Multiple roles, multiple lives: the protective effects of role responsibilities on the health functioning of African American mothers

A scoping review of the concept of resilience among African American women

Resilience, thriving in the face of adversity, is a critical component of well-being in African American women. However, traditional definitions and approaches to operationalize resilience may not capture race- and gender-related resilience experiences of African American women. A more complete conceptualization of resilience may help facilitate future investigation of the mechanisms through which resilience influences health in this group. Our team conducted a scoping review of the literature published during twenty years, between 2000 and 2019, on resilience and health in African American women. We included a multidisciplinary set of databases (PubMed, CINAHL, PsycINFO, Scopus, Social Work Abstracts, Sociological Abstracts, Academic Search Premier). Using Covidence software a multi-step review process was conducted; 904 abstracts were initially screened for eligibility, 219 full-text studies were screened in stage two, and 22 remaining studies were reviewed for extraction. The studies reviewed revealed limitations of unidimensional approaches to conceptualizing/operationalizing resilience in African American women. The review highlighted culturally-relevant components of resilience including spirituality/religion, strength, survival, active coping, and social support. Findings highlight the importance of operationalizing resilience as a multidimensional construct so it can be optimally included in research designed to investigate the quality of life, cardiovascular risk, and other health outcomes in African American women.

Socioeconomic inequalities in type 2 diabetes comorbidities in different population subgroups: trend analyses using German health insurance data

While socioeconomic inequalities in the prevalence and management of type 2 diabetes (T2D) are well established, little is known about whether inequalities exist in the prevalence and the temporal development of T2D comorbidities. Previous research points towards expansion of morbidity in T2D as depicted mainly by a rising trend of T2D comorbidities. Against this background, and using German claims data, this study aims to examine whether socioeconomic status (SES) inequalities exist in the rates and the temporal development of T2D comorbidities. Since previous research indicates varying risk levels for T2D prevalence in the population subgroups: working individuals, nonworking spouses and pensioners, the analyses are stratified by these three population subgroups. The study is done on a large population of statutory insured individuals with T2D in three time-periods between 2005 and 2017. Predicted probabilities of three comorbidity groups and the number of comorbidities were estimated using logistic and ordinal regression analyses among different income, education and occupation groups. Interaction analyses were applied to examine whether potential SES inequalities changed over time. The study showed that neither the cross-sectional existence, nor the temporal development of T2D comorbidities differed significantly among SES groups, ruling out SES inequalities in the prevalence and the temporal development of T2D comorbidities in Germany. In men and women of all examined population subgroups, predicted probabilities for less severe cardiovascular (CVD) comorbidities, other vascular diseases and the number of comorbidities per individual rose significantly over time regardless of SES, but little if any change took place for more severe CVD comorbidities. Another important finding is that the population subgroup of nonworking spouses had markedly higher predicted probabilities for most of the examined outcomes compared to working individuals. The study indicates that the expansion of morbidity in T2D in Germany does not appear to be SES-dependent, and applies equally to different population subgroups. Yet, the study highlights that nonworking spouses are a susceptible population subgroup that needs to be focused upon when planning and implementing T2D management interventions.

Domestic violence survivors' housing stability, safety, and well-being over time: Examining the role of domestic violence housing first, social support, and material hardship

Intimate partner violence remains a significant public health issue and survivors often need various forms of support to achieve safety. The increased likelihood of experiencing housing instability and homelessness among survivors has led to an uptake in domestic violence agencies implementing housing-based interventions, such as Domestic Violence Housing First (DVHF), to address survivors' needs. The present study expands on prior research supporting the effectiveness of DVHF to examine situational factors that moderate the outcomes associated with this model among 406 survivors seeking services from domestic violence agencies located in the Pacific Northwestern region of the United States. Using latent profile analysis, participants were grouped into three latent classes: (a) "high abuse/instability," (b) "still affected," and (c) "doing better." Latent transition analysis was used to estimate the probability that participants would transition into a different latent class over time with social support (SS), material hardship, and receipt of DVHF services included as model predictors. Receipt of DVHF predicted improvements in survivors' safety, housing stability, mental health, and well-being, such that receiving DVHF was associated with higher odds of survivors transitioning into the "doing better" class. Social support and material hardship also emerged as significant factors predicting class membership, such that higher levels of social support and financial stability predicted membership in the "doing better" class. Additionally, social support and financial stability appeared to augment receipt of DVHF services, with DVHF being more strongly associated with positive outcomes among participants who also had high levels of social support and lower levels of material hardship. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Beliefs and willingness towards participating in genetic testing for depression in low-income and racial/ethnic minority mothers at-risk

PURPOSE

To identify mothers' salient normative, behavioral and control beliefs and willingness towards participating in genetic salivary testing for depression.

