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Clark EM, Ma L, Rigdon SE, Williams BR, Park CL, Ghosh D, Woodard N, Knott CL. Identifying Variation in Physical Health Behaviors and Depressive Symptoms among Religiosity Clusters of African American Adults in the United States. JOURNAL OF RELIGION AND HEALTH 2024; 63:3027-3049. [PMID: 38970680 DOI: 10.1007/s10943-024-02074-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/08/2024]
Abstract
Religiosity is an important factor in the lives of many African Americans, who suffer a greater health burden than their White counterparts. In this study, we examined associations between dimensions of religiosity with health behaviors and depressive symptoms in a sample of African American adults in the United States. Participants (N = 2086) completed five measures of religiosity (religious involvement, positive and negative religious coping, scriptural influence, belief in illness as punishment for sin) and measures of several health behaviors, cancer screening behaviors, and depressive symptoms. Using cluster analysis to examine the deep structure of religiosity, three clusters emerged: Positive Religious, Negative Religious, and Low Religious. In general, the Positive Religious group engaged in more healthy behaviors (e.g., fruit and vegetable consumption, fecal occult blood test) and fewer risky health behaviors (e.g., smoke and consume alcohol), and reported fewer depressive symptoms than did the Negative Religious and/or Low Religious groups. Theoretical implications and implications for interventions by clergy and mental health professionals are discussed.
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Affiliation(s)
- Eddie M Clark
- Department of Psychology, Saint Louis University, Morrissey Hall, 3700 Lindell Blvd., St. Louis, MO, 63108, USA.
| | - Lijing Ma
- Department of Psychology, University of San Francisco, San Francisco, CA, USA
| | - Steven E Rigdon
- Department of Epidemiology and Biostatistics, Saint Louis University, St. Louis, MO, USA
| | - Beverly R Williams
- Division of Gerontology, Geriatrics, and Palliative Care of the Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut - Storrs, Storrs, CT, USA
| | - Debarchana Ghosh
- Department of Geography, University of Connecticut - Storrs, Storrs, CT, USA
| | - Nathaniel Woodard
- Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
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2
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Duckett KA, Kassir MF, Nguyen SA, Brennan EA, Chera BS, Sterba KR, Halbert CH, Hill EG, McCay J, Puram SV, Jackson RS, Sandulache VC, Kahmke R, Osazuwa-Peters N, Ramadan S, Nussenbaum B, Alberg AJ, Graboyes EM. Factors Associated with Head and Neck Cancer Postoperative Radiotherapy Delays: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2024. [PMID: 38842034 DOI: 10.1002/ohn.835] [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: 03/03/2024] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE Initiating postoperative radiotherapy (PORT) within 6 weeks of surgery for head and neck squamous cell carcinoma (HNSCC) is included in the National Comprehensive Cancer Network Clincal Practice Guidelines and is a Commission on Cancer quality metric. Factors associated with delays in starting PORT have not been systematically described nor synthesized. DATA SOURCES PubMed, Scopus, and CINAHL. REVIEW METHODS We included studies describing demographic characteristics, clinical factors, or social determinants of health associated with PORT delay (>6 weeks) in patients with HNSCC treated in the United States after 2003. Meta-analysis of odds ratios (ORs) was performed on nonoverlapping datasets. RESULTS Of 716 unique abstracts reviewed, 21 studies were included in the systematic review and 15 in the meta-analysis. Study sample size ranged from 19 to 60,776 patients. In the meta-analysis, factors associated with PORT delay included black race (OR, 1.46, 95% confidence interval [CI]: 1.28-1.67), Hispanic ethnicity (OR, 1.37, 95% CI, 1.17-1.60), Medicaid or no health insurance (OR, 2.01, 95% CI, 1.90-2.13), lower income (OR, 1.38, 95% CI, 1.20-1.59), postoperative admission >7 days (OR, 2.92, 95% CI, 2.31-3.67), and 30-day hospital readmission (OR, 1.37, 95% CI, 1.29-1.47). CONCLUSION Patients at greatest risk for a delay in initiating guideline-adherent PORT include those who are from minoritized communities, of lower socioeconomic status, and experience postoperative challenges. These findings provide the foundational evidence needed to deliver targeted interventions to enhance equity and quality in HNSCC care delivery.
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Affiliation(s)
- Kelsey A Duckett
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Mohamed Faisal Kassir
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Emily A Brennan
- MUSC Libraries, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Bhisham S Chera
- Department of Radiation Oncology, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Chanita Hughes Halbert
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Elizabeth G Hill
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jessica McCay
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
- Department of Genetics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Ryan S Jackson
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Vlad C Sandulache
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
- ENT Section, Operative CareLine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Russel Kahmke
- Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, USA
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Salma Ramadan
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Brian Nussenbaum
- American Board of Otolaryngology-Head and Neck Surgery, Houston, Texas, USA
| | - Anthony J Alberg
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
| | - Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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3
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Wang Y, Thier K, Ntiri SO, Quinn SC, Adebamowo C, Nan X. Beliefs in COVID-19 Vaccine Misinformation Among Unvaccinated Black Americans: Prevalence, Socio-Psychological Predictors, and Consequences. HEALTH COMMUNICATION 2024; 39:616-628. [PMID: 36794382 DOI: 10.1080/10410236.2023.2179711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Health-related misinformation is a major threat to public health and particularly worrisome for populations experiencing health disparities. This study sets out to examine the prevalence, socio-psychological predictors, and consequences of beliefs in COVID-19 vaccine misinformation among unvaccinated Black Americans. We conducted an online national survey with Black Americans who had not been vaccinated against COVID-19 (N = 800) between February and March 2021. Results showed that beliefs in COVID-19 vaccine misinformation were prevalent among unvaccinated Black Americans with 13-19% of participants agreeing or strongly agreeing with various false claims about COVID-19 vaccines and 35-55% unsure about the veracity of these claims. Conservative ideology, conspiracy thinking mind-set, religiosity, and racial consciousness in health care settings predicted greater beliefs in COVID-19 vaccine misinformation, which were associated with lower vaccine confidence and acceptance. Theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Yuan Wang
- Department of Communication, University of Maryland, College Park
| | - Kathryn Thier
- Department of Communication, University of Maryland, College Park
| | - Shana O Ntiri
- Department of Family & Community Medicine, University of Maryland, School of Medicine, Baltimore
| | - Sandra Crouse Quinn
- Department of Family Science, University of Maryland, School of Public Health, College Park
| | - Clement Adebamowo
- Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore
| | - Xiaoli Nan
- Department of Communication, University of Maryland, College Park
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4
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Woodard N, Butler J, Ghosh D, Green KM, Knott CL. The Association between State-Level Structural Racism and Alcohol and Tobacco Use Behaviors among a National Probability Sample of Black Americans. Cancer Epidemiol Biomarkers Prev 2024; 33:261-269. [PMID: 38032218 PMCID: PMC10872984 DOI: 10.1158/1055-9965.epi-23-0873] [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: 07/27/2023] [Revised: 10/24/2023] [Accepted: 11/28/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Structural racism is how society maintains and promotes racial hierarchy and discrimination through established and interconnected systems. Structural racism is theorized to promote alcohol and tobacco use, which are risk factors for adverse health and cancer-health outcomes. The current study assesses the association between measures of state-level structural racism and alcohol and tobacco use among a national sample of 1,946 Black Americans. METHODS An existing composite index of state-level structural racism including five dimensions (subscales; i.e., residential segregation and employment, economic, incarceration, and educational inequities) was merged with individual-level data from a national sample dataset. Hierarchical linear and logistic regression models, accounting for participant clustering at the state level, assessed associations between structural racism and frequency of alcohol use, frequency of binge drinking, smoking status, and smoking frequency. Two models were estimated for each behavioral outcome, one using the composite structural racism index and one modeling dimensions of structural racism in lieu of the composite measure, each controlling for individual-level covariates. RESULTS Results indicated positive associations between the incarceration dimension of the structural racism index and binge drinking frequency, smoking status, and smoking frequency. An inverse association was detected between the education dimension and smoking status. CONCLUSIONS Results suggest that state-level structural racism expressed in incarceration disparities, is positively associated with alcohol and tobacco use among Black Americans. IMPACT Addressing structural racism, particularly in incarceration practices, through multilevel policy and intervention may help to reduce population-wide alcohol and tobacco use behaviors and improve the health outcomes of Black populations.
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Affiliation(s)
- Nathaniel Woodard
- Cancer Care Quality Training Program, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James Butler
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| | - Debarchana Ghosh
- Department of Geography, University of Connecticut, University of Connecticut, Storrs, CT, USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| | - Cheryl L. Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
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5
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Lateef H, Baldwin-White A, Jellesma F, Borgstrom E, Nartey P. Afrocentric Cultural Norms, Mental Health Functioning, and the Perception of Intimate Partner Violence Among Young Black Men. J Racial Ethn Health Disparities 2024; 11:505-515. [PMID: 36849861 DOI: 10.1007/s40615-023-01536-2] [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: 10/25/2022] [Revised: 01/21/2023] [Accepted: 02/10/2023] [Indexed: 03/01/2023]
Abstract
Intimate partner violence (IPV) is a serious public health concern that profoundly impacts the lives of women globally. While IPV cuts across race, socioeconomic status, age groups, and geography, Black women are disproportionately affected. Prior studies report that Black women predominantly couple with Black men and thus, understanding factors associated with IPV perpetration among Black men is essential. Subsequently, the present study explored an important gap in the literature, exploring how collectivism, a core belief ascribed to Afrocentric cultural norms, and factors associated with mental health functioning in emerging adult Black men in the USA is associated with their views of IPV. Data for the study was drawn from a sample of self-identifying Black American males between the ages of 18 and 25 (n=300). Regression analysis demonstrated no significant relationship between age, household income, and education level among participants. Anxiety had a significant relationship with intimate partner beliefs with participants with increased anxiety having more problematic intimate partner beliefs. A model including anxiety, collectivism, and aggressiveness was a significant predictor of problematic intimate partner beliefs. In the final model, collectivism and aggressiveness were statistically significant predictors of perceptions endorsing IPV. Participants who reported higher levels of global aggressive confrontation with others were more likely to endorse IPV. Overall, participants with a sense of value for collectivism over individualism were least likely to endorse IPV. This study provides evidence that cultural norms potentially have a role in Black men's beliefs about IPV. Implications for future research are provided.
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Affiliation(s)
- Husain Lateef
- Washington University in St. Louis, St. Louis, MO, 63130, USA.
| | | | | | - Ellie Borgstrom
- Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Portia Nartey
- Washington University in St. Louis, St. Louis, MO, 63130, USA
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Moss J, Alexander L, Barré I, Parham I, Gillyard T, Davis J, Cunningham-Erves J. Understanding Physical Distancing and Face Mask Use Across High-Risk African American Subgroups During the COVID-19 Pandemic: Application of Health Belief Model. Health Promot Pract 2024; 25:49-59. [PMID: 36710489 PMCID: PMC9902790 DOI: 10.1177/15248399221151176] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Physical distancing and face masks remain frontline prevention strategies due to suboptimal vaccine uptake and the highly infectious COVID-19 variants. Communities of color are disproportionately impacted by a chronic disease burden that places them at higher risk of severe COVID-19 disease. Therefore, they can greatly benefit from face mask use and physical distancing, especially if the individual(s) have not received the vaccine. We applied the Health Belief Model to explore barriers and motivators influencing physical distancing and face mask use among high-risk, Black American subgroups during the early COVID-19 pandemic stages. We conducted 62 semi-structured interviews among four Black American subgroups: young adults, individuals with underlying medical conditions, essential workers, and parents. Thematic analysis, guided by the Health Belief Model, yielded six themes: (1) Knowledge on Face Mask Use and Physical Distancing, (2) Perceived Susceptibility and Severity Varies by Subgroup, (3) Experience with and Perceived Self-Efficacy to Engage in Preventive Behavior, (4) Perceived Benefits to engaging in preventive behaviors, (5) Perceived Barriers to engage in preventive behaviors, and (6) Cues to action to increase participation. Each subgroup's unique experience informed multilevel, tailored approaches that can be used by health promotion practitioners to improve face mask use and physical distancing among uniquely vulnerable Black American subgroups in the current and future pandemic.
