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Reed D, Dangerfield T, Robinson R, Ray K, Danberry K, Tieman K. Breaking chains of tobacco: empowering African American churches in West Virginia for a healthier future. Front Public Health 2024; 12:1472654. [PMID: 39363979 PMCID: PMC11448452 DOI: 10.3389/fpubh.2024.1472654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 09/09/2024] [Indexed: 10/05/2024] Open
Abstract
Across West Virginia, tobacco use continues to be a significant public health challenge. Specifically, tobacco use is linked to high poverty across the state and disproportionately affects African Americans. A faith-based tobacco prevention network was formed to address these concerns and increase education and cessation. The West Virginia African American Tobacco Prevention Network (WVAATPN) was formed in 2021 and since then has expanded its reach across the state, involving 22 congregations. The Network's model includes annual training for lay leaders on various tobacco-related topics, tailored educational curriculum for congregations, and collaboration with national experts to enhance program efficacy. The Network has run educational and cessation workshops and promoted events such as No Menthol Sunday. Workshops have yielded positive outcomes among participants, including increased awareness of tobacco marketing tactics, higher cessation rates, and improved understanding of the health impacts of tobacco. The WVAATPN continues to expand its reach and effectiveness by advocating for policy change, enhancing community engagement, and fostering partnerships to combat tobacco-related disparities in West Virginia's African American communities.
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Affiliation(s)
- Donald Reed
- School of Health Sciences, Public and Community Health, Liberty University, Lynchburg, VA, United States
| | - Truman Dangerfield
- Marriott School of Business (Student), Brigham Young University, Provo, UT, United States
| | - Rhonda Robinson
- West Virginia African American Tobacco Prevention Network, Beckley, WV, United States
| | - Kenneth Ray
- Center for Black Health and Equity, Atlanta, GA, United States
| | - Kathy Danberry
- West Virginia Division of Tobacco Prevention, Charleston, WV, United States
| | - Kim Tieman
- Claude Worthington Benedum Foundation, Pittsburgh, PA, United States
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Peralta-Garcia A, Laurent J, Bazzano AN, Payne MJ, Anderson A, Alvarado F, Ferdinand KC, He J, Mills KT. Barriers and Facilitators to Improving Cardiovascular Health in Churches with Predominantly Black Congregations. Ethn Dis 2023; DECIPHeR:96-104. [PMID: 38846733 PMCID: PMC11099528 DOI: 10.18865/ed.decipher.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Objective Black communities bear a disproportionate burden of cardiovascular disease (CVD). Barriers and facilitators for improving cardiovascular health (CVH) in churches with predominantly black congregations were explored through a qualitative needs assessment. Methods Four focus groups with church members (n=21), 1 with wellness coordinators (n=5), and 1 with primary care providers (n=4) and 7 individual interviews with church leaders were completed in New Orleans and Bogalusa, Louisiana. Virtual, semistructured interviews and focus groups were held between October 2021 and April 2022. The Theorical Domains Framework (TDF) guided a framework analysis of transcribed data based on inductive and deductive coding to identify themes related to determinants of CVH. Results The following four domains according to the TDF were identified as the most relevant for improving CVH: knowledge, professional role, environmental context, and emotions. Within these domains, barriers expressed by church leadership and members were a lack of knowledge of CVD, provider distrust, and little time and resources for lifestyle changes; facilitators included existing church wellness programs and social support, community resources, and willingness to improve patient-provider relationships. Primary care providers recognized a lack of effective communication and busy schedules as obstacles and the need to strengthen communication through increased patient autonomy and trust. Potential strategies to improve CVH informed by the Expert Recommendation for Implementing Change compilation of implementation strategies include education and training, task shifting, dissemination of information, culturally tailored counselling, and linkage to existing resources. Conclusions These findings can inform the implementation of interventions for improving cardiovascular health and reducing disparities in black church communities.
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Affiliation(s)
- Ana Peralta-Garcia
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Jodie Laurent
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | | | - Marilyn J. Payne
- Payne & Associates Counseling & Consulting Services, New Orleans, LA
| | - Andrew Anderson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Flor Alvarado
- School of Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Keith C. Ferdinand
- School of Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Jiang He
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- School of Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Katherine T. Mills
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
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Mills KT, Laurent J, Allouch F, Payne MJ, Gustat J, He H, Alvarado F, Anderson A, Bundy JD, Chen J, Ferdinand KC, He J. Engaging Predominantly Black Churches in an Intervention to Improve Cardiovascular Health and Reduce Racial Inequities. Ethn Dis 2023; DECIPHeR:89-95. [PMID: 38846730 PMCID: PMC11099532 DOI: 10.18865/ed.decipher.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality in the United States and disproportionately impacts Black adults. Effective implementation of interventions to improve cardiovascular health in the Black community is needed to reduce health inequities. The Church-Based Health Intervention to Eliminate Health Inequalities in Cardiovascular Health (CHERISH) study is implementing interventions recommended by the 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD in Black communities to improve cardiovascular health and reduce health disparities. The recently completed 3-year planning phase of CHERISH has focused on engaging with the predominantly Black church community in New Orleans with the goals of informing study protocol development and recruiting churches for study participation. Community engagement approaches include convening a community advisory board (CAB), conducting qualitative and quantitative needs assessments, and hosting and attending church events. These activities have resulted in an engaged CAB that has contributed meaningfully to planning activities and the study protocol. The needs assessment found that while there are substantial barriers to cardiovascular health, such as knowledge, access to healthy foods, and safe spaces for physical activity, people are willing to make lifestyle changes and think that the proposed intervention components are feasible. Community engagement activities have resulted in the recruitment of 50 geographically and denominationally diverse predominantly Black churches willing to participate in the study (exceeding our goal of 42). Overall, a multicomponent approach to extensive community engagement has produced effective church enrollment for study participation and meaningful input on study design and implementation.
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Affiliation(s)
- Katherine T. Mills
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Jodie Laurent
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Farah Allouch
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Marilyn J. Payne
- Payne & Associates Counseling & Consulting Services, New Orleans, LA
| | - Jeanette Gustat
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Hua He
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Flor Alvarado
- Translational Science Institute, Tulane University, New Orleans, LA
- School of Medicine, Tulane University, New Orleans, LA
| | - Andrew Anderson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Joshua D. Bundy
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
| | - Jing Chen
- Translational Science Institute, Tulane University, New Orleans, LA
- School of Medicine, Tulane University, New Orleans, LA
| | - Keith C. Ferdinand
- Translational Science Institute, Tulane University, New Orleans, LA
- School of Medicine, Tulane University, New Orleans, LA
| | - Jiang He
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Science Institute, Tulane University, New Orleans, LA
- School of Medicine, Tulane University, New Orleans, LA
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Trigg J, Skelton E, Lum A, Guillaumier A, McCarter K, Handley T, Judd L, Lye A, Bonevski B. Smoking Cessation Interventions and Abstinence Outcomes for People Living in Rural, Regional, and Remote Areas of Three High-Income Countries: A Systematic Review. Nicotine Tob Res 2023; 25:1709-1718. [PMID: 37338988 PMCID: PMC10475608 DOI: 10.1093/ntr/ntad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/10/2023] [Accepted: 06/16/2023] [Indexed: 06/22/2023]
Abstract
INTRODUCTION Tobacco smoking rates in high-income countries are greater in rural, regional, and remote (RRR) areas compared to cities. Yet, there is limited knowledge about interventions targeted to RRR smokers. This review describes the effectiveness of smoking cessation interventions for RRR smokers in supporting smoking abstinence. AIMS AND METHODS Seven academic databases were searched (inception-June 2022) for smoking cessation intervention studies to include if they reported on RRR residents of Australia, Canada, or the United States, and short- (<6 months) or long-term (≥6 months) smoking abstinence outcomes. Two researchers assessed study quality, and narratively summarized findings. RESULTS Included studies (n = 26) were primarily randomized control (12) or pre-post (7) designs, from the United States (16) or Australia (8). Five systems change interventions were included. Interventions included cessation education or brief advice, and few included nicotine monotherapies, cessation counseling, motivational interviewing, or cognitive behavioral therapy. Interventions had limited short-term effects on RRR smoking abstinence, decreasing markedly beyond 6 months. Short-term abstinence was best supported by contingency, incentive, and online cessation interventions, and long-term abstinence by pharmacotherapy. CONCLUSIONS Cessation interventions for RRR smokers should include pharmacotherapy and psychological cessation counseling to establish short-term abstinence, and identify effective means of maintaining abstinence beyond 6 months. Contingency designs are a suitable vehicle for psychological and pharmacotherapy support for RRR people who smoke, and intervention tailoring should be explicitly considered. IMPLICATIONS Smoking disproportionately harms RRR residents, who can encounter access barriers to smoking cessation support. High-quality intervention evidence and outcome standardization are still required to support long-term RRR smoking abstinence.
