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This paper presents reflections on mentorship from scientists and mentors of the National Institute on Aging (NIA)-funded Carolina Center on Alzheimer’s Disease and Minority Research (CCADMR). Using a network approach to mentoring, this program aims to increase the pipeline of underrepresented minority (URM) scientists studying Alzheimer’s disease (AD) disparities. Six mentors and five scientists participated in interviews. Thematic analysis identified recurring themes; transcripts of mentors and scientists were compared. Most common thematic categories identified by mentors included experience interacting with scientists, goals as a mentor, recruitment of underrepresented minorities, scientists’ challenges, and programmatic qualities. The most mentioned categories by scientists were challenges, seminars, working with mentors, career development, and project experience. The CCADMR will use findings to enhance the experience and training methods for future grant years. Results can benefit other training programs focused on aging and AD.

Diverse representation in higher education leadership is critical to the Academy’s mission of teaching, research, and service. As academic leadership positions are rarely occupied by faculty from u...

Objectives: Diversity is needed within the aging and Alzheimer’s disease and related dementias (ADRD) research and practice workforce to comprehensively address health inequities faced by underrepresented minority (URM) older adults. We conducted a scoping review of training programs designed to diversify the pool of researchers and practitioners in the field of aging and ADRD. Methods: Online database searches yielded 3976 articles published from 1999 to 2019. Fourteen studies met the inclusion criteria. Results: All programs were from the United States and included URM populations. Nine programs included students, one targeted university faculty, and four targeted clinical staff. Only five programs were guided by theory. Discussion: Our review identified URMs’ desire for culturally diverse and representative mentorship, the need for career development support at various training stages, and the importance of incorporating theory to program design. It also identified key characteristics for future program development, creation of systematic evaluation standards, and opportunities for promotion.

Collaborative Online International Learning (COIL) is a teaching and learning approach whereby entire courses or modules are co-developed and team taught by instructors from different institutions for students of both institutions. Since 2006, the approach has been gaining in mass appeal; however, considering our present-day global coronavirus pandemic, COILs have a renewed relevance in academia. Faculty from the University of South Carolina (United States) and Coventry University (England) embarked on a COIL partnership yielding a valuable experience that can serve as a model for other institutions that are interested in developing innovative and cross-cultural distance learning opportunities. The purpose of this paper is to explain how the institutional partnership emerged, describe the course content, and provide lessons that our team learned through the COIL development and implementation process. Our experience as a first-time COIL partnership is a model for others to consider as the landscape for the academic enterprise expands the confines of brick-and-mortar institutions.

To explore the relationship between past 30-day nonmedical prescription stimulant use (NPSU) and past 30-day marijuana and/or alcohol use, past 30-day risky marijuana and/or alcohol use, student demographics, and student activity involvement among college students.

Social environmental influences on pregnancy-related practices and outcomes have been studied, yet few studies explore these influences qualitatively from the perspectives of women’s personal social networks and the larger social networks that exist within their communities. This study sought to understand and describe the social environment related to pregnancy and planning for pregnancy in Harare, Zimbabwe from the perspectives of women’s social networks, and its influence on pregnancy-related decisions and practices. Semi-structured, in-depth, qualitative interviews were conducted in both Shona and English with 24 key community stakeholders (6 healthcare workers, 6 school teachers, 6 family members of females aged 14–24 years, and 6 community leaders) who lived or worked in 2 low-income, high-density communities in Harare. Data were analyzed thematically using NVivo 10 software. The social environment related to pregnancy and planning for pregnancy described by participants was deeply rooted in culture and cultural practices and centered on four themes: (1) pregnancy importance to the role of a woman in the community and the fulfillment of marriage, (2) pregnancy silence to prevent adverse pregnancy outcomes and adolescent and out of wedlock pregnancies, (3) patriarchal pregnancy culture, and (4) community support during pregnancy. Maternal health efforts in Zimbabwe should acknowledge cultural influences on pregnancy and address pregnancy silence to improve reproductive health communication, empower women to be partners in the pregnancy decision-making process, and include women’s social networks.