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Affiliation(s)
- Jamal Moss
- Meharry Medical College, Nashville, TN, USA
| | | | - Iman Barré
- Meharry Medical College, Nashville, TN, USA
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7
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Wang C, Bertrand KA, Trevino-Talbot M, Flynn M, Ruderman M, Cabral HJ, Bowen DJ, Hughes-Halbert C, Palmer JR. Ethical, legal, and social implications (ELSI) and challenges in the design of a randomized controlled trial to test the online return of cancer genetic research results to U.S. Black women. Contemp Clin Trials 2023; 132:107309. [PMID: 37516165 PMCID: PMC10544717 DOI: 10.1016/j.cct.2023.107309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/27/2023] [Accepted: 07/26/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND A central challenge to precision medicine research efforts is the return of genetic research results in a manner that is effective, ethical, and efficient. Formal tests of alternate modalities are needed, particularly for racially marginalized populations that have historically been underserved in this context. METHODS We are conducting a randomized controlled trial (RCT) to test scalable modalities for results return and to examine the clinical utility of returning genetic research results to a research cohort of Black women. The primary aim is to compare the efficacy of two communication modalities for results return: 1) a conventional modality that entails telephone disclosure by a Board-certified genetic counselor, and 2) an online self-guided modality that entails results return directly to participants, with optional genetic counselor follow-up via telephone. The trial is being conducted among participants in the Black Women's Health Study (BWHS), where targeted sequencing of 4000 participants was previously completed. RESULTS Several ethical, legal, and social implications (ELSI) and challenges presented, which necessitated substantial revision of the original study protocol. Challenges included chain of custody, re-testing of research results in a CLIA lab, exclusion of VUS results, and digital literacy. Bioethical principles of autonomy, justice, non-maleficence, and beneficence were considered in the design of the study protocol. CONCLUSION This study is uniquely situated to provide critical evidence on the effectiveness of alternative models for genetic results return and provide further insight into the factors influencing access and uptake of genetic information among U.S. Black women. CLINICALTRIALS gov: NCT04407611.
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Affiliation(s)
- Catharine Wang
- Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA.
| | - Kimberly A Bertrand
- Slone Epidemiology Center at Boston University, 72 East Concord St, L-7, Boston, MA 02118, USA.
| | | | - Maureen Flynn
- MGH Institute of Health Professions, 36 1st Ave, Boston, MA 02129, USA.
| | - Maggie Ruderman
- Boston University Chobanian & Avedisian School of Medicine, 72 East Concord St, Boston, MA 02118, USA.
| | - Howard J Cabral
- Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA.
| | - Deborah J Bowen
- University of Washington, 1959 NE Pacific Street, Box 357120, Seattle, WA 98195, USA.
| | - Chanita Hughes-Halbert
- University of Southern California, 1845 North Soto Street, MC 9C 9239, Los Angeles, CA 90089, USA.
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, 72 East Concord St, L-7, Boston, MA 02118, USA; Boston University Chobanian & Avedisian School of Medicine, 72 East Concord St, Boston, MA 02118, USA.
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8
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Lateef H, Adams L, Bernard D, Jellesma F, Frempong MRK, Boahen-Boaten BB, Leach BCB, Borgstrom E, Nartey PB. Mental Health Treatment-Seeking Appraisal, Afrocentric Cultural Norms, and Mental Health Functioning: Buffering Factors of Young Black Men's Externalizing Behavior. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01771-7. [PMID: 37624539 PMCID: PMC10894312 DOI: 10.1007/s40615-023-01771-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Depression rates are disproportionately high among Black American Men. This disparity--compounded by low mental healthcare seeking rates and high incorrect diagnosis rates in men--could be related to masculine norms, including self-reliance, restrictive emotionality, and stoicism. Furthermore, men are more likely to engage in externalized behavior, such as aggression, to cope with mental health challenges; this pattern is influenced by cultural and environmental factors. Contrary to these detrimental factors, social relationships, belief in social networks, and collectivism have been associated with positive mental health in these populations. Similarly, an Afrocentric worldview (including concepts like Ubuntu and African self-consciousness) has been hypothesized to promote positive mental health outcomes among Black American men. However, little research exists on harnessing these factors as a means of increasing health-seeking behaviors in young Black males. AIM To elucidate the effect of region, depression, African humanism, collectivism, and help-seeking values and needs concerning aggression in young Black males. METHOD This study included Black or African American participants (n = 428) identifying as male, aged 18-25 years, who responded to a Qualtrics survey with questions on region, aggression, depression, African humanism, collectivism, and help-seeking value and need. RESULTS Hierarchical linear regression revealed that collectivism, humanness, value, and the need for seeking treatment were inversely associated with aggression (p < 0.001). DISCUSSION/CONCLUSION Highlighting the effect of cultural norms and help-seeking behaviors and the aggravating effect of depression on aggression in young Black males can help to develop aggression-mitigating interventions rooted in Afrocentric Norms.
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Affiliation(s)
- Husain Lateef
- Washington University in St. Louis, St. Louis, MO, USA.
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9
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Buro AW, Carson TL, Small BJ, Fan W, Oswald LB, Jim HSL, Salas E, Zambrano K, Bryant C, Yamoah K, Gwede CK, Park JY, Gonzalez BD. Sociocultural factors associated with physical activity in Black prostate cancer survivors. Support Care Cancer 2023; 31:482. [PMID: 37479918 PMCID: PMC10388711 DOI: 10.1007/s00520-023-07898-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/21/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE Prostate cancer disproportionately affects Black men. Physical activity protects long-term health and quality of life outcomes in prostate cancer survivors. This study aimed to identify sociocultural factors related to physical activity among Black prostate cancer survivors to inform culturally tailored intervention development. METHODS This secondary analysis included data from 257 men who identified as Black or African American and were diagnosed with prostate cancer between 2013 and 2018. Participants completed validated self-report measures of perceived history of racial discrimination, religiosity, fatalism, sociodemographic (e.g., age, ethnicity, income) and clinical characteristics (e.g., years since diagnosis, comorbidity burden), and leisure-time physical activity. Regression analyses were conducted to examine the associations between sociocultural factors and mild, moderate, and vigorous physical activity. RESULTS Participants were on average 68.7 years old (SD = 7.7), and most were non-Hispanic (97.3%), married (68.9%), reported an annual household income above $50,000 (57.1%), received at least some college education (74.1%), and were overweight or had obesity (78.5%). Participants reported on average 88.1 (SD = 208.6) min of weekly mild physical activity, and most did not meet guidelines for weekly moderate (80.5%) or vigorous (73.0%) physical activity. After adjusting for covariates, older age and greater religiosity were associated with mild physical activity (ps ≤ 0.05). Higher levels of fatalism were associated with lower odds of meeting guidelines for moderate physical activity (OR = 0.87, 95% CI = 0.77-0.99). CONCLUSIONS Sociocultural factors such as religiosity and fatalism may be associated with some forms of physical activity in Black prostate cancer survivors. These findings suggest that incorporating faith-based practices into health behavior interventions may be appropriate for this population.
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Affiliation(s)
- Acadia W Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA.
- College of Population Health, University of New Mexico, Albuquerque, NM, USA.
| | - Tiffany L Carson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
| | - Brent J Small
- School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Wenyi Fan
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, FL, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
| | - Endrina Salas
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
| | - Kellie Zambrano
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
| | - Crystal Bryant
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
| | - Kosj Yamoah
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Clement K Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
| | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, USA
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Chandler J, Christon LM, Benfield K, Pairet S, Hoffman M, Treiber F, Mueller M, James WE. Design and rationale of a pilot randomized clinical trial investigating the use of a mHealth app for sarcoidosis-associated fatigue. Contemp Clin Trials Commun 2023; 32:101062. [PMID: 36718177 PMCID: PMC9883180 DOI: 10.1016/j.conctc.2023.101062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/30/2022] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
Fatigue is the most reported symptom in patients with sarcoidosis (SPs) and is a significant predictor of decreased quality of life that is strongly associated with stress and negative mood states. Few medications exist for treating fatigue in SPs, and outpatient physical rehabilitation programs are limited by availability and cost. Sarcoidosis in the US predominantly impacts minorities and underserved populations who are of working age and often have limited resources (e.g., financial, transportation, time off work) that may prevent them from attending in-person programs. The use of mobile health (mHealth) is emerging as a viable alternative to provide access to self-management resources to improve quality of life. The Sarcoidosis Patient Assessment and Resource Companion (SPARC) App is a sarcoidosis-specific mHealth App intended to improve fatigue and stress in SPs. It prompts SPs to conduct breathing awareness meditation (BAM) and contains educational modules aimed at improving self-efficacy. Herein we describe the design and methods of a 3-month randomized control trial comparing use of the SPARC App (10-min BAM twice daily) to standard care in 50 SPs with significant fatigue (FAS ≥22). A Fitbit® watch will provide immediate heartrate feedback after BAM sessions to objectively monitor adherence. The primary outcomes are feasibility and usability of the SPARC App (collected monthly). Secondary endpoints include preliminary efficacy at improving fatigue, stress, and quality of life. We expect the SPARC App to be a useable and feasible intervention that has potential to overcome barriers of more traditional in-person programs.
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Affiliation(s)
- Jessica Chandler
- MUSC, College of Nursing, Department of Nursing, Technology Applications Center for Healthful Lifestyles, United States
| | - Lillian M. Christon
- Medical University of South Carolina (MUSC), College of Medicine, Department of Psychiatry & Behavioral Sciences, United States
| | - Katie Benfield
- MUSC, College of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Susan Pearlstine Sarcoidosis Center of Excellence, United States
| | - Samantha Pairet
- MUSC, College of Nursing, Department of Nursing, Technology Applications Center for Healthful Lifestyles, United States
| | - Maria Hoffman
- MUSC, College of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Susan Pearlstine Sarcoidosis Center of Excellence, United States
| | - Frank Treiber
- MUSC, College of Nursing, Department of Nursing, Technology Applications Center for Healthful Lifestyles, United States
| | - Martina Mueller
- MUSC, College of Nursing, Department of Nursing, Technology Applications Center for Healthful Lifestyles, United States
| | - W. Ennis James
- MUSC, College of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Susan Pearlstine Sarcoidosis Center of Excellence, United States
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Moon J, Lieber RJ, Bayazitli I, Mello ZR. An Examination of Multidimensional Time Perspective and Mental Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4688. [PMID: 36981597 PMCID: PMC10048536 DOI: 10.3390/ijerph20064688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
We examined the associations between time perspective and mental health outcomes (N = 337; Mage = 22.74, SDage = 5.59; 76% female). Time perspective included multiple dimensions (feelings, frequency, orientation, and relation) and time periods (past, present, and future). Mental health outcomes included depressive symptoms, anxiety, and rumination. To demonstrate the reliability of the time perspective scales, test-retest analyses were completed. Multivariate analyses showed that (a) positive feelings about time were associated with lower anxiety; (b) negative feelings about time were associated with greater anxiety; and (c) more frequent thoughts about the past were associated with greater depressive symptoms and anxiety. Associations remained when controlling for anxiety and depressive symptoms, respectively. Moreover, (a) positive feelings about time were associated with lower rumination; (b) negative feelings about time were associated with greater rumination; and (c) more frequent thoughts about the past were associated with greater rumination. Time perspective scales yielded scores that were moderate to high in test-retest reliability. Findings demonstrate the value of examining separate time perspective dimensions and time periods. Results highlight the role of time perspective in mental health interventions for adults.