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Affiliation(s)
- Joshua Trigg
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Eliza Skelton
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Alistair Lum
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Ashleigh Guillaumier
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Kristen McCarter
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Tonelle Handley
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Lucy Judd
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Alexie Lye
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Bringing Treatment to the Patients: Community-Based Tobacco-Dependence Treatment and Interventions. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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Gillum RF. Frequency of Attendance at Religious Services and Exposure to Environmental Tobacco Smoke. JOURNAL OF RELIGION AND HEALTH 2021; 60:1760-1765. [PMID: 33389437 DOI: 10.1007/s10943-020-01130-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
Exposure to environmental tobacco smoke (ETS) is associated with increased risk of disease and death. Reports on ETS and religion are lacking. Data from the National Health and Nutrition Examination Survey were used to test this association. In 4,712 nonsmokers, serum cotinine level of 0.05-3.99 ng/mL indicated ETS exposure. Frequency of attendance at religious services was categorized as > = weekly or less. In bivariate analysis, ETS exposure occurred in 28.6% of those with > = weekly attendance but 36.4% of less frequent attenders (p = 0.0004). In logistic regression controlling for multiple confounders OR = 0.72, 95%CI 0.61-0.85. ETS exposure was negatively associated with religion.
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Affiliation(s)
- Richard Frank Gillum
- Department of Medicine, Howard University College of Medicine, 1112 Nora Drive, Silver Spring, MD, 20904, USA.
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7
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Sherman JJ, Smith BL. Effect of a smoking cessation educational intervention on knowledge and confidence of pharmacy students versus community leaders. Pharm Pract (Granada) 2019; 17:1302. [PMID: 31015867 PMCID: PMC6463408 DOI: 10.18549/pharmpract.2019.1.1302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 02/11/2019] [Indexed: 11/29/2022] Open
Abstract
Background: Training programs of various intensities and durations have been implemented
to assist healthcare providers and students in leading smokers in a quit
attempt. While some training programs have been developed to help community
leaders provide these services, the focus for community leaders has been to
assist with recruitment efforts. Objective: The objective of this study was to compare knowledge and confidence of
students and community members before and after a smoking cessation
educational intervention. Methods: After approval from the institutional review board, pharmacy students and
community members were recruited for two-hour educational interventions.
Topics covered included smoking health risks, benefits of quitting,
behavioral, cognitive, and stress-management techniques, smoking cessation
medications, and how to start a formal class. Pre- and post-intervention
survey instruments were given to all participants with comparisons made via
Student’s or Paired T-tests, as appropriate. Results: Knowledge scores increased significantly (p<0.05) after the
educational intervention for pharmacy students (n=30) and community members
(n=8). Confidence scores increased significantly for pharmacy students
(p<0.05), but not for community members. Pharmacy students had
significantly greater knowledge score changes (53.7%,
pre-intervention; 81.8%, post-intervention; p<0.05) versus
community members (32.1%, pre-intervention; 50.1%,
post-intervention; p<0.05). When comparing individual confidence
questions, only scores evaluating the change in confidence for providing
counseling were higher for students versus community members (2.13 vs. 1.8,
respectively; p<0.05). Conclusions: Pharmacy students and community leaders exhibited increased knowledge after a
smoking cessation educational intervention, and pharmacy students had
increased confidence scores. All confidence scores did not change
significantly for community members. Developing coalitions between
healthcare providers and community leaders, focusing on the roles of each,
may be productive in initiating smoking cessation programs.
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Affiliation(s)
- Justin J Sherman
- Associate Professor of Pharmacy Practice. School of Pharmacy, University of Mississippi. Jackson, MS (United States).
| | - Brett L Smith
- Clinical Instructor of Pharmacy Practice. School of Pharmacy, University of Mississippi. Jackson, MS (United States).
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Akinyemi E, Watkins DC, Kavanagh J, Johnson-Lawrence V, Lynn S, Kales HC. A qualitative comparison of DSM depression criteria to language used by older church-going African-Americans. Aging Ment Health 2018; 22:1149-1155. [PMID: 28612654 DOI: 10.1080/13607863.2017.1337717] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Depression in late life is associated with substantial suffering, disability, suicide risk, and decreased health-related quality of life. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), a depression diagnosis is derived from a constellation of symptoms that may be described differently by different people. For example, the DSM language may be inadequate in capturing these symptoms in certain populations such as African-Americans, whose rates of depression misdiagnosis is high. METHODS This study reports the findings from a church-based, qualitative study with older African-Americans (n = 50) regarding the language they use when discussing depression and depression treatment, and how this compares to the DSM-IV depression criteria. Content analyses of the in-depth discussions with African-American male and female focus group participants resulted in a deeper understanding of the language they used to describe depression. This language was then mapped onto the DSM-IV depression criteria. RESULTS While some words used by the focus group participants mapped well onto the DSM-IV criteria, some of the language did not map well, such as language describing irritability, negative thought processes, hopelessness, loneliness, loss of control, helplessness, and social isolation. CONCLUSIONS The focus group setting provided insight to the language used by older, church-going African-Americans to describe depression. Implications include the advantages of using qualitative data to help inform clinical encounters with older African-Americans.
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Affiliation(s)
- Esther Akinyemi
- a Department of Psychiatry , Henry Ford Health System , Detroit , MI , USA
| | - Daphne C Watkins
- b School of Social Work , University of Michigan , Ann Arbor , MI , USA
| | - Janet Kavanagh
- c Department of Psychiatry , University of Michigan Medical School , Ann Arbor , MI , USA
| | - Vicki Johnson-Lawrence
- d Department of Pubic Health and Health Sciences , University of Michigan Flint , Flint , MI , USA
| | - Shana Lynn
- c Department of Psychiatry , University of Michigan Medical School , Ann Arbor , MI , USA
| | - Helen C Kales
- c Department of Psychiatry , University of Michigan Medical School , Ann Arbor , MI , USA
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Knowledge of and Attitudes Toward Alcoholism Among Church Leaders in Saint Vincent/Grenadines. Int J Ment Health Addict 2017. [DOI: 10.1007/s11469-017-9760-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Valera P, McClernon FJ, Burkholder G, Mugavero MJ, Willig J, O'Cleirigh C, Cropsey KL. A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV. AIDS Behav 2017; 21:1975-1984. [PMID: 27942999 DOI: 10.1007/s10461-016-1634-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.
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Affiliation(s)
- Pamela Valera
- Division of Social Solutions and Services Research, The Nathan Kline Institute for Psychiatric Research and Department of Psychiatry, New York University School of Medicine, 140 Old Orangeburg Rd, Orangeburg, NY, 10962, USA
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Addiction Division, Duke University School of Medicine, 2628 Erwin Rd, Durham, NC, 27707, USA
| | - Greer Burkholder
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - Michael J Mugavero
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - James Willig
- Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Behavioral Medicine, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, Boston, MA, 02114, USA
| | - Karen L Cropsey
- Department of Psychiatry & Behavioral Neurobiology, University of Alabama at Birmingham, 1720 2nd Ave S., Birmingham, AL, 35294-0017, USA.