Alzheimer's disease and related dementias (ADRD) are at the forefront of the United States (US) public health agenda due to their tremendous human and financial burden. Further, disproportionately high ADRD rates among racial/ethnic minorities require incorporating the unique perspectives of racially and ethnically diverse scientists, which will necessitate diversifying the scientific workforce that investigates disparities in aging. The purpose of this paper is to describe the training and mentorship initiatives of the National Institute on Aging (NIA)-funded Carolina Center on Alzheimer's Disease and Minority Research, emphasizing lessons learned from our engagement with underrepresented minority and minoritized (URM) Scientists. We highlight three aims of the Center's training and mentorship component: (1) Fund pilot projects for URM Scientists conducting research on sociocultural, behavioral, and environmental factors that influence ADRD-related health disparities; (2) Provide mentorship to build the research capacity of Center Scientists; and (3) Offer research education in Health Disparities and Minority Aging Research to Center Scientists and interested researchers at all partner institutions. Our experience may be a practical resource for others developing interdisciplinary training programs to increase the pipeline of URM Scientists conducting ADRD research.

BACKGROUND Culture-specific interventions based on storytelling can address the social and cultural context of HIV that is unique to Southern African American women. METHODS We describe a community-engaged process to construct scripted stories to promote HIV prevention based on cultural narratives from African American women living with HIV. Our process involved (1) the collection of cultural narratives, (2) establishment of a community advisory board (CAB), (3) identification of important intervention themes, (4) narrative analysis to identify stories, and (5) script writing/peer review to produce composite narrative HIV prevention messages. LESSONS LEARNED Engaging community members is a strength; however, outreach should be strategic to individuals interested in a script writing creative process. This process is an adaptation of widely accepted methods to produce stories that incorporate culture organically in ways that allow for greater identification and engagement by the target audience. CONCLUSIONS Authentic stories harvested and produced from and for a culture-specific population is a critical consideration for narrative health promotion.

Background Examination of racial/ethnic differences in positive childhood experiences (PCEs) is needed, as the absence of supportive factors may hinder children from healthy processing and mitigation of adversity. Objective The purpose of this study was to examine the prevalence of PCEs in a nationally representative sample of children and determine whether PCE exposure differed across race and ethnic groups. Participants and Setting Data were drawn from the nationally representative 2017–2018 National Survey of Children’s Health (NSCH) (n = 33,747). Methods Descriptive statistics and bivariate analyses were used in order to calculate frequencies, proportions, and unadjusted associations for each variable. Multivariable regression models were used to examine the association between race/ethnicity and PCEs. Results All racial-ethnic minority groups of children had a lower likelihood of mentorship, living in a safe neighborhood, or living in a supportive neighborhood, than their Non-Hispanic White counterparts. Non-Hispanic Black children had a lower likelihood of having a mentor for advice or guidance (aOR 0.50; 95 % CI 0.38−0.62), living in a safe neighborhood (aOR 0.62; 95 % CI 0.52−0.73), and living in a supportive neighborhood (aOR 0.75; 95 % CI 0.64−0.87) than Non-Hispanic white children. Conclusions The information from this study highlights the negative disparities borne by racial/ethnic minority populations. Findings can be used to inform policymakers, program developers, and stakeholders on where to target interventions and how to bring together families and communities to not only confront adversity in childhood, but also to leverage community and family-level assets to create PCEs for all children.

BACKGROUND In the United States, a disproportionate number of unintended pregnancies occur among African Americans, particularly those in their later teenage years and early 20s. Mobile technology is becoming more ubiquitous as a method for health promotion; however, relatively little research has been done with this population to determine their perspectives about unintended pregnancy, the potential of successfully using mobile technology to prevent unintended pregnancy, and the content of such programs. OBJECTIVE The purpose of this study was to obtain the perspectives of African American emerging adults about unintended pregnancy and the use of mobile technology to reduce unintended pregnancy rates. METHODS Focus groups and interviews were conducted with 83 African Americans, aged 18-21 years. Data were analyzed using an open coding process. Emergent codes were then added as needed, and themes and subthemes were identified. RESULTS Participants cited the social environment and lack of education as primary reasons for disproportionate rates of unintended pregnancy. They noted that unintended pregnancy is an important issue and that they desire more sexual health information. They enthusiastically supported mobile technology as a means to communicate unintended pregnancy prevention programming and offered many suggestions for program content, look, and feel. CONCLUSIONS Young and emerging adult African Americans want and need sexual health resources, and a mobile-based platform could be widely accepted and address needs to lower disproportionate rates of unintended pregnancy. An essential next step is to use these findings to inform the development of a mobile-based unintended pregnancy prevention and sexual health program prototype to determine feasibility.

