Reproductive justice for Black, Indigenous, Women of Color: Uprooting race and colonialism.

Historically, atrocities against Black, Indigenous, and Women of Color's (BIWoC) reproductive rights have been committed and continue to take place in contemporary society. The atrocities against BIWoC have been fueled by White supremacy ideology of the "desirable race" and colonial views toward controlling poverty and population growth, particularly that of "undesirable" races and ethnicities. Grounded in Critical Race Theory, this paper aims to provide a critical analysis of historical and contemporary violations of BIWoC reproductive rights; discuss interventions based on empowerment and advocacy principles designed to promote women's reproductive justice; and discuss implications for future research, action, and policy from the lenses of Critical Race Theory and Community Psychology. This paper contributes to the special issue by critically analyzing historical and contemporary racism and colonialism against BIWoC, discussing implications for future research and practice, and making policy recommendations.

Racial reckoning, resistance, and the revolution: A call to community psychology to move forward.

This article introduces a special issue of the American Journal of Community Psychology that features racial reckoning, resistance and the revolution in the context of a syndemic, the historical subjugation of communities of Color (COC) to racial hierarchies and the coronavirus (COVID-19). More specifically, this special issue underscores the need for community psychology and other allied disciplines to address this syndemic facing COC. The special issue delivers on the stories of the lived experiences from researchers and community members as it relates to COVID-19 and COC. Twelve articles are illuminated to challenge the field to create social change.

COVID-19 and vulnerable populations.

At the time of this special issue, coronavirus disease 2019 (COVID-19) is the leading cause of death in the United States and has contributed to millions of deaths worldwide. The world had no idea how the pandemic was going to impact our lives. COVID-19 exposed the inequities in our world and the individuals that were most impacted by it: vulnerable populations. Vulnerable populations may be defined as those living in poverty, living with disability, and racial, ethnic, sexual, and gender minorities. Additionally, as community psychologists we understand that the impact of inequities do not appear singlehandedly since as human beings we do not exist in a vacuum and there are multiple factors that create our level of health and well-being. Therefore, the idea of examining COVID-19 in a syndemic framework allows us to explore how a synergistic epidemic (i.e., the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions) exacerbates the prognosis and burden of disease, which can impact vulnerable populations simultaneously. The main goal of this special issue concentrates on how COVID-19 had a synergistic impact on vulnerable populations and how these populations reacted and coped with these events.

College Students Opinions on Gun Violence.

Gun violence and control issues have become serious public health problems. This study gathered the opinions from 419 college students from a Midwestern University. Participants were asked about beliefs about purchasing assault weapons, beliefs about bringing handguns to college campuses and beliefs about contributing factors that lead to gun violence. Participants completed surveys online. The findings showed that overall 54 % of respondents believed that military assault weapons should be banned and 53 % agree that teachers should be allowed to carry a registered handgun on campus. There were statistically significant differences between males and females on these issues. For instance, females believed military assault weapons and high capacity magazines should be banned more than 1.9 times (p = .004) p < .05 compared to male students. On the other hand, female students were more likely to believe that school teachers should be allowed to carry registered handguns on school campuses more than 1.55 times (p = .046) p < .05 compared to their male student counterparts. There were no statistically significant differences between ethnic groups. The top four contributing factors that students believed led to gun violence were decline in parenting and family values (17 %), gang involvement (14 %), bullying (13.8 %) and guns being easy to obtain (13.8 %). Limitations and implications for policy work are discussed.

Assessing Whether Religious Behaviors and Positive and Negative Affect are Associated with Alcohol Use and Abuse Among a Sample of College Students Living in the Midwest.

Alcohol use and abuse are a problem on college campuses. Religious behaviors (religious attendance, prayer, and importance) have been shown to be a protective factor against alcohol use among college students. This study examined the role religious behaviors and positive and negative affect had on drinking (alcohol use and alcohol to intoxication). College students (765) completed an online survey. The results showed that college students who attended religious services were less likely to use alcohol than those who did not attend religious services. The results have important implications for college administrators and policy makers. Limitations and future research will be discussed.

Get the message: targeting beliefs to develop risk reduction intervention messages for African American adolescents.

