Sample Of African American Adults Research Articles

Attitudes toward extended-release naltrexone treatment for opioid use disorder among African Americans

BackgroundExtended-release naltrexone (XR-NTX; Vivitrol®) is a long-acting injectable form of naltrexone, which is a medication used to treat opioid use disorder (OUD). In 2010, XR-NTX received Food and Drug Administration approval to treat OUD, becoming the first non-addictive and non-psychoactive medication for this condition. Because uptake of XR-NTX has been relatively low, less is known regarding how persons with OUD view this form of treatment. And because previous studies tend to rely on samples that lack racial diversity or are conducted outside the United States, we know very little about how African Americans view XR-NTX. The objective of this study, therefore, was to identify/explain the most salient attitudes toward XR-NTX as a form of OUD treatment among African Americans. Methods: In-depth interviews (n = 30) were conducted with a sample of African American adults who used opioids in Southwest Florida between August 2021 and February 2022. Audiotapes of interviews were transcribed, coded, and thematically analyzed. Results: Analyses revealed that participants’ attitudes toward XR-NTX were generally positive. Specifically, participants found XR-NTX’s monthly injection administration, non-addictive and non-intoxicating properties, and perceived effectiveness (compared to other medications for OUD) most appealing. Conclusions: Study findings suggest that African Americans who use opioids may have more favorable attitudes toward XR-NTX than other medications for OUD (e.g., methadone), which tend to be highly stigmatized. These data uniquely contribute to the literature by capturing the voices of African Americans who use opioids, a group with high rates of opioid-related deaths.

Uncorrected Refractive Error in the African American Eye Disease Study

Refractive error remains the largest cause of correctable visual impairment in the US. Correction of refractive error will reduce visual impairment and its associated morbidity but also improve quality of life and productivity. To determine the burden of and risk factors (RFs) associated with any uncorrected refractive error (UCRE) and unmet refractive need (URN) in a population-based sample of African American adults. This cross-sectional study, conducted from April 2014 to April 2018, included a population-based sample of self-identified African American participants 40 years and older from 30 contiguous census tracts in Inglewood, California. Participants underwent a complete ophthalmic examination and an in-home-administered questionnaire to assess sociodemographic, lifestyle, biological, medical, and health care and eye care usage RFs associated with UCRE and URN. Measurements of visual acuity (VA) were performed using a standard Early Treatment Diabetic Retinopathy Study protocol. Noncycloplegic automated refraction with supplemental subjective refraction was performed. UCRE was defined as an improvement of 2 or more lines with refraction in the better-seeing eye. URN was defined as an improvement of 2 or more lines with refraction in the better-seeing eye in those persons who were visually impaired. Sex- and age-specific burden of UCRE and URN were calculated, and multiple regression analyses were used to identify independent RFs. Study data were analyzed from May 2018 to December 2023. Presence or absence of correctable refractive error. Self-reported sex- and age-specific prevalence of and risk indicators of UCRE and URN. Of the 7957 eligible participants in the African American Eye Disease Study (AFEDS), 6347 (80%) completed both the in-home interview and the clinical examination. Of these, 6337 participants (mean [SD] age, 61 [11] years; 3997 female [63%]) with complete refractive error data were included in the analysis. Refractive error-related correctable visual impairment was present in over two-thirds of participants with visual impairment (68.7%). The overall prevalence of any UCRE was 14.6% (925 of 6337), and the overall prevalence of any URN was 5.4% (URN1 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve 20/40 or better with correction], 157 of 2893; URN2 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve an improvement of 2 or more lines with refractive correction], 155 of 2891). Results of this cross-sectional study suggest a high burden of refractive error-associated correctable refractive error in African American adults, making it the leading cause of visual impairment in this population. Providing universal coverage for vision care and prescription glasses is an affordable and achievable health care intervention that could reduce the burden of visual impairment in African American adults by over two-thirds and likely raise the quality of life and work productivity, especially in this vulnerable minority population.

