Exploring the dietary practices and perceptions of African immigrants in Illinois- a qualitative study of immigrants from Nigeria and Congo.

OBJECTIVE: Previous studies suggest an increased prevalence of diet-related chronic diseases among African immigrants with increased length of stay in the U.S. The objective of the current study is to understand the dietary practices and perceptions of recent African immigrant families. DESIGN: Focus group sessions were conducted with Nigerian and Congolese immigrant parents residing in Illinois. Participants were recruited using convenience sampling methods and focus group sessions were conducted via videoconference. Participants discussed dietary practices, meal preparation, and family mealtimes for their families. They also discussed experiences with eating different kinds of foods since arrival in the U.S. Verbatim transcription of focus group sessions were completed and deductive thematic analysis of transcribed data was conducted using NVivo (QSR International Pty Ltd. [2020] NVivo [version 12]). RESULTS: Twenty African immigrant parents (Mean age: 42 years, Female: 95%) residing in Northern and Central Illinois participated in a total of five focus group sessions. Seven themes were derived from the analysis. Participants had a positive attitude toward healthy diet and had a high level of interest in receiving educational resources to make healthier food choices. Participants preferred and mostly consumed foods they were familiar with before migration. A majority of the participants perceived 'American foods' as unhealthy, characterizing them as containing a high amount of sugar and salt. Parents reported that their school-aged children often preferred a western diet over traditional African meals. CONCLUSION: This study helps to understand unique diet-related practices and perceptions of recent Nigerian and Congolese African immigrants in Illinois. Findings could help to inform cultural adaptation of evidence-based nutrition education programs for these groups of African immigrants.

Perceived Barriers and Benefits of Exercise Among Men with Histories of Sexual Violence: Impact of PTSD and Physical Activity Status.

This study reported on perceived benefits and barriers of exercise among men with histories of sexual violence (SV) and compared these perceptions by activity level and post-traumatic stress disorder (PTSD) status. An online, cross-sectional, survey of men with histories of SV (N = 198) was completed using Amazon Mechanical Turk. Inclusion criteria were identifying sex at birth as male, age between 18 and 65 years, self-reported history of SV, and living in the United States (U.S.). A total of 1,260 men were screened for the study, of which 316 met the inclusion criteria, and 198 met all data quality requirements and were included in the study. Sociodemographic information, exercise behavior, PTSD symptoms, and perceived exercise barriers/benefits were collected. Comparisons by activity and PTSD status were analyzed. Additionally, two open-ended qualitative research questions were included to provide nuance to perceived barriers/benefits of exercise. The most salient benefits included physical performance, psychological outlook, and preventative health. Open-ended responses also noted the mental and physical benefits of exercise. The most salient barrier was physical exercise, with open-ended responses emphasizing lack of time, chronic pain and health concerns, and poor mental health and lack of motivation as impediments to exercise. Significant differences were found in benefits (psychological outlook, physical performance) and barriers (exercise environment, high time expenditure, and family discouragement) between active and insufficiently active men with histories of SV (ps < .05; Cohen's ds = 0.32-0.57). Significant differences were found by PTSD status on benefits (physical performance, social interaction, and preventative health) and barriers (exercise milieu, time expenditure, hard physical exercise, family discouragement) (ps < .05; Cohen's ds = 0.40-1.10). Findings provide new gender-specific strategies for promoting exercise among men with histories of SV: integrating exercise physiologists into trauma recovery programs, psychoeducation, engaging friends and family members, peer-support, and building self-efficacy.

Perceived Barriers and Benefits of Exercise Among Women Survivors of Sexual Violence by Physical Activity Level and Posttraumatic Stress Disorder Status.

An online, cross-sectional survey of women survivors of sexual violence (SV; N = 355) gathered information on perceived barriers and benefits of exercise, along with exercise level and posttraumatic stress disorder (PTSD) symptoms. This study reports exercise perceptions and provides comparisons by exercise level and PTSD status. Differences by exercise level were found in life enhancement, physical performance, psychological outlook, and social interaction (ps < 0.05; rs = -0.04-0.25). Differences were found by PTSD status in physical performance, social interaction, and preventative health and exercise milieu, time expenditure, and family discouragement (ps < 0.05; rs = -0.39-0.21). Findings provide new information relevant for promoting exercise among women survivors of SV.

Impact of Military Affiliation on Exercise Perceptions Among Survivors of Sexual Violence.

