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Kipp C, Wilson DK, Brown A, Quattlebaum M, Loncar H, Sweeney AM, Abshire DA. Compounding effects of stress on diet, physical activity, and wellbeing among African American parents: a qualitative study to inform the LEADS health promotion trial. J Behav Med 2024:10.1007/s10865-024-00477-3. [PMID: 38460063 DOI: 10.1007/s10865-024-00477-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/01/2024] [Indexed: 03/11/2024]
Abstract
The purpose of the study was to conduct in-depth qualitative interviews to understand the lived experiences of African American parents of overweight adolescents who had previously participated in a family-based weight loss program and to utilize these insights to inform the essential elements of the LEADS trial, an integrated resilience stress management and health promotion intervention. Participants (N = 30) were African American parents and/or caregivers (96.7% female; Mage = 49.73, SD = 10.88; MBMI = 37.63, SD = 8.21) of adolescents with overweight and/or obesity. Interviews were transcribed and coded using inductive and deductive approaches for themes by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. Prominent stress themes included caregiver responsibilities, work, interpersonal family conflict, and physical and emotional consequences of chronic stress. Participants also noted decreases in physical activity and poor food choices due to stress. Coping mechanisms included prayer/meditation, church social support, and talking with family/partner. Results highlight the importance of mitigating stress among African American parents through stress management and cultural/familial resilience approaches to increase the likelihood of engagement in behavioral strategies in health promotion programs. Future studies should assess the utility of incorporating stress management components and health promotion techniques to improve health outcomes among African American families.
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Affiliation(s)
- Colby Kipp
- Department of Psychology, University of South Carolina, Columbia, SC, USA.
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Asia Brown
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Mary Quattlebaum
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Haylee Loncar
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Erving CL, McKinnon II, Van Dyke ME, Murden R, Udaipuria S, Vaccarino V, Moore RH, Booker B, Lewis TT. Superwoman Schema and self-rated health in black women: Is socioeconomic status a moderator? Soc Sci Med 2024; 340:116445. [PMID: 38043442 PMCID: PMC10959495 DOI: 10.1016/j.socscimed.2023.116445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 10/12/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The Superwoman Schema (SWS) construct elucidates Black women's socialization to be strong, suppress their emotions, resist vulnerability, succeed despite limited resources, and help others at their own expense. Drawing from intersectionality and social psychological research on self-schemas, this study examined the extent to which SWS was associated with Black women's self-rated health. We also investigated whether socioeconomic status (SES) moderated the association between SWS, its five dimensions, and self-rated health. METHODS Data were from the Mechanisms Underlying Stress and Emotions (MUSE) in African-American Women's Health Study, a cohort of African American self-identified women. SWS was assessed using Giscombé's 35-item Superwoman Schema Scale. Socioeconomic status was measured by household income and educational attainment. Ordered logistic regression models were used and statistical interactions were run to test for moderation (N = 408). RESULTS First, SWS dimension "obligation to help others" was associated with worse self-rated health (p < .05). Second, household income, but not education, moderated the association between SWS and self-rated health (p < .05): SWS overall was associated with worse self-rated health among higher income women but better self-rated health among lower income women. Third, income moderated the association between SWS dimension "obligation to present an image of strength" and self-rated health (p < .05): presenting strength was associated with better self-rated health for lower income women only. Fourth, moderation results revealed that SWS dimension "obligation to help others" was inversely associated with self-rated health particularly among higher income women. CONCLUSIONS Findings speak to the complex interplay between SES and SWS dimensions as they relate to Black women's perceived health.
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Affiliation(s)
- Christy L Erving
- The University of Texas at Austin, College of Liberal Arts, Department of Sociology, Population Research Center, USA.
