The relationships between perceived mental illness prevalence, mental illness stigma, and attitudes toward help-seeking.

Previous research suggests that, despite the commonality of mental illness in the United States, the majority of U.S. individuals with mental illness do not seek treatment. One important factor that contributes to this lack of treatment utilization is mental illness stigma. Such stigma may result, in part, from many individuals in the U.S. underestimating the prevalence of mental illness. To test whether this is the case, 638 adults from across the U.S. completed measures related to perceived prevalence of mental illness, private stigma, perceived public stigma, and help-seeking. Findings indicated participants significantly underestimated the given-year prevalence rate of mental illness. The perceived given-year prevalence rate was significantly correlated with lower private stigma and more positive attitudes towards help-seeking. Personal stigma significantly predicted attitudes towards help-seeking. Findings also suggested that individuals who have received mental health services have a higher perceived prevalence rate of mental illness, as well as lower levels of personal stigma and more positive attitudes towards help-seeking. These findings support the notion that helping the general public recognize the true prevalence rate of mental illness could reduce personal mental illness stigma and facilitate help-seeking behaviors. However, future experimental studies are needed to test this hypothesis.

A longitudinal study of social, religious, and spiritual capital and physical and emotional functioning in a national sample of African-Americans.

The present study builds on prior research by examining the moderating relationships between different types of capital on physical functioning, emotional functioning, and depressive symptoms using a 2.5-year longitudinal design with a national sample of African-American adults. Results indicated a significant T1 social capital × T1 religious capital interaction such that among low T1 religious capital participants, those with high T1 social capital had lower T2 physical functioning than those with lower T1 social capital. There was also a marginally significant T1 social capital × T1 spiritual capital interaction suggesting that among low T1 spiritual capital participants, those with higher T1 social capital reported a decline in depressive symptoms compared to those with lower T1 social capital. Future research and implications for intervention and policy development are discussed.

Disability and Health in African Americans: Population Research and Implications for Occupational Therapy Community-Based Practice.

Background: Population-based research and community-based interventions are integral to occupational therapy's scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model. Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health behaviors and psychosocial health indicators across five US regions. Results: Findings suggest that African Americans RDP are engaging in fewer positive physical health behaviors and experiencing worse psychosocial health compared to their counterparts FTE. There are also nuanced regional variations in the differences between African Americans RDP and FTE in physical health behaviors and psychosocial health indicators. Conclusion: This research highlighted some health challenges of African Americans RDP and FTE using a regional lens, demonstrating the value of OT population-based research. There is a need for OT population-specific community-based practice to address the health disparities of underserved and minority populations, such as African Americans.

I hope my partner can make me change: expected relational self-changes and relational outcomes.

The Two-Dimensional Model of Relational Self-change (TDM) suggests four types of self-change that may be elicited by romantic relationships: self-expansion, self-adulteration, self-pruning, and self-contraction. Previous research has shown that these four types of relational self-change were associated with relational outcomes. Prior research has also shown that positive illusions and expectations in romantic relationships can lead to positive relational outcomes. The current study used a longitudinal design to investigate how the four types of expected relational self-change affect future relationship satisfaction and commitment. Results indicated that participants had higher expected self-changes than their actual self-changes after three months, but their expected self-changes and actual self-changes were correlated. At Time 1 of their relationship, participants' relationship satisfaction and commitment were related to their expected self-changes. However, controlling for Time 1 relationship satisfaction and commitment, expected self-changes predicted commitment, but not relationship satisfaction, three months later.

Meaning in Life Predicts Decreased Depressive Symptoms and Increased Positive Affect over Time but Does Not Buffer Stress Effects in a National Sample of African-Americans.

