The race gap in support group participation by breast cancer survivors: real or artifact?

Addressing methodological weaknesses of previous research, this study assesses whether African American women are, in fact, less likely to participate in breast cancer support groups than are White women. Of the breast cancer survivors, 958 (26% African Americans, 73% Caucasian) completed interviews concerning demographic characteristics, other support networks, effects of illness on home and spiritual life, and support group participation. Contrary to previous research, no race difference was found in support group participation. This research suggests more effort needs to be paid to sampling techniques and other methodological factors to adequately reflect the experiences and needs of breast cancer survivors, specifically African American women.     

HIV/AIDS Prevention in the African American Community:

The high rate of AIDS cases among African Americans, especially women, suggests that HIV risk reduction behavior change programs and messages have not been highly successful in preventing HIV transmission among this population. This paper recommends that the situational and environmental context of African Americans' lives, and their responses to HIV/AIDS be addressed and incorporated into HIV prevention programs in an effort to make these programs more relevant to high risk African Americans. A multilevel system intervention approach grounded in an ecosystem perspective which focuses on the community as the primary target level of intervention is proposed to increase the effectiveness of HIV prevention efforts among African Americans.     

Recruiting fathers to parenting programs: Advice from dads and fatherhood program providers

The benefits of high-quality father–child relationships for fathers and children alike are well documented. While evidence suggests parenting programs can improve the quality of father–child relationships, few fathers participate in such programs. This qualitative study aims to fill the gap in knowledge on best practices for recruiting urban African American fathers, a group of fathers with unique parenting challenges, to parenting programs. Focus groups were conducted with 29 fathers to gain their perspectives on recruitment strategies. Semi-structured interviews were also conducted with a nationwide sample of 19 fatherhood program providers to learn about their most successful recruitment strategies. Recruitment strategies based on emergent themes from the focus groups and interviews are presented here. Themes included using word-of-mouth recruitment, increasing advertising, targeting advertising specifically to urban African American fathers, providing transportation and incentives, recruiting through the courts, collaborating with other community agencies, and offering parenting programming along with other programming valued by fathers such as employment assistance. Implications for developing strategies for recruiting urban African American fathers to parenting programs are discussed.     

Reaching the ‘hard to reach’: strategies to recruit black and minority ethnic service users with rare long-term neurological conditions

Little is known about health and social care experiences of patients with rare long-term neurological conditions. Furthermore, black and minority ethnic (BME) service users are often perceived to be under-represented in health services research. BME service users have been described as ‘hard to reach’ in the past. However, evidence suggests that a variety of recruitment methods need to be used in order to increase recruitment. We employed a range of recruitment strategies shown to be effective in recruiting BME patients, to recruit patients to participate in one-to-one interviews to establish experiences of health and social care. Strategies included community and clinically based strategies. In total we recruited 15 participants through these recruitment methods, with all recruits ultimately coming from neurology clinics and disease-specific charities. Despite community-based strategies generating interest and a willingness to be involved, the rare nature of these conditions resulted in a lack of recruits from these strategies. Consequently we conclude that researchers need to plan and prioritise strategies carefully in order to maximise recruitment and utilise resources efficiently dependent on the nature of the research.     

In Circle: A Healthy Relationship,Domestic Violence,and HIV Intervention for African American Couples

While marriage and healthy relationship education has grown, limited interventions have been developed specifically to support the development and flourishing of African American couples. African Americans are also disproportionately impacted by HIV/AIDS and are more likely to experience lethality and serious injury due to domestic violence compared to Whites. Despite this, African American couples have been resilient and managed to thrive in relationships. Little has been done to capture these strategies, build on cultural strengths, and design an intervention specifically crafted for this population. This article describes an intervention “In Circle” developed, implemented, and evaluated for African American couples to support healthy relationship and healthy marriage education. The intervention is based on an Ancient Egyptian value system and undergirded by three integrated theoretical perspectives. The article also includes implications for practice and research.     

Family-Based HIV Preventive Intervention

Summary

Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth's exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth's best hope to grow up and survive multiple dangers in urban neighborhoods (Pequegnat& Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided.     

Research Note: The LIVITY study: research challenges and strategies for engaging with the black caribbean community in a study of HIV infection

There is an increasing incidence of new HIV‐1 diagnoses among black Caribbeans in the UK, but there has been limited research in this area. The LIVITY study is the first in‐depth epidemiological and behavioural study to examine the impact of HIV among black Caribbeans in the UK. The UK black Caribbean community has traditionally been regarded as less likely to participate in clinical research and surveys. We identified three major challenges to recruitment to the LIVITY study: general distrust of the research process; the considerable stigma surrounding HIV in the black Caribbean community and the sensitivity of obtaining detailed sexual histories. The strategies devised to help overcome these barriers to optimise recruitment included: the establishment of a black Caribbean Community Advisory Group to facilitate communication between the community and the researchers and assist in questionnaire design to improve acceptability to the participants; use of healthcare practitioners as gatekeepers; extensive piloting and modification of the questionnaire among black Caribbean patients; reassurances of confidentiality during recruitment; and ethnic matching between interviewer and study participants. Another challenge was the high rate of loss to follow‐up among eligible patients, potentially compromising the study’s generalisability. Nevertheless, use of the above strategies resulted in a satisfactory enrolment rate of 57%, who were representative of all eligible patients.     

