Exploring self-care practices of African American informal kinship caregivers.

African American caregivers providing informal kinship care are vulnerable to chronic stress. Research has indicated stress increases individuals' risk for many adverse physical and mental health outcomes, including cardiovascular disease, Alzheimer's disease and depression. Given the adverse outcomes related to stress, identifying mechanisms to help these caregivers lower and manage their stress is critical to their overall health and well-being. This pilot qualitative study aimed to explore the self-care practices of 12 African Americans providing informal kinship care using a phenomenological approach. Three themes emerged: (a) behaviours to manage stress levels, (b) support network reminding caregivers to take care of themselves and (c) prioritizing my own needs. Specifically, our findings indicate that some caregivers have high-stress levels and engage in maladaptive coping behaviours. The children they cared for reminded them to take care of themselves by attending doctors' appointments or getting their nails done. Nevertheless, some caregivers prioritized their needs by participating in positive self-care behaviours, such as listening to jazz and gospel music and exercising. Prevention and intervention programs that focus on improving caregivers' health should consider the role of self-care practices.

Life Events, Barriers to Care, and Outcomes Among Minority Women Experiencing Depression: A Longitudinal, Mixed-Method Examination.

ABSTRACT: The long-term course of depression is not well-understood among minority women. We assessed depression trajectory, barriers to depression care, and life difficulties among minority women accessing health and social service programs as part of the Community Partners in Care study. Data include surveys ( N = 339) and interviews ( n = 58) administered at 3-year follow-up with African American and Latina women with improved versus persistent depression. The majority of the sample reported persistent depression (224/339, 66.1%), ≥1 barrier to mental health care (226/339, 72.4%), and multiple life difficulties (mean, 2.7; SD, 2.3). Many barriers to care ( i.e. , related to stigma and care experience, finances, and logistics) and life difficulties ( i.e. , related to finances, trauma, and relationships) were more common among individuals reporting persistent depression. Results suggest the importance of past experiences with depression treatment, ongoing barriers to care, and negative life events as contributors to inequities in depression outcomes experienced by minority women.

Race and income moderate the association between depressive symptoms and obesity.

Complex interrelationships between race, sex, obesity and depression have been well-documented. Because of differences in associations between socioeconomic status (SES) and health by race, determining the role of SES may help to further explicate these relationships. The aim of this study was to determine how race and income interact with obesity on depression. Combining data from the 2007-2014 National Health and Nutrition Examination Survey, depressive symptoms was measured with the Patient Health Questionnaire-9 and obesity was assessed as body mass index ≥30 kg/m2. Three-way interactions between race, income and obesity on depressive symptoms were determined using ordered regression models. Significant interactions between race, middle income and obesity (OR = 0.66, 95% CI = 0.22-1.96) suggested that, among white women, obesity is positively associated with depressive symptoms across income levels, while obesity was not associated with depression for African American women at any income level. Obesity was only associated with depressive symptoms among middle-income white men (OR = 1.44, 95% CI = 1.02-2.03) and among high-income African American men (OR = 4.65, 95% CI = 1.48-14.59). The associations between obesity and depressive symptoms vary greatly by race and income. Findings from this study underscore the importance of addressing obesity and depression among higher income African American men.

Considerations in cultural adaptation of parent-child interventions for African American mothers and children exposed to intimate partner violence.

African American women are at disproportionate risk of experiencing intimate partner violence (IPV) and consistently report more severe and recurrent IPV victimization in comparison to their White and Hispanic counterparts. IPV is more likely to occur in families with children than in couples without children. Parenting in the wake of IPV is a challenging reality faced by many African American women in the United States. Despite the urgent need to support mothers who have survived IPV, there is currently no culturally adapted parenting intervention for African American mothers following exposure to IPV. The aim of this review is to summarize and integrate two disparate literatures, hitherto unintegrated; namely the literature base on parenting interventions for women and children exposed to IPV and the literature base on parenting interventions through the lens of African American racial and cultural factors. Our review identified 7 questions that researchers may consider in adapting IPV parenting interventions for African American women and children. These questions are discussed as a possible roadmap for the adaptation of more culturally sensitive IPV parenting programs.

Using the Colaizzi Method to Explore Intimate Partner Violence Caseworkers' Subjective Experience: Pathways to Intimate Partner Violence Work and What Keeps Them Going.

Successful intimate partner violence (IPV) safety, advocacy, and intervention programs require recruitment and retention of persons of experience and commitment. To examine lived experiences of IPV advocates working in transitional shelter programs for women exiting IPV relationships, focus group discussions of 15 transitional housing and IPV shelter caseworkers were analyzed using the Colaizzi seven-step phenomenological method of analysis. Several themes emerged through the analysis, including historical, intergenerational pathways to IPV work and unity in sisterhood with IPV clients. The seven-step Colaizzi method is presented with examples of how each Colaizzi step yields an understanding of what motivates and sustains IPV caseworkers.

Mind, body, and spirit: a constructivist grounded theory study of wellness among middle-class Black women.

Previous studies show that Black women in the United States experience disproportionately poorer health outcomes compared to women of other racial/ethnic groups. Recently the focus is on improving the health of Black women in the United States. However, there is little empirical evidence on what Black women need to improve their health to be well. The goal of this constructivist grounded theory was to increase the understanding of wellness among middle-class Black women (N = 30) in a large Midwestern city in the United States through an intersectional lens. The findings show that the connection and balance between mind, body, and spirit was the core experience of wellness among middle-class Black women. Mind, body, and spirit was described in three ways-(a) mentally managing, (b) physically caring for my body, and (c) connecting spiritually-with the women also noting the barriers and facilitators they endured to be well. Each of these categories highlight the tension middle-class Black women experience with trying to be well. Implications for future practice and research with middle-class Black women are discussed.

