Urban African American Women Research Articles

Selected Lifestyle Practices in Urban African American Women—Relationships to Pregnancy Outcome, Dietary Intakes and Anthropometric Measurements

The relationships of selected lifestyle factors (cigarette smoking, consumption of alcoholic beverages, recreational drug use, and exercise during pregnancy), all self-reported, to pregnancy outcomes, dietary intake during pregnancy, and maternal anthropometric measurements, were investigated in a group of urban African American pregnant women. The 234 subjects were aged 16-35 years and were free of diabetes and abnormal hemoglobins. The lifestyle data were collected by trained interviewers during the subjects' prenatal clinic visits, and the dietary data by monthly, quantitative 24-hour food recalls conducted during these same visits. Maternal anthropometric measurements were obtained from the subjects' hospital records, and pregnancy outcome data during physical examinations of the newborn infants. Both cigarette smoking and drug use were associated with significantly lower mean birth weight, length, and head circumference, while exercise was associated with a significantly higher mean birth weight, and head circumference (P < 0.05). Drug use during pregnancy was associated with a significantly higher intake of vitamin C, and a significantly lower intake of iron; while women reporting drug use before pregnancy had significantly higher mean intakes of food energy, protein, total and saturated fat, and zinc. Prepregnancy weight, percent ideal prepregnancy body weight, prepregnancy body mass index, and delivery weight were significantly lower among those reporting drug use before pregnancy. Multiple regression analyses indicated that smoking explained a relatively small proportion of the variance in infant birth weight compared with delivery weight and percent of ideal prepregnancy body weight.

Dietary Intakes, Anthropometric Measurements and Pregnancy Outcomes

The relationships of maternal prenatal dietary intakes and anthropometric measurements to pregnancy outcomes were investigated in a prospective observational study of urban African American women. The 322 subjects, a subset of the 744 women recruited for the study using purposive sampling, were all nulliparous, free of diabetes mellitus and abnormal hemoglobins, and delivered term, singleton infants. Sociodemographic data and monthly quantitative 24-hour food recalls were collected by trained interviewers. Maternal anthropometric measurements were obtained from the subjects' hospital records. Pregnancy outcome data were obtained by physical examinations of the newborn infants by the project pediatrician. With the exception of vitamin C, average maternal dietary intakes were within the ranges of intakes obtained in previous studies. Mean intakes of protein, vitamins A and C, thiamin, riboflavin, and niacin exceeded the 1989 RDA, while those of food energy, vitamin B-6, folate, calcium, iron, magnesium, and zinc were below the RDA. Underweight prior to pregnancy and low pregnancy weight gains were found among 12.9% and 44.4% of the subjects respectively. Dietary intakes were not significantly correlated with pregnancy outcomes. Maternal anthropometric measurements significantly correlated with pregnancy outcomes included delivery weight, pregnancy weight gain, weekly weight gain, prepregnancy weight, net weight gain, height, prepregnancy body mass index, and % ideal prepregnancy body weight (P < 0.05). Using the stepwise selection procedure in multiple regression analysis, delivery weight, % ideal prepregnancy body weight, and prepregnancy body mass index were selected as being predictive of infant birth weight. It was concluded that anthropometric measurements were better nutritional predictors of pregnancy outcome than dietary intake.

The Relation of Neighborhood Racial and Income Polarity to Preterm Birth Rates in Chicago.

To investigate the extent to which spatial social polarization is associated with preterm birth among urban African-American and non-Latinx white women, and whether prenatal care modifies this relationship. We performed multilevel logistic regression analyses on a 2013-2017 dataset of Chicago vital records (N = 29,179) with appended Index of Concentration at the Extremes (ICE) values for race and income. Women who resided in the bottom ICE quintile neighborhoods had a preterm birth rate of 11.5%, compared to 7.3% for those who live in the top ICE quintile areas; adjusted odds ratio (aOR) equaled 1.72 (95% confidence interval [CI] = 1.39, 2.12). This disparity widened for early (< 34weeks) preterm birth rates, aOR = 2.60 (1.77, 3.81). These associations persisted among women with adequate prenatal care utilization. Spatial polarization of race and income in urban African-American and non-Latinx white women's residential environment is strongly associated with preterm birth rates, even among those who receive adequate prenatal care. These findings highlight the benefit of using ICE to contextualize the impact of urban neighborhood-level characteristics on preterm birth rates.

