Abstracts for poster session

Maria Chao, MPA, Fredi Kronenberg, Ph.D., Christine Wade, Debra Kalmuss, Ph.D., Linda F. Cushman, Ph.D., Whitney Dessio, Mailman School of Public Health and the Richard and Hinda Rosenthal Center for Complementary Medicine, Columbia University. 

Introduction: The current use of complementary and alternative medicine (CAM) has received increasing attention from researchers and policymakers as well as being further buttressed by recent legislation and insurance coverage. Our knowledge of CAM use among minority populations, however, is limited. Non-Hispanic whites and those of higher socioeconomic status (SES) have been associated with greater CAM use in national surveys. Whether lower CAM use among minorities and those of low SES results from less access to health insurance has not been examined.
Methods: Using data from a national telephone survey of 3,172 women, we assessed the mediating effects of health insurance on SES and race/ethnic differences of CAM usage among women in four race/ethnic populations. CAM use was defined as using chiropractic, acupuncture, massage, or acupressure in the year before the survey.
Results: When insurance was included in the model, SES was no longer significantly associated with CAM use; race/ethnic differences in CAM use persisted but were slightly attenuated. Non-Hispanic white women were significantly more likely to use CAM in the previous year than African-, Mexican-, or Chinese-American women in univariate and multivariate analyses. Women with health insurance were almost twice as likely to have used CAM in the past year, controlling for race/ethnicity and SES (AOR= 1.66, 95% CI=1.31, 2.10).
Conclusion: As CAM is increasingly integrated into health insurance plans, equity and access issues for the poor and minority populations need to be considered. In addition, although health insurance accounts for SES differences in CAM use, factors contributing to race/ethnic differences warrant further exploration.

Cheryl Woods Giscombé, M.A., R.N. and Marci Lobel, Ph.D.Department of Psychology, State University of New York at Stony Brook. 

Introduction:  African-American women have disproportionately higher rates of preterm birth and low birthweight delivery compared to European-American women.  A prevailing theory to explain this ethnic difference is the higher prevalence of Bacterial vaginosis (BV) among African-American women.  BV during pregnancy has been shown to be associated with adverse birth outcomes.  Separate bodies of evidence indicate that stress also contributes to adverse birth outcomes and that stress increases susceptibility to infection.  Psychosocial conditions in an ethnically diverse sample of women of childbearing age will be examined in conjunction with infection by BV to determine whether this condition is more common in African-American women as a result of greater exposure to life stressors, including ethnic discrimination.

Methods:  African-American and European-American women ages 18 to 45 will complete structured interviews comprised of psychometrically validated measures of stress, discrimination, coping, and other relevant psychosocial variables. BV will be diagnosed by Gram-stain of vaginal fluid samples.

Predicted Results:  African-American women will evidence greater likelihood of BV infection and will report more exposure to discrimination and other life stressors.  These variables will mediate the association between African-American ethnicity and infection with BV. 

Conclusion:  Differential exposure to psychological stressors contributes to the greater prevalence of BV among African-American women, and offers a mechanism to explain the disproportionate rate of adverse birth outcomes in this population.

Norma Bowe, Assistantt Proffessor, Kean University, New Jersey

A model diabetes outreach program is being conducted in Elizabeth New Jersey, where the total population is 120,568 and 59,627 are Latinos.  A conservative 35% live below the poverty line, and an estimated prevalence rate of diagnosed and undiagnosed diabetes is 53.3 per 1000. The city of Elizabeth is estimated to have approximately 3000 Latinos not yet diagnosed with type II diabetes.  Using the "Stages of Change" model (Prochaska and DiClemente), the diabetes outreach program provides screening, outreach and community awareness in order to facilitate treatment and prevention and education. A triage system is in place for those people with elevated blood sugar levels. A cookbook is being developed using “favorite" community recipes and converting to diabetic ingredients. A "cook off" contest using the adapted recipes will take place. The community cookbook will be disseminated. As the diabetes outreach program progresses, successes and barriers have emerged. This poster session will address both, and will evaluate the efficacy of screening and triage. A sample of the community cookbook will be demonstrated.