Risk reduction interventions that promote condom use, a vital component of most HIV prevention interventions, have been successful in increasing condom use among African American adolescents. Understanding theoretical components that lead to behavior change and selecting relevant risk reduction messages remain important considerations for targeting new interventions and tailoring existing interventions. The present study sought to (1) identify the most important theoretical determinants of condom use intention in African American adolescent males and females, separately, using the integrative model of behavior prediction, and (2) identify underlying beliefs within the determinants that were good candidates for message development in similar interventions. Using 446 African American adolescents, multi-group SEM indicated that the gender-specific IM exhibited a better fit than the overall model. Specifically, the IM had a stronger capacity for predicting condom use intention and condom use behavior for adolescent boys. Using a specific criteria for message selection, specific condom use beliefs were discussed as potential candidate messages for both African American males and females.

Compassion Fatigue and Spiritual Leaders: A Pilot Study.

This is a pilot study on compassion fatigue experienced by spiritual leaders. The sample consisted of 15 religious affiliations with a total of 41 participants (30 males and 11 females). In this sample, spiritual leaders were not experiencing significant levels of compassion fatigue, and they were satisfied with their work. There was a significant negative correlation between satisfaction and exhaustion, r = -.62, n = 35, p < .01. Additionally, participants reported their coping strategies and support systems.

Examining Patient and Provider Experiences with Integrated Care at a Community Health Clinic.

The purpose of this study was to examine patient and provider experiences of integrated behavioral health care at a Federally Qualified Health Center (FQHC). Using a mixed methodology design, both patients (n = 186) and providers (n = 17) completed a survey regarding satisfaction with care and the extent of integration at the clinic, as well as attended a focus group or interview (n = 11 patients; n = 12 providers) regarding their satisfaction and experiences. Both patients and providers found integration to be acceptable and satisfactory and the integration of services among different health care providers occurred fairly regularly. Themes from the provider and patient interviews/focus groups highlighted both positive aspects of the integration and specific challenges within the clinic. This more nuanced perspective of integration both replicates and extends upon previous research regarding satisfaction with integrated care and emphasizes the complexities and challenges of integration within community health clinics.

Mental health strategies for prevention and intervention: Community perspectives.

The current issue is a call to action on the mental health crisis America is experiencing. Prevention and intervention programs are needed to address the gap in services. This current issue gathers the voices and perspectives from various populations' lived experiences with the intent to develop recommendations and solutions.

Perceived stress, substance use, and mental health issues among college students in the Midwest.

Perceived stress and mental health on college campuses is a major concern. College students are under a tremendous strain. This study was designed to measure the perceived stress among Whites and Nonwhites using the Perceived Stress Scale, the Center for Epidemiologic Studies Depression Scale Revised, Positive and Negative Affect Scale (PANAS) and other behavioral indicators (diet and nutrition) to determine the overall well-being of college students. College students attending a mid-sized University in the Midwest completed an 80 item online survey. The results showed that thirty-six percent of the sample displayed depressive symptoms, 10% of the respondents endorsed high perceived stress and 56% reported experiencing moderate stress levels. Females had higher levels of perceived stress than males and Whites displayed statistically significant lower depression scores than Nonwhites although Whites displayed significantly higher mean scores on the CES-D-R depression scores than Nonwhites. Overall, fruit intake of college students was as an indication of poor diet and nutrition among college students because they were not eating fruit in their diets prior to taking the survey. Limitations and future directions will be explored.

An examination of suicidality of African American adolescents at a local and national level.

Suicidality is a serious concern in this country. In the U.S. nearly 40,000 people die by suicide each year. It is the 10th leading cause of death. For those 15-24, it is the 2nd leading cause of death. Using data from the Add Health Longitudinal data set and data gathered from a local organization an examination of suicidality among African American youth was conducted. Given the trauma and low resourced situations many African American adolescents find themselves in, interventions are needed to address these health concerns before other issues such as education and other life options (i.e., careers) are addressed. Questions that participants were asked related to suicidal ideation and suicide attempts; did you ever seriously consider attempting suicide and did you attempt suicide? The results showed that the local sample had higher suicidal ideation than the Add health national sample (20% vs. 13.6%), respectively. The local sample had higher percentages of suicide attempts in the past twelve months compared to the National sample. There was a statistically significant difference between females and males in the sample. Limitations and future research are found in the discussion.

