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Black men have higher rates of diabetes that are compounded by obesity and limited physical activity leading to poor self-rated health. The purpose of this study was to provide a nationally representative snapshot of indicators for lower self-rated health in Black men with diabetes. An exploratory secondary analysis was conducted of self-report data, physical measurements, and clinical assessments from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) dataset. The analytic sample included 270 Black men 45 years of age or older, who were randomly selected from the dataset through statistical processes. After adjusting for sociodemographic and physiologic characteristics, having diabetes (ß = -0.13), fewer days of physical activity (ßß = 0.13), and more depressive symptoms (ßß = -0.34) had statistically significant associations with self-rated health scores (ps < 0.05). Such associations support the use of self-rated health indices as a monitor for quality of life in clinical practice and identify gaps in research related to self-rated health in Black men.

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The objective of this study was to determine the effect of self-reported leisure-time physical activity, converted to kilocalorie expenditure and expressed as average daily expenditure, on all-cause mortality among older males 65 years of age and older in the University of Alabama at Birmingham (UAB) Study of Aging (SOA). Mean age of participants was 75.4 years. Multivariable Cox proportional hazard models evaluated the predictors of overall survival. Kilocalorie expenditure (p = .01), Black race (p = .02), young age (p < .00), fewer depressive symptoms (p = .00), and absence of cognitive impairment (p < .00) were significant independent predictors of higher rates of survival. Low body mass index was a significant independent predictor of death (p = .03). Veteran status did not improve survival. Further study about kilocalorie expenditure and mortality could lead to reductions in premature mortality in community-dwelling older men in the Deep South.

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NPs are ideal candidates for implementing positive health changes for obese patients. Providers have medical expertise and can promote obesity reduction strategies to their patients. Increased awareness of the influence of health policy and clinical implications for obesity management are needed.

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Physical inactivity among older adults around the world is a growing concern. In the United States, older African Americans report high levels of physical inactivity, especially older African Americans with chronic conditions. This study examined the influence of chronic conditions on aerobic activity among a sample of community-dwelling, older African Americans with a self-reported diagnosis of type 2 diabetes and other chronic conditions, such as hypertension and arthritis. Findings indicate that regardless of age, the number of chronic conditions was a significant influence in self-report of aerobic activity. Successful self-management of type 2 diabetes and other chronic conditions may promote physical activity among sedentary older African Americans with multiple chronic conditions. Furthermore, research that considers a life course epidemiological approach are needed to enhance our understanding about the cumulative effects of MCC on physical activity among sedentary, older African Americans with MCC.

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Pre-diabetes is the underlying pathology for type 2 diabetes. The Diabetes Prevention Program is a proven, effective strategy to control or prevent type 2 diabetes; however, there is limited data on what motivates people with pre-diabetes to participate in a Diabetes Prevention Program. Cross-sectional analysis of survey data from adults with pre-diabetes was conducted from October to November 2015. Fisher's exact test was utilized to examine relationships between study variables. Findings indicated that muscle strength was related to commitment to healthy lifestyle behaviors (p = 0.02). Findings also suggested that perceived muscle strength could impact healthful living for patients with pre-diabetes. Future studies for individuals with pre-diabetes are needed to provide afull assessment of motivationfactors for participation in the Diabetes Prevention Program. Nurse Practitioners should work to improve perceived muscle strength in patients with pre-diabetes, which could translate into increased Diabetes Prevention Program attendance.

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The objective of this study was to develop and validate a new diabetes self-management instrument for older African-Americans 65 years of age and older. The Self-Care Utility Geriatric African-American Rating (SUGAAR) was developed using the American Diabetes Association's standards for the management of type 2 diabetes in older adults and cognitive interviews with older African-Americans. The instrument underwent extensive review by a panel of experts, two rounds of cognitive interviews, and a pilot test before it was administered in an interview format to 125 community-dwelling older African-Americans. The instrument demonstrated content validity and significant, but modest, convergent validity with items from an established diabetes self-management instrument. Social workers and health care professionals can use the SUGARR to assess diabetes self-management and to identify areas for education and support for older African-Americans with type 2 diabetes.

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OBJECTIVE: To examine life-space mobility over 8.5 years among older Black and White male veterans and non-veterans in the Deep South. DESIGN: A prospective longitudinal study of community-dwelling Black and White male adults aged >65 years (N=501; mean age=74.9; 50% Black and 50% White) enrolled in the University of Alabama at Birmingham (UAB) Study of Aging. Data from baseline in-home assessments with follow-up telephone assessments of life-space mobility completed every 6 months were used in linear mixed-effects modeling analyses to examine life-space mobility trajectories. MAIN OUTCOME MEASURES: Life-space mobility. RESULTS: In comparison to veterans, non-veterans were more likely to be Black, single, and live in rural areas. They also reported lower income and education. Veterans had higher baseline life-space (73.7 vs 64.9 for non-veterans; P<.001). Race-veteran subgroup analyses revealed significant differences in demographics, comorbidity, cognition, and physical function. Relative to Black veterans, there were significantly greater declines in life-space trajectories for White non-veterans (P=.009), but not for White veterans (P=.807) nor Black non-veterans (P=.633). Mortality at 8.5 years was 43.5% for veterans and 49.5% for non-veterans (P=.190) with no significant differences by race-veteran status. CONCLUSIONS: Veterans had significantly higher baseline life-space mobility. There were significantly greater declines in life-space trajectories for White non-veterans in comparison to other race-veteran subgroups. Black veterans and non-veterans did not have significantly different trajectories.

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OBJECTIVE: The objectives of this study were to assess the dimensionality and reliability of a frequently used scale for predicting the desire to institutionalize among White, African American, and Hispanic caregivers of persons with dementia. METHOD: Exploratory factor analysis (EFA) and reliability analyses were performed on a slightly modified version of Morycz's (1985) Desire to Institutionalize (DTI) scale separately for each racial group using data from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) II study (Belle et al., 2006). RESULTS: The EFA revealed a one-factor structure that was equivalent across all racial groups. The scale demonstrated moderate reliability with KR-20 alpha of .694 for Whites, .742 for African Americans, and .767 for Hispanics. DISCUSSION: Findings suggest that Morycz's DTI scale is a consistently reliable measure for assessing the desire to institutionalize across White, African American, and Hispanic dementia caregivers.

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