Behaviors Of African American Women Research Articles

Perspectives of African American women about barriers to breast cancer prevention and screening practices: A qualitative study.

Breast cancer is a severe illness that often has fatal consequences. Adherence to the recommendations for breast cancer surveillance is poorly practiced among African American women. The study aimed to identify barriers to preventative screening for breast cancer among African American women (AAW) using a qualitative research design. We explored the influence of personal barriers, stereotypes, socioeconomic status, culture, attitudes, and beliefs on African American women's behavior regarding breast cancer screening. Fourteen African American women were interviewed. Data analysis was completed with Interpretative Phenomenology Approach (IPA). This study's findings demonstrated that African American women perceived the barriers to breast cancer screening include lack of information about available resources, belief that screening cannot change genetic predisposition, embarrassment from exposing the breast for a mammogram, fear of mammograms, and fear of a positive result. These findings may be used to develop interventions to increase AAW's participation in breast cancer screening.

Abstract A037: Motivation through relational communication: Examining the normative social behavior of African American women who participate in breast cancer clinical trials

Abstract Black women die of breast cancer (BC) at a higher rate than any other racial group, but examination of the exact reasoning behind this phenomenon is hampered by African Americans’ (AAs) well-documented unwillingness to participate in medical research. According to research, AAs’ exhibited behavioral norms regarding clinical trial (CT) participation demonstrate a fear of being treated like guinea pigs, deep memories of previous abusive CTs, and strongly held perceptions of receiving unequal treatment in emergency departments and clinics. The Theory of Normative Social Behavior (TNSB) distinguishes descriptive norms (people’s perceptions about a behavior’s prevalence) from injunctive norms (people’s perceptions of the acceptable attitudes and behaviors of their defined group) and describes normative outcomes as injunctive norms joined with expected outcomes and group identity, that serve to influence the effects of descriptive norms on people’s behavior. Through the lens of the TSB, this study identifies the descriptive norms and normative mechanisms of Black/AA women who participate in BC CTs, and explores how their decisions to participate were guided by their relational communication practices. Thirteen self-identified Black or AA women (N=13) who are BC survivors or currently in treatment for BC, and who have previously taken part or are currently enrolled in a BC CT, participated in this study. The women answered interview questions such as, “How were you exposed to the idea of participation in a CT? What were the thoughts of your physicians/friends/family about your participation in particular? What is your experience with other AA women who have participated in BC CTs?” This study’s main finding was that each of these participants demonstrated very high levels of self-advocacy and self-efficacy, evidenced by their common admission of having made their decision on their own to take part in a CT, informing friends, family members, and physicians of their decision rather than seeking input or advice before deciding. Other results confirmed the presence of many already well-known AA descriptive norms such as distrust of CTs; however, the participants expressed feelings that generally, all African American women who have been diagnosed with BC should consider taking part in some kind of CT. Other findings were that these women showed strong racial identity, and were motivated to participate by the expectation of personal positive outcomes, monetary and non-monetary incentives, and a strong desire to help others. Citation Format: Katherine E Ridley-Merriweather. Motivation through relational communication: Examining the normative social behavior of African American women who participate in breast cancer clinical trials [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A037.

Abstract A018: Community outreach navigation of minority and medically underserved women in rural Arkansas to mammography facilities: Evolution and experiential results of the National Witness Project® from the last decade

