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Berry JA, Cranford J, Powell R. The Stress of Advancement: A Nurse Practitioner's Exploration in Providing Culturally Competent Obesity Prevention Counseling in Black Women. Health Promot Pract 2024:15248399231221767. [PMID: 38264870 DOI: 10.1177/15248399231221767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND Black women are diagnosed, disabled, and die from obesity and associated chronic diseases at higher rates than any other sex or race. Advanced practice registered nurses (APRN) can potentially improve culturally relevant health education and counseling by using health literacy communication tools. OBJECTIVE Explore individualized barriers and APRNs' role in providing obesity prevention education and counseling by assessing the efficacy of the Teach-Back Method (TBM) to understand health habits and attitudes. METHODS Black women aged 18-45, previously diagnosed as overweight or obese, and identified with perceived barriers were recruited from a predominantly Black church in Atlanta. They engaged in weekly, 1-hour educational sessions via Zoom, addressing four common barriers identified in the literature. Sessions ended with a 5-10 minute Teach-Back session. Pre- and post-intervention Readiness to Change Questionnaire (RCQ) were completed. Descriptive statistics and quantitative data from surveys and pre- and post-RCQ were analyzed. RESULTS Twenty women completed the intervention. Paired sample t-test revealed no statistical significance or correlation between pre- and post-RCQ scores after using TBM in educational sessions. However, Pearson's correlation showed positive associations between elevated body mass index levels as one advances their education and annual income, with a p-value of 0.05. DISCUSSION Increased rates of obesity are experienced despite higher educational attainment or pay. Stress and high-coping mechanisms contributed to disordered eating, decreased physical activity engagement, and decreased motivation toward habit change. Clinicians should be held accountable for delivering culturally sensitive care using the TBM, addressing social determinants of health, performing routine stress assessments, and checking their implicit biases.
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Affiliation(s)
- Jasmine A Berry
- VA Tennessee Valley Healthcare System, Geriatric Research Education and Clinical Center (GRECC), Nashville, TN, USA
- Georgia State University, Atlanta, GA, USA
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Janevic T, McCarthy K, Liu SH, Huyhn M, Kennedy J, Tai Chan H, Mayer VL, Vieira L, Tabaei B, Howell F, Howell E, Van Wye G. Racial and Ethnic Inequities in Development of Type 2 Diabetes After Gestational Diabetes Mellitus. Obstet Gynecol 2023; 142:901-910. [PMID: 37678923 PMCID: PMC10510784 DOI: 10.1097/aog.0000000000005324] [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: 02/06/2023] [Revised: 04/17/2023] [Accepted: 05/04/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To estimate racial and ethnic disparities in type 2 diabetes mellitus after gestational diabetes mellitus (GDM) and to investigate baseline pregnancy clinical and social or structural characteristics as mediators. METHODS We conducted a retrospective cohort of individuals with GDM using linked 2009-2011 New York City birth and hospital data and 2009-2017 New York City A1c Registry data. We ascertained GDM and pregnancy characteristics from birth and hospital records. We classified type 2 diabetes as two hemoglobin A 1c test results of 6.5% or higher. We grouped pregnancy characteristics into clinical (body mass index [BMI], chronic hypertension, gestational hypertension, preeclampsia, preterm delivery, caesarean, breastfeeding, macrosomia, shoulder dystocia) and social or structural (education, Medicaid insurance, prenatal care, and WIC [Special Supplemental Nutrition Program for Women, Infants, and Children] participation). We used Cox proportional hazards models to estimate associations between race and ethnicity and 8-year type 2 diabetes incidence, and we tested mediation of pregnancy characteristics, additionally adjusting for age and nativity (U.S.-born vs foreign-born). RESULTS The analytic data set included 22,338 patients with GDM. The 8-year type 2 diabetes incidence was 11.7% overall and 18.5% in Black, 16.8% in South and Southeast Asian, 14.6% in Hispanic, 5.5% in East and Central Asian, and 5.4% in White individuals with adjusted hazard ratios of 4.0 (95% CI 2.4-3.9), 2.9 (95% CI 2.4-3.3), 3.3 (95% CI 2.7-4.2), and 1.0 (95% CI 0.9-1.4) for each group compared with White individuals. Clinical and social or structural pregnancy characteristics explained 9.3% and 23.8% of Black, 31.2% and 24.7% of Hispanic, and 7.6% and 16.3% of South and Southeast Asian compared with White disparities. Associations between education, Medicaid insurance, WIC participation, and BMI and type 2 diabetes incidence were more pronounced among White than Black, Hispanic, and South and Southeast Asian individuals. CONCLUSION Population-based racial and ethnic inequities are substantial in type 2 diabetes after GDM. Characteristics at the time of delivery partially explain disparities, creating an opportunity to intervene on life-course cardiometabolic inequities, whereas weak associations of common social or structural measures and BMI in Black, Hispanic and South and Southeast Asian individuals demonstrate the need for greater understanding of how structural racism influences postpartum cardiometabolic risk in these groups.
