.     

Factors Affecting the Validity of Self-Reported Data on Health Services from the Community Health Survey in Korea

Purpose

As a follow-up for the validity study of Community Health Surveys (CHSs), the purpose of this study was to evaluate the factors affecting the accuracy of CHSs by investigating subjects'' characteristics.

Materials and Methods

We used data from 11,217 participants (aged 19 years or older) who had participated in the CHS, conducted by a local government in 2008 and analyzed the variables affecting the sensitivity and specificity of hospitalization and outpatient visit.

Results

Multivariate logistic regression analysis showed that, factors related with the sensitivity of hospitalization and outpatient visit questions were gender, age, marital status, chronic diseases, medical checkup, the subjective health status and necessary medical services. Factors related with the specificity were gender, marital status, educational background, chronic diseases, medical checkup, alcohol consumption, necessary medical services and sadness.

Conclusion

This study revealed the subject-related factors associated with the validity of the CHS. Efforts to improve the sensitivity and the specificity from self-report questionnaires should consider how the characteristics of subjects may affect their responses.     

Psychosocial HIV/AIDS Prevention for High-Risk African American Men: Guiding Principles for Clinical Psychologists

Among African American men who have sex with men (MSM), HIV infection has become an epidemic and requires psychosocial prevention. This population faces racism, HIV discrimination, heterosexism, and hate crime while living with its own internalized homophobia and denial. I discuss the principles for psychosocial HIV prevention. I posit that HIV services need to gather resources to tackle life circumstances of MSM of color; to empower them via social support, acceptance, and integration of their racial and sexual identities; to provide social skill training; to disseminate correct HIV and health information; and to modify the norms of safer sex behaviors. Clinical psychology as a field should collaborate with community psychology, train more African American MSM, and conduct evaluation of culture-specific prevention efforts.     

Mammography adherence and beliefs in a sample of low-income African American women

The purpose of this article is to describe the relation of perceptions of perceived breast cancer risks and perceived benefits and barriers to mammography and stage of mammography adherence in a convenience sample of low-income African American women. The theoretical framework of the Health Belief Model and the Transtheoretical Model were used to identify concepts and stage of mammography adherence. Data were obtained in waiting rooms of multipurpose centers. Scores for susceptibility and benefits were lowest for those who were in (a) precontemplation (had not thought about having a mammogram); as compared to (b) contemplation (had thought about having a mammogram, but not yet acted); (c) action (had a mammogram as recommended by the American Cancer Society); and (d) relapse (had a mammogram in the past, but overdue). Barriers scores were highest for those who had not had a mammogram (precontemplators and contemplators). In addition, individual bamers were significantly lower for women in action. Results have implications for interventions to increase screening in low-income African American women.     

Assessment of skin conductance in African American and Non–African American participants in studies of conditioned fear

Skin conductance (SC) is a psychophysiological measure of sympathetic nervous system activity that is commonly used in research to assess conditioned fear responses. A portion of individuals evidence very low or unmeasurable SC levels (SCL) and/or response (SCR) during fear conditioning, which precludes the use of their SC data. The reason that some individuals do not produce measurable SCL and/or SCR is not clear; some early research suggested that race may be an influencing factor. In the current article, archival data from five fear conditioning samples collected from four different laboratories were examined to explore SCL and SCR magnitude in African American (AA) and non–African American (non‐AA) participants. Across studies, the aggregate group difference for exclusion due to unmeasurable SCL or no measurable SCR to an unconditioned stimulus reflected a significant medium effect size (d = 0.54). Furthermore, 24.3% (range: 0–48.3%) of AA participants met SC exclusion criteria versus 14.3% (range: 4.3–24.2%) of non‐AA participants. AA participants also displayed significantly lower SCL during habituation (d = 0.58). The low SC levels and responses in AA individuals and the consequent exclusion of their contributions to fear conditioning study results impacts the generalizability of findings across races. Given higher rates of posttraumatic stress disorder (PTSD) and chronic anxiety in AA individuals, it is important that AA individuals not be excluded from fear conditioning research, which informs the treatment of anxiety and PTSD. Examination of the basis of very low SCL and/or SCR is a potentially informative direction for future research.     

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.     

