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Nutrition education and policy, systems and environmental (PSE) change interventions may be able to address food insecurity and obesity, conditions which are disproportionately experienced by African Americans. Work that seeks to address these disparities and advance social justice should uplift and learn from participant voices, particularly from marginalised groups. This scoping review aimed to summarise the available literature describing African Americans' perceptions of and experiences participating in nutrition interventions. We conducted an electronic literature search with the assistance of a research librarian which encompassed six databases (MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX and ProQuest Dissertations & Theses) and identified thirty-five sources meeting our inclusion criteria. The majority of studies assessing African Americans' satisfaction with interventions examined educational interventions alone, and about half of the included studies assessed satisfaction through quantitative methods alone. The only studies which found participants to be dissatisfied with interventions used qualitative methods and examined interventions providing education alone. Future work should evaluate African Americans' experience with nutrition-focused PSE changes, interventions which may be better able to address racial disparities in obesity and food insecurity. Nutrition educators working with African Americans should also consider evaluating future interventions using qualitative inquiry, to obtain an in-depth understanding of participant experiences with interventions. [ABSTRACT FROM AUTHOR]

African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care and other settings. Nutrition education and nutrition-focused policy, systems and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarise the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them with the 'Getting to Equity in Obesity Prevention' framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing six databases: MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX and ProQuest Dissertations & Theses. A total of thirty sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the 'reduce deterrents' and 'improve social and economic resources' aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) vaccination can prevent numerous cancers, yet uptake remains low for adolescents. Given disproportionate burden of cancers among African Americans, it is important to identify factors that influence HPV vaccination decisions among African American parents, specifically the role and preferences of vaccine campaign messages. The objectives of this study were to (1) identify the predictors of parents' decisions to get their children vaccinated against HPV, (2) assess parents' evaluation of current HPV vaccination campaign messages, and (3) uncover message strategies or themes parents consider to be effective and motivating to vaccinate their children against HPV. Focus groups were conducted with African American mothers and fathers (n = 18) in person. Several themes emerged regarding HPV vaccine acceptability including the desire to be informed, the unfamiliarity of vaccination, and mistrust toward government, pharmaceutical companies, and healthcare providers. Parental review of existing campaign messages highlighted the importance of clarifying risks and benefits of vaccination, including cancer prevention, and the preference for straightforward language. When brainstorming strategies to craft effective messages, parents highlighted need for the inclusion of diverse groups across race, gender, and age. Additionally, parents recommended clear language on side effects, eligibility, and additional resources for further information. Our findings highlight concerns and potential strategies to promote HPV vaccination tailored to African American parents and their children. Targeted interventions to increase vaccination need to consider the importance of building trust and representation in health promotional materials. Considerations for how messages were shared were also discussed such as physical locations, word of mouth, and social media. [ABSTRACT FROM AUTHOR]

Abstract Background Unfair treatment such as discrimination and racism contribute to depression and perceived stress in African Americans. Although studies have examined how responding to such treatment is associated with ameliorating depressive symptoms and levels of perceived stress, most do not focus on African Americans. The purpose of this study is to assess how talking to others in response to unfair treatment is associated with self-reported depressive symptoms and perceived stress levels in African Americans. Methods A sample from the 2010–2013 Minority Health Genomics and Translational Research Bio-Repository Database was used and consisted of 376 African American adults aged 30–55 years old residing in the southern region of the United States. Linear regression models were used to assess the association between talking to others following unfair treatment, compared to keeping it to oneself, on self-reported depressive symptoms and perceived stress. The predictor variable was based on the question “If you have been treated unfairly, do you usually talk to people about it or keep it to yourself?”. Results Talking to someone after being treated unfairly was inversely associated with perceived stress ( $$\beta$$ β : -3.62, SE: 1.14, p ≤ 0.05) and depressive symptoms ( $$\beta$$ β : -3.62, SE: 1.14, p ≤ 0.05). Conclusions African Americans who talked to others in response to unfair treatment had lower depressive symptoms and perceived stress than those who kept it to themselves. More outreach to African Americans regarding the importance of talk in response to exposure to unfair treatment is needed as a potential coping mechanism.

