Blacks Research Articles

Clinical and Demographic Factors Associated Suicide Risk in Patients With Colorectal Cancer.

Mental health is adversely affected by a cancer diagnosis. As the incidence of colorectal cancer (CRC) is on the rise, data regarding mental health and suicide among CRC patients is lacking. The primary aim of this study is to investigate the incidence of suicide among CRC patients in comparison to the general population. The secondary aim is to identify factors that are associated with increased risk of suicide among patients with CRC. A cross-sectional study was conducted utilizing the Surveillance, Epidemiology, and End Results Program database from 2000 to 2018. Standardized Mortality Ratios (SMRs) were calculated for 5-y age groups. Cox's cause-specific hazards model was utilized to compare covariates that increased the risk of suicide. A total of 530,711 patients were included. 289,363 (54%) were male. Overall, there were 782 (0.15%) suicides, of which 687 (88%) occurred in males. The SMR due to suicide was significantly higher in males (SMR 1.60, 95% confidence interval [CI] 1.481-1.722; P<0.001) including ages 35-49 ys and over 60ys, however, not in females (SMR 1.12, 95% CI 0.91-1.375; P=0.276). Factors independently associated with increased suicide risk included distant disease (hazard ratio [HR] 2.57; CI 1.96, 3.39; P=<0.0001), radiation (HR 1.45; CI 1.16, 1.80; P=0.0009), and increased age (HR 1.05 per 5-y increase; CI 1.02, 1.09; P=0.0013). Factors associated with decreased risk of suicide included non-Hispanic Black race (HR 0.27; CI 0.18, 0.41; P= <0.0001), Hispanic race (HR 0.31; 95% CI 0.21, 0.45; P=<0.0001), being married (HR 0.56; CI 0.49, 0.65; P=<0.0001), living in metropolitan area (HR 0.74; CI 0.61, 0.90; P=0.003), and receiving chemotherapy (HR 0.71; CI 0.58, 0.86; P=0.0001). Male colorectal patients aged 35-49 ys and over 60 ys are at a higher risk of suicide than the general United States population. Understanding factors that increase a patient's risk for suicide will be important to develop strategies to mitigate this risk and improve overall mental health.

Paths well travelled: Imaginative contours of the juridical ummah

ABSTRACT This article explores how the subaltern Muslim animated the imaginative politics and juridical contours of the Ottoman nation between 1876-1913. I discuss how the members of the ummah, the global 'Muslim nation', were called to settle and work the lands of the Ottoman Empire. In the late 19th century, the ports and provincial capitals of the empire welcomed immigrants from across the Balkans-to-Bengal axis. However, not all who landed in the Levantine shores enjoyed the entitlements of property and protection promised by the Ottoman immigration state. The provenance of immigrants, the legality of their arrival, and the racial fault lines running through the ummah each set the terms of their inclusion in or their exclusion from the Ottoman nation. Building on the 1902 Resolution to the Ottoman Immigration Law of 1857, this article further explains how the Ottoman nation was delineated by a juridical identity—Ottoman nationality—that was categorically majoritarian and contractually exclusionary because of, and not despite, its global aspirations. I argue that Ottoman sovereignty conceived in the image of a juridical ummah found its terrestrial expression in the Ottoman nation: to the categorical exclusion of non-Muslims, predominantly Armenians; the conditional inclusion of subaltern Muslims; and the tacit rejection of Black Africans. This article thus explores imaginative entanglements of law, race, and religion in the age of empires.

Tired of being tired: Black college students' experiences of racial battle fatigue from highly publicized anti-Black violence.

The highly publicized murders of Breonna Taylor, George Floyd, and Ahmaud Arbery in 2020 sparked public outrage and widespread discussion around anti-Black violence. While some studies have examined the effects of anti-Black violence exposure on mental health outcomes, there is a paucity of research that explores how these racially charged events contribute to cumulative stress and "weathering" for Black people, particularly. Informed by racial battle fatigue theory, this in-depth qualitative study explored the lived experiences of 30 Black male and female undergraduate college students (aged 18-28) exposed to highly publicized acts of anti-Black violence. Thematic analysis revealed four predominant themes: (a) witnessing an endless cycle of anti-Black violence, (b) experiencing cumulative and prolonged psychosocial effects, (c) grieving while Black, and (d) navigating the tension between activism and burnout. Findings expose the cyclical and inescapable nature of anti-Black violence, including the toll of these events on the lives of Black college students. Research, practice, and policy implications underscore the need for culturally relevant interventions to support resilience among Black people in the aftermath of anti-Black violence. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The role of Black-led community organisations in supporting Black mental health: a Black emancipatory action research project