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Spencer L, Pagell F, Hallion ME, Adams TB. Applying the Transtheoretical Model to Tobacco Cessation and Prevention: A Review of Literature. Am J Health Promot 2016; 17:7-71. [PMID: 12271754 DOI: 10.4278/0890-1171-17.1.7] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To comprehensively review all published, peer-reviewed research on the Transtheoretical Model (TTM) and tobacco cessation and prevention by exploring the validity of its constructs, the evidence for use of interventions based on the TTM, the description of populations using TTM constructs, and the identification of areas for further research. The three research questions answered were: “How is the validity of the TTM as applied to tobacco supported by research?” “How does the TTM describe special populations regarding tobacco use?” “What is the nature of evidence supporting the use of stage-matched tobacco interventions?” Data Source. Computer Database search (PsychInfo, Medline, Current Contents, ERIC, CINAHL-Allied Health, and Pro-Quest Nursing) and manual journal search. Inclusion/Exclusion Criteria. All English, original, research articles on the TTM as it relates to tobacco use published in peer-reviewed journals prior to March 1, 2001, were included. Commentaries, editorials, and books were not included. Data Extraction and Synthesis. Articles were categorized as TTM construct validation, population descriptions using TTM constructs, or intervention evaluation using TTM constructs. Summary tables including study design, research rating, purpose, methods, findings, and implications were created. Articles were further divided into groups according to their purpose. Considering both the findings and research quality of each, the three research questions were addressed. Results. The 148 articles reviewed included 54 validation studies, 73 population studies, and 37 interventions (some articles fit two categories). Overall, the evidence in support of the TTM as applied to tobacco use was strong, with supportive studies being more numerous and of a better design than nonsupportive studies. Using established criteria, we rated the construct validity of the entire body of literature as good; however, notable concerns exist about the staging construct. A majority of stage-matched intervention studies provided positive results and were of a better quality than those not supportive of stage-matched interventions; thus, we rated the body of literature using stage-matched tobacco interventions as acceptable and the body of literature using non–stage-matched interventions as suggestive. Population studies indicated that TTM constructs are applicable to a wide variety of general and special populations both in and outside of the United States, although a few exceptions exist. Conclusions. Evidence for the validity of the TTM as it applies to tobacco use is strong and growing; however, it is not conclusive. Eight different staging mechanisms were identified, raising the question of which are most valid and reliable. Interventions tailored to a smoker's stage were successful more often than nontailored interventions in promoting forward stage movement. Stage distribution is well-documented for U.S. populations; however, more research is needed for non-U.S. populations, for special populations, and on other TTM constructs.
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Affiliation(s)
- Leslie Spencer
- Department of Health and Exercise Science, Rowan University, 201 Mullica Hill Road, Glassboro, NJ 08028, USA.
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Holt CL, Lewellyn LA, Rathweg MJ. Exploring Religion-Health Mediators among African American Parishioners. J Health Psychol 2016; 10:511-27. [PMID: 16014389 DOI: 10.1177/1359105305053416] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This qualitative study examined the religiosity-health association among African Americans, with particular attention to mediators through which religiosity positively impacts health. We conducted 31 interviews across seven African American churches of different Christian denominations. Semi-structured interviews were completed with male and female parishioners. Participants were asked to describe the religiosity-health association in their own terms, and if and how their beliefs and practices impact their health. They were also asked about specific mediators proposed in this literature, such as social support and coping with stress. Respondents spontaneously mentioned that church helps them through spiritual health locus of control, coping with stress, positive affect and scriptural influence on lifestyle. These mediators may hold promise for translation into church-based health interventions.
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Affiliation(s)
- Cheryl L Holt
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, USA.
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Schoenberg NE, Studts CR, Shelton BJ, Liu M, Clayton R, Bispo JB, Fields N, Dignan M, Cooper T. A randomized controlled trial of a faith-placed, lay health advisor delivered smoking cessation intervention for rural residents. Prev Med Rep 2016; 3:317-23. [PMID: 27419031 PMCID: PMC4929151 DOI: 10.1016/j.pmedr.2016.03.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/11/2016] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Rural US residents smoke at higher rates than urban or suburban residents. We report results from a community-based smoking cessation intervention in Appalachian Kentucky. STUDY DESIGN Single-blind, group-randomized trial with outcome measurements at baseline, 17 weeks and 43 weeks. SETTING/PARTICIPANTS This faith-placed CBPR project was located in six counties of rural Appalachian Kentucky. A total of 590 individual participants clustered in 28 churches were enrolled in the study. INTERVENTION Local lay health advisors delivered the 12-week Cooper/Clayton Method to Stop Smoking program, leveraging sociocultural factors to improve the cultural salience of the program for Appalachian smokers. Participants met with an interventionist for one 90 min group session once per week incorporating didactic information, group discussion, and nicotine replacement therapy. MAIN OUTCOME MEASURES The primary outcome was self-reported smoking status. Secondary outcomes included Fagerström nicotine dependence, self-efficacy, and decisional balance. RESULTS With post-intervention data from 92% of participants, those in intervention group churches (N = 383) had 13.6 times higher odds of reporting quitting smoking one month post-intervention than participants in attention control group churches (N = 154, p < 0.0001). In addition, although only 3.2% of attention control group participants reported quitting during the control period, 15.4% of attention control participants reported quitting smoking after receiving the intervention. A significant dose effect of the 12-session Cooper/Clayton Method was detected: for each additional session completed, the odds of quitting smoking increased by 26%. CONCLUSIONS The Cooper/Clayton Method, delivered in rural Appalachian churches by lay health advisors, has strong potential to reduce smoking rates and improve individuals' health.
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Affiliation(s)
| | | | - Brent J. Shelton
- Division of Cancer Biostatistics, Department of Biostatistics, University of Kentucky, United States
| | - Meng Liu
- Department of Biostatistics, University of Kentucky, United States
| | - Richard Clayton
- Department of Health Behavior, University of Kentucky, United States
| | | | - Nell Fields
- Faith Moves Mountains, Whitesburg, Kentucky, United States
| | - Mark Dignan
- Prevention Research Center, University of Kentucky, United States
| | - Thomas Cooper
- College of Dentistry, University of Kentucky, United States
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Mitchell SA, Kneipp SM, Giscombe CW. Social Factors Related to Smoking among Rural, Low-Income Women: Findings from a Systematic Review. Public Health Nurs 2015; 33:214-23. [DOI: 10.1111/phn.12233] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Star A. Mitchell
- School of Nursing; The University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | - Shawn M. Kneipp
- School of Nursing; The University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | - Cheryl W. Giscombe
- School of Nursing; The University of North Carolina at Chapel Hill; Chapel Hill North Carolina
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Ward BW, Allen A, Gryczynski J. Racial/ethnic differences in the relationship among cigarette use, religiosity, and social norms for U.S. adolescents. J Ethn Subst Abuse 2015; 13:337-61. [PMID: 25397636 DOI: 10.1080/15332640.2014.958636] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study investigated the racial/ethnic differences in the role of social norms in the protective relationship between religiosity and cigarette smoking. The 2009 National Survey on Drug Use and Health was used to investigate the relationships between smoking, religiosity, and social norms of U.S. adolescents (N = 13,278). Significant indirect effects between religiosity and smoking were found through social norms for non-Hispanic White adolescents. Findings were mixed for non-Hispanic Black adolescents. Mechanisms driving the religiosity-smoking association differ across subpopulations. Smoking prevention efforts and messaging campaigns that include partnerships with religious communities may require consideration of these racial/ethnic differences when planning prevention strategies.
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Affiliation(s)
- Brian W Ward
- a African American Studies Department , University of Maryland , College Park , Maryland
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Borrelli B, Bartlett YK, Tooley E, Armitage CJ, Wearden A. Prevalence and Frequency of mHealth and eHealth Use Among US and UK Smokers and Differences by Motivation to Quit. J Med Internet Res 2015; 17:e164. [PMID: 26149323 PMCID: PMC4526978 DOI: 10.2196/jmir.4420] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/16/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Both mHealth and eHealth interventions for smoking cessation are rapidly being developed and tested. There are no data on use of mHealth and eHealth technologies by smokers in general or by smokers who are not motivated to quit smoking. OBJECTIVE The aims of our study were to (1) assess technology use (eg, texting, social media, Internet) among smokers in the United States and United Kingdom, (2) examine whether technology use differs between smokers who are motivated to quit and smokers who are not motivated to quit, (3) examine previous use of technology to assist with smoking cessation, and (4) examine future intentions to use technology to assist with smoking cessation. METHODS Participants were 1000 adult smokers (54.90%, 549/1000 female; mean age 43.9, SD 15.5 years; US: n=500, UK: n=500) who were recruited via online representative sampling strategies. Data were collected online and included demographics, smoking history, and frequency and patterns of technology use. RESULTS Among smokers in general, there was a high prevalence of mobile and smartphone ownership, sending and receiving texts, downloading and using apps, using Facebook, and visiting health-related websites. Smokers who were unmotivated to quit were significantly less likely to own a smartphone or handheld device that connects to the Internet than smokers motivated to quit. There was a significantly lower prevalence of sending text messages among US smokers unmotivated to quit (78.2%, 179/229) versus smokers motivated to quit (95.0%, 229/241), but no significant differences between the UK groups (motivated: 96.4%, 239/248; unmotivated: 94.9%, 223/235). Smokers unmotivated to quit in both countries were significantly less likely to use a handheld device to read email, play games, browse the Web, or visit health-related websites versus smokers motivated to quit. US smokers had a high prevalence of app downloads regardless of motivation to quit, but UK smokers who were motivated to quit had greater prevalence of app downloads than smokers unmotivated to quit. US smokers were significantly more likely to have a Facebook account (87.0%, 435/500) than UK smokers (76.4%, 382/500), but smokers unmotivated to quit in both countries used Facebook less frequently than smokers motivated to quit. Smokers who were unmotivated to quit were less likely to have used eHealth or mHealth platforms to help them quit smoking in the past and less likely to say that they would use them for smoking cessation in the future. CONCLUSIONS Although smokers unmotivated to quit make less use of technology than smokers motivated to quit, there is sufficient prevalence to make it worthwhile to develop eHealth and mHealth interventions to encourage cessation. Short and low-effort communications, such as text messaging, might be better for smokers who are less motivated to quit. Multiple channels may be required to reach unmotivated smokers.
