This dissertation is a critical investigation of the engagements of scriptures in the life and speeches of U.S. Congresswoman Barbara C. Jordan (1936–1996). I engage in a research methodology that utilizes critical historical, auto/biographical, literary, and rhetorical analyses. My research agenda is to explain how scriptures work and are used by Barbara Jordan to illustrate an example of a larger phenomenon of scripturalizing and scripturalization outside of the context of institutional religion. In order to give a fuller context to Barbara Jordan’s rhetorical strategies, as an African American woman, I first consider the lives, speeches and use of scriptures of formidable 19th century African American women orators and political activists, Maria W. Stewart and Anna Julia Cooper, who serve as functional equivalents or precursors to Barbara Jordan. In this study, I found that Barbara Jordan makes American scripture, i.e. the Constitution, function in her speeches as a central component in a discursive rhetorical strategy of indirection, which I refer to as signifying on scriptures. She uses the Constitution, along with her personal history as an African American woman, to pretend mere sociopolitical conviction about social injustice. However, at the same time, she is strategic and intends to promote advocacy for racial justice and gender equality. Jordan uses the Constitution to signify on scriptures in a similar manner to how Maria W. Stewart and Anna Julia Cooper use Christian scriptures, i.e. the Bible, in their speeches to negotiate social and political power.

Much research conducted on stepmothers has not been racially representative. This includes Janice Nadler's (1976) research on three psychological stresses (anxiety, depression, and anger) of stepmotherhood. To investigate the stress of black stepmotherhood, this study replicated a portion of Nadler's investigation on a black sample. It was hypothesized that 1) black stepmothers would report more stress than black natural mothers; and that 2) black stepmothers would report more stress than the white stepmothers in Nadler's study. The data indicated no significant difference in the levels of stress experienced by black stepmothers and black natural mothers. Overall, white stepmothers reported more stress than black stepmothers. The former may be attributable to black stepmothers and natural mothers having the same support system, the black extended family.

Black women are disproportionately affected by cardiovascular disease (CVD). While chronic stress has been identified as a key contributor to CVD risk, research has not identified the specific mechanisms through which stress influences CVD risk among Black women. Research suggests that in response to stress, Black women who internalize the SBW Schema engage in high effort coping, avoidant coping, postponement of self-care, and other maladaptive health behaviors and experience premature health deterioration. However, it is important to consider that internalization of the SBW Schema may exert differential effects on the physiological profiles of Black women due to varied interpretations of experiences filtered through the Schema and differences in emotion regulation. As emotion regulation has a robust impact on cardiovascular outcomes, individual differences in internalization of the SBW Schema may be explained by this related construct. Given that limited research has examined the impact of psychological factors associated with CVD risk in Black women, the current study examined relations between CVD risk, chronic stress, emotion regulation, and the Strong Black Woman (SBW) Schema. Hypotheses were: 1) internalization of the SBW Schema (i.e., higher levels of endorsement) and chronic stress are unique predictors of CVD risk, 2) the relation between internalization of the SBW Schema and CVD risk will be partially mediated by emotion regulation, and 3) the effect of chronic stress on CVD risk will be moderated by internalization of the SBW Schema. Results provided partial support for the first hypothesis and did not support the second and third hypotheses. Results of exploratory analyses revealed relationships among psychological variables, such that greater endorsement of SBW Schema characteristics (obligation to manifest strength, dedication to care, independence, and emotion suppression) was related to greater overall difficulties with emotion regulation. Additionally, greater dedication to care predicted lower CVD risk and greater emotional suppression predicted higher CVD risk. The relationship between emotional suppression and CVD risk was mediated by emotion regulation. Results stand to inform future research and culturally specific prevention strategies to decrease CVD risk in Black women.

Objective: This study was to identify factors associated with High Sexual Risk Behavior (HSRB) in single Afro American women seen in an Epidemiology/Sexual transmitted disease (EPID/STD) Clinic in Richmond, Virginia from January 2006 through April 2006.Method: Participants were 154 single women (no history of marriage) between the ages of 18-30 visiting the EPID/STD clinic for the first time.Demographic information was obtained from their records. A volunteer interview was given that contained 101 variables to evaluate for High Sexual Risk Behavior (HSRB). HSRB was defined to response 'yes' to the question, "During the past 3 months did you have sex with some one you just met (i.e., within the past week or so)." We evaluated the association of HSRB and the pre-disposing factors that affect risk behavior using univariate and multivariate logistic regression.Results: There were 154 women interviewed of which 16% responded yes to the HSRB question. Eight percent reported a first sexual encounter prior to the age of 13, 69% reported 6 or more lifetime sexual partners, 39% reported > than one pregnancy, 53% said they had heard information on the risk of STDs often or a lot. Girls who initiated sex from 13 to 15 were protected against HSRB as an adult according to our data. There was an association between HSRB and number of lifetime sexual partners as well as the number of lifetime pregnancies. In logistic regression, predictors for HSRB were found to include number of lifetime sexual partners as well as the number of lifetime pregnancies, with the highest adjusted POR for 16 or more lifetime sexual partners 13.69 (95%CI 2.03,92.23). In addition, women who had more than one pregnancy had an adjusted POR for HSRB of 5.13 (95% CI 1.14, 23.15).Conclusion: The results indicated that there was an association for HSRB, as measured by the report of sex with someone you just met in the past three months, with having 16 or more lifetime sexual partners and with one or more pregnancies. Also, in this study group, girls who initiated sex between the ages of 13-15 were protected against HSRB as adults. We need to target these at risk individuals to educate them an dincrease their awareness of negative outcomes linked to this type of behavior.

