Exploring the association between mental health climate and depression: the protective role of positive mental health and sense of belonging among Black college students.

Objective: To explore relationships between mental health climate, positive mental health, sense of belonging, and depression among a U.S. national sample of Black college students. Participants: 1303 Black undergraduate and graduate students from 15 colleges and universities throughout the U.S. Methods: Data were from the 2018-2019 Healthy Minds Study. Analysis included hierarchical regression models. Results: A more positive perception of mental health climate and higher levels of both positive mental health and sense of belonging were significantly associated with lower levels of depression. Significant interactions existed between positive mental health and climate and sense of belonging and climate with buffering effects being most pronounced for students reporting high levels of positive mental health. Conclusion: Black college students' perceptions of an institution's mental health climate are associated with psychological outcomes. College health stakeholders should consider the buffering effects of protective factors on mental health when designing initiatives for Black college students.

Racial Equity as a Human Rights Issue: Field Agency Practices and Field Instructors' Knowledge and Attitudes.

Racial equity which, at minimum, is defined as the state in which health, social, and economic outcomes are no longer predicted by race has become a critical issue for social workers who work with and advocate for the rights of marginalized communities. Despite its importance, it remains to be seen if field instructors and the agencies they work for understand racial equity as a human rights issue. Through an anonymous survey, we assessed field instructor's racial equity awareness, knowledge, and understanding and examined actions agencies have taken to address and advance racial equity. It was hypothesized that field instructors who view racial equity as a human right would report promoting and advancing these important concepts with their students and organizations. A total of 170 field instructors accessed the survey through an emailed link in this exploratory effort. Descriptive analyses found that field instructors believe that racial equity is a significant human rights issue and that their agency's culture views racial equity as important; however, issues with time, resources, funding, and expertise to promote racial equity initiatives create obstacles to bring about change. The discussion emphasizes the importance of building capacity among field educators to address racial equity through a human rights lens, which is integral to advancing the collective social work goals of social justice and dismantling systemic oppression.

Quantitative Evaluation of the Community Research Fellows Training Program.

CONTEXT: The community research fellows training (CRFT) program is a community-based participatory research (CBPR) initiative for the St. Louis area. This 15-week program, based on a Master in Public Health curriculum, was implemented by the Division of Public Health Sciences at Washington University School of Medicine and the Siteman Cancer Center. OBJECTIVES: We measure the knowledge gained by participants and evaluate participant and faculty satisfaction of the CRFT program both in terms of meeting learning objectives and actively engaging the community in the research process. PARTICIPANTS: We conducted analyses on 44 community members who participated in the CRFT program and completed the baseline and follow-up knowledge assessments. MAIN OUTCOME MEASURES: Knowledge gain is measured by a baseline and follow-up assessment given at the first and final session. Additionally, pre- and post-tests are given after the first 12 sessions. To measure satisfaction, program evaluations are completed by both the participants and faculty after each topic. Mid-way through the program, a mid-term evaluation was administered to assess the program's community engagement. We analyzed the results from the assessments, pre- and post-tests, and evaluations. RESULTS: The CRFT participants' knowledge increased at follow-up as compared with baseline on average by a 16.5 point difference (p < 0.0001). Post-test scores were higher than pre-test scores for 11 of the 12 sessions. Both participants and faculty enjoyed the training and rated all session well. CONCLUSION: The CRFT program was successful in increasing community knowledge, participant satisfaction, and faculty satisfaction. This success has enhanced the infrastructure for CBPR as well as led to CBPR pilot projects that address health disparities in the St. Louis Greater Metropolitan Area.

Increasing research literacy: the community research fellows training program.

The Community Research Fellows Training (CRFT) Program promotes the role of underserved populations in research by enhancing the capacity for community-based participatory research (CBPR). CRFT consists of 12 didactic training sessions and 3 experiential workshops intended to train community members in research methods and evidence-based public health. The training (a) promotes partnerships between community members and academic researchers, (b) enhances community knowledge of public health research, and (c) trains community members to become critical consumers of research. Fifty community members participated in training sessions taught by multidisciplinary faculty. Forty-five (90%) participants completed the program. Findings demonstrate that the training increased awareness of health disparities, research knowledge, and the capacity to use CBPR as a tool to address disparities.

Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.

OBJECTIVE: Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population. METHODS: 1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. RESULTS: No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p < .0001); respondents with marginal (OR = 1.54; p = .005) or limited (OR = 1.85; p = .009) health literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (ß = -0.41; p < .001) and Hispanics (ß = -0.25; p = .033) intended to change fewer health habits than Whites; health literacy was negatively associated with number of health habits participants intended to change. CONCLUSIONS: Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.

Brentwood community health care assessment.

