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Ellis KR, Raji D, Pennings JS, Thorpe RJ, Bruce MA. Caregiving and Obesity among Black American Adults. Soc Work Res 2024; 48:38-47. [PMID: 38455109 PMCID: PMC10915901 DOI: 10.1093/swr/svae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/19/2022] [Accepted: 01/26/2023] [Indexed: 03/09/2024]
Abstract
Black American adults often report higher rates of obesity and caregiving compared with other racial or ethnic groups. Consequently, many Black American caregivers and care recipients are obese or have obesity-related chronic conditions (e.g., diabetes, hypertension). This study investigated associations between caregiving and obesity among Black Americans, including the role of health behaviors and chronic conditions. The sample included data from 2015 and 2017 Behavioral Risk Factor Surveillance System for non-Hispanic Black (NHB) or African American adult caregivers (n = 2,562) and noncaregivers (n = 7,027). The association between obesity (dependent variable) and caregiving status, fruit consumption, vegetable consumption, physical activity, and number of chronic conditions (independent variables) were evaluated using hierarchical binomial logistic regressions. Caregiving, being female, and chronic conditions were associated with higher odds of obesity, while physical activity was associated with lower odds of obesity. Physical activity, diet, and chronic conditions did not account for differences in obesity among caregiving and noncaregiving Black Americans. Increasing understanding of health behaviors and chronic disease burden of NHB caregivers has implications for programs aiming to improve obesity-related outcomes for caregivers and recipients. Future research should investigate multilevel factors that contribute to observed differences.
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Affiliation(s)
- Katrina R Ellis
- PhD, MPH, MSW, is assistant professor, School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Dolapo Raji
- MPH, MHI, is research associate specialist intermediate, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jacquelyn S Pennings
- PhD, PStat, is research associate professor, Department of Orthopaedic Surgery, Department of Biostatistics, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roland J Thorpe
- PhD, is professor, Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Baltimore, MD, USA
| | - Marino A Bruce
- PhD, is associate dean for research and clinical professor, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
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Reeder NK, Reneker JC, Beech BM, Bruce MA, Heitman E, Norris KC, Talegawkar SA, Thorpe RJ. Adherence to the healthy eating index-2010 and alternative healthy eating index-2010 in relation to metabolic syndrome among African Americans in the Jackson heart study. Public Health Nutr 2024; 27:e74. [PMID: 38361460 PMCID: PMC10966834 DOI: 10.1017/s1368980024000016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 11/11/2023] [Accepted: 12/21/2023] [Indexed: 02/17/2024]
Abstract
OBJECTIVE The primary objective of this study was to determine whether Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) scores were associated with incident metabolic syndrome. DESIGN This study is a secondary analysis of data from the Jackson Heart Study. HEI and AHEI scores were divided into quintiles and Cox proportional hazards regression models were analysed for 1864 African American adults free from metabolic syndrome at Exam 1 to examine the incidence of metabolic syndrome by quintile of dietary quality score. SETTING Hinds, Madison and Rankin counties, Mississippi, USA. PARTICIPANTS African American adults, ages 21-94 years, 60·9 % female. RESULTS Over a mean follow-up time of 6·7 years, we observed 932 incident cases of metabolic syndrome. After adjusting for multiple covariates, a higher HEI score at Exam 1 was not associated with the risk of incident metabolic syndrome, except when looking at the trend analysis for the subgroup of adults with two metabolic syndrome components at Exam 1 (P-trend = 0·03). A higher AHEI score at Exam 1 was associated with the risk of incident metabolic syndrome (hazard ratio for those in the highest quintile compared to the lowest: 0·80 (95 % CI: 0·65, 0·99), P-trend = 0·03). CONCLUSION These findings suggest that a dietary pattern that scores higher on the AHEI may help reduce the risk of metabolic syndrome, even for adults who already have two of the minimum of three components required for a diagnosis of metabolic syndrome.
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Affiliation(s)
- Nicole K Reeder
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, MS, USA
| | - Jennifer C Reneker
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS, USA
| | - Bettina M Beech
- UH Population Health, University of Houston, Houston, TX, USA
| | - Marino A Bruce
- UH Population Health, University of Houston, Houston, TX, USA
- Department of Behavioral and Social Sciences, University of Houston, Tilman J. Fertitta Family College of Medicine, Houston, TX, USA
| | - Elizabeth Heitman
- Program in Ethics in Science and Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Keith C Norris
- Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins School of Public Health, 624 N. Broadway, Ste 708, Baltimore, MD, USA
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Johnson JL, Coleman A, Kwarteng JL, Holmes AU, Kermah D, Bruce MA, Beech BM. The Association between Adult Sport, Fitness, and Recreational Physical Activity and Number and Age of Children Present in the Household: A Secondary Analysis Using NHANES. Int J Environ Res Public Health 2023; 20:5942. [PMID: 37297546 PMCID: PMC10253130 DOI: 10.3390/ijerph20115942] [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] [Received: 04/21/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
Only one in three adults in the United States meets the weekly recommendation for physical activity (PA). The presence of children in the home may restrict adult PA. The purpose of this study was to examine the association between adult moderate and vigorous sport, fitness, and recreational physical activities and the number and age (0-5 and 6-17) of children in their household. Secondary data were drawn from the National Health and Nutrition Examination Survey (NHANES) from 2007-2016. Adults with complete survey data for self-reported moderate (MPA) and vigorous physical activities (VPA), number of children in the home, and other sociodemographic variables were included. The final sample included 2034 adults from 22-65 years of age. Analyses included ANOVAs and separate multivariable regression analyses to determine if the number of children in the household aged 0-5 and 6-17 were significant predictors of weekly moderate-to-vigorous physical activity (MVPA) after controlling for covariates. For MPA, no differences were found between adult PA regardless of the number and age of children in the home. For VPA, adults with two or more children aged 0-5 reported 80 fewer minutes of weekly VPA (p < 0.05) compared to those with no children or just one child in this age group after controlling for all covariates. Finally, adults with three or more children in the household aged 6-17 reported fifty fewer minutes of weekly VPA (p < 0.05) compared to those with no children, one, or just two in the household. These findings highlight a need to support the vigorous PA behaviors of this population, as the majority of the family-based PA intervention studies to date have primarily focused on family dyads.
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Affiliation(s)
- Jerraco L. Johnson
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, TX 76203, USA
| | - Ailton Coleman
- Department of Health Sciences, James Madison University, Harrisonburg, VA 22807, USA;
| | - Jamila L. Kwarteng
- Division of Community Health, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Ahondju U. Holmes
- University of Oklahoma Stephenson Cancer Center, Oklahoma City, OK 73014, USA;
| | - Dulcie Kermah
- Urban Health Institute Student Research Core Charles R., Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Marino A. Bruce
- Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX 77021, USA; (M.A.B.); (B.M.B.)
- UH Population Health, University of Houston, Houston, TX 77021, USA
| | - Bettina M. Beech
- Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX 77021, USA; (M.A.B.); (B.M.B.)
- UH Population Health, University of Houston, Houston, TX 77021, USA
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Cohen-Winans S, Heitman E, Bruce MA, Thorpe RJ, Norris KC, Newton RL, Beech BM. Abstract P440: Household Physical Activity is Not Associated With Hypertension Among African Americans: The Jackson Heart Study. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Introduction:
Hypertension (HTN) develops at a disproportionately higher rate among African Americans compared to any other racial group. Substantial evidence indicates that aerobic exercise mitigates HTN. However, only 41% of African Americans report meeting leisure-time aerobic exercise recommendations, the lowest percentage compared to other racial groups. Household activities have been reported as the most common, daily PA among African Americans compared to occupational and leisure-time PA. Household activities, such as major cleaning and caretaking, are a type of light-to-moderate intensity PA that is associated with blood pressure (BP) reductions. Among African Americans, women report higher levels of household tasks than men.
Hypothesis:
We assessed the hypothesis that the association between household PA and HTN among African Americans varies by sex.
Methods:
The JHS is a longitudinal, community-based, observational study among African Americans residing in Jackson, Mississippi’s tri-county area. Of the 5,306 African American participants from JHS’s Exam 1, 1,419 had missing data on key variables, leaving a total of 3,887 for the analytic sample. HTN, the outcome variable, was defined using JNC-7’s standards, systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90mmHg, given that baseline data was collected between 2000-04. Household PA, the primary independent variable, was categorized as high or low frequency. PA was assessed at the baseline, in-home interview using the 30-item JHS PA Survey, which is a modification of the Baecke and Atherosclerosis Risk in the Community activity questionnaires. Sociodemographic characteristics, cardiovascular disease risk factors, and area-level factors were included as covariates. Total sample and sex-stratified multivariable logistic regression models were estimated to examine the association between household PA and HTN using STATA/SE Version 16.
Results:
Approximately 55% of the sample had HTN and 65.6% reported low frequency household PA. A significant difference in HTN status was found. The proportion of those with HTN was lower for those reporting high frequency household PA than the corresponding percentage for low frequency household PA (OR = 0.78, 95% CI: 0.69-0.90). A greater percentage of individuals under age 50 reported high frequency household PA. This association did not hold in the adjusted models. Household PA was not related to HTN (OR = 0.90, 95% CI: 0.74-1.09). The interaction term between household PA and sex was not associated with HTN (OR = 1.06, 95% CI: 0.77-1.44). Age was a confounder that attenuated the association.
Conclusions:
In conclusion, we found that household activities are not associated with HTN; however, this type of light-to-moderate intensity PA may be beneficial for improving BP among African Americans, especially among those who are otherwise physically inactive.
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Woodard L, Gilbert L, King B, Adepoju OE, Bruce MA, McDougle L, Moultry AM, Beech BM. Examining Black and Hispanic physicians and other healthcare providers' attitudes toward the COVID-19 vaccine. J Natl Med Assoc 2023; 115:53-65. [PMID: 36610827 PMCID: PMC9815487 DOI: 10.1016/j.jnma.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/11/2022] [Accepted: 12/07/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Recognizing that the voice delivering the message is as important as the information being shared, we examined vaccine perceptions and willingness to encourage patients to obtain COVID-19 vaccinations among Black and Hispanic healthcare providers. METHODS We conducted a cross-sectional, online survey of Black and Hispanic healthcare providers who were members of the National Medical Association (NMA), National Hispanic Medical Association (NHMA), and National Pharmaceutical Association (NPhA) between January 11 - March 3, 2021, shortly after emergency use authorization (EUA) for the Pfizer and Moderna COVID-19 vaccines. Three multivariable logistic regression models were used to determine factors associated with the willingness to encourage COVID-19 vaccination. RESULTS The analytic sample consisted of 542 fully completed surveys. Pharmacists reported intent to take the vaccine (75.0% "as soon as you can" vs 91.4% for MD/DOs; p<0.001) and encouraged patients to get vaccinated (78.6% vs 91.0% for MD/DOs; p = 0.01). Providers in a suburban practice location were less likely to recommend vaccines to patients (OR=0.43, 95%CI: 0.22-0.87) and personal family (OR=0.45, 95%CI: 0.22-0.92) compared to those practicing in urban areas. Providers over age 45 were also more likely to report intent to take the vaccine themselves as soon as it was available (OR=3.72, 95%CI: 1.30-10.64). CONCLUSIONS This is likely the first cross-sectional study in the United States demonstrating the substantial vaccine confidence among Black and Hispanic healthcare providers who serve minoritized communities that have borne the greatest risk of adverse COVID-related outcomes.