DESIGN

A qualitative, descriptive design was employed. 41 multi-ethnic mothers completed surveys that underwent directed content analysis according to The Theory of Planned Behavior. Percentages and frequency counts were used to categorize responses and calculate willingness.

FINDINGS

Salient beliefs included: Behavioral: Finding a cure/treatment for depression (29.3 %), Normative: Family would approve (46.3 %), and Church associates would disapprove (19.5 %).

CONTROL

Lacking information/explanations (34.1 %) as barriers, convenient locations (24.4 %) as facilitators. Most mothers indicated a willingness to participate (90.2 %).

CONCLUSIONS

Interventions should target families, emphasize benefits, explain purposes and procedures, and use community based participatory methods.

An Intersectional Analysis of Women's Social Role Engagement and Mental Health

Objective

Guided by role theory and the intersectionality framework, this study assesses whether social role volume, role type, and role configuration influence the mental health of Non-Latina White, African American, Afro-Caribbean, Mexican, Cuban, Puerto Rican, Chinese, Filipina, and Vietnamese American women.

Background

Contemporary shifts in the primary roles (i.e., worker, spouse, parent) women occupy and in the ethnic composition of the U.S. necessitate a re-examination of how roles impact U.S. women's mental health. Moreover, family member and friend roles are relatively understudied.

Method

Drawing data from the nationally representative Collaborative Psychiatric Epidemiology Surveys (CPES) (N=7370), ordinary least squares (OLS) regression analysis is used to assess the relationship between role volume, role type, role configuration, and mental health for women across nine ethnic groups. We report ethnicity-stratified models.

Results

On one hand, role accumulation was psychologically beneficial for Non-Latina White, African American, Puerto Rican, and Chinese women. On the other hand, the psychological benefits of social roles diminished after accumulating three social roles for Cuban, Mexican, and Filipina women. The psychological influence of specific roles and role configurations for women was dependent on ethnicity.

Conclusion

This study demonstrates the powerful impact of ethnicity on social role engagement as well as the influence of such roles on women's psychological health.

When the Bough Breaks: A systematic review and meta-analysis of mental health symptoms in mothers of young children during the COVID-19 pandemic

Parents have experienced considerable challenges and stress during the COVID‐19 pandemic, which may impact their well‐being. This meta‐analysis sought to identify: (1) the prevalence of depression and anxiety in parents of young children (<age 5) during the COVID‐19 pandemic, and (2) sociodemographic (e.g., parent age, being racially minoritized) and methodological moderators (e.g., study quality) that explain heterogeneity among studies. A systematic search was conducted across four databases from January 1, 2020 to March 3, 2021. A total of 18 non‐overlapping studies (8981 participants), all focused on maternal mental health, met inclusion criteria. Random‐effect meta‐analyses were conducted. Pooled prevalence estimates for clinically significant depression and anxiety symptoms for mothers of young children during the COVID‐19 pandemic were 26.9% (95% CI: 21.3–33.4) and 41.9% (95% CI: 26.7–58.8), respectively. Prevalence of clinically elevated depression and anxiety symptoms were higher in Europe and North America and among older mothers. Clinically elevated depressive symptoms were lower in studies with a higher percentage of individuals who were racially minoritized. In comparison, clinically elevated anxiety symptoms were higher among studies of low study quality and in samples with highly educated mothers. Policies and resources targeting improvements in maternal mental health are essential.

