Nonblack Respondents Research Articles

Telephone Survey-Reported Perceptions of Telehealth Visits Among Black and Non-Black Patients Diagnosed With Cancer.

Empirical evidence underscores both benefits of telehealth visits and persistent disparities in use for Black adults. Guided by the Technology Acceptance Model, we evaluated perceptions regarding telehealth visits among Black and Non-Black adults receiving cancer care from two academic health systems. Between April 2022 and October 2023, a survey was conducted among adult patients treated for cancer in the past 3 years. Survey recruitment was stratified by visit type (telehealth or in-person) and race. Before a scheduled oncology visit, respondents completed a telephone survey to assess their perceptions of usefulness, ease of use, and attitudes toward telehealth visits. Frequency differences were estimated using chi-square tests, and prevalence differences using logistic regression. The survey was completed by 773 respondents (42% Black) with a 15% response rate. Black respondents were younger and less likely to report male sex, being married, having a college education, comfortable income, or confidence in medical and e-literacy. Compared with Non-Black respondents, Black respondents perceived telehealth visits as less useful for determining health needs (37% v 48%) and asking questions (9% v 15%). They thought that telehealth visits were less easy with regard to understanding their health care provider (14% v 21%) and the ability to connect (23% v 30%). Black respondents expressed more concern about internet access (26% v 15%), access to electronic devices (17% v 9%), and finding assistance for connecting (24% v 12%). They also found telehealth visits to be less private (19% v 34%). Racial differences in telehealth ease of use and usefulness perceptions highlight the need for oncology practices to couple connectivity support with effective communication strategies to avoid disparities in oncology telehealth services.

Beauty Inside Out: Examining Beauty Product Use Among Diverse Women and Femme-Identifying Individuals in Northern Manhattan and South Bronx Through an Environmental Justice Framework.

The disproportionate use of chemical straighteners and skin lighteners by women of color is a growing public health concern given the link between product use and adverse health effects. Prior studies examined product use as an individual choice but neglected social-structural factors, which influence beauty perceptions and personal decisions around product use. We used a community-based participatory research approach to characterize product use by demographics and investigated how racialized beauty norms impact use among 297 women and femme-identifying individuals in Northern Manhattan and the South Bronx. Product use varied by race/ethnicity, nativity, and messaging from family and peers. Black respondents were more likely to ever use chemical straighteners than non-Black respondents (OR = 2.0; 95% CI = 1.2-3.2), as were respondents who heard that family members express a preference for straight hair compared with respondents whose family members expressed mixed preferences about hairstyles (OR = 2.0; 95% CI = 1.1-3.7). Compared with non-Asian respondents and respondents born in the United States, Asian respondents and respondents born in other countries, respectively, had threefold higher odds of ever using skin lighteners (Asian: OR = 3.2; 95% CI = 1.4-7.0; born in other countries: OR = 3.4; 95% CI = 1.9-6.1). Respondents' perceptions that others believe straight hair or lighter skin confer benefits such as beauty, professionalism, or youth were associated with greater use of chemical straighteners and skin lighteners. These findings highlight the pervasiveness of racialized beauty norms and point to the need to reduce the demand for and sale of these products through community education, market-based strategies, and public policy.

Increasing Black patient participation in metastatic breast cancer clinical trials: The BECOME (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement) project.

