1
|
Akinsanya J, Smith JB, Langer-Gould A. Traumatic brain injury, race, ethnicity and cognition in newly diagnosed persons with multiple sclerosis. Mult Scler Relat Disord 2024; 86:105577. [PMID: 38579569 DOI: 10.1016/j.msard.2024.105577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/08/2024] [Accepted: 03/24/2024] [Indexed: 04/07/2024]
Abstract
We sought to determine whether a history of traumatic brain injury (TBI) could explain the lower symbol digit modalities test (SDMT) scores observed among newly diagnosed multiple sclerosis (MS) and control participants identifying as Black or Hispanic versus white in the MS Sunshine Study (n = 1172). 330 (29.2 %) participants reported a history of ≥1 TBI. Accounting for TBI did not explain the significant independent associations between having MS, being Black or Hispanic and lower SDMT. The pervasive effects of systemic racism in the United States remain the best explanation for the lower SDMT scores observed in Black and Hispanic participants.
Collapse
Affiliation(s)
- Jemima Akinsanya
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
| | - Jessica B Smith
- Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA
| | - Annette Langer-Gould
- Department of Neurology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA; Department of Clinical Science, Kaiser Permanente School of Medicine, Pasadena CA, USA.
| |
Collapse
|
2
|
Garland M, Wilbur J, Schoeny M, Reed M, Semanik P, Halloway S, Waters T. Determinants of Physical Activity Among Black Women During Pregnancy. J Obstet Gynecol Neonatal Nurs 2024; 53:172-184. [PMID: 38072009 DOI: 10.1016/j.jogn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women. DESIGN Longitudinal cohort. SETTING Medical center obstetric clinic. PARTICIPANTS Pregnant Black women (n = 40 in second trimester, n = 38 in third trimester) METHODS: We measured background determinants (demographic and pregnancy characteristics, discrimination, and neighborhood walkability) during the second trimester. We measured modifiable theoretical determinants (self-efficacy and social support) and physical activity using self-report and device measures during the second and third trimesters. We used paired t tests to determine differences in the modifiable theoretical determinants from the second trimester to third trimester and used Pearson correlations among background and modifiable determinants and physical activity measures during the second trimester. RESULTS Participants' physical activity levels were low during the second and third trimesters (32% and 22% met recommendation, respectively). We found no changes in self-efficacy or social support between trimesters and found no associations between these modifiable determinants and actual physical activity. We found a positive correlation between previous pregnancies and physical activity measured by devices, r(36) = .33, p = .048. Pregnancy-specific stress, r(38) = -.40, p = .013, was negatively correlated, and age, r(38) = .38, p = .017, was positively correlated with self-reported physical activity. CONCLUSIONS Low levels of physical activity during pregnancy coupled with the absence of an association with modifiable factors affecting pregnancy physical activity indicate a need to further examine the social, cultural, and environmental determinants of physical activity.
Collapse
|
3
|
Meeker TJ, Kim HJ, Tulloch IK, Keaser ML, Seminowicz DA, Dorsey SG. Secondary analysis: heat and self-report pain sensitivity associate with biological sex and racialized sociocultural group but may not be mediated by anxiety or pain catastrophizing. Pain Rep 2024; 9:e1133. [PMID: 38283650 PMCID: PMC10811695 DOI: 10.1097/pr9.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Previous studies have demonstrated associations between sex and racialized group on pain sensitivity and tolerance. We analyzed the association of sex and racialized group on heat pain sensitivity, sensibility to painful suprathreshold mechanical pain (STMP), and pain sensitivity questionnaire (PSQ). We hypothesized that anxiety and pain catastrophizing reported by racialized minority groups and women would mediate enhanced pain sensitivity. Our secondary aim was to evaluate validity of the PSQ in a diverse population. Methods Using quantitative sensory testing for painful heat, STMP (forces: 64, 128, 256, and 512 mN), and PSQ, we evaluated pain sensitivity in 134 healthy participants [34 (18 women) Asian, 25 (13 women) Black, and 75 (41 women) White]. We used general linear and linear mixed models to analyze outcomes. We assessed mediation of state and trait anxiety and pain catastrophizing on pain sensitivity. Results Racialized minority status was associated with greater heat pain sensitivity (F = 7.63; P = 0.00074) and PSQ scores (F = 15.45; P = 9.84 × 10-7) but not associated with STMP (F = 1.50; P = 0.23). Female sex was associated with greater heat pain sensitivity (F = 4.9; P = 0.029) and lower PSQ (F = 9.50; P = 0.0025) but not associated with STMP (F = 0.0018; P = 0.97). Neither anxiety nor pain catastrophizing mediated associations between sex or racialized group with heat pain threshold or PSQ. Differential experience of individual items (F = 19.87; P = 3.28 × 10-8) limited PSQ face validity in racialized minorities. Conclusion Consistent with previous research, sensitivity to painful heat was associated with racialized minority status and female sex. By contrast, there was no significant effect of racialized minority status or female sex on STMP. Some PSQ items are inapplicable to participants from racialized minority groups.
