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Jones LM, Hawkins J, Mitchell J, Wright KD, Cuffee Y. Health Social Networks of Black Women With Hypertension. Nurs Res 2023; 72:489-494. [PMID: 37890162 PMCID: PMC10617651 DOI: 10.1097/nnr.0000000000000679] [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] [Indexed: 10/29/2023]
Abstract
BACKGROUND The prevalence of hypertension is 55% among African American/Black women, who have a higher risk for poor health outcomes compared to women from other racial and ethnic groups, in part because of uncontrolled blood pressure. Previous research results suggest that peers may positively influence self-management of chronic conditions like hypertension. However, few studies have described the personal characteristics of peers in the health social networks of Black women. OBJECTIVE This substudy aimed to examine health social networks and describe the peers' characteristics, as reported by a convenience sample of Black women with hypertension. METHODS In this analysis of data from a larger study, 94 Black women with hypertension attending a church conference participated in a cross-sectional, descriptive study. Their mean age was 59 years, and their mean systolic blood pressure was 143 mm Hg. All participants completed a survey to gather data about (a) the characteristics of individuals they discussed health matters with (their peers or health social network) and (b) their perceptions about hypertension status and knowledge of hypertension among the peers in their health social network. RESULTS Collectively, participants from the larger study named a total of 658 peers who were part of their health social networks; the mean health social network size was six peers. The peers were mostly women, Black, family members, and, on average, 54 years old. The participants discussed hypertension with 71% of the peers, reported that 36% had hypertension, and felt that 67% were somewhat or very knowledgeable about the condition. A small, positive correlation existed between the participants' health social network size (number of peers named) and their systolic blood pressure levels. DISCUSSION The health social network peers were similar to those in the larger study, with most of the same gender, race, and age. The findings of this analysis may be used to help practitioners and scientists guide patients in building health social networks for support in self-managing hypertension and conducting future studies to examine the best strategies for developing and using health social networks to improve health outcomes and reduce health disparities.
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Jones LM, Piscotty RJ, Sullivan S, Manzor Mitrzyk B, Ploutz-Snyder RJ, Ghosh B, Veinot T. Psychometric Evaluation of the Modes of Health Information Acquisition, Sharing, and Use Questionnaire: Prospective Cross-Sectional Observational Study. J Med Internet Res 2023; 25:e44772. [PMID: 37695669 PMCID: PMC10520769 DOI: 10.2196/44772] [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: 12/14/2022] [Revised: 03/22/2023] [Accepted: 07/30/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Health information is a critical resource for individuals with health concerns and conditions, such as hypertension. Enhancing health information behaviors may help individuals to better manage chronic illness. The Modes of Health Information Acquisition, Sharing, and Use (MHIASU) is a 23-item questionnaire that measures how individuals with health risks or chronic illness acquire, share, and use health information. Yet this measure has not been psychometrically evaluated in a large national sample. OBJECTIVE The objective of this study was to evaluate the psychometric properties of the self-administered MHIASU in a large, diverse cohort of individuals living with a chronic illness. METHODS Sharing Information, a prospective, observational study, was launched in August 2018 and used social media campaigns to advertise to Black women. Individuals who were interested in participating clicked on the advertisements and were redirected to a Qualtrics eligibility screener. To meet eligibility criteria individuals had to self-identify as a Black woman, be diagnosed with hypertension by a health care provider, and live in the United States. A total of 320 Black women with hypertension successfully completed the eligibility screener and then completed a web-based version of the MHIASU questionnaire. We conducted a psychometric evaluation of the MHIASU using exploratory factor analysis. The evaluation included item review, construct validity, and reliability. RESULTS Construct validity was established using exploratory factor analysis with principal axis factoring. The analysis was constricted to the expected domains. Interitem correlations were examined for possible item extraction. There were no improvements in factor structure with the removal of items with high interitem correlation (n=3), so all items of the MHIASU were retained. As anticipated, the instrument was found to have 3 subscales: acquisition, sharing, and use. Reliability was high for all 3 subscales, as evidenced by Cronbach α scores of .81 (acquisition), .81 (sharing), and .93 (use). Factor 3 (use of health information) explained the maximum variance (74%). CONCLUSIONS Construct validity and reliability of the web-based, self-administered MHIASU was demonstrated in a large national cohort of Black women with hypertension. Although this sample was highly educated and may have had higher digital literacy compared to other samples not recruited via social media, the population captured (Black women living with hypertension) are often underrepresented in research and are particularly vulnerable to this chronic condition. Future studies can use the MHIASU to examine health information behavior in other diverse populations managing health concerns and conditions.
