Crystal N. Piper

Spiritual coping, religiosity and quality of life: A study on Muslim patients undergoing haemodialysis

The number of haemodialysis patients globally is increasing and spiritual resources may help overcome adjustment problems among such patients. This study examined the relationships between spiritual/religious, demographic and clinical variables and quality of life among Iranian Muslims undergoing haemodialysis.

Trust, Medication Adherence, and Hypertension Control in Southern African American Men

We examined the relationship between trust in the medical system, medication adherence, and hypertension control in Southern African American men. The sample included 235 African American men aged 18 years and older with hypertension. African American men with higher general trust in the medical system were more likely to report better medication adherence (odds ratio [OR] = 1.06), and those with higher self-efficacy were more likely to report better medication adherence and hypertension control (OR = 1.08 and OR = 1.06, respectively).

Disparities in access to care among asthmatic children in relation to race and socioeconomic status.

Asthma is one of the leading chronic illnesses among children in the United States. International epidemiological studies have also shown asthma prevalence is an increasing problem. The objective of this study was to examine the correlates of access to care among asthmatic children age 0—17 in the United States. This is a retrospective study and secondary data analysis of the 2000 National Health Interview Survey. Parametric testing using univariate, bivariate, and multivariate analyses were performed to examine health care utilization among children with asthma in the United States. It was found that Black children were highly associated with not visiting a general doctor in the past 12 months (OR 0.47; 95% CI 0.30, 0.75). Uninsured asthmatic children were associated with the risk of not seeing a general doctor in the past 12 months (OR 0.40; 95% CI 0.23, 0.69). Our study findings indicate disparities among Black children with asthma and their ability to access appropriate health care services. Additional studies are required to identify factors that contribute to the temporal trends in asthma and country of origin.

Association Between Education and Domestic Violence Among Women Being Offered an HIV Test in Urban and Rural Areas in Kenya

The objective of this study was to examine the association between education and domestic violence among women being offered an HIV test in urban and rural areas in Kenya. A sample selection of women who experienced physical (n = 4,308), sexual (n = 4,309), and emotional violence (n = 4,312) aged 15 to 49 allowed for the estimation of the association between education and domestic violence with further analysis stratified by urban and rural residence. The main outcome of interest was a three-factor (physical, sexual, and emotional) measure for violence with the main predictor being education. Nearly half of all domestic violence, physical (46%), sexual (45%), and emotional (45%) occurred among women aged 15 to 29. After adjusting for confounding variables, women who resided in urban areas and had a postprimary/vocational/secondary and college/university education were 26% (OR = 0.74, 95% CI: [0.64, 0.86]), p < .001 and 22% (OR = 0.78, 95% CI: [0.66, 0.92]), p < .01 less likely to have experienced physical violence compared to those who had a primary education respectively. This was 17% (OR = 0.83, 95% CI: [0.73, 0.94]), p < .01 and 17% (OR = 0.83, 95% CI: [0.72, 0.96]), p < .05 less likely among women who resided in rural areas. A surprising finding was that women residing in rural areas with less than a primary education were 35% less likely to have experienced sexual violence (OR = 0.65, 95% CI: [0.43, 0.99]), p < .01 compared to those who had a primary education. These findings suggest that physical, sexual, and emotional violence were prevalent in Kenya among married and formerly married women. This study indicates that more research is needed to understand factors for HIV/AIDS among Kenyan women who have specifically tested positive for HIV or identified as AIDS-positive and the implications for women’s health.

Dietary, Physical Activity, and Lifestyle Behaviors of Rural African American South Carolina Children

Overweight and obese children continue to be a growing problem, and differences exist, especially among racial and ethnic groups. Even though a poor diet and lack of physical activity are attributable factors to being overweight among children, indications exists that geographic location may also be important. In rural areas in the United States, childhood obesity is often higher than the national average. This study analyzed dietary, physical, activity, and lifestyle behaviors of rural African American children and their risk for becoming overweight. This study is a cross-sectional convenience sample of 98 students from a rural county in South Carolina in 2002. Findings showed rural female children were significantly more likely than rural male children to engage in physical activity for at least 20 minutes per day (odds ratio, 5.57; p = .0056). Given the increase in the prevalence of obesity especially among minority populations, the need exists to develop culturally appropriate nutrition and exercise interventions to assistchildren in a healthy weight loss attempt. Increased prevalence of obesity and other diseases among African Americans warrants aggressive interventions to reduce risk factors in this vulnerable population.

A model-based educational intervention to increase physical activity among Iranian adolescents.