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Villalobos AVK, Turner MM, Lapinski MK, Hull S, Long S, Wang J, Moore EWG. Predicting Breastfeeding Intentions: A Test and Extension of the Theory of Normative Social Behavior with African American Social Identity. HEALTH COMMUNICATION 2023; 38:101-113. [PMID: 34105433 DOI: 10.1080/10410236.2021.1936750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Breastfeeding is a health promoting social behavior but statistics suggest a persistent disparity of lower rates among African American mothers. The Theory of Normative Social Behavior (TNSB) explains when and how norms influence behaviors, but has produced inconsistent results with respect to proposed moderators group identity and injunctive norms (IN), limiting its predictive value in diverse cultural groups. Cultural norms are one of many influences on breastfeeding behaviors, yet little is known about their mechanisms of influence. The TNSB has not been tested in the breastfeeding context or within an exclusively African American cultural group. Given this knowledge gap, a survey of 528 African American mothers in the Washington, D.C. area was conducted to test the moderating effects of IN and subjective norms (SN) and social identity on the descriptive norms (DN) to intentions relationship as predicted by the TNSB. Structural equation modeling was used to show that when controlling for education and breastfeeding history, norms significantly predicted 26.4% of the variance in breastfeeding intentions. SN and DN interacted negatively to enhance breastfeeding intentions. Latent profile analysis using ethnic pride, collectivism, and religiosity scales detected four profiles of African American social identity. Social identity profile membership was a significant moderator on the DN to intentions pathway in the structural equation model. Profiles with the highest ethnic pride were significantly influenced by DN to intend to breastfeed. Implications from this study for public health intervention and communication messaging are discussed.
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Affiliation(s)
- Aubrey Van Kirk Villalobos
- Department of Prevention and Community Health, Milken Institute School of Public Health at the George Washington University
- School of Medicine and Health Sciences, The George Washington University Cancer Center
| | | | | | - Shawnika Hull
- Department of Prevention and Community Health, Milken Institute School of Public Health at the George Washington University
| | - Sahira Long
- Department of General and Community Pediatrics, Children's National Health System
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences
| | - Jichuan Wang
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University
- Children's National Health System, Children's National Research Institute
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Adegboyega A, Wiggins A, Obielodan O, Dignan M, Schoenberg N. Beliefs associated with cancer screening behaviors among African Americans and Sub-Saharan African immigrant adults: a cross-sectional study. BMC Public Health 2022; 22:2219. [PMID: 36447190 PMCID: PMC9710024 DOI: 10.1186/s12889-022-14591-x] [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: 04/29/2022] [Accepted: 11/10/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Beliefs influence cancer screening. However, there are conflicting findings about how belief influence cancer screening among Black adults. The aim of this study was to evaluate the relationships between beliefs (religiosity, fatalism, temporal orientation, and acculturation) and cervical, breast, and colorectal cancer screening behaviors among African Americans and sub-Saharan African immigrants. METHODS We conducted a cross-sectional survey of 73 African American and 59 English speaking Sub-Saharan immigrant adults recruited from Lexington and surrounding cities in Kentucky. Data collected included sociodemographic variables, cancer screening behaviors, and several instruments that characterize beliefs, including religiosity, fatalism, temporal orientation, and acculturation. RESULTS Participants' mean age was 43.73 years (SD = 14.0), 83% were females, and 45% self-identified as sub-Saharan immigrants. Based on eligibility for each screening modality, 64% reported having ever had a Pap test, 82% reported ever having mammogram, and 71% reported ever having a colonoscopy. Higher education (OR = 2.62, 95% CI = 1.43-4.80) and being insured (OR = 4.09, 95% CI = 1.10 - 15.18) were associated with increased odds of cervical cancer screening (pap test), while cancer fatalism (OR = 0.24, 95% CI = 0.07 - 0.88) was associated with decreased odds. Increased age (OR = 1.57, 95% CI = 1.06 - 2.32) and reduced present orientation (OR = 0.42, 95% CI = 0.22 - 0.80) were associated with receipt of a mammogram. Nativity was the only factor associated with colonoscopy screening. Compared to African Americans, sub-Saharan African immigrants were 90% less likely to have had a colonoscopy (OR = 0.10, 95% CI = 0.02 - 0.66). CONCLUSION This study contributes to the existing literature by confirming that beliefs are important in cancer screening behaviors among African American and sub-Saharan African immigrants. These findings should inform the development of cancer control and prevention programs for Black adults. TRIAL REGISTRATION US National Library of Science identifier NCT04927494. Registered June 16, 2021, www. CLINICALTRIALS gov.
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Affiliation(s)
- A. Adegboyega
- grid.266539.d0000 0004 1936 8438University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232 USA
| | - A.T. Wiggins
- grid.266539.d0000 0004 1936 8438University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232 USA
| | - O. Obielodan
- grid.266539.d0000 0004 1936 8438University of Kentucky College of Public Health, Lexington, USA
| | - M. Dignan
- grid.266539.d0000 0004 1936 8438Prevention Research Center, University of Kentucky College of Medicine, Lexington, KY USA
| | - N. Schoenberg
- grid.266539.d0000 0004 1936 8438Center for Health Equity Transformation, College of Medicine, University of Kentucky, 468 Healthy Kentucky Research Building, Lexington, KY 40536 USA ,grid.266539.d0000 0004 1936 8438Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, USA
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14
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Lake PW, Conley CC, Pal T, Sutton SK, Vadaparampil ST. Anxiety and depression among Black breast cancer survivors: Examining the role of patient-provider communication and cultural values. PATIENT EDUCATION AND COUNSELING 2022; 105:2391-2396. [PMID: 35440374 PMCID: PMC10777429 DOI: 10.1016/j.pec.2021.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/29/2021] [Accepted: 12/11/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Breast cancer survivors frequently experience anxiety and depression post-treatment. Patient-provider communication and cultural values may impact these psychological outcomes. We examined the impact of patient-provider communication and cultural values on anxiety and depression among Black breast cancer survivors. METHODS Using an observational, cross-sectional design, 351 survivors self-reported patient-provider communication (quality, confidence), cultural values (religiosity, collectivism, future time orientation), anxiety, and depression. Patients were categorized into high, moderate, and low levels of communication and cultural values. Separate linear regressions examined the effect of levels of communication and cultural values on anxiety and depression, controlling for sociodemographic variables. RESULTS A subset of breast cancer survivors reported clinically significant symptoms of anxiety (40%) and depression (20%). Communication was associated with anxiety (β = -0.14, p = 0.01) and depression (β = -0.10, p = 0.04). Specifically, women reporting higher levels of communication quality/confidence reported lower levels of anxiety and depression. There was a trend towards a significant association between cultural values and depression (β = -0.09, p = 0.06). CONCLUSIONS Black breast cancer survivors experience poor psychological functioning. Effective patient-provider communication may reduce anxiety and depression post-treatment. PRACTICE IMPLICATIONS Patient-provider relationships and patient empowerment may be key components of cancer survivorship. Special attention should be paid to patient-centered communication for Black breast cancer survivors.
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Affiliation(s)
- Paige W Lake
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, Tampa, FL, USA
| | - Claire C Conley
- Georgetown University, Department of Oncology, Washington, DC, USA
| | - Tuya Pal
- Vanderbilt University Medical Center, Department of Medicine, Nashville, TN, USA
| | - Steven K Sutton
- Moffitt Cancer Center, Department of Biostatistics and Bioinformatics, Tampa, FL, USA
| | - Susan T Vadaparampil
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, Tampa, FL, USA.
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15
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Blackman Carr LT, Samuel-Hodge CD, Tate DF. The Multi-Caregiver Role and Its Relationship to Behavioral Adherence and Weight Among Treatment Engaged Black Women. Am J Health Promot 2022; 36:1162-1169. [PMID: 35417263 DOI: 10.1177/08901171221092389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the relationship between the multiple caregiver role and its perceived barriers to self-care on behavioral adherence in a weight loss intervention. DESIGN A secondary analysis of data from a behavioral weight loss intervention. SETTING The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. SUBJECTS Eighty-one Black women with overweight/obesity (age = 48.4 ± 10.9 years [M ± SD], BMI = 36.4 ± 4.5 kg/m2 [M ± SD]). MEASURES Identification with the multiple caregiver role and barriers was assessed with the Multiple Caregiving Measurement Instrument. Weight was measured with a digital scale and height with a stadiometer. The Block food frequency questionnaire evaluated dietary intake. Moderate-to-vigorous physical activity (MVPA) was measured objectively with an accelerometer. Study adherence was measured by session attendance, self-weighing, and self-monitoring (diet and physical activity) frequency. ANALYSIS Generalized linear models were used to examine the relationship between the multiple caregiver scales and the outcomes of interest, controlling for study arm, cohort, and income. Chi-square tests tested correlations. RESULTS Greater identification with the multiple caregiver role was associated with decreased session attendance (β = -.56 [SE = .27], P < .05) and a trend towards weight gain (β = .36, [SE = .19], P = .07). Greater multiple caregiver barriers score predicted a decrease in fruit/vegetable intake (β = -.17 [SE = .07], P < .05). All regression results are unstandardized. Negative correlations between multiple caregiver barriers and MVPA (r = -.24, P = .06) and daily self-weighing (r = -.19, P = .10) approached significance. CONCLUSIONS Participants' identification with multiple caregiving role and barriers can reduce adherence, behavior and weight change. Interventions to address Black women's multiple roles and barriers during weight loss are needed to maximize outcomes.
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Affiliation(s)
| | - Carmen D Samuel-Hodge
- Department of Nutrition, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah F Tate
- Department of Nutrition, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Behavior, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Schrode K, Poareo E, Li M, Harawa NT. Minority Stress and Sexual Functioning Among African American Women With At-Risk Partners in South Los Angeles. J Sex Med 2022; 19:603-612. [PMID: 35272947 PMCID: PMC8995363 DOI: 10.1016/j.jsxm.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preliminary evidence indicates that acute and chronic psychological stress affect sexual arousal and satisfaction. African American women, in particular, are vulnerable to the impacts of gender- and race-related stress, given their socially constructed identities as African Americans and as women. AIM We examined associations between minority stress and sexual function using data from 248 African American women. METHODS Surveys were conducted with 248 African American women in South LA with male partners at risk for acquiring HIV. We analyzed self-reports on (i) stress indicators: chronic burden, perceived racism/sexism, and histories of trauma/sexual abuse; (ii) Female Sexual Function Index domains: desire, arousal, and satisfaction; and (iii) potential moderators: social support and spirituality. We used multiple regression, adjusting for potential confounding factors, to examine the relationships between stress indictors, potential moderators, and sexual function domains. OUTCOMES The outcomes were the female sexual function index domains of desire, arousal, and satisfaction. RESULTS This largely low-income sample experienced significant chronic and acute stressors, was highly spiritual and reported strong social support. Moderate-high chronic burden and increasing sexism scores were independently associated with decreased arousal (B = -0.38, 95%CI = -0.75, -0.02) and satisfaction (B = -0.03, 95%CI = -0.06, 0.00) scores, respectively. CLINICAL IMPLICATIONS Providers may want to explore chronic burden in patients who complain about low sexual arousal. Additionally, to develop effective HIV- and other STI-related interventions that impact behaviors that can confer sexual risk, prevention strategies are needed that either reduce contextual stressors or mitigate their impact. STRENGTHS Strengths of this research are that it focuses on sexual function among previously under-studied, low-income African American women and that it takes into account the unique set of stressors faced by these women. LIMITATIONS A limitation is that the sample size may have been too small to capture the effects of potential moderators. CONCLUSIONS Low-income African American women accumulate life stressors that may harm sexual function. Schrode K, Poareo E, Li M, et al. Minority Stress and Sexual Functioning Among African American Women With At-Risk Partners in South Los Angeles. J Sex Med 2022;19:603-612.
