RESUMO
Background: An understanding of the factors that influence cardiovascular (CVD) risk among young Black men is critically needed to promote cardiovascular health earlier in the life course and prevent poor outcomes later in life. Purpose: To explore how individual (eg, depression, racial discrimination) and environmental factors (eg, neighborhood resources) are associated with CVD risk factors among young Black men. Methods: We conducted a convergent mixed methods study (qualitative/quantitative, QUAL+quant) with Black men aged 18 to 30 years (N = 21; 3 focus groups). Participants completed a self-administered electronic survey immediately prior to the focus groups. Results: Participants (M age = 23) reported: two or more CVD risk factors (75%; eg, high blood pressure); racial discrimination (32%); and depressive symptoms in the past 2 weeks (50%). Five themes emerged: 1) emergence and navigation of Black manhood stressors; 2) high expectations despite limited available resources; 3) heart disease socialization: explicit and vicarious experiences; 4) managing health care needs against fear, avoidance and toughing it out; and 5) camaraderie and social support can motivate or deter. The integrated qualitative and quantitative analyses highlight race, gender, and class intersectionality factors that are relevant to what it means to be young, Black, male and of lower socioeconomic status in the United States. Conclusion: Our findings help to identify modifiable, culturally specific and contextually relevant factors that relate to CVD risk factors among young Black men. Such work is crucial to inform interventions, primary prevention efforts, policies, and social-structural changes to thwart the development of CVD and advanced disease stages.
Assuntos
Doenças Cardiovasculares , Racismo , Negro ou Afro-Americano , População Negra , Doenças Cardiovasculares/epidemiologia , Humanos , Masculino , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
Understanding health beliefs is important to facilitate health promotion and disease prevention as they influence health behaviors, outcomes, and disease management. Given the rise of hypertension-related diseases in the Dominican Republic, the purpose of our study was to identify hypertension-related health beliefs of Dominicans in order to inform the development of culturally appropriate interventions for hypertension prevention, care, and treatment. Semi-structured interviews were conducted with 20 Dominicans, 15 of whom were receiving treatment for hypertension. Operating within the interpretative paradigmatic framework, we conducted thematic analyses of interview data to identify hypertension-related health beliefs and practices. Iterative data analysis revealed the following themes: 1) Negative emotions are a primary cause of hypertension, 2) Medication is the best treatment but adherence is challenging, 3) Systemic barriers impede treatment access, 4) Hypertension negatively impacts mental and physical well-being, and 5) Lifestyle changes, relaxation, and social support help manage hypertension. Data gathered from member checking validated these findings. This study enhances understanding of the beliefs and experiences of Dominicans and emphasize the importance of implementing culturally competent health programming and care.
Assuntos
Cultura , Comportamentos Relacionados com a Saúde/fisiologia , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Inquéritos Epidemiológicos/métodos , Hipertensão/prevenção & controle , Hipertensão/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , República Dominicana , Emoções/fisiologia , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Hipertensão/psicologia , Entrevistas como Assunto/métodos , Entrevistas como Assunto/estatística & dados numéricos , Estilo de Vida , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Apoio SocialRESUMO
PURPOSE/OBJECTIVES: To describe the development and feasibility of a protocol for nonpsychiatric subspecialty research staff members to screen research participants who endorse suicidal ideations or behaviors during data collectionâ©. DESIGN: Descriptive protocol development.â©. SETTING: The Children's Hospital of Philadelphia and the University of Pennsylvania.â©. SAMPLE: 186 mother caregivers and 134 adolescent or young adult survivors of childhood brain tumors, with the protocol implemented for 5 caregivers and 11 survivors. METHODS: During telephone- and home-based interviews, the interviewer assessed the participant using the Columbia-Suicide Severity Rating Scale (C-SSRS). MAIN RESEARCH VARIABLES: Expressed suicidal ideation or behaviorâ©. FINDINGS: Implementation of the C-SSRS by nonpsychiatric subspecialty staff members was feasible and valid. Interviewers' conclusions based on this instrument matched those of the mental health professional who followed up with participants. Process notes contained themes about the participants, including anger and sadness in survivors and the physical and emotional demands of the survivor in caregivers. Progress notes for the interviewer included a reiteration of events, whether the assessment was successful, and whether the recommendation of the interviewer was in agreement with that of the mental health professionalâ©. CONCLUSIONS: The protocol based on the C-SSRS was useful and feasible for nonpsychiatric subspecialty staff members to use in the collection of data from survivors of childhood brain tumors and their caregivers. IMPLICATIONS FOR NURSING: Survivors of childhood brain tumors and their caregivers may experience psychosocial distress. Nurses, as research assistants or in other roles, can use tools such as the C-SSRS to assist in front-line assessments. â©.