Collapse
Affiliation(s)
- Timothy J. Meeker
- Department of Biology, Morgan State University, Baltimore, MD, USA
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
| | - Hee Jun Kim
- Community of Acute and Chronic Care, The George Washington University, Washington, DC, USA
| | - Ingrid K. Tulloch
- Department of Psychology, Morgan State University, Baltimore, MD, USA
| | - Michael L. Keaser
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
| | - David A. Seminowicz
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - Susan G. Dorsey
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
- Department of Pain and Translational Symptom Sciences, University of Maryland School of Nursing, Baltimore, MD, USA
| |
Collapse
|
4
|
Ray K. When Black Health, Intersectionality, and Health Equity Meet a Pandemic. J Bioeth Inq 2023; 20:585-590. [PMID: 37843674 DOI: 10.1007/s11673-023-10299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/24/2023] [Indexed: 10/17/2023]
Abstract
Using the example of Black people's inequitable COVID-19 outcomes and their health outcomes prior to the pandemic, I argue that the pandemic has forever changed how we should think about the conceptual and practical nature of health equity. From here on, we can no longer think of health equity without the concept of intersectionality. In particular, we must acknowledge that discrimination (e.g. sexism, ableism, racism, classism, etc.) within our social institutions intersect to withhold resources needed for health from people who themselves have intersecting identities that make them vulnerable to the effects of discrimination. To ignore intersectionality in our work on health equity would mean ignoring a great injustice imposed on some of the most overlooked people in our communities, which would also be a great disserve to bioethics' professional longevity.
Collapse
Affiliation(s)
- Keisha Ray
- McGovern Center for Humanities and Ethics, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, Jesse Jones Library 450, Houston, TX, 77030, USA.
| |
Collapse
|
5
|
Owusu-Bempah A, Nicholson HL, Butler A, Croxford R, Kouyoumdjian FG. Opioid toxicity deaths in Black persons who experienced provincial incarceration in Ontario, Canada 2015-2020: A population-based study. Prev Med 2023; 177:107778. [PMID: 37967621 DOI: 10.1016/j.ypmed.2023.107778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/17/2023] [Accepted: 11/10/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE In the context of mass incarceration and the opioid toxicity crisis in North America, there is a lack of data on the burden of opioid toxicity deaths in Black persons who experience incarceration. We aimed to describe absolute and relative opioid toxicity mortality for Black persons who experienced incarceration in Ontario, Canada between 2015 and 2020. METHODS We linked data for all persons incarcerated in provincial correctional facilities and all persons who died from opioid toxicity in Ontario between 2015 and 2020, and accessed public data on population sizes. We described the characteristics of Black persons who were incarcerated and died from opioid toxicity, and calculated absolute mortality rates, as well as age-standardized mortality rates compared with all persons in Ontario not incarcerated during this period. RESULTS Between 2015 and 2020, 0.9% (n = 137) of 16,177 Black persons who experienced incarceration died from opioid toxicity in custody or post-release, for an opioid toxicity death rate of 0.207 per 100 person years. In the two weeks post-release, the opioid toxicity death rate was 1.34 per 100 person years. Standardized for age and compared with persons not incarcerated, the mortality ratio (SMR) was 17.8 (95%CI 16.4-23.1) for Black persons who experienced incarceration. CONCLUSIONS We identified a large, inequitable burden of opioid toxicity death for Black persons who experience incarceration in Ontario, Canada. Work is needed to support access to culturally appropriate prevention and treatment in custody and post-release for persons who are Black, and to prevent incarceration and improve determinants of health.
Collapse
Affiliation(s)
| | - Harvey L Nicholson
- University of Toronto Department of Sociology, Toronto, Ontario, Canada.
| | - Amanda Butler
- McMaster University Department of Family Medicine, Hamilton, Ontario, Canada; Department of Criminology, Simon Fraser University, Canada.
| | | | | |
Collapse
|
6
|
Van Baak B, Powell A, Fricas J, Caupain Sanderson A. Essential Nursing Actions to Reduce Inequities for Black Women in the Perinatal Period. J Obstet Gynecol Neonatal Nurs 2023; 52:454-466. [PMID: 37597534 DOI: 10.1016/j.jogn.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/21/2023] Open
Abstract
Perinatal nurses play a critical role in the care of, advocacy for, and research with Black women in the perinatal period. Despite awareness of inequities in the perinatal health care system that stem from racism in the United States, many nurses report feeling detached from the crisis. In this critical commentary, we provide a five-step nursing action guide to address this health disparity that is aligned with the Future of Nursing report and the American Nurses Association Code of Ethics. We recommend nursing activities in each step: understand drivers of health inequities among Black women, reflect on implicit bias, use respectful care frameworks with Black women, conduct ethical research, and advocate for change. The article includes a sharable and printable action sheet that can be used in the work environment to remind nurses of their roles in enacting change.
