scholarly journals Associations between Perceived Racial Discrimination and Tobacco Cessation among Diverse Treatment Seekers

2020 ◽  
Vol 30 (3) ◽  
pp. 411-420
Author(s):  
Monica Webb Hooper ◽  
Patricia Calixte-Civil ◽  
Christina Verzijl ◽  
Karen O. Brandon ◽  
Taghrid Asfar ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Tobacco Cessation ◽  
Perceived Discrimination ◽  
Controlled Trial ◽  
Ethnic Discrimination ◽  
Post Intervention ◽  
American Black ◽  
Prospective Longitudinal ◽  
Racial Ethnic

Objectives: This study investigated a) racial/ethnic differences in past-year discrimination experiences and b) associa­tions between discrimination and smoking abstinence.Design: Prospective, longitudinal analysis of smoking status. Perceived past-year discrimi­nation was assessed at baseline. ANCOVAs and intent-to-treat hierarchical logistic regressions were conducted.Setting: Dual-site (Tampa, FL and Miami, FL) randomized controlled trial testing the effects of a group cessation intervention plus pharmacotherapy.Participants: Treatment-seeking adult smokers (N=347; non-Hispanic White, non-Hispanic African American/Black, or Hispanic).Main Outcome Measures: Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention and at 6-month follow-up.Results: After controlling for covari­ates, African Americans/Blacks reported greater perceived discrimination compared with non-Hispanic Whites (P=.02), and Hispanics (P=.06). Non-Hispanic Whites and Hispanics did not differ in perceived racial/ethnic discrimination experiences over the past year. Irrespective of race/ ethnicity, past-year perceived discrimina­tion was inversely associated with 7-day ppa, both post-intervention (AOR=.97, CI: .95-.99) and at 6-months (AOR=.98, CI: .96-.99). Among African Americans/Blacks, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.95, CI: .92-.97) and at 6-months (AOR=.97, CI: .94-.99). Perceived discrimination was unrelated to 7-day ppa among Hispanics. Among non-Hispanic Whites, past-year perceived discrimination was inversely associated with post-intervention 7-day ppa (AOR=.95, CI: .91-.99), but not 6-months.Conclusions: Perceived racial/ethnic discrimination was greater among African American/Black smokers compared with non-Hispanic Whites. Perceived discrimina­tion was negatively associated with tobacco cessation in the full sample, and for African Americans at 6-months post-intervention. These data have implications for interven­tion delivery and health disparities.Ethn Dis. 2020;30(3):411-420; doi:10.18865/ed.30.3.411

Translational Research Principles of an Effectiveness Trial for Diabetes Care in an Urban African American Population

2005 ◽  
Vol 31 (6) ◽  
pp. 880-889 ◽  
Author(s):  
Tiffany L. Gary ◽  
Felicia Hill-Briggs ◽  
Marian Batts-Turner ◽  
Frederick L. Brancati
Keyword(s):  
African American ◽  
African Americans ◽  
Diabetes Care ◽  
Large Scale ◽  
Health Workers ◽  
Controlled Trial ◽  
Phase 1 ◽  
Community Setting ◽  
Minority Community ◽  
Effectiveness Trials

Purpose Large-scale effectiveness trials designed to translate evidence-based diabetes care to community settings are few. Studies describing these methods among high-risk minority populations are particularly limited. Methods The authors describe Project Sugar, a randomized controlled trial conducted in 2 phases: Project Sugar 1 (1994-1999), which piloted a 4-arm clinic and homebased intervention using nurse case management and community health workers in 186 urban African Americans with type 2 diabetes, and Project Sugar 2 (2000-2005), which examined effectiveness of this intervention among 542 diabetic, urban African Americans. Results and Conclusions Project Sugar had success with regard to recruitment and retention, both in phase 1 (80% rate at 24 months) and phase 2 (>90% at 24 months). Using the RE-AIM framework, planning and research design for Project Sugar 2 is described in detail for elements that contributed to the reach, effectiveness, adoption, implementation, and maintenance of this study within a minority community setting. In addition to successful strategies, challenges to conducting effectiveness trials in an inner-city African American community are identified.

scholarly journals Reasons for Exclusion from a Smoking Cessation Trial: An Analysis by Race/Ethnicity