Abstract “…intensive, community-based, culturally sensitive educational programs incorporating the spiritual environment of the faith community can positively influence screening behaviors in rural, underserved groups of African American women” Deborah O. Erwin, 1999 The Witness Project is a culturally competent, community-based outreach navigation program founded in Arkansas (AR) where access to mammography screening was especially problematic in certain areas. The (now) National Witness Project® (NWP) has been widely disseminated across the country. Women identify NWP as trusted and familiar providers of breast and cervical cancer education and invaluable assistance. Objective: Examine the NWP-AR chapter's evolution and past 10 years' experiences navigating rural women. Methods: NWP-AR provides African-American (AA) and all medically underserved women in rural communities with education and outreach navigation services to mammography as needed. They facilitate implementations of modular or mobile units in areas without facilities (service deserts). In 2007 NWP-AR was implemented in 34 counties and 9 in 2017. Results: In 2007 there were 1,374 women enrolled in NWP-AR, 84.6% of whom were rural folk. New enrollees (n=1,305) between March 2002-July 2007 were 54.9+/-11.5 years old and mostly AA, Caucasian, or Hispanic (75.7%, 22.1%, 1.7%), married or single (39.9%, 38.2%), and uninsured (82.1%). Medicare or Medicaid use was 31.7%. Initial service location choices were mobile, modular, and freestanding (54.9%, 25.9%, 14.6%). Over time rural women without facilities in their county (n=382) used modular or mobile (62.3%, 30.9%), rural women with facilities in their county (n=725) used mobile or modular (81.5%, 8.7%), and urban women (n=175) used freestanding or modular (61.1%, 19.4%). 2004 AR and national screening rates were 51.0% and 58.3%. In fiscal 2017, NWP-AR held 23 education/outreach events in 9 counties at mostly religious or residential centers (34.8%, 23.9%) and formed 10 new community partnerships in 8 counties. New enrollees (n=446) were ≥40 years of age (78.9%), AA or Caucasian (92.6%, 7.2%, 0.2%), and insured (92.6%). They made 488 contacts with enrollees. Modular units were phased out in favor of mobile units. In the 10 screening events in 8 counties, 138 AA or Caucasian (81.9%, 18.1%) women 40-49 (20.3%), 50-64 (40.6%), and ≥65 (39.1%) years of age were screened. All were insured. Navigation services to screening and later diagnostic testing were used by 67.4% and 2.9%. 2016 AR and national screening rates were 67.8% and 72.4%. Conclusion: In the 1990s NWP-AR pioneered activations of mobile mammography to rural and underserved areas. They have maintained their positive influences on the screening behavior of AA women. Despite a more focused implementation (34 vs. 9 counties), new enrollment rates almost doubled (~241 in 2007 to 446 in 2017), likely due to the feasibility of the mobile bus units. More work is needed as AR rates remain below average. Citation Format: Julia Devonish, Deborah O. Erwin, Detric Johnson, Frances Harfouche, Levi Ross, Cynthia Maxwell. Community outreach navigation of minority and medically underserved women in rural Arkansas to mammography facilities: Evolution and experiential results of the National Witness Project® from the last decade [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A018.

Cultural Identity, Africultural Coping Strategies, and Depression as Predictors of Suicidal Ideations and Attempts Among African American Female College Students

Suicide prevention is a growing health concern in America for many minority groups. Although experts agree suicide is associated with cultural practices and beliefs, there is limited evidence on how African American women cultural values and practices influence their low rates of suicide. This study explores cultural identity, Africultural coping strategies, and depression as predictors of suicidal ideations and attempts among African American female college students. It was hypothesized that suicidal ideations and attempts are negatively related to cultural identity and Africultural coping styles, but positively related to depression. One hundred and thirty-seven African American female students were administered a battery of measures assessing cultural identity, coping strategies, and suicidal ideations and attempts. Results revealed that Africultural coping strategies and depression emerged as significant predictors of suicidal ideation and attempts. Results are discussed in terms of African American culture as a buffer to possible suicidal behavior in African American women.

Social Norms, Gender Ratio Imbalance, Perceptions of Risk, and the Sexual Behaviors of African American Women at Historically Black Colleges and Universities

This literature review provides a summary of the sexual risk literature focused on black college students and identifies some of the risk factors associated with African American women attending Historically Black Colleges and Universities (HBCUs). The review included analysis of scholarly work and web-based data with an emphasis on studies exploring the sexual behaviors of students attending HBCUs published between 2000 and 2016. The results indicated that social norms, religiosity, gender ratio imbalances on campus, and perceived STD risk remain important factors associated with the sexual behaviors of African American women at HBCUs. Black college students in general and African American women specifically remain underrepresented and understudied in the research focused on sexual risk behaviors. The review suggests that additional empirical studies are needed to examine the sexual behaviors of African American college women as well as the programs in place at HBCUs to increase student knowledge about STIs.

Religious/Spiritual Coping in Older African American Women

The purpose of this study was to identify religious/spiritual coping behaviors of African American women with hypertension (HTN) and explore how religious/spiritual coping influences adherence to high blood pressure (HBP) therapy in older African American women. A mixed-method research design guided this study. Twenty African American women with primary HTN were enrolled in this study using a mixed methods concurrent triangulation design. Data collection included physiologic, descriptive, and sociodemographic data. Adherence was measured using the Hill-Bone Compliance to High Blood Pressure Therapy scale (Kim, Hill, Bone, & Levine, 2000), and religious/spiritual coping was evaluated with the Brief Religious/Spiritual Coping scale. Qualitative data were obtained by audiotaped interviews using a semi-structured interview guide. Descriptive, physiologic data and data from questionnaires were analyzed. Five themes emerged. (a) Feelings of dizziness, lightheadedness, and feeling sick; (b) Belief in God or a Supreme Being, (c) Prayer as the primary coping mechanism, (d) Adherence conceptualized as obedience to God’s will, and (e) Need for healthcare providers to pray and provide more health information. This study provided insight into the influence of religious/spiritual coping behaviors on adherence to HTN treatment in older African American women with HTN in a rural medically underserved area. Nurses and other healthcare providers are in a key position to influence positive health outcomes in rural settings with limited resources using culturally appropriate strategies.

