Mental health promotion for vulnerable African American youth

Fifty-six African American youth between 10–14 years of age participated in a community-based 14-week expressive arts program designed for youth at risk of involvement with the juvenile justice system. Positive and statistically significant findings for pre-post changes in self-control, protective factors, and resilience were found. Difficulty in engaging parents and the strong racial biases of the community appear to have influenced the lack of improvement in self-esteem scores.     

The underserved aged and the role of the African American church

Historically, the church has been a central institution in the life of the African American community, and caring for bodies, as well as souls, has been a critical aspect of its ministry. The significance of this role will increase in importance in the foreseeable future given the escalating costs of health care services. There is an increasing realization that churches must be involved in the provision of health services if society is to improve the health status of this population. This paper examines the role of the African American church in providing formal and informal health care services to the underserved aged.     

Perceived health status in African American and Caucasian men 40 to 70 years old

There is limited data on the relationship between perceived health status and the demographic variables of education and income in African American men. A sample of 2,001 men (72% African Americans and 28% Caucasians) who were participating in prostate cancer screening was studied to identify predictors of men's health status. Data on the concepts of self-rated health status, age, race, education, income, living arrangements, and marital status were collected. Findings indicated that men who were more likely to report excellent health status were older Caucasians, had more than a high school education, an annual income over 25,021 dollars, were living with others, and were married. Men more likely to report fair health status were older African Americans, unmarried, had less than a high school education, had an annual income less than 9,600 dollars, were living alone, and were unmarried. Implications for targeting at-risk men are presented.     

Contribution of attitudinal factors to blood donation in African American church attendees

BACKGROUND: Historically, African Americans have a general mistrust for the health care system that has contributed to significant health disparities. The goal of this study was to evaluate whether this distrust among African Americans affects attitudes toward blood donation. STUDY DESIGN AND METHODS: Fifteen African American churches in metropolitan Atlanta participated in an 81‐item self‐administered survey. The questionnaire assessed barriers and motivators for, and knowledge and beliefs about, blood donation in African Americans. Bivariate analysis and logistic regression models were performed. RESULTS: A total of 930 individuals responded to the survey. This group was 99% African Americans, 71% female, and 84% college educated, 54% with a household income of at least $50,000 and mean age of 47 ± 14 years. Donation history was 3% current donors, 46% lapsed donors, and 40% nondonors. Respondents who trusted versus distrusted hospitals had more knowledge of the blood supply and less fear of donation and were more likely to respond to blood needs of the community. In a multivariate logistic regression model, donors were more likely to trust hospitals (p = 0.003) and were more likely to have participated in research (p < 0.001) than nondonors. CONCLUSION: African American distrust of the health care system is associated with decreased likelihood of previous blood donation. This may be secondary to donor centers being viewed as a component of the health care system. Building trust between donor centers and African American community by ensuring the safety of donation may increase African American blood donation rates.     

Design of a mental health promotion program for vulnerable African American youth

The purpose of this study was to develop a mental health promotion program for vulnerable middle school-age African American youths to reduce the risk of first-time involvement with the juvenile justice system. A review of the literature, pilot testing of instruments, and community collaboration led to the development of the program, which was funded through the Office of Rural Health.     

The African American church as a donation site: motivations and barriers

BACKGROUND: In the United States, African Americans donate at approximately half the rate of whites and therefore are underrepresented in the volunteer blood donor pool. The goal of this study was to identify motivators and barriers to African Americans donating blood. STUDY DESIGN AND METHODS: A consortium of 15 predominantly African American churches of varying denominations in metropolitan Atlanta, Georgia, participated in an 81‐item self‐administered survey. The questionnaire was designed to assess participant's demographic background, blood donation frequency, motivators and barriers to donation, knowledge and beliefs regarding donation, and overall health status. RESULTS: A total of 930 participants completed the survey: 72% female, 55% age 40 or older, 99% African American, and 58% college‐educated. The most frequent reported motivators were donating to help save a life (96%) and donating because blood is needed (95%), while the most frequent barriers were that they rarely think about it and they were afraid, nervous, or anxious to give blood (35%). The association of barriers with donation status, age, gender, and education level was stronger than for motivators. Fear was more common in nondonors than lapsed and current donors, youngest compared to older adults, and women than men and less in those with higher income. CONCLUSION: Motivators and barriers to blood donation in African American church attendees differ depending on the respondents' demographics. To increase the effectiveness of church drives, donor recruitment should focus on addressing these barriers and motivators.     

