Search

The influential roles of culture and ethnic identity are frequently cited in developing disordered eating and body dissatisfaction, constituting both protective and risk factors. For African American women, strongly identifying with African American cultural beauty ideals may protect against disordered eating to lose weight, but may actually increase risk in development of disordered eating directed at weight gain, such as binge eating. This study compares African American and Caucasian women on disordered eating measures, positing that African American women show greater risk for binge eating due to the impact of ethnic identity on body dissatisfaction. Findings indicate low levels of ethnic identity represent a risk factor for African American women, increasing the likelihood of showing greater binge eating and bulimic pathology. In Caucasian women, high levels of ethnic identity constitute a risk factor, leading to higher levels of both binge eating and global eating pathology. Implications for prevention and treatment are discussed.

Elders' use of home care services varies globally. The authors tested the relationship of cultural/ethnic, contextual, and social structural factors with elders' use of home care services in the United States. Fifty-seven non-Hispanic White or "Anglo" and 56 Mexican American elders participated. Use of services significantly correlated with Anglo and Mexican American elders' cultural/ethnic and contextual factors. Perceived need and service awareness were the two factors that were significant for both groups and that the authors believe would be amenable to change in future transcultural nursing interventions to decrease use of services disparities.

Research on African American and white attitudes, perceptions, and knowledge of hospice care has focused predominantly on patients and providers in institutions and community-based care settings. Little is known about patients receiving home health services, despite growing trends toward noninstitutional care in the United States. This study of home health clients who are eligible for hospice, but not currently receiving it, found few differences between racial groups with regard to attitudes about end-of-life care. An alarming proportion of African American and white home health clients held erroneous ideas about hospice care and had not discussed this option with their providers. These findings suggest that increased referrals to home-based hospice care among home health clients depend on the availability and professional dissemination of accurate, spiritually sensitive information.

Despite research on work and health having a long-standing concern about unjust exposures and inequitable burdens of disease, there are few studies that document the joint distribution and health effects of physical and psychosocial hazards (e.g., noise, dusts, fumes, and job strain) and social hazards (e.g., racial discrimination and gender harassment) encountered at work. Also, there is a paucity of data on how these exposures, singly and combined, are distributed in relation to sociodemographic characteristics including race/ethnicity, gender, socioeconomic position, and nativity. This article presents a conceptual model for redressing these knowledge gaps and describes recruitment strategies and the characteristics of study participants in the United for Health study. Working with labor unions, the authors recruited 14 (67%) of 21 worksites from manufacturing, meat processing, retail, and transportation, and 1,282 workers (72% response rate), of whom 62 percent were men, 36 percent were women, 39 percent were black, 23 percent were Hispanic, 25 percent were white, 31% earned less than a living wage, 40 percent were below the poverty level, and 23 percent had less than a high school education.

Prisons and prison inmates present important targets for HIV/AIDS prevention interventions. Inmates often have histories of high-risk behavior that place them in danger of contracting HIV/AIDS, and rates of HIV/AIDS tend to be much higher in this population. The goal of this study was to assess the effectiveness of a prison-based HIV/AIDS intervention to change attitudes toward HIV prevention, norms supporting HIV prevention, perceived behavioral control (i.e., self-efficacy) for HIV prevention behaviors, and intentions to engage in HIV prevention behaviors postrelease. The intervention also had the goal of encouraging inmates to become HIV/AIDS peer educators. The intervention appeared most successful at influencing beliefs and behaviors related to peer education and somewhat successful at influencing beliefs and intentions related to condom use. Analyses also showed some significant differences in effectiveness by race/ethnicity. Results are discussed from the perspectives of both research and practice with regard to prison-based HIV prevention efforts.

Objective: Investigation into the relationship between lifestyle factors (particularly cigarette smoking) and perceived oral health has been limited. Data from the third National Health and Nutrition Examination Survey (NHANES II), 1988-1994, were used to explore this relationship in a large sample of U.S. adults., Methods: This study used data on 13,357 dentate participants in NHANES III aged 20-79 years. In NHANES III, information on perceived dental health, sociodemographic attributes, smoking status, frequency of dental visits, dental insurance, and general health perception were collected during a home interview, and oral health status was assessed at a mobile examination center., Results: Overall, 34.4% of individuals in the study sample reported having an unfavorable perception of their dental health by qualifying it as "fair" or "poor." Furthermore, 46.6% of smokers had an unfavorable dental health perception, compared to 28.3% of non-smokers. An interaction between smoking and race/ethnicity was found in logistic regression modeling. Stratified results show that cigarette smoking was not a significant predictor for an unfavorable dental health perception among individuals who self-identified as Mexican American, but smoking was a significant predictor for an unfavorable dental health perception among those who identified as non-Hispanic black or non-Hispanic white., Conclusions: This is the first study to describe the effects of smoking on dental health perception while controlling for examined oral health status. Because perceived dental health is a potential indicator for dental care utilization, a better knowledge of the factors that influence dental health perception is not only important for dental services planning, but also for understanding oral health-related quality of life issues. Additionally, given that smoking may negatively affect dental health perception, these findings have potential implications for smoking cessation activities conducted by dental care providers.

Researchers from the North Carolina BEAUTY and Health Project conducted an observational study in 10 North Carolina beauty salons to gain insight into naturally occurring conversations between cosmetologists and customers, and to assess features of the salon environment that might be used to inform the development of salon-based health promotion interventions. Results revealed that the social environment of a salon is a place where cosmetologists and customers talk openly about many subjects, including health. Information, advice, appraisal, humor, and empathy are typically shared in these health conversations. Several features of the physical environment of the salon may be mobilized to support health--access to healthy foods, snacks, and beverages; smoking restrictions; and availability of print or video materials, signs, or displays that include healthy messages. Implications for planning salon-based health promotion interventions--including the training of licensed cosmetologists to deliver health messages--are discussed in light of these findings.

