ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundAfrican American women living in the Southeast experience a higher mortality due to cardiovascular (CV) disease than their White counterparts. It is unclear if this vulnerability to CV disease is due to race, socioeconomic status, or health behaviors.ObjectivesTo examine the disparities in cardiovascular health between Southern rural, African American and White women to determine if a CV Risk-Index differed by race, education, or income levels and if differences persisted when controlling for body mass index (BMI).MethodsSubjects were 1,110 women (27% African American, 73% White) residing in rural North Carolina. Data were collected by mailed questionnaire and analyzed using analysis of variance (ANOVA) and analysis of covariance (ANCOVA).ResultsAfrican American women had significantly lower education and lower income than Whites, higher BMI, and a much greater prevalence of hypertension, angina, and diabetes. In a three-way ANOVA including race, income, and education, education and race were significant predictors of the CV Risk Index, but when adjusted for BMI race was no longer significant (p= .3039); the only significant predictors were BMI and educational level.DiscussionWomen with the least education had the highest CV Risk-Index, regardless of race. These findings suggest the need to focus risk reduction interventions on all Southern rural women with limited education, not only African American women. This supports the current literature that suggests race should be viewed as a risk marker rather than a risk factor.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundAlthough numerous studies have shown that Black patients are less likely than White patients to undergo cardiac procedures, most of these studies did not consider clinical and demographic factors that could account for observed racial differences.ObjectiveTo determine if there are racial differences in the use of coronary angiography and revascularization procedures in patients with acute myocardial infarction, while controlling for multiple potentially important demographic and clinical variables.MethodsIn this retrospective cohort study, data were obtained from medical records of 642 consecutive Black and White patients with acute myocardial infarction at a regional cardiac referral center in southern New England.ResultsBlacks were significantly less likely than Whites to undergo angiography (p= .004; adjusted odds ratio = .36; 95% confidence interval = .18 – .72) and revascularization procedures (p= .006; adjusted odds ratio = .21; 95% confidence interval = .07 – .64). In the subgroup admitted directly to the hospital (n= 465), rather than transferred in from outlying hospitals, there were no racial differences in the use of angiography, but Blacks were significantly less likely to undergo revascularization procedures (p= .004; adjusted odds ratio = .18; 95% confidence interval = .06 – .58).ConclusionsIn patients hospitalized with acute myocardial infarction, there are substantial racial differences in the use of angiography and revascularization procedures that cannot be explained by clinical or demographic factors.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundLinkages among family violence, maternal mental health, and parenting attitudes are not clearly understood.ObjectiveTo investigate the relationships of abuse (childhood and/or partner), everyday stressors, self-esteem, depressive symptoms, and anger with abusive parenting attitudes.MethodCross-sectional analysis of data collected in interviews with 53 low-income, single mothers from wave two of a 3-wave study. A conceptual framework and bivariate correlations guided a series of multiple regressions to identify the best predictors for each variable.ResultsA high prevalence of abuse, depressive symptoms, and abusive parenting attitudes was found. Few women had ever received mental health treatment. Abuse (partner and childhood physical) predicted higher everyday stressors which in turn predicted lower self-esteem. Childhood abuse and lower self-esteem predicted more depressive symptoms. More depressive symptoms were related to higher levels of state anger. More everyday stressors and more depressive symptoms predicted higher levels of trait anger. Higher levels of anger expression were associated with higher everyday stressors and lower self-esteem. The presence of partner abuse best predicted higher levels of overall abusive parenting attitudes and more parent-child role reversal. Less parental empathy was associated with higher levels of state anger.ConclusionsThis study partially explains the relationships of maternal abuse history and mental health status with parenting attitudes. Other predictors of parenting attitudes remain to be identified. The findings underscore the need for healthcare providers to consider the mental health status and abuse histories of low-income, single mothers. The potential disturbance in the parenting process of single mothers in abusive relationships warrants further investigation.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundHomeless adolescents are at very high risk for sexually transmitted diseases (STDs), but few street-based interventions have been developed, tested, and made available to reduce risk and promote sexual health within this growing population.ObjectivesThis study, part of a larger study of the sexual health practices of homeless adolescents, explores participants’ perceived need for more knowledge about sexual health and their ideas about developing a brief intervention to promote positive sexual health practices that would reflect their perspective.MethodsFour focus groups with five to six participants each were conducted with 22 youth aged 16–20 years, randomly selected from the study sample of 425 homeless youth. Most participants (82%) were White, one was American Indian, two were Hispanic, and one did not indicate ethnicity. Local groups were audiotape recorded, transcribed, and analyzed for manifest and latent content.ResultsParticipants were knowledgeable about symptoms, transmission, prevention, and treatment of STDs, but perceived the need for more knowledge about types of hepatitis, cancer, and long-term sequelae of untreated STDs. Participants identified barriers to seeking diagnosis and treatment for symptoms of STDs including cost, not knowing where to go, and lack of services specifically for females. They suggested developing a sexual health intervention based on respect that would provide concrete examples of how to promote their sexual health.ConclusionsHomeless adolescents were generally knowledgeable about symptoms and prevention of STDs and thought that street outreach interventions should be (a) brief, (b) gender-specific, (c) focused on the unique vulnerabilities and strengths of homeless youth, and (d) accessible.