Shahrzad Bazargan

The role of alcohol use and depression in intimate partner violence among black and Hispanic patients in an urban emergency department.

OBJECTIVES The primary objective of this study was to assess the role of alcohol use and depression in intimate partner violence (IPV) victimization and perpetration among Blacks and Hispanics in an underserved urban emergency department population. METHODS This cross-sectional study surveyed male and female patients presenting to an urban emergency department. The outcome measures were physical or sexual IPV victimization and perpetration in the previous 12 months. The independent predictors included demographic variables, alcohol and drug use, and depressive symptoms. Logistic regression analyses calculated the adjusted odds ratio (AOR) and 95% confidence interval (CI) for predictors of IPV victimization and perpetration in separate models. RESULTS The prevalence of IPV victimization among Blacks and Hispanics were similar (14% and 10%, respectively) but blacks were nearly twice as likely to report IPV perpetration (17% vs. 9%, respectively). Predictors of IPV perpetration were Black race, married or living with a partner, heavy drinking, illicit drug use, and current depression. Depression, but not substance use, also predicted IPV victimization, in addition to Black race, married or living with a partner, and younger age. Screening for substance abuse and depression in an inner city emergency department population may help to identify individuals at high risk of IPV, particularly IPV perpetration.

Violence-related injury and intimate partner violence in an urban emergency department

BACKGROUND To facilitate the identification of ED patients at risk for intimate partner violence (IPV), we assessed the relationship of acute violence-related injury and history of IPV victimization or perpetration. METHODS : This cross-sectional study systematically sampled patients presenting to an urban ED. Reason for visit, past year history of IPV victimization and perpetration, alcohol and drug use and abuse, and sociodemographic factors were assessed. We hypothesized that violence-related injury would be positively associated with a history of IPV victimization and with IPV perpetration. RESULTS The odds of violence-related injury was increased three-fold among persons with a history of IPV victimization and nearly two-fold (although not statistically significant) among those with IPV perpetration history. Male gender, younger age, and problem drinking were independent risk factors in both models. CONCLUSION Screening for IPV among individuals presenting with a violence-related injury may be helpful in identifying individuals at risk of partner violence.

Screening for alcohol problems: comparison of the audit, RAPS4 and RAPS4-QF among African American and Hispanic patients in an inner city emergency department

OBJECTIVE to compare brief screening instruments for alcohol use disorders, the RAPS4, RAPS4-QF, and AUDIT, against DSM-IV criteria for alcohol dependence and alcohol abuse among African Americans and Hispanics in a sample of inner city emergency department (ED) patients. METHOD a probability sample of 395 African American and Hispanic patients seeking care at King Drew Medical Center Emergency Department were interviewed regarding items related to the screening and diagnostic instruments, quantity and frequency of drinking and demographic characteristics. RESULTS no difference was found between the RAPS4 and AUDIT for alcohol dependence. Sensitivity of the RAPS4-QF (the RAPS4 plus a quantity item and a frequency item) was significantly better than the AUDIT for African Americans and Hispanics, and for males, but not for females, although the RAPS4-QF identified all of those women positive for alcohol abuse criteria, compared to 93% identified by the AUDIT. CONCLUSION the data suggest the RAPS4 and the RAPS4-QF perform well for identifying alcohol dependence and alcohol abuse, respectively, among minority ED patients. Additional research is needed to evaluate the RAPS4-QF as a stand-alone instrument and to evaluate both instruments across gender and ethnic subgroups in other populations and in other cultural settings.

Gambling Habits Among Aged African Americans

Abstract In a cross-sectional study we investigated the correlates of gambling habits among a sample of 80 independently living African-American elderly persons. The participants were selected from two Senior Citizen Centers that provide inexpensive or free pleasure trips from Los Angeles, California to gambling sites in Nevada. The data for this study were collected through face-to-face interviews conducted by three trained female middle-aged African-American interviewers in October and November 1998. Our data identified 64% of this sample as non- or occasional gamblers, 19% as light to moderate gamblers and 17% as heavy to pathological gamblers. Our data document a statistically significant relationship between gambling behaviors and psychological well-being, anxiety, obsessive-compulsive symptoms, perceived health status, health locus of control, religiousness, and stressful life-events. Results of this study point to an urgent need for: (1) publicizing the potentially lethal physical and mental consequences of gambling among elderly persons; (2) developing educational programs and interventions to prevent gambling addiction from developing among the elderly; and (3) providing primary care practitioners with training to facilitate early detection and treatment of gambling problems among at-risk aged persons

A multivariate comparison of elderly African Americans and Caucasians voting behavior: how do social, health, psychological, and political variables effect their voting?

No study until now has examined the impact of the physical and psychological condition on voter turnout among elderly African Americans and Caucasians. Utilizing data from a national survey (Aging in the Eighties) and using multiple logistic regression, the present study examines the impact of health rating and life satisfaction as well as other socio-psychological characteristics on voting turnout among elderly Caucasian and African Americans. The results provide some empirical evidence that the pattern of election participation can be significantly influenced by the self-assessment of health and life satisfaction. For elderly Caucasians self-assessment of health is significantly related to voting behavior, whereas among elderly African Americans life satisfaction shows significant impact on turnout. Elderly African Americans who identified their personal political philosophy as “liberal” were more likely to vote, while among elderly Caucasians, those who identified their personal political philosophy as “conservative” were more likely to vote. In addition, SES, age, and organizational activity proved to have significant independent impact on elderly Caucasian turnout, whereas among elderly African Americans, education was detected as a significant predictor.

The preventive health education and medical home project: a predictive and contextual model for low-income families.

The Preventive Health Education and Medical Home Project (PHEMHP) is a predictive and contextual model intended to reduce low levels of health services utilization and improve preventive health techniques and disease self-management for low-income families in South Central Los Angeles, with the ultimate goal of attaching each child to a medical home. The model is designed to be implemented through educational and case management strategies. This paper presents the conceptual framework, critical intervention activities, and the different implementation variations the PHEMHP has already assumed. Implications for research, policy, and practice are discussed.

Self-Reported Memory Function and Psychological Well-Being Among Elderly African American Persons

This study examinedthe impact of self-reported memory deficits on psychological well-being among a sample of 998 elderly African American persons. Using multiple regression and employing other related variables (that previously have been identified as common predictors of psychological well-being), the findings of this study suggest that the risk of having a lower level of psychological well-being was greater for persons with more memory problems, even after demographic characteristics, functional limitations, health status, and cognition were included in regression equations. Self-reported memory deficits werefound to be the strongest predictor of psychological well-being. The strength of relationship between self-reported memory deficits and psychological well-being was stronger among women than men.