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Affiliation(s)
- LeChauncy Woodard
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Lauren Gilbert
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US.
| | - Ben King
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Omolola E Adepoju
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Marino A Bruce
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Leon McDougle
- The Ohio State University Wexner Medical Center, 410W. 10th Ave., Columbus, Ohio 43210 US
| | | | - Bettina M Beech
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
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Chavez JV, Crenshaw D, Kripalani S, Szetela C, Bruce MA, Isasi R, Behar-Zusman V. Helping the science speak for itself: lessons learned developing video summaries for a precision medicine and health disparities collaborative. Per Med 2022; 19:475-482. [PMID: 36250524 PMCID: PMC9709906 DOI: 10.2217/pme-2021-0122] [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: 09/17/2021] [Accepted: 07/10/2022] [Indexed: 11/21/2022]
Abstract
Skills to effectively communicate research findings are important to expand meaningful inclusion of the public in research, but attempts to summarize findings may be challenging given increasing reliance on succinct communications. Led by our Ethics Advisory Board and within the context of this work with the Precision Medicine and Health Disparities Collaborative, the authors decided to engage in the iterative process of developing video summaries. Our stakeholders taught us to incorporate novel strategies to engage broader audiences, leading to the production of two video summaries, a public summary toolbox and an adapted process for developing video summaries. The authors refreshed the static concept of 'research summaries' and found ways of producing summaries which emphasized a dynamic reframing of the shared benefits of science.
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Affiliation(s)
- Jennifer V Chavez
- University of Miami School of Nursing & Health Studies, Coral Gables, FL 33146, USA
- University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - David Crenshaw
- Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Sunil Kripalani
- Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | | | - Marino A Bruce
- University of Houston, Tilman J Fertitta Family College of Medicine, Houston, TX 77204, USA
| | - Rosario Isasi
- University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Bruce MA, Beech BM, Kermah D, Bailey S, Phillips N, Jones HP, Bowie JV, Heitman E, Norris KC, Whitfield KE, Thorpe RJ. Religious service attendance and mortality among older Black men. PLoS One 2022; 17:e0273806. [PMID: 36054189 PMCID: PMC9439243 DOI: 10.1371/journal.pone.0273806] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/16/2022] [Indexed: 11/18/2022] Open
Abstract
Religious institutions have been responsive to the needs of Black men and other marginalized populations. Religious service attendance is a common practice that has been associated with stress management and extended longevity. The objective of this study was to examine the relationship between religious service attendance and all-cause mortality among Black men 50 years of age and older. Data for this study were from NHANES III (1988–1994). The analytic sample (n = 839) was restricted to participants at least 50 years of age at the time of interview who self-identified as Black and male. Mortality was the primary outcome for this study and the NHANES III Linked Mortality File was used to estimate race-specific, non-injury-related death rates using a probabilistic matching algorithm, linked to the National Death Index through December 31, 2015, providing up to 27 years follow-up. The primary independent variable was religious service attendance, a categorical variable indicating that participants attended religious services at least weekly, three or fewer times per month, or not at all. The mean age of participants was 63.6±0.3 years and 36.4% of sample members reported that they attended religious services one or more times per week, exceeding those attending three or fewer times per month (31.7%), or not at all (31.9%). Cox proportional hazard logistic regression models were estimated to determine the association between religious service attendance and mortality. Participants with the most frequent religious service attendance had a 47% reduction of all-cause mortality risk compared their peer who did not attend religious services at all (HR 0.53, CI 0.35–0.79) in the fully adjusted model including socioeconomic status, non-cardiovascular medical conditions, health behaviors, social support and allostatic load. Our findings underscore the potential salience of religiosity and spirituality for health in Black men, an understudied group where elevated risk factors are often present.
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Affiliation(s)
- Marino A. Bruce
- Faith, Justice and Health and Men’s Health Collaboratories, University of Houston Population Health, University of Houston, Houston, TX, United States of America
- Department of Behavioral and Social Science, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, United States of America
- Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, United States of America
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- * E-mail:
| | - Bettina M. Beech
- Faith, Justice and Health and Men’s Health Collaboratories, University of Houston Population Health, University of Houston, Houston, TX, United States of America
- Department of Behavioral and Social Science, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, United States of America
- Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, United States of America
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Dulcie Kermah
- Charles R. Drew University School of Medicine and Science, Los Angeles, CA, United States of America
| | - Shanelle Bailey
- Charles R. Drew University School of Medicine and Science, Los Angeles, CA, United States of America
| | - Nicole Phillips
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Harlan P. Jones
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Janice V. Bowie
- Faith, Justice and Health and Men’s Health Collaboratories, University of Houston Population Health, University of Houston, Houston, TX, United States of America
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Elizabeth Heitman
- Faith, Justice and Health and Men’s Health Collaboratories, University of Houston Population Health, University of Houston, Houston, TX, United States of America
- Program Ethics in Science and Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Keith C. Norris
- Faith, Justice and Health and Men’s Health Collaboratories, University of Houston Population Health, University of Houston, Houston, TX, United States of America
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Keith E. Whitfield
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- University of Nevada-Las Vegas, Las Vegas, Nevada, United States of America
| | - Roland J. Thorpe
- Faith, Justice and Health and Men’s Health Collaboratories, University of Houston Population Health, University of Houston, Houston, TX, United States of America
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Booker R, Beech BM, Bruce MA, Thorpe RJ, Norris KC, Heitman E, Newton RL, Holmes ME. The Association of Sedentary Behavior and Physical Activity with Different Measurements of Metabolic Syndrome: The Jackson Heart Study. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221118044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: Cross-sectional investigation of the association of sedentary behavior and physical activity with metabolic syndrome (MetS) among the African American participants in the Jackson Heart Study (JHS). Methods: Prevalence, number of individual components, and MetS severity z-score (MetS-Z) were examined. MetS was classified using ATP-III thresholds. MetS-Z was calculated using sex-, race-, and ethnicity-specific formulas. Sedentary behavior and physical activity were calculated from the JHS Physical Activity Cohort survey (JPAC). Associations between sedentary behavior and physical activity with MetS were assessed by logistic, negative binomial, and ordinary least squares regressions. Results: The mean participant age ( N = 3370) was 61.7 ± 11.9 years and most were female (63.9%). Among all participants, 60.5% were classified with MetS. Overall MetS-Z was moderately high (.31 ± 1.07). Most waking hours were sedentary, with just under 40 daily minutes of self-reported physical activity. Physical activity was associated with lower prevalence of MetS, the number of individual components, and MetS-Z score ( p < .05). Sedentary behavior was not associated with MetS in any fully adjusted models ( p > .05). Conclusions: Physical activity was associated with lower cardiometabolic risk, irrespective of sedentary behavior. Further studies are needed to better understand why no relation was found between sedentary behavior and cardiometabolic risk in this cohort of African American adults.
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Affiliation(s)
- Robert Booker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
| | - Bettina M. Beech
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
| | - Marino A. Bruce
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
| | - Roland J. Thorpe
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
| | - Keith C. Norris
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
| | - Elizabeth Heitman
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
| | - Robert L. Newton
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
| | - Megan E. Holmes
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA (RB); University of Houston Population Health, University of Houston, Houston, TX, USA (BMB); Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA (BMB, MAB); Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, MD,
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Eneanya ND, Boulware LE, Tsai J, Bruce MA, Ford CL, Harris C, Morales LS, Ryan MJ, Reese PP, Thorpe RJ, Morse M, Walker V, Arogundade FA, Lopes AA, Norris KC. Health inequities and the inappropriate use of race in nephrology. Nat Rev Nephrol 2022; 18:84-94. [PMID: 34750551 PMCID: PMC8574929 DOI: 10.1038/s41581-021-00501-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [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] [Accepted: 10/04/2021] [Indexed: 12/13/2022]
Abstract
Chronic kidney disease is an important clinical condition beset with racial and ethnic disparities that are associated with social inequities. Many medical schools and health centres across the USA have raised concerns about the use of race - a socio-political construct that mediates the effect of structural racism - as a fixed, measurable biological variable in the assessment of kidney disease. We discuss the role of race and racism in medicine and outline many of the concerns that have been raised by the medical and social justice communities regarding the use of race in estimated glomerular filtration rate equations, including its relationship with structural racism and racial inequities. Although race can be used to identify populations who experience racism and subsequent differential treatment, ignoring the biological and social heterogeneity within any racial group and inferring innate individual-level attributes is methodologically flawed. Therefore, although more accurate measures for estimating kidney function are under investigation, we support the use of biomarkers for determining estimated glomerular filtration rate without adjustments for race. Clinicians have a duty to recognize and elucidate the nuances of racism and its effects on health and disease. Otherwise, we risk perpetuating historical racist concepts in medicine that exacerbate health inequities and impact marginalized patient populations.