| | - Izraelle I McKinnon
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Miriam E Van Dyke
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Raphiel Murden
- Emory University, Rollins School of Public Health, Biostatistics and Bioinformatics Department, USA
| | - Shivika Udaipuria
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Viola Vaccarino
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Reneé H Moore
- Drexel University, Dornsife School of Public Health, Department of Epidemiology and Biostatistics, USA
| | - Bianca Booker
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Tené T Lewis
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
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Martin ZT, Al-Daas IO, Cardenas N, Kolade JO, Merlau ER, Vu JK, Brown KK, Brothers RM. Peripheral and Cerebral Vasodilation in Black and White Women: Examining the Impact of Psychosocial Stress Exposure Versus Internalization and Coping. Hypertension 2023; 80:2122-2134. [PMID: 37534492 PMCID: PMC10530116 DOI: 10.1161/hypertensionaha.123.21230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Black women have among the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function remains incompletely understood. Recent studies suggest that stress internalization and coping strategies are more important than stress exposures alone. We hypothesized that Black women would have blunted peripheral and cerebral vasodilation and that, among Black women, this would be inversely related with psychosocial stress internalization/coping but not stress exposures. METHODS Healthy Black (n=21; 20±2 years) and White (n=16; 25±7 years) women underwent testing for forearm reactive hyperemia, brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity. Psychosocial stress exposures (adverse childhood experiences; past week discrimination) and internalization/coping techniques (John Henryism Active Coping Scale; Giscombe Superwoman Schema Questionnaire) were assessed. RESULTS Reactive hyperemia and cerebrovascular reactivity were not different between groups (P>0.05), whereas FMD was lower in Black women (P=0.007). Neither adverse childhood experiences nor past week discrimination were associated with FMD in either group (P>0.05 for all). John Henryism Active Coping Scale scores were negatively associated with FMD in Black women (P=0.014) but positively associated with FMD in White women (P=0.042). Superwoman Schema-Succeed was negatively associated (P=0.044) and Superwoman Schema-Vulnerable tended to be negatively associated (P=0.057) with FMD in Black women. CONCLUSIONS These findings indicate that blunted FMD in Black women may be due more to stress internalization and maladaptive coping than stress exposures alone.
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Affiliation(s)
- Zachary T Martin
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - Iman O Al-Daas
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - Natalia Cardenas
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - John O Kolade
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - Emily R Merlau
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - Joshua K Vu
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - Kyrah K Brown
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
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Denyse T, Martin KJ, Kim JHJ, Pageot YK, Owoyemi P, DeLuz KD, Stanton AL. "No Complaining, No Crying": A Qualitative Study of the Strong Black Woman Schema in the Breast Cancer Context. Ann Behav Med 2023; 57:733-742. [PMID: 37318273 PMCID: PMC10441856 DOI: 10.1093/abm/kaad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Black women have the highest mortality from breast cancer compared with other racial/ethnic groups. Black women with breast cancer also evidence compromised quality of life in some domains. Culturally relevant aspects of their experience are understudied. PURPOSE The goal of this qualitative study was to examine the relevance of the Strong Black Woman schema in the cancer context. METHODS Three Gatherings (i.e., culturally curated focus groups) were conducted with Black women who had been diagnosed with breast cancer and recruited from cancer-related listservs and events. A five-person team conducted reflexive thematic analysis of Gathering transcripts. RESULTS The 37 participants ranged in age (30 to 94 years) and in diagnosis duration (2 months to 29 years). Reflexive thematic analysis yielded six themes that characterized the women's experience: historical legacy of the Strong Black Woman, navigating intersecting Strong Black Woman identities, everyday challenges encountered on the battlefield by Strong Black Women, Strong Black Woman in action during the breast cancer journey, the complexities of seeking and accepting support, and the liberated Strong Black Woman. The schema's negative consequences included the oncologic team and others expecting the participants to be strong and not to need support. Expectations to suppress emotions and continue caring for others to the neglect of the self also were evident. Positive consequences included engaging in self-advocacy in the oncologic context and redefining strength to include expressing emotions and accepting help. CONCLUSIONS The Strong Black Woman schema is highly relevant in the breast cancer context and could be addressed in culturally centered interventions.
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Affiliation(s)
| | - Kimberly J Martin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jacqueline H J Kim
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Yrvane K Pageot
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Praise Owoyemi
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Misiura MB, Butts B, Hammerschlag B, Munkombwe C, Bird A, Fyffe M, Hemphill A, Dotson VM, Wharton W. Intersectionality in Alzheimer's Disease: The Role of Female Sex and Black American Race in the Development and Prevalence of Alzheimer's Disease. Neurotherapeutics 2023; 20:1019-1036. [PMID: 37490246 PMCID: PMC10457280 DOI: 10.1007/s13311-023-01408-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
It is well known that vascular factors and specific social determinants of health contribute to dementia risk and that the prevalence of these risk factors differs according to race and sex. In this review, we discuss the intersection of sex and race, particularly female sex and Black American race. Women, particularly Black women, have been underrepresented in Alzheimer's disease clinical trials and research. However, in recent years, the number of women participating in clinical research has steadily increased. A greater prevalence of vascular risk factors such as hypertension and type 2 diabetes, coupled with unique social and environmental pressures, puts Black American women particularly at risk for the development of Alzheimer's disease and related dementias. Female sex hormones and the use of hormonal birth control may offer some protective benefits, but results are mixed, and studies do not consistently report the demographics of their samples. We argue that as a research community, greater efforts should be made to not only recruit this vulnerable population, but also report the demographic makeup of samples in research to better target those at greatest risk for the disease.
