Health Of African American Women Research Articles

Does stress from incarceration of family and friends contribute to signs of early vascular ageing in African American women?

BackgroundEarly vascular ageing (EVA) contributes to elevated risk of cardiovascular disease (CVD), which disproportionately affects African American women. Incarceration, an event disproportionately impacting African Americans, may be a stressor contributing...

Superwoman Schema and self-rated health in black women: Is socioeconomic status a moderator?

BackgroundThe Superwoman Schema (SWS) construct elucidates Black women's socialization to be strong, suppress their emotions, resist vulnerability, succeed despite limited resources, and help others at their own expense. Drawing from intersectionality and social psychological research on self-schemas, this study examined the extent to which SWS was associated with Black women's self-rated health. We also investigated whether socioeconomic status (SES) moderated the association between SWS, its five dimensions, and self-rated health. MethodsData were from the Mechanisms Underlying Stress and Emotions (MUSE) in African-American Women's Health Study, a cohort of African American self-identified women. SWS was assessed using Giscombé’s 35-item Superwoman Schema Scale. Socioeconomic status was measured by household income and educational attainment. Ordered logistic regression models were used and statistical interactions were run to test for moderation (N = 408). ResultsFirst, SWS dimension “obligation to help others” was associated with worse self-rated health (p < .05). Second, household income, but not education, moderated the association between SWS and self-rated health (p < .05): SWS overall was associated with worse self-rated health among higher income women but better self-rated health among lower income women. Third, income moderated the association between SWS dimension “obligation to present an image of strength” and self-rated health (p < .05): presenting strength was associated with better self-rated health for lower income women only. Fourth, moderation results revealed that SWS dimension “obligation to help others” was inversely associated with self-rated health particularly among higher income women. ConclusionsFindings speak to the complex interplay between SES and SWS dimensions as they relate to Black women's perceived health.

FEASIBILITY OF A COMMUNITY-LED VIRTUAL SELF-CARE PROGRAM FOR AFRICAN AMERICAN FAMILY CAREGIVERS

Abstract As the population of older adults in the U.S. increases, the need for family caregivers will mirror this growth. Despite a greater intensity of caregiving, African American caregivers are less likely to access formal support services and engage in self-care practices. To address the self-care needs of African American family caregivers, a community-engaged approach was used to develop and implement a half-day virtual self-care program. The development of the program was guided by the Individual and Family Self-Management Theory. This study evaluates experiences of program attendees. The specific aims are to examine the acceptability and practicality of the virtual self-care program. Women who self-identified as African American and a caregiver (i.e., taking care of another adult) were personally invited to attend. All attendees were emailed an electronic survey containing Likert-type and open-ended questions. Responses were examined for patterns and key content-related categories using inductive content analysis. Eleven of the sixteen attendees responded to the survey. All eleven strongly agreed (64%) or agreed (36%) that the event met their expectations and/or needs. In addition to providing opportunity to take time to engage in self-care, the event created a virtual space for women to focus on themselves. Women spoke about three distinct ways the event met their needs: 1) learning and trying new things, 2) access to resources, and 3) having a shared experience. These findings suggest that virtual programs may be used as an additional resource to support the health of African American women who care for older adults.

Perceptions of Chronic Stress and Mental Well-Being of African American Women Who Experience Perinatal Loss and Pregnancy Subsequent to Loss

This study explored perceived stressors and mental health complexities of African American women before, during, and after a perinatal loss and during a subsequent pregnancy. There is limited research examining multiple oppressions of African American women and their association with mental health and birth outcomes. There is even less research that explores African American women’s lived experiences of perinatal loss and pregnancy subsequent to that loss. The findings from this study will help improve and promote the health of African American women and their newborns. This research will help empower nurses by educating them on mental health complexities and perinatal loss in African American women. Through education, nurses may feel more prepared to assist patients who are navigating their loss journey.

