Barbara L. Dancy

Correlates of Physical Activity in Urban Midwestern African-American Women

BACKGROUND African-American women are at higher risk than white women of cardiovascular disease and stroke. In addition, fewer African-American women reap the cardiovascular benefits of exercise, because of low physical activity. The study goals were to identify personal, social environmental, and physical environmental correlates of physical activity of urban-dwelling, Midwestern, African-American women and to obtain their recommendations for increasing exercise in their communities. METHODS A face-to-face interview (Women and Physical Activity Survey) covering personal, social environmental, and physical environmental correlates of physical activity was administered to 399 volunteer African-American women aged 20 to 50 years, living in Chicago. Physical activity was measured with questions on lifestyle and planned leisure-time activity (exercise) from the Behavioral Risk Factor Surveillance System. RESULTS The women were from a wide socioeconomic spectrum of education and income. Forty-two percent of the women met current recommendations for moderate or vigorous physical activity; 48% were insufficiently active; and 9% were inactive. The following groups of women were more likely to be physically active: women with at least a high school education; women with perceived good health; women who knew people who exercise; and women who viewed the neighborhood as safe. These findings were statistically significant. CONCLUSIONS Interventions that target urban African-American women must address the safety of the physical environment and personal and social environmental correlates of physical activity, and they should focus especially on inactive women who have less than a high school education or perceive themselves to be in poor health.

Correlates of physical activity in urban Midwestern Latinas

BACKGROUND Latinas (Latino women) are at higher risk than non-Latina white women of cardiovascular disease and stroke, primarily because of higher rates of obesity and type-2 diabetes mellitus. Increases in physical activity help control these cardiovascular risk factors, but a higher percentage of Latinas than white women are inactive. The study goals were to identify personal, social environmental, and physical environmental correlates of physical activity of urban-dwelling, Midwestern Latinas and to obtain their recommendations for increasing exercise in their communities. METHODS A face-to-face interview (Women and Physical Activity Survey) that covered personal, social environmental, and physical environmental correlates of physical activity was performed with 300 volunteer Latinas (242 in Spanish, 58 in English), aged 20 to 50 years, living in Chicago. Physical activity was measured with questions on lifestyle and planned leisure activity (exercise) from the Behavioral Risk Factor Surveillance System survey. RESULTS The sample consisted of urban-dwelling Latinas who were primarily from Mexico and who spoke predominantly Spanish. The breakdown was as follows: 36% met current recommendations for moderate or vigorous physical activity, 52.3% were insufficiently active, and 11.7% were inactive. Physical activity was higher among younger women, married women, and women with the following characteristics: had some confidence about becoming more active, saw people exercising in the neighborhood, attended religious services, or lived in areas with heavy traffic. CONCLUSIONS Interventions need to focus on encouraging Latinas, especially those who are older, to reach the level of physical activity recommended to benefit health. The church may be a suitable community setting for initiating programs that provide women with the knowledge, skills, and motivation to become more active so that they can bring back to the larger Latina community.

Outcomes of a Home-Based Walking Program for African-American Women

Purpose. As compared with minimal treatment (MT), to determine the effectiveness of a home-based walking intervention enhanced by behavioral strategies targeted and tailored to African-American women (enhanced treatment [ET]) on adherence, physical activity, fitness, and body composition at 24 and 48 weeks. Design. Using a quasi-experimental design, treatments were randomly assigned to one of two community health centers. Setting. The centers were in predominately African-American communities. Participants. Sedentary women (156 ET, 125 MT) 40 to 65 years were recruited within a 3-mile radius of each center. Intervention. Both treatments had the same orientation. The ET group had four targeted workshops followed by weekly tailored telephone calls over 24 weeks. Methods. Generalized linear mixed models were used to test effects of treatments on adherence, physical activity, aerobic fitness, and body composition. Results. Adherence was significantly higher in the ET than the MT group and was related to the number of workshops attended (r = .58) and tailored calls (r = .25) received. On-treatment analysis showed significant postintervention improvement in waist circumference and fitness in the ET group; however, these improvements were not statistically different between the two groups. Intent to treat analysis showed a significant increase in fitness, decrease in waist circumference, and no change in body mass index in both treatments. Conclusion. Findings suggest the potential impact of workshop group support on adherence in African-American women.

The context of risky behaviors for Latino youth.

Background and significance: Alarming numbers of Latino teens continue to engage in behaviors that place them at risk for pregnancy and sexually transmitted infections including HIV. Design: This study includes data from six focus groups with 38 Latinas. The primary purpose of the focus groups was to elicit antecedents to unsafe sex to guide the development of an HIV-prevention intervention for adult Latinas. The data were reanalyzed using the rich content that had been elicited about community teens. Findings: Six major themes were identified surrounding teen issues and concerns. These are (a) the culture of risky behaviors; (b) romance: illusion and reality; (c) parental involvement: a protective factor; (d) HIV: knowledge versus ignorance; (e) HIV among youth: fear, stigma, and anger; and (f) saving our youth. Implications: A multimodal approach is required to help teens adopt healthy life styles, remain in school, and have a positive relationship with their parents.