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17
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But CH, Li JCH, Tze VMC. Boredom coping profiles among international students in canada and canadian students: similarities and differences. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03031-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Del Pino HE, Steers WN, Lee M, McCuller J, Hays RD, Harawa NT. Measuring Gender Role Conflict, Internalized Stigma, and Racial and Sexual Identity in Behaviorally Bisexual Black Men. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1019-1030. [PMID: 34136991 PMCID: PMC8674384 DOI: 10.1007/s10508-021-01925-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/17/2020] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
Black men who have sex with men and women (BMSMW) experience pressure to fill hypermasculine ideals and may not identify with "gay" cultural norms. Existing measures of gender role expectations and internalized homophobia are not culturally appropriate for BMSMW. Researchers generally measure categorical identification with race, gender, and sexual orientation groups separately, whereas BMSMW may identify with multiple categories. We modified the Gender Role Conflict Scale to create the M-GRCS and the Internalized Homophobia Scale to include biphobia (Internalized Bi/Homophobia Scale, IBHS). To examine identification at the intersection of race, gender, and sexual orientation, we created 11 Integrated Race and Sexuality Scale (IRSS) items. With data from 429 BMSMW, we conducted exploratory factor analysis of the 59 items using categorical principal axis factoring with unweighted least squares extraction and Promax factor rotation. We created simple-summated multi-item scales and evaluated their construct validity. The rotated solution yielded four factors with 47 items and a simple factor structure: M-GRCS defined two factors (α = .93 for restricted emotionality/affection; .87 for success/power/competition); the IBHS (α = .89) and IRSS (α = .74) each defined a single factor. The IRSS factor was positively correlated with the Lukwago Racial Pride Scale, r(417) = .40. The IBHS factor was negatively correlated with the IRSS factor, r(414) = - .22. The two M-GRCS factors suggest that the construct of hypermasculinity impacts BMSMW. The high IBHS reliability indicates that homophobia and biphobia were positively correlated in this sample. These three scales have potential for future studies with BMSMW.
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Affiliation(s)
- Homero E Del Pino
- Department of Psychiatry and Human Behavior, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - W Neil Steers
- Department of Medicine, David Geffen School of Medicine at UCLA, Suite 850, 1100 Glendon Ave., Los Angeles, CA, 90024, USA
| | - Martin Lee
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Jason McCuller
- College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Ron D Hays
- Department of Medicine, David Geffen School of Medicine at UCLA, Suite 850, 1100 Glendon Ave., Los Angeles, CA, 90024, USA
| | - Nina T Harawa
- Department of Psychiatry and Human Behavior, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
- Department of Medicine, David Geffen School of Medicine at UCLA, Suite 850, 1100 Glendon Ave., Los Angeles, CA, 90024, USA.
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19
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SCHULZ E, BAY RC, CLARK EM. Predictors of African American Belief in Illness as Punishment for Sin. SPIRITUAL PSYCHOLOGY AND COUNSELING 2021. [DOI: 10.37898/spc.2021.6.3.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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20
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Hurtado-de-Mendoza A, Gonzales F, Song M, Holmes EJ, Graves KD, Retnam R, Gómez-Trillos S, Lopez K, Edmonds MC, Sheppard VB. Association between aspects of social support and health-related quality of life domains among African American and White breast cancer survivors. J Cancer Surviv 2021; 16:1379-1389. [PMID: 34655040 PMCID: PMC10166003 DOI: 10.1007/s11764-021-01119-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Social support is associated with breast cancer survivors' health-related quality of life (HRQoL). More nuanced information is needed regarding aspects of social support associated with different HRQoL domains among diverse populations. We assessed the association between emotional/informational and tangible support and five HRQoL domains and evaluated race as an effect modifier. METHODS African American and White women (n = 545) diagnosed with hormone-receptor-positive breast cancer completed a survey that assessed sociodemographic, clinical, and psychosocial factors. We assessed bivariate relationships between emotional/informational and tangible support along with overall HRQoL and each HRQoL domain.We tested interactions between race and emotional/informational and tangible social support using linear regression. RESULTS The sample included African American (29%) and White (71%) breast cancer survivors. Emotional/informational social support had a statistically significant positive association with emotional well-being (β = .08, p = 0.005), social well-being (β = 0.36, p < 0.001), functional well-being (β = .22, p < .001), breast cancer concerns (β = .16, p = 0.002), and overall HRQoL (β = .83, p < .001). Similarly, tangible social support had a statistically significant positive association with emotional well-being (β = .14, p = 0.004), social well-being (β = .51, p < .001), functional well-being (β = .39, p < .001), and overall HRQoL (β = 1.27, p < .001). The interactions between race and social support were not statistically significant (p > 0.05). CONCLUSIONS Results underscore the importance of the different social support types among breast cancer survivors, regardless of survivors' race. IMPLICATIONS FOR CANCER SURVIVORS Population-based interventions can be standardized and disseminated to provide guidance on how to increase emotional/information and tangible support for all breast cancer survivors by caregivers, health providers, and communities.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA. .,Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA.
| | - Felisa Gonzales
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.,The Colorado Trust, Denver, CO, USA
| | - Minna Song
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Esther J Holmes
- Department of Health Behavior and Policy, VCU School of Medicine, Richmond, VA, USA
| | - Kristi D Graves
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Reuben Retnam
- Department of Health Behavior and Policy, VCU School of Medicine, Richmond, VA, USA
| | - Sara Gómez-Trillos
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Katherine Lopez
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Megan C Edmonds
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanessa B Sheppard
- Department of Health Behavior and Policy, VCU School of Medicine, Richmond, VA, USA.,Office of Health Equity and Disparities Research, VCU Massey Cancer Center, Richmond, VA, USA
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21
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Chen X, Schofield E, Orom H, Hay JL, Kiviniemi MT, Waters EA. Health Literacy, Education, and Internal Consistency of Psychological Scales. Health Lit Res Pract 2021; 5:e245-e255. [PMID: 34533393 PMCID: PMC8447849 DOI: 10.3928/24748307-20210728-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Measurement error might lead to biased estimates, causing ineffective interventions and service delivery. Identifying measurement error of health-related instruments helps develop accurate assessment of health-related constructs. Objective: We compared the internal consistency of eight psychological scales used in health research in groups with adequate versus limited health literacy and in groups with higher versus lower education. Methods: Participants (N = 1,005) from a nationally representative internet panel completed eight self-report scales: (1) information avoidance, (2) cognitive causation, (3) unpredictability, (4) perceived severity, (5) time orientation, (6) internal health locus of control, (7) need for cognition, and (8) social desirability. The first four assess beliefs about diabetes and colon cancer. We used the Newest Vital Sign to categorize participants' health literacy (limited vs. adequate). We also categorized participants' education (high school or less vs. more than high school). We compared the Cronbach's alpha for each psychological scale between groups with different health literacy and education levels using the Feldt test. Key Results: Among all the 13 subscales, scale internal consistency was significantly lower among people with limited health literacy than those with adequate health literacy for five subscales: information avoidance for colon cancer (0.80 vs. 0.88), unpredictability of diabetes (0.84 vs. 0.88), perceived severity for diabetes (0.66 vs. 0.75), need for cognition (0.63 vs. 0.82), and social desirability (0.52 vs. 0.68). Internal consistency was significantly lower among people who had a high school education or less than among those with more than a high school education for four scales: perceived severity of diabetes (0.70 vs. 0.75), present orientation (0.60 vs. 0.66), need for cognition (0.73 vs. 0.80), and social desirability (0.61 vs. 0.70). Conclusions: Several psychological instruments demonstrated significantly lower internal consistency when used in a sample with limited health literacy or education. To advance health disparities research, we need to develop new scales with alternative conceptualizations of the constructs to produce a measure that is reliable among multiple populations. [HLRP: Health Literacy Research and Practice. 2021;5(3):e244–e255.] Plain Language Summary: We compared the internal consistency of several psychological scales in groups with adequate versus limited health literacy and higher versus lower education. For several scales, internal consistency was significantly lower among (1) people with limited health literacy compared those who have adequate health literacy and/or (2) people who had a high school education or less compared to those with more than a high school education.
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Affiliation(s)
- Xuewei Chen
- Address correspondence to Xuewei Chen, PhD, School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, 429 Willard Hall, Stillwater, OK 74078;
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22
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Edmonds MC, Sutton AL, Cummings Y, Sheppard VB. Opportunities to Improve Women's Health: Engaging Racial/Ethnic Diverse Women to Provide Biospecimens for Research. J Womens Health (Larchmt) 2021; 30:1321-1327. [PMID: 33428522 PMCID: PMC8558085 DOI: 10.1089/jwh.2020.8502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: Inclusion of women in biomedical cancer research have the potential to close gaps in cancer health disparities and improve adjuvant therapies for women; yet samples needed to advance this area of science are lacking. We developed low-cost educational recruitment strategies to increase our collection of biospecimens from women. Materials and Methods: Women diagnosed with hormone receptor positive (HR+) breast cancer that initiated hormonal therapy were recruited from three integrated health systems. The analytical sample (n = 144) consisted of women who consented but did not return a saliva sample within 1 year of the initial assessment (baseline). Brief informational recruitment materials were developed via published literature and preliminary data. Women received recruitment materials, which included a personalized information letter, a colorful low-literacy instruction sheet, a postage-paid envelope, and collection kits. We evaluated intervention materials and performed descriptive and bivariate statistics to describe factors associated with biospecimen donation. Results: Of the total sample, 61% were white and 34% were black. Overall, 29 surveys (20%) and 25 (17%) saliva kits were returned. Women found the materials helpful and easy to read and understand. Women with higher levels of functional well-being and lower ratings of religiosity were more likely to return biospecimens (p < 0.005) after receiving enhanced materials. Conclusion: This article provides recruitment strategies to enhance biospecimen samples among women. Receipt of brief informational print materials inclusive of personalized messages enhanced our outreach strategies and increased our overall biospecimen provision rate by 17%. The inclusion of messages with a focus on spirituality and other cultural messages may further increase biospecimen provision in racial/ethnic diverse groups of women; however, further study is needed to support this claim. Clinical Trail Registration Number: NCT02992730.
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Affiliation(s)
- Megan C. Edmonds
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- VCU Massey Cancer Center Office of Health Equity and Disparities Research, Richmond, Virginia, USA
| | - Arnethea L. Sutton
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- VCU Massey Cancer Center Office of Health Equity and Disparities Research, Richmond, Virginia, USA
| | - Yvonne Cummings
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- VCU Massey Cancer Center Office of Health Equity and Disparities Research, Richmond, Virginia, USA
| | - Vanessa B. Sheppard
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- VCU Massey Cancer Center Office of Health Equity and Disparities Research, Richmond, Virginia, USA
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23
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Mudd AL, van Lenthe FJ, Verra SE, Bal M, Kamphuis CBM. Socioeconomic inequalities in health behaviors: exploring mediation pathways through material conditions and time orientation. Int J Equity Health 2021; 20:184. [PMID: 34391423 PMCID: PMC8364086 DOI: 10.1186/s12939-021-01522-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/24/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Socioeconomic inequalities in health behaviors have been attributed to both structural and individual factors, but untangling the complex, dynamic pathways through which these factors influence inequalities requires more empirical research. This study examined whether and how two factors, material conditions and time orientation, sequentially impact socioeconomic inequalities in health behaviors. METHODS Dutch adults 25 and older self-reported highest attained educational level, a measure of socioeconomic position (SEP); material conditions (financial strain, housing tenure, income); time orientation; health behaviors including smoking and sports participation; and health behavior-related outcomes including body mass index (BMI) and self-assessed health in three surveys (2004, 2011, 2014) of the longitudinal GLOBE (Dutch acronym for "Health and Living Conditions of the Population of Eindhoven and surroundings") study. Two hypothesized pathways were investigated during a ten-year time period using sequential mediation analysis, an approach that enabled correct temporal ordering and control for confounders such as baseline health behavior. RESULTS Educational level was negatively associated with BMI, positively associated with sports participation and self-assessed health, and not associated with smoking in the mediation models. For smoking, sports participation, and self-assessed health, a pathway from educational level to the outcome mediated by time orientation followed by material conditions was observed. CONCLUSIONS Time orientation followed by material conditions may play a role in determining socioeconomic inequalities in certain health behavior-related outcomes, providing empirical support for the interplay between structural and individual factors in socioeconomic inequalities in health behavior. Smoking may be determined by prior smoking behavior regardless of SEP, potentially due to its addictive nature. While intervening on time orientation in adulthood may be challenging, the results from this study suggest that policy interventions targeted at material conditions may be more effective in reducing socioeconomic inequalities in certain health behaviors when they account for time orientation.