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Affiliation(s)
- Belinda Borrelli
- Boston University, Henry M Goldman School of Dental Medicine, Boston, MA, United States.
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Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner‐Brown J, Krause LK. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database Syst Rev 2015; 2015:CD009905. [PMID: 26075988 PMCID: PMC10656573 DOI: 10.1002/14651858.cd009905.pub2] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models. OBJECTIVES To assess effects of community coalition-driven interventions in improving health status or reducing health disparities among racial and ethnic minority populations. SEARCH METHODS We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index, Dissertation Abstracts, System for Information on Grey Literature in Europe (SIGLE) (from January 1990 through September 30, 2013), and Global Health Library (from January 1990 through March 31, 2014). SELECTION CRITERIA Cluster-randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time series studies, and prospective controlled cohort studies. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population and at least two community public or private organizations are included. Major outcomes of interest are direct measures of health status, as well as lifestyle factors when evidence indicates that these have an effect on the direct measures performed. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias for each study. MAIN RESULTS Fifty-eight community coalition-driven intervention studies were included. No study was considered to be at low risk of bias. Behavioral change outcomes and health status change outcomes were analyzed separately. Outcomes are grouped by intervention type. Pooled effects across intervention types are not presented because the diverse community coalition-led intervention studies did not examine the same constructs or relationships, and they used dissimilar methodological designs. Broad-scale community system level change strategies led to little or no difference in measures of health behavior or health status (very low-certainty evidence). Broad health and social care system level strategies leds to small beneficial changes in measures of health behavior or health status in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions led to beneficial changes in health behavior measures of moderate magnitude in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions may lead to beneficial changes in health status measures in large samples of community residents; however, results were not consistent across studies (low-certainty evidence). Group-based health education led by professional staff resulted in moderate improvement in measures of health behavior (very low-certainty evidence) or health status (low-certainty evidence). Adverse outcomes of community coalition-led interventions were not reported. AUTHORS' CONCLUSIONS Coalition-led interventions are characterized by connection of multi-sectoral networks of health and human service providers with ethnic and racial minority communities. These interventions benefit a diverse range of individual health outcomes and behaviors, as well as health and social care delivery systems. Evidence in this review shows that interventions led by community coalitions may connect health and human service providers with ethnic and racial minority communities in ways that benefit individual health outcomes and behaviors, as well as care delivery systems. However, because information on characteristics of the coalitions themselves is insufficient, evidence does not provide an explanation for the underlying mechanisms of beneficial effects. Thus, a definitive answer as to whether a coalition-led intervention adds extra value to the types of community engagement intervention strategies described in this review remains unattainable.
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Affiliation(s)
- Laurie M Anderson
- University of WashingtonDepartment of Epidemiology, School of Public HealthP.O. Box 357236SeattleWAUSA98195‐7236
| | - Kathryn L Adeney
- Washington State Institute for Public PolicyEpidemiology and Public Health110 Fifth Avenue SE, Suite 214SeattleWAUSA98504
| | - Carolynne Shinn
- New Hampshire Department of Health and Human ServicesNew Hampshire Division of Public Health ServicesConcordNew HampshireUSA03301‐3852
| | - Sarah Safranek
- University of WashingtonHealth Sciences Library1959 NE Pacific StreetSeattleWAUSA98195‐7155
| | - Joyce Buckner‐Brown
- Centers for Disease Control and PreventionNational Center for Chronic Disease Prevention and Health Promotion, Division of Community Health, Research Surveillance & Evaluation Branch4770 Buford Hwy NE, Mailstop K81AtlantaGeorgiaUSA30341
| | - L Kendall Krause
- Bill & Melinda Gates FoundationEpidemiology and Surveillance DivisionSeattleWAUSA
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Schoenberg NE, Bundy HE, Baeker Bispo JA, Studts CR, Shelton BJ, Fields N. A rural Appalachian faith-placed smoking cessation intervention. JOURNAL OF RELIGION AND HEALTH 2015; 54:598-611. [PMID: 24691565 PMCID: PMC4183727 DOI: 10.1007/s10943-014-9858-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although health promotion programming in faith institutions is promising, most faith-based or placed health projects focus on diet, exercise, or cancer screening and many have been located in urban environments. This article addresses the notable absence of faith programming for smoking cessation among underserved rural US residents who experience tobacco-related health inequities. In this article, we describe our faith-oriented smoking cessation program in rural Appalachia, involving 590 smokers in 26 rural churches randomized to early and delayed intervention groups. We present three main themes that account for participants' positive evaluation of the program; the program's ability to leverage social connections; the program's convenience orientation; and the program's financial support for smoking cessation. We also present themes on the roles of faith and church in smoking cessation programming, including some mixed perceptions on smoking stigma and comfort in church settings; challenges in faith-placed smoking cessation recruitment; and the positive perception of such programming by church leaders. We conclude that faith-placed smoking cessation programs offer great potential, although they must be administered with great sensitivity to individual and community norms.
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Affiliation(s)
- Nancy E. Schoenberg
- Marion Pearsall Professor of Behavioral Science, 125 Medical Behavioral Science Building, University of Kentucky, Lexington KY USA 40536-0086, tel: (859) 323-8175, fax: (859) 323-5350
| | | | | | | | - Brent J. Shelton
- Division of Cancer Biostatistics and Department of Biostatistics, University of Kentucky
| | - Nell Fields
- Project Director, Faith Moves Mountains, Whitesburg, KY
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Wang Z, Koenig HG, Al Shohaib S. Religious involvement and tobacco use in mainland China: a preliminary study. BMC Public Health 2015; 15:155. [PMID: 25886594 PMCID: PMC4336676 DOI: 10.1186/s12889-015-1478-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 01/27/2015] [Indexed: 11/09/2022] Open
Abstract
Background Cigarette smoking causes serious health, economic, and social problems throughout the world. Religious involvement is known to be an important predictor of health behaviors and substance use. The present study examines the correlation between religious involvements and tobacco use, and explores connections between religiosity and tobacco use in Muslims and non-Muslims in Western China. Methods Data were examined from a representative sample of 2,770 community-dwelling adults in the province of Ningxia located in Western China. Self-report smoking, past smoking, religious attendance and the importance of religious in daily life were measured. The WHO Composite International Diagnostic Interview was used to diagnose tobacco use disorders. Three separate logistic regression models were used to examine correlations between religious involvement and smoking status. Results In the overall sample, religious attendance was inversely associated with current smoking (p < 0.001), as was importance of religion (p < 0.05). Current smoking was also less common in those categorized as high on religious involvement. No association, however, was found between religious involvement and either past smoking or tobacco use disorders. In Muslims, both religion attendance and high religiosity were inversely associated with current smoking (p < 0.001), although no association was found in non-Muslims. Conclusions Religious involvement is inversely related to current smoking in Western China, although this association depends on religious affiliation.
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Affiliation(s)
- Zhizhong Wang
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China.
| | - Harold G Koenig
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China. .,Departments of Psychiatry and Behavioral Sciences, and Department of Medicine, Duke University Medical Center, Durham, 27705, USA. .,Department of Medicine, King Abdulaziz University (KAU), Jeddah, Saudi Arabia.
| | - Saad Al Shohaib
- Department of Medicine, King Abdulaziz University (KAU), Jeddah, Saudi Arabia.