Superwoman Schema and John Henryism among African American women: An intersectional perspective on coping with racism

RationaleJohn Henryism and Superwoman Schema (SWS) are dispositional characteristics adopted to overcome the challenges of chronic psychosocial stress, and have particular salience for African American women. Both show protective and harmful effects on health and share conceptual similarities and distinctions, yet there is no empirical evidence of the potential overlap resulting in uncertainty about the unique roles they may each play concerning the health of African American women. ObjectiveWe examined: 1) whether and to what extent John Henryism and SWS represent similar or distinct constructs relevant to the unique sociohistorical and sociopolitical position of African American women, and 2) whether the two differentially predict health outcomes. MethodsData are from a purposive and socioeconomically diverse sample of 208 African American women in the San Francisco Bay Area. First, we conducted a progressive series of tests to systematically examine the conceptual and empirical overlap between John Henryism and SWS: correlation analysis, exploratory factor analysis (EFA), principal component analysis and k-modes cluster analysis. Next, we used multivariable regression to examine associations with psychological distress and hypertension. ResultsJohn Henryism and SWS were moderately correlated with one another (rs = 0.30–0.48). In both EFA and cluster analyses, John Henryism items were distinct from SWS subscale items. For SWS, feeling an obligation to present an image of strength and an obligation to help others predicted higher odds of hypertension (p < 0.05); having an intense motivation to succeed predicted lower odds (p = 0.048). John Henryism did not predict hypertension. Feeling an obligation to help others and an obligation to suppress emotions predicted lower levels of psychological distress (p < 0.05) whereas John Henryism predicted higher distress (p = 0.002). ConclusionsWe discuss the implications of these findings for the measurement of culturally specific phenomena and their role in contributing to the unequal burden of ill health among African American women.

Commentary: Infant Mortality Among African Americans, Using Life Course Perspective to Encourage Transformation.

Commentary: Infant Mortality Among African Americans, Using Life Course Perspective to Encourage Transformation.

Effects of exercise training on health capabilities and life satisfaction among overweight and obese African American women.

More importance has been placed on exercise training due to increase in the overweight and obese population. However, few studies have researched the effects of exercise training on the health capabilities and life satisfaction levels of overweight and obese African American women. This study sought to determine the effect of a 12-week exercise training on health capabilities and life satisfaction levels of overweight and obese African American women. Participants, who passed an initial screening and pre-assessment, were measured current health capabilities and life satisfaction levels both prior to, and following, the 12-week exercise training. The results from this study indicated an improvement in health capabilities, although with no significant differences following exercise training, while a significantly higher life satisfaction levels was observed among the overweight and obese African American women. The findings suggest that exercise training can be beneficial to enhance overweight and obese African American women's health capabilities and life satisfaction levels. Exercise professionals should provide the appropriate exercise trainings so that overweight and obese African American women can optimize life satisfaction levels.

Gender, Stress, and Mental Health Among Older African Americans

Across studies on social stress exposure on the mental health of older African Americans, most investigate singular stress exposures (discrimination). Furthermore, this research rarely assesses gender differences in the psychological effects of specific stress exposures. I use the National Survey of American of Life to assess: (1) gendered patterns of stress exposure among older African Americans; (2) gendered nuances in the individual, collective, and cumulative effects of stress exposure on mental health. I find gender patterns of stress exposure differed by type of stressor. Women and men shared some stress predictors of mental health (everyday discrimination). Other stress predictors were specific to women (health-related mobility challenges) or to men (perceived neighborhood crime). Study findings challenge gerontologists to consider how race-gender groups are at distinct risks for stressors that elicit poor mental health and provide a call for tailored strategies for improving the psychological health of African American women and men.

'I was broken in so many different ways': The intersection of complex factors impacting homeless and at-risk African American women's mental health and well-being.

African American women are at higher risk of poor mental ill health compared with other racial and ethnic groups in the United States. For low-income and homeless African American populations, the risk of poor mental ill health is even higher. The purpose of our study was to learn what programmes at a long-term transitional living centre helped at-risk and homeless African American mothers to succeed on their own, in accordance with self-identified goals. We conducted ten focus group interviews with 39 graduates of a long-term transitional living centre located in a Midwestern city, and an individual interview with the founder of that centre (N = 40). Our study was informed by Black Feminist Thought, Life Course Theory, and an instrumental case study design. Thematic analysis was used to identify patterns in the qualitative data collected. Findings pertaining to mental health included impacts of adverse childhood experiences, lack of social networks, child placement in foster care, and implications on self-esteem and self-worth. Our findings demonstrate the need for healthcare providers to take into account the intersecting factors facing African American women experiencing homelessness undergirded by systemic racism, which impacts their mental health and well-being.

