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Goh PH, Loh HY, Chung KR, Ramadas A. Body (dis)satisfaction and health screening behaviors: A systematic review of observational studies. J Health Psychol 2024; 29:137-155. [PMID: 37493189 PMCID: PMC10799541 DOI: 10.1177/13591053231189413] [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] [Indexed: 07/27/2023] Open
Abstract
Engagement in health-promoting behaviors has been argued to be dependent on psychological factors in addition to simply having knowledge or access to resources. We systematically reviewed the evidence for the association between body (dis)satisfaction and health screening behaviors using six electronic databases and supplementary manual searches in the current study. To be included in the review, studies had to be empirical, in any language, and examined the potential link between body (dis)satisfaction and health screening. Findings from the final 16 quantitative and 12 qualitative studies generally suggest that people who were more satisfied or less dissatisfied with their bodies were more likely to engage in health screening. This review also highlighted key gaps in the literature such as the limited studies that included men as participants and the lack of examination of the underlying mechanisms and contingencies of the relationship between body (dis)satisfaction and health screening behaviors.
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Devane-Johnson S, Williams R, Woods Giscombe C. Historical Research: The History of African American Breastfeeding in the United States. J Hum Lact 2022; 38:723-731. [PMID: 36082633 DOI: 10.1177/08903344221118542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Ronald Williams
- African American Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cheryl Woods Giscombe
- Chapel Hill School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Agrawal P, Chen TA, McNeill LH, Acquati C, Connors SK, Nitturi V, Robinson AS, Martinez Leal I, Reitzel LR. Factors Associated with Breast Cancer Screening Adherence among Church-Going African American Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168494. [PMID: 34444241 PMCID: PMC8392666 DOI: 10.3390/ijerph18168494] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022]
Abstract
Relative to White women, African American/Black women are at an increased risk of breast cancer mortality. Early detection of breast cancer through mammography screening can mitigate mortality risks; however, screening rates are not ideal. Consequently, there is a need to better understand factors associated with adherence to breast cancer screening guidelines to inform interventions to increase mammography use, particularly for groups at elevated mortality risk. This study used the Andersen Behavioral Model of Health Services Use to examine factors associated with adherence to National Comprehensive Cancer Network breast cancer screening guidelines amongst 919 African American, church-going women from Houston, Texas. Logistic regression analyses measured associations between breast cancer screening adherence over the preceding 12 months (adherent or non-adherent) and predisposing (i.e., age, education, and partner status), enabling (i.e., health insurance status, annual household income, employment status, patient-provider communication, and social support), and need (i.e., personal diagnosis of cancer, family history of cancer, and risk perception) factors, separately and conjointly. Older age (predisposing: OR = 1.015 (1.007-1.023)), having health insurance and ideal patient-provider communication (enabling: OR = 2.388 (1.597-3.570) and OR = 1.485 (1.080-2.041)), and having a personal diagnosis of cancer (need: OR = 2.244 (1.058-4.758)) were each associated with greater odds of screening adherence. Only having health insurance and ideal patient-provider communication remained significantly associated with screening adherence in a conjoint model; cancer survivorship did not moderate associations between predisposing/enabling factors and screening adherence. Overall, results suggest that interventions which are designed to improve mammography screening rates amongst African American women might focus on broadening health insurance coverage and working to improve patient-provider communication. Implications for multi-level intervention approaches, including the role of churches in their dissemination, are proposed.
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Affiliation(s)
- Pooja Agrawal
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA; (P.A.); (T.A.C.); (S.K.C.); (V.N.); (I.M.L.)
- School of Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Tzuan A. Chen
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA; (P.A.); (T.A.C.); (S.K.C.); (V.N.); (I.M.L.)
- Health Research Institute, University of Houston, Houston, TX 77204, USA
| | - Lorna H. McNeill
- MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX 77230, USA; (L.H.M.); (C.A.)
| | - Chiara Acquati
- MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX 77230, USA; (L.H.M.); (C.A.)
- Graduate College of Social Work, University of Houston, Houston, TX 77204, USA
| | - Shahnjayla K. Connors
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA; (P.A.); (T.A.C.); (S.K.C.); (V.N.); (I.M.L.)
