Browsing by Author "Carmack, Chakema C."
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Item Addressing Sexual Health among Black College Women: Results of a HIV-Prevention Intervention Group Pilot Randomized Control Trial(2016-05) Averette, Cedrina K.; Coleman, M. Nicole; Smith, Nathan Grant; Carmack, Chakema C.; Williams Jennings, ShearaThe HIV/AIDS epidemic continues to affect the lives of many, with African American women being uniquely at risk when compared to women from other racial groups. Black/African American women have a higher proportion of cases at all stages of the virus (CDC, 2016a). The primary form of HIV contraction among this group is by way of heterosexual contact with an at-risk sexual partner. However, Black women may not be fully aware of the potential risks inherit in their sexual relationships. The epidemic calls for approaches, resolutions, and interventions to stop the spread and increase of diagnoses among African American heterosexual women. The primary purpose of this study was to test the feasibility and acceptability of a group-based HIV-prevention intervention for young African American college women (ages 18 to 29). Using the theoretical foundations of Social Cognitive Theory (SCT) and the Theory of Gender and Power (TGP), the intervention educated participants about HIV-related information and transmission, taught communication skills related to assertive expression of safer sex practices, and addressed the unique intrapersonal, interpersonal, and contextual factors that impact Black college women. The intervention was culturally specific, gender appropriate, educational, and engaging. In the pilot study, participants were randomly assigned to either an experimental intervention condition or a no-attention control condition. Data on primary and secondary variables were collected at baseline and two months post-intervention to test the main hypothesis that the pilot study was feasible and acceptable among the target population. It was expected that the study would demonstrate that the intervention could be successfully carried out and be undertaken on a larger scale in the future. It was also hypothesized that a pilot version of a sex-risk reduction intervention that is gender-appropriate, culturally-relevant and skill-building would show a trend of increased consistent condom use, condom use self-efficacy, sexual communication, sexual relationship power, condom use intentions, and HIV knowledge (secondary measures) compared to the no-attention control group condition. Quantitative data were analyzed using descriptive statistics. Measures of mean and variance including standard deviations (SD) and ranges were used to describe the full range of data at baseline and at follow-up across two conditions and at two time points. The outcome data for this study were analyzed using the Statistical Package for the Social Sciences (SPSS/Mac version 23.0 for IBM PC/MAC and PS/2, SPSS, Inc., Armonk, NY, 2015). Qualitative data in the form of participant and facilitator feedback were used to analyze intervention feasibility and acceptability. The findings of this pilot study suggest that the delivery of a theoretically-based and culturally-relevant intervention is feasible within a university college setting and that the content of the intervention was accessible to participants. Additionally, there was an overall trend in increased condom use rate regardless of condition placement. In addition, intervention participants reported increased condom use self-efficacy, intention to practice safer sex, relationship control, decision-making dominance and HIV knowledge at follow-up.Item Departmentalized versus Self-Contained Balanced Literacy Instruction: Its Effect on Second Grade Comprehension Levels(2014-05) Thomas, Katina L.; Hutchison, Laveria F.; Carmack, Chakema C.; Mountain, Mignonette; White, Cameron S.The initiatives in U.S. school reform constantly serve as a reflection of the academic, political, and economical sentiment of the time. The College Entrance Exam Board’s decision in 1909 to establish a 40 to 60 minute class schedule that mirrored the Carnegie unit’s structure of efficiency and mass production remained the tradition until 1959, when J. Lloyd Trump introduced a flexible instructional schedule that allotted for an 85 to 100 minute “block” of time for each subject. The government report, A Nation at Risk (1983), found that 13% of seventeen year olds were functionally illiterate, and that schools were not utilizing school time efficiently. By 2001, the No Child Left Behind Act established a structured accountability system for schools; however, by 2013, the National Center for Educational Statistics (2013) reported five year stagnation in reading performance for fourth, eighth, and twelfth graders. The current outcomes have caused administrators and educators to revisit current instructional and organizational practices for more efficient and effective approaches to maximize learning opportunities and increase school performance. This study examined the effects of implementing a balanced literacy approach to reading in self-contained and departmentalized classrooms in second grade classrooms. In a review of the literature, little research has been conducted on self-contained and departmentalized classroom settings in the elementary school prior to third grade. Previous studies primarily focused on students in third grade and higher, and concentrated on student