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Affiliation(s)
- Andrea L Mudd
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Sanne E Verra
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Michèlle Bal
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
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Sheppard VB, Sutton AL, Hurtado-de-Mendoza A, He J, Dahman B, Edmonds MC, Hackney MH, Tadesse MG. Race and Patient-reported Symptoms in Adherence to Adjuvant Endocrine Therapy: A Report from the Women's Hormonal Initiation and Persistence Study. Cancer Epidemiol Biomarkers Prev 2021; 30:699-709. [PMID: 33514603 PMCID: PMC8330157 DOI: 10.1158/1055-9965.epi-20-0604] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/14/2020] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adjuvant endocrine therapy (AET) improves outcomes in women with hormone receptor-positive (HR+) breast cancer. Suboptimal AET adherence is common, but data are lacking about symptoms and adherence in racial/ethnic minorities. We evaluated adherence by race and the relationship between symptoms and adherence. METHODS The Women's Hormonal Initiation and Persistence study included women diagnosed with nonrecurrent HR+ breast cancer who initiated AET. AET adherence was captured using validated items. Data regarding patient (e.g., race), medication-related (e.g., symptoms), cancer care delivery (e.g., communication), and clinicopathologic factors (e.g., chemotherapy) were collected via surveys and medical charts. Multivariable logistic regression models were employed to calculate odds ratios and 95% confidence intervals (CIs) associated with adherence. RESULTS Of the 570 participants, 92% were privately insured and nearly one of three were Black. Thirty-six percent reported nonadherent behaviors. In multivariable analysis, women less likely to report adherent behaviors were Black (vs. White; OR, 0.43; 95% CI, 0.27-0.67; P < 0.001) and with greater symptom burden (OR, 0.98; 95% CI, 0.96-1.00; P < 0.05). Participants more likely to be adherent were overweight (vs. normal weight) (OR, 1.58; 95% CI, 1.04-2.43; P < 0.05), sat ≤ 6 hours a day (vs. ≥6 hours; OR, 1.83; 95% CI, 1.25-2.70; P < 0.01), and were taking aromatase inhibitors (vs. tamoxifen; OR, 1.91; 95% CI, 1.28-2.87; P < 0.01). CONCLUSIONS Racial differences in AET adherence were observed. Longitudinal assessments of symptom burden are needed to better understand this dynamic process and factors that may explain differences in survivor subgroups. IMPACT Future interventions should prioritize Black survivors and women with greater symptom burden.
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Affiliation(s)
- Vanessa B Sheppard
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
- Office of Health Equity and Disparities Research, VCU Massey Cancer Center, Richmond, Virginia
| | - Arnethea L Sutton
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | | | - Jun He
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Bassam Dahman
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Megan C Edmonds
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Mary Helen Hackney
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Mahlet G Tadesse
- Department of Mathematics and Statistics, Georgetown University, Washington, DC
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Jordan A, Babuscio T, Nich C, Carroll KM. A feasibility study providing substance use treatment in the Black church. J Subst Abuse Treat 2020; 124:108218. [PMID: 33771290 DOI: 10.1016/j.jsat.2020.108218] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 10/02/2020] [Accepted: 11/30/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Black adults with substance use disorders (SUDs) experience health care disparities, including access to and retention in treatment. The Black church is a trusted institution in the Black community and could be a novel setting for providing SUD treatment. METHOD We conducted a nonrandomized feasibility study evaluating (1) whether it was possible to conduct a clinical trial of SUD treatment in this setting, (2) whether an adequate number of individuals with SUDs would participate in technology-based treatment in this setting, and (3) whether an adequate number of individuals would be retained in this setting. We evaluated computer-based training for cognitive behavioral therapy (CBT4CBT), with modifications that the church-based health advisors (CHAs), who delivered the intervention within the church, made. RESULTS Participants were 40 Black adults, all of whom met DSM-5 criteria for a current SUD, (55% severe). The mean number of sessions completed was 6.8 and 31 completed all 7 sessions of CBT4CBT. Both self-reports and weekly urine toxicology screens indicated reduction in substance use over time. CONCLUSION We demonstrated feasibility, as we were able to (1) collect weekly data and protect participant confidentiality, (2) recruit an adequate number of individuals with SUD, with (3) high uptake and retention of an adapted CBT4CBT in the Black church. If demonstrated to be effective in a future randomized clinical trial, delivery of technology-based treatments in the Black church may prove a promising, easily disseminable strategy to provide evidence-based interventions to an underserved and undertreated population.
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Affiliation(s)
- Ayana Jordan
- Department of Psychiatry, Yale University School of Medicine, 300 George St, Suite 901, New Haven, CT 06511, USA.
| | - Theresa Babuscio
- Department of Psychiatry, Yale University School of Medicine, 300 George St, Suite 901, New Haven, CT 06511, USA.
| | - Charla Nich
- Department of Psychiatry, Yale University School of Medicine, 300 George St, Suite 901, New Haven, CT 06511, USA.
| | - Kathleen M Carroll
- Department of Psychiatry, Yale University School of Medicine, 300 George St, Suite 901, New Haven, CT 06511, USA.
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Wang M, Wong YJ, Nyutu PN, Fu C. Suicidality Protective Factors Among Black College Students: Which Cultural and Personal Resources Matter? JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2020. [DOI: 10.1002/jmcd.12198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Y. Joel Wong
- Department of Counseling and Educational Psychology Indiana University Bloomington
| | - Pius N. Nyutu
- Department of Psychology Fayetteville State University
| | - Chu‐Chun Fu
- Department of Psychology Fayetteville State University
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Sutton AL, Salgado TM, He J, Hurtado-de-Mendoza A, Sheppard VB. Sociodemographic, clinical, psychosocial, and healthcare-related factors associated with beliefs about adjuvant endocrine therapy among breast cancer survivors. Support Care Cancer 2020; 28:4147-4154. [PMID: 31897782 PMCID: PMC7329595 DOI: 10.1007/s00520-019-05247-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/11/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Adjuvant endocrine therapy (AET) reduces the risk of recurrence and mortality in women with hormone receptor-positive breast cancer. However, adherence to AET remains suboptimal. Women's beliefs about medication have been associated with medication adherence. The purpose of this study was to identify multilevel factors associated with women's beliefs about AET. METHODS Beliefs about AET, measured using the Belief about Medicines Questionnaire (BMQ), sociodemographic (e.g., age), psychosocial (e.g., religiosity), and healthcare factors (e.g., patient-provider communication), were collected via survey. Clinical data were abstracted from medical records. Two stepwise regression analyses models were performed to assess relationships between variables and necessity and concern beliefs. RESULTS In our sample of 572 women, mean BMQ concern score was 11.19 and mean necessity score was 13.85 (range 5-20). In the regression models, higher ratings of patient-provider communication were associated with lower concern and higher necessity beliefs. Higher concern beliefs were related to more AET-related symptoms (Β = 0.08; 95% CI 0.06 to 0.10; p < 0.001), lower patient satisfaction (Β = - 0.07; 95% CI - 0.09 to - 0.04; p < 0.001), and higher religiosity (Β = 0.05; 95% CI 0.01 to 0.08; p = 0.007). Higher necessity beliefs were associated with prior chemotherapy use (Β = 0.11; 95% CI 0.06 to 0.16; p < 0.005) and less education (Β = 1.00; 95% CI 0.27 to 1.73; p = 0.008). CONCLUSIONS Modifiable factors are related to women's AET beliefs. Healthcare interactions may play a key role with regard to shaping women's beliefs about their AET medication.
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Affiliation(s)
- Arnethea L Sutton
- Department of Health Behavior and Policy, Virginia Commonwealth, University School of Medicine, P.O. Box 980149, Richmond, VA, 23219, USA.
| | - Teresa M Salgado
- Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth, University School of Pharmacy, Richmond, VA, USA
| | - Jun He
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Vanessa B Sheppard
- Department of Health Behavior and Policy, Virginia Commonwealth, University School of Medicine, P.O. Box 980149, Richmond, VA, 23219, USA
- Office of Health Equity and Disparities Research, VCU Massey Cancer Center, Richmond, VA, USA
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de Dios MA, Childress SD, Cano MÁ, McNeill LH, Reitzel LR, Vaughan E. Elevated cholesterol among African American adults: the role of fatalistic attitudes about health. ETHNICITY & HEALTH 2020; 25:835-842. [PMID: 29716391 DOI: 10.1080/13557858.2018.1469734] [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] [Received: 03/13/2017] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
Objectives: Cardiovascular disease (CVD) affects 47% of African-American adults (AAs) in the United States. Elevated cholesterol, the greatest risk factor for CVD, is highly prevalent among AAs, potentially as the result of engagement in behavioral risk factors. Religiosity has been associated with a beneficial effect in health promoting behaviors, yet findings have been mixed depending on methods employed. Religious health fatalism, defined as 'the belief that health outcomes are inevitable and/or determined by God', is a more specific domain of a religiosity that needs further exploration through scientific research. The purpose of the current study is to examine the relationship between RHFQ subscales and self-reported lifetime history of elevated cholesterol. Methods: Participants (n = 135) were recruited from a large, predominately African American church. A multiple logistic regression model was used to test whether the three subscales of the Religious Health Fatalism Questionnaire (RHFQ) were cross-sectional predictors of self-reported lifetime history of elevated cholesterol. Sets of variables were entered into a stepwise logistic regression model with the first set (Block 1) including significant demographic variables and religiosity (i.e. sex, age, level of education, employment status and scores on the Lukwago Religiosity Scale score [LRS]. The three RHFQ subscales were entered into Block 2 as our predictors of interest. Results: After adjusting for covariates, the likelihood of elevated cholesterol increased significantly (OR = 3.21, 95% CI = 1.81-5.69, p < .001) as Helpless Inevitability (RHFQ subscale) scores increased. Conclusions: A greater degree of Helpless Inevitability was found to be significantly associated with self-reported elevated cholesterol level. Future research is needed to further understand the complex interplay of factors associated with religiosity and fatalism that contribute to increased risk of elevated cholesterol among AAs.
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Affiliation(s)
- Marcel A de Dios
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, TX, USA
- HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Sarah D Childress
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Lorna H McNeill
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, TX, USA
- HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, TX, USA
- HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Ellen Vaughan
- Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, IN, USA
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Orom H, Biddle C, Waters EA, Kiviniemi MT, Sosnowski AN, Hay JL. Causes and consequences of uncertainty about illness risk perceptions. J Health Psychol 2020; 25:1030-1042. [PMID: 29243523 PMCID: PMC5984187 DOI: 10.1177/1359105317745966] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We identified determinants of uncertainty about perceived risk judgments and demonstrated that uncertainty is associated with lower engagement in risk-reducing behavior. We found that people likely have metacognitive awareness of when their judgments are overly pessimistic, resulting in uncertainty and that question context (more constraints) and people's time orientation (future orientation) are associated with lower uncertainty. Uncertainty about conditioned risk judgments was associated with lower engagement in exercising and eating a healthy diet in order to reduce risk for heart disease. As a potential determinant of behavior, uncertainty about risk judgments merits further consideration for integration into theories of health behavior.
