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Ashe JJ, Evans MK, Zonderman AB, Waldstein SR. Absent Relations of Religious Coping to Telomere Length in African American and White Women and Men. Exp Aging Res 2024; 50:459-481. [PMID: 37258109 PMCID: PMC10687320 DOI: 10.1080/0361073x.2023.2219187] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVES This study investigated whether race and sex moderated the relations of religious coping to telomere length (TL), a biomarker of cellular aging implicated in race-related health disparities. METHODS Participant data were drawn from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, which included 252 socioeconomically diverse African American and White men and women aged (30-64 years old). Cross-sectional multivariable regression analyses examined interactive associations of religious coping, race, and sex to TL, adjusting for other sociodemographic characteristics. RESULTS Religious coping was unrelated to TL in this sample (p's > .05). There were no notable race or sex differences. Post hoc exploratory analyses similarly found that neither secular social support coping use nor substance use coping was associated with TL. CONCLUSION There was no evidence to support that religious coping use provided protective effects to TL in this sample of African American and White women and men. Nevertheless, future studies should use more comprehensive assessments of religious coping and intersectional identities to provide an in-depth examination of religiosity/spirituality as a potential culturally salient protective factor in cellular aging among African Americans in the context of specific chronic stressors such as discrimination.
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Affiliation(s)
- Jason J. Ashe
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, US
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, US
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, US
| | - Shari R. Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, US
- Division of Gerontology and Geriatric Medicine, University of Maryland School of Medicine, Baltimore, MD, US
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Singer J, Cummings C, Coccaro EF. Parental separation and death during childhood as predictors of adult psychopathology: An examination of racial differences. Psychol Trauma 2024; 16:184-192. [PMID: 35737525 PMCID: PMC10262299 DOI: 10.1037/tra0001291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Parental separation and parental death during childhood are common but understudied forms of adverse childhood events (ACEs), thus little is known about the impact on psychological functioning in adulthood. We examined whether parental death and parental separation during childhood was associated with risk of diagnostic criteria for depressive disorders, anxiety disorders, posttraumatic stress disorder (PTSD), or personality disorders during adulthood. Second, we compared parental separation and parental death and psychopathology across African Americans (N = 499) and Whites (N = 782). METHOD The sample consists of 1,211 participants (n = 669 females). Diagnostic interviews were administered by master's or doctorate-level degree holders in Clinical Psychology or Social Work. There was good to excellent interrater reliabilities (mean kappa of .84 ± .05; range: .79-.93) spanning anxiety, mood, anxiety, trauma, and personality disorders. RESULTS White participants reporting parental separation during childhood were more likely to report depressive disorders (OR = 2.151, p < .001), PTSD (OR = 2.218, p < .01) and personality disorders (OR = 1.764, p < .001) during adulthood. African American endorsement of parental separation during childhood did not predict depressive disorders (OR = 1.21, p = .357), anxiety disorders (OR = 1.107, p = .659), PTSD (OR = 1.351, p = .425) or personality disorders (OR = 1.432, p = .098) during adulthood. Overall, participants who reported parental death did not have significantly higher rates of depressive disorders (OR = 1.100, p = .668), anxiety disorders (OR = 1.357, p = .207), PTSD (OR = 1.351, p = .425), and personality disorders (OR = 1.432, p = .098). CONCLUSIONS Parental separation was a significant risk factor for adult psychopathology, but only for White participants. Parental death was not a risk factor for adult psychopathology no matter the person's race. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Emil F Coccaro
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center
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3
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Herrera-Luis E, Rosa-Baez C, Huntsman S, Eng C, Beckman KB, LeNoir MA, Rodriguez-Santana JR, Villar J, Laprise C, Borrell LN, Ziv E, Burchard EG, Pino-Yanes M. Novel insights into the whole-blood DNA methylome of asthma in ethnically diverse children and youth. Eur Respir J 2023; 62:2300714. [PMID: 37802634 PMCID: PMC10841414 DOI: 10.1183/13993003.00714-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 10/03/2022] [Accepted: 08/20/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The epigenetic mechanisms of asthma remain largely understudied in African Americans and Hispanics/Latinos, two populations disproportionately affected by asthma. We aimed to identify markers, regions and processes with differential patterns of DNA methylation (DNAm) in whole blood by asthma status in ethnically diverse children and youth, and to assess their functional consequences. METHODS DNAm levels were profiled with the Infinium MethylationEPIC or HumanMethylation450 BeadChip arrays among 1226 African Americans or Hispanics/Latinos and assessed for differential methylation per asthma status at the CpG and region (differentially methylated region (DMR)) level. Novel associations were validated in blood and/or nasal epithelium from ethnically diverse children and youth. The functional and biological implications of the markers identified were investigated by combining epigenomics with transcriptomics from study participants. RESULTS 128 CpGs and 196 DMRs were differentially methylated after multiple testing corrections, including 92.3% and 92.8% novel associations, respectively. 41 CpGs were replicated in other Hispanics/Latinos, prioritising cg17647904 (NCOR2) and cg16412914 (AXIN1) as asthma DNAm markers. Significant DNAm markers were enriched in previous associations for asthma, fractional exhaled nitric oxide, bacterial infections, immune regulation or eosinophilia. Functional annotation highlighted epigenetically regulated gene networks involved in corticosteroid response, host defence and immune regulation. Several implicated genes are targets for approved or experimental drugs, including TNNC1 and NDUFA12. Many differentially methylated loci previously associated with asthma were validated in our study. CONCLUSIONS We report novel whole-blood DNAm markers for asthma underlying key processes of the disease pathophysiology and confirm the transferability of previous asthma DNAm associations to ethnically diverse populations.
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Affiliation(s)
- Esther Herrera-Luis
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Spain
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carlos Rosa-Baez
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Spain
| | - Scott Huntsman
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Celeste Eng
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Michael A LeNoir
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Spain
- Bay Area Pediatrics, Oakland, CA, USA
| | - Jose R Rodriguez-Santana
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Spain
- Centro de Neumología Pediátrica, San Juan, Puerto Rico
| | - Jesús Villar
- Multidisciplinary Organ Dysfunction Evaluation Research Network, Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Li Ka Shing Knowledge Institute at St Michael's Hospital, Toronto, ON, Canada
| | - Catherine Laprise
- Département des Sciences Fondamentales, Université du Québec à Chicoutimi, Saguenay, QC, Canada
- Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Saguenay, QC, Canada
| | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Elad Ziv
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
- Division of General Internal Medicine, Department of Medicine and Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Esteban G Burchard
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Division of General Internal Medicine, Department of Medicine and Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Instituto de Tecnologías Biomédicas, Universidad de La Laguna (ULL), La Laguna, Spain
| | - Maria Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Tecnologías Biomédicas, Universidad de La Laguna (ULL), La Laguna, Spain
- These authors contributed equally as senior authors
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Zelaya CM, Francis DB, Williams LB. Understanding COVID-19 Vaccine Knowledge, Beliefs, and Trusted Information Sources Among Black Women in Kentucky: Implications for Vaccine Uptake. J Health Commun 2023; 28:680-688. [PMID: 37667624 PMCID: PMC10592059 DOI: 10.1080/10810730.2023.2252367] [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] [Indexed: 09/06/2023]
Abstract
To optimize COVID-19 vaccination rates among Black women in the United States, it is crucial to understand their vaccine beliefs and determine the most effective communication sources and messages to encourage vaccination. Consequently, we conducted seven focus groups with 20 Black women from Kentucky (aged 18-37 years) between October and November 2020. We identified five themes reflecting the participants' level of awareness, knowledge of the vaccine and vaccine development process; their uncertainty about vaccine safety and clinical trials; their willingness to get vaccinated, and their preferences for trusted sources and persuasive messages to motivate vaccine uptake. Despite the participants' high level of awareness about the vaccine's development, significant concerns were identified regarding the speed of the vaccine's development and clinical trials, known medical injustices against Black people, political influence, vaccine efficacy, and potential side effects that fed their unwillingness to vaccinate. Based on our findings, we recommend vaccination campaigns targeting Black women should prioritize messaging highlighting the benefits and limitations of the vaccine while emphasizing its protective benefits for self, family, and community. Campaigns should also include Black healthcare providers as sources of messages. The findings have additional implications for encouraging continued confidence in the vaccine and improving uptake.
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Ajufo A, Adigun AO, Mohammad M, Dike JC, Akinrinmade AO, Adebile TM, Ezuma-Ebong C, Bolaji K, Okobi OE. Factors Affecting the Rate of Colonoscopy Among African Americans Aged Over 45 Years. Cureus 2023; 15:e46525. [PMID: 37927674 PMCID: PMC10625396 DOI: 10.7759/cureus.46525] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
African Americans continue to have a low rate of colonoscopy screening despite the U.S. Preventive Services Taskforce's (USPSTF) recommendations and its proven benefits. Colonoscopy has proven to be an effective screening and therapeutic procedure. Understanding the root cause of the problem is a crucial step toward achieving the desired colonoscopy rate among this population. This paper evaluates factors that contribute to the underutilization of colonoscopy. The paper also analyzes strategies that could be maximized to increase colonoscopy rates, minimize colorectal cancer inequalities, and promote optimal colorectal health among African Americans.
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Affiliation(s)
- Afomachukwu Ajufo
- Internal Medicine, All Saints University School of Medicine, Roseau, DMA
| | - Aisha O Adigun
- Infectious Diseases, University of Louisville, Louisville, USA
| | - Majed Mohammad
- Geriatrics, Mount Carmel Grove City Hospital, Grove City, USA
| | - Juliet C Dike
- Internal Medicine, University of Calabar, Calabar, NGA
| | - Abidemi O Akinrinmade
- Medicine and Surgery, Benjamin S. Carson School of Medicine, Babcock University, Ilishan-Remo, NGA
| | - Temitayo M Adebile
- Public Health, Georgia Southern University, Statesboro, USA
- Nephrology, Boston Medical Center, Malden, USA
| | | | | | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
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Li X, Roy S, Damonte J, Park HY, Hoogland AI, Jamison K, Komrokji KR, Yeo CD, Kim Y, Dhillon J, Gudenkauf LM, Oswald LB, Jim HS, Yamoah K, Pow-Sang JM, Kanetsky PA, Gwede CK, Park JY, Gonzalez BD. Recruiting African American Prostate Cancer Survivors for a Population-based Biobank Study. Cancer Epidemiol Biomarkers Prev 2023; 32:768-775. [PMID: 36958853 PMCID: PMC10308568 DOI: 10.1158/1055-9965.epi-22-1157] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Prostate cancer affects African American men disproportionately compared with men of other racial/ethnic groups. To identify biological bases for this health disparity, we sought to create a state-wide biobank of African American prostate cancer survivors in Florida. METHODS African American men diagnosed with prostate cancer between 2013 and 2017 and living in Florida at diagnosis were identified through the State of Florida's cancer registry. Individuals were approached via mail and telephone, assessed for eligibility, and asked for informed consent. χ2 and t tests were conducted to identify differences between eligible and reachable individuals (i.e., had valid contact information) versus consented participants. RESULTS Of the 5,960 eligible and reachable individuals, 3,904 were eligible and contacted at least once, and 578 consented [overall consent rate = 10% (578/5,960); adjusted consent rate = 15% (578/3,904)]. Statistically significant (Ps < 0.05) but small differences in demographic and clinical variables were observed. Consented participants were less likely to be older than 64 (35% vs. 41%) and less likely to have received radiotherapy (36% vs. 41%) and hormone therapy (16% vs. 21%), but more likely to have regional prostate cancer (13% vs. 11%) and have undergone surgery (44% vs. 39%). Consented participants did not differ from reachable individuals on other demographic and clinical factors (Ps > 0.05). CONCLUSIONS Recruiting African American prostate cancer survivors to biobanking research through a cancer registry is feasible. However, the consent rate was low, and existing challenges limit consent and participation. IMPACT Strategies for overcoming barriers to informed consent and increasing participation in biospecimen research are needed to address cancer disparities.