Few studies have specifically focused on meaning in life in African Americans and many important questions remain, including whether effects of meaning in life are direct or moderated by levels of stress. In a national sample of 909 African Americans, we tested meaning in life as a prospective predictor of changes in depressive symptoms and positive affect over a 2.5-year period. Controlling for demographics and hassles, meaning in life predicted decreased depressive symptoms and increased positive affect across the span of 2.5 years. Moderation effects were not found for hassles, age, or income. Gender moderated the effect of meaning on positive affect such that effects were stronger for women than for men. These results suggest that, for African Americans, meaning in life appears to robustly protect against future depressive symptoms and promote positive affect over time unaffected by amount of stress experienced or most demographic factors.

Do neighborhood characteristics contribute beyond individual demographics to cancer control behaviors among African American adults?

BACKGROUND: Recent years have seen increased interest in the role of neighborhood factors in chronic diseases such as cancers. Less is known about the role of neighborhood factors beyond individual demographics such as age or education. It is particularly important to examine neighborhood effects on health among African American men and women, considering the disproportionate impact of cancer on this group. This study evaluated the unique contribution of neighborhood characteristics (e.g., racial/ethnic diversity, income) beyond individual demographics, to cancer control behaviors in African American men and women. METHODS: Individual-level data were drawn from a national survey (N = 2,222). Participants' home addresses were geocoded and merged with neighborhood data from the American Community Survey. Multi-level regressions examined the unique contribution of neighborhood characteristics beyond individual demographics, to a variety of cancer risk, prevention, and screening behaviors. RESULTS: Neighborhood racial/ethnic diversity, median income, and percentage of home ownership made modest significant contributions beyond individual factors, in particular to smoking status where these factors were associated with lower likelihood of smoking (ps < .05). Men living in neighborhoods with older residents, and greater income and home ownership were significantly more likely to report prostate specific antigen testing (ps < .05). Regional analyses suggested different neighborhood factors were associated with smoking status depending on the region. CONCLUSION: Findings provide a more nuanced understanding of the interplay of social determinants of health and neighborhood social environment among African American men and women, with implications for cancer control interventions to eliminate cancer disparities.

A longitudinal examination of social support as a mediator of the personality-health relationship in a national sample of African Americans.

The present study investigates whether social support mediates the relationship between personality traits and health among African Americans over a five-year period, filling a gap in the literature on longitudinal tests of the personality-health association. Data were collected from a national probability sample of African American adults (N = 200). Personality was assessed at Time 1 (T1), social support was assessed 2.5 years later (T2), and physical functioning was examined 5 years (T3) after T1. Telephone surveys included measures of the Five Factor Model personality traits (T1), social support (T2), and physical functioning (T3). Results suggested that relationships between the T1 personality traits and T3 physical functioning were not mediated by T2 social support. Secondary analyses found that among all T1 personality traits, higher openness and lower neuroticism uniquely predicted higher T2 social support. Further, among T1 personality traits, higher conscientiousness uniquely predicted better T3 physical functioning. This information may be useful to healthcare providers and community members in developing prevention and intervention strategies for African Americans.

Unrequited love: The role of prior commitment, motivation to remain friends, and friendship maintenance.

This study tested a moderated mediation model that commitment prior to an unrequited love episode will be related to higher levels of friendship maintenance behaviors after the episode and that this relationship will be mediated by the individual's motivations to remain friends with the rejecter. We predicted that rejection distress would weaken the mediational model among those reporting high distress. Participants wrote about an unrequited love experience as a pursuer and completed measures of pre-unrequited love commitment, rejection distress, motivations to remain friends, and friendship maintenance behaviors. Our results confirmed the moderated mediation model when the motivations to remain friends measure overall score, the interpersonal connection motivation, or the social connections motivation was the mediator. When covariates were added, only the model with the overall motivations score as mediator was supported. These data can help laypersons and mental health professionals understand and potentially repair friendships following an unrequited love episode.

Unique contribution of education to behavioral and psychosocial antecedents of health in a national sample of African Americans.

