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The present study aimed to use CBCT to compare the influence of White and Black ethnicity on gingival and bone thickness. A total of 84 individuals of both genders, aged between 18 and 59 years old, were divided into Black (BG; n = 42) and White (WG; n = 42) groups and were analyzed from June 2020 to April 2021. The gingival thickness (GT) and buccal bone plate thickness (BBPT) were measured using CBCT in all maxillary anterior teeth. Mann-Whitney, t test, chi-square, Pearson correlation, and Spearman correlation were used for comparisons and correlations with a 5% significance level. Black individuals had mean GT (1.45 ± 0.29 mm) and BBPT (1.07 ± 0.21 mm) significantly thicker (gingival: P < .0001; bone: P = .0002) than White individuals (1.17 ± 0.28 mm and 0.91 ± 0.17 mm, respectively). The variables presented greater values for men. A positive correlation between the BBPT and GT was found in two teeth in the WG (left and right central incisors) and one tooth in the BG (left canine). Moreover, a correlation between BBPT and GT immediately below the alveolar bone crest (0 mm) was found in four teeth in the WG (left and right lateral and central incisors) and the BG (left and right canine, left lateral and central incisors). Black race was shown to significantly influence the GT and BBPT, with Black patients presenting thicker structures than White patients. [ABSTRACT FROM AUTHOR]

Pickleball offers sociopsychological and physical activity benefits for older adults but lacks racial diversity. The purpose of this study was to identify constraints to pickleball participation with Black older adults (65+ years) as well as examine differences based on physical activity and sex. A Qualtrics panel included Black older adults (N = 292) who have heard of pickleball and are physically able to play but have not played. Results found Knowledge, Accessibility, Interpersonal, and Interest were the most salient constraints overall. Multivariate analysis of variance found that those who report low physical activity had significantly higher Interpersonal, Psychological, Costs, and Perceived Racism constraints. Additionally, females report significantly higher Knowledge, Psychological, and Cost constraints compared to males. The results further the theoretical application of constraints to physical activity research and provide insights into practitioner implications to grow the sport of pickleball for Black older adults. [ABSTRACT FROM AUTHOR]

The Integrated Change Model describes several social and cognitive factors (e.g., health attitudes, social support, self-efficacy) that can affect medication adherence. Guided by this model, we sought to identify profiles of socio-cognitive facilitators of ART (antiretroviral therapy) adherence among diversely minoritized persons living with HIV enrolled in a behavioral intervention trial in Atlanta, Georgia (N = 477). To do this, we performed latent profile analysis on baseline responses to scales assessing 6 indicators of interest: HIV-care self-efficacy, social support, TasP (treatment-as-prevention) beliefs, trust in healthcare providers, perceived need for ART, and trust in ART. We regressed emergent profiles on internalized, enacted, and microaggressive HIV stigma and compared prospective 30-day ART adherence and several cross-sectional HIV outcomes across profiles. Mean age was 29 years; 83% of participants were non-Hispanic Black, 53% were gay/homosexual-identifying, and 12% were gender expansive. Three profiles emerged: "Constrained/Capable" (6%), featuring high self-efficacy but low-moderate provider trust, social support, TasP beliefs, ART trust, and ART need; "Conflicted" (13%), featuring high TasP beliefs, provider trust, and ART need but moderate self-efficacy, ART trust, and social support; and "Motivated" (81%), featuring high levels of all indicators. Greater internalized, enacted, and microaggressive stigma were positively associated with "Conflicted" relative to "Motivated" profile membership. ART-nonadherence, unsuppressed viral load, and viral load unawareness were more likely for the "Conflicted" relative to the "Motivated" profile. Personalized HIV care tailored to such profiles may improve ART adherence and related outcomes for minoritized persons living with HIV. [ABSTRACT FROM AUTHOR]

This study explores Black Canadian youth's relationship with religion and the impact religion has on their mental health and wellbeing. In addition, we probed promising practices for religious leaders and service providers who want to improve Black youth's access to care. The results of this article draw from a larger study that aimed to explore the barriers and facilitators to mental healthcare for Black youth in Ontario, Canada. 128 (n = 66 youth, n = 35 service providers, n = 27 family and community members; 91% Black, 24% people of colour, 67% white) participants from six regions across Ontario were engaged in 23 qualitative focus groups held virtually between March 2020 and August 2021. Data were analyzed using thematic analysis. Three themes emerged from the data: The stigma and taboo nature of mental illness, the influence of religion and mental health and suggestions to improve care for Black youth. Mental illness is stigmatized in specific ways in Black communities and intergenerational differences exist in how mental illness is conceptualized. In addition, Black Two-Spirit, lesbian, gay, bisexual, transgender, queer/questioning and other diverse or marginalized sexual orientations and gender identities (2SLGBTQ+) youth face additional difficulties in relation to stigma. Religion and religious affiliation stigmatized mental illness yet, both were considered important for inclusion in traditional mental health supports. To improve access to care for Black youth, there is a need for community-practitioner partnerships, incorporating religion into traditional mental healthcare, and increasing mental health awareness in religious and community spaces. This study is among the first to explore the impact of religion on Black youth's mental health, findings can contribute to increased access to affirming and responsive care for this population. [ABSTRACT FROM AUTHOR]

Much of what is known about non-resident fathers is based on studies conducted in North America and Europe, and on the accounts of only one family member. This article draws from a study which utilised a family systems perspective and obtained the views of four members of ten Black South African non-resident father families (N = 40) with infrequent father–child contact. The aim was to investigate if and how non-resident fathers' contact with adolescent children was influenced by relationships with various family members. Individual interviews were conducted with each of the family member and thematically analysed. Here, we engage with one of the master themes that shows the circular dynamic in families in which various family members held implicit assumptions about who was responsible for father–child contact and, subsequently, did not view the responsibility to be theirs. Infrequent or lack of non-resident father–child contact should therefore be addressed as a family systems issue. [ABSTRACT FROM AUTHOR]

Background. Several disparities exist for Black mothers during the postpartum period, including but not limited to increased maternal mortality and morbidity rates, decreased access to care, and limited access to resources. Given the racial discrepancies in attention to postpartum care, coupled with the critical importance of the postpartum period for preventing adverse maternal health outcomes, research is warranted to explore how mobile health (mHealth) applications may help to alleviate maternal health disparities by optimizing postpartum care and addressing barriers to care for postpartum Black women. Thus, this review examines the perceptions of mHealth applications and their utility in health outcomes among postpartum Black women. Methods. We undertook a comprehensive literature search using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We included peer-reviewed articles published between 2010 and 2022 that were written in English, utilized mHealth as a primary intervention, and focused on postpartum health and access to resources, primarily among Black women in the United States. Results. A total of eight articles were included in our synthesis, encompassing mobile phone-based interventions for Black women. Cultural tailoring was included in five studies. Interventions that incorporated tailored content and fostered interactions reported high rates of follow-up. Conclusions. Tailored mHealth interventions can effectively promote behavior change and improve health care outcomes for Black women. However, there is a critical need for more research to assess user engagement and retention and whether these improvements indicate long-term sustainability. [ABSTRACT FROM AUTHOR]

Background: Black women are diagnosed, disabled, and die from obesity and associated chronic diseases at higher rates than any other sex or race. Advanced practice registered nurses (APRN) can potentially improve culturally relevant health education and counseling by using health literacy communication tools. Objective: Explore individualized barriers and APRNs' role in providing obesity prevention education and counseling by assessing the efficacy of the Teach-Back Method (TBM) to understand health habits and attitudes. Methods: Black women aged 18–45, previously diagnosed as overweight or obese, and identified with perceived barriers were recruited from a predominantly Black church in Atlanta. They engaged in weekly, 1-hour educational sessions via Zoom, addressing four common barriers identified in the literature. Sessions ended with a 5–10 minute Teach-Back session. Pre- and post-intervention Readiness to Change Questionnaire (RCQ) were completed. Descriptive statistics and quantitative data from surveys and pre- and post-RCQ were analyzed. Results: Twenty women completed the intervention. Paired sample t -test revealed no statistical significance or correlation between pre- and post-RCQ scores after using TBM in educational sessions. However, Pearson's correlation showed positive associations between elevated body mass index levels as one advances their education and annual income, with a p -value of 0.05. Discussion: Increased rates of obesity are experienced despite higher educational attainment or pay. Stress and high-coping mechanisms contributed to disordered eating, decreased physical activity engagement, and decreased motivation toward habit change. Clinicians should be held accountable for delivering culturally sensitive care using the TBM, addressing social determinants of health, performing routine stress assessments, and checking their implicit biases. [ABSTRACT FROM AUTHOR]