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Affiliation(s)
- Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Siddhartha Roy
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA
| | - Jennifer Damonte
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Hyun Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Kala Jamison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Khaled R. Komrokji
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Chang Dong Yeo
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | | | - Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Kosj Yamoah
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL
| | - Julio M. Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | | | - Clement K. Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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Wyatt GE, Loeb TB, Cooley-Strickland M, Chin D, Wyatt LE, Smith-Clapham A. Novel methodologies using history to document the effects of African American sexual trauma: Perspectives of Gail E. Wyatt, PhD. Am Psychol 2023; 78:563-575. [PMID: 37384508 PMCID: PMC10414760 DOI: 10.1037/amp0001132] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
This article describes the nearly half a century career of Dr. Gail E. Wyatt, PhD, and her development of novel methodologies and measures of sexual trauma, specifically the Wyatt Sex History Questionnaire and the University of California, Los Angeles, Life Adversities Screener. These approaches broke the silence around experiences of sexual violence, particularly among African Americans, identifying their effects on sexual functioning and mental health. These novel methods are designed without assuming sexual literacy of respondents, knowledge of anatomy, or that discussing sex is easy or common; they include topics that are considered private and may evoke emotions. Trained professionals administering face-to-face interviews can serve to establish rapport and educate the participant or client while minimizing possible discomfort and shame around the disclosure of sexual practices. In this article, four topics are discussed focusing on African Americans, but they may also be relevant to other racial/ethnic groups: (a) breaking the silence about sex, (b) sexual harassment: its disclosure and effects in the workplace, (c) racial discrimination: identifying its effects as a form of trauma, and (d) the cultural relevance of promoting sexual health. Historical patterns of abuse and trauma can no longer be ignored but need to be better understood by psychologists and used to improve policy and treatment standards. Recommendations for advancing the field using novel methods are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Gail E. Wyatt
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Tamra Burns Loeb
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Michele Cooley-Strickland
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Lance E. Wyatt
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Amber Smith-Clapham
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Shaw AR, Lofton S, Vidoni ED. A Virtual Photovoice Study of Older African Americans Perceptions of Neurovascular Clinical Trials. Alzheimer Dis Assoc Disord 2023; 37:113-119. [PMID: 36944170 PMCID: PMC10219665 DOI: 10.1097/wad.0000000000000550] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/17/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Alzheimer disease (AD) poses a major public health crisis, especially among African Americans (AAs) who are up to 3 times more likely to develop AD compared with non-Hispanic Whites. Moreover, cardiovascular risk factors represent a precursor to cognitive decline, which contributes to racial/ethnic disparities seen within AD. Despite these disparities, AAs are underrepresented in neurovascular research. The purpose of this qualitative virtual photovoice project is to explore how older Midwestern AAs perceive neurovascular clinical trials. METHODS Five photovoice sessions were held virtually over a 3-month period. Participants took photos each week that captured the salient features of their environment that described their perceptions and experiences related to neurovascular clinical trials. Structured discussion using the SHOWED method was used to generate new understandings about the perspectives and experiences in neurovascular clinical trials. Data was analyzed using strategies in participatory visual research. RESULTS A total of 10 AAs aged 55 years and older participated and a total of 6 themes emerged from the photovoice group discussions. CONCLUSION Findings from this study inform the development of culturally appropriate research protocols and effective recruitment strategies to enhance participation among older AAs in neurovascular clinical trials.
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Affiliation(s)
- Ashley R. Shaw
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS
| | - Saria Lofton
- College of Nursing, University of Illinois Chicago, Chicago, IL
| | - Eric D. Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS
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Gerido LH, Resnicow K, Stoffel E, Tomlin T, Cook-Deegan R, Cline M, Coffin A, Holdren J, Majumder MA, He Z. Big Advocacy, Little Recognition: The Hidden Work of Black Patients in Precision Medicine. Res Sq 2023:rs.3.rs-2340760. [PMID: 36993185 PMCID: PMC10055541 DOI: 10.21203/rs.3.rs-2340760/v1] [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] [Indexed: 03/31/2023]
Abstract
Public health genomics prioritizes effective and ethical translation of genomic science into population health precision medicine. With the rapid development of cost-effective, next-generation genome sequencing, calls are growing for greater inclusion of Black people in genomic research, policy, and practice. Genetic testing is often the first step in precision medicine. This study explores racial differences in patient concerns about genetic testing for hereditary breast cancer. Employing a community-based participatory mixed methods research design, we developed a semi-structured survey that was shared broadly. There were 81 survey respondents, of which, forty-nine (60%) self-identified as Black, twenty-six (32%) indicated they had a history of a breast cancer diagnosis, or had received BRCA genetic testing. Black participants who expressed concerns about genetic testing were fairly equally distributed between concerns that could be addressed with genetic counseling (24%) and concerns about the subsequent use of their genetic data (27%). The concerns expressed by the participants in our study underscore a need for transparent disclosures and assurances regarding the use and handling of genetic data. These findings should be viewed in context with patient-led efforts to overcome systemic inequities in cancer care, as Black cancer patients have joined forces with advocates and researchers to develop protective health data initiatives and to improve their representation in genomic datasets. Future research should prioritize the information needs and concerns of Black cancer patients. Interventions should be developed to support their hidden work as a means to reduce barriers and improve representation in precision medicine.
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Perez NB, D'Eramo Melkus G, Wright F, Yu G, Vorderstrasse AA, Sun YV, Crusto CA, Taylor JY. Latent Class Analysis of Depressive Symptom Phenotypes Among Black/African American Mothers. Nurs Res 2023; 72:93-102. [PMID: 36729771 PMCID: PMC9992148 DOI: 10.1097/nnr.0000000000000635] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Depression is a growing global problem with significant individual and societal costs. Despite their consequences, depressive symptoms are poorly recognized and undertreated because wide variation in symptom presentation limits clinical identification-particularly among African American (AA) women-an understudied population at an increased risk of health inequity. OBJECTIVES The aims of this study were to explore depressive symptom phenotypes among AA women and examine associations with epigenetic, cardiometabolic, and psychosocial factors. METHODS This cross-sectional, retrospective analysis included self-reported Black/AA mothers from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study (data collected in 2015-2020). Clinical phenotypes were identified using latent class analysis. Bivariate logistic regression examined epigenetic age, cardiometabolic traits (i.e., body mass index ≥ 30 kg/m 2 , hypertension, or diabetes), and psychosocial variables as predictors of class membership. RESULTS All participants were Black/AA and predominantly non-Hispanic. Over half of the sample had one or more cardiometabolic traits. Two latent classes were identified (low vs. moderate depressive symptoms). Somatic and self-critical symptoms characterized the moderate symptom class. Higher stress overload scores significantly predicted moderate-symptom class membership. DISCUSSION In this sample of AA women with increased cardiometabolic burden, increased stress was associated with depressive symptoms that standard screening tools may not capture. Research examining the effect of specific stressors and the efficacy of tools to identify at-risk AA women are urgently needed to address disparities and mental health burdens.
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Poindexter M, Stokes A, Mellman TA. Neighborhood Stress Predicts Fear of Sleep Independently of Posttraumatic Stress Disorder. Behav Sleep Med 2023; 21:185-192. [PMID: 35471154 PMCID: PMC10292665 DOI: 10.1080/15402002.2022.2067162] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Chronic insufficient sleep is linked to a variety of adverse health outcomes, and African Americans have been found to have poorer sleep than their non-Hispanic White counterparts. African Americans disproportionately live in low-income disordered neighborhoods which increases their risk of trauma exposure and adversely affects their sleep. Fear of sleep is a construct linked to posttraumatic stress disorder (PTSD). We have reported a relationship between fear of sleep and insomnia in urban residing African Americans. Our objective is to report the relative contributions of neighborhood stress along with PTSD to fear of sleep. METHODS The present study features a nonclinical sample of 117 African Americans (ages 18-35) who reside in DC. RESULTS After controlling for gender, hierarchical linear regression analyses revealed that PTSD severity and perceptions of the neighborhood environment accounted for approximately 32% of the variance in sleep-related fears (∆R2 = .320, p < .001). Regression coefficients suggest that perceptions of the neighborhood (β = .360) predict sleep-related fears to a similar degree as PTSD severity (β = .368). CONCLUSION Results from this study have implications for interventions to help African Americans to cope with their neighborhood environments effect on their sleep.
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12
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Joseph RP, Ainsworth BE, Vega-López S, Adams MA, Todd M, Gaesser GA, Keller C. Cardiometabolic Risk Factors Among Insufficiently Active African American Women With Obesity: Baseline Findings From Smart Walk. J Cardiovasc Nurs 2023; 38:198-204. [PMID: 35794781 PMCID: PMC9813275 DOI: 10.1097/jcn.0000000000000930] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Low moderate-to-vigorous physical activity (MVPA) levels and obesity are associated with increased cardiometabolic disease risk. OBJECTIVE The aim of this study was to describe MVPA and cardiometabolic risk characteristics of insufficiently active African American women with obesity (N = 60) enrolled in a culturally tailored MVPA intervention. METHODS We assessed accelerometer-measured and self-reported MVPA, blood pressure, serum lipid profiles, cardiorespiratory fitness (VO 2 peak), and aortic pulse wave velocity. RESULTS Participants (mean age, 38.4; mean body mass index, 40.6 kg/m 2 ) averaged 15 min/d of accelerometer-measured MVPA and 30 min/wk of self-reported MVPA. Systolic and diastolic blood pressure levels were elevated (135.4 and 84.0 mm Hg, respectively). With the exception of low-density lipoprotein cholesterol (121.4 mg/dL) and high-density lipoprotein cholesterol (47.6 mg/dL), lipid profiles were within reference ranges. Compared with normative reference values, average VO 2 peak was low (18.7 mL/kg/min), and pulse wave velocity was high (7.4 m/s). CONCLUSIONS Our sample of insufficiently active African American women with obesity was at an elevated risk for cardiometabolic disease.
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Affiliation(s)
- Rodney P. Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Barbara E. Ainsworth
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
- Department of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA
| | - Marc A. Adams
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Glenn A. Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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13
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Gyamfi A, Spatz DL, Jefferson UT, Lucas R, O'Neill B, Henderson WA. Breastfeeding Social Support Among African American Women in the United States: A Meta-Ethnography. Adv Neonatal Care 2023; 23:72-80. [PMID: 35939758 PMCID: PMC9891275 DOI: 10.1097/anc.0000000000001021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Indexed: 01/31/2023]
Abstract
BACKGROUND In the United States, there are racial disparities in 6 months of exclusive breastfeeding. Only, 25.8% of American infants were breastfed for the first 180 days of life, with African American infants least (19.8%) exclusively breastfed in 2018. PURPOSE The meta-ethnography explored the breastfeeding support for African American women in the United States. DATA SOURCES The online databases of American Psychological Association, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, PubMed, and Scopus were searched with key words, and the search was not limited by the year of publication. STUDY SELECTION The inclusion criteria for the study selection entailed all qualitative studies conducted on breastfeeding support among self-identified African American women in the United States, written in English language, peer reviewed, or dissertation. The initial search produced 905 articles of which 8 met the eligibility criteria. DATA EXTRACTION Data extraction and analysis were guided by Noblit and Hare's (1988) meta-ethnography approach. The analysis process was completed by a team of researchers, inclusive of breastfeeding experts. RESULTS Five overarching themes emerged including trustworthy information; early postpartum support by key influencers; maternal culture; tangible resources, and Black mothers' empowerment. IMPLICATIONS FOR PRACTICE AND RESEARCH Social support is a major determinant for the initiation and continuation of breastfeeding among African American women in the United States. Future longitudinal studies are warranted to explore the social support of breastfeeding among African American women in the United States.