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Affiliation(s)
- Nwamaka D Eneanya
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - L Ebony Boulware
- Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer Tsai
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, University of Houston College of Medicine, Houston, TX, USA
| | - Chandra L Ford
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Christina Harris
- VA Greater Los Angeles Healthcare System, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Leo S Morales
- Division of General Internal Medicine, University of Washington, Seattle, WA, USA
| | - Michael J Ryan
- Division of General Internal Medicine, University of Washington, Seattle, WA, USA
| | - Peter P Reese
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michelle Morse
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Valencia Walker
- Department of Paediatrics, Ohio State University College of Medicine, Columbus, OH, USA
| | | | - Antonio A Lopes
- Clinical Epidemiology and Evidence-Based Medicine Unit of the Edgard Santos University Hospital and Department of Internal Medicine, Federal University of Bahia, Salvador, Brazil
| | - Keith C Norris
- VA Greater Los Angeles Healthcare System, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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10
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Bruce MA, Norris KC. Race, Social Class, and CKD: The Way Forward. Kidney Med 2022; 4:100400. [PMID: 35072052 PMCID: PMC8767137 DOI: 10.1016/j.xkme.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Marino A. Bruce
- Program for Research on Faith, Justice and Health, Department of Behavioral and Social Sciences, University of Houston College of Medicine and Department of Health System and Population Health Sciences, University of Houston, Houston, Texas
| | - Keith C. Norris
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, California
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11
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Abstract
IMPORTANCE The American Medical Association has acknowledged the public health threat posed by racism in medicine. While clinicians in psychiatry have echoed the sentiment, the research community has largely been silent. Current understanding of the biological domains that underlie psychiatric disorders was historically established by studying White populations, often leaving widely used treatments ineffective for Asian, Black, Hispanic, Indigenous, and other racial and ethnic minority individuals. This article addresses how undersampling of racial and ethnic minority individuals has led to overgeneralized physiological findings, the implications for development of psychiatric treatments, and steps to improve service to racially diverse communities. OBSERVATIONS Three primary observations regarding differences associated with race and ethnicity have been addressed in the existing psychiatric research: misdiagnosis, medication nonadherence, and treatment efficacy and expression of adverse effects. While cultural factors have been discussed as potential factors associated with these differences, a lack of understanding of physiologic systems may be foundational to each of these issues. Recent evidence points to race differences in psychophysiological measures, likely attributed to factors including the lived experience of racism as opposed to inherent biological differences. This mounting evidence supports a reassessment of existing work to examine potential divergent patterns within racial and ethnic groups. The following strategies may improve understanding of the influence of racism on physiology, allowing clinicians to better address psychiatric symptoms and improve existing treatment approaches. Thus, psychiatric researchers need to (1) understand the historic and current terminology for race and ethnicity and use appropriate terms and categories as defined by sociologists, population health experts, and databases while respecting individuals' right to self-identify, (2) refine research questions, and (3) reexamine research data to determine whether patterns observed in largely White populations can extend to other groups. To appropriately implement these steps, researchers must accept the discomfort that accompanies growth, invite scientists from diverse backgrounds to participate, and use resources to increase diversity in recruitment of study participants. This will require a commitment from funding agencies to provide adequate support to recruit and investigate large, diverse samples. CONCLUSIONS AND RELEVANCE To create more suitable medical treatments and improve the quality of care received by those with psychiatric conditions, further discussion is needed surrounding the physiologic toll that racism has had on multiple generations of racial and ethnic minority groups and how that may alter responsivity to biobehavioral interventions. To better inform psychiatric research, the resources provided must be expanded, basic physiologic studies should be replicated with more diverse samples and adequate analyses, and psychiatry scientists must reconsider approaches to clinical research.
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Affiliation(s)
- Julianne L Price
- Department of Kinesiology and Health, Center of Alcohol and Substance Use Studies, Rutgers University, New Brunswick, New Jersey
| | - Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, University of Houston College of Medicine, Houston, Texas
| | - Bryon Adinoff
- Anschutz Medical Campus, University of Colorado, Denver
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12
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Desta R, Blumrosen C, Laferriere HE, Saluja A, Bruce MA, Elasy TA, Griffith DM, Norris KC, Cavanaugh KL, Umeukeje EM. Interventions Incorporating Therapeutic Alliance to Improve Medication Adherence in Black Patients with Diabetes, Hypertension and Kidney Disease: A Systematic Review. Patient Prefer Adherence 2022; 16:3095-3110. [PMID: 36404799 PMCID: PMC9673796 DOI: 10.2147/ppa.s371162] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Black Americans have a disproportionately increased risk of diabetes, hypertension, and kidney disease, and higher associated morbidity, mortality, and hospitalization rates than their White peers. Structural racism amplifies these disparities, and negatively impacts self-care including medication adherence, critical to chronic disease management. Systematic evidence of successful interventions to improve medication adherence in Black patients with diabetes, hypertension, and kidney disease is lacking. Knowledge of the impact of therapeutic alliance, ie, the unique relationship between patients and providers, which optimizes outcomes especially for minority populations, is unclear. The role and application of behavioral theories in successful development of medication adherence interventions specific to this context also remains unclear. OBJECTIVE To evaluate the existing evidence on the salience of a therapeutic alliance in effective interventions to improve medication adherence in Black patients with diabetes, hypertension, or kidney disease. DATA SOURCES Medline (via PubMed), EMBASE (OvidSP), Cumulative Index of Nursing and Allied Health Literature (CINAHL) (EBSCOhost), and PsycINFO (ProQuest) databases. REVIEW METHODS Only randomized clinical trials and pre/post intervention studies published in English between 2009 and 2022 with a proportion of Black patients greater than 25% were included. Narrative synthesis was done. RESULTS Eleven intervention studies met the study criteria and eight of those studies had all-Black samples. Medication adherence outcome measures were heterogenous. Five out of six studies which effectively improved medication adherence, incorporated therapeutic alliance. Seven studies informed by behavioral theories led to significant improvement in medication adherence. DISCUSSION/CONCLUSION Study findings suggest that therapeutic alliance-based interventions are effective in improving medication adherence in Black patients with diabetes and hypertension. Further research to test the efficacy of therapeutic alliance-based interventions to improve medication adherence in Black patients should ideally incorporate cultural adaptation, theoretical framework, face-to-face delivery mode, and convenient locations.
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Affiliation(s)
- Russom Desta
- Department of Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Charlotte Blumrosen
- Department of Medicine and Pediatrics, University of Rochester Medical Center, New York, NY, USA
| | | | - Aades Saluja
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marino A Bruce
- Department of Behavioral and Social Sciences, University of Houston, Tilman J. Fertitta Family College of Medicine, Houston, TX, USA
| | - Tom A Elasy
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Derek M Griffith
- Department of Health Management & Policy, School of Health, Georgetown University, Washington, DC, USA
- Center for Men’s Health Equity, Racial Justice Institute, Georgetown University, Washington, DC, USA
| | - Keith C Norris
- Division of General Internal Medicine & Health Services Research, UCLA, Los Angeles, CA, USA
| | - Kerri L Cavanaugh
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ebele M Umeukeje
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
- Correspondence: Ebele M Umeukeje, Division of Nephrology, Vanderbilt University Medical Center, 1161 21 Avenue MCN S-3223, Nashville, TN, USA, Tel +1 615 936-3283, Fax +1 615 875-5626, Email
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13
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Jones R, Norris KC, McCoy SM, Thorpe RJ, Bruce MA, Heitman E, Beech BM. Association Between Occupational Sitting With High Sensitivity C-Reactive Protein: The Jackson Heart Study. Am J Lifestyle Med 2021. [DOI: 10.1177/15598276211059760] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Modifiable, behavioral risk factors like occupational sitting may contribute to inflammation, an important cardiovascular risk factor. This study evaluated the association of self-reported occupational sitting with changes in c-reactive protein (CRP) and the role of sex. We examined occupational sitting and baseline CRP levels for 2889 African American participants in the Jackson Heart Study. Four multivariable linear regression models were estimated to determine the association of occupational sitting and CRP. Analyses were conducted in 2020. The mean age was 50.8 years and 61% were female. Participants who reported occupational sitting as “often/always” had CRP levels of 4.9±6.8 mg/L, “sometimes” had levels of 4.8±8.1 mg/L, and “never/seldom” had levels of 4.3±6.8 mg/L. In the unadjusted model, “often/always” engaging in occupational sitting was significantly associated with higher levels of CRP when compared to “never/seldom” ( P < .05). This differed by sex with female participants who reported “often/always” occupational sitting had CRP levels of 6.0±7.6 mg/L compared to only 5.1±6.9 mg/L for “never/seldom.” Neither the overall association nor the female-specific association remained statistically significant in the adjusted models. We found an association between occupational sitting and inflammation, measured by CRP. This association varied by sex but did not remain significant after fully adjusting for covariates.
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Affiliation(s)
- Raymond Jones
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Keith C. Norris
- Division of Nephrology, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Stephanie M. McCoy
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Roland J. Thorpe
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marino A. Bruce
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Elizabeth Heitman
- Program in Ethics in Science and Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bettina M. Beech
- Department of Health Systems and Population Health Sciences, University of Houston College of Medicine, Houston, TX, USA
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14
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Beech BM, Dobbins J, Woodard L, Liaw W, Bruce MA. Multisector Partnerships and Service Colocation to Increase Adoption of Influenza Vaccines and Address Food Insecurity. Popul Health Manag 2021; 25:430-432. [PMID: 34882018 DOI: 10.1089/pop.2021.0295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Bettina M Beech
- Department of Health Systems and Population Health Science, University of Houston, Houston, Texas, USA
| | | | - LeChauncy Woodard
- Department of Health Systems and Population Health Science, University of Houston, Houston, Texas, USA.,Humana Integrated Health System Sciences Institute, University of Houston, Houston, Texas, USA
| | - Winston Liaw
- Department of Health Systems and Population Health Science, University of Houston, Houston, Texas, USA
| | - Marino A Bruce
- Department of Health Systems and Population Health Science, University of Houston, Houston, Texas, USA.,Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, University of Houston, Houston, Texas, USA
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15
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Abstract
The purpose of this article is to discuss poverty as a multidimensional factor influencing health. We will also explicate how racism contributes to and perpetuates the economic and financial inequality that diminishes prospects for population health improvement among marginalized racial and ethnic groups. Poverty is one of the most significant challenges for our society in this millennium. Over 40% of the world lives in poverty. The U.S. has one of the highest rates of poverty in the developed world, despite its collective wealth, and the burden falls disproportionately on communities of color. A common narrative for the relatively high prevalence of poverty among marginalized minority communities is predicated on racist notions of racial inferiority and frequent denial of the structural forms of racism and classism that have contributed to public health crises in the United States and across the globe. Importantly, poverty is much more than just a low-income household. It reflects economic well-being, the ability to negotiate society relative to education of an individual, socioeconomic or health status, as well as social exclusion based on institutional policies, practices, and behaviors. Until structural racism and economic injustice can be resolved, the use of evidence-based prevention and early intervention initiatives to mitigate untoward effects of socioeconomic deprivation in communities of color such as the use of social media/culturally concordant health education, social support, such as social networks, primary intervention strategies, and more will be critical to address the persistent racial/ethnic disparities in chronic diseases.