Assessing health-related stereotype threats and mental healthcare experiences among a LGBT sample.

Stereotype threats have been documented in an academic and work setting and have been found to have a significant impact on an individual's behavior as it could be a barrier in receiving healthcare services. This paper explores the impact of health-related stereotype threats and its influence within a LGBT sample with the use of an online survey to explore underlying and unconscious barriers within mental health services. A series of regressions were used to analyze and explore the potential predictability the health-related stereotype threats may have on the fear of communicating with a physician, delay in mental health services, and poor mental health outcomes. High reports of health-related stereotype threats significantly predicted high reports of fear of the physician which could indicate that many LGBT patients are afraid to communicate with their providers about their mental health due to stereotype threats (F (1,91) = 9.844, p < .005). In addition, high reports of health-related stereotype threats slightly but significantly predicted reported delays in seeking mental health services (χ2(1) = 4.220, p < .05). In addition, although there was no significance related to positive affect scores, health related stereotype threats significantly predicted self-reported poor mental health outcomes (F (1,90) = 4.545, p < .05) and high rates of negative affect scores (i.e., anxiety, depression; F (1,89) = 4.933, p < .05). Recommendations and future study will also be discussed.

Does the physical and mental health of veterans differ by military branch?

The purpose of this study was to examine the relationship between health behaviors and their levels of positive and negative affect and determine the overall level of physical health and mental health among members of the armed forces. Overall, the results showed that veterans in the Army, Navy and Marines are more often than members who are in the Air Force to be deployed. Members in the Army, Navy and Marines also experience higher levels of reported cases of PTSD, higher levels of negative affect (i.e. anxiety), a lower health composite score and report poorer perception of their own health. This study also showed that veterans of the Air Force had a stronger emphasis on their physical health which resulted in higher levels of positive affect (excited about life). Limitations and future directions of this research are discussed.

Results from a community mental health assessment in a historically black church: A call for action.

African Americans' rates of mental illness are similar to those of the general population, however, their rates of utilization of any mental health service is lower than many other ethnic/racial groups, specifically, non-Hispanic, Whites. Many African Americans do not receive adequate treatment for mental health issues due to several barriers to help-seeking behavior. Despite these barriers, African American communities have traditionally sought support from pastors or ministers of historically black churches in times of crises or when experiencing mental health issues. Research has shown that African Americans rely on faith, family, and their churches for emotional support rather than turning to health care professionals. To address the stigma of mental health and identify barriers to seeking mental health care in African American communities in Wichita, KS, a local Wichita historically black church, developed and hosted a mental/emotional health awareness conference. Approximately 30% of the 249 participants who attended the conference were surveyed to assess conference impact, conference satisfaction, and barriers to seeking mental health services. Results indicated approximately 37% of those surveyed lived in lower-income neighborhoods. Conference impact and satisfaction were both rated favorably. Lastly, the top three barriers to mental health care were: (1) "I don't want to be labeled," (2) "I can't afford it," and (3) "I don't know where to go for care." These data highlight the need for stigma reducing interventions and for additional policy changes to address the disparity in health-seeking behaviors of African Americans.

Breast Cancer Treatment Experiences of Witness Project of Kansas Participants.

BACKGROUND: African American women continue to die at a higher rate than White women from breast cancer. Kansas has a high death rate among African American women. Their voices needed to be heard. OBJECTIVES: This exploratory study will ask the following questions: 1) Were African American and White women having different breast cancer treatment experiences with their health care providers? And 2) How satisfied were they with their treatment? METHOD: A total of 15 breast cancer survivors were recruited to participate in this qualitative research study. We conducted focus groups in two communities in the Midwest. Forty percent of the sample was White women, 53% of the sample was African American women and 7% of the sample was Hispanic/Latina. RESULTS: Overall six themes emerged. Generally both African American women and White women were satisfied with their health care; both felt they were treated equally by health care professionals. However, they felt that health care professionals should pay more attention to their significant others and to continue to educate young women about early detection. CONCLUSIONS: As a result of the focus groups a gap in services emerged in educating the patient's partners about what is needed for their significant others and what role partners play in the recovery process.