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Affiliation(s)
- Adwoa Gyamfi
- Correspondence: Adwoa Gyamfi, PhD, MPH, BSc, RN, University of Connecticut, School of Nursing, 231 Glenbrook Rd Unit 4026, Storrs, CT 06269 ()
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14
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Fritz K, Hong J, Basdeo D, Byrnes K, Cordoba A, Dunn K, Haider U, Kashif M, Lee N, Mohamed Nuhuman AS, Santos R, Jacobs RJ. United Network for Organ Sharing (UNOS) Database Analysis of Factors Associated With Kidney Transplant Time on Waiting List. Cureus 2023; 15:e34679. [PMID: 36909033 PMCID: PMC9997046 DOI: 10.7759/cureus.34679] [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: 01/07/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION In the United States (U.S.), African Americans and other minority groups have longer wait times for kidney transplantation than Caucasians. To date, many studies analyzing time spent on the waitlist for each race/ethnicity have been done. However, there are few to no studies examining waitlist time after the 2019 policy changes to the geographic distribution of donated kidneys. METHODS Data collected from the National Organ Procurement and Transplantation Network database were used to analyze associations between race and time spent on the waitlist for a kidney transplant in the U.S. Additional sub-categorical data were analyzed to determine further associations and potential covariates, such as gender, age, citizenship, primary source of payment, region of transplant center, BMI, Kidney Donor Profile Index (KDPI), renal diagnosis, and presence/type of diabetes. Data were analyzed using odds ratios and validated by Bonferroni-Holm's corrected chi-square tests at confidence intervals of 95% to determine if there are statistically significant differences between transplant time spent on the waitlist and ethnicity, as well as age, diagnosis category, region of transplant center, and KDPI. RESULTS Statistically significant increased odds of remaining on the transplant list at two years existed for all non-white races/ethnicities, except those identifying as multiracial. Asian American candidates had the greatest odds of remaining on the waitlist greater than two years in comparison to white candidates: 1.51 times that of a patient categorized as white (odds ratio [OR] 1.51, confidence interval [CI] 1.44-1.57). African American/Black, (OR 1.38, CI 1.34-1.43) Pacific Islander (OR 1.38, CI 1.17-1.63), Hispanic candidates (OR 1.37, CI 1.32-1.41), and American Indian or Native Alaskan candidates (OR 1.23, CI 1.12-1.46) also had increased odds of remaining on the transplant waitlist greater than two years compared to white candidates. DISCUSSION In this study, ethnic disparities persisted as a barrier for non-white individuals receiving treatment for end-stage kidney disease, specifically in the context of time spent on the waitlist for a kidney transplant. Further research is needed regarding the causes of these disparities in time spent on the waitlist, such as cultural restrictions in organ donation, racial differences in parameters for organ match, and institutionalized racism in health care practitioners.
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Affiliation(s)
- Kristina Fritz
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Jennifer Hong
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Devina Basdeo
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Kimberly Byrnes
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Andres Cordoba
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Kylie Dunn
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Umbul Haider
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Mareena Kashif
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Nick Lee
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | | | | | - Robin J Jacobs
- Epidemiology and Public Health, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
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15
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Rabinowitz JA, Reboussin BA, Thrul J, Drabick DAG, Kahn G, Green KM, Ialongo NS, Huhn AS, Maher BS. Early Childhood Behavioral and Academic Antecedents of Lifetime Opioid Misuse among Urban Youth. J Clin Child Adolesc Psychol 2022; 51:864-876. [PMID: 33688771 PMCID: PMC8977050 DOI: 10.1080/15374416.2021.1875324] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Opioid misuse has become an epidemic in the United States. In the present study, we examine potential malleable early childhood predictors of opioid misuse including whether childhood achievement, aggressive behavior, attention problems, and peer social preference/likability in first grade predicted opioid misuse and whether these relationships differed depending on participant sex. METHOD Data are drawn from three cohorts of participants (N = 1,585; 46.7% male) recruited in first grade as part of a series of elementary school-based, universal preventive interventions conducted in a Mid-Atlantic region of the US. In first grade, participants completed standardized achievement tests, teachers reported on attention problems, and peers nominated their classmates with respect to their aggressive behavior and social preference/likability. At approximately age 20, participants reported on their misuse of opioids defined as lifetime use of heroin or misuse of prescription opioids. RESULTS Higher levels of peer nominations for aggressive behavior in first grade predicted a greater likelihood of opioid misuse. An interaction between participant sex and attention problems was observed such that females higher in attention problems were more likely to misuse opioids, particularly prescription opioids, than females lower in attention problems. An interaction was also found between participant sex and peer likability such that males lower in peer-nominated likability were more likely to misuse opioids relative to males higher in likability. CONCLUSION Given the malleable nature of attention problems, aggression, and social skills in early childhood, prevention programs that target these behaviors during this developmental period may attenuate risk for opioid misuse.
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Affiliation(s)
- Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Geoffrey Kahn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Andrew S Huhn
- Department of Psychiatry and Behavioral Services, Johns Hopkins Bloomberg School of Public Health
| | - Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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16
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Leventhal AM, Conti DV, Ray LA, Baurley JW, Bello MS, Cho J, Zhang Y, Pester MS, Lebovitz L, Budiarto A, Mahesworo B, Pardamean B. A genetic association study of tobacco withdrawal endophenotypes in African Americans. Exp Clin Psychopharmacol 2022; 30:673-681. [PMID: 34279980 PMCID: PMC8928755 DOI: 10.1037/pha0000492] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Genome-wide association (GWA) genetic epidemiology research has identified several variants modestly associated with brief self-report smoking measures, predominately in European Americans. GWA research has not applied intensive laboratory-based measures of smoking endophenotypes in African Americans-a population with disproportionately low quit smoking rates and high tobacco-related disease risk. This genetic epidemiology study of non-Hispanic African Americans tested associations of 89 genetic variants identified in previous GWA research and exploratory GWAs with 24 laboratory-derived tobacco withdrawal endophenotypes. African American cigarette smokers (N = 528; ≥10 cig/day; 36.2% female) completed two counterbalanced visits following either 16-hr of tobacco deprivation or ad libitum smoking. At both visits, self-report and behavioral measures across six unique "sub-phenotype" domains within the tobacco withdrawal syndrome were assessed (Urge/Craving, Negative Affect, Low Positive Affect, Cognition, Hunger, and Motivation to Resume Smoking). Results of the candidate variant analysis found two significant small-magnitude associations. The rs11915747 alternate allele in the CAD2M gene region was associated with .09 larger deprivation-induced changes in reported impulsivity (0-4 scale). The rs2471711alternate allele in the AC097480.1/AC097480.2 gene region was associated with 0.26 lower deprivation-induced changes in confusion (0-4 scale). For both variants, associations were opposite in direction to previous research. Individual genetic variants may exert only weak influences on tobacco withdrawal in African Americans. Larger sample sizes of non-European ancestry individuals might be needed to investigate both known and novel loci that may be ancestry-specific. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Adam M. Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
- Department of Psychology, University of Southern California
| | - David V. Conti
- Department of Psychology, University of Southern California
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles
| | | | | | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Yi Zhang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | | | - Lucas Lebovitz
- Keck School of Medicine, University of Southern California
| | - Arif Budiarto
- Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia
| | - Bharuno Mahesworo
- Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia
| | - Bens Pardamean
- BioRealm LLC, California
- Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia
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17
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Gao X, Barcelona V, DeWan A, Prescott L, Crusto C, Sun YV, Taylor JY. Depressive Symptoms and Blood Pressure in African American Women: A Secondary Analysis From the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study. J Cardiovasc Nurs 2022; 37:E89-E96. [PMID: 37707976 PMCID: PMC8443694 DOI: 10.1097/jcn.0000000000000800] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression is a risk factor for hypertension, yet few studies have been conducted in African American women. OBJECTIVE We conducted a secondary analysis of depressive symptoms and high blood pressure among African American women from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure longitudinal study (N = 250). METHODS Logistic regression was used to examine depressive symptoms and blood pressure, adjusting for education, employment, and racism/discrimination. Growth curve modeling was used to investigate longitudinal associations between depressive symptoms and systolic (SBP) and diastolic (DBP) blood pressures at 4 time points (T1-T4). RESULTS Depressive symptoms at baseline were not prospectively associated with hypertension prevalence. Participants with Beck Depression Inventory scores higher than 10 had higher estimated marginal SBP and DBP over time compared with participants with lower scores. CONCLUSION Depressive symptoms were not associated with hypertension prevalence at T4, but they were associated with higher estimated marginal SBP and DBP. Future research is needed to elucidate mechanisms and implications for clinical care and prevention.
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18
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Still CH, Jack AI, Wright KD, Sattar A, Moore SM. Neural Processing of Health Information and Hypertension Self-Management in African Americans. Nurs Res 2022; 71:303-12. [PMID: 35302958 DOI: 10.1097/NNR.0000000000000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Uncontrolled blood pressure (BP) rates are persistently high among African Americans with hypertension. Although self-management is critical to controlling BP, little is known about the brain-behavior connections underlying the processing of health information and the performance of self-management activities. OBJECTIVES In this pilot study, we explored the associations among neural processing of two types of health information and a set of self-management cognitive processes (self-efficacy, activation, decision-making, and hypertension knowledge) and behaviors (physical activity, dietary intake, and medication taking) and health status indicators (BP, health-related quality of life, anxiety, and depression). METHODS Using a descriptive cross-sectional design, 16 African Americans with uncontrolled hypertension (mean age = 57.5 years, 68.8% women) underwent functional magnetic resonance imaging to assess activation of two neural networks, the task-positive network and the default mode network, and a region in the ventromedial prefrontal cortex associated with emotion-focused and analytic-focused health information. Participants completed self-reports and clinical assessments of self-management processes, behaviors, and health status indicators. RESULTS Our hypothesis that neural processing associated with different types of health information would correlate with self-management cognitive processes and behaviors and health status indicators was only partially supported. Home diastolic BP was positively associated with ventromedial prefrontal cortex activation ( r = .536, p = .09); no other associations were found among the neural markers and self-management or health status variables. Expected relationships were found among the self-management processes and behaviors and health status indicators. DISCUSSION To advance our understanding of the neural processes underlying health information processing and chronic illness self-management, future studies are needed that use larger samples with more heterogeneous populations and additional neuroimaging techniques.
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19
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Watson CWM, Kamalyan L, Tang B, Hussain MA, Cherner M, Mindt MR, Byrd DA, Franklin DR, Collier AC, Clifford DB, Gelman B, Morgello S, McCutchan JA, Ellis RJ, Grant I, Heaton RK, Marquine MJ. Ethnic/Racial Disparities in Longitudinal Neurocognitive Decline in People With HIV. J Acquir Immune Defic Syndr 2022; 90:97-105. [PMID: 35081558 PMCID: PMC8986565 DOI: 10.1097/qai.0000000000002922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 05/18/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND To examine longitudinal neurocognitive decline among Latino, non-Latino Black, and non-Latino White people with HIV (PWH) and factors that may explain ethnic/racial disparities in neurocognitive decline. METHODS Four hundred ninety nine PWH (13.8% Latino, 42.7% Black, 43.5% White; baseline age: M = 43.5) from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study completed neurocognitive, neuromedical, and laboratory assessments every 6-12 months with up to 5 years of follow-up. Longitudinal neurocognitive change was determined via published regression-based norms. Survival analyses investigated the relationship between ethnicity/race and neurocognitive change, and baseline and time-dependent variables that may explain ethnic/racial disparities in neurocognitive decline, including socio-demographic, HIV-disease, medical, psychiatric, and substance use characteristics. RESULTS In Cox proportional hazard models, hazard ratios for neurocognitive decline were increased for Latino compared with White PWH (HR = 2.25, 95% CI = 1.35 to 3.73, P = 0.002), and Latino compared with Black PWH (HR = 1.86, 95% CI = 1.14 to 3.04, P = 0.013), with no significant differences between Black and White PWH (P = 0.40). Comorbidities, including cardiometabolic factors and more severe neurocognitive comorbidity classification, accounted for 33.6% of the excess hazard for Latino compared with White PWH, decreasing the hazard ratio associated with Latino ethnicity (HR = 1.83, 95% CI = 1.06 to 3.16, P = 0.03), but did not fully account for elevated risk of decline. CONCLUSIONS Latino PWH may be at higher risk of early neurocognitive decline compared with Black and White PWH. Comorbidities accounted for some, but not all, of this increased risk among Latino PWH. Future research examining institutional, sociocultural, and biomedical factors, including structural discrimination and age-related biomarkers, may further explain the observed disparities.