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Affiliation(s)
- Bettina M. Beech
- Department of Health Systems and Population Health Science, University of Houston College of Medicine, Houston, TX, United States
| | - Chandra Ford
- Department of Community Health Sciences, Center for the Study of Racism, Social Justice and Health at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Roland J. Thorpe
- Department of Health, Behavior, and Society, Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Marino A. Bruce
- Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, University of Houston College of Medicine, Houston, TX, United States
| | - Keith C. Norris
- Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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16
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Bruce MA, Thorpe RJ, Teng F, Heitman E, Reneker JC, Norris KC, Beech BM. Social and Behavioral Factors Associated with BMI and Waist Circumference among Adolescents: The Jackson Heart KIDS Pilot Study. Ethn Dis 2021; 31:453-460. [PMID: 34295133 DOI: 10.18865/ed.31.3.453] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background African American children and adolescents make up a disproportionately large segment of those classified as overweight and obese. The purpose of this study was to examine social and behavioral factors associated with accelerated accumulation of weight and adiposity among this group. Methods The data for this cross-sectional study were drawn from the Jackson Heart KIDS Pilot Study - an offspring cohort study comprising 12- to 19-year-old descendants of Jackson Heart Study participants (N=212). Body mass index (BMI) and waist circumference were the outcomes of interest. Daily hassles, fruit and vegetable consumption, physical activity, television watching, parent/grandparent weight status and participant birth weight, age and sex were the independent variables included in the analyses. Results Males and females were equally represented in the study and the mean BMI and waist circumference for adolescents in the study was 25.81±7.78 kg/m2 and 83.91 ± 19.81 cm, respectively. Fully adjusted linear regression models for the total sample produced results indicating that age, television viewing, weight control, and parental weight status were positively associated with BMI and waist circumference, respectively. Findings from sex-stratified models for BMI and waist circumference indicated that the significance of coefficients for age, television viewing, and parent/grandparent weight status varied by sex. Conclusions Knowledge is limited about how sex or gender interact with social and behavioral factors to influence African Americans' health and additional studies are needed to specify how these factors interact to accelerate weight gain and adipose tissue accumulation over the life course.
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Affiliation(s)
- Marino A Bruce
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Department of Behavioral and Social Sciences; University of Houston College of Medicine, University of Houston, Houston, TX.,Program for Research on Men's Health, Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Roland J Thorpe
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Program for Research on Men's Health, Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Fei Teng
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
| | | | - Jennifer C Reneker
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
| | - Keith C Norris
- Program for Research on Men's Health, Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Bettina M Beech
- Program for Research on Men's Health, Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Health Systems and Population Health Sciences; University of Houston College of Medicine, University of Houston, Houston, TX
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17
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Beech BM, Bruce MA, Cohen-Winans S, Harris K, Jones R, Tyrone RS, Thorpe RJ. Weight Misperception among African American Adolescents: The Jackson Heart KIDS Pilot Study. Ethn Dis 2021; 31:461-468. [PMID: 34295134 DOI: 10.18865/ed.31.3.461] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Weight misperception is a common problem among adolescents; however, few studies have examined contributing factors among an exclusively African American population. The purpose of this study was to examine factors associated with weight misperception among 12- to 19-year-old participants in the Jackson Heart KIDS Pilot Study (JHS-KIDS). Methods Data were drawn from JHS-KIDS, a prospective, observational examination of cardiovascular-related risk factors among African American adolescents who were children or grandchildren of participants in the Jackson Heart Study. Adolescent weight misperception - discordance between measured weight status and perceived weight status - was the primary outcome of interest. Self-reported weight control behaviors, parent concerns about adolescents' weight, parent-perceived responsibility for adolescent's weight and daily hassles were the primary independent variables of interest. Results The analytic sample was equally divided by females (n=107) and males (n=105) and one third of study participants (33.5%) had discordance between their actual and perceived weight. Results from fully adjusted sex-stratified modified Poisson regression models indicated that weight behavior control was significant among females (PR = .66, 95%CI:1.20-2.30). Parental concerns about child weight were significant for males. Each additional point increase in the parent's concern about their weight score was associated with a 9% increase in the adjusted prevalence of weight misperception among males (95%CI: 1.03-1.16). Conclusions The sex-specific patterns in this study highlight heterogeneity among African American adolescents and an urgent need to consider sex and gender when developing targeted interventions for youth who are at high risk for weight misperceptions and unhealthy weight control practices.
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Affiliation(s)
- Bettina M Beech
- Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston, Houston, TX.,Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, College of Medicine, University of Houston, Houston, TX
| | - Marino A Bruce
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, College of Medicine, University of Houston, Houston, TX.,Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
| | - Samantha Cohen-Winans
- Department of Health, Exercise Science and Recreation Management, University of Mississippi, Oxford, MS
| | - Kisa Harris
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
| | - Raymond Jones
- School of Medicine, University of Alabama-Birmingham, Birmingham, AL
| | - Rachel S Tyrone
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
| | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, College of Medicine, University of Houston, Houston, TX.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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18
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Bruce MA, Bowie JV, Barge H, Beech BM, LaVeist TA, Howard DL, Thorpe RJ. Religious Coping and Quality of Life Among Black and White Men With Prostate Cancer. Cancer Control 2021; 27:1073274820936288. [PMID: 32638611 PMCID: PMC7346696 DOI: 10.1177/1073274820936288] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 11/29/2022] Open
Abstract
Prostate cancer is a significant impediment in men’s lives as this condition often exacerbates stress and reduces quality of life. Faith can be a resource through which men cope with health crises; however, few studies examine how religion or spirituality can have implications for racial disparities in health outcomes among men. The purpose of this study is to assess the associations between religious coping and quality of life among black and white men with prostate cancer. Data for this investigation were drawn from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 624 black and white men with complete information on the primary outcome and predictor variables. The primary outcome for this study was overall quality of life as measured by the Functional Assessment of Cancer Therapy-Prostate questionnaire. The main independent variable was religious coping measured by 2 subscales capturing positive and negative forms of coping. Black men in the study had lower overall quality of life scores (134.6 ± 19.6) than their white peers (139.8 ± 14.1). Black men in the sample also had higher average positive religious coping scores (12.9 ± 3.3) than white men (10.3 ± 4.5). Fully adjusted linear regression models of the total sample produced results indicating that positive religious coping was correlated with an increase in quality of life (β = .38, standard error [SE] = 0.18, P < .05). Negative religious coping was associated with a reduction in quality of life (β = −1.48, SE = 0.40, P < .001). Faith-oriented beliefs or perceptions can have implications for quality of life among men with prostate cancer. Sensitivity to the role of religion, spirituality, and faith should be seen by providers of health care as potential opportunities for improved outcomes in patients with prostate cancer and survivors.
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Affiliation(s)
- Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Janice V Bowie
- Hopkins Center for Health Disparities Solutions, Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Haley Barge
- Franklin and Marshall University, Lancaster, PA, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bettina M Beech
- Department of Health Systems and Population Health Sciences, University of Houston College of Medicine, University of Houston, Houston, TX, USA
| | | | - Daniel L Howard
- Department of Psychological and Brain Sciences, Diversity Science Research Cluster, Texas A&M University, College Station, TX, USA
| | - Roland J Thorpe
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Hopkins Center for Health Disparities Solutions, Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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19
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Bruce MA, Bowie JV, Beech BM, Norris KC, LaVeist TA, Howard DL, Thorpe RJ. Church Attendance and Mobility Limitation Among Black and White Men With Prostate Cancer. Am J Mens Health 2021; 15:1557988321993560. [PMID: 33576283 PMCID: PMC7883168 DOI: 10.1177/1557988321993560] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer is a significant impediment that can reduce physical functional status. Mobility is fundamental for quality of life and church attendance to be associated with improved physical functioning. Few studies have examined how religious participation have implications for mobility limitation among men in general and among prostate cancer survivors in particular. The purpose of this study was to assess the association between church attendance and mobility limitation among Black and White prostate cancer patients and survivors. Data for this investigation were drawn from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 804 Black and White men with complete information on the primary outcome and predictor variables. Mobility limitation was the primary outcome variable, and church attendance was the main independent variable. The analytic sample was almost equally divided between Black (N = 382) and White men (N = 422). The proportion of Black men reporting mobility limitation (30.09%) more than doubled the corresponding percentage for White men (14.7%). Black men had a higher proportion of individuals who reported weekly church attendance (49.2% vs. 45.0%). Fully adjusted modified Poisson regression models produced results indicating that respondents attending church weekly had a lower mobility limitation prevalence (PR = 0.56, 95% CI [0.39, 0.81]) than those never attending church. Results from this study contribute to the body of evidence asserting the health benefits of church attendance. These findings suggest that health providers should consider how religion and spirituality can present opportunities for improved outcomes in prostate cancer patients and survivors.
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Affiliation(s)
- Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Behavioral and Social Sciences, Univeristy of Houston College of Medicine, University of Houston, Houston, TX, USA
| | - Janice V Bowie
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Department of Health Behavior and Society, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bettina M Beech
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Health Systems and Population Health Sciences, University of Houston College of Medicine, University of Houston, Houston, TX, USA
| | - Keith C Norris
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | | | - Daniel L Howard
- Department of Psychological and Brain Sciences, Diversity Science Research Cluster, Texas A&M University, College Station, TX, USA
| | - Roland J Thorpe
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Health Behavior and Society, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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20
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Golestaneh L, Karaboyas A, Cavanaugh K, Umeukeje EM, Johns TS, Thorpe RJ, Bruce MA, Griffith DM, Melamed ML, Norris KC. The Role of Place in Disparities Affecting Black Men Receiving Hemodialysis. Kidney Int Rep 2021; 6:357-365. [PMID: 33615061 PMCID: PMC7879205 DOI: 10.1016/j.ekir.2020.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/21/2020] [Accepted: 10/13/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Black men are over-represented in the end stage kidney disease population and are at disproportionate risk of unfavorable outcomes. There is a paucity of investigation to elucidate the mediators of this risk. This study attempts to identify residential community attributes as a possible contributor. METHODS A post-hoc analysis of prospectively collected data from a cohort of Black men enrolled in the US Dialysis Outcomes and Practice Patterns Study (DOPPS), 2010--2015, linked to the American Community Survey, by dialysis facility zip codes was undertaken. The exposure variable was the dialysis facility community composition as defined by percent Black residents. Negative binomial regression was used to estimate incidence rate ratio (IRR) of hospitalization (first outcome) for Black men in crude and adjusted models. Similarly, Cox proportional hazards modeling was used to estimate mortality (second outcome) for Black men by type of community. RESULTS A total of 702 Black men receiving chronic hemodialysis were included in the study. Black men receiving hemodialysis in communities with greater proportions of Black residents had lower Charlson scores and fewer comorbidities, but a higher rate of hypertension. They had equivalent adherence to dialysis treatments, but a lower rate of arteriovenous fistula use and fewer dialysis minutes prescribed. Black men receiving dialysis in communities with a greater proportion of Black residents (per 10% increase) had higher adjusted hospitalization rates (IRR 1.09, 95% confidence interval [CI] 1.00-1.19) and mortality (hazard ratio [HR] 1.29, 95% CI 1.05-1.59). CONCLUSIONS This study supports the unique role of residential community as a risk factor for Black men with end stage kidney disease, showing higher hospitalization and mortality in those treating in Black versus non-Black communities, despite equivalent adherence and fewer comorbidities.