Effective Recruitment for Parenting Programs Within Ethnic Minority Communities

This article describes the results of a demonstration project which focused on exploring recruitment and retention of ethnic minority families to a parent training program aimed to prevent substance abuse among their children. The Parenting for Drug-Free Children project sought to deliver a curriculum to parents from several ethnic groups in an urban setting. The targeted ethnic communities were African American, Latino, Native American, and Samoan. The project successfully recruited diverse groups of families to participate in a drug prevention program, many of whom had never participated before in a parenting program. The identification of key individuals for recruiting and accessing networks of potential participants proved to be an effective means of recruitment.     

Ideological schisms about HIV/AIDS helping systems in the African American community, with an emphasis on women

This article is an initial exploration about the impact of ideological beliefs on helping services in the African American community. Newly infected HIV/AIDS cases place African Americans at 45% of such new cases, with African American women becoming infected at a rate 18 times that of Whites. Yet, helping services that are organic to African American women should be stronger through a discussion of cultural beliefs held in the community, where the genesis of helping services exists. Values and beliefs should be at the center of community partnerships, public media strategies, generalist-practice curricula in macro-level systems, and creating more space for relationship dialogue between African American men and women, which includes gender and racial distortions. Given the exponentially high numbers of HIV/AIDS cases in the African American community, a more earnest examination of values and beliefs is warranted.     

Condom Failure: Examining the Objective and Cultural Meanings Expressed in Interviews With African American Adolescents

The purpose of this study was to explore the meaning and context of self-reported “condom failure” among sexually active African American adolescents. Semistructured interviews regarding methods of protection from pregnancy and sexually transmitted disease (STD) with 124 youth (ages 14–19 years) were content analyzed. The findings suggested three meanings of condom failure. First, condom failure represents a legitimate and important risk related to sexual activity. Second, it can serve as an excuse repertoire for adolescents who engaged in unprotected sex and later experienced either pregnancy or a STD. Third, it may serve as an explanation for males who deceive their partners into having unprotected sex. The findings are discussed with regard to their implications for HIV or STD prevention and research.     

Coping with chronic community violence: the variety and implications of women's efforts

To date, most researchers concerned with chronic community violence have studied children, and focused on the types, extent, and effects of their violence experiences. In contrast, using a series of in-depth repeated interviews, the current study explored African American women's methods for coping with chronic community violence. This article describes the variety of ways these women developed to avoid, minimize, or manage their own and their children's encounters with community violence. It argues for the importance of using these data to inform professional intervention and suggests specific implications for practice, program development, and policy.     

Racial Disparities in Drug Court Graduation Rates: The Role of Recovery Support Groups and Environments

There are more than 3,000 drug courts in the United States, and research has demonstrated that, in some drug courts, African American participants are less likely to graduate than their White counterparts. Quantitative studies have documented the problem, but qualitative studies are needed to develop an in-depth understanding of this phenomenon through participants’ experiences. This qualitative study asked African American participants (n = 31) about their lived experiences in drug court to develop insight into the factors that might contribute to racial disparities in drug court outcomes. African Americans had favorable views toward both mandated and natural recovery support groups, and they felt that participating in these support groups increased their likelihood of graduating drug court. Conversely, African Americans felt that a barrier to graduating drug court was their environments, mainly risk factors posed by family, neighborhoods, and peers. Implications for drug court practice are discussed.     

Masturbation and Sexual Health

Abstract

In this study we applied research examining the hypothesized benefits of masturbation in dealing with sexual problems to the urgent health crisis posed by the HIV/AIDS pandemic. This is the first study to test the hypothesized relationship between masturbation and HIV risk as predicted by the Sexual Health Model, a sex-positive approach to sexual health developed in response to the need for a more explicit focus on sexuality and relationships in HIV prevention. This is also the first study to examine the relationship between several masturbation variables (i.e., masturbation guilt, lifetime masturbation, and current masturbation) and HIV-related sexual behaviors and attitudes in a sample of African American women (N =239). Data was collected using face-to-face structured interviews as part of the Women's Initiative for Sexual Health (WISH), a randomized, controlled trial of an HIV prevention intervention based on the Sexual Health Model, targeting low income, adult African American women. Contrary to expectations, results showed that participants who reported masturbating were more likely to report having multiple partners, being in a nonmonogamous relationship and engaging in high-risk sexual behaviors. There was no significant relationship between level of masturbation guilt and HIV risk nor between masturbation and consistent condom use or attitudes toward condoms. This study adds to the growing empirical support for associations between sexual health variables and safer sex and argues for a more explicit focus on sexuality in HIV prevention.     