Perceptions of fentanyl among African Americans who misuse opioids: implications for risk reduction

BackgroundFentanyl is a powerful synthetic opioid that is 50 times more powerful than heroin and has become ubiquitous in the illicit drug supply in the USA. Studies show that among people who use drugs, fentanyl is sometimes viewed as a desirable substance due to its high potency and low cost, while others have an unfavorable perception because of its association with overdose. Unfortunately, studies on the perceptions of fentanyl are relatively rare and existing studies tend to rely on samples with little African American representation. The objective of this study, therefore, was to identify and describe perceptions of fentanyl among African Americans who misuse opioids, while capturing their motivations for seeking out or avoiding fentanyl.MethodsIn-depth interviews (n = 30) were conducted with a sample of African American adults who misuse opioids in Southwest Florida between August 2021 and February 2022. Audiotapes of interviews were transcribed, coded, and thematically analyzed.ResultsAnalyses revealed the presence of three subtypes of fentanyl-related perceptions: (1) fentanyl as an avoided adulterant, (2) fentanyl as a tolerated adulterant, and (3) fentanyl as a drug of choice.ConclusionsThese findings show that African Americans’ perceptions of fentanyl are not monolithic and suggest the distribution of fentanyl test strips and naloxone may be an effective risk reduction strategy. Given that most studies on fentanyl rely on quantitative data from drug seizures and death certificates, this study uniquely contributes to the literature by capturing the voices of African Americans who use drugs.

Prevalence and Predictors of Medical Mistrust Among African Americans with Serious Mental Illness Receiving Care in an Urban Setting.

Patients with serious mental illness are reported to have a 10-25 year reduction in life expectancy. Medical mistrust may influence their willingness to seek care (Bynum, S. A., Davis, J. L., Green, B. L., & Katz, R. V. (2012). Unwillingness to participate in colorectal cancer screening: Examining fears, attitudes, and medical mistrust in an ethnically diverse sample of adults 50 years and older. American Journal of Health Promotion : Ajhp, 26(5), 295-300. https://doi.org/10.4278/ajhp.110113-QUAN-20 ). This cross-sectional study used baseline data from a SAMHSA funded demonstration project to describe the prevalence and of medical mistrust among a sample of African American adults with serious mental illness. Medical mistrust was identified using the Medical Mistrust Scale. One hundred and fifty-four participants completed the medical mistrust scale. Approximately, a third (34.4%) reported medical mistrust. After adjusting for financial stability, those endorsing medical mistrust reported nearly 3 times the odds of lacking support (AOR [95% CI]: 2.84 [1.01-7.97]) compared to those not endorsing medical mistrust. The study is among the first to describe elevated rates of medical mistrust among a sample of African Americans people with serious mental illness. An association between medical mistrust and lack of social support was demonstrated.

Pan-African identity, psychological well-being, and mental health among African Americans

ABSTRACT Studies show that racial and ethnic identity can significantly improve mental health and well-being among marginalized ethnoracial groups who experience racism and discrimination. However, the relationships between Pan-African identity, psychological well-being, and mental health have received less attention. Using a national sample of African American adults, I examine whether Pan-African identity impacts psychological well-being and self-rated mental health. The results show that respondents who feel closer towards members of the African diaspora and Black people in Africa and prefer Pan-African labels have better self-rated mental health and higher levels of self-esteem. Moreover, the analysis finds that respondents who prefer Pan-African labels have higher levels of mastery. Although self-esteem explains the self-rated mental health benefits of both Pan-African closeness and Pan-African label preferences, only mastery explains the relationship between Pan-African label preferences and self-rated mental health. This study demonstrates the possible psychological benefits of a globalized identity for marginalized groups in Eurocentric contexts.

SIGH, what's in a name? An examination of the factor structure and criterion validity of the (Structured Interview Guide for the) Hamilton Anxiety scale (SIGH-A) in a sample of African American adults with co-occurring trauma experience and heavy alcohol use.

