A Cohort Study Investigating the Psychological Correlates of Vigorous Physical Activity Among African-American Adolescent Females.

As a result of severe acute respiratory syndrome coronavirus 2, there has been a surge in the prevalence and severity of non-syndromic pediatric overweight (NSPO) in the United States. Prevention interventions such as engagement in regular moderate-to-vigorous physical activity have been consistently shown to mitigate the development and maintenance of NSPO. Yet, African-American adolescent females, a subgroup of the population disparately impacted by NSPO, are less likely to engage in regular physical activity. Although multidimensional global self-concept has been identified as a possible predictor of physical activity engagement, dimensional linkage with physical activity engagement among members of this subgroup has yet to be established. This secondary analysis of data from N = 312 urban dwelling African-American adolescent females sought to evaluate the contribution that selected dimensions of global self-concept had on engagement in vigorous physical activity. Findings from a 3-Model hierarchical regression analysis found that in addition to socioeconomic position, several social desirability and competence dimensions of global self-concept were significant predictive contributors to physical activity engagement among members of the study cohort. Specifically, these were the dimensions of physical appearance, romantic appeal, close friendship, social acceptance, and scholastic competence. Although more research is needed, results from this study have important implications for population health.

Covid-19, Pregnancy, and Vaccinations.

Pregnancy in the presence of COVID-19 increases the risk for illness severity. Data suggest that pregnant women with COVID-19 are more likely to be hospitalized, to be admitted to the intensive care unit, and to require life support. Vaccination is currently considered the most effective preventive intervention against COVID-19 in the United States. However, the unsurprising exclusion of pregnant women as participants in initial COVID-19 vaccine clinical trials has led to a gap in the scientific data regarding the safety profile and subsequent use of COVID-19 vaccine for women who are pregnant. Experts believe current COVID-19 vaccines developed using either mRNA or viral vector vaccine technologies and authorized for emergency use by the United States Food and Drug Administration are unlikely to pose obstetrical or neonatal risks. Still, current vaccination recommendations for women who are pregnant have been both mixed and contradictory. The need to expeditiously identify, collate, and disseminate available vaccine-related safety data is critical to preventing severe illness while also advancing the health and wellness of an underserved high-risk population subgroup.

Pregnancy and Postpartum Challenges During COVID-19 for African-African Women.

The purpose of this article is to discern and examine causative factors that are likely to influence the higher consequences of health disparities experienced by pregnant and postpartum African-American women with COVID-19. Although understudied, pregnancy in the presence of COVID-19 increases the risk for illness severity. Data suggest that pregnant women with COVID-19 are more likely to be hospitalized, to be admitted to the intensive care unit, and to require life support. Similarly, COVID-19 poses significant challenges to maternal and obstetric care during the postpartum recovery period. African- American women bear a disproportionately higher morbidity and mortality burden for diseases such as diabetes, obesity, and hypertension. Pre-existing chronic health conditions may place pregnant and postpartum women at a higher risk for developing severe health consequences from COVID-19 before, during, and after delivery. In addition, social determinants of health are hypothesized to modulate the deleterious impact of COVID-19 among pregnant and postpartum African-American women.

Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: Review and Appraisal of Current Evidence.

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated coronavirus disease 19 (COVID-19) began ravaging most of the globe in November 2019. In the United States more than 25 million people have been infected with SARS-CoV-2. To date, COVID-19 has killed close to 400,000 U.S. citizens. In the face of limited pharmacotherapies, the current burden of SARS-CoV-2 and COVID-19 signals overwhelming sickness and trillions in healthcare costs ahead. The need to expeditiously identify safe and efficacious prophylaxis and treatment options is critical. Drug repositioning may be a promising strategy toward mitigating the impact of SARS-CoV-2 and COVID-19. This rapid review appraises available evidence on the viability of vintage antimalarial drugs chloroquine (CHQ) and its analog hydroxychloroquine (HCQ) repositioned for SARS-CoV-2 prophylaxis and COVID-19 treatment. Findings suggest neither the use of CHQ nor HCQ singularly, or concomitantly, with azithromycin and/or zinc provide definitive benefits for use against SARS-CoV-2 infection or COVID-19 illness. Moreover, administration of these medications was linked to significant and sometimes fatal complications.

Exploration of African-American Nurses' Perceptions Toward Seeking and Utilizing Genetic Information.