Background: Students from underrepresented groups, including those attending predominantly Black institutions, encounter challenges that hinder first-time success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Method: This retrospective, descriptive study included a convenience sample (N = 122) of nursing students. Data for students who attempted the NCLEX-RN at three different time periods were used to identify factors associated with passing the NCLEX-RN on the first attempt. Results: Students who scored 80 or higher in a medical-surgical course were more likely to pass the NCLEX-RN than those who scored below 80. Conclusion: Students' performance in predictor courses at predominantly Black institutions may determine success on the NCLEX-RN. Students who did not demonstrate success in identified program predictor courses may benefit from additional preparation and support prior to taking the NCLEX-RN. [J Nurs Educ. 2024;63(11):773–776.] [ABSTRACT FROM AUTHOR]

Objectives: Perceived discrimination is associated with racial cognitive health disparities. Links between discrimination and cognitive performance, like working memory, in everyday settings (i.e. ambulatory performance) require investigation. Depressive symptoms may be a mechanism through which discrimination relates to ambulatory working memory. Method: Discrimination, retrospective and momentary depressive symptoms/mood, and aggregated and momentary working memory performance among older Black and White adults were examined within the Einstein Aging Study. Results: Racially stratified analyses revealed that discrimination did not relate to Black or White adults' ambulatory working memory. Among Black adults, however, more frequent discrimination was associated with greater retrospectively reported depressive symptoms, which related to more working memory errors across two weeks (indirect effect p < 0.05). This path was not significant among White adults. Links between discrimination and momentary working memory were not explained by momentary reports of depressed mood for Black or White adults. Conclusion: Depressive symptoms may play an important role in the link between discrimination and ambulatory working memory among Black adults across extended measurements, but not at the momentary level. Future research should address ambulatory cognition and momentary reports of discrimination and depression to better understand how to minimize cognitive health disparities associated with discrimination. [ABSTRACT FROM AUTHOR]

Introduction: The awarding gap between White and Black students in UK health curricula is well established. Critical race theory (CRT) is a lens to deconstruct pedagogic practice and consider the intersectionality of Black student lived experience to provide a realist critique of the phenomenon of Whiteness in higher education and the impact this has on Black attainment. Using one UK pharmacy programme as a case study, this paper aims to explore Black lived experience as a means of problematising and disrupting structural oppressions. Methods: Sixteen Black students from one UK pharmacy degree programme were purposively recruited to the study. Love and breakup letter methodology (LBM) was used to facilitate sharing experiences of intersectionality in relation to their undergraduate education, with data thematically analysed through the lens of CRT. Results: Two meta‐themes (identity and inclusion; and cultural capital) and four subthemes (social capital; access; family expectations; and help‐seeking) were identified. The intersectionality of Black students was articulated as not possessing the social capital and the 'language' to succeed within the White structures of the curriculum. The conflict of capital and the absence of Black culture gave rise to confined help‐seeking behaviours. Whilst Black students experienced equality of access to the curriculum, an absence of rights to legitimate involvement (inclusion) worked to diminish participation in the curriculum. Discussion: This is the first study to consider the intersectionality of Black pharmacy students in relation to academic awarding gaps and has found that oppressive educational structures marginalise and other Black experience. Black students experience the curriculum as a place where their social and cultural capital is undervalued, and as a White space where they lack the artefacts to succeed, leading to peripheral participation and detachment. The approach used in this study can be adopted across medical and health education as a means to problematise racial inequality through the exemplar of White:Black awarding gaps. In this article, @AndrewMawdsley1 et al. use critical race theory as a lens to understand Black student intersectionality and its role in awarding gap deficits [ABSTRACT FROM AUTHOR]

The late Bay Area Hip Hop legend Shock G stated that Tupac Shakur "rhymed from this pit of his stomach," asserting that Tupac's greatness was in the potency and relevance of his message more than the technical skill of his lyricism. Tattooed across the stomach that Tupac rhymed from was the acronym "T.H.U.G.L.I.F.E." Tupac proclaimed that it stood for "The Hate You Gave Little Infants, Fucks Everyone," a statement that reflected his worldview and echoed sentiments of those like Frantz Fanon, James Baldwin and Huey P. Newton who viewed youth as the centerpiece of the struggle for Black Liberation. Though Tupac was murdered in 1996, his lyrics and interviews resurfaced in the aftermath of the police killing of Oscar Grant in 2009 and introduced a generation born after his death to his thug persona and T.H.U.G.L.I.F.E. ideology as relavent, and accessible symbols of Black Rebellion. This article explores how Pac Babies, Black youth born after Tupac's death, have adopted his Persona and Ideology to inform their entry into the Post Racial, social media era of the Black Freedom Struggle. I offer that, by providing T.H.U.G.L.I.F.E. as an alternative to the politics of respectability of the Civil Rights Movement and being resurrected as mythical super hero battling police violence, Tupac influenced both the street protests and social media engagement during the protest phase of "Black Lives Matter!". [ABSTRACT FROM AUTHOR]

In the 25-plus years since his death, Tupac Shakur's legacy has been reimagined as one of a fighter of social injustice and revolutionary whose discography ushered in an era of more "conscious" rap. The consensus scholarly and popular re-imagining of Shakur's legacy as that of a progressive social justice advocate in the nearly 30 years since his death downplays or altogether overlooks his occasional alignment with conservative ideas. But this reimagining also ignores a longer history of Black music and conservative values. This essay examines Tupac's complicated relationship with conservative thought and how his musings on the Black family mirrored the laments of conservative intellectuals like George Schuyler, Albert Murray, Stanley Crouch, Walter E. Williams, and Shelby Steele, as well as political figures such as Keyes, Armstrong Williams, and JC Watts. The authors also argue that looking at the legacies of rappers such as Tupac Shakur from purely a left/right perspective doesn't properly account for the extent to which hip-hop culture has always been in conversation with the gamut of political discourses in the United States over the past 50 years. [ABSTRACT FROM AUTHOR]

In the United States, Black men who have sex with men (BMSM) represent the most vulnerable population for HIV infection. A potential vaccine could ultimately be the most effective HIV prevention strategy. Understanding the factors that may adversely affect HIV vaccine acceptance among BMSM is critical. We conducted two online surveys with BMSM; one recruited 432 respondents, and another recruited 204. Respondents completed a demographic assessment and questions derived from health behavior change theories and the relevant empirical literature. The two surveys yielded similar results. The findings indicate that vaccine uptake self-efficacy, perceived likelihood of important others receiving the vaccine, and susceptibility to HIV were related to intentions to receive a future HIV vaccine. Other potentially important variables include perceived HIV stigma, response efficacy, how much one conceals one's sexual orientation, and perceived HIV discrimination. Future research and health communication campaigns should consider these factors in potential HIV vaccine programs. [ABSTRACT FROM AUTHOR]