Successful substance use disorder recovery in transitional housing: Perspectives from African American women.

Through the lens of Black Feminist Thought, the intersectionality of poverty, racism, and sexism in the lives of urban dwelling African American women was explored. Reflections on recovery among women previously enrolled in a transitional housing treatment program were gathered via semistructured interviews, using an instrumental case study design. Four major themes surrounding the context of recovery were identified and analyzed: Knowledge and awareness of addiction, importance of social support and support groups, peace of mind that resulted from a new lifestyle, and women's desire to maintain their recovery status. Many women did not realize that their drug use constituted an addiction prior to their enrollment in the program. Social support and support groups such as AA, NA, and AODA helped the women to maintain their recovery, and this newfound recovery resulted in additional stress relief. Finally, many women felt empowered to maintain their recovery, not only for themselves but also their children. Paradigm shifts in treatment and recovery processes are needed to better serve minority populations, specifically focusing on women and African Americans. Recovery services must shift from previously male centered, hegemonic, pathology-oriented treatment modalities to serve populations more efficiently and equitably. Furthermore, to create effective social change in recovery, programs must address the social determinants of substance misuse, addictive behaviors, and underlying structural inequalities resulting from the intersection of racism, sexism, and classism. Deeper understandings of complex social issues must be disseminated, particularly for women battling substance misuse who are homeless, racially discriminated against and marginalized. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Polybrominated Diphenyl Ether Serum Concentrations and Depressive Symptomatology in Pregnant African American Women.

(1) Polybrominated diphenyl ethers (PBDEs) were widely produced in the United States until 2004 but remain highly persistent in the environment. The potential for PBDEs to disrupt normal neuroendocrine pathways resulting in depression and other neurological symptoms is largely understudied. This study examined whether PBDE exposure in pregnant women was associated with antenatal depressive symptomatology. (2) Data were collected from 193 African American pregnant women at 8–14 weeks gestation. Serum PBDEs and depressive symptoms were analyzed and a mixture effect was calculated. (3) Urban pregnant African American women in the Southeastern United States had a high risk of depression (27%) compared to the National average. Increased levels of PBDEs were found. BDE-47 and -99 exposures are significantly associated with depressive symptomatology in the pregnant cohort. The weighted body burden estimate of the PBDE mixture was associated with a higher risk of mild to moderate depression using an Edinburgh Depression Scale cutoff score of ≥10 (OR = 2.93; CI 1.18, 7.82). (4) Since antenatal depression may worsen in postpartum, reducing PBDE exposure may have significant clinical implications.

Making meaning of motherhood: Self and life transitions among African American adolescent mothers.

Although adolescent childbearing is widely viewed as a major social problem, and research suggests that young mothers and their children are at risk for poor economic and academic outcomes, these ideas may be in need of revision. Recent scholarship has pointed out that young mothers have been unfairly blamed and stigmatized for problems that should be attributed to social and economic inequality, racism, and poverty. The present study extends that research by listening to the voices of young mothers. In total, 179 urban African American women were asked at 4, 12, and 24 months after giving birth to describe how their lives had changed since becoming a mother. A team of coders content coded themes with rigorous checks for intercoder reliability. Positive themes were far more prevalent than negative themes. Motherhood was often described as a positive developmental change, providing the young women with a sense of maturity, responsibility, motivation, and commitment to placing the baby's needs ahead of their own. Motherhood was sometimes described as a life-turning point whereby young women turned away from undesirable activities and became focused on school, work, and their family's future. Challenges reflected common stresses of parenting for people of all ages, such as lack of sleep and burden of caregiving, but also limited time to socialize with friends. Findings suggest that although policymakers and professionals view adolescent parenthood as a social ill to be eradicated, for the mothers themselves, the experience is more complex, meaningful, and positive. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Using Text Messaging to Improve Access to Prenatal Health Information in Urban African American and Afro-Caribbean Immigrant Pregnant Women: Mixed Methods Analysis of Text4baby Usage.

