The study was conducted in two phases. Phase I consisted of generating models of risk reduction behaviors in order to implement and test risk reduction interventions for Phase II. The purposes of Phase I were: (a) to identify among a group of African-Americans individual and group risk factors for hypertension, and to identify demographic and psychosocial variables most predictive of risk reduction behaviors for hypertension, (b) to design and test a model that combines important demographic and psychosocial determinants of risk reduction behaviors, and (c) to generate data based models of the predictors of each risk reduction behavior for hypertension in the group of African-Americans. The conceptual model for the study was developed by combining variables from the Health Belief Model--susceptibility, severity, and barriers with variables from social learning theory-health locus of control and self-efficacy. The focus of Phase I was to test the model to determine the interactions among the variables, because the assumptions of the underlying theories suggest multiplicative rather than linear relationships. One hundred forty-three subjects completed Phase I. The demographic variables age, gender, and education entered the model as direct effects and strong moderators. Education was a direct effect for stress reduction and moderated the effect of risk severity in diet fat. Age as a direct effect explained 19 percent of the variance in diet sodium intake and 21 percent of the variance in diet fat as a direct effect and moderating effect of risk severity. Twenty-seven percent of the variance in alcohol use was explained by age (B = -.24) difficulty (B =.26), and risk health value moderated by age (B = -.27). Sixty-three percent of the variance in smoking behaviors was explained by the direct effects of age (B = -.20), gender (B = -12) and difficulty (B =.25), and by the interaction of age and difficulty (B =.52). In Phase II, interventions were developed that used either motivational or educational skills strategies such as monetary incentives, screening, risk assessment, health education, dietary analysis, and self-monitoring. Twenty-eight subjects participated in the pilot test of Phase II. Participants were most interested in modifying their diet fat intake and increasing stress reduction. The findings that each risk reduction behavior was predicted by different variables and/or different interaction patterns of the same variables supports further study of each risk reduction behavior rather than looking at risk reduction behavior as a conglomerate or as a summed health-promotive behavior. The study also supported the underlying theoretical assumptions of the Health Belief Model, and Social Learning Theory that the relationships between the variables is multiplicative, as moderating effects were found, but no mediating effects were supported.

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Objectives: Menthol is an organic compound synthesized or naturally obtained from peppermint or other mint oils and once added to cigarettes, is believed to have caused extra adverse health consequences (Kolawole S. Okuyemi 2004) compared with non-menthol cigarettes. This review has multi-purposes: First, to review and summarize the causes of African Americans’ high preference over menthol cigarettes; Second, to review smoking cessation studies and determine the association between menthol cigarettes and reduced quitting rates for African American smokers; Third, to gather information of evidence-based interventions for menthol cigarette smoking cessation. Methods: This article reviewed 16 journal articles through PubMed search using the following key words: menthol cigarette, smoking cessation, African American. And only one Chinese article was found by searching the key word “薄荷?” in CNKI Chinese database. Further search was done by using Google search engine and got 11 electronic articles or webpages for this topic. According to the objectives of this article, 3 journal papers were reviewed for examining the causes of African American smokers’ high preference over menthol cigarettes; 8 journal papers were reviewed for determining the association between menthol cigarettes and reduced quitting rates for African American smokers. In this section, the inclusion criteria include: age (18-65); gender (male, female); study design (cohort, cross-sectional, RCT). At last, 5 journal papers and 5 electronic resources including news were reviewed to gain an up-to-date insight for possible interventions of menthol cigarette smoking. Results: The leading causes for African American smokers’ high preference over menthol cigarettes include: like the minty/cool flavor; perceive menthol cigarette as having medicinal effects; menthol smokers’ influences from one’s social network; tobacco companies’ tailored marketing strategies. Overall, there were lower quitting rates for menthol cigarette smokers compared to non-menthol cigarette smokers at least among African American smokers. For menthol cigarettes and smoking cessation among African American smokers, 4 studies got significant results. For menthol cigarette and non-menthol cigarette smoking cessation among African American smokers: study 1 (TABLE 2), 6 weeks abstinence rate 28.3% vs. 41.5%, p=0.006; study 2 (TABLE 2), 4 weeks abstinence OR=0.32, 95% CI [0.16, 0.62], p<0.05, 6 months abstinence OR=0.48, 95% CI [0.25, 0.9], p<0.05; study 3 (TABLE 2), 6 months abstinence OR=0.23, 95% CI [0.17, 0.31], p<0.05. Study 4 (TABLE 2) compared African menthol cigarette smokers to Whites non-menthol cigarette smokers, OR=0.72, 95% CI [0.53, 0.97], p=0.031. For another 4 studies, they got non-significant results but still revealed such an association. Conclusions: Causes for African American smokers’ high preference over menthol cigarettes were identified as: tailored marketing strategies; physical properties of menthol cigarette (taste, smell); and demographic/social/psychological/cultural/attitudinal causes. There were significantly lower quitting rates for menthol cigarette smokers compared to non-menthol cigarette smokers at least among African American smokers. For menthol cigarette smoking cessation interventions, whether or not a ban on menthol would be implemented or not, comprehensive programs that include educational program, clinical menthol cigarette smoking cessation aids, taxation for price control, and smoke free and related regulations are needed. At last, China should learn experiences from the US regarding analysis of preference and possible clinical, educational, and policy interventions for menthol cigarette smoking cessation and prevention. / published_or_final_version / Medicine / Master / Master of Public Health