The Hamilton Anxiety Inventory (HAM-A) is one of the oldest and most commonly used anxiety rating scales in clinical research. Despite its ubiquity, no studies have examined the scale's underlying factor structure and criterion validity among Black and African American adults with psychopathology (Mage = 42.25, SD = 11.44). Therefore, we estimated a confirmatory factor analysis of the commercially available Structured Interview Guide for the Hamilton Anxiety scale (SIGH-A; Williams, 1996) among African American adults (n = 88; 43% female) with co-occurring heavy alcohol use and trauma-related symptoms. Next, we examined the criterion validity of its Psychic and Somatic factors and overall anxiety severity score from participants who completed a single screening session (i.e., cross-sectional analysis) for a larger study. Results indicated that a two-factor solution provided an adequate fit to the data. Regression analyses indicated that the total SIGH-A score, but not its subscales, significantly predicted posttraumatic stress disorder (PTSD) severity. Neither the SIGH-A subscales nor total scores were significant predictors of alcohol consumption. The current findings suggest that the SIGH-A factor structure among African American adults with alcohol and trauma-related conditions is similar to previous reports that have tested largely White samples but highlight potential shortcomings when its subscales are used independently. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

"I am African American": Racial-ethnic self-designation, self-concept, and major depression among African Americans.

Research remains mixed on whether racial-ethnic self-designation impacts psychological health and well-being among Americans of African descent. Existing studies mainly use non-representative samples to address this question. Some scholars argue that Black people who express an African-centered identity should experience improved mental health because it enhances one's sense of self. However, what role self-designation may have on depression, one of the most common forms of disability, is largely unknown among African Americans. There is also limited evidence on whether one's self-concept can help us understand the relationship between self-designation and mental health among African Americans. Using data from a national probability sample of African American adults (n = 3,329), I examined whether self-designation as African American, Afro-American, Negro, Black American, or some other label versus Black was associated with self-esteem, mastery, and major depressive episodes. Using OLS models, I found that respondents who preferred the terms African American or Afro-American exhibited higher mastery levels compared to individuals who preferred the label Black, the most common term used among respondents. African American identifying respondents also exhibited significantly higher levels of self-esteem compared to Black identifying individuals. Using logistic regression models, I found that only African American identifying respondents were significantly less likely than Black identifying respondents to meet the criteria for major depressive episodes in the past-year. Higher levels of mastery and self-esteem helped to explain such differences. In sum, among Americans of African descent, identification as African American rather than Black may help fight depressive episodes because such self-designation may enhance one's self-concept. Further research is necessary to explore other possible psychological implications of self-designation among the African American/Black population.

Psychometric properties of the Connor-Davidson Resilience Scale 10 in a community sample of African American adults: Exploring the role of gender.

Psychometric properties of the Connor-Davidson Resilience Scale 10 in a community sample of African American adults: Exploring the role of gender.

Interleukin‐8 (IL‐8) as a Potential Mediator of an Association Between Trimethylamine N‐Oxide (TMAO) and Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) among African‐Americans at Risk for Cardiovascular Disease

Trimethylamine N‐Oxide (TMAO) is a microbial metabolite derived from the hepatic‐gut axis and linked to inflammation and cardiovascular disease (CVD). Studies have shown that TMAO is linked to CVD and its risk factor hyperlipidemia by enhanced macrophage foam cell formation or alterations in reverse cholesterol transport. Other mechanisms have not been reported to date. Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) is a largely hepatic expressed protein that blocks Low Density Lipoprotein (LDL) receptor recycling, leading to hyperlipidemia. The primary objective of this study was to investigate a potential relationship between TMAO and PCSK9 in order to explore a novel mechanism linking TMAO and CVD risk. We hypothesized that TMAO and PCSK9 would have a direct association among a sample of African American adults, a population at increased risk for CVD, and that this relationship would be mediated by inflammatory cytokines.African‐American adults at risk for CVD living in the Washington, DC area were recruited to participate in a cross‐sectional community‐based study that involved clinical examination and collection of fasting blood samples. Serum samples were analyzed for clinical CVD risk factors. Fasting levels of inflammatory cytokines (interleukin (IL)‐1 beta, tumor necrosis factor‐alpha, and interleukin‐8), TMAO, and PCSK9 were measured using Luminex and ELISA, respectively. Univariate and multivariate linear regression analyses and structural equation mediation analyses were conducted using STATA. All models were adjusted for body mass index (BMI) and atherosclerotic CVD risk score (ASCVD).The participant sample (n = 60) included a majority of self‐identified African‐American women (93.33%), who presented as obese (Mean BMI = 33). A significant association between TMAO and PCSK9 was identified in both unadjusted (β = 0.30, p = 0.02) and adjusted (β = 0.31, p =0.02) models. Both TMAO and PCSK9 were significantly associated with IL‐8 (TMAO: β = 0.45, p = 0.00; PCSK9: β = 0.23, p = 0.05) in adjusted models. Mediation analysis indicated that 34.77% of the relationship between TMAO and PCSK9 was explained by IL‐8 (Figure 1).Our findings indicate a potential PCSK9 involved pathway for TMAO and CVD risk. Furthermore, our results suggest this pathway is mediated by the inflammatory cytokine, IL‐8. Future studies may identify the role of dietary or stress‐related factors that could increase IL‐8 and potentially influence the TMAO‐PCKSK9 relationship.