BackgroundThe Text4baby (T4B) mobile health (mHealth) program is acclaimed to provide pregnant women with greater access to prenatal health care, resources, and information. However, little is known about whether urban African American and Afro-Caribbean immigrant pregnant women in the United States are receptive users of innovative health communication methods or of the cultural and systematic barriers that inhibit their behavioral intent to use T4B.ObjectiveThis study aimed to understand the lived experiences of urban African American and Afro-Caribbean immigrant pregnant women with accessing quality prenatal health care and health information; to assess usage of mHealth for seeking prenatal health information; and to measure changes in participants’ knowledge, perceptions, and behavioral intent to use the T4B mHealth educational intervention.MethodsAn exploratory sequential mixed methods study was conducted among pregnant women and clinical professionals for a phenomenological exploration with focus groups, key informants, interviews, and observations. Qualitative themes were aligned with behavioral and information technology communications theoretical constructs to develop a survey instrument used. repeated-measures pre- and post-test design to evaluate changes in participants’ knowledge, attitudes, and beliefs, of mHealth and T4B after a minimum of 4 weeks’ exposure to the text message–based intervention. Triangulation and mixing of both qualitative and quantitative data occurred primarily during the survey development and also during final analysis.ResultsA total of 9 women participated in phase 1, and 49 patients signed up for T4B and completed a 31-item survey at baseline and again during follow-up. Three themes were identified: (1) patient-provider engagement, (2) social support, and (3) acculturation. With time as a barrier to quality care, inadequate patient-provider engagement left participants feeling indifferent about the prenatal care and information they received in the clinical setting. Of 49 survey participants, 63% (31/49) strongly agreed that T4B would provide them with extra support during their pregnancy. On a Likert scale of 1 to 5, participants’ perception of the usefulness of T4B ranked at 4.26, and their perception of the compatibility and relative advantage of using T4B ranked at 4.41 and 4.15, respectively. At follow-up, there was a 14% increase in participants reporting their intent to use T4B and a 28% increase from pretest and posttest in pregnant women strongly agreeing to speak more with their doctor about the information learned through T4B.ConclusionsUrban African American and Afro-Caribbean immigrant pregnant women in Brooklyn endure a number of social and ecological determinants like low health literacy, income, and language that serve as barriers to accessing quality prenatal health care and information, which negatively impacts prenatal health behaviors and outcomes. Our study indicates a number of systematic, political, and other microsystem-level factors that perpetuate health inequities in our study population.

Patterns and correlates of substance use among young adult African American women

Patterns and correlates of substance use among urban African American young women (ages 18–19, n = 459) were examined. Four patterns were identified: no/infrequent alcohol and marijuana use (64.9%); recent alcohol only use (18.2%); recent marijuana only use (7.9%); and recent alcohol and marijuana use (9.0%). Having a recent male sexual partner and a history of sexual coercion were associated with increased odds of marijuana-only and dual use. Greater family support and childhood sexual abuse were associated with increased odds of alcohol-only use. Results suggest that sexual relationships and history of abuse/coercion are important factors in young African American women’s substance use.

The relationship of public and private religiosity to African American women caregivers’ use of alcohol for coping with caregiving burden

The number of African American women providing unpaid care to an older person is increasing. Multiple stresses are associated with the caregiving experience. This article examines the relationship of both public and private religiosity to the use of alcohol to cope with these stresses. Data were from the Black Rural and Urban Caregivers Mental Health and Functioning Study. This cross-sectional study included 521 midwestern urban (n = 256) and rural (n = 265) African American women who were caregivers of dependent African Americans age 65 years and older. Results of heiarchical multinomial logistic regression revealed that those who are younger, those living in an urban area, and those with lower levels of religious attendance were more likely to use alcohol to cope with the stresses of caregiving. Helping professionals can use a strengths perspective, which highlights the importance of emphasizing strengths to increase caregivers’ personal power, the development of strong coping skills, and the improvement of social support systems to create a positive approach to self-care with a focus on community building.

Neighborhood Tax Foreclosures, Educational Attainment, and Preterm Birth among Urban African American Women.

Ecological evidence suggests that neighborhoods with more tax foreclosures also have more adverse birth outcomes. However, whether neighborhood-level tax foreclosures impact individual-level risk for adverse birth outcomes is unknown. We assessed whether living in a neighborhood with high tax foreclosures is associated with a woman’s preterm birth (PTB) risk and tested for effect modification by educational attainment, among urban African American women from the Life Influence on Fetal Environments Study (2009–2011; n = 686). We linked survey and medical record data to archival, block-group level tax foreclosure data from the county treasurer. We used Modified Poisson regression with robust error variance and included a foreclosure X education interaction in adjusted models. In the overall sample, neighborhood tax foreclosures did not predict PTB (adjusted relative risk: 0.93, CI: 0.74, 1.16), but the association was modified by educational attainment (interaction p = 0.01). Among women with lower education (n = 227), neighborhood tax foreclosures did not predict PTB risk. The association for women with higher education (n = 401) was statistically significant for a reduction in risk for PTB (adjusted relative risk: 0.74, CI: 0.55, 0.98) among those who lived in neighborhoods with high versus low tax foreclosures. Future studies should seek to identify the mechanisms of this association.