Tina B. Henderson, MA

Introduction: The church has long been the source of support on many health issues.  With the issue of HIV/AIDS, there seems to be a lack of clergy involvement in educating and preventing.  Research findings have indicated that ministers are resistant to implementing HIV/AIDS education within their churches.  HIV/AIDS is perceived as a homosexual and/or a sexually promiscuous disease and thus may be perceived as divine retribution for such “sinful” behavior.  The faith community is not immune to negative perceptions and attitudes, which may impact their level of involvement in HIV/AIDS intervention.
Methods: The proposed study will assess the attributions of approximately 150 clergy from Christian faiths in which large percentages of African Americans are members (i.e., AME, Church in Jesus Christ, Pentecostal, Baptist).  Clergy will complete a paper and pencil questionnaire assessing their level of conservatism, knowledge about AIDS, moral views, HIV/AIDS intervention efforts, and attributions.
Proposed Hypotheses and Analyses:It is hypothesized that those clergy who perceive HIV/AIDS disease as a sickness will be more sympathetic and thus be more willing and cooperative to implement a sex education intervention with an emphasis on HIV/AIDS, whereas those who perceive the disease as divine retribution will be less sympathetic and will be less willing and less cooperative to implement such a sex education intervention.  The aim of this study is to help understand that clergy’s’ causal beliefs and assignment of responsibility of HIV/AIDS could generate feelings of anger and sympathy that, in turn, direct their social conduct towards others and ultimately impacts the way they are responding or failing to respond to the HIV/AIDS health education implementation.  ANOVA, MANOVA, t-test and regression models will be applied to the data.

Maya Rockeymoore, Ph.D.

This paper examines the evolution of the Congressional Black Caucus AIDS Initiative, the first-ever AIDS policy drafted entirely for communities of color.  Placing pressure on and working with elected officials to address issues of special interest has long been an effective means by which interest groups have influenced the policy process.  This strategy of legislative advocacy, however, is still a nascent form of political action by minority groups who are relative newcomers to the U.S. political scene.  Yet it was exactly this strategy that led AIDS activists based in the minority community to successfully lobby members of the Congressional Black Caucus to do more to combat the devastating effects of HIV/AIDS in minority communities.  Their efforts resulted in the procurement of federal funds ($165.7 million in fiscal year 1999, $250.9 million in FY00, etc.) for HIV/AIDS prevention and treatment programs in African American communities.  How did the CBC accomplish this initiative as a minority within a minority within the House of Representatives?  How did activists and community-based organizations help to shape this initiative?  How did the resulting policy affect the landscape of AIDS services?  These are the primary questions explored in this paper.

Acting, Inspiring, and Motivating Toward Change:  A Photovoice Project with Latino Adolescents in Central North Carolina 

J. Matt Streng MPH(c); Scott D. Rhodes, PhD, MPH, CHES; Ramiro Arceo; Selena Phipps, CHES

Introduction:  The project explores how Latino adolescents perceive their lives in rural, central North Carolina using a Participatory Action Research (PAR) method known as Photovoice.  Participants are members of AIM (Action, Inspiration, and Motivation) Clubs which are middle and high school-based Clubs that provide after-school, supplemental programming for Latino students.  Because of the higher drop-out rates of Latino students, these programs provide support for Latino adolescents as they navigate the challenges associated with new schools, a new language, new cultural environments, and the substantial family changes associated with migration and immigration.
Methods:  Disposable cameras were distributed to participants who then documented their responses to group-defined themes.  Photographs were developed and each participant selected 2-3 photographs to present to the group.  These photographs were then discussed by the group using SHOWED, discussion probes that build on the Freirian process of root-cause questioning and discussion.  Researchers tape recorded and transcribed the discussions in preparation for qualitative data analysis.
Results:  Results reveal a perceived sense of racism and prejudice within school and community settings.  Community strengths included the roles of family and religion.
Conclusion:  Participants face a number of barriers to acculturation and social integration.  Understanding these barriers and their affects on the health and well-being of Latino adolescents is important to the development of effective services and policies.  A community exhibition will provide an opportunity for Latino adolescents to share their insight with community members, local service providers and policy makers in an effort to make services and policies more responsive to the issues and assets of Latino adolescents. 

 

Edgar G. Villanueva, BA, BSPH

Introduction: The CDC National Immunization Information Hotline (NIIH), operated by the ASHA, provides free information, referrals and publications throughout the US.  NIIH is staffed by Health Communication Specialists trained in technical immunization information, communication skills and data collection.   
Methods: Calls are randomly selected to be surveyed for content and demographic information. One out of six calls is surveyed for the English service and one out of two calls is surveyed for the Spanish line. 
Results: In 2001, staff answered 103,200 calls on the English line and 12,600 calls on the Spanish service.  Of the surveyed calls from the English service, 10% were from African Americans.  Thirty-six percent of African American callers discussed child immunization issues, with 90% of these callers being female.  Most of the African American callers with child immunization concerns were between the ages of 25-34 (41%) and have a high school education (37%).  The majority (80%) reported getting their immunization information from a healthcare professional or health department. However, 6% reported getting their immunization information from the media, 6% from books, 3% from family members, 3% from hotlines and 3% from the Internet.  
Conclusions:  According to the 2000 US Census Bureau report, African Americans currently make up an estimated 12.3% of the US population. NIIH provides information tailored to callers’ needs and offers resources such as publications, referrals to immunization related agencies and valuable Web site addresses to special populations.  NIIH is an instrumental tool in bridging the gap between those who may or may not have the resources to acquire information about immunizations or VPDs.  

