RESUMEN
Objective: To explore relationships between mental health climate, positive mental health, sense of belonging, and depression among a U.S. national sample of Black college students. Participants: 1303 Black undergraduate and graduate students from 15 colleges and universities throughout the U.S. Methods: Data were from the 2018-2019 Healthy Minds Study. Analysis included hierarchical regression models. Results: A more positive perception of mental health climate and higher levels of both positive mental health and sense of belonging were significantly associated with lower levels of depression. Significant interactions existed between positive mental health and climate and sense of belonging and climate with buffering effects being most pronounced for students reporting high levels of positive mental health. Conclusion: Black college students' perceptions of an institution's mental health climate are associated with psychological outcomes. College health stakeholders should consider the buffering effects of protective factors on mental health when designing initiatives for Black college students.
RESUMEN
Human papillomavirus (HPV) vaccination rates remain low, but college student vaccination could offset this trend. This study identifies characteristics that could enhance HPV vaccination among U.S. college students. Data were from the National College Health Assessment II survey (fall 2012, N = 18,919). Univariate and logistic regression analyses were used to examine associations among demographic characteristics, college region and size, health status, receipt of health services, sexual health information, and HPV vaccination status. Among women, ethnic minorities, students attending schools in the South, those not receiving routine gynecological care in the past 12 months, and those unsure of when they last received gynecological care were less likely to report HPV vaccination. Among men, African Americans, students attending schools in the South and West, and those receiving sexually transmitted infection information were more likely to report vaccination. Data suggest that college health education can help to improve U.S. HPV vaccination rates. Campus health practitioners providing sexual health information and referrals are positioned to assist in this effort.
Asunto(s)
Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Universidades , Vacunación , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Aceptación de la Atención de Salud , EstudiantesRESUMEN
OBJECTIVE: This study investigated the association between evaluated need and mental health service use among African-American emerging adults, when controlling for other predictor variables. METHOD: Secondary analysis of data from the National Survey of American Life (2001-2003) was conducted. A nationally representative sample of African-American emerging adults, ages 18 to 29 years (N = 806), was assessed with the Composite International Diagnostic Interview. The sample included females and males with a mean age of 23 years. Evaluated need was determined by endorsement of mood, anxiety, substance use, or impulse control diagnoses. Respondents who reported ever voluntarily using mental health or general medical services to address these problems were considered to have used services. RESULTS: Forty-seven percent of the sample demonstrated an evaluated need for services, whereas a quarter of the sample used services in their lifetime. Respondents who were females, had received religious/spiritual support, and who had an evaluated need for services were significantly more likely to have used services in their lifetime compared with males, those who had not received religious/spiritual support, and those without a need for services. CONCLUSIONS: Literature indicates that evaluated need is a strong predictor of mental health service use, yet research examining its impact on service use among African American emerging adults is limited. This study found that along with having an evaluated need, this population was more likely to use services when supported by a religious/spiritual leader. Mental health outreach and education that incorporates the informal support systems identified by African American emerging adults, particularly males, is needed.
Asunto(s)
Ansiedad/diagnóstico , Negro o Afroamericano/psicología , Necesidades y Demandas de Servicios de Salud , Servicios de Salud Mental/provisión & distribución , Trastornos Relacionados con Sustancias/diagnóstico , Adolescente , Adulto , Ansiedad/etnología , Ansiedad/psicología , Femenino , Encuestas de Atención de la Salud , Humanos , Conducta Impulsiva , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Modelos Estadísticos , Espiritualidad , Trastornos Relacionados con Sustancias/etnología , Trastornos Relacionados con Sustancias/psicología , Estados Unidos , Adulto JovenRESUMEN
The high rates of sexual risk behaviors, particularly among African American youths who may not be aware of their HIV status, provide indication that, unless prevention efforts are enhanced, this vulnerable group of youths will remain at greater risk for negative health status outcomes. Parents are important in efforts to reduce risk among youths and often have a willingness to be sexuality educators for their children; however, communication barriers often impede their ability to provide preventive sexual health knowledge to their youths. Social workers are often presented with opportunities to help parents develop effective sexual health communication skills in informal settings when formal interventions are not feasible. The present effort considers solution-focused strategies social workers can use to help parents overcome barriers and communicate more positively with their youths about sexual health.
Asunto(s)
Negro o Afroamericano , Comunicación , Relaciones Padres-Hijo , Padres , Educación Sexual/métodos , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Asunción de Riesgos , Conducta SexualRESUMEN
Previously published work finds significant benefit from medical and behavioral health team care among safety-net patients with major depression. This qualitative study assessed clinical social worker, psychiatrist and patient navigator strategies to increase depression treatment among low-income minority cancer patients participating in the ADAPt-C clinical depression trial. Patient care retention strategies were elicited through in-depth, semi-structured interviews with nine behavioral health providers. Using grounded theory, concepts from the literature and dropout barriers identified by patients, guided interview prompts. Retention strategies clustered around five dropout barriers: (1) informational, (2) instrumental, (3) provider-patient therapeutic alliance, (4) clinic setting, and (5) depression treatment. All strategies emphasized the importance of communication between providers and patients. Findings suggest that strong therapeutic alliance and telephone facilitates collaborative team provider communication and depression treatment retention among patients in safety-net oncology care systems.