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development.

African-American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e., 57% are obese, 49% have cardiovascular disease). The marked health disparities among African-American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring physical activity programs to address the sociocultural norms, values, beliefs, and behaviors of African-American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African-American women and to present a conceptual framework to guide intervention development. Development of the framework was based on our previous physical activity research with African-American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African-American culture, and key determinants of physical activity engagement among African-American women. Three key concepts are discussed in the conceptual framework: (1) Developmental milestones and life stage transitions of African-American women; (2) Historical, social, and cultural influences associated with physical activity engagement; and (3) Intervention delivery strategies. Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African-American women.

Environmental and personal correlates of physical activity and sedentary behavior in African American women: An ecological momentary assessment study

ABSTRACTThe authors of this study examined within-person associations of environmental factors (weather, built and social environmental barriers) and personal factors (daily hassles, affect) with moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) in African American women aged 25–64 years living in metropolitan Chicago (n = 97). In 2012–13, for seven days, women wore an accelerometer and were signaled five times per day to complete a survey covering environmental and personal factors on a study-provided smartphone. Day-level measures of each were derived, and mixed regression models were used to test associations. Poor weather was associated with a 27.3% reduction in daily MVPA. Associations between built and social environmental barriers and daily MVPA or SB were generally not statistically significant. Negative affect at the first daily signal was associated with a 38.6% decrease in subsequent daily MVPA and a 33.2-minute increase in subsequent daily SB. Each one-minute increase in MVPA during the day was associated with a 2.2% higher likelihood of positive affect at the end of the day. SB during the day was associated with lower subsequent positive affect. Real-time interventions that address overcoming poor weather and negative affect may help African American women increase MVPA and/or decrease SB.

Partnership-Level Analysis of African American Women's Risky Sexual Behavior in Main and Non-Main Partnerships.

The majority of research on risky sexual behavior in African American women has examined global associations between individual-level predictors and behavior. However, this method obscures the potentially significant impact of the specific relationship or relationship partner on risky sexual behavior. To address this gap, we conducted partnership-level analysis of risky sexual behavior among 718 African American women recruited from HIV counseling, testing, and referral sites in four states. Using mixed model regressions, we tested relationships between condomless vaginal intercourse with men and variables drawn from the Theory of Planned Behavior, Theory of Gender and Power, and previous research specifically on sexual risks among African American women. Significant associations with risky sexual behavior indicate the need for continued emphasis on condom attitudes, condom negotiation behaviors, and overcoming partner resistance to condoms within both main and non-main partnerships when implementing interventions designed to address HIV and sexually transmitted infection risks among African American women.

The Perceived and Actual Physical Activity Behaviors of African American Women.

Lack of physical activity is a leading contributor to obesity in the US. The unusually high rates of obesity in African-American (AA) women corroborate with lack of recommended levels of exercise in this population. The purpose of this study was to describe exercise behaviors and intention to change using the stages of change (SOC) model in a sample of AA women. A population-based observational study was conducted with 292 AA women in Florida. Outcome variables were engaging in aerobic, strength-based, and stretching exercise. More than half (61.25 %) did not engage in strength-based exercise, more than a third (37.7 %) did not engage in aerobic exercise, and a little less than half (45.9 %) did not participate in stretching exercise. SOC was the main independent variable. Women in action and maintenance SOC were significantly more likely to engage in aerobic exercise (OR 16.1, 95 % CI 7.09-25.7), strength-based exercise (OR 15.4, 95 % CI 6.58-22.7), and stretching exercise (OR 3.80, 95 % CI 1.91-7.52). The SOC is reflective of actual exercise behavior in AA women. A large number of AA women do not engage in regular recommended levels of exercise. Understanding SOC can be essential to developing culturally appropriate and motivation matched interventions for improving AA women's exercise habits.