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Affiliation(s)
| | | | - Bin Tang
- University of California, San Diego, San Diego, CA
| | | | | | | | | | | | - Ann C. Collier
- University of Washington School of Medicine, Seattle, WA
| | | | | | | | | | | | - Igor Grant
- University of California, San Diego, San Diego, CA
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20
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Abstract
The experience of chronic pain is influenced by gender, race, and age but is understudied in older Black women. Society and family alike expect Black older women to display superhuman strength and unwavering resilience. This qualitative study examined the narratives of 9 rural- and urban-dwelling Black older women to identify the ways in which they displayed strength while living with chronic osteoarthritis pain. Their "herstories" parallel the 5 characteristics of the Superwoman Schema/Strong Black Woman. Two additional characterizations emerged: spiritual submission for strength and code switching to suffering Black woman; these may be unique to Black Americans with pain.
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Affiliation(s)
- Lakeshia Cousin
- College of Nursing, University of Florida, Gainesville, FL 32610
| | | | - Staja Q. Booker
- College of Nursing, University of Florida, Gainesville, FL 32610
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL 32610
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21
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Colvin CL, Safford MM, Muntner P, Colantonio LD, Kern LM. Health care fragmentation and blood pressure control among adults taking antihypertensive medication. Am J Manag Care 2022; 28:108-115. [PMID: 35404546 PMCID: PMC9358913 DOI: 10.37765/ajmc.2022.88837] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To determine the association of fragmented ambulatory health care with uncontrolled blood pressure (BP) and apparent treatment-resistant hypertension (aTRH) among older adults taking antihypertensive medication, overall and by race and gender. STUDY DESIGN Cross-sectional study using data from 2868 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants 66 years and older who completed a study examination in 2013-2016, had Medicare fee-for-service coverage, and were taking antihypertensive medication. METHODS We used logistic regression to analyze the association of fragmented health care with uncontrolled BP and aTRH. Fragmented health care was operationalized as a reversed Bice-Boxerman Index score in the 75th percentile or higher, calculated using the number of ambulatory providers and health care visits in the year preceding the study examination. Uncontrolled BP was defined by systolic BP of at least 140 mm Hg or diastolic BP of at least 90 mm Hg. aTRH was defined by taking 3 or more classes of antihypertensive medication with uncontrolled BP or 4 or more classes with controlled BP. RESULTS The overall adjusted odds ratios (95% CIs) for uncontrolled BP, aTRH with controlled BP, and aTRH with uncontrolled BP associated with fragmented health care were 1.10 (0.89-1.37), 1.08 (0.80-1.47), and 1.32 (0.96-1.81), respectively. Fragmented health care was not associated with uncontrolled BP or aTRH among White participants, women, or men. Among Black participants, the odds ratio (95% CI) associated with fragmented health care was 1.21 (0.81-1.82) for uncontrolled BP, 1.22 (0.72-2.07) for aTRH with controlled BP, and 1.82 (1.07-3.11) for aTRH with uncontrolled BP. CONCLUSIONS Fragmented health care may increase the likelihood of aTRH with uncontrolled BP among older Black adults taking antihypertensive medication.
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Affiliation(s)
| | | | | | | | - Lisa M Kern
- Department of Medicine, Weill Cornell Medicine, 420 E 70th St, Box 331, New York, NY 10021.
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22
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Henderson V, Strayhorn SM, Bergeron NQ, Strahan DC, Ganschow PS, Khanna AS, Watson K, Hoskins K, Molina Y. Healthcare Predictors of Information Dissemination About Genetic Risks. Cancer Control 2022; 29:10732748221104666. [PMID: 35658635 PMCID: PMC9174561 DOI: 10.1177/10732748221104666] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives Despite the benefits of genetic counseling and testing (GCT), utilization is
particularly low among African American (AA) women who exhibit breast cancer
features that are common in BRCA-associated cancer. Underutilization is
especially problematic for AA women who are more likely to die from breast
cancer than women from any other race or ethnicity. Due to medical mistrust,
fear, and stigma that can be associated with genetic services among
racial/ethnic minorities, reliance on trusted social networks may be an
impactful strategy to increase dissemination of knowledge about hereditary
cancer risk. Informed by the social cognitive theory, the purpose of this
study is to determine: 1) which AA patients diagnosed with breast cancer and
with identified hereditary risk are sharing information about hereditary
risk with their networks; 2) the nature of the information dissemination;
and 3) if personal GCT experiences is associated with dissemination of
information about hereditary risk. Methods Among consented participants (n = 100) that completed an interview
administered using a 202-item questionnaire consisting of open- and
closed-ended questions, 62 patients were identified to be at higher risk for
breast cancer. Descriptive statistics, bivariable chi-square, Pearson’s
exact tests, and regression analyses were conducted to examine differences
in characteristics between high-risk participants who disseminated
hereditary risk information and participants who did not. Results Among high-risk participants, 25 (40%) indicated they had disseminated
information about hereditary risk to at least one member in their
family/friend network and 37 (60%) had not. Receipt of both provider
recommendations and receipt of GCT services was associated with greater odds
of disseminating information about hereditary risk with networks, OR = 4.53,
95%CI [1.33, 15.50], p = .02. Conclusion Interventions that increase self-efficacy gained through additional
personalized knowledge and experience gained through provider
recommendations and by undergoing GCT may facilitate information
dissemination among social/familial networks.
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Affiliation(s)
- Vida Henderson
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA, USA.,14681Community Health Sciences Division, University of Illinois Chicago, Chicago, IL, USA
| | - Shaila M Strayhorn
- 14621School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Nyahne Q Bergeron
- 14681Community Health Sciences Division, University of Illinois Chicago, Chicago, IL, USA
| | - Desmona C Strahan
- 14681Community Health Sciences Division, University of Illinois Chicago, Chicago, IL, USA
| | - Pamela S Ganschow
- College of Medicine, University of Illinois Chicago, Chicago, IL, USA.,Cancer Center, University of Illinois Chicago, Chicago, IL, USA
| | - Aditya S Khanna
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Karriem Watson
- All of Us Program, National Institutes of Health, Bethesda, MD, USA
| | - Kent Hoskins
- College of Medicine, University of Illinois Chicago, Chicago, IL, USA.,Cancer Center, University of Illinois Chicago, Chicago, IL, USA
| | - Yamile Molina
- 14681Community Health Sciences Division, University of Illinois Chicago, Chicago, IL, USA.,Cancer Center, University of Illinois Chicago, Chicago, IL, USA
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23
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Xu Y, Su S, Brown M, Snieder H, Harshfield G, Wang X. Ethnic differences and heritability of blood pressure circadian rhythm in African and European American youth and young adults. J Hypertens 2022; 40:163-170. [PMID: 34857708 PMCID: PMC8646444 DOI: 10.1097/hjh.0000000000002988] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The aim of this study was to investigate whether blood pressure (BP) circadian rhythm in African Americans differed from that in European Americans. We further examined the genetic and/or environmental sources of variances of the BP circadian rhythm parameters and the extent to which they depend on ethnicity or sex. METHOD Quantification of BP circadian rhythm was obtained using Fourier transformation from the ambulatory BP monitoring data of 760 individuals (mean age, 17.2 ± 3.3; 322 twin pairs and 116 singletons; 351 African Americans). RESULTS BP circadian rhythm showed a clear difference by ethnic group with African Americans having a lower amplitude (P = 1.5e-08), a lower percentage rhythm (P = 2.8e-11), a higher MESOR (P = 2.5e-05) and being more likely not to display circadian rhythm (P = 0.002) or not in phase (P = 0.003). Familial aggregation was identified for amplitude, percentage rhythm and acrophase with genetic factors and common environmental factors together accounting for 23 to 33% of the total variance of these BP circadian rhythm parameters. Unique environmental factors were the largest contributor explaining up to 67--77% of the total variance of these parameters. No sex or ethnicity difference in the variance components of BP circadian rhythm was observed. CONCLUSION This study suggests that ethnic differences in BP circadian rhythm already exist in youth with African Americans having a dampened circadian rhythm and better BP circadian rhythm may be achieved by changes in environmental factors.
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Affiliation(s)
- Yanyan Xu
- Georgia Prevention Institute, Department of Medicine
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Shaoyong Su
- Georgia Prevention Institute, Department of Medicine
| | | | - Harold Snieder
- Georgia Prevention Institute, Department of Medicine
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Xiaoling Wang
- Georgia Prevention Institute, Department of Medicine
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta, Georgia, USA
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Madubata I, Spivey LA, Alvarez GM, Neblett EW, Prinstein MJ. Forms of Racial/Ethnic Discrimination and Suicidal Ideation: A Prospective Examination of African-American and Latinx Youth. J Clin Child Adolesc Psychol 2022; 51:23-31. [PMID: 31517518 PMCID: PMC7067665 DOI: 10.1080/15374416.2019.1655756] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Although suicide is the second leading cause of death among adolescents, research revealing potent predictors of suicidal thoughts above and beyond the effects of depressive symptoms is limited, especially among racial and ethnic minority youth. This prospective study examined two subtypes of racial/ethnic discrimination (i.e., overt and more subtle forms), among African American and Latinx youth. Both African American (n = 85) and Latinx (n = 73) adolescents completed measures of perceived discrimination, suicidal ideation, and depression at baseline (9th-grade spring) as well as a measure of suicidal ideation 1 year later. Factor analyses revealed subscales reflecting both overt and more subtle forms of racial/ethnic discrimination, consistent with the concept of microaggressions. Findings revealed that subtle forms of discrimination were concurrently associated with suicidal ideation among African American and Latinx youth and were prospectively associated with suicidal ideation among African American adolescents, above and beyond the effects of depressive symptoms. Findings underscore the deleterious effects of subtle forms of discrimination on adolescents' risk for suicidal thoughts.
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Abstract
BACKGROUND Previous research suggests that parents' characteristics and race-related experiences shape the racial socialization messages they give their children. Parents' beliefs about race may also relate to how they interpret and respond to race-related stressors. The current study drew on the Sociohistorical Integrative Model for the Study of Stress in Black Families to examine the moderating roles of gender and racial identity subscales (i.e., racial centrality, private regard, and public regard) on the relations between race-related stressors (i.e., personal, vicarious, and anticipated racial discrimination) and racial socialization. METHOD Path analyses were conducted in Mplus 8.2 using online survey data from a national sample of 567 African American parents of adolescents. RESULTS There were seven significant three-way interactions. Racial centrality and gender moderated the relations between both personal and vicarious racial discrimination and each racial socialization message. Private regard and gender moderated the relations between personal racial discrimination and preparation for bias and between vicarious racial discrimination and cultural socialization. Public regard and parent gender moderated the relation between personal racial discrimination and cultural socialization. CONCLUSIONS The findings highlighted that parents' experiences of personal, vicarious, and anticipated racial discrimination have different relations with their racial socialization messages. In addition, they highlighted that racial identity and parent gender are related to the type of racial socialization messages African American parents who are exposed to race-related stressors give their children. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Abstract
OBJECTIVE The purposes of this study were to assess the association between changes in goal-striving stress (GSS) and changes in sleep duration in African Americans (AAs) and to determine if the association varies by sex, age, and/or educational attainment. METHODS We completed a longitudinal analysis using examination 1 (2000-2004, n = 5306) and examination 3 (2009-2013, n = 3819) data from the Jackson Heart Study, with a final sample of 3500. Changes in GSS and changes in sleep duration were calculated by subtracting examination 1 GSS from examination 3 GSS. Mean differences (β [standard error]) between changes in GSS and changes in sleep duration were assessed using linear regression models that adjusted for length of follow-up, sociodemographics, health behaviors/risk factors, and stressors. RESULTS In the fully adjusted models, the increase in GSS from examination 1 to examination 3 was associated with a decrease in sleep duration (in minutes) from examination 1 to examination 3 in the overall cohort (β = -7.72 [2.44], p < .002), in high school graduates (β = -21.23 [5.63], p < .001), and in college graduates (β = -7.57 [3.75], p = .044) but not in those with less than a high school education (β = 1.49 [8.35], p = .86) or those who attended college but did not graduate (β = 0.44 [4.94], p = .93). CONCLUSIONS Changes in GSS were inversely associated with changes in sleep duration over a mean period of 8 years in AA subgroups. Interventions that reduce stress related to goal striving should be considered to help improve sleep health in AAs.