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Affiliation(s)
- Heather Orom
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Caitlin Biddle
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Erika A. Waters
- Department of Surgery (Division of Public Health Sciences), Washington University Medical School, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63130 USA
| | - Marc T. Kiviniemi
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Amanda N. Sosnowski
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
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Conley CC, Small BJ, Christie J, Hoogland AI, Augusto BM, Garcia JD, Pal T, Vadaparampil ST. Patterns and covariates of benefit finding in young Black breast cancer survivors: A longitudinal, observational study. Psychooncology 2020; 29:1115-1122. [PMID: 32323400 DOI: 10.1002/pon.5398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/03/2020] [Accepted: 04/14/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the patterns and covariates of benefit finding over time among young Black breast cancer (BC) survivors. METHODS Black women (N = 305) with invasive BC diagnosed ≤50 years were recruited an average of 1.9 years post-BC diagnosis. Participants completed self-report questionnaires of benefit finding, social support, and illness intrusions at three time points (M time since BC diagnosis: T2 = 3.1 years, T3 = 4.0 years). Relationships between posttraumatic growth constructs (social support, illness intrusions) and benefit finding over time were examined using mixed models. Models controlled for cultural variables (religiosity, time orientation, and collectivism), receipt of chemotherapy, general health status, and partner status. RESULTS Participants reported high levels of benefit finding (M = 2.99, SE = 0.04 on a 0-4 scale). When accounting for covariates, benefit finding did not change over time since BC diagnosis (P = .21). Benefit finding scores at BC diagnosis were associated with more illness intrusions, greater religiosity, and having received chemotherapy (all Ps < .04). Social support was associated with change in benefit finding scores over time, such that a 1-point increase in social support was associated with a 0.05 increase in benefit finding per year (P = .02). CONCLUSIONS This study addresses key gaps in knowledge regarding benefit finding among Black cancer survivors. Consistent with findings from majority White samples, social support and illness intrusions appear to play a key role in benefit finding in Black BC survivors. Cultural constructs-including religiosity-must also be considered in future studies of benefit finding among minority populations.
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Affiliation(s)
- Claire C Conley
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Brent J Small
- School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Juliette Christie
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Bianca M Augusto
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Jennifer D Garcia
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Tuya Pal
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
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Edmonds MC, Sutton AL, He J, Perera RA, Sheppard VB. Correlates of Adjuvant Therapy Attitudes in African American Breast Cancer Patients. J Natl Med Assoc 2020; 112:167-175. [PMID: 32197898 DOI: 10.1016/j.jnma.2020.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/11/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE Black breast cancer patients delay and underutilize adjuvant breast cancer therapies; yet, very few studies have specifically examined Black women's attitudes toward breast cancer therapy. This study observed the influence of self-reported interpersonal processes of care (e.g. self-efficacy) clinical and sociodemographic factors and sociocultural (e.g. religiosity), related to Black breast cancer patients' attitudes toward radiation and systemic therapies (chemotherapy and adjuvant endocrine therapy - "AET"). METHODS This was a secondary analysis of data from the Narrowing Gaps in Adjuvant Therapy Study (2006-2011). The analysis included 210 Black women who were newly diagnosed with breast cancer. Bivariate and multiple regression analyses were performed between independent variables (e.g., demographics) and three outcome variables (chemotherapy, AET, and radiation therapy) to asses women's perceptions of therapy type. The lasso method was used to select variables correlated with therapy attitudes. RESULTS Most women reported negative attitudes toward AET (56%) and radiation (54%); fewer negative attitudes were observed toward chemotherapy (47%). Higher education and greater perceived susceptibility of a recurrence were associated with more positive attitudes toward chemotherapy. Regarding radiation therapy, women with greater patient satisfaction were more likely to have more positive attitudes. CONCLUSIONS Our study findings may aid in the development of behavioral interventions targeted to mitigate Black women breast cancer treatment disparities. We found modifiable factors (e.g. communication, satisfaction ratings) that support opportunities for clinicians to better address Black women's needs regarding adjuvant treatment options. The development of tailored interventions for newly diagnosed Black breast cancer patients on patient related factors in health care are warranted for Black women with lower educational levels.
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Affiliation(s)
- Megan C Edmonds
- Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA.
| | - Arnethea L Sutton
- Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA
| | - Jun He
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Robert A Perera
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, USA
| | - Vanessa B Sheppard
- Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA
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Snead F, Slade AN, Oppong BA, Sutton AL, Sheppard VB. Narrowing Racial Gaps in Breast Cancer: Factors Affecting Probability of Adjuvant Radiation Therapy. Adv Radiat Oncol 2020; 5:17-26. [PMID: 32051886 PMCID: PMC7004948 DOI: 10.1016/j.adro.2019.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/21/2019] [Accepted: 07/15/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Adjuvant radiation therapy has historically been underused by black patients with breast cancer compared with white patients. We prospectively investigated factors, including sociocultural, psychosocial, and health care factors, that may be associated with the use or omission of adjuvant radiation therapy by both racial groups. METHODS AND MATERIALS Women with primary invasive, nonmetastatic breast cancer were recruited from hospitals and through community outreach efforts in the Washington, DC, and Detroit, Michigan, areas between July 2006 and April 2011. Data were collected via telephone interviews regarding psychosocial (eg, self-efficacy) and health care factors (eg, communication) at the time they received a diagnosis. Clinical data were extracted from their medical charts after the completion of treatment. We examined the association among multiple demographic, socio-cultural, healthcare process factors and the use of radiotherapy. Logistic multivariable regression models identified associations with radiotherapy receipt. RESULTS Among 395 eligible and consenting women, 315 had complete baseline data, and 217 were in the final analytical sample, having met criteria for adjuvant breast or chest wall radiation therapy after breast conservation surgery or mastectomy. Among women eligible for radiation, all were insured, 59% were black, the mean age was 55.4 years, and the majority had stage I or II disease. Overall, approximately 70% percent of women received adjuvant radiation therapy. On multivariable analyses, the likelihood of receiving adjuvant radiation therapy was higher for those who were black with any level of indication for radiation therapy (odds ratio 2.21; P < .01), those for whom comorbidities were present, and those who demonstrated positive sociocultural factors such as self-efficacy and high reported rates of provider communication about radiation therapy (odds ratio 1.20; P < .05). Among women with strong indications for radiation therapy, there was no significant association with race on multivariable analysis. CONCLUSIONS Our findings suggest that among women with any indication for radiation therapy, black patients were more likely to receive radiation therapy compared with white patients. Furthermore, data suggest improved provider communication and self-efficacy are important predictors of receipt of radiation therapy. Further studies exploring the effects of provider communication and sociocultural factors to diverse patient populations may be warranted.
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Affiliation(s)
- Felicia Snead
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, Pennsylvania
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Johnson VE, Carter RT. Black Cultural Strengths and Psychosocial Well-Being: An Empirical Analysis With Black American Adults. JOURNAL OF BLACK PSYCHOLOGY 2019. [DOI: 10.1177/0095798419889752] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Based on historical literature, Black Americans have persisted through centuries of oppression in North America. To survive, they retained Africultural values and adopted group-specific practices. Black cultural values and practices can potentially, if bolstered, increase psychosocial health in this population. In the current study, we examined specific Black values and practices and their collective ability to predict psychosocial health. In a sample 486 Black, middle-class, American adults with a mean age of 31 years, we used structural equation modeling to test a first- and a second-order measurement model, as well as a structural model. We hypothesized that health-promoting aspects of Black racial identity (e.g., racial centrality), racial socialization (e.g., cultural socialization), and racism-related coping (e.g., confrontation), as well as higher levels of communalism and spirituality would indicate one latent factor, Black Cultural Strength. Furthermore, we hypothesized that Black Cultural Strength would be predictive of psychosocial health. After slight model modifications, we found an acceptable fit for the data. Clinical implications and future research directions are discussed.
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Rayan-Gharra N, Balicer RD, Tadmor B, Shadmi E. Association between cultural factors and readmissions: the mediating effect of hospital discharge practices and care-transition preparedness. BMJ Qual Saf 2019; 28:866-874. [PMID: 31113835 DOI: 10.1136/bmjqs-2019-009317] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The study examines whether hospital discharge practices and care-transition preparedness mediate the association between patients' cultural factors and readmissions. METHODS A prospective study of internal medicine patients (n=599) examining a culturally diverse cohort, at a tertiary medical centre in Israel. The in-hospital baseline questionnaire included sociodemographic, cultural factors (Multidimensional Health Locus of Control, family collectivism, health literacy and minority status) and physical, mental and functional health status. A follow-up telephone survey assessed hospital discharge practices: use of the teach-back method, providers' cultural competence, at-discharge language concordance and caregiver presence and care-transition preparedness using the care transition measure (CTM). Clinical and administrative data, including 30-day readmissions to any hospital, were retrieved from the healthcare organisation's data warehouse. Multiple mediation was tested using Hayes's PROCESS procedure, model 80. RESULTS A total of 101 patients (17%) were readmitted within 30 days. Multiple logistic regressions indicated that all cultural factors, except for minority status, were associated with 30-day readmission when no mediators were included (p<0.05). Multiple mediation analysis indicated significant indirect effects of the cultural factors on readmission through the hospital discharge practices and CTM. Finally, when the mediators were included, strong direct and indirect effects between minority status and readmission were found (B coefficient=-0.95; p=0.021). CONCLUSIONS The results show that the association between patients' cultural factors and 30-day readmission is mediated by the hospital discharge practices and care transition. Providing high-quality discharge planning tailored to patients' cultural characteristics is associated with better care-transition preparedness, which, in turn, is associated with reduced 30-day readmissions.
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Affiliation(s)
| | - Ran D Balicer
- Clalit Research Institute, Clalit Health Services, Tel-Aviv, Israel
| | - Boaz Tadmor
- The Rabin Medical Center Research Authority, Clalit Health Services, Petah Tikva, Israel
| | - Efrat Shadmi
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
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You S, Yoo JE, Koh Y. Religious practices and mental health outcomes among Korean adults. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.01.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Thompson T, McQueen A, Croston M, Luke A, Caito N, Quinn K, Funaro J, Kreuter MW. Social Needs and Health-Related Outcomes Among Medicaid Beneficiaries. HEALTH EDUCATION & BEHAVIOR 2019; 46:436-444. [PMID: 30654655 DOI: 10.1177/1090198118822724] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Unmet social needs-including food, housing, and utilities-have been associated with negative health outcomes, but most prior research has examined the health associations with a single unmet need or analyzed samples that were homogeneous along one or more dimensions (e.g., older adults or patients with chronic health conditions). We examined the association between unmet social needs and psychosocial and health-related outcomes in a sample of Medicaid beneficiaries from 35 U.S. states. In 2016-2017, 1,214 people completed an online survey about social needs, demographics, and health-related and psychosocial outcomes. Seven items assessing social needs formed an index in which higher scores indicated higher levels of unmet needs. Participants were eligible if they were ≥18 years and had Medicaid. The sample was predominantly female (87%). Most (71%) lived with at least one child ≤18 years, and 49% were White and 33% were African American. Average age was 36 years ( SD = 13). The most common unmet needs were not enough money for unexpected expenses (54%) and not enough space in the home (25%). Analyses controlling for recruitment method and demographics showed that increasing levels of unmet social needs were positively associated with stress, smoking, and number of chronic conditions, and negatively associated with future orientation, attitudes toward prevention, days of exercise/week, servings of fruits or vegetables/day, and self-rated health (all p < .01). Results add to the evidence about the relationship between unmet social needs and health. Interventions to help meet social needs may help low-income people improve both their economic situations and their health.