Background and Objective Work discrimination is an important public health problem with consequences for health. This study examined the effect of chronic work discrimination on 4-year changes in HbA1c, as a reflection of glucose control and type 2 diabetes risk in older workers and assessed whether allostatic load (AL) affected the strength of this association. Research Design and Methods We used Health and Retirement Study data (2010–2016, n  = 3,246). Conditional change multinomial logistic regression examined the association between chronic work discrimination, high AL (4 or more out of 8 high-risk biomarkers), and HbA1c, while accounting for relevant covariates. Results Black participants had the highest rates of baseline (22.7%) and follow-up (28%) HbA1c levels, AL (38%), and chronic work discrimination (39%; p  < .01). Severe chronic work discrimination was associated with elevated HbA1c (relative risk ratio [RRR] = 1.61, 95% confidence interval [CI] = 1.07, 2.43). AL was associated with elevated HbA1c (RRR = 1.49, 95% CI = 1.04, 2.14). Relative to White participants, Hispanic (RRR = 1.52, 95% CI = 1.07, 2.16, RRR = 1.81, 95% CI = 1.051, 3.12), and Black (RRR = 2.42, 95% CI = 1.82, 3.23; RRR = 3.00, 95% CI = 1.97, 4.56) participants had an increased risk of intermediate and elevated HbA1c, respectively. Among those with long job tenure (≥5 years), both moderate (RRR = 1.81, 95% CI = 1.11, 2.96) and severe (RRR = 1.90, 95% CI = 1.15, 3.12) chronic work discrimination was associated with elevated HbA1c. Discussion and Implications Chronic work discrimination was associated with HbA1c; however, no moderating effects of AL were observed. Findings underscore a need for organizational and public health measures to establish strong anti-discrimination laws in the workplace to improve the work environment of older workers and reduce diabetes risk. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion of black and minoritised groups. The paper will go on to identify the implications for the dementia wellness pathway and make recommendations regarding how services can be more inclusive. Design/methodology/approach: This paper examines the policy/practice landscape around dementia care provision and observes if lessons can be learnt to improve health outcomes for people living with dementia from black and minoritised communities. Findings: A review of dementia policy demonstrates how opportunities to improve the awareness, diagnosis and post-diagnostic support for minoritised communities are being missed. The outcomes of this mean that individuals are denied vital treatment and support, which could enhance quality of life and delay the progression of dementia. Practical implications: The authors' premise is that not meeting the dementia support needs of less-heard communities has negative financial as well as social and health-related outcomes and has wider resonance and implications for all stages of the dementia wellness pathway. Moreover, there is a legal responsibility for public services to provide culturally sensitive, responsive, appropriate and available care, to all people, without discrimination. Originality/value: This paper offers a valuable review of policy and practice around dementia care in the UK and makes recommendations to improve health outcomes for people living with dementia from black and minoritised communities. [ABSTRACT FROM AUTHOR]

The late Bay Area Hip Hop legend Shock G stated that Tupac Shakur "rhymed from this pit of his stomach," asserting that Tupac's greatness was in the potency and relevance of his message more than the technical skill of his lyricism. Tattooed across the stomach that Tupac rhymed from was the acronym "T.H.U.G.L.I.F.E." Tupac proclaimed that it stood for "The Hate You Gave Little Infants, Fucks Everyone," a statement that reflected his worldview and echoed sentiments of those like Frantz Fanon, James Baldwin and Huey P. Newton who viewed youth as the centerpiece of the struggle for Black Liberation. Though Tupac was murdered in 1996, his lyrics and interviews resurfaced in the aftermath of the police killing of Oscar Grant in 2009 and introduced a generation born after his death to his thug persona and T.H.U.G.L.I.F.E. ideology as relavent, and accessible symbols of Black Rebellion. This article explores how Pac Babies, Black youth born after Tupac's death, have adopted his Persona and Ideology to inform their entry into the Post Racial, social media era of the Black Freedom Struggle. I offer that, by providing T.H.U.G.L.I.F.E. as an alternative to the politics of respectability of the Civil Rights Movement and being resurrected as mythical super hero battling police violence, Tupac influenced both the street protests and social media engagement during the protest phase of "Black Lives Matter!". [ABSTRACT FROM AUTHOR]

This article explores the impact of the coronavirus disease 2019 (COVID-19) pandemic on racially minoritised children and young people. It draws on a study that investigated the factors that impacted the well-being and resilience of Black and Asian children and young people in the UK during the pandemic. The study employed a qualitative approach using semi-structured interviews and focus groups with Black and Asian children aged twelve to nineteen years, to explore their perspectives of the contributing factors that impacted the health, well-being and the coping strategies and support they were able to draw upon to navigate challenges. The thematic analysis highlighted themes of: (1) Support and well-being and (2) coping strategies and resilience to understand the layered elements of multiple intersecting identities and inequities. The findings revealed insights into the intersection of multiple disadvantages, namely economic stressors, food poverty, digital inequality, disrupted education and disproportionate losses that impacted family functioning, peer-to-peer support, friendships and social connection. Through the lens of community cultural wealth, this article seeks to examine key factors that need to be foregrounded when lived experiences are rooted in the cumulative effects of multiple intersecting inequalities. The findings provide insights into the challenges exacerbated by structural inequalities and racial disparities that disproportionately impacted youth experiences. [ABSTRACT FROM AUTHOR]

PURPOSE: For patients who seek to camouflage cancer-related hair loss, cranial prostheses such as wigs and hair pieces exist. We sought to determine the availability of yaki-textured, type IV curls, and afro wigs at boutiques in Comprehensive Cancer Centers (CCCs). METHODS: The 56 CCCs in the United States were surveyed to see whether they had an affiliated wig boutique for patients experiencing hair loss. Boutique workers were then asked a series of seven questions regarding cranial prostheses options for patients seeking yaki-textured, type IV curls, and afro wigs. The availability of wigs was compared with US Census data on population size and density of Black residents. RESULTS: Of the 56 CCCs, 27 (46%) institutions had active affiliated hair boutiques. We were able to reach 19 (70%) of the 27 boutiques, of which 53% (n = 10) offered yaki-textured wigs, 37% (n = 7) offered type IV curls or afro wigs, and 47% (n = 9) offered neither. Two additional boutiques offered in-store catalogs for Black patients who were interested in naturally appearing wigs. Although two institutions offered a wig bank that was free to all patients, neither had yaki-textured or afro wigs in stock. There was no significant relationship between population size or density of Black residents and availability of these wigs. CONCLUSION: Many Black patients undergoing cancer treatment interested in cranial prosthesis do not have consistent access to wigs with textures comparable with type IV hair at CCCs. With increased inventory of racially inclusive wigs, partnerships with third-party vendors, and support for the previous authorization process, we can better support Black patients experiencing cancer-related hair loss. [ABSTRACT FROM AUTHOR]

Background: Youth mental health is a growing concern in research, practice, and policy. Practice standards, guidelines, or strategies provide an invisible infrastructure that fosters equity, quality, and safety, potentially addressing inconsistencies and more effectively attending to the mental wellness of Black youth as a particular population of concern. This scoping review aimed to address the following question: What standards exist for the delivery of mental health services to Black youth in community, primary care, and educational settings? Due to a limited initial search yield on publications about standards for the delivery of mental health services for Black youth population, our goal was then to identify and map mental health standards, recommendations, or guidelines for the delivery of mental health services using the same settings to all youth. Methods: Searches were conducted in various databases, including PubMed/MEDLINE, PsycINFO, Embase, SocINDEX, CINAHL, Gender Studies Database, Social Services Abstracts, Sociological Abstracts, Scopus, Web of Science, and Google Scholar. Screening was independently conducted by two reviewers, with disagreements resolved by a third. Information extraction was performed by two independent reviewers. Results: Out of the 2,701 screened publications, 54 were included in this scoping review. Among them, 38.9% were published between 2020 and 2023, with 40.7% originating from the United States of America, 20.4% from the United Kingdom, and 13% from Canada. Concerning the settings, 25.9% of the publications focused on primary care, 24.1% on health care services, 20.4% on educational settings, and 3.7% on the community. Additionally, 25.9% were classified as general because recommendations were applicable to various settings. Attention-deficit/hyperactivity disorder (11.1%) was the most frequently considered specific condition, followed by autism spectrum disorder (9.3%) and depression (9.3%). However, 31.5% of the included references addressed mental health in general. Only three references provided specific recommendations for the Black population. Conclusions: Recommendations, guidelines, or standards for Black youth mental health services in community, primary care, or educational settings are scarce and limited to North American countries. This scoping review emphasizes the need to consider ethnicity when developing guidelines or standards to improve racial equity and reduce disparities in access to mental health services. [ABSTRACT FROM AUTHOR]