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Affiliation(s)
- Maria B Misiura
- Department of Psychology, Georgia State University, Atlanta, GA, USA.
- Center for Translational Research in Neuroimaging & Data Science, Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA.
| | - Brittany Butts
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Bruno Hammerschlag
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Chinkuli Munkombwe
- Department of Psychology, Georgia State University, Atlanta, GA, USA
- Center for Translational Research in Neuroimaging & Data Science, Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
- Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | - Arianna Bird
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Mercedes Fyffe
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Asia Hemphill
- Department of Psychology, Georgia State University, Atlanta, GA, USA
- Center for Translational Research in Neuroimaging & Data Science, Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Vonetta M Dotson
- Department of Psychology, Georgia State University, Atlanta, GA, USA
- Gerontology Institute, Georgia State University, Atlanta, GA, USA
| | - Whitney Wharton
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
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Brownlow BN. How Racism "Gets Under the Skin": An Examination of the Physical- and Mental-Health Costs of Culturally Compelled Coping. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 18:576-596. [PMID: 36179058 DOI: 10.1177/17456916221113762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Historically and contemporarily, Black Americans have been compelled to use effortful coping styles characterized by high behavioral and emotional restraint in the face of systematic racism. Lynch and colleagues have previously conceptualized a class of regulatory strategies-overcontrolled coping-characterized by emotional suppression, hypervigilance for threat, and high distress tolerance, which bear close analogy to coping styles frequently used among individuals facing chronic racial stress. However, given the inherent culture of racism in the United States, engaging in highly controlled coping strategies is often necessitated and adaptive, at least in the short term. Thus, for Black Americans this class of coping strategies is conceptualized as culturally compelled coping rather than overcontrolled coping. In the current article, I offer a critical examination of the literature and introduce a novel theoretical model-culturally compelled coping-that culturally translates selected components of Lynch's model. Cultural translation refers to considering how the meaning, function, and consequences of using overcontrolled coping strategies changes when considering how Black Americans exist and cope within a culture of systematic racism. Importantly, this model may offer broad implications for future research and treatment by contextualizing emotion regulation as a central mechanism, partially answering how racism "gets under the skin" and affects the health of Black Americans.
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Rahal D, Kurtz-Costes B, Volpe VV. Ethnic Identity in Arab Americans: Gender, Religious Upbringing, and Age Differences. SOCIAL IDENTITIES 2022; 28:544-569. [PMID: 36935868 PMCID: PMC10021341 DOI: 10.1080/13504630.2022.2110464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/31/2022] [Indexed: 06/18/2023]
Abstract
Arab Americans constitute a diverse, sizeable ethnic minority in the United States. However, limited research has examined the content of Arab American ethnic identity and whether this ethnic identity differs by demographic factors. In the present study, we developed measures of Arab American ethnic identity and cultural practice, and assessed differences in those variables by gender, religious affiliation (Muslim, Christian), and age. Arab American adults recruited online from Amazon Mechanical Turk (N = 391) completed an adaptation of the Multidimensional Inventory of Black Identity and a measure of cultural practice that was created for this study based on pre-existing scales. Items loaded onto dimensions of identity (ethnic centrality, private regard, public regard), and subscales showed invariance across gender and religious upbringing. When examining group differences in ethnic identity, we found that attitudes regarding being Arab American varied by gender, such that Arab American women reported higher private regard and lower public regard than men. In turn, participants raised in Muslim households reported higher ethnic centrality and cultural practice than those raised in Christian households, potentially related to Muslims' status as a religious minority in the United Status. Finally, young adults were lower in centrality and private regard than older adults, suggesting either that ethnic identity may develop into adulthood or that young adults' ethnic identity may be influenced by growing up in American society post-9/11. Taken together, findings illustrate the heterogeneity in the ethnic identity of Arab Americans; further research is needed to understand individual differences in Arab Americans' ethnic identity.
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Affiliation(s)
- Danny Rahal
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, State College, Pennsylvania, USA
| | - Beth Kurtz-Costes
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Vanessa V. Volpe
- Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA
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OUP accepted manuscript. THE GERONTOLOGIST 2022; 62:647-649. [DOI: 10.1093/geront/gnac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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