Hypertension is a preventable and yet major risk factor for early death and morbidity among African Americans. Compared to other women in the US, African American women continue to die earlier and more frequently from preventable and controllable chronic health conditions that are notably due to hypertension and hypertension-related illnesses. While there are multiple factors contributing to the high death rates of African American women, hypertension is one of the most common and modifiable risk factors associated with fatal health outcomes among African American women. The rate of death resulting from hypertension is more than double for African American females compared to white females. Even armed with increased knowledge and awareness, African American women are encountering barriers to controlling their hypertension, which places them at higher risk of becoming sicker and dying earlier than their white counterparts. The purpose of this mixed-methods study was to examine the effects of psychosocial stress on the hypertension self-management behaviors. The rationale for the study is supported by findings from a systematic literature review identifying gaps and contributions in the health literature on African American women and hypertension management. Findings underscore a need to continue to examine psychosocial factors as barriers to African American women’s hypertension self-management. Specifically, the study found statistically significant associations between psychosocial stress and depression as it relates to the hypertension self-management of African American women. Further investigation is warranted to better understand the significance of the relationships between psychosocial stress, depression and African American women’s hypertension self-management.

Background: Disparities exist in mortality rates in African American breast cancer survivors (AABCS), partly due to modifiable lifestyle behaviors. Gaps remain in developing effective tools to assess AABCS' motivations to prevent weight gain. Conceptual Framework: This research study used the Theory of Planned Behavior (TPB) to guide development of the elicitation study and the AABCS-Weight Gain Prevention Intention Questionnaire (AABCS-WGPIQ). Purpose: Aim One was to use the elicitation approach of the TPB to identify, define and describe AABCS' salient behavioral (advantages/disadvantages), normative (social influence) and control (facilitators/barriers) beliefs related to the prevention of post diagnosis weight gain. Aim Two was to develop and pilot test a questionnaire based on qualitative data to quantify the magnitude of influences of attitudes, subjective norms and perceived behavioral controls related to intentions to prevent weight gain in AABCS. Methods: Guided by the TPB, this cross-sectional, descriptive study used an internet based qualitative elicitation questionnaire to identify salient beliefs of 27 AABCS regarding their motivations to prevent weight gain and inform development of the quantitative AABCS-WGPIQ. Initial psychometric testing of the questionnaire included content and face validity and temporal stability assessment of belief constructs, using the test-retest approach. Findings: Aim One: Motivators to preventing weight gain among AABCS included improving health and well-being (advantages), social support from family and friends (approvals), external support systems, and personal accountability (facilitators). Time and effort required preventing weight gain (disadvantages), lack of social support (disapprovals), and time constraints, lack of accountability, unhealthy eating and health issues (barriers) negatively influenced AABCS' decisions to prevent weight gain. Future interventions aiming to increase motivation to prevent weight gain in AABCS should emphasize positive benefits of preventing weight gain, include social support systems, focus on skill building for time management, planning and goal setting, managing health issues and incorporate weight loss management strategies. Aim Two: The AABCS-WGPIQ has acceptable content validity, face validity and temporal stability of belief constructs. The AABCS-WGPIQ has the potential to be a valid instrument for assessing correlates of weight gain prevention in AABCS. Future research with larger groups of AABCS should include assessing internal consistency and construct validity.

Thesis advisor: Janet E. Helms / The extant theory and research on race-related stress and coping has not adequately examined how internalized racial and gender socialization factors influence levels of stress and coping strategies of elderly African American women. Consequently, little is known about how to address their mental health concerns effectively. Therefore, the purpose of the present study was to investigate the complex relationships among racial identity attitudes, culture and gender specific coping strategies, and race-related stressors that have been hypothesized to affect psychological distress among elderly African American women. Elderly African American women (N = 125), who were at least 65 years old, completed a demographic questionnaire and measures of Black racial identity (Helms, 2003), race-related stress (Utsey, 1999), Black women's coping strategies (Phields, 2002), and a mental health inventory (Veit & Ware, 1983). Three canonical correlation analyses were used to investigate how the women's appraisal of race-related stress, use of prototypical Black women coping strategies, and psychological distress were interrelated. Results of the analyses revealed four statistically significant patterns: (a) "Self-Reliant Internalization," women described by this pattern endorsed Internalization (transcendent identity) as a primary appraisal strategy, self-reliance as a coping strategy, and less psychological distress; (b) "High SES," women defined by this pattern used education, social class, and self-reliance as buffers against institutional race-related stress and psychological distress; (c) "Self-Reliant, Multiply Distressed," a pattern in which greater individual and cultural race-related stress, were associated with use of self-reliance as a coping strategy and greater psychological distress; and (d) "Internalized Individual Racism as Stressors," a pattern in which endorsement of the Preencounter (pro-White/anti-Black) and Immersion (pro-Black/anti-White) racial identity statuses as appraisal strategies were related to higher levels of individual race-related stress and psychological distress. Results were used to speculate about how the factors investigated might be integrated to form a model for addressing research and practice for elderly African American women. Limitations of this study and implications for research and practice, and future research are discussed. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