This study explored the associations between Adverse Childhood Experiences (ACEs) and functioning across several school readiness domains among preschoolers with disruptive behavior problems. The sample included 115 children (Mage= 5.18, 67.8% male; 32.2% female) from a large, urban, high-poverty community, with predominantly Black families, who were about to enroll in a summer treatment program prior to kindergarten. As part of pre-treatment assessments, caregivers completed interviews and questionnaires about adverse experiences and stressors in their children's lives. Children's behavioral, academic, and social functioning were also assessed at this time. We identified exposure to ACEs using multimodal parent reports. A path analysis was conducted between preschoolers' exposures to ACEs and their school readiness, covarying outcomes with one another to isolate the effect of ACEs. Our findings indicate a dose-effect, such that exposure to a higher number of ACEs is significantly associated with more severe disruptive behaviors, internalizing problems, and global impairment in the child's functioning. However, there were no significant associations between total number of ACEs and academic or social functioning. Notably, the prevalence of ACEs among this sample of preschoolers living in highly under-resourced communities was strikingly higher than national samples, with 93.9% of parents reporting exposure to at least one ACE by age 5, compared to 19–26% in a nationally samples; moreover, 62.6% experienced 3 or more ACEs, compared to 5.35% in same-aged samples (Briggs-Gowan et al., 2010; Jackson et al., 2021). Our study contributes to the growing literature on the importance of recognizing the heightened risk of early and compounding adversity in school readiness outcomes for young children with special needs. Implications for early intervention timing and the need to consider readiness for preschool are discussed. Study Highlights: We investigate associations between adversity and school readiness in preschoolers with disruptive behaviors living in a low income community. We identify exposure to ACEs using multimodal parent report from clinical interviews and surveys. We find that 94% of participants had experienced at least 1 ACE and 49% had experienced 4 or more. We find a dose effect between number of ACEs and severity of disruptive and internalizing problems, and global impairment. [ABSTRACT FROM AUTHOR]

Multiple and continuous traumatic events experienced by Black men impose altering effects on their identities, and their mentalization and presentation of themselves in society. However, the unique dynamics of the impact of trauma in shaping Black men's identities are not well understood, because their experiences with trauma are not well documented. This paper is a secondary analysis of the qualitative component of a mixed method study that explored trauma, social support, and resilience among 103 racialized youth survivors of gun violence in Toronto, Canada. The analysis for this paper specifically focused on young Black male participants in the study to understand their disproportional experiences with gun violent trauma. Thematic analysis of their narrative demonstrated three themes: 1) trapped by the trauma of systemic oppression; 2) identity marred by the trauma of systemic oppression; and 3) masculinity shifted by the trauma of systemic oppression. The thematic mapping of themes and subthemes yielded the trauma-altered identity (TAI), a concept coined to represent the intersections of trauma, systemic oppression, masculinity, and the identity of Black male survivors. Using a metaphoric artwork to conceptualise the TAI, we explore its psychosocial impacts and set strategies for deconstructing its influence on Black men. While we acknowledge that trauma experiences may vary among Black males, we recognise that understanding intersections of risks associated with trauma among young Black males presents opportunities for policy discussions, advocacy, and social justice reforms. [ABSTRACT FROM AUTHOR]

Black women in community supervision programs (CSPs) are disproportionately affected by HIV and other sexually transmitted infections (STIs). A randomized controlled trial of a group intervention titled Empowering African-American Women on the Road to Health (E-WORTH) demonstrated effectiveness in reducing sexual risk behaviors and STI incidence among Black women in CSPs. This secondary analysis aimed to assess the moderating effects of housing status and food security on E-WORTH effectiveness in reducing sexual risk behaviors and cumulative incidence of STIs over a 12-month period which were found significant in the original trial among a sample of 351 Black women in CSPs in New York City who use drugs and/or engage in binge drinking who reported engaging in HIV risk behaviors or testing positive for HIV. We examined the moderating effects of housing stability, housing independence, and food insecurity on reducing cumulative STI incidence and number of unprotected sex acts using mixed-effects negative binomial regression and logistic regression models that controlled for age, high school education, employment status, and marital status. Findings indicate that the intervention effect was moderated by housing stability, but not housing independence or food security. Compared to the control group, E-WORTH participants who were housing insecure had 63% fewer acts of condomless sex. Our findings highlight the importance of interventions designed for women in CSPs that account for upstream determinants of health and include service linkages to basic needs provisions. Further research is needed to unpack the cumulative impacts of multiple experiences of poverty faced by this population. [ABSTRACT FROM AUTHOR]

Prior suicide attempt serves as one of the strongest predictors of future suicide attempt and risk for death by suicide among youth. Disparities, however, persist in determining which groups have access to services following an attempt. Thus, we compare the experiences of Black youth with a history of lifetime suicide attempt to youth from other race groups who also attempted suicide in efforts to identify both gaps in treatment and promising opportunities for prevention and intervention. This study is a secondary analysis of cross-sectional data from 7704 youth ages 12–17 who participated in the 2004–2019 National Survey on Drug Use and Health (NSDUH). The NSDUH is a national survey of households in the US. Cross-race and within-group sex comparisons for Black youth were assessed across 24 separate indicators of mental health service utilization, school engagement, and religious involvement. Findings indicate that 35.83% of Black youth with a history of lifetime suicide attempt received treatment from a therapist within the past year, while nearly 52% of White youth reported receiving treatment from a therapist within this same timeframe. Notably, 57% of Black youth who attempted suicide were insured through Medicaid or CHIP, though Asian, Multiracial and White youth were more likely to have private insurance. Forty percent of Black youth who previously attempted suicide strongly agreed that their religious beliefs were important to them; this percentage is far greater than reports provided by youth from all other race groups. Black youth also attended religious services more often when compared to youth of other races. Black boys with a history of lifetime suicide attempt were less likely to report seeing a therapist within the past year relative to Black girls. Suicide prevention interventions should integrate concepts that are most important to Black youth to ensure that mental health services are culturally salient, economically feasible, and readily accessible. [ABSTRACT FROM AUTHOR]

Already in the 1980s, Black feminists contributed to political debates on the Dutch welfare state. Their intersectional analyses of social citizenship were directly based on the lived experiences of Black women in the Netherlands. However, then and now, these contributions have been largely overlooked in both Dutch politics and welfare state research, leading to social policies that do not correspond with the lived experiences of all women. Through archive research, and using the analytical framework of political claims-making, this article sheds light on the social rights claims of the Surinamese-Dutch feminist organization Ashanti that was active between 1980 and 1987. Their Black feminist perspectives provide important insights into the underlying mechanisms of in- and exclusion of the Dutch welfare state, from the standpoints of Dutch citizens and families that did not necessarily fit the picture of the "imagined citizens" for whom the Dutch welfare state was built. [ABSTRACT FROM AUTHOR]

Background: Accidental suffocation and strangulation in bed continues to be a critical issue in Black communities, despite the widespread initiatives to promote safe sleep. Doulas are in an ideal position to promote safe sleep, particularly in hard-to-reach communities that are more distrusting of conventional medical providers. Little is known about their practices and perspectives for putting infants down to rest. This study informs this gap in the literature. Purpose: The purpose of this study was to explore doulas' perspectives and practices in the field of putting infants down to sleep. The researchers aimed to determine whether Black caregivers that work with doulas are likely to encounter safe sleep education. Methods: The researchers used a descriptive approach to inquiry. They conducted three focus groups with a total of 17 Black doulas. The researchers independently and critically reviewed the transcriptions and observation notes from each group to identify codes. They then triangulated the results using Artificial Intelligence-driven tools. Findings: The study found four themes: (1) Individualized Services, (2) Cultural Sensitivity, (3) Negotiating Safety, and (4) Safe Sleep Education. Conclusions: The study concluded doulas have a commitment to promoting safe sleep. The researchers found that doulas engage in practices that help caregivers to integrate safe sleep practices into their lifestyle and to adapt them to meet their needs. The researchers also documented a desire for more information and instruction on safe sleep among practicing doulas. Significance: Scholars recognize that doulas play a vital role in infant and maternal health in Black communities, but little is known about their role in promoting safe sleep. This study contributes to this knowledge base, revealing that doulas uphold a commitment to safe sleep practices and are integral in helping Black caregivers negotiate safe sleep. [ABSTRACT FROM AUTHOR]