Advances in genetics and genomics have revolutionized the treatment possibilities for common diseases. Many treatment prospects demonstrate promise for addressing population health disparities. African-American nurses have a crucial role in facilitating the translation of scientific discovery into real-world practice among at-risk populations. The primary aims of this pilot study were to gain insight into the contextual perspectives of African-American nurses' views about factors that impede, support, and/or promote genetics and genomics knowledge in practice and participation in research. Data were obtained from a focused discussion of N = 6 registered nurses who attended the 2011 National Black Nurses Association (NBNA) annual conference. Utilizing a grounded theory approach, themes extrapolated from the focused discussion included the need for genetic and genomic education, distrust, cultural competency in care interactions, and the role of the NBNA in providing education. Suggestions for explanatory relationships are also presented.

The Community Compass Project: A Community Engagement Model Targeting African-Americans in the Low Country of South Carolina.

Despite cutting edge progress in early detection, risk reduction, and prevention, unique contextual and sociocultural factors contribute to higher mortality rates for selected cancers in African-American men and women. Collaborative community engagement and outreach programming strategies that focus on sustainability and grass-roots organizing can inform health risk disparities, build trust, and allow communities to take ownership of their own health needs. This paper describes a successful evidence-based community engagement intervention woven into the social and interpersonal fabric of the African-American community in Charleston, South Carolina. Through the creation of a coalition of community partners that included the state's only National Cancer Institute designated cancer center, collaboratively developed platforms devoted to population-specific preventive interventions for cancer and obesity education, awareness, and research initiatives were implemented within the identified community.

Non-Biological (Fictive Kin and Othermothers): Embracing the Need for a Culturally Appropriate Pedigree Nomenclature in African-American Families.

Although the Family Health History (FHH) is the most cost-effective tool in the staratification of disense risk, it is not designed to collect information from non-biological family members (NBFM). Significant NBFM, defined as "fictive kin and othermothers," tend to play a major role in the transmission of culture, health promotion, and decision-making; yet, their influence cannot be captured using the standard FHH. Participants attending the National Black Nurses Association (NBNA) 2012 genetic workshop were divided into groups to role-play FHH. All participants (N = 50) indicated difficulties with the standard FHH, ranking collection of sensitive data as the number 1 challenge. Consequently, a new symbol was developed with support from NBNA genetics workshop participants. Having such a symbol afforts an apportunity for inclusion of all NBFM to help guide risk-specific recommendations for disense management, prevention, and health promotion of common chronic diseases. This report will describe the process, presentation, and adoption of the symbol.

Views of Black nurses toward genetic research and testing.

PURPOSE: To describe views and beliefs that Black nurses hold regarding several conceptual areas of genetic research and testing. DESIGN: Data were generated using a descriptive, cross-sectional design. The sample consisted of 384 Black nurses attending the 2009 annual conference of the National Black Nurses Association in Las Vegas, Nevada. METHODS: The chi-squared test was used to evaluate group differences by education level, functional area, age, and gender. FINDINGS: One half of the Black nurses surveyed believed the potential for the discriminative misuse of genetic information against minority populations exists. However, 84% of these nurses believed the possibility of information misuse should not be used as a barrier to participation in genetic research and testing by the Black populace. CONCLUSIONS: Black nurses expressed concerns about the potential for discriminatory use of genetic information gleaned from research and testing. Yet, Black nurses recognize the importance of racial-ethnic minority participation in genetic research and testing. CLINICAL RELEVANCE: Participation in genetic research and testing by diverse populations will provide opportunities to improve the healthcare delivery system and aid the eradication of health disparities. More research is needed to clarify factors that contribute to the bifurcation of importance for participation, reluctance to participate, and what interventions might reduce reluctance.

A cohort study evaluating the implications of biology, weight status and socioeconomic level on global self-esteem competence among female African-American adolescents.

The link between obesity and self-esteem among minority youth has received minimal empirical evaluation. This study aims to describe the magnitude of risk that body mass index, household income, and transitional age have on global self-esteem levels among African-American adolescents. These analyses were conducted on cross-sectional data obtained from 264 urban-dwelling African-American females between 14 and 18 years of age. Survey data on global self-esteem levels, transitory age, and socioeconomic levels were collected using self-administered questionnaires. Measured height and weight values were used to calculate and categorize weight status according to body mass index. Logistic regression models examined the probability of reporting less than average levels of global self-esteem. Adolescent African-American females residing in low-income households were 10 times more likely to report lower global self-esteem scores than those individuals from more affluent households (95% CI: 1.94, 60.19, p < .001). Neither weight status (95% CI: 0.81, 2.55; p = .26) nor age (95% CI: 0.05, 1.87; p = .82) were significant risk indicators for lower than average levels of global self-esteem among participants in this study. Household income appears to be the greatest predictor of global self-esteem levels. Further research in this area is needed to fully elucidate precursors for psychological health vulnerability and facilitate intervention development.