OBJECTIVE To conduct an evaluation of an educational program based on the health promotion model (HPM) and stages of change to improve physical activity (PA) behavior among Iranian adolescents. METHODS This was a group randomized controlled trial with 165 participants in two groups (intervention/control). Data were collected using self-reported questionnaires based upon HPM constructs (benefits and barriers of action, self-efficacy, activity-related affect, interpersonal influences, and situational influences). The stages of change scale was used to select eligible participants (were placed on precontemplation, contemplation, or preparation stages) and to assess the trend. After collecting baseline data, the intervention was administered to the participants and follow-up data was collected 3 months after intervention. RESULTS In all, 88 males and 77 females with a mean age of 13.99±0.4 participated in the study. The differences in all HPM constructs, except activity-related affect and social influences, were significant (p < 0.01) between baseline and follow-up measurements. Adolescents in the intervention as compared to the control group were placed in action (70%) or preparation (30%) stages at follow-up. Multiple regression analysis revealed that competing preferences, social norms, role models, (p < 0.001), and commitment to action plan can significantly predict PA behavior. The model accounted for 22.5% of the variance in PA. CONCLUSIONS The results suggest that educational interventions based on stages of change can have important implications for improving PA among adolescents in more constructs of HPM.

Beliefs and Perception of Risks of HIV Among Women That Have Never Been Tested for HIV in the United States

PURPOSE To assess womens attitudes, beliefs, characteristics, the perception of risks, and their relationships with not utilizing human immunodeficiency virus (HIV) testing services. METHODS This study is a retrospective study and secondary data analysis of the 2006 National Health Interview Survey. Parametric testing using univariate, bivariate, and multivariate analyses was performed to examine perception of HIV acquisition and the relationship with not utilizing HIV testing services among women in the United States. RESULTS More than half of the women in this study had never been tested for HIV (52.26%). In the multivariate analysis, using SAS callable SUDAAN, women who had not been tested for HIV that believed they had no risk of getting HIV were more likely to have never been married (odds ratio [OR], 0.37; 95% CI, 0.31-28.73; p = .0013). In addition, women who had never been tested for HIV that believed they had no risk of getting HIV were more likely to have less than a high school diploma (OR, 0.35; 95% CI, 0.15-0.78; p = .0022). CONCLUSION Findings from this study can lend themselves to the development of more efficient and sustainable interventions to prevent HIV infection and decrease high-risk behaviors among more susceptible populations and for the development of HIV testing policy.

Disparities Between Asthma Management and Insurance Type Among Children

Asthma is a chronic illness among children. Minority children may be vulnerable to asthma complications since more than half are from households that are poor or near poor, and some have no health insurance. Asthma management plans are important for the long-term treatment of asthma and beneficial for self-management. This study analyzed insurance type and the relationship between having an asthma management plan among children across all races with asthma. This study utilized the 2002 and 2003 National Health Interview Survey. Findings showed that whites were significantly more likely than Non-Hispanic blacks and Hispanics to have an asthma management plan (OR, 1.66; p = .0031). In this study, children who reported Childrens Health insurance Program (CHIP) coverage were twice as likely to have an asthma management plan (OR, 2.67; p = .0004). Mandating all insurers to provide an asthma management plan to children with asthma may reduce the race-based inequities and differences in asthma management plan status.

Multidimensional Fatigue Inventory in People With Hepatitis B Infection: Cross-cultural Adaptation and Psychometric Evaluation of the Persian Version

There is no valid and well-established tool to measure fatigue in people with chronic hepatitis B. The aim of this study was to translate the Multidimensional Fatigue Inventory (MFI) into Persian and examine its reliability and validity in Iranian people with chronic hepatitis B. The demographic questionnaire and MFI, as well as Chronic Liver Disease Questionnaire and EuroQol-5D (to assess criterion validity), were administered in face-to-face interviews with 297 participants. A forward–backward translation method was used to develop a culturally adapted Persian version of the questionnaire. Cronbachs &agr; was used to assess the internal reliability of the scale. Pearson correlation was used to assess criterion validity, and known-group method was used along with factor analysis to establish construct validity. Cronbachs &agr; for the total scale was 0.89. Convergent and discriminant validities were also established. Correlations between the MFI and the health-related quality of life scales were significant (p < .01). The scale differentiated between subgroups of persons with the hepatitis B infection in terms of age, gender, employment, education, disease duration, and stage of disease. Factor analysis indicated a four-factor solution for the scale that explained 60% of the variance. The MFI is a valid and reliable instrument to identify fatigue in Iranians with hepatitis B.

Individual and structural factors influencing HIV care linkage and engagement: Perceived barriers and solutions among HIV-positive persons

ABSTRACT To meet the National HIV/AIDS Strategy’s goals of reducing and preventing HIV transmission, understanding factors that shape HIV-positive persons’ care-seeking behaviors is critical. Accordingly, this study examined factors that affect HIV care linkage and engagement. Six focus groups were conducted with 33 HIV-positive persons living in North Carolina. A variety of factors influenced care behaviors, including: structural and policy factors, relationship with HIV care systems, and individuals’ personal characteristics. Participants also provided solutions for addressing specific factors to care. Improving clinical services and utilizing context-specific strategies can help facilitate greater care linkage and engagement.