Fatherhood interventions have emerged as significant tools for strengthening father identity and parenting skills. Despite the growing evidence of the effectiveness and benefits of these interventions for fathers and their families, there are limited studies on fathers' and providers' perspectives and experiences with the implementation of father‐based interventions. To fill this gap, we explore the unique experiences of the Black and Latino programme staff and fathers in the implementation of the 24/7 Dad® intervention. Qualitative data were collected between October 2021 and February 2022 from all programme staff (n = 7) and selected Dad 24/7 fathers (n = 20) from the English (n = 10) and Spanish (n = 10) intervention groups. All programme staff completed a semi‐structured interview via phone and/or video conferencing. A qualitative descriptive approach was used for analysis. Average age of staff was 53 years; mean age of fathers was 43 years. Among staff, 43% were Black, and 57% were Latino. Fathers self‐identified as Black (30%) and Latino (70%). Three key staff themes were benefits to fathers, impact on fathers and facilitators, and ways to strengthen fatherhood interventions. Three key father themes were intervention benefits, intervention impact (what 'made it work') and ways to strengthen intervention services. Fathering is a key component in maintaining healthy families and communities. Fatherhood interventions have great potential for empowering fathers and strengthening families. Finding ways to a relational approach, allocating more time for robust participation and building on facilitators' experiences and assets can help strengthen the impact of fatherhood interventions. [ABSTRACT FROM AUTHOR]

Psychotherapy between Black/African American clients and White American counselors poses unique challenges and can be fraught, especially when race is discussed. The present study seeks to identify what counselor behaviors or sequences of client and counselor behaviors tend to occur when Black American clients and White American counselors discuss race during counseling, and which behavioral sequences are associated with more positive therapy processes. Twenty psychotherapy sessions in which Black American clients broached race-related topics with non-Hispanic White American counselors were selected from a larger study of broaching race in cross-racial therapy (data collected in 2012). Video recordings of psychotherapy sessions were analyzed qualitatively using pattern coding. Black American clients were more likely to broach the topic of race than the White American counselors. When clients broached the topic of race, counselors who asked exploratory questions, attended to the racial content, shared experiential self-disclosures, validated and affirmed the client's unique racial experiences, and managed their anxiety tended to elicit deeper self-disclosures from clients and fewer rupture events. In order to improve the quality of mental health care provided to minoritized clients, White counselors are encouraged to seek out training; education; and supervision to increase their multicultural awareness, apply microcounseling skills during discussions of race, and manage racial anxiety. Public Significance Statement: This study found that in Black client–White counselor dyads, clients tend to broach the topic of race more than their counselors. When clients broached the topic of race, counselors who asked exploratory questions, attended to the racial content, shared experiential self-disclosures, validated and affirmed the client's unique racial experiences, and managed their anxiety tended to elicit deeper self-disclosures from clients and fewer rupture events. [ABSTRACT FROM AUTHOR]

In this article, we offer insights derived from an analysis of a structured dialogue on methodological decision making. Our analysis highlights the ways in which our dialogic process for revising a manuscript reflected key onto-epistemic qualities of Black women's ways of knowing. Drawing from an Afrocentric feminist epistemological standpoint, we tease apart how shared ways of knowing can facilitate heightened clarity about one's engagement in the research process. By positioning structured dialogues as a methodological tool, we offer several insights regarding their generative nature in facilitating researcher clarity on methodological decision making and in elucidating key shifts in the evolution of a researcher's methodological self. Indeed, as a form of facilitated reflexive praxis, engaging in structure dialogues about one's methodological choices is requisite for defining and understanding oneself as a researcher, scholar, and intellectual. [ABSTRACT FROM AUTHOR]

Every year, millions of people experience intimate partner violence (IPV) and commercial sexual exploitation (CSE), with researchers increasingly discussing the overlap between these two forms of interpersonal violence. However, researchers have not yet used quantitative methods to examine the link between IPV and CSE or to explore potential mechanisms underlying the overlap, including child maltreatment risk factors and psychological mechanisms. One potential mechanism is trauma-related shame, a symptom of post-traumatic stress disorder commonly experienced by both victims of CSE and IPV. The current study explores trauma-related shame, childhood maltreatment, and IPV and their associations with CSE using a sample of 174 primarily Black women. Binomial logistic regression is used to analyze the impact of IPV, child abuse and neglect, and trauma-related shame on CSE. Results indicate that IPV and trauma-related shame are both significant predictors of CSE. Implications for future research and the incorporation of shame in trauma-related treatment are discussed. [ABSTRACT FROM AUTHOR]

To assess the impact of a school-based health intervention on adolescents' health knowledge, psychosocial assets and health behaviors, including comparisons of implementation mode: remote, hybrid or in-person. The Stanford Youth Diabetes Coaches Program, an 8-week, school-based health promotion and coaching skills program, was offered to adolescents (ages 14–18 years) from four low-income US communities. Mode of program implementation was remote, hybrid or in-person. Participants completed online pre- and postsurveys. Analysis included paired t -tests, linear regression and qualitative coding. From Fall 2020 to Fall 2021, 262 adolescents enrolled and 179 finished the program and completed pre- and postsurveys. Of the 179, 80% were female, with a mean age of 15.9 years; 22% were Asian; 8% were Black or African American; 25% were White; and 40% were Hispanic. About 115 participants were remote, 25 were hybrid and 39 were in-person. Across all participants, significant improvements (P  < 0.01) were reported in health knowledge, psychosocial assets (self-esteem, self-efficacy and problem-solving) and health behaviors (physical activity, nutrition and stress reduction). After adjusting for sex and age, these improvements were roughly equivalent across the three modes of delivery. Participation was associated with significant improvements in adolescent health behaviors. Furthermore, remote mode of instruction was just as effective as in-person and hybrid modes. [ABSTRACT FROM AUTHOR]

Community-based participatory action research can facilitate counseling psychologists' engagement in social justice to benefit Black people's mental health. One way to improve Black mental health is to equip credible and trustworthy community members with mental health knowledge and skills to support other community members experiencing mental health challenges. This study presents the Neighborhood Healers Project—a community-based participatory action research project that trains Black adults (Neighborhood Healers Fellows) in Mental Health First Aid (MHFA). During the inaugural 12-month fellowship year, we collected longitudinal qualitative data from N = 20 Fellows on the relevance of MHFA to Black people. In this paper, we examined their responses using reflexive thematic analysis. Findings included two themes with affiliated subthemes: (a) Liberatory Paradigm Shift and (b) For Us By Us: Culturally Relevant Curriculum. We conclude with implications for counseling psychologists. [ABSTRACT FROM AUTHOR]

A report entitled Say Her Name: Resisting Police Brutality against Black Women underscores the paucity of research examining police violence toward Black women. This study focused on how valuing a White police officer and symbolic racism moderate reactions when the officer fatally shoots a Black or White woman during a traffic stop. At high levels of officer valuing, symbolic racism was positively associated with perceptions the victim presented a threat to the officer, but negatively associated with support for punishing the officer and perceived victim compliance; these associations were stronger when the victim was Black relative to White. At low officer valuing levels, there was no variability in the link between symbolic racism and the outcome variables as a function of victim race. Implications for bias in judicial outcomes for the victim and officer are discussed. [ABSTRACT FROM AUTHOR]