performance on state-mandated tests in reading. No studies to date have investigated self-contained and departmentalized comprehension levels prior to a grade level that has been designated for a state-mandated test. As a result, this study examined the following research questions: 1) What effect does receiving balanced literacy instruction in a self-contained or departmentalized classroom have on the reading comprehension of second graders as measured by district assessments, and 2) Are there gender differences in the observed reading comprehension of second graders with regard to a self-contained or departmentalized classroom? The research also qualitatively examines what effect teachers’ experiences, perceptions, and opinions about self-contained and departmentalized instruction have on the implementation and academic outcomes of the instructional organization of the classroom. This study examined second grade students from an urban school district in a metropolitan area in Texas. The sample was taken from three self-contained second grade classrooms (N = 61) and four departmentalized second grade classrooms (N = 86) from the same elementary campus. The departmentalized classrooms served as the quasi-experimental group and the self-contained classrooms served as the control group. Statistical tests were conducted to answer the first two research questions. Repeated measures were administered to compare beginning middle, and end of year comprehension levels within each group to determine significant progress. A 2 x 2 x 3 mixed ANOVA was used on the subpopulation (gender) to determine if any gender differences exist. Individual interviews of the second grade teachers that participated in the study were conducted to collect feedback regarding teachers’ beliefs, opinions, and preparation for self-contained and departmentalized literacy instruction. Results from separate analyses of the comprehension levels indicated that both the departmentalized and self-contained groups made significant progress from the beginning to the middle of the school year, and again at the end of school year. However, there was no significant difference in the rate of increase in self-contained and departmentalized groups. Significant progress was also made for each group within the gender subpopulation. When the departmentalized and self-contained groups were compared, there was not a significant difference between the comprehension levels of males and females at the end of the year. There was also no significant difference in the rate of increase in comprehension levels of departmentalized and self-contained males, and the rate of increase in comprehension levels of departmentalized and self-contained females at the end of the year. Feedback from teachers revealed that all of them supported the opportunity for more preparation and focus on one subject. However, self-contained teachers preferred the opportunities to teach one theme across all subjects, while departmentalized teachers preferred opportunities to engage in more cooperative learning activities during the literacy block. This study demonstrates that balanced literacy instruction is effective in increasing student comprehension levels from the beginning to the end of the school year in primary classrooms that implement both a departmentalized and self-contained schedule. It also demonstrates that departmentalized and self-contained balanced literacy can also increase student comprehension levels from the beginning to the end of the year within both gender groups.Item DHEA Reactivity to Acute Stress: Examining the Effect of Coping Styles(2022-08-17) Yan, Sandra; Obasi, Ezemenari M.; Reitzel, Lorraine R.; Smith, Nathan Grant; Carmack, Chakema C.Background: The culmination of economic and social disadvantages such as chronic exposure to systemic racism, discrimination, access to quality education, substandard housing, affordable health care, and food insecurity experienced by African Americans may result in greater susceptibility to stressors associated with the social determinants of health. Enduring exposure to these risk factors has been linked to a variety of adverse health conditions such as coronary vascular disease, obesity, diabetes, cancers, depression, cognitive impairment, age-related diseases, as well as the inflammatory and immunomodulation system in the body. Based on the adverse effects that chronic stress has on the mental and physical health of African Americans, investigations into the mechanisms associated with adaptive coping strategies may provide novel targets for prevention and intervention. Unfortunately, research on potential mechanisms of exposure to chronic stress that underlie health disparities affecting the African American community has received limited focus in the scientific literature. Purpose: This study aims to provide biomarker support for the potential effects that coping styles have on stress reactivity to acute stress during a controlled laboratory experiment. Identifying mechanisms that work toward an explanation of within-group differences in African American health disparities is both needed and informative for culturally informed prevention and intervention efforts. Methods: A metropolitan sample of African American emerging adults (N = 277) completed a battery of assessments, the Trier Social Stress Test (TSST), and provided six samples of salivary DHEA: before TSST instructions, before speech task, following the TSST, 15 min after