“At This Age, This Is Who I Am”: CeCe Winans, Exilic Consciousness, and the American Popular Music Star System

Abstract My paper addresses the intersections of the American popular music star system, Black female Gospel singers, Gospel Music, and the exilic consciousness of the Sanctified Church with special attention to life and music of Gospelwoman Priscilla Marie “CeCe” Winans Love. I argue that CeCe Winans and the marketing campaign for Winans’ album Let Them Fall in Love, is indicative of the encroachment of American popular music’s star system into self-elected “exiled” Gospel Music and into the lives of “exiled” Gospelwomen. Gospelwomen are 20th and 21st century urban African American Protestant Christian women who are paid for singing Gospel Music and who have recorded at least one Gospel album for national distribution. The self-elected exile of Gospelwomen refers to their decision to live a life based on the values of the Kingdom of God while encountering and negotiating opposing values in American popular culture. Gospelwomen and Gospel Music are impacted by the demands of stardom in America’s celebrity culture which includes achieved success and branding. Gospelwomen negotiate these components of stardom molding them into mechanisms that conform to their beliefs and needs.

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

ABSTRACTIn this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers’ self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers’ self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers’ self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.

Is Active Transportation Associated with Cardiometabolic Health Outcomes Among Minority Women?

Background Active transportation (AT) is a form of physical activity (PA), which improves cardiometabolic risk factors among non-Hispanic white adults in the United States. However, research among minority women is sparse. This study explored associations between AT and cardiometabolic risk factors among urban African American and Hispanic women (N=410). Methods This was a secondary analysis of data from the Health is Power study, a randomized controlled trial conducted in Houston and Austin, Texas (2006–2008) to increase PA or fruit and vegetable consumption among minority women. The sample comprised 63% African American and 37% Hispanic/Latina women (N=367 M=45.0±9.4 years). Sociodemographics (ethnicity, age, education, household income) and the International Physical Activity Questionnaire metabolic equivalent of task (MET)-minutes per week spent in AT and total PA were measured via interviewer administered questionnaire. Cardiometabolic risk factors (body mass index [BMI], body fat percentage [BF%], resting heart rate [RHR], systolic [SBP] and diastolic blood pressures [DBP]) were collected using established protocols. Unadjusted bivariate associations and associations adjusted for covariates (sociodemographics, site, total PA minus AT) between dichotomized AT use (any AT use [n=159] versus no AT use [n=208]) and cardiometabolic risk factors were examined. Results Participants reported mean AT MET-min/wk of 219.86±827.3. AT use was not significantly related to sociodemographic factors. AT users reported more AT MET-min/wk (M=507.5±1199.4) and total PA (M=3408.5±3930.0 MET-min/wk) than non-users (M=2324.3±3552.9 MET-min/wk; t(365)=-2.77, p=.006). When comparing PA levels excluding AT, the PA levels of AT users remained higher (M=2901.0±3499.0 MET-min/wk), though this difference was not significant (p=.122). SBP was lower for AT users (M=122.8±18.9) compared to non-users (M=125.0±13.4), but not significantly so (p=.208). AT was not associated with BMI, RHR, BF%, SBP, or DBP (all ps>.05). Conclusions Results showed no significant associations between AT use and cardiometabolic outcomes; however, SBP was slightly lower for AT users. Mean MET-min/wk of AT use was slightly lower than the minimum recommended PA guideline of 600 MET-min/wk to achieve health benefits with most (82%) AT users falling below 500 MET-min/wk. Total PA for both AT users and non-users was well above recommended guidelines, demonstrating small doses of AT may not provide additional benefits when meeting current recommendations. Further research should investigate the presence of a dose response in larger samples with participants engaging in higher levels of AT. This study was supported by a grant from the National Cancer Institute (1R01CA109403) to Dr. Rebecca E. Lee and Jonas Scholar Nurse Leader Cohort 2016–2018 to Elizabeth Lorenzo.