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Affiliation(s)
- Ladan Golestaneh
- Division of Nephrology, Department of Medicine Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Angelo Karaboyas
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Kerri Cavanaugh
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Tanya S. Johns
- Division of Nephrology, Department of Medicine Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Roland J. Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marino A. Bruce
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Derek M. Griffith
- Center for Research on Men’s Health, Vanderbilt University, Nashville, Tennessee, USA
| | - Michal L. Melamed
- Division of Nephrology, Department of Medicine Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Keith C. Norris
- Division of General Internal Medicine and Nephrology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
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21
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Nair D, Bonnet K, Wild MG, Umeukeje EM, Fissell RB, Faulkner ML, Bahri NS, Bruce MA, Schlundt DG, Wallston KA, Cavanaugh KL. Psychological Adaptation to Serious Illness: A Qualitative Study of Culturally Diverse Patients With Advanced Chronic Kidney Disease. J Pain Symptom Manage 2021; 61:32-41.e2. [PMID: 32711122 PMCID: PMC7770006 DOI: 10.1016/j.jpainsymman.2020.07.014] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 12/27/2022]
Abstract
CONTEXT Psychological distress is associated with adverse health outcomes in serious illness and magnified among patients of low socioeconomic status. Aspects of one's culture, such as religion and spirituality, can influence these patients' coping response to distress. Advanced chronic kidney disease (CKD) is a serious illness that disproportionately affects patients of low socioeconomic status, but a theory-based understanding of this group's lived experience of CKD is lacking. OBJECTIVES We explored the cognitions, emotions, and coping behaviors of patients with CKD with emphasis on those of low socioeconomic status. We further inquired into any influences of religion or spirituality. METHODS We interviewed 50 English-speaking or Spanish-speaking adults with advanced CKD from three medical centers in Nashville, Tennessee. Analyses occurred with isolation of themes; development of a coding system; and creation of a conceptual framework using an inductive-deductive approach. RESULTS Median age was 65 years; median annual income was $17,500 per year; and 48% of participants had not progressed beyond high school. Key beliefs (awareness of mortality and lack of control) influenced patients' emotions (existential distress in the form of death anxiety, prognostic uncertainty, and hopelessness) and coping behaviors (acceptance, avoidance, emotion regulation via spirituality, and seeking socialsupport via a religious community). CONCLUSION Individuals with advanced CKD and low socioeconomic status lack control over disease progression, experience death anxiety and existential distress, and emphasize spirituality to cope. Our study identifies novel components for a psychotherapeutic intervention for patients with advanced CKD at high risk for adverse health outcomes.
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Affiliation(s)
- Devika Nair
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA.
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Marcus G Wild
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Ebele M Umeukeje
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA
| | - Rachel B Fissell
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA
| | | | - Nader S Bahri
- Division of Nephrology, Meharry Medical College, Nashville, Tennessee, USA
| | - Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Population Health, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA; Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David G Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Kenneth A Wallston
- Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kerri L Cavanaugh
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee, USA; Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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22
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Thorpe RJ, Cobb R, King K, Bruce MA, Archibald P, Jones HP, Norris KC, Whitfield KE, Hudson D. The Association Between Depressive Symptoms and Accumulation of Stress Among Black Men in the Health and Retirement Study. Innov Aging 2020; 4:igaa047. [PMID: 33354627 PMCID: PMC7737789 DOI: 10.1093/geroni/igaa047] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men. RESEARCH DESIGN AND METHODS This project used the 2010 and 2012 wave of the Health and Retirement Study enhanced face-to-face interview that included a biomarker assessment and psychosocial questionnaire. Depressive symptoms, assessed by the endorsement of 3 or more symptoms on the Center for Epidemiological Studies-Depression 8-item scale, was the outcome variable. The main independent variable, AL, score was calculated by summing the number values that were in the high range for that particular biomarker value scores ranging from 0 to 7. black men whose AL score was 3 or greater were considered to be in the high AL group. Modified Poisson regression was used to estimate prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs). RESULTS There was a larger proportion of black men in the high AL group who reported depressive symptoms (30.0% vs. 20.0%) compared with black men in the low AL group. After adjusting for age, education, income, drinking, and smoking status, the prevalence of reporting 3 or more depressive symptoms was statistically significant among black men in the high AL group (PR = 1.61 [95% CI: 1.20-2.17]) than black men in the low AL group. DISCUSSION AND IMPLICATIONS Exposure to chronic stress is related to reporting 3 or more depressive symptoms among black men after controlling for potential confounders. Improving the social and economic conditions for which black men work, play, and pray is key to reducing stress, thereby potentially leading to the reporting of fewer depressive symptoms.
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Affiliation(s)
- Roland J Thorpe
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ryon Cobb
- Department of Sociology, University of Georgia, Athens
| | - Keyonna King
- Department of Health Promotion, University of Nebraska Medical Center, Omaha
| | - Marino A Bruce
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson
| | - Paul Archibald
- Department of Social Work, College of Staten Island, The City University of New York
| | - Harlan P Jones
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth
| | - Keith C Norris
- Department of Medicine, University of California, Los Angeles
| | | | - Darrell Hudson
- Brown School at Washington University in St. Louis, Missouri
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23
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Blumrosen C, Desta R, Cavanaugh KL, Laferriere HE, Bruce MA, Norris KC, Griffith DM, Umeukeje EM. Interventions Incorporating Therapeutic Alliance to Improve Hemodialysis Treatment Adherence in Black Patients with End-Stage Kidney Disease (ESKD) in the United States: A Systematic Review. Patient Prefer Adherence 2020; 14:1435-1444. [PMID: 32884245 PMCID: PMC7443008 DOI: 10.2147/ppa.s260684] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/10/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In the US, Blacks with end-stage kidney disease (ESKD) have a four-fold higher prevalence rate of hemodialysis treatment and higher subsequent rates of hemodialysis treatment nonadherence and hospitalization compared to their White peers. Nonadherence to prescribed dialysis therapy is an underestimated life-threatening behavior, because of its association with increased morbidity and mortality. Few studies have specified and systematically evaluated targeted methods of increasing hemodialysis treatment adherence among Black hemodialysis patients with added focus on therapeutic alliance, a rewarding patient-centered relationship between patients and providers, based on common goals and objectives. This review seeks to evaluate the state of the science to determine the salience of a therapeutic alliance for the development of effective interventions positively impacting hemodialysis treatment adherence among Black patients. METHODS Medline (via PubMed), Embase (OvidSP), Cumulative Index of Nursing and Allied Health Literature (CINAHL; EBSCOhost), and PsycInfo (ProQuest) databases were used to search for abstracts with the keywords "dialysis", "therapeutic alliance", and "treatment adherence and compliance", including all underlying index terms and alternative variations of terms, in order to cover the entire scope of the field. Only randomized clinical trials and pre/postintervention studies published in the previous 10 years (2009-2019) and including a proportion of Black patients >25% were included for review. RESULTS Only three intervention studies met these criteria, for a total aggregated sample of 130 - mean age 58.1 years and 53% female. None of these studies was composed exclusively of Black patients (range 62%-91.3%), nor did they present data specifically for Blacks. Despite the lack of robust data informing strategies to improve hemodialysis adherence among Blacks with ESRD, a limited number of intervention studies have reported positive effects on hemodialysis attendance. DISCUSSION/CONCLUSION Further research is warranted to fill this significant gap in our understanding of theoretically based, therapeutic alliance-enhanced, and culturally tailored hemodialysis treatment-adherence interventions among Blacks.
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Affiliation(s)
| | | | - Kerri L Cavanaugh
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Heather E Laferriere
- Eskind Biomedical Library, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marino A Bruce
- Department of Population Health Science, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Keith C Norris
- Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USA
| | - Derek M Griffith
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN, USA
| | - Ebele M Umeukeje
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
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24
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Ward LM, Pendergrass DB, Chima CC, Thorpe RJ, Bruce MA, Blackburn HF, Palombo CF, Beech BM. Access to medications among adults with type 2 diabetes using pharmacy- or clinic-based medication assistance programs: A systematic review. J Am Pharm Assoc (2003) 2020; 60:e411-e421. [PMID: 32778516 DOI: 10.1016/j.japh.2020.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this systematic review was to assess the literature regarding access to, and utilization of medication for type 2 diabetes (T2D) and pre-post improvements in diabetes outcomes for adults enrolled in clinic- or pharmacy-based medication assistance programs. DATA SOURCES The databases searched were PubMed, CINAHL, Scopus, Embase, Ovid HealthSTAR, PapersFirst, and OpenGrey. STUDY SELECTION Databases were searched from the beginning of each database to Feburary 29, 2020. Articles were included if (1) the population of interest was adults 18 years of age or older with a T2D diagnosis, (2) the study addressed access to medication for diabetes patients in a clinic- or pharmacy-based setting, and (3) the study was conducted in the United States. DATA EXTRACTION Data extracted from the selected studies included location of study, patient inclusion criteria, sample size, medication assistance program description, and reported diabetes medication access and medication related adherence outcomes. RESULTS Eleven articles met the inclusion criteria for the study. The mean reduction in glycated hemoglobin level following the use of medication assistance programs ranged from 0.45 to 0.8. Across studies, the mean number of antihyperglycemic medications used by patients in medication assistance programs ranged from 1 to 1.9. Medication adherence was reported at 45% across studies that reported adherence measures. CONCLUSION Among the 11 studies identified that assessed access to medication for adults with T2D using clinic- or pharmacy-based medication assistance programs, study findings indicated that many of these programs showed some positive changes in medication access and diabetes-related outcomes.
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25
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Abstract
Religious institutions have historically been an essential resource in African American communities and can serve as indispensable partners during a public health crisis. The purpose of this perspective is to establish African American churches, mosques, and temples as essential for an immediate, comprehensive, and sustained response to the elevated risk for and spread of COVID-19 among African Americans.
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Affiliation(s)
- Marino A Bruce
- Program for Research on Faith and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
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26
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Affiliation(s)
- Marino A. Bruce
- Program for Research on Faith and Health, Center for Research on Men’s Health, Vanderbilt University, Nashville, Tennessee
- Center for Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee
| | - Keith C. Norris
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Roland J. Thorpe
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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27
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Thorpe RJ, Beech BM, Norris KC, Heitman E, Bruce MA. Writing Accountability Groups Are a Tool for Academic Success: The Obesity Health Disparities PRIDE Program. Ethn Dis 2020; 30:295-304. [PMID: 32346275 DOI: 10.18865/ed.30.2.295] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Introduction The current hypercompetitive extramural funding environment in the United States emphasizes the critical need for effective research training programs that focus not only on grantsmanship, but on skill development across the full range of research activities, culminating in writing research results for publication. Using Writing Accountability Groups (WAG), the National Heart, Lung, and Blood Institute (NHLBI) funded Obesity Health Disparities (OHD) PRIDE is one of the few research training and mentoring programs that places an equal focus on scientific writing and grant writing. This article reports on the utility of WAGs for OHD PRIDE mentees. Method Participants included 14 of 26 individuals who were fellows in the OHD PRIDE research training and mentoring program. A typical WAG has between four and eight members who meet for one hour each week over a 10-week period and commit a priori to attend at least 70% of the sessions. Summary statistics were produced to characterize number of peer-reviewed publications, grants, years in academic rank, and category of current academic rank, barriers to frequency of writing, and duration of writing. Results from pre- and post-WAG surveys were compared to determine the overall impact of the WAG. The study period discussed in this article took place between January and December 2017 and included data from three 10-week cycles beginning in February, May, and September. Results Fifty-three percent of OHD PRIDE participants successfully completed at least one 10-week WAG cycle. The WAGs did not have a statistically significant impact on either the frequency of writing or the duration of writing. However, the majority of the participants who successfully completed at least one WAG cycle reported that they either maintained or increased their frequency or duration of writing. Conclusion By providing a structured approach to developing and/or enhancing a practice of consistent writing, time management skills, and collaborative relationships, the WAG has promise for enhancing scientific writing skills for many trainees and early-career faculty. Longer term follow-up is needed to more fully assess the potential impact of WAGs.