ABSTRACT Objective To explore the role of Black-led community organisations in supporting Black mental health and wellbeing in the UK. Design A qualitative, Black Emancipatory Action Research Framework was adopted. Framework application involved adequately compensating community organisations for their consultancy role; having ‘research conversations’ rather than interviewing participants; and focusing outputs on community benefit. Eight individual and group research conversations took place with nine Black directors, employees and volunteers working with Black-led community organisations, aged between 19 and 62, living in the UK. Reflexive thematic analysis was used to analyse conversations. Results Three themes were developed in relation to what Black-led community organisations do for Black mental health. These are: identify and respond to mental health needs; selectively build relationships with mainstream services; and drive social and systemic improvements. Findings revealed that Black-led community organisations uniquely identify and address mental wellbeing by offering respite from racism, hosting activities, and meeting urgent needs. They navigate and facilitate access to health and social systems, protect communities from harmful services, and advocate for social and systemic change. Drawing on the study design, findings, and the broader literature, we propose three key changes to current funding, community, and research practices. These are a reconsideration of how Black-led organisations’ work is valued and measured, a forging of greater collaboration between these organisations, and bolder consideration of how research practice can benefit Black communities. Conclusions Black-led organisations play multiple roles in supporting individual and collective mental health, crucial for mediating the effects of racism and mitigating ethnic inequalities. To our knowledge, this is the first study to both illuminate the critical role of community organisations in promoting Black mental health in the UK and to prioritise participant, and community, benefit throughout the research process.

BIPOC Community Perspectives on Environmental Justice in Georgia

For decades, the environmental and climate justice spaces have been predominantly spearheaded by white activists and institutions, even as Black, Brown, and immigrant communities experience the brunt of climate change’s impact. The resulting exclusion of Black, Indigenous, and other people of color’s (BIPOC) experiences, perspectives, and leadership from environmental policy and conservation work has created significant blind spots that further perpetuate inequality (Jones, 2020). In a moment of reckoning, the historically white-led environmental and climate justice movements have begun to acknowledge the exclusion of people of color and its detrimental effects on BIPOC peoples and the movement overall. In order to rectify this exclusion, communities of color must be centered in movement strategy going forward. Furthermore, before community advocacy organizations and community members can advocate for and enact policies and other political decisions on behalf of these communities, we must first ask them what environmental harm has looked like and what solutions they need as we look toward the future. Toward that end, Democracy Lab South and partners conducted the first and only multilingual statewide environmental justice survey of Georgia’s BIPOC and immigrant communities in 2022. This survey establishes a baseline understanding of these communities’ current perceptions, needs, practices, and potential localized solutions. It is our hope that the survey and resulting policy report will serve as a catalyst for building a robust statewide environmental movement that centers those most affected by climate and environmental issues.

Building an Oral Repository of African Immigration Experiences in French: The Griotte Project’s Reparative Historiographic Praxis Through Service-Learning at the University of Central Arkansas

Central Arkansas and the campus of the University of Central Arkansas are home to a vibrant and growing community of multilingual French speakers of diverse cultural and national identities of West and Central Africa. French serves as an important tool of Black transnational community building, networking, and civic organization in our area. However, Black French speakers in the United States are often erased in official records of the presence and activities of immigrants in Arkansas, as well as from representation in French syllabi. To address and repair these gaps, the author, advanced French students, and community members are building a repository of oral histories of Arkansas African immigration stories in French, activating the university archive as a dynamic teaching and learning space. This article critically reflects on the translation of decolonial, antiracist, and feminist theory into pedagogical praxis through the coordination of a French-language oral history service-learning project from the academic perspective of an associate professor in French in affiliation with the Africana Studies and Gender Studies programs of a predominantly white public regional teaching university in the American South. The UCA Griotte Project entrusts students, the majority of whom are women of African descent, with collaborative leadership of the project to decentralize historical authority and destabilize the teacher/learner dichotomy. When we occupy and open the archive as a space of experiential learning and shared knowledge creation, we are transforming an institutional site of memory to write a more accurate, just, and inclusive history for the future.