Lessons learned from The Black Cosmetologists Promoting Health Program: A randomized controlled trial testing a diabetes education program

PurposeDiabetes is reaching epidemic proportions in the United States and African Americans are at greater risk than most. Disparities in the incidence of diabetes place African American women at a much higher risk than their white counterparts. As such, the purpose of this study was to evaluate a community-based educational intervention program aimed at changing diabetes attitudes, knowledge, and screening behaviors of African American women via cosmetologists trained as community health educators.MethodsTwenty African American cosmetologists joined the Black Cosmetologist Promoting Health Program. Their salons were randomized to disseminate diabetes or breast cancer information and given educational materials to display in their salons and give to their clients. Their clients (n = 984 women) consented to help evaluate the program, completing a baseline and 6-month follow-up survey regarding their knowledge, attitudes, and behaviors related to diabetes and breast cancer.ResultsAt the 6-month follow-up, self-reported knowledge about diabetes increased across both groups. However, despite similar programmatic structure offered to the two groups, there were no significant differences in diabetes knowledge, attitudes, and screening at follow-up.ConclusionThis non-significant outcome contrasted with the positive outcomes achieved by the parallel breast cancer program. Gladwell's Tipping Point theory could explain the different outcomes. The programs differed in message content, messaging tone, and the environment in which the messages were delivered. The diabetes program lacked a clear, memorable, and upbeat call-to-action and an environment that socially and financially supported the uptake of the recommended actions.

The effect of neighborhood disadvantage, social ties, and genetic variation on the antisocial behavior of African American women: A multilevel analysis

Social disorganization theory posits that individuals who live in disadvantaged neighborhoods are more likely to engage in antisocial behavior than are those who live in advantaged neighborhoods and that neighborhood disadvantage asserts this effect through its disruptive impact on social ties. Past research on this framework has been limited in two respects. First, most studies have concentrated on adolescent males. In contrast, the present study focused on a sample of adult African American females. Second, past research has largely ignored individual-level factors that might explain why people who grow up in disadvantaged neighborhoods often do not engage in antisocial behavior. We investigated the extent to which genetic variation contributes to heterogeneity of response to neighborhood conditions. We found that the impact of neighborhood disadvantage on antisocial behavior was mediated by neighborhood social ties. Further, the analysis indicated that the effects of neighborhood disadvantage and social ties on antisocial behavior were moderated by genetic polymorphisms. Examination of these moderating effects provided support for the differential susceptibility model of Gene × Environment. The effect of Gene × Neighborhood Disadvantage on antisocial behavior was mediated by the effect of Gene × Neighborhood Social Ties, providing support for an expanded view of social disorganization theory.

Religion, kinship and health behaviors of African American women.

A positive relationship exists between functional health and religion. We present an empirical definition of religion and describe the key elements of religious behavior, building a model that can be used to explore the presumed relationship between religion and health. Semi-structured interactive interviews were conducted with 22 participants over a 6-month period. Head Start programs and churches located in the inner city of a large metropolitan area. Twenty-two African American women were aged from 21 to 45. We focus on social relationships and propose that prophet-created religions mimic kinship relationships and encourage kinship-like cooperation between members.

A Review of the Health Effects of Sexual Assault on African American Women and Adolescents

To review the research findings for mental and physical health outcomes and health behaviors of African American women and adolescents after sexual assault. Searches of the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO, and PubMed from January 2001 through May 2012 using the terms Blacks, African Americans, sexual abuse, sexual offenses, and rape. Criteria for inclusion included (a) results of primary research conducted in the United States and published in English, (b) African American females age 13 and older, (c) sexual assault or sexual abuse reported as distinct from other types of abuse, and (d) health status as an outcome variable. Twenty-one publications met inclusion criteria. Articles were reviewed for the mental and physical health and health behavior outcomes associated with sexual assault of African American women and adolescents. Sexual assault was associated with increased risk of poor mental and physical health outcomes in the general population of women and adolescents. There was an increased risk of unhealthy behaviors (e.g., drinking, drug use, risky sexual behaviors) for all women and adolescents, with the highest risk reported for African American women and adolescents. Help seeking from family and friends demonstrated conflicting results. Cumulative effects of repeated assaults appear to worsen health outcomes. Sexual assault has significant effects on the physical and mental health and health behaviors of women and adolescents in the general population. Less evidence is available for differences among African American women and adolescents. More research is needed to understand the influence of race on women's and adolescents' responses to assault.

Cancer Screening Behaviors of African American Women Enrolled in a Community-Based Cancer Prevention Trial

Background: African American women have increased mortality rates for cervical, breast, and colorectal cancers, yet not all receive the recommended screening tests for these cancers. We characterized the cancer screening behaviors of African American women enrolled in a community-based cancer prevention trial. Methods: We examined cross-sectional data from 1123 African American customers aged ≥18 years from 37 beauty salons in North Carolina who completed the North Carolina BEAUTY and Health Project baseline survey. Mixed logistic regression models were used to identify correlates of receiving cervical, breast, and colorectal cancer screening tests within recommended screening guidelines. Results: Overall, 94% (1026 of 1089) of women aged ≥18 years reported receiving a Pap smear test within the last 3 years, 70% (298 of 425) of women aged ≥40 years reported receiving a mammography within the last year, and 64% (116 of 180) of women aged ≥50 years were considered to be within recommended screening guidelines for colorectal cancer. Age was correlated with recent Pap smear testing and mammography. Women who reported receiving a recent Pap smear test were more likely to report a mammogram in the last year, and women with a recent mammogram were more likely to be within recommended screening guidelines for colorectal cancer. Many women reported multiple barriers to getting recommended cancer screening tests. Conclusions: Almost all women reported receiving a Pap smear test within the last 3 years. Future interventions should focus on increasing breast and colorectal cancer screening among African American women.