Collapse
|
7
|
Vriz O, Mushtaq AH, Elshaer AN, Shaik A, Landi I, Alzahrani T. Takotsubo Syndrome in Black Americans: Insights From the National Inpatient Sample. Tex Heart Inst J 2023; 50:e228055. [PMID: 37853912 PMCID: PMC10658156 DOI: 10.14503/thij-22-8055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND Data on race-related differences in the clinical outcomes of Takotsubo syndrome are limited, particularly for Black patients. This study aimed to assess whether race and sex may have an additional impact on the inpatient mortality of patients with Takotsubo syndrome. METHODS A total of 4,628 patients from the United States' National Inpatient Sample from 2012 to 2016 were identified; propensity score analysis revealed a similar propensity score between Black patients (n = 2,314) and White patients (n = 2,314), which was used to balance observed covariates. Sex and age distributions were identical between the 2 groups. The groups were also similar in baseline characteristics, including cardiovascular risk factors. White patients were compared with Black patients on in-hospital outcomes and inpatient mortality. A logistic regression analysis was conducted to measure the difference in mortality based on race and sex. RESULTS Compared with White patients, Black patients had a higher percentage of in-hospital complications, including cerebrovascular accidents (4.9% vs 2.5%, P ≤ .01), acute kidney injury (25% vs 19%, P ≤ .01); longer lengths of stay (8 vs 7 days, P ≤ .01); and higher inpatient mortality (6.1% vs 4.5%, P < .01). When analysis was conducted with race and sex combined, inpatient mortality was higher among Black men than among White women (odds ratio, 2.7 [95% CI, 1.80-3.95]; P ≤ .01). CONCLUSION This study showed that Black patients with Takotsubo syndrome have higher in-hospital complications and inpatient mortality rates. When race and sex were combined, inpatient mortality was significantly higher among Black men than among either White men and women or Black women.
Collapse
Affiliation(s)
- Olga Vriz
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Department of Cardiology and Sport Medicine, San Antonio Hospital, San Daniele del Friuli, Udine, Italy
| | - Ali Hassan Mushtaq
- School of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ahmed Nahid Elshaer
- School of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Abdullah Shaik
- School of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Irene Landi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Talal Alzahrani
- Department of Medicine, College of Medicine, Taibah University, Medina, Saudi Arabia
| |
Collapse
|
8
|
Cody SL, Newman S, Bui C, Sharp-Marbury R, Scott L. Substance use and opioid-related stigma among Black communities in the rural South. Arch Psychiatr Nurs 2023; 46:127-132. [PMID: 37813495 DOI: 10.1016/j.apnu.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 07/03/2023] [Accepted: 09/03/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE This study examined perceived substance use, opioid knowledge, and barriers to Black people accessing treatment for substance and opioid use disorder (SUD/OUD). METHODS Thirty-nine participants completed the community survey and The Brief Opioid Overdose Knowledge questionnaire. Qualitative interviews were conducted with 18 stakeholders and 9 people with SUD/OUD. FINDINGS Out of 39 participants, <50 % knew where to refer someone for treatment and fewer knew where to access naloxone. Majority of the stakeholders and people with SUD/OUD reported stigma as a treatment barrier. CONCLUSION Studies related to provider anti-stigma trainings and psychoeducation for Black people living in the rural South are warranted.
Collapse
Affiliation(s)
- Shameka L Cody
- Capstone College of Nursing, The University of Alabama in Tuscaloosa, AL 35401, USA.