Introduction: Hereditary transthyretin amyloidosis (hATTR) can cause multisystem organ disorders including polyneuropathy and cardiomyopathy. Amongst the many known pathologic mutations of the transthyretin (TTR) gene, the Val122Ile (V122I) mutation can be found in 3–4% of African Americans. Up to 47% of patients with the V122I hATTR cardiomyopathy had a history of carpal tunnel syndrome (CTS). This raises the question should we screen for this mutation in African Americans with bilateral CTS for the purpose of preventing advanced disease associated with hATTR. This is a prospective pilot study to determine the likelihood of African Americans with bilateral CTS having the V122I mutation and whether various clinical factors contribute to that probability. Methodology: Adult African American patients without prior history of amyloidosis diagnosed with bilateral CTS were recruited for the study. They received genetic testing to screen for a TTR mutation. They also completed questionnaires to screen for symptoms of cardiomyopathy and neuropathy, other risk factors for CTS, and family history of CTS and cardiomyopathy. Result: Two of the sixteen patients (12.5%) in this cohort were found to have the V122I mutation. The absence of polyneuropathy and cardiomyopathy symptoms, presence of other CTS risk factors, and absence of family history of CTS and cardiomyopathy did not decrease the likelihood of V122I mutation in this cohort. Conclusion: The frequency of V122I transthyretin mutation in African Americans with bilateral CTS may be higher than 3–4%. The presence of bilateral CTS alone may be a justification to screen for TTR mutation in this population. [ABSTRACT FROM AUTHOR]

• Poor health outcomes among African American adults are well-documented. • The impact of discriminatory experiences might be a contributing factor. • Biological pathways incompletely understood, but might involve immune function. • Associations were tested between perceived discrimination and leukocyte composition. • Perceived discrimination burden predicted a higher neutrophil-to-lymphocyte ratio. African American adults suffer disproportionately from several non-communicable and infectious diseases. Among numerous contributing factors, perceived discrimination is considered a stressor for members of historically marginalized groups that contributes to health risk, although biological pathways are incompletely understood. Previous studies have reported associations between stress and both an up-regulation of non-specific (innate) inflammation and down-regulation of specific (adaptive) immunity. While associations between perceived discrimination and markers of inflammation have been explored, it is unclear if this is part of an overall shift that also includes down-regulated adaptive immunity. Relying on a large cross-section of African American adults (n = 3,319) from the Jackson Heart Study (JHS) in Jackson, Mississippi, we tested whether perceived everyday and lifetime discrimination as well as perceived burden from lifetime discrimination were associated with counts of neutrophils (innate), monocytes (innate), lymphocytes (adaptive), and the neutrophil-to-lymphocyte ratio (NLR), derived from complete white blood cell counts with differential. In addition, DNA methylation (DNAm) was measured on the EPIC array in a sub-sample (n = 1,023) of participants, allowing estimation of CD4T, CD8T and B lymphocyte proportions. Unexpectedly, high lifetime discrimination compared to low was significantly associated with lower neutrophils (b : -0.14, [95% CI: -0.24, -0.04]) and a lower NLR (b : -0.15, [95% CI: -0.25, -0.05]) after controlling for confounders. However, high perceived burden from lifetime discrimination was significantly associated with higher neutrophils (b : 0.17, [95% CI: 0.05, 0.30]) and a higher NLR (b : 0.16, [95% CI: 0.03, 0.29]). High perceived burden was also associated with lower lymphocytes among older men, which our analysis suggested might have been attributable to differences in CD4T cells. These findings highlight immune function as a potentially important pathway linking perceived discrimination to health outcomes. [ABSTRACT FROM AUTHOR]