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Factors associated with seasonal influenza immunization among church-going older African Americans. Vaccine 2014; 32:7085-90. [PMID: 25444831 DOI: 10.1016/j.vaccine.2014.10.068] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/15/2014] [Accepted: 10/27/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Churches and faith institutions can frequently influence health behaviors among older African Americans. The church is a centerpiece of spiritual and social life among African American congregants. We explored its influence on influenza immunization coverage during the 2012-2013 influenza season. METHODS A cross-sectional study was conducted among congregation members ages 50-89 years from six churches in the Atlanta region in 2013-2014. We computed descriptive statistics, bivariate associations, and multivariable models to examine factors associated with immunization uptake among this population. RESULTS Of 208 study participants, 95 (45.7%) reported receiving the influenza vaccine. Logistic regression showed that increased trust in their healthcare providers' vaccine recommendations was a positive predictor of vaccination among participants who had not experienced discrimination in a faith-based setting (OR: 14.8 [3.7, 59.8]), but was not associated with vaccination for participants who had experienced such discrimination (OR: 1.5 [0.2, 7.0]). Belief in vaccine-induced influenza illness (OR: 0.1 [0.05, 0.23]) was a negative predictor of influenza vaccination. CONCLUSION Members of this older cohort of African Americans who expressed trust in their healthcare providers' vaccine recommendations and disbelief in vaccine-induced influenza were more likely to obtain seasonal influenza immunization. They were also more likely to act on their trust of healthcare provider's vaccine recommendations if they did not encounter negative influenza immunization attitudes within the church. Having healthcare providers address negative influenza immunization attitudes and disseminate vaccine information in a culturally appropriate manner within the church has the potential to enhance future uptake of influenza vaccination.
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Wallen J, Randolph S, Carter-Pokras O, Feldman R, Kanamori-Nishimura M. Engaging African Americans in Smoking Cessation Programs. AMERICAN JOURNAL OF HEALTH EDUCATION 2014. [DOI: 10.1080/19325037.2014.893850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Liu JJ, Wabnitz C, Davidson E, Bhopal RS, White M, Johnson MRD, Netto G, Sheikh A. Smoking cessation interventions for ethnic minority groups--a systematic review of adapted interventions. Prev Med 2013; 57:765-75. [PMID: 24076130 DOI: 10.1016/j.ypmed.2013.09.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 08/22/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Existing smoking cessation interventions tend to be under utilized by ethnic minority groups. We sought to identify smoking cessation interventions that have been adapted to meet the needs of African-, Chinese- and South Asian-origin populations, to increase understanding of the approaches used to promote behavior change, to assess their acceptability to the target populations, and to evaluate their effectiveness. METHODS Two reviewers independently searched for, identified, critically appraised and extracted data from studies identified from 11 databases (January 1950-April 2013). Study quality was assessed using validated instruments (EPHPP and STROBE). Adaptations were independently coded using an established typology, and findings descriptively summarized and thematically synthesized. RESULTS 23 studies described interventions adapted for African-Americans, and five for Chinese-origin populations. No intervention adapted for South-Asian populations was identified. Six studies directly compared a culturally adapted versus a non-adapted intervention. Adapted interventions were more acceptable to ethnic minority groups, but this did not translate into improvements in smoking cessation outcomes. CONCLUSIONS Given the evidence of greater acceptability of adapted interventions, it may be ethically preferable to use these. There is, however, no clear evidence of the effectiveness of adapted interventions in promoting smoking cessation in ethnic minority groups.
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Affiliation(s)
- Jing Jing Liu
- Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
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O’Mara-Eves A, Brunton G, McDaid D, Oliver S, Kavanagh J, Jamal F, Matosevic T, Harden A, Thomas J. Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. PUBLIC HEALTH RESEARCH 2013. [DOI: 10.3310/phr01040] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundCommunity engagement has been advanced as a promising way of improving health and reducing health inequalities; however, the approach is not yet supported by a strong evidence base.ObjectivesTo undertake a multimethod systematic review which builds on the evidence that underpins the current UK guidance on community engagement; to identify theoretical models underpinning community engagement; to explore mechanisms and contexts through which communities are engaged; to identify community engagement approaches that are effective in reducing health inequalities, under what circumstances and for whom; and to determine the processes and costs associated with their implementation.Data sourcesDatabases including the Cochrane Database of Systematic Reviews (CDSR), The Campbell Library, the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment (HTA) database, the NHS Economic Evaluation Database (NHS EED) and EPPI-Centre’s Trials Register of Promoting Health Interventions (TRoPHI) and Database of Promoting Health Effectiveness Reviews (DoPHER) were searched from 1990 to August 2011 for systematic reviews and primary studies. Trials evaluating community engagement interventions reporting health outcomes were included.Review methodsStudy eligibility criteria: published after 1990; outcome, economic, or process evaluation; intervention relevant to community engagement; written in English; measured and reported health or community outcomes, or presents cost, resource, or implementation data characterises study populations or reports differential impacts in terms of social determinants of health; conducted in an Organisation for Economic Co-operation and Development (OECD) country. Study appraisal: risk of bias for outcome evaluations; assessment of validity and relevance for process evaluations; comparison against an economic evaluation checklist for economic evaluations. Synthesis methods: four synthesis approaches were adopted for the different evidence types: theoretical, quantitative, process, and economic evidence.ResultsThe theoretical synthesis identified key models of community engagement that are underpinned by different theories of changes. Results from 131 studies included in a meta-analysis indicate that there is solid evidence that community engagement interventions have a positive impact on health behaviours, health consequences, self-efficacy and perceived social support outcomes, across various conditions. There is insufficient evidence – particularly for long-term outcomes and indirect beneficiaries – to determine whether one particular model of community engagement is likely to be more effective than any other. There are also insufficient data to test the effects on health inequalities, although there is some evidence to suggest that interventions that improve social inequalities (as measured by social support) also improve health behaviours. There is weak evidence from the effectiveness and process evaluations that certain implementation factors may affect intervention success. From the economic analysis, there is weak but inconsistent evidence that community engagement interventions are cost-effective. By combining findings across the syntheses, we produced a new conceptual framework.LimitationsDifferences in the populations, intervention approaches and health outcomes made it difficult to pinpoint specific strategies for intervention effectiveness. The syntheses of process and economic evidence were limited by the small (generally not rigorous) evidence base.ConclusionsCommunity engagement interventions are effective across a wide range of contexts and using a variety of mechanisms. Public health initiatives should incorporate community engagement into intervention design. Evaluations should place greater emphasis on long-term outcomes, outcomes for indirect beneficiaries, process evaluation, and reporting costs and resources data. The theories of change identified and the newly developed conceptual framework are useful tools for researchers and practitioners. We identified trends in the evidence that could provide useful directions for future intervention design and evaluation.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- A O’Mara-Eves
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - G Brunton
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - D McDaid
- Personal Social Services Research Unit and European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, UK
| | - S Oliver
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - J Kavanagh
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
| | - F Jamal
- Institute for Health and Human Development, University of East London, London, UK
| | - T Matosevic
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - A Harden
- Institute for Health and Human Development, University of East London, London, UK
- Barts Health NHS Trust, London, UK
| | - J Thomas
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Institute of Education, London, UK
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Plunkett R, Leipert BD. Women's health promotion in the rural church: a Canadian perspective. JOURNAL OF RELIGION AND HEALTH 2013; 52:877-889. [PMID: 21935724 DOI: 10.1007/s10943-011-9535-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The rural church may be an effective health resource for rural Canadian women who have compromised access to health resources. The purpose of this paper is to explore the relevance of the Christian church and faith community nurses in promoting the health of rural Canadian women in the evolving rural context. The findings from an extensive literature search reveal that religion and spirituality often influence the health beliefs, behaviors, and decisions of rural Canadian women. The church and faith community nurses may therefore be a significant health resource for rural Canadian women, although this phenomenon has been significantly understudied.
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Affiliation(s)
- Robyn Plunkett
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, N6A 5C1, Canada.
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Webb B, Bopp M, Fallon EA. A qualitative study of faith leaders' perceptions of health and wellness. JOURNAL OF RELIGION AND HEALTH 2013; 52:235-46. [PMID: 21409482 DOI: 10.1007/s10943-011-9476-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The effectiveness of faith-based health and wellness interventions is moderated by the attitudes, perceptions, and participation of key leaders within faith-based organizations. This qualitative study examined perceptions about the link between health, spirituality, and religion among a volunteer sample of faith leaders (n = 413) from different denominations. The major themes included: influences on health and wellness promotion and a relationship between spirituality and health. The results indicated that perceptions about the link among health, spirituality, and religion vary among faith leaders, regardless of denomination. Future faith-based interventions should be developed with consideration for denomination as a socially and culturally relevant factor.