Population pharmacokinetics of bedaquiline: a systematic review.

Bedaquiline (BDQ) plays a critical role in the treatment of multidrug-resistant tuberculosis (MDR-TB). However, the large pharmacokinetic (PK) variability of BDQ presents a significant challenge in its clinical use. This study aimed to summarize the population PK characteristics of BDQ and to identify significant covariates affecting the PK variation of BDQ. The PubMed and Web of Science databases were systematically searched from their inception to October 1, 2023. Population pharmacokinetics (PPK) studies on BDQ were searched and identified in this review. The PK characteristics of included studies and the significant covariates were systematically summarized. Eight studies conducted in adults and one in children and adolescents were included in this review. A three disposition compartments with dynamic absorption transport chamber model was the commonly used structural model for BDQ. Body weight, race, albumin, and concomitant medication were significant covariates affecting BDQ PK variation. With the increase of weight and albumin levels, the clearance (CL) of BDQ was gradually increased. The average CL value per body weight in children was 1.49-fold higher than that in adults. Black race patients had an 84% higher CL than other populations. Moreover, combined with rifampicin and rifapentine, BDQ had 378% and 296% higher clearance rates, respectively. Body weight, race, albumin level, and concomitant medication may be important factors affecting patients' exposure differences. Further PPK studies of BDQ are needed to facilitate optimal dosing regimens.

Cost-Effectiveness of a Polypill for Cardiovascular Disease Prevention in an Underserved Population

The Southern Community Cohort Study (SCCS) Polypill Trial showed that a cardiovascular polypill (a single pill containing a statin and 3 half-standard dose antihypertensive medications) effectively controls cardiovascular disease (CVD) risk factors in a majority Black race and low-income population. The cost-effectiveness of polypill treatment in this population has not been previously studied. To determine the cost-effectiveness of the cardiovascular polypill. A discrete-event simulation version of the well-established CVD policy model simulated clinical and economic outcomes of the SCCS Polypill Trial from a health care sector perspective. A time horizon of 10 years was adopted. Polypill treatment was priced at $463 per year in the base-case analysis. Model input data were derived from the National Health and Nutrition Examination Survey, Medical Expenditure Panel Survey, pooled longitudinal cohort studies, the SCCS Polypill Trial, and published literature. Two cohorts were analyzed: an SCCS Polypill Trial-representative cohort of 100 000 individuals and all trial-eligible non-Hispanic Black US adults. Study parameters and model inputs were varied extensively in 1-way and probabilistic sensitivity analysis. Polypill treatment or usual care. Primary outcomes were direct health care costs (US dollar 2023) and quality-adjusted life-years (QALYs), both discounted 3% annually, and the incremental cost per QALY gained. In the trial-representative cohort of 100 000 individuals (mean [SD] age, 56.9 [5.9] years; 61 807 female [61.8%]), polypill treatment was projected to yield a mean of 1190 (95% uncertainty interval, 287-2159) additional QALYs compared with usual care, at a cost of approximately $10 152 000. Hence, polypill treatment was estimated to cost $8560 per QALY gained compared with usual care and was high value (<$50 000 per QALY gained) in 99% of simulations. Polypill treatment was estimated to be high value when priced at $559 or less per year and cost saving when priced at $443 or less per year. In almost all sensitivity analyses, polypill treatment remained high value. In a secondary analysis of 3 602 427 trial-eligible non-Hispanic Black US adults (mean [SD] age, 55.4 [7.6] years; 2 006 597 female [55.7%]), polypill treatment was high value, with an estimated cost of $13 400 per QALY gained. Results of this economic evaluation suggest that polypill treatment could be a high value intervention for a low-income, majority Black population with limited access to health care services. It could additionally reduce health disparities.

Community Music Education for Black Africans during Apartheid and in Post-Apartheid South Africa

Community Music Education for Black Africans during Apartheid and in Post-Apartheid South Africa

Racial and Ethnic Trends in Cesarean Delivery on Maternal Request.