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Affiliation(s)
- Tess Thompson
- 1 Washington University in St. Louis, St. Louis, MO, USA
| | - Amy McQueen
- 1 Washington University in St. Louis, St. Louis, MO, USA
| | | | - Alina Luke
- 1 Washington University in St. Louis, St. Louis, MO, USA
| | - Nicole Caito
- 1 Washington University in St. Louis, St. Louis, MO, USA
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Clark EM, Williams BR, Huang J, Roth DL, Holt CL. A Longitudinal Study of Religiosity, Spiritual Health Locus of Control, and Health Behaviors in a National Sample of African Americans. JOURNAL OF RELIGION AND HEALTH 2018; 57:2258-2278. [PMID: 29322285 PMCID: PMC6039282 DOI: 10.1007/s10943-017-0548-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present longitudinal study examined religious beliefs and behaviors, spiritual health locus of control (SHLOC), and selected health-related behaviors and outcomes in a national sample of 766 African American adults. Participants were interviewed by telephone three times over a 5-year period. Results indicated that stronger religious beliefs and religious behaviors were associated with greater changes in active SHLOC. There was some evidence of direct effects of religious beliefs and behaviors on changes in health behaviors. Religious behaviors were related to greater passive SHLOC over time across some health outcomes. Passive SHLOC was associated with some less desirable health outcomes over time.
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Affiliation(s)
- Eddie M. Clark
- Department of Psychology, Saint Louis University, Morrissey Hall, 3700 Lindell Blvd., St. Louis, MO 63108, USA. . Phone: (314) 977-2272
| | - Beverly Rosa Williams
- UAB Comprehensive Center for Healthy Aging, CH19 218K, 1720 2nd Ave S, Birmingham, AL 35294-1304, USA. . Phone: (205) 789-5814
| | - Jin Huang
- Center on Aging and Health, Johns Hopkins University, Baltimore MD, 21205, USA. . Phone: (410) 502-6635
| | - David L. Roth
- Center on Aging and Health, Johns Hopkins University, Baltimore MD, 21205, USA. . Phone: (410) 955-0491
| | - Cheryl L. Holt
- Department of Behavioral and Community Health, 1234W School of Public Health Bldg. (255), 422 Valley Drive, School of Public Health, University of Maryland, College Park, MD 20742, USA. . Phone: (301) 405-6659
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Owczarzak J, Broaddus M, Tarima S. Effectiveness of an evidence-based HIV prevention intervention when implemented by frontline providers. Transl Behav Med 2018; 8:917-926. [PMID: 29385559 PMCID: PMC6248864 DOI: 10.1093/tbm/ibx041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Carefully conducted randomized trials have established that sexual behavior change interventions can significantly reduce intervention participants' risk of acquiring HIV. Establishing the effectiveness of these evidence-based interventions when implemented by frontline HIV prevention service providers is increasingly important in order to achieve maximum public health impact. This study sought to assess the effectiveness of an evidence-based intervention when implemented by frontline HIV prevention service providers. We evaluated Sisters Informing Sisters on Topics about AIDS (SISTA), an HIV prevention intervention for heterosexual African American women, as implemented by four AIDS service organizations. Women enrolled in HIV counseling, testing, and referral (CTR) at each agency served as contemporaneous controls. Measures included self-reported number of occasions of unprotected vaginal intercourse and number of vaginal sex partners in the previous 90 days. 1,262 participants completed baseline and follow-up assessments across both conditions (SISTA = 537 [57%]; CTR = 725 [62%]). In the full sample of HIV-negative women, CTR participants' odds of having had unprotected sex decreased over time by 38% while SISTA participants' odds of having had unprotected sex did not change. Similar results were found among only those participants who had sex at baseline. Hypothesized interaction effects indicating positive changes in sexual risks over time for SISTA participants were not observed.
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Affiliation(s)
- Jill Owczarzak
- Department of Health, Behavior, and Society, Johns Hopkins
- Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michelle Broaddus
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sergey Tarima
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
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Ashdown BK, Faherty AN, Brown CM, Hanno O, Belden A, Weeks PB. Fathers and Perceptions of God Play an Important Role in Psychological Adjustment Among Emerging Adults in Guatemala and the United States. The Journal of Genetic Psychology 2018; 179:270-285. [PMID: 30300107 DOI: 10.1080/00221325.2018.1502148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Interpersonal acceptance-rejection theory posits that people require parental acceptance in childhood to develop healthy psychological adjustment. People's beliefs about and their relationship with deity also influences their psychological adjustment. The purpose of the present study was to investigate how both perceived parental acceptance and a relationship with deity are related to psychological adjustment for emerging adults in Guatemala and the United States. Participants (N = 189) from Guatemala and the United States completed measures of perceived parental acceptance-rejection, images of God, attachment to God, and psychological adjustment. Results indicate that perceived paternal acceptance-rejection was only a significant predictor of psychological adjustment in U.S. participants, and not in Guatemalan participants. In both samples, images of God did not predict psychological adjustment. However, an anxious attachment with God predicted psychological maladjustment for both groups. The findings suggest that two important factors to be considered by researchers, educators, and mental health professionals are adults' perceptions of their father's level of acceptance-rejection and the amount of anxiety they experience in their relationship with God.
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Affiliation(s)
- Brien K Ashdown
- a Department of Psychology , Hobart & William Smith Colleges , Geneva , New York , USA
| | - Amanda N Faherty
- a Department of Psychology , Hobart & William Smith Colleges , Geneva , New York , USA
| | - Carrie M Brown
- b Western Governors University , Oak Park , Illinois , USA
| | - Olivia Hanno
- a Department of Psychology , Hobart & William Smith Colleges , Geneva , New York , USA
| | - Alexandra Belden
- a Department of Psychology , Hobart & William Smith Colleges , Geneva , New York , USA
| | - Peter B Weeks
- a Department of Psychology , Hobart & William Smith Colleges , Geneva , New York , USA
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Sheppard VB, Walker R, Phillips W, Hudson V, Xu H, Cabling ML, He J, Sutton AL, Hamilton J. Spirituality in African-American Breast Cancer Patients: Implications for Clinical and Psychosocial Care. JOURNAL OF RELIGION AND HEALTH 2018; 57:1918-1930. [PMID: 29627925 DOI: 10.1007/s10943-018-0611-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Spirituality has been shown to be important to many individuals dealing with a cancer diagnosis. While African-American breast cancer survivors have been reported to have higher levels of spirituality compared to White women, little is known about how levels of spirituality may vary among African-American breast cancer survivors. The aims of this study were to examine factors associated with spirituality among African-American survivors and test whether spirituality levels were associated with women's attitudes about treatment or health care. The primary outcome, spirituality, was nine-item scale (Cronbach's α = .99). Participants completed standardized telephone interviews that captured sociocultural, healthcare process, and treatment attitudes. Medical records were abstracted post-adjuvant therapy for treatment and clinical information. In bivariate analysis, age was not correlated with spirituality (p = .40). Married/living as married women had higher levels of spirituality (m = 32.1) than single women (m = 30.1). Contextual factors that were associated with higher levels spirituality were: collectivism (r = .44; p < 0.0001, Afrocentric worldview (r = .185; p = .01), and self-efficacy scale (r = .17; p = .02). In multivariable analysis, sociodemographic factors were not significant. Collectivism remained a robust predictor (p < 0.0001). Attitudes about the efficacy of cancer treatment were not associated with spirituality. The high levels of spirituality in African-American survivors suggest consideration of integrating spiritual care within the delivery of cancer treatment. Future studies should consider how spirituality may contribute to positive coping and/or behaviors in African-American women with high levels of spirituality.
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Affiliation(s)
- Vanessa B Sheppard
- Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 E Main St, PO Box 980149, Richmond, VA, 23298, USA.
| | | | | | | | - Hanfei Xu
- Georgetown University Medical Center, Washington, DC, USA
| | | | - Jun He
- Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 E Main St, PO Box 980149, Richmond, VA, 23298, USA
| | - Arnethea L Sutton
- Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 E Main St, PO Box 980149, Richmond, VA, 23298, USA
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Escoto KH, Milbury K, Nguyen N, Cho D, Roberson C, Wetter D, McNeill LH. Use of Complementary Health Practices in a Church-Based African American Cohort. J Altern Complement Med 2018; 24:1204-1213. [PMID: 29883196 DOI: 10.1089/acm.2018.0076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objectives: Few studies have examined the use of complementary health practices (e.g., mind/body practices and dietary supplements) among African Americans, particularly those who identify as being spiritual and/or religious. Furthermore, research on the health and health behavior profiles of such complementary health users is scant. The purpose of this study was to explore the use of complementary health practices and their lifestyle and health indicator correlates in a large, church-based African American population. Design: Cross-sectional analysis of 1467 African American adults drawn from a church-based cohort study. Participants reported use of complementary health practices, lifestyle behaviors (e.g., diet and smoking status), and health indicators (e.g., physical health and medical problems). Multiple logistic regressions were conducted to examine associations between lifestyle variables, health indicators, and use of complementary health practices. Outcome measures: Outcomes included prevalence of mind/body practices (e.g., meditation and Reiki) and dietary supplements (multivitamins) along with health indicator and lifestyle correlates of use. Results: Use of complementary health practices was high; 40% reported using any mind/body practice and 50% reported using dietary supplements. Poorer physical health was associated with use of mind/body practices, while likelihood of meeting fruit and vegetable recommendations was significantly associated with dietary supplement use. Conclusions: Complementary health practices were used heavily in a church-based sample of African American adults. Poorer physical health was associated with use of complementary health practices, yet users also displayed health conscious behaviors. Given the high engagement in complementary health practices, it may be prudent to consider adapting complementary health approaches for use in wellness interventions targeting African Americans in faith-based settings.
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Affiliation(s)
- Kamisha Hamilton Escoto
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kathrin Milbury
- Integrative Medicine Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nga Nguyen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Crystal Roberson
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David Wetter
- Department of Population Health Sciences, University of Utah Human Cancer Institute, Salt Lake City, UT
| | - Lorna H McNeill
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
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Mastery, self-esteem, and optimism mediate the link between religiousness and spirituality and postpartum depression. J Behav Med 2018; 41:711-721. [DOI: 10.1007/s10865-018-9941-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 05/25/2018] [Indexed: 10/14/2022]
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Zhuang J, Lapinski MK, Peng W. Crafting messages to promote water conservation: Using time-framed messages to boost conservation actions in the United States and China. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2018. [DOI: 10.1111/jasp.12509] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jie Zhuang
- Department of Communication Studies; Texas Christian University
| | | | - Wei Peng
- Department of Media and Information Studies; Michigan State University
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Cunningham-Erves J, Forbes L, Ivankova N, Mayo-Gamble T, Kelly-Taylor K, Deakings J. Black mother's intention to vaccinate daughters against HPV: A mixed methods approach to identify opportunities for targeted communication. Gynecol Oncol 2018; 149:506-512. [PMID: 29588103 DOI: 10.1016/j.ygyno.2018.03.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The cervical cancer disparity continues to exist and has widened between Black and non-Hispanic White women. Human Papillomavirus (HPV) vaccines could potentially reduce this disparity, yet remain underused among Black female adolescents. We investigated psychosocial and cultural factors associated with Black mothers' intentions to vaccinate their daughters against HPV, and explored views toward a HPV vaccine mandate. METHODS In this quantitative dominant, mixed methods study, cross sectional surveys (n=237) and follow-up semi-structured interviews (n=9) were conducted with Black mothers of daughters. A 2-step logistic regression determined factors associated with Black mothers' intention. Thematic content analysis determined emerging themes. RESULTS Perceived susceptibility (p=.044), perceived barriers (p<.001), and subjective norms (p=.001) were significant predictors of maternal HPV vaccination intentions. Follow-up interviews provided insight into factors influencing mothers' intentions. Mothers with low intentions did not perceive their daughter to be currently sexually active or in near future, thus, not at HPV risk. Pediatricians were identified as the most influential person on maternal decision-making if there was a pre-existing relationship. However, many mothers had not received a pediatricians' recommendation for their daughters. Barriers influencing mother's decision-making include knowledge, daughters' age, and mistrust in pharmaceutical companies and physicians. Mothers were not in favor of the HPV vaccine mandate. CONCLUSIONS Findings demonstrate the need to develop and evaluate physician-led interventions on HPV and vaccine importance, and engage these mothers in intervention development to build trust between physicians, researchers, and Black mothers to improve HPV vaccine uptake in Black female adolescents.