Cancer Screening Behaviors of African American Women Enrolled in a Community-Based Cancer Prevention Trial

Cancer Screening Behaviors of African American Women Enrolled in a Community-Based Cancer Prevention Trial

Self-Care Behaviors of African American Women Living With HIV: A Qualitative Perspective

Significant numbers of African American (AA) women have been diagnosed with HIV over the past decade. HIV may be viewed as a chronic condition that can be actively managed through the use of self-care behaviors, yet little is known about how these women define self-care (SC) for themselves, and still less is known about what facilitates and hinders SC behaviors among these women. This article highlights the results of a qualitative research study undertaken with AA women living with HIV in a metropolitan city in the southeastern United States. The objective of this study was to systematically collect data about the SC experiences of these women. Focus group methodology was used. Content analysis of the data was conducted. Two primary domains emerged: do what the doctor says and living healthy. SC activities included seeking social support, managing disclosure, engaging in pampering, taking part in religious customs, and maintaining recovery.

Development of Wagle Health-Specific Religiousness Scale

African American women have a lower rate of regular mammography screening, resulting in higher incidence of advanced-stage breast cancer at diagnosis and a lower 5-year survival rate as compared with white women. Researchers have demonstrated that several health beliefs relate to mammography screening in African American women, but little attention has been paid to the importance of religiousness. Although some authors have attempted to determine a link between religiousness and health, we lack a valid and reliable instrument to measure religiousness that can be found in the context of health behaviors. The purpose of this article is to describe the development and psychometric testing of the Wagle Health-Specific Religiousness (WHSR) scale, an instrument used to measure religious beliefs and the influence of those beliefs on mammography screening for African American women. A sample of 344 low-income African American women who were nonadherent to mammography at accrual participating in a randomized trial completed the WHSR. Data from this trial were used to determine the validity and reliability of the WHSR. The 19-item WHSR scale had a Cronbach alpha of. 94. Construct validity was supported via factor analysis and analysis of theoretical relationships. Although further testing is warranted, this analysis indicates that the concept of religiousness is an important component of mammography behavior in African American women.

Romantic Unions in an Era of Uncertainty: A Post-Moynihan Perspective on African American Women and Marriage

This article provides a brief overview of how African American women are situated in and around the thesis of the Moynihan Report. The authors take the lens of uncertainty and apply it to a post-Moynihan discussion of African American women and marriage. They discuss uncertainty in the temporal organization of poor women's lives and in the new terrains of gender relationships and how both influence African American women's thoughts and behaviors in their romantic relationships and marriages. They argue that much is to be learned from by focusing the lens in this way. It allows us to look at the contemporary romantic relationship and marriage behaviors of African American women in context and in ways that do not label them as having pathological behaviors that place them out of sync with broader societal trends.

HIV Risk Reduction in Rural African American Women Who Use Cocaine

ABSTRACT Research has demonstrated associations between cocaine use and sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV). More research has been conducted among the sub-population of women, with less focus on rural African American women. Investigation of the social context that influences rural African American women's behavior that places them at risk for STI/HIV has received limited attention. The results of one component of the comprehensive study presented here focused on perceived STI/HIV risk reduction strategies of U.S. southern rural African American women who used cocaine. This ethnographic study of 30 rural African American women using cocaine was conducted over four years. Respondents described HIV risk reduction strategies and their motives for using them. Condoms were used more with casual partners (80%) than primary partners (16%) and with partners who were less known, less trusted, young, or physically or sexually “dirty.” Condoms were also used to prevent pregnancy (60%) more than to prevent STI/HIV (40%). HIV testing patterns varied, as did the motives for seeking testing. The sexual behavior of the women in this study exposed them to increased risk of STI/HIV. Although many perceived that they were using sexual risk reduction strategies, these strategies were not scientifically sound risk reduction strategies. Consequently, their exposure to STI/HIV continued as they used ineffective strategies both in assessing partner risk and in implementing risk reduction behaviors.