INTRODUCTION: Military service members disproportionately experience sexual violence (SV) and its related health concerns. Although recent work has shown physical activity to be an effective strategy for improving physical and mental health among trauma-exposed military populations, little of this work has focused specifically on military service members with a history of SV. To address these gaps in knowledge and practice, this study identified the most salient perceived benefits/barriers of exercise among men and women survivors of SV with military affiliations. Additionally, these analyses explore willingness to engage in exercise programs, and preferences for the structure/content of these programs, among men and women survivors of SV with military affiliations. MATERIALS AND METHODS: An online, cross-sectional survey of women (n = 355) and men (n = 198) survivors of SV was completed using Amazon Mechanical Turk. Inclusion criteria were men and women, age between 18 and 65 years, self-reported history of SV, and located in the United States. Information on sociodemographics and post-traumatic stress disorder symptoms was collected alongside perceived barriers and benefits to exercise, willingness to engage in exercise programs, and preferences for the structure/content of these programs. Analyses were stratified by sex. Comparisons by history of military involvement (active duty military or veteran; no military involvement/civilian) were reported. RESULTS: Both military-involved men (n = 68) and women (n = 139) were more likely to prefer at-home and online exercise options when compared to civilians (Ps < .05; Cramer's Vs 0.19-0.36). Additionally, both men and women with military involvement reported strongly favoring exercising with an instructor over no instructor and preferred that this instructor identifies with their same gender (Ps < .01; Cramer's Vs 0.28-0.36). Women with military involvement also preferred shorter program durations and exercising alone or in a group online or in person, whereas men with military involvement were open to longer program durations, when compared to their civilian counterparts (Ps < .05; Cramer's Vs 0.19-0.37). Women and men with military involvement were more likely than their civilian counterparts to perceive that exercise benefits their psychological outlook and social interactions. They were also more likely than civilians to indicate poor exercise environment, high time expenditure, and family discouragement as perceived barriers to exercise (Ps < .05; Cohen's ds 0.21-0.97). Military-involved women were also more likely than civilian women to endorse the perceived barrier of hard physical exercise (P < .05; Cohen's d = 0.25). CONCLUSIONS: This study identified perceived benefits and barriers to exercise, along with willingness to engage in exercise programs, and exercise preferences among men and women survivors of SV with military involvement. Targeting these factors in intervention planning will be important for physical activity promotion and program engagement among veterans to reduce the disproportionate impact of SV and disease burden among U.S. service members and veterans.

Factors associated with use of assistive walking devices among older adults in Brazil / Fatores associados ao uso de tecnologia assistiva para auxiliar na mobilidade entre idosos no Brasil

Abstract Background Walking devices and other forms of assistive technology (AT) can benefit older adults by supporting mobility and social interactions, but usage outside of high-income countries is generally low. Objective To examine the factors associated with AT use and whether AT use is associated with higher levels of social participation among older adults in Brazil. Method The 2013 Brazilian National Health Survey interviewed 23,815 individuals 60 years or older. Descriptive and logistic regression analyses were used to examine AT use, including canes and walkers, to assist with walking and social participation. Results Among older adults with mobility difficulty, 34.0% (95% CI 31.2- 36.9) reported using AT. Prevalence of the use of AT for walking increases with age: 21.4% of those 60-69 years reported using AT while 58.5% of those 90 years or older did. AT was negatively associated with participation in social activities. Conclusion Our analyses focused on older adults with mobility limitations who need appropriate transportation and environment adaptations to engage socially. Contrary to studies in more developed countries, among Brazilians, AT use is negatively associated with social interactions. The resulting confinement seems to lead to social isolation.

Resumo Introdução Os dispositivos de tecnologia assistiva (TA) podem ajudar idosos na mobilidade e nas interações sociais, mas o uso fora de países de alta renda é geralmente baixo. Objetivo Analisar os fatores associados ao uso de TA e se o uso de TA está associado a níveis mais elevados de participação social entre idosos no Brasil. Método A Pesquisa Nacional de Saúde - PNS 2013 no Brasil entrevistou 23.815 indivíduos com 60 anos ou mais. Análises descritivas e de regressão logística foram utilizadas para examinar a utilização de TA para auxiliar na mobilidade e participação social. Resultados Entre idosos com dificuldade de locomoção, 34,0% (95% IC 31,2-36,9) relataram uso de TA. A prevalência do uso de TA para se locomover aumenta com a idade: 21,4% dos 60-69 anos relataram usar TA enquanto a proporção aumenta para 58,5% entre os de 90 anos ou mais. Uso de TA está negativamente associado à participação em atividades sociais. Conclusão Entre idosos no Brasil com limitações de mobilidade que necessitam de adaptações adequadas de transporte e meio ambiente para engajar socialmente, o uso de TA foi associado negativamente às interações sociais. Esse resultado difere de estudos em países mais desenvolvidos.

