African American beliefs about diabetes

In this presentation, a diabetes explanatory model of rural, African American adults at high risk for diabetes is described. Kleinman's explanatory model of illness was used as the organizing framework. African American men and women (N=42), between the ages of 18 and 51, participated. Participants described their knowledge and beliefs about diabetes, preventing diabetes, and whether diabetes could be cured or controlled. A common explanatory model of diabetes was not shared among the participants, and gender and age differences were apparent. Common themes included diabetes "running in families", "eating too much sugar", and "not taking care of yourself" as causes of diabetes. Weight and physical activity or exercise were not seen as contributing to the development of diabetes. Participants were not sure if diabetes could be prevented. These results provide information to address primary prevention of diabetes in this at-risk group.     

Health beliefs and high-risk sexual behaviors among HIV-infected African American men.

The purpose of this study was to describe whether the health beliefs of HIV-infected African American heterosexual men and men who have sex with men predict condom use during anal, vaginal, and oral sex. The sample consisted of 130 HIV-infected African American men with a mean age of 46 years. Multiple logistic regression analysis showed that the odds of noncondom use during anal sex was highest among heterosexual men and those with perceived barriers to condoms. Furthermore, participants without a relationship and those not discussing safe sex with their partners were more likely not to use condoms during vaginal sex.     

Cardiovascular risk factors and socioeconomic status in African American and Caucasian women

Self-reported cardiovascular risk factors of obesity, physical inactivity, and smoking in African American and Caucasian women in North Carolina were compared, controlling for socioeconomic status (SES). Participants were 1,945 women aged 23 to 53 years; 20.1% African American and 79.9% Caucasian. Of the African American women, 38.8% were obese, 51.7% were inactive, and 31.2% smoked; of the Caucasians, 19.9% were obese, 31.2% were inactive, and 33.8% smoked. SES differed significantly by race (p < 0.001). Low and middle SES African American women were much more likely than high SES African Americans to be obese, inactive, and smokers. Among Caucasian women, those with low SES had the greatest prevalence for all three risk factors. After controlling for income and education, African American women were more than twice as likely as Caucasian women to be obese and to be inactive, but were only half as likely to smoke. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21: 285–295, 1998     

Recruitment and cardiovascular risk characteristics of African American and Caucasian midlife women

This article describes the use of multiple strategies to recruit women, particularly African American women, into a home-based, moderate-intensity walking intervention and compares African American to Caucasian midlife women on cardiovascular risk characteristics at entry into the program. One hundred seventy-three women aged 45 to 65 years were recruited using a variety of strategies. Baseline findings showed that, on average, the women in the program had modifiable cardiovascular risk factors with proportionately more African American women than Caucasian women having hypertension and low physical fitness. The findings also illustrate the importance of using multiple recruitment strategies to encourage midlife African American and Caucasian women to participate in intervention trials.     

HIV risk reduction strategies for low-income African American women

Intervention strategies from the Health Education Reaching Out into the Community project that can be used in the clinical setting to assist low-income African American women adopt sexual behavior that is low risk for human immunodeficiency virus are discussed. These strategies include allocation of adequate time, the nurse practitioner's acceptance of the client, the use of adult learning principles, and active client participation through discussion, return demonstration, role play, and promotion of the client's ownership of the information learned.     

Prenatal care utilization among low-income African American women

The purpose of this study was to assess prenatal care utilization among low-income African American women, examine the relations of demographic and other selected variables to the adequacy of prenatal care utilization, and to describe the women's positive and negative experiences with prenatal care. The sample consisted of 126 African American women who had a child 1 year old or younger. A structured interview developed by the investigator was used. Adequacy of prenatal care utilization (APNCU) was calculated using Kotelchuck's index (Kotelchuck, 1994b). The findings indicated that 13% of the women did not receive any prenatal care and that only 50.8% of the women had adequate utilization of prenatal care. Women who perceived prenatal care as important utilized the services significantly more than other women, chi 2(1, N = 126) = 8.04, p = .01. Demographic variables, presence of health problems during pregnancy, and whether or not pregnancy was planned were not significantly related to APNCU. Several positive aspects of prenatal care were expressed by the women, and 24% of those who obtained care stated that there was nothing negative about it. The negative experiences mentioned by some women were clinic waiting time, waking up in the morning, transportation difficulties, having morning sickness, and disliking seeing a doctor.     