Biracial Americans' Experience with Identity,Gender Roles,and Anxiety

The current study aims to shed light on the experiences of a small but growing group, biracial Americans with one African American and one European American birth parent. Prior results suggest that it would be useful to study ethnic identity and its correlates among members of this group. Additionally, although research to date suggests different gender role norms for African Americans and European Americans, and that anxiety level differs across gender role categories, apparently no research so far has looked at these factors among biracial Americans. The measures used in the study were the Revised Multigroup Ethnic Identity Measure (R-MEIM), the Personal Attributes Questionnaire (PAQ), and the Inventory of Depression and Anxiety Scale (IDAS). Results from the Well-being scale of the IDAS show low levels for biracial participants with feminine/undifferentiated gender roles and high levels for those with masculine/androgynous roles. Additional findings, implications, and study limitations are further discussed.     

CROSSRACIAL DIFFERENCES IN THE RACIAL PREFERENCES OF POTENTIAL DATING PARTNERS: A Test of the Alienation of African Americans and Social Dominance Orientation

Studying interracial romance has been useful for understanding general race relations. Theories of African American alienation and social dominance orientation help explain why previous research has found African Americans to be the least desired racial dating partners. Alienation predicts that African Americans are less willing to interracially date than other racial groups since they are not allowed to participate in the majority culture. Social dominance orientation predicts that African Americans are more willing to interracially date than other racial groups because they occupy the lowest position in our racial hierarchy. This study utilizes an Internet dating website to explore the racial dating preferences of European Americans, African Americans, Hispanic Americans, and Asian Americans. The theory of African American alienation is upheld, as African Americans are generally less willing to interracially date than other races and are especially less willing to date European Americans.     

Sex work: constructing ‘families’ with community of practice theory

This article examines the construction and maintenance of fictive kinships within a street-level sex work community. The analysis is supported by interviews of 14 street-level sex workers regarding everyday language use within their community. Utilizing community of practice theory to demonstrate how peripheral participants of the sex work community are socialized to understand and participate in fictive kinships, a primary finding is that language use within this community operates as a discursive framework which creates a metaphorical family where kin terms are used as an identity-making strategy. The implications of this research suggest that familial structures impact sex workers' sense of agency in relation to other members of the community. Finally, this article discusses the implications for understanding the discourse of a street-level sex worker community in the context of relationship formation and maintenance.     

The influence of gender and ethnicity on judgments of culpability in a domestic violence scenario

Using an experimental analog design, in this study we examined 503 European American, African American, and Latino undergraduate students' responses to a domestic violence scenario in which the ethnicity and gender of the perpetrator were manipulated. Results indicated that participants perceived perpetration of domestic assault significantly more criminal when committed by a man than when committed by a woman. That finding was robust across European Americans, African Americans, and Latinos and was expressed by both genders. Also, European American participants expressed significantly more criticism toward African American perpetrators of assault than they did toward European American and Latino perpetrators of the exact offense, suggestive of racial bias consistent with stereotypes about African Americans being excessively aggressive. Finally, Latino participants expressed significantly more sympathy toward women who assault their husbands than toward assaulting husbands. Implications of the findings are discussed.     

The last mile of the way: understanding caregiving in African American families at the end-of-life

This research is based on in-depth ethnographic interviews and focus groups with 88 African American family caregivers from various regions of the United States during a stressful time in their family development--caregiving at the end-of-life--and the grieving during the aftermath. The study employed a stratified purposeful sampling strategy. Subjects were African Americans from the Northern, Southern, and Midwestern United States. Formal care is complicated by the distrust that many African Americans hold toward the health care system, which has resulted from years of exclusion, racism and discrimination. The findings highlight the importance of hearing from African American families to gain an understanding of what services, including family therapy and other psychotherapy, they will need during this process.     

Shattering the Myth of Invulnerability: Exploring the Prevention Needs of Sexual Minority Women Living with HIV/AIDS

Developing effective safer-sex programs for women living with HIV/AIDS (WLH/A) is a national HIV prevention priority. Existing programs focus predominantly on heterosexual women's experiences and ignore the needs of sexual minority women (SMW). Thus, we conducted semi-structured interviews with 16 sexual minority WLH/A to better understand their sexual risk behaviors and corresponding HIV prevention needs. Most of the interviewees were African American (75%) and poor (75%). We used strategies of Grounded Theory to code the interviews for key themes, which included the following: differences between relationships, risk, and protective behaviors in male and female relationships; links between substance abuse and unsafe sex; need for safer-sex or prevention programs to address SMW-specific skills and topics; and the importance of addressing women's resiliency and the social context of women's risk in prevention programs. Conclusions include concrete suggestions to make safer-sex programs more responsive to the needs of SMW.