TSST, 30 min after TSST, and 45 min after TSST. It was predicted that DHEA levels would increase in response to a controlled laboratory inducement of acute stress and individual coping strategy parameters: engagement in active coping (John Henryism), coping styles (Coping with Stressful Situations), and coping self-efficacy (Coping Self Efficacy) will affect DHEA reactivity to acute stress. Partial correlations between coping strategy parameters, Area under the Curve (AUC), and peak DHEA response (PDR) were run while controlling for age and sex. A two-level HLM was run with predictors of DHEA in acute stress included at the within-subjects level (i.e., level 1). Results: Marginally significant correlations between PDR and CISS avoidance subscale scores were found (r=-0.135, p=0.051). Avoidance coping styles (CISS_A=-1.645, t (200) =-1.89, p=0.061) was a marginally significant predictor of DHEA response during acute stress with a significant interaction also present between PDR*CISS_A (PDR*CISS_A=0.008, t (200) = 2.07, p=0.040). Conclusion: The results of this study suggest that the use of avoidance-focused coping styles may be a prime target for further investigation as a modifiable risk factor for the deleterious effects of chronic stress on the stress regulatory system. Additional research on identifying mechanisms for different indicators of HPA axis functioning in acute stress (e.g., reactivity vs. overall hormonal levels) may assist in further understanding of within-group differences in African American health disparities as well as being informative for culturally sensitive prevention and intervention efforts.Item Examining the Role of Media Influence and Parental Involvement in the Sexual Socialization of African American Adolescent Girls(2016-08) Hill, LaWanda; Coleman, M. Nicole; Horn, Catherine L.; Smith, Nathan Grant; Carmack, Chakema C.There are disparate rates of sexually transmitted infections (STIs) and unplanned teenage pregnancies among African American adolescent girls in comparison to other ethnic female peers (CDC, 2011). The literature has demonstrated that endorsement of permissive sexual attitudes promoted by the media have explanatory value in negative sexual health outcomes (Ward & Rivadeneyra, 1999; Ward & Friedman, 2006), while parents, namely mothers/female caregivers, are cited to be health promoting sexual socialization agents (DiIorio, Pluhar & Belcher, 2003). The literature is limited, however, in providing a comprehensive understanding of both media influence and parental involvement in the process of sexual socialization among African American adolescent girls. Thus, the purpose of this study was to bridge theoretical and methodological gaps in the current literature by addressing the aforementioned limitation. This was accomplished by specifically exploring Black-oriented television exposure rates, television and music video viewing motives, parent-adolescent communication about sexuality, process of sexual communication and the sexual attitudes of a heterogonous sample of African American adolescent girls between the age of 13 and 18. These variables were explored among 174 self-identified African American adolescent girls (M age = 15.61 years; SD= 1.50) sampled from 13 states within the United States. Participants were recruited through social media, non-profit organizations, churches, and public and charter schools throughout several states and administered the following measures: Viewing Motives Scale (Ward & Friedman, 2006), Sexual Communication Scale (Somers & Caniverz, 2003), Process of Sexual Communication Scale (Miller, Kotchick, Dorsey, Forehand, & Ham, 1998), and Brief Sexual Attitudes Scale (Hendrick, Hendrick, & Reich, 2006). In order to assess overall weekly television and Hip Hop music videos media consumption and Black-oriented television exposure, an adaption of Ward’s (2002) measure of Media Exposure Scale was utilized. Means and standard deviations and bivariate correlations among primary variables were examined. Additionally, frequencies were derived to provide descriptive information of the sample’s overall weekly television and Hip Hop music video consumption and favorite genre of television. Analysis revealed overall high rates of Black-oriented television exposure among adolescent participants with both entertainment and learning viewing motives. Additionally, little conversation about sexuality occurred among adolescents and their mother/female caregiver and conversation that did occur was restricted and narrow in scope. However, despite the high rates of Black-oriented television exposure and infrequent and limited conversations about sexuality, participants in this study did not endorse permissive sexual attitudes that are associated with risky sexual behaviors. Furthermore, neither media influence nor parental involvement was significant predictors of sexual attitudes among this sample. The implications of findings are discussed in terms of future research endeavors.Item Gender Variation among Perceived Social Concomitants of Sexual Behavior in Emerging Adulthood(2018-10-18) Johnson, Keilan; Rodriguez, JoannaThe decision to engage in sex may be associated with perceived social rewards and consequences, and are therefore referred to as social concomitants of sexual behavior. Likewise, such social concomitants may vary by gender. The present study examined gender differences regarding social concomitants of sexual behavior, and gender variation