Mitigating the Spread of COVID-19: Differential Perceptions of Midwestern University Students.

Racially minoritized groups have disproportionately borne the impacts of the COVID-19 pandemic in America. We draw on Public Health Critical Race Praxis to investigate racial differences in college students' attitudes about mitigation efforts to limit the spread of COVID-19 and concerns about one's own and others' actions in these efforts. We used survey data from a random sample of Midwestern undergraduates (n = 620) who participated in a fall 2020 COVID-19 study; chi-square tests and logistic regression modeling were employed. Students of color were more likely than white students to report mitigation strategies as not sufficiently restrictive and that communities ought to prioritize limiting the spread of COVID-19. Students of color were also more likely to be concerned that the actions of others were spreading COVID-19. Universities need to continuously ask how their policies and practices acknowledge the broader racial context and seek the perspectives of diverse students.

How Do African-American Community Members' Perceptions About Environmental Risks of Breast Cancer Compare with the Current State of the Science?

African-American (AA) women experience higher mortality from breast cancer than any other racial group. Understanding community-held perceptions of environmental contaminants as risk factors for breast cancer can inform the development of tailored prevention and education efforts for improve health outcomes. Six focus groups were conducted with AA participants in two counties in South Carolina, and themes were identified using open and axial coding. Perceived environmental risks for breast cancer most frequently discussed by participants were compared to findings from published systematic reviews. Frequently discussed environmental risk factors by participants were deodorants containing aluminum, plastics, pesticides, and air and water pollution. While perceptions of aluminum and air pollution as risk factors did not align with the state of the science, perceived risk factors of chemicals in plastics and pesticides were found to be in alignment. There is some congruence between perceived environmental risks for breast cancer within the AA community and the current state of the science; however, there is a need to communicate information that reflects current science regarding commonly held misconceptions. Development of evidence-based, clear, and culturally appropriate messaging that reflects the current state of the science is warranted.

"Mentally you don't function the same": a Qualitative Examination of the Normalization, Embodiment, and Psychological Impact of Everyday Racism.

Everyday racism consists of covert and oppressive practices that uphold systems of power and reproduce White supremacy through subtle forms of repetitive and normalized discriminatory actions. While attention to the material and physical damage everyday racism evokes upon Black Americans is receiving increased attention, inconsistencies regarding its conceptualization and operationalization are impeding our understanding of the impact of everyday racism. Utilizing critical race theory (CRT) as an analytical framework, this article intends to respond to gaps in the literature and deepen the understanding of the psychological burden experiences of everyday racism places upon a sample of (n = 40) Black Americans. We engaged with the racial realism and Whiteness as property tenets to analyze individual in-depth interviews and (1) enhance our interrogation of micro/macro-level interactions and (2) aid in the conceptualization of everyday racism. Three themes emerged from the data: hypervigilance and the normalization of everyday racism, mental preparation for navigating White spaces, and the mental health impact of everyday racism. Participant narratives reveal how the normalization of everyday racism impacts them on a psychological and corporeal (i.e., bodily) level. Their accounts also spoke to how Whiteness operates as a property right that exacerbates everyday racism and places invisible boundaries upon how they navigate space. This study provides conceptual clarity about the realities of racism, deeper awareness of structural and individual measures, and an in-depth understanding of how often taken for granted and assumed "normal" forms of racism generate pathways to negative mental health outcomes.

Examining racial disparities in the diagnosis of mild cognitive impairment.

Black individuals are less likely to receive an accurate diagnosis of mild cognitive impairment (MCI) than their White counterparts, possibly because diagnoses are typically made by a physician, often without reference to objective neuropsychological test data. We examined racial differences in actuarial MCI diagnoses among individuals diagnosed with MCI via semi-structured clinical interview (the Clinical Dementia Rating) to examine for possible biases in the diagnostic process. Participants were drawn from the National Alzheimer's Coordinating Center Uniform Data Set and included 491 individuals self-identifying as Black and 2,818 individuals self-identifying as White. Chi-square tests were used to examine racial differences in rates of low scores for each cognitive test (domains assessed included attention, processing speed/executive functioning, memory, language, and visual skills). Next, we tested for racial differences in probability of meeting actuarial criteria for MCI by race. Compared to Black participants diagnosed with MCI via clinical interview, White individuals diagnosed with MCI via clinical interview demonstrated significantly higher rates of low demographically-adjusted z-scores on tests of memory, attention, processing speed, and verbal fluency. Furthermore, White individuals were significantly more likely to meet actuarial criteria for MCI (71.60%) than Black individuals (57.90%). Results suggest there may be bias in MCI classification based on semi-structured interview, leading to over diagnosis among Black individuals and/or under diagnosis among White individuals. Examination of neuropsychological test data and use of actuarial approaches may reduce racial disparities in the diagnosis of MCI. Nonetheless, issues related to race-based norming and differential symptom presentations complicate interpretation of results.

