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Correlates of Health Promotion in a Community Sample of African American Churches
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Though many African American churches offer health promotion activities to their members, less is known about organizational factors that predict the availability of this programming. This study examines organizational capacity as a predictor of the amount and type of health programming offered by a convenience sample of 119 African American churches. Leaders completed a survey of health promotion activities provided in the previous 12 months and a measure of organizational capacity. Churches offered an average of 6.08 (SD = 2.15) different health programs targeting 4.66 (SD = 3.63) topics. Allocation of space and having a health ministry were positively associated with both the number of health programs and health topics addressed. When seeking to initiate health programming in an African American church setting, it is recommended that stakeholders partner with churches that have existing structures to support health promotion such as a health ministry, or help them build this capacity.
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MPRC People
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Craig Fryer, Dr.P.H.
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Craig Fryer Publications
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Reproductive readiness predicts a woman’s non-use of contraception in the postpartum months in U.S.
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Michael S. Rendall and Monica L. Caudillo examine reproductive readiness in U.S. Women’s Postpartum Non-Use of Contraception
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Research
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Selected Research
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Intentionally or Ambivalently Risking a Short Interpregnancy Interval: Reproductive-Readiness Factors in Women’s Postpartum Non-Use of Contraception
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A focus of research on short interpregnancy intervals (IPI) has been on young disadvantaged women whose births are likely to be unintended. Later initiation of family formation in the United States and other high-income countries points to the need to also consider a woman’s attributes indicative of readiness for purposefully accelerated family formation achieved through short IPIs. We test for whether factors indicating “reproductive readiness”—including being married, being older, and having just had a first birth or a birth later than desired—predict a woman’s non-use of contraception in the postpartum months. We also test for whether this contraceptive non-use results explicitly from wanting to become pregnant again. The data come from the 2012–2015 Pregnancy Risk Assessment Monitoring System, representing women who recently gave birth in any of 35 U.S. states and New York City ( N = 120,111). We find that these reproductive-readiness factors are highly predictive of women’s postpartum non-use of contraception because of a stated desire to become pregnant and are moderately predictive of contraceptive non-use without an explicit pregnancy intention. We conclude that planning for, or ambivalently risking, a short IPI is a frequent family-formation strategy for women whose family formation has been delayed. This is likely to become increasingly common as family formation in the United States is initiated later in the reproductive life course.
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MPRC People
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Monica Caudillo, Ph.D.
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Monica Caudillo Publications
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A Credible Messenger: The Role of the Violence Intervention Specialist in the Lives of Young Black Male Survivors of Violence
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For hospital-based violence intervention programs (HVIPs), gun violence intervention and the treatment of firearm-related injuries for male survivors require a sui generis network of team members that includes physicians, caseworkers, mental health care providers, and violence intervention specialists (VIS). The VIS can play a vital part in the success of HVIPs, but there is no published literature about the roles, functions, and best practices of this position. A case study conducted at the Capital Region Violence Intervention Program, an emerging HVIP at the University of Maryland Prince George's Hospital Center, demonstrates the importance of the VIS fostering deep levels of interpersonal connection with survivors of violent injury. The VIS actively seeks to increase the rate of psychosocial services usage. Due to cultural competence, street experience, and a willingness to share lived experiences as a survivor of violent injury, the VIS has credibility when discussing mental health symptomatology and usage of services for young Black male survivors of violence. The relationship between the VIS and male survivors of violent injury markedly enhanced the provision of trauma-informed care, peer support, and mentoring. This case study demonstrates the importance of marshalling the shared lived experiences of the VIS to increase trust and perceived credibility by young Black male survivors of gun violence as a means to decrease trauma recidivism.
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MPRC People
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Joseph Richardson, Ph.D.
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Joseph Richardson Publications
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Racial non-equivalence of Socioeconomic Status and Health among African Americans and Whites
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Racial health inequities are not fully explained by socioeconomic status (SES) measures like education, income and wealth. The largest inequities are observed among African American and white college graduates suggesting that African Americans do not receive the same health benefits of education. African Americans do not receive the same income and wealth returns of college education as their white counterparts indicating a racial non-equivalence of SES that may affect health inequities. The aim of this study is to determine whether racial non-equivalence of SES mediates race inequities in self-rated health by education and sex. Using data from the 2007–2016 National Health and Nutrition Examination Survey in the United States, the mediation of the associations between race and self-rated health through household income ≥400% federal poverty line, homeownership, and investment income were assessed among college graduates and non-college graduates by sex. Indirect associations were observed among college graduate women (odds = 0.08, standard error (s.e.) = 0.03), and non-college graduate men (odds = 0.14, s.e. = 0.02) and women (odds = 0.06, s.e. = 0.02). Direct associations between race and self-rated health remained after accounting for household income and wealth indicators suggesting that race differences in income and wealth partially mediate racial inequities in self-rated health. This study demonstrates that the racial non-equivalence of SES has implications for health inequities, but the magnitude of indirect associations varied by sex. Other factors like discrimination, health pessimism and segregation should be considered in light of the racial non-equivalence of SES and racial inequities in self-rated health.
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Retired Persons
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Caryn Bell, Ph.D.