Longitudinal pathways from unconventional personal attributes in the late 20s to cannabis use prior to sexual intercourse in the late 30s

A quarter of people living with human immunodeficiency virus (HIV) infection in the United States are women. Furthermore, African American and Hispanic/Latina women continue to be disproportionately affected by HIV, compared with women of other races/ethnicities. Cannabis use prior to intercourse may be associated with increased risky sexual behaviors which are highly related to HIV. The ultimate goal of this research is to better understand the relationships between unconventional personal attributes (e.g., risk-taking behaviors) in the late 20s, substance use (e.g., alcohol) in the mid 30s, and cannabis use prior to intercourse in the late 30s using a community sample; such an understanding may inform interventions. This study employing data from the Harlem Longitudinal Development Study includes 343 female participants (50% African Americans, 50% Puerto Ricans). Structural equation modeling indicated that unconventional personal attributes in the late 20s were associated with substance use in the mid 30s (β=0.32, p<0.001), which in turn, was associated with cannabis use prior to sexual intercourse in the late 30s (β=0.64, p<0.001). Unconventional personal attributes in the late 20s were also directly related to cannabis use prior to sexual intercourse in the late 30s (β=0.39, p<0.01). The findings of this study suggest that interventions focused on decreasing unconventional personal attributes as well as substance use may reduce sexual risk behaviors among urban African American and Puerto Rican women. Also, the implications of this study for health care providers and researchers working in HIV prevention are that these precursors may be useful as patient screening tools.

Inter-relationships between objective and subjective measures of the residential environment among urban African American women

PurposeThe inter-relationships between objective (census based) and subjective (resident reported) measures of the residential environment is understudied in African American (AA) populations. MethodsUsing data from the Life Influences on Fetal Environments Study (2009–2011; n = 1387) of AA women, we quantified the area-level variation in subjective reports of residential healthy food availability, walkability, safety, and disorder that can be accounted for with an objective neighborhood disadvantage index (NDI). Two-level generalized linear models estimated associations between objective and subjective measures of the residential environment, accounting for individual-level covariates. ResultsIn unconditional models, intraclass correlation coefficients for block-group variance in subjective reports ranged from 11% (healthy food availability) to 30% (safety). Models accounting for the NDI (vs. both NDI and individual-level covariates) accounted for more variance in healthy food availability (23% vs. 8%) and social disorder (40% vs. 38%). The NDI and individual-level variables accounted for 39% and 51% of the area-level variation in walkability and safety, respectively. Associations between subjective and objective measures of the residential environment were significant and in the expected direction. ConclusionsFuture studies on neighborhood effects on health, especially among AAs, should include a wide range of residential environment measures, including subjective, objective, and spatial contextual variables.

“Women and Girls in Jeopardy by His False Testimony”: Charles Dancy, Urban Policing, and Black Women in New York City during the 1920s

Troubling partnerships between the New York City Police Department (NYPD) and criminal informants during the mid-1920s adversely impacted urban African American women’s daily lives. Part of multiple hierarchies of municipal corruption, undercover surveillance operations represented one of many apparatuses law enforcers employed to criminalize black women’s ordinary behavior, to reinforce Progressive era images of black female criminality and promiscuity, and to deny women of their personhood and civil rights. Black New Yorker and criminal informant Charles Dancy, identified by local black newspapers as a vicious con artist and serial rapist, figured prominently in undercover police operations. Dancy falsely identified black women as sex workers and had them arrested, and in the process sexually assaulted women. New York blacks were outraged by some NYPD members’ use of informants as well as black women’s erroneous legal confinement. Situating informant work within the context of police brutality, racial inequity, and the denial of American citizenship, New York African American race leaders, newspaper editors, and ordinary folks devised and took part in resistance strategies that contested police surveillance operations and spoke on behalf of those who were subjected to state sanctioned violence.

Neighborhood Context and Preterm Delivery among African American Women: the Mediating Role of Psychosocial Factors.