IntroductionHereditary transthyretin amyloidosis (hATTR) can cause multisystem organ disorders including polyneuropathy and cardiomyopathy. Amongst the many known pathologic mutations of the transthyretin (TTR) gene, the Val122Ile (V122I) mutation can be found in 3–4% of African Americans. Up to 47% of patients with the V122I hATTR cardiomyopathy had a history of carpal tunnel syndrome (CTS). This raises the question should we screen for this mutation in African Americans with bilateral CTS for the purpose of preventing advanced disease associated with hATTR. This is a prospective pilot study to determine the likelihood of African Americans with bilateral CTS having the V122I mutation and whether various clinical factors contribute to that probability.MethodologyAdult African American patients without prior history of amyloidosis diagnosed with bilateral CTS were recruited for the study. They received genetic testing to screen for a TTR mutation. They also completed questionnaires to screen for symptoms of cardiomyopathy and neuropathy, other risk factors for CTS, and family history of CTS and cardiomyopathy.ResultTwo of the sixteen patients (12.5%) in this cohort were found to have the V122I mutation. The absence of polyneuropathy and cardiomyopathy symptoms, presence of other CTS risk factors, and absence of family history of CTS and cardiomyopathy did not decrease the likelihood of V122I mutation in this cohort.ConclusionThe frequency of V122I transthyretin mutation in African Americans with bilateral CTS may be higher than 3–4%. The presence of bilateral CTS alone may be a justification to screen for TTR mutation in this population.

Background: Unfair treatment such as discrimination and racism contribute to depression and perceived stress in African Americans. Although studies have examined how responding to such treatment is associated with ameliorating depressive symptoms and levels of perceived stress, most do not focus on African Americans. The purpose of this study is to assess how talking to others in response to unfair treatment is associated with self-reported depressive symptoms and perceived stress levels in African Americans. Methods: A sample from the 2010–2013 Minority Health Genomics and Translational Research Bio-Repository Database was used and consisted of 376 African American adults aged 30–55 years old residing in the southern region of the United States. Linear regression models were used to assess the association between talking to others following unfair treatment, compared to keeping it to oneself, on self-reported depressive symptoms and perceived stress. The predictor variable was based on the question "If you have been treated unfairly, do you usually talk to people about it or keep it to yourself?". Results: Talking to someone after being treated unfairly was inversely associated with perceived stress (β : -3.62, SE: 1.14, p ≤ 0.05) and depressive symptoms (β : -3.62, SE: 1.14, p ≤ 0.05). Conclusions: African Americans who talked to others in response to unfair treatment had lower depressive symptoms and perceived stress than those who kept it to themselves. More outreach to African Americans regarding the importance of talk in response to exposure to unfair treatment is needed as a potential coping mechanism. [ABSTRACT FROM AUTHOR]

