Jean Anthony

The Culture of Pregnancy and Infant Care in African American Women: An Ethnographic Study

In Hamilton County, Ohio, the infant mortality rate for African American infants in 2002 was 18.1 per 1,000 live births compared with 14.4 for the United States. It is essential to engage community residents and leaders in identifying the underlying cultural factors contributing to this disparity. The purpose of the study was to explore the cultural contexts of prenatal and infant care practices among African American women of childbearing age living in an urban community located in Hamilton County, Ohio. This was an ethnographic community-based participatory research study. Seven participants were recruited for the study. Family support from mothers and sisters in obtaining needed resources related to pregnancy and child care emerged as the central theme. A strong family-based social network was core to the culture of pregnancy and infant care for these women. Nurses should consider developing family-centered interventions to reduce disparity in infant health.

African American Families on Autism Diagnosis and Treatment: The Influence of Culture

Cultural factors such as health care access and autism spectrum disorder (ASD) symptom interpretations have been proposed as impacting delayed diagnosis and treatment for African American children with ASD. A qualitative study of urban African American families caring for their child with autism was conducted with 24 family members and 28 ASD professionals. Cultural caring meant families protected their child from harm including potential or actual distrustful encounters, and took action for their child and community to optimize their child’s health and address the knowledge deficits of ASD within their community. Families and professionals believed cultural influences delayed families’ receiving and seeking appropriate health care for the African American child with ASD affecting timely autism diagnosis and treatment.

Reinvention of Depression Instruments by Primary Care Clinicians

PURPOSE Despite the sophisticated development of depression instruments during the past 4 decades, the critical topic of how primary care clinicians actually use those instruments in their day-to-day practice has not been investigated. We wanted to understand how primary care clinicians use depression instruments, for what purposes, and the conditions that influence their use. METHODS Grounded theory method was used to guide data collection and analysis. We conducted 70 individual interviews and 3 focus groups (n = 24) with a purposeful sample of 70 primary care clinicians (family physicians, general internists, and nurse practitioners) from 52 offices. Investigators’ field notes on office practice environments complemented individual interviews. RESULTS The clinicians described occasional use of depression instruments but reported they did not routinely use them to aid depression diagnosis or management; the clinicians reportedly used them primarily to enhance patients’ acceptance of the diagnosis when they anticipated or encountered resistance to the diagnosis. Three conditions promoted or reduced use of these instruments for different purposes: the extent of competing demands for the clinician’s time, the lack of objective evidence of depression, and the clinician’s familiarity with the patient. No differences among the 3 clinician groups were found for these 3 conditions. CONCLUSIONS Depression instruments are reinvented by primary care clinicians in their real-world primary care practice. Although depression instruments were originally conceptualized for screening, diagnosing, or facilitating the management of depression, our study suggests that the real-world practice context influences their use to aid shared decision making—primarily to suggest, tell, or convince patients to accept the diagnosis of depression.

A study of the level of knowledge about diabetes management of low-income persons with diabetes

Diabetes education has proven to be an effective intervention for the management of diabetes. Persons with lower education levels, the majority of whom have low incomes, receive less diabetes self-management education (DSME) than their peers. This study compared the diabetes knowledge level of low-income adults who did not have a high school diploma or general equivalency diploma with those who did. We conducted a survey among residents of 4 low-income neighborhoods in Cincinnati, Ohio, using a cross-sectional descriptive design. Surveys included information related to diabetes self-management and level of education. The only questions for which there was a significant difference between the 2 groups were those pertaining to the causes and treatment of hypoglycemia. Survey results were used to validate the need for a DSME program for low-income adults in Cincinnati, Ohio. A DSME program was developed specifically for persons with low literacy.

Recruiting and Keeping African American Women in an Ethnographic Study of Pregnancy: The Community-Based Partnership Model

The authors report here on the application of the community-based participatory research (CBPR) model to recruit and retain African American women in an ethnographic study of how urban African American women learn mothering skills and experience pregnancy. The project facilitated collaboration among academics, neighborhood leaders, and community agencies. Using the CBPR strategy, seven participants were recruited to and were retained in the study through two interviews, an average of 6 weeks apart.

Parenting African American Children With Autism The Influence of Respect and Faith in Mother, Father, Single-, and Two-Parent Care

Purpose: Parents are the most significant contributor to care of children with autism spectrum disorder (ASD), and as such research on African American parenting in ASD is conspicuously absent. Findings relevant to parenting are discussed from a study with urban African American families caring for children with ASD. Design: An ethnonursing study was conducted with 24 African American family members of children with ASD and 28 professionals. Data were analyzed and reported as themes. Findings: Two universal themes of were found of respect and faith in God and family that influenced parental care. Two diverse themes of mother’s watchful care and father’s protective care, along with differences in feelings of isolation and dependence on supports were found among single- and two-parent families. Discussion and Practice Implications: When health care professionals increase their knowledge and understanding of cultural practices in the parental care of children with ASD, they provide health care that is culturally congruent.

Equipping African American Clergy to Recognize Depression.

ABSTRACT: Many African Americans (AAs) use clergy as their primary source of help for depression, with few being referred to mental health providers. This study used face-to-face workshops to train AA clergy to recognize the symptoms and levels of severity of depression. A pretest/posttest format was used to test knowledge (N = 42) about depression symptoms. Results showed that the participation improved the clergys ability to recognize depression symptoms. Faith community nurses can develop workshops for clergy to improve recognition and treatment of depression.