Abstract
IntroductionChronic diseases are common among African Americans, but the extent to which research has focused on addressing chronic diseases across multiple members of African American families is unclear. This systematic scoping review summarizes the characteristics of research addressing coexisting chronic conditions among African American families, including guiding theories, conditions studied, types of relationships, study outcomes, and intervention research.MethodsThe literature search was conducted in PsycInfo, PubMed, Social Work s, Sociological s, CINAHL, and Family and Society Studies Worldwide to identify relevant articles published from January 2000 through September 2016. We screened the title and abstracts of 9,170 articles, followed by full-text screening of 530 articles, resulting in a final sample of 114 articles. Fifty-seven percent (n = 65) of the articles cited a guiding theory/framework, with psychological theories (eg, social cognitive theory, transtheoretical model) being most prominent. The most common conditions studied in families were depression (70.2%), anxiety (23.7%), and diabetes (22.8%), with most articles focusing on a combination of physical and mental health conditions (47.4%).ResultsIn the 114 studies in this review, adult family members were primarily the index person (71.1%, n = 81). The index condition, when identified (79.8%, n = 91), was more likely to be a physical health condition (46.5%, n = 53) than a mental health condition (29.8%, n = 34). Among 343 family relationships examined, immediate family relationships were overwhelmingly represented (85.4%, n = 293); however, extended family (12.0%, n = 41) and fictive kin (0.6%, n = 2) were included. Most (57.0%, n = 65) studies focused on a single category of outcomes, such as physical health (eg, obesity, glycemic control), mental health (eg, depression, anxiety, distress), psychosocial outcomes (eg, social support, caregiver burden), or health behaviors (eg, medication adherence, disease management, health care utilization); however, 43.0% (n = 49) of studies focused on outcomes across multiple categories. Sixteen intervention articles (14.0%) were identified, with depression the most common condition of interest.ConclusionRecognizing the multiple, simultaneous health issues facing families through a lens of family comorbidity and family multimorbidity may more accurately mirror the lived experiences of many African American families and better elucidate intervention opportunities than previous approaches.
Highlights
Introduction Chronic diseases are common amongAfrican Americans, but the extent to which research has focused on addressing chronic diseases across multiple members of African American families is unclear
The most common conditions studied in families were depression (70.2%), anxiety (23.7%), and diabetes (22.8%), with most articles focusing on a combination of physical and mental health conditions (47.4%)
Most (57.0%, n = 65) studies focused on a single category of outcomes, such as physical health, mental health, psychosocial outcomes, or health behaviors; 43.0% (n = 49) of studies focused on outcomes across multiple categories
Summary
African Americans, but the extent to which research has focused on addressing chronic diseases across multiple members of African American families is unclear. At the intersection of family health and chronic health problems, Burton and Whitfield [8] introduced the concept family comorbidity as the existence of physical or mental health problems in a primary caregiver (mother or grandmother) and/or a child in a family. This definition was later refined to include “the presence of multiple cooccurring physical and/or mental health problems within individuals or families” beyond parent/child dyads [9]. The concept of family comorbidity highlights an opportunity to increase understanding of health experiences within families, with specific attention to current health status and day-to-day needs of multiple household members (often representing several generations)
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