This meta-analysis investigated the difference in perceptions of health-related quality of life (HRQOL) among long-term early-stage breast cancer survivors (BCS). The comparison was between African American and European American women. Initial pilot searches suggested that enough studies existed for a meaningful meta-analysis of a BCS population at least 5 years post diagnosis. Only studies using the outcome measure HRQOL were included in the study; this yielded an initial sample of 212 study reports, with 56 reports entering the coding phase of the process. African American women were grossly underrepresented in this set of studies in comparison to the overall breast cancer population. Separate analyses of Medical Outcomes Study 36- Item Short- Form Health Survey, Quality of Life-Cancer Survivor and Quality of Life Index - Cancer Version III instruments were executed. However, no stringent comparison across instruments of the difference between the HRQOL of African American and European American women was possible. When African American women were included in the populations, researchers often did not report their data separately but rather included their data in an overall population and thus differences were masked. The data that were available, including qualitative studies for African American women, suggested that there was a lower perception of the quality of survival in some areas for African American women. These differences suggest the need for greater attention to the physical components of African American BCS. The results point to a need to improve African American participant recruitment in research and to use online databases as a results repository to improve data availability for analysis.

Researchers have revealed that rural African American communities, which have been adversely impacted by disasters, could minimize personal injuries and property damage by being prepared before a disaster strikes. Data from past studies have shown that social networks, such as faith-based organizations (FBOs), have been instrumental in assisting rural African American communities recover from disasters such as floods and fires. This exploratory qualitative case study addressed the research question: How a rural, FBO organized resources to build a community based, all-volunteer fire department. The conceptual framework for this study incorporated concepts from social network theory and social capital theory. Purposeful sampling was used to recruit 11 participants. Data were collected through interviews, newspapers articles, and church documents. Data were analyzed using inductive analysis and Colaizzi's method for determining emergent themes. Results revealed that community members lacked the knowledge and resources needed to build the fire department. Findings further revealed that the FBO was the hub of activities where social networks organized the social capital needed to engage, recruit, and unite members in building the fire station. The themes of determination, dedication, resilience, and persistence further revealed that community members used social networks and social capital to overcome obstacles to building the fire station. Findings from this study contributes to positive social change by providing information to human services professionals, government agencies, policy makers, and community members on how FBOs can be utilized as social networks that can leverage the social capital needed to prepare isolated, rural communities for disasters.

Little is known about health care professionals' perceptions of eating disorder etiology among African American (AA) women. The purpose of this quantitative research study was to examine the associations among health care professionals' race, cultural awareness, and perceptions of media influence on eating disorder-related factors in AA women. Festigner's social comparison theory; Bandura's social learning theory; and Garcia, Cartwright, Winston, and Borzuchowska's transcultural integrative model served as the theoretical frameworks for this study. Specifically, this study examined whether race and cultural awareness of health care professionals relate to their perceptions of the extent to which media influences AA women's eating disorders, and whether cultural awareness moderates the association between their race and media influences. Data were obtained through a researcher-created demographic questionnaire, the Multicultural Counseling Inventory, and a modified Sociocultural Attitudes Toward Appearance Scale-3 with a purposive sample of 49 participants. Data were analyzed using descriptive statistics, Spearman's Rho correlation, Pearson correlation, and a hierarchical multiple linear regression. Compared to their Caucasian American counterparts, AA health care professionals perceived greater media pressure on AA women's body image concerns. Additionally, participants' cultural awareness was positively correlated with their ratings of AA women's desire to have more athletic bodies. The implications for positive social change stemming from this study are directed at health care professionals as additional training may increase their awareness, early detection, diagnosis, and treatment of eating disorders among AA women.

