Purpose: This DNP project examines the effectiveness of a brief educational presentation to improve cultural competency care for obesity among African Immigrants. This project focused on providers at southwestern urban primary care clinic to become culturally competent in caring for African immigrants with obesity. The findings and recommendations of this project also serve as resource for other providers locally and nation-wide who provide care for African immigrant population. Method: Utilizing a purposeful sampling method, quantitative pre-test and post-test questionnaires were used to evaluate cultural knowledge and intended clinical practices of participants (N =5), feasibility and satisfaction of the educational activity. Aggregate data collected from the pre-and post-test questionnaires were analyzed and discussed through thematic and descriptive analysis. Results: All participants demonstrated significant enhancement in cultural competency in knowledge in regard to nutrition, physical activity and linguistics/communication, body image perception and obesity management in African cultural context. Also, one hundred percent (n=5) of the participants recorded very high level of satisfaction of the intervention content and delivery. Conclusion: The education intervention was successful in enhancing providers’ cultural knowledge and competence in caring for African immigrants with obesity. It also serves as valuable initiative to further develop culturally competent care based on evidence-based practice to enhance the quality of care delivery for African immigrants as well as other vulnerable minority populations. For the over two million African Immigrants in the United States, obesity and its related complications is a constant struggle for this minority population. Health disparities exist for all minority groups suffering from poverty in the US, and the immigrant population is at a higher risk for these disparities due to the slower rate of acculturation. The effort to address obesity among immigrants especially those of African descent is significantly influenced by providers’ cultural knowledge, sensitivity and competency in healthcare delivery. This project outlines the development, implementation and evaluation of a brief PowerPoint presentation aiming to educate healthcare providers on cultural competency and appropriateness in caring for African Immigrants with obesity.

The prevalence of type 2 diabetes (T2D) continues to rise and is predicted to increase to 30 million people by 2030 in the United Sates alone. African Americans (AA) have one of the highest prevalence rates of T2D among all ethnic groups. African American Women (AAW) are 100% more likely to develop T2D compared with their white counterparts. The aim of this study was to quantitatively investigate the relationship of the perceptions of AAW not previously identified that could lead to a reduction in risk of T2D among AAW. A cross-sectional study of 183 AAW 20 to 65 years old was conducted to identify any correlation among the variables, using validated surveys. The participants were recruited via flyers and online. The health belief model and the theory of planned behavior served as the theoretical framework. Spearman's rho correlation was used to determine the strength of the correlations. The majority of respondents had moderate to high lifestyle and behavior changes relative to diet (59%) and blood sugar testing (93%), as well as low participation for exercise (62%). The majority of the AAW had low awareness of T2D severity (72%), low interference to daily activities (88%), and low social support for diabetes management (74%). A significant correlation was observed between healthy diet and severity, interference, outcome expectancies, and self-efficacy (p < .001). A significant relationship was found between exercise and severity, interference, outcome expectancies, and self-efficacy (p < .001). This study may inspire social change by creating awareness among healthcare workers regarding educational resources, environmental changes, and community interventions to reduce the economic burden associated with health care costs, to mitigate T2D, and to reduce health disparity.

Essential hypertension (HTN) has been and continues to be a serious public health problem across the globe, particularly among Black races, with an estimated morbidity rate of over 1 billion people and an estimated mortality rate of 9.4 million people worldwide. Essential HTN can lead to a host of chronic diseases including cardiovascular disease (CVD), stroke, myocardial infarction, brain damage, kidney failure, and retinopathy. The main purpose of this quantitative, descriptive, nonexperimental study was to investigate the association of physical inactivity, length of stay in the United States, immigrants' health status, and food security as risk indicators in the development of essential HTN among African-born immigrants after accounting for age and education. The conceptual framework for this study was the socioecological model of health (SEMH). A secondary dataset from the National Health Interview Survey (NHIS), for the year 2014, was used for this study, including data for Africa-born immigrants over the age of 40 who participated in the survey. Logistic regression was used for statistical analyses. The results of the study revealed that length of stay or years in spent in the United States have a significant association with the development of essential HTN. Results from this study could be used to promote positive social change by identifying and assessing challenges in implementing intervention programs meant to assist in controlling essential HTN among African-born immigrants and Black populations who are disproportionately affected by this condition.

Obesity is a chronic disease that is caused by a number of factors such as diet, genetics, physical inactivity, and poor dietary habits. This research focused on how income affects obesity among a target population in the African American community in Durham, North Carolina (NC). It has been noted that chronic diseases that are diet-related, for example, obesity, diabetes, hypertension, and high cholesterol, affect African Americans disproportionately, especially those who earn low income. Some studies have also reported that those who make higher income have higher rates of obesity. This inconsistency and gap in the literature prompted research on this topic. Therefore, the purpose of this research was to study the relationship between family income and obesity among African Americans. The study sought to address the key factors that contribute to low family income among African Americans in Durham, NC and the ways in those key factors contribute to obesity among African Americans in Durham, NC. This study implored a qualitative approach by using an individual interview method to glean the lived experiences of participants in Durham, NC. Thirty participants were interviewed and themes from the interviews were analyzed. The health belief model was chosen as the theoretical framework for this study to understand the data and explain beliefs, attitudes, and health behaviors. Key results indicated that low family income contributes to obesity. The study contributes to social change by recommending that policy makers advocate for an increase in national minimum wage, encourage educational approaches to prevent obesity, promote good eating habits, and promote adequate physical activity among African Americans.

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