Barriers to Mammography Screening among Black Women at a Community Health Center in South Florida, USA.

Background: In the United States (US), Black/African American women suffer disproportionately from breast cancer health disparities with a 40% higher death rate compared to White women. Mammography screening is considered a critical tool in mitigating disparities, yet Black women experience barriers to screening and are more likely to be diagnosed with advanced-stage breast cancer. The purpose of this study was to assess the relative frequency of mammography screening and to examine perceived and actual barriers to screening among women who receive care in our nurse-led community health center. Methods: We conducted a survey examining frequency of mammography screening and beliefs about breast cancer including perceived susceptibility, perceived benefits, and perceived barriers to mammography screening, guided by the Champion Health Belief Model. Results: A total of 30 Black/African American women completed the survey. The mean age of the participants was 54.3 years ± 9.17 (SD); 43.3% had a high school education or less; 50% had incomes below $60,000 per year; 26.7% were uninsured; 10% were on Medicaid; and only 50% were working full-time. We found that only half of the participants reported having annual mammograms 16 (53.3%), 1 (3.3%) every 6 months, 8 (26.6%) every 2-3 years, and 5 (16.7%) never had a mammogram in their lifetime. Frequently cited barriers included: 'getting a mammogram would be inconvenient for me'; 'getting a mammogram could cause breast cancer'; 'the treatment I would get for breast cancer would be worse than the cancer itself'; 'being treated for breast cancer would cause me a lot of problems'; 'other health problems would keep me from having a mammogram'; concern about pain with having a mammogram would keep me from having one; and not being able to afford a mammogram would keep me from having one'. Having no health insurance was also a barrier. Conclusion: This study found suboptimal utilization of annual screening mammograms among low-income Black women at a community health center in Florida and women reported several barriers. Given the high mortality rate of breast cancer among Black/African American women, we have integrated a Patient Navigator in our health system to reduce barriers to breast cancer screening, follow-up care, and to facilitate timely access to treatment, thus ultimately reducing breast cancer health disparities and promoting health equity.

Comparison of Rectal and Esophageal Sensitivity in Women With Functional Heartburn.

This study tested the primary hypothesis that there is a correlation of maximum pain threshold (MPT) in the esophagus and rectum in persons with functional heartburn. Secondary aims evaluated correlations with initial perception threshold (IPT) and pain threshold (PT). This study explored objective sensory endpoints of IPT, PT, and MPT in the esophagus and rectum of 14 females with functional heartburn to determine whether visceral hypersensitivity is generalized or organ-specific. Data on volume and pressure measurements at IPT, PT, and MPT with esophageal and rectal barostat distention were collected. The relationship of sensation and pain to volume, pressure, and compliance was analyzed. Esophageal and rectal IPT balloon volume scores were highly and significantly correlated (r = .61, p = .02). Esophageal and rectal PT balloon volume scores were highly and significantly correlated (r = .6, p = .02). Esophageal and rectal MPT balloon volume scores were not correlated (r = .35, p = .26). The correlation of visceral sensitivity in the esophagus and rectum in persons with functional heartburn supports the hypothesis that visceral sensory changes in functional gastrointestinal disorders are not organ specific.

Correlates of physical activity and the theory of planned behavior between African American women who are physically active and those who are not.

Many people have positive intention to engage in physical activity but fail to act. In general, Physical activity (PA) levels among Americans are declining. However, when compared to all other racial groups, middle aged African American women (AAW) have the lowest rate of PA participation. The lack of physical activity has dire illness consequences for AAW Despite significant efforts to increase physical activity to levels that benefit health, the need to understand successful translation of intention to engage in physical activity, attitude, subjective norm, and perceived behavioral control is warranted in order to design theoretically derived culturally tailored interventions to increase physical activity participation among middle aged AAW. Moreover, there is a paucity of studies that use theoretical underpinnings to elucidate the differences between middle aged AAW who are physically active and those who are not physically active. Therefore, the Theory of Planned Behavior's (TPB) measuring the constructs of intention, subjective norm, attitude, and perceived behavioral control was used to guide the design of this study. One-hundred-fifty-three respondents completed the socio-demographic profile, a Theory of Planned Behavior Questionnaire (TPBQ), and the International Physical Activity Questionnaire (IPAQ). The Pearson's Product-Moment Correlation Coefficient indicated the highest correlation between intention and attitude r (137) = .740, p < .001. The correlation between intention and perceived behavior control was r (137) = .546, p < .001; intention and physical activity r (137) = .439, p < .001; attitude and perceived behavior control r (137) = .487, p < .001; and attitude and physical activity r (137) = .429, p < .001 demonstrated a moderately strong positive relationship. Subjective norm and perceived behavior control demonstrate the smallest correlational significance r (137) = .264, p <.001. Multiple regression analysis revealed attitude towards physical activity, and perceived behavior control for physical activity were statistically and clinically significant predictors of physical activity among the middle-aged African American women in this study.

Outcomes of the Saturday School: a church-based approach to enhance achievement in reading & mathematics.

Excellence in reading and math enable children entry to all of the professions. This is especially true for the nursing profession. Therefore, the purpose of this paper is to provide background information on the national crisis in reading and math achievement among school children, present the methodology of the Saturday School church-based approach to enhance reading and math skills, and the seven year outcomes.

Decisions to participate in fragile X and other genomics-related research: Native American and African American voices.

UNLABELLED: The lack of adequate minority representation, including Native-Americans (NA) and African-Americans (AA), in health related research is well documented. Nowhere is this truer than in the area of genomics-related research, which is especially troubling as NA and AA have some of the highest rates of overall morbidity and mortality due to genetic diseases. OBJECTIVES: The purpose of this study is to explore factors associated with the under representation of NA and AA adults in genetic research including: (1) decision barriers, (2) the influence of health care networks, (3) recruitment preferences, and (4) health conditions. METHODS: Eight focus groups were conducted, each by led by individuals who shared racial/cultural identification with participants. Adherence to tenants of Community Based Participatory Research (CBPR) was maintained. Qualitative data were analyzed using NVIVO program analyses and the constant comparative method. RESULTS: Themes supported the efficacy of CBPR to help demolish barriers while facilitating a willingness to participate in genetics-related research. CONCLUSIONS: Community-based approaches may enhance representation of minorities in genomics-related research crucial to eliminating health disparities.

State of the science: a cultural view of Native Americans and diabetes prevention.

The purpose of this article is to present a review of the literature on diabetes type 2 prevention interventions for Native American populations. The interrelation of the cultural role of food in Native American diets, educational policies related to food, outcomes of federal policies, and the historical background of diabetes are addressed. In addition, published studies of diabetes prevention interventions with Native American populations are examined. Lastly, exemplars of programs that represent best practices in the prevention of diabetes are described.