African Americans diagnosed with diabetes are less likely to self-manage diabetes-specific modifiable risk factors. As a result, utilization of healthcare services occurs at a greater rate than other racial groups, and thereby incurs higher than expected healthcare costs. This ethnographic study explored the elements of diabetes educational material African Americans in a large city in the southern part of the United States found most useful to facilitate self-management of their disease. Bandura's self-efficacy theory provided the theoretical framework. Research questions addressed the preferred educational content, layout of material, and methods for educational delivery and caregiver support. A purposive sample of 30 African Americans with diabetes who had engaged in diabetes education classes participated in this study. Data were collected through in-depth personal interviews, which were inductively coded and then categorized around emergent themes. A key finding of this study is that participants preferred group learning formats, but perceived educational material to be confusing and difficult to understand. They also expressed some preferences for the use of color, pictures, and presentation of graphical information that may provide the basis for a revision of educational materials. Interestingly, participants indicated a tendency to seek out church members rather than family for support. The positive social change implications of this study include recommendations to healthcare professionals to adopt educational curricula that reflect cultural nuances and needs of target populations in order to support better health outcomes for at-risk populations and cost efficiency improvements.

<p><italic>Bodily Trespass</italic> situates the fantastic as a discourse of spatial production in twentieth-century black American literature. Eruptions of the fantastic in realist and surrealist narratives index and ameliorate the spatial constriction that informs black American subjectivity from the Middle Passage up through to the contemporary carceral state. The black fantastic is a narrative response to a spatial crisis that is corporeal and ontological. As a literary mode, in the Todorovian sense, the fantastic identifies the real as a production of the "unreal" and calls attention to ideological and institutional apparatuses that sustain the dominant order. Taking Pauline Hopkins' turn of the twentieth-century serial <italic>Of One Blood, Or, The Hidden Self</italic> as a point of departure, this project examines the fantastic as a discourse of Pan-Africanism during a period Farah Griffin describes as the "nadir" of post-emancipation black life. Hopkins reaches outside of U.S. borders suturing Ethiopia to America in order to fashion a new and "rival" black geography that challenges the eradication of black legal, civic, and social space.</p><p>In the postwar years, the production of imaginative space extends to the task of recording and refuting the racial discourse that articulates urbanity. Chester Himes' <italic>The Real Cool Killers</italic>, Ann Petry's <italic>The Street</italic>, and Gwendolyn Brooks' <italic>Maud Martha</italic> depict racially encoded urban geographies as corporeally informed psychosocial "interfaces." These novels identify cartographic locution as a strategy for spatial occupation and psychic rehabilitation. James Baldwin's "Sonny's Blues" and Ralph Ellison's "The King of the Bingo Game locate in the sonic a blueprint for refashioning the space of the modern metropolis according to a logic of interiority. Baldwin and Ellison identify the fantastic as a discourse of aurality that alters the texture of space by channeling what I call "scalar consciousness," a heightened awareness of the ways in which one might manipulate scale in the service of spatial production. Meditations on belonging, displays of corporeal violence, discourses of Africanity, and the identification of the aural as a pathway for liberation illustrate, in all these works, the black fantastic's rootedness in spatial production, subject formation, and resistance to a dehumanizing social order.</p> / Dissertation

African American men have the highest prostate cancer occurrence and deaths of any population, yet many are unaware of screening opportunities or prognoses if diagnosed with the disease. The focus of this study was to learn whether a web-based prostate health education decision aid would increase prostate cancer knowledge, declared intention to be screened, and the likelihood of scheduling a prostate-specific antigen (PSA) test. The transtheoretical model of behavior change served as the theoretical framework for the study to assess readiness to adopt new behaviors. A total of 128 African American men between the ages of 40--65 without a history of prostate cancer participated in the study and were divided into 2 nonequivalent groups. The control group had 48 participants, and the intervention group had 80. After reviewing the web-based intervention, participants completed a demographic questionnaire, The Prostate Knowledge Questionnaire, and an Intent-to-Screen Tool. Mean differences in knowledge change were compared while adjusting for covariates using least squares regression. There was no significant improvement in the Prostate Knowledge Change score between the experimental and control groups. Therefore, the alternate hypothesis cannot be accepted. The social change implications suggest that the web-based decision aid studied in this project may not be the best tool to increase knowledge about prostate cancer screening. Therefore, more research is needed regarding ways to reach and inform African American men about the pros and cons of prostate cancer screening to foster informed decision making.