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Affiliation(s)
- Benjamin Webb
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA
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Torrence WA, Phillips DS, Guidry JJ. The Assessment of Rural African-American Churches' Capacity to Promote Health Prevention Activities. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2005.10608178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- William A. Torrence
- a University of Arkansas for Medical Sciences , University Mall, 300 S. University Ave., Little Rock , AR , 72205 , USA
| | - Danielle S. Phillips
- b Department of Health and Kinesiology , Texas A&M University , College Station , TX , 77843 , USA
| | - Jeffrey J. Guidry
- c Department of Health & Kinesiology , Texas A&M University , MS 4243, College Station , TX , 77843 , USA
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Hood NE, Ferketich AK, Paskett ED, Wewers ME. Treatment adherence in a lay health adviser intervention to treat tobacco dependence. HEALTH EDUCATION RESEARCH 2013; 28:72-82. [PMID: 22843347 PMCID: PMC3549587 DOI: 10.1093/her/cys081] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 06/13/2012] [Indexed: 06/01/2023]
Abstract
Lay health advisers (LHAs) are increasingly used to deliver tobacco dependence treatment, especially with low-socioeconomic status (SES) populations. More information is needed about treatment adherence to help interpret mixed evidence of LHA intervention effectiveness. This study examined adherence to behavioral counseling and nicotine patches in an LHA intervention with 147 Ohio Appalachian female daily smokers. Participants were randomly selected from clinics and randomized to the intervention condition of a randomized controlled trial. Overall, 75.5% of participants received all seven planned LHA visits, 29.3% used patches for >7 weeks and approximately half received high average ratings on participant responsiveness. Depressive symptoms and low nicotine dependence were associated with lower patch adherence while high poverty-to-income ratio was associated with high responsiveness. Compared with those with fewer visits, participants who received all visits were more likely to be abstinent (22.5 versus 2.8%, P=0.026) or have attempted quitting (85.0 versus 47.4%, P=0.009) at 3 months. High participant responsiveness was associated with 12-month abstinence. LHA interventions should focus on improving adherence to nicotine patches and managing depression because it is an independent risk factor for low adherence.
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Affiliation(s)
- N E Hood
- College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
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Nierkens V, Kunst AE, De Vries H, Voorham TAJ, Stronks K. Reach and Effectiveness of a Community Program to Reduce Smoking Among Ethnic Turkish Residents in Rotterdam, the Netherlands: A Quasi-Experimental Design. Nicotine Tob Res 2013; 15:112-20. [DOI: 10.1093/ntr/nts096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Dai Y, Ma S. Variable selection for semiparametric regression models with iterated penalization. J Nonparametr Stat 2012; 24:283-298. [PMID: 22685376 DOI: 10.1080/10485252.2012.661054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Semiparametric regression models with multiple covariates are commonly encountered. When there are covariates not associated with response variable, variable selection may lead to sparser models, more lucid interpretations and more accurate estimation. In this study, we adopt a sieve approach for the estimation of nonparametric covariate effects in semiparametric regression models. We adopt a two-step iterated penalization approach for variable selection. In the first step, a mixture of the Lasso and group Lasso penalties are employed to conduct the first-round variable selection and obtain the initial estimate. In the second step, a mixture of the weighted Lasso and weighted group Lasso penalties, with weights constructed using the initial estimate, are employed for variable selection. We show that the proposed iterated approach has the variable selection consistency property, even when number of unknown parameters diverges with sample size. Numerical studies, including simulation and analysis of a diabetes dataset, show satisfactory performance of the proposed approach.
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Affiliation(s)
- Ying Dai
- School of Public Health, Yale University, New Haven, CT, USA
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Hankerson SH, Weissman MM. Church-based health programs for mental disorders among African Americans: a review. Psychiatr Serv 2012; 63:243-9. [PMID: 22388529 PMCID: PMC3952019 DOI: 10.1176/appi.ps.201100216] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. METHODS A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. RESULTS Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. CONCLUSIONS Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans.
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Affiliation(s)
- Sidney H Hankerson
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City, NY, USA.
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Wei F, Zhu H. Group coordinate descent algorithms for nonconvex penalized regression. Comput Stat Data Anal 2012. [DOI: 10.1016/j.csda.2011.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Cox LS, Okuyemi K, Choi WS, Ahluwalia JS. A review of tobacco use treatments in U.S. ethnic minority populations. Am J Health Promot 2011; 25:S11-30. [PMID: 21510783 DOI: 10.4278/ajhp.100610-lit-177] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tobacco use is the leading preventable cause of disease and death in the United States. Among racial and ethnic minorities, disparities in tobacco use, knowledge of health risks and treatment resources, and access to and utilization of treatment contribute to a disproportionate disease burden from tobacco use. Furthermore, racial and ethnic minorities have been underrepresented within tobacco treatment studies. PURPOSE/OBJECTIVE This paper provides a review of published studies examining tobacco treatment interventions among ethnic and minority populations in the United States. STUDY DESIGN/METHODS Literature searches were used to identify smoking cessation interventions involving racial/ethnic minority populations. Identified studies were published between 1985 and 2009 involving African-American, Latino, Native American, and Asian or Pacific Islander smokers. Studies included in the review (1) targeted one or more ethnic minority group or had at least 10% of study participants from ethnic minority groups and (2) reported abstinence outcomes. RESULTS Sixty-four studies were included in this review. Of studies meeting inclusion criteria, 28 included a primary focus on African-Americans, 10 focused on Latinos, 4 focused on Native Americans, and 3 focused on Asian-American smokers. An additional 19 studies reported samples including participants from more than one minority group. Sample inclusion criteria, intervention content and duration, follow-up, abstinence assessment, and limitations of these studies were reviewed. CONCLUSIONS Individuals from racial and ethnic minority populations are interested in stopping smoking and willing to participate in treatment research. Variations in the content of treatment intervention and study design produced a range of abstinence outcomes across studies. Additional research is needed for all groups, including African-American smokers, and special attention is warranted for Latino, Native American, and Asian groups given the paucity of published studies. Although there were limited evaluations of pharmacotherapy, the existing data support use of pharmacotherapy in addition to counseling for enhancing abstinence outcomes. Further attention to level of individual smoking, variability in smoking patterns, and use of other tobacco products is needed, given known variation within and between racial and ethnic groups. Overall, findings are consistent with recommendations from the 2008 Clinical Practice Guidelines calling for increased research devoted to evaluating and enhancing tobacco use treatment interventions among racial and ethnic minority populations.
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Affiliation(s)
- Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas 66160, USA.
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Holt CL, Shipp M, Eloubeidi M, Fouad MN, Britt K, Norena M. Your Body Is the Temple. Health Promot Pract 2011; 12:577-588. [DOI: 10.1177/1524839910370421] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Colorectal cancer (CRC) is third in cancer incidence and mortality, due in part to lack of awareness and low rates of screening. The purpose of the present study was to evaluate the efficacy of a spiritually based CRC educational intervention delivered by trained Community Health Advisors, in Alabama churches. The aim of the intervention was to increase knowledge and awareness of CRC and early detection, and to eventually increase CRC screening rates. Participants age-eligible for screening ( N = 122) completed baseline, 6-month, and 12-month surveys by telephone. Increases in CRC knowledge, perceived benefits of CRC screening, and awareness of the screening modalities and decreases in perceived barriers to screening suggested that this type of intervention may be promising for CRC control and should be examined further.
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Affiliation(s)
- Cheryl L. Holt
- Department of Public and Community Health, University of Maryland School of Public Health, College Park, Maryland
| | - Michele Shipp
- The Ohio State University School of Public Health, Columbus, Ohio
| | - Mohamad Eloubeidi
- Department of Gastroenterology and Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Mona N. Fouad
- Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Kristi Britt
- Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Maria Norena
- Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
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Translation of the National Institutes of Health Diabetes Prevention Program in African American Churches. J Natl Med Assoc 2011; 103:194-202. [DOI: 10.1016/s0027-9684(15)30301-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Austin S, Harris G. Addressing health disparities: the role of an African American health ministry committee. SOCIAL WORK IN PUBLIC HEALTH 2011; 26:123-135. [PMID: 21213192 DOI: 10.1080/10911350902987078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Healthy People 2010 identified the need to address health disparities among African Americans, Asians, American Indians, Hispanics, Alaskan American, and Pacific Islanders. These are groups disproportionately affected by cancer, cardiovascular disease, diabetes, HIV infection, and AIDSs. Despite the growing body of research on health disparities and effective interventions, there is a great need to learn more about culturally appropriate interventions. Social work professional values and ethics require that service delivery be culturally competent and effective. Social workers can collaborate with community based health promotion services, exploring new ways to ensure that health disparities can be addressed in institutions to which African Americans belong. This article presents findings of an African American health ministry committee's health promotion initiatives and probed the viability of a health ministry committee' role in addressing health disparities through education. The promising role of the Black church in addressing health disparities is explored.
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Affiliation(s)
- Sandra Austin
- School of Social Wellfare, University of Albany, State University of New York, Albany, New York, USA.