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundThe majority of research related to depression among women of Mexican descent has focused on risk factors and resources without considering intrinsic strength factors that may have a protective function. An additional focus on mastery, resilience, and life satisfaction will expand the context for understanding the mental health of women of Mexican descent.ObjectivesThis study describes the level of depressive symptoms experienced by low-income women of Mexican descent living in an urban community in northern California and compares the level of symptoms by exposure to the United States (US) during childhood. Rather than focus only on negative demographic characteristics (such as lower socioeconomic status) associated with high levels of depressive symptoms, this study also focused on strengths and resources that may minimize or modify depressive symptoms.MethodsQuestionnaires were completed by a cross-sectional convenience sample of 315 women of Mexican descent, aged 21–40 years. Data were analyzed using descriptive statistics and multiple regression.ResultsWomen who spent all of their childhood years in Mexico before coming to the US had a lower level of depressive symptoms (p< .05) and more satisfaction with life than women who were exposed to the US in childhood (p= .001). While income, adequacy of financial resources, partner status, alcohol use, and childhood exposure to the US accounted for 13% of the variance in depressive symptoms, intrinsic strength factors such as mastery, life satisfaction, and resilience accounted for an additional 31% of the variance (p< .001).DiscussionAlthough intrinsic strength factors have rarely been included in research related to depression in women of Mexican descent, they were more directly related to lack of depressive symptoms than traditional demographic risk factors.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundAlthough it is recognized that African Americans experience racial discrimination, relatively little research has explored the health implications of this experience. Few studies have examined the relationship between racial discrimination and specific health risks.ObjectivesTo examine the relationship between smoking habits and perceptions of racial discrimination among African American adolescent girls and to identify and test potential psychological mechanisms through which racial discrimination may operate to increase smoking among this group.MethodsA sample of 105 African American adolescent girls (mean age 15.45 years) derived from a larger cross-sectional research project comprised the sample. Univariate analyses were conducted to provide descriptive data on the participants of the study, including information about their use of licit and illicit substances. Bivariate correlational analyses were conducted to evaluate the relationship between perceptions of discrimination and smoking habits. The ability of stress to mediate the relationship between discrimination and smoking was examined by using standard analytical procedures for testing mediation models as outlined byBaron and Kenny (1986).ResultsThe sample (93%) reported experiencing discrimination and racial discrimination was highly correlated with cigarette smoking (r= .35,p> .001). Removing the effects of stress significantly reduced the relationship between racial discrimination and smoking (r= .17,p< .05), indicating that racial discrimination is related to smoking because of its stressful nature.ConclusionPerceptions of racial discrimination are related to the smoking habits of African American adolescent girls.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundLong-term management of hypertension and diabetes, which are more prevalent in minority and socioeconomically disadvantaged populations, presents challenges for healthcare providers in community health centers.ObjectivesThe purpose of the study was twofold: to examine health outcomes for persons with hypertension and diabetes and to compare these outcomes for disparities in patients who were Black, Hispanic, or White.MethodsMedical records (N= 280) from an urban community health center that serves predominantly uninsured adults were reviewed for selected clinical outcomes of primary care. Measures included outcomes of hypertension and diabetes control, lifestyle behaviors, preventive care, and patient status. Chi-square tests,ttests, and one-way analysis of covariance were used to analyze racial/ethnic group differences.ResultsData revealed significant differences in smoking status, influenza immunization, and blood pressure. Racial/ethnic group differences were minimal compared with the overall high prevalence of risk factors such as smoking and obesity. Regular access to primary care did not result in improved clinical outcomes.ConclusionThe findings support the need for more effective interventions that promote healthy lifestyle if health disparities in low-income populations with chronic conditions are to be reduced.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundAlthough multiple interventional approaches to reduce perceived burden among caregivers of the frail elderly have been investigated for over a decade, the effectiveness of those interventions and the benefits of group versus individual interventions are largely unclear.ObjectivesThis meta-analysis was undertaken to (a) assess the effectiveness of group and individual interventions on decreasing burden of caregivers of the frail elderly, and (b) identify factors with potential influence on the magnitude of the effects.MethodComputerized literature searches and manual searches of published true and quasi-experimental studies with control groups were performed. A coding form was developed to record methodological and other study characteristics, including study design, attrition rate, and reliability and validity of the measures.ResultsEighteen group and eight individual interventional studies published from 1985 to 2000 were included. For group interventions, the sample size for individual studies ranged from 20 to 486, with a total of 1,970. The weighted mean effect size was 0.41 (95% CI: 0.32 to 0.51), indicating a significant positive treatment effect. A significant homogeneity test (Q17= 56.37,p< .0001) indicated that there were variations in effect sizes among the studies attributable to study characteristics. The effect size in the 11 true experimental studies was smaller (M:0.26, 95% CI: 0.15 to 0.37) but still existed. For individual interventions, the sample sizes ranged from 16 to 168, with a total of 472. The weighted effect sizes were homogeneous with a mean of 0.48 (95% CI: 0.30 to 0.67), indicating a positive treatment effect.DiscussionAvailable evidence supports the premise that both group and individual interventions reduce perceived burden, however, this evidence is inconclusive. Further studies of large scale and high quality designs are needed.

ISSN:0029-6562    

出版商:OVID    

年代:2002

数据来源: OVID