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Affiliation(s)
- Roland J Thorpe
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS
| | - Bettina M Beech
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS
| | - Keith C Norris
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS.,David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Elizabeth Heitman
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,University of Texas Southwestern Medical Center, Dallas, TX
| | - Marino A Bruce
- Center for Research on Men's Health and Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN
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28
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Yeh VM, Bergner EM, Bruce MA, Kripalani S, Mitrani VB, Ogunsola TA, Wilkins CH, Griffith DM. Can Precision Medicine Actually Help People Like Me? African American and Hispanic Perspectives on the Benefits and Barriers of Precision Medicine. Ethn Dis 2020; 30:149-158. [PMID: 32269456 DOI: 10.18865/ed.30.s1.149] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective To better understand African American and Hispanic perspectives on the potential benefits of precision medicine, along with the potential barriers that may prevent precision medicine from being equally beneficial to all. We also sought to identify if there were differences between African American and Hispanic perspectives. Design Six semi-structured focus groups were conducted between May 2017 and February 2018 to identify benefits and barriers to precision medicine. Three groups occurred in Nashville, TN with African American participants and three groups occurred in Miami, FL with Hispanic participants. Setting At community-based and university sites convenient to community partners and participants. Participants A total of 55 individuals participated (27 in Nashville, 28 in Miami). The majority of participants were women (76.5%) and the mean age of participants was 56.2 years old. Results Both African Americans and Hispanics believed precision medicine has the potential to improve medicine and health outcomes by individualizing care and decreasing medical uncertainty. However, both groups were concerned that inadequacies in health care institutions and socioeconomic barriers would prevent their communities from receiving the full benefits of precision medicine. African Americans were also concerned that the genetic and non-genetic personal information revealed through precision medicine would make African Americans further vulnerable to provider racism and discrimination in and outside of health care. Conclusions While these groups believed precision medicine might yield benefits for health outcomes, they are also skeptical about whether African Americans and Hispanics would actually benefit from precision medicine given current structural limitations and disparities in health care access and quality.
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Affiliation(s)
- Vivian M Yeh
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN
| | - Erin M Bergner
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN
| | - Marino A Bruce
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN.,Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN
| | - Sunil Kripalani
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN.,Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Victoria B Mitrani
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL
| | | | - Consuelo H Wilkins
- Department of Internal Medicine, Meharry Medical College, Nashville, TN.,Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN.,Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN.,Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN
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29
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Thorpe RJ, Bruce MA, Howard DL, LaVeist TA. Race differences in mobility status among prostate cancer survivors: The role of socioeconomic status. Adv Cancer Res 2020; 146:103-114. [PMID: 32241385 DOI: 10.1016/bs.acr.2020.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The objective of this paper was to determine whether there were any race differences in mobility limitation among PCa survivors, and understand the impact of socioeconomic status (SES) on this relationship. Data consisted of 661 PCa survivors (296 Black and 365 White) from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes (DAD) Study. Mobility limitation was defined as PCa survivors who reported difficulty walking a quarter mile or up 1 flight of stairs. Race was based on the PCa survivors self-identification of either White or Black. SES consisted of education level (i.e., less than high school, high school/GED, some college/associate, bachelors, masters/PhD) and annual household income (i.e., less than $50,000; $50,000-$100,000; greater than $100,000). Adjusting for age, marital status, health insurance, Gleason Score, treatment received, and time to treatment, Black PCa survivors had a higher prevalence of mobility limitation (PR=1.58, 95% CI: 1.17-2.15) relative to White PCa survivors. When adding education and income to the adjusted model, Black PCa survivors had a similar prevalence of mobility limitation (PR=1.12, 95% CI: 0.80-1.56) as White PCa survivors. The unequal distribution of SES resources between Black and White PCa survivors accounted for the observed race differences in mobility limitation. This work emphasizes the importance of SES in understanding race differences in mobility among PCa survivors.
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Affiliation(s)
- Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Marino A Bruce
- Program for Research on Faith and Health, Center for Research on Men's Health, Vanderbilt University, Nashville, TN, United States
| | - Daniel L Howard
- Public Policy Research Institute and Department of Sociology, Texas A&M University, College Station, TX, United States
| | - Thomas A LaVeist
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Health Policy and Management, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
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30
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Bruce MA, Beech BM, Wilder T, Burton ET, Sheats JL, Norris KC, Thorpe RJ. Religiosity and Excess Weight Among African-American Adolescents: The Jackson Heart KIDS Study. J Relig Health 2020; 59:223-233. [PMID: 30649707 PMCID: PMC8559570 DOI: 10.1007/s10943-019-00762-5] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent studies suggest that religion and spirituality can yield health benefits for young African-Americans. We examined the relationship between religious practices, spirituality, and excess weight among African-American adolescents (N = 212) residing in the Deep South. Results from modified Poisson regression analysis indicate that adolescents who prayed daily had a lower prevalence of excess weight (PR 0.77 [95% CI 0.62-0.96]) than those who did not. This relationship was only significant for 12-15 year-old participants in age-stratified analysis. These findings suggest that preventive interventions offered to children and younger adolescents can have implications for weight status across the lifespan.
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Affiliation(s)
- Marino A Bruce
- Program for Research on Faith and Health, Center for Research on Men's Health, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN, 37235-1665, USA.
- Center for Medicine, Health and Society, Vanderbilt University, Nashville, TN, USA.
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA.
| | - Bettina M Beech
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
| | - Tanganyika Wilder
- Department of Biological Sciences, Florida A&M University, Tallahassee, FL, USA
| | - E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Jylana L Sheats
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Keith C Norris
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
- David C. Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Roland J Thorpe
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Beech BM, Norris KC, Thorpe RJ, Heitman E, Bruce MA. Conversation Cafés and Conceptual Framework Formation for Research Training and Mentoring of Underrepresented Faculty at Historically Black Colleges and Universities: Obesity Health Disparities (OHD) PRIDE Program. Ethn Dis 2020; 30:83-90. [PMID: 31969787 DOI: 10.18865/ed.30.1.83] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The development of research training opportunities for investigators from the untapped pool of traditionally underrepresented racial/ethnic groups has gained intense interest at the National Institutes of Health (NIH). The significant and persistent disparity in the likelihood of R01 funding between African American and Whites was highlighted in the groundbreaking 2011 report, Race, Ethnicity, and NIH Research Awards. Disparities in funding success were also shown to exist at the institutional level, as 30 institutions receive a disproportionate share of federal research funding. Historically Black Colleges and Universities (HBCUs) have a dual commitment to education and research; however, the teaching loads at HBCUs may present challenges for research-oriented faculty. Few research training and mentoring programs have been specifically designed for this group. During 2015 and 2016, we held three conversation cafés with 77 participants in Jackson, Mississippi and Baltimore, Maryland. The purpose of this article is to describe findings from these conversation cafés regarding barriers and facilitators to building robust research careers at HBCUs, and to illustrate how these data were used to adapt the conceptual framework for the NHLBI-funded Obesity Health Disparities (OHD) PRIDE program. Identified barriers included teaching and advising loads, infrastructures, and lack of research mentors on campus. The benefit of incorporating research into classroom teaching was a noted facilitator.
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Affiliation(s)
- Bettina M Beech
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS
| | - Keith C Norris
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS.,David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Roland J Thorpe
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS.,Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Elizabeth Heitman
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS.,University of Texas Southwestern Medical Center, Houston, TX
| | - Marino A Bruce
- Program for Research on Faith and Health, Center for Research on Men's Health and Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN
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Burns PA, Williams MS, Mena LA, Bruce MA, Bender M, Burton ET, Beech BM. Leveraging Community Engagement: The Role of Community-Based Organizations in Reducing New HIV Infections Among Black Men Who Have Sex with Men. J Racial Ethn Health Disparities 2020; 7:193-201. [PMID: 31942692 DOI: 10.1007/s40615-019-00691-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 09/08/2019] [Revised: 12/17/2019] [Accepted: 12/27/2019] [Indexed: 12/16/2022]
Abstract
There is growing recognition that a singular focus on biomedical treatments is insufficient to address the HIV prevention and health-care needs of Black men who have sex with men (Black MSM). Ending the HIV epidemic requires a multifactorial approach accounting for the social, cultural, economic, and environmental factors that drive transmission of HIV and other STDs. The two case studies presented were implemented by community-based organizations that have extensive experience with the target population and previous experience implementing HIV prevention-related programs and projects in the Jackson, Mississippi, metropolitan area. Culturally appropriate HIV prevention interventions that explicitly acknowledge the social determinants of health, particularly stigma and discrimination, both racial and sexual, are critical to reducing the number of new infections. These culturally appropriate and locally derived HIV prevention interventions provide a model for HIV health-care providers, public health officials, and community leaders to address the unique needs of Black MSM.
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Affiliation(s)
- Paul A Burns
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, USA.
| | - Michelle S Williams
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, USA
| | - Leandro A Mena
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, USA
| | - Marino A Bruce
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Melverta Bender
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, USA
| | - E Thomaseo Burton
- Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Bettina M Beech
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, USA
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Chima CC, Bruce MA, Pendergrass DB, Thorpe RJ, Ward LM, Blackburn HF, Palombo CF, Beech BM. Strengthening the U. S. Medication Safety Net by Connecting Abundance to Need. J Health Care Poor Underserved 2020; 31:503-518. [PMID: 33410786 DOI: 10.1353/hpu.2020.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cost-related medication non-adherence (CRN) is a major population health concern in the United States, especially for patients with chronic conditions. It is associated with disease progression and increases the likelihood of emergency department utilization and hospitalization, thereby increasing overall health care expenditures. In this paper, we describe the prescription medication safety net in the United States and assess its reliability. We also introduce Dispensary of Hope (DoH), a charitable medication distribution network, as a reliable medication access program that is capable of filling gaps in medication coverage for low-income and uninsured Americans. Our critical assessment of the medication safety net in the United States suggests that an expansion of DoH could reduce CRN in the United States, improve chronic illness care, and help health systems achieve the triple aim of improving patient experiences and population health while reducing cost.