Preterm delivery (PTD), or birth before 37 completed weeks of gestation, is a serious public health issue, and racial disparities persist. In a recently published study, perceptions of the residential environment (or neighborhood context) were associated with PTD rates among urban African American women with low educational attainment (≤12years); however, the mechanisms of these associations are unknown. Given this gap in the literature, we used data from the Life Influences on Fetal Environments Study of postpartum African American women from Metropolitan Detroit, Michigan (2009-2011; n = 399), to examine whether psychosocial factors (depressive symptomology, psychological distress, and perceived stress) mediate associations between perceptions of the neighborhood context and PTD. Validated scales were used to measure women's perceptions of their neighborhood safety, walkability, healthy food availability (higher=better), and social disorder (higher=more disorder). The psychosocial indicators were measured with the Center for Epidemiologic Studies-Depression Scale, Kessler's Psychological Distress Scale (K6), and Cohen's Perceived Stress Scale. Statistical mediation was assessed using an unadjusted logistic regression-based path analysis for estimating direct and indirect effects. The associations between perceived walkability, food availability, and social disorder were not mediated by psychosocial factors. However, perceptions of neighborhood safety were inversely associated with depressive symptoms which were positively associated with PTD rates. Also, higher perceived neighborhood social disorder was associated with higher PTD rates, net of the indirect paths through psychosocial factors. Future research should identify other mechanisms of the perceived neighborhood context-PTD associations, which would inform PTD prevention efforts among high-risk groups.

Cardiovascular Risk in Midlife African American Women Participating in a Lifestyle Physical Activity Program.

Cardiovascular disease (CVD) is the largest contributor to disparate morbidity and mortality in African American women. The aims of this article are to describe in a cohort of sedentary, urban community-based midlife African American women eligible for a physical activity program their (1) CVD risk factors and (2) awareness, treatment, and control of hypertension and hypercholesterolemia. Cross-sectional baseline findings on 297 women were examined at baseline of a controlled physical activity clinical trial. Cardiovascular disease risks included hypertension, hypercholesterolemia, smoking, diabetes, and obesity. Among women with hypertension and hypercholesterolemia, rates of awareness, treatment, and control were calculated. Our sample had significantly more hypertension and obesity than reported in other national samples of African American women. The women mirrored national samples of African American women: fewer than 60% had adequate control of hypertension. Versus national samples of African Americans (men/women combined), our study groups both showed significantly lower low-density-lipoprotein cholesterol level: treatment, 33% versus 63.8%, and control, 24.8% versus 45.3%. Because national samples are more heterogeneous, our sample provides important information about CVD risks in inactive, urban community-dwelling, midlife African American women. Given the opportunity, many such women at elevated risk for CVD are willing to participate in a physical activity intervention. They must be identified and offered pharmacological and lifestyle interventions.

The Georgia WIC Farmers’ Market Nutrition Program’s Influence on Fruit and Vegetable Intake and Nutrition Knowledge and Competencies Among Urban African American Women and Children

Objective: Evaluate the impact of Farmers’ Market Nutrition Program (FMNP) among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants.Methods: Prospective study enrolling non-FMNP and FMNP (received $30 of FMNP coupons for fresh fruits and vegetables [F&V]) WIC recipients. Three surveys collected F&V intake for mother and child and nutrition knowledge/competencies. FMNP groups were compared on main outcomes using bivariate analyses and logistic regression.Results: Among participants using all coupons upon issuance, F&V intake significantly increased across surveys. In addition, intake significantly increased among >50% of FMNP participants reporting learned competencies (P = .03).Conclusions: WIC FMNP may be more effective with requirement to use all FMNP coupons upon issuance. F&V intakes may increase with nutrition education on competencies.

The Prevalence of and Factors Associated with Alcohol-Related Problems in a Community Sample of African American Women.

Purpose. This study examines the prevalence of alcohol-related problems, the factors underlying these problems, and whether or not there is evidence of syndemic effects in a community population of southern, urban African American women. Methods. Questionnaire-based interviews were conducted with 817 women, all African American, from 80 targeted census block groups in Atlanta, Georgia. Results. Most of the alcohol users (67.8%) experienced at least one problem as a result of their alcohol (ab)use, with most women experiencing two or more such problems. Eight factors were found to be associated with experiencing more alcohol problems: being aged 30 or older, having had no recent health insurance, lower levels of educational attainment, self-identifying as lesbian or bisexual, experiencing greater amounts of childhood maltreatment, greater impulsivity, perceiving one's local community or neighborhood to be unsafe, and having a larger number of criminally involved friends. Conclusions. Drinking-related problems were prevalent in this population. Numerous factors underlie the extent to which African American women experienced problems resulting from their alcohol use. There is strong evidence of syndemic-type effects influencing drinking problems in this population, and future efforts to reduce the negative impact of alcohol (ab)use ought to consider the adoption of programs using a syndemics' theory approach.