College students carry a disproportionate burden of depression when compared to the general population. The purpose of this study is to explore the association between the use of social technologie...

Introduction: The high rate of maternal mortality among Black women in the United States continues to gain attention; yet research has not yet fully illuminated the precursors to these events, most impactful among them being “maternal near misses.” A maternal near miss occurs when a woman nearly dies but survives a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. Researchers have focused on reviewing patient medical records after sentinel maternal events to help determine major contributors to them; however, qualitative studies with near-miss survivors, especially among Black women, may be a more useful approach. Methods: Using a qualitative methodology, we conducted semi-structured interviews with 12 Black women to explore how they perceived the care provided to them during their near-miss experiences. Our study also employed a phenomenology framework to understand the lived experience of Black women who had a maternal near miss in the context of a hospital setting. Results: We interviewed 12 women between October 2020 and March 2021. All participants had a maternal near miss between the years 2010 and 2020 and were aged between 19 and 41 years when they had their near-miss experience. These women identified communication, patient–provider relationship, skills/competency of staff, provider discrimination, systems issues, and emotional distress as major contributors to their experiences. Conclusion: Maternal near misses serve as a precursor to maternal mortality events. By listening to patients and their families recount their perspectives on what leads up to these near misses, we can unearth valuable lessons that can aid in the development of strategies and interventions to decrease the numbers of pregnancy-related deaths; especially among Black women who suffer disproportionately from maternal morbidity and mortality. Based on these findings, we recommend that hospitals and OB-GYN practices consider the unique predispositions of their Black patients; account for their own personal biases, revisit the near-miss experiences of past patients to keep patients central to care and build rapport between patients and hospital birthing support staff; and center discussions about improvements in care around racist structures and systems.

Psychological stressors have been observed immediately following disasters, yet less is known about the long-term effects on the mental health of vulnerable communities. In 2005, Graniteville, S.C. was ravaged by a train derailment that leaked approximately 60 tons of chlorine gas and left several people dead in the small community. The purpose of this study was to examine the mental health of Graniteville-area residents in the nine years following the train disaster using a mixed methods approach. Using the photovoice method, participants reported compromised mental health with symptoms consistent with depression, post-traumatic stress disorder, fear, and anxiety. Medical records analysis indicated that mental health-related hospital encounters generally increased post-disaster. Mental health concerns should be anticipated in the long-term aftermath of disasters. Addressing these concerns is particularly vital in resource-poor communities. Our findings can be useful in developing mental health disaster management protocols and policies for communities in the long-term post-disaster period.

Objectives: African American women are disproportionately impacted upon by HIV, particularly in the Southern states of the USA where the percentage of new cases of HIV and the percentage of people living with HIV in the USA are highest. This study describes the lived experiences of HIV-positive African American women based on their written stories. Design: Naturalistic qualitative design. Setting: Three organisations serving people living with HIV in a Southern state in the USA. Method: HIV-positive African American women 18 years of age and older ( N = 23) recruited from organisations working with people living with HIV were given the opportunity to write their own story following their participation in a semi-structured individual private interview. Content analysis was conducted on the written accounts. Results: Analysis of narratives written by HIV-positive African American women revealed themes of self-actualisation and self-worth. While some stories highlighted experiences of helplessness/hopelessness, most stories were more optimistic in nature, offering advice for prevention and highlighting individual efforts of advocacy and education. Stories also touched on risk/protective behaviour and women’s acknowledgement of their own responsibility in their HIV status. Conclusion: Strengths and resources are expressed in stories, as well as the acknowledgement of stressors associated with HIV. These within-culture narratives may be useful in programmes and interventions to inform culturally resonant prevention efforts and promote self-management activities among women living with HIV.

African American women living with HIV (WLWH) in the U.S. South encounter heightened marginalization due to the complex intersections of race, gender, poverty, and HIV status. Social vulnerabilities experienced by individuals and communities in daily life have the potential to sharpen ethical tensions in the context of research. Thus, conducting ethical research requires attention to the contextual challenges and concerns of diverse research populations to tailor participant protections to a particular sociocultural context. Using principles from the Belmont Report, the present report draws on data from a qualitative study with 42 African American WLWH in the South by highlighting the first author's accounts of ethical challenges that emerged during data collection. Findings suggest that engaging participants in their natural environments can inform the development of ethical research strategies germane to women's lived experiences. Study findings also contribute to empirical guidance for investigators engaging marginalized populations in scientific research.