This ethnographic analysis examines the life stories and lyrics of four African blues singers. Specifically, it compares the cultural themes that emerge their life stories to the cultural themes at emerge from their commercially released music. The findings suggest that the singers recognize, to varying degrees, the impact of racism, sexism, and classism on their personal and careers. These same themes, however, are not present in the lyrics of the music that they choose to sing. Both the stories and the lyrics reveal internal inconsistencies that mirror one another. The conclusion suggests that the inconsistencies within their stories and music are consistent with their liminal position with regard to dominant and subordinate cultures.

Two serious adverse health effects of obesity are development of cardiovascular disease and type 2 diabetes, which may also lead to stroke, kidney failure, blindness, and non-traumatic amputations. Diabetes and obesity occur more commonly among U.S. African-American women than among white women. One postulated mechanism in the development of obesity and diabetes is disruption of the neuroendocrine system by chronic psychosocial stress. Using data from the Black Women’s Health Study (BWHS), we examined three psychosocial stressors more prevalent in African-American women than white women, and their possible contribution to the incidence of diabetes and obesity among African-American women. Study 1 examined perceived racism and incidence of diabetes over 16 years (1997–2013), among 45,781 women. Women with higher scores for perceived everyday or lifetime racism had greater risk of diabetes compared to women with lesser exposure. Mediation by BMI may have accounted for half of these associations. Study 2 examined abuse victimization with incidence of diabetes in adulthood over eight years (2005–2013), among 29,193 women. Compared to women reporting no abuse in their life span, there was an increased risk of diabetes among women who experienced abuse only during adolescence, or only adolescence and childhood. Higher frequency of sexual abuse or greater severity of abuse increased risk of diabetes. There was some evidence for mediation by BMI, and as a modifier; in stratified analyses overweight women experienced an increased risk of diabetes with childhood sexual abuse. Study 3 evaluated the association of night shift work and weight change over an eight year period (2005–2013), among 28,565 women. Stratified analyses showed BMI modified the association: normal and overweight women who worked a night shift gained significantly more weight than women who did not work a night shift; this was not found among obese women. Younger night shift workers who worked 10 or more years appeared to gain more weight than younger non-night shift workers. In conclusion, there is evidence that perceived racism, abuse, and night shift work may be psychosocial stressors whose downstream effects may contribute to type 2 diabetes and weight gain among African-American women.

Effective communication is essential for both a satisfying and productive patient-provider relationship. Ineffective communication can lead to many detrimental patient outcomes including a lack of access to care, an inability to navigate the healthcare environment, a decreased adherence to treatment recommendations, and a lack of patient understanding about disease risk factors, prevention, and management. The Healthy People 2010 initiative recognized the importance of communication by including several health communication-related goals in its objectives. A goal of one of these objectives included increasing the percentage of patients who reported that their care providers have satisfactory communication skills. Researchers can gain insight about those barriers that prevent providers from experiencing effective communication by examining the patients' perspectives about communication. The primary aim of this pilot study was to explore urban African American women's perspectives about the communication utilized during clinical encounters with providers via the use of semi-structured interviews. The semi-structured interviews collected data about a variety of topics including participants' breast cancer-related knowledge, attitudes, beliefs, and practices. Data was also collected about participants' clinical encounter experiences, including their comprehension of health information and their communication experiences with medical providers and other types of health care professionals. Any responses that discussed participants' communication experiences with providers, comprehension of health information, or perspectives about factors that could impede or facilitate communication were selected for analysis. In addition to the semi-structured interviews, participants also completed two health literacy assessments in order to gauge their health literacy levels. Women were administered the Rapid Estimate of Adult Literacy in Medicine (REALM), a word recognition assessment, and the Short Test of Functional Health Literacy in Adults (STOFHLA), a comprehension assessment. Eligibility criteria included women who: (1) were aged 50 and older, (2) were English-speaking, (3) able to respond to interview questions without assistance, (4) of African descent, (5) were Harlem residents, and (6) had never received a diagnosis of breast cancer. One hundred women participated in the study. Data about the effectiveness of providers' communication skills, patients' abilities to comprehend health information, patients' communication experiences with various types of health care providers, and preferred sources of health information were collected from the interviews. Open-ended questions were utilized to gather information about factors that women deemed as either impediments or facilitators to effective communication with providers. Collected data from interviews were analyzed qualitatively. In addition to information about participants' health literacy scores from the literacy assessments, final results included demographic information, preferred sources of health information, and information about those factors that women viewed as either impediments or facilitators to effective communication with doctors and with other health care providers both in and outside of the medical appointment. Additionally, findings from the qualitative analysis results were utilized in order to inform the creation of health communication recommendations for providers who treat urban African American female patients.