Informed by ecological and Black feminist approaches, this inductive, thematic analysis analyzed narratives from 24 Black college women, ages 18–25, about the sexual socialization they received from multiple agents within and outside of the family. The themes were: Avoidance, Safety and Consent, Fun and Action-Centered Acts, (Mis)Information About Sexual Health, Gendered Norms, and Purity versus Sexual Freedom. The women received messages of avoidance, purity, safety, consent, and gendered norms, from their families and schools. Peers and media socialized women to view sex as fun and action centered. Given the persistent increases in sexually transmitted infections and diseases, and formation of longer-lasting romantic relationships during the college years, it is important for young adult women, including Black women, to receive adequate knowledge and skills to advocate for safe and healthy romantic sexual relationships. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

This article explores the experiences of Black newly qualified social workers and student social workers in England. Drawing on related studies that have begun to outline the challenges faced by Global Ethnic Majority social workers in the UK, the article highlights that this is both an important and under‐researched area. The article provides a much‐needed contribution to understanding the unique experiences of Black social workers through a thematic analysis of interviews with Black social workers, providing an opportunity for social work colleagues, managers, educators, and academics to understand the challenges and obstacles that these social workers face. The research reveals a dire situation in which Black social workers are hindered by racial stereotyping, discrimination, and invisibility. Black social worker voices also highlight suggestions for best practice and guidance for the social work sector about how to improve. By centering these underrepresented voices, this article provides an opportunity to acknowledge and begin to rectify the barriers and challenges that Black social workers face. [ABSTRACT FROM AUTHOR]

Background: Black Americans experience the highest prevalence of heart failure (HF) and the worst clinical outcomes of any racial or ethnic group, but little is known about end-of-life care for this population. Objective: Compare treatment intensity between Black and White older adults with HF near the end of life. Design: Negative binomial and logistic regression analyses of pooled, cross-sectional data from the Health and Retirement Study (HRS). Setting/Subjects: A total of 1607 U.S. adults aged 65 years and older with HF who identify as Black or White, and whose proxy informant participated in an HRS exit interview between 2002 and 2016. Measurements: We compared four common measures of treatment intensity at the end of life (number of hospital admissions, receipt of care in an intensive care unit (ICU), utilization of life support, and whether the decedent died in a hospital) between Black and White HF patients, controlling for demographic, social, and health characteristics. Results: Racial identity was not significantly associated with the number of hospital admissions or admission to an ICU in the last 24 months of life. However, Black HF patients were more likely to spend time on life support (odds ratio [OR] = 2.16, confidence interval [CI] = 1.35–3.44, p = 0.00) and more likely to die in a hospital (OR = 1.53, CI = 1.03–2.28, p = 0.04) than White HF patients. Conclusion: Black HF patients were more likely to die in a hospital and to spend time on life support than White HF patients. Thoughtful and consistent engagement with HF patients regarding treatment preferences is an important step in addressing inequities. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate associations among social determinants of health (SDOH), stress, interleukin-6 (IL-6), and quality of life among non-Hispanic Black and Hispanic cancer survivors. SAMPLE & SETTING: Individuals who had completed cancer treatment and did not identify as White (N = 46) were recruited through community partnerships in western Massachusetts and a state cancer registry. METHODS & VARIABLES: This descriptive crosssectional study used questionnaires and morning salivary samples to collect data between June 2022 and September 2023. RESULTS: Most participants were breast cancer survivors, were female, identified as African American or Black, and reported moderate levels of stress and low physical activity. Cortisol levels were higher among African American or Black participants, those with lower body mass index, and those with less consumption of fruit and vegetables. Higher symptom experience was associated with higher IL-6 levels. No associations were identified between IL-6 and cortisol or perceived stress and cortisol levels. IMPLICATIONS FOR NURSING: Incorporating SDOH in self-reported outcomes, including health behaviors and associated biologic indicators, can facilitate early identification and interventions to improve symptom experience and health outcomes of cancer survivors. [ABSTRACT FROM AUTHOR]

Introduction: Ethnic and gender differences in plasma lipid composition have been widely reported among the general population, but there are scarce data on athletes. Aim: To assess ethnic and gender differences in lipid profile across a large cohort of Olympic athletes practicing different sport disciplines Methods: We enrolled 1165 Olympic athletes divided into power, endurance, and mixed disciplines according to European Society of Cardiology classification. Sixty-two (5.3%) were Afro-Caribbean. Body composition and fat mass percentage were measured. Blood samples were collected and lipid profile was investigated. Results: Compared to Caucasians, Afro-Caribbeans had better lipid profile characterized by lower LDL (90 ± 25 mg/dL vs. 97.1 ± 26.2 mg/dL, p = 0.032) lower LDL/HDL ratio (1.39 ± 0.5 vs. 1.58 ± 0.6, p = 0.012), lower non-HDL-cholesterol (102.5 ± 27.4 mg/dL vs. 111.5 ± 28.5 mg/dL, p = 0.015) and lower TC/HDL (2.59 ± 0.6 vs. 2.82 ± 0.7, p = 0.010). Female Afro-Caribbeans showed lower TG/HDL ratio (p = 0.045) and TC/HDL ratio (p = 0.028), due to higher HDL (p = 0.005) compared to male Afro-Caribbeans. In Caucasian athletes, females showed even more evident differences with lower TC, LDL, and higher HDL with subsequent lower ratios compared to men. Moreover, endurance Caucasian athletes had lower LDL (p = 0.003) and TG (p = 0.017) plasmatic levels and higher HDL levels compared to non-endurance Caucasian athletes (p< 0.0001) Conclusions: Ethnicity and gender have a significant influence on plasmatic lipid balance in elite athletes and Afro-Caribbeans have favorable lipid profiles compared to Caucasians. Moreover, endurance sports, particularly in Caucasian athletes, are associated with better lipid profile compared to other type of sports. [ABSTRACT FROM AUTHOR]

Background and Objectives This study examined the performance of the Modified Caregiver Strain Index (MCSI) in a sample of Black and White caregivers of persons living with dementia. Research Design and Methods Data on 153 dyads enrolled in the Care Ecosystem dementia care management program were analyzed, including sociodemographic variables, dementia severity, and caregiver burden and wellbeing. Factor structure, item-response patterns, and concurrent validity were assessed across racial groups. Results Differences between Black and White caregivers included gender, dyad relation, and socioeconomic disadvantage. Factor structure and item loadings varied by racial cohort, with parameters supporting a 3-factor model. For Black caregivers, finances and work, emotional and physical strain, and family and personal adjustment items loaded together on individual factors. For White caregivers physical and emotional strain items loaded on separate factors, although personal and family adjustment items loaded with work and financial strain items. Item-level analysis revealed differences between groups, with Black caregivers endorsing physical strain to a greater degree (p  = .003). Total MCSI scores were positively correlated with concurrent measures like the PHQ-9 (White: r  = 0.67, Black: r  = 0.54) and the GAD-2 (White: r  = 0.47, Black: r  = 0.4), and negatively correlated with self-efficacy ratings (White: r  = −0.54, Black: r  = −0.55), with a p  < .001 for all validity analysis. Discussion and Implications The MCSI displayed acceptable statistical performance for Black and White caregivers of persons living with dementia and displayed a factor structure sensitive to cultural variations of the construct. Researchers results highlight the inherent complexity and the relevance of selecting inclusive measures to appropriately serve diverse populations. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy (HDP) are maternity-related increases in blood pressure (eg, gestational hypertension, preeclampsia, and eclampsia). Compared with women of other races in high-income countries, Black women have a comparatively higher risk of an HDP. Intersectionality helps to provide a deeper understanding of the multifactorial identities that affect health outcomes in this high-risk population. Objective: In this review, we sought to explore the literature on HDP risk factors in Black women living in high-income countries and to assess the interaction of these risk factors using the conceptual framework of intersectionality. Methods: We conducted this review using the Arksey and O'Malley methodology with enhancements from Levac and colleagues. Published articles in English on HDP risk factors with a sample of not less than 10% of Black women in high-income countries were included. Six databases, theses, and dissertations were searched from January 2000 to July 2021. A thematic analysis was used to summarize the results. Results: A final total of 36 studies were included from the 15 480 studies retrieved; 4 key themes of HDP risks were identified: (1) biological; (2) individual traditional; (3) race and ethnicity, geographical location, and immigration status; and (4) gender related. These intersectional HDP risk factors intersect to increase the risk of HDP among Black women living in high-income countries. Conclusion: Upstream approaches are recommended to lower the risks of HDP in this population. [ABSTRACT FROM AUTHOR]