This study describes cultural attitudes, knowledge, and skill of 409 health care workers using the Ethnic Attitude Scale, the Cultural Self-Efficacy Scale, and a demographic inventory. Findings suggest cultural knowledge and educational preparation of the health worker may influence cultural skills. Workers that were most confident in their cultural skills in working with other cultural groups were more confident in knowledge of cultural concepts and had higher education levels. The results also suggest gaps in workers' knowledge of other cultures and how to care for them in culturally sensitive ways. Educational interventions may enhance workers' knowledge. Whether such enhanced knowledge yields improved patient care outcomes remains to be answered.

Issues and Purpose: Chronic illnesses, such as asthma experienced by children, are difficult for families and school professionals to manage. This study explored beliefs about asthma and asthma management among schoolchildren, parents, and teachers in an African American school., Design and Methods: Focus groups were conducted with schoolchildren, parents, and teachers. Data were analyzed by content analysis; segments of information were categorized into groups that were later abstracted into themes illustrating beliefs and behaviors about asthma., Results: The children reported fear of not being able to breathe and the limitations of living with asthma. The teachers were concerned that they did not have a sufficient understanding of asthma to manage children's asthma during the school day. Parents described complex lifestyles and the challenges of asthma management.

Eight instruments to evaluate grant interventions aimed at increasing recruitment and retention of Hispanic/Latino and American Indian nurses were developed for a Nursing Workforce Diversity Grant. This article compares expert reviewer responses during content validation of these instruments with (a) current literature and (b) seven filmed intervals of Hispanic/Latino and American Indian nurses speaking about their educational experiences. White reviewers responded differently to certain items than did Hispanic/Latino and American Indian reviewers (or reviewers closely affiliated with such persons). Responses of Hispanic/Latino and American Indian experts were aligned with one another but not aligned with the responses of White experts, who also agreed with one another, prompting literature and film comparisons with their responses. Faculty development may be needed to help teachers uncover their assumptions about students of color, acquire knowledge about cultural perspectives, recognize institutional racism, and attain the skills necessary to develop and implement a curriculum of inclusion.

Objective: This study determined rates of breastfeeding advice given to African American and white women by medical providers and WIC nutrition counselors, and sought to determine whether racial differences in advice contributed to racial differences in rates of breastfeeding., Methods: The study used data from the 1988 National Maternal and Infant Health Survey, a cross-sectional survey of a nationally representative sample of mothers with a live birth, infant death, or fetal death in 1988. The authors compared white women (n=3,966) and African American women (n=4,791) with a live birth in 1988 on self-reported rates of medical provider and WIC advice to breastfeed, WIC advice to bottlefeed, and breastfeeding., Results: Self-reported racial identification did not predict medical provider advice. However, being African American was associated with less likelihood of breastfeeding advice and greater likelihood of bottlefeeding advice from WIC nutrition counselors. In multivariate analyses controlling for differences in advice, being African American was independently associated with lower breastfeeding rates (odds ratio [OR] = 0.41, 95% CI 0.32, 0.52)., Conclusions: African American women were less likely than white women to report having received breastfeeding advice from WIC counselors and more likely to report having received bottlefeeding advice from WIC counselors. However, African American and white women were equally likely to report having received breastfeeding advice from medical providers. Lower rates of breastfeeding advice from medical or nutritional professionals do not account for lower rates of breastfeeding among African American women.

Objectives: The objectives of this study were to assess racial/ethnic trends in surveillance data in four states--California, New York, Florida and Texas, identify structural barriers to and facilitators of access to HIV pharmaceuticals by individuals in Medicaid and the AIDS Drug Assistance Program (ADAP), and identify treatment education and outreach efforts responding to the needs of ethnic minority HIV patients., Methods: State surveillance and claims data were used to assess trends by race/ethnicity in AIDS cases and mortality as well as participation rates in Medicaid and ADAP. Key informant interviews with state program administrators and local clinic-based benefit eligibility workers were used to identify social and policy barriers to and facilitators of access to HIV drugs and state strategies for overcoming racial/ethnic disparities., Results: Racial/ethnic disparities in the reduction of AIDS-related mortality were identified in three of the four states studied. Policy barriers included Medicaid requirements for legal immigration status and residency, limits on Medicaid eligibility based on disability requirements, and state-imposed income and benefit limits on ADAP. Social barriers to accessing AIDS medications included lack of information, distrust of government, and HIV-related stigma. State strategies for overcoming disparities included contracting with community-based organizations for treatment education and outreach, the use of regional minority coordinators, and public information campaigns., Conclusions: State policies play a significant role in determining access to HIV drugs, and state policies can be used to reduce racial/ethnic disparities in pharmaceutical access. Overall, eliminating racial/ethnic disparities in access to HIV pharmaceuticals appears to be an achievable goal.

The purpose of this study was to examine the assessment of AIDS-related social skills (measured by role play) in Anglo and Latino adolescents (N = 383) and to explore ethnic and gender differences on these skills. Eight skills were assessed on five measures evaluating molar, molecular, verbal, and nonverbal dimensions of behavior. Interrelationships between skills and measurement dimensions were examined using factor analysis. Results revealed that Anxiety and Nonverbal Behavior each loaded across different skills on individual respective factors, whereas verbal content and assertiveness measures loaded by skill on separate factors. Differences in skill emerged between female and male, and Latino and Anglo youth. Preliminary social validity data were collected for the skills assessed. Social validity results were skill specific, with judges validating certain skills and certain measurement dimensions more than others. Implications for future assessment and intervention research of AIDS-related social skills are discussed.