Childhood obesity is a global concern among all ethnic groups. Childhood obesity is a problem that continues into adulthood, exacerbating the incidence of diseases such as diabetes or heart disease. The purpose of this phenomenological study was to explore, understand, and describe the perceptions and experiences of African American parents in the management and care of their obese or overweight children. This study used the health-belief model (HBM) as its theoretical foundation, focusing on the constructs of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. This research study used an interview tool and an 8-item demographic questionnaire to explore and describe how African American parents managed the care of obese children between the ages of 6 and 11. Interviews were transcribed and then inductively analyzed for themes. Parents reported having a difficult time deciding how to implement successful overweight strategies on a daily basis. Parents felt helpless in supporting their child's efforts to lose weight. Parents shared that their child and family members participated in weight-loss activities such as making diet changes and physical activities. The implication for social change from this study is in providing local public health leaders with increased understanding of the personal experiences of African American parents in the management of overweight children. Findings may assist in effective program development for the targeted population.

Osteoporosis is a serious disease which often brings pain, disability, hospitalization, and even death. An increasing number of studies have been conducted on the prevention and treatment of osteoporosis in White women, yet a paucity of research exists to explain disparities in screening and treatment of osteoporosis in Black women. This narrative study describes the perspectives of Black women regarding individual barriers to osteoporosis screening. The purpose of this study was to better understand the perspectives of Black women regarding prevention of and screening for osteoporosis. Selections included purposive, criterion sampling of 10 Black women who were 50 years and older, could speak and write English, and lived in Southeastern Virginia. Recruitment flyers were distributed to Black women who were members of 3 local churches. The conceptual framework for this study was the behavioral model of health services, which holds that individual's acceptance to use health service is partly controlled by that individual's predisposing, enablement, and need. Data were collected by in-depth face-to-face interviews and analyzed using open, axial, and selective coding. Four major themes emerged in this study including awareness of osteoporosis, knowledge of the screening, health beliefs, and sharing of information. While the narratives indicated positive effects from engaging in osteoporosis screening, there was a discrepancy in understanding the disease and explanations of screening results. This study addresses social change by identifying how awareness and knowledge may help Black women become more effective when they engage in osteoporosis screening, which can help to ensure health and a better quality of life.

Enrollment by African American students in U.S. colleges and universities has increased since 2009, but graduation and retention remains low for this group. Within the African American community, education is considered a central aspect of social empowerment; however, the effect of discrimination, bias, and stereotyping are key when considering achievement indices within a cultural framework. The coping mechanisms that African Americans have developed to combat discrimination, bias, and stereotype threat may contribute to poor performance in college. The purpose of this study was to examine the relationship between racial socialization and African American students' academic motivation, academic self-efficacy, and likelihood of attending graduate school. Drawing from self-determination theory, it was hypothesized that the variables have a positive relationship. A quantitative survey design was used. One hundred-three African American undergraduate students were recruited via convenience sampling to participate in an online survey. Results from a multiple regression analyses indicated no significant relationship between the variables. The findings from this study are not consistent with previous findings that indicate racial socialization has an impact on African Americans' academic performance and motivations, implying the need for future research to include multiple variables that might impact outcomes such as family functioning, access to educational resources, or peer association. Greater numbers of African Americans enrolled in undergraduate programs may, in turn, increase the pool of participants eligible to attend graduate programs. Future research can help parents, researchers, and practitioners better understand the diverse and unique needs of African American youths.

Even though there are high diagnosis rates of ADHD among young African American men, policy makers and parents have largely viewed the use of Ritalin as a psychotrop ic drug that raises public health concerns. African American parents may be reluctant to treat their children pharmacologically. Very few studies have fully explored the perceptions of African American men about the consequences of their Ritalin use as chi ldren. The purpose of this qualitative study was to explore the experiences of African American men who used Ritalin as children so that policy makers and parents of children with ADHD might better understand the social and public health implications of tr eatment options. The theoretical framework for this study included Anderson's cultural identity theory of drug abuse and Brady and O'Conno r's community organizing theory . Data were collected through semistructured interviews with 9 African American men who were prescribed Ritalin as children. These data were then inductively coded and analyzed using Braun and Clarke's thematic analysis approach. Participants believed that Ritalin helped them with focus in their academic endeavors and did not lead them to dr ug abuse or addiction . By giving voice to the experiences of this population , educators and policy makers can better assist parents who might be reluctant to give their child Ritalin as their fears about Ritalin prescriptions leading to drug abuse and addiction later in life may be less founded than some believe. This presents a social change advantage for all communities, especially those in low income areas.

