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Ahmed S, Pinnock H, Steed L. Exploring the perspectives of healthcare professionals on providing supported asthma self-management for Bangladeshi and Pakistani people in the UK. PLoS One 2024; 19:e0302357. [PMID: 38857297 PMCID: PMC11164332 DOI: 10.1371/journal.pone.0302357] [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: 07/05/2021] [Accepted: 04/02/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Self-management support improves asthma outcomes and is widely recommended in guidelines, yet it is poorly implemented in routine practice. There may be additional challenges in the context of ethnic minority groups, where making sense of culture may be necessary. This study aimed to explore the perspectives of healthcare professionals on supporting UK Bangladeshi and Pakistani patients to self-manage their asthma. METHODS One-to-one semi-structured interviews with professionals (primary and secondary care; medical and nursing) who routinely provide asthma care to Bangladeshi or Pakistani patients. Topics addressed included perceptions of professionals in supporting patients with asthma self-management and ideas for improving culturally competent care. Data were analysed thematically. RESULTS Nine professionals, from a range of ethnic backgrounds, with considerable experience of treating patients from these communities were interviewed. Despite organisational restrictions (language and time/resources) and expressed gaps in cultural knowledge and training, all interviewees reported attempting to tailor support according to culture. They used their perception of the patient's culture (e.g., big families and family involvement), integrated with their perception of patients' ability to self-manage (e.g., degree of responsibility taken for asthma), to formulate theories about how to culturally adapt their approach to supported self-management, e.g., supporting barriers in understanding asthma. There was consensus that gaps in cultural knowledge of professionals needed to be addressed through training or information. Interventions recommended for patients included basic education, group meetings, and culturally relevant action plans. CONCLUSION In the absence of formal training and constrained by organisational limitations, self-management support was adapted based on personal and professional perception of culture. These ideas were based on experience and formulated a chain of reasoning. Professionals recognised the limitations of this approach and potential to overgeneralise their perceptions of culture and adaptations of supported self-management. Interventions were desired and need to address professional training in cultural competence and the provision of culturally relevant materials.
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Affiliation(s)
- Salina Ahmed
- The Institute of Population Health Sciences, Asthma UK Centre for Applied Research, Queen Mary, School of Medicine and Dentistry, University of London, London, United Kingdom
- University of Greenwich, School of Health Sciences, London, United Kingdom
| | - Hilary Pinnock
- Usher Institute of Population Health Sciences and Informatics, Asthma UK Centre for Applied Research, School of Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Liz Steed
- The Institute of Population Health Sciences, Asthma UK Centre for Applied Research, Queen Mary, School of Medicine and Dentistry, University of London, London, United Kingdom
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Louis K, Crum AJ, Markus HR. Negative consequences of self-presentation on disclosure of health information: A catch-22 for Black patients? Soc Sci Med 2023; 316:115141. [PMID: 35778285 DOI: 10.1016/j.socscimed.2022.115141] [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: 11/28/2021] [Revised: 05/19/2022] [Accepted: 06/10/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE Most patients assume that it is adaptive to present oneself in a positive light when interacting with medical professionals. Here in two studies focused on Black patients we ask: might this desire to present oneself well inhibit the disclosure of health-relevant information when patients are concerned about negative and stereotypic evaluations by their health care providers? OBJECTIVE Specifically, we explore three important questions: First, whether self-presentational efforts (e.g., working hard to sound knowledgeable or "smart") are negatively associated with disclosure of health information (e.g., not taking certain medications); Second, whether patient-provider racial congruence (e.g. Black patients interacting with a Black vs. a White doctor) moderates that relationship; and third, more broadly, what factors promote or inhibit disclosure of health information for Black patients in medical interactions. METHODS These questions were investigated using mixed methodology (survey, experimental, qualitative) studies on CloudResearch and Prolific. RESULTS We found a potential catch-22: participants who spend more effort self-presenting tend to be less comfortable disclosing health information to their healthcare providers. Moreover, Study 1 (N = 321) indicated that the negative relationship between self-presentation and disclosure was significant in Black-incongruent (i.e., Black patient and White provider) and White-congruent (i.e., White patient and White provider) medical interactions. Study 2 (N = 361) did not find a significant moderation by race of the provider but instead suggested that the relationship between self-presentation and disclosure was moderated by expectations of unfair treatment. Exploratory qualitative analyses suggested that some Black participants face a dilemma when deciding whether to disclose information to their healthcare providers. They weigh the kind of information they will share, and how sharing some information might lead to embarrassment and judgment. CONCLUSION Mitigating the potentially counteractive effects of self-presentation on disclosure and working to foster contexts that encourage honest disclosure of health information may help to reduce health care inequalities.
