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Bea VJ, Cunningham JE, Alberg AJ, Burshell D, Bauza CE, Knight KD, Hazelton TR, Varner H, Kramer R, Bolick S, Hurley D, Mosley C, Ford ME. Alcohol and Tobacco Use in an Ethnically Diverse Sample of Breast Cancer Patients, Including Sea Island African Americans: Implications for Survivorship. Front Oncol 2018; 8:392. [PMID: 30319964 PMCID: PMC6170649 DOI: 10.3389/fonc.2018.00392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/31/2018] [Indexed: 11/13/2022] Open
Abstract
Background/Objective: Data suggest that modifiable risk factors such as alcohol and tobacco use may increase the risk of breast cancer (BC) recurrence and reduce survival. Female BC mortality in South Carolina is 40% higher among African Americans (AAs) than European Americans (EAs). Given this substantial racial disparity, using a cross-sectional survey design we examined alcohol and tobacco use in an ethnically diverse statewide study of women with recently diagnosed invasive breast cancer. This included a unique South Carolina AA subpopulation, the Sea Islanders (SI), culturally isolated and with the lowest European American genetic admixture of any AA group. Methods: Participants (42 EAs, 66 non-SI AAs, 29 SIs), diagnosed between August 2011 and December 2012, were identified through the South Carolina Central Cancer Registry and interviewed by telephone within 21 months of diagnosis. Self-reported educational status, alcohol consumption and tobacco use were obtained using elements of the Behavior and Risk Factor Surveillance System questionnaire. Results:Alcohol: EAs were approximately twice as likely to consume alcohol (40%) and to be moderate drinkers (29%) than either AA group (consumers: 24% of non-SI AAs, 21% of SIs; moderate drinkers 15 and 10% respectively). Users tended to be younger, significantly among EAs and non-SI AAs, but not SIs, and to have attained more education. Heavy drinking was rare (≤1%) and binge drinking uncommon (≤10%) with no differences by race/ethnicity. Among both AA subgroups but not EAs, alcohol users were six to nine times more likely to have late stage disease (Regional or Distant), statistically significant but with wide confidence intervals. Tobacco: Current cigarette smoking (daily or occasional) was reported by 14% of EAs, 14% of non-SI AAs and 7% of SIs. Smoking was inversely associated with educational attainment. Use of both alcohol and cigarettes was reported by 3–6% of cases. Conclusions: Prevalences of alcohol and cigarette use were similar to those in the general population, with alcohol consumption more common among EAs. Up to half of cases used alcohol and/or tobacco. Given the risks from alcohol for disease recurrence, and implications of smoking for various health outcomes, these utilization rates are of concern.
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Affiliation(s)
- Vivian J Bea
- Department of Breast Surgical Oncology, MD Anderson Cancer Center at Cooper, Camden, NJ, United States
| | - Joan E Cunningham
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States.,National Coalition of Independent Scholars, San Antonio, TX, United States
| | - Anthony J Alberg
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, United States
| | - Dana Burshell
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Colleen E Bauza
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Kendrea D Knight
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Tonya R Hazelton
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Heidi Varner
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Rita Kramer
- Department of Hematology/Oncology, Medical University of South Carolina, Charleston, SC, United States
| | - Susan Bolick
- South Carolina Department of Health and Environmental Control, Columbia, SC, United States
| | - Deborah Hurley
- South Carolina Department of Health and Environmental Control, Columbia, SC, United States
| | - Catishia Mosley
- South Carolina Department of Health and Environmental Control, Columbia, SC, United States
| | - Marvella E Ford
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
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Klonoff EA, Landrine H. Revising and Improving the African American Acculturation Scale. JOURNAL OF BLACK PSYCHOLOGY 2016. [DOI: 10.1177/0095798400026002007] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The African American Acculturation Scale (AAAS) was revised and improved with a sample of 520 African American adults. Items that some participants in prior studies found objectionable were dropped, and a new version of the scale was created by factor analyzing the remaining items. The revised AAAS (AAAS-R) consists of 47 items that no participant has objected to; these comprise eight new, empirically derived subscales (i.e., factors) that have high reliability and validity and correlate r = .97 with the original 74-item version of the scale. It is strongly recommended that researchers interested in studying acculturation among African Americans use this new version of the scale.