How does role accumulation enhance career adaptability? A dual mediation analysis

Investigating the contributing factors of career adaptability has always been an important topic in the field of vocational psychology research. From the perspective of person-environment interaction, this study introduced the role accumulation theory into the researches of career adaptability. Using a sample of 379 Chinese college students (mean age = 20.36 years, SD = 1.67), a model of role accumulation affecting college students’ career adaptability was constructed, and the parallel mediating mechanisms of self-efficacy and social support were also discussed. Participants filled out questionnaires regarding role accumulation, self-efficacy, social support, and career adaptability. The results of structural equation modeling (SEM) showed that: (1) Role accumulation positively predicted career adaptability in college students; (2) Role accumulation also indirectly predicted career adaptability through self-efficacy and social support. The present study is the first to validate the psychological pathways linking role accumulation to career adaptability via self-efficacy and social support. The contribution of this study to the literature is to provide a new perspective that can clarify the predictors of career adaptability. In addition, for educational administrators and career practitioners, targeting role accumulation is valuable for developing college students’ career adaptability.

Gender, Race and Parenthood Impact Academic Productivity During the COVID-19 Pandemic: From Survey to Action

The coronavirus disease 2019 (COVID-19) pandemic is altering dynamics in academia, and people juggling remote work and domestic demands - including childcare - have felt impacts on their productivity. Female authors have faced a decrease in paper submission rates since the beginning of the pandemic period. The reasons for this decline in women's productivity need to be further investigated. Here, we analyzed the influence of gender, parenthood and race on academic productivity during the pandemic period based on a survey answered by 3,345 Brazilian academics from various knowledge areas and research institutions. Productivity was assessed by the ability to submit papers as planned and to meet deadlines during the initial period of social isolation in Brazil. The findings revealed that male academics - especially those without children - are the least affected group, whereas Black women and mothers are the most impacted groups. These impacts are likely a consequence of the well-known unequal division of domestic labor between men and women, which has been exacerbated during the pandemic. Additionally, our results highlight that racism strongly persists in academia, especially against Black women. The pandemic will have long-term effects on the career progression of the most affected groups. The results presented here are crucial for the development of actions and policies that aim to avoid further deepening the gender gap in academia.

Gender, Race and Parenthood Impact Academic Productivity During the COVID-19 Pandemic: From Survey to Action

The coronavirus disease 2019 (COVID-19) pandemic is altering dynamics in academia, and people juggling remote work and domestic demands - including childcare - have felt impacts on their productivity. Female authors have faced a decrease in paper submission rates since the beginning of the pandemic period. The reasons for this decline in women's productivity need to be further investigated. Here, we analyzed the influence of gender, parenthood and race on academic productivity during the pandemic period based on a survey answered by 3,345 Brazilian academics from various knowledge areas and research institutions. Productivity was assessed by the ability to submit papers as planned and to meet deadlines during the initial period of social isolation in Brazil. The findings revealed that male academics - especially those without children - are the least affected group, whereas Black women and mothers are the most impacted groups. These impacts are likely a consequence of the well-known unequal division of domestic labor between men and women, which has been exacerbated during the pandemic. Additionally, our results highlight that racism strongly persists in academia, especially against Black women. The pandemic will have long-term effects on the career progression of the most affected groups. The results presented here are crucial for the development of actions and policies that aim to avoid further deepening the gender gap in academia.

The role of perceived thought control ability in the psychological functioning of Black American mothers

OBJECTIVES

The purpose of the study was to investigate the extent to which perceived thought control ability (PTCA) promotes the psychological functioning of Black American mothers, as well as moderates the negative effects of key stressors faced by this population, including discrimination experiences, financial strain, and parenting stress.

METHODS

An online survey was administered to 305 Black American mothers across the U.S. Participants completed measures of PTCA, psychological well-being (life satisfaction and emotional well-being), psychological distress (depressive and anxiety symptoms), and stressors (discrimination experiences, financial strain, and parenting stress).

RESULTS

Discrimination experiences, financial strain, and parenting stress were related to higher anxiety and depressive symptoms. Financial strain and parenting stress were also related to lower life satisfaction and emotional well-being. PTCA protected against the link between discrimination experiences and depressive symptoms (β = -.15, p < .001), discrimination experiences and anxiety (β = -.15, p < .001), and parenting stress on anxiety (β = .08, p = .04). PTCA also was associated with higher life satisfaction (β =.19, p = .001) and emotional well-being (β =.42, p < .001).