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Affiliation(s)
| | - Alia J Crum
- Department of Psychology, Stanford University, United States
| | - Hazel R Markus
- Department of Psychology, Stanford University, United States
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Hampton-Anderson JN, Watson-Singleton NN, Mekawi Y, Dunn SE, Kaslow NJ. Intimate Partner Violence, Existential Well-Being, and Africultural Coping in African American Women. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2022; 31:660-676. [PMID: 35846383 PMCID: PMC9282718 DOI: 10.1080/10926771.2022.2038751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 09/03/2021] [Accepted: 11/08/2021] [Indexed: 06/15/2023]
Affiliation(s)
| | | | - Yara Mekawi
- Department of Psychological and Brain Science, University of Louisville
| | - Sarah E. Dunn
- Department of Psychiatry and Behavioral Sciences, Emory University
| | - Nadine J. Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University
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Florez IA, Mekawi Y, Hunnicutt-Ferguson K, Visser K, Clunie A, Dunn SE, Kaslow NJ. Childhood abuse, posttraumatic stress symptoms, and alcohol misuse among African-American women. J Ethn Subst Abuse 2022; 21:174-196. [PMID: 32065558 PMCID: PMC8493960 DOI: 10.1080/15332640.2020.1725707] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The study explored associations among childhood abuse, post-traumatic stress symptoms (PTSS), and alcohol misuse in a sample of low-income African-American women (N = 172). Using bootstrapping techniques, a mediation effect was found of childhood physical and emotional abuse on alcohol misuse via PTSS symptom severity, avoidance, and hyperarousal, as well as for childhood sexual abuse on alcohol misuse via PTSS symptom severity and hyperarousal. Our results suggest that PTSS indicators, particularly symptom severity and hyperarousal, may be important mechanisms underlying the association of experiences of abuse during childhood and alcohol misuse in adulthood.
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Affiliation(s)
- Ivonne Andrea Florez
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Yara Mekawi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kallio Hunnicutt-Ferguson
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Amber Clunie
- Department of Psychology, Spelman College, Atlanta, GA, USA
| | - Sarah E. Dunn
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Nadine J. Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA,Correspondence should be addressed to: Nadine J. Kaslow, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Grady Health System, 80 Jesse Hill Jr. Drive NE, Atlanta, GA, USA, 30303;
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van den Broek KL, Luomba J, van den Broek J, Fischer H. Evaluating the Application of the Mental Model Mapping Tool (M-Tool). Front Psychol 2021; 12:761882. [PMID: 34970194 PMCID: PMC8712333 DOI: 10.3389/fpsyg.2021.761882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Mental models influence how individuals think and act in relation to their external environment and have been identified as leverage points to address sustainability challenges. Given the importance of mental models, a new tool to assess mental models has been developed: the Mental Model Mapping Tool (M-Tool). M-Tool was designed to have a standardized format and to be user-friendly for low literacy populations, using pictograms and audio instructions. In this paper, we evaluate M-Tool's application in two studies with Tanzanian fishers. In Study 1, we investigated M-tool's convergent validity compared to standard interviewing methods (n = 30). Study 2 investigated M-Tool's construct validity by relating mental model complexity to participants' education level (n = 185), a relationship that has been well established. The findings show that (1) mental models produced with M-Tool are more complex than mental models obtained through interviewing techniques; (2) model composition is similar across the two methods; and (3) participants with higher levels of education tend to produce more complex mental models with M-Tool than participants with lower levels of education, in line with previous research. These findings suggest that M-Tool can successfully capture mental models among diverse participants. This tool offers researchers and practitioners an instrument to map and compare perceptions of (conservation) challenges across groups.