This study addresses the struggles for housing among older women, including the meaning attached to ownership and control of urban houses among low-income households. It analyses the extent to which older women in low-income suburbs of Bulawayo, Zimbabwe, can age-in-place. I explain how the ideal of ageing in place for the nineteen women in this research (ages 60 – 90) is dependent on factors such as access to and control of one’s housing situation, which are impacted by whether or not they have good sibling and intergenerational family relationships. Family conflicts and unpleasant interactions with siblings, adult children, nephews, nieces, and grandchildren affect their chances of ageing well in their place of choice forcing some of them to begrudgingly retrace their steps back to the rural areas. These older women are poor and do not have reliable sources of income to look after themselves and the children under their care. [ABSTRACT FROM AUTHOR]

We used results from an optimization randomized controlled trial which tested five behavioral intervention components to support HIV antiretroviral adherence/HIV viral suppression, grounded in the multiphase optimization strategy and using a fractional factorial design to identify intervention components with cost-effectiveness sufficiently favorable for scalability. Results were incorporated into a validated HIV computer simulation to simulate longer-term effects of combinations of components on health and costs. We simulated the 32 corresponding long-term trajectories for viral load suppression, health related quality of life (HRQoL), and costs. The components were designed to be culturally and structurally salient. They were: motivational interviewing counseling sessions (MI), pre-adherence skill building (SB), peer mentorship (PM), focused support groups (SG), and patient navigation (short version [NS], long version [NL]. All participants also received health education on HIV treatment. We examined four scenarios: one-time intervention with and without discounting and continuous interventions with and without discounting. In all four scenarios, interventions that comprise or include SB and NL (and including health education) were cost effective (< $100,000/quality-adjusted life year). Further, with consideration of HRQoL impact, maximal intervention became cost-effective enough to be scalable. Thus, a fractional factorial experiment coupled with cost-effectiveness analysis is a promising approach to optimize multi-component interventions for scalability. The present study can guide service planning efforts for HIV care settings and health departments. [ABSTRACT FROM AUTHOR]

The underrepresentation of non-Hispanic Black adults in clinical research impacts the generalizability and usefulness of research findings. The purpose of this article is to discuss recruitment strategies used in a research study examining the self-care of diabetes and diabetes distress in non-Hispanic Black adults with type 2 diabetes. In this cross-sectional correlation study, the participants were non-Hispanic Black adults with type 2 diabetes living in North Carolina. A questionnaire collected sociodemographic and clinical characteristics. This study was analyzed using descriptive statistics. In total, 512 individuals accessed the online survey. After data screening, 275 participants were used for data analysis. Sixteen recruitment sites provided letters of support, and 13 were active in the recruitment process. Most participants learned about the research study via social media. Social connections resulting in recruitment partners and using social media supported the successful recruitment. The recruitment strategies implemented can inform researchers of effective evidence-based recruitment strategies to increase the participation of non-Hispanic Black adults in clinical research. [ABSTRACT FROM AUTHOR]

The Strong Black Woman (SBW) schema is described as a statue of unrelenting strength, resilience, and self-sufficiency, serving as a shield of protection and cultural adaptation to suppress and control manifestations of racial and gender oppression. Stemming from superwoman syndrome, a conceptual model exploring the multifactorial roles women hold and their impact, the SBW extends beyond gender roles to the sociopolitical context of the Black woman's lived experience. Endorsement of the SBW posits risk for health disparities including stress, anxiety, depression, and obesity. This review was conducted to explore the SBW schema and experiences of Black women who endorse it, to delineate how Black women describe themselves in relation to the SBW persona, and to inform further inquiry, nursing practice, and clinical approaches to improving health outcomes of this population. A systematic review of qualitative studies was conducted with a literature search from CINAHL, APA PsycINFO, MEDLINE, PubMed, and SocINDEX databases yielding seven relevant papers for this analysis. Studies using the superwoman schema and the SBW schema with participants who identified as Black women were included in the review. Consistent with the SBW phenomenon, many participants described examples and consequences of being an SBW. While most women identified with SBW, not all endorsed the persona entirely, challenging its ideal and reinforcing positive self-care. Themes include (a) Strength by nature, not choice, (b) Suppressed emotion, (c) Success over everything, and (d) Prioritizing others over self. Additional emerging themes are also included. Black women increasingly recognize the negative impacts of the SBW schema, pinpointing how their internal feelings manifest in their external world. The conceptual framework itself is an anomaly, incongruently impacting both the mental and physical health of Black women, further contributing to the long-term health and sociopolitical disparities that Black women experience. Simply acknowledging and understanding these experiences by healthcare practitioners are not enough to prevent or eliminate the risks involved with the endorsement of the SBW schema but rather intentionally addressing these as a contributing social determinant of health that predisposes them to long-term chronic conditions. [ABSTRACT FROM AUTHOR]

The experience of racism and discrimination in the therapy room has largely been studied from the perspective of clients who are people of color (POC). There is little literature on when the clinician is a POC and on the receiving end of discrimination from their client. The purpose of this pilot study is to give voice to the experience of discrimination directed towards clinicians of color (COC) in their clinical work and how they navigated the discrimination. A heuristic phenomenological approach was chosen for this pilot study. A total of 20 participants completed the study, with 17 female and three male identified participants. Eight identified as Hispanic/Latino, seven identified as Black/African American, and five as Asian/Asian American. We constructed two main themes that illuminate participants' experience of discrimination from their clients: Maintaining Therapeutic Engagement and Clinician Responses. The findings suggest that COC who experience discrimination are affected by the event. However, despite personal discomfort, clinicians continued to provide therapeutic care in an ethical and respectful manner. Clinical and supervisory implications are provided. [ABSTRACT FROM AUTHOR]

