Naomi N. Modeste

Peer Support and Breastfeeding Intentions Among Black WIC Participants

The purpose of this study was to identify what factors impact low-income womens infant feeding decisions. A cross-sectional convenience sample of 109 black pregnant women, ages 18 to 45, regularly attending Women, Infant, and Children (WIC) clinics and associated programs in the Inland Empire Region of California were recruited to complete a structured questionnaire about their breastfeeding beliefs and intentions. Multivariable logistic regression was used to explore participants intentions to breastfeed. After adjusting for confounding factors, results indicate that women who attended support groups were more than twice as likely to intend to breastfeed compared with women who did not. These results highlight the importance of social influences on the decision to breastfeed, and indicate the need for broadened community-based education for the promotion of breastfeeding. J Hum Lact. 25(2):157-162.

Barriers to early detection of breast cancer among women in a Caribbean population

The purpose of this descriptive study was to identify and describe barriers to early detection of breast cancer, as well as current breast cancer screening behaviors and attitudes regarding the disease, among women aged 20 and older on the Caribbean island of Tobago. Tobago is the smaller of the two islands that make up the nation of Trinidad and Tobago. Between February and June 1996, 265 women fitting the age criteria completed a structured survey questionnaire. Women of African descent made up 89% of the respondents. In terms of age, 48% of those surveyed were between 20 and 39, 40% were between 40 and 59, and 12% were 60 or older. Barriers to early detection identified were a low level of breast self-examination, infrequent clinical breast examinations as part of regular care, unavailability of mammography services on Tobago, cost of screening, and difficulty of traveling to Trinidad for mammography. Furthermore, only a minority of the study participants had ever attended early detection or public awareness programs. The results were nearly the same for individuals with a family history of breast cancer, who would have a higher risk of occurrence of the disease. In addition, the majority of the respondents reported what can be considered a cultural barrier to early detection practices, a belief that no matter what they did, if they were to get breast cancer, they would get it. The authors recommend that mammography services be made available on Tobago. The authors also intend to use the findings to help develop an appropriate, culturally sensitive breast cancer awareness and early detection program for women on the island.

Exploring family factors and sexual behaviors in a group of Black and Hispanic adolescent males.

OBJECTIVE To explore family factors that influence sexual behaviors among a group of Black and Hispanic adolescent males. METHODS One hundred seventy-eight subjects were selected from a convenience sample of 431 adolescents who participated in a 1996 Youth Survey conducted in San Bernardino County, California. RESULTS Having a sibling who was a teen parent was significantly associated with engaging in sexual intercourse among Hispanics. Among Blacks, having a father who was a teen dad was significantly associated with sexual intercourse. CONCLUSIONS Findings showed relationships between family characteristics and sexual attitudes and behaviors among participants.

Closing the Gap in Mammogram Screening An Experimental Intervention Among Low-Income Hispanic Women in Community Health Clinics

A low rate of mammogram screening exists among low-income Hispanic women. To address this disparity, an experimental intervention containing audiovisual and written media was conducted using the health belief model as a framework. The purpose of this study was to determine if low-income Hispanic women, more than 40 years of age, who received targeted cancer prevention education (n = 105) had a significantly greater perceived threat of breast cancer, greater benefits and lower barriers to screening, and stronger intentions to obtain mammograms compared to a control group (n = 105). Intervention participants reported significantly greater perceived benefits, self-efficacy, and mammogram screening intentions than the control group. Predictors of mammogram screening intentions, when controlling for covariates, included receiving the intervention, and having greater perceived benefits, self-efficacy, and lower barriers. Results demonstrate the effectiveness of a low-cost, theory-based intervention aimed at increasing mammogram screening to assist in the monitoring of Healthy People 2020 objectives.

AIDS-related knowledge, attitudes, beliefs, and behavioral intentions of adolescents in trinidad: a pilot study.

The purpose of this study was to describe AIDS knowledge, beliefs, attitudes, and behavioral intentions among adolescents attending high school in the Republic of Trinidad, a Caribbean island. This information will be useful in planning and implementing appropriate AIDS education and prevention programs. A structured questionnaire consisting of five sections was administered to fifty-one randomly selected students aged thirteen to eighteen years and studying in forms III, IV, and V (equivalent to the last three grades of U.S. high school) in three high schools. Ninety-six percent of respondents knew the cause of AIDS and mode of transmission, but 26 percent felt that they could get AIDS from insect bites. Student knowledge did not correlate with behavior intentions, but there was a high correlation with perception of risk and their intention to use condom or abstain from sexual practice. There appears to be some association between level of education and likelihood of safe sexual practices (p = .06). There was a significant (p < .05) relationship between students attending all girls school and behavior intentions. There was also a significant relationship (p < .05) between knowledge level and newspapers or magazines as the sources of knowledge.

Partner communication and HIV testing among US Chinese college students.

OBJECTIVES To explore the role of partner communication and relationship status on HIV testing among Chinese/Chinese American college students in northern California. METHODS We used a cross-sectional study design to conduct focus groups and an online or paper-pencil questionnaire (N = 230). RESULTS The majority (60%) of respondents were in committed partnerships, with 21% in casual partnerships. Less than one third (30%) of respondents had ever obtained an HIV test. History of HIV tested was associated with relationship status and partner communication. CONCLUSIONS Interventions to increase partner communication skills while taking into account sociocultural factors among this population and their partners are needed.