Even with access to well-known breast cancer treatment centers, older African American women continue to have higher breast cancer mortality compared to their European American counterparts. Researchers have theorized relationships among diagnostic delay, socioeconomic status (SES) factors, beliefs, culture, and breast cancer mortality in African American women ages 40 to 64, but these same relationships among African American women ages 65 to 80 have not been investigated. The purpose of this qualitative study was to describe older African American women's experiences with abnormal mammograms. The quality-caring model and critical race theory were used through narration to show the association of structure and process within the context of race. Purposeful, criterion-based sampling was used to select and interview 12 African American women ages 65 to 80 who had an abnormal mammogram result after breast cancer screening (BCS) within the previous 2 years. Through narrative analysis with triangulation it was demonstrated that clinical and social systems within the process of BCS affected the women's perceptions of providers and outcome. Their independence, motivation, health outlook, and spiritualistic beliefs kept them adherent to BCS and longterm follow-up. Health promotion activities were supported by family, friends, and spirituality. Variations in mammography practices and poor provider communication were obstacles to health maintenance. Positive social change is supported through health care providers' understanding of the barriers that impede older African American women's follow-up of abnormal mammogram results. Removing these barriers may assist in the reduction of breast cancer mortality.

Over the past 30 years there has been an increase in socioeconomic inequities between Black and White persons in the United States. Some research suggests that political ideology, which in turn impacts political competition levels, may at least partially explain these disparities, though the body of academic literature in this area is sparse. Little is known about how Black political ideology is formed by perceptions of inequality. The purpose of this study was to examine the phenomenon of Black political ideology, political competition, and socioeconomic status to determine how political competition relates to social inequities between Blacks and Whites. The theoretical framework of the study was Lockean social contract theory. The overarching question guiding this study explored how competition could better defend natural rights to reduce social disparities and the obligations of government to equally protect, similarly to the protections of government historically extended to Whites. Multiple and multivariate regression models were developed using data from the 2010 General Social Survey, the 2010 American Community Survey, and the presidential election results of 2008. Results showed no significant relationship between Black beliefs of inequality with Black political ideology and that high political competition rates might contribute to the increasing Black/White socioeconomic gaps. Contrary to economic competition models developed through Locke's social contract, there was no evidence that political competition reduces socioeconomic inequities between Blacks and Whites. The implications for positive social change include education of policy makers that higher political competition rates in their states contribute to lower socioeconomic outcomes for Blacks.

Cultural beliefs on healthcare in the 21st century by the African immigrants in the United States have contributed to the severity of illnesses in their communities. The results of this research identified the healthcare barriers experienced by members of the Bronx Ghanaian Immigrant Muslim Community (BGIMC) in New York City. The purpose of this research was to investigate the influence of education, immigration status, health insurance status, and cultural beliefs on the BGIMC members' perceived access and willingness to use healthcare services for various ailments. A sample of 156 male and female members of the BGIMC completed the survey questionnaire. The study was grounded in the conceptual frameworks of critical theory and complexity theory. The results of logistic and linear multiple regressions indicated that those with insurance were 9 times more likely to report that they had access to healthcare than those who did not have insurance. Additionally, those with health insurance were almost 7 times more likely to report using healthcare services in the past 12 months. Results of the multiple linear regressions indicated that immigration status, health insurance status, and education levels did not predict willingness to use healthcare when an arm was broken, nor did they predict willingness to use healthcare for a severe fever. However, immigration status, health insurance status, and education levels did predict willingness to use healthcare when experiencing dizziness. Understanding the social and cultural factors related to use of health care services will lead to tailored health insurance and access initiatives for the BGIMC; this increased understanding will also promote positive social change in their community and serve as a model for other African communities in the United States.

