Jeffrey J. Guidry

Barriers to breast cancer control for African-American women: the interdependence of culture and psychosocial issues.

This study evaluates the cultural context of the behaviors and beliefs of African‐American women to determine the success or failure of breast cancer prevention and control interventions. Cultural and psychologic reactions, such as fear, distrust, fatalism, and other “historic rooted” factors, are major determinants to participation in these interventions by African‐American women.

Closing the divide: Diverse populations and cancer survivorship†

Currently, there is a “divide” between cancer survivorship initiatives and minority participation. The level of participation is nearly nonexistent in many cancer support and control initiatives. Cancer survivorship resources that facilitate access to treatment, psychosocial interventions, clinical trials, and research are key components to eliminating this divide. Differences in cancer results among minority populations are caused by several factors, including biologic reactions to environmental activities, socioeconomic status, perceived beliefs and notions of medical professionals, a lack of resources to participate in cancer support groups, and having personal contact with cancer survivors. Health professionals, advocates, and researchers hold the key to opening more opportunities for the improvement of cancer survivorship among minorities. The belief that “one size fits all” is unrealistic. These beliefs can influence participation in innovative clinical trials, decisions about treatment, emotional responses, and social support relationships. To help ensure participation in these programs, researchers and health workers must understand the role of social and psychosocial implications and results of the assessment, strategies, and sustainability that must be included in the development stage of any cancer support and survivorship initiatives. For this article, the authors examined mechanisms that can be used by cancer‐control researchers and program staff to limit the divide between cancer survivorship initiatives and minority participation. They identified three strategies that must be used to address this divide effectively: the inclusion of minorities in clinical trials, intervention studies, treatment, and research programs; the development of culturally sensitive environments; and the ability to sustain minority participation. In summary, cancer survivorship includes many components that are developed individually and collectively to formulate sound strategies for including minorities in cancer‐control initiatives. These programs should go beyond basic support groups and should include research studies, clinical trials, and alternative treatments for increasing cancer survival rates and quality of life among minorities. The divide can be addressed only through a proactive initiative that brings cancer survivorship initiatives and minority communities together in full partnership. Cancer 2005.

The readability levels of cancer‐prevention materials targeting African Americans

BACKGROUND Several studies have examined the readability levels of cancer-prevention materials, but the readability levels of materials targeting African Americans have not been documented. The Cancer Prevention Materials and African-Americans project, funded in 1994 by the Texas Cancer Council, was developed to assess the readability levels and cultural sensitivity of cancer-prevention materials targeting African Americans. METHODS This study assessed the readability of 100 cancer-prevention materials using McLaughlins SMOG grading. Illustrations and point sizes were also examined by research staff members. RESULTS Seventy-two percent of the material contained illustrations and 88% were printed using a 12-point font. An overall mean SMOG grade of 9.32 was found, which suggests that ninth graders can read and comprehend the text. CONCLUSIONS Although this grade level is lower than those indicated by previous studies, many of the printed materials may not be appropriate for African Americans at high risk for cancer: those with low incomes and little education. Health professionals should focus on decreasing the reading levels of print materials, pretesting audiences to determine their actual reading levels, and examining other factors that influence readability and comprehension.

What are Asian-American Youth Consuming? A Systematic Literature Review

Numerous studies have explored dietary practices among children, but there are limited studies on children of Asian background in the US. This review had three aims: (a) review literature regarding Asian-American youth’s dietary behaviors, (b) critically evaluate the methodological quality of such research, and (c) provide recommendations for future nutrition-related research on Asian-American youth. The authors conducted a systematic literature review through MEDLINE (EBSCO), CINAHL Plus with Full Text (EBSCO), and Embase (Ovid); extracted descriptive data; and evaluated methodological quality. Thirteen articles were included. Major findings included: (a) frequent consumption of milk, fruit, meat, unenriched white rice, vegetables, and high-fat and high-sugar items among Asian-American children and (b) acculturation’s influences on diet, resulting in Asian-American youth consuming diets characterized by both Asian and American foods. Findings from this review may inform education and promotion programs and services for Asian Americans in the US.

The Assessment of Rural African-American Churches' Capacity to Promote Health Prevention Activities

Abstract Throughout history, the African-American church has played a vital role in social, political and educational arenas. Often viewed as the cornerstone of the African-American community, the African-American church is an excellent medium to promote health prevention and promotion interventions. This article identifies several elements for the facilitation of this process, identifies the role of culture within this concept and explores the history of the African-American church as it relates to health promotion activities. The African-American church has become a valuable mechanism by which health professionals are able to reach underserved populations.