Fresh- and lean-pork intake in relation to functional limitations among US older adults, 2005-2016.

BACKGROUND: Pork consumption, in particular fresh/lean-pork consumption, provides protein and other essential micronutrients that older adults need daily and may hold the potential to prevent functional limitations resulting from sub-optimal nutrition. AIM: Assess fresh/lean-pork intake in relation to functional limitations among older adults in the USA. METHODS: Individual-level data came from the National Health and Nutrition Examination Survey (NHANES) 2005-2016 waves. Nineteen validated questions assessed five functional limitation domains: activities of daily living (ADLs); instrumental activities of daily living (IADLs); leisure and social activities (LSAs); lower extremity mobility (LEM); and general physical activities (GPAs). Logistic regressions were performed to examine pork, fresh-pork and fresh lean-pork intake in relation to functional limitations among NHANES older adults (n = 6135). RESULTS: Approximately 21, 18 and 16% of older adults consumed pork, fresh pork and fresh lean pork, respectively. An increase in pork consumption by 1 oz-equivalent/day was associated with a reduced odds of ADLs by 12%, IADLs by 10% and any functional limitation by 7%. An increase in fresh-pork consumption by 1 oz-equivalent/day was associated with a reduced odds of ADLs by 13%, IADLs by 10%, GPAs by 8%, and any functional limitation by 8%. Similar effects were found for fresh lean-pork consumption on ADLs, IADLs, GPAs and any functional limitation. CONCLUSION: This study found some preliminary evidence linking fresh/lean-pork consumption to a reduced risk of functional limitations. Future studies with longitudinal/experimental designs are warranted to examine the influence of fresh/lean-pork consumption on functional limitations.

Fresh and Fresh Lean Beef Intake in Relation to Functional Limitations among US Older Adults, 2005-2016.

Objectives: In this study, we assessed fresh and fresh lean beef intake in relation to functional limitations among US adults 65 years and older. Methods: We conducted logistic regressions on individual-level 24-hour dietary recall and health indicator data (N = 6135) retrieved from 2005-2016 National Health and Nutrition Examination Survey. Results: Approximately 51%, 14%, and 9% of older adults consumed beef, fresh beef, and fresh lean beef, respectively. Daily increase in fresh beef consumption by one-ounce-equivalent was associated with a reduction in the odds of lower extremity mobility limitation (LEM) by 16% (95% confidence interval [95% CI]: 4%-27%), general physical activities limitation by 13% (95% CI: 1%-24%), and any functional limitation by 14% 95% CI: (2%-24%). Daily increase in fresh lean beef consumption by one-ounce-equivalent was associated with a reduction in the odds of LEM by 22% (95% CI: 7%-34%) and any functional limitation by 15% (95% CI: 1%-28%). We identified no association with activities of daily living, instrumental activities of daily living, or leisure and social activities limitations. Conclusions: Preliminary evidence links fresh and fresh lean beef consumption to reduced functional limitation risk. Future studies with longitudinal/experimental design are warranted to examine the relationship between fresh/lean beef consumption and functional limitations among older adults.

Total, Fresh, Lean, and Fresh Lean Beef Consumption in Relation to Nutrient Intakes and Diet Quality among U.S. Adults, 2005⁻2016.

(1) Background: This study assessed the influence of beef consumption on nutrient intakes and diet quality among U.S. adults. (2) Methods: Nationally-representative sample (n = 27,117) from 2005⁻2016 National Health and Nutrition Examination Survey was analyzed. First-difference estimator addressed confounding bias from time-invariant unobservables (e.g., eating habits, taste preferences) by using within-individual variations in beef consumption between 2 nonconsecutive 24 h dietary recalls. (3) Results: Approximately 54%, 39%, 12%, and 7% of U.S. adults consumed beef, lean beef, fresh beef, and fresh lean beef, respectively. Overall diet quality measured by the Health Eating Index-2015 (HEI-2015) score among beef, fresh beef, lean beef, and fresh lean beef consumers was lower than beef non-consumers. Regression analyses found that beef, fresh beef, lean beef, and fresh lean beef consumption was associated with higher daily intakes of total energy, protein, sodium, choline, iron, selenium, zinc, phosphorus, and multiple B vitamins. Beef, fresh beef, and lean beef consumption but not fresh lean beef consumption was associated with higher saturated fat intake. Beef consumption was not found to be associated with overall dietary quality measured by the HEI-2015 score. (4) Conclusions: Beef consumers may increase the intake of fresh and lean beef over total beef consumption to maximize the nutritional gains from beef portions while minimizing the resulting increases in energy, saturated fat, and sodium.