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Gryczynski J, Ward BW. Social Norms and the Relationship Between Cigarette Use and Religiosity Among Adolescents in the United States. HEALTH EDUCATION & BEHAVIOR 2010; 38:39-48. [DOI: 10.1177/1090198110372331] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated the social dynamics that underlie the negative association between religiosity and cigarette use among U.S. adolescents. Using data from the 2007 National Survey on Drug Use and Health, the authors used a theory-based conceptual model (vicarious learning networks [VLN]) to examine the role that key reference group norms play in the religiosity—smoking relationship. This relationship is partially mediated by parents’ and close friends’ perceived disapproval for smoking. However, religiosity maintains a strong negative association with smoking. Consistent with the VLN model, cigarette use varied substantively based on reference group normative configurations. To the extent that the protective effects of religiosity arise from its influence in structuring the social milieu, some of religiosity’s benefits could potentially be leveraged through interventions that promote healthy norms among reference groups within the social network. The VLN model may be a useful tool for conceptualizing the transmission of health behavior through social learning processes.
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Abstract
Korean Americans experience many challenges to obtaining adequate health care coverage and access to needed services. Because a large proportion of Korean Americans attend churches on a regular basis, churches may be a promising venue where health programs can be delivered. In order to gain an in-depth understanding of Korean American churches with respect to conducting future health intervention research, we conducted exploratory interviews and focus groups with 58 leaders from 23 Korean American churches and three community organizations. From these interviews and focus groups, we found that Korean churches and church leaders seek to meet a variety of social and health needs of their congregation and their surrounding community. Several leaders have stated that assisting with social and medical needs of their members is an important component of their current ministry. They described profound health needs of their congregations and have suggested various ways in which the university can partner with the local churches to help address these needs through research. Additionally, they described various resources churches can provide to researchers such as: their personal assistance, church volunteer base, church facility, and church network and contacts. Our findings suggest that Korean churches have a high potential to serve an important role in the health of Korean Americans. On the basis of the promising results of the present study, we are planning to conduct a cross sectional survey of Korean church leaders and members in Los Angeles County to substantiate our findings in a larger representative sample.
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Gillum RF, Bennett G, Santibañtez S, Donahue M. Associations of Prayer, Mind-Body Therapy, and Smoking Cessation in a National Survey. Psychol Rep 2009; 105:593-604. [DOI: 10.2466/pr0.105.2.593-604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Smoking is the leading preventable cause of death. Many people use mind-body therapies and/or prayer to assist them in smoking cessation, but more information on their effectiveness is needed. In the 2002 National Health Interview Survey, 5,864 persons aged 18 or older reported smoking in the prior 12 mo.; among these, users of any of 10 mind-body therapies or prayer were compared to nonusers to assess smoking cessation attempts and smoking cessation over a 1-yr. period. Weighted logistic regression showed that the adjusted odds of reporting quit attempts during the year prior to interview or of reporting no longer smoking at interview were significantly higher in those using prayer alone, any mind-body therapy alone, or both, compared with those who used neither. In the subset of 2,839 persons who reported smoking 12 mo. prior to interview and attempting to quit during the year prior to interview, the odds of reporting no longer smoking at interview were no greater for those who used prayer, any mind-body therapy, or both, than in those using neither.
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Affiliation(s)
- R. F. Gillum
- School of Divinity and College of Medicine Howard University
| | | | | | - Michael Donahue
- Institute for the Psychological Science Alexandria, Virginia
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Fleury J, Keller C, Perez A, Lee SM. The role of lay health advisors in cardiovascular risk reduction: a review. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2009; 44:28-42. [PMID: 19533327 DOI: 10.1007/s10464-009-9253-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Interventions are needed to reduce the negative impact of cardiovascular disease. The combination of health risks for disease, disability, and mortality, particularly among underserved populations, might be best addressed with programs designed to enhance awareness and development of resources within a context of community support. The objectives of this review were to: (1) provide a comprehensive review and evaluation of the roles, evaluation, and effectiveness of LHA in community-based programs with an emphasis on cardiovascular risk reduction; and (2) provide recommendations for future research involving LHA in such programs. Computer and manual searches were conducted of articles in the English-language literature from 1980 to 2007. Twenty articles were evaluated, which emphasized the role of the LHA in cardiovascular risk reduction. A review of research literature provides a starting point for determining salient approaches for intervention and evaluation, issues related to program implementation and sustainability, and strengths and limitations of existing approaches.
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Affiliation(s)
- Julie Fleury
- College of Nursing & Healthcare Innovation, Arizona State University, Phoenix, AZ 85004, USA.
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Abstract
This pilot study sought to dismantle the efficacy of culturally specific print materials for smoking cessation. Two-hundred sixty-one African American smokers were randomized into 1 of 2 conditions: standard booklet or culturally specific booklet. The content and length of the interventions were identical yet varied in their degree of cultural specificity. Three-month follow-up assessments were completed by 70% (N = 183) of participants. Dependent variables included content evaluation, readiness to quit smoking, and actual behavior change. Evidence suggested that the culturally specific material was more effective at capturing attention, providing encouragement and gaining interest compared to standard materials; however, greater credibility was found for standard materials. In addition, greater readiness to quit and more 24-hour quit attempts were found in the standard condition. No differences were found in abstinence rates. In conclusion, culturally specific interventions may be preferred over standard approaches among African American smokers. Culturally specific approaches, however, may not result in greater behavior change. Implications for written interventions and cultural specificity are discussed.
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Affiliation(s)
- Monica S Webb
- Department of Psychology, University of Miami, Coral Gables, FL 33124-0751, USA.
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Kannan S, Sparks AV, Webster JD, Krishnakumar A, Lumeng J. Healthy Eating and Harambee: curriculum development for a culturally-centered bio-medically oriented nutrition education program to reach African American women of childbearing age. Matern Child Health J 2009; 14:535-47. [PMID: 19655237 DOI: 10.1007/s10995-009-0507-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2007] [Accepted: 07/15/2009] [Indexed: 10/20/2022]
Abstract
The purpose was to develop, implement and evaluate a peer-led nutrition curriculum Healthy Eating and Harambee that addresses established objectives of maternal and infant health and to shift the stage for African American women of childbearing age in Genesee County toward healthier dietary patterns using a socio-cultural and biomedical orientation. The PEN-3 model, which frames culture in the context of health promotion interventions, was integrated with the Transtheoretical Model to guide this 13-week pre-test/post-test curriculum. Materials developed included soul food plate visuals, a micronutrient availability worksheet, a fruit stand, and gardening kits. Learning activities included affirmations, stories, case-scenarios, point-of-purchase product recognition, church health teams, and community health fairs. We investigated health-promoting dietary behaviors (consumption of more fruits and vegetables (F&V), serving more F&V to their families, and moderating dietary sodium and fat intakes), and biomedical behaviors (self-monitoring blood pressure and exercising) across five stages of change. Session attendance and program satisfaction were assessed. N = 102 women participated (mean age = 27.5 years). A majority (77%) reported adopting at least one healthy eating behavior (moderating sodium, serving more F&V to their families), 23% adopted at least two such behaviors (reading food labels for sodium; using culinary herbs/spices; serving more F&V to their families), and 45% adopted both dietary (moderating sodium; eating more fruits) and biomedical behaviors. Participants and facilitators favorably evaluated the curriculum and suggested improvements. A multi-conceptual approach coupled with cultural and biomedical tailoring has potential to promote young African American women's movement to more advanced stages of change and improve self-efficacy for fruit and vegetable intake, dietary sodium moderation, and self-monitoring blood pressure and physical activity.
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Affiliation(s)
- Srimathi Kannan
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, 209 Chenoweth Laboratory, 100 Holdsworth Way, Amherst, MA 01003, USA.
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Holt CL, Roberts C, Scarinci I, Wiley SR, Eloubeidi M, Crowther M, Bolland J, Litaker MS, Southward V, Coughlin SS. Development of a spiritually based educational program to increase colorectal cancer screening among African American men and women. HEALTH COMMUNICATION 2009; 24:400-412. [PMID: 19657823 DOI: 10.1080/10410230903023451] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study describes the development of a spiritually based intervention to increase colorectal cancer screening through African American churches by framing the health message with spiritual themes and scripture. The intervention development phase consisted of ideas from an advisory panel and core content identified in focus groups. In the pilot-testing phase, prototypes of the intervention materials were tested for graphic appeal in additional focus groups, and content was tested for acceptability and comprehension in cognitive interviews. Participants preferred materials showing a variety of African Americans in real settings, bright color schemes, and an uplifting message emphasizing prevention and early detection. Spiritual themes such as stewardship over the body, being well to serve God, and using faith to overcome fear, were well received. The materials were then finalized for implementation and will be used by community health advisors to encourage screening.