- Department of Social Sciences, University of Houston-Downtown, Houston, TX 77002, USA
| | - Vijay Nitturi
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA; (P.A.); (T.A.C.); (S.K.C.); (V.N.); (I.M.L.)
- Health Research Institute, University of Houston, Houston, TX 77204, USA
| | - Angelica S. Robinson
- Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Isabel Martinez Leal
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA; (P.A.); (T.A.C.); (S.K.C.); (V.N.); (I.M.L.)
- Health Research Institute, University of Houston, Houston, TX 77204, USA
| | - Lorraine R. Reitzel
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA; (P.A.); (T.A.C.); (S.K.C.); (V.N.); (I.M.L.)
- Health Research Institute, University of Houston, Houston, TX 77204, USA
- Correspondence: ; Tel.: +1-713-743-6679
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Ramos-Pibernus AG, Rivera-Segarra ER, Rodríguez-Madera SL, Varas-Díaz N, Padilla M. Stigmatizing Experiences of Trans Men in Puerto Rico: Implications for Health. Transgend Health 2020; 5:234-240. [PMID: 33381650 DOI: 10.1089/trgh.2020.0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Purpose: The past decade has seen an increase in efforts aimed at understanding the health needs of the transgender population. In the context of Puerto Rico (PR), those efforts have primarily focused on trans women due to their high human immunodeficiency virus (HIV) incidence. However, due to the low impact of the HIV epidemic among trans men, this remains an understudied population in PR. Thus, it is important that research efforts ad- dress the health care needs of trans men in a range of cultural settings, including PR. Recent literature emphasizes the role of stigmatization as a social determinant associated with deleterious health consequences for diverse groups. Despite this worrisome scenario, little is known about how trans men in PR experience and are negatively impacted by social stigma. The objective of this study was to document the stigmatization experiences faced by trans men in PR and its impact on their overall health. Methods: We conducted an exploratory qualitative study with 29 trans men. We implemented focus groups and in-depth qualitative interviews. Thematic analysis guided our interpretation of the findings. Results: Three categories of stigma are discussed: (1) structural stigmatization, (2) interpersonal stigmatization, and (3) individual stigmatization. The health implications of these stigma experiences are discussed. Conclusion: This study represents an initial step toward understanding the social context of this "invisible" community and its health and well-being. We provide recommendations to address social and health concerns related to this understudied community.
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Affiliation(s)
| | - Eliut R Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | | | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, Florida, USA
| | - Mark Padilla
- Global and Sociocultural Studies, Florida International University, Miami, Florida, USA
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Austin JD, Shelton RC, Lee Argov EJ, Tehranifar P. Older Women’s Perspectives Driving Mammography Screening Use and Overuse: a Narrative Review of Mixed-Methods Studies. CURR EPIDEMIOL REP 2020. [DOI: 10.1007/s40471-020-00244-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Abstract
Purpose of Review
Examining what older women know and perceive about mammography screening is critical for understanding patterns of under- and overuse, and concordance with screening mammography guidelines in the USA. This narrative review synthesizes qualitative and quantitative evidence around older women’s perspectives toward mammography screening.
Recent Findings
The majority of 43 identified studies focused on promoting mammography screening in women of different ages, with only four studies focusing on the overuse of mammography in women ≥ 70 years old. Older women hold positive attitudes around screening, perceive breast cancer as serious, believe the benefits outweigh the barriers, and are worried about undergoing treatment if diagnosed. Older women have limited knowledge of screening guidelines and potential harms of screening.
Summary
Efforts to address inequities in mammography access and underuse need to be supplemented by epidemiologic and interventional studies using mixed-methods approaches to improve awareness of benefits and harms of mammography screening in older racially and ethnically diverse women. As uncertainty around how best to approach mammography screening in older women remains, understanding women’s perspectives along with healthcare provider and system-level factors is critical for ensuring appropriate and equitable mammography screening use in older women.