To evaluate race and ethnicity differences in rates of cesarean delivery on maternal request (CDMR) in nulliparous, term, singleton, vertex presentation (NTSV) cesarean deliveries. We conducted a retrospective cohort study of NTSV cesarean deliveries within our institution from 2016 to 2020. The primary outcome was CDMR and the primary predictor was maternal race and ethnicity. Multivariable logistic regression models were used to evaluate associations between race and ethnicity, CDMR, and various maternal and perinatal factors. Among 12,351 NTSV cesarean deliveries, 594 (4.81%) underwent CDMR; 4605 (37.28%) identified as non-Hispanic White, 3731 (30.21%) as Asian/Hawaiian/Pacific Islander, 2840 (22.99%) as Hispanic, 785 (6.36%) as Black, and 390 (3.16%) as multiple races/American Indian/Alaskan Native. Adjusted models showed increased odds of CDMR among non-Hispanic White people. Multiple races/American Indian/Alaskan Native people had the lowest odds of CDMR compared to non-Hispanic White people (adjusted OR [aOR] = 0.48, 95% CI 0.26-0.82), followed by Asian/Hawaiian/Pacific Islander (aOR = 0.58, 95% CI 0.47-0.72), Black (aOR = 0.61, 95% CI 0.40-0.89), and Hispanic (aOR = 0.70, 95% CI 0.55-0.88) people. Non-Hispanic White people undergo CDMR more frequently compared to Asian/Hawaiian/Pacific Islander, Black, and Hispanic people. Our findings are notable in light of the growing body of research demonstrating that White people have the lowest odds of cesarean delivery overall. Profound racial disparities in maternal obstetric outcomes exist in the United States. It is well established that non-Hispanic Black people have disproportionately higher cesarean birth rates and higher rates of birth complications, including maternal death. Racial and ethnic differences in rates of primary elective cesarean delivery, or cesarean delivery on maternal request, are not well understood. This research shows that non-Hispanic White people have more cesarean deliveries on maternal request than other racial and ethnic groups among low-risk nulliparous patients.

Enhancing COVID-19 Vaccine Acceptance Within Scotland Black, African, and Caribbean Communities and Lessons for Future Vaccination Programmes.

This study highlights how the intersection of multiple factors shapes the experiences of Scotland's Black, African, and Caribbean communities in their access and uptake of COVID-19 vaccines in the vaccination programme's first, second, and booster stages. There was particular interest in understanding the vaccination journey, from scheduling an appointment to attending the appointment. Data in this study was collected between the 1 and 30 April 2022 using a triangulated approach, including a survey (with 408 responses), interviews (26), and focus group discussions (5 groups involving 30 participants). The study shows that 62% of respondents found scheduling a COVID-19 appointment easy, with less than 1% of respondents indicating that the process was complex. Online booking, appointment letters, and walk-in appointments were the most common ways of securing vaccination appointments. Letter appointments, specifically the blue envelope, were beneficial reminder mechanisms. It also provided information about COVID-19 vaccines and what to expect when attending the appointments. Other forms of securing vaccination appointments, such as through GP surgeries, were less commonly used. Around 21.5% of participants felt that receiving an appointment letter provided useful pre-vaccination information and a helpful reminder for their appointment. The accessibility of the vaccination centre, professionalism of the staff, and friendly approach enhanced the vaccine user access, use, and experience of COVID-19 vaccination.

Ongoing Failure to Deliver Guideline-Concordant Care for Patients with Pancreatic Cancer.