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Abstract
There is growing recognition that the genomic and precision medicine revolution in health care can deepen health disparities. This has produced urgent calls to prioritize inclusion of historically underrepresented populations in research and to make genomic databases more inclusive. Answering the call to address health care disparities in the delivery of genomic and precision medicine requires a consideration of important, yet understudied, legal issues that have blocked progress. This article introduces a special issue of Ethnicity & Disease which contains a series of articles that grew out of a public conference to investigate these legal issues and propose solutions. This 2018 conference at Meharry Medical College was part of an NIH-funded project on "LawSeqSM" to evaluate and improve the law of genomics in order to support appropriate integration of genomics into clinical care. This conference was composed of presentations and interactive sessions designed to specify the top legal barriers to health equity in precision medicine and stimulate potential solutions. This article synthesizes the results of those discussions. Multiple legal barriers limit broad inclusion in genomic research and the development of precision medicine to advance health equity. Problems include inadequate privacy and anti-discrimination protections for research participants, lack of health coverage and funding for follow-up care, failure to use law to ensure access to genomic medicine, and practices by research sponsors that tolerate and entrench disparities. Analysis of the legal barriers to health equity in precision medicine is essential for progress. Progressive use of law is vital to avoid worsening of health care disparities.
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Affiliation(s)
- Susan M. Wolf
- Consortium on Law and Values in Health, Environment & the Life Sciences; Law School; Medical School, University of Minnesota, Minneapolis, MN
| | - Vence L. Bonham
- Social and Behavioral Research Branch, Division of Intramural Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
| | - Marino A. Bruce
- Program for Research on Faith and Health, Vanderbilt Center for Research on Men’s Health, Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN
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Bruce MA, Thorpe RJ. STRESS, FAITH, AND HEALTH AMONG BLACK MEN IN MIDDLE AND LATE LIFE. Innov Aging 2019. [PMCID: PMC6846464 DOI: 10.1093/geroni/igz038.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
African American men experience extremely high levels of social and psychological stress from unfavorable social and economic circumstances emerging from institutional discrimination and unfair treatment. Stress has been linked to disproportionate risks for illness, disease and premature mortality among this population. But, few studies have examined how African American men manage or cope with stress, and even fewer have assessed how their coping responses have implications for their health. Faith has been considered a stress coping strategy and a growing number of studies explore how religiosity and spirituality have implications for health outcomes. No studies to our knowledge have examined how faith impacts stress and its influence on the health among African American men. The purpose of this chapter is to demonstrate how faith has implications for socio-biologic interactions associated with elevated risk for disease and premature death among this marginalized population.
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Affiliation(s)
- Marino A Bruce
- Vanderbilt University, Nashville, Tennessee, United States
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
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Abstract
Although Black-White disparities in health and mortality among men persist, there is a paucity of work focusing on race differences in physiological dysregulation of biological processes resulting from the cumulative impact of stressors among men. The purpose of this study was to assess potential race differences in Allostatic Load (AL) among adult men and if such differences vary by age. Data were drawn from the 1999-2010 NHANES, and the study population included 2700 non-Hispanic Black (NHB) and 19930 Non-Hispanic White (NHW) born in US. AL was derived by summing across cardiovascular, metabolic, and inflammatory biomarkers considered to be high risk, resulting in a count variable ranging from 0 to 9. Race was based on self-report. Age was categorized: 18-24, 25-44, 45-64, and 65 years and older. Negative binomial regression was used to examine the relationship between race and AL score. Models included education, marital status, family income, health insurance and self-reported health. Adjusting for potential confounders, NHB men had a higher AL score ((incidence rate ratio (IRR) = 1.06, 95% confidence interval (CI) 1.01, 1.11) than NHW men. NHB men 25-44 years old had a higher AL score than (IRR = 1.14, 95% CI;1.04, 1.24) than their NHW peers. No race differences with respect to AL score were observed among the other age groups. Race differences in AL vary by age categories. Efforts to improve longevity should focus on developing age-tailored health promoting strategies to reduce stress among Black men during early adulthood.
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Affiliation(s)
- Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Hossein Zare
- Sr. Programmer, JHU, Baltimore, Maryland, United States
| | - Paul Archibald
- Morgan State University, Baltimore, Maryland, United States
| | - Marino A Bruce
- Vanderbilt University, Nashville, Tennessee, United States
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Griffith DM, Cornish EK, Bergner EM, Bruce MA, Beech BM. "Health is the Ability to Manage Yourself Without Help": How Older African American Men Define Health and Successful Aging. J Gerontol B Psychol Sci Soc Sci 2019; 73:240-247. [PMID: 28977532 DOI: 10.1093/geronb/gbx075] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 09/29/2016] [Accepted: 05/23/2017] [Indexed: 11/13/2022] Open
Abstract
Objective Few studies have explored how older African American men understand the relationship between health and successful aging. The goal of this study was to examine how older African American men's conceptions and definitions of health and notions of successful aging are interrelated. Method Using data from 22 semistructured individual interviews with African American men ages 55-76, we examine how cultural and normative ideals about health map onto the core components of Rowe and Kahn's (1997) definition of successful aging. We also explore how these notions influence factors that have implications for health. Results Consistent with prior research, we found that older African American men operationalized notions of health in ways that mapped onto three elements of successful aging: (a) the absence of disease and disability, (b) the ability to maintain physical and cognitive functioning, and (c) meaningful social engagement in life. A fourth theme, what men actually do, emerged to highlight how regular health practices were key components of how men define health. Conclusions These findings highlight key elements of how older African American men conceptualize health in ways that are interrelated with yet expand notions of successful aging in ways that are critical for health promotion research and interventions.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health.,Center for Medicine, Health and Society, Vanderbilt University, Nashville, Tennessee
| | | | | | - Marino A Bruce
- Center for Research on Men's Health.,Center for Medicine, Health and Society, Vanderbilt University, Nashville, Tennessee
| | - Bettina M Beech
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, Jackson, Mississippi.,John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson
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Bruce MA, Norris KC, Beech BM, Bowie JV, Thorpe RJ. Perspective: A Call for Precision in Faith-based Initiatives Promoting Health among African Americans. Ethn Dis 2019; 29:17-20. [PMID: 30713411 DOI: 10.18865/ed.29.1.17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Ethn Dis. 2019;29(1):17-20; doi:10.18865/ed.29.1.17
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Affiliation(s)
- Marino A Bruce
- Program for Research on Faith and Health, Center for Research on Men's Health, Vanderbilt University.,Center for Medicine, Health and Society, Vanderbilt University.,Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center
| | - Keith C Norris
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center.,David Geffen School of Medicine at UCLA
| | - Bettina M Beech
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center
| | - Janice V Bowie
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health
| | - Roland J Thorpe
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health
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Ward LM, Bruce MA, Thorpe RJ, Mena L, Nunn A, Crosby R. Correlates Associated With Willingness to Start Pre-exposure Prophylaxis Among Young Black Men Who Have Sex With Men (MSM) in Jackson, Mississippi. Fam Community Health 2019; 42:189-196. [PMID: 31107729 DOI: 10.1097/fch.0000000000000225] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Black men who have sex with men have the greatest risk for human immunodeficiency virus infection. Pre-exposure prophylaxis (PrEP) is a highly effective prevention method. However, uptake in this group is extremely low. Data from a sample of 225 human immunodeficiency virus-negative young black men who have sex with men residing in Jackson, Mississippi, were analyzed to examine correlates associated with willingness to start PrEP. Consistent condom users for both insertive and receptive sex were more likely to be willing to start PrEP than inconsistent condom users. Heterogeneity among this high-risk population is an important consideration for future studies assessing PrEP uptake and evaluating prevention efforts.
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Affiliation(s)
- Lori M Ward
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson (Drs Ward, Bruce, Thorpe, and Mena); Program for Research on Faith and Health, Center for Research on Men's Health, and Center for Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee (Dr Bruce); Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, and Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Thorpe); Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson (Dr Mena); Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island (Dr Nunn); and Department of Health Behavior, College of Public Health, University of Kentucky, Lexington (Dr Crosby)
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Burton ET, Wilder T, Beech BM, Bruce MA. Associations Among Caregiver Feeding Practices and Blood Pressure in African American Adolescents: The Jackson Heart KIDS Study. Fam Community Health 2019; 42:133-139. [PMID: 30768478 PMCID: PMC6383774 DOI: 10.1097/fch.0000000000000215] [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: 06/09/2023]
Abstract
Caregiver feeding practices have been linked to youth health outcomes. The present study examined associations among caregiver feeding practices and blood pressure in 212 African American adolescents via the Child Feeding Practices Questionnaire. Results revealed a positive association between caregivers' concern about their child's weight and diastolic blood pressure, which was more acute for older adolescent boys. Caregivers' perceived responsibility for the quality and quantity of food their child receives was also associated with lower diastolic blood pressure in older adolescent boys. Feeding practices are ideal targets of lifestyle intervention, and health care providers should continue to involve caregivers as adolescents approach adulthood.
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Affiliation(s)
- E. Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
- Children’s Foundation Research Institute, Le Bonheur Children’s Hospital, Memphis, TN
| | - Tanganyika Wilder
- Department of Biological Sciences, Florida A&M University, Tallahassee, FL
| | - Bettina M. Beech
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS
| | - Marino A. Bruce
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN
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Hartfield JA, Griffith DM, Bruce MA. Gendered Racism is a Key to Explaining and Addressing Police-Involved Shootings of Unarmed Black Men in America. ACTA ACUST UNITED AC 2018. [DOI: 10.1108/s0195-744920180000020008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Williams JR, Yeh VM, Bruce MA, Szetela C, Ukoli F, Wilkins CH, Kripalani S. Precision Medicine: Familiarity, Perceived Health Drivers, and Genetic Testing Considerations Across Health Literacy Levels in a Diverse Sample. J Genet Couns 2018; 28:10.1007/s10897-018-0291-z. [PMID: 30105426 PMCID: PMC6374217 DOI: 10.1007/s10897-018-0291-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 08/06/2018] [Indexed: 01/25/2023]
Abstract
A clear awareness of a patient's knowledge, values, and perspectives is an important component of effective genetic counseling. Advances in precision medicine, however, have outpaced our understanding of patient perceptions of this new approach. Patient views may differ across the three domains of precision medicine (genetics, behavioral, and environmental determinants of health), ethnic/racial groups, and health literacy levels. This study describes and compares group differences in familiarity, perceptions, and preferences for precision medicine in a diverse sample. Between 2016 and 2017, 252 participants completed a 10-15-min survey in three primary care clinics in Florida and Tennessee. The final sample was 42.5% African American/Black, 25.8% Hispanic/Latino, 25.0% White, and 6.7% other ethnicity/race. Less than a quarter of participants reported being familiar with the term "precision medicine," but were more familiar with basic genetic terms. Participants with higher health literacy reported greater familiarity with terms (p ≤ .003). African Americans/Black participants were more likely to identify ethnicity/race and discrimination as influencing their health (p ≤ .004). When deciding to get a genetic test, individuals across ethnic/racial groups shared similar considerations. Those with higher health literacy, however, gave significantly greater importance to provider trust (p ≤ .008). Given the recent emergence of precision medicine, at present there may be limited differences in patient perceptions across ethnic/racial groups. Culturally sensitive efforts, tailored to health literacy level, may aid equitable precision medicine uptake.