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Orji CC, Kanu C, Adelodun AI, Brown CM. Factors that Influence Mammography Use for Breast Cancer Screening among African American Women. J Natl Med Assoc 2020; 112:578-592. [PMID: 32641257 DOI: 10.1016/j.jnma.2020.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 06/03/2019] [Accepted: 05/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of this study was to assess factors that influence use of mammography screening among African American women, with a focus on social and cultural influences using Andersen's behavioral model (ABM), and to assess the methodological quality of the included studies. METHODS A literature review was conducted using PubMed, CINAHL, PSYCINFO, and Web of Science. Search terms included a combination of the following words using Boolean operators: breast cancer screening, mammography, repeat mammography, and African American. Studies that met the following criteria were included in the review: 1) examined factors associated with mammography screening, 2) included African American women as a majority, 3) published in a peer-reviewed English language journal between 2005 and 2017, and 4) conducted in the United States. Literature reviews, commentaries and non-research studies were excluded. Cited references from identified studies were examined for additional, relevant articles. Associated factors were grouped into predisposing, enabling, and need factor domains of ABM. The reviewed studies were rated using a methodological quality score (MQS) ranging from 0 to 20, with higher scores indicating higher methodological quality. RESULTS Twenty-four studies met the inclusion criteria. Fifteen factors that affect breast cancer screening in African American women were identified: predisposing (age, education, knowledge, beliefs, mistrust, religiosity, fears and fatalism), enabling (health insurance, access to care, income, health utilization), and need (physician recommendation, family/personal history, pain/discomfort, family responsibilities) factors. The most common factor was insurance status, although cultural issues (e.g., mistrust) were evident. Most of the identified factors are modifiable. The mean MQS was 12.2, indicating that the studies were slightly above average in quality. CONCLUSIONS Financial and cultural issues were important hindrances to breast cancer screening in African American women. These findings highlight the importance of affordable health care for preventive health services as well as the relevance of culturally embedded issues to health, while the MQS accentuates the need for more rigorous research articles. Breast cancer screening interventions in this population should attend to barriers identified in this review.
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Affiliation(s)
- Chinelo C Orji
- Health Outcomes & Pharmacy Practice, University of Texas, Austin, TX, USA.
| | - Chisom Kanu
- Health Outcomes & Pharmacy Practice, University of Texas, Austin, TX, USA
| | | | - Carolyn M Brown
- Health Outcomes & Pharmacy Practice, University of Texas, Austin, TX, USA
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Taylor KA, Knibb JN. Don't give US pink ribbons and skinny girls: Breast cancer survivors' evaluations of cancer advertising. Health Mark Q 2019; 36:186-202. [PMID: 31294675 DOI: 10.1080/07359683.2019.1618007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Breast cancer related promotions, advertising, and pink ribbons are now ubiquitous in October, yet comparatively little is known about how this advertising impacts breast cancer survivors specifically. The present research uses an embodied knowledge perspective to explore the impact of cancer advertising on female breast cancer survivors. Five focus groups were conducted with 42 participants, and the discussions were analyzed to find common themes. The survivors expressed a desire for cancer advertising to be representative, informative (particularly regarding detection and treatment options), hopeful, and transparent about the organization's motivation and support. Implications and recommendations are also discussed.