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Affiliation(s)
- Loretta R Cain-Shields
- From the Department of Data Science, John D Bower School of Population Health (Cain-Shields), University of Mississippi Medical Center, Jackson, Mississippi; Department of Epidemiology, Rollins School of Public Health (Johnson), Emory University, Atlanta, Georgia; Department of Epidemiology, Gillings School of Global Public Health (Glover), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Department of Medicine, School of Medicine (Sims), University of Mississippi Medical Center, Jackson, Mississippi
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Baugher AR, Whiteman A, Jeffries WL, Finlayson T, Lewis R, Wejnert C. Black men who have sex with men living in states with HIV criminalization laws report high stigma, 23 U.S. cities, 2017. AIDS 2021; 35:1637-1645. [PMID: 34270489 PMCID: PMC9030111 DOI: 10.1097/qad.0000000000002917] [Citation(s) in RCA: 1] [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: 11/27/2022]
Abstract
OBJECTIVES To examine the association between HIV laws, perceived community stigma, and behaviors and to compare differences between and within Black and White men who have sex with men (MSM). DESIGN/METHODS National HIV Behavioral Surveillance conducted interviews and HIV testing with MSM in 23 U.S. cities in 2017 using venue-based sampling methods. We used weighted cross-sectional data to compare MSM living in states with versus without HIV laws using Rao-Scott chi-square tests. We modeled the association between stigma and state HIV laws within racial groups to obtain adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs). RESULTS Among 7392 MSM, 56% lived in a state with HIV laws. In law states, Black MSM were more likely than White MSM to report their community would discriminate against persons with HIV (PWH) (59 versus 34%), not support the rights of PWH (20 versus 9%), not be friends with PWH (19 versus 10%), believe PWH 'got what they deserved' (27 versus 16%), and be intolerant of MSM (14 versus 5%). Adjusted for confounders, Black MSM in HIV law states were more likely to think their community would discriminate against PWH (aPR, 1.14; 95% CI, 1.02-1.29; P = 0.02) and be intolerant toward MSM (aPR, 2.02; 95% CI, 1.43-2.86; P < 0.001) than Black MSM in states without such laws. CONCLUSIONS HIV laws were related to higher stigma, but only for Black MSM. Future research regarding HIV-related laws should account for racial/ethnic disparities. Modernizing laws can delegitimize stigma and promote focusing on effective HIV prevention strategies.
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Affiliation(s)
- Amy R. Baugher
- Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ari Whiteman
- Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, assigned to DHAP, Oak Ridge, TN, USA
| | - William L. Jeffries
- Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Teresa Finlayson
- Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rashunda Lewis
- Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cyprian Wejnert
- Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Taggart T, Mayer KH, Vermund SH, Huang S, Hayashi K, Ransome Y. Interaction of Religion/Spirituality With Internalized HIV Stigma, Depression, Alcohol Use, and Sexual Risk Among Black Men Who Have Sex With Men: The 6 City HPTN 061 Study. J Acquir Immune Defic Syndr 2021; 87:e188-e197. [PMID: 33633033 PMCID: PMC8131231 DOI: 10.1097/qai.0000000000002667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 11/04/2020] [Accepted: 02/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Black men who have sex with men (BMSM) remain at highest risk for HIV in the United States. Internalized HIV stigma and depression contribute to substance use and condomless anal intercourse (CAI). Religion and spirituality (R/S) are associated with decreased HIV-related risk behaviors for some groups, but their impact among BMSM is uncertain. We investigated the main and moderating roles of R/S on pathways from internalized HIV stigma to CAI while under the influence of drugs. METHODS We used baseline data from 1511 BMSM from the HIV Prevention Trials Network (HPTN) 061 study to examine the associations between internalized HIV stigma, depressive symptoms, alcohol use, and CAI while under the influence of drugs, adjusting for covariates in generalized structural equation models. We then tested whether R/S moderated the association between (1) internalized HIV stigma and depressive symptoms, (2) depressive symptoms and alcohol use, and (3) alcohol use and CAI while under the influence of drugs. RESULTS Spiritual beliefs [F(1,2) = 9.99, P < 0.001], spiritual activities [F(1,2) = 9.99, P < 0.001], and religious attendance [F(1,2) = 9.99, P < 0.001] moderated the pathway between internalized HIV stigma and depressive symptoms. As internalized HIV stigma increased, those with lower spiritual activity scores experienced significantly higher increases in depressive symptoms compared with those with higher spiritual activity scores whose depressive symptom scores remained unchanged [stigma × spiritual activities B = -0.18 (SE = 0.07), P < 0.001]. CONCLUSIONS Religion and spirituality were protective against CAI among BMSM. Future intervention research should explore ways to incorporate religious and/or spiritual activities to reduce internalized HIV stigma as one way to reduce depressive symptoms among BMSM.
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Affiliation(s)
- Tamara Taggart
- Department of Prevention and Community Health, George Washington University, Milken Institute School of Public Health
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Shu Huang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Kamden Hayashi
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Kamimura D, Cain-Shields LR, Clark D, Oshunbade AA, Ashley KE, Guild CS, Loprinzi PD, Newton R, Blaha MJ, Suzuki T, Butler J, Hall JE, Correa A, Hall ME. Physical Activity, Inflammation, Coronary Artery Calcification, and Incident Coronary Heart Disease in African Americans: Insights From the Jackson Heart Study. Mayo Clin Proc 2021; 96:901-911. [PMID: 33714604 PMCID: PMC8026689 DOI: 10.1016/j.mayocp.2020.09.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/16/2020] [Accepted: 09/23/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine associations between physical activity (PA), inflammation, coronary artery calcification (CAC), and incident coronary heart disease (CHD) in African Americans. METHODS Among Jackson Heart Study participants without prevalent CHD at baseline (n=4295), we examined the relationships between PA and high-sensitivity C-reactive protein, the presence of CAC (Agatston score ≥100), and incident CHD. Based on the American Heart Association's Life's Simple 7 metrics, participants were classified as having poor, intermediate, or ideal PA. RESULTS After adjustment for possible confounding factors, ideal PA was associated with lower high-sensitivity C-reactive protein levels (β, -0.15; 95% CI, -0.15 to -0.002) and a lower prevalence of CAC (odds ratio, 0.70; 95% CI, 0.51-0.96) compared with poor PA. During a median of 12.8 years of follow-up, there were 164 incident CHD events (3.3/1000 person-years). Ideal PA was associated with a lower rate of incident CHD compared with poor PA (hazard ratio, 0.55; 95% CI, 0.31-0.98). CONCLUSION In a large community-based African American cohort, ideal PA was associated with lower inflammation levels, a lower prevalence of CAC, and a lower rate of incident CHD. These findings suggest that promotion of ideal PA may be an important way to reduce the risk of subclinical and future clinical CHD in African Americans.
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Affiliation(s)
- Daisuke Kamimura
- Department of Medicine, University of Mississippi Medical Center, Jackson; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | | | - Donald Clark
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | | | - Kellan E Ashley
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Cameron S Guild
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Paul D Loprinzi
- Center for Health Behavior Research, University of Mississippi, University
| | - Robert Newton
- PA & Ethnic Minority Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD
| | - Takeki Suzuki
- Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - John E Hall
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson; Department of Physiology and Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson
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Shelton RL, Hall M, Ford S, Cosby RL. Telehealth in a Washington, DC African American Religious Community at the Onset of COVID-19: Showcasing a Virtual Health Ministry Project. Soc Work Health Care 2021; 60:208-223. [PMID: 33779526 DOI: 10.1080/00981389.2021.1904322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/15/2020] [Revised: 02/20/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic, with its disproportionate health and social-economic effects on the African American community, mandates bold new models to ensure that vulnerable communities receive maximum support and services. This article highlights a social work practice innovation model adapted from a traditional social work casework model. A group of multidisciplinary leaders strategized about ways to meet the needs of older African-American adults as many traditional government agencies were not sending staff into the community due to COVID-19. The result birthed a faith-based virtual health ministry.Using a faith-based virtual health ministry, church lay leaders and other professionals partnered with Master of Social Work (MSW) level social workers using a telehealth platform with technology tools to assist shut-in older adults in Washington, DC. The project uses a structured, coordinated care telehealth support model for a marginalized population. Telehealth within the rubric of healthcare models has not been demonstrated in African American communities, particularly older adults. Meeting the needs of shut-in older adults and marginalized groups within the COVID-19 pandemic may show innovation that can be translational for local governments and traditional safety net providers within a social work milieu.
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Affiliation(s)
- Rachel L Shelton
- Howard University School of Social Work, Multidisciplinary Gerontology Center, Washington, United States
| | - Mewelau Hall
- Howard University School of Social Work, Multidisciplinary Gerontology Center, Washington, United States
| | - Seairra Ford
- Howard University School of Social Work, Multidisciplinary Gerontology Center, Washington, United States
- Howard University School of Social Work, Multidisciplinary Gerontology Center
| | - Robert L Cosby
- Howard University School of Social Work, Multidisciplinary Gerontology Center, Washington, United States
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Cole BS, Gudiseva HV, Pistilli M, Salowe R, McHugh CP, Zody MC, Chavali VRM, Ying GS, Moore JH, O'Brien JM. The Role of Genetic Ancestry as a Risk Factor for Primary Open-angle Glaucoma in African Americans. Invest Ophthalmol Vis Sci 2021; 62:28. [PMID: 33605984 PMCID: PMC7900887 DOI: 10.1167/iovs.62.2.28] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/27/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose POAG is the leading cause of irreversible blindness in African Americans. In this study, we quantitatively assess the association of autosomal ancestry with POAG risk in a large cohort of self-identified African Americans. Methods Subjects recruited to the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study were classified as glaucoma cases or controls by fellowship-trained glaucoma specialists. POAAGG subjects were genotyped using the MEGA Ex array (discovery cohort, n = 3830; replication cohort, n = 2135). Population structure was interrogated using principal component analysis in the context of the 1000 Genomes Project superpopulations. Results The majority of POAAGG samples lie on an axis between African and European superpopulations, with great variation in admixture. Cases had a significantly lower mean value of the ancestral component q0 than controls for both cohorts (P = 6.14-4; P = 3-6), consistent with higher degree of African ancestry. Among POAG cases, higher African ancestry was also associated with thinner central corneal thickness (P = 2-4). Admixture mapping showed that local genetic ancestry was not a significant risk factor for POAG. A polygenic risk score, comprised of 23 glaucoma-associated single nucleotide polymorphisms from the NHGRI-EBI genome-wide association study catalog, was significant in both cohorts (P < 0.001), suggesting that both known POAG single nucleotide polymorphisms and an omnigenic ancestry effect influence POAG risk. Conclusions In sum, the POAAGG study population is very admixed, with a higher degree of African ancestry associated with an increased POAG risk. Further analyses should consider social and environmental factors as possible confounding factors for disease predisposition.
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Affiliation(s)
- Brian S. Cole
- Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Harini V. Gudiseva
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Maxwell Pistilli
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Rebecca Salowe
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | | | - Michael C. Zody
- New York Genome Center, New York City, New York, United States
| | - Venkata R. M. Chavali
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Gui Shuang Ying
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Jason H. Moore
- Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Joan M. O'Brien
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Coughlin SS, Mann P, Jennings B. A Gay Epidemiologist and the DC Commission of Public Health AIDS Advisory Committee. Narrat Inq Bioeth 2021; 11:133-140. [PMID: 34334487 PMCID: PMC8340937 DOI: 10.1353/nib.2021.0043] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Based upon the lead author's deep personal and professional experience, this case narrative illustrates the importance of engagement between public health practitioners and members of affected populations and their advocates. The case underscores the need to build strong coalitions to address serious public health and social issues. It also illustrates how decisions about control groups in research raise ethical issues. In addition, the case illustrates the reality that public health and social services are sometimes inadequate in the face of dire circumstances. Justice in public health has both a distributive aspect (how to allocate limited resources and distribute potential benefits as fairly as possible) and a procedural dimension (ensuring public participation, especially of those most affected). Frameworks for public health ethics, which post-date the events detailed in the autobiographical case narrative, highlight both distributive justice and procedural justice.
