• The influence of perceived barriers and self-efficacy on care-seeking behavior and health responsibility and among African-American men

      Smith, Rachel Wheeler; Mills, Mary Etta C. (1996)
      The purposes of this study were: (1) to examine the relationship between perceived barriers, self-efficacy, and sociodemographic characteristics among African American males; (2) to examine the relationship between each of the perceived barriers, self-efficacy, and care-seeking behavior while controlling for sociodemographic characteristics; and (3) to examine the relationship between each of the perceived barriers, self-efficacy, and health responsibility while controlling for sociodemographic characteristics. The model used to direct the study was a combination of three models: The Health Belief Model; The Health Promotion Model; and The Theory of Care-Seeking Behavior. Components of the model included perceived barriers to preventive health care, self-efficacy, health responsibility, and sociodemographic characteristics (age and SES). A self-selected sample of 400 African American men was surveyed using a self-report questionnaire. Two-hundred fourteen questionnaires were returned for a response rate of 54%. Data analysis procedures included bivariate correlations and hierarchial stepwise multivariate regressions using care-seeking behavior and health responsibility as dependent variables. Findings suggested that African American men in this study with a high SES index, that is, education, income, and occupational status, experienced a greater sense of self-efficacy, perceived fewer barriers to obtaining preventive services, assumed more responsibility for their own health care, and sought health care sooner than African American males with less education, income and occupational status. Age was not related to perceived barriers or self-efficacy, but significantly related to socioeconomic status. Older men demonstrated higher SES levels. African American men in this study had relatively high levels of self-efficacy. Individuals with low self-efficacy perceived barriers to preventive health care related to the site of care, provider consumer relationships, costs, inconvenience, and fear. The probability of engaging in preventive health behavior was not influenced by SES, age, self-efficacy or perceived barriers. However, probability of assuming responsibility for health was significantly influenced by age, SES, and fear.
    • Intergenerational health promotion in African-Americans

      McArthur, Donna Behler; Dennis, Karen E. (1997)
      Heart disease is the leading cause of death for people over the age of 25 and is largely preventable through behavioral changes. Diet and physical activity patterns, which may be amenable to change through age- and generation-appropriate interventions, have not been extensively tested in school-based programs. The purposes of this study were to: (1) Assess the impact of a school-based intervention in promoting healthy cardiovascular behaviors in elementary school children; and, (2) Evaluate the efficacy of elementary school children as conduits of health promotion information for older generations. Three inner city public elementary schools located within a one mile radius were randomly assigned to treatment or control groups. Individual participants were six classes of African-American students (n = 135) and their grandparent partners (n = 44). The four-week intervention incorporated workshops from Heart Power!TM with take-home activities to be shared with the grandparent partner. Constructs from the Intergenerational Health Promotion Model guided the development of the instruments and the intervention. Self-report measures assessed the effectiveness of the intervention: the Family Health Tree (FHT), the Heart Healthy Questionnaire (HHQ), the Physical Activity Record, and the 24-hour Food Record. A significant effect for the intervention was found for the knowledge of a heart healthy diet and physical activity in one of the two intervention schools (School B) (ANCOVA) (F (2.94) = 5.77, p=0.004). Although there were no significant treatment effects on attitudes, self-efficacy, or stages of change subscales, scores from the two intervention schools were higher than those of the control school. There were no significant differences among grandparents of students from the three schools on any of the variables. Overall, scores were higher for physical activity behaviors than nutrition behaviors. Sixty-six percent of the students in the intervention schools participated with their partners in one or more take-home workshop activities, with the greatest participation (88%) from School B. Since cardiovascular risk factors originate early in life, interventions through school-based programs are a promising mechanism for educating an entire family or kinship network in a community about heart healthy lifestyle behaviors as supported by the sharing of information across generations.
    • Protective factors associated with delayed sexual activity among urban African American females

      Butler, Georgene A.; Plowden, Keith O. (2005)
      A disproportionate number of African American females are engaging in early sexual activity. This behavior has placed them at risk for consequences such as multiple partners, unplanned pregnancies, and sexually transmitted diseases. Literature suggests multiple risk and protective factors associated with this behavior. This study explored protective factors associated with delayed sexual activity among urban African American females. Informants were recruited and interviewed from Baltimore City. For this study qualitative interviews were conducted with ten key informants and fifteen general informants. Key informants were females who delayed their initial sexual intercourse until age sixteen or after. General informants were those who had a special knowledge about protective factors associated with delaying sexual activity in urban African American females. Study results revealed that protective factors helpful in delaying early sexual activity include: caring proximal social environment, positive individual attributes, positive parenting, and positive communication. These findings have implications for nursing education, research, practice and policy. Results of this study can be used to design and implement a developmentally and culturally appropriate intervention for this group.
    • The relationship between the rewards, costs, and coping strategies of black family caregivers

