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Individuals with sickle cell disease experience a life-time of morbidity as well as a decreased lifespan. Since African Americans are disproportionately affected by the disease, sickle cell contributes to growing health disparities within this population. Thus, addressing issues related to the disease presents an increased need for health education programming. A narrative literature review was conducted to assess the application of the health belief model in sickle cell trait screening research. Research articles were identified through an interdisciplinary search of peer-reviewed manuscripts. Articles including the following three criteria were selected for review: (1) use of the health belief model, (2) application to sickle cell disease/sickle cell trait, and (3) practical implementation in the field of public health education. Findings from this review indicate that the health belief model is not effective in all sickle cell trait screening interventions. Additional theories of health behavior should be considered when designing health education programs and interventions geared toward sickle cell screening.

Objective: This study examined the meaning of sickle cell trait and sickle cell trait screening from the lay perspective of African Americans. Design and Methods: African Americans (N = 300), ages 18-35 and unaware of their sickle cell trait status, completed two open-ended questions from a larger survey. One question asked for their understanding of sickle cell trait; the other asked for their understanding of sickle cell trait screening. Content analysis occurred in two phases: (1) In vivo and holistic coding; and (2) focused coding. Results: Four categories emerged illustrating lay conceptions of sickle cell trait; (1) Perceived as an illness; (2) Perceived recognition of the inheritance pattern of sickle cell trait; (3) Perceived lack of knowledge of sickle cell trait; and (4) Perceived importance of sickle cell trait. Five categories emerged illustrating lay conceptions for sickle cell trait screening: (1) Perceived recognition that screening means getting tested for sickle cell trait; (2) Perceived lack of knowledge of sickle cell trait screening; (3) Perceived health benefit of sickle cell trait screening; (4) Perceived importance of sickle cell trait screening; and (5) Perceived barriers to sickle cell trait screening. Conclusions: Sickle cell trait and sickle cell trait screening are concepts that are both regarded as important among this high-risk population. However, there is still misunderstanding concerning the hereditary nature and reproductive implications of sickle cell trait. Interventions seeking to improve communication on the need for sickle cell trait screening should begin by identifying what the population at large understands, knows and/or believes to improve their ability to make informed health decisions. [ABSTRACT FROM AUTHOR]

Health literacy plays a vital role in patients’ understanding of their prescribed medication instructions. To inform strategies to assist providers in communicating in a manner that is easily understood by patients, it would be beneficial to determine the relationship between health literacy and the day-to-day aspects of medication adherence. This study identified: 1) differences of health literacy levels in medication adherence; 2) the association between health literacy and medication adherence; and 3) and factors associated with medication adherence score. A convenience sample of older predominantly African-American patients (N = 389), over the age of 60, completed a cross-sectional survey. Chi-square analysis assessed health literacy differences in five aspects of medication adherence. Ordinary linear regression analysis determined factors associated with medication adherence score. Patients with limited health literacy were more likely to forget to take their medications and more likely to take less medication than instructed than patients with adequate health literacy (χ2(5) = 15.91, p =.007, χ2(5) = 10.31, p =.036, respectively). REALM score was also significantly associated with medication adherence score (β=.016, p <.001, β =.009, p =.033), respectively). Findings suggest that providers seeking to improve medication adherence in older adults, particularly African-American patients, should focus communication on assessing health literacy levels prior to discussing medication instructions. [ABSTRACT FROM AUTHOR]

Individuals with sickle cell disease experience a lifetime of morbidity as well as a decreased lifespan. Since African Americans are disproportionately affected by the disease, sickle cell contributes to growing health disparities within this population. Thus, addressing issues related to the disease presents an increased need for health education programming. A narrative literature review was conducted to assess the application of the health belief model in sickle cell trait screening research. Research articles were identified through an interdisciplinary search of peer-reviewed manuscripts. Articles including the following three criteria were selected for review: (1) use of the health belief model, (2) application to sickle cell disease/sickle cell trait, and (3) practical implementation in the field of public health education. Findings from this review indicate that the health belief model is not effective in all sickle cell trait screening interventions. Additional theories of health behavior should be considered when designing health education programs and interventions geared toward sickle cell screening. [ABSTRACT FROM AUTHOR]