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Affiliation(s)
- Kimberly A Taylor
- a Department of Marketing and Logistics, College of Business, Florida International University , Miami , FL , USA
| | - Jana N Knibb
- b Community College of Rhode Island , Warwick , RI , USA
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DeVane-Johnson S, Wright YJ, Godwin L, Williams JM. Breast-Feeding and Practice Tips for Case Managers. Prof Case Manag 2019; 23:158-162. [PMID: 29601430 DOI: 10.1097/ncm.0000000000000291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Stephanie DeVane-Johnson
- Stephanie DeVane-Johnson, PhD, CNM, is an assistant professor in the School of Nursing at Duke University. Her passion and research interests are decreasing the breast-feeding disparity in the African American community utilizing a cultural and historical lens. Yvette J. Wright, BSN, MSHEP, RN, is a registered nurse and health educator who embraces a holistic approach toward delivering health promotion for low-income African American women in preconception and pregnancy through case management and primary care practices. Yvette is a trained doula and enjoys supporting births. LaKasha Godwin, MSN, FNP-BC, is a doctoral of nursing practice (DNP) student at The University of North Carolina at Chapel Hill. Her research interest is breast-feeding in minority populations. Janiya Mitnaul Williams, MA, IBCLC, CLC, is an internationally board-certified lactation consultant and a certified lactation counselor. She holds degrees in Speech-Language Pathology, and Audiology and Human Lactation. Janiya currently works at the Alamance Regional Medical Center and runs a breast-feeding support group named Mahogany Milk
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Rayne S, Schnippel K, Benn C, Kruger D, Wright K, Firnhaber C. The Effect of Access to Information on Beliefs Surrounding Breast Cancer in South Africa. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:806-813. [PMID: 28540645 DOI: 10.1007/s13187-017-1234-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Breast cancer is the most common cancer affecting women in South Africa. There is little knowledge of beliefs to help identify key areas to improve support and education in this demographically and culturally diverse population. Women with a variety of demographic and socioeconomic characteristics accessing care for breast cancer were asked their agreement to statements of knowledge and beliefs about breast cancer. Of the 259 participants, positive statements of medical cure (87.9%) and family support (90.5%) were most commonly believed. Beliefs in faith-based cure and alternative treatments were also present (79.5 and 24.9%, respectively). Negative beliefs were initially more likely in black patients (RR: 11.57, 95%CI: 1.37-97.69) as was belief of cancer as a punishment (RR: 6.85, 95%CI: 1.41-33.21). However, in multivariate analysis adjusting for age, education and access to information (by newspaper, Internet and confidence in reading and writing), there was no difference between racial groups or hospital attended. Reading a newspaper or accessing the Internet was the most protective against belief that cancer was a punishment or curse (Internet use: aRR: 0.12, 95%CI: 0.02-0.99), belief in alternative methods of cure (newspaper use: aRR: 0.51, 95%CI: 0.27-0.96) and the negative beliefs of death and disfigurement (Internet use: aRR: 0.00, 95%CI: 0.00-0.00). Positive expressions of cure and beating cancer were found equally in all women. Attitudes and beliefs about cancer showed little independent demographic or socioeconomic variance. Negative beliefs were mitigated by access to information and confidence in literacy.
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Affiliation(s)
- Sarah Rayne
- Department of Surgery, Helen Joseph Hospital, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
| | - Kathryn Schnippel
- Right to Care, Johannesburg, South Africa
- Clinical HIV Research Unit, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Carol Benn
- Department of Surgery, Helen Joseph Hospital, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Deirdre Kruger
- Department of Surgery, Helen Joseph Hospital, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Kathryne Wright
- Department of Surgery, Helen Joseph Hospital, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Cynthia Firnhaber
- Right to Care, Johannesburg, South Africa
- Clinical HIV Research Unit, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
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Pila E, Sabiston CM, Taylor VH, Arbour-Nicitopoulos K. "The Weight Is Even Worse Than the Cancer": Exploring Weight Preoccupation in Women Treated for Breast Cancer. QUALITATIVE HEALTH RESEARCH 2018; 28:1354-1365. [PMID: 29683062 DOI: 10.1177/1049732318770403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cancer-related changes in body weight are problematic given that excess weight is associated with an increased risk of cancer reoccurrence and mortality. The purpose of this qualitative study was to explore the experiences of weight-concerned women treated for early-stage breast cancer. A purposeful sample of women were selected based on criteria for high weight and body image concerns ( n = 11; Mage = 65.31 ± 10.96 years). Each participant engaged in a one-on-one semi-structured interview. Five themes were identified: weight concerns contributed to psychological distress, prevalent history of weight cycling and ongoing quest to manage weight, shifting psychological impact of cancer versus weight, perceptions of failure around goal-oriented weight management behaviors, and internalized and explicit social pressures for weight loss in the context of risk reduction. In light of the fundamental challenges of weight management, and the present findings, improving weight-related distress should be a clinical priority to improve the well-being of women in survivorship.