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Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Human Studies, University of Alabama at Birmingham, 1720 2nd Ave S., EB 207, Birmingham, AL 35294-1250, United States.
| | - Laura Forbes
- Department of Human Studies, University of Alabama at Birmingham, 1720 2nd Ave S., EB 207, Birmingham, AL 35294-1250, United States
| | - Nataliya Ivankova
- Departments Health Services Administration and Acute, Chronic, and Continuing Care, University of Alabama at Birmingham, 569 SHPB, 1716 9th Ave S, Birmingham, AL 35294-1212, United States
| | - Tilicia Mayo-Gamble
- Department of Family Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208-3599, United States
| | - Kendria Kelly-Taylor
- School of Graduate Studies and Research, Meharry Medical College, Nashville, TN 37208-3599, United States
| | - Jason Deakings
- School of Graduate Studies and Research, Meharry Medical College, Nashville, TN 37208-3599, United States
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Sheppard VB, de Mendoza AH, He J, Jennings Y, Edmonds MC, Oppong BA, Tadesse MG. Initiation of Adjuvant Endocrine Therapy in Black and White Women With Breast Cancer. Clin Breast Cancer 2017; 18:337-346.e1. [PMID: 29422259 DOI: 10.1016/j.clbc.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/20/2017] [Accepted: 12/01/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Adjuvant endocrine therapy reduces risk of recurrence and mortality in women with hormone receptor-positive breast cancer, yet many women never initiate it. We examined the influence of race, sociocultural factors, and process-of-care factors on initiation of adjuvant endocrine therapy in a racially diverse sample. PATIENTS AND METHODS Eligible women were originally recruited for the Narrowing the Gaps in Adjuvant Therapy Study (2006-2011). Sociocultural and process-of-care factors were collected via telephone surveys before adjuvant therapy. Clinical factors were abstracted from charts. Penalized LASSO (least absolute shrinkage and selection operator) logistic regression model was used to identify variables associated with initiation. RESULTS Of the 270 women, 55.6% were black and the rest were white. Most women (74.8%) initiated therapy. A significant interaction (P = .008) was found between race and age. Black women aged ≤ 50 years had the lowest initiation (59.7%) compared to black women > 50 years (87.1%), white women ≤ 50 years (73.7%), or white women > 50 years (72.0%). Multivariate analysis found that younger black women exhibited a marginally higher risk of noninitiation compared to older black women. Additionally, ratings of financial access, presence of comorbidities, and levels of communication were all associated with endocrine therapy initiation. CONCLUSION Black women ≤ 50 years of age and women with financial constraints may be important subgroups for interventions. Patient-provider communication appears to be an important leverage point to foster therapy uptake.
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Affiliation(s)
- Vanessa B Sheppard
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA.
| | | | - Jun He
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Yvonne Jennings
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Megan C Edmonds
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Bridget A Oppong
- Georgetown University Medical Center, Georgetown University, Washington, DC
| | - Mahlet G Tadesse
- Department of Mathematics and Statistics, Georgetown University, Washington, DC
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Yoo J. The Effect of Religious Involvement on Life Satisfaction among Korean Christians: Focused on the Mediating Effect of Spiritual Well-Being and Self-Esteem. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2017; 71:257-266. [PMID: 29224523 DOI: 10.1177/1542305017743432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present study examined the relationship between two categories of religious involvement, namely religious belief and religious behavior, and life satisfaction among Korean Christians (N = 278) with spiritual well-being and self-esteem as potential mediators in this relationship by using structural equation modeling (SEM). The results supported the full mediated structural model and indicated that religious belief had a significant indirect effect on life satisfaction through the mediators, spiritual well-being and self-esteem. Religious behavior did not have an indirect or direct effect on life satisfaction among Korean Christians. The significance, implications, and limitations of the study were discussed.
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Affiliation(s)
- Jieun Yoo
- 65423 Anyang University , Anyang, Republic of Korea
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Davis RE, Dal Cin S, Cole SM, Reyes LI, McKenney-Shubert SJ, Fleischer NL, Densen LC, Peterson KE. A Tale of Two Stories: An Exploration of Identification, Message Recall, and Narrative Preferences Among Low-Income, Mexican American Women. HEALTH COMMUNICATION 2017; 32:1409-1421. [PMID: 27767353 PMCID: PMC6208143 DOI: 10.1080/10410236.2016.1228029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Additional research is needed to guide the design of narratives for use in practice-oriented, naturalistic settings to maximize health behavior change, particularly among populations affected by health disparities. This mixed-methods study explored the influence of cultural tailoring and emotional arousal on identification and message recall in narratives promoting childhood obesity prevention among 40 Mexican American mothers. Participants were also asked about narrative exposure, narrative preferences, and beliefs about the purpose of a story. Participants were randomly assigned to listen to two stories: (a) a story tailored on noncultural or cultural variables, and (b) a story designed to enhance or minimize emotional arousal. Participants reported high engagement and identification with all stories. Participants generally envisioned protagonists as Latina, despite limited cues, and identified with protagonists in four ways: sharing personal characteristics; having similar thoughts and feelings; engaging in similar actions; and experiencing similar situations. Mothers were most interested in narratives that helped them to improve their lives. Findings from this study yield several hypotheses for consideration in future study, including ways in which story setting and message enactment may moderate message recall.
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Affiliation(s)
- Rachel E Davis
- a Department of Health Promotion, Education, and Behavior , University of South Carolina
| | - Sonya Dal Cin
- b Department of Communication Studies , University of Michigan
| | - Suzanne M Cole
- c Department of Nutritional Sciences, School of Public Health , University of Michigan
| | - Ligia I Reyes
- d Department of Health Promotion, Education, and Behavior , University of South Carolina
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Dickey SL, Whitmore A, Campbell E. The Relation among Prostate Cancer Knowledge and Psychosocial Factors for Prostate Cancer Screening among African American Men: a Correlational Study. AIMS Public Health 2017; 4:446-465. [PMID: 30155498 PMCID: PMC6111273 DOI: 10.3934/publichealth.2017.5.446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/17/2017] [Indexed: 11/18/2022] Open
Abstract
African American (AA) men face disproportionately higher rates of prostate cancer (PCa) in comparison to other races. In addition, higher mortality rates from PCa amongst AA men signifies PCa as a formidable health disparity. Inconsistent PCa screening guidelines among medical organizations, further clouds one's decision on receiving a PCa screening. Examining various relations among factors which influence PCa screening may provide insight into their decision whether or not to receive a PCa screening. The purpose of the study was to examine the presence of associations among PCa knowledge, psychosocial factors, and PCa screening over a six month time frame. There were 76 participants at baseline, intervention group (n = 37) and control group (n = 35) and 54 participants, intervention group (n = 26) and control group (n = 28) remained at the 6 month follow up. At the six month follow up, the control group was more likely to have not received a PCa screening and the intervention group was more likely to have received a PCa screening, p < 0.01. PCa knowledge scores rose from 49% to 71%, intervention group, and 52% to 58%, control group. Significant associations were found among the following covariates, age and religion (rs = 0.499, p < 0.01), income and education (rs = 0.535, p < 0.01), income and healthcare coverage (rs = 0.528, p < 0.01), income and PCa knowledge at 6 months (rs = 0.424, p < 0.01), PCa screening and religion (rs = 0.353, p < 0.01), healthcare empowerment and preparation for decision making (rs = 0.421, p < 0.01), decisional self-efficacy and active surveillance knowledge (rs = 0.377, p < 0.01), and active surveillance knowledge and PCa knowledge (rs = 0.497, p < 0.01). The study revealed associations among PCa knowledge and psychosocial factors regarding a decision for PCa screening among the PCa high risk group, AA men.
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Affiliation(s)
- Sabrina L. Dickey
- Florida State University, College of Nursing, Tallahassee, Florida, USA
| | - Aurellia Whitmore
- Florida Agricultural & Mechanical University, Tallahassee, Florida, USA
| | - Ellen Campbell
- Florida Agricultural & Mechanical University, Tallahassee, Florida, USA
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Clark EM, Huang J, Roth DL, Schulz E, Williams BR, Holt CL. The relationship between religious beliefs and behaviors and changes in spiritual health locus of control over time in a national sample of African Americans. Ment Health Relig Cult 2017; 20:449-463. [PMID: 29398951 DOI: 10.1080/13674676.2017.1356274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Using data from a sample of African Americans, the present study examined the role of religious beliefs and behaviors in predicting changes in spiritual health locus of control (SHLOC), or beliefs about the role that God plays in a person's health. A national sample of African American adults was recruited using a telephone survey and re-contacted 2.5 years later. Overall, results indicated that both higher religious beliefs and behaviors predicted increases in active SHLOC, or the view that one collaboratively works with God to maintain one's health. However, only religious behaviors predicted increases in passive SHLOC, or the view that because God is in complete control of health that one's own behaviors are unnecessary. Among men, religious beliefs predicted strengthening active SHLOC beliefs, while religious behaviors predicted growing passive SHLOC beliefs. Among women, religious behaviors predicted strengthening active and passive SHLOC beliefs.
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Affiliation(s)
- Eddie M Clark
- Department of Psychology, Saint Louis University, Morrissey Hall, 3700 Lindell Blvd., St. Louis, MO 63108, USA.
| | - Jin Huang
- Center on Aging and Health, Johns Hopkins University, Baltimore MD, 21205, USA.
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University, Baltimore MD, 21205, USA.
| | - Emily Schulz
- Department of Occupational Therapy, A.T. Still University, Arizona School of Health Sciences, 5850 E. Still Circle, Mesa, AZ 85206, USA.
| | - Beverly Rosa Williams
- UAB Comprehensive Center for Healthy Aging, CH19 218K, 1720 2nd Ave S, Birmingham, AL 35294-1304, USA.
| | - Cheryl L Holt
- Department of Behavioral and Community Health, 2369 School of Public Health Bldg. (255), 422 Valley Drive, School of Public Health, University of Maryland, College Park, MD 20742, USA.
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50
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Holt CL, Roth DL, Huang J, Clark EM. Role of religious social support in longitudinal relationships between religiosity and health-related outcomes in African Americans. J Behav Med 2017; 41:62-73. [PMID: 28776192 DOI: 10.1007/s10865-017-9877-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/22/2017] [Indexed: 12/27/2022]
Abstract
This study tested a longitudinal model of religious social support as a potential mediator of the relationship between religious beliefs and behaviors, and multiple health-related outcomes (e.g., depressive symptoms, functioning, diet, alcohol use, cancer screening). A national probability sample of African Americans enrolled in the religion and health in African Americans study completed three waves of telephone interviews over a 5-year period (N = 766). Longitudinal structural equation models indicated that religious behaviors, but not beliefs, predicted the slowing of a modest overall decline in positive religious social support, while negative interactions with congregational members were stable. Positive religious support was associated with lower depressive symptoms and heavy drinking over time, while negative interaction predicted increases in depressive symptoms and decreases in emotional functioning. Positive religious support mediated the relationship between religious behaviors and depressive symptoms and heavy drinking. Findings have implications for mental health interventions in faith-based settings.
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Affiliation(s)
- Cheryl L Holt
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, 1234W School of Public Health Building (255), College Park, MD, 20742, USA.
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jin Huang
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eddie M Clark
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
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