Education has demonstrated consistent links with many aspects of physical health and is theorized to relate to a variety of behavioral and psychosocial antecedents of health that may ultimately account for these associations. However, many of these associations and the extent to which they manifest specifically for African Americans have not been thoroughly tested. We examined associations of education-distinct from income-with established behavioral and psychosocial antecedents of health in a national sample of African Americans. Education favorably related to many behavioral (e.g., fruit/vegetable intake, lifetime smoking) and psychosocial (e.g., self-efficacy, personality traits, self-esteem, psychological well-being) antecedents of health, but not to all. Some evidence of stronger salutary relations of education for women was found. Results suggest that, for African Americans, education is generally favorably associated with an array of behavioral and psychosocial antecedents of physical health, partially explaining health disparities and providing a point of intervention moving forward.

Personality, Social Capital, and Depressive Symptomatology Among African Americans.

The present study examined the relationship between social capital and depressive symptoms and the moderating role of the Big Five personality constructs in a national sample of African American adults. Data were collected from a national probability sample of 803 African American men and women using a telephone survey including measures of the Big Five personality traits, social capital, and depressive symptomatology. Most interestingly, there was evidence for Personality X Social Capital interactions on depressive symptoms. Higher social capital was related to lower depressive symptomology among persons with low conscientiousness, low extraversion, or high neuroticism. However, social capital was significantly but not as strongly related to depressive symptoms among those with high conscientiousness, high extraversion, or low neuroticism. This study reinforces the importance of personality traits when considering potential protective health effects of social capital in understanding depressive symptoms. This information may be useful to practitioners and community members in prevention and treatment.

A Longitudinal Study of Religiosity, Spiritual Health Locus of Control, and Health Behaviors in a National Sample of African Americans.

The present longitudinal study examined religious beliefs and behaviors, spiritual health locus of control (SHLOC), and selected health-related behaviors and outcomes in a national sample of 766 African American adults. Participants were interviewed by telephone three times over a 5-year period. Results indicated that stronger religious beliefs and religious behaviors were associated with greater changes in active SHLOC. There was some evidence of direct effects of religious beliefs and behaviors on changes in health behaviors. Religious behaviors were related to greater passive SHLOC over time across some health outcomes. Passive SHLOC was associated with some less desirable health outcomes over time.

Role of religious social support in longitudinal relationships between religiosity and health-related outcomes in African Americans.

This study tested a longitudinal model of religious social support as a potential mediator of the relationship between religious beliefs and behaviors, and multiple health-related outcomes (e.g., depressive symptoms, functioning, diet, alcohol use, cancer screening). A national probability sample of African Americans enrolled in the religion and health in African Americans study completed three waves of telephone interviews over a 5-year period (N = 766). Longitudinal structural equation models indicated that religious behaviors, but not beliefs, predicted the slowing of a modest overall decline in positive religious social support, while negative interactions with congregational members were stable. Positive religious support was associated with lower depressive symptoms and heavy drinking over time, while negative interaction predicted increases in depressive symptoms and decreases in emotional functioning. Positive religious support mediated the relationship between religious behaviors and depressive symptoms and heavy drinking. Findings have implications for mental health interventions in faith-based settings.

Longitudinal effects of religious involvement on religious coping and health behaviors in a national sample of African Americans.

Many studies have examined associations between religious involvement and health, linking various dimensions of religion with a range of physical health outcomes and often hypothesizing influences on health behaviors. However, far fewer studies have examined explanatory mechanisms of the religion-health connection, and most have overwhelmingly relied on cross-sectional analyses. Given the relatively high levels of religious involvement among African Americans and the important role that religious coping styles may play in health, the present study tested a longitudinal model of religious coping as a potential mediator of a multidimensional religious involvement construct (beliefs; behaviors) on multiple health behaviors (e.g., diet, physical activity, alcohol use, cancer screening). A national probability sample of African Americans was enrolled in the RHIAA (Religion and Health In African Americans) study and three waves of telephone interviews were conducted over a 5-year period (N = 565). Measurement models were fit followed by longitudinal structural models. Positive religious coping decreased modestly over time in the sample, but these reductions were attenuated for participants with stronger religious beliefs and behaviors. Decreases in negative religious coping were negligible and were not associated with either religious beliefs or religious behaviors. Religious coping was not associated with change in any of the health behaviors over time, precluding the possibility of a longitudinal mediational effect. Thus, mediation observed in previous cross-sectional analyses was not confirmed in this more rigorous longitudinal model over a 5-year period. However, findings do point to the role that religious beliefs have in protecting against declines in positive religious coping over time, which may have implications for pastoral counseling and other faith-based interventions.

