Superwomen and Sleep: an Assessment of Black College Women Across the African Diaspora.

BACKGROUND: Women and racial/ethnic minority groups in the U.S. report poor sleep health. While stress and alcohol use may contribute to sleep problems, few studies have examined the roles of stress and alcohol use on sleep among Black college women. Gender-racial ideology of Black womanhood may also play a role in sleep. This exploratory study sought to examine the relationships between stress, alcohol, ethnic-gender identity, and sleep. METHOD: Guided by the biopsychosocial model and intersectionality theory, a cross-sectional study design recruited undergraduate women (18-24 years) attending a Historically Black College and University (HBCU) who self-identified as Black (N = 110). Participants completed the Insomnia Severity Index, Pittsburgh Sleep Quality Index, Perceived Stress Scale, Alcohol Use Disorders Test, and Giscombe Superwoman Schema Questionnaire. Univariate and multiple linear regressions were conducted to examine independent and multiple effects of stress, alcohol, and ethnic-gender identity on insomnia and sleep quality. RESULTS: Participants (mean age 19.4 years) represented diverse ethnic groups, 53% American, 25% African, and 20% Caribbean. Nearly 23% reported moderate to severe levels of insomnia. Scores from the Perceived Stress Scale, the Alcohol Use Disorders Test, and the Giscombe Superwoman Schema Questionnaire were independently associated with insomnia and sleep quality. In multivariate analyses, only perceived stress exhibited a significant association with insomnia and sleep quality. CONCLUSION: This exploratory study demonstrated that stress, excessive alcohol use, and ethnic-gender identity have relational impact on sleep health. Yet, stress may have greater importance and further research is needed to explore factors that mediated the relationship between stress and sleep.

Factors Associated with Exercise Motivation among African-American Men.

OBJECTIVE: The primary aims of this study were to: (1) characterize exercise stages of change among a sample of African-American men, (2) determine if exercise motivation was associated with self-reported exercise behavior, and (3) examine if groups of personal (i.e., age, BMI, income, educational attainment, and perceived health), psycho-social (i.e., exercise self-efficacy, personality type, social influence), and environmental factors (i.e., neighborhood safety) predicted stages of change for physical exercise among African-American men. METHODS: One hundred seventy African-American male participants were recruited for this study (age: 47.63(10.23) years). Participants completed a self-report questionnaire assessing study variables. Multinomial logistic regression models were used to examine the association of exercise stages of change with an array of personal, psychosocial, and environmental factors. RESULTS: BMI, exercise self-efficacy, and nighttime neighborhood safety were entered as independent variables in the full model. BMI and exercise self-efficacy continued to be significant predictors of exercise stages of change in the full model. Obese men had a 9.24 greater odds of being in the action stage of change than in the maintenance stage. Also, men reporting greater exercise self-efficacy had lower odds of being in the lower stages of change categories (pre-preparation, preparation, and action) than in the maintenance stage. CONCLUSION: Our results confirmed that using an ecological framework explained more of the variance in exercise stages of change than any of the individual components alone. Information gleaned from this study could inform interventionists of the best ways to create tailored exercise programs for African-American men.

Standardized patient assessment of medical student empathy: ethnicity and gender effects in a multi-institutional study.

PURPOSE: To examine, primarily, the effects of ethnicity and gender, which could introduce bias into scoring, on standardized patient (SP) assessments of medical students and, secondarily, to examine medical students' self-reported empathy for ethnicity and gender effects so as to compare self-perception with the perceptions of SPs. METHOD: Participants were 577 students from four medical schools in 2012: 373 (65%) were white, 79 (14%) black/African American, and 125 (22%) Asian/Pacific Islander. These students were assessed by 84 SPs: 62 (74%) were white and 22 (26%) were black/African American. SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and the Global Ratings of Empathy tool. Students completed the Jefferson Scale of Empathy and two Interpersonal Reactivity Index subscales. The investigators used 2,882 student-SP encounters in their analyses. RESULTS: Analyses of SPs' assessments of students' empathy indicated significant interaction effects of gender and ethnicity. Female students, regardless of ethnicity, obtained significantly higher mean JSPPPE scores than men. Female black/African American, female white, and female Asian/Pacific Islander students scored significantly higher on the JSPPPE than their respective male counterparts. Male black/African American students obtained the lowest SP assessment scores of empathy regardless of SP ethnicity. Black/African American students obtained the highest mean scores on self-reported empathy. CONCLUSIONS: The significant interaction effects of ethnicity and gender in clinical encounters, plus the inconsistencies observed between SPs' assessments of students' empathy and students' self-reported empathy, raise questions about possible ethnicity and gender biases in the SPs' assessments of medical students' clinical skills.

Impact of perceived racial discrimination on health screening in black women.

Perceived discrimination has been shown to be related to health screening behavior. The present study examines the effect of discrimination on cancer screening among women in the Black Women's Health Study. Five self-report items measured discrimination in everyday life and three items measured experiences of major discrimination. Logistic regression was used to test associations of discrimination with Pap smear, mammography, or colonoscopy utilization. At the start of follow-up, 88.8% had a Pap smear in the previous year, 52.7% had a mammogram, and 20.0% had received a colonoscopy. Both everyday and major discrimination were associated with not having received a Pap smear, even after adjusting for other variables. Discrimination was not associated with mammography or colonoscopy utilization. In conclusion, perceived everyday and major discrimination is associated with poorer utilization of Pap smears for cervical cancer screening among Black women.

Validation of physical activity instruments: Black Women's Health Study.

PURPOSE: Few studies have reported on the validity of physical activity measures in African Americans. The present study was designed to determine the validity of a self-administered physical activity questionnaire (PAQ) that was used in a large prospective study of African American women in the United States against an accelerometer (actigraph), an objective assessment of movement, and a seven-day activity diary. METHODS: The study was conducted among 101 women enrolled in the Black Women's Health Study (BWHS) cohort who resided in the Washington, DC, metropolitan area, representing 11.2% (101/900) of this sample. Physical activity levels were obtained from the parent BWHS PAQ (eg, 1997 and 1999) and repeated in the present study. This information entailed hours per week of participation in walking for exercise, hours per week of moderate activity (eg, housework, gardening, and bowling), and hours per week of strenuous activity (eg, basketball, swimming, running, and aerobics) during the previous year. The participants were required to wear actigraphs for seven days and then record their physical activities in their diaries (seven-day physical activity diary) during this time. The diaries were used to record the amount and pattern of daily energy expenditure. RESULTS: Significant positive correlations were seen between the BWHS PAQ and the actigraph for total activity, r=.28; walking, r=.26; and vigorous activity, r=.40, P<.001. For the seven-day physical activity diary, the BWHS PAQ also demonstrated significant correlations for total (r=0.42, P<.01); moderate (r=.26, P<.05); and vigorous activities (r=.41, P<.01). CONCLUSIONS: The BWHS PAQ is a useful measure of physical activity in the BWHS cohort and thus has utility in prospective epidemiologic research.