(1) Background: Comprehensive evaluation of guideline-concordant care (GCC) across all PDAC stages has yet to be thoroughly conducted. This study aimed to characterize treatment patterns and assess factors associated with receiving GCC among patients with pancreatic ductal adenocarcinoma (PDAC) in California. (2) Methods: Data on adult patients with PDAC were extracted from the California Cancer Registry (2004-2020). GCC is defined according to the recommendations provided by the National Comprehensive Cancer Network. We used multivariable logistic regression to identify factors associated with receiving GCC. A Cox model was used to examine the association of GCC with overall survival. (3) Results: A total of 50,346 PDAC patients were included (stage 1: 10%; stage 2: 25%; stage 3: 11%; stage 4: 54%). Only 46.7% of all patients received GCC (stage 1: 20%; stage 2: 40%; stage 3: 69%; stage 4: 50%). Only 31% of stage 1 patients underwent surgery. Factors inversely associated with receiving GCC were Hispanic ethnicity (OR 0.78; p < 0.001), Black race (OR 0.74; p < 0.001), having no insurance (OR 0.40; p < 0.001]), and a Charlson-Deyo score of ≥2 (OR 0.68; p < 0.001). Adherence to GCC was associated with improved survival (Hazard Ratio 0.39; p < 0.001). Notably, patients with stage 1 PDAC who received GCC had a median survival of 47 months vs. 8 months for those who did not. (4) Conclusions: Although stage 1 PDAC patients have the greatest potential for survival with GCC, only 20% of patients received such treatment. Thus, it is crucial to identify and address the modifiable factors contributing to these suboptimal care patterns.

Assessing reagents and techniques for identifying RhCE variants in routine serological testing.

Identifying RhCE variants is essential to prevent alloimmunization and manage complex cases. Unfortunately, these variants are often only detected after antibody formation, as they may go unnoticed in serological tests. This study aimed to assess monoclonal antisera using various methodologies to define the reactivity patterns of some variants by variable expression of RhCE antigens. Samples were chosen based on atypical reactivity on routine RhCE typing of donors, screening of Afro-descendant donors using tube testing and patient samples with antibodies against their own antigens. All 53 samples were tested using tube, gel and microplate tests with five antisera. Antigen expression was assessed by flow cytometry, and RhCE variants were molecularly classified. Tube test screening of African descent donors proved more effective in identifying a broad range of weak or partial antigens, particularly when using anti-e composed of MS-21, MS-16, MS63 clones and anti-c from the MS8011531019 clone. Automated instrument phenotyping successfully identified samples with RHCE*ceJAL allele, while most other variants were detected as positive (4+), similar to gel test, which intensified most reactions. When comparing methods and antisera for detecting variant e antigens, tube test identified a higher percentage of weak samples (63%-77%) compared with microplate (35%) and gel tests (14%). The results highlight the critical role of tube test in serological routines and the need to select clones capable of identifying RhCE variants. Detecting reduced RhCE antigen expression during routine serological testing can guide further molecular investigations and help prevent Rh alloimmunization.

Racial, Socioeconomic, and Geographic Disparities in Preamputation Vascular Care for Patients With Chronic Limb-Threatening Ischemia.

Black patients, those with low socioeconomic status (SES), and those living in rural areas have elevated rates of major lower extremity amputation, which may be related to a lack of subspecialty chronic limb-threatening ischemia care. We evaluated the association between race, rurality, SES, and preamputation vascular care. Among patients aged 66 to 86 years with fee-for-service Medicare who underwent major lower extremity amputation for chronic limb-threatening ischemia from July 2010 to December 2019, we compared the proportion who received vascular care in the 12 months before amputation by race (Black versus White), rurality, and SES (dual eligibility for Medicaid versus no dual eligibility) using multivariable logistic regression adjusting for clinical and demographic covariates. Among 73 237 patients who underwent major lower extremity amputation, 40 320 (55.1%) had an outpatient vascular subspecialist visit, 60 109 (82.1%) had lower extremity arterial testing, and 28 345 (38.7%) underwent lower extremity revascularization in the year before amputation. Black patients were less likely to have an outpatient vascular specialist visit (adjusted odds ratio [adjOR], 0.87 [95% CI, 0.84-0.90]) or revascularization (adjOR, 0.90 [95% CI, 0.86-0.93]) than White patients. Compared with patients without low SES or residing in urban areas, patients with low SES or residing in rural areas were less likely to have an outpatient vascular specialist visit (adjOR, 0.62 [95% CI, 0.60-0.64]; low SES versus nonlow SES; adjOR, 0.82 [95% CI, 0.79-0.85]; rural versus urban), lower extremity arterial testing (adjOR, 0.78 [95% CI, 0.75-0.81]; low SES versus nonlow SES; adjOR, 0.90 [95% CI, 0.0.86-0.94]; rural versus urban), or revascularization (adjOR, 0.65 [95% CI, 0.63-0.67]; low SES versus nonlow SES; adjOR, 0.89 [95% CI, 0.86-0.93]; rural versus urban). Black race, rural residence, and low SES are associated with failure to receive subspecialty chronic limb-threatening ischemia care before amputation. To reduce disparities in amputation, multilevel interventions to facilitate equitable chronic limb-threatening ischemia care are needed.