| | - Sharlene Newman
- Alabama Life Research Institute, The University of Alabama in Tuscaloosa, AL 35401, USA
| | - Chuong Bui
- Alabama Life Research Institute, The University of Alabama in Tuscaloosa, AL 35401, USA
| | | | - Letisha Scott
- Capstone College of Nursing, The University of Alabama in Tuscaloosa, AL 35401, USA
| |
Collapse
|
9
|
Khush KK, Valantine HA. The Time to Act Is Now: Racial Disparities After Heart Transplantation. Circulation 2023; 148:207-209. [PMID: 37459406 DOI: 10.1161/circulationaha.123.064499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Kiran K Khush
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, CA
| | - Hannah A Valantine
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, CA
| |
Collapse
|
10
|
Motley RO, Chen YC, Motley JD. Prevalence and Correlates of Adverse Mental Health Outcomes among Male and Female Black Emerging Adults with a History of Exposure (Direct versus Indirect) to Police Use of Force. Soc Work Res 2023; 47:125-134. [PMID: 37197700 PMCID: PMC10183966 DOI: 10.1093/swr/svad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/14/2021] [Accepted: 02/17/2022] [Indexed: 05/19/2023]
Abstract
Anxiety, depression, and psychological distress are public health concerns for Black emerging adults ages 18-29, given their prevalence in this population. However, we have scant empirical research investigating the prevalence and correlates of negative mental outcomes among Black emerging adults with a history of exposure to police use of force. Thus, the current study examined the prevalence and correlates of depression, anxiety, and psychological well-being and how they vary among a sample of Black emerging adults with a history of direct or indirect exposure to police use of force. Computer-assisted surveys were administered to a sample of Black emerging adults (N = 300). Univariate, bivariate, and multiple linear regression analyses were conducted. Black women with a history of direct or indirect exposure to police use of force had significantly less favorable scores on the depression and anxiety scales compared with Black men. Study findings suggest that Black emerging adults, particularly women, with a history of exposure to police use of force are at risk of experiencing adverse mental health outcomes. Future research with a larger and ethnically diverse sample of emerging adults that examines the prevalence and correlates of adverse mental health outcomes and how they vary by gender, ethnicity, and exposure to police use of force is warranted.
Collapse
Affiliation(s)
- Robert O Motley
- Jr., PhD, is assistant professor, School of Social Work, Boston College, 140 Commonwealth Avenue, McGuinn Hall, Chestnut Hill, MA 02467, USA
| | - Yu-Chih Chen
- PhD, is assistant professor, Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong
| | - Jamie D Motley
- PhD, is Anne Shen Chao ’74 Director of Student Success, Wellesley College, Wellesley, MA, USA
| |
Collapse
|
11
|
Olanlesi-Aliu A, Alaazi D, Salami B. Black Health in Canada: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e42212. [PMID: 37227759 DOI: 10.2196/42212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/28/2023] [Accepted: 04/20/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Black Canadians experience poor health care, poor health outcomes, and a greater burden of health inequalities, much of which is rooted in the unequal distribution of social determinants of health. Despite Canada's emphasis on social inclusion, Canada's Black population faces substantial social inequities that affect their health and well-being. These disparities may specifically be attributed to racial discrimination, immigration status, precarious housing, underemployment, and increased poverty among Black Canadians. OBJECTIVE This paper describes a protocol for a scoping review that aims to understand the range and nature of research conducted on the health of Black Canadians as well as the gaps in this literature. METHODS Arksey and O'Malley's methodological framework guided the conduct of the scoping review. We searched electronic databases (CINAHL, Embase, Global Health, MEDLINE, PsycINFO, Scopus, Sociological Abstracts, and Web of Science) and grey literature sources for peer-reviewed articles and grey reports on the health of Black Canadians. Six reviewers independently screened the abstracts and full text of studies to determine eligibility for inclusion. According to the PRISMA-ScR (Preferred Reporting Items for Systematics Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, the findings will be synthesized quantitatively and qualitatively through thematic analysis. RESULTS Title, abstract, and full-text screening concluded in October 2022. Data collection is in progress and is expected to be completed by April 2023. Data analysis and drafting of the manuscript will be done thereafter. Findings from the scoping review are expected to be provided for peer review in 2023. CONCLUSIONS This review will collect important data and evidence related to the health (mental, reproductive, and sexual; social determinants of health) of the Black population in Canada. The findings could help identify existing gaps in the health of Black individuals in Canada and inform future research paradigms. The findings will further inform the development of a knowledge hub on Black Canadians' health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/42212.
Collapse
Affiliation(s)
| | - Dominic Alaazi
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
12
|
Jacob G, Faber SC, Faber N, Bartlett A, Ouimet AJ, Williams MT. A Systematic Review of Black People Coping With Racism: Approaches, Analysis, and Empowerment. Perspect Psychol Sci 2023; 18:392-415. [PMID: 36006823 PMCID: PMC10018067 DOI: 10.1177/17456916221100509] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reviews the current research literature concerning Black people in Western societies to better understand how they regulate their emotions when coping with racism, which coping strategies they use, and which strategies are functional for well-being. A systematic review of the literature was conducted, and 26 studies were identified on the basis of a comprehensive search of multiple databases and reference sections of relevant articles. Studies were quantitative and qualitative, and all articles located were from the United States or Canada. Findings demonstrate that Black people tend to cope with racism through social support (friends, family, support groups), religion (prayer, church, spirituality), avoidance (attempting to avoid stressors), and problem-focused coping (confronting the situation directly). Findings suggest gender differences in coping strategies. We also explore the relationship between coping with physical versus emotional pain and contrast functional versus dysfunctional coping approaches, underscoring the importance of encouraging personal empowerment to promote psychological well-being. Findings may help inform mental-health interventions. Limitations include the high number of American-based samples and exclusion of other Black ethnic and national groups, which is an important area for further exploration.