Background: In the U.S., the prevalence of diabetes and hypertension are higher among African American/Black (Black), Latinx, and Filipino adults than non-Hispanic White (White) and Chinese adults. We compared the racial/ethnic-specific prevalence of several modifiable cardiometabolic risks in an insured adult population to identify behaviors that may drive racial/ethnic differences in cardiometabolic health.Methods: This cross-sectional study used data for middle-aged (35-64) and older (65-79) Kaiser Permanente Northern California (KPNC) adult health plan members. Smoking status and BMI were derived from electronic health record data. Weighted pooled self-reported data from the 2014/2015 and 2017 KPNC Member Health Survey cycles were used to estimate daily number of servings of fruits/vegetables, general sodium avoidance, sugar-sweetened beverage (SSB) consumption frequency, alcohol use within daily recommended limit, weekly exercise frequency, and number of hours of sleep daily. Age-standardized estimates of all cardiometabolic risks were produced for middle-aged and older-aged women and men in the five racial/ethnic groups. Analyses focused on racial/ethnic differences within age-gender groups and gender and age group differences within racial/ethnic groups.Results: In both age groups, Black, Latinx, and Filipino adults were more likely than White and Chinese adults to have overweight and obesity and were less likely to engage in health promoting dietary (fruit/vegetable and SSB consumption, sodium avoidance (women only)) and sleep behaviors. Middle-aged Black and Filipino men were more likely than White men to be current smokers. Less racial/ethnic variation was seen in exercise frequency. Significant gender differences were observed for dietary behaviors overall and within racial/ethnic groups, especially among middle-aged adults; however, these gender differences were smaller for sleep and exercise. Age differences within gender and racial/ethnic groups were less consistent. Racial/ethnic and gender differences in these behaviors were also seen in the subsample of adults with diabetes and/or hypertension and in the subsample of adults who reported they were trying to engage in health promoting behaviors.Conclusions: Black, Latinx, and Filipino adults were more likely than White and Chinese adults to report dietary and sleep behaviors associated with development and worsening of cardiometabolic conditions, with men exhibiting poorer dietary behaviors than women. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine perceptions of COVID-19 related to prevention, coping, and testing of African American residents in under-resourced communities in Alabama. Guided by the PRECEDE-PROCEED model, virtual focus groups were conducted in five urban and rural Alabama communities using secure Zoom meetings. Community residents and stakeholders (N = 36 total) participated; meetings were audio- and video-recorded, transcribed, and analyzed according to Thematic Analysis. Themes were organized by the PRECEDE portion of the model in Predisposing, Reinforcing, and Enabling barriers and facilitators in three focus areas: prevention, coping, and testing. Prevention barriers included apathy, difficulty with social distancing, lack of information, mixed messages from authority figures, and lack of personal protective equipment (PPE). Prevention facilitators included concerns about contracting COVID-19, clear and consistent messages from trusted sources, contact tracing, and the provision of PPE. Coping barriers included food insecurity, mental health issues, isolation, economic hardships, lack of health care access, and issues with virtual schooling and church services, which were exacerbated by the inability to connect to the internet. Facilitators to coping included religious faith, increased physical activity, and a sense of hope. Testing barriers included misunderstanding, fear, mistrust, testing restrictions, and location of testing sites. Facilitators to testing included incentives, clear information from trusted sources, convenient testing locations, and free tests. Gaining community members' perspectives can identify barriers and facilitators to prevention, coping, and testing and potentially improve outcomes. While addressing the social determinants of health (e.g. income, education, medical trust) would be an effective path by which to diminish health disparities related to COVID-19, there is an urgent need to mitigate the spread and severity of COVID-19 in vulnerable populations. Interventions should focus on downstream determinants, such as those emerging from our study. [ABSTRACT FROM AUTHOR]

African Americans who use substances experience a particular risk for HIV. Negative attitudes towards condoms are a strong predictor of risk and can serve as barriers to safe sex. They also vary by gender. In a secondary analysis of data from two National Drug Abuse Treatment Clinical Trials Network trials collecting data from 2004 to 2006, the relationship between gender, unprotected sex, and condom barriers among 203 African Americans in substance use treatment was examined. Results indicated that no gender differences were present in unprotected sex. Men reported more motivational barriers to condom use and were more likely to believe that condoms would impede sexual experience (the latter not statistically significant). For both genders, the perception that condoms might negatively impact sexual experience was associated with unprotected sex. Gender did not moderate the relationship between condom barriers and unprotected sex. These findings suggest the need for gender and race-specific prevention strategies that focus on motivation and address pleasure-based concerns regarding condoms. Substance use treatment facilities are well-positioned to support interventions to target these issues. [ABSTRACT FROM AUTHOR]

This study examined the acceptance of HIV vaccine by African Americans, a group that has experienced a disproportionate burden of infection. It focused on 124 African American women from diverse socio-economic backgrounds living in Forsyth County in the Piedmont Triad region of North Carolina. On the surface, an HIV vaccine certainly looks attractive. The United States spends huge sums annually to support those carrying the AIDS virus, but the vaccine would be pointless if high-risk populations, such as African American women, refuse it. Most of the participants in this study said they would accept an HIV vaccine as protection. However, the findings also show multidimensional barriers to acceptance, including misinformation, concerns about efficacy, and past racist and ethical controversies involving the US medical system. The symbolic interactionist view that we can understand human behavior from the meanings individuals attach to social reality guided data analysis. The study sought to understand African American women's perceptions of HIV and AIDS, an HIV vaccine, and its proponents. [ABSTRACT FROM AUTHOR]

