An Exploration of Mental Health Literacy Among African American Clergy

ABSTRACT

The purpose of this qualitative study was to explore African American clergy's mental health literacy with older congregants 60 years of age and older. Using a grounded theory approach, we recruited a purposive sample of 9 African American clergy representing diverse ages, denominations, locales, and educational levels. Data was coded and classified according to Kevin's (1976) Kevin, R. C. 1976. Factors influencing the judgment and referral of mental health presenting problems by clergymen and psychologists, Unpublished doctoral dissertation: University of Texas, Austin.  [Google Scholar] typology of pastoral counseling and Jorm et al.'s (1997) Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B. and Pollitt, P. 1997. “Mental health literacy”: A survey of the public's ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166: 182–186. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] conceptual model of mental health literacy. Findings from data analysis revealed study respondents were adherents of Kevin's Religious–Community (R–C) model. Additionally, the following themes emerged: loss of cognitive functioning, psychosocial stressors, religiosity, and appreciation for professional assistance, cultural barriers, and key informants/familiarity with formal mental health providers which partially maps onto Jorm et al.'s conceptual model of mental health literacy.     

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers’ self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers’ self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers’ self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.     

Unmet Home Care Service Needs of Rural Older Adults With Alzheimer's Disease: A Perspective of Informal Caregivers

This study assessed unmet service needs of rural older adults with Alzheimer's disease (AD) and identified factors that were related to these needs. Data were collected from 109 informal caregivers of AD patients. Over half of the patients experienced unmet service needs in 1 or more areas of activities of daily functioning. Informal caregiver burden and patient's gender and functional status were significantly related to patients' unmet service needs. Patients' use of formal services was marginally related to their unmet service needs. To better address patients' service needs, a comprehensive needs assessment should be conducted with both patients and their caregivers.     

Gender Differences in Determinants of Self-Rated Health Among African American in Omaha Nebraska: A Church-Based Study

Abstract

This study assessed the gender differences in determinants of fair/poor self-rated health among African American churchgoers in Omaha, Nebraska. Using data collected from 353 African American (245 women and 108 men) by the Center for Reducing Health Disparities at the University of Nebraska Medical Center in 2017, univariate and multivariate logistic regressions were performed to examine the gender differences in the relationships between fair/poor self-rated health and potential health determinants. Overall, 14.3% of women and 17.6% of men reported fair/poor self-rated health. There was a significant association between depression and poor/fair self-rated health among women (p?=?0.044) and men (p?=?0.001). For women, the fully controlled model confirmed the crude association between perceived poor/fair self-rated health and heart disease (OR = 3.10) and education (OR = 2.19). For men, the final model identified significant determinants of perceived fair/poor self-rated health such as depression (OR = 12.51) and diabetes (OR = 3.89). When assessing gender differences in determinants of self-rated health, similarities are higher than differences between the two groups. In both groups, the presence of depression was the strongest determinant of poor health. Future research should assess the immunological aspects of the association between psychological factors and perceived chronic diseases.     

Alzheimer's Aggression: Influences on Caregiver Coping and Resilience

This study assessed impact of Alzheimer's patients' aggressive behavior (AD aggression) on caregiver coping strategies (task-, emotion-, and avoidance-focused) and caregiver resilience, and examined whether coping strategy moderated the AD aggression–caregiver resilience relationship. Informal caregivers across Louisiana (N?=?419) completed surveys with measures of demographics, AD aggression, caregiver coping strategies, and caregiver resilience. Task-focused coping positively related to resilience. Aggression negatively predicted caregiver resilience. Emotion- and avoidance-focused coping strategies separately interacted with aggression and increased its negative relationship to caregiver resilience. Task-focused coping showed no moderation. Implications for social work professionals are discussed.     

Involvement in the Juvenile Justice System for African American Adolescents: Examining Associations with Behavioral Health Problems

While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health problems, substance abuse, and delinquent or youth offending behaviors. Additional findings documented that the higher the number of juvenile justice system contacts, the higher the rates of delinquent behaviors, alcohol and marijuana use, sex while high on drugs, and commercial sex. These findings suggest that identifying and targeting youth who have multiple juvenile justice system contacts, especially those in low-resourced communities for early intervention services, may be beneficial. Future research should examine whether peer network norms might mediate the relationships between juvenile justice involvement and youth problem behaviors.     