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Affiliation(s)
- Jessica R Williams
- School of Nursing, University of North Carolina at Chapel Hill, 5004 Carrington Hall, Campus Box 7460, Chapel Hill, NC, 27599-7460, USA.
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.
| | - Vivian M Yeh
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marino A Bruce
- Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Carolyn Szetela
- Department of Professional and Medical Education, Meharry Medical College, Nashville, TN, USA
| | - Flora Ukoli
- Department of Surgery, Meharry Medical College, Nashville, TN, USA
| | - Consuelo H Wilkins
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Meharry-Vanderbilt Alliance, Nashville, TN, USA
| | - Sunil Kripalani
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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Beech BM, Bruce MA, Thorpe RJ, Heitman E, Griffith DM, Norris KC. Theory-Informed Research Training and Mentoring of Underrepresented Early-Career Faculty at Teaching-Intensive Institutions: The Obesity Health Disparities PRIDE Program. Ethn Dis 2018; 28:115-122. [PMID: 29725196 PMCID: PMC5926854 DOI: 10.18865/ed.28.2.115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Mentoring has been consistently identified as an important element for career advancement in many biomedical and health professional disciplines and has been found to be critical for success and promotion in academic settings. Early-career faculty from groups underrepresented in biomedical research, however, are less likely to have mentors, and in general, receive less mentoring than their majority-group peers, particularly among those employed in teaching-intensive institutions. This article describes Obesity Health Disparities (OHD) PRIDE, a theoretically and conceptually based research training and mentoring program designed for early-career faculty who trained or are employed at Historically Black Colleges and Universities (HBCUs).
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Affiliation(s)
- Bettina M Beech
- John D. Bower School of Population Health, University of Mississippi Medical Center
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center
| | - Marino A Bruce
- John D. Bower School of Population Health, University of Mississippi Medical Center
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center
- Center for Research on Men's Health and Center for Medicine, Health, and Society, Vanderbilt University
| | - Roland J Thorpe
- John D. Bower School of Population Health, University of Mississippi Medical Center
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center
- Program for Research on Men's Health, Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health
| | - Elizabeth Heitman
- John D. Bower School of Population Health, University of Mississippi Medical Center
- University of Texas Southwestern Medical Center
| | - Derek M Griffith
- John D. Bower School of Population Health, University of Mississippi Medical Center
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center
- Center for Research on Men's Health and Center for Medicine, Health, and Society, Vanderbilt University
| | - Keith C Norris
- John D. Bower School of Population Health, University of Mississippi Medical Center
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center
- David Geffen School of Medicine at UCLA
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Bruce MA, Griffith DM, Thorpe RJ. Foreword. Fam Community Health 2018; 41:195-196. [PMID: 30134333 PMCID: PMC9629172 DOI: 10.1097/fch.0000000000000207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Odoms-Young A, Bruce MA. Examining the Impact of Structural Racism on Food Insecurity: Implications for Addressing Racial/Ethnic Disparities. Fam Community Health 2018; 41 Suppl 2 Suppl, Food Insecurity and Obesity:S3-S6. [PMID: 29461310 PMCID: PMC5823283 DOI: 10.1097/fch.0000000000000183] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Food insecurity is defined as "a household-level economic and social condition of limited or uncertain access to adequate food." While, levels of food insecurity in the United States have fluctuated over the past 20 years; disparities in food insecurity rates between people of color and whites have continued to persist. There is growing recognition that discrimination and structural racism are key contributors to disparities in health behaviors and outcomes. Although several promising practices to reduce food insecurity have emerged, approaches that address structural racism and discrimination may have important implications for alleviating racial/ethnic disparities in food insecurity and promoting health equity overall.
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Affiliation(s)
- Angela Odoms-Young
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago (Dr Odoms-Young); and Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee (Dr Bruce)
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Bruce MA, Thorpe RJ, Beech BM, Towns T, Odoms-Young A. Sex, Race, Food Security, and Sugar Consumption Change Efficacy Among Low-Income Parents in an Urban Primary Care Setting. Fam Community Health 2018; 41 Suppl 2 Suppl, Food Insecurity and Obesity:S25-S32. [PMID: 29461313 PMCID: PMC5824648 DOI: 10.1097/fch.0000000000000184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The purpose of this study was to examine relationships between food security and parents' self-efficacy to reduce consumption of sugar-sweetened beverages and sugary snacks in a sample of parents in waiting rooms in community-based primary care clinics in West Tennessee. Results from logistic regression models underscore the need for nuanced analysis, as the results from the pooled regression models differ from those stratified by food security status. Self-efficacy is an important factor for behavior change, and our study highlights the need for additional research examining how social, psychological, and behavioral factors have implications for behavior change self-efficacy.
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Affiliation(s)
| | | | - Bettina M. Beech
- John D. Bower School of Population Health, University of Mississippi Medical Center
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Abstract
Ethn Dis.2017;27(4):363-366; doi:10.18865/ed.27.4.363.
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Affiliation(s)
- Marino A Bruce
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee
| | | | - Keith C Norris
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Bettina M Beech
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi
| | - Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee
| | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Burton ET, Wilder T, Beech BM, Bruce MA. Caregiver feeding practices and weight status among African American adolescents: The Jackson Heart KIDS Pilot Study. Eat Behav 2017; 27:33-38. [PMID: 29127938 PMCID: PMC5709039 DOI: 10.1016/j.eatbeh.2017.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 07/18/2017] [Revised: 11/05/2017] [Accepted: 11/05/2017] [Indexed: 11/20/2022]
Abstract
Adolescence is a stage in the life course during which youth become more autonomous in their health behaviors. Overweight and obesity during this developmental period are associated with short- and long-term physical and emotional morbidity, and African American youth are at pronounced risk for these health outcomes. The style of parenting employed by caregivers influences health behaviors in children, though the persistence of this influence into adolescence is not clear. This study examined associations among caregiver feeding practices, body mass index z-score (zBMI), and waist circumference (WC) in a cohort of 212 African American adolescents (50.5% girls; Mage=15.16years). Participants were children and grandchildren of individuals enrolled in the Jackson Heart Study, a prospective epidemiologic evaluation of cardiovascular disease among African Americans based in Jackson, Mississippi. Youth zBMI and WC were primary outcomes, and caregivers completed the Child Feeding Questionnaire, an assessment of attitudes, beliefs, and practices related to obesity proneness. Regression analyses revealed that while controlling caregiver feeding practices were associated with zBMI and WC, perceived responsibility for the type and amount of food provided to adolescents was not related to weight status. Among younger adolescents, more oversight of their eating practices was related to higher zBMI. Similarly, boys whose intake of unhealthy foods was restricted were more likely to have higher zBMI and WC. Results suggest that caregiver feeding practices continue to be associated with weight status during adolescence, and underscore the importance of culturally and developmentally appropriate prevention and intervention efforts targeting overweight and obesity.
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Affiliation(s)
- E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap Street, Room 452R, Memphis, TN 38103, USA; Children's Foundation Research Institute, Le Bonheur Children's Hospital, 50 N. Dunlap Street, Room 452R, Memphis, TN 38103, USA.
| | - Tanganyika Wilder
- Department of Biological Sciences, Florida A&M University, 1530 Martin Luther King Boulevard JH 514, Tallahassee, FL 32308, USA.
| | - Bettina M Beech
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA.
| | - Marino A Bruce
- Center for Research on Men's Health, Vanderbilt University, 300CC Calhoun Hall, 2301 Vanderbilt Place, Nashville, TN 37235, USA.
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Beech BM, Norris KC, Bruce MA. Aiming for Quality Improvement: Aligning Population Health and Higher Education. Popul Health Manag 2017; 21:255-257. [PMID: 29022769 DOI: 10.1089/pop.2017.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bettina M Beech
- 1 John D. Bower School of Population Health at the University of Mississippi Medical Center , Jackson, Mississippi
| | - Keith C Norris
- 2 David Geffen School of Medicine at UCLA , Los Angeles, California
| | - Marino A Bruce
- 3 Center for Research on Men's Health, Vanderbilt University , Nashville, Tennessee
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Bruce MA, Beech BM, Norris KC, Griffith DM, Sims M, Thorpe RJ. Sex, Obesity, and Blood Pressure Among African American Adolescents: The Jackson Heart KIDS Pilot Study. Am J Hypertens 2017. [PMID: 28633388 DOI: 10.1093/ajh/hpx071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This study examined the degree to which sex, weight status, and the presence of hypertension and obesity in parents/grandparents were associated with systolic (SBP) and diastolic (DBP) blood pressure (BP) among African American youth in a pilot offspring study examining obesity-related cardiovascular disease (CVD) risks among adolescents. RESULTS Fully adjusted linear regression models of the total sample produced results indicating that obesity was associated with BP (SBP: β = 7.08, P < 0.01; DBP: β = 8.14, P < 0.001). Sex-stratified analyses indicated that overweight and obesity were associated with SBP (overweight: β = 6.77, P < 0.01; obese: β = 11.65, P < 0.001) and obesity was correlated with DBP (β = 9.86, P < 0.001) among males. For females, overweight was correlated with SBP (β = 4.11, P < 0.05) while obesity was associated with DBP (β = 6.98, P < 0.01). Attempting to lose weight was inversely related to SBP (β = -4.01, P < 0.05) in the full sample and among males (β = -11.94, P < 0.001). Familial presence of hypertension and/or obesity was significantly associated with SBP among adolescent females but not males. CONCLUSIONS The relationship between weight status, familial hypertension and obesity status, and BP among adolescents vary by sex. This study underscores the need for additional research investigating the relationship between individual sex, weight status, BP and familial BP, and obesity status on risk among African American adolescents.
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Affiliation(s)
- Marino A Bruce
- Center for Research on Men’s Health, Vanderbilt University, Nashville, Tennessee, USA
- Center for Medicine, Health and Society, Vanderbilt University, Nashville, Tennessee, USA
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, Jackson Mississippi, USA
| | - Bettina M Beech
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, Jackson Mississippi, USA
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Keith C Norris
- David C. Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Derek M Griffith
- Center for Research on Men’s Health, Vanderbilt University, Nashville, Tennessee, USA
- Center for Medicine, Health and Society, Vanderbilt University, Nashville, Tennessee, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Roland J Thorpe
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Baltimore, Maryland, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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