‘It changes everything’: the impact of HIV-related stigma on sexual health and intimacy among African American women

Little is known about the experiences of sexual health and intimacy among African American women living with HIV, who account for more than 50% of the women living with HIV in the USA. Public discourse surrounding the sexual health of this population often centres on HIV prevention and transmission. Medical advances such as antiretroviral therapy, biomedical interventions to prevent transmission, and treatment as prevention campaigns highlight the changing trajectory of the illness and the need for a more comprehensive examination of sexuality in relation to HIV-related disease. HIV-related stigma has been found to play a pivotal role in these experiences impacting the self-perceptions, interpersonal relationships and sexual behaviours of women living with HIV. This study utilised a phenomenological approach to examine the ways in which HIV-related stigma impacts the sexual health and experiences of intimacy among African American women living with HIV. In depth, semi-structured qualitative interviews with 16 African American women in Upstate New York revealed three emergent themes: (1) rejecting relationships; (2) navigating relationships; and (3) processing sexuality. Findings from the study highlight the ways in which HIV-related stigma affects the sexual health of African American women living with HIV and subsequently results in the renegotiation of sexuality.

Association of body image dissatisfaction, behavioral responses for healthy eating, and cardiovascular health in African-American women with overweight or obesity: A preliminary study

BackgroundAfrican-American (AA) women have the lowest prevalence of ideal categorizations of diet and body mass index (BMI), as defined by the American Heart Association (AHA) Life's Simple 7 (LS7) cardiovascular health (CVH) components compared to other racial/ethnic groups, regardless of sex/gender. There is limited research exploring the interplay of unique psychosocial influences on CVH such as body image dissatisfaction (BID) and behavioral responses for healthy eating among AA women with overweight or obesity. ObjectiveThis study aimed to assess the association of BID with behavioral responses for healthy eating and LS7 components. MethodsA cross-sectional analysis of baseline data was conducted among 32 AA women with overweight or obesity from a larger, community-based participatory research study. Self-reported measures were used to assess BID and behavioral responses to healthy eating (diet self-regulation to reduce fat or caloric intake and motivation for healthy eating [intrinsic motivation and integrated regulation]) using previously validated instruments. The LS7 components (e.g., BMI, diet, etc.) and composite score were evaluated using the AHA LS7 metrics rubric. ResultsWomen with no or lower BID had greater diet self-regulation to reduce fat or caloric intake (mean, 3.5 vs 3.0; P=.05), intrinsic motivation for healthy eating (mean, 5.3 vs 4.2; P=.01), and integrated regulation for healthy eating (mean, 5.3 vs 3.7; P=.002) than those with higher BID. These significant differences remained after adjustment for BMI. Women with higher BID had a higher proportion of BMI within the obesity range compared with those with no or lower BID (94.4% vs 57.1%, P=.03). BID was not significantly associated with other LS7 components or composite score. ConclusionBID and other psychosocial influences for healthy eating are potential targets for culturally tailored lifestyle interventions among AA women.

Direct and Vicarious Racial Discrimination at Three Life Stages and Preterm Labor: Results from the African American Women's Heart & Health Study.

Health disparities research has demonstrated a negative relationship between racial discrimination and African American women's maternal health outcomes. Yet, the relationship between racial discrimination and preterm labor, a key measure of maternal health, remains understudied. This study sought to examine the associations between preterm labor and direct and vicarious racial discrimination among African American women at three life stages: childhood, adolescence, and adulthood. Logistic regression methods were used to analyze cross-sectional data from the African American Women's Heart & Health Study (AAWHHS; N = 173). The AAWHHS includes detailed maternal health information on a community sample of African American women residing in the San Francisco Bay Area. Findings indicated each unit increase in adolescent direct racial discrimination was associated with a 48% increase in the odds of preterm labor (OR: 1.480, 95% CI 1.002-2.187, p < 0.05) and each unit increase in childhood vicarious racial discrimination was associated with a 45% increase in the odds of preterm labor (OR: 1.453, 95% CI 1.010-2.092, p < 0.05) after adjusting for number of pregnancies and socioeconomic variables. This study provides evidence of an association between life-stage racial discrimination and preterm labor risk among African American women, underscoring a need to consider how both directly and vicariously experienced racial discrimination at different developmental periods impact racial disparities in birth outcomes.

Reproductive Health and Reproductive Justice for Muslim Women

Reproductive justice is defined as “women and girls achieving economic, social, and political power, and the resources to make healthy decisions about one's bodies, sexuality, and reproductive health for themselves and their families and their communities in all areas of [their] lives” (Zavella 2016, 1). Women of color are the targets of much prejudice in American society. (Ginsburg and Rapp 1995). Since September 11th and especially in the Trump era, Muslims continue to be “otherized” and racialized, further marginalizing Muslim women. Muslim women's reproductive health is impacted by reductive and essentialized perspective of their religious practice, a typical view held by contemporary America. Analyzing these disparities through an intersectional lens allows the researcher to confront popular essentialisms to understand the simultaneous interaction of race, class, and gender in the lives of Muslim women. Using this approach in her study of the reproductive health of African American women in Harlem, Leith Mullings (2005).identifies certain structural constraints, including political and economic factors, that cause stressors during pregnancy and health problems for both mother and child. Her findings and similar studies on Latina women beg the question: how do gender and racial discrimination, class bias, and Islamophobia affect the reproductive health of Muslim women? In this paper, I argue that intersectionality as a method and theoretical approach should be applied to Muslim women's reproductive health and reproductive justice issues, and I sketch out the beginning of an answer to that question.