1014 Background: Among U.S. racial/ethnic groups, Black people with breast cancer have the highest death rate and shortest survival. Although ̃15% of cancer patients in the U.S. are Black, only 4-6% of clinical trial participants are Black. Only when trial participants reflect the diversity of the general population can oncologists understand how a drug works across subpopulations. The objectives of the BECOME initiative are to understand barriers to trial participation by Black patients with metastatic breast cancer (MBC) and to identify actions to increase participation. Methods: BECOME is sponsored by the Metastatic Breast Cancer Alliance, a consortium of representatives from nonprofit organizations, pharmaceutical/biotech companies, and patient advocates, many of whom are living with MBC. Findings from a literature review and Key Informant interviews informed a survey of U.S. adults living with MBC. Results: Of 424 survey respondents, 102 (24%) self-identified as Black. Black respondents’ trust and satisfaction with their oncology care team were high (> 90%), and 83% of Black respondents were somewhat or very likely to consider trial participation. However, 40% of Black respondents reported no one on their care team had discussed trials. Black respondents’ reasons to not participate in a trial included concerns about side effects (73%) and effectiveness (63%). Black respondents were more likely than non-Black respondents to believe unstudied treatments may be harmful (57% vs 31%). Black respondents were less likely than non-Black respondents to indicate they trust trials (73% vs 91%) and trust that people of all races/ethnicities get fair treatment in trials (32% vs 56%). Black respondents were more likely than non-Black respondents to value receiving trial information from someone with the same racial/ethnic identity (67% vs 10%), who has had breast cancer (73% vs 44%) or MBC (73% vs 51%), or who has been in a trial (72% vs 48%). Black respondents were also more likely to be motivated to participate to ensure people with their racial or ethnic identity will benefit (83% vs 51%). Conclusions: Black patients with MBC are willing to consider participating in clinical trials. Actionable steps to increase Black patient participation include: 1) enhancing awareness about trials by informing patients, increasing education, training healthcare providers to deliver patient-friendly information in an unbiased manner, and providing messaging from people of shared racial/ethnic identity and health experience; 2) building trust through clear communication; 3) addressing concerns about side effects, effectiveness, harm, and fair treatment; and 4) helping patients find and access trials. All stakeholder groups have a role to play in increasing Black patient participation in MBC clinical trials.

Masks and racial stereotypes in a pandemic: the case for surgical masks

AbstractTo contain the spread of COVID-19, experts emphasize the importance of wearing masks. Unfortunately, this practice may put black people at elevated risk for being seen as potential threats by some Americans. In this study, we evaluate whether and how different types of masks affect perceptions of black and white male models. We find that non-black respondents perceive a black male model as more threatening and less trustworthy when he is wearing a bandana or a cloth mask than when he is not wearing his face covering—especially those respondents who score above average in racial resentment, a common measure of racial bias. When he is wearing a surgical mask, however, they do not perceive him as more threatening or less trustworthy. Further, it is not that non-black respondents find bandana and cloth masks problematic in general. In fact, the white model in our study is perceived more positively when he is wearing all types of face coverings. Although mandated mask wearing is an ostensibly race-neutral policy, our findings demonstrate the potential implications are not.

Toxic Stress in a Mid-Sized Urban Community: An Initial Needs Assessment of Families with Children in Maywood, IL.

BackgroundLoyola Medical Center is located in Maywood, IL, a community that faces high rates of poverty, violence, and barriers to healthcare. These factors can contribute to toxic stress, which has been shown to negatively impact children’s health.ObjectivesThe goal of this project was to partner with community organizations to obtain a baseline needs assessment from families in Maywood regarding sources of toxic stress and to identify interventions of interest.MethodsIn total, 75 anonymous surveys were collected from the Loyola Outpatient Center Pediatric Clinic and a Maywood community center. Survey responses were statistically analyzed in order to determine toxic stressors most commonly impacting families in Maywood as well as interventions of most interest to the community.ResultsThere were 78 respondents for a response rate of approximately 71%. The most common stressors were smoking in the home (33.3%), food insecurity (29.5%), and exposure to violence (26.9%). In this sample, Black respondents were 11.5 times more likely than non-Black respondents to report that their child was exposed to violence in the community – even after controlling for concern about their child’s behavior which served as a surrogate measure of the child’s exposure to toxic stress (P = 0.001). Further, those living with food insecurity were 7.40 times more likely to report that access to food and transportation vouchers were important (P < .001). For every 1-point increase in the total toxic stress score, respondents were 1.35 times more likely to report that increasing access to mental health resources was important to them, though this was not significant (P = .10).ConclusionThe data demonstrate that toxic stressors, health risks and unmet social needs are prevalent in the Maywood community, which puts local children at risk for future adverse health outcomes. With this information, pediatricians at Loyola Medical Center can work with community organizations to allocate resources to address toxic stressors in Maywood.

