This study addressed the long-standing crisis of Black severe maternal morbidity in the U.S., while the COVID-19 pandemic led to even worse outcomes. The purpose of the study was to identify significant predictors of the quality of patient-provider relationships during a birth hospitalization. The sample of Black women (N=182) gave moderate ratings for quality of patient provider relationships, and for level of trust, rapport, and communication with providers. Providers were rated as having a fair level of cultural sensitivity, competence, and humility—while 30.2% rated them as poor. For experiences of racism, discrimination and inequities in service delivery, combining categories of a “few times” and “many times,” 53.3% felt racially stereotyped or treated like a racial stereotype, 52.5% were treated with less respect than a White woman would have been, 39.7% were verbally abused or yelled at, 43.8% were scolded, ridiculed, mocked, and shamed, 47.2% felt belittled and put down, 42.7% felt threatened, coerced, lied to, and manipulated, and 46% felt their pain was not managed the same way as for a White woman. Women entered the hospital with risk factors of cardiovascular disease (20.3%), hypertension (23.6%), obesity (18.1%), and diabetes (13.7%). Further, 74.2% had COVID-19 in the past two years, 25.8% had long COVID-19, 34.1% had COVID-19 during their pregnancy, and 34.1% had COVID-19 at delivery. Medical events during their delivery hospitalization included hemorrhage (40.7%), blood clot (25.3%), and a hypertensive disorder of pregnancy (25.3%). Women had high rates (over 75%) of past year depression, anxiety, and trauma—with 68.1% receiving counseling; and higher rates (over 85%) the year post-partum—with 76.9% receiving counseling. Noteworthy significant predictors of a higher quality of patient-provider relationships were higher education, higher trust/ rapport/ communication with providers, and lower global racism/ discrimination/ inequities during service delivery—while entering the hospital with lower risk factors for pregnancy-related complications (69.8% of variance predicted). The study contributes to literature on the crisis of severe maternal morbidity for Black women in the U.S, as well as factors that need to be addressed to reduce it, while offering a cache of culturally appropriate measures for ongoing research.

Depression is one of the most widespread and disabling mental health disorders affecting adults worldwide, and Black women bear a disproportionate burden of this disorder. With its varied symptom presentation, depression can be difficult to diagnose. In addition, Black women may be less likely to report symptoms due to cultural stigma. The purpose of this dissertation is to examine the associations between social determinants of health and depressive symptoms using DNA methylation data and machine learning to predict depressive symptoms in Black women. Chapter 2 contains two comprehensive literature reviews: a scoping review of machine learning methods used to analyze omics data to classify depressed cases and healthy controls and a concept analysis of depression in Black mothers. Chapter 3 examines associations between social determinants of health, depressive symptoms, and DNA methylation. Chapter 3A focuses on socioeconomic deprivation; Chapter 3B focuses on perceived income inadequacy; and Chapter 3C identifies differential methylation associated with depressive symptoms. Chapter 4 utilizes supervised machine learning algorithms to predict depressive symptoms and perform feature selection. These chapters show the harmful effects that perceived discrimination can have on the mental health of Black women. Additionally, the results indicate that DNA methylation is associated with depressive symptoms, an area which requires further research.

The images in our world that render ideas of prejudice are reciprocally related to racism and sexism and have the ability to make us aware of how we base our evaluations of ourselves and others mainly on visual appearance. In the case of African American women in American society, this is magnified. My art is about my relationship to history and a personal understanding of obsessions with visual appearance. Through portrait painting, performance art and sculptural forms, I am attempting to express a personal interpretation or the collective cultural identity of African American women of my generation in the 21st, century.

Psychology / M. A. (Clinical Psychology)

Psychology / M. A. (Clinical Psychology)

The study explored the body image of Professional Black South African women, cultural expectations, and their experiences in Westernised working milieus, utilising a phenomenological approach and qualitative exploratory design, located within Constructionism. Data were collected through purposive sampling (and snowballing) through individual face-to-face voice-recorded semi-structured interviews with 11 participants in/around Gauteng. Analysis was done through content analysis utilising thematic networks (Attride-Stirling). Major findings: Western values have influenced participants; Lower weight and thinness do not automatically correspond with assumptions about HIV/AIDS, instead correspond with healthier lifestyle choices; Body shape not weight or size was the prominent area of focus for most participants; Clothes size determines perception of overweight; Overweight has consequences. Forty-five per cent of participants were content with their bodies, 18% dissatisfied/unhappy, 18% satisfied, one happy, one apathetic. Tswanas were generally smaller-figured; Zulus, Northern Sotho/Pedi, Xhosa in general traditionally expected full-bodied women. Overt expectations in the workplace were not found. / Psychology / Master of Arts (Psychology)

The study explored the body image of Professional Black South African women, cultural expectations, and their experiences in Westernised working milieus, utilising a phenomenological approach and qualitative exploratory design, located within Constructionism. Data were collected through purposive sampling (and snowballing) through individual face-to-face voice-recorded semi-structured interviews with 11 participants in/around Gauteng. Analysis was done through content analysis utilising thematic networks (Attride-Stirling). Major findings: Western values have influenced participants; Lower weight and thinness do not automatically correspond with assumptions about HIV/AIDS, instead correspond with healthier lifestyle choices; Body shape not weight or size was the prominent area of focus for most participants; Clothes size determines perception of overweight; Overweight has consequences. Forty-five per cent of participants were content with their bodies, 18% dissatisfied/unhappy, 18% satisfied, one happy, one apathetic. Tswanas were generally smaller-figured; Zulus, Northern Sotho/Pedi, Xhosa in general traditionally expected full-bodied women. Overt expectations in the workplace were not found. / Psychology / M.A. (Psychology)