2019 ◽  
Vol 29 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Monica Webb Hooper ◽  
Taghrid Asfar ◽  
Marina Unrod ◽  
Asha Dorsey ◽  
John B. Correa ◽  
...  
Keyword(s):  
African Americans ◽  
Drug Use ◽  
Randomized Clinical Trials ◽  
Nicotine Patch ◽  
Unintended Consequences ◽  
Treatment Attendance ◽  
Tobacco Treatment ◽  
Quasi Experimental ◽  
American Black ◽  
Racial Ethnic

Objective: The exclusion criteria of tobacco cessation randomized clinical trials (RCTs) may have unintended consequences on inclusion and cessation disparities. We examined racial/ethnic differences in: a) ex­clusion from a group-based cessation RCT; and b) reasons for exclusion.Design: Quasi-experimental. Inclusion criteria were self-identification as African American/Black, non-Hispanic White, or Hispanic (any race), adults, minimum five cigarettes/day or carbon monoxide reading of ≥ 8 parts per million (ppm), interest in quitting, and spoke/read English. Data were obtained from a parent trial, which is ongo­ing and will be completed in 2019. Analyses for our present study on participant screen­ing and enrollment were conducted in 2018.Main Outcome Measures: Study ineligi­bility, and reasons for exclusion (contra­indications for nicotine patch use, serious mental illness [SMI, eg, bipolar disorder or schizophrenia], alcohol dependence or illicit drug use, current tobacco treatment, attendance barriers [eg, transportation], and other concerns [eg, aggressive, intoxicated, disruptive, visibly ill]).Results: Of 1,206 individuals screened, 36% were ineligible. The most frequent reasons were SMI (28%), alcohol depen­dence or drug use (10%), and attendance barriers (7%). Ineligibility was greater among African Americans (42%) and Hispan­ics (37%), compared with Whites (24%; P<.001). Compared with African Americans and Hispanics, Whites were more likely to be excluded for single reasons, including attendance barriers, and medical conditions (P<.05). African Americans were more than twice as likely as Whites to be excluded for 3 or more reasons (12% vs 5% respectively, P<.05).Conclusions: A notable proportion of smokers were ineligible for this RCT, with SMI as the greatest single cause. Racial/ ethnic minorities were more likely to be excluded, with African Americans deemed ineligible for multiple reasons. Findings have implications for RCT generalizabil­ity, addressing tobacco disparities and health equity.Ethn Dis. 2019;29(1):23-30; doi:10.18865/ed.29.1.23.

New Perspectives on New Deal Housing Policy: Explicating and Mapping HOLC Loans to African Americans

2019 ◽  
Vol 46 (1) ◽  
pp. 150-180 ◽  
Author(s):  
Todd M. Michney ◽  
LaDale Winling
Keyword(s):  
African American ◽  
African Americans ◽  
Housing Policy ◽  
New Deal ◽  
Racial Segregation ◽  
Working Capital ◽  
Class Bias ◽  
Loan Corporation ◽  
Racial Ethnic

Scholarship on the Home Owners’ Loan Corporation (HOLC) has typically focused on this New Deal housing agency’s invention of redlining, with dire effects from this legacy of racial, ethnic, and class bias for the trajectories of urban, and especially African American neighborhoods. However, HOLC did not embark on its now infamous mapping project until after it had issued all its emergency refinancing loans to the nation’s struggling homeowners. We examine the racial logic of HOLC’s local operations and its lending record to black applicants during the agency’s initial 1933-1935 “rescue” phase, finding black access to its loans to have been far more extensive than anyone has assumed. Yet, even though HOLC did loan to African Americans, it did so in ways that reinforced racial segregation—and with the objective of replenishing the working capital of the overwhelmingly white-owned building and loans that held the mortgages on most black-owned homes.

scholarly journals Increasing Physical Activity in Black Women: Results from a Randomized Trial Conducted in Faith-Based Settings

