Joseph R. Merighi

Gender and ethnic differences in health beliefs and behaviors

This study explored the extent to which college men and women of various racial and ethnic groups differ in their health beliefs and behaviors. Exploratory factor analyses of survey responses from a diverse sample of 1816 undergraduate students identified 21 items in six cohesive domains: Diet; Anger and Stress; Preventive Care; Medical Compliance; Substance Use; and Beliefs about Masculinity. Analyses of variance explored group differences across these domains. Findings revealed consistent gender differences, with men engaging in riskier behaviors and holding riskier beliefs than women. Main effects for ethnicity were also observed, but only for the diet domain was a gender by ethnicity interaction found. Implications for establishing gender- and ethnicity-based health promotion and disease prevention interventions are discussed.

Coming out to families in a multicultural context

This article examines how young gay men disclose their sexual identity to family members and how their family members respond to this disclosure. Qualitative data were collected from a nonrandom sample of 57 African-, European-, Mexican-, and Vietnamese-American gay males, ages 18 to 24. Findings revealed similarities across racial and ethnic groups in how these young gay men came out to family members and the responses they received after their initial self-disclosure. Implications for practice are discussed.

Understanding Quality-of-Life Issues in Chinese Women With Breast Cancer: A Qualitative Investigation

Little is known about the cultural beliefs and quality of life (QOL) of US-born and foreign-born Chinese women with breast cancer. We conducted individual semistructured qualitative interviews to explore the meaning of QOL, identify beliefs about cancer, and make comparison between US-born and foreign-born survivors. Women in this study identified the stigma of breast cancer that exists in the Asian community. They also described interpersonal support as central to a good QOL. However, when describing QOL, foreign-born Chinese women referred to wealth more frequently, while US-born Chinese women indicated friendship more frequently. The study findings support the need for culturally appropriate interventions that take into consideration the cancer-related beliefs and QOL of breast cancer survivors in the Chinese community.

Complementary and Alternative Medicine for Pain Management in U.S. - and Foreign-Born Chinese Women with Breast Cancer

This study explores beliefs about complementary and alternative medicine (CAM) use for pain management among 15 U.S.-born and 15 foreign-born Chinese women with breast cancer. For this investigation, trilingual interviewers conducted individual, face-to-face, qualitative interviews in Cantonese, Mandarin, or English. All study participants lived in San Francisco, and the foreign-born women had resided in the U.S. for 15 years or fewer. Findings indicate that many participants consider CAM a viable method of pain management. However, concerns about affordability and quality of treatment prevent some women from using CAM on a regular basis. Many participants indicated that Western health care providers are poorly equipped to provide CAM to manage the pain resulting from breast cancer treatment. Future research should explore how access to CAM can be improved for poor and uninsured patients with cancer and how alternative approaches to pain management can be integrated more broadly in the U.S. health care system.

Adoption Preparedness, Cultural Engagement, and Parental Satisfaction in Intercountry Adoption

Intercountry adoption offers both benefits and challenges for people wishing to become adoptive parents. Survey data from 326 U.S. families with intercountry adoptees were gathered to assess parental preparation for the adoption process, satisfaction with their adoption services, and participation in activities that correspond to the adopted childs birth culture. Findings indicated that preparation was positively associated with satisfaction and negatively associated with medical, psychological, and developmental challenges. In addition, family involvement in cultural activities was positively associated with preparation and negatively associated with medical, psychological, and developmental challenges. Implications are discussed for social workers and other professionals involved in adoption-related activities.

Belief, Optimism and Caring : Findings from a Cross-national Study of Expertise in Mental Health Social Work.

What characterizes expertise in mental health social work? This article attempts to answer this question by reporting on the findings of a cross-national Australian and American study of social work practice expertise in mental health settings, particularly in working with people with long-term serious mental illness. The study identified expert practitioners through a peer-nomination process and asked each of them to describe a memorable practice situation in focus groups. These group interviews were transcribed verbatim and analysed using a constant comparative method. In the face of often complex and demanding work situations, these social workers demonstrated qualities specific to mental health social work that were designated as belief, optimism and caring. These three qualities are delineated and discussed in this article, as well as the implications for social work practice and education

Maternal Emotional Reactions to Young Children with Different Types of Handicaps

Emotional reactions were examined cross-sectionally over the 1-to 6-year period in mothers of children with Down syndrome (N = 25) and with predominantly motor impairments (N = 20). Mothers rated their degree of concern about 16 early milestones and four events, and were also interviewed with the Vineland Adaptive Behavior Scales. Although milestones occurring during the first year caused higher levels of maternal concern than did later-occurring ones, concern was also evident for some later milestones. Mothers of Down syndrome and of motor-impaired children were equally concerned about motor milestones, but mothers in the Down syndrome group were more concerned about developments in communication. The two groups modulated their maternal concern based on different aspects of the childs communication skills. The timing, specificity, and sensitivity of maternal reactions identified in this study are discussed in relation to the unidirectional, time-bound model of “maternal mourning.” J Dev Behav Pediatr 13:118–123, 1992.

The Relation of Social Comparison to Subjective Well-Being and Health Status in Older Adults

Abstract Purpose: Studies of subjective well-being and health status have given limited attention to the role of social comparisons. Based on theories of social cognition and cognitive appraisal, this paper examines the mediating role of social comparisons and subjective well-being in health status across time. Design and Methods: Data from 2,558 Medicare enrollees is used to test the hypothesized model; this is a secondary analysis of data. Structural equation modeling, with EQS, is used for analyses. Results: Social comparison has a significant influence on subjective well-being. With 2-year follow-up data, the model predicted almost 20% of the variance in physical and mental health outcomes. The influence of current physical health status on physical and mental health outcomes differs for men and women. Implications: Study findings suggest that social comparison is a key factor in enhancing subjective well-being, which influences longevity and reduces depressive symptoms in older adults.

Substance use, sexual identity, and health care provider use in men who have sex with men.

This article describes the association between substance use, sexual identity, and seeing a health care provider on a regular basis for 257 men who have sex with men (MSM). Data from in-person interviews were gathered from MSM who resided in Massachusetts between 2003 and 2007. A logistic regression analysis that controlled for demographic characteristics, health insurance status, HIV/AIDS status, drug use, and social support revealed that MSM who identified as heterosexual, compared with those who identified as gay or bisexual, were 60% less likely to access a health care provider on a regular basis. Further, the likelihood of seeing a provider regularly was 54% lower for MSM who had used illegal drugs in the past 30 days and 32% higher for MSM who had more social support. Study limitations and implications are discussed.

Technology Access and Use, and Their Associations With Social Engagement Among Older Adults: Do Women and Men Differ?

Objectives To examine how information and communication technology (ICT) access and use are conceptually incorporated in the Successful Aging 2.0 framework. Method Using data from the 2011 National Health and Aging Trends Study (N = 6,476), we examined how ICT access and use for different purposes are associated with social engagement (i.e., informal and formal social participation) by gender. Weighted logistic regression analyses were performed. Results Findings revealed that men were more likely to access and use ICT than women. ICT access was positively associated with all types of womens social engagement, but only with mens informal social participation. Information technology (IT) use for health matters was positively associated with formal social participation for women and with informal social participation for men. IT use for personal tasks was negatively associated with formal social participation for older adults. Communication technology use was positively associated with formal and informal social participation for women and men. Discussion This study supports the expansion of the successful aging model by incorporating ICT access and use. Further, it assists in the identification of specific technologies that promote active engagement in later life for women and men.