Association of Cardiovascular Disease Risk Factors With Sociodemographic Characteristics and Health Beliefs Among a Community-Based Sample of African American Adults in Minnesota

ObjectiveTo assess cardiovascular disease (CVD) and CVD risk factors and their association with sociodemographic characteristics and health beliefs among African American (AA) adults in Minnesota. MethodsA cross-sectional analysis was conducted of a community-based sample of AA adults enrolled in the Minnesota Heart Health Program Ask About Aspirin study from May 2019 to September 2019. Sociodemographic characteristics, health beliefs, and self-reported CVD and CVD risk factors were collected. Prevalence ratio (PR) estimates were calculated using Poisson regression modeling to assess the association between participants’ characteristics and age- and sex-adjusted CVD risk factors. ResultsThe sample included 644 individuals (64% [412] women) with a mean age of 61 years. Risk factors for CVD were common: hypertension (67% [434]), hyperlipidemia (47% [301]), diabetes (34% [219]), and current cigarette smoking (25% [163]); 19% (119) had CVD. Those with greater perceived CVD risk had a higher likelihood of prevalent hyperlipidemia (PR, 1.34; 95% CI, 1.14 to 1.57), diabetes (PR, 1.61; 95% CI, 1.30 to 1.98), and CVD (PR 1.61; 95% CI, 1.16 to 2.23) compared with those with lower perceived risk. Trust in health care provider was high (83% [535]) but was not associated with CVD or CVD risk factors. ConclusionIn this community sample of AAs in Minnesota, CVD risk factors were high, as was trust in health care providers. Those with greater CVD risk perceptions had higher CVD prevalence. Consideration of sociodemographic and psychosocial influences on CVD and CVD risk factors could inform development of effective cardiovascular health promotion interventions in the AA Minnesota community.

Predictors of African American Belief in Illness as Punishment for Sin

While religious participation is positively associated with health, and faith traditions often promote wholesome behavior among followers, religious beliefs endorsing the notion of illness as punishment for sin can be negatively related to health. To date, little is known about the correlates of this belief. This study examined demographic characteristics and religiosity as predictors of the belief that illness occurs as punishment for sin in a national probability sample of African American adults. Of 3,173 participants completing a telephone survey, 2,172 (68.45%) moderately endorsed belief in illness as punishment for sin (mean of 16 [SD=4.59] out of possible 32). Spearman correlations and linear regression modeling were conducted. Findings suggested that participants who were men, less educated, with lower income levels, lower religious beliefs, greater religious participation, greater use of negative religious coping, and both active and passive spiritual health locus of control beliefs, reported significantly stronger belief in illness as punishment for sin. Age, employment, and positive religious coping were not significant predictors. Psychologists, counselors, and health professionals working with African Americans may consider these findings in helping clients find healthy ways to reflect on their illnesses in collaboration with clergy, that are client-centered and respectful of their faith traditions.

The Intersection of Pain Outcomes and Social Isolation Among African Americans.