No Justice, No Peace? Protest Participation for People with Criminal Legal Contact

Previous research shows that people who have criminal legal (CL) contact are less likely to vote, but there is little information about whether or not CL contact influences protest participation. While people with CL contact may be more likely to engage in critiques of the state, they are also more vulnerable to the risks associated with protesting. Because the CL system is highly racialized in the United States, race is central to an analysis of CL contact. In this article, I analyze the relationship between protest participation, CL contact, and race in Illinois. With survey data from the 2014 Chicago Area Study, I show how race and CL contact interact to increase the likelihood of protesting for Black respondents with CL contact, suggesting that one’s experience of a personal perceived injustice is a driving factor in deciding to protest. I also find that non-Black respondents with CL contact are equally as likely to participate in protests as their counterparts without CL contact. This article contributes to literature on political participation and criminology, showing how race and CL contact interact in a way that is associated with participation rates for protest.

“Just Do It? An Examination of Race on Attitudes Associated with Nike’s Advertisement Featuring Colin Kaepernick”

ABSTRACT The relationship between race and just about any social issue has been and continues to be controversial. Within the context of literature on public opinion regarding sports and social movements, this study considers the intersections between race, business, and athlete activism by examining attitudes related to Nike’s controversial advertisement campaign with former NFL quarterback Colin Kaepernick. Results obtained from a sample of young adults reveals a deep racial divide between black and non-black respondents. At almost a ratio of 2:1, blacks were more likely to agree with Nike’s decision to use the former player in their advertisement, that Nike should address social issues in their ads, and that Nike should contribute to his charity. These race differences remain in models that control for a variety of other correlates, including political orientation, income, discrimination, player protests, and whether they watch the NFL.

Changing the Narrative: Police–Community Partnerships and Racial Reconciliation

Police–community relations are strained in the United States, especially along racial lines. This paper assesses community perceptions of crime and the police before and after the implementation of an intervention aimed at eliminating overt drug markets through focused deterrence and police–community partnerships emphasizing racial reconciliation. Mail surveys were sent to every household living within a two-mile radius of the block group where the intervention took place and we estimate differences-in-differences OLS models to examine whether the intervention changed perceptions of crime and police trust and legitimacy. Relative to non-black respondents, black respondents perceived a reduction in non-violent crimes and disorder as well as less racial profiling after the intervention; these results are robust to a number of robustness checks. We did not observe a change with respect to perceptions of police effectiveness, fairness, or other measures of police legitimacy.

Race and Perceptions of Police: Experimental Results on the Impact of Procedural (In)Justice

Procedural justice theory posits that people will view law and legal institutions as more legitimate and will be more willing to cooperate and comply with these institutions and their agents when treated in a procedurally just manner. While research supports this basic premise, questions remain about the influence of race on this process, especially in the wake of several recent highly publicized and controversial deadly force incidents involving white officers and black suspects. In this study, 546 participants were randomly assigned to view one of six videos depicting a simulated traffic stop. The videos featured three procedural justice conditions (positive, negative, and neutral) and two driver race conditions (white and African American). The findings showed that procedural justice improved encounter-specific assessments of police. Furthermore, black respondents assessed police less favorably than non-black respondents. In addition, the positive effect of procedural justice was larger when the driver was white.

Exposure to Smoking in Movies and Smoking Initiation Among Black Youth

Black adolescents see more substance use in mainstream media but seem less responsive to it than other U.S. adolescents. Black-oriented media may be more personally relevant to them. To determine smoking exposure separately for black-oriented (BSME) and mainstream (MMSE) movies and assess their longitudinal relationships with smoking among black and other-race adolescents. Two-wave (2007-2009) national cohort survey of 2341 nonsmoking (at baseline) U.S. adolescents (aged 13-19 years), analyzed in 2012. The surveys determined BMSE and MMSE based on respondents' exposure to random subsets of 50 movies from a contemporary sample of 95 black-oriented and 288 mainstream movies previously content-coded for smoking. Outcome was smoking initiation. Black teens had significantly more BMSE and MMSE than other teens (p's <0.001). At follow-up, 23.5% of black and 29.0% of nonblack respondents had tried smoking. Among black respondents, BMSE was related to smoking initiation at follow-up but MMSE was not. For other adolescents, both BMSE and MMSE were related to smoking initiation. A prospective relationship was found between exposure to smoking in movies and smoking initiation. Among black adolescents in the U.S., this was only for black-oriented movies, suggesting the importance of personal relevance of the exposures. Parents, practitioners, and producers should be aware of these potential influences of media on black teen viewers.