in social concomitants’ influence on the idea of having sex within the next three months. African American emerging adults (N=229; ages 18-21) completed an online survey. T-tests and moderated logistic regressions examined 10 social concomitants of sex. Women held greater endorsement that parents would be proud to know that they remained a virgin throughout high school (p<.001), perception that parents would be angry if they were having sex in college (p=.003), and the likelihood of AIDS with multiple partners (p=.008). Those who perceived that parents would be proud of their high school virgin status were 1.4 times more likely to think having sex would be a bad idea. Additionally, women who valued their mother’s opinion more were 1.9 times more likely to think having sex was a bad idea, compared to men. Parent influence and gender socialization are discussed as avenues for future research.Item Interesting Associations Among Sexual Health Services Utilization and School Exposure to Sexual Health Information(2018-10-18) Staley, EvelynThe purpose of this study was to examine associations of school exposure to sexual health information and the utilization of sexual health services using Wave I and II from the National Longitudinal Study of Adolescent to Adult National Probability Study. The analytic sample included 4819 participants who were adolescents at the time of survey administration. Logistic regression analyses were performed between school exposure data in Wave I and sexual health utilization in Wave II. Students who learned about pregnancy were 1.5 times more likely to get testing or treatment for sexually transmitted diseases (STDs) (p<.045) but were not more likely to receive family planning. Students who learned about AIDS were not more likely to get testing or treatment for STDs or receive family planning; neither were students who learned about where to receive health services. These associations were unexpected, as learning about pregnancy should theoretically positively influence the receipt of family planning. Likewise, learning about AIDS should theoretically positively influence the receipt of testing and treatment for STDs. These are important preliminary results that will serve as further inquiry for studies that examine the impact of school-based health-related knowledge on sexual health service utilization among adolescents.Item Investigating Parental Health-Related Quality of Life in Pediatric Type 1 Diabetes: A Social Determinants Framework(2023-12) Eshtehardi, Sahar Soror; Reitzel, Lorraine R.; Hilliard, Marisa E.; Mire, Sarah S.; Carmack, Chakema C.Background: Caring for a child with type 1 diabetes (T1D) is complex and taxing. For parents of youth with T1D, health-related quality of life (HRQOL) is an important construct to consider, representing the impact of their child’s medical condition on their own physical, emotional, mental, and social functioning. Supporting parents’ HRQOL is critical as poor parental well-being is consistently linked to poorer youth behavioral and glycemic outcomes. Social determinants of health (SDOH) – or non-medical factors closely related to health – play a vital role in an individual’s perceived HRQOL. SDOH are organized into five key domains: (1) economic stability, (2) education, (3) health and health care, (4) neighborhood and built environment, and (5) social and community context. To date, limited literature has examined how SDOH relate to experiences of parenting a child with T1D. Understanding the potential social determinants of HRQOL in parents is needed to assess the appropriateness of current supportive interventions, support the development of future interventions, and ultimately improve youth diabetes outcomes. Purpose: The three-part dissertation aimed to investigate the associations of SDOH with parental HRQOL by: (1) exploring diabetes-specific financial experiences in parents; (2) assessing potential sociodemographic differences in parents’ HRQOL; and (3) characterizing parents’ experiences with and perceptions of diabetes-specific social support. Together, these studies explored three domains of SDOH: economic stability (studies 1 & 2), health/health care (studies 1, 2, & 3), and social and community context (study 3). Methods & Results: All studies were secondary analyses of data from a larger mixed-methods study about HRQOL in people with T1D and their families. Study 1, which was previously published (Eshtehardi et al., 2020), used qualitative methods to explore perspectives on diabetes-related expenses in parents of youth with T1D (n=23). Following the principles of hybrid thematic analysis, two primary themes were generated: “Sacrifices & Hardships” and “Gratitude.” Study 2 used quantitative methods to evaluate whether there are differences in HRQOL in parents of youth with T1D (N=369, Mage=43.3±8.7, 80% female) across demographic, medical, and socioeconomic groups. Multivariate regression analyses revealed that a model inclusive of demographic (youth age), medical (HbA1c, diabetes duration, continuous glucose monitoring (CGM) use, insulin regimen), and SDOH (race/ethnicity, marital status, youth health insurance) variables significantly predicted parental HRQOL, though CGM use and HbA1c were the only variables independently associated with HRQOL in the final model. Study 3 characterized how parents (n=23) feel about and seek emotional support related to their role as a parent of someone with T1D using qualitative research