Stress and cancer-related lifestyle factors among African American heterosexual couples.

Intimate partners can have a profound influence on individuals’ health behaviors. In this exploratory research, we investigated the concordance of cancer-related lifestyle factors including smoking, body mass index, physical activity, fruit and vegetable intake, red meat intake, and alcohol use within African American heterosexual couples. We also examined whether females’ stress is associated with their own (actor effect) and males’ cancer-related lifestyle factors (partner effect), and vice versa. We analyzed a total of 216 heterosexual couples (i.e., N = 432 individuals) recruited from black churches. Intraclass correlation coefficients (ICCs) were calculated and multilevel modeling in which individuals are nested within couples was conducted. Results showed that there was high concordance of body mass index (ICC = 1.68, p < .001), fruit and vegetable intake (ICC = 1.62, p < .001), red meat intake (ICC = 1.50, p = .001), and alcohol use (ICC = 1.74, p < .001) between spouses. A multilevel analysis showed that there were actor and partner effects of stress on females’ BMI; females’ stress was positively associated with their own BMI (actor effect; β = .42, p = .006) and males’ stress was positively associated with females’ BMI (partner effect; β = .39, p = .026). Also, females’ stress was positively associated with their own red meat intake (actor effect; β = .20, p = .019). In conclusion, high concordance of cancer-related lifestyle factors (BMI, fruit and vegetable intake, red meat intake and alcohol use) exists between African American spouses. Given the identified actor and partner effects of stress on females’ BMI, a couple-based lifestyle or weight management intervention that targets both male and female spouses’ stress and coping will be promising, particularly to enhance African American women’s health behaviors. Future studies need to investigate mechanisms underlying concordance and discordance of cancer-related lifestyle factors in African American couples. Also, factors that explain African American male spouses’ health behaviors need to be uncovered.

The Impact of Health Narratives on Persuasion in African American Women: A Systematic Review and Meta-Analysis

ABSTRACT African American women (AAW) experience higher burdens of disease and have the highest rate of heart disease, cancer, stroke, and diabetes when compared to females of other ethnic groups. Health narratives are a communication strategy that has been used to improve population health outcomes. Narrative storytelling is considered to be effective for improving health outcomes in African Americans because of the strong cultural storytelling background. The purpose of this study was to determine if health narratives have a significant effect on persuasion among AAW, as measured by changes in attitudes, beliefs, intentions, and behaviors. Meta-analysis of health narrative experiments (k = 13) for AAW (N = 2,746) revealed that health narratives have a significant overall effect on persuasion (d = .243; p < .01). Sub-group analyses revealed no significant difference between audio-visual and written-based narratives, and no significant difference between general health topics and cancer topics. Narrative communication was effective for promoting health in AAW. These findings imply that narratives can effectively be used as an audio-visual or written-based communication for AAW, and that health topic may not impact outcomes of narrative communication.

African American Sexual Assault Survivors and Mental Health Help-Seeking: A Mixed Methods Study.

Little research has focused on African American women's sexual assault victimization and mental health seeking. A mixed methods study was conducted to explore African American women's sexual assault in relationship to mental health seeking and experiences with mental health providers in a large community sample. Quantitative survey and qualitative interview data indicated unique correlates of immediate and longer term seeking of help from various mental health sources. Barriers and facilitators of African American women's mental health seeking were identified and qualitative themes were uncovered relevant to this group of survivors. Implications for research and clinical practice with this population are provided.