Thesis (DPhil (Social Work))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: This is an exploratory study on the perceptions and experiences of African women in violent partner relationships. The study was conducted in two phases at Ilitha Community Psychological Centre at Ezibeleni Township near Queenstown. Since this is a qualitative exploratory study, in-depth interviews were conducted with a sample of twenty women. In addition a focus group interview was also conducted with five women from the same site in order to gain a better insight into the phenomenon of violence in partner relationships. A literature review that focused on the existing literature concerning African women in violent partner relationships was conducted. African women’s perspectives on the experiences of abuse were explored, a gender perspective based on radical feminist views was discussed and ethnicsensitive empowerment needs and the role of the social service practitioners were investigated. The findings suggest that many African women experience violence in partner relationships. They sustain physical, emotional and economic abuse. A patriarchal system, alcohol abuse, infidelity and failure to support the children financially have been cited as some of the reasons for abuse. Formal and informal social networks assisted these women to some extent. However, there is need for an ethnic-sensitive interdisciplinary training approach and a legal system that is accessible to rural women to prevent further battery. Various recommendations have been postulated. The study indicated a need for ethnic-sensitive empowerment programmes for the abused women, rehabilitative programmes for these women and for the abusers, and an effective legal system to curb violence in partner relationships. / AFRIKAANSE OPSOMMING: Hierdie studie, wat verkennend van aard is, handel oor die persepsies en ervaringe van Afrikavroue wat binne gewelddadige saamwoonverhoudings verkeer. Die studie is in twee fases by die Ilitha Community Psychological Centre en die Ezibeleniwoonbuurt naby Queenstown onderneem. Aangesien dit ’n kwalitatief-verkennende studie is, is diepgaande onderhoude met ’n eksperimentele groep van twintig vroue gevoer. Hierbenewens is fokusgroeponderhoude ook met vyf vroue van dieselfde buurt gevoer ten einde beter insig te verkry van die fenomeen van geweld binne saamwoonverhoudings. ’n Studie van relevante literatuur wat op bestaande literatuur ten opsigte van Afrika-vroue in gewelddadige saamwoonverhoudings betrekking het, is onderneem. Die perspektiewe van Afrika-vroue oor die wyse waarop hulle mishandeling ervaar, is verken. ’n Geslagsgebaseerde perspektief gebaseer op feministiese beskouinge is onderling bespreek en die behoefte aan etniessensitiewe bemagtigingsbehoeftes asook die rol van sosiale diensleweringspraktisyns het aandag geniet. Die bevindinge dui daarop dat ‘n groot aantal Afrika-vroue geweld binne saamwoonverhoudings ervaar. Hulle ondervind fisieke, emosionele en ekonomiese mishandeling. ’n Patriargale stelsel, alkoholmisbruik, ontrouheid, en gebrek aan geldelike versorging van die kinders binne die gesin, is genoem as sommige van die redes vir die mishandeling. Formele en informele netwerke het hierdie vroue in ’n sekere mate bygestaan. Daar bestaan egter ’n behoefte aan ’n etnies-sensitiewe interdissiplinêre opleidingsbenadering asook ’n regstelsel wat toeganklik is vir landelike vroue om verdere mishandeling te voorkom. Verskeie aanbevelings is gepostuleer. Die studie het aangetoon dat daar ’n behoefte bestaan aan etnies-sensitiewe bemagtigingsprogramme vir mishandelde vroue, rehabilitasieprogramme vir sodanige vroue asook vir diegene wat hulle mishandel, en ’n effektiewe regstelsel om geweld binne saamwoonverhoudings aan bande te lê.

No abstract available. / Thesis (Ph.D.)-University of Natal, Durban, 2003.

Infant mental health in South Africa has been receiving more attention in recent years. Mothers appear to be the main caregivers of infants but they face many psychosocial, economic and cultural challenges. There exists very little evidence suggesting that mothers living in shelters or institutions have access to the necessary support and education to help them to understand their circumstances and how this may impact on the attachment with their infant. The New Beginnings Programme, as an early intervention model, is aimed at improving attachment between mother and infant so as to reduce the potential risk of mental health problems later in life for the infants, the mothers and future generations. This evidence based intervention focuses on the mother and her capacity for mentalisation, which refers to the mother’s capacity to hold her infant in mind and recognise and respond to the inner states of the infant. The pilot study of the New Beginnings Programme within a South African context took place in two shelters in the Greater Johannesburg area. This particular study formed part of this bigger research effort. The aim of this study was to explore the experiences of the mothers who attended the New Beginnings programme. A secondary aim was to explore these mothers’ experiences of the programme within the context of living in a shelter. The adaptation of this programme to a South African context could contribute significantly to bridging the gap in mother-infant attachment which could influence the future mental health of the infant and their ability to foster ongoing healthy attachments later in life. This qualitative study used semi-structured interviews and a narrative analysis from the theoretical perspective of psychoanalytic attachment theory. Thirteen mothers from two shelters participated in this research study.