Perceived health status in urban minority young adolescents

PURPOSE: To describe perceptions of health status among a sample of urban minority adolescents and the contribution of demographics, intrinsic motivation, general self-efficacy, risk taking, and stressful life experiences on the adolescent's perception of health status. METHOD: Correlational design. A total of 71 adolescents were studied using the Adolescent Health Chart for perceived health status, the Health Self-Determinism Index for Children, the Self-Efficacy Scale, the Risk Taking Instrument, and the Life Events Checklist. RESULTS: There were no statistically significant effects of demographics on perceived health status. Scores of Perceived Health Status correlated with scores of self-efficacy (r = 0.56; p <.0001), risk-taking (r = 0.39; p <.001), negative events (r = 0.32; p <.01) and violent events (r = -0.41; p <.001). CLINICAL IMPLICATIONS: The study findings suggest that self-efficacy, risk taking, and life events are predictive of perceived health status in urban minority adolescents. The results contribute to the present body of knowledge about patterns of adolescent health as perceived by the adolescent. In addition to expanding the understanding of the minority adolescent experience in relation to health promotion attributes and health compromising behaviors, the results identify antecedents that are predictive of improved perceived health status for the urban adolescent.     

An Integrative Review of American Nurses'' Perceived Cultural Self-Efficacy

PURPOSE: To review use of the Cultural Self-Efficacy Scale (CSES) and to summarize the cumulative findings. METHODS: A combination of literature searches and questionnaires to those who have requested the scale indicated 26 known uses. Fifteen reported sufficient data for statistical analysis. FINDINGS: Of the 26 known uses of the CSES, 8 were published in peer-reviewed journals, 5 in dissertations, 8 in theses, and 3 as data sets only. Two additional theses were not retrievable for the study. On a 5-point Likert-type scale, nurses reported the highest degree of self-efficacy with African American (3.1) and Hispanic (3.1) patients and the lowest with Asian American patients (2.4). Six of the reports include Cronbach's alpha coefficients, ranging from .86 to .98. In the final sample of 15 studies, nurses did not report feeling confident caring for patients from other cultures. CONCLUSIONS: Although the CSES has been used in many settings with over 3,000 nurses, inconsistencies in the data preclude specific conclusions. Further research is needed using consistent reporting practices and sufficient predictor variables to draw further conclusions regarding the scale's psychometric properties.     

Mental health training needs of primary health care nurses

The primary health care team (PHCT) has a critical role to play in the care of people with mental health problems. However, little attention has been paid to the mental health training and preparation required by primary health care nurses. This paper reports on a training needs assessment undertaken in one London health authority area. The findings indicate that primary health care nurses are undertaking a wide range and increasing volume of mental health work with little preparation and training. Specific training needs include time and space to identify training gaps; basic training in mental health, safe working practices and management of role boundaries; and multidisciplinary training. In addition, NHS trusts, primary care groups and health authorities need to clarify which aspects of nurses' mental health workloads are appropriate to their role and develop policies, procedures and training to support them in undertaking that role.     

Factors contributing to the development of an HIV ministry within an African American church

Having an HIV ministry within a church depends on the religious culture of that church. However, little is known about how a church's religious culture influences an HIV ministry. This study's purpose was to examine how an African American church's religious culture supported the development, implementation, and maintenance of an HIV ministry within the church. An ethnographic case study research design was used. Data were collected through interviews, nonparticipant and participant observations, review of pertinent documents, and survey of congregants. Results revealed the following as important for an HIV ministry: (a) a belief in helping others and treating everyone with respect and dignity, (b) feelings of compassion toward individuals infected with HIV, and (c) HIV education. This information can assist in developing interventions to enhance the African American church movement toward HIV ministries.     

甲状腺机能亢进症患者健康教育需求分析

目的为了落实“以人为本,以患者为中心”的整体护理,进一步了解甲状腺机能亢进症患者对健康教育的需求.方法用自行设计的《甲状腺机能亢进症手术患者健康教育需求调查表》对本院外科住院甲状腺机能亢进症100例手术患者进行问卷调查.结果53%患者选择健康教育最佳时间为术前;60%选择健康教育实施者为医生,45%选择护士;68%愿意主动参与健康教育活动;对健康教育方式的选择呈多样化.针对上述特点,提出了对患者实施健康教育的对策.结论根据患者的需求提供健康教育,能使健康教育工作更具科学性、针对性、实效性.     