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Affiliation(s)
- Teresa Janevic
- Department of Population Health Science and Policy, the Department of Obstetrics, Gynecology, and Reproductive Science, the Division of General Internal Medicine, Department of Medicine, and the Department of Maternal and Fetal Medicine, Icahn School of Medicine at Mount Sinai, and the Department of Health & Mental Hygiene, Bureau of Vital Statistics, New York, New York; and the Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Aderibigbe T, Walsh S, Henderson WA, Lucas RF. Psychometric testing of the breastfeeding self-efficacy scale to measure exclusive breastfeeding in African American women: a cross-sectional study. Front Public Health 2023; 11:1196510. [PMID: 37822543 PMCID: PMC10563511 DOI: 10.3389/fpubh.2023.1196510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
Background In United States, African American women are the least likely group to breastfeed exclusively compared with Hispanic and non-Hispanic white women. It is crucial to examine the perceived confidence of African American women towards practicing exclusive breastfeeding. Previous studies have examined breastfeeding self-efficacy and other factors influencing exclusive breastfeeding. However, there is no research on exclusive breastfeeding self-efficacy of this population. The purpose of this study was to examine the validity and reliability of the breastfeeding self-efficacy scale to measure exclusive breastfeeding, and the relationship between exclusive breastfeeding self-efficacy and general self-efficacy and demographic variables in African American women. Methods Descriptive cross-sectional design was used. A convenience sample of 53 pregnant African American women completed an online survey. Construct and criterion-related validity were assessed and reliability of the breastfeeding self-efficacy scale to measure exclusive breastfeeding (BSES-EBF) was examined using Cronbach's reliability. The general self-efficacy scale measured general self-efficacy. Descriptive statistics, bivariate correlation and non-parametric analyses were performed using statistical package for social sciences (v.28). Results The breastfeeding self-efficacy to measure exclusive breastfeeding scale had a Cronbach's alpha score of 0.907. One principal component was extracted from the BSES-EBF scale, with an Eigenvalue of 5.271 and which explained 58.57% of the variance in the instrument. The mean prenatal exclusive breastfeeding self-efficacy of participants was 35.15 (±7.41) from a range of 9 to 45. Exclusive breastfeeding was significantly associated with general self-efficacy (r = 0.503, p ≤ 0.001) and exclusive breastfeeding intention (p = 0.034). Conclusion Breastfeeding self-efficacy scale to measure exclusive breastfeeding is a valid and reliable tool to measure exclusive breastfeeding self-efficacy in African American women. African American women had high exclusive breastfeeding self-efficacy (internal motivation). Hence, there is a need to address breastfeeding barriers and provide access to culturally sensitive support (external motivation) to increase exclusive breastfeeding in African American women.
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Affiliation(s)
- Tumilara Aderibigbe
- School of Nursing, University of Connecticut, Storrs, CT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Stephen Walsh
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Wendy A. Henderson
- School of Nursing, University of Connecticut, Storrs, CT, United States
- School of Medicine, University of Connecticut, Storrs, CT, United States
| | - Ruth F. Lucas
- School of Nursing, University of Connecticut, Storrs, CT, United States
- School of Medicine, University of Connecticut, Storrs, CT, United States
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Sart G, Bayar Y, Danilina M. Impact of educational attainment and economic globalization on obesity in adult females and males: Empirical evidence from BRICS economies. Front Public Health 2023; 11:1102359. [PMID: 36866088 PMCID: PMC9971565 DOI: 10.3389/fpubh.2023.1102359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Obesity has considerably increased since 1980 and become a global epidemic. Obesity-related health problems and the negative social and economic implications of obesity have led international institutions and countries to combat it. This study investigates the role of educational attainment and economic globalization in the global prevalence of obesity in samples of adult females and males in BRICS economies for 1990-2016 through causality and cointegration tests. The results of the causality tests reveal that educational attainment and economic globalization have a significant influence on obesity in both adult females and males in the short run. Furthermore, cointegration analysis indicates a negative effect of educational attainment on obesity in all BRICS economies in the long run, but the influence of economic globalization on obesity differs among the BRICS economies. Furthermore, the negative influence of educational attainment on obesity is revealed to be relatively higher in females than males.
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Affiliation(s)
- Gamze Sart
- Department of Educational Sciences, Hasan Ali Yucel Faculty of Education, Istanbul University-Cerrahpaşa, Istanbul, Turkey,*Correspondence: Gamze Sart ✉
| | - Yilmaz Bayar
- Department of Public Finance, Faculty of Economics and Administrative Sciences, Bandirma Onyedi Eylul University, Bandirma-Balikesir, Turkey
| | - Marina Danilina
- Department of Economics, Plekhanov Russian University of Economics (PRUE), Moscow, Russia,Department of Economics, Financial University Under the Government of the Russian Federation, Moscow, Russia
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Brown NR, Wingate LT. The Influence of Memorable Message Receipt on Dietary and Exercise Behavior among Self-Identified Black Women. HEALTH COMMUNICATION 2022; 37:1157-1166. [PMID: 34402348 DOI: 10.1080/10410236.2021.1962587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Guided by Control Theory and the memorable messages framework, the current investigation examined the relationship between receipt of a health-related memorable message and self-reported diet and exercise behavior. A cross-sectional survey methodology was utilized to evaluate the relationship between receipt of a memorable message and dietary and exercise behaviors in a sample of Black women. Over 80% of the research sample (N = 121) reported receiving a memorable health message regarding diet and/or exercise. Women receiving a memorable message reported a significantly higher number of days engaging in healthy eating and exercise behaviors each week. Messages from medical professionals had the greatest impact on healthy dietary practices, while media-based messages were most influential on the enactment of exercise behavior. Additional research is warranted to determine how the utilization and reinforcement of memorable messages impacts health outcomes among Black women.