In the United States, African-American residents are an underserved population with evidence of higher health disparities than those associated with any other race, contributing to escalating health care costs. Despite the absence of health promotion and wellness training, pastors in predominately Black churches accept the responsibility for addressing more than the spiritual needs of their church members. The purpose of this qualitative grounded theory research study was to explore the perspectives of African-American Christian pastors on giving health guidance and their lived experiences as health promotion advocates. A total of 10 African-American Christian pastors were voluntarily recruited from 3 southern U.S. states using both purposeful and theoretical sampling strategies. Interviewing was the main data collection method. Social cognitive theory along with grounded theory were used to examine the interactions based on participants' points of view, and inductive analysis was also used. The results indicated that pastors have knowledge of their congregational members' health challenges and goals and have achieved positive health outcomes. The pastors also agreed that seminary should incorporate more information on health and wellness into the curriculum. These findings suggest that pastors, who are faith-based resources outside of health care systems, need to be educated, equipped, guided, and groomed as health leaders to assist efforts to reduce or eliminate health care disparities. Members of the clergy, their church members, and surrounding community residents would all benefit from the knowledge, understanding, and development of skills to change their unhealthy lifestyle habits and effective self- management of chronic diseases to achieve positive health outcomes.

State standardized tests results indicated that between 2012 and 2016, fewer African American students at a rural, Title I elementary school met state standards in reading compared with other racial/ethnic groups of students. A gap in practice existed because the school and district had not conducted studies to understand teacher knowledge and practice as they related to teaching reading to African American students. The purpose of this qualitative case study was to address the problem and gap in practice by exploring elementary teacher knowledge and understanding of the learning needs in reading among African American students. Tomlinson's theory of differentiated instruction served as the conceptual framework for this study. Interview data were analyzed from 10 experienced elementary teachers using 2-cycle provisional coding and pattern coding, which revealed the themes that constituted the findings of my study: (a) teachers understanding of factors that contribute to underachievement in reading of some African American students, (b) professional development and preparation of teachers for teaching African American students, (c) classroom pedagogy for teaching African American students, (d) challenges that teachers encounter when teaching reading to African American students, and (e) resources and supports that teachers perceive as necessary for teaching reading to African American students. The findings indicated that elementary teachers would benefit from participating in professional development, which would help them better teach reading to African American students. The study and resulting project may affect local positive social change by increasing teacher knowledge about the learning needs in reading among African American students, leading to an eventual increase in reading achievement among African American students at the study school.

Obesity is a pandemic that has a substantial impact among African American women. Biological, social, and cultural acceptance of obesity, collectively referred to as biosociocultural factors, represents an obstacle to efforts to address this health risk among this group. The purpose of this study was to develop a better understanding of the relationship between biosociocultural factors and motivation to lose weight. Self-determination theory, objectification theory, and social learning theory formed the study's theoretical framework. The key research question concerned the extent to which the investigated constructs (BMI, internalized body image, and social networks) helped to explain motivation for weight loss among nonpregnant obese African American heterosexual or bisexual women who preferred to date and mate with African American men. The study used a quantitative and correlational cross-sectional survey design. Data were collected from a sample of 183 African American women with obesity. Survey components included a demographic questionnaire, Pulvers's Culturally Relevant Body Image Scale and Questionnaire, the Social Support for Eating Habits Survey, and the Dieting Readiness Test. Multiple regression analyses were used to examine the predictive strength of these factors (BMI, 3 components of internalized body image, and 4 components of social network) for motivation to lose weight. A statistically significant positive relationship was found between motivation to lose weight and 3 predictors (2 components of body image and 1 component of social network). Further examination indicated that body image was the most reliable construct predicting motivation to lose weight. Insights gained from this study may inform the development of culturally sensitive approaches to obesity prevention and intervention for this population.