      Picot, Sandra J.; Baldwin, Beverly Ann, 1941-; Rasin, Joyce (1991)
      This study was designed to describe the relationship between perceived rewards, costs, and coping strategies of black family caregivers who provided care to an elderly demented relative. Selection of coping strategies is predicated on a continuous transaction between the caregiver's appraisal of what is at stake for the caregiver in the caregiving situation and her personal resources (Folkman & Lazarus, 1980). However, research studies have suggested the caregiver's ethnicity, household income, relationship to the carereceiver, carereceiver's geographic area of residence, and the caregiving demands may serve as confounding variables. Most caregiver studies have either used predominantly white samples or treated black subjects as a homogeneous group. Therefore, the relationship of rewards, costs, and coping strategy selection with controls for the above confounding variables in an all black sample has not been done. Face-to-face interviews of 83 black female caregivers of elderly demented relatives were conducted. Coping was measured by the Jalowiec Coping Scale, rewards from the Picot Caregiver Rewards Scale, and costs from the Cost of Care Index. The demographics form included caregiver-carereceiver relationship, caregiver household income, and carereceiver geographic area of residence. The Modified Wood's Social Support Questionnaire measured the perceived quality of social support; and the Texas Research Institute of Mental Sciences Behavioral Problem Checklist evaluated caregiving demands. The seven major predictors (together) accounted for a significant amount of the overall variance in selected coping strategies, palliative emotive, confrontive active, positive thinking, problem analysis, and social support use coping. When the influences of all of the variables were removed except rewards and costs, the overall variance in palliative emotive coping, positive thinking, and problem analysis was significantly explained by rewards and costs. Caregiving demands and perceived quality of social support emerged as major predictors of total coping and social support use. Caregiver household income was a major predictor of both confrontive active and palliative emotive coping. Costs, also, predicted palliative emotive coping. Rewards were the most influential predictors of both positive thinking and problem analysis. Neither caregiver-carereceiver relationship nor carereceiver geographic area of residence emerged as significant predictors of either total coping score or individual coping strategies.
    • Relationship of African-Americans' socioeconomic status to their perceptions of cancer

      Clarke-Tasker, Veronica A.; Belcher, Anne E. (1996)
      The purpose of this study was to determine the relationship of African Americans' socioeconomic status to their perceptions of cancer. Maiman and Becker's (1974) Health Belief Model was adapted as the theoretical framework. Using this theoretical perspective, a descriptive study was designed to determine the relationship of African Americans' socioeconomic status to their perceptions of cancer screening and early cancer detection, perceptions of cancer risk factors, perceived susceptibility to cancer and cancer prevention. African Americans from a large church in an urban area of Maryland participated in the study. The perceptions subscales of the Cancer Awareness Inventory developed by Underwood (1992) was used for data collection. Additional questions were developed by the researcher to obtain additional information pertinent to African Americans: socioeconomic status, past experience with cancer, and demographic data. A total of 139 African Americans completed the questionnaires, of which 39 were male and 100 were female. Data from the questionnaires were analyzed using multiple regression. Participants in this study perceived themselves susceptible to developing cancer; believed that known and/or suspected activities as well as exposure to carcinogens may increase their cancer risks; believed engaging in recommended cancer preventive activities may decrease their cancer risks; believed that early cancer detection may discover cancer in the absence of symptoms; and believed that one could have cancer in the absence of symptoms. When a general multiple regression was performed, SES was related to three of the dependent variables (i.e., detection, risk and prevention). Age was unrelated to all five dimensions and gender was related only to the risk subscale. When age and gender were statistically controlled, SES was significantly related to all five dependent variables, although the control variables were significantly related only to the participants' perceptions of risk. The knowledge gained from this study will be useful in designing and implementing culturally relevant early cancer prevention and detection programs that take into account African Americans' perceptions of cancer.
    • Sensation seeking in urban African-American male substance abusers: Modification of the Sensation Seeking Scale

      Malone, Sandra Beth; Allen, Karen, Ph.D., R.N. (1998)
      In light of the strong positive relationship between sensation seeking and substance abuse and the fact that African Americans have historically scored lower than Caucasians on Zuckerman's Sensation Seeking Scale, this study was undertaken to: (a) Explore the sensation seeking concept within a specific population of urban African American males, (b) Modify the Sensation Seeking Scale to make it culturally relevant for urban African Americans, (c) Evaluate the psychometric properties of the modified scale and, (d) Examine the relationship between sensation seeking and selected demographic variables. The study employed a sequential triangulation design of a qualitative research methodology (focus groups) to modify Form V of the Sensation Seeking Scale, followed by a quantitative design to assess the psychometric properties of the modified scale and to examine the demographic variables. The qualitative study consisted of five focus group sessions, comprised of 38 urban African American males. Each session was audiotaped and an abridged transcript of the tapes from each session was prepared. Data analysis and coding occurred according to the interpretive/descriptive method. Modification of the scale occurred after saturation was reached and all focus group data were analyzed. The quantitative study consisted of a convenience sample of 126 urban African American male outpatients enrolled in substance abuse programs at a Veterans Affairs Medical Center. Sixty-three subjects were randomly assigned Form V and 63 subjects were randomly assigned the modified scale. Psychometric assessment of the modified scale consisted of test-retest reliability, internal consistency reliability, content validity and hypothesis testing construct validity. Data were analyzed using t-tests, ANOVAS and Pearsons Correlations. Scores obtained for the modified sample were significantly higher than scores obtained for the Form V sample, suggesting that the modified scale is a more appropriate measure of sensation seeking in urban African Americans. The overall findings from the psychometric assessment of the scale lent support for the reliability and validity of the Modified Sensation Seeking Scale, with the exception of the Boredom Susceptibility subscale. Additional refinement of the Boredom Susceptibility subscale, further exploration of the concept and more extensive assessment of the Modified Sensation Seeking Scale is warranted. Findings from the study indicate that there was no significant difference in sensation seeking based on education or drug of choice. There was a significant difference in sensation seeking based on polysubstance abuse.