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Affiliation(s)
- Eva Pila
- 1 University of Toronto, Toronto, Ontario, Canada
| | | | - Valerie H Taylor
- 1 University of Toronto, Toronto, Ontario, Canada
- 2 Women's College Hospital Research Institute, Toronto, Ontario, Canada
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Brown T, Dyck I, Greenhough B, Raven-Ellison M, Dembinsky M, Ornstein M, Duffy SW. Fear, family and the placing of emotion: Black women's responses to a breast cancer awareness intervention. Soc Sci Med 2017; 195:90-96. [DOI: 10.1016/j.socscimed.2017.10.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/22/2017] [Accepted: 10/31/2017] [Indexed: 12/16/2022]
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Dodgen L, Spence-Almaguer E. Beyond Body Mass Index: Are Weight-loss Programs the Best Way to Improve the Health of African American Women? Prev Chronic Dis 2017; 14:E48. [PMID: 28617664 PMCID: PMC5477783 DOI: 10.5888/pcd14.160573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
African American women have higher prevalence (82%) of overweight (body mass index [BMI] 25–29) and obesity (BMI ≥30) than white women (63.2%) or Hispanic women (77.2%), and weight-loss programs yield minimal results in this population. We examine the concept of BMI as a measure of health for African American women and suggests a more holistic, multifaceted approach to preventing chronic disease.
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Affiliation(s)
- Leilani Dodgen
- University of North Texas Health Science Center, 3500 Camp Bowie Blvd., EAD 738, Fort Worth, TX 76107.
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DeVane-Johnson S, Woods-Giscombé C, Thoyre S, Fogel C, Williams R. Integrative Literature Review of Factors Related to Breastfeeding in African American Women: Evidence for a Potential Paradigm Shift. J Hum Lact 2017; 33:435-447. [PMID: 28380305 DOI: 10.1177/0890334417693209] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Human milk has widespread health benefits for infants, mothers, and society. However, not all populations of women, particularly African American women, engage in human milk feeding at high rates. Research aim: The purpose of this integrative literature review is twofold: (a) to examine factors that influence low rates of human milk feeding among African American women and (b) to introduce a need for a methodological paradigm shift to develop culturally relevant and effective interventions. METHODS The authors searched four electronic social science databases for peer-reviewed journal articles pertaining to human milk among African American women published from 1990 to 2015. Both coauthors independently assessed these articles using thematic analysis and validation. The database search yielded 47 peer-reviewed articles. RESULTS Three main themes emerged explaining the human milk feeding disparity: (a) the social characteristics of women likely not to feed human milk (e.g., low socioeconomic status, single); (b) women's perceptions of human milk feeding; and (c) the quality of human milk feeding information provided by health care providers (i.e., limited human milk information). CONCLUSION Current literature does include sociohistorical factors that have shaped current norms. Adding sociohistorical frameworks, paying particular attention to the embodied experience of historical trauma, could lead to the development of new evidence-based, culturally sensitive interventions to enhance human milk feeding in the African American community.
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Affiliation(s)
| | | | - Suzanne Thoyre
- 1 School of Nursing, University of North Carolina at Chapel Hill, Durham, NC, USA
| | - Cathie Fogel
- 1 School of Nursing, University of North Carolina at Chapel Hill, Durham, NC, USA
| | - Ronald Williams
- 2 African American and Diaspora Studies, University of North Carolina at Chapel Hill, Durham, NC, USA
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Golden AG, Pomerantz A. Interpretative repertoires that shape low-income African American women's reproductive health care seeking: "don't want to know" and "taking charge of your health". HEALTH COMMUNICATION 2014; 30:746-757. [PMID: 25144501 DOI: 10.1080/10410236.2014.898363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the context of reproductive and sexual health, African American women have higher incidence of disease and poorer outcomes on key indicators when compared with White women. In this study, we used discourse analysis to identify and examine the workings of two clusters of interpretive resources ("interpretative repertoires") associated with reproductive/sexual health care seeking among low-income African American women who participated in semistructured interviews as part of a health promotion initiative. Interpretative repertoires are ways of accounting for engaging in or refraining from engaging in actions, which are shared by people in a community. We labeled the two interpretative repertoires "Don't Want to Know," and "Take Charge of Your Health." Within the "Don't Want to Know" repertoire, that testing would lead to threatening findings was assumed, a chain of devastating consequences was imagined, and a preference for uncertainty over certain knowledge was expressed. Conversely, the "Take Charge of Your Health" repertoire valued certainty over uncertainty, though in both interpretive frameworks, knowledge-based and emotion-based decision-making were intertwined. We conclude that health promotion initiatives--if they are to succeed in encouraging women to obtain valuable preventive health care services--must respond, in their choices of language and outreach strategies, to the expressed dilemma of wishing for reassurance but fearing bad news, to the intertwining of emotional reasoning and technorationality in health decision making, and to the particular relational experiences of African American women. Failure to do so will contribute to the continuation of reproductive and sexual health disparities.