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Affiliation(s)
- Steven S. Coughlin
- Department of Population Health Sciences, Medical College of Georgia, Augusta University
| | - Paul Mann
- Center for Bioethics and Health Policy, Institute of Public and Preventive Health, Augusta University
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Singh A, Zhong Y, Nahlawi L, Park CS, De T, Alarcon C, Perera MA. Incorporation of DNA methylation into eQTL mapping in African Americans. Pac Symp Biocomput 2021; 26:244-255. [PMID: 33691021 PMCID: PMC7958994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Epigenetics is a reversible molecular mechanism that plays a critical role in many developmental, adaptive, and disease processes. DNA methylation has been shown to regulate gene expression and the advent of high throughput technologies has made genome-wide DNA methylation analysis possible. We investigated the effect of DNA methylation on eQTL mapping (methylation-adjusted eQTLs), by incorporating DNA methylation as a SNP-based covariate in eQTL mapping in African American derived hepatocytes. We found that the addition of DNA methylation uncovered new eQTLs and eGenes. Previously discovered eQTLs were significantly altered by the addition of DNA methylation data suggesting that methylation may modulate the association of SNPs to gene expression. We found that methylation-adjusted eQTLs that were less significant compared to PC-adjusted eQTLs were enriched in lipoprotein measurements (FDR=0.0040), immune system disorders (FDR = 0.0042), and liver enzyme measurements (FDR=0.047), suggesting that DNA methylation modulates the genetic regulation of these phenotypes. Our methylation-adjusted eQTL analysis also uncovered novel SNP-gene pairs. For example, we found that the SNP, rs1332018, was associated to GSTM3. GSTM3 expression has been linked to Hepatitis B which African Americans suffer from disproportionately. Our methylation-adjusted method adds new understanding to the genetic basis of complex diseases that disproportionally affect African Americans.
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de Souza TA, da Silva PHA, da Silva Nunes AD, de Araújo II, de Oliveira Segundo VH, de Oliveira Viana Pereira DM, Barbosa IR, de Vasconcelos Torres G. The association between race and risk of illness and death due to COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22828. [PMID: 33181651 PMCID: PMC7668480 DOI: 10.1097/md.0000000000022828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Corona Virus Disease, 2019 (COVID-19) pandemic revealed many social disparities that already exist in countries that have social inequalities in their historical context. Studies have already been published on the epidemiological and clinical characteristics of population groups considered to be at risk where they reveal that Black people are at greater risk of becoming ill and dying from this cause. In this context, this protocol describes a systematic review that aims to analyze the association of race as the higher risk for illness and death due to COVID-19. METHODS This protocol will be developed based on the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P). For this, we will conduct searches in the PubMed, Web of Science, Scopus, Lilacs, and ScienceDirect databases in the search for cross-sectional studies. All cross-sectional studies that analyzed hospitalization and death by COVID-19 as race in its determinant will be included. The search will be carried out by 2 independent researchers who will carry out the selection of articles, then the duplicate studies will be removed and screened using the Rayyan QCRI application. To assess the risk of bias, the instrument proposed by Downs and Black will be used. Meta-analyzes and subgroup analyzes will be carried out according to included data conditions. RESULTS Based on this review, it will be possible to carry out a high-quality synthesis of available evidence that brings race as a factor for illness and death by COVID-19 and to verify which race is most affected by this disease. CONCLUSION The relevance of this systematic review to the current context is considered, as it has a high potential to assist in the development of public health strategies and policies that address existing racial differences.Record of systematic review: CRD42020208767.
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Affiliation(s)
| | | | | | - Ivani Iasmim de Araújo
- Faculty of Health Science of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil
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Bardach SH, Barber JM, Schmitt FA, Van Eldik LJ, Boggess MB, Yarbrough M, Jones KC, Jicha GA. The Effectiveness of Community-based Outreach Events for the Promotion of African American Research Participation. Alzheimer Dis Assoc Disord 2020; 34:344-349. [PMID: 32809985 PMCID: PMC7677178 DOI: 10.1097/wad.0000000000000404] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION African Americans (AA) are disproportionately affected by Alzheimer's disease and related dementias yet are under-represented in clinical research. Outreach events for AA are offered to encourage research participation; however, this approach's effectiveness remains largely unexplored. METHODS To explore the effectiveness of AA-focused versus general audience events, the authors examined attendance data over 5 years, encompassing 10 general audience events and 4 events focused on AA. For each individual, the authors searched center records for recruitment contacts and research enrollment. Summary scores for attendance at AA-focused events, general audience events, and total events were compared between those with and without research involvement. RESULTS Out of 773 unique AA that attended ≥1 event, 88 became or were involved in research (11.4% engagement). AA-focused events achieved greater AA attendance than general audience events. Although research-engaged individuals were more likely to have ever attended an AA-focused event than a general audience event, attendance at AA-focused events did not statistically relate to research engagement. In contrast, attendance at events focused on the general public was related to an increased likelihood of research participation. DISCUSSION These findings have important implications for designing and implementing community events to encourage AA research participation.
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Affiliation(s)
- Shoshana H Bardach
- Sanders-Brown Center on Aging
- Graduate Center for Gerontology, College of Public Health
| | | | | | - Linda J Van Eldik
- Sanders-Brown Center on Aging
- Neuroscience, College of Medicine, University of Kentucky, Lexington, KY
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Abstract
OBJECTIVES Our study aims to explore the differential impact of this pandemic on clinical presentations and outcomes in African Americans (AAs) compared to white patients. BACKGROUND AAs have worse outcomes compared to whites while facing heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, and HIV/AIDS. However, there is no current study to show the impact of COVID-19 pandemic on the AA communities. METHODS This is a retrospective study that included patients with laboratory-confirmed COVID-19 from 2 tertiary centers in New Orleans, LA. Clinical and laboratory data were collected. Multivariate analyses were performed to identify the risk factors associated with adverse events. RESULTS A total of 157 patients were identified. Of these, 134 (77%) were AAs, whereas 23.4% of patients were Whites. Interestingly, AA were younger, with a mean age of 63 ± 13.4 compared to 75.7 ± 23 years in Whites (P < 0.001). Thirty-seven patients presented with no insurance, and 34 of them were AA. SOFA Score was significantly higher in AA (2.57 ± 2.1) compared to White patients (1.69 ± 1.7), P = 0.041. Elevated SOFA score was associated with higher odds for intubation (odds ratio = 1.6, 95% confidence interval = 1.32-1.93, P < 0.001). AA had more prolonged length of hospital stays (11.1 ± 13.4 days vs 7.7 ± 23 days) than in Whites, P = 0.01. CONCLUSION AAs present with more advanced disease and eventually have worse outcomes from COVID-19 infection. Future studies are warranted for further investigations that should impact the need for providing additional resources to the AA communities.
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Affiliation(s)
- Emad Kandil
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Abdallah S Attia
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Mohanad R Youssef
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Mohammad Hussein
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Kareem Ibraheem
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Mohamed Abdelgawad
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
| | | | - Juan Duchesne
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
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Abstract
BACKGROUND Black men experience the highest rate of disability compared to White, Asian, and Hispanic men. Yet, we know little about how Black men with disabilities experience the embodiment of their gender, race, social class, and disability positionalities and how they draw from their cultural backgrounds as they engage in health-seeking behaviors. OBJECTIVES The purpose of this study was to explore how young Black men experienced the onset of chronic disabling conditions while negotiating health-promoting activities in the context of gender, race, social class, disability positionalities, and culture. METHODS This descriptive study used hermeneutic phenomenology to achieve study objectives. This study's research questions were answered using audiotaped, one-on-one qualitative interviews, along with detailed field notes. Each participant was interviewed twice at a mutually decided upon location to ensure their privacy and comfort. RESULTS In relation to their embodied interactions of self in the context of disability, these men described their health-related decisions using four themes: maintaining manhood, economic constraints, the "risk" of healthcare, and health promotion. CONCLUSIONS By examining the experiences of young adult Black men living with disabilities, knowledge of their perspectives and experiences at earlier stages in their life course contributes to the understanding of their personal challenges, health needs, and their perspectives of health-promoting strategies.
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Affiliation(s)
- Tiffany N Ricks
- Tiffany N. Ricks, PhD, RN, is Research Scientist, Ascension Seton, Austin, Texas. Angela Frederick, PhD, is Assistant Professor, Department of Sociology and Anthropology, The University of Texas at El Paso. Tracie Harrison, PhD, RN, FAAN, is Professor and Director, Center for Aging Services and Long-Term Care, School of Nursing, The University of Texas at Austin
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Su J, Kuo SIC, Derlan CL, Hagiwara N, Guy MC, Dick DM. Racial discrimination and alcohol problems among African American young adults: Examining the moderating effects of racial socialization by parents and friends. Cultur Divers Ethnic Minor Psychol 2020; 26:260-270. [PMID: 31328948 PMCID: PMC6980251 DOI: 10.1037/cdp0000294] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Racial discrimination is a stressor that may put African Americans at risk for alcohol use and related problems. We examined whether experiences of blatant (racist events) and subtle (racial microaggressions) forms of racial discrimination were associated with alcohol consumption and alcohol problems among African American young adults, and whether childhood/adolescence racial socialization by parents and friends moderated these associations. METHOD The sample included 383 African American young adults (Mage = 20.65, SD = 2.28; 81% female) who completed an electronic survey in Fall, 2017. Hierarchical linear regression analyses were conducted in Mplus. RESULTS Experiences of racist events and racial microaggressions were associated with higher levels of alcohol consumption and more alcohol problems. Racial socialization by friends, but not parents, moderated these associations. Specifically, cultural socialization by friends buffered the effect of racist events on alcohol consumption and alcohol problems, whereas promotion of mistrust by friends exacerbated the effect of racial microaggressions on alcohol problems. CONCLUSIONS Both blatant and subtle forms of racial discrimination were associated with higher risk for alcohol use or problems among African American young adults. Racial socialization by friends while growing up may play an important role in alcohol use outcomes during young adulthood. Findings highlight the importance of considering different forms of racial discrimination and emphasize the unique roles of racial socialization across different social contexts (i.e., parent and peers or friends) in relation to psychosocial outcomes among African American individuals. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Jinni Su
- Department of Psychology, Virginia Commonwealth University
| | | | | | - Nao Hagiwara
- Department of Psychology, Virginia Commonwealth University
| | - Mignonne C. Guy
- Department of African American Studies, Virginia Commonwealth University
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University
- Department of Human and Molecular Genetics, Virginia Commonwealth University
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Caughy MO, Brinkley DY, Smith EP, Owen MT. Fathering quality in early childhood and kindergarten achievement in low-income racial-ethnic minority children. J Fam Psychol 2020; 34:215-225. [PMID: 31789530 PMCID: PMC7012709 DOI: 10.1037/fam0000611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The relative lack of attention to fathers' effects on children's achievement is even more apparent when examining fathering among low-income racial-ethnic minorities. We examined relations of fathering qualities when children were 2-3 years old with subsequent reading and mathematics achievement in kindergarten in a sample of low-income African American (n = 119) and primarily Mexican-origin Latino children (n = 193) from multiple neighborhood areas of a large city in the southwestern United States. Measures of parenting qualities were based on qualitative ratings of videotaped observations of father-child and mother-child interactions collected in the home during semistructured play activities. Mathematics and reading achievement scores were based on administration of the Woodcock-Johnson Revised (Woodcock & Muñoz-Sandoval, 1993) or the Batería Woodcock-Muñoz (Woodcock & Munoz-Sandoval, 1996), as appropriate depending upon the child's language. A structural equations model in which kindergarten mathematics and reading achievement were regressed on early childhood fathering displayed good model fit, χ2(72) = 131.30, p < .001, comparative fit index = .954, root mean square error of approximation = .051, standardized root mean square residual = .079. Results indicated that sensitive support from African American and Latino resident fathers was associated with their children's mathematics achievement even after controlling for mothers' sensitive support, but fathering quality was not associated with reading achievement. The implications of these findings for the study of fathering in racial-ethnic minority populations as well as for the development of early preventive interventions to support academic achievement are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Dawn Y. Brinkley