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Affiliation(s)
- Cheryl L Holt
- Department of Public and Community Health, School of Public Health, University of Maryland, College Park, MA 20742, USA.
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Samuel-Hodge CD, Keyserling TC, Park S, Johnston LF, Gizlice Z, Bangdiwala SI. A randomized trial of a church-based diabetes self-management program for African Americans with type 2 diabetes. THE DIABETES EDUCATOR 2009; 35:439-54. [PMID: 19383882 DOI: 10.1177/0145721709333270] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study developed and tested a culturally appropriate, church-based intervention to improve diabetes self-management. Research Design and Methods This was a randomized trial conducted at 24 African American churches in central North Carolina. Churches were randomized to receive the special intervention (SI; 13 churches, 117 participants) or the minimal intervention (MI; 11 churches, 84 participants). The SI included an 8-month intensive phase, consisting of 1 individual counseling visit, 12 group sessions, monthly phone contacts, and 3 encouragement postcards, followed by a 4-month reinforcement phase including monthly phone contacts. The MI received standard educational pamphlets by mail. Outcomes were assessed at 8 and 12 months; the primary outcome was comparison of 8-month A1C levels. RESULTS At baseline, the mean age was 59 years, A1C 7.8%, and body mass index 35.0 kg/m(2); 64% of participants were female. For the 174 (87%) participants returning for 8-month measures, mean A1C (adjusted for baseline and group randomization) was 7.4% for SI and 7.8% for MI, with a difference of 0.4% (95% confidence interval [CI], 0.1-0.6, P = .009). In a larger model adjusting for additional variables, the difference was 0.5% (95% CI, 0.2-0.7, P < .001). At 12 months, the difference between groups was not significant. Diabetes knowledge and diabetes-related quality of life significantly improved in the SI group compared with the MI group. Among SI participants completing an acceptability questionnaire, intervention components and materials were rated as highly acceptable. CONCLUSIONS The church-based intervention was well received by participants and improved short-term metabolic control.
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Affiliation(s)
- Carmen D Samuel-Hodge
- The Department of Nutrition, Schools of Public Health and Medicine and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (Dr Samuel-Hodge)
| | - Thomas C Keyserling
- Department of Medicine, School of Medicine and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (Dr Keyserling)
| | - Sola Park
- Department of Biostatistics, School of Public Health and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (Dr Park), Dr Park is currently at Family Health International,
Research Triangle Park, North Carolina
| | - Larry F Johnston
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (Mr Johnston, Dr Gizlice)
| | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (Mr Johnston, Dr Gizlice)
| | - Shrikant I Bangdiwala
- Department of Biostatistics, School of Public Health and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (Dr Bangdiwala)
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Barnes PA, Curtis AB. A National Examination of Partnerships Among Local Health Departments and Faith Communities in the United States. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2009; 15:253-63. [DOI: 10.1097/01.phh.0000349740.19361.ac] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Murray RL, Bauld L, Hackshaw LE, McNeill A. Improving access to smoking cessation services for disadvantaged groups: a systematic review. J Public Health (Oxf) 2009; 31:258-77. [PMID: 19208688 DOI: 10.1093/pubmed/fdp008] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Smoking is a main contributor to health inequalities. Identifying strategies to find and support smokers from disadvantaged groups is, therefore, of key importance. METHODS A systematic review was carried out of studies identifying and supporting smokers from disadvantaged groups for smoking cessation, and providing and improving their access to smoking-cessation services. A wide range of electronic databases were searched and unpublished reports were identified from the national research register and key experts. RESULTS Over 7500 studies were screened and 48 were included. Some papers were of poor quality, most were observational studies and many did not report findings for disadvantaged smokers. Nevertheless, several methods of recruiting smokers, including proactively targeting patients on General Physician's registers, routine screening or other hospital appointments, were identified. Barriers to service use for disadvantaged groups were identified and providing cessation services in different settings appeared to improve access. We found preliminary evidence of the effectiveness of some interventions in increasing quitting behaviour in disadvantaged groups. CONCLUSIONS There is limited evidence on effective strategies to increase access to cessation services for disadvantaged smokers. While many studies collected socioeconomic data, very few analysed its contribution to the results. However, some potentially promising interventions were identified which merit further research.
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Affiliation(s)
- Rachael L Murray
- Division of Epidemiology and Public Health, UK Centre for Tobacco Control Studies, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK.
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Niederdeppe J, Kuang X, Crock B, Skelton A. Media campaigns to promote smoking cessation among socioeconomically disadvantaged populations: what do we know, what do we need to learn, and what should we do now? Soc Sci Med 2008; 67:1343-55. [PMID: 18691793 DOI: 10.1016/j.socscimed.2008.06.037] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Indexed: 11/25/2022]
Abstract
Little is known about whether media campaigns are effective strategies to promote smoking cessation among socioeconomically disadvantaged populations or whether media campaigns may unintentionally maintain or widen disparities in smoking cessation by socioeconomic status (SES). This paper presents a systematic review of the literature on the effectiveness of media campaigns to promote smoking cessation among low SES populations in the USA and countries with comparable political systems and demographic profiles such as Canada, Australia and Western European nations. We reviewed 29 articles, summarizing results from 18 studies, which made explicit statistical comparisons of media campaign effectiveness by SES, and 21 articles, summarizing results from 13 studies, which assessed the effectiveness of media campaigns targeted specifically to low SES populations. We find that there is considerable evidence that media campaigns to promote smoking cessation are often less effective, sometimes equally effective, and rarely more effective among socioeconomically disadvantaged populations relative to more advantaged populations. Disparities in the effectiveness of media campaigns between SES groups may occur at any of three stages: differences in meaningful exposure, differences in motivational response, or differences in opportunity to sustain long-term cessation. There remains a need to conduct research that examines the effectiveness of media campaigns by SES; these studies should employ research designs that are sensitive to various ways that SES differences in smoking cessation media effects might occur.
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Affiliation(s)
- Jeff Niederdeppe
- Department of Communication, Cornell University, Ithaca, NY 14853-4203, United States.
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Pisinger C, Glümer C, Toft U, von Huth Smith L, Aadahl M, Borch-Johnsen K, Jørgensen T. High risk strategy in smoking cessation is feasible on a population-based level. The Inter99 study. Prev Med 2008; 46:579-84. [PMID: 18400285 DOI: 10.1016/j.ypmed.2008.02.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 11/14/2007] [Accepted: 02/15/2008] [Indexed: 11/25/2022]
Abstract
INTRODUCTION A high risk strategy is one of more strategies in public health. Smoking remains the most important contributor to the burden of disease in developed countries. METHODS A population-based multi-factorial intervention study, Inter99 (1999-2006), Copenhagen, Denmark, using a high risk strategy. All 2408 daily smokers were repeatedly offered individual face-to-face lifestyle counselling. Smokers in the high-intensity group were offered participation in smoking cessation groups. We measured point abstinence at 1, 3 and 5-year follow-up and compared with a control group, using adjusted intention-to treat analyses. RESULTS Compared with the control group it was twice as likely to be self-reported abstinent at 5-year follow-up in the high-intensity intervention group (OR: 2.19; 95%CI: 1.7-2.8; p<0.001). The effect of the intervention was significant, even when comparing validated abstinence in the intervention groups with self-reported abstinence in the control group (OR: 1.38; 95%CI: 1.1-1.8; p=0.014). Male gender, vocational training, higher age at onset of smoking, high knowledge of harm of smoking and lower tobacco consumption predicted abstinence. CONCLUSION A high risk strategy showed a significant effect on smoking in the long term. Proactive recruitment, face-to-face setting, repeated offer of assistance to quit and a multi-factorial approach may explain the success of the intervention.
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Affiliation(s)
- Charlotta Pisinger
- Research Centre for Prevention and Health, The Capital Region of Denmark, Denmark.
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Hutcheson TD, Greiner KA, Ellerbeck EF, Jeffries SK, Mussulman LM, Casey GN. Understanding Smoking Cessation in Rural Communities. J Rural Health 2008; 24:116-24. [DOI: 10.1111/j.1748-0361.2008.00147.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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King A, Sánchez-Johnsen L, Orman SV, Cao D, Matthews A. A Pilot Community-Based Intensive Smoking Cessation Intervention in African Americans: Feasibility, Acceptability and Early Outcome Indicators. J Natl Med Assoc 2008; 100:208-17. [DOI: 10.1016/s0027-9684(15)31209-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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