Black women carry a disproportionate number of new HIV infections in the USA. Studies that have assessed HIV risk perception along with HIV prevention interventions for Black women have primarily ...focused on Black women of low socioeconomic status. Few studies have assessed HIV risk perceptions and sexual behavior among college-educated Black women of higher socioeconomic status despite their high risk of HIV. College-educated Black women are most likely to acquire HIV while in college, and there has been a marked absence of research assessing the environmental and cultural influences present throughout college-campuses, coupled with evaluating how these factors shape sexual behaviors. We conducted surveys with Black female students attending a historically Black college and Black female students attending a predominately White university, and compared baseline differences in sexual behaviors among both populations. Results showed that for participants attending the historically Black college certain sociocultural elements, such as music and media, had a significantly stronger influence on sexuality and sexual behaviors compared with students attending predominately White universities. The development of future HIV prevention interventions for Black women necessitates an understanding of the diverse microcultures that Black women come from. This research is high priority for college-educated Black women given this population’s lack of inclusion in HIV prevention research.
Despite the importance of persons with dementia (PWDs) engaging in advance care planning (ACP) at a time when they are still competent to appoint a surrogate decision maker and meaningfully ...participate in ACP discussions, studies of ACP in PWDs are rare.
We conducted an intervention development study to adapt an efficacious ACP intervention, SPIRIT (sharing patient's illness representations to increase trust), for PWDs in early stages (recent Montreal Cognitive Assessment MoCA score ≥13) and their surrogates and assess whether SPIRIT could help PWDs engage in ACP.
A formative expert panel review of the adapted SPIRIT, followed by a randomized trial with qualitative interviews, was conducted. Patient-surrogate dyads were randomized to SPIRIT
(in a private room in a memory clinic) or SPIRIT
(via videoconferencing from home).
Twenty-three dyads of PWDs and their surrogates were recruited from an outpatient brain health center. Participants completed preparedness outcome measures (dyad congruence on goals of care, patient decisional conflict, and surrogate decision-making confidence) at baseline and two to three days post-intervention, plus a semistructured interview. Levels of articulation of end-of-life wishes of PWDs during SPIRIT sessions were rated (3 = expressed wishes very coherently, 2 = somewhat coherently, and 1 = unable to express coherently).
All 23 were able to articulate their end-of-life wishes very or somewhat coherently during the SPIRIT session; of those, 14 PWDs had moderate dementia. While decision-making capacity was higher in PWDs who articulated their wishes very coherently, MoCA scores did not differ by articulation levels. PWDs and surrogates perceived SPIRIT as beneficial, but the preparedness outcomes did not change pre-post.
SPIRIT engaged PWDs and surrogates in meaningful ACP discussions, but requires testing of efficacy and long-term outcomes.
Introduction
Perineal lacerations during childbirth affect more than 65% of women in the United States. Little attention has been given to the long‐term biologic consequences associated with perineal ...lacerations or possible associations with postpartum mental health. In this article, we describe the results of a study that explored inflammatory cytokines in women who reported perineal lacerations during childbirth and the relationship with stress and depressive symptoms during the first 6 months postpartum.
Methods
A repeated measures design was used to explore the relationship between varying degrees of perineal lacerations, inflammatory cytokines, postpartum stress, and depressive symptoms in 153 women over 6 months. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), and maternal stress was measured using the Perceived Stress Scale. Plasma was analyzed for proinflammatory (tumor necrosis factor alpha, interleukin 6 (IL‐6), interleukin‐1 beta, interferon gamma) and anti‐inflammatory (interleukin 10) cytokines. Levels of cytokines were compared between women with or without varying degrees of injury.
Results
A relationship was identified between symptoms of depression and a second‐degree or more severe perineal laceration starting at one month postpartum (P = .04) and continuing through 3 months postpartum (P = .03). Similarly, stress symptoms were higher at 3 months postpartum (P = .02). Markers of inflammation were significantly higher among this group, with IL‐6 increased at 2 weeks postpartum (P = .02) and remaining elevated through 2 months postpartum (P = .003); there were also significant differences in pro‐ to anti‐inflammatory cytokine ratios out to 6 months postpartum. Regression analysis indicated that second‐degree or more severe lacerations accounted for 5.9% of the variance in EPDS score at one month postpartum (P = .024, F = 2.865, t = 2.127), increasing substantially when the one month stress score was included as well.
Discussion
This study suggests that perineal lacerations, inflammation, stress, and depressed mood are associated; however, more research is needed to elucidate the actual relationship between inflammation and mental health in women who experience such injuries.
