Barriers to and Facilitators of Using mHealth Technology Among African-Americans Living with Hypertension.

MHealth provides a new way of promoting hypertension self-management behaviors. However, the acceptance, feasibility, and effectiveness of interventions incorporating mHealth technology have been understudied in African-Americans with hypertension. This study aimed to explore participants' (n = 30) experiences using a community and technology-based intervention to self-manage their hypertension (COACHMAN). Focus groups were conducted with African-Americans living with hypertension. Focus groups were audio-recorded, and the data were transcribed verbatim and analyzed qualitatively using thematic analysis. Regarding the use of mHealth-enabled self-management hypertension interventions to support hypertension control among African-Americans, the thematic analysis produced the following five barrier themes: (a) lack of knowledge regarding how to use technology, (b) resistance to learning new technology, (c) lack of access to technology, (d) privacy and security concerns, and (e) issues with the medication management support features. Facilitator themes that emerged from the thematic analysis were all related to the intervention components, which were: (a) reminders, (b) rewards, and (c) education modules. This study focused on mHealth barriers and facilitators as described by African-Americans living with hypertension. Results provide a starting point for developing a mHealth intervention for African-Americans that incorporates a self-management program.

Tragedy in Haiti: Suicidality, PTSD, and Depression Associated with Intimate Partner Violence Among Haitian Women After the 2010 Earthquake.

Across the world, suicidal behaviors are responsible for more than one million deaths each year. In Haiti, suicidal behaviors were found to be related to intimate partner violence (IPV) against women. This study was conducted after the 2010 earthquake in Haiti and women were asked about IPV before and after that event. A sample of women between 18 and 44 years of age responded to a questionnaire about physical, psychological, or sexual abuse by an intimate or non-intimate partner. The women were divided into two groups: (a) women who were abused by partners (n = 133) and (b) women who were not abused (n = 75). Those who were abused had 2.2 times higher odds for suicidal thoughts and 1.9 times higher odds for suicidal attempts and were significantly more likely to suffer from depression and PTSD. For each 1-unit increase in a measured PTSD score, the odds of being abused increased by 105.7%. For each 1-unit increase in the measured depression score, the odds of being abused increased by 14.9%.

Medical Mistrust Among Black Women in America.

This qualitative research study highlights medical mistrust as a significant barrier to quality health care for Black women. Unraveling mistrust is essential for reducing health disparities and improving well-being for women and their families. Three research sites were included: Florida, Ohio, and the U.S. Virgin Islands. Three 90-minute focus groups were convened with 10 women in each of them. The discussions were recorded. Five themes will be discussed through the voices of women from each of the sites. Mistrust of healthcare professionals was associated with fears about being rejected, embarrassed, and misunderstood during the clinical encounter. Others reported that providers who were reluctant to make physical contact with them during the clinical visits provoked feelings that the color of their skin might seem "dirty." Finally, this research will help to inform discussions about COVID-19 vaccine hesitancy, which remains a critical health concern among Black women and healthcare providers.

A Power Conundrum: Black Women and Their Sexual Partners in the Midwest.

The purpose of this research was to determine the extent to which women of African ancestry manifested power in their relationships regarding sexual activities and to examine the influence that specific variables had on their sexual partnerships. A sample (N = 200) of midlife women aged 40-65, who lived in the Midwest participated in this research. The Sexual Relationship Power Scale was used to examine these relationships. Face-to-face interviews occurred in community settings. Multiple regression equations were used to examine the potential impact of specific variables on sexual functioning. Results of the analysis revealed that variables such as mental quality of life, decision-making, and health promotion were positively associated with sexual relationships. Conversely, depression and life stress scores were negatively linked to sexual relationships. Knowledge gained from this research could be used to explore the phenomena of power as expressed in the daily lives of women of African descent. The research can also be discussed from the perspective of a "Black tax," that has burdened Black women for centuries and is manifested through years of discrimination, bias, and the lack of equity in most domains of American institutions.

A Novel Mentoring Program for Inner-City Middle and High School Students.

