Collaborating with African American churches to overcome minority disaster mental health disparities: What mental health professionals can learn from Hurricane Katrina.

The purpose of this qualitative study was to explore how mental health professionals and African American pastors and their churches could collaborate to overcome minority disaster mental health disparities. Forty-one African American pastors of churches located in south Mississippi, in counties directly affected by Hurricane Katrina, participated in semi-structured interviews approximately 1 year after the storm. The majority of participants reported being interested in collaborating with mental health professionals to: (a) develop educational and outreach opportunities, (b) lead assessment procedures, (c) offer consultation activities, (d) provide clinically focused services, and (e) utilize spiritual resources and support. Participants provided further insight into how these collaborative activities could be modified to meet post-disaster needs and offered novel applications. Following from these discussions, the article provides a number of recommendations that can be used to aid in the development of disaster collaborative activities between African American pastors and churches and mental health professionals to serve minority communities while also decreasing disparities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping African American clergy and churches address minority disaster mental health disparities: Training needs, model, and example.

Using an action participatory research approach, the authors conducted qualitative interviews with 41 African American clergy 1 year after Hurricane Katrina in severely affected areas of south Mississippi. These interviews revealed how mental health professionals can work with African American clergy and their churches by providing training that targets minority disaster mental health disparities. A 3-tier training model for equipping African American clergy and churches to respond to disasters in hopes of reducing minority disaster mental health disparities is offered. Identified training needs and suggested training delivery formats are discussed. A sample outreach and educational training project designed to equip African American clergy and churches in their response to minority disaster mental health disparities is also highlighted. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reaching out to the African American community through innovative strategies

PURPOSE/OBJECTIVES: To describe the University of Pittsburgh Cancer Institute's African American Cancer Program, including innovative strategies that were used, barriers that were encountered, an evaluation of each component, and future directions and implications. DATA SOURCES: Published articles, references from bibliographies, census data, personal contact, unpublished data. DATA SYNTHESIS: Cancer morbidity and mortality is higher among African Americans than Caucasians. The University of Pittsburgh Cancer Institute pilot-tested four interventions to increase awareness, provide education and early detection opportunities, and overcome barriers to cancer care among African Americans. CONCLUSION: Constant presence, cultural sensitivity, and repetition are necessary to overcome the barriers to increased awareness and behavioral changes in the African American community. A more formalized evaluation component is necessary to draw definitive conclusions. IMPLICATIONS FOR NURSING PRACTICE: To develop cancer prevention and education programs that meet the unique needs of African Americans, nurses must be aware of barriers and cultural differences.     

Culturally competent interventions for abused and suicidal African American women.

This article focuses on interventions with low-income, African American women who are survivors of domestic abuse and who have made one or more suicide attempts. The authors review the literature on domestic abuse and suicidal behavior in African American women, and discuss the association between abuse and suicide in this population. Next, they propose an integrated theoretical model for understanding suicidal behavior as one possible coping response to the stress of a domestic abuse situation. The model utilizes concepts from the literature on stress and coping as well as stages of change. A culturally sensitive group treatment intervention that is based on the theoretical model is presented. The intervention focuses on ensuring women's safety, increasing coping skills and resource mobilization, and promoting supportive relationships in a manner that is consistent with each woman's sociocultural context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantifying the effects of community mental health consultation interventions.

A review of 1,643 consultation outcomes through meta-analytic studies reveals a moderate overall mean effect for consultation interventions. Utility formulas demonstrate these consultation interventions will provide an 11% improvement in outcome measures of consultee and organizational functioning. While the empirical evidence of the efficacy of consultation interventions is very substantial, the acceleration of the rate of change and the increasing complexity of organizational functioning require continuous reconsideration of current conceptual models of consultation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and the American health professional community in transition.