Asunto(s)
Depresión/terapia , Hispánicos o Latinos , Grupos Minoritarios , Neoplasias/psicología , Cooperación del Paciente/psicología , Pacientes Desistentes del Tratamiento/psicología , Pobreza , Actitud del Personal de Salud , California/epidemiología , Depresión/etnología , Depresión/etiología , Depresión/psicología , Trastorno Depresivo Mayor/etnología , Trastorno Depresivo Mayor/etiología , Trastorno Depresivo Mayor/psicología , Trastorno Depresivo Mayor/terapia , Femenino , Humanos , Entrevistas como Asunto , Masculino , Neoplasias/etnología , Cooperación del Paciente/etnología , Cooperación del Paciente/estadística & datos numéricos , Pacientes Desistentes del Tratamiento/etnología , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Relaciones Profesional-Paciente , Investigación Cualitativa , Estudios Retrospectivos , Proveedores de Redes de SeguridadRESUMEN
OBJECTIVE: This study examined factors associated with mental health service utilization among African-American emerging adults, specifically, when services were used (recency) and the types of providers visited (mental health versus non-mental health). METHODS: Guided by the behavioral model for vulnerable populations, secondary analysis of responses to the National Survey of American Life (2001-2003) was conducted. A nationally representative sample of African-American emerging adults, ages 18-29 (N=806), were assessed with the Composite International Diagnostic Interview. "Evaluated need" was determined by endorsement of mood, anxiety, substance use, or impulse control diagnoses. Respondents who reported a need for services for emotional or substance use problems were considered to have a "perceived need." Those who reported voluntary use of mental health or general medical services to address these problems were considered to have utilized services. RESULTS: Twenty-five percent of the sample utilized services in their lifetime, whereas 9% utilized services in the past 12 months. Females were more likely than males to utilize services in three of the four service use categories (lifetime, mental health sector, and non-mental health sector). Respondents with an evaluated need for services were two to 12 times more likely to have used services compared with those without a need for them. CONCLUSIONS: Little is known about why African-American emerging adults underutilize mental health services. Being female and having an evaluated need for services were associated with greater odds of service use, which would suggest the need for additional examination of gender differences in service utilization and greater mental health outreach and education among African-American males.
Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , Encuestas de Atención de la Salud/estadística & datos numéricos , Trastornos Mentales/terapia , Servicios de Salud Mental/estadística & datos numéricos , Adolescente , Adulto , Negro o Afroamericano/psicología , Femenino , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Estados Unidos , Adulto JovenRESUMEN
An important step in using culture to increase colorectal cancer screening is the development and use of a reliable and valid measure. Measurement items that work well are defined as those that use clear and simple language, do not result in significant missing data, do not yield unexpected frequencies or patterns of association, and capture an important component of the underlying construct. The authors' work to develop such a measure includes cognitive response testing. This article describes 41 African American participants' reactions to and processing of items that have been used in the public health literature to assess cultural attitudes believed to be relevant to colorectal cancer screening. Participants were asked to verbalize thoughts, feelings, interpretations, and ideas that came to mind while examining or responding to 10 to 11 survey items. The results of cognitive response testing suggest negative reactions to items addressing the fatalism construct, concerns about appearing racist when responding to discrimination and mistrust items, and resistance to phrasing or terminology that conveys negative attitudes or frames of reference. When items were framed in a positive way, participants reported less frustration, confusion, and concern for how they would be perceived by others. The responses of older African Americans in this sample were consistent with research previously completed by Pasick et al.; participants questioned the relevance of items related to cultural constructs to health and cancer preventive behaviors. Recommendations for the assessment and use of cultural constructs and items assessing constructs are provided.
Asunto(s)
Negro o Afroamericano/psicología , Competencia Cultural , Neoplasias/etnología , Anciano , Comprensión , Detección Precoz del Cáncer/psicología , Femenino , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Masculino , Neoplasias/psicologíaRESUMEN
OBJECTIVE: This study examined the effects (affective reactions, cognitive reactions and processing, perceived benefits and barriers and intent to screen) of targeted peripheral+evidential (PE) and peripheral+evidential+socio-cultural (PE+SC) colorectal cancer communications. METHODS: This study was a two-arm randomized control study of cancer communication effects on affective, cognitive processing, and behavioral outcomes over a 22-week intervention. There were 771 African American participants, 45-75 years, participating in the baseline survey related to CRC screening. Three follow-up interviews that assessed intervention effects on affective response to the publications, cognitive processing, and intent to obtain CRC screening were completed. RESULTS: There were no statistically significant differences between PE and PE+SC intervention groups for affect, cognitive processing or intent to screen. However, there were significant interactions effects on outcome variables. CONCLUSIONS: The advantages and disadvantages of PE+SC targeted cancer communications and implications of sex differences are considered. PRACTICE IMPLICATIONS: While there do not appear to be significant differences in behavioral outcomes when using PE and PE+SC strategies, there appear to be subtle differences in affective and cognitive processing outcomes related to medical suspicion and ethnic identity, particularly as it relates to gender.