RELATIONSHIP BETWEEN COPING STRATEGIES AND DEPRESSION AMONG EMPLOYED KOREAN IMMIGRANT WIVES

Coping strategies, such as working harder and negotiation, may have an effect on depression for employed Korean immigrant wives. Additionally, income and education have been associated with depression in previous research. A cross-sectional survey research design was used to explore which coping strategies and demographic variables were significantly related to depression for employed Korean immigrant wives. The results of multiple regression analysis revealed that coping strategies and demographic variables accounted for 24% of the variance in depression. Specifically, as wives worked harder cleaning the house, their depression increased, whereas when they negotiated with their husbands, they were less likely to be depressed. To enhance negotiation among Korean wives, mental health nurses need to work within the community to foster the development of cultural and traditional norms that sanction negotiation between husbands and wives.

Factors Contributing to the Development of an HIV Ministry Within an African American Church

&NA; Having an HIV ministry within a church depends on the religious culture of that church. However, little is known about how a churchs religious culture influences an HIV ministry. This studys purpose was to examine how an African American churchs religious culture supported the development, implementation, and maintenance of an HIV ministry within the church. An ethnographic case study research design was used. Data were collected through interviews, nonparticipant and participant observations, review of pertinent documents, and survey of congregants. Results revealed the following as important for an HIV ministry: (a) a belief in helping others and treating everyone with respect and dignity, (b) feelings of compassion toward individuals infected with HIV, and (c) HIV education. This information can assist in developing interventions to enhance the African American church movement toward HIV ministries.

Using Multilevel, Multisource Needs Assessment Data for Planning Community Interventions:

African Americans and Latinos share higher rates of cardiovascular disease (CVD) and diabetes compared with Whites. These diseases have common risk factors that are amenable to primary and secondary prevention. The goal of the Chicago REACH 2010–Lawndale Health Promotion Project is to eliminate disparities related to CVD and diabetes experienced by African Americans and Latinos in two contiguous Chicago neighborhoods using a community-based prevention approach. This article shares findings from the Phase 1 participatory planning process and discusses the implications these findings and lessons learned may have for programs aiming to reduce health disparities in multiethnic communities. The triangulation of data sources from the planning phase enriched interpretation and led to more creative and feasible suggestions for programmatic interventions across the four levels of the ecological framework. Multisource data yielded useful information for program planning and a better understanding of the cultural differences and similarities between African Americans and Latinos.

Condom Use Predictors for Low-Income African American Women

The purpose was to investigate whether an HIV-prevention curriculum and a health maintenance curriculum produced different rates of change in reported consistent condom use and to explore what mediating variables predicted reported consistent condom use over time. A longitudinal crossover research design with extended posttest observations was used with a sample of 279 African American women. After pretesting, women received the designated curriculum and were posttested at completion, 3, 6, and 9 months. After the 9-month posttest, the curriculum was switched, and the above procedure was repeated. Using SAS macro GLIMMIX, the data revealed that the HIV curriculum yielded higher consistent condom use than did the health maintenance curriculum and that the mediating variables that predicted consistent condomuse over time were self-efficacy for low-risk HIV behavior, HIV-related community behavior, and social norms. Enhancing consistent condom use over time may require the promotion and reinforcement of these mediating variables.

A primary health care intervention to mobilize health workers for HIV prevention in Malawi

For the last 4 years we have implemented a model to mobilize rural health workers as leaders for HIV prevention in Malawi. We use a conceptual framework that integrates the World Health Organization’s (WHO) primary health care (PHC) model, the social‐ cognitive model of behavioural change, and contextual tailoring of the intervention. Health workers are potential rural HIV prevention leaders because they have community trust and respect. However, their leadership potential has been limited by both health system barriers such as inadequate workers, supplies, and training and personal barriers such as risky occupational and personal behaviours. In the first phase of the project, we developed collaborative relationships and conducted qualitative research to adapt a peer group intervention for rural health workers and community members. In the ongoing second phase, we trained the health workers, who then volunteered and provided the intervention to adults in the communities their health centres serve. The intervention was adapted for young people through a community participatory process. Currently the adapted intervention is being offered to young people. As a guide to replication, we discuss barriers encountered in implementing this collaborative project and how we overcame them. This project demonstrates that health workers can be effective leaders for community AIDS prevention in African countries. The primary health care model offers a feasible, cost-effective and sustainable approach to maximizing health worker-community collaboration to reduce the spread of HIV.

College Student Engaging in Cyberbullying Victimization: Cognitive Appraisals, Coping Strategies, and Psychological Adjustments

The studys purpose was to explore whether frequency of cyberbullying victimization, cognitive appraisals, and coping strategies were associated with psychological adjustments among college student cyberbullying victims. A convenience sample of 121 students completed questionnaires. Linear regression analyses found frequency of cyberbullying victimization, cognitive appraisals, and coping strategies respectively explained 30%, 30%, and 27% of the variance in depression, anxiety, and self-esteem. Frequency of cyberbullying victimization and approach and avoidance coping strategies were associated with psychological adjustments, with avoidance coping strategies being associated with all three psychological adjustments. Interventions should focus on teaching cyberbullying victims to not use avoidance coping strategies.