Collapse
Affiliation(s)
| | | | | | - Amy Bartlett
- Department of Classics and Religious
Studies, University of Ottawa
| | | | - Monnica T. Williams
- School of Psychology, University of
Ottawa
- Monnica T. Williams, School of Psychology,
University of Ottawa
| |
Collapse
|
13
|
Josiah N, Shoola H, Rodney T, Arscott J, Ndzi M, Bush AD, Wilson PR, Jacques K, Baptiste DL, Starks S. Addressing systemic racism and intergenerational transmission of anxiety using Bowenian family therapy with African American populations: A Discursive paper. J Adv Nurs 2023; 79:1714-1723. [PMID: 36825628 DOI: 10.1111/jan.15610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/23/2022] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
AIM To examine the intergenerational impact of systemic racism on mental health, depicting the evolution and patterns of anxiety symptoms and the application of the Bowenian family therapy to understand the interrelatedness and long-standing impact of intergenerational trauma in African American families. This article highlights interventions that increase awareness of and promotes physical and mental health for African American populations. DESIGN Discursive Paper. METHOD Searching literature published between 2012 and 2022 in PubMed, SCOPUS, EBSCO Host and Google Scholar, we explored factors associated with systemic racism and generational anxiety. DISCUSSION Evidence-based literature supports the application of the Bowenian family therapy theoretical framework to understand the intergenerational impact of systemic racism and to address the transmission of anxiety symptoms in African American populations. CONCLUSION Culturally appropriate interventions are needed to decrease anxiety symptoms in an attempt to heal intergenerational trauma and to improve family dynamics in African American populations. IMPACT TO NURSING PRACTICE Nurses play an integral role in providing holistic quality patient-centred care for African American populations who have experienced racial trauma. It is critical for nurses to implement culturally responsive and racially informed care with patients that focuses on self-awareness, health promotion, prevention and healing in efforts to address racial trauma. Application of Bowenian family therapy can aid in the reduction of both intergenerational transmission of racial trauma and generational anxiety. NO PATIENT OR PUBLIC CONTRIBUTION There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion.
Collapse
Affiliation(s)
- Nia Josiah
- Columbia University School of Nursing, New York, New York, USA
| | - Hakeem Shoola
- Columbia University School of Nursing, New York, New York, USA
| | - Tamar Rodney
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Joyell Arscott
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maureen Ndzi
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Ashley D Bush
- Department of Defense, Department of Human Resources, Fort Detrick, Maryland, USA
| | - Patty R Wilson
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Keilah Jacques
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Shaquita Starks
- Emory Nell Hodgson Woodruff, School of Nursing, Atlanta, Georgia, USA
| |
Collapse
|
14
|
Zingano CP, Escott GM, Rocha BM, Porgere IF, Moro CC, Delanaye P, Silveiro SP. 2009 CKD-EPI glomerular filtration rate estimation in Black individuals outside the United States: a systematic review and meta-analysis. Clin Kidney J 2023; 16:322-330. [PMID: 38021375 PMCID: PMC10665997 DOI: 10.1093/ckj/sfac238] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Indexed: 12/01/2023] Open
Abstract
Background The 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is the most used equation to estimate glomerular filtration rate (GFR), with race being a factor thereof, increasing GFR by 16% in self-identified Black persons compared with non-Black persons. However, recent publications indicate that it might overestimate GFR for Black adults outside the USA. In this meta-analysis, we assessed the accuracy, evaluated by the percentage of estimated GFR within 30% of measured GFR (P30), of the 2009 CKD-EPI equation in estimating GFR with and without the race coefficient in Black individuals outside the United States of America (USA). Methods We searched MEDLINE and Embase from inception to 9 July 2022, with no language restriction, supplemented by manual reference searches. Studies that assessed the CKD-EPI P30 accuracy with or without the race coefficient in Black adults outside the USA with an adequate method of GFR measurement were included. Data were extracted by independent pairs of reviewers and were pooled using a random-effects model. Results We included 11 studies, with a total of 1834 Black adults from South America, Africa and Europe. The race coefficient in the 2009 CKD-EPI equation significantly decreased P30 accuracy {61.9% [95% confidence interval (CI) 53-70%] versus 72.9% [95% CI 66.7-78.3%]; P = .03}. Conclusions Outside the USA, the 2009 CKD-EPI equation should not be used with the race coefficient, even though the 2009 CKD-EPI equation is not sufficiently accurate either way (<75%). Thus we endorse the Kidney Disease: Improving Global Outcomes guidelines to use exogenous filtration markers when this may impact clinical conduct.