The Impact of Intimate Partner Violence on Women's Physical Health: Findings From the Missouri Behavioral Risk Factor Surveillance System.

Intimate partner violence (IPV) is a significant public health problem. It has far reaching consequences such as social and economic costs, as well as a negative impact on women's health outcomes. This study assessed the relationship between IPV and health risk factors, health behaviors, and poor mental health in Missouri women utilizing 2005 Missouri Behavioral Risk Factor Surveillance System (BRFSS) data ( n = 3,110). Moderators (demographic indicators) of the relationship between IPV and health risk factors (high blood pressure, high cholesterol, and obesity) and health behaviors (physical inactivity, smoking, and binge drinking) were also examined. Women with a history of IPV were more likely to engage in health-compromising behaviors such as smoking and binge drinking, be obese, and report more poor mental health days compared with women without a history of IPV. Demographic variables moderated the relationship between IPV, obesity, smoking, high blood pressure, and high cholesterol. These findings underscore the importance that clinics, community, or other health care settings can play in identifying women who are victims of or have a history of IPV and provide them with appropriate resources as well as targeted interventions to reduce morbidity in this population.

I get so lonely, baby: The effects of loneliness and social isolation on romantic dependency.

Individuals lacking fulfilling interpersonal interactions may experience feelings of loneliness. Consequently, these individuals may over-rely on their romantic partners to fulfill the need to belong. This study examined the effects of loneliness and social isolation on dependency on a romantic partner in a sample of college students (N = 104). Participants who were in a romantic relationship completed measures of loneliness, social isolation, and romantic dependency near the beginning of the semester (Time 1) and approximately 6 weeks later toward the end of the semester (Time 2). Toward the beginning of the semester, there were no significant predictors of dependency. Toward the end of the semester, individuals who reported higher social isolation reported higher levels of dependency. Time 1 dependency also predicted Time 2 dependency. Future methodological directions and suggestions regarding the examination of perceptions of loneliness and relationship expectations are discussed.

Fruit and Vegetable Consumption, and Physical Activity with Partner and Parental Status in African American Adults.

OBJECTIVES: The purpose of this study was to examine the relationships between partner and parental status and self-reported weekly fruit and vegetable consumption and level of physical activity in African American adults. METHODS: A national sample of 2,370 African Americans participated in a telephone survey. Demographic data were collected and compared with fruit and vegetable consumption and physical activity responses. RESULTS: When controlling for age (mean age = 53.6 ± 14.8 years) and education level, having children in the household was associated with greater fruit consumption. Being partnered was associated with moderate physical activity weekly for a higher percentage of women, and yet a shorter duration of minutes of moderate physical activity weekly for both women and men. Males (38.2% of the sample) reported being more physically active and females (61.8% of the sample) reported eating more fruits and vegetables. CONCLUSIONS: By understanding the role of partner and parental status in relation to healthy lifestyle for African Americans, family scientists and health care practitioners may be able to target the needs of this population to help prevent obesity and chronic illness.

The relationship between religious beliefs and behaviors and changes in spiritual health locus of control over time in a national sample of African Americans.

