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Patients with HIV/AIDS are likely to have numerous interactions with health care providers (HCPs) during the course of their disease. Research has shown that satisfaction with one's HCP is related to better medication adherence in patients with HIV/AIDS. Although a patient's attitude toward his or her HCP is important, little has been done to assess how it relates to appointment attendance. The current study assessed how attitudes toward HCPs as well as social support and depression relate to outpatient appointment attendance. Further, this study used a newly developed, psychometrically valid scale to assess specific patient attitudes toward HCPs including those related to disease stigma. Participants were predominantly low-income African American men (N = 109) recruited from a public southern HIV clinic. Analyses indicated that attitudes toward HIV HCPs, social support, and medication status but not depression or satisfaction with social support were associated with appointment attendance.

Purpose. To examine the efficacy of a stage-targeted physical activity intervention among low-income African-Americans. Methods. 207 participants were randomly assigned to groups and administered baseline measures. Intervention participants were mailed stage-targeted physical activity information, whereas control participants received low-sodium diet brochures. Measures were readministered by phone 1 and 6 months later, with response rates of 69% and 46%, respectively. Results. 69% of participants were African-American and 64% had a monthly household income of 2 test. Gains attenuated by 6 months. Conclusions. The current study supports the use of this intervention among low-income African-Americans. Limitations include use of self-report measures and small sample size.

The Weekly Stress Inventory (WSI) has been used both in research and in clinical settings to measure minor stress. Although this tool offers a reliable and valid measure to assess minor stress, it lacks brevity that would make it more feasible for rapid assessments of stress needed in many research and clinical settings. The current study assessed the psychometrics of the newly developed Weekly Stress Inventory Short Form (WSI-SF), a 25-item scale to measure minor stress. Adults attending general medicine clinics (n = 171) at a public teaching hospital completed the WSI-SF and the WSI. The WSI-SF was found to have good internal consistency for both the events score (.92) and impact score (.91) and good convergent validity with the WSI. The results of the present study suggest that the WSI-SF is a reliable and valid instrument for use in assessing minor stress.

Patient attitudes toward their health care providers can play an important role in determining health behavior change. The frequency of contact with health care professionals and disease stigma makes assessing patients' perception of this relationship of particular interest in an HIV medical population. While past general satisfaction and attitude tools have been used to assess this construct, there is a need for an assessment tool specific to patient attitudes in an HIV setting. This study was designed to validate the Attitudes toward HIV Health Care Provider scale (AHHCP) in an HIV medical population. Principal components analysis of the AHHCP yielded a two-factor structure accounting for 53.3% of the total variance in attitudes toward health care providers. The two factors represented items concerning Professionalism and Emotional Support. The AHHCP was found to have good internal consistency (0.92) and convergent validity with a measure of patient satisfaction (r = 0.59). The results of the present study suggest that the AHHCP is a reliable and valid instrument for use in assessing patient attitudes toward their health care providers.

The Beck Depression Inventory-II (BDI-II) is one of the most common self-report instruments used for depression screening. However, there is a lack of research examining the effectiveness of this instrument in detecting depression in an African American primary care sample. The current study included 220 African American primary care patients who completed the BDI-II and were administered a diagnostic interview to establish depressive diagnoses. Results indicated that depressed patients demonstrated significantly greater BDI-II total scores compared to non-depressed patients. The recommended cutoff score of 14 for screening for depression appears to be appropriate for African American patients in the primary care setting. This cutoff yielded sensitivity of 87.7% and specificity of 83.9%. Positive predictive value of the BDI-II was .70, and negative predictive value was .94. Similar to findings with predominantly Caucasian samples, current results suggest the BDI-II is an appropriate and accurate instrument to use for depression screening among African American primary care patients.

The current study examined social support and stress as mediators of the hostility—coronary heart disease (CHD) relationship as suggested by the psychosocial vulnerability model in a sample of low-income African Americans. Among 95 CHD patients and 30 healthy controls, hostility was negatively correlated with social support, but was not related to minor stress. CHD patients endorsed higher levels of hostility; however, the relationship between hostility and CHD status was diminished once stress and social support were included in the model. This study lends partial support for the psychosocial vulnerability model of hostility in African Americans, but suggests that the relationship between hostility and stress may be impacted by socioeconomic status.

Physical activity is one of the most neglected aspects of the type 2 diabetes treatment regimen (1). Environmental barriers may play a role (2), particularly among African-American patients who report more physical activity barriers than Caucasians (3,4). African-American focus groups reported numerous barriers, including unsafe walking areas, transportation problems, lack of child care, peripheral neuropathy, and degenerative joint disease, some of which are not assessed by existing questionnaires (5,6). Despite these initial qualitative findings from focus groups, there is limited quantitative research addressing physical activity barriers specific to African-American or low-income diabetic samples. The current objective was to examine barriers reported by this population. The relationships between barriers and medical outcomes, demographic variables, and attitudes about exercise were examined. Participants included 105 adult patients with type 2 diabetes attending primary care appointments. The clinic was affiliated with a public teaching hospital providing care to predominantly low-income African-American patients. Patients were approached in the waiting room before appointments. After obtaining informed consent, study personnel administered demographic and diabetes history questionnaires. They assessed 35 perceived barriers to physical activity, which were taken from several …