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Affiliation(s)
- Lenette M Jones
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | | | - Stephen Sullivan
- Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Beatriz Manzor Mitrzyk
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, United States
| | | | - Bidisha Ghosh
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Tiffany Veinot
- School of Information, University of Michigan, Ann Arbor, MI, United States
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Saslow LR, Jones LM, Sen A, Wolfson JA, Diez HL, O'Brien A, Leung CW, Bayandorian H, Daubenmier J, Missel AL, Richardson C. Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial. Ann Fam Med 2023; 21:256-263. [PMID: 37217318 PMCID: PMC10202504 DOI: 10.1370/afm.2968] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/14/2023] [Accepted: 01/24/2023] [Indexed: 05/24/2023] Open
Abstract
PURPOSE Adults with a triple multimorbidity (hypertension, prediabetes or type 2 diabetes, and overweight or obesity), are at increased risk of serious health complications, but experts disagree on which dietary patterns and support strategies should be recommended. METHODS We randomized 94 adults from southeast Michigan with this triple multimorbidity using a 2 × 2 diet-by-support factorial design, comparing a very low-carbohydrate (VLC) diet vs a Dietary Approaches to Stop Hypertension (DASH) diet, as well as comparing results with and without multicomponent extra support (mindful eating, positive emotion regulation, social support, and cooking). RESULTS Using intention-to-treat analyses, compared with the DASH diet, the VLC diet led to greater improvement in estimated mean systolic blood pressure (-9.77 mm Hg vs -5.18 mm Hg; P = .046), greater improvement in glycated hemoglobin (-0.35% vs -0.14%; P = .034), and greater improvement in weight (-19.14 lb vs -10.34 lb; P = .0003). The addition of extra support did not have a statistically significant effect on outcomes. CONCLUSIONS For adults with hypertension, prediabetes or type 2 diabetes, and overweight or obesity, the VLC diet resulted in greater improvements in systolic blood pressure, glycemic control, and weight over a 4-month period compared with the DASH diet. These findings suggest that larger trials with longer follow-up are warranted to determine whether the VLC diet might be more beneficial for disease management than the DASH diet for these high-risk adults.
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Affiliation(s)
- Laura R Saslow
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Lenette M Jones
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Ananda Sen
- Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Heidi L Diez
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan
- Pharmacy Innovations and Partnerships, Michigan Medicine, Ann Arbor, Michigan
| | - Alison O'Brien
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Cindy W Leung
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Hovig Bayandorian
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Jennifer Daubenmier
- Institute for Holistic Health Studies, San Francisco State University, San Francisco, California
| | - Amanda L Missel
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Caroline Richardson
- Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
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Jones LM, Wright KD, Jack AI, Friedman JP, Fresco DM, Veinot T, Lu W, Moore SM. The relationships between health information behavior and neural processing in african americans with prehypertension. J Assoc Inf Sci Technol 2018; 70:968-980. [PMID: 31799335 DOI: 10.1002/asi.24098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Information behavior may enhance hypertension self-management in African-Americans. The goal of this substudy was to examine relationships between measures of self-reported health information behavior and neural measures of health information processing in a sample of 19 prehypertensive African-Americans (mean age=52.5, 52.6% women). We measured 1) health information seeking, sharing, and use (surveys) and 2) neural activity using functional magnetic resonance imaging (fMRI) to assess response to health information videos. We hypothesized that differential activation (comparison of analytic vs. empathic brain activity when watching a specific type of video) would indicate better function in three, distinct cognitive domains: 1) Analytic Network, 2) Default Mode Network (DMN), and 3) ventromedial prefrontal cortex (vmPFC). Scores on the information sharing measure (but not seeking or use) were positively associated with differential activation in the vmPFC (rs=.53, p=.02) and the DMN (rs=.43, p=.06). Our findings correspond with previous work indicating that activation of the DMN and vmPFC is associated with sharing information to persuade others, and with behavior change. Although health information is commonly conveyed as detached and analytic in nature, our findings suggest that neural processing of socially and emotionally salient health information is more closely associated with health information sharing.