How Ancestral Trauma Informs Patients' Health Decision Making.

This article considers intergenerational trauma by drawing on the experience of a 37-year-old Black woman whose great-grandfather died as a result of involuntary involvement in the US Public Health Service Syphilis Study at Tuskegee. Although she never met her great-grandfather, the abuse, exploitation, and human rights violations he suffered at the hands of the US government profoundly influenced her health experiences. This article contextualizes her experiences in light of past medical abuse and microethics.

Black women and COVID-19: The need for targeted mental health research and practice.

COVID-19 has significantly impacted a substantial number of Black Americans. Black women, in particular, are facing challenges financially, physically, and mentally during this unprecedented time. Between serving as frontline workers, being concerned about contracting the virus, contributing to their families financially, and worrying about their loved ones' health, Black women are experiencing great strain on their mental health and well-being. These stressors illustrate the need for social work researchers and practitioners to address Black women's mental health. This paper presents our reflections, experiences, and response to COVID-19 as Black women and scholars. Guided by our reflections and personal experiences, we put forth suggestions and reflexive thoughts for social work researchers and practitioners to prioritize Black women's mental health during and after these unprecedented times.

Feasibility of Delivering an on-Campus Food Distribution Program in a Community College Setting: A Mixed Methods Sequential Explanatory Investigation.

Despite community college students experiencing food insecurity there has been a dearth of research conducted on the feasibility of providing a program designed to increase access to fruits and vegetables among community colleges. This study used a mixed methods sequential explanatory design to examine the feasibility of delivering an on-campus food distribution program (FDP) to community college students and to examine the association between FDP and food insecurity and dietary intake. The study also explored the student's experiences related to barriers and facilitators of program utilization. In phase one, the FDP occurred for eight months and students could attend twice per month, receiving up to 60 pounds of food per visit. Online questionnaires were used to collect students' food security and dietary intake. Among the 1000 students offered the FDP, 495 students enrolled, with 329 students (66.5%) attending ≥ 1. Average attendance = 3.27 (SD = 3.08) [Range = 1-16] distributions. The FDP did not reduce food insecurity nor improve dietary intake. In phase two, a subsample of students (n = 36) discussed their FDP experiences through focus groups revealing three barriers limiting program utilization: program design and organization, personal schedule and transportation, and program abuse by other attendees. Facilitators to greater program utilization included: the type of food distributed and welcoming environment, along with allowing another designated individual to collect food. To maximize program use, it is suggested that reported barriers be addressed, which might positively influence food insecurity and dietary intake.

Lifetime Major Discrimination Experiences Moderate the Impact of Depressive Symptoms on Chronic Conditions among Black Americans.

To clarify the ways in which Black Americans' experiences of structural racism may influence their mental and physical health in distinct ways, the present study evaluated whether major discrimination moderates the association between depressive symptoms and chronic physical health conditions among this population. t-tests and chi-squared tests of significance were used to determine significant differences between women and men. The association between major discrimination and depressive symptoms was examined by assessing mean depressive symptoms scores across levels of major discrimination. ANOVA tests indicated whether there were significant differences in symptom scores across each discrimination category. Additional t-tests determined significant gender differences within each level of discrimination. Gender-stratified negative binomial models were used, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the relationship between depressive symptoms, major discrimination, and chronic conditions. Our findings indicated that the association between depressive symptoms and chronic conditions depends on lifetime experiences of major discrimination among Black Americans and varies significantly between women and men. Considering that major discrimination conditioned the depressive symptom-chronic conditions association among our sample, this provides insight into potential pathways for intervention in efforts to offset the detrimental mental and physical consequences of experiencing racism.

Conceptualizing healing through the African American experience of historical trauma.

For the African American healing journey, it is essential for cultural strengths that preceded and followed the original injury of enslavement, and consequent racially based trauma, to be recognized and elevated. Historical trauma has offered an important framework for understanding how the structural determinants of health are related to mass group-level subjugation for Indigenous people across generations, with a growing focus on protective factors. Here, we expand the application of the historical trauma framework to African Americans, with a focus on intergenerational healing. This exploratory study examined historical evidence of healing among enslaved people of African ancestry on Southern plantations. Two themes associated with how healing practices and strategies were used by healers and seekers of healing-figuring out what to do and fighting back/resisting-were developed using a thematic analysis of a historical text. A conceptual model is introduced illustrating the intergenerational transmission of healing and well-being across generations of African Americans. Implications for policy, practice, and research are explored. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social support from friends and depression among African Americans: The moderating influence of education.

BACKGROUND: This cross-sectional study examined the association between various characteristics of friendships and 12-month major depressive disorder (MDD) and whether these associations vary by education level among African Americans. METHODS: The analytic sample included 3434 African American respondents drawn from the National Survey of American Life: Coping with Stress in the 21st Century. Logistic regression analyses were performed to test the associations between friendship characteristics (i.e., frequency of contact, subjective closeness, receipt of support, provision of support) and 12-month MDD. Interaction terms between education and each of the four friendship variables were used to test whether these associations varied by education level. Analyses adjusted for sociodemographic factors and chronic health problems. RESULTS: Frequency of contact and subjective closeness were negatively associated with 12-month MDD. An interaction between education and contact indicated that contact was negatively associated with MDD among high education respondents but unrelated to MDD among low education respondents. The interactions between education and receipt of support and education and provision of support demonstrated that receipt and provision of support were negatively associated with MDD among high education respondents but was positively associated with MDD among low education respondents. LIMITATIONS: Given the cross-sectional design, it is not possible to make causal inferences. CONCLUSION: This investigation provides an important first step to understanding within-group differences in how social relationships function as both a risk and protective factor for MDD among African Americans.