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Affiliation(s)
- Annis G Golden
- a Department of Communication , University at Albany, State University of New York
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16
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Salamonsen A, Kruse T, Eriksen SH. Modes of embodiment in breast cancer patients using complementary and alternative medicine. QUALITATIVE HEALTH RESEARCH 2012; 22:1497-1512. [PMID: 22910592 DOI: 10.1177/1049732312457077] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Breast cancer patients are frequent users of complementary and alternative medicine (CAM). They often have complex reasons for, and experiences from, their use of CAM. Bodily experiences are important and almost unexplored elements in CAM use. Our aim was to explore the meaning and importance of bodily experiences among breast cancer patients who were using CAM as a supplement or an alternative to conventional treatment (CT). Our findings based on qualitative interviews with 13 women suggest that bodily experiences were particularly important when positioned outside conventional health care prior to medical diagnosis and as users of CAM as alternative to CT. We introduce three central modes of embodiment related to CAM use: the right to one's body, the body used as a gauge, and the body used as a guide. Patients' positioning between treatment systems should be further explored from a bodily perspective to safeguard and optimize their treatment choices.
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Davey MP, Niño A, Kissil K, Ingram M. African American parents' experiences navigating breast cancer while caring for their children. QUALITATIVE HEALTH RESEARCH 2012; 22:1260-1270. [PMID: 22767699 DOI: 10.1177/1049732312449211] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
African American parents who are navigating breast cancer while parenting their school-age children are an understudied population. We used family systems and sociocultural theories to conduct three focus groups with a total sample of 9 African American parents to understand how they cared for their school-age children (ages 11 to 18) while coping with the diagnosis and treatment of breast cancer. Our content analysis of these focus groups yielded themes that described a variety of ways they protected their children from the emotional consequences of breast cancer. Seven primary themes emerged: (a) increased desire to protect their children, (b) parental concerns for children's coping, (c) openness and transparency with children, (d) reliance on children for support, (e) calibration of their own responses, (f) use of the illness experience as a teachable moment for children, and (g) reliance on others for parenting support. Clinicians and researchers can improve their care by developing culturally sensitive family intervention programs that promote family resilience.
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Affiliation(s)
- Maureen P Davey
- Drexel University College of Nursing and Health Professions, Department of Couple and Family Therapy, Philadelphia, Pennsylvania 19102, USA.
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Wood RY, Della-Monica NR. Psychosocial factors influencing breast cancer risk appraisal among older women. QUALITATIVE HEALTH RESEARCH 2011; 21:783-795. [PMID: 21411761 DOI: 10.1177/1049732311401036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Although the incidence of breast cancer increases with age, many older women are uninformed about the increased risk and have lower mammography screening rates than younger women. Understanding older women's perceptions of risk might assist health care providers in offering appropriate resources that result in screening. In this study, we explored psychosocial components influencing older women's breast cancer risk appraisal. To identify key psychosocial components of breast cancer risk appraisal, we conducted focus group interviews. Data saturation occurred with four groups (N = 36) of older Black (58%) and White (42%) women with no prior history of breast cancer. On analysis of the data, we found three themes representing psychosocial factors influencing breast cancer risk appraisal with this cohort. Our findings revealed that worry/fear/anxiety, self-regulating empowerment, and realistic optimism were psychosocial mechanisms older Black and White women in this sample used in appraising breast cancer risk.
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Affiliation(s)
- Robin Y Wood
- Boston College, Chestnut Hill, Massachusetts 02467, USA.