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Affiliation(s)
- Lenette M Jones
- University of Michigan, School of Nursing, Department of Health Behavior and Biological Sciences, 400 N. Ingalls Room 2180, Ann Arbor, MI 48109
| | - Kathy D Wright
- The Ohio State University College of Nursing 1585 Neil Avenue, Columbus, Ohio 43210 phone: 614-292-0309, fax: 614-292-7976
| | - Anthony I Jack
- Case Western Reserve University, Department of Philosophy, Cleveland, OH, USA, 216-368-6996
| | - Jared P Friedman
- Case Western Reserve University, Weatherhead School of Management, Department of Organizational Behavior, Cleveland, OH, USA
| | - David M Fresco
- Kent State University, Department of Psychological Sciences, Kent, OH, USA phone: 330-672-4049, fax: 330-672-3786
| | - Tiffany Veinot
- School of Information and School of Public Health, University of Michigan, 3443 North Quad, 105 S. State Street, Ann Arbor, MI 48109-1285, voice/fax: 734-615-8281
| | - Wei Lu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106
| | - Shirley M Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, phone: 216-368-5978
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Huh J, Koola J, Contreras A, Castillo AK, Ruiz M, Tedone KG, Yakuta M, Schiaffino MK. Consumer Health Informatics Adoption among Underserved Populations: Thinking beyond the Digital Divide. Yearb Med Inform 2018; 27:146-155. [PMID: 30157518 PMCID: PMC6115231 DOI: 10.1055/s-0038-1641217] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives:
Underserved populations can benefit from consumer health informatics (CHI) that promotes self-management at a lower cost. However, prior literature suggested that the digital divide and low motivation constituted barriers to CHI adoption. Despite increased Internet use, underserved populations continue to show slow CHI uptake. The aim of the paper is to revisit barriers and facilitators that may impact CHI adoption among underserved populations.
Methods:
We surveyed the past five years of literature. We searched PubMed for articles published between 2012 and 2017 that describe empirical evaluations involving CHI use by underserved populations. We abstracted and summarized data about facilitators and barriers impacting CHI adoption.
Results:
From 645 search results, after abstract and full-text screening, 13 publications met the inclusion criteria of identifying barriers to and facilitators of underserved populations' CHI adoption. Contrary to earlier literature, the studies suggested that the motivation to improve health literacy and adopt technology was high among studied populations. Beyond the digital divide, barriers included: low health and computer literacy, challenges in accepting the presented information, poor usability, and unclear content. Factors associated with increased use were: user needs for information, user-access mediated by a proxy person, and early user engagement in system design.
Conclusions:
While the digital divide remains a barrier, newer studies show that high motivation for CHI use exists. However, simply gaining access to technology is not sufficient to improve adoption unless CHI technology is tailored to address user needs. Future interventions should consider building larger empirical evidence on identifying CHI barriers and facilitators.