Household income and spiritual well-being but not body mass index as determinants of poor self-rated health among African American adolescents.

Very little is known about predictors of subjective health status among African American adolescents. This study was designed to determine whether selected anthropometric, psychological, lifestyle behavioral, and structural variables predicted poor self-rated general health in a cross-sectional nonclinical sample of 310 female African American adolescents, 14-18 years old. The odds of reporting poor self-rated health were 2-3 times greater for African American teens from lower socioeconomic households when compared to teens residing in higher socioeconomic households and for those reporting infrequent participation in activities that promote spiritual well-being compared to those who participate more frequently in activities that enhance spiritual health. Findings indicate that socioeconomic level and engagement in behaviors that enhance healthy spirituality appear to be the most salient predictors of self-rated health. In addition to biodiversity considerations that influence perceptions of health status, culturally focused interventions should integrate variables shown to influence self-rated health among African American teens. These inclusions may inform a more integrated understanding of health, health outcomes, and health disparities in this vulnerable population.

The validity of self-report weight and height as a surrogate method for direct measurement.

Bland-Altman analysis used to determine the extent of bias, agreement, and precision between self-report and the "gold standard" of actual weight and height measurement revealed significant discrepancies between methods. Use of self-report data by health care providers and researchers should be made based on the clinical situation, patient safety, and research goals.

Measuring self-concept among African-Americans: validating the factor structure of the self-perception profile for adolescents.

The purpose of this investigation was to examine the reliability and factor structure of the Harter Self-Perception Profile for Adolescents (SPPA) with African-Americans. While the SPPA has demonstrated strong psychometric properties with European-Americans, limited information exists with African-Americans. Three hundred and ten (N = 310) female adolescents, from 14 through 18 years of age, completed the SPPA. Estimations of internal consistency reliability with Cronbach's alpha (alpha), item suitability with Pearson (gamma) correlations, and evaluation of factor structure fit utilizing principle axis extraction with oblimin (oblique) rotation were conducted. When compared with Harter's normative data, psychometric properties of the SPPA varied significantly with the current sample. Findings suggested cautious interpretation of data generated with demographically similar cohorts. Further study is warranted to ascertain the factor structure that is most relevant for use with African-American adolescents.

A systematic review of strategies that increase the recruitment and retention of African American adults in genetic and genomic studies.

BACKGROUND: The National Institutes of Health mandates the inclusion of ancestrally diverse populations into federally funded biomedical and clinical trials research. However, low participation of ethnic minorities in genetics-genomics research continues to be one of the most difficult aspects of conducting human subjects research. OBJECTIVE: This systematic review was conducted to document effective recruitment strategies that increase participation in genetics-genomics studies. METHODS: Extensive literature search strategies were employed to locate and appraise relevant literature reporting original data in which strategies to recruit African American adults into genetics-genomics research studies had been evaluated. RESULTS: Six studies published up to July, 2011 were included. Informal recruitment strategies for initial contact appeared to have a more positive impact on increasing recruitment and participation numbers than formal mailings of letters and postcards. Another key stratagem identified was participant-recruiter like-ancestry. Other methods such as monetary incentives and support of the research project by community leaders were not as effective. CONCLUSIONS: Some strategies bolstered recruitment rates while others did not. More research is needed to determine the efficacy of recruitment strategies with African Americans.

The mediating effect of global self-worth on physical activity in African-American adolescent females.

Having an excess of body fat has been identified as a predictor for participatory frequency in physical activity, a behavior that influences the development and persistence of obesity. However, the psychological factors that contribute to this pathway have not been as easily identified. This is particularly significant for population subgroups that are not only uniquely impacted by obesity-related morbidities but who are underrepresented in research as well. This study sample consisted of African-American adolescent females (N = 310), from 14 to 18 years of age, who were recruited from the urban South. Data obtained from self-reported and demographic questionnaires, as well as from anthropometric measurements, were analyzed to explore the mediating effect of global self-worth between BMI and physical activity. Mediation analysis revealed that 2% of the influence that BMI exerts on how frequently African-American adolescent females engaged in physical activity can be attributed to global self-worth.

Rural Health and the Nonemergency Use of Emergency Medical Services.

The use of emergency department (ED) services for nonemergent conditions is common and seems to be growing. At a time when health care reform efforts are focused on delivering the right care, at the right time, and in the right place, understanding access barriers to health care and the impact of these barriers on the achievement of health equity for everyone is critical to achieving identified Healthy People 2020 national objectives. This article describes motivations for nonemergent use of ED services by individuals living in rural southeastern United States.