Collapse
Affiliation(s)
- Carolina Pires Zingano
- Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto, Alegre
| | - Gustavo Monteiro Escott
- Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto, Alegre
| | - Bruna Martins Rocha
- Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto, Alegre
| | - Indianara Franciele Porgere
- Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto, Alegre
| | - Candice Cristine Moro
- Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto, Alegre
| | - Pierre Delanaye
- Department of Nephrology, Dialysis, Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium
- Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
| | - Sandra Pinho Silveiro
- Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto, Alegre
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| |
Collapse
|
15
|
Ogueji IA, Demoko Ceccaldi BM, Okoloba MM, Maloba M, Adejumo AO, Ogunsola OO. Black People Narrate Inequalities in Healthcare Systems that Hinder COVID-19 Vaccination: Evidence from the USA and the UK. J Afr Am Stud (New Brunsw) 2022; 26:297-313. [PMID: 36247030 PMCID: PMC9552157 DOI: 10.1007/s12111-022-09591-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 06/16/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health emergency. As a novel condition, there is no known definitive treatment for the condition, except for the use of vaccines as a control measure. In the literature, the issue of inequalities in healthcare systems has been documented as a hindrance to COVID-19 vaccination; however, the specific inequalities in healthcare systems that hinder COVID-19 vaccination are poorly understood. Guided by the fundamental cause theory (FCT), this study aims to address this gap among Black people, a minority group vulnerable to inequalities in healthcare systems. Thirty-five Black people (age range = 21-58 years) residing in either the United States of America (USA) or the United Kingdom (UK) participated in this study. Qualitative data were collected and analyzed using thematic analysis. Most USA participants and a few UK participants narrated that no inequalities in healthcare systems hinder them from receiving COVID-19 vaccines. Contrarily, most UK participants and a few USA participants narrated inequalities in healthcare systems that hinder them from receiving COVID-19 vaccines. These are mistrust of the healthcare system, health policies regarding COVID-19 vaccination, historical factors (such as historical abuse of Black bodies by health professionals), residential location, and dissatisfaction with health services. In terms of what governments must do to correct these inequalities, participants recommended the need for acknowledgment and community engagement. This is the first international collaboration to examine this problem. Important implications for theory, healthcare systems, and COVID-19 vaccination program planning are highlighted. Finally, there are members of other minority groups and vulnerable communities who are not Black people. Such groups could face unique inequalities that hinder COVID-19 vaccination. Therefore, future studies should include such groups.
Collapse
Affiliation(s)
| | | | | | - May Maloba
- Global Health Innovations (GHI), Nairobi, Kenya
| | - Adebayo O. Adejumo
- Department of Psychology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Oyo State Nigeria
| | | |
Collapse
|
16
|
Moore T, Payne-Foster P, Oliver JS, Spears EG, Spencer CH, Maye J, Allen RS. Community Perspectives and Environmental Justice Issues in an Unincorporated Black Township. Int J Environ Res Public Health 2022; 19:7490. [PMID: 35742740 DOI: 10.3390/ijerph19127490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 02/04/2023]
Abstract
Through each era, the southeastern United States was and continues to be an epicenter for industrial companies to establish factories and plants. Though this development attracts economic gain for the companies and surrounding areas, low-income and predominantly Black communities bear the brunt of the environmental consequences while frequently remaining stagnant economically. This qualitative, community-based participatory research study grew out of a larger study designed to recruit lay community advisors from communities labeled as hard to reach in research. We focus on Holt, Alabama, an unincorporated community in the southeastern United States region. The primary goal of this research inquiry is to thematically analyze community interviews stemming from a topic of research, practice, and policy interest to community members: the effects of industrial pollution on Holt citizens’ daily lives. Content analysis of focus-group transcripts revealed four emergent themes, including: (1) how the pollution affects their water, soil, and air quality; (2) illness related to pollution; (3) community engagement and empowerment; and (4) suggestions regarding what government officials could do to address this area of need. Building upon the prior research regarding environmental justice, human flourishing, and the definition of nurturing environments, suggestions are made regarding the creation, implementation, and maintenance of project advisory councils focused on issues of environmental justice. Community advocacy and empowerment as well as community and scientific partnerships are imperative to alleviate problems associated with environmental justice.