W. N. Robiner and D. P. Crew (2000) have provided a very useful assessment of the dynamics of the psychology workforce in the United States today (see record 2000-03894-001). Their conclusion that the overall supply of psychologists exceeds the current and projected future level of demand is consistent with other analysis of similar health professions. The action recommendations they offered, although dramatic, are precisely those that must be taken in order to prevent the situation from deteriorating and bringing more peril to the profession and current and future practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contextual community prevention theory: Building interventions with community agency collaboration.

Translation from research to practice faces numerous problems that include replicating effectiveness, fidelity to the protocol and processes, and adaptations to different types of target populations. Working collaboratively with existing service providers can speed up the time for development and can ease the implementation of empirical randomized trials. Contextual community prevention theory is an innovative approach that focuses on changing behaviors of community members by creating a visible institutional presence that draws and pulls the targeted population into the organization’s activities and interventions. The result is an institution or organization within the community that provides a new active and dynamic context, engaging its community members into its activities, interventions, and functions. An HIV prevention program developed collaboratively from the ground up for Latino gay/bisexual men is presented. Results from the program evaluation efforts across the years suggest promise for testing its efficacy through a randomized trial. HIV prevention efforts need to develop dynamic support systems within communities where these men have ownership, have control, and feel safe; otherwise HIV infection rates in this population will increase. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Planning and evaluating strategies for AIDS health education interventions in the Muslim community in Uganda

In 1992 the Islamic Medical Association of Uganda designed an AIDS prevention project. A baseline survey was conducted to assess prevailing knowledge, attitudes, and practices among the Muslim communities in two districts. A low rate of incorrect beliefs about HIV transmission was found, although gaps in knowledge remain, particularly regarding vertical transmission and asymptomatic HIV infection. Less than 10% knew that condoms can protect against HIV transmission. Lack of knowledge was documented regarding the risk of HIV transmission associated with practices common in the Islamic community, such as polygamous marriages, circumcision, and ablution of the dead. The AIDS prevention project has incorporated specific messages and interventions as a result of these findings.     

Hostility, relationship quality, and health among African American couples.

Objective: This study investigated the association between hostility and health and whether it is moderated by the quality of an individual's primary romantic relationship. Method: Longitudinal data were provided by 184 African Americans, including 166 women. Participants averaged 38 years old and were married or in long-term marriagelike relationships. Hostility and relationship quality were measured at the first assessment. Hostility was based on participants' responses to items tapping cynical attitudes about relationships. Relationship quality was based on trained observer ratings of videotaped couple interactions on behavioral scales reflecting warmth, support, and communication skills. At 2 assessments approximately 5 and 7 years later, participants provided health data. Health index scores were formed from responses to five scales of the SF-12 (Ware, Kosinski, & Keller, 1998) as well as to responses to questions about the number of chronic health conditions and the number of prescribed medications. Results: Stepwise regression analyses controlling for demographic variables and the earlier health score tested the main and interactive effects of hostility and relationship quality on longitudinal changes in health. Whereas no main effects were supported, the interaction of hostility and relationship quality was significant (p     

Direct and moderating effects of community context on the psychological well-being of African American women.

The effects of community characteristics on well-being were examined among 709 African American women. Direct and moderating effects of neighborhood characteristics on distress were tested. Aggregate-level ratings of neighborhood cohesion and disorder were significantly related to distress, although the relation between cohesion and distress became nonsignificant when individual risk factors were statistically controlled. Aggregate-level neighborhood variables interacted significantly with individual risk and resource variables in the prediction of distress, consistent with trait-situation interaction theories (D. Magnusson & N. S. Endler, 1977). Community cohesion intensified the benefits of a positive life outlook. Community disorder intensified both the benefits of personal resources and the detrimental effects of personal risk factors. Results showed evidence of resilience among African American women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health service utilization among African American and Caucasian mothers and fathers.