Although many studies have been conducted on the increased pressure and stress facing women who are trying to fulfill work and family demands, little is known about African American women in executive positions and their perspectives about work-life balance. A particular gap in the research literature exists on the lived experience of African American nonprofit executive women in maintaining work-life balance. The conceptual framework of this phenomenological study was the bidirectional frame of both work interfering with family and family interfering with work. Data were collected through semistructured telephone interviews of 12 African American women ages 30 to 45 and with children under the age of 18 who work as full-time executive directors for nonprofit organizations in the Northeastern US. The data from the transcribed interviews were stored, coded, reported in themes, and summarized by using the data analysis program HyperRESEARCH, followed by member checking with the participants. The participants included suggestions to improve the work-life balance for nonprofit executive women, such as exercising, networking and strong family support, delegating and scheduling work responsibilities, and utilizing flexible work schedules; however, it was clear from the interviews that the participants were not practicing the suggestions they provided to help balance work-life activities. The participants found it difficult to combine their own work-family responsibilities because of the time constraints at work. The implications for positive social change include informing organizations of the need to recognize the importance of family-friendly policies and flexible work arrangements, and to implement them in the workplace.

African American men have been incarcerated at unprecedented rates in the United States over the past 30 years. This study explored how African American females experience adverse psychosocial responses to separation from an incarcerated mate. The purpose of this qualitative grounded theory (GT) study was to construct a theory to explain their responses to separation and loss. Given the paucity of literature on this topic, helping professionals may not understand this problem or know how to support these women. Disenfranchised grief and the dual process model of bereavement were used as a theoretical lens for this study. Data were collected using semi-structured interviews conducted with 20 African American women over the age of 18, from the Washington D.C. metropolitan area, and who had incarcerated mates. Systematic data analysis revealed that women in the sample experienced grief similar to losing a loved one through death. They also were found to engage in prolonged states of social isolation, emulating their mate's state of incarceration. As a result of this study, a grounded theory of symbolic imprisonment, grief, and coping (SIG-C) was developed to answer this study's research questions and explain how loss occurs on psychological, social, symbolic, and physical levels. The findings from this study may promote positive social change by informing the human services research community of SIG-C and assisting helping professionals with a basis for context-specific support for affected women to contribute to their well-being during their mate's incarceration.

In 2009, 713,220 new cases of cancer were diagnosed for women in the United States with more than a quarter million deaths. African American women and lesbians exhibit behavioral risk factors as well as diminished access to and utilization of breast cancer screening that reduces opportunities for early detection. This secondary analysis of a national convenience-based study examined screening compliance among 647 African American lesbian and bisexual women. Barriers to accessing screening represented the theoretical framework for this study. Bivariate chi square analysis was used to assess the association between independent variables: sociodemographic characteristics; participation in wellness activities; sexual orientation/gender identity; and experience with health care providers and the three dependent breast cancer screening compliance variables: breast self-examination (BSE), clinical breast examination (CBE), and mammography screening. Statistically significant associations between dependent and independent variables at the .05 level were further analyzed with logistic regression. Results of the ten regression models found that BSE was predicted by socioeconomic characteristics and participation in wellness activities. Compliance with CBE guidelines was predicted by sociodemographic characteristics, wellness activities, sexual orientation/gender identity and provider experience. Sociodemographic variables and provider experience also predicted mammography screening. Overall compliance was predicted by sociodemographic characteristics, namely insurance status. The social change implications of this research are an improved understanding of African American lesbian and bisexual women's screening behavior and guidance toward interventions that can improve and breast cancer screening compliance with guidelines.

Juvenile delinquency continues to be a major social problem in the United States. One of the more salient problems with the juvenile justice system in the United States is its staggering incarceration rate, which poses a significant problem for youth exposed to the juvenile justice system, and the community as a whole. The purpose of this qualitative case study was to understand the perspective of the program facilitators about the effectiveness of the restorative justice program in reducing recidivism for African American males aged 12 to 17 in Baltimore City's urban community. This study relied upon restorative justice theory as conceptualized by Braithwaite as the theoretical framework. Using intrinsic case study design, data were collected from 7 restorative justice facilitators, who participated in face-to-face interviews using semistructured, open-ended questions. Miles and Huberman's qualitative content analysis was used to analyze the data and to record emerging themes and patterns. The key finding of this study indicates that facilitators believe restorative justice results in a reduction of the recidivism rate specifically through the conferencing program when Braithwaite's reintegrative shaming is incorporated into the process. According to the program facilitators, the conferencing program is effective in reducing juvenile recidivism as it promotes transparency and openness to all stakeholders through being very clear and upfront on all levels with the juveniles, parents, and volunteers. As such, there are implications for positive social change by involving all the stakeholders---family, community, policy makers, and juvenile justice practitioners---that may result in reduced incidences of juvenile offending, thereby promoting safer communities.