This article discusses the Provost Scholars, a novel University five-year Mentoring Program for middle and high school students in an inner-city school district. The Provost Scholars is an innovative enrichment Program in which a partnership was formed between an under-resourced inner city school district and a private research university in Cleveland, Ohio. The Program was formed to help students graduate from high school. As these students experience success and empowerment, their willingness and ability to give back to the health of the community is enhanced. The primary goal of the Provost Scholars Mentoring Program is to prepare students for entry into and graduation from colleges/universities, technical/vocational schools, or to find a successful place in the workforce. This article describes a number of initiatives established to ensure the success of the Scholars. One key aspect of the Programs' success is a strong personal interest, caring, engagement, and partnership between the administrative staffs of the following two educational institutions: Case Western Reserve University and the East Cleveland School District, as well as the committed relationships of the university Mentors and the Scholars. Students who participate in the Program are expected to demonstrate improved grades, higher ACT/SAT scores, and to meet the requirements for admission to the colleges and universities of their choice, or to develop skills for meaningful employment in industry.

Swazi Pregnant Women's Knowledge on Consuming Alcoholic Beverages.

Fetal alcohol spectrum disorders (FASD) affect all nations harshly, however, very little is known about the scope of FASD in Swaziland. Alcohol exposure in utero is one of the leading preventable causes of poor fetal birth outcomes. This study assessed the knowledge and practices of pregnant Swazi women, revealing that most participants had knowledge deficit on the effects of consuming alcohol on both the woman (63.3%, n = 19) and her fetus (83.3%, n = 25). The majority (83.0%, n = 25) of the participants reported that they did not drink alcohol, while 16.7% (n = 5) reported that they did consume alcohol. In health facilities, there is a need to intensify health education concerning the effects of alcohol consumption to both the fetus and the pregnant woman. A policy that enforces screening of pregnant women at risk for giving birth to infants with FASD is essential.

Beck Depression Inventory-II: Factor Analyses with Three Groups of Midlife Women of African Descent in the Midwest, the South, and the U.S. Virgin Islands.

This research encompasses a factor analysis of the Beck Depression Inventory-II (BDI-II), which involves three groups of midlife women of African descent who reside in the Midwest, the South, and the U.S. Virgin Islands. The purpose of the study was to determine the factor structure of the BDI-II when administered to a sample of women aged 40-65 of African descent who reside in the three distinct geographical regions of the United States. A correlational, descriptive design was used, and 536 women of African descent were invited to participate in face-to-face interviews that transpired in community settings. Results of the factor analysis revealed a two-factor explanation. Factor one included symptoms such as punishment feelings and pessimism (cognitive), and the second factor included symptoms such as tiredness and loss of energy (somatic-affective). The application of the Beck Depression Inventory-II among the three groups of women generated specific information about each group and common findings across the groups. Knowledge gained from the research could help to guide specific intervention programs for the three groups of women, and explicate the common approaches that could be used for the three groups.

Culturally Anchoring an Intervention for Gender-Based Violence.

Haitians continue to rebuild following the devastating earthquake in 2010, as many also strive to recover and heal from associated horrific events. Immediately following the earthquake, domestic and international agencies reported dramatic increases in violence against women and girls in this small Caribbean nation that shares the island of Hispaniola with the Dominican Republic. In this article we highlight one segment of a situational analysis used as groundwork for developing an intervention to address gender-based violence (GBV). We sought to rapidly identify existing and needed resources and services for internally displaced women and girls in Haiti and to facilitate an immediate and sustainable response. During an eight-day period, we convened focus groups in Port au Prince. Displaced women and older girls, directors of nongovernmental organizations (NGOs), healthcare providers and administrators, and community youth leaders participated in the focus groups. Findings from these focus groups illuminate the multiple influences of GBV on displaced women and girls. Gaps, strengths, and limitations of existing resources, capacities, systems, and services for internally displaced Haitian women and girls were identified. In addition, factors that could potentially support or hinder effective implementation of preventive and response interventions were revealed. Our findings provided a foundation and structure for developing a culturally- specific educational and safety plan which was used in Haiti following the earthquake and continues to have relevance for use, today.

Transition-Aged Youths With Dual Diagnoses.

The current study provides an overview of the research knowledge about unique problems encountered by transition-aged youths with dual diagnoses. A description of the considerable physical and emotional changes experienced by transition-aged youths provides a foundation for exploring the pressures and challenges compounded by mental health issues and substance abuse. Programs that provide intensive support throughout the transition years pay valuable dividends. However, transition-aged youths with dual diagnoses of mental disorders and substance abuse find themselves faced with limited or nonexistent options. There is a confusing lack of continuity and consistency of supports and services, which complicates the already perplexing circumstances that beleaguer the lives of young adults with dual diagnoses.

The Transition to Independence Process: Promoting Self-Efficacy in Transition-Aged Youths.