Collapse
|
17
|
Giaquinto AN, Miller KD, Tossas KY, Winn RA, Jemal A, Siegel RL. Cancer statistics for African American/ Black People 2022. CA Cancer J Clin 2022; 72:202-229. [PMID: 35143040 DOI: 10.3322/caac.21718] [Citation(s) in RCA: 176] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 12/19/2022] Open
Abstract
African American/Black individuals have a disproportionate cancer burden, including the highest mortality and the lowest survival of any racial/ethnic group for most cancers. Every 3 years, the American Cancer Society estimates the number of new cancer cases and deaths for Black people in the United States and compiles the most recent data on cancer incidence (herein through 2018), mortality (through 2019), survival, screening, and risk factors using population-based data from the National Cancer Institute and the Centers for Disease Control and Prevention. In 2022, there will be approximately 224,080 new cancer cases and 73,680 cancer deaths among Black people in the United States. During the most recent 5-year period, Black men had a 6% higher incidence rate but 19% higher mortality than White men overall, including an approximately 2-fold higher risk of death from myeloma, stomach cancer, and prostate cancer. The overall cancer mortality disparity is narrowing between Black and White men because of a steeper drop in Black men for lung and prostate cancers. However, the decline in prostate cancer mortality in Black men slowed from 5% annually during 2010 through 2014 to 1.3% during 2015 through 2019, likely reflecting the 5% annual increase in advanced-stage diagnoses since 2012. Black women have an 8% lower incidence rate than White women but a 12% higher mortality; further, mortality rates are 2-fold higher for endometrial cancer and 41% higher for breast cancer despite similar or lower incidence rates. The wide breast cancer disparity reflects both later stage diagnosis (57% localized stage vs 67% in White women) and lower 5-year survival overall (82% vs 92%, respectively) and for every stage of disease (eg, 20% vs 30%, respectively, for distant stage). Breast cancer surpassed lung cancer as the leading cause of cancer death among Black women in 2019. Targeted interventions are needed to reduce stark cancer inequalities in the Black community.
Collapse
Affiliation(s)
- Angela N Giaquinto
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Kimberly D Miller
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Katherine Y Tossas
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Robert A Winn
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Rebecca L Siegel
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| |
Collapse
|
18
|
Abstract
Facilities that emit hazardous toxins, such as toxic landfills, oil refineries, and chemical plants, are disproportionately located in predominantly Black, Latinx, and Indigenous neighborhoods. Environmental injustices like these threaten just distribution of health itself, including access to health that is not dependent on having the right skin color, living in the right neighborhood, or making the right amount of money. Facilities that emit environmental toxins wrongly make people's race, ethnicity, income, and neighborhood essential to who is allowed to breathe clean air and drink clean water, and thus, who is allowed to be healthy. This can be seen in the environmental crises in Louisiana; Mississippi; Houston, Texas; and Flint, Michigan. Since bioethics purports to concern itself with the principle of justice as applied to individuals and increasingly to populations, the field ought to concern itself more with environmental injustice.
Collapse
|
19
|
Abstract
During the fall of 2020, several panel discussions were held to highlight the perspectives of Black parasitologists. Here, I summarize the themes from three such discussions, held at the Molecular Parasitology Meeting, Black in Microbiology Week, and the Annual Meeting of the American Society of Tropical Medicine & Hygiene, respectively.
Collapse
|
20
|
Isoya H, Yamada H. Hidden internet-based measure of discrimination and mental health of Black people. Soc Sci Med 2021; 273:113776. [PMID: 33610972 DOI: 10.1016/j.socscimed.2021.113776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/22/2022]
Abstract
Incorporating the internet-based measure of discrimination obtained by Google Trends into state-level panel data, we conduct a fixed-effect model estimation to elucidate the relationship between racial discrimination and depression among Black people. We find that the deterioration of mental health among Black people, measured as the percentage of Black people with depression, is closely associated with our measure of discrimination.
Collapse
|
21
|
Blot S, Bauer G, Fraser M, Nleya M, Wadham M. AIDS Service Organization Access Among African, Caribbean and Other Black Residents of an Average Canadian City. J Immigr Minor Health 2018; 19:851-860. [PMID: 26895153 DOI: 10.1007/s10903-016-0359-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Due to heightened vulnerability to HIV/AIDS, African, Caribbean and Black (ACB) communities are priority groups for prevention and intervention services in Canada. However, it is not clear which factors may affect ACB communities' access to these services. We evaluated access to the local AIDS service organization (ASO) in Middlesex-London by using data from the Black, African and Caribbean Canadian Health Study. Modified Poisson regression was used to obtain prevalence risk ratios for factors associated with three measures of access: familiarity with the ASO, willingness to access, and realized access. In adjusted analyses, older ACB community members were more likely to be familiar with the ASO, willing to access it, and have actually gone there. Canadian-born participants were less likely to have been to the ASO than recent immigrants. These results have implications for reaching specific segments of ACB communities for HIV/AIDS-related services in Canada.