CONCLUSIONS

This study provides evidence that PTCA is a culturally relevant and practical psychological resource for psychological functioning among Black American mothers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Socioeconomic inequalities in type 2 diabetes in employed individuals, nonworking spouses and pensioners

Type 2 diabetes (T2D) is a rising global epidemic with lower socioeconomic groups being more affected. Considering specific population subgroups to examine prevalence and socioeconomic inequalities in T2D is rare. Moreover, using one indicator to depict socioeconomic inequalities in health is a common practice despite evidence on differences in what different socioeconomic indicators ought to measure. This study has two aims:

1. Examine the prevalence of T2D in employed individuals, nonworking spouses and pensioners.

2. Examine socioeconomic inequalities in T2D in the three population subgroups and determine the explanatory power of income, education and occupation in employed individuals and nonworking spouses.

This study is based on claims data from a statutory health insurance provider in Lower Saxony, Germany. T2D prevalence in the period between 2013 and 2017 was examined in employed individuals, nonworking spouses and pensioners. Multivariate logistic regression analysis was applied to examine socioeconomic inequalities in T2D in the three population subgroups. Explanatory power of the three socioeconomic indicators was determined by deviance analysis.

Results showed that T2D prevalence was four times higher in male nonworking spouses (24.2%) and 2.6 times higher in female nonworking spouses (12.7%) compared to employed men (6.4%) and women (4.7%) respectively, while it accounted for 40% of men and 36% of women in pensioners. T2D inequalities emerged for all three socioeconomic indicators and were observed in the three subgroups. School education had the highest explanatory power in employed men and women and male nonworking spouses.

Nonworking spouses are an important target group in T2D prevention interventions. The three socioeconomic indicators have independent effects and differ in their explanatory power where low school education appears to be a major risk factor. It can be discussed that health literacy and the associated health behavior play a role in mediating the association between school education and T2D.

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Different population subgroups have varying risk levels for type 2 diabetes prevalence.

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The population subgroup “nonworking spouses” is an important target group for type 2 diabetes prevention interventions.

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Education, occupation and income have different explanatory powers in health inequalities.

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The level of school education is an important determinant of health inequalities in type 2 diabetes.

Financial Strain and Contraceptive Use Among Women in the United States: Differential Effects by Age

INTRODUCTION

Low-income and young women experience disproportionately high rates of unintended pregnancy. Traditional measures of socioeconomic status may not be appropriate indicators of financial status, particularly during emerging adulthood. This study investigates the relationship between financial strain and contraceptive use, focusing on the differential effects by age group.

METHODS

Multinomial logistic regression analyses assessed the relationship between financial strain and contraceptive use in a national sample of U.S. women ages 18-39 years (N = 932). Models were adjusted for income, employment status, and other sociodemographic characteristics and tested the interaction of financial strain and age group.

RESULTS

Women with high financial strain were less likely to use short-acting methods (compared with using no method) in the adjusted model; when the age and financial strain interaction was included, associations held only for women ages 18-24 and 25-29 years of age. Relative to contraceptive nonuse, women ages 18-24 years with high financial strain were less likely to use long-acting reversible (relative risk ratio [RRR], 0.10; 95% confidence interval [CI], 0.01-0.99) and short-acting hormonal (RRR, 0.03; 95% CI, 0.00-0.18) methods. Women ages 25-29 with high financial strain were less likely to use short-acting hormonal (RRR, 0.20; 95% CI, 0.05-0.87) and coital-specific (RRR, 0.11; 95% CI, 0.02-0.51) methods.

IMPLICATIONS FOR PRACTICE AND/OR POLICY

Young women may be vulnerable to the effect of high financial strain on contraceptive nonuse. Providers working with this group should consider incorporating financial strain into screening tools to identify patients who may need extra attention in contraceptive decision-making conversations. Antipoverty programs could also have a positive effect on effective contraceptive use.

Toxic Stress and Vulnerable Mothers: A Multilevel Framework of Stressors and Strengths

Toxic stress is associated with poor health outcomes that extend across the life span. Although caregivers can protect their children from toxic stress through supportive caregiving, this can be challenging for vulnerable mothers living in socioeconomically disadvantaged environments. We aim to advance the science of toxic stress prevention by exploring the stressors and strengths experienced by vulnerable mothers through application of a theoretical framework, Bronfenbrenner's bioecological model. Following Arksey and O'Malley's five-stage scoping study framework, 179 articles were included. Key information was abstracted and each article was reviewed for relevance to the bioecological model. Results revealed that the sources of stress and strength are multilayered, transactional, and have a complex influence on caregiving in families at risk of toxic stress. Future research should include empirical investigations of the complex relationships among these stressors and strengths, and the development of preventive interventions to support vulnerable families at risk of toxic stress.