Chitotriosidase activity in colostrum from African and Caucasian women.

Chitotriosidase (ChT), a protein produced by activated macrophages, belongs to the chitinases, a group of enzymes able to hydrolyze chitin, a structural component of fungi and nematodes. A codominant inherited deficiency in ChT activity is frequently reported in plasma of Caucasian subjects, whereas in the African population this deficiency is rare. This study compares ChT activity in colostrum of 53 African women and 50 Caucasian women. Samples were collected at 24-48 and 72 h after delivery. We found elevated ChT in colostrum of African women on the first day after delivery (1230+/-662 nmol/mL/h) which decreased to 275+/-235 nmol/mL/h on the third day. The ChT activity on the first day after delivery in the colostrum of Caucasian women, however, was significantly lower (293+/-74 nmol/mL/h) and decreased to 25+/-20 and 22+/-19 nmol/mL/h on the 2nd and 3rd day, respectively. The ChT activity in plasma of African women was also higher (101+/-80 nmol/mL/h) than that of Caucasian women (46+/-16 nmol/mL/h), but no correlation was found between plasma and colostrum ChT activity. The elevated ChT activity in colostrum of African women suggests the presence of activated macrophages in human milk, consistent with the genetic characteristics of the African population.     

Health promoting behaviors among African American women with faith-based support.

The purpose of this qualitative exploratory study was to document health perceptions, beliefs and attitudes, intentions and social pressures that influence health promoting behaviors as expressed by community level aggregates of African American women with faith support. Twenty-six African American women from two large urban congregations with an active health ministry program participated in this study. Focus group interviews guided by the Theory of Planned Behavior (Ajzen & Fishbein, 1980 & 1991) were used to identify salient health perceptions, beliefs and attitudes, intentions, and social pressures influencing health-promoting behaviors in African American women with faith-based support. Positive health perceptions, attitudes, and beliefs were identified as important to engaging in a healthy lifestyle. Exercise, well balanced diets, weight reduction and stress management were the most salient health concerns among the respondents. Key referents identified included the pastor, congregational nurses, physicians, and church/family members. Control beliefs among these women reflected salient spiritual and fatalistic beliefs concerning health-promoting behaviors. Trusting relationships, open communication, safe, comfortable, and familiar environments were identified as important considerations when planning health promotion interventions for an African American faith community. CONCLUSIONS: Health beliefs, attitudes, and behaviors are not developed outside of social systems, therefore, the facilitation of healthy lifestyle behaviors may be best assessed and influenced within a context of reciprocal social interaction such as in a faith-based community. In the context of a community level aggregate with faith-based support, behaviors to promote a healthy lifestyle may be positively influenced.     

Parental depression, family functioning and obesity among African American children

Obesity has reached an epidemic level in America (National Center for Health Statistics [NCHS] 1999), and this epidemic is more acute for African Americans than for other groups of Americans. In this study, 44 parent-child dyads completed measurements of height, depression, and body fat composition. In addition, parents completed a demographic questionnaire, and instruments, which measured family functioning, parental psychopathology, child behavior, and cardiovascular risks. Several models emerged for predicting childhood and parental body mass index, parental depression, and child behavioral problems. Findings indicated a role for parental depression in childhood obesity. These findings are discussed in light of Bandura's Social Cognitive Theory, and the family's role in childhood obesity.     