Tracey A. Adams and Penny Simpson

Introduction: African American and Hispanic populations are at particular risk for HIV and other STDs. Telephone hotlines provide important health information for these populations. The American Social Health Association (ASHA) under contract with the Centers for Disease Control and Prevention (CDC) operates the CDC National STD and AIDS Hotlines (CDC NSTDAH), offering English, Spanish and TTY services. ASHA also operates the National HPV Hotline and the National Herpes Hotline.
Methods: Calls to the CDC NSTDAH are anonymously surveyed on a random basis. This abstract reveals demographic information collected between April 2001 and April 2002.
Results: Interesting differences between these populations and their use of the hotlines appeared. African Americans call the toll-free CDC NSTDAH at a rate about double their representation in the population, while their use of the toll numbers is much lower. Television and radio are important sources of information on hotline services for Hispanic callers. For both African American and Hispanic callers, symptoms and testing concerns are the prime reasons for calling all the services.
Conclusion: These results have important implications for the development of effective health policy and health education, especially where Hispanics and African Americans are concerned. The availability of a free service is important for many African Americans and Hispanics, who are too often economically disadvantaged. Television is effective in promoting health information to Hispanics. For any population, the symptom stage is too late to reach people with prevention and early intervention messages, and greater efforts at health promotion need to be made.

Smoking & Babies Just Don’t Mix: Developing a Citizen Action and Health Policy Campaign to Reduce Infant Mortality  

J. Nelson-Weaver, DrPH, MA

In April of 2002, the Forsyth County Infant Mortality Reduction (FCIMR) Coalition identified tobacco smoke as a major contributor to infant deaths in our community and to African American infant deaths in particular. The various members of the FCIMR Coalition decided to create a public policy and community education campaign with the two long-term goals of a) reducing the number of women in our community who smoke while they are pregnant and b) reducing women and children’s exposure to environmental tobacco smoke in public places throughout our county.

The FCIMR Coalition and our partners dedicated six months to our research, planning, and message development process. We gathered epidemiological data specifically for our community, identified focus areas for our campaign, developed strategies, and created appropriate messages with the help of community members.

The Smoking & Babies Just Don’t Mix campaign, launched during a major press event in November of 2002 includes these two major components:

1. Public Policy: Citizen action campaign for 100% smoke free restaurants
2. Community Education: Media campaign specifically encouraging African American smoking women to quit and the various members of their peer group to encourage them to quit.   

This poster session will enable other communities to learn from the process developed, the strengths created and the challenges encountered by the FCIMR Coalition in our endeavor to reduce the impact of tobacco smoke on our most vulnerable citizens.

An Analysis of a Program Addressing Teenage Parenthood for At Risk Minority Eighth Graders in Lenoir County, North Carolina

Jenelle Mallette, B.S., Graduate Student, Recreational Therapy Administration, East Carolina University

Introduction:  Since 1995 NC school districts have been operating under a policy that mandates “Abstinence Until Marriage” instruction be included in the Standard Course of Study for grades K-9 (G.S. 115 C-81).  One year later, the United States Congress in the Welfare Reform Act provided money to states for abstinence education.   While there is much controversy about the merits of these policies, the teenage pregnancy is still a concern to rural counties with identified “at-risk” teens.  Another issue is that teenage pregnancy rates continue to be higher among minorities than for whites.
Methods:  This presentation will describe a complementary after school program that offered 8^th grade “at-risk” minority students in Lenoir County the opportunity to experience the responsibilities, skills, and demands of parenthood while enhancing self-esteem.  East Carolina University students and faculty partnered with community members to develop a service-learning project that provided youth with a simulated intensive parenting experience.  Seven undergraduate students, supervised by one graduate student from ECU’s Department of Recreation and Leisure Studies implemented the program.
Results:  The program had a significant positive effect on the participants. These results will be articulated through analysis of pre and post questionnaires regarding perception of parenthood and self-esteem and through analysis of pre-and post videotaped interviews with students. 
Conclusion:  This project program indicated that after-school programs can be effective extensions of the “abstinence until marriage” mandates for at-risk minority youth.