Transition to adulthood is a developmental stage that presents unique and challenging problems. For individuals with dual diagnoses of mental disorders and substance abuse, the tragic dilemma confronting them is one of limited or nonexistent options as they attempt to navigate their way from child and adolescent services to adult programs. The Transition to Independence Process (TIP) is designed to facilitate more successful outcomes in the transition to adulthood by offering continuity of support. Nursing plays a crucial role in enabling young adults to develop a healthy sense of self-efficacy, thus facilitating the success of a TIP program. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 49-53.].

Stress and Coping among Black Women Employed in Non-professional Service and Professional Occupations in Florida and Georgia.

Culture enhances the ability to address the stressors related to ethnicity/race, employment, and lifestyle. From this interaction, two coping patterns emerge: individualist-oriented or collectivist-oriented, of which women prefer the latter. However, there is limited knowledge about the impact of ethnicity/race on the coping strategies of Black working women in the USA. Therefore, the purpose of this cross-sectional survey was to examine the coping strategies of two groups of Black women, those who work in non-professional service-related jobs and those employed as professionals. We explored Black women from two southern states, Florida and Georgia, in their use of coping strategies for everyday stressors. A modified version of Lazarus and Folkman's Transactional Model was used as the framework of this study. The sample for this cross-sectional survey consisted of 313 Black women employed in non-professional service jobs and 343 in professional roles. The thoughts and actions related to coping in everyday stressors were measured with The Ways of Coping Questionnaire.

Young Victims Telling their Stories of Sexual Abuse in the Emergency Department.

Among young children, child sexual abuse is a common type of maltreatment. Child sexual abuse (CSA) is an important national public health problem that has a devastating impact on the emotional and psychological makeup of the child, family, and society. The purpose of this analysis is to explore the young victim's own stories of disclosure of child sexual abuse and is an exploratory case study using reported assault histories of victims of CSA between the ages of 6 and 14, taken in the immediate wake of the assault. The data were extracted from the hospital records of child victims treated in an emergency department between 2006 and 2010. This qualitative research, using thematic analysis, explored the stories of sexual abuse for children as told by them. Two themes emerged regarding the experience of sex abuse and the immediate outcomes on the children: (1) Abuse Circumstances, which included the child's level of awareness of child sexual abuse, predisposing factors, and the perpetrator's preparation (physical, behavioral, and verbal tactics), and (2) Physical/Psychological Suffering associated with disclosure. These have important implications for all service and health care providers.

Factors Associated with African-American Women's Decisions to Participate in Genetic Research.

The purpose of this study was to determine the factors that are associated with African-American (AA) women's decisions to participate in genetic research. Using a descriptive correlational design, a convenience sample of African-American women (age ≥ 40) was recruited from various locations in the Midwest. During semi-structured interviews, demographics, psychological factors, knowledge of and attitudes toward genetics were collected. Of the 98 women (mean age 53), 66% indicated that they were unwilling to participate, despite having positive attitudes. Correlations were found between genetic knowledge and attitudes toward genetics (r = .35, p = .001), and decision-making to participate and attitudes toward genetics (r = .40, p = .001). Data revealed decisions were largely associated with their lack of knowledge and resulting perceptions. Efforts should be made to inform African-American women about the benefits of the new science through planned, culturally specific, and sensitive interventions that incorporate genetic and health literacy programs.

Social determinants of adolescent depression: an examination of racial differences.

Conventional behavior theories that assert adolescent risk behaviors are determined by peer and parental relationships are being challenged as research begins to consider broader socioenvironmental factors. This study, using data from the Longitudinal Study for Adolescent Health (Add Health), Wave II, Public Use Data, and the Social Determinants of Adolescent Risk Behaviors (SDOARB) framework, examines relationships among socioeconomic status (SES), academic performance, perceived peer prejudice, and perceived teacher discrimination as predictors of depressive symptoms among high school adolescents. Overall, the study found that GPA was a significant predictor of depressive symptoms across all three racial groups (Black, White, and Other Minority). Teacher discrimination predicted depressive symptoms among White and Other minority adolescents, but not Black adolescents. These findings suggest the need for interventions within schools for both students and teachers around racial differences in perceptions of prejudice and discrimination. Failure to address overt and covert subtleties of discrimination and prejudice within schools and policies which affect these interpersonal dynamics may have a significant impact on the overall mental wellbeing of adolescents.

Personal characteristics and health status among southern rural African-American menopausal women.