HIV disproportionately impacts African American women of childbearing age residing in the Southern United States. Antiretroviral therapy has increased the quantity and quality of life for people living with HIV and produced viable and safe reproduction possibilities for women living with HIV. However, little is known about reproductive decision-making processes for African American women living with HIV. The overall goal of our study was to qualitatively explore perspectives related to reproduction and motherhood in HIV-infected African American women of childbearing capacity. HIV-infected African American women of childbearing capacity in South Carolina (N = 42) participated in in-depth interviews. Our respondents held positive views about pregnancy and motherhood, despite non-supportive pregnancy messages from interpersonal influences, including health care providers. Study findings uncovered the need for programs and interventions to support women’s reproductive autonomy and focus on reducing conception- and pregnancy-related transmission risks to infants and uninfected sexual partners.

Background In the United States, a disproportionate number of unintended pregnancies occur among African Americans, particularly those in their later teenage years and early 20s. Mobile technology is becoming more ubiquitous as a method for health promotion; however, relatively little research has been done with this population to determine their perspectives about unintended pregnancy, the potential of successfully using mobile technology to prevent unintended pregnancy, and the content of such programs. Objective The purpose of this study was to obtain the perspectives of African American emerging adults about unintended pregnancy and the use of mobile technology to reduce unintended pregnancy rates. Methods Focus groups and interviews were conducted with 83 African Americans, aged 18-21 years. Data were analyzed using an open coding process. Emergent codes were then added as needed, and themes and subthemes were identified. Results Participants cited the social environment and lack of education as primary reasons for disproportionate rates of unintended pregnancy. They noted that unintended pregnancy is an important issue and that they desire more sexual health information. They enthusiastically supported mobile technology as a means to communicate unintended pregnancy prevention programming and offered many suggestions for program content, look, and feel. Conclusions Young and emerging adult African Americans want and need sexual health resources, and a mobile-based platform could be widely accepted and address needs to lower disproportionate rates of unintended pregnancy. An essential next step is to use these findings to inform the development of a mobile-based unintended pregnancy prevention and sexual health program prototype to determine feasibility.

Purpose: To examine sexual, mobile technology, and sexting behaviors of college students. Design: A cross-sectional study design was employed. Setting: Study sites were 2 universities in the southern United States. Subjects: Data were collected from 254 participants via online survey of college students. Measures: The survey included 268 items inclusive of measures from previously validated sources. Variables for this study included technology ownership/use, online/mobile dating site use, sexting behaviors/attitudes, and sexual behaviors. In particular, the Sexting Attitudes Scale has been previously validated with other researchers providing comparative data. Analysis: Chi-square and Mann-Whitney tests were used for group comparisons. Logistic regression analysis was used to examine predictors of sexting behavior. Results: Of the 254 participants, over 80% had ever had sex, and participants were more likely to use condoms with partners who they were not in a committed relationship compared to those to whom they were committed (χ2 = 27.324, P = .0001). Seventy percent had ever sexted, and sexting attitudes ranged from approximately 80% agreeing that sexting is “risky” or can leave one “vulnerable” compared to 43% agreeing that sexting is “fun.” Sexting was associated with having multiple sexual partners (odds ratio [OR] = 2.47, 95% confidence interval [CI]: 1.36-4.47) and sexually transmitted infection testing history (OR = 2.08, 95% CI: 1.03-4.18). Conclusion: Study findings should be considered as interventionists plan sexual health and risk prevention programs for college students.

Zimbabwe has one of the highest rates of maternal mortality, yet little is understood about adolescent girls’ and young women’s perspectives on pregnancy or planning for pregnancy. The research study took an emic approach to understand and describe how adolescent girls and young women (14–24 years) in Harare, Zimbabwe, conceptualize pregnancy and planning for pregnancy and how these conceptualizations inform pregnancy decisions. Semi-structured, in-depth, qualitative interviews were conducted with adolescent girls and young women ( N = 48) and data were analyzed thematically using NVivo 10. Pregnancy was conceptualized across nine themes: carrying a child and oneself, growing a family, motherhood, the best time for pregnancy, pregnancy decision makers, who is responsible for the pregnancy, pregnancy burden, pregnancy dangers, and increase in social status with pregnancy. Planning for pregnancy was conceptualized during the prepregnancy, pregnancy, and postpregnancy phases. Findings emphasize considering sociocultural views concerning pregnancy and including social networks in maternal health efforts.