There is increasing evidence suggesting the influence social isolation has on health outcomes and mental well-being. Chronic medical conditions, such as pain, have been shown to impact social relationships and isolation among majority populations, but there is little evidence documenting this relationship among African Americans. To address this lack of scholarly work, the current study aimed to examine subjective and objective social isolation, pain interference with daily life, and problems with pain in a sample of African American adults 18 + years of age. Taken from the National Survey of American Life: Coping with Stress in the 21st Century (NSAL), results showed that participants who were objectively isolated from family only were more likely to have a chronic health problem that was associated with increased pain. Data further showed that those reporting subjective isolation from both family and friends experienced greater interference from pain than those who were not isolated from family and friends. Findings from this study acknowledge a larger issue that addresses the impact social isolation has on health, quality of life, and general well-being. Recognizing the influence of such may allow systems to acknowledge the determinants that perpetuate social isolation, while still recognizing the needs of marginalized groups.

Differences in post-disaster mental health among Vietnamese and African Americans living in adjacent urban communities flooded by Katrina.

Some communities recover more quickly after a disaster than others. Some differentials in recovery are explained by variation in the level of disaster-related community damage and differences in pre-disaster community characteristics, e.g., the quality of housing stock. But distinct communities that are similar on the above characteristics may experience different recovery trajectories, and, if so, these different trajectories must be due to more subtle differences among them. Our principal objective is to assess short-term and long-term post-disaster mental health for Vietnamese and African Americans living in two adjacent communities in eastern New Orleans that were similarly flooded by Hurricane Katrina. We employ data from two population-based cohort studies that include a sample of African American adults (the Gulf Coast Child and Family Health [GCAFH study]) and a sample of Vietnamese American adults (Katrina Impacts on Vietnamese Americans [KATIVA NOLA study]) living in adjacent neighborhoods in eastern New Orleans who were assessed near the second and thirteenth anniversaries of the disaster. Using the 12-Item Short Form Survey (SF-12) as the basis of our outcome measure, we find in multivariate analysis a significant advantage in post-disaster mental health for Vietnamese Americans over their African American counterparts at the two-year mark, but that this advantage had disappeared by the thirteenth anniversary of the Katrina disaster.

Social Support as a Mediator of the Personality-Physical Functioning Relationship in a National Sample of African Americans: A Two-Wave Longitudinal Study

The present study investigates whether social support mediates the relationship between personality traits and physical functioning among African Americans over 2.5 years. Data were collected from a national probability sample of African American adults (analytic sample N = 312). Telephone surveys included measures of the five-factor model personality traits, social support, and physical functioning. Personality traits were assessed at Time 1 (T1), and social support and physical functioning were assessed 2.5 years later at Time 2 (T2). Physical functioning was assessed using the SF-12 at T2. Results indicated that T2 social support mediated the relationship between T1 personality traits and T2 physical functioning for the traits of conscientiousness, extraversion, agreeableness, and neuroticism, but not for openness to experience. This information may be useful to healthcare providers and community members in developing strategies targeting personality traits in cultivating social support for health promotion.

Gender differences in African Americans' reactions to and coping with discrimination: Results from The National Study of American Life.

The aim of this paper is to examine coping behaviors in the context of discrimination and possible gender-specific differences among a national sample of African American adults in the 2001-2003 National Survey of American Life (NSAL). Results show that in multivariable logistic regression models, African American women (vs. African American men) were less likely to accept discrimination as a fact of life but were more likely to get mad about experiences of discrimination, pray about it, and talk to someone. After adjusting for differences in the frequency of discrimination, African American women were also significantly more likely to try to do something about it. African American men were more likely to accept discrimination as a fact of life with higher frequency of day-to-day discrimination while women tended to talk to someone with a higher frequency of day-to-day discrimination and lifetime discrimination. These findings suggest gender differences in behavior concerning discrimination.

Supplemental Material for Psychometric Properties of the Connor-Davidson Resilience Scale 10 in a Community Sample of African American Adults: Exploring the Role of Gender

Supplemental Material for Psychometric Properties of the Connor-Davidson Resilience Scale 10 in a Community Sample of African American Adults: Exploring the Role of Gender

Investigating the applicability of the Two-Track Model of Bereavement to a Southern sample of African American adults

ABSTRACT Established bereavement and grief theory is often created by non-Hispanic White researchers and normed in non-Hispanic White populations. However, this can fail to capture the diversity of the grief experience. We used semi-structured interviews with 14 middle-to-older aged African Americans to investigate whether responses to loss were consistent with the well-established Two-Track Model of Bereavement. African Americans were found engage with their losses in ways that were mostly consistent with the model, though there was moderate cultural nuance unaddressed by the model. Findings could help inform the modification of the Two-Track Model for increased sensitivity to bereaved African American populations.

