Centering culture in an mHealth adaptation of an alcohol-exposed pregnancy prevention program for American Indian Youth.

Native WYSE CHOICES adapted an Alcohol Exposed Pregnancy (AEP) prevention curriculum for mobile health delivery for young urban American Indian and Alaska Native (AIAN) women. This qualitative study explored the relevance of culture in adapting a health intervention with a national sample of urban AIAN youth. In total, the team conducted 29 interviews across three iterative rounds. Participants expressed interest in receiving culturally informed health interventions, were open to cultural elements from other AIAN tribes, and highlighted the importance of culture in their lives. The study underscores why community voices are central in tailoring health interventions for this population.

Beyond Virtue-Signaling: Advancing Equity Through Design Justice and Public Health Critical Race Praxis.

As public health mourns the inequitable loss of lives to coronavirus disease 2019 (COVID-19) and confronts other major social crises, practitioners must explicitly address systems of oppression in their everyday praxis. We describe how the principles of public health critical race praxis (PHCRP) and design justice (DJ) can advance equity in public health. We begin with an overview of PHCRP and DJ, and develop an integrated approach to facilitate community-led change. We apply this approach to the example of COVID-19 vaccine distribution and conclude with a call to action, arguing for PHCRP and DJ to become integral part of public health practice.

Crisis-Resilient and Antiracist Approaches to Community-Based Participatory Research During COVID-19 and Beyond.

Social and health inequities among communities of color are deeply embedded in the United States and were exacerbated by the COVID-19 pandemic. Community-based participatory research (CBPR) is a powerful approach to advance health equity. However, emergencies both as global as a pandemic or as local as a forest fire have the power to interrupt research programs and weaken community relationships. Drawing from Public Health Critical Race Praxis (PHCRP), as well as our research experience during the pandemic, this article proposes an expansion of prior CBPR principles with an emphasis on advocacy and storytelling, community investment, and flexibility. The article summarizes key principles of CBPR and PHCRP, contextualizes their relevance in COVID-19, and outlines a practical vision for crisis-resilient research through deeper engagement with antiracism scholarship. Structural barriers remain an issue, so policy changes to funding and research institutions are recommended, as well, to truly advance health equity.

Preferred level of categorization as strategy to manage chronic illness-related identity among individuals with type 1 versus type 2 diabetes.

The present investigation examined social identification management among individuals affected by chronic illness. Because diabetes is a chronic medical condition that consists of a broad superordinate group with two nested subgroups of differing relative status (type 1 versus type 2), it is well-suited to an examination of positive identity management strategies used by individuals with chronic illness. A cross-sectional survey was conducted on individuals with diabetes (N = 399) to assess diabetes-related identity. Results indicated that individuals with type 1 diabetes reported greater identity centrality and greater preference for subgroup self-categorization ("individual affected by type 1 diabetes") over superordinate group categorization ("individual affected by diabetes") than did individuals with type 2 diabetes. The relationship between diabetes type and preferred categorization level was moderated by perceived intractability of their condition and perceived stigmatization of the lower status subgroup (i.e., type 2), suggesting that categorization level functions to maintain a positive self-concept. Further, categorization level moderated the negative relationship between identity centrality and feelings of depression and anger, suggesting that self-categorization might function to protect against self-concept threat. The present findings highlight the roles of group status, group boundary permeability, and perceived stigma on identity management strategies used by individuals with a chronic illness.

Weight-related genomic information and provider communication approach: looking through the lens of patient race.

Aim: This report explores the process of weight-related genomic information provision considering patient race as an important potential moderator of patient response. Methods: Health beliefs and perceived stigma were assessed following provision of genomic (versus behavioral) information by a virtual reality-based physician using either a supportive or directive communication style. Participants included 168 women with overweight. Results: Genomic explanations, combined with supportive communication, resulted in some improved health behavior-related and interpersonal outcomes for white patients, but not black participants. Black participants, on average, did not have diminished outcomes when provided with genomic information. Conclusion: Genomic communications may elicit more positive interpersonal responses than behavioral explanations among both majority and minority populations, but these effects may be moderated by patient race.

Diabetes causal attributions among affected and unaffected individuals.

Objective: The present study aims to describe and compare causal attributions for type 1 diabetes (T1D) and type 2 diabetes (T2D) among affected and unaffected individuals and to investigate the relationships among attributions, attitudes, and beliefs. Research design and methods: Adults with no diabetes (N=458), T1D (N=192), or T2D (N=207) completed an online survey. Measures assessed diabetes conceptual knowledge, causal attributions for T1D and T2D, perceived control over diabetes onset, and favorability judgements of individuals affected by each type. Results: Results indicate general agreement on causal attributions for T1D and T2D among all respondent groups, with some divergences by disease status. All respondents attributed both T1D and T2D to genetics, and genetic attributions were positively associated with favorability judgements of individuals with T2D, but not those with T1D. Conclusions: This report sets the stage for investigations into how and why attributions for T1D and T2D differ and the implications of these differences including stigmatization of individuals with diabetes and diabetes-related self-concept. Additionally, this work can inform efforts towards clinical and public health education to prevent and optimize treatment of T1D and T2D.