While previous scholarship on the sexual practices of college students in the USA has explored how the co-constitution of whiteness, economic privilege and gender inequality are central to 'hooking up', less attention has been paid to how the sexual culture of predominantly white universities shape Black college women's sexual practices. In this article, we use an intersectional theoretical framework informed by Black feminism to analyse interviews with Black, cisgender, heterosexual women, aged 18-22, attending a university in the south-eastern USA. We explore how they interpret the university's sexual culture and in turn how that informs their sexual decision-making. We find that the intersection of racism and sexism limits Black college women's sexual partner options and leads them to pursue sexual relationships outside the university setting. While most do not engage in committed romantic relationships with off-campus partners, they do engage in a range of strategies to protect their social, emotional and sexual well-being. The study findings expand the scholarship on hook-up culture by centring the narratives of a group often excluded from the literature.

The Sexual Health in Faith Traditions Study evaluated the relationships between religiosity, spirituality, internalized homonegativity, and sexual risk behaviors among a sample of African American men who have sex with men living in the Deep South. Participants were recruited primarily from Black Gay Pride celebrations to complete a self-administered, paper-and-pencil survey. Structural equation modeling was used to determine relationships between key constructs and condom use for insertive ( n = 285) and receptive ( n = 263) anal intercourse in the past 3 months. Almost half of respondents reported using condoms “every time” when engaging in insertive (48.3%) or receptive (45.1%) anal intercourse. Religiosity and spirituality were differentially associated with dimensions of internalized homonegativity. While no significant direct relationships were reported between either religiosity or spirituality and condom use, dimensions of internalized homonegativity mediated significant indirect relationships. Findings suggest that religiosity and spirituality influence African American men who have sex with men’s internalized homonegativity and, subsequently, engagement in safer sex behaviors.

Introduction In 2005, a train derailment and subsequent chlorine spill ravaged the rural town of Graniteville in South Carolina, resulting in one of the worst chlorine gas exposures in US. History Significant health and economic challenges persist in the community more than a decade later. Healthcare providers offered healthcare services to community members in the immediate aftermath of the disaster, and many still live in the community and continue to provide healthcare services. As such, healthcare professionals provide a unique and important perspective to help understand the impact of the disaster on the community's health. The purpose of this study was to explore healthcare providers' perspectives about the long-term effects of the disaster on community health, healthcare access, and wellbeing. Methods Semi-structured interviews were conducted with 30 healthcare providers who treated survivors of the Graniteville train disaster. A qualitative, essentialist, inductive thematic analytic approach was used to analyze study data. Results Four themes emerged regarding the disaster's long-term impact: effects of chlorine exposure on physical health, issues with healthcare access, residual effects of the disaster on personal and community wellbeing, and improving health and community wellbeing. Conclusions Disaster recovery should not be considered solely an acute event; agencies must be prepared for long-term, potentially chronic ailments, particularly in underserved, rural communities. Efforts to address the long-term health needs of communities post-disaster should consider the perspectives of healthcare providers to offer a well-rounded assessment of community needs. Study findings can help inform future disaster response strategies in communities locally and globally.

African American women bear a disproportionate burden of HIV/AIDS in the United States. Although they constitute only 13% of the US population, African Americans account for nearly 65% of all new HIV infections among American women. In addition, this population suffers comparatively greater adverse health outcomes related to HIV status. African American women living with HIV in the South may be further burdened by HIV/AIDS stigma, which is comparatively more pronounced in this region. To further explore this burden, we used narrative data and the Social Ecological Model to explore how African American women living with HIV in the US South recount, conceptualize, and cope with HIV/AIDS stigma at interpersonal, community, and institutional levels. Our narrative analysis suggests that HIV-positive African American women living in the South are vulnerable to experiences of multilevel HIV stigma in various settings and contexts across multiple domains of life. Stigma subsequently complicated disclosure decisions and made it difficult for women to feel supported in particular social, professional and medical settings that are generally regarded as safe spaces for noninfected individuals. Findings suggest that the debilitating and compounded effect of multilevel HIV/AIDS stigma on HIV-positive African American women in the South warrants closer examination to tailor approaches that effectively address the unique needs of this population.