The purpose of this article is to present an application of two tools the ecomap (Hartman, 1995) and cultural ecogram (Yasui, 2015) used sequentially so that it may help in the process of assisting health professionals in determining ways to improve culturally informed, instead of culturally competent healthcare provision. Both tools have been developed in the context of clinical delivery of social services, have some known research that points to the benefits of their use in health and mental healthcare (Lloyd, 2005), but have not yet been applied to promoting the cultural sensitivity with awareness in healthcare management of diabetes type 2 with urban African American grandparents who are caretakers of children. [ABSTRACT FROM AUTHOR]

The aim of this article is to explicate a terror management theory (TMT) analysis of the poor social and psychological well-being of African Americans by drawing upon a model of cultural trauma to explain the antecedents and effects of posttraumatic slave syndrome. Cultural trauma is defined as a state that occurs when a people's cultural worldview has been destabilized to the point where it does not effectively meet its TMT function of providing a buffer against basic anxiety and uncertainty. The article outlines how the impact of slavery was a significant trauma to African American people, which was carried forward through successive generations; providing an explanation of their current anxiety-related conditions, poor health, and maladaptive behaviors. Findings from health and justice research and qualitative data from narratives of African Americans are presented to substantiate the adaptation of a model of cultural trauma for understanding the contemporary situation of African Americans. [ABSTRACT FROM AUTHOR]

BACKGROUND Evidence consistently shows children in the United States gain 3 to 5 times more weight during summer vacation (∼2.5 months) compared to the 9‐month school year. The purpose of this study is to examine within‐child differences in 4 obesogenic behaviors (physical activity [PA], sedentary/screen‐time, diet, and sleep) during school versus summer. METHODS: We used a repeated‐measures within‐subjects design. Children (N = 30 mean age = 8.2 years; 57% female; 37% overweight/obese; 100% African American) wore accelerometers on the nondominant wrist for 24 hr/d over 9 consecutive days during school and summer of 2016 to capture PA, sedentary time, and sleep. Parents completed a daily diary to report bed/wake times, diet, and screen‐time of their child each day. Mixed‐effect models compared summer and school behaviors. RESULTS: Children spent more time sedentary (69% vs 67% of wake wear time), less time in light PA (25% vs 23% of wake wear time), had higher screen‐time (242 vs 123 minutes/day), slept longer (428 vs 413 minutes/night), and consumed more sugar‐based foods (6 days vs 2.5 days/week) and fruit (7 days vs 4.7 days/week) during summer compared to school (p <.05). CONCLUSION: Initial evidence suggests children are displaying multiple unfavorable obesogenic behaviors during summer compared to school that may contribute to accelerated weight gain during summer. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the impact of race and socioeconomic status on breast tumor clinicopathological features and survival outcomes. This study used breast cancer data from the Washington D.C. Cancer Registry (2000-2010). Logistic regression and survival analysis assessed the association between race, socioeconomic (SES) variables, clinicopathological variables, recurrence-free survival and overall survival. African American (AA) breast cancer patients had an increased risk for stage III, ER-, and PR- breast cancer compared with White and Hispanic breast cancer patients. Additionally, D.C. geographical areas of lower socioeconomic status had higher incidences of stage III and stage IV breast cancer. A nested analysis demonstrated that AAs with higher median incomes compared with AAs with lower incomes revealed no differences for clinicopathological variables, nor were differences found between overall and recurrence-free survival. This study suggests that the biology of breast cancer in AAs could be driving breast cancer disparities. [ABSTRACT FROM AUTHOR]