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Affiliation(s)
- Jina Huh
- Michigan State University, MI, USA
| | - Jejo Koola
- University of California San Diego, CA, USA
| | - Alejandro Contreras
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Alanah Kp Castillo
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Melissa Ruiz
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Keely G Tedone
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Melissa Yakuta
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Melody K Schiaffino
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
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Conn VS. Google Consultation. West J Nurs Res 2018; 40:615-616. [DOI: 10.1177/0193945917752095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jones LM, Rosemberg MAS, Wright KD. Opportunities for the Advanced Practice Nurse to Enhance Hypertension Knowledge and Self-management Among African American Women. CLIN NURSE SPEC 2017; 31:311-318. [PMID: 28991014 PMCID: PMC5679274 DOI: 10.1097/nur.0000000000000331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Despite increased awareness and the advent of methods to manage the disease, hypertension is poorly controlled among African American women. This study explored hypertension knowledge and blood pressure in a sample of African American women. DESIGN A descriptive, cross-sectional design was used to collect survey data on hypertension knowledge. METHODS African American women attending a church conference were invited to complete a questionnaire, which included the Check Your High Blood Pressure Prevention IQ survey, and had their blood pressures measured. RESULTS Of the 151 women who participated, 62% were diagnosed with hypertension. Many of the women, even those not diagnosed with hypertension, had elevated blood pressures. Although the average scores showed that the women scored well on the survey, there were 4 items on the survey that a percentage of the women had difficulty with: questions about (1) stress as a cause of hypertension, (2) symptoms associated with high blood pressure, (3) whether hypertension could be cured, and (4) the amount of exercise needed to help reduce blood pressure. CONCLUSION Despite efforts to increase awareness and control of hypertension, considerable misconceptions about the disease were found in this sample of African American women. To improve self-management of hypertension among this group, advanced practice nurses need to directly address these misconceptions.
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Affiliation(s)
- Lenette M Jones
- Author Affiliations: Assistant Professor (Dr Jones), Department of Health Behavior and Biological Sciences and Assistant Professor (Dr Rosemberg), Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan, Ann Arbor; and Assistant Professor (Dr Wright), the Ohio State University College of Nursing, Columbus
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Jones LM, Wright KD, Wallace MK, Veinot T. "Take an opportunity whenever you get it": Information Sharing among African-American Women with Hypertension. J Assoc Inf Sci Technol 2017; 69:168-171. [PMID: 29546230 DOI: 10.1002/asi.23923] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Nearly half of African-American women have hypertension, which increases their risk for cardiovascular disease and stroke. A plethora of consumer health information products and services exist to inform people with hypertension and to promote self-management among them. Promotion of information sharing by African-American women represents a promising, culturally-applicable strategy for consumer health information services focused on hypertension self-management. Yet, how African-American women share hypertension information with others is unclear. The purpose of this qualitative, descriptive study was to examine practices of information sharing in African-American women with hypertension. Thirteen women (mean age = 73, SD = 9.87) participated in one of two focus groups held at an urban community health center. Thematic analysis revealed that the women shared information about how they self-managed their blood pressure 1) with female family members and friends, 2) about ways in which they adapted self-management strategies to work for them, 3) mostly in group settings, and 4) because they wanted to prevent others from suffering and reinforce their own knowledge about hypertension self-management. New findings emerged regarding assessing "readiness" for information. Study findings will be used to inform the design of an information sharing intervention to support self-management of hypertension in African-American women.
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Affiliation(s)
- Lenette M Jones
- Postdoctoral Researcher, FPB School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, phone 216-368-2637, fax 216-368-3542,
| | - Kathy D Wright
- KL2 Scholar, FPB School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, phone 216-368-1928, fax 216-368-3542,
| | - McKenzie K Wallace
- Doctoral Student, FPB School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, phone 216-368-1928, fax 216-368-3542,
| | - Tiffany Veinot
- Associate Professor, School of Information and School of Public Health, University of Michigan, 3443 North Quad, 105 S. State Street, Ann Arbor, MI 48109-1285, voice/fax 734-615-8281,
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