Olivia G. M. Washington

Effects of nurse-managed telemonitoring on blood pressure at 12-month follow-up among Urban African Americans

Background: Nearly one in three adults in the United States has hypertension. Hypertension is one of the largest risk factors for cardiovascular diseases, and it is growing in prevalence, especially among African Americans. Objectives: To test the hypothesis that individuals who participate in usual care (UC) plus blood pressure (BP) telemonitoring (TM) will have a greater reduction in BP from baseline to 12-month follow-up than would individuals who receive UC only. Methods: A two-group, experimental, longitudinal design with block stratified randomization for antihypertensive medication use was used. African Americans with hypertension were recruited through free BP screenings offered in the community. Data were collected through a structured interview and brief physical exam. Cross tabs, repeated measures analysis of variance, and independent t tests were used to analyze the studys hypothesis. Results: The TM intervention group had a greater reduction in systolic BP (13.0 mm Hg) than the enhanced UC group (7.5 mm Hg; t = −2.09, p = .04) from baseline to the 12-month follow-up. Although the TM intervention group had a greater reduction in diastolic BP (6.3 mm Hg) compared with the enhanced UC group (4.1 mm Hg), the differences were not statistically significant (t = −1.56, p = .12). Discussion: Telemonitoring of BP resulted in clinically and statistically significant reductions in systolic BP over a 12-month period; if maintained over a longer period of time, the reductions could improve care and outcomes significantly for African Americans with hypertension.

Telling my story: from narrative to exhibit in illuminating the lived experience of homelessness among older African American women.

The authors document the integration of methods from the arts and humanities into a social research and development project, the objectives of which are to create and test promising interventions helpful in assisting older homeless African American women get and stay out of homelessness in the city of Detroit, Michigan, USA. The exhibit incorporates multiple forms of narrative, includes performative features, promotes public awareness of homelessness in the city of Detroit, and engages homeless and formerly homeless women in social action. The authors examine the prototype design and the involvement of participants in creating artistic portrayals of their homeless experience.

Poor Nutrient Intake and High Obese Rate in an Urban African American Population with Hypertension

Objective: To describe the nutrient intake patterns and general health conditions in an African American (AA) hypertensive population living in Detroit, MI. Methods: Demographic, anthropometric, general health condition and 3-day dietary recalls were collected from 387 AAs in community-based settings. Only data from 342 participants who met the inclusion criteria were reported. Results: The obesity and type 2 diabetes prevalence in this minority population were significantly higher, and both energy and nutrient intakes were significantly lower than the RDAs or those reported in NHANES. Female participants reported their highest weight at an earlier age but their body weight reduced in the older group. No such trend was observed in male participants. Both males and females consumed significantly fewer servings of fruit, vegetable and grains as recommended by USDA. As household income increased, the consumption of fruits and vegetables were also increased. Conclusion: In order to reduce the incidence of obesity and hypertension in this minority population, dietary intervention should begin at adolescence or even earlier. DASH diet would be beneficial for this population.

The Use of Prayer in Group Work With African American Women Recovering From Chemical Dependency

The authors discuss the relevance, propriety, and use of prayer in addressing the recovery of women from substance use. They describe the use of prayer to facilitate the process of rehabilitation and recovery of women who are chemically dependent and illustrate the application of prayer in the context of group treatment and support.

Strengths-Based Recovery Practice in Chemical Dependency: A Transpersonal Perspective

Given the tremendous damage chemical dependency can inflict on the human spirit, a transpersonal perspective is relevant to the recovery process because it assigns importance to the development of personal meaning and life purpose. The use of a transpersonal perspective can foster hope for both providers and consumers of services, particularly during periods of recovery when people are struggling with relapse and despair, and when it appears almost impossible to surmount barriers to recovery. During these challenging times people may look to a higher power for strength and fortification however they may conceive of this power (Frankl, 1997).

Normative health research experiences among African American elders.

Objectives:Data are meager regarding the prevalence of participation and the overall experience of African American elders in research across a variety of health-related studies. This study sought to increase our knowledge about older African Americans’ participation in health research by capturing some of their normative experiences and attitudes. Methods:Atelephone-based surveywas conducted on 1,290 urban African Americans = 60 years old. The assessment focused on issues of housing, neighborhoods, health, and experiences with health research. Results:The overall prevalence of respondents who took part in a health research projectwas 14%. Significant predictors included income, attitudes about fairness, perceptions of protection from harm, understanding of research as a key to improving health care, and participation in survey research. Discussion:Findings underscore the importance of addressing economic, educational, and trust barriers to research participation as well as the importance of conveying a sense of caring for the health of individuals and the community as a whole.