Breast cancer knowledge, attitude and screening behaviors among hispanics in South Texas Colonias

This study examines breast cancer knowledge, attitudes and screening behaviors of Hispanic women living in the South Texas colonias of Maverick and Val Verde Counties. We used the Health Belief Model to analyze the effects of HBM constructs on clinical breast exam (CBE) and mammogram screening. Using a multistage systematic sampling approach we interviewed women living within these colonias. Logistic regression analysis was used to predict CBE and mammography screening behaviors. The results indicate that knowledge, susceptibility, barriers and source of health information were statistically significant in predicting CBE among these women. In addition, background variables such as marital status and health insurance were also significant in predicting CBE. Findings further indicate that source of health information, barriers, and health insurance significantly predicts mammography screening behaviors. Results suggest that for women living in colonias along the South Texas Border socio-demographic variables play a significant role in CBE and mammography utilization.

Understanding the essence and lived experience of self-care management among African-American men living with type 2 diabetes

Purpose: To explore, understand and describe the lived experience of African-American men (AA men) living with type 2 diabetes, with emphasis on capturing perceptions of challenges, facilitators and perceived barriers associated with self-care management. Materials and Methods: Participants (n = 19) were AA men ages 35-69 years, who were diagnosed with type 2 diabetes. Participants were recruited via community outreach efforts, including barbershops and churches located in predominantly African-American communities in southeast US. Upon consent, individual interviews were conducted, audio-recorded and subsequently transcribed. Transcripts were analyzed using a phenomenological approach, and focused on identifying common themes among the descriptions of AA men′s experiences specific to type 2 diabetes. Results: AA men perceived their experience of managing type 2 diabetes as tedious, complicated, demanding, and frustrating. Common themes included the perception of family histories and personal behaviors as causes or contributors to the development of diabetes, albeit there was lack of clarity regarding biological versus behavioral familial contributions. Other theses included fears related to long-term complications of type 2 diabetes, and the critical role of social support as a factor assisting with self-care management. Limb amputation, insulin injections and vision changes were fears related to having type 2 diabetes. Commensurately, important referent others (e.g., family and close friends) provided critical encouragement and support toward managing their diabetes. Conclusions: Future diabetes research and education should give attention to how masculinity may have a powerful influence on diabetes management behavior among African-American men′s as well as utilizing preventive health services.

Evaluating Coalition Capacity to Strengthen Community–Academic Partnerships Addressing Cancer Disparities

The Arkansas Cancer Connection Program is a community–academic partnership between the University of Arkansas for Medical Sciences and nine community-based coalitions designed to address cancer health disparities through community-based participatory research. In 2005, a survey measuring coalition capacity was administered to 51 Cancer Council members to assess training needs and increase coalition capacity. The highest scoring components were leadership and member engagement while the lowest were development and capacity effectiveness. Effectiveness correlated with aspects of coalition capacity. The evaluation identified training needs, which were met by projects leveraging the coalitions strengths to advance community-based participatory research addressing cancer disparities.

What about Health Educators? Nutrition Education for Allied Health Professionals: A Review of the Literature

Abstract Background: Health educators are critical members of the health care team who may be called upon to provide nutrition education. However, are health educators prepared for this task? What have scholars concluded regarding this pertinent topic? Purpose: This study has three purposes: (1) to determine the definition of and criteria for nutrition education among allied health professionals, (2) to identify commonalities across health professions for nutrition education definitions and training requirements, and (3) to determine if there are criteria for nutrition education and training for health educators. Methods: A comprehensive review of the literature. Results: Twenty-three articles addressed how researchers conceptualize nutrition and their rationale for nutritions inclusion into the respective allied health disciplines curriculum. None of the studies examined nutrition education or the advocacy of nutrition for pre-professional or professional health educators. Discussion: Scholarly literature is currently silent on the topics of nutrition education provided by health educators, the ability of health educators to deliver nutrition education, and the advocacy of nutrition by the health education profession. Translation to Health Education Practice: This study represents the first step towards addressing the limitations associated with the role of nutrition educator and identifying possible changes needed for the health education profession.

Recruiting, Training, and Retaining Rural Health Professionals

Since the United States was founded, the country’s population has shifted from what was once overwhelmingly rural-95% in 1790—to what is now predominantly urban, reported as 75% in 1990. During the 1970s there was a movement toward rural living; it became known as the “rural renaissance.” The country witnessed a loss of rural population in the 1980s, but data indicate there may be another turnaround to increased rural population in the years to come (Ricketts, Johnson-Webb, & Randolph, 1999).