The Self-Forgiveness Process of Caregivers After the Death of Care-Receivers Diagnosed With Alzheimer's Disease

ABSTRACT

This study explores the relationship of self-forgiveness and adaptive coping, religious/spiritual practices, social support, decreased grief, and mental well-being. 133 caregivers were surveyed. Bivariate analysis and stepwise regression models revealed that decreased grief, adaptive coping, and social support were significant in explaining the variation in self-forgiveness. This is one of the first studies to address self-forgiveness as part of the grieving process of Alzheimer's caregivers. Future directions are explored supporting inclusion of self-forgiveness as an aspect of grief and adaptive coping; which is further enhanced by the level of social support experienced by the caregiver.     

Efficacy of an Educational Program for Relatives of Persons in the Early Stages of Alzheimer's Disease

Abstract

This article describes the results of an educational intervention for family caregivers of persons in the early stages of Alzheimer's disease. A total of 45 family caregivers participated in this intervention that consisted of five weekly educational sessions about the disease and aspects of caring for someone in the early stages. Measures of knowledge about Alzheimer's disease, self-efficacy, reactions to patients' memory impairment, and level of depression at pretest and posttest were analyzed. Participants' knowledge about the disease improved substantially, self-efficacy and reactions to patients' impairments improved moderately, and level of depression showed no significant improvement. Results suggest that this intervention has merit for family caregivers coping with the early stages of Alzheimer's disease. Implications for implementation and evaluation are discussed.     

Perceptions of Caregiving Role by Son's Caring for a Parent with Alzheimer's Disease

Abstract

In this qualitative study, 18 sons were interviewed about the factors that led them to assume the role of primary caregiver for a parent with progressive memory loss, such as Alzheimer's disease, as well as the personal challenge that they experienced in this role. The analysis demonstrated that sons experience a range of emotional reactions, personal and professional conflict, as well as learn about new roles and responsibilities as they attempt to access the needed services for their parent. Clinical recommendations for geriatric social workers are discussed.     

Exploring African American and Latino Populations Perceptions of Parenting Education Programs: A Qualitative Assessment of Enablers and Barriers

Abstract

Parenting education programs aim to enhance the quality of parenting. Preferences vary between African American and Latino parents, but the context is not well known, and the ethnic/racial differences may have implications for parenting education programs. Focus groups were conducted with seven African American and eight Latino parents, and semi-structured interviews with eight key informants. This qualitative assessment provided information to identify barriers and enablers to participation in parenting education programs. Enablers included parental interest in learning about the developmental stages of their children, the convenience of locations and times, and incentives. Minority parents desired to obtain adequate parenting education. The scarcity of culturally sensitive programs, transportation, affordability, and childcare were significant barriers. There were both significant similarities and differences between the two parent groups. From the perspectives of African American, Latino parents and key informants, a range of resources are necessary to enable the participation and the delivery of high-quality parenting education. The findings from our research will help address the unmet parenting education needs of African American and Latino parents. Future research should work to develop a tailored and culturally sensitive parenting education programs to reduce the divergence between parents and service providers.     

The Probable Impact of Proposed Legislative and Budgetary Changes on the Lives of the Elderly and Their Families

The decade of the 1980s is characterized by economic uncertainty and political ambiguity regarding the direction of American public policy for the elderly. The purpose of this paper is to: (1) review demographic trends that particularly affect older adults; (2) summarize theReagan Administration's proposed cutbacks in programs and policies for the elderly; and (3) address the effects of these cuts on older individuals as well as on family systems across generations. It is our contention that the proposed budget cuts will seriously reduce a number of federal programs which have been developed to meet the needs of older adults. The impact of these cuts will be felt by all of the elderly and to a considerable extent, their families. However, the effects will be most severe for people who have poverty or near-poverty incomes, single women, and the "frail" elderly. The discussion suggests that these proposed budget cuts seem to reflect a lack of appreciation and recognition of both needs of the older individuals and those of their families. In addition, suggestions for program and policy directions, as well as further research are addressed.     

‘Sex is violence’: African‐American parents' perceptions of the link between exposure to community violence and youth sexual behaviours

In Chicago, African‐American youth experience disproportionately high rates of exposure to community violence. Growing evidence documents that such exposures are related to youth sexual behaviours. This qualitative study seeks to illuminate the various ways in which violence and sex are intertwined in the lives of African‐American youth. Analysing data from four focus groups (N = 54), major themes indicated that parents linked community violence with: (i) influencing youth sexual interests and opportunities for having sex; (ii) specific notions of youth sexual identities and social status; (iii) increased gang involvement and sexual initiations; and (iv) girls' grudges and their sexual concurrency with boys. These findings suggest that addressing these specific issues is important in parent‐centred and community‐grounded interventions aimed at reducing risky sexual behaviours among African‐American youth.