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Caryn Bell Publications
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Testing a Syndemic Index of Psychosocial and Structural Factors associated with HIV Testing among Black Men
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Black populations in the United States are disproportionately affected by HIV. This disparity may be affected by social and structural barriers to HIV testing, leading to undiagnosed infection and prolonged HIV transmissibility. Using data from a nationally representative sample of 1,727 Black men in the 2015 Behavioral Risk Factor Surveillance System we tested for differences in poverty, depression, and health care barriers between Black men who had been HIV tested in the past year and those who had not. We also tested a syndemic index of these factors. Number of syndemic factors was linearly associated with less HIV testing (aPR=0.79, 95% CI 0.66-0.95). Assumptions of unidimensionality were met. The use of a syndemic index was a superior approach to analyzing these factors individually, both in terms of model fit and associations detected. The accumulation of poverty, depression, and health care barriers has an adverse impact on HIV testing among Black men.
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Retired Persons
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Natalie Slopen, Sc.D.
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Natalie Slopen Publications
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Testing a Syndemic Index of Psychosocial and Structural Factors associated with HIV Testing among Black Men
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Black populations in the United States are disproportionately affected by HIV. This disparity may be affected by social and structural barriers to HIV testing, leading to undiagnosed infection and prolonged HIV transmissibility. Using data from a nationally representative sample of 1,727 Black men in the 2015 Behavioral Risk Factor Surveillance System we tested for differences in poverty, depression, and health care barriers between Black men who had been HIV tested in the past year and those who had not. We also tested a syndemic index of these factors. Number of syndemic factors was linearly associated with less HIV testing (aPR=0.79, 95% CI 0.66-0.95). Assumptions of unidimensionality were met. The use of a syndemic index was a superior approach to analyzing these factors individually, both in terms of model fit and associations detected. The accumulation of poverty, depression, and health care barriers has an adverse impact on HIV testing among Black men.
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MPRC People
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Bradley Boekeloo, Ph.D., Sc.M.
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Bradley Boekeloo Publications
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The Role of Social Support in Moderating the Relationship between Race and Hypertension in a Low-Income, Urban, Racially Integrated Community
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In the US, African Americans have a higher prevalence of hypertension than Whites. Previous studies show that social support contributes to the racial differences in hypertension but are limited in accounting for the social and environmental effects of racial residential segregation. We examined whether the association between race and hypertension varies by the level of social support among African Americans and Whites living in similar social and environmental conditions, specifically an urban, low-income, racially integrated community. Using data from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) sample, we hypothesized that social support moderates the relationship between race and hypertension and the racial difference in hypertension is smaller as the level of social support increases. Hypertension was defined as having systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg, or the participant reports of taking antihypertensive medication(s). The study only included participants that self-reported as “Black/African American” or “White.” Social support was measured as functional social support and marital status. After adjusting for demographics and health-related characteristics, we found no interaction between social support and race (DUFSS score, prevalence ratio 1.00; 95% confidence interval 0.99, 1.01; marital status, prevalence ratio 1.02; 95% confidence interval 0.86, 1.21); thus the hypothesis was not supported. A plausible explanation is that the buffering factor of social support cannot overcome the social and environmental conditions which the participants live in. Further, these findings emphasize social and environmental conditions of participants in EHDIC-SWB may equally impact race and hypertension.
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Retired Persons
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Caryn Bell, Ph.D.
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Caryn Bell Publications
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Associations Between Community-Level LGBTQ-Supportive Factors and Substance Use Among Sexual Minority Adolescents
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Purpose: Using representative school-based data and community-level primary data, we investigated how environmental factors (e.g., school and community climate) might be protective against substance use behaviors among a vulnerable population of adolescents. Methods: We analyzed a sample of 2678 sexual minority adolescents using a combination of student-level data (British Columbia Adolescent Health Survey) and primary community-level data (assessing lesbian, gay, bisexual, transgender, and queer [LGBTQ]-specific community and school environments). Using multilevel logistic regression models, we examined associations between lifetime substance use (alcohol, illegal drugs, marijuana, nonmedical use of prescription drugs, and smoking) and community-level predictors (community and school LGBTQ supportiveness). Results: Above and beyond student characteristics (e.g., age and years living in Canada), sexual minority adolescents residing in communities with more LGBTQ supports (i.e., more supportive climates) had lower odds of lifetime illegal drug use (for boys and girls), marijuana use (for girls), and smoking (for girls). Specifically, in communities with more frequent LGBTQ events (such as Pride events), the odds of substance use among sexual minority adolescents living in those communities was lower compared with their counterparts living in communities with fewer LGBTQ supports. Conclusions: The availability of LGBTQ community-level organizations, events, and programs may serve as protective factors for substance use among sexual minority adolescents. In particular, LGBTQ-supportive community factors were negatively associated with substance use, which has important implications for our investment in community programs, laws, and organizations that advance the visibility and rights of LGBTQ people.
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MPRC People
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Jessica N Fish, Ph.D.
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Jessica N Fish Publications
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Marian MacDorman featured in Vox on Maternal Mortality Rate
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U.S. lags behind in terms of maternal mortality rate
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News