This study examined the psychometric properties of the Internalized Homonegativity Inventory (IHNI) among African American men who have sex with men (AAMSM) in the southeastern United States. Data from 261 AAMSM were analyzed using exploratory factor analysis. Results showed evidence of a two-factor solution: personal and moral homonegativity and gay affirmation. Internal consistencies were greater than .80, and correlations with other variables (e.g., sociodemographics, religiosity, masculinity) provided evidence of validity. Findings suggesting a two-factor instead of a three-factor solution may indicate that the IHNI manifests differently for AAMSM in the Deep South than for predominantly White MSM. Further research should examine how incorporating new conceptions of internalized homonegativity into culturally specific health-promotion interventions for AAMSM might enhance effectiveness.

Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to a lack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Care established a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant women receiving daily iron and folic acid (IFA) at their first antenatal care visit and throughout pregnancy. Despite these efforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand the experiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare, Zimbabwe, and the influence of health‐service and social environments on utilization. Semi‐structured in‐depth interviews were conducted in Shona and English, with pregnant women (n = 24) and healthcare workers (n = 14) providing direct antenatal care services to pregnant women in two high‐density community clinics. Data were analysed thematically using NVivo 10. Influences on utilization were at the individual and structural environmental levels. Reasons for low utilization of IFA supplementation included forgetting to take IFA, side effects, misconceptions about IFA, limited access to nutrition information, delayed entry or non‐uptake of antenatal care and social norms of pregnant women for IFA supplementation. Utilization was enhanced by knowledge of risks and benefits of supplementation, fear of negative health complications with non‐utilization, family support and healthcare worker recommendation for supplementation. Study findings can inform approaches to strengthen micronutrient supplementation utilization to improve the micronutrient status of pregnant women to decrease maternal mortality and improve overall maternal and child health in Zimbabwe. © 2016 John Wiley & Sons Ltd

© 2016, Taylor & Francis Group, LLC. College students represent an important population for studying and understanding factors that influence sexual risk given the populations' high risk of sexually transmitted infections and unintended pregnancies. Using a quasi-experimental design, the efficacy of a brief and theory-driven mobile application intervention designed to decrease sexual risk behaviors among young college students (N = 118) was tested. Ninety-six percent (n = 114) of the participants showed an increase in contraceptive use knowledge from pretest to posttest (p =.013). Participants did not show a statistically significant change in intention to reduce sexual risk behaviors or actual risk reduction. This study supports the use of technology to educate college students about sexual health.

Introduction. Determining spatial patterns of cancer risk from air toxics is important to reduce environmental health disparities that cause cancer in areas experiencing disparate environmental exp...

Introduction. This study assessed spatial variations in cancer risk and cancer outcomes (incidence and mortality) by racial and socioeconomic composition in South Carolina. Methods. Cancer risk dat...

Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and environmental factors, which in turn shape health decision-making. A paucity of studies has explored risk perceptions and worry in metropolitan areas with disparate environmental conditions and cancer outcomes. This study examined perceptions of cancer risk, neighborhood environmental health risks, and risk-reducing health behaviors among Blacks. A 59-item survey was administered to respondents in Metropolitan Charleston, South Carolina from March to September 2013. A convenience sample of males and females was recruited at local venues and community events. Descriptive statistics, bivariate analyses (Chi square tests), and logistic regression models were estimated using SAS 9.3 software. Respondents (N = 405) were 100 % Black, 81 % female (n = 323), and ranged from 18 to 87 years of age (M = 49.55, SD = 15.27). Most respondents reported lower perceptions of cancer risk (37 %) and equated their cancer beliefs to direct or indirect (i.e. personal or family) experiences. Low perceived cancer risk (absolute risk) was significantly associated (p

Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to a lack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Care established a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant women receiving daily iron and folic acid (IFA) at their first antenatal care visit and throughout pregnancy. Despite these efforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand the experiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare, Zimbabwe, and the influence of health-service and social environments on utilization. Semi-structured in-depth interviews were conducted in Shona and English, with pregnant women (n = 24) and healthcare workers (n = 14) providing direct antenatal care services to pregnant women in two high-density community clinics. Data were analysed thematically using NVivo 10. Influences on utilization were at the individual and structural environmental levels. Reasons for low utilization of IFA supplementation included forgetting to take IFA, side effects, misconceptions about IFA, limited access to nutrition information, delayed entry or non-uptake of antenatal care and social norms of pregnant women for IFA supplementation. Utilization was enhanced by knowledge of risks and benefits of supplementation, fear of negative health complications with non-utilization, family support and healthcare worker recommendation for supplementation. Study findings can inform approaches to strengthen micronutrient supplementation utilization to improve the micronutrient status of pregnant women to decrease maternal mortality and improve overall maternal and child health in Zimbabwe. © 2016 John Wiley & Sons Ltd