Knowledge, attitudes, and beliefs about seasonal influenza and H1N1 vaccinations in a low-income, public health clinic population

The Public Health Center Vaccine Survey (PHCVS) examines the knowledge, attitudes, and beliefs about seasonal influenza and H1N1 vaccinations in a largely low-income, urban, public health clinic population in Los Angeles County, USA. A cross-sectional survey of vulnerable individuals at risk for severe influenza infection was conducted in one of the nation's largest local public health jurisdictions. A total of 1541 clinic patients were recruited in the waiting rooms of five large public health centers in Los Angeles County from June to August, 2010. Among prospective respondents who met eligibility criteria, 92% completed the survey. The majority was black or Latino and most were between the ages of 18 and 44 years. More than half were unemployed; two-thirds had no health insurance; and nearly one-half reported having a high school education or less. About one-fifth reported they had received the H1N1 vaccine during the previous flu season. In comparative analyses, negative beliefs about vaccine safety and efficacy were highly predictive of H1N1 vaccination. Blacks were less likely than non-black respondents to report receiving the H1N1 vaccine (OR=0.7, 95% CI=0.6-1.0). Blacks were also less likely than other respondents to agree that vaccines can prevent disease (OR=0.4, 95% CI=0.3-0.5), that vaccines are safe (OR=0.5, 95% CI=0.4-0.6), and that they trust doctors/clinicians who recommend vaccines (OR=0.5, 95% CI=0.4-0.7). Study findings provide a useful risk profile of vulnerable groups in Los Angeles County, which may be generalizable to other urban jurisdictions in the United States. They also describe real world situations that can be used to forecast potential challenges that vaccine beliefs may pose to national as well as local influenza pandemic planning and response, especially for communities with limited access to these preventive services.

Consequences of Black Exceptionalism? Interracial Unions with Blacks, Depressive Symptoms, and Relationship Satisfaction

Using data from Wave 4 (2008) of the National Longitudinal Study of Adolescent Health (N = 7,466), we examine potential consequences of black exceptionalism in the context of interracial relationships among nonblack respondents. While increasing racial diversity and climbing rates of interracial unions have fostered the notion that racial boundaries within the United States are fading, our results add to the accumulating evidence that racial/ethnic boundaries persist in U.S. society. Results suggest that among non-Black respondents there is more stigma and disapproval attached to relationships with Blacks than there are to relationships with members of other racial/ethnic groups. Specifically, our results indicate that nonblack individuals with black partners have significantly more depressive symptoms and less relationship satisfaction than their counterparts with nonblack partners, regardless of respondent race and whether the nonblack partner is the same versus a different race from the respondent. Further, the relationship between partner race and depressive symptoms is partially and significantly mediated by relationship satisfaction.

Chlamydia trachomatis infection among 15- to 35-year-olds in Baltimore, MD.

Chlamydia trachomatis (Ct) is the most frequently reported infectious disease in the United States. This article reports population and subpopulation prevalence estimates of Ct and correlates of infection among 15- to 35-year-olds in Baltimore, MD. The Monitoring STIs Survey Program (MSSP) monitored sexually transmitted infection (STI) prevalence among probability samples of residents of Baltimore, a city with high STI rates. MSSP respondents completed telephone audio computer-assisted self-interviews and provided biospecimens for STI testing. Among 2120 Baltimore residents aged 15 to 35 years, the estimated prevalence of chlamydia was 3.9% (95% confidence interval [CI]: 2.8, 5.0). Prevalence was 5.8% (95% CI: 4.1, 7.6) among black MSSP respondents versus 0.7% (95% CI: 0.0, 1.4) among nonblack respondents; all but 4 infections detected were among black respondents. Sexual behaviors and other factors associated with infection were far more prevalent among black than nonblack Baltimore residents. Racial disparities persisted after adjustment for sociodemographic, behavioral, and health factors. The MSSP highlights a higher Ct prevalence among young people in Baltimore than in the United States overall, with notable racial disparities in infection and associated risk behaviors. Public health efforts are needed to improve the diagnosis and treatment of asymptomatic infections in this population.