Older African American women's beliefs, attitudes, and behaviors about breast cancer

Breast cancer poses a greater risk for African American than Caucasian women due to persistent health disparities. To reduce mortality risk, culturally specific knowledge is needed to support and encourage regular breast cancer screening and risk-reduction behaviors in older African American women. The specific aims of this study were to identify social, cultural, and behavioral factors associated with regular participation in breast cancer screening and risk-reduction behaviors; examine health beliefs that may influence regular participation in breast cancer screening and risk-reduction behaviors; and identify perceived facilitators and barriers to regular breast cancer screening and risk-reduction behaviors. African American women older than 65 (N = 57) participated in six focus groups. Analysis of focus group data revealed six major themes: Being Blessed, Cancer as a Death Sentence, Fear/Fear of Disfigurement, Avoiding Finding Out, Beliefs About Breast Cancer, and Tending to One's Family. These themes could be used by health care providers to develop culturally relevant educational initiatives to promote breast health practices and risk-reduction behaviors in this vulnerable population, thus helping reduce breast cancer disparities.     

Interventions to promote physical activity among African American women

The lack of routine physical activity among African American women places them at risk for negative health outcomes associated with inactivity. The number of studies focused on African American women has increased dramatically in the past decade. This review examined the intervention research literature testing strategies to increase activity among African American women. Eighteen studies with 1,623 subjects were retrieved. Diverse interventions, settings, and measures were reported. Common methodologic weaknesses included lack of randomization of subjects, single-group design, instruments without documented validity and reliability, significant attrition, and questionable timing of outcome variable measurement. Strategies to design and deliver culturally appropriate interventions are reviewed. Suggestions for future research, such as examining intragroup differences and communal resources, are provided.     

Parental depression, family functioning, and obesity among African American children

Obesity has reached an epidemic level in America (National Center for Health Statistics [NCHS] 1999), and this epidemic is more acute for African Americans than for other groups ofAmericans. In this study, 44 parent-child dyads completed measurements of height, weight, depression, and body fat composition. In addition, parents completed a demographic questionnaire, and instruments, which measured family functioning, parental psychopathology, child behavior, and cardiovascular risks. Several models emerged for predicting childhood and parental body mass index, parental depression, and child behavioral problems. Findings indicated a role for parental depression in childhood obesity. These findings are discussed in light of Bandura 's Social Cognitive Theory, and the family's role in childhood obesity.     

African American women's beliefs about mental illness,stigma, and preferred coping behaviors

We examined African American women's representations/beliefs about mental illness, preferred coping behaviors if faced with mental illness, whether perceived stigma was associated with treatment‐seeking, and if so, whether it was related to beliefs and coping preference, and whether these variables differed by age group. Participants were 185 community‐dwelling African American women 25 to 85 years of age. Results indicated the women believed that mental illness is caused by several factors, including family‐related stress and social stress due to racism, is cyclical, and has serious consequences but can be controlled by treatment. Participants endorsed low perceptions of stigma. Major preferred coping strategies included praying and seeking medical and mental health care. Age differences were found in all variables except stigma. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:480–492, 2009     

Knowledge and beliefs related to cervical cancer and screening among Korean American women

The purpose of this article is to examine knowledge and health beliefs associated with cervical cancer screening among Korean American women. A telephone survey was conducted with 189 Korean American women in the Chicago area. Age, marital status, income, knowledge of early detection method for cervical cancer, and perceived beliefs about benefits of and barriers to receiving Pap tests were all related to outcomes of ever having a Pap test and having had one in the preceding 3 years. Variables uniquely related to ever having a Pap test were education, employment status, fluency in English, and proportion of life spent in the United States. Variables uniquely related to having had the test during the preceding 3 years were having a usual source of care and regular checkups. Different intervention components are suggested for the groups of Korean American women who have never had a Pap smear and for those who have not had one in the preceding 3 years, in addition to common intervention strategies that aim to increase knowledge and perceived benefit and to decrease perceived barriers to receiving Pap tests.