Factors influencing pursuit of hearing evaluation: Enhancing the health belief model with perceived burden from hearing loss on communication partners

Abstract Objective: There is limited application of health behavior-based theoretical models in hearing healthcare, yet other fields utilizing these models have shown their value in affecting behavior change. The health belief model (HBM) has demonstrated appropriateness for hearing research. This study assessed factors that influence an individual with suspected hearing loss to pursue clinical evaluation, with a focus on perceived burden of hearing loss on communication partners, using the HBM as a framework. Design: Cross-sectional design collecting demographics along with three validated hearing-loss related questionnaires. Study sample: Patients from Duke University Medical Center Otolaryngology Clinic aged 55–75 years who indicated a communication partner had expressed concern about their hearing. A final sample of 413 completed questionnaire sets was achieved. Results: The HBM model construct ‘cues to action’ was a significant (p <0.001) predictor of pursuing hearing evaluation. Perceived burden of hearing loss on communication partners was a significant (p <0.001) predictor of pursuing hearing evaluation and improves the model fit when added to the HBM: 72.0% correct prediction when burden is added versus 66.6% when not (p <0.0001). Conclusions: Hearing healthcare initiatives that incorporate these factors may improve hearing help-seeking behavior. More research using sound theoretical models in hearing healthcare is warranted.

Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors

PurposeThis study explored the relationships between systemic- and individual-level contextual factors and health-related quality of life (HRQOL) in a cohort of African American and Latina breast cancer survivors (BCS).MethodsBaseline questionnaire data of 320 BCS who participated in a HRQOL psycho-educational intervention were abstracted from the parent study. Hierarchical regression analysis tested the independent effects of contextual factors on HRQOL.ResultsHRQOL was higher in BCS who: were diagnosed at < stage 2 (b = − 1.38, p < 0.05), expressed satisfaction with their health care (b = 0.20, p < 0.001), had fewer comorbidities (b = − 0.60, p < 0.001) and depressive symptoms (b = − 0.30, p < 0.001), and practiced healthy diet and exercise habits (b = 0.02, p < 0.05). Demographic and cancer-related factors accounted for 14 % of the variance in HRQOL (F[6, 274] = 7.25, p < 0.001). The socio-cultural context (i.e., ethnicity, life stress, perceived social support) explained 20 % of the variance in HRQOL (FΔ[3, 271] = 27.32, p < 0.001). The health care system context contributed an additional 8 % to explaining HRQOL (FΔ[1, 270] = 34.88, p < 0.001). Health status and behavioral factors accounted for 18 % of the variance (FΔ[4, 266] = 29.55, p < 0.001). The full model explained 59 % of the variance in HRQOL (F[14, 266] = 27.76, p < 0.001).ConclusionsHRQOL in ethnic minority BCS is multifaceted and is significantly influenced by cancer-related, socio-cultural, health care system, health status, and behavioral contextual factors. Therefore, survivorship research and practice must address broad multi-level domains to achieve equitable and optimal breast cancer outcomes.Implications for cancer survivorsTo enhance HRQOL, survivors must be provided the know-how and support to maintain healthy lifestyle and self-management practices. Advocates must engage the care team to consider systemic factors, including life stress and community resources, to be more patient-centered.

Attitudes and Beliefs Predicting Taiwanese Older Adults’ Intentions to Attend Strength and Balance Training Programs

While strength and balance training (SBT) programs are effective in preventing falls, older adults rarely participate. A cross-sectional study design was used to explore factors that influence their decisions to attend SBT programs. Questionnaires were collected that measured theory of planned behavior constructs from 221 community-dwelling Taiwanese older women between the age of 55 and 94. Results suggest that (a) benefits of SBT programs such as increasing independence in daily life, (b) participation approval and involvement from the older adults’ family members, and (c) SBT programs conducted in familiar places strengthened potential participants’ positive attitude, subjective norm, and perceived behavioral control, respectively. Health care professionals should consider incorporating these factors in the recruitment materials or the actual design of SBT programs to enhance older adults’ decision to attend and increase the recruitment rate of such programs.

Saudi Women's Beliefs on the Use of Car Infant Restraints: A Qualitative Study

Objective: The focus of this study was to identify the salient beliefs of pregnant women in Saudi Arabia that may influence their intentions to use infant restraints for their children. These beliefs were later used to inform a subsequent quantitative study. Methods: This qualitative study employed Ajzens theory of planned behavior to elicit the salient behavioral, normative, and control beliefs of Saudi pregnant women regarding the use of infant restraints for their future children. Twenty-five pregnant women participated in 2 focus groups conducted in June 2013 at Dallah Hospital in Riyadh. Results: Lack of health education and law enforcement; cultural pressure and traditions; counsel from family, specifically from husbands and mothers; desire to stay close to the child; family size; and car size were key factors in deciding whether or not to use car seats; the high cost of car seats was not. Conclusions: Aside from providing awareness to future mothers and the general public, health interventions should target the specific beliefs identified in this study. Because participants identified husbands as significant referents, further studies are needed to examine the husbands’ attitudes and beliefs.