BACKGROUND: The Community Alliance for Research Empowering Social Change (CARES) is an academic-community research partnership designed to train community members on research methods and develop the infrastructure for community-based participatory research (CBPR) to examine and address racial/ethnic health disparities. The Brentwood Community Health Assessment (BCHA) was developed through a CBPR pilot project grant from CARES. OBJECTIVES: The purpose of the BCHA is to assess health care utilization and identify existing barriers to health care access among a multi-ethnic community in the Hamlet of Brentwood, New York. METHODS: Using CBPR approaches, the community-academic research partnership develop the study design and survey instrument. Trained Bilingual (English/Spanish) data collectors verbally administered surveys door-to-door to residents of Brentwood from October 2010 to May 2011. Inclusion criteria required participants to be at least 18 years of age and speak either English or Spanish. RESULTS: Overall, 232 residents completed the BCHA; 49% were male, 66% Hispanic, 13% non-Hispanic White, 13% non-Hispanic Black, 29% had less than a high school education, and 33% were born in United States. The assessment results revealed that most residents are able to access health care when needed and the most significant barriers to health care access are insurance and cost. CONCLUSIONS: We describe the community-academic partnered process used to develop and implement the BCHA and report assessment findings; the community-partnered approach improved data collection and allowed access into one of Suffolk County's most vulnerable communities.

Quantitative assessment of participant knowledge and evaluation of participant satisfaction in the CARES training program.

BACKGROUND: The purpose of the Community Alliance for Research Empowering Social change (CARES) training program was to (1) train community members on evidence-based public health, (2) increase their scientific literacy, and (3) develop the infrastructure for community-based participatory research (CBPR). OBJECTIVES: We assessed participant knowledge and evaluated participant satisfaction of the CARES training program to identify learning needs, obtain valuable feedback about the training, and ensure learning objectives were met through mutually beneficial CBPR approaches. METHODS: A baseline assessment was administered before the first training session and a follow-up assessment and evaluation was administered after the final training session. At each training session a pretest was administered before the session and a posttest and evaluation were administered at the end of the session. After training session six, a mid-training evaluation was administered. We analyze results from quantitative questions on the assessments, pre- and post-tests, and evaluations. RESULTS: CARES fellows knowledge increased at follow-up (75% of questions were answered correctly on average) compared with baseline (38% of questions were answered correctly on average) assessment; post-test scores were higher than pre-test scores in 9 out of 11 sessions. Fellows enjoyed the training and rated all sessions well on the evaluations. CONCLUSIONS: The CARES fellows training program was successful in participant satisfaction and increasing community knowledge of public health, CBPR, and research methodology. Engaging and training community members in evidence-based public health research can develop an infrastructure for community-academic research partnerships.

Self-reported segregation experience throughout the life course and its association with adequate health literacy.

Residential segregation has been shown to be associated with health outcomes and health care utilization. We examined the association between racial composition of five physical environments throughout the life course and adequate health literacy among 836 community health center patients in Suffolk County, NY. Respondents who attended a mostly White junior high school or currently lived in a mostly White neighborhood were more likely to have adequate health literacy compared to those educated or living in predominantly minority or diverse environments. This association was independent of the respondent's race, ethnicity, age, education, and country of birth.

Weight perceptions and perceived risk for diabetes and heart disease among overweight and obese women, Suffolk County, New York, 2008.

INTRODUCTION: Many Americans fail to accurately identify themselves as overweight and underestimate their risk for obesity-related diseases. The purpose of this study was to investigate associations between weight perceptions and perceived risk for diabetes and heart disease among overweight or obese women. METHODS: We examined survey responses from 397 overweight or obese female health center patients on disease risk perceptions and weight perceptions. We derived odds ratios (ORs) and 95% confidence intervals (CIs) from multivariable logistic regression analyses to examine predictors of perceived risk for diabetes and heart disease. We further stratified results by health literacy. RESULTS: Perceiving oneself as overweight (OR, 2.78; 95% CI, 1.16-6.66), believing that being overweight is a personal health problem (OR, 2.46; 95% CI, 1.26-4.80), and family history of diabetes (OR, 3.22; 95% CI, 1.53-6.78) were associated with greater perceived risk for diabetes. Perceiving oneself as overweight (OR, 4.33; 95% CI, 1.26-14.86) and family history of heart disease (OR, 2.25; 95% CI, 1.08-4.69) were associated with greater perceived risk for heart disease. Among respondents with higher health literacy, believing that being overweight was a personal health problem was associated with greater perceived risk for diabetes (OR, 4.91; 95% CI, 1.68-14.35). Among respondents with lower health literacy, perceiving oneself as overweight was associated with greater perceived risk for heart disease (OR, 4.69; 95% CI, 1.02-21.62). CONCLUSION: Our findings indicate an association between accurate weight perceptions and perceived risk for diabetes and heart disease in overweight or obese women. This study adds to research on disease risk perceptions in at-risk populations.

Increasing research literacy in minority communities: CARES fellows training program.

The community alliance for Research Empowering Social Change (CARES) is an academic-community research partnership designed to: (1) train community members about evidence based public health, (2) increase community members' scientific literacy, and (3) develop the infrastructure for community-based participatory research so that local stakeholders can examine and address racial/ethnic health disparities in their communities. Nineteen community members enrolled in the CARES training. The training consisted of 11 didactic training sessions and 4 experiential workshops, taught by a multidisciplinary faculty from research institutions. Results suggest that the training increased research literacy, prepared community members for collaborative work with academic researchers, and empowered them to utilize scientific research methods to create social change in their communities.