- Department of Human Development and Family Science, University of Georgia
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Obasi EM, Chen TA, Cavanagh L, Smith BK, Wilborn KA, McNeill LH, Reitzel LR. Depression, perceived social control, and hypothalamic-pituitary-adrenal axis function in African-American adults. Health Psychol 2020; 39:107-115. [PMID: 31697108 PMCID: PMC6957753 DOI: 10.1037/hea0000812] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/08/2022]
Abstract
OBJECTIVE Social determinants may negatively affect health via Hypothalamic-Pituitary-Adrenal (HPA) axis dysfunction. The potential contribution of social determinants and related factors to HPA-axis functioning is important to study among African American adults, who are more likely to experience societal inequities and health disparities relative to other racial/ethnic groups. This study examined the relationship between depressive symptoms and perceived social control on HPA-axis functioning among African American adults. METHOD Participants (N = 107; Mage = 50, 79% female) were administered measures including the Center for Epidemiologic Studies-Depression and Informal (neighborhood) Social Control. Study procedures included the provision of 6 saliva samples for cortisol analysis (at wakeup, 30- and 90-min post-wakeup, 2:00 PM, 5:00 PM, and prebedtime). The relationship between depression and social control on the functioning of the HPA-axis were simultaneously examined within a 2-level hierarchical linear model. RESULTS Variability in the Cortisol Awakening Response (CAR) was accounted for by depressive symptomatology (p = .023) and perceived social control (p = .016), whereby greater depression was associated with a blunted CAR (less awakening cortisol production) and greater perceptions of neighborhood social control with a higher CAR. CONCLUSIONS Elevated depressive symptoms and low perceptions of neighborhood social control may serve as mechanisms that help to explain within-group variability in the functioning of stress physiology among African American adults. Findings enhance understanding of how social determinants may affect African Americans' health. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Ezemenari M. Obasi
- Hwemudua Addictions and Health Disparities Laboratory, University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204
- HEALTH Research Institute, Health-2, 4849 Calhoun Rd., Houston, TX 77204
| | - Tzu-An Chen
- HEALTH Research Institute, Health-2, 4849 Calhoun Rd., Houston, TX 77204
| | - Lucia Cavanagh
- Hwemudua Addictions and Health Disparities Laboratory, University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204
| | - B. Katherine Smith
- Hwemudua Addictions and Health Disparities Laboratory, University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204
| | - Kristin A. Wilborn
- Hwemudua Addictions and Health Disparities Laboratory, University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204
- HEALTH Research Institute, Health-2, 4849 Calhoun Rd., Houston, TX 77204
| | - Lorna H. McNeill
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, P.O. Box 301402, Houston, TX 77230
| | - Lorraine R. Reitzel
- HEALTH Research Institute, Health-2, 4849 Calhoun Rd., Houston, TX 77204
- Social Determinants / Health Disparities Laboratory, University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204
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Mauck MC, Linnstaedt SD, Bortsov A, Kurz M, Hendry PL, Lewandowski C, Velilla MA, Datner E, Pearson C, Domeier R, Fillingim RB, Beaudoin FL, Ting JP, McLean SA. Vitamin D insufficiency increases risk of chronic pain among African Americans experiencing motor vehicle collision. Pain 2020; 161:274-280. [PMID: 31651575 PMCID: PMC10657726 DOI: 10.1097/j.pain.0000000000001728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/07/2023]
Abstract
African Americans experience an increased burden of motor vehicle collision (MVC), post-MVC musculoskeletal pain, and vitamin D insufficiency. In this prospective multicenter study, we tested the hypothesis that African Americans (n = 133) presenting to the emergency department after MVC with low peritraumatic vitamin D levels would have worse chronic musculoskeletal pain outcomes compared to individuals with sufficient vitamin D. Vitamin D levels were assessed in the early aftermath of MVC through enzyme-linked immunosorbent assay, and pain severity was assessed using the 0 to 10 numeric rating scale at 6 weeks, 6 months, and 1 year. In repeated-measures analysis, African American MVC survivors with vitamin D insufficiency experienced more severe chronic pain (β = 1.18, P = 0.031). In secondary analyses, we assessed for evidence that the effect of vitamin D on post-MVC pain outcomes is mediated, at least in part, by the influence of vitamin D on genetic variants in genes involved in immune system regulation (IL-10 and NLRP3). Genotyping was performed using a genome-wide microarray using collected DNA samples. Secondary analyses suggest that the effect of vitamin D on post-MVC pain outcomes may be influenced by genetic variation in IL-10 and NLRP3. Further studies are needed to assess the impact of vitamin D insufficiency on pain outcomes in African Americans experiencing MVC and other common trauma exposures, to assess factors affecting this relationship, and to assess the efficacy of administering vitamin D in the immediate aftermath of MVC to prevent chronic pain. Such low-cost, nonopioid interventions are urgently needed to address chronic pain development after MVC.
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Affiliation(s)
- Matthew C Mauck
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, United States
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, United States
| | - Andrey Bortsov
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, United States
| | - Michael Kurz
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, United States
| | | | | | - Elizabeth Datner
- Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, United States
| | - Claire Pearson
- Department of Emergency Medicine, Detroit Receiving, Detroit, MI, United States
| | - Robert Domeier
- Department of Emergency Medicine, St. Joseph Mercy Health System, Ypsilanti, Michigan
| | - Roger B Fillingim
- Department of Community Dentistry & Behavioral Science, University of Florida College of Dentistry, Gainesville, FL, United States
| | - Francesca L Beaudoin
- Department of Emergency Medicine, Rhode Island Hospital, The Alpert Medical School of Brown University, Providence, RI, United States
| | - Jenny P Ting
- Lineberger Cancer Center and the Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC, United States
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, United States
- Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, United States
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Crawford DC, Lin J, Bailey JNC, Kinzy T, Sedor JR, O’Toole JF, Bush WS. Frequency of ClinVar Pathogenic Variants in Chronic Kidney Disease Patients Surveyed for Return of Research Results at a Cleveland Public Hospital. Pac Symp Biocomput 2020; 25:575-586. [PMID: 31797629 PMCID: PMC6931908] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Return of results is not common in research settings as standards are not yet in place for what to return, how to return, and to whom. As a pioneer of large-scale of return of research results, the Precision Medicine Initiative Cohort now known of All of Us plans to return pharmacogenomic results and variants of clinical significance to its participants starting late 2019. To better understand the local landscape of possibilities regarding return of research results, we assessed the frequency of pathogenic variants and APOL1 renal risk variants in a small diverse cohort of chronic kidney disease patients (CKD) ascertained from a public hospital in Cleveland, Ohio genotyped on the Illumina Infinium MegaEX. Of the 23,720 ClinVar-designated variants directly assayed by the MegaEX, 8,355 (35%) had at least one alternate allele in the 130 participants genotyped. Of these, 18 ClinVar variants deemed pathogenic by multiple submitters with no conflicts in interpretation were distributed across 27 participants. The majority of these pathogenic ClinVar variants (14/18) were associated with autosomal recessive disorders. Of note were four African American carriers of TTR rs76992529 associated with amyloidogenic transthyretin amyloidosis, otherwise known as familial transthyretin amyloidosis (FTA). FTA, an autosomal dominant disorder with variable penetrance, is more common among African-descent populations compared with European-descent populations. Also common in this CKD population were APOL1 renal risk alleles G1 (rs73885319) and G2 (rs71785313) with 60% of the study population carrying at least one renal risk allele. Both pathogenic ClinVar variants and APOL1 renal risk alleles were distributed among participants who wanted actionable genetic results returned, wanted genetic results returned regardless of actionability, and wanted no results returned. Results from this local genetic study highlight challenges in which variants to report, how to interpret them, and the participant's potential for follow-up, only some of the challenges in return of research results likely facing larger studies such as All of Us.
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Affiliation(s)
- Dana C. Crawford
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Genetics and Genome Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - John Lin
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - Jessica N. Cooke Bailey
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - Tyler Kinzy
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
| | - John R. Sedor
- Department of Physiology and Biophysics, Case Western Reserve University,Department of Nephrology and Hypertension, Glickman Urology and Kidney and Lerner Research Institutes, Cleveland Clinic, Cleveland, OH 44106, USA
| | - John F. O’Toole
- Department of Nephrology and Hypertension, Glickman Urology and Kidney and Lerner Research Institutes, Cleveland Clinic, Cleveland, OH 44106, USA
| | - William S. Bush
- Cleveland Institute for Computational Biology, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA,Department of Genetics and Genome Sciences, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Cleveland, OH 44106, USA
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Boggess MB, Barber JM, Jicha GA, Caban-Holt A. Subjective Memory Complaints Are an Important Surrogate for Objective Cognitive Performance in African Americans. Alzheimer Dis Assoc Disord 2020; 34:79-84. [PMID: 31633556 PMCID: PMC7170708 DOI: 10.1097/wad.0000000000000348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/01/2023]
Abstract
PURPOSE Subjective memory complaints (SMCs) have been shown to be associated with lower neuropsychological test scores cross-sectionally. However, it remains unclear whether such findings hold true for African American (AA) older adults. METHODS Baseline visit data from the National Alzheimer's Coordinating Center database collected from September 2005 to March 2018 were used. Generalized linear mixed models specifying binomial distributions were used to examine how neuropsychological test scores affect the likelihood of reporting SMCs. PATIENTS Inclusion criteria were participants who reported AA as their primary race, 60 to 80 years of age, were cognitively unimpaired, and had a Mini-Mental Status Examination score ≥26. A total of 1021 older AA adults without missing data met the criteria. RESULTS A total of 258 participants reported a SMC. SMCs were more likely with lower scores on measures of episodic memory and processing; however, SMCs were also more likely with higher scores on a measure of working memory. Working memory appeared to mediate reporting of SMC among participants with lower episodic memory scores. DISCUSSION These findings demonstrate that SMCs are associated with lower scores on objective neuropsychological measures among older AAs. Additional work is needed to determine whether SMCs are further associated with a risk for clinical transition to mild cognitive impairment or dementia among AA older adults.
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Affiliation(s)
| | | | - Gregory A. Jicha
- Sanders-Brown Center on Aging, University of Kentucky
- Department of Neurology, College of Medicine, University of Kentucky
| | - Allison Caban-Holt
- Sanders-Brown Center on Aging, University of Kentucky
- Department of Behavioral Science, College of Medicine, University of Kentucky
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Udoko AN, Graff J, Ransone S, Coday M, Gatwood JD, Bailey JE. Characteristics of Health-related Text Messages Preferred by Medically Underserved African-American Patients with Diabetes. Cureus 2019; 11:e5743. [PMID: 31723504 PMCID: PMC6825447 DOI: 10.7759/cureus.5743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 01/13/2023] Open
Abstract
Introduction Text messaging (TM) is increasingly used by the U.S. medical practices and healthcare delivery systems, but little is known about preferences of medically underserved minority patients for TM supporting improved self-care decisions. We sought to determine the characteristics of text messages and TM programs preferred by African-American patients with diabetes in medically underserved areas. Methods This convergent mixed methods study employed a self-administered survey and focus group interviews. Quantitative and qualitative data were collected simultaneously, analyzed separately, and merged to provide a holistic view of the TM characteristics patients preferred. Participants (N = 36) were recruited from a medically underserved area in Memphis, Tennessee. Focus group data were uploaded into the NVivo qualitative data analysis software program, and main themes were identified. Standard frequencies were calculated for survey responses. Results Participants ranged in the age of 22-74 years (M = 54.1; SD = 14.6) were predominantly female (77.8%), African-Americans (88.9%), and had at least a high school education (91.7%). A majority used mobile phones for sending (69.4%) and receiving (72.2%) text messages. Participants wanted to receive daily (44.4%) or weekly (47.2%) text messages from their healthcare provider (61.1%), or a motivational message program (33.3%). They preferred actionable messages with a positive tone and wanted options to customize message type, content, and frequency according to their preferences, goals, and needs. Discussion Medically underserved African-American diabetes patients want customized text messages that are practical, actionable, encouraging, and from their doctor. Healthcare providers seeking to develop patient-centered TM programs for medically underserved minority patients should personalize and tailor messages according to patient preferences, health goals, and self-care needs.