Beyond Personal Experiences: Examining Mediated Vicarious Experiences as an Antecedent of Medical Mistrust

ABSTRACT African Americans consistently report higher levels of medical mistrust than their White counterparts. As a result, medical mistrust is considered to be a contributor to racial health disparities. Despite calls to address medical mistrust, few studies have explicitly examined it as a phenomenon of interest; those that have, tended to focus on personal experiences while neglecting vicarious experiences. The current study a) explicitly tests the effects of two types of news story content on reported levels of medical mistrust within an African American adult sample and b) examines two widely used medical mistrust measures. Participants (N = 410) were randomly assigned to view a news story based on a 2 (health care, non-health care) x 2 (racial discrimination, nonracial discrimination) experimental design. Results indicated that individually, both health care content and racial discrimination content increased race-based medical mistrust, but had no effect on general medical mistrust. However, when all four conditions were examined, exposure to health-related racial discrimination stories resulted in higher levels of race-based and general medical mistrust than non-health, nonracial discrimination stories. Findings are discussed in terms of the theoretical and practical implications for health communication scholars.

Discrimination and Social Isolation Among African Americans Across the Lifespan

Social isolation is associated with a wide range of health problems, including early mortality. However, little is known about the risk factors for social isolation specifically among African Americans. This study examined 1) the associations between discrimination and objective and subjective social isolation and 2) how these associations vary by age in a nationally representative sample of African American adults from the National Survey of American Life (N=3570). Multinomial logistic regression analyses indicated that discrimination was positively associated with being subjectively isolated from friends only and family only. Discrimination did not predict objective isolation. A significant interaction revealed that the association between discrimination and subjective isolation from friends only varied by age, with older adults being most vulnerable to the effects of discrimination. These findings argue for a more nuanced and systematic investigation of the detrimental effects of discrimination on older African Americans’ social relationships, especially perceptions of relationships.

Slowed processing speed contributes to cognitive deficits in amnestic and non‐amnestic mild cognitive impairment

AbstractBackgroundMild cognitive impairment (MCI) is characterized by deficits across functional domains, with pronounced memory impairment among amnestic (aMCI) patients. The mixture of cognitive complaints is a challenge in diagnosis and is further complicated by interactions between cognitive domains that are typical for neuropsychological performance.MethodWe aim to examine if slow processing speed may convey MCI‐related deficits across cognitive domains in a sample of African American adults (ages 56‐90): 61 cognitively typical, 28 aMCI, and 14 non‐amnestic MCI. Working memory, executive function, declarative memory and processing speed indices were estimated in structural equation modeling, including indirect effects with bootstrapped 95% confidence intervals (CI).ResultMCI diagnosis predicted deficits in processing speed (b=‐0.53, p=0.02), executive function (b=‐0.37, p=0.03), working memory (b=‐0.62, p=0.001), and episodic memory (b=‐0.61, p<0.001). Slow processing speed predicted low function across domains and in turn partially accounted for effects of diagnosis on executive function (‐0.21, CI:‐0.37/‐0.10), working memory (‐0.12, CI: ‐0.24/‐0.05) and a non‐significant trend for declarative memory (‐0.05, CI: ‐0.15/0.01). Slow processing speed explained approximately 36% of MCI‐related deficits in executive function, 16% in working memory and 8% in declarative memory. In comparison between typical aging and specifically aMCI, processing speed explained deficits in executive function (‐0.19, CI: ‐0.39/‐0.06; 37% indirect) and working memory (‐0.09, CI: ‐0.22/‐0.01; 13%), and a non‐significant trend in declarative memory (‐0.06, CI: ‐0.19/0.00; 8%).ConclusionSlowed processing speed contributes to typical cognitive aging and conveys MCI‐related deficits across domains. Identification of deficits in processing speed may provide insight into MCI progression and opportunities for clinical intervention.