Effectiveness of a cardiovascular health promotion education intervention on the attitudes of urban African American school-age children

African American children are at risk for high rates of morbidity and mortality associated with cardiovascular (CV) disease as they become adults, yet little is known about the effectiveness of CV risk-reduction interventions in African American children. This study explored the effectiveness of a concentrated CV health promotion educational program on health-related attitudes of 76 African American children enrolled in a mid-southern school system. The Children's Cardiovascular Health Promotion Attitude Scale was used to examine differences in attitude prior to and 2 weeks following a focused health education intervention. Results demonstrate that children have preconceived attitudes regarding practice of health behaviors and that these attitudes are modifiable with age and developmental level specific educational interventions. Findings indicate the need for health care providers to assume more active roles in reducing the risk of future CV disease and death in African Americans through health promotion education of individuals who influence the development of children's attitudes.     

Faith and feminism: how African American women from a storefront church resist oppression in healthcare

It is well documented that racism in the US healthcare system, including the objectification and disparagement of women of color, contributes to disparities in health status. However, it is a mistaken notion to characterize women of color as unknowing victims. In this study, black feminist standpoint epistemology is used in methodological approach and analysis to understand how a small group of African American church-going women use religious beliefs to help them cope with and resist the racism and discriminatory objectification they encounter in healthcare encounters.     

African American women's coping with health care prejudice

African American clients have reported racism and prejudice in health care; yet there is limited documentation of the strategies used to cope with these experiences. This study describes African American women's perceptions of prejudice in health care and the strategies used to cope with the experiences. This qualitative study used the constructivist perspective of interpretive interactionism for paradigmatic and methodological guidance. Participants were 20 women ranging from age 26 to 74 years with 50% having a high school education. Individual interviews consisting of five areas were conducted with three instruments measuring ethnic identity, socioeconomic status, and general demographics. The analyses provide two themes: experience with the "White health care system" and strategies for coping with the prejudice, which included getting angry, learning to unlearn, being assertive, and walking away. Consistent with the discussions of race in the United States, racism in health care has become a subtle entity that infuses health care relationships.     

African American participation in public health research.

The author discusses the lack of current African American participation in health research and the historical background regarding the distrust of African American's past experiences in health research.     

空巢老人对社区医疗护理需求的质性研究

目的探讨空巢老人对社区医疗护理的具体需求,为空巢老人的社区健康管理提供参考信息。方法采用质性研究方法 ,以半结构式的开放性访谈问卷对25名城市社区空巢老人进行个体化的深入访谈,使用内容分析法分析资料。结果空巢老人对社区医疗护理的需求包括基本医疗护理服务和具有社区特色的医疗护理服务,这些需求可以通过改善社区医疗条件、完善管理制度、提高服务质量和水平等途径来实现。结论针对空巢老人对社区医疗护理的需求,应拓展社区医疗护理服务项目和内容,为其提供个体化的服务。     

Understanding the HIV risk reduction needs of heterosexual African American substance-abusing men.

With the increasing prevalence of HIV/AIDS, nurses find themselves caring for diverse populations at risk for HIV. One subpopulation at risk is African American men with a history of substance use. To better understand the risk reduction needs of these men, a focus group was conducted with 16 African American men attending an outpatient drug treatment program in Philadelphia. The purpose was to identify perceptions of HIV risk, engagement in HIV risk behaviors, and barriers to condom use in order to generate recommendations for risk reduction programs tailored to the needs of this population. Results revealed that African American substance-abusing men perceive themselves to be at risk for HIV infection and other adverse health outcomes yet lacked adequate information related to HIV prevention. The need for culture- and gender-specific interventions to reduce HIV-related risk behaviors among African American substance-using men is discussed.     

CVD prevention strategies with urban and rural African American women.

Using Pender's Health Promotion Model, this study tested a work site cardiovascular disease (CVD) risk factor reduction intervention among low-income African American (LAAW) women. Individual CVD risk profiles were identified at the work site through (1) health risk appraisal, (2) blood pressure measurement, (3) body mass index calculation, (4) individual interviews about diet and exercise behaviors, and (5) total cholesterol analysis. Two LAAW groups, one urban and one rural, exhibited higher or similar pretest CVD relative risks (RR) when statistically compared with a national sample of African American women. The LAAW study samples were younger and more educated. Pretest cholesterol and fat intake for the rural women were higher than for the urban women (<.05). Posttest changes in cholesterol and fat intake risks were more significant in rural LAAW than in urban LAAW (<.05).