Infant Feeding Exposure and Personal Experiences of African American Mothers.

Background: Although exposure and personal experiences can guide breastfeeding decisions, the extant research on African American mothers is limited regarding the influence of infant feeding exposure. The persistent race-based breastfeeding disparities also underscore the lack of effective interventions to support breastfeeding among African Americans. Objective: To describe infant feeding exposure and personal experiences of African American mothers in the Midwestern United States with regard to decision making about breastfeeding behavior. Materials and Methods: Thirty individual qualitative interviews using a semistructured interview guide were conducted with African American mothers ≥18 years old with an infant 1-6 months of age. Interviews addressed participants' breastfeeding and formula feeding decisions. Data were coded line by line using thematic analysis. Results: Positive exposure to breastfeeding and health care providers' prenatal advice influenced nearly all participants to try breastfeeding. However, breastfeeding experiences were unexpected, they did not know how to handle challenges, and nearly half did not continue. Five central themes important to their decision-making processes were identified in the data including contact with breastfeeding mothers, guidance from health care providers, navigating the demands of breastfeeding, making the switch to formula, and my own research. Conclusion: Our findings support the importance of both prenatal and postnatal education, the influence of health care providers, and the impact of close social role models. Appropriate education about realistic breastfeeding information is needed to support African American mothers in their breastfeeding decision making. The high use of the Internet to access information also emphasizes the potential opportunity for breastfeeding interventions delivered through technology.

'When you take pills you must eat': Food (in)security and ART adherence among older people living with HIV.

South Africa has increasing numbers of persons living with HIV on antiretroviral treatment (ART). There is evidence for a relationship between food, food security and HIV. Despite increasing rates of people older than 50 living with HIV coinciding with greater levels of co-morbidity, the existing research is largely limited to those aged 15-49 years. In this paper, we therefore explore how older people living with HIV (OPLWH) in two urban communities within South Africa negotiate and ensure they have sufficient access to food and how food insecurity may affect their retention in care and ART adherence. This study used exploratory qualitative semi-structured in-depth interviews with 23 OPLWH to collect data in isiXhosa. Data were analysed using thematic content analysis. Factors at the community, household and individual levels influence (a) access to sufficient and quality food, and (b) beliefs about ART and food based on (mis)understandings of messaging from health care providers. The results demonstrate the need to explore further and clarify the nutritional guidelines that OPLWH receive from providers to ensure this does not result in reduced adherence or retention in care. They also demonstrate the role that social welfare and family or kin obligations plays in ensuring the food security of OPLWH.

Differential perceptions of a hypothetical sexual assault survivor based on race and ethnicity: Exploring victim responsibility, trauma, and need for social support.

Objective: Explore the ways in which a sample of college women interpret racially/ethnically coded vignettes to understand their perceptions of responsibility and trauma experienced by a hypothetical female sexual assault survivor and her need for social support. Participants: Convenience sample of college women (N = 51) attending a large, predominately white university in the Southeastern United States recruited between January and March 2013. Methods: Participants were randomly assigned one of three vignettes describing a hypothetical date rape scenario. Vignette scenarios were identical except for discrete statements coded to signify either an African American, Latina, or white female student. Participants responded to open-ended questions that gauged their interpretations of responsibility, trauma, and social support. Results: Qualitative analysis of open-ended responses revealed six overarching themes, including overt victim blaming/shaming, justification of the sexual assault, and perceived need for social support. Conclusions: Findings point to the significance of including race in discussions about and programs that address sexual assault on college campuses to ensure that all women who experience sexual violence receive the support that they need.