Mental health services have been routinely underutilized. This study investigated the influence of parents' gender, race, and psychopathology on perceived barriers and attitudes toward mental health utilization for themselves and for their children. A unique contribution of this study is the examination of father, mother, and child factors influencing service utilization from the parents' perspective. A total of 194 African American and Caucasian parents were recruited from the community to participate. Parents completed measures on barriers and attitudes toward treatment for themselves and for their children, history of mental health service utilization for themselves and for their children, and their own current psychological symptoms. Results indicated that 36.3% and 19.4% of parents and children, respectively, had used mental health services during their lifetime. Parents perceived fewer barriers and had more positive attitudes toward seeking services for their children than for themselves. Race and gender differences were found in parents' perceptions of barriers and attitudes toward treatment. Furthermore, barriers, attitudes, and psychopathology predicted parents' plans for future utilization of mental health services. The clinical implications of this study and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical discipline among African American and European American mothers: Links to children's externalizing behaviors.

The aim of this study was to test whether the relation between physical discipline and child aggression was moderated by ethnic-group status. A sample of 466 European American and 100 African American children from a broad range of socioeconomic levels were followed from kindergarten through 3rd grade. Mothers reported their use of physical discipline in interviews and questionnaires, and mothers, teachers, and peers rated children's externalizing problems annually. The interaction between ethnic status and discipline was significant for teacher- and peer-rated externalizing scores; physical discipline was associated with higher externalizing scores, but only among European American children. These findings provide evidence that the link between physical punishment and child aggression may be culturally specific. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intimate partner violence and its effects on the health of African American HIV-positive women.

The medical outcomes of women infected with HIV are typically worse than those of HIV-positive men. HIV-positive women report high rates of intimate partner violence, and there is evidence that traumatic events have a negative impact on health status. In addition, African American women make up 1 of the fastest growing groups of HIV-positive individuals. Therefore, this study sought to examine the impact of intimate partner violence on HIV medication adherence, HIV-related physical health outcomes, and health-related quality of life in 40 HIV-positive African American women. The results were that women who had experienced intimate partner violence had worse HIV-related health as indicated by reduced CD4 counts and increased HIV viral load. In addition, posttraumatic stress disorder symptoms were related to both intimate partner violence and health-related quality of life. Lastly, HIV medication adherence mediated the relationships between intimate partner violence and the HIV-related health outcomes. Implications for further work and clinical interventions to address intimate partner violence, medication adherence, and health-related quality of life in this population are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discrimination and unfair treatment: Relationship to cardiovascular reactivity among African American and European American women.

This study examined the relationship of cardiovascular reactivity to both interpersonal mistreatment and discrimination in a community-based sample of African American and European American women (N?=?363) in midlife. Subtle mistreatment related positively to diastolic blood pressure (DBP) reactivity for African American participants but not their European American counterparts. Moreover, among the African American participants, those who attributed mistreatment to racial discrimination exhibited greater average DBP reactivity. In particular, these women demonstrated greater DBP reactivity to the speech task, which bore similarities to an encounter with racial prejudice but not to a nonsocial mirror tracing task. These findings are consistent with the hypothesis that racial discrimination is a chronic stressor that can negatively impact the cardiovascular health of African Americans through pathogenic processes associated with physiologic reactivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community health centers and quality of care: a goal to provide effective health care to the community

The uniqueness of community health centers provides for a sound environment for total quality management (TQM). Structure, process, and outcome are valued equally under TQM. With strong management leadership and a framework for quality of care, community health care specialists (e.g., advanced practice nurses) can easily incorporate the TQM measurement criteria in their daily practice routines. By applying the principles of TQM, the community health center will advance toward its goal of enhancing the effectiveness of health care delivery to a community and its members in partnership with the community.     

African American women and the academy: Using career mentoring to increase research productivity.

The success of African American women academicians has been hampered by sex and racial discrimination. Difficulties with developing a successful research program are the primary reasons many are denied promotions and tenure. The majority of the mentoring literature details the benefits of receiving mentorship to assist African American women to cope with psychosocial difficulties, but the benefits of research mentoring are rarely discussed. This position article explores the sex- and race-related factors that directly and indirectly affect African American women faculty's research and provides suggestions for specific research mentoring at the predoctoral and postdoctoral levels to increase career advancement among African American women in research-oriented academic institutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)