Opportunities to address lung cancer disparities among African Americans.

Race and socioeconomic status are well known to influence lung cancer incidence and mortality patterns in the U.S. Lung cancer incidence and mortality rates are higher among blacks than whites. In this article we review opportunities to address disparities in lung cancer incidence, mortality, and survivorship among African Americans. First, we summarize recent advances in the early detection and treatment of lung cancer. Then we consider black-white disparities in lung cancer treatment including factors that may contribute to such disparities; the literature on smoking cessation interventions for patients with or without a lung cancer diagnosis; and the important roles played by cultural competency, patient trust in their physician, and health literacy in addressing lung cancer disparities, including the need for culturally competent lung cancer patient navigators. Intervention efforts should focus on providing appropriate quality treatment for lung cancer and educating African Americans about the value of having these treatments in order to reduce these disparities. Culturally competent, patient navigation programs are needed that support lung cancer patients, especially socioeconomically disadvantaged patients, from the point of diagnosis to the initiation and completion of treatment, including cancer staging.

Health literacy and asthma management among African-American adults: an interpretative phenomenological analysis.

OBJECTIVE: African-Americans share a disproportionate burden of asthma and low health literacy and have higher asthma morbidity and mortality. Factors that link the relationship between health literacy and health outcomes are unclear. This study aimed to use patients' experiences of managing asthma to better understand the relationship between health literacy and health outcomes. METHODS: This study was the qualitative component of a mixed methods study. Following quantitative data collection, four participants, two with low print-related health literacy and two with adequate print-related health literacy, completed semi-structured interviews. Interview data were analyzed using interpretative phenomenological analysis. RESULTS: Three themes emerged from the analysis: information desired versus information received, trial and error, and expectations of the patient-provider relationship. Individuals with adequate print-related health literacy had different strategies for overcoming barriers related to communicating with their providers, learning about their disease and experiences of discrimination within the healthcare system. CONCLUSIONS: Individuals with adequate print-related health literacy may be more equipped to participate in shared decision making and feel more confident to successfully manage their disease. It is also important that health literacy is discussed in the context of the cultural and racial background of the population of interest. This interdependent relationship between health literacy and culture is particularly important for African-Americans.

Acute exercise does not attenuate postprandial oxidative stress in prediabetic women.

Individuals with impaired lipid and glucose metabolism are at increased risk for postprandial oxidative stress. Acute exercise can attenuate the rise in both blood triglyceride (TAG) and glucose, and increase antioxidant enzyme activity after food intake, which may decrease the oxidative stress response. This study investigated the effect of acute exercise on blood TAG and oxidative stress biomarkers in prediabetic women. Sixteen prediabetic women (30 +/- 3 years of age; fasting blood glucose, 107 +/- 3 mg x dL(-1); body mass index, 32 +/- 2 kg x m(-2)) consumed a high-fat meal with and without a session of aerobic exercise 15 minutes preceding the meal (45-minute duration, 65% heart rate reserve), in a random order cross-over design. Blood samples were collected premeal (fasted) and at 1, 2, 4, and 6 hours postmeal and assayed for Trolox equivalent antioxidant capacity (TEAC), xanthine oxidase (XO) activity, hydrogen peroxide (H2O2), malondialdehyde (MDA), TAG, and glucose. No interaction or condition main effects were noted (P > 0.05). However, time main effects were noted for XO, H2O2, MDA, and TAG (P < 0.0001), with values higher from 1 to 6 hours postmeal compared with premeal, and for TEAC (P = 0.05), with values lower at 4 hours postmeal. Glucose remained relatively unchanged (P > 0.05). Acute exercise, performed at the intensity and duration of the present study, does not influence postprandial TAG and oxidative stress in obese prediabetic women. Such individuals may need a greater volume of exercise for measurable effects.