The Brand's PREACH Survey: A Capacity Assessment Tool for Predicting Readiness to Engage African American Churches in Health.

The purpose of this study was to develop the Brand's PREACH (Predicting Readiness to Engage African American Churches in Health) Survey, a capacity assessment tool based on the Brand's PREACH Model to predict the readiness of African American (AA) churches to engage in health promotion programming (HPP). The survey assessed church infrastructure (physical structure, personnel, funding, and cultural/social support), frequency of HPP and readiness to engage in HPP. The survey was administered to 108 AA churches in Illinois and North Carolina. The study findings revealed that churches with more infrastructure tended to engage in more HPP. Churches with less infrastructure tended to engage in less HPP. Overall, infrastructure was associated with and able to predict the readiness of AA churches to engage in HPP.

The Brand's PREACH Model: Predicting Readiness to Engage African American Churches in Health.

Despite many attempts to reduce health disparities, health professionals face obstacles in improving poor health outcomes within the African American (AA) community. To promote change for improved health measures, it is important to implement culturally tailored programming through a trusted institution, such as the AA church. While churches have the potential to play an important role in positively impacting health among AAs, it is unclear what attributes are necessary to predict success or failure for health promotion within these institutions. The purpose of this study was to create a model, the Brand's PREACH ( Predicting Readiness to Engage African American Churches in Health) Model, to predict the readiness of AA churches to engage in health promotion programming. Thirty-six semistructured key informant interviews were conducted with 12 pastors, 12 health leaders, and 12 congregants to gain information on the relationship between church infrastructure (physical structure, personnel, funding, and social/cultural support), readiness, and health promotion programming. The findings revealed that church infrastructure has an association with and will predict the readiness of a church to engage in health promotion programming. The ability to identify readiness early on will be useful for developing, implementing, and evaluating faith-based interventions, in partnership with churches, which is a key factor for sustainable and effective programs.

Assistive technology use by disability type and race: exploration of a population-based health survey.

PURPOSE: To examine the relationships among Assistive Technology (AT) use, race, type of disability and selected other demographic characteristics. METHOD: Using 2009 National Health Interview Survey, descriptive statistics, statistical interactions and binary logistic regression were performed to identify, contrast and predict the likelihood of using AT based on the type of disability among African Americans (AAs) and European Americans (EAs). RESULTS: We found that more AAs (10% within group proportion of total AAs) used AT compared to EAs (7.5% within group proportion of total EAs). Physical (p < 0.001), auditory (p = 0.028) and emotional (p = 0.008) impairments were statistically significant predictors of AT use. However, physical impairment as a predictor of AT use was greater among AAs (OR = 222.49, CI: 64.04-773.04, p < 0.001) than EAs (OR = 50.77, CI: 31.78-81.12, p < 0.001). EAs had a greater number of disabling conditions that predict the use of AT than AAs, whereas AAs had more demographic characteristics beyond race that predict AT use than EAs. CONCLUSIONS: Disparities were observed in AT usage by disability types and demographic characteristics between AAs and EAs. Moreover, the predictive strength of AT usage based on disability types and other demographic variables differed by races. Overall, the findings about the different relationships among race, disability type, and AT use are found. Implications for Rehabilitation The finding may inform the development of initiatives by rehabilitation leaders to encourage the use of AT by AAs and EAs according to their type of impairment. Having identified physical impairment as statistically significant predictor of AT use greater among AAs, rehabilitation leaders should ensure that people living with those types of disability have access to the corresponding type of AT and can use them effectively.

Assistive technology and veterans with severe disabilities: examining the relationships among race, personal factors, medical support, income support, and use.

