Health-promoting behaviors of black and white college women

The Relationship Between Culture, Health Conceptions, and Health Practices

This study investigated cultural variations in health conceptions and practices using a quasi-experimental design. A total of 60 participants, recruited from three cultural groups in Canada, were individually interviewed between the fall of 2009 and the fall of 2010. Transcribed interviews were quantified according to the importance participants ascribed to emergent themes. The data generated three intriguing findings: (a) Consistent with an interdependent self-construal or ecological self, First Nations participants were more likely to report health conceptions and practices that expand beyond the individual self to include their family, the community, and the environment when compared with Anglophones and Francophones of European ancestry; (b) First Nations participants placed more importance on maintaining their traditions and culture as a health-promoting strategy, compared with Anglophones and Francophones; and (c) some of the health conceptions identified by all three groups significantly predicted the practices they engage in to promote health. These findings suggest that culture has a noticeable impact on health conceptions, which in turn influence health practices. There are at least two important implications: (a) Health policy makers need to take into account the role culture plays in the way people conceptualize health to ensure that health policies and programs reflect the particular beliefs and needs of their target populations and (b) health-care professionals need to be aware of the diverse views of their patients to provide culturally appropriate care.

Evaluating race/ethnicity in moderating baseline cardiometabolic risk and body composition changes in North Carolina first-year college women

The roles of race/ethnicity and geographical region in the context of first-year college weight gain remain largely under-examined. The present study evaluated whether race/ethnicity: (1) at baseline was associated with greater representation in cardiometabolic health risk categories for body mass index, percent body fat, waist circumference, and waist-to-hip ratio in the full sample of 54 Black/African American and 80 White/European American first-year female undergraduates attending a North Carolina state university; and (2) moderated body composition changes between the beginning of the fall and spring semesters among the 83 participants who completed baseline and follow-up visits (N = 39 Black/African Americans). More Black/African Americans than White/European Americans had percent body fat values ≥32% at baseline; a greater proportion of White/European Americans than Black/African Americans had a waist-to-hip ratio >0.80. Among those who completed baseline and follow-up visits, White/European Americans had higher waist-to-hip ratios (unadjusted: p <0.01, adjusted for family income: p < 0.01) and waist circumferences (adjusted for family income: p < 0.05) at both time points. No strong moderating effects of race/ethnicity were detected. Preliminary results suggested that greater consideration of racial/ethnic indicators and potential regional variation in these biometric attributes among first-year college students is warranted.

Which College Students Are at Higher Health Risk?

An electronic health risk appraisal was used to determine which demographic factors were associated with higher health risk among college students at an urban state university. Students’ real age was assessed as the primary indicator of health risk and it was associated to demographic characteristics. Real age represents the physiological age of the body based on lifestyle choices, and this is often different to chronological age. Approximately 26.0% of 576 students were more than 5 years older than their chronological age, 29.8% were 0 to 5 years older, 29.8% were 0 to 5 years younger, and 14.1% were more than 5 years younger than their chronological age. Students who were male, Black, and nonnutrition majors had significantly higher positive real age differentials: their bodies were more likely to be more than 5 years older than their chronological age. Students with significantly lower negative real age differential—those whose real age was lower than their chronological age—were female and nutrition majors. Students were significantly more likely to report that they were “very motivated” if they were female (88.6%), compared with male (66.7%). These data suggest that when health disparities are assessed at the level of real age differential and motivation to make lifestyle changes, male Black college students are at highest health risk and they are less likely to be “very motivated” to make lifestyle changes than their peers.

Mothers' mental distress and parenting practices with infants and toddlers

The purpose of this study was to examine whether maternal mental distress affects parenting practices related to monitoring activities (i.e. daily routines, enrichment activities). The nationally representative sample consisted of 1638 mothers. Maternal mental distress was assessed by the 5-item Mental Health Index (MHI). Logistic regression models were conducted, controlling for covariates (e.g. marital status, education level, etc.). Approximately 14% of the women reported high levels of mental distress and 25% of the women failed to engage in enrichment activities or consistent daily routines with their children. There was a significant adverse relationship between mental distress and routines, with women who were mentally distressed being more likely to not engage in daily routines. There was no significant relationship between mental distress and enrichment activities. Race differentials were evident among these relationships. These findings highlight the prevalence of maternal mental distress and its deleterious effects on select parenting behaviors.

Barriers to Coronary Heart Disease Risk Modification in Women without Prior History of Coronary Heart Disease

PURPOSE

To explore the extent to which women perceive barriers to coronary heart disease (CHD) risk modification and to determine if access to a nurse practitioner (NP) decreases perceived barriers to CHD risk modification.

DATA SOURCES

Surveys completed by 120 women between the ages of 35 and 60 years, with no known history of CHD. The barriers scale was used to examine women's perceived barriers to CHD risk modification.

CONCLUSIONS

Women with access to an NP had less perceived barriers to CHD risk modification.