Black women have the highest rate of hypertension (HTN) in the U.S. and perhaps the world. Because they are deemed the most religiously devout group in the U.S., it is plausible that faithfulness to spiritual/religious practices may yield more adherence to HTN medication regimens. This study examined spiritual/religious beliefs in relation to antihypertensive medication adherence in Black women with HTN. Although results showed no association between beliefs and adherence, women who developed trusting relationships with their healthcare provider were more likely to be adherent to their medications. [ABSTRACT FROM AUTHOR]

As we have traversed the last 2 years of the COVID-19 pandemic juxtaposed against an increased awakening to the realities of racial inequities in society and health care, the grief of Black individuals and communities has largely been underrecognized. This reflective essay explores the grief experience of Blacks in the wake of continual losses and acknowledges the impact of racism in these losses. I speak from my experiences as a Black mother, survivor of sibling loss, and pediatric palliative care pediatrician to examine this complex issue and what the medical community can do to stand with Black patients and families in their grief experience. [ABSTRACT FROM AUTHOR]

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population. Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs. Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, sexual self-efficacy and safe sex practices. Participants were recruited though a mass media campaign and local youth serving organizations within Sedgwick County, KS. Results: Our findings indicate significant differences exist between genders in perception of sexual self-efficacy among African American adolescents. Females were found to have higher perceived sexual self-efficacy compared to males. Having high negotiation skills and a sexual partner who approved of condom use were significant predictors for high perceived sexual self-efficacy. Conclusions: African American adolescent females were more likely to have higher perceived sexual self-efficacy then African American male adolescents. Because of the dynamics that exist in male and female relationships and the mediating role sexual self-efficacy might play in engaging in safe sex practices, it is important to design gender specific interventions in order to curb the spread of HIV/AIDS and other STDS/STI's. [ABSTRACT FROM AUTHOR]

IntroductionThe objective of our study was to assess the psychometric properties of the Medical Outcomes Study’s 12-Item Short Form Survey Instrument (SF-12) for use in a low-income African American community. The SF-12, a commonly used functional health status assessment, was developed based on responses of an ethnically homogeneous sample of whites. Our assessment addressed the appropriateness of the instrument for establishing baseline indicators for mental and physical health status as part of Nashville, Tennessee’s, Racial and Ethnic Approaches to Community Health (REACH) 2010 initiative, a community-based participatory research study.MethodsA cross-sectional random residential sample of 1721 African Americans responded to a telephone survey that included the SF-12 survey items and other indicators of mental and physical health status. The SF-12 was assessed by examining item-level characteristics, estimates of scale reliability (internal consistency), and construct validity.ResultsConstruct validity assessed by the method of extreme groups determined that SF-12 summary scores varied for individuals who differed in self-reported medical conditions. Convergent and discriminate validity assessed by multitrait analysis yielded satisfactory coefficients. Concurrent validity was also shown to be satisfactory, assessed by correlating SF-12 summary scores with independent measures of physical and mental health status.ConclusionThe SF-12 appears to be a valid measure for assessing health status of low-income African Americans.

IntroductionPhysical activity participation is low among blacks, and strategies are needed to successfully create immediate and sustained behavior change related to physical activity. Churches can play an important role in health promotion efforts among blacks because of their central role in spiritual guidance, communication, social support, and networking. This pilot study evaluated the feasibility and acceptability of implementing a physical activity program for sedentary black adults in churches.MethodsWe used a preintervention/postintervention single-group design to evaluate the effect of a 3-month faith-based physical activity intervention on daily walking and moderate- and vigorous-intensity physical activity among sedentary blacks. Eighty-seven black adults participated in eight group sessions that included discussion of physical activity-related topics, an instructor-led physical activity session, and weekly incentives to promote physical activity. We used a questionnaire to assess moderate and vigorous physical activity in minutes per week at baseline and after 3 months. Walking was assessed weekly in steps per day by using a pedometer.ResultsParticipants (mean age, 52 yrs; mean body mass index, 35 kg/m2) reported 27 ± 54 and 10 ± 25 minutes per week in moderate-intensity and vigorous-intensity physical activity, respectively, and walked 4822 ± 2351 steps per day at baseline. After 12 weeks, moderate- and vigorous-intensity physical activity increased by 67 ± 78 and 44 ± 66 minutes per week, respectively (P ≤ .01), and daily walking increased by 1373 ± 728 steps per day (P < .001).ConclusionThese data suggest that a faith-based physical activity intervention may be an appropriate strategy for increasing physical activity among sedentary black adults. Future research will determine the impact of this program in a randomized, controlled design.

