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BackgroundHispanic women have increased risk of gestational diabetes mellitus (GDM), which carries an increased risk for future type 2 diabetes, compared to non-Hispanic women. In addition, Hispanic women are less likely to engage in healthy eating and physical activity, which are both risk factors for type 2 diabetes. Supporting patients to engage in healthy lifestyle behaviors through mobile health (mHealth) interventions is increasingly recognized as a viable, underused tool for disease prevention, as they reduce barriers to access frequently experienced in face-to-face interventions. Despite the high percentage of smartphone ownership among Hispanics, mHealth programs to reduce risk factors for type 2 diabetes in Hispanic women with prior GDM are lacking. ObjectiveThis study aimed to (1) develop a mobile app (¡Hola Bebé, Adiós Diabetes!) to pilot test a culturally tailored, bilingual (Spanish/English) lifestyle program to reduce risk factors for type 2 diabetes in Hispanic women with GDM in the prior 5 years; (2) examine the acceptability and usability of the app; and (3) assess the short-term effectiveness of the app in increasing self-efficacy for both healthy eating and physical activity, and in decreasing weight. MethodsSocial cognitive theory provided the framework for the study. A prototype app was developed based on prior research and cultural tailoring of content. Features included educational audiovisual modules on healthy eating and physical activity; personal action plans; motivational text messages; weight tracking; user-friendly, easy-to-follow recipes; directions on building a balanced plate; and tiered badges to reward achievements. Perceptions of the app’s acceptability and usability were explored through four focus groups. Short-term effectiveness of the app was tested in an 8-week single group pilot study. ResultsIn total, 11 Hispanic women, receiving care at a federally qualified community health center, aged 18-45 years, and with GDM in the last 5 years, participated in four focus groups to evaluate the app’s acceptability and usability. Participants found the following sections most useful: audiovisual modules, badges for completion of activities, weight-tracking graphics, and recipes. Suggested modifications included adjustments in phrasing, graphics, and a tiering system of badges. After app modifications, we conducted usability testing with 4 Hispanic women, with the key result being the suggestion for a “how-to tutorial.” To assess short-term effectiveness, 21 Hispanic women with prior GDM participated in the pilot. There was a statistically significant improvement in both self-efficacy for physical activity (P=.003) and self-efficacy for healthy eating (P=.007). Weight decreased but not significantly. Backend process data revealed a high level of user engagement. ConclusionsThese data support the app’s acceptability, usability, and short-term effectiveness, suggesting that this mHealth program has the potential to fill the gap in care experienced by Hispanic women with prior GDM following pregnancy. Future studies are needed to determine the effectiveness of an enhanced app in a randomized controlled trial. Trial RegistrationClinicalTrials.gov NCT04149054; https://clinicaltrials.gov/ct2/show/NCT04149054

Three focus groups examined stress and conflict among 30 older African American women in Boston. Stress stemmed from worries about functional disability, accessing transportation, conflicts with family and peers, and grandchildren's lack of respect. Participants tended to use avoidant strategies to deal with stress and conflict. A training program in constructive conflict strategies for older African American women is presented. (Contains 46 references.) (TD)

Older African American women are at high risk for morbidity due to anger suppression and stress. Yet sources of everyday stress and conflict in the lives of older African American women have not been documented. Such information is essential for developing health promotion programs. A focus group study was conducted with older African American women on everyday stress and conflict. Everyday stress stemmed from worries about functional disability and about accessing transportation. Everyday conflicts occurred with adult children, teenaged grandchildren, and older neighbors or peers. Conflicts with adult children centered on how the adult child was raising his/her children. Conflicts with grandchildren centered on social respect. Conflicts with neighbors/peers centered on perceived rudeness or past transgressions. Participant strategies for dealing with stress and conflict tended to be avoidant. A training program in constructive conflict strategies for older African American women is presented that draws on information gained in the focus groups. KEYWORDS. Minority women, interpersonal conflict, stress

Research indicates that minority caregivers use fewer outside social and medical services than white, European-American caregivers. Qualitative research has shown nonocaregiving stressors stemming from family and community environments as affecting burden and service use among minority caregivers. Yet few studies of caregiver service use include multiple groups of minority caregivers, or quantitatively evaluate the influence of non-caregiving stress. Using Pearlin, Mullan, Semple and Skaff's (1990) model of caregiver stress, we examined the relationship of ethnicity, non-caregiving stressors, and other stress-associated variables to service use by African-American, Chinese, and Latino caregivers. A group of white, European-American caregivers served as a reference group. Results show ethnicity, non-caregiving stress, and the dementia-affected elder's impairment level to predict unmet service need. The results also point to the usefulness of a new measure of non-caregiving stress in evaluating service use among minority caregivers. Keywords: Caregiving, social service, medical service, Alzheimer's disease

Background and Objective Sexually transmitted diseases (STDs) are increasing among older adults concomitant with a rise in divorce after the age of 50 years. The objective of this study was to examine the effectiveness of a web-based human immunodeficiency virus (HIV)/STD risk reduction intervention for divorced and separated women aged more than 50 years. Research Design and Methods Two hundred nineteen divorced or separated women, aged 50 years and older, participated in 60-day randomized pre–post control group study. Recruitment occurred via health agencies in Boston and Columbia, SC, and Craigslist advertisements placed in Boston, Columbia, Charleston, New York City, Washington DC, Baltimore, Chicago, Atlanta, Orlando, and Miami. Results Intervention group reported greater intention to practice safe sex compared to the control group (B =.55, p =.03). Intention to practice safe sex differed by perceived stress (B =.15, p =.005), with no difference between control and intervention groups for those with low levels of stress. For high levels of stress, intervention group reported greater intention to practice safe sex compared to controls. Sexual risk was reduced by 6.10 points (SD : 1.10), and self-efficacy for sexual discussion was increased by 2.65 points (SD : 0.56) in the intervention group. Discussion and Implications A web-based intervention represents a promising tool to reduce HIV/STD risk among older women. Offering HIV/STD education in the context of other topics of interest to at-risk older women, such as divorce, may solve the problem of at-risk older women not seeking out prevention information due to lack of awareness of their heightened risk. [ABSTRACT FROM AUTHOR]

Everyday problem solving within the interpersonal domain has been identified as propelling cognitive development in adulthood, and may be particularly relevant to women's development. Yet few studies of everyday problem solving in adulthood focus on interpersonal problems, on women, or on the middle adult years. We examined strategies middle-aged women used for real-life interpersonal problems, and contextual variables associated with strategy use. In contrast to research with younger and older women, in which lower-level strategies were favored, strategy use here was fairly evenly split between higher and lower levels. Also in contrast to other research with younger and older women, participants here favored lower-level strategies that were directive, rather than submissive. Thematic analyses showed a high degree of felt emotional distress to be associated with lower-level strategy use, and attempts at controlling emotions and overcoming fundamental attribution errors in judgment to be related to higher-level strategy use.

We present the evaluation of a pilot videotape training program for older African American women in constructive conflict resolution. The program was developed because research shows: (a) older African American women suffer disproportionately from hypertension, (b) hypertension is linked to anger inhibition, and (c) older African American women tend to inhibit their anger in interpersonal conflict. Community-dwelling and institutionalized older women participated in the training. Evaluation findings indicate that the training led to increased knowledge of health-promoting skills for handling conflict, and that providing a brief group intervention in a familiar, non-stigmatizing setting may be an effective means of mental health promotion for older African American women. [ABSTRACT FROM PUBLISHER]