We examined environmental cancer risk disparities in Metropolitan Charleston by determining the variability in cancer risk and outcomes geographically by racial and socioeconomic characteristics. We mapped total cancer risk from the 2005 National-Scale Air Toxics Assessment (NATA) and five-year (2006-2010) cancer outcomes (incidence and mortality) from the South Carolina Central Cancer Registry. Data were georeferenced to the 2000 Decennial United States Census tract boundaries in Metropolitan Charleston (i.e. Berkeley, Charleston, and Dorchester County). A Spearman's rank-order correlation was run to determine the relationship between cancer risk or cancer outcomes and characteristics of environmental justice (percent (%) Black, poverty, and low-income). Correlations were performed in SPSS 22.0. Bivariate choropleth maps were created in ArcGIS 10.2 to represent the geographic associations between cancer data and environmental justice variables. Our findings demonstrate an inverse relationship between cancer risk and five-year cancer incidence (rs = -1.90, p = .040). Cancer risk was positively correlated with % Black (rs = .324) and % poverty (rs = .474), yet negatively related to % income (rs = -.542). Bivariate maps showed that 80% of the tracts with high cancer incidence/high percent Black population were simultaneously high cancer mortality/high Black population tracts. None of the high incidence or high mortality tracts had simultaneously high cancer risk. Findings from this study have implications for reducing place-based environmental cancer disparities. With a better understanding of patterns of risk, public health professionals can tailor interventions and develop community-based environmental health programs that will inform policies to reduce cancer inequities. Citation Format: LaShanta J. Rice, Christopher T. Emrich, Heather M. Brandt, Lucy Annang Ingram, James W. Hardin, Sacoby M. Wilson, Chanita Hughes Halbert. Exploring the distribution of environmental cancer risk by air toxics using geographic information systems. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A07.

Purpose: Several studies have demonstrated the impact of cancer and environmental health disparities on African Americans, but a paucity of research has documented the risk perceptions associated with the aforementioned factors from the perspective of this population. The purpose of this study was to: 1) document perceptions of cancer risk and cancer worry, neighborhood environmental health risks, and risk-reduction health behaviors, and 2) determine the association between low perceived cancer risk and health behaviors among African Americans. Methods: A 59-item survey was administered to respondents in Metropolitan Charleston, South Carolina (Berkeley, Charleston, and Dorchester Counties) from March 2013 to September 2013. A convenience sample of males and females was recruited at local venues (e.g., libraries, housing authority, and hair salons) and community events. Eight health behaviors (sun exposure, smoking, physical activity, diet, cancer screenings, vaccinations, weight, and alcohol use) were assessed. Descriptive statistics, bivariate analyses (chi square), and logistic regressions were estimated using SAS 9.3. Results: Respondents (N=405) were all African American, 81% female (n=323), 19% male (n=75), and ranged from 18 to 87 years of age (mean age=49). Most respondents' cancer risk perceptions were low and believed to be the result of past personal or family experiences and information received from a medical or health provider. The environment was perceived to play a very important role in causing disease. Specifically, 69% of respondents perceived the environment played a major role in the development of cancers. Approximately 47% of respondents rated their community as a somewhat good place to live, yet 81% of the sample reported a high level of concern about harmful environmental conditions. No significant associations were observed between perceived environmental health risk and low cancer risk perceptions, cancer worry or health behaviors. Low perceived cancer risk (absolute risk) was associated with non-alcohol consumption and colon cancer screening, sex, and older age (24-65, p Conclusions: This study demonstrates that perceived cancer risk and cancer worry are important indicators of health behaviors among African Americans in environmental justice communities. In addition, African Americans in Metropolitan Charleston are generally knowledgeable about the role of the environment in cancer development. Evaluating perceived cancer risks in environmentally vulnerable populations could have long term implications for controlling cancer through preventive action. Future research will investigate the triadic relationship between neighborhood environment, risk perceptions, and health behaviors. Citation Format: LaShanta Rice Rice, Heather M. Brandt, Lucy Annang Ingram, James W. Hardin, Sacoby M. Wilson. Documenting community perceptions of cancer risk, environmental health, and health behaviors: A study in metropolitan Charleston. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A53.