IntroductionLow-income African Americans who live in rural areas of the Deep South are particularly vulnerable to diseases associated with unhealthy energy imbalance. The Centers for Disease Control and Prevention (CDC) has suggested various physical activity strategies to achieve healthy energy balance. Our objective was to conduct formal, open-ended discussions with low-income African Americans in the Mississippi Delta to determine 1) their dietary habits and physical activity levels, 2) their attitudes toward CDC’s suggested physical activity strategies, and 3) their suggestions on how to achieve CDC’s strategies within their own environment. MethodsA qualitative method (focus groups) was used to conduct the study during 2005. Prestudy meetings were held with African American lay health workers to formulate a focus group topic guide, establish inclusion criteria for focus group participants, select meeting sites and times, and determine group segmentation guidelines. Focus groups were divided into two phases.ResultsAll discussions and focus group meetings were held in community centers within African American neighborhoods in the Mississippi Delta and were led by trained African American moderators. Phase I focus groups identified the following themes: overeating, low self-esteem, low income, lack of physical exercise, unhealthy methods of food preparation, a poor working definition of healthy energy balance, and superficial knowledge of strategies for achieving healthy energy balance. Phase 2 focus groups identified a preference for social support-based strategies for increasing physical activity levels. ConclusionEnergy balance strategies targeting low-income, rural African Americans in the Deep South may be more effective if they emphasize social interaction at the community and family levels and incorporate the concept of community volunteerism.

Obesity is more prevalent among African Americans and other racial and ethnic minority populations than among whites. The behaviors that determine weight status are embedded in the core social and cultural processes and environments of day-to-day life in these populations. Therefore, identifying effective, sustainable solutions to obesity requires an ecological model that is inclusive of relevant contextual variables. Race and ethnicity are potent stratification variables in U.S. society and strongly influence life contexts, including many aspects that relate to eating and physical activity behaviors. This article describes a synthesis initiated by the African American Collaborative Obesity Research Network (AACORN) to build and broaden the obesity research paradigm. The focus is on African Americans, but the expanded paradigm has broader implications and may apply to other populations of color. The synthesis involves both community and researcher perspectives, drawing on and integrating insights from an expanded set of knowledge domains to promote a deeper understanding of relevant contexts. To augment the traditional, biomedical focus on energy balance, the expanded paradigm includes insights from family sociology, literature, philosophy, transcultural psychology, marketing, economics, and studies of the built environment. We also emphasize the need for more attention to tensions that may affect African American or other researchers who identify or are identified as members of the communities they study. This expanded paradigm, for which development is ongoing, poses new challenges for researchers who focus on obesity and obesity-related health disparities but also promises discovery of new directions that can lead to new solutions.

How do gunshot victims manage pain without health care? This paper examines this question through ethnographic data of a single gunshot victim who self-medicated with Percocet. The observations for this paper were collected in Philadelphia between January of 2010 and October of 2011, and were part of a larger ethnographic study that included 40 gunshot victims recruited from an outpatient trauma clinic. Although this victim was able to manage his pain, he ultimately became addicted to Percocet and became entangled in the personal stress and conflicts of his pill hustlers. His story shows how health care insecurity can funnel victims of gun violence into increasingly risky ventures to find pain relief. The findings from this study show the pressing need to expand rehabilitative care to all gunshot victims. [Copyright &y& Elsevier]