PURPOSE: Examine the relationship among assistive technology (AT), race, and other demographic characteristics (eg, sex, educational attainment, and employment status), medical coverage, as well as government support for veterans with severe disabilities. METHODS: Data were analyzed from the Rehabilitation Services Administration-911 dataset collected in the United States in 2012. Descriptive and multivariate analyses were performed. RESULTS: Among veterans with severe disabilities, factors that increased AT usage for European Americans (EAs) and African Americans (AAs) were employment, medical coverage (eg, access to private insurance and Medicare), government support (eg, Supplemental Security Income or Social Security Disability Income), and having a sensory type of disability. Having a mental disability was associated with decreased use of AT for EAs and AAs. Whereas EAs) had more factors associated with a decreased likelihood of using AT, AAs had more factors associated with an increased likelihood. For EA veterans with severe disabilities, receiving Medicaid, veteran benefits, and Workers' Compensation were associated with a decreased likelihood of using AT. AA veterans with severe disabilities were 60% less likely to use AT compared with EAs. CONCLUSIONS: Racial differences between AAs and EAs were observed in the use of AT by veterans with severe disabilities based on sex, education, employment status, medical coverage, and government support. AAs were generally less likely to use AT; however, greater exposure to resources such as employment, insurance, and government income support partially explained the differential AT use between EAs and AAs. Future policies and research should address these racial disparities in veterans with severe disabilities to promote equitable AT use and healthy functioning.

Utilization of assistive technology by persons with physical disabilities: an examination of predictive factors by race.

PURPOSE: Examine the relationship between race, use of assistive technology (AT), gender, educational attainment, income, employment status and access to health care. METHODS: Data were analyzed from the national Behavioral Risk Factor Surveillance System (BRFSS) collected in USA in 2007. Descriptive statistics and logistic regression were performed. RESULTS: Among those who used AT, more European Americans (EAs) were educated, employed, made >$25,000 per year and had better access to health coverage. In contrast, more African Americans (AAs) who used AT were less educated, unemployed, made <$25,000 per year and had worse health coverage. Overall, AAs used AT more than EAs. The trend was consistent with predictive factors. AAs were 29% more likely to use AT compared to EAs. For EAs and AAs, predictors for use of AT were age, gender, education, employment status, income, health coverage and medical costs. CONCLUSIONS: Racial differences between AAs and EAs were observed in the use of AT by persons with physical disabilities based on age, gender, education, employment status, income levels, health care coverage and medical costs. Even though EAs and AAs had the same predictors, there were racial differences in the magnitude of the predictors.

Disability and race: a comparative analysis of physical activity patterns and health status.

PURPOSE: Minority groups, specifically African Americans (AAs), are more likely to be physically inactive than the general population. Although the aforementioned finding is well documented, there is a dearth of literature that examines levels of physical activity among AA adults with disabilities. The purpose of this article was to study the patterns of physical activity and health status among AA adults with disabilities in comparison with their White counterparts. METHODS: Data from the Centers for Disease Control and Preventions 2007 Behavioral Risk Factor Surveillance System survey were used to conduct comparative analyses of physical activity patterns and health status among 7315 AAs and 82 482 Whites who self-reported a disability. RESULTS: Significant differences (p < 0.05) were found between health status and physical activity patterns across racial groups. AAs with disabilities were less likely to engage in moderate and vigorous physical activity than their White counterparts. AAs were also less likely to engage in physical activity as health status declined in comparison with White respondents. CONCLUSION: When considering the health of minorities with disabilities, physical activity must be central to improving their health status. The authors of this study provide additional support for developing unique health programming for AAs with disabilities. Rehabilitation and health care professionals can gain insight into lifestyle patterns of minorities with disabilities, which can be useful in addressing health behaviors that may be counter to physical well-being.

Understanding preventive behaviors among mid-Western African-American men: a pilot qualitative study of prostate screening.

BACKGROUND: African-American men bear a disproportionate burden for disease compared to other ethnic and racial groups. Due to gender differences in socialization and lifestyle practices, men are more likely to adopt attitudes and beliefs that undermine their health and well-being, including beliefs related to masculinity. The purpose of this study was to explore and understand the contextual factors in the attitudes and beliefs of African-American men's view of health in general, and as related to prostate cancer in particular. METHODS: Qualitative data from 15 African-American men were collected from two focus groups and analyzed for common themes using a qualitative descriptive design. RESULTS: Three themes emerged that focused on the beliefs and attitudes regarding general health and prostate cancer screening: (i) traditional beliefs about masculinity; (ii) psychosocial impact from family medical history; and (iii) sexual mores regarding digital rectal exams. CONCLUSIONS: The socialization of African-American men and masculinity ideologies may be significant factors in the focus group member's decisions to seek preventive health behavior changes. Further research is needed to examine the determinants of African-American men's health seeking behavior, in particular on the influence of masculine beliefs.