Menopause affects all women regardless of race, socio-economic backgrounds, and geographic locale. Annually, about 1.7 million women reach menopause in the United States. African-American women experience more health disparities, higher poverty levels, have more disabilities, more severe physiological symptoms of menopause, limited health insurance, more hypertensive and diabetic related conditions, and shorter life spans when compared with their White counterparts. African-American menopausal women have not been adequately included in scientific research and health-policy related studies that have addressed their health status and wellbeing. The purpose of this study was to examine the relationship between personal characteristics and health status among rural southern African-American menopausal women. This descriptive correlational study used secondary data obtained from 206 southern rural African-American women between 40 and 60 years of age. The study findings revealed that knowledge on menopause, social support, being employed full-time, and decision-making were significantly associated with favorable self-perceived physical health status.

Relationship between Provider Communication Behaviors and the Quality of Life for Patients with Advanced Cancer in Saudi Arabia.

Context: Patients with advanced cancer from Saudi Arabia are often not well informed about diagnoses, prognoses, and treatment options. Poor communication can lead to health-care decisions that insufficiently meet patients' preferences, concerns, and needs and that subsequently affect patients' quality of life. Objectives: The purpose of this study is to examine the relationship between provider communication behaviors and the quality of life of patients with advanced cancer. Method: A cross-sectional, correlation design was used in the present study, in which 159 patients with confirmed diagnoses of stage III or IV solid cancer were surveyed. Results: The mean summary score of the patients' quality of life was 57.31. We found a significant relationship between provider communication behaviors and patient quality of life (ß = 0.18, b = 0.35, SE = 0.15, p = 0.021). In addition, R2 shows that only 3.4% of variance in patient quality of life is predicated on provider communication behaviors. Conclusions: The relationship between provider communication behaviors and patient quality of life was low (r = 0.18). A possible reason for this is that provider communication behaviors are not the only factor that affects patient quality of life; other variables, such as the patient's age, cancer type, and level of awareness, can also have an effect. Another possible explanation is that communication behaviors between patients and providers may vary depending on the level of cultural contact.

Age-Related Child Sexual Abuse Experiences.

The study aimed to describe differences in the types of sexual abuse injuries between two age groups of children presenting to an emergency department. This descriptive correlational study explored the relationships between sexual abuse type and child's age using data from the hospital health records of 95 children ages 6-14 years. Descriptive analysis indicated that sexually abused child victims' ages were significantly associated with different types of penetrations and mucosal tears or injuries (p < 0.05). These findings highlighted the need for increased awareness about the different types of physical trauma associated with the ages of the child victims.

Culturally specific dance to reduce obesity in African American women.

This article provides evidence of a culturally specific dance intervention to decrease obesity as measured by body fat and body mass index (BMI) in African American women. A community partnership was formed with two African American churches to develop an intervention to address the issue of obesity. The culturally specific dance intervention was delivered two times per week for 8 weeks, choreographed to gospel music selected by the experimental group participants, and taught by an African American woman. Body fat and BMI were assessed at three time points and revealed significant differences between the two groups. Attending a minimum of 7 classes was enough to show an observed dose effect and the intervention was found to be culturally specific by understanding their roles as African American women. This community partnership was an effective way to promote a church-based, culturally specific dance intervention to improve the health of African American women.

Association of Psychosocial Symptoms, Blood Pressure, and Menopausal Status in African-American Women.

African-American women have disproportionate rates of hypertension that can be further complicated as they transition through menopause. Stress, coupled with depression and hypertension in perimenopausal African-American women has not been fully explored. This study examines the associations of stress, depression, and social support on systolic blood pressure (SBP) among a sample of 184 perimenopausal African-American women. We used descriptive statistics, Pearson's correlation, and logistic regression to analyze data stratified by menopausal status (perimenopausal or menopausal) and SBP status (<130 mmHg vs. >130 mmHg). Women classified as menopausal reported higher levels of stress and depressive symptoms, and lower levels of social support. Age, body mass index (BMI), health insurance, and perceived health status were significant predictors of SBP in menopausal women. Stress, depression, and social support did not play a role in SBP. It is necessary that future research focus on reducing cardiovascular risk include addressing menopausal health.

A culturally-specific dance intervention to increase functional capacity in African American women.

This study examined a culturally-specific dance intervention on functional capacity in African American women at three time points. The intervention was two times per week for 8 weeks using two African American churches randomly assigned to either the experimental or comparison group, had 126 participants, ages 36-82 years. Analysis of covariance revealed that both groups improved over time and the only significant difference between groups was at 18 weeks. The increase at 18 weeks in the experimental group remained when controlling for baseline covariates. This study supported culturally-specific dance as an intervention to improve functional capacity in African American women.