A family-based model for Iranian women's health: a grounded theory study

Background

In many societies, women are vulnerable to specific situations and inequalities, which may negatively impact their own and their family's health. The purpose of this qualitative study was to explore Iranian women's perspectives on this issue and to develop a categorical model for their health.

Methods

The study was conducted using a grounded theory approach via 25 semi-structured interviews.

Results

The results revealed that family dynamism was the core variable and identified four main categories: understanding of health, reduction of women's health, the pleasure and difficulties of motherhood, cultural and/or social factors influencing women's health.

Conclusion

Policymakers should consider policies that empower women, reduce gender inequality and provide social security to maximize the probability of women being healthy.

"It's Not All About My Baby's Sleep": A Qualitative Study of Factors Influencing Low-Income African American Mothers' Sleep Quality

Low-income African American mothers are at particular risk for poor postpartum sleep. This study sought to understand facilitators and barriers that exist to getting a good night's sleep among these high-risk mothers. Semistructured interviews with 18 low-income African Americans (3-6 months postpartum) were conducted. Most mothers described their own sleep quality to be poor, despite the fact that their babies' sleep improved substantially from the newborn period. Mothers kept themselves awake due to their own internal worry and anxiety, along with external factors that were largely independent of babies' sleep, including work and school commitments and the home environment. For the few mothers with good sleep quality, time management and family support were strong facilitators. Findings lay the groundwork for sleep improvement interventions.

Stress and the multiple-role woman: taking a closer look at the "superwoman"

In the academic literature there is debate as to whether women who engage in multiple social roles experience more or less stress than women in fewer roles. For the present research we examined the relationship between levels of engagement in seven distinct roles and perceived stress and life satisfaction in a small non-random sample of women in North America (N = 308). We did not find a significant correlation between role engagement and perceived stress, though we did find a small but significant positive correlation between role engagement and life satisfaction. Similarly, in a subset of the participants (N = 31), there was not a significant relationship between the level of role engagement and physiological stress as measured by hair or urinary cortisol levels. We found a significant negative correlation between perceived stress and life satisfaction, and role satisfaction. The results from multiple regression models did not identify the level of role engagement as a significant predictor of either perceived stress or life satisfaction. Role satisfaction in addition to several life style variables such as the frequency of sex and exercise were identified as significant predictors of both outcome variables. We also examined the popularized notion of the "superwoman", which we defined as women who fell within the 4th quartile of role engagement, or those engaged in the wife/mother/worker/homemaker role combination. Based on popular discourses surrounding the superwoman we expected that superwomen would exhibit higher levels of perceived stress. Our results revealed that superwomen do not experience a significantly higher level of perceived stress than non-superwomen. The results of our study therefore suggest that multiple role engagement in women, even at a relatively high level as experienced by "superwomen", is not associated with significantly higher stress, or reduced life satisfaction.

Family Functioning and Stress in African American Families

Having social support substantially reduces the effects of stressful experiences. Family relationships are central components of social support for African Americans. In a community-based sample of African Americans ( n = 255), the relationship between family functioning and stress was examined, as well as possible mediators of this relationship, independent of demographic variables. Using multiple regression analysis, close and flexible family relationships were linked to lower perceived stress levels. The association of family functioning and stress operated through the internal processes of anxiety, depression, daily hassles, and higher hardiness and explained more than half of the variance in stress levels. These findings also remained above and beyond the known stressor of discrimination and the known stress reducer of spirituality. These findings suggest that expanding traditional stress management programs to include strategies for bolstering family functioning could have significant benefits.

Progression of coronary artery calcification in black and white women: do the stresses and rewards of multiple roles matter?

BACKGROUND

Black women experience higher rates of cardiovascular disease (CVD) than white women, though evidence for racial differences in subclinical CVD is mixed. Few studies have examined multiple roles (number, perceived stress, and/or reward) in relation to subclinical CVD, or whether those effects differ by race.

PURPOSE

The aim of this study was to investigate the effects of multiple roles on 2-year progression of coronary artery calcium.

METHODS

Subjects were 104 black and 232 white women (mean age 50.8 years). Stress and reward from four roles (spouse, parent, employee, caregiver) were assessed on five-point scales. Coronary artery calcium progression was defined as an increase of ≥10 Agatston units.