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Affiliation(s)
| | - La'Marcus T Wingate
- College of Pharmacy, Department of Clinical & Administrative Pharmacy Sciences, Howard University
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Strieter L, Besana T, Arena R, Hall G. Where are we now? The intersection of healthy living medicine and social justice within our school systems. Prog Cardiovasc Dis 2022; 71:43-50. [PMID: 35523310 DOI: 10.1016/j.pcad.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Abstract
Alongside the tensions brought forth by the pandemic, such as health and safety concerns from transmission and economic insecurity, there was also a rise in racial and social tension, bringing issues of equity and justice to the forefront. Consequently, there has been a call for reform and an urgency for change in legal, political, economic, and healthcare spheres. Change only occurs through change, with a pivotal point to target the beginning stages in life which will have a greater likelihood to subsist throughout the lifecourse. The crossroads of healthy living medicine (HLM) and education are an appropriate context for necessary change. If healthy living medicine is to embody the ideals of social justice, then people need equal access to resources of well-being - physical, social, and emotional - in their school systems. This paper examines the current intersection of health and social justice within the school systems in the United States. It is both a critique of how school systems have not yet provided such an intersection and highlight those efforts that have proven valuable and successful in providing HLM resources to populations that are historically under-resourced and under-served. Ultimately, this paper looks to provide a path forward, providing ideas for sustainable, feasible, actionable change in school systems K-12 and in higher education.
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Affiliation(s)
- Lindsey Strieter
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - Tiffany Besana
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Grenita Hall
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
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McMillian MM, Thorpe RJ. Relationships of Educational Attainment and Household Food Insecurity with Obesity: Findings from the 2007-2016 National Health and Nutrition Examination Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7820. [PMID: 34360113 PMCID: PMC8345562 DOI: 10.3390/ijerph18157820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to determine whether 1882 Black young adults' educational attainment was associated with their obesity ([BMI] ≥ 30) and whether this association varied with household food insecurity. Data from interviews with Black young adults and a medical examination from the 2007-2016 National Health and Nutrition Examination Survey were analyzed. Modified Poisson regressions with robust standard errors were used. Educational attainment was not associated with obesity (prevalence ratio [PR] = 1.05, 95% confidence interval [CI]: 0.85, 1.30) after adjusting for age, sex, marital status, smoking status, drinking status, income, health insurance status, physical activity level, and household food insecurity. The interaction between educational attainment and household food insecurity was also not significant (PR = 1.11, 95% CI: 0.56, 2.19) after adjusting for the same covariates. These findings indicated that college graduates were as likely to be obese as those with less education, and the relationship between educational attainment and obesity did not vary with household food insecurity. Future studies should conduct longitudinal analyses of these relationships. There is a need to identify the roles that education, household food insecurity, and other measures of socioeconomic status play in Black young adults' obesity.
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Affiliation(s)
- M. Monique McMillian
- Teacher Education and Professional Development, School of Education and Urban Studies, Morgan State University, Baltimore, MD 21251, USA
| | - Roland J. Thorpe
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
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Long C, Liu P, Yi C. Does Educational Attainment Affect Residents' Health? Healthcare (Basel) 2020; 8:healthcare8040364. [PMID: 32987916 PMCID: PMC7712141 DOI: 10.3390/healthcare8040364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 11/16/2022] Open
Abstract
Based on the data of the Chinese General Social Survey 2015 (CGSS2015), this article conducts an empirical analysis on the relationship between education and health status of Chinese residents by using the structural equation model (SEM), the propensity score matching (PSM) method, and generalized ordered logit (Gologit) model. Our study found that education promotes both the subjective and objective health of residents, and the finding holds true after considering the selection bias. In addition to having a direct role, education could promote health through improved mental health, economic status, and healthy behaviors. The finding is consistent with the explanations in existing research of “efficiency-improving effect”, “mental health effect”, and “budget relaxation effect”. Further research on the mechanism of education affecting health through structural equation modeling finds that mental health plays a more important role than healthy behaviors and economic status. In terms of the differences of various groups, education has stronger effect on vulnerable groups with fewer social resources, which shows that education helps reduce health inequality. The conclusion has important policy significance.
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Affiliation(s)
- Cuihong Long
- School of Economics, East China Normal University, Shanghai 200062, China; (C.L.); (P.L.)
| | - Pei Liu
- School of Economics, East China Normal University, Shanghai 200062, China; (C.L.); (P.L.)
| | - Chengzhi Yi
- School of International and Public Affairs, China Institute for Urban Governance, Shanghai Jiaotong University, Shanghai 200030, China
- Correspondence:
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