Highlights: [•] A theoretical discussion of democracy, the Constitution, and government public relations is presented. [•] President Clinton's apology to Tuskegee survivors is used as a case and is examined. [•] General principles of relationship management are not adequate to account for repairing certain damaged relationships. [•] Trying to establish a relationship with publics that don’t want one is undemocratic. [•] Relationship management frameworks should be expanded to account for publics that might be deemed as “nonvoluntary publics”. [ABSTRACT FROM AUTHOR]

The article discusses results of a study that examined the association of smoking in African American (AA) women with spiritual well-being (SWB), perceived stress and coping. The health effects of smoking are discussed, with emphasis on AA women. Some reasons why AA women find it difficult to quit smoking include the lack of access to culturally appropriate help with smoking cessation. It cites SWB as a way to help AA women cope with stress and motivate them to quit smoking.

Much of the scientific literature in the area of health continues to ask the question, "How can we get African Americans involved in research and prevention activities?" The African American Health Initiative represents an answer to this question and is in many ways a success story of a local Black population that willingly engaged in health planning through a community-based participatory research process. A mixed-method sequential exploratory design was utilized to implement the health planning process. A social ecological model was created with five levels of influence and was utilized as a guide for engagement. A total of 1,078 individuals (95% Black) participated. A comprehensive plan was created with nine recommendations for the improvement of the health of the local and neighboring Black populations. [ABSTRACT FROM AUTHOR]

Abstract: This paper investigates urban retail food markets and health in Syracuse, New York. A structured observational analysis found that a majority of corner markets do not sell fresh produce or low fat dairy products, but conduct a lively business selling lottery tickets, cigarettes, and liquor. A comparison of census tracts with and without access to supermarkets that sell fresh produce and other healthy food found that pregnant women living in proximity to a supermarket had significantly fewer low birth weight births than other pregnant women regardless of income level. [Copyright &y& Elsevier]

Health disparities are inequalities in the quality of health and health care across ethnic, racial, and socioeconomic groups. This article focuses on the health disparities of African Americans and identifies several consumer health Internet resources. [ABSTRACT FROM AUTHOR]

This study examined the correlates of self-efficacy for physical activity in African American women. In bivariate analyses, self-efficacy was higher among women reporting fewer social role constraints, more positive perceptions of physically active women, more positive sense of community, better perceived health, and higher levels of physical activity. In a simultaneous multivariate model, more positive perceived health status (p = .001), higher physical activity level (p = .007), and lower social role constraint (p = .02) were independently associated with higher self-efficacy. Thus, physical activity interventions for African-American women should include strategies to decrease social role constraint and offer safe activities for women with health conditions hindering physical activity. [ABSTRACT FROM AUTHOR]

Employing a narrative framework, this article explores President Clinton's speech of apology for the Tuskegee Syphilis Experiment. Catalysts leading to the experiment, how the experiment was enacted, and the lingering impact of the experiment on African Americans' perceptions of the public health system are described. The U.S. government's rhetorical stance toward the experiment is analyzed in terms of how it creates a narrative of remembrance, redefinition, and reconciliation. The article argues the discourse serves to redefine the role of the Tuskegee Institute in the experiment while embracing the grand narrative of modernism. [ABSTRACT FROM AUTHOR]

The relationship between genetic risk variants associated with glucose homeostasis and type 2 diabetes risk has yet to be fully explored in African American populations. We pooled data from 4 prospective studies including 4622 African Americans to assess whether β-cell dysfunction (BCD) and/or insulin resistance (IR) genetic variants were associated with increased type 2 diabetes risk. The BCD genetic risk score (GRS) and combined BCD/IR GRS were significantly associated with increased type 2 diabetes risk. In cardiometabolic-stratified models, the BCD and IR GRS were associated with increased type 2 diabetes risk among 5 cardiometabolic strata: 3 clinically healthy strata and 2 clinically unhealthy strata. Genetic risk scores related to BCD and IR were associated with increased risk of type 2 diabetes in African Americans. Notably, the GRSs were significant predictors of type 2 diabetes among individuals in clinically normal ranges of cardiometabolic traits. [ABSTRACT FROM AUTHOR]