Using data from a sample of African Americans, the present study examined the role of religious beliefs and behaviors in predicting changes in spiritual health locus of control (SHLOC), or beliefs about the role that God plays in a person's health. A national sample of African American adults was recruited using a telephone survey and re-contacted 2.5 years later. Overall, results indicated that both higher religious beliefs and behaviors predicted increases in active SHLOC, or the view that one collaboratively works with God to maintain one's health. However, only religious behaviors predicted increases in passive SHLOC, or the view that because God is in complete control of health that one's own behaviors are unnecessary. Among men, religious beliefs predicted strengthening active SHLOC beliefs, while religious behaviors predicted growing passive SHLOC beliefs. Among women, religious behaviors predicted strengthening active and passive SHLOC beliefs.

Religious Involvement and Health over Time: Predictive Effects in a National Sample of African Americans.

In this study, two telephone interviews that assessed both religious involvement and health-related quality of life were conducted approximately 2.5 years apart in a national sample of 290 African Americans. Religious involvement was assessed with an instrument that measured both personal religious beliefs (e.g., having a personal relationship with God) and more public religious behaviors (e.g., attending church services). Health-related quality of life was measured with version 2 of the Medical Outcomes Study 12-item short form (SF-12v2). Structural equation models indicated that higher religious beliefs at baseline predicted better physical and mental health 2.5 years later. Higher religious behaviors at baseline contributed smaller, complementary suppression effects. Physical and mental health indicators from the SF-12v2 at baseline did not predict changes in either religious beliefs or religious behaviors over time. These findings indicate that, for African Americans, personal religious beliefs lead to beneficial health effects over time, whereas individual differences in health do not appear to predict changes in religious involvement.

Religious Participation is Associated with Increases in Religious Social Support in a National Longitudinal Study of African Americans.

This study reports on the association between religious beliefs and behaviors and the change in both general and religious social support using two waves of data from a national sample of African Americans. The Religion and Health in African Americans (RHIAA) study is a longitudinal telephone survey designed to examine relationships between various aspects of religious involvement and psychosocial factors over time. RHIAA participants were 3173 African American men (1281) and women (1892). A total of 1251 men (456) and women (795) participated in wave 2 of data collection. Baseline religious behaviors were associated with increased overall religious social support from baseline to wave 2 (p < .001) and with increased religious social support from baseline to wave 2 in each of the following religious social support subscales: emotional support received (p < .001), emotional support provided (p < .001), negative interaction (p < .001), and anticipated support (p < .001). Religious beliefs did not predict change in any type of support, and neither beliefs nor behaviors predicted change in general social support. African Americans who are active in faith communities showed increases in all types of religious social support, even the negative aspects, over a relatively modest longitudinal study period. This illustrates the strength of the church as a social network and the role that it plays in people's lives.

Participant Retention in a Longitudinal National Telephone Survey of African American Men and Women.

OBJECTIVE: The purpose of this article is to describe participant demographic factors related to retention, and to report on retention strategies in a national study of African Americans re-contacted 2.5 years after an initial baseline telephone interview. DESIGN & SETTING: The Religion and Health in African Americans (RHIAA) study was originally developed as a cross-sectional telephone survey to examine relationships between religious involvement and health-related factors in a national sample of African Americans. The cohort was re-contacted on average of 2.5 years later for a follow-up interview. PARTICIPANTS: RHIAA participants were 2,803 African American men (1,202) and women (1,601). INTERVENTIONS: RHIAA used retention strategies consistent with recommendations from Hunt and White. Participants also received a lay summary of project findings. MAIN OUTCOME MEASURES: Retention at the follow-up interview. RESULTS: Retention rates ranged from 39%- 41%. Retained participants tended to be older and female. In age- and sex-adjusted analyses, retained participants were more educated, single, and in better health status than those not retained. There was no difference in religious involvement in adjusted analyses. CONCLUSIONS: Although overall retention rates are lower than comparable longitudinal studies, RHIAA was not originally designed as a longitudinal study and so lacked a number of structures associated with long-term studies. However, this project illustrates the feasibility of conducting lengthy cold call telephone interviews with an African American population and helps to identify some participant factors related to retention and study strategies that may aid in retention.