Simple Summary: Helicobacter pylori (H. Pylori) eradication has been the mainstream for preventing and treating gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Prior studies have shown variations in the eradication rates of H. Pylori in the US. This can influence gastric MALT lymphoma occurrence and outcomes. Therefore, we conducted a comprehensive analysis of incidence and mortality rates of gastric MALT lymphoma in different demographic-specific populations. We found that gastric MALT lymphoma incidence rates have been decreasing in the US over the past two decades. This decline was observed in both sexes, various age groups, and all race/ethnic populations except Black individuals. The decrease was also seen in early-stage tumors but not in late-stage tumors. Mortality analysis showed decreasing mortality in males, older adults, early-stage tumors, and most race/ethnic groups but not in females, younger adults, Black individuals, or late-stage tumors, which had non-decreasing rates. Our findings hold important public health implications and encourage further investigations of gastric MALT lymphoma risk factors, including disparities in H. Pylori screening, management, and outcomes. Background: Helicobacter pylori (H. Pylori) eradication has been the mainstream for preventing and treating gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Prior data showed disparities in eradication rates of H. Pylori between different populations. This can potentially impact the occurrence of gastric MALT lymphoma. There are limited data on the incidence and mortality rates and trends of gastric MALT lymphoma in the US. Therefore, the aim of the current study was to conduct a time-trend analysis of gastric MALT lymphoma incidence and mortality rates in different populations. Methods: The incidence rates of gastric MALT lymphoma were calculated from the United States Cancer Statistics (USCS) database (which covers nearly 98% of the US population) between 2001–2020 and were age-adjusted to the standard 2000 US population using SEER*Stat software (version 8.4.3, national cancer institute "NCI"). Incidence-based mortality (IBM) rates, also age-adjusted to the standard 2000 US population, were calculated from the Surveillance Epidemiology and End Results (SEER) database. Tumor location was specified using ICD-O-3 codes C 160–C 169 with malignant behavior. Histopathology was specified using the ICD-O-3 code 9699. The rates were categorized by sex, age, race/ethnicity, and tumor stage at diagnosis. Age groups were older adults (aged 55 years or older) and younger adults (aged younger than 55 years). Race/ethnic groups included Non-Hispanic White (White), Non-Hispanic Black (Black), Hispanic, Non-Hispanic Asian/Pacific Islander (API), and Non-Hispanic American Indian/Alaska Native (AI/AN), as reported in the database. Stage at diagnosis included early stage (in situ and localized tumors) and late stage (regional and distant site tumors). Joinpoint Regression Software (version 5.0.2, NCI) using the weighted Bayesian Information Criteria method was used to generate time trends. Trends were reported as annual percentage change (APC) and average APC (AAPC). Parametric estimations were used with a two-sided t-test to evaluate the trends with a p-value cutoff at 0.05. Results: There were 21,625 patients diagnosed with gastric MALT lymphoma in the US between 2001 and 2020. Overall, incidence rates were significantly decreasing over the study period (AAPC = −1.93). This decrease was seen in males (AAPC = −1.67) and in females (AAPC = −1.66) (Figure). When categorized by age groups, older adults also experienced a significant decrease in gastric MALT lymphoma incidence rates (AAPC = −1.66). While this was also seen in younger adults, the rates were decreasing at a slower pace (AAPC = −1.38). When categorizing the trends by race/ethnicity, incidence rates were significantly decreasing in White (AAPC = −2.09), Hispanic (AAPC = −1.61), and API (AAPC = −3.92) populations. However, the rates were stable among Blacks. While early-stage tumors experienced a significant decrease (AAPC = −1.10), the rates were stable for late-stage tumors. When evaluating mortality, there were 11,036 patients whose death was attributed to gastric MALT lymphoma between 2000 and 2020. IBM rates were decreasing in males (AAPC = −1.47), older adults (AAPC = −1.55), Whites (AAPC = −1.23), Hispanics (AAPC = −1.73), APIs (AAPC = −2.30), and early-stage tumors (AAPC = −1.08). On the other hand, IBM rates were stable in females, younger adults, Blacks, and late-stage tumors. Discussion: An extensive nationwide data analysis encompassing nearly 98% of patients diagnosed with gastric MALT lymphoma in the US unveils a declining trend in the incidence of cancer overall over the past two decades. This decline is observed in both sexes and various age groups. When stratifying by race and ethnicity, this incidence has been decreasing in all populations except among Black individuals. While early-stage tumors have also demonstrated a significant decrease in incidence rates, late-stage tumors have shown no parallel decline. Mortality evaluation also revealed an improvement in most of the US population except among females, younger adults, Black individuals, and late-stage tumors. While the cause of our findings is unclear, it could be driven by disproportionate exposure to risk factors, including H. Pylori, and disparities in screening, management, and outcomes. Future studies are warranted to investigate factors contributing to worse outcomes of gastric MALT lymphoma, especially in the Black population. [ABSTRACT FROM AUTHOR]

Understanding Black therapists' educational decisions contributes to increasing Black therapists' representation and accessibility. The present study explored the role of racial identity attitudes, demographic factors, and motivations for becoming a therapist (e.g., personal experiences, altruism) in predicting membership in the subfields of counseling, clinical psychology, and social work. Black therapists (N = 129) were surveyed about their career trajectories and personal characteristics. Predictors of subfield membership were examined using multinomial logistic regression. Black therapists who endorsed the racial identity status of internalization and those who were motivated by family problems were more likely to be social workers or counselors than clinical psychologists. Attending a historically Black college/university and being motivated by professional altruism predicted membership in social work relative to clinical psychology, whereas those who were motivated by the experience of personal problems were more likely to be clinical psychologists than counselors or social workers. We conclude that Black therapists' career decision making appears to be consistent with the expressed values of psychotherapy subfields. Understanding Black therapists' motivations and career trajectories can inform recruitment and retention efforts within psychotherapist training and employment. Public Significance Statement: This survey study suggests that among Black therapists, there are important differences between social workers, clinical psychologists, and counseling psychologists. Observed differences included motivation for becoming a therapist, racial identity (attitudes related to race, society, and one's own life), and history of attending a historically Black college or university. Understanding why Black therapists choose particular career paths can help therapist training programs recruit and retain Black students. [ABSTRACT FROM AUTHOR]

Black women report higher rates of adult sexual assault (ASA) and sexual objectification compared to White women. Sexual objectification serves as a reminder that Black women's bodies are viewed as sexual objects based on racist/sexist ideologies, though trauma research rarely includes race-specific stressors. In this study, we examined sexual objectification racial microaggressions as a moderator of the relation between ASA severity and posttraumatic stress disorder (PTSD) symptoms among Black women. Data were collected from 129 Black college and community women (M age = 33.84). ASA severity was associated with greater overall PTSD symptoms and symptom clusters. The interaction between ASA severity and sexual objectification microaggressions was associated with greater PTSD symptoms and the PTSD symptom cluster, negative alterations in cognition and mood. ASA severity was associated with PTSD at mean and high sexual objectification racial microaggressions but not low levels. Associations with other PTSD symptom clusters were not significant. Findings suggest sexual objectification racial microaggressions amplify the positive relation between ASA and PTSD symptoms, specifically symptoms related to cognition and mood. It is essential that clinicians assess for race-specific stressors during trauma interventions to help reduce mental health disparities. Post-assault interventions should be tailored with multiculturally sensitive practices to address the ways racial discrimination can exacerbate trauma symptoms. [ABSTRACT FROM AUTHOR]

The United States (U.S.) racial caste system and White dominance began in slavery, culminating in Black intergenerational racial trauma. Until recently, Black intergenerational racial trauma largely was ignored by family scholars and therapists. Given that Black intergenerational racial trauma is inseparable from racial caste in the United States, it should be regarded as a wider, systemic problem, requiring intervention at the micro (e.g., family) and macro (e.g., society) levels. The U.S. dominant White society's investment in conserving racial caste furthers the ideological (e.g., political) and sentimental (e.g., democratic ideals) nullification of Black intergenerational racial trauma. Therefore, Black intergenerational racial trauma is often disenfranchised and can hamper Black people's experience of racial trauma as a collective. As passive bystanders, family scholars and therapists are co‐conspirators in the long, enduring suffering of Black people. As advocates, family scholars and therapists are called upon to name the racial hierarchy in the United States as a caste system and to advance Black humanization. Specifically, Wilkerson's (Caste: The origins of our discontents. Random House, 2020) notion of the U.S. racial hierarchy as a functioning caste system frames the discussion of Black intergenerational racial trauma and includes the following topics: Black racial trauma, disenfranchised Black intergenerational racial trauma, collective Black intergenerational racial trauma, Black intergenerational racial trauma and the U.S. academy (traditionally White institutions of higher learning), history and its impact on Black intergenerational racial trauma, the Black body and racial trauma, intersectionality and the U.S. caste system, and collective hope and resilience. [ABSTRACT FROM AUTHOR]

Although research on racial socialization is well established, few studies have examined the influence of specific, highly publicized racialized events. We sought to gain a deeper understanding of Black parents' preparation for bias with young children following the murder of George Floyd and other high-profile anti-Black murders during the pandemic. Researchers generated the following themes from parents' responses using reflexive thematic analysis: determining their child's readiness for the talk, reasons to delay the talk, initiating the talk, and recommendations for beginning the talk. The majority of parents of children age six and younger did not engage in preparation for bias following the murder of George Floyd due to perceptions of children's inability to understand racism as well as desires to preserve children's "innocence" and positive perceptions of police. [ABSTRACT FROM AUTHOR]