2017 ◽  
Vol 27 (4) ◽  
pp. 411 ◽  
Author(s):  
Melicia C. Whitt-Glover ◽  
Moses V. Goldmon ◽  
Ziya Gizlice ◽  
Marie Sillice ◽  
Lyndsey Hornbuckle ◽  
...  
Keyword(s):  
Physical Activity ◽  
African American ◽  
Black Women ◽  
African American Women ◽  
Controlled Trial ◽  
Control Group ◽  
High Risk Population ◽  
Post Intervention ◽  
American Women

<p><strong>Objective: </strong>The Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life study compared a faith-integrated (FI) and a secular (SEC) intervention for increasing physical activity with a self-guided (SG) control group among African American women. <strong></strong></p><p><strong>Design/Setting/Participants: </strong>L.A.D.I.E.S. was a cluster randomized, controlled trial. Churches (n=31) were randomized and women within each church (n=12 – 15) received the same intervention. <strong></strong></p><p><strong>Interventions: </strong>FI and SEC participants received 24 group-based sessions, delivered over 10 months. SG participants received printed materials to review independently for 10 months. Participants were followed for 12-months post-intervention to assess long-term intervention impact. </p><p><strong>Main Outcome Measures: </strong>Data on participant characteristics, physical activity, and intervention-related constructs were collected at baseline, 10 months, and 22 months. <strong></strong></p><p><strong>Results: </strong>Intervention session attendance was greater for FI compared with SEC participants (15.7 + 5.7 vs 12.4 + 7.3 sessions, respectively, P&lt;.01). After 10 months, FI and SEC participants significantly increased daily walking (+1,451 and +1,107 steps/ day, respectively) compared with SG participants (-128 steps/day). Increases were maintained after 22 months in the FI group compared with the SG group (+1092 vs. +336 daily steps, P&lt;.01). Between-group changes in accelerometer-assessed physical activity were not statistically significant at any time point. <strong></strong></p><p><strong>Conclusions: </strong>The FI intervention is a feasible strategy for short- and long-term increases in physical activity among African American women. Additional dissemination and evaluation of the strategy could be useful for reducing chronic disease in this high-risk population. <em></em></p><p><em>Ethn Dis.</em>2017;27(4):411- 420; doi:10.18865/ed.27.4.411. </p>

scholarly journals Clinician–Patient Racial/Ethnic Concordance Influences Racial/Ethnic Minority Pain: Evidence from Simulated Clinical Interactions

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3109-3125 ◽  
Author(s):  
Steven R Anderson ◽  
Morgan Gianola ◽  
Jenna M Perry ◽  
Elizabeth A Reynolds Losin
Keyword(s):  
African American ◽  
Pain Treatment ◽  
The United States ◽  
Ethnic Discrimination ◽  
Medical Procedure ◽  
Black African ◽  
Clinical Interactions ◽  
Racial Ethnic ◽  
Hispanic White ◽  
White Patients

Abstract Objective Racial and ethnic minorities in the United States report higher levels of both clinical and experimental pain, yet frequently receive inadequate pain treatment. Although these disparities are well documented, their underlying causes remain largely unknown. Evidence from social psychological and health disparities research suggests that clinician–patient racial/ethnic concordance may improve minority patient health outcomes. Yet whether clinician–patient racial/ethnic concordance influences pain remains poorly understood. Methods Medical trainees and community members/undergraduates played the role of “clinicians” and “patients,” respectively, in simulated clinical interactions. All participants identified as non-Hispanic Black/African American, Hispanic white, or non-Hispanic white. Interactions were randomized to be either racially/ethnically concordant or discordant in a 3 (clinician race/ethnicity) × 2 (clinician–patient racial/ethnic concordance) factorial design. Clinicians took the medical history and vital signs of the patient and administered an analogue of a painful medical procedure. Results As predicted, clinician–patient racial/ethnic concordance reduced self-reported and physiological indicators of pain for non-Hispanic Black/African American patients and did not influence pain for non-Hispanic white patients. Contrary to our prediction, concordance was associated with increased pain report in Hispanic white patients. Finally, the influence of concordance on pain-induced physiological arousal was largest for patients who reported prior experience with or current worry about racial/ethnic discrimination. Conclusions Our findings inform our understanding of the sociocultural factors that influence pain within medical contexts and suggest that increasing minority, particularly non-Hispanic Black/African American, physician numbers may help reduce persistent racial/ethnic pain disparities.

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