RESULTS

White women reported higher rewards from their multiple roles than black women, yet black women showed cardiovascular benefits from role rewards. Among black women only, higher role rewards were related significantly to lower progression of coronary artery calcium, adjusting for body mass index, blood pressure, and other known CVD risk factors. Blacks reported fewer roles but similar role stress as whites; role number and stress were unrelated to coronary artery calcium progression.

CONCLUSION

Rewarding roles may be a novel protective psychosocial factor for progression of coronary calcium among black women.

The mediating role of social support, cognitive appraisal, and quality health care in black mothers' stress-resilience process following loss to gun violence

Although much attention has been granted to the perpetrators and victims of gun violence, limitations exist in our understanding of the psychological well-being of parents grieving children lost to gun violence. The purpose of this study was to examine the mediating effects of social support, cognitive appraisal, and quality health care on the relationship between traumatic stress and resilience among Black mothers bereaving children to gun violence. A cross-sectional design and network sampling method were used to recruit 48 Black mothers living in a large Canadian city. Participants completed a survey either by phone or in person. Social support and positive appraisal were found to be protective factors of resilience for study participants. The traumatic stress experienced by the sample decreased with increased social support (beta = -.291, p = .045), leading to an increase of their resilience (beta = .297, p = .032). With positive appraisal of the loss, the stress levels of study participants decreased (beta = -.334, p = .023), leading to increased resilience (beta = .441, p = .003). Quality health care showed a significant positive relationship with the resilience of the women (beta = .313, p = .023) but did not mediate the relationship between their stress and resilience. For Black mothers who experience loss of a child to gun violence, policy and social change efforts should focus on strengthening their access to formal and informal supports and improving their abilities to find meaning in their loss.

Mind-Body Interventions to Reduce Risk for Health Disparities Related to Stress and Strength Among African American Women: The Potential of Mindfulness-Based Stress Reduction, Loving-Kindness, and the NTU Therapeutic Framework

In the current article, the authors examine the potential role of mind-body interventions for preventing or reducing health disparities in a specific group-African American women. The authors first discuss how health disparities affect this group, including empirical evidence regarding the influence of biopsychosocial processes (e.g., psychological stress and social context) on disparate health outcomes. They also detail how African American women's unique stress experiences as a result of distinct sociohistorical and cultural experiences related to race and gender potentially widen exposure to stressors and influence stress responses and coping behaviors. Using two independent, but related, frameworks (Superwoman Schema [SWS] and the Strong Black Woman Script [SBW-S]), they discuss how, for African American women, stress is affected by "strength" (vis-à-vis resilience, fortitude, and self-sufficiency) and the emergent health-compromising behaviors related to strength (e.g., emotional suppression, extraordinary caregiving, and self-care postponement). The authors then describe the potential utility of three mind-body interventions-mindfulness-based stress reduction (MBSR), loving-kindness meditation (LKM), and NTU psychotherapy-for specifically targeting the stress-, strength-, and contextually related factors that are thought to influence disparate outcomes for African American women. Self-awareness, self-care, inter- and intrapersonal restorative healing and a redefinition of inner strength may manifest through developing a mindfulness practice to decrease stress-related responses; using LKM to cultivate compassion and forgiveness for self and others; and the balance of independence and interdependence as a grounding NTU principle for redefining strength. The authors conclude with a discussion of potential benefits for integrating key aspects of the interventions with recommendations for future research.

Pleasing the masses: messages for daily life management in African American women's popular media sources

OBJECTIVES

Using African American women's insights on their own health experiences, we explored how their daily life management was linked to the "strong Black woman" (SBW) script, and the health implications of that script.

METHODS

Using the search term "strong Black woman," we identified 20 articles from African American women's magazines and 10 blog sites linked to the SBW script and analyzed their content. We created thematic categories (role management, coping, and self-care) and extracted issues relevant to African American women's health.

RESULTS

Adherence to the SBW script was linked to women's daily life management and health experiences. Themes such as self-sacrificial role management ("please the masses"), emotional suppression ("game face"), and postponement of self-care ("last on the list") incited internal distress and evinced negative health consequences.

CONCLUSIONS

Scientists, activists, and health care professionals would be aided in forming initiatives aimed at reducing health disparities among African American women by heeding the insights on their health experiences that they express in popular media sources.