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Williams LA, Olshan AF, Tse CK, Bell ME, Troester MA. Alcohol intake and invasive breast cancer risk by molecular subtype and race in the Carolina Breast Cancer Study. Cancer Causes Control 2016; 27:259-69. [PMID: 26705260 PMCID: PMC5074055 DOI: 10.1007/s10552-015-0703-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Alcohol is an established breast cancer risk factor, but there is little evidence on whether the association differs between African Americans and whites. METHODS Invasive breast cancers (n = 1,795; 1,014 white, 781 African American) and age- and race-matched controls (n = 1,558; 844 white, 714 African American) from the Carolina Breast Cancer Study (Phases I-II) were used to estimate odds ratios (ORs) and 95 % confidence interval (CI) for pre-diagnosis drinks per week and breast cancer risk. RESULTS African American controls reported lower alcohol intake than white controls across all age groups. Light drinking (0 to ≤2 per week) was more prevalent among African American controls. Moderate-to-heavy drinking was more prevalent in white controls. African Americans who reported drinking >7 drinks per week had an elevated risk compared to light drinkers [adjusted OR, 95% CI 1.62 (1.03-2.54)]. A weaker association was observed among whites [adjusted OR, 95% CI 1.20 (0.87-1.67)]. The association of >7 drinks per week with estrogen receptor-negative [adjusted OR, 95% CI 2.17 (1.25-3.75)] and triple-negative [adjusted OR, 95% CI 2.12 (1.12-4.04)] breast cancers was significant for African American, but not white women. We observed significantly elevated ORs for heavy intake at ages <25 and >50 years of age for African American women only. We found no evidence of statistical interaction between alcohol intake and oral contraceptive use or smoking. CONCLUSIONS Drinking more than seven alcoholic beverages per week increased invasive breast cancer risk among white and African American women, with significant increases only among African American women. Genetic or environmental factors that differ by race may mediate the alcohol-breast cancer risk association.
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Affiliation(s)
- Lindsay A Williams
- Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC, 27599, USA.
| | - Andrew F Olshan
- Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27514, USA
| | - Chui Kit Tse
- Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC, 27599, USA
| | - Mary Elizabeth Bell
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27514, USA
| | - Melissa A Troester
- Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC, 27599, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27514, USA.
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Chartier KG, Hesselbrock MN, Hesselbrock VM. Alcohol problems in young adults transitioning from adolescence to adulthood: The association with race and gender. Addict Behav 2011; 36:167-74. [PMID: 21115225 PMCID: PMC3018558 DOI: 10.1016/j.addbeh.2010.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 08/30/2010] [Accepted: 10/18/2010] [Indexed: 11/20/2022]
Abstract
Race and gender may be important considerations for recognizing alcohol related problems in Black and White young adults. This study examined the prevalence and age of onset of individual alcohol problems and alcohol problem severity across race and gender subgroups from a longitudinal study of a community sample of adolescents followed into young adulthood (N=166; 23-29 yrs. old who were drinkers). All alcohol problems examined first occurred when subjects were in their late teens and early 20s. Drinking in hazardous situations, blackouts, and tolerance were the most common reported alcohol problems. In race and gender comparisons, more males than females experienced alcohol problems. Blacks generally had a later age of onset of alcohol problems. Multivariate regressions showed greater alcohol problem severity in males compared to females, but no significant differences between Blacks and Whites. Education, family environment and earlier alcohol use behaviors and expectancies were reliable predictors of alcohol problem severity in young adulthood. White males were at particular risk for experiencing more severe alcohol problems. Findings may inform the design of more targeted interventions for alcohol problems in different populations.