Objective: We assessed acceptability, feasibility, and preliminary efficacy of a culturally appropriate, cancer education program to improve cancer knowledge, attitudes, subjective norms, and screening intentions for oropharynx, colon, and prostate cancers among African American men. We detailed the community-engaged research process used for African American men to design, implement, and evaluate the program., Materials and Methods: We recruited 84 (61 in-person, 23 online) African American men over 2-months across 4 churches in Middle Tennessee in 2021. A single group, pre-post-test design was used to evaluate the 2.5-h hybrid program. Scales used were: General self-efficacy for cancer screening ; attitudes toward cancer ; general cancer knowledge ; and subjective norms related to cancer . One-item measured cancer screening intention . Taba robust partial correlation measured the degree of association between changes in means of each explanatory variable with changes in means of each outcome variable. IBM SPSS version 28 and R/RStudio version 3.6.0 was used for data analysis. We conducted three focus groups ( n  = 17) to assess program acceptability. Microsoft Excel version 26 was used to conduct thematic analysis for this data., Findings: Quantitative Significant differences were found in the pre/post comparisons of knowledge (mean difference: 0.22; p -value = 0.015), self-efficacy (mean difference: 0.23; p -value < 0.001), and prostate cancer screening intention (mean difference: 0.19; p -value = 0.049) scores. This indicates the mean score for knowledge, self-efficacy, and prostate cancer screening intention was significantly higher post-intervention. Qualitative Focus group themes were: (1) Impact of Program on Participants Psychosocial Health (2) Perspectives on Life after the program. (3) Views on Programmatic Components; (4) Recommendations for Program Improvement., Conclusions: Results demonstrate our program is feasible, acceptable, and could increase cancer screening intentions and behavior. Psychosocial providers should demonstrate cultural awareness and humility when providing services to address the psychological and social needs for cancer screening among African American men.

Background: Individuals with sickle cell disease (SCD) and their caregivers may benefit from technology-based resources to improve disease self-management., Objective: This study explores the preferences regarding a mobile health (mHealth) app to facilitate self-management in adults with SCD and their caregivers living in urban and rural communities., Methods: Five community listening sessions were conducted in 2 urban and rural communities among adults with SCD and their caregivers (N=43). Each session comprised 4 to 15 participants. Participants were asked questions on methods of finding information about SCD self-care, satisfaction with current methods for finding SCD management information, support for SCD management, important features for development of an mHealth app, and areas of benefit for using an mHealth app for SCD self-management. An inductive-deductive content analysis approach was implemented to identify the critical themes., Results: Seven critical themes emerged, including the current methods for receiving self-management information, desired information, recommendations for communicating sickle cell self-management information, challenges of disease management, types of support received for disease management, barriers to and facilitators of using an mHealth app, and feature preferences for an mHealth app. In addition, we found that the participants were receptive to using mHealth apps in SCD self-management., Conclusions: This study expands our knowledge on the use of mHealth technology to reduce information access barriers pertaining to SCD. The findings can be used to develop a patient-centered, user-friendly mHealth app to facilitate disease self-management, thus increasing access to resources for families of patients with SCD residing in rural communities., (©Tilicia L Mayo-Gamble, Delores Quasie-Woode, Jennifer Cunningham-Erves, Margo Rollins, David Schlundt, Kemberlee Bonnet, Velma McBride Murry. Originally published in JMIR Formative Research (https://formative.jmir.org), 30.11.2021.)

Objectives: Healthcare utilization and participation in diabetes management programs have shown to be beneficial to overall health in patients with type 2 diabetes mellitus (T2DM). To improve the effectiveness of healthcare activities on diabetes health outcomes, factors associated with healthcare activities such as physician seeking and participating in a diabetes management class need to be identified., Design and Methods: A retrospective multi-year cross-sectional analysis was conducted. Data were collected using data sets from the 2006 to 2010 Behavioral Risk Factor Surveillance System Survey. A Poisson regression was conducted to capture the influence of predisposing, enabling, and need factors on the number of physician visits for diabetes. A logistic regression was conducted to capture the influence of the aforementioned factors on participation in a diabetes management class., Results: Results of the Poisson regression indicate patients who were taking insulin, more frequently check for sores, or have hemoglobin exams, had made more physician visits (incident rate ratios = 1.34, 1.04, and 1.05, respectively; all P < .01). Results of the logistic regression indicate patients who were taking insulin or more frequently check for sores (odds ratio [OR] = 1.48, 1.37, 1.43, 0.74, 1.30, 1.07, and 1.06, respectively; all P < .01), were more likely to participate in a diabetes management class. Results also indicated patients who were male or married were less likely to participate in a diabetes management class (OR = 0.69, P < .05; OR = 0.81, P < .01 respectively)., Conclusions: Evidence supports sociological factors as important facilitators promoting healthcare utilization in patients with increased T2DM severity levels. Interventions to improve healthcare utilization should acknowledge sociological factors, particularly self-care factors.