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Clarke C, McCorry NK, Dempster M. The role of identity in adjustment among survivors of oesophageal cancer. J Health Psychol 2010; 16:99-108. [PMID: 20929944 DOI: 10.1177/1359105310368448] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The study sought to contextualize the physical, social and emotional adjustments that are faced by oesophageal cancer patients following surgery. Semi-structured interviews were conducted with five survivors, guided by the principles of Interpretative Phenomenological Analysis (IPA). Participants' accounts encompassed descriptions of personal, social and medical relationships, illness and treatment experiences, eating behaviours, and spiritual and religious perspectives, representing myriad challenges to the self-concept. Surviving patients may have a role in addressing patient expectations about eating. The importance of attempts to nurture and maintain a sense of self should be recognized by those providing care.
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Affiliation(s)
- Ceara Clarke
- Northern Health & Social Care Trust, Northern Ireland, UK
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Yehya NA, Dutta MJ. Health, religion, and meaning: a culture-centered study of Druze women. QUALITATIVE HEALTH RESEARCH 2010; 20:845-58. [PMID: 20181823 DOI: 10.1177/1049732310362400] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Against the backdrop of contesting the mainstream biomedical models of health communication, the culture-centered approach suggests dialogic research methodologies to coconstruct meanings of health through direct engagement with cultural communities. In this project, we engaged in in-depth interviews and informal conversations with elderly Druze women and their caregiver daughters to develop an understanding of the intersections of religion and health meanings in the context of aging women in this Lebanese community. Attending to the cultural constructions of health, particularly in religious contexts, opens up the discursive spaces of health communication to alternative cosmologies of health, illness, healing, and curing. Four themes emerged as a result of our grounded theory analysis: health as faith; mistrust, privacy, and modern medicine; polymorphic health experiences; and health as structure. These themes serve as the backdrop for playing out the competing tensions between the local and the global in the realm of interpretations of health meanings.
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Affiliation(s)
- Nadine A Yehya
- Department of Communication, Purdue University, Beering Hall of Liberal Arts and Education, Room 2114, 100 N.University St., West Lafayette, IN 47907-2098, USA.
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Woods-Giscombé CL. Superwoman schema: African American women's views on stress, strength, and health. QUALITATIVE HEALTH RESEARCH 2010; 20:668-83. [PMID: 20154298 PMCID: PMC3072704 DOI: 10.1177/1049732310361892] [Citation(s) in RCA: 330] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Researchers have suggested that health disparities in African American women, including adverse birth outcomes, lupus, obesity, and untreated depression, can be explained by stress and coping. The Strong Black Woman/Superwoman role has been highlighted as a phenomenon influencing African American women's experiences and reports of stress. The purpose of this study was to develop a preliminary conceptual framework for Superwoman Schema (SWS) by exploring women's descriptions of the Superwoman role; perceptions of contextual factors, benefits, and liabilities; and beliefs regarding how it influences health. Analysis of eight focus group discussions with demographically diverse African American women yielded themes characterizing the Superwoman role and personal or sociohistorical contextual factors. Participants reported that the Superwoman role had benefits (preservation of self and family or community) and liabilities (relationship strain, stress-related health behaviors, and stress embodiment). The SWS framework might be used to enhance future research on stress and African American women's health.
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Affiliation(s)
- Cheryl L Woods-Giscombé
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460, USA.
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McCorry NK, Dempster M, Clarke C, Doyle R. Adjusting to life after esophagectomy: the experience of survivors and carers. QUALITATIVE HEALTH RESEARCH 2009; 19:1485-1494. [PMID: 19805810 DOI: 10.1177/1049732309348366] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Following surgery for esophageal cancer, patients can experience complex physical, social, and emotional changes. Investigation of these challenges, particularly from the perspective of the patient and his or her carer, has been limited. The current study explored the emotional and cognitive experiences of esophageal cancer survivors and those of their carers, using focus groups conducted with members of a patient support group. Analysis of the patients' data yielded three themes: coping with a death sentence, adjusting to and accepting an altered self, and the unique benefits of peer support. Analysis of the carers' data also yielded three themes: the carer as buffer, representations of recovery and recurrence, and normalizing experiences through peer support. Esophageal cancer patients and their carers require holistic support in their efforts to adjust to the social, emotional, and physical consequences of esophagectomy. Peers could be an effective channel for the support of patients and carers.
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Affiliation(s)
- Noleen K McCorry
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
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