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Affiliation(s)
- Karlijn L. van den Broek
- Research Centre for Environmental Economics, University of Heidelberg, Heidelberg, Germany
- Copernicus Institute of Sustainable Development, Utrecht University, Utrecht, Netherlands
| | - Joseph Luomba
- Tanzanian Fisheries Research Institute, Mwanza, Tanzania
| | - Jan van den Broek
- Department of Theoretical Epidemiology, Utrecht University, Utrecht, Netherlands
| | - Helen Fischer
- Max Planck Institute for Human Development, Berlin, Germany
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Phares TM, Sherin K, Harrison SL, Mitchell C, Freeman R, Lichtenberg K. Intimate Partner Violence Screening and Intervention: The American College of Preventive Medicine Position Statement. Am J Prev Med 2019; 57:862-872. [PMID: 31753269 DOI: 10.1016/j.amepre.2019.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/30/2019] [Accepted: 07/01/2019] [Indexed: 11/27/2022]
Abstract
The purpose of this paper is to produce a position statement on intimate partner violence (IPV), a major sociomedical problem with recently updated evidence, systematic reviews, and U.S. Preventive Services Task Force guidelines. This position statement is a nonsystematic, rapid literature review on IPV incidence and prevalence, health consequences, diagnosis and intervention, domestic violence laws, current screening recommendations, barriers to screening, and interventions, focusing on women of childbearing age (15-45 years). The American College of Preventive Medicine (ACPM) recommends an integrated system of care approach to IPV for screening, identification, intervention, and ongoing clinical support. ACPM only recommends screening that is linked to ongoing clinical support for those at risk. ACPM recommends greater training of clinicians in IPV screening and interventions and offers health systems and research recommendations.
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Affiliation(s)
- Tanya M Phares
- Department of Medicine, University of Nevada, Reno, Reno, Nevada.
| | - Kevin Sherin
- Department of Family Medicine and Rural Health, Florida State University, Tallahassee, Florida
| | | | - Connie Mitchell
- Center for Family Health, California Department of Public Health, Sacramento, California
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Wolford-Clevenger C, Smith PN, Kuhlman S, D'Amato D. A Preliminary Test of the Interpersonal-Psychological Theory of Suicide in Women Seeking Shelter From Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:2476-2497. [PMID: 27456533 DOI: 10.1177/0886260516660974] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Women seeking shelter from intimate partner violence (IPV) are at greater risk of suicide ideation and attempts compared with women in the general population. A theoretically grounded understanding of suicide risk in shelter-seeking women is critical to improve assessment and management of suicide risk in this population. The interpersonal-psychological theory of suicide (IPTS) proposes that suicide ideation results from hopelessness about thwarted belongingness and perceived burdensomeness. However, suicide ideation does not progress to death by suicide unless one has acquired the capability for suicide (i.e., pain tolerance and fearlessness about death) via repeated exposure to painful and fearsome events. The present study provides a preliminary test of the IPTS in a sample of 134 women seeking shelter from IPV. First, we examined factors theoretically related to suicide ideation, demonstrating that only at high levels of hopelessness was perceived burdensomeness associated with suicide ideation. The study also examined factors theoretically related to the acquired capability for suicide (ACS), indicating that physical partner violence perpetration was associated with ACS. These findings suggest that perceived burdensomeness, particularly in the context of increased hopelessness, is important in the assessment and treatment of suicide ideation. Furthermore, violence perpetration may indicate greater risk of the capability to die by suicide among women seeking shelter from IPV.
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Vercruyssen A, Wuyts C, Loosveldt G. The effect of sociodemographic (mis)match between interviewers and respondents on unit and item nonresponse in Belgium. SOCIAL SCIENCE RESEARCH 2017; 67:229-238. [PMID: 28888288 DOI: 10.1016/j.ssresearch.2017.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 02/21/2017] [Accepted: 02/28/2017] [Indexed: 06/07/2023]
Abstract
Interviewer characteristics affect nonresponse and measurement errors in face-to-face surveys. Some studies have shown that mismatched sociodemographic characteristics - for example gender - affect people's behavior when interacting with an interviewer at the door and during the survey interview, resulting in more nonresponse. We investigate the effect of sociodemographic (mis)matching on nonresponse in two successive rounds of the European Social Survey in Belgium. As such, we replicate the analyses of the effect of (mis)matching gender and age on unit nonresponse on the one hand, and of gender, age and education level (mis)matching on item nonresponse on the other hand. Recurring effects of sociodemographic (mis)match are found for both unit and item nonresponse.
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Affiliation(s)
- Anina Vercruyssen
- Centre for Sociological Research, KU Leuven, University of Leuven, Belgium
| | - Celine Wuyts
- Centre for Sociological Research, KU Leuven, University of Leuven, Belgium
| | - Geert Loosveldt
- Centre for Sociological Research, KU Leuven, University of Leuven, Belgium.