Youth empowerment implementation project evaluation results: A program designed to improve the health and well-being of low-income African-American adolescents.

Adolescent obesity is a major health issue facing today's youth. This may be the first generation to have a lower life expectancy than their parents. The Youth Empowerment Implementation Project's (YEIP) goal was to increase fruit and vegetable intake, lower junk food consumption, and increase physical activity among low-income African-American youth living in the Midwest. Thirty middle school aged youth participated in an evidenced-based program (i.e., Botvin's Life Skills Training) and were engaged in health education and physical activities. The results from baseline to follow-up demonstrated a reduction in junk food intake for participants and an increase in fruit and vegetable intake but not for physical activity. The health behaviors of participants improved for three out of four indicators following the intervention. Limitations, future research, and implications for future programs are also discussed.

Exploring the Experience of Life Stress Among Black Women with a History of Fetal or Infant Death: a Phenomenological Study.

INTRODUCTION: Disparate birth outcomes among Black women continue to be a major public health problem. Whereas prior research has investigated the influence of stress on Black women's birth outcomes, few studies have explored how stress is experienced among Black women across the life course. The objectives of this study were to describe the experience of stress across the life course among Black women who reported a history of fetal or infant death and to identify stressful life events (SLE) that may not be represented in the widely used SLE inventory. METHODS: Using phenomenological, qualitative research design, in-depth interviews were conducted with six Black women in Kansas who experienced a fetal or infant death. RESULTS: Analyses revealed that participants experienced multiple, co-occurring stressors over the course of their lives and experienced a proliferation of stress emerging in early life and persisting into adulthood. Among the types of stressors cited by participants, history of sexual assault (trauma-related stressor) was a key stressful life event that is not currently reflected in the SLE inventory. CONCLUSION: Our findings highlight the importance of using a life-course perspective to gain a contextual understanding of the experiences of stress among Black women, particularly those with a history of adverse birth outcomes. Further research investigating Black women's experiences of stress and the mechanisms by which stress impacts their health could inform efforts to reduce disparities in birth outcomes. An additional focus on the experience and impact of trauma-related stress on Black women's birth outcomes may also be warranted.

Evaluating the impact of a hypertension program for African Americans.

Although hypertension affects all racial and ethnic groups, its prevalence is highest in the African-American community. The goal of Healthy People 2010 is to reduce hypertension among African Americans from 40% to 16%. Although current levels remain high, culturally sensitive, community-based clinical projects might be helpful in addressing this problem. The goal of this study was to assess whether a community-based clinic's program was effective in improving blood pressure control among a sample of 134 African-American adults. The program design involved health education and physical fitness classes offered over a nine-month period, with blood pressure checks being conducted pre- and postphases to determine whether the program was effective in controlling high blood pressure. Health questionnaires were also administered pre- and posttest to assess whether health behaviors and perceived health status were influenced by the project. Two-thirds (70%) of the sample had high blood pressure at baseline and 43% at program conclusion. This was a statistically significant difference (p=0.003). Overall self-reported health survey results indicated improved health behaviors and health status changes. Findings suggest that culturally sensitive, community-based clinic programs that incorporate both health education and physical fitness might be effective in reducing hypertension among African Americans.

Reducing and eliminating health disparities: a targeted approach.

Health disparities have dominated recent discourse among public health and medical researchers. Ever since the United States began to compile health statistics, differences in health status have been noted between majority and non-majority populations. Myriad approaches have been undertaken in an attempt to reduce or eliminate racial and ethnic disparities in health. However, the disparities continue to persist. We are at a point in our history where innovative strategies must be explored that will be more effective in addressing racial and ethnic disparities in health. In large part, health disparities exist as a result of inequitable distribution of goods, resources, services and power in America. We have learned that improvements in health cannot come about solely through primary and secondary interventions but rather through an examination of the availability of resources that would allow individuals to improve their health. The goal of this paper is to provide an overview of the contextual factors that affect health disparities, to integrate theory to address disparities and to provide recommendations to encourage systematic changes to eliminate health disparities. It is hoped that this paper will bring about a national discussion relating to addressing the real issues we face in reducing and ultimately eliminating health disparities.