Do fairness and race matter in generosity? Evidence from a nationally representative charity experiment

We present a dictator game experiment where the recipients are local charities that serve the poor. Donors consist of approximately 1000 participants from a nationally representative sample. We manipulate the perceived worthiness and race of the charities' recipients with an audiovisual presentation. Respondents then decide how much to give to the charities and report their perceptions of recipient worthiness and racial composition. We have four main findings. First, treatments describing recipients as worthy significantly increase giving. Second, the treatment where respondents viewed photos mostly of the black recipients rather than white recipients had no significant effect on giving, even though it successfully manipulated perceptions of racial composition. Third, we find significant racial bias in perceptions of worthiness; the black picture treatment lowers perceived recipient worthiness significantly more among non-black respondents than among black respondents. Finally, we decompose the reduced-form effect of the black picture treatment on giving into two channels: one operating via perceptions of recipient worthiness and one running through perceptions of recipient racial composition. The worthiness perceptions channel is statistically significant, while the race perceptions channel is not. Thus, racially biased worthiness perceptions have a significant effect on giving but this effect is not strong enough to cause a significant reduced-form effect of the black picture treatment on giving.

Fear of Walking Outdoors: A Multilevel Ecologic Analysis of Crime and Disorder

Although a number of studies have tested ecologic models that postulate relationships among social networks, the built environment, and active living, few neighborhood-based studies have considered the role of crime and violence. This study investigates the degree to which individual-level demographic characteristics and neighborhood-level physical and social characteristics are associated with increased fear of crime. Data were analyzed in 2007 from a 2005 survey of 901 randomly selected individuals living in 55 neighborhoods in Washington DC. Multilevel ordered logit regression was used to examine associations between individual-level and neighborhood-level characteristics and how often fear of crime prevents a respondent from walking outdoors. Age and female gender were associated with an increase in fear; the percentage of a resident's life spent in the same neighborhood was associated with a decrease in fear. Results of cross-level interactions showed that at the neighborhood level, women were more fearful than men in neighborhoods without violence, but that the difference in fear between men and women shrinks as neighborhood violence increases. Collective efficacy was found to increase fear among black respondents and had no effect on fear among nonblack respondents. If the study of neighborhoods and active living is to progress and contribute to both etiologic understanding and policy formation, it is essential that theoretical and empirical models consider the impact of violence and fear on walking. Efforts to increase active living in urban neighborhoods that do not account for the impact of crime and fear may fall short of their intended outcomes.

Incarceration Rates of Persons With First-Admission Psychosis

Incarceration Rates of Persons With First-Admission Psychosis

Substantial Proportions of Contraceptive Clinic Clients Would Try Methods That Can Cause Amenorrhea

Womens attitudes toward menstruation and toward contraceptives that can cause amenorrhea differ significantly across settings and ethnic groups. According to a survey of a thousand female family planning clinic clients more than half of respondents in Scotland and China and of nonblack respondents in Africa do not like having periods; at least three-quarters of black Africans however report that they like having them. One-third to three-fourths of women in each area would consider trying a contraceptive method that can induce amenorrhea; however the vast majority of health care providers from those clinics believed that menstruating while using contraceptives is important to their clients. Even so most providers said that they would recommend a contraceptive method that can stop bleeding. (excerpt)

Incorporating Health into Models of Marriage Choice: Demographic and Sociological Perspectives

Data for this study were obtained from the 1979-91 US National Longitudinal Survey of Youth among all never-married non-Hispanic and non-Black respondents in 1979. Proportional hazard models were used to test hypotheses about the relationship between health-related characteristics and the timing of first marriage. Health-related variables included height weight health conditions that limited or prevented work abuse of alcohol tobacco or drugs and criminal delinquency. Potential factors that affect whether when and whom to marry were grouped into those that reflect traits at birth and those that are achievement-oriented or health-related after childhood. The theoretical framework was derived from studies of assortative mating and those focusing on the timing of first marriage relative to other life course events. This study serves to broaden the conception of health-related selection into marriage and to select individual-level data as the appropriate analytic technique. Three hazard models were produced for introducing all health-related variables all health-related and socioeconomic variables and selected interaction terms between age- and health-related variables. Findings support the hypothesis that health-related variables are related to the timing of first marriage in the US. People with unhealthy behaviors and with poor physical characteristics (obesity and short height) had lower marriage rates. Health limitations were unrelated. Findings suggest that heavy users of drugs and alcohol overweight women and short men are less desirable in the marriage market and face greater difficulties in finding an acceptable spouse.