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Florez IA, Allbaugh LJ, Harris CE, Schwartz AC, Kaslow NJ. Suicidal ideation and hopelessness in PTSD: spiritual well-being mediates outcomes over time. ANXIETY STRESS AND COPING 2017; 31:46-58. [PMID: 28846030 DOI: 10.1080/10615806.2017.1369260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background There is an increased interest in understanding the mechanisms through which post-traumatic stress disorder (PTSD) relates with hopelessness and suicidal ideation. Spiritual well-being could help explain the link between PTSD and both hopelessness and suicidal ideation in African Americans. However, no study has examined the mediational role of existential and religious well-being among these variables. Objectives To examine if initial levels of existential and religious well-being mediated the relation between levels of PTSD symptoms and prospective levels of hopelessness and suicidal ideation in a sample of African American females. Design The study used a longitudinal design with a 10-week time interval. Methods The sample comprised of 113 disadvantaged African American women survivors of a recent suicide attempt recruited from a southern hospital. Self-report measures of PTSD symptoms, hopelessness, suicidal ideation, and spiritual well-being were administered to examine the variables of interest. Bootstrapping techniques were used to test the mediational models. Results Existential, but not religious well-being, mediated the relationship between levels of PTSD symptoms severity and both levels of hopelessness and suicidal ideation over time. Conclusions Existential well-being appears to play a promising protective role against the negative effects of PTSD on both hopelessness and suicidal ideation.
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Affiliation(s)
- Ivonne Andrea Florez
- a Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Lucy J Allbaugh
- a Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Catherine E Harris
- a Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Ann C Schwartz
- a Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Nadine J Kaslow
- a Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
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Wolford-Clevenger C, Smith PN. The Conditional Indirect Effects of Suicide Attempt History and Psychiatric Symptoms on the Association Between Intimate Partner Violence and Suicide Ideation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016; 106:46-51. [PMID: 29056805 DOI: 10.1016/j.paid.2016.10.042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Women seeking shelter from intimate partner violence (IPV) experience heightened risk for suicide ideation and attempts compared to abused and non-abused women in the general population. However, few theory-guided studies have examined what cognitive-emotional symptoms might underlie this increased risk. METHODS Guided by fluid vulnerability theory, this cross-sectional, survey study tested whether depressive symptoms, PTSD symptoms, and hopelessness mediate the association between IPV (coercive control and physical violence) and suicide ideation and whether suicide attempt history facilitated these mediated relations in 134 women seeking shelter from IPV. RESULTS Depressive symptoms, but not PTSD symptoms or hopelessness, mediated the relation between coercive control and suicide ideation, and suicide attempt history facilitated this association. No variables mediated the association between physical violence and suicide ideation. LIMITATIONS The small sample size may have limited statistical power. The cross-sectional design precludes temporal conclusions from being drawn. CONCLUSIONS Shelter-seeking women subjected to coercive control who experience associated depressive symptoms may be at risk of suicide ideation, with history of a suicide attempt increasing this risk. Fluid vulnerability theory may help guide suicide risk assessment and intervention efforts among women seeking shelter from IPV.
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Affiliation(s)
- Caitlin Wolford-Clevenger
- Department of Psychology, University of Tennessee-Knoxville, 310 Austin Peay Bldg., Knoxville, TN 37996-0900
| | - Phillip N Smith
- Psychology Department, University of South Alabama, UCOM 1000, 75 S. University Blvd., Mobile, AL 36688
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Zhang H, Pittman DM, Lamis DA, Fischer NL, Schwenke TJ, Carr ER, Shah S, Kaslow NJ. Childhood Maltreatment and PTSD: Spiritual Well-Being and Intimate Partner Violence as Mediators. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2015; 24:501-519. [PMID: 26989343 PMCID: PMC4792129 DOI: 10.1080/10926771.2015.1029182] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Childhood maltreatment places individuals, including African American women who are undereducated and economically disadvantaged, at risk for developing posttraumatic stress disorder (PTSD) symptoms. Participants were 192 African American women with a history in the prior year of both a suicide attempt and intimate partner violence (IPV) exposure. They were recruited from a public hospital that provides medical and mental health treatment to mostly low-income patients. A simple mediator model was used to examine if (1) existential well-being (sense of purpose) and/or religious well-being (relationship with God) mediated the link between childhood maltreatment and adult PTSD symptoms. Sequential multiple mediator models determined if physical and nonphysical IPV enhanced our understanding of the mediational association among the aforementioned variables. Findings suggest that existential well-being mediated the association between childhood maltreatment and adult PTSD symptoms in a simple mediator model, and existential well-being and recent nonphysical IPV served as sequential multiple mediators of this link. However, religious well-being and physical IPV were not significant mediators. Findings underscore the importance of enhancing existential well-being in the treatment of suicidal African American women with a history of childhood maltreatment and IPV.
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Affiliation(s)
| | | | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | | | - Tomina J Schwenke
- Georgia Department of Behavioral Health and Department of Disabilities
| | | | | | - Nadine J Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
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