PARENTAL STRESS AMONG AFRICAN AMERICAN PARENTS AND GRANDPARENTS

The purpose of this study was to examine the relationships among parental stress, health (defined as level of systolic and diastolic blood pressure and body mass index), childcare characteristics, and social support. The study used a correlational research design and the setting was the metropolitan Detroit area. The sample consisted of 120 hypertensive African American parents and grandparents who reported caring for 1 to 9 children living in the household. Several variables (average diastolic blood pressure, number of children/grandchildren in home, child/grandchild is physically/mentally disabled, ability to decrease stress) were statistically significant predictors of parental stress. These results indicate that the multiple demands of parenting may become a barrier to making life-style changes for parents and grandparents diagnosed with hypertension. Nursing implications of the findings are discussed.

Effects of cognitive and experiential group therapy on self-efficacy and perceptions of employability of chemically dependent women.

This quasi-experimental study assessed effects of cognitive and experiential group therapy on self-efficacy and perceptions of employability for 52 chemically dependent adult women. The sample was 98% African American. Therapy consisted of six 90-min group sessions held twice weekly. The participants were pre- and posttested with the Self-Efficacy Scale (M. Sherer et al., 1982) and the Ghiselli Self-Description Inventory (E. E. Ghiselli, 1975). After the intervention, the cognitive group had significantly higher levels than the experiential group of social self-efficacy and need for self-actualization, an indicator of aspiration for employment. General self-efficacy and decisiveness, indicators of employability, significantly increased over time for both groups. Interventions to enhance peoples belief in their ability to successfully perform tasks and control outcomes, promote personal growth, teach responsibility, and enhance self-awareness could be used to develop employability skills that reduce recidivism.

Lessons Learned from Three Projects Linking Social Work, the Arts, and Humanities

The aims of this paper are to illustrate how social workers can collaborate with designers and artists in addressing social issues facing communities and to identify the implications of such collaboration for social work education. The authors examine three projects linking social work, the arts, and humanities [Arts in Recovery (AIR), the Leaving Homelessness Intervention Research Project (LHIRP), and Interdisciplinary Research on Environmental Design (IRED)] for the lessons they offer social work education. They pay particular attention to the art exhibit and its catalog as products that educate the public on various social issues, as well as the exhibit visitation experience that parallels key components of traditional group work and community development. Implications for social work include teaching interdisciplinary collaboration, integrating the arts into social work methods, emphasizing the importance of participatory action research, and creating settings that promote community engagement. The authors then draw implications for how the arts and humanities can influence or otherwise shape the paradigm of social work education and instruction in the areas of policy, human behavior, practice methods, and research.

Five Dimensions of Faith and Spiritually of Older African American Women Transitioning Out of Homelessness

Background Homelessness among older African American women is emerging as a serious social problem. The increasing cost of living, diminishing community resources, and shrinking retirement benefits, as well as reduced social services are resulting in greater numbers of older minority women becoming homeless. Aims This investigation explores the relevance of faith and spirituality to an advocacy assessment designed to help participants resolve issues that operate as barriers to their leaving and staying out of homelessness. Methods A substudy of a larger research and development project was undertaken, in which qualitative interview methods were used to illuminate the role of faith and spirituality resources in the lives of 84 older homeless African American women. Comparative thematic analysis of illustrative cases was undertaken to better understand the role of faith and spirituality in the women’s lives and in how they used faith and spirituality in coping with homelessness. Findings Five dimensions of faith and spirituality, (a) identity and beliefs; (b) affiliation and membership; (c) involvement; (d) practices; and (e) benefits, served as promising resources in understanding life spaces of homeless minority women and identified promising advocacy strategies. Two cases describe the realities of homelessness for older minority women endeavoring to transition out of homelessness and illustrate how faith and spirituality can buffer stress, facilitate coping, and sustain motivation. Conclusions How older homeless African American women use their faith and spiritual resources to cope with demands of homelessness, challenges of transition, and recovery from the multiple traumas resulting from being homeless makes the assessment of faith and spirituality an important part of the advocacy process.