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A Doctor’s Food Journey
No full textLearning how to nourish ourselves is a journey. In this short film from the Nourish, pediatrician Nadine Burke discusses the evolution of her eating habits over the years, and how she learned that eating well can be fun. How has your relationship to food and health changed throughout your life
Using a Family History Intervention to Improve Cancer Risk Perception in a Black Community.
No full textFew studies examine the use of family history to influence risk perceptions in the African American population. This study examined the influence of a family health history (FHH) intervention on risk perceptions for breast (BRCA), colon (CRC), and prostate cancers (PRCA) among African Americans in Pittsburgh, PA. Participants (n = 665) completed pre- and post-surveys and FHHs. We compared their objective and perceived risks, classified as average, moderate, or high, and examined the accuracy of risk perceptions before and after the FHH intervention. The majority of participants had accurate risk perceptions post-FHH. Of those participants who were inaccurate pre-FHH, 43.3%, 43.8%, and 34.5% for BRCA, CRC, and PRCA, respectively, adopted accurate risk perceptions post-FHH intervention. The intervention was successful in a community setting. It has the potential to lead to healthy behavior modifications because participants adopted accurate risk perceptions. We identified a substantial number of at-risk individuals who could benefit from targeted prevention strategies, thus decreasing racial/ethnic cancer disparities
Beginning a discussion of nutrition and health disparities
No full textIn 2005, the American Society for Nutrition (ASN) created a Minority Affairs Committee (MAC). The goal of the committee is to enhance the participation of scientists from minority groups in the activities of the ASN. Because of the marked disparities in health conditions between white Americans and ethnic minority groups, the MAC also aims to promote scholarly interaction in the area of nutrition in health disparities. To that end, in 2010, the MAC held its first symposium at Experimental Biology. The goal of the symposium was to begin a discussion within the ASN of the role of nutrition in disparities..
Do Biological Differences Help Explain Tobacco-Related Disparities?
No full textSmoking behaviors vary by age, educational level, economic status, gender, race/ethnicity, and geographic location. Results from national surveys in the United States have consistently shown substantial variation in smoking prevalence as well as cigarette consumption rates by these factors.1 Epidemiologic and behavioral research have identified patterns of higher smoking prevalence rates among men, whites and African-Americans, and persons with less than high school education among nonimmigrants.1 Immigrants from Latin America and Asia tend to have lower smoking prevalence rates, especially among women. In addition, nondaily smoking and smoking five or fewer cigarettes per day is common among nonwhite smokers.2 Tobacco researchers have tried to understand the behavioral and social aspects of why smoking rates and related diseases differ by race/ethnicity. The potential role of racial/ethnic differences in nicotine metabolism and response to cessation drug therapy has not been fully explored
Effectiveness of a Barber-Based Intervention for Improving Hypertension Control in Black Men: The BARBER-1 Study: A Cluster Randomized Trial
No full textBACKGROUND: Barbershop-based hypertension (HTN) outreach programs for black men are becoming increasingly common, but whether they are an effective approach for improving HTN control remains uncertain.
METHODS: To evaluate whether a continuous high blood pressure (BP) monitoring and referral program conducted by barbers motivates male patrons with elevated BP to pursue physician follow-up, leading to improved HTN control, a cluster randomized trial (BARBER-1) of HTN control was conducted among black male patrons of 17 black-owned barbershops in Dallas County, Texas (March 2006-December 2008). Participants underwent 10-week baseline BP screening, and then study sites were randomized to a comparison group that received standard BP pamphlets (8 shops, 77 hypertensive patrons per shop) or an intervention group in which barbers continually offered BP checks with haircuts and promoted physician follow-up with sex-specific peer-based health messaging (9 shops, 75 hypertensive patrons per shop). After 10 months, follow-up data were obtained. The primary outcome measure was change in HTN control rate for each barbershop.
RESULTS: The HTN control rate increased more in intervention barbershops than in comparison barbershops (absolute group difference, 8.8% [95% confidence interval (CI), 0.8%-16.9%]) (P = .04); the intervention effect persisted after adjustment for covariates (P = .03). A marginal intervention effect was found for systolic BP change (absolute group difference, -2.5 mm Hg [95% CI, -5.3 to 0.3 mm Hg]) (P = .08).
CONCLUSIONS: The effect of BP screening on HTN control among black male barbershop patrons was improved when barbers were enabled to become health educators, monitor BP, and promote physician follow-up. Further research is warranted.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00325533
Advancing the Science of Community-Level Interventions
No full textCommunity interventions are complex social processes that need to move beyond single interventions and outcomes at individual levels of short-term change. A scientific paradigm is emerging that supports collaborative, multilevel, culturally situated community interventions aimed at creating sustainable community-level impact. This paradigm is rooted in a deep history of ecological and collaborative thinking across public health, psychology, anthropology, and other fields of social science. The new paradigm makes a number of primary assertions that affect conceptualization of health issues, intervention design, and intervention evaluation. To elaborate the paradigm and advance the science of community intervention, we offer suggestions for promoting a scientific agenda, developing collaborations among professionals and communities, and examining the culture of science. (Am J Public Health. Published online ahead of print June 16, 2011:e1-e10. doi:10.2105/AJPH.2010.300113)
Estimating the Potential Health Impact and Costs of Implementing a Local Policy for Food Procurement to Reduce the Consumption of Sodium in the County of Los Angeles
No full textObjectives. We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. Methods. We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions' potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations. Results. Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629724 in direct health care costs. Conclusions. Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow. (Am J Public Health. Published online ahead of print June 16, 2011: e1-e7. doi:10.2105/AJPH.2011.300138)
Using a Qualitative Approach to Develop an Evaluation Data Set for Community-Based Health Promotion Programs Addressing Racial and Ethnic Health Disparities
No full textCDC Fact Sheet: Highlights of CDC Activities Addressing HIV Prevention Among African American Gay, Bisexual, and Other Men Who Have Sex With Men
No full textAmong MSM in 2009, white MSM represented the largest number of new HIV infections (11,400),followed closely by black/African American MSM(10,800) and Hispanic MSM (6,000). Among all men in 2009, MSM accounted for 86% of new infections among white men, 73% of new infectionamong black/African American men and 81% of new infections among Hispanic men. Young black/African American MSM aged 13-29
are especially affected by the HIV/AIDS epidemic. While HIV incidence was relatively stable among MSM overall from 2006 through 2009, CDC estimates that new HIV infections among black/African American MSM aged 13 to 29 increased 48% during that four-year time period, with a statistically significant 12.2% estimated annual percentage increase
Exploring Unconscious Bias in Disparities Research and Medical Education
No full textThe evidence that physician behavior and decision making may contribute to racial inequalities in health care1,2,3,4,5 is difficult to reconcile with the fact that most physicians are genuinely motivated to provide good care to all their patients.6 This apparent contradiction can cause considerable cognitive dissonance, the uncomfortable feeling that occurs when holding 2 conflicting ideas simultaneously. Cognitive dissonance has been shown to be so aversive that people are highly motivated to resolve it, often by discounting the evidence supporting one of the conflicting beliefs. For scientists, however, cognitive dissonance motivates inquiry into how 2 seemingly contradictory sets of facts can coexist. The study by Haider and colleagues 7 in this issue of JAMA is part of a growing body of work applying concepts and methods from cognitive and social psychology to medical care and education research to understand and inform