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Landrine H, Klonoff EA. Culture Change and Ethnic-Minority Health Behavior: An Operant Theory of Acculturation. J Behav Med 2004; 27:527-55. [PMID: 15669443 DOI: 10.1007/s10865-004-0002-0] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Data on acculturation and ethnic-minority health indicate that acculturation has opposite effects on the same health behavior among different ethnic groups; opposite effects on different health behaviors within an ethnic group; opposite effects on the same health behavior for the women vs. the men of most ethnic groups; and no effect whatsoever on some health behaviors for some ethnic groups. This evidence is so incoherent that it is unintelligible, and hence it continues to be largely useless to health psychology and behavioral medicine. This paper presents a new theory of acculturation that renders these confusing data coherent by predicting such changes in minority health behavior a priori. By so doing, the operant model of acculturation has the potential to improve health promotion and disease prevention and thereby reduce ethnic health disparities.
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Affiliation(s)
- Hope Landrine
- San Diego State University-University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, California, USA.
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Dawson DA, Room R. Towards agreement on ways to measure and report drinking patterns and alcohol-related problems in adult general population surveys: the Skarpö conference overview. JOURNAL OF SUBSTANCE ABUSE 2001; 12:1-21. [PMID: 11288465 DOI: 10.1016/s0899-3289(00)00037-7] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A thematic conference of the Kettil Bruun Society (KBS) for Social and Epidemiological Research on Alcohol was held in Skarpö, near Stockholm, on April 3-7, 2000. The goals of the meeting were to develop consensus sets of questionnaire items for measuring alcohol consumption and social harm, to delineate statistical and practical concerns related to the aggregation of consumption and harm data and to identify summary measures to be used for descriptive purposes and in analyses of the association between alcohol intake and alcohol-related outcomes. The results of the conference discussions are summarized below, with emphasis on both areas where the conference yielded recommendations for measures and methods of aggregation for analysis, and on areas where consensus could not be obtained and/or where additional research is needed.
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Affiliation(s)
- D A Dawson
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Suite 514, Willco Building, 6000 Executive Boulevard, MSC 7003, Bethesda, MD 20892-7003, USA.
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Jasinski JL, Williams LM, Siegel J. Childhood physical and sexual abuse as risk factors for heavy drinking among African-American women: a prospective study. CHILD ABUSE & NEGLECT 2000; 24:1061-71. [PMID: 10983816 DOI: 10.1016/s0145-2134(00)00158-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
OBJECTIVE This study examines the associations among characteristics of child sexual abuse. childhood physical abuse, lack of parental care, and heavy drinking in a relatively young, urban population of African-American women all of whom have documented histories of child sexual abuse. METHODOLOGY The sample consists of 113 African American child victims who were brought to a city hospital emergency room for treatment and collection of forensic evidence in the 1970s and re-interviewed as adults in the 1990s. RESULTS The results of this research suggest that multiple incidents of child sexual abuse, more than the characteristics of such abuse is an important predictor of adult heavy alcohol use and binge drinking. These results remain even after controlling for the effects of parental drinking behavior. CONCLUSION Although the victim of multiple child sexual assaults is more likely to suffer force and penetration, these analyses suggest that it is the multiple victimization and not the force or penetration that drives the relationship between child sexual assault and drinking behaviors.
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Affiliation(s)
- J L Jasinski
- Department of Sociology & Anthropology, University of Central Florida, Orlando 32816-1320, USA
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Bennett ME, Miller JH, Woodall WG. Drinking, binge drinking, and other drug use among southwestern undergraduates: three-year trends. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 1999; 25:331-50. [PMID: 10395164 DOI: 10.1081/ada-100101864] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study examined substance use patterns and consequences in college students over a three year period. Students were surveyed at a large, southwestern university, allowing for a diverse sample that included a large percentage of minority respondents. Students (total N = 2710) in 1994, 1995, and 1996 responded anonymously to the Core Survey of Alcohol and Drugs. Over 80% of students at each time point were current drinkers, and over one-third at each time period reported binge drinking. Binge drinking was associated with greater weekly drinking and with a range of negative consequences. Underage drinking was prevalent at all time points, and underage drinkers reported drinking in a range of on- and off-campus situations. Hispanic students reported higher rates of binge drinking than other ethnic groups. Nonwhite, non-Hispanic students reported greater rates of abstinence than other students. Although other drug use was much less prevalent, drug use in combination with drinking was associated with more problematic patterns of drinking and more negative consequences. Results are discussed in terms of implications for interventions with college students.