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atisfaction with diabetes care, perceived feelings of empowerment to participate in self-care management, and glycemic control in a sample of older African American men and women with diabetes. A descriptive correlational quantitative design was used. The participants in this study were 73 men and women of African descent who were at least 50 years, English speaking, and diagnosed with diabetes for at least one year. The participants were asked to complete three survey instruments: the Patient Satisfaction Questionnaire-18 (PSQ-18), which measured how satisfied the participants were with their medical care; the Diabetes Empowerment Scale-Short Form (DES-SF), which measured attitudes towards diabetes and self-management of diabetes; and a demographic form, which collected data on the demographics of each participant. The most recent hemoglobin A1c (HbA1c) of each participant was obtained from the medical records. The correlations between HbA1c, DES, and the PSQ-18 subscales were exam ined. The study data indicated all correlations were statistically significant and negative with one exception. There was no correlation between HbA1c and time spent, a satisfaction subscale. Approximately half the participants were high school graduates, married, and reported being born in the Caribbean. Most had primary care physicians, but less than half reported attending a diabetes education program. The average BMI was 33.0. The findings of this study indicated older African adults who reported higher satisfaction with the care provided by their health care provider reported feeling more empowered to participate in diabetes self-care and reported lower HbA1c levels, suggesting better glycemic control (R2 = .39; P=<.001). / The implications of this study are that feeling empowered to participate in diabetes self-care management may result in improved glycemic control. Positive diabetes outcomes have been linked in the literature with persons feeling empowered to participate in diabetes self-care. The significance of the findings from this study is that given the relationship between empowerment and glycemic control, nurses should support the empowerment model of diabetes teaching. Diabetes education should provide written materials that are culturally sensitive for African American elders. / by Bridgette M. Johnson. / Thesis (Ph.D.)--Florida Atlantic University, 2012. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2012. Mode of access: World Wide Web.

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This dissertation seeks to incrementally explain the impact of individual, interpersonal, and environmental levels of risk upon HIV/STI incidents among heterosexual African American serodiscordant couples residing in four metropolitan cities. Using archival data from a cluster-RCT (Project EBAN) and governmental surveillance reports, analytic methods that can model heterogeneous pathways within and across each level of risk were used. Findings from this dissertation revealed unique patterns and pathways via which African American females in serodiscordant relationships contracted HIV/STI.

Health disparities among rural African Americans include disproportionately higher morbidity and mortality rates associated with cardiovascular disease. Interventions designed to decrease cardiovascular risk can potentially improve health outcomes among rural, underserved communities. The purpose of this study was to test the effect of a cardiovascular health promotion intervention among rural African Americans. An experimental study randomized by church clusters was done in two rural counties in northern Florida. A total of 229 participants, 114 in the intervention group and 115 in the control group, were recruited from twelve rural African American churches. The pretest-posttest design included instruments chosen to measure cardiovascular health habits and knowledge as well as changes in produce consumption, dietary fat intake, and exercise using the major components of the Integrated Model of Behavioral Prediction: intentions, norms, attitudes, and self-efficacy. Linear mixed model was the statistical test used to detect the program effects. Participants who received the intervention had significant increases in scores for the cardiovascular health habits (p < .01) and health knowledge (p < .01) variables compared with the control group. There were also significant group differences regarding intentions to increase produce consumption (p < .01) and reduce dietary fat intake (p < .01). The cardiovascular health program was associated with other statistically significant results including produce consumption attitudes (p = .01) and norms (p < .01), dietary fat attitudes (p = .04) and norms (p < .01), and exercise attitudes (p < .01). There were also significant results found for perceived behavioral control/self-efficacy regarding increasing produce consumption (p < .01), reducing dietary fat intake (p = .03), and increasing exercise (p = .01). Compared to the control group, the cardiovascular health promotion intervention was effective in fostering positive health effects for most of the variables measured. The findings supported the theoretical framework used for guiding the study, the Integrative Model of Behavioral Prediction Nurse-led health promotion interventions within church settings can be effective means for reducing overall cardiovascular risk and health disparities among rural African American populations. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

In light of health disparities involving African Americans having disproportionately high rates of obesity, type II diabetes, cancer risk, heart disease and hypertension, the study was conducted with an all-Black adult sample (n= 470). Some 53.0% were female and the sample had a mean age of 32 years. The study evaluated the Knowledge of Physical Activity and Dietary Intake Guidelines Survey (KOPA-DIGS-40) as a new True-False knowledge test—with all True items. The study found moderately high levels of knowledge using the KOPA-DIGS-40. Findings using paired t-tests found evidence that ratings for (1) knowledge of guidelines and (2) self-efficacy for adherence to guidelines were significantly higher after taking the test. The study found noteworthy predictors of a higher KOPA-DIGS-40 score to be older age, higher education, and higher Body Mass Index. The study focused on three time periods (1-before the COVID-19 pandemic, 2-during the pandemic, 3-currently) and ratings on four health dimensions (1-physical health, 2-mental/emotional health, 3-physical activity level, 4-eating a healthy diet). Findings showed declines on the four dimensions during the pandemic, yet by Spring 2023 there were significant improvements—with a return by Spring 2023 to pre-pandemic levels. Findings suggested evidence of resilience after experiencing the stress of a global pandemic. Thus, a resilience theory and framework may be vital in guiding a future era of health disparities research with African Americans. Further, the study found an increase in social support during the pandemic, which continued into their current lives. Future research should continue to utilize the innovation of the genre of research reflected in this study’s use of the new Knowledge of Physical Activity and Dietary Intake Guidelines Survey (KOPA-DIGS-40)—as a True-False test with all True items; this follows from evidence the KOPA-DIGS-40 served as a brief online e-health intervention associated with increases in (1) knowledge of the guidelines and (2) self-efficacy for adherence to physical activity and dietary intake guidelines. Given the high rates of obesity, type II diabetes, cancer risk, heart disease and hypertension for African Americans, the findings make an important contribution to the literature—while suggesting future directions in research and interventions.