Black men less likely to receive early cancer diagnosis

Black men less likely to receive early cancer diagnosis

Using Anti-Blackness and Historical Inquiry to Ground Nursing and Research Practice in Black Populations.

Since the "Black Lives Matter" reckoning of 2020, professional health organizations have made public statements and apologized for not recognizing the role of racism in the creation of health disparities. For the American Nurses Association, this has taken the form of the National Commission to Address Racism in Nursing. One result of that work has been the Report on the History of Racism in Nursing, which details the constant maligning of the competence of Black nurses and their systematic exclusion from institutions within the profession. In this article, we want to take these ideas further and argue that the issue for nursing is not so much a generic kind of racism that a professional reorganization can address, but rather a deep and abiding "anti-blackness" that is intrinsic to the heart and soul of medical and health knowledge itself. Anti-blackness as an idea comes from a collection of theoretical interventions developed by Black philosophers, literary theorists, sociologists, and historians who continue to grapple with the question posed by W.E.B. DuBois: "How does it feel to be a problem?" Anti-blackness is the "relegation of Black people to inhumanity and non-being" and "is a global phenomenon that takes on distinct forms of expression in each sociocultural context." Given the call to understand the role of historical, social, political, environmental, and economic factors via the social determinants of health, a more expansive approach is needed to articulate the Black lived experience. Anti-blackness is one tool available to nurses interested in a deeper level of analysis.

Incidence Rate Trends of Breast Cancer Overall and by Molecular Subtype by Race and Ethnicity and Age.

Black and Hispanic women in the US experience higher incidence rates of aggressive molecular subtypes of breast cancer, including triple-negative disease. However, how these rates are changing, particularly across different age groups, has not been well documented. To assess changes in overall and subtype-specific breast cancer incidence rates in the US by age and race and ethnicity. This cohort study used Surveillance, Epidemiology, and End Results program cancer registry data from 22 US cancer registries on 1 123 658 females who received a diagnosis of invasive breast cancer from 2010 to 2019. Statistical analysis was conducted from August 2023 to October 2024. Age and race and ethnicity. Age-adjusted incidence rates of invasive breast cancer overall and across the 4 major molecular subtypes by age and by race and ethnicity, as well as their associated annual percentage changes using Joinpoint Trend Analysis software. Of the 1 123 658 participants in the study, 219 112 (19.5%) were younger than 50 years, 409 257 (36.4%) were aged 50 to 64 years, and 495 289 (44.1%) were 65 years or older. A total of 141 703 participants (12.6%) were Hispanic, 3253 (0.3%) were non-Hispanic American Indian or Alaska Native, 78 306 (7.0%) were non-Hispanic Asian or Pacific Islander, 124 560 (11.1%) were non-Hispanic Black, 769 043 (68.4%) were non-Hispanic White, and 6793 participants (0.6%) had an unknown race and/or ethnicity. Overall, breast cancer incidence rates increased 0.5% per year from 2010 to 2019. Variation by race and ethnicity was observed, with increases of 1.4% per year among Hispanic females, 1.9% per year among non-Hispanic American Indian or Alaska Native females, and 2.1% per year among non-Hispanic Asian or Pacific Islander females, while rates increased only 0.8% per year among non-Hispanic Black females and 0.5% per year among non-Hispanic White females. In subtype analyses, increases of the greatest magnitude in recent years were observed in the incidence rates of triple-negative breast cancer per year among participants aged 65 years or older (Hispanic females, 2.3%; non-Hispanic Asian or Pacific Islander females, 5.5%; and non-Hispanic Black females, 4.3%), while remaining unchanged among non-Hispanic White females. In this cohort study of 1 123 658 females with breast cancer over the 10-year period from 2010 to 2019, there were substantial differences in trends in the incidence rates of breast cancer overall and by subtype across different racial and ethnic groups. Further research is needed to understand the factors associated with these trends.

A socioecological taxonomy of determinants to colorectal cancer screening in black men: Insights from a mixed-methods systematic review.