APOE genotypes in African American female multiple sclerosis patients

Multiple sclerosis (MS) is a chronic inflammatory CNS disorder, resulting in progressive neurological dysfunction. The disease has a higher incidence in Caucasian Americans (CA) than African Americans (AA); however, the latter may have a more aggressive disease course. We used cluster analysis to determine whether there is a difference in disease progression between the races and whether the APOE AND APOC1 genotypes influence the disease progression. AA female patients were younger and had a higher progression index and MS severity score than CA female MS patients. AA females who were APOE 4/4, 2/4, or 2/3 and APOC1 AA had a younger age-of-onset, had primarily a relapsing remitting disease course, with a higher progression index and MS severity score, as assessed by cluster analysis. Cluster analysis also indicated that CA female patients were of two groups. One group was younger, had the APOE 3/3 genotype with relapsing remitting less severe disease. The second CA group was older, had the APOE 3/4 or 2/3 genotypes with more of the secondary progressive more severe disease phenotype. Thus, the AA MS female patients who were APOE 4 carriers had an earlier age-of-onset and more severe disease course than CA MS female patients.     

Correlates of Psychosomatic Stress Symptoms among Farm Women: A Research Note on Farm and Family Functioning

Abstract

The relationship between self-reported psychosomatic stress symptoms and dimensions of family and farm functioning were examined in a sample of New York State dairy farm wives (N = 126). The farm women completed a questionnaire assessing home and farm task loads, farm complexity, intrapersonal role conflict, interpersonal role conflict, husband support, and marital satisfaction. The psychosomatic stress symptoms included nervousness, restlessness, insomnia, shortness-of-breath, and fainting. In general, stress symptoms showed little relationship to task loads, farm complexity, and intrapersonal role conflict. Much stronger relationships were found for interpersonal role conflict, husband support, and marital satisfaction. Thus, these findings point to the greater importance of family relationships in preventing or buffering stress in comparison with simple role-related task expectations of farm systems.     

Effects of cognitive style and maintenance strategies on breast self-examination (BSE) practice by African American women

A convenience sample of 159 African American women, 18–45 years old, was trained to perform breast self-examination (BSE) and was categorized according to the participants' cognitive style (monitors/blunters). Participants were then randomly assigned to one of four groups differing in BSE maintenance strategy (self-management, positive reinforcement, both, or neither). Self-reported monthly compliance with BSE was subsequently assessed during a 9-month period. A significant interaction between maintenance strategies and cognitive style was found. For blunters, the highest compliance rates and the highest competency scores occurred in the group with no maintenance strategy, whereas for monitors, the highest compliance rates and competency scores were found in the groups receiving positive reinforcement and/or self-management strategies. Additional results indicate that high levels of BSE competency were achieved across conditions and that competency improved over time.This paper was supported in part by National Cancer Institute Grant 5 RO3CA48388-02 and in part by Biomedical Research Support Grant PHS RR-05665-22 (Penn), University of California, San Diego.     

汶川地震极重灾区妇女创伤后应激症状、心理健康及其影响因素

目的:考察极重灾区妇女创伤后应激症状、心理健康问题的发生特点及影响因素。方法:对汶川地震极重灾区99名妇女(47名地震中丧亲妇女,52名未丧亲妇女)采用创伤后应激障碍检查表平民版(PCL-C)、社会支持量表(SSRS)和一般健康问卷(GHQ28)进行测查。结果:①)极重灾区妇女PTSD总检出率37.4%,丧亲妇女检出率55.3%,未丧亲妇女21.1%,心理健康问题总检出率79.8%,丧亲妇女检出率为89.3%,未丧亲妇女检出率71.2%,丧亲妇女检出率均显著高于未丧亲妇女。文化程度不同的妇女PTSD检出率有显著差异。②总体PCL-C与GHQ-28测量结果之间各维度均呈现显著正相关。③丧亲状况的主效应显著,丧亲妇女和未丧亲妇女之间创伤后应激症状总分及各维度分数均存在显著差异。④丧亲是极重灾区妇女PTSD症状和心理健康的危险因素;社会支持是保护性因素。     

Spirituality,Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study

ABSTRACT

Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12–19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07–1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02–1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.     

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.