A HEALTHY LIFE FOR AFRICAN AMERICAN WOMEN CARING FOR OLDER ADULTS: A CONCEPT MAPPING STUDY

Achieving optimal health and well-being among African American older adults with chronic conditions requires addressing the needs of their caregivers. This study aimed to elucidate how African American females caring for older adults view health and the factors that influence health. We identified African American women ages 24 to 64 caring for an adult 60 years or older for group concept mapping (GCM), a mixed-methods approach. Participants (N=25) first completed idea generation by providing unlimited short, free-text responses to the focus prompt, “A healthy life for a caregiver includes: ___.” The 512 identified factors were reduced to 99 unique ideas. Participants then sorted the 99 ideas into clusters based on conceptual similarity and rated each idea on desirability and familiarity. Ratings were recorded on a 5-point Likert scale, ranging from very undesirable to extremely desirable and not at all familiar to extremely familiar. Data were analyzed and mapped via CS Global Max software. A cluster map with 12 outcome domains best fits the data. Identified clusters included: (1) Spirituality, (2) Maintaining relationships, (3) Good character, (4) Action to cope, (5) Preserving self, (6) Support, (7) Personal empowerment, (8) Resources, (9) Release (10) Striving for peace, (11) Wellness, (12) Self-care. Seven of the 99 ideas (representing 5 of 12 domains) were rated as desirable but unfamiliar (“go zone”). We identified elements necessary for health and wellbeing from the perspective of African American caregivers. Go-zone items represent opportunities to intervene to promote the health of African American women caring for older adults.

Promoting Cardiovascular Health for African American Women: An Integrative Review of Interventions.

Background: African American (AA) women bear a disproportionate burden of cardiovascular disease. Promoting ideal cardiovascular health is one strategy to promote health equity for this disparate population. The goal of this integrative review was to summarize and evaluate the research evidence for cardiovascular risk reduction interventions specifically targeting, tailored, or adapted for AA women. Materials and Methods: A review of the literature was conducted using the EBSCOHost platform. Study elements from articles in the final analysis were extracted. Results: Fourteen interventions were included in the final analysis (16 peer-reviewed articles). Most studies targeted two or more areas of cardiovascular health with the most common areas being physical activity and diet. Primary and secondary outcome measures varied; the most common measures were self-reported dietary intake, physical activity, and knowledge-related measures. Eleven studies reported health outcomes; only five reported long-term intervention effects. Most studies employed at least one cultural tailoring or adaptation strategy for AA women. The most common strategies included incorporating feedback from the target population before implementation and tailoring intervention material to reflect the target population. Conclusions: There is a need to develop and evaluate tailored or adapted evidence-based interventions for AA women. Additional research is needed to design interventions for subgroups of the population such as low-income or rural AA women.

Environmental Exposures, the Epigenome, and African American Women's Health.

Stress is a common feature of modern life, but both the extent of exposure to stressors and the downstream effects of these stress exposures can vary considerably among individuals, communities, and populations. When individuals are exposed to repeated or chronic stress, wear and tear on the body can accumulate and manifest in many ways. The term "allostatic load" represents the physiological consequences of repeated or chronic exposure to environmental stressors and is linked to fluctuating and/or heightened neural or neuroendocrine responses. African American women are one population subgroup that has been identified as potentially having both an elevated allostatic load and an enhanced resilience to external factors. One mechanism by which environmental stressors may impact human health is via epigenetic remodeling of the genome. This review will focus on what is known about how different types of environmental stressors may affect the epigenome and explore links between epigenetic reprogramming and altered allostatic load and resilience as it pertains to African American women's health.

Enacted HIV-related stigma and breast-health beliefs and practices among African American women living with HIV: The mediating roles of internalized HIV-related stigma and depressive symptoms.

Reducing HIV-related stigma among African American women living with HIV is a priority to improve HIV-specific health outcomes, but may also impact other health beliefs and practices. Testing this hypothesis is important because African American women experience worse health outcomes, including for breast cancer. This study examines the relationship between enacted HIV-related stigma and breast health beliefs and practices and the mediating effects of depressive symptoms and internalized HIV-related stigma. We use baseline data from a stigma reduction intervention trial for adult African American women living with HIV in Chicago, IL and Birmingham, AL (n = 237). Data were collected using computer-assisted self-interviewing software. After adjusting for covariates, enacted HIV-related stigma was associated with greater perceived threat of breast cancer, specifically in terms of breast cancer fear (p <0.0001), but not regular breast healthcare engagement (p = .17). Internalized HIV-related stigma and depressive symptoms were associated with enacted HIV-related stigma, perceived threat of breast cancer, and regular breast healthcare engagement (all p <.05). Internalized HIV-related stigma mediated the relationship between enacted HIV-related stigma and perceived threat of breast cancer (p = .001); depressive symptoms did not (p = .84). We provide evidence concerning broader influences of internalized HIV-related stigma for the health of African American women living with HIV. Future studies should consider the impact of HIV stigma on other health beliefs and behaviors.