In the United States, African/Black American (henceforth Black) men face significantly higher mortality rates from colorectal cancer (CRC) compared to other gender, racial, and ethnic groups. Although CRC is preventable and treatable with early detection, screening rates among Black men remain low. This study aimed to synthesize existing literature on the barriers and facilitators (determinants) of CRC screening to offer guidance to primary care teams in their efforts to improve screening uptake. We performed a comprehensive systematic review of full-text, peer-reviewed studies published in English to explore the various determinants influencing CRC screening among Black men. Using key terms like "Black or African American," "male," and "colorectal cancer screening," we searched databases including PubMed, PsychInfo, CINAHL, and Embase, published between 2009 and 2022. The search identified 1235 articles, with 54 meeting the inclusion criteria. Most studies were cross-sectional, examining determinants across the socioecological system. Key barriers included a lack of CRC screening knowledge, poor patient-provider communication, lack of access to screening, and medical mistrust stemming from systemic racism. Significant facilitators included aging, receiving a provider recommendation, having social support, and effective culturally appropriate outreach strategies. Key themes and significant findings from the review provide actionable strategies for primary care teams. These include enhancing knowledge about CRC screening within the patient population, improving patient-provider interactions, and reducing barriers to accessing screening. Future research should aim to develop culturally appropriate and collaborative preventive care strategies to improve screening adherence and CRC-related outcomes.

Identification of Factors Affecting the Accrual of Black Males Into Prostate Cancer Clinical Trials in the United States.

Black males have the highest incidence and mortality rates from prostate cancer of any racial group in the United States, yet are underrepresented in prostate cancer clinical trials. The Prostate Health Education Network surveyed its members about experiences regarding prostate cancer clinical trials and explored reasons for lack of participation. Black males residing in the United States with a diagnosis of prostate cancer were eligible to participate. Of 480 members contacted, 115 (24.0%) completed the survey. Respondents were diverse in age, geography, education, and socioeconomic status, and 58 (50.4%) had a family history of prostate cancer; 12 of 115 (10.4%) had participated in a prostate cancer clinical trial. The most common reasons for nonparticipation (N = 89) included not being asked (55.1%) and a lack of information about risks and benefits (13.5%). No respondents cited lack of trust in the healthcare system based on personal experience, although 2 (2.2%) cited the Tuskegee study. Factors that would influence future decisions around trial participation included whether respondents (N = 99) perceived the treatment or diagnostic option to be effective for themselves (54.5%), to have the potential to advance medical science (45.5%), and to have minimal side effects (44.4%). This survey of Prostate Health Education Network members found that the principal reason for Black males not participating in prostate cancer clinical trials was that they were not being asked. This highlights an unmet need for stronger collaboration between patients, health professionals, the pharmaceutical industry, and clinical trial investigators to address barriers to Black males enrolling in prostate cancer clinical trials.

Embracing anti-racism: Co-creating recommendations with Black people for how addiction treatment needs to change

In the United States, Black people face harsher health and social consequences of addiction compared to people who are not Black. These differential consequences are largely attributable to systemic racism. While addiction treatment may mitigate health disparities related to substance use, Black people also experience structural barriers and direct interpersonal racism which contribute to inequitable access and treatment outcomes. Improvements in addiction treatment for Black people are urgently needed, but there is little guidance or consensus on how to achieve this. Our interdisciplinary work group is comprised of 16 researchers and clinicians from one urban safety-net hospital in the Northeast US, and 9 community members with lived experience of substance use disorder (SUD) who came together from 2022 to 2024 for a community-engaged initiative to identify how to make addiction treatment more appealing, effective, and equitable for Black people. This paper's objective is two-fold. First, we provide a broad overview of the project, which included 6 scoping literature reviews, 7 focus groups, and 4 day-long convenings which included an additional 30 experts on addiction treatment for Black patients, drawn primarily from the Northeast U.S. Altogether, we engaged more than 70 people with expertise in substance use and treatment, the majority of whom identify as Black. Second, we present major findings from the convenings, where we identified actions that can be taken now to improve the care of Black people and challenge the racist features of our addiction treatment system. Making addiction treatment more appealing, effective, and equitable will help to achieve health equity for Black people who use substances.