This study evaluated a 12-week, home-based combined aerobic exercise (walking) and computerized cognitive training (EX/CCT) program on heart failure (HF) self-care behaviors (Self-care of HF Index ...SCHFI), disease specific quality of life (Kansas City Cardiomyopathy Questionnaire KCCQ), and functional capacity (6-minute walk distance) compared to exercise only (EX) or a usual care attention control (AC) stretching and flexibility program. Participants (N = 69) were older, predominately female (54%) and African American (55%). There was significant improvement in self-care management, F(2, 13) = 5.7, p < .016; KCCQ physical limitation subscale, F(2, 52) = 3.4, p < .039; and functional capacity (336 ± 18 vs 388 ± 20 m, p < .05) among the EX/CCT participants. The underlying mechanisms that EX and CCT targets and the optimal dose that leads to improved outcomes are needed to design effective interventions for this rapidly growing population.
A disproportionate number of new HIV infections in the United States occur in Black women. We pilot-tested feasibility and acceptability of a manualized HIV prevention intervention developed with and ...for Black college women. We used a prospective, randomized 2-group design, with 3 data collection times. Participants included 18- to 24-year-old Black women (N = 65), who were enrolled at 2 southern universities; 46 completed pre- and post-assessments. We found that participants in the intervention arm had positive changes in HIV knowledge (p < .0001) and behavioral intentions (p = .039) outcomes. There were, however, no significant differences between intervention and control groups when considering motivational factors and behavioral skills that promoted HIV prevention: social norms, condom use self-efficacy, and assertive sexual communication. We found preliminary evidence of efficacy for an HIV prevention intervention tailored to Black college women. Researchers should partner with Black college women to develop and implement HIV prevention interventions.
Abstract
Purpose: Especially with the COVID19 pandemic, the necessity of technology-based interventions using computers and mobile devices has increased in cancer survivorship management including ...symptom management. However, little is known about the effectiveness of a technology-based intervention in improving symptom experience of racial/ethnic minorities including Asian American breast cancer survivors. The purpose of this study was to examine the efficacy of a technology-based intervention in improving symptom experience of Asian American breast cancer survivors.
Methods: This study was conducted as a part of an ongoing randomized clinical trial among 199 Asian American breast cancer survivors. The technology-based intervention included three sub-ethnic specific social media sites, interactive online educational sessions, and online resources. Both groups (intervention and control groups) used the American Cancer Society’s website on breast cancer, and only the intervention group used the technology-based intervention. Only the data collected using the questionnaire on background characteristics and health/disease status and the Memorial Symptom Assessment Scale-Short Form (MSAS) were analyzed for this study. The data were analyzed using separate intent-to-treat growth curve models.
Results: While both groups reported decreases in symptom scores from the pre-test to post 3-months (p<.01), the intervention group had larger decreases in symptom scores compared with the control group (p<.01). There existed significant group * time interactive effects on the Global Distress Index (β = - 0.234), the Physical Symptom Distress scores (β = -0.266), the psychological symptom distress scores (β = - 0.212c), the total number of symptoms (β = -0.261), and the total symptom distress scores ( β = -0.261).
Conclusions: The findings of this study clearly indicated symptom improvement among Asian American breast cancer survivors by a technology-based intervention using computers and mobile devices. Further studies with diverse racial/ethnic minorities are warranted to confirm the effectiveness of technology-based interventions in improving symptom experience of cancer survivors across different types of cancer.
Citation Format: Eun-Ok Im, Gayeong Kim, Ruiqi Jin, Mi-Yong Choi, Sudeshna Paul, Wonshik Chee. A technology-based intervention using computers and mobile devices: To improve symptom experience of Asian American breast cancer survivors abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT512.
Introduction
Psychological distress symptoms (symptoms of depression, anxiety, and posttraumatic stress) are common following stillbirth. Black women who experience stillbirth are less likely to seek ...support than White women, consistent with the strong Black woman (SBW) construct, which expects Black women to tolerate stress and trauma gracefully, without seeking help.
Methods
In this cross‐sectional study we sought to determine the relative contributions of SBW belief, perceived lack of social support, and culturally relevant coping behaviors to psychological distress symptoms in Black women bereaved by stillbirth. We partnered with a stillbirth support organization to recruit a sample of 91 Black women bereaved by stillbirth in the 3 years prior to study participation. The online study survey measured SBW belief, culturally relevant coping behaviors, perceived social support, and psychological distress symptoms along with sociodemographics, pregnancy history, and stillbirth characteristics. We used stepwise selection in multiple linear regression to determine the relative contributions of SBW belief, perceived social support, and coping behaviors to measures of psychological distress symptoms in our sample.
Results
Higher SBW belief, lower perceived social support, and higher collective coping (coping behaviors involving other people) were associated with increases in all 3 measures of psychological distress symptoms, controlling for age and other traumatic events.
Discussion
Further understanding of the influence of SBW belief on Black women's psychological distress following stillbirth may assist with the development of culturally appropriate interventions to mitigate psychological distress symptoms in this group.
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