Gina L. Newsome, B.S., 2005 & Becky Stephenson, MD, University of North Carolina Medical School
 

Sexually Transmitted Infections (STIs) are disproportionately high in the African American community. These infections contribute to a substantial amount of mortality and morbidity every year. African Americans have a greater incidence and prevalence of gonorrhea, chlamydia, and syphilis infections, painful outbreaks of herpes, and deaths from AIDS than any other group. The specific causes for the disparity are poorly understood; even after adjusting for socioeconomic status, the differences remain. Some proposed theories include differences in sexual behavior, differing patterns of sexual networks and partnership concurrency, lack of access to health care, and the prevalence of STIs within a particular population. This research was done as a literature review and found that, while most of the literature to date has focused on these issues in an attempt to describe the causes for the disparity, the role of historical discrimination has been grossly overlooked. Yet structural and individual discrimination have been a pervasive social force in the health history of African-Americans with long-range repercussions that continue to play an important role. The paper discusses the recent theories about the STI disparity within a historical framework. It is suggested that a similar approach be taken in the future.  

Othelia Lee

Introduction: Previous studies showed a positive direct relationship between spirituality and subjective well-being among older adults. Furthermore, the relationship between spirituality/religiousness and race/ethnicity as predictors of mental health outcomes poses an important area of investigation.
Methods: Using non-probability quota sampling, participants (n = 289) were drawn from community dwelling older adults, representing ethnic groups of White and African Americans. In an attempt to measure a broad range of spirituality/religiousness, spiritual experiences, spiritual coping, and religious support were assessed with the multidimensional measures of religiousness and spirituality. Perception of social support has been considered as an exogenous variable. The subjective well-being as an endogenous variable has two dimensions: satisfaction with life and depression.
Results: The results of regression analyses found relationships between race, education, spirituality/religiousness, and perception of social support with higher levels of subjective well-being among the participants. African American elders were more likely to use spiritual/religious coping, compared to their White peers, however, their spirituality did not accounted for subjective well-being. Social support becomes the strongest predictor of depression and life satisfaction.
Implications for practice: Findings suggest that mental health providers may need to routinely include assessment of spirituality and religious practices when working with older adults. In particular, the unique needs of minority older adults should be considered in service provision. Culturally sensitive outreach approaches should take into account the importance of faith and faith-based community for ethnic minority elders.

Impact of Immigrant Health ACCESS Project on Newly Arrived Immigrants and Refugees

Jerono Phylis Rotich, Ph.D Candidate, Immigrant Health ACCESS Project at the Center For New North Carolinians at UNC-Greensboro.

Introduction: IHAP ( Immigrant Health ACCESS Project) is a program at the center for New North Carolinians at the University of North Carolina Greensboro. It provides services which bridge the gap between healthcare providers and the immigrant and refugee communities. Guilford population of immigrants and non-native English speakers is around 50,000 people.
Services Provided: Interpretations, translations, transportations, wellness and health education workshops, cross cultural workshops ( to providers and the immigrant and refugee community), and information and referrals. All these Services are provided in over 15 different languages from various parts of the world.
Impacts of the program: Over the past IHAP has continued to grow in terms of activities and clientele. Data collected indicates an increase in; health prevention measures among the immigrant and refugee clients, responsibility and independence among clients, cross-culturally competency and sensitivity among health and human service providers, improved quality services by providers (due to interpretations, and translations, cross-cultural education by IHAPstaff) and Community awareness.
Next Steps: Empower the community to be independent through training community mentors and more interpreters, train more providers and community on cross-cultural competence and empower and focus more on the multicultural youth program.

Does it Pay to Advertise? An Evaluation of Social Marketing Campaigns Intended for Latino Populations

Susan E. Webster, Ph.D., M.Ed.-  The Gordon Group, Miami, FL.

Background:Results from “Healthy People 2000” indicated that health status and quality of care for minorities is inferior in the U.S.  The National Institute of Medicine’s recent report on the status of healthcare in the U.S. echoed the results of “Healthy People 2000” in terms of minorities and healthcare. Our analyses of public health and social marketing campaigns and studies conducted over the past two years intended for U.S. Latino populations have indicated that 1) often Latino populations in the U.S. are often treated as a homogenous group, employing colloquialisms with which only a segment of Latinos can identify 2) there are common language mistakes in translation of English campaigns.  Both these issues make for ineffective communication practices and diminish the effect of the campaign.  There have also been improvements in some areas that make for a more effective campaign.  This presentation will review studies and campaigns, and provide insights into effective national and large regional social marketing campaigns geared toward Latino populations.
Significance: 1)The analysis will provide insights for social marketers and public health officials on how to effectively communicate with intended audience. 2)Improved communication methods will allow for the intended audience to better attend to essential public health messages on how to improve health and well-being.  
Program Description and Theory: This presentation will address some of the fundamental components in social marketing identified by researchers and practitioners in public health, and apply them to campaigns intended for diverse Latino audiences.

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