Collapse
Affiliation(s)
- Soraya Blot
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
| | - Greta Bauer
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
- Women's Studies and Feminist Research, The University of Western Ontario, London, ON, Canada
| | | | - Mercy Nleya
- Regional HIV/AIDS Connection, London, ON, Canada
- African and Caribbean Council on HIV/AIDS in Ontario, Toronto, ON, Canada
| | - Mbaka Wadham
- Regional HIV/AIDS Connection, London, ON, Canada
- Women and HIV/AIDS Initiative, Toronto, ON, Canada
| |
Collapse
|
22
|
Nlandu Y, Lepira F, Makulo JR, Engole Y, Sumaili E, Wameso MN, Mokoli V, Luse J, Longo A, Zinga C, Akilimali P, Nkodila A, Bavassa M, Kajingulu F, Bukabau J, Nseka N. Reverse epidemiology of elevated blood pressure among chronic hemodialysis black patients with stroke: a historical cohort study. BMC Nephrol 2017; 18:277. [PMID: 28854899 PMCID: PMC5577846 DOI: 10.1186/s12882-017-0697-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 08/22/2017] [Indexed: 11/13/2022] Open
Abstract
Background Stroke is the third leading cause of cardiovascular mortality in dialysis patients. The objective of this study was to assess the extent of stroke in chronic hemodialysis patients. Methods Historical cohort of patients enrolled in two hemodialysis (HD) centers from January 1, 2010 to December 31, 2011, including 191 patients (mean age 52 years, 68% men). Incidence curves and survival time analysis between the first day of HD and the end of the study were described by the Kaplan-Meier method. Independent stroke predictors were identified by multiple logistic regression analysis. P < 0.05 defined the level of statistical significance. Results 12 incident stroke were recorded during the study period, with 1622.1 person-months (PM), a stroke incidence rate of 7.4 cases per 1000 PM (95% CI = 7.35–7.44) at the point date. The incidence of stroke at 6 months, 12 months and 24 months was 9.8%, 11.9% and 13%, respectively. Only the absence of arterial hypertension (RR = 5.7, 95% CI: 1.52–21.42) emerged as an independent determinant of stroke. Conclusion The high incidence of stroke in Kinshasa HD centers is partially explained by reverse epidemiology. Efforts must be made to understand this phenomenon in order to reduce its impact.
Collapse
Affiliation(s)
- Yannick Nlandu
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo.
| | - François Lepira
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Jean-Robert Makulo
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Yannick Engole
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Ernest Sumaili
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Marie-Noelle Wameso
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Vieux Mokoli
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Jeannine Luse
- Nephrology Unit, Department of Internal medicine, General Provincial of Kinshasa Hospital, Kinshasa, Democratic Republic of Congo
| | - Augustin Longo
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Chantal Zinga
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Pierre Akilimali
- Kinshasa School of Public Health, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Aliocha Nkodila
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Mélanie Bavassa
- Radiology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - François Kajingulu
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Justine Bukabau
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| | - Nazaire Nseka
- Nephrology Unit, Department of Internal medicine, Faculty of Medicine, University of Kinshasa Hospital, University of Kinshasa, BP 123, Kinshasa, Democratic Republic of Congo
| |
Collapse
|
23
|
Baidoobonso S, Bauer GR, Speechley KN, Lawson E. Social and Proximate Determinants of the Frequency of Condom Use Among African, Caribbean, and Other Black People in a Canadian City: Results from the BLACCH Study. J Immigr Minor Health 2017; 18:67-85. [PMID: 24488693 DOI: 10.1007/s10903-014-9984-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
African, Caribbean, and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about condom use in this population. This exploratory community-based research project addresses this gap in knowledge. 125 sexually active ACB people completed a questionnaire covering condom use and social determinants of health. The data were analyzed using ordinal logistic regression and mediation analyses. 20.5 % of sexually active ACB adults used condoms consistently. Male gender, wealth, unstable immigration classes, and unsecure employment statuses were independently associated with more frequent condom use. Proximate determinants mediating these relationships included: not having a cohabiting regular partner, not disliking condoms, and having a history of unwanted sex. The proximate determinants mediated 85.7-97.6 % of the effects of the social determinants. These results link social context and proximate factors with condom use. They can be used to design evidence-informed interventions for ACB people.
Collapse
Affiliation(s)
- Shamara Baidoobonso
- Epidemiology and Biostatistics, The University of Western Ontario, London, Canada.
| | - Greta R Bauer
- Epidemiology and Biostatistics, The University of Western Ontario, London, Canada.,Women's Studies and Feminist Research, The University of Western Ontario, London, Canada
| | | | - Erica Lawson
- Women's Studies and Feminist Research, The University of Western Ontario, London, Canada
| | | |
Collapse
|