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Affiliation(s)
- Aniekan N Udoko
- Pediatrics, University of Tennessee Health Science Center, Memphis, USA
| | - Joyce Graff
- Pediatrics, University of Tennessee Health Science Center, Memphis, USA
| | | | - Mace Coday
- Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Justin D Gatwood
- Pharmacy, University of Tennessee Health Science Center, Nashville, USA
| | - James E Bailey
- Internal Medicine, University of Tennessee Health Science Center, Memphis, USA
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Fadiran O, Balogun AF, Ogunti R, Buhari O, Lanka C, Atanda A, Larbi DA, Prafulla M. In-hospital Outcomes and Characteristics of Heart Failure in Sickle Cell Disease. Cureus 2019; 11:e5660. [PMID: 31720136 PMCID: PMC6823030 DOI: 10.7759/cureus.5660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 12/31/2022] Open
Abstract
Sickle cell disease (SCD) predominantly affects African-Americans (AAs) in the United States (US). Due to increasing life expectancy in developed countries, SCD-associated cardiomyopathy is typically seen in adults. The aim of this study was to distinguish hospitalization for this phenotype from traditional heart failure (HF) in AAs. We used the National Inpatient Sample (NIS) database to identify HF hospitalizations in AAs between 2005 and 2014 and stratified them according to SCD status. We compared the characteristics and outcomes before and after matching in a 1:3 ratio for age, gender, insurance, smoking status and admission year. Amongst the 1,195,718 HF admissions in AAs, SCD accounted for 7835. The age (mean ± SD) in the SCD cohort was significantly younger (45.66 ± 13.2) vs non-SCD (64.8 ± 15.2), p<0.001. SCD adults had significantly higher rates of pulmonary hypertension (PH), deep vein thrombosis, and pulmonary embolism while non-SCD adults had higher rates of cardiogenic shock and respiratory failure requiring intubation. The national hospitalization rate for HF in AAs increased from 151 to 257 per million between 2005 and 2011 before declining to 241 per million in 2014. There was a decrease in in-hospital mortality in AAs from 4.8% in 2005 to 3.6% in 2014. We also identified independent predictors of in-hospital mortality in SCD with HF. In conclusion, we described hospitalizations for an emerging heart failure phenotype in AAs. Although there is a national decreasing rate of HF hospitalizations in the US, this may not be reflective of the AA population.
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Affiliation(s)
- Olusayo Fadiran
- Internal Medicine, Howard University Hospital, Washington, USA
| | | | - Richard Ogunti
- Internal Medicine, Howard University Hospital, Washington, USA
| | - Olajide Buhari
- Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, USA
| | - Chandana Lanka
- Internal Medicine, Howard University Hospital, Washington, USA
| | - Adebayo Atanda
- Cardiovascular Disease, George Washington University Hospital, Washington, USA
| | - Daniel A Larbi
- Internal Medicine, Howard University Hospital, Washington, USA
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Abstract
Objectives: In this study, we examined how racial discrimination and neighborhood perceptions relate to physical activity and sedentary behavior mediated through depression symptoms. Methods: Data were from the first year of a longitudinal cohort study, Project Creating a Higher Understanding of cancer Research and Community Health (CHURCH), based on a convenience community sample of church-attending African Americans collected between April 2012 and March 2013 (N = 370) in Houston, Texas. Measures included racial discrimination, perceived neighborhood problems and vigilance, depression (CES-D), physical activity (IPAQ-short), and sedentary behavior. Results: Main effects from the structural equation model showed that racial discrimination (b = .20, p < .01) was related to greater depression symptoms. The same pattern emerged for neighborhood problems, but the effect was not significant (b = .20, p = .07). Further, depression symptoms were related to less physical activity (b = -.62, p = .03) and greater sedentary behavior (b = .64, p < .01). Indirect effects showed that depression mediated the relationship between racial discrimination and neighborhood problems on physical activity and sedentary behavior. Conclusions: Depression symptoms are an important mechanism by which racial discrimination and perceived neighborhood problems impact physical activity and sedentary behavior.
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Affiliation(s)
- Ivan H C Wu
- Postdoctoral Research Fellow, University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX;,
| | - Larkin L Strong
- Assistant Professor, University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX
| | - Nga T Nguyen
- Senior Statistical Analyst, University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX
| | - Dalnim Cho
- Instructor, University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX
| | - Jemima John
- Postdoctoral Research Fellow, University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX
| | - Lorna H McNeill
- Associate Professor and Chair, University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX
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Zapolski TC, Beutlich MR, Fisher S, Barnes-Najor J. Collective ethnic-racial identity and health outcomes among African American youth: Examination of promotive and protective effects. Cultur Divers Ethnic Minor Psychol 2019; 25:388-396. [PMID: 30556705 PMCID: PMC6579722 DOI: 10.1037/cdp0000258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Racial discrimination is associated with numerous negative health outcomes, including increased risk for depression and anxiety symptoms and substance use. Positive affect toward of one's ethnic or racial group (i.e., ethnic-racial identity affirmation) has been shown to buffer the negative effects of racial discrimination on health outcomes. The extent to which one believes his or her group is valued by others (i.e., positive collective ethnic-racial identity) has also been proposed to be protective. However, to date a limited body of research has examined the moderating effect of collective ethnic-racial identity on health, and among available studies, findings are mixed. METHOD African American youth (N = 612; 58.2% female, M grade = 8) completed measures on experiences of discrimination, mood symptoms, substance use, ethnic-racial identity affirmation, and collective ethnic-racial identity (assessed using the Collective Self-Esteem Scale). RESULTS Controlling for demographic variables and affirmation, a significant main effect was found for collective ethnic-racial identity, such that believing that others viewed your group positively was associated with better health outcomes among African American youth. However, collective ethnic-racial identity was not found to buffer the effects of discrimination on health outcomes. CONCLUSIONS These findings highlight the importance of examining collective ethnic-racial identity and the promotive effect it can have on health outcomes for African Americans. More research is needed to better understand if there are health outcomes in which collective ethnic-racial identity may also mitigate risk as a consequence of racial discrimination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Liang X, Su S, Hao G, Snieder H, Treiber F, Kapuku G, Wang X. Determinants of pulse wave velocity trajectories from youth to young adulthood: the Georgia Stress and Heart Study. J Hypertens 2019; 37:563-571. [PMID: 30234784 PMCID: PMC6355367 DOI: 10.1097/hjh.0000000000001933] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 02/07/2023]
Abstract
OBJECTIVE Increased arterial stiffness measured by pulse wave velocity (PWV) has been shown to be an important parameter of cardiovascular risk. Longitudinal development of PWV from youth to early adulthood and its possible sociodemographic, anthropometric, hemodynamic and behavioral moderators will be illustrated. METHODS Individual growth curves of carotid-distal PWV across age were created for 559 African American and European American men and women with a maximum of five assessments over an average of 7-year follow-up (mean age at participants' first assessment, 22.3 ± 3.4). RESULTS African Americans and men had significantly higher PWV than did European Americans and women (Ps < 0.01), respectively. A three-way interaction (P < 0.001) between age, sex and ethnicity was observed with African American men displaying a larger rate of increase in PWV with age than the other three ethnic and sex groups. The ethnicity and sex effects on PWV persisted when controlling for other moderators. Waist circumference was the strongest anthropometric predictor but its effect on PWV was only significant in women. Mean arterial pressure was the strongest hemodynamic predictor, marital status of parents was the strongest socioeconomic predictor and marijuana use was the strongest behavioral predictor of PWV. The best-fitting full model explained in total 59.4% of the between-subject variance in PWV with ethnicity, sex and age explaining 25.6%. CONCLUSION We observed significant ethnic and sex differences in longitudinal trajectories of PWV in youth and young adults. In addition, individual differences in PWV growth can largely be explained by mean arterial pressure, waist, marital status of parents and marijuana use.
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Affiliation(s)
- Xiaohua Liang
- Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China,
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Shaoyong Su
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Guang Hao
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Frank Treiber
- College of Nursing, Medical University of South Carolina, Charleston, USA
| | - Gaston Kapuku
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
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Manove EE, Lowe SR, Bonumwezi J, Preston J, Waters MC, Rhodes JE. Posttraumatic growth in low-income Black mothers who survived Hurricane Katrina. Am J Orthopsychiatry 2019; 89:144-158. [PMID: 30676050 PMCID: PMC6666311 DOI: 10.1037/ort0000398] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This mixed-methods study aimed to gain knowledge of the lived experience of posttraumatic growth (PTG) in 32 low-income Black mothers whose New Orleans' homes were damaged or destroyed by Hurricane Katrina, and half of whom had relocated indefinitely to Houston. Data from in-depth interviews with participants were examined in conjunction with quantitative scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996). Participants were interviewed face-to-face on a range of postdisaster experiences, including positive changes, in 2009. Participants also completed the PTGI via a telephone survey within six months of being interviewed. Most (26 out of 32) participants described experiencing PTG within the 5 domains of the PTGI, with the domains most frequently coded, in descending order, being New Possibilities, Relating to Others, Personal Strength, Appreciation for Life, and Spiritual Change. PTG stemmed heavily from exposure to opportunities in survivors' postdisaster communities, including increased racial diversity, improved neighborhoods, and new educational and economic opportunities. Participants' frequency of all PTG codes was associated with their overall PTGI scores with a small-to-moderate effect size (r = .32; p = .078) in a relationship that trended toward significance. Without minimizing the catastrophic losses they entail, disasters may in some cases create spaces for PTG for survivors, including through new opportunities in areas where survivors formerly experienced oppression. Policymakers should examine how to make such opportunities available, visible and accessible to individuals absent a disaster. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Emily E Manove
- Department of Psychiatry, Cambridge Health Alliance/ Harvard Medical School, Harvard University
| | - Sarah R Lowe
- Department of Psychology, Montclair State University
| | | | - Justin Preston
- Department of Psychology, University of Massachusetts, Boston
| | | | - Jean E Rhodes
- Department of Psychology, University of Massachusetts, Boston
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Gamaldo AA, Wright RS, Aiken-Morgan AT, Allaire JC, Thorpe RJ, Whitfield KE. The Association between Subjective Memory Complaints and Sleep within Older African American Adults. J Gerontol B Psychol Sci Soc Sci 2019; 74:202-211. [PMID: 28633326 PMCID: PMC6327663 DOI: 10.1093/geronb/gbx069] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Received: 10/09/2016] [Indexed: 11/13/2022] Open
Abstract
Objective The purpose of the current study is to examine the association between subjective memory complaints and sleep (quantity and quality) in African American older adults. Method Participants from the Baltimore Study of Black Aging (BSBA; n = 351; mean age = 71.99) completed a self-report sleep scale, subjective memory complaint scale, global cognitive status measure, and demographic questionnaire. Results Worse overall sleep quality was significantly associated with subjective reports of difficulty recalling the placement of objects, recalling specific facts from reading materials, and worse memory currently compared to the past. Specific sleep parameters (e.g., longer sleep latency and shorter sleep duration) were associated with negative appraisals of participants' ability to do specific tasks involving memory (e.g., difficulty recalling placement of objects). Participants classified as poor sleepers (Pittsburgh Sleep Quality Index [PSQI] total score > 5) were more likely to report worse memory now compared to the past than participants classified as good sleepers (PSQI total score ≤ 5). Conclusions Evaluation of sleep may be warranted when older adults, particularly African Americans, communicate concerns regarding their memory. Insufficient sleep may be a useful marker of acute daytime dysfunction and, perhaps, cognitive decline. Given memory problems are the hallmark of dementia, our findings support further evaluation of whether poor sleep can aid in the diagnosis of cognitive impairment.
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Affiliation(s)
- Alyssa A Gamaldo
- Human Development and Family Studies, Penn State University, University Park
| | | | - Adrienne T Aiken-Morgan
- Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina
- Department of Psychology, North Carolina A&T State University, Greensboro
| | | | - Roland J Thorpe
- Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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