IMPLICATIONS FOR PRACTICE

NPs are ideally suited to decrease the mortality and morbidity associated with CHD through education strategies and attention to individual barriers women face when attempting to incorporate CHD risk factor modification into their lifestyles.

Psychometrics of the Laffrey Health Conception Scale for Adolescents

The purposes of this methodological study were to factor analyze the Laffrey Health Conception Scale (LHCS) and to assess construct validity of the instrument with early adolescents. The final sample consisted of 230 early adolescents, aged 12 to 14, who responded to instrument packets in classrooms in an urban middle school. Data obtained on the LHCS were subjected to principal components factor analysis with oblique rotation. A two-factor solution was accepted, which is consistent with early adolescents’ conceptions of health. Factor I was labeled Wellness and Factor II was labeled Clinical Health. A higher order factor analysis yielded one factor with 26 items, labeled the LHCS for Early Adolescents. The 26-item LHCS had a coefficient alpha of .95. Construct validity was assessed by testing three theoretical propositions, which significantly linked health conception to social support, self-esteem, and positive health practices. The findings indicate that the LHCS is a reliable and valid measure of health conceptions in early adolescents. Results also offer flexibility to researchers interested in testing theory involving the constructs of the definition of health, wellness, and clinical health in early adolescents.

The effect of maternal depressive symptomatology on maternal behaviors associated with child health

National prevalence rates for depression among women are twofold compared with those of men, with women of childbearing age at greatest risk. Maternal depression not only negatively affects the health of the mother but may also influence the health and development of her offspring. This study examined the relationship between maternal depression and its influence on certain maternal behaviors associated with child health. A nationally representative, longitudinal data set with information on demographic, behavioral, and health care variables obtained from women in 1988 and 1991 was used. The results from logistic regression modeling indicate that maternal depression is associated with maternal behaviors (i.e., an increased likelihood of engagement in smoking, in not administering vitamins to a child, and not restraining children in appropriate car seats). Moreover, race differentials were found among these relationships. The implications of these results suggest the need to screen for depression among mothers of young children.

Preventive health services use, lifestyle health behavior risks, and self-reported health status of women in Ohio by ethnicity and completed education status

This study assessed the health status and behavior of college-educated and non-college-educated African American women and European American women in Ohio. Analyses focused on health services utilization, health status, and life style/health behaviors from the 1998 Ohio Family Health Survey. College-educated African American women used more preventive health services and had better health status than non-college-educated African American women. Even so, college-educated African American women still had higher body mass index values, lower health status, and higher percent currently smoking than college-educated European American women. We conclude that college-educated African American women may face unique barriers to implementing all types of health-promoting behaviors available consequent to their higher education. Partnerships with respected community institutions, such as churches, may help these women develop good health practices in their entire community as well as in themselves.

Social support and health behavior in hostile black and white men and women in CARDIA. Coronary Artery Risk Development in Young Adults

OBJECTIVE

These cross-sectional analyses of the Coronary Artery Risk Development in Young Adults (CARDIA) data were stimulated by previous CARDIA analyses that showed an adverse association between hostility and several health behaviors: physical activity, cigarette smoking, alcohol consumption, and caloric intake, in both black and white men and women, such that the higher the hostility, the worse the health behavior profile. The current study investigated whether high social support was associated with better health behavior than low social support in individuals with high hostility scores.

METHODS

The subjects were 5115 healthy black and white men and women ranging in age from 18 to 30 years. The hypothesis was that the association between hostility and certain adverse health behaviors would be diminished in the presence of high social support. Race-gender specific median cutpoints of the Cook-Medley Hostility scale and an index of social support defined levels of high and low hostility and social support.

RESULTS

After controlling for age and body mass index (BMI), support was positively associated with more exercise in all groups except black women, but when coupled with high hostility, this positive association between support and exercise remained only in men. White women with high support were less often smokers but this association did not hold when examined only in the high-hostile group. Black men and white women with high support in the presence of high hostility consumed more alcohol, but the amount was moderate.

CONCLUSIONS

We conclude that social support in the presence of high hostility only sometimes reduces the association of hostility to adverse health behaviors and that these effects are complex. Additional research investigating types of social support on health behavior in different race-gender groups is advocated.

The evolving concept of health in nursing research: 1988-1998

This article concerns the evolution of the concept of health, as reported in selected nursing journals, over the last 10 years. It builds on an analysis reported by Reynolds [Reynolds CL. The measurement of health in nursing research. Adv Nurs Sci 1988;10(4):23-31.] who initially investigated the concept of health and the means by which it was measured during the period 1977-1987. Using the same journals as Reynolds, the methodology of systematic review is used to analyse the way in which health is defined, the frequency with which it is investigated and the means by which it is measured, and these data are compared with Reynolds findings. The results indicate that; three times as many studies have been conducted in the last 10 years, a more holistic concept of health has emerged, and the instruments used are becoming more sophisticated. These findings are discussed and the implications for patient education and health care professionals considered.