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Affiliation(s)
- M E Bennett
- Department of Psychology, The University of New Mexico, Albuquerque 87131-1161, USA.
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Watson AL, Sher KJ. Resolution of alcohol problems without treatment: Methodological issues and future directions of natural recovery research. ACTA ACUST UNITED AC 1998. [DOI: 10.1111/j.1468-2850.1998.tb00131.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sample EB, Li L, Moore D. ALCOHOL USE, ETHNICITY, AND DISABILITY: A COMPARISON OF AFRICAN-AMERICAN AND CAUCASIAN GROUPS. SOCIAL BEHAVIOR AND PERSONALITY 1997. [DOI: 10.2224/sbp.1997.25.3.265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Previous research has consistently reported that alcohol consumption among the general population varies across cultural groups. However, studies investigating risk factors and drinking patterns of African-Americans and Caucasians with disabilities have been limited. The current study
explored the factors of alcohol use among African-Americans and Caucasians with disabilities who were seeking rehabilitation services in three mid-western states of the USA. Multivariate data analysis revealed that African-Americans were more likely to use alcohol than their Caucasian counterparts
when other demographic and disability variables were controlled. Additionally, separate multiple-regression models differentiated patterns between African-Americans and Caucasians in selected variables on alcohol use. Cultural issues and implications for rehabilitation services are discussed.
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Dalgalarrondo P, Lotz M. Religious affiliation and psychiatric diagnosis: the influence of Christian sect membership on diagnosis distribution. Eur Arch Psychiatry Clin Neurosci 1993; 243:47-53. [PMID: 8399410 DOI: 10.1007/bf02191523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Minority religions, sects and cults are an increasingly common socio-cultural phenomenon, of which the effects concerning mental health and illness are still poorly understood. In the present study, we compared socio-demographical and clinical characteristics between members of Christian sects and the remaining general inpatient population admitted to a psychiatric clinic in Germany between 1978 and 1991. In comparison to the general patient population, Christian sect patients presented significantly more frequently with a diagnosis of functional psychoses (P < 0.02) and less frequently with diagnoses of neuroses (P < 0.10). Dissimilarities among sub-cultural groups in help-seeking behavior are suggested to explain the heterogeneous diagnoses distribution found in the study.
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Booth BM, Blow FC, Cook CA, Bunn JY, Fortney JC. Age and ethnicity among hospitalized alcoholics: a nationwide study. Alcohol Clin Exp Res 1992; 16:1029-34. [PMID: 1335219 DOI: 10.1111/j.1530-0277.1992.tb00694.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Little is known about the broad-scale demographic characteristics of low income or indigent alcoholics in public hospital systems. The purpose of the study was to examine issues relative to age, race/ethnicity, and marital status for a large group (n = 62,829) of alcoholic men receiving inpatient care in Department of Veterans Affairs (VA) medical centers nationally. Subjects were VA inpatients completing alcoholism treatment (n = 27,562), in brief alcohol detoxification or short intervention (n = 9,322), or hospitalized for primary diagnoses other than alcoholism but with a secondary diagnosis of alcohol dependence syndrome (n = 25,945). Minority alcoholics were significantly younger than Caucasian alcoholics. Hispanic and African-American men, as well as older alcoholics, were significantly less likely to complete treatment or attend detoxification and more likely to be hospitalized for other primary diagnoses. Native Americans, however, were most likely to complete alcoholism treatment. Results suggest that members of some minority groups and elderly alcoholics seek inpatient care for diagnoses other than alcoholism and that, as a result, such individuals may need targeted interventions to encourage them to seek alcohol-specific care.
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