methods. Data generated three major themes and nine subthemes, suggesting parents receive emotional support of different types and from various sources based on preferences at the individual, interpersonal, and community levels. Discussion: Findings suggest individual needs, experiences, and SDOH relate to parental HRQOL. Considering the intersectionality of SDOH, medical outcomes, and HRQOL, clinical approaches should emphasize universal parental HRQOL screening and tailored interdisciplinary interventional approaches. Future research is needed to advance opportunities for HRQOL equity in parents, including collecting qualitative and quantitative data on housing, environmental safety, transportation, and socioeconomic status across a larger time frame.Item Maladaptive Perfectionism, Expressive Suppression, and Familism Among Young Adult Children of Immigrants: Risk or Resilience to Suicide Ideation?(2020-05) Odafe, Mary O.; Walker, Rheeda L.; Alfano, Candice A.; Carmack, Chakema C.; Hunter, Carla Desi-AnnObjectives: Children of immigrants (i.e., born in the U.S. to immigrant parents or foreign-born who migrated to the U.S. during childhood) constitute one quarter of the U.S. population. Ethnic minority individuals across this generational status consistently show greater vulnerability to suicide than their foreign-born parents, suggesting the presence of risk factors that are unique to the social and cultural context of being raised in the U.S. Suicide is a leading cause of death among young adults in the general population, yet little is known about potential risk factors unique to the cultural contexts of young adult children of immigrants. In the current study, maladaptive perfectionism, expressive suppression, and attitudinal familism are examined as culturally-relevant psychosocial predictors of suicide ideation in Asian, African/Black Caribbean, and Hispanic/Latinx young adult children of immigrants. Method: University and community-based young adults (1.5 and 2nd generation American; N = 376) completed measures of maladaptive perfectionism, expressive suppression, attitudinal familism, suicide ideation, depressive symptoms, and demographic variables. Results: Two moderated mediation analyses were initially conducted. Expressive suppression (M) was not a significant mediator of maladaptive perfectionism (X) and suicide ideation (Y). Further, this association did not vary by levels of familism – Familial Honor (W1) and Subjugation of Self for Family (W2). However, a third moderated mediation analysis revealed that maladaptive perfectionism, when entered as a mediator (M), accounted for the association of expressive suppression (X) and suicide ideation (Y). Further, this association varied by participant race/ethnicity (W) with Asian and African/Black Caribbean participants showing a significantly larger mediation effect than Hispanic/Latinx participants. Predictors remained significant above and beyond the potentially confounding effects of depressive symptoms, age, gender, and education level. The overall model containing expressive suppression, maladaptive perfectionism, participant race/ethnicity, and covariate variables was significant (R2=0.263, df = 6, 349, F = 20.733, p <.001) and accounted for 26% of the variance in suicide ideation. Conclusions: For young adult children of immigrants who endorse maladaptive perfectionism, suppressive coping strategies may reinforce stringent perfectionist beliefs and ultimately contribute to suicide vulnerability. This association may be strongest for Asian and African/Black Caribbean young adults, relative to Hispanic/Latinx young adults. More research is needed to understand racial/ethnic differences and define cultural protective factors that may promote resilience to suicide and overall psychological well-being among young adult children of immigrants.Item Modern Discrimination Still Hurts: Effects of Covert and Overt Racial-Ethnic Discrimination on Risky Behavioral Intentions and Sexual Risk-Taking(2023-08) Segundo, Joahana; Derrick, Jaye L.; Neighbors, Clayton; Carmack, Chakema C.Racial-ethnic discrimination contributes to adverse outcomes for people of color (POC), such as poor psychological well-being, illness, and risky behaviors (e.g., sexual risk-taking). However, it is still unclear if covert discrimination—subtle and often ambiguous acts of prejudice—is as harmful to POC as overt discrimination. Furthermore, the underlying mechanisms for the association between racial-ethnic discrimination and sexual risk-taking are still not well understood. In the present study, I examined the effects of covert and overt discrimination surrounding English language use on risky behavioral intentions and sexual risk-taking using an experimental analog. The final sample was composed of 133 UH students. Participants were randomly assigned to an experimental condition. All participants completed a challenging reading comprehension task adapted from a Graduate Records Examinations (GRE) General Test. After seven minutes, the experimenter interrupted them. In the neutral control condition, the experimenter made an innocuous comment. In the overt discrimination condition, the experimenter blamed participants’ English proficiency for them taking too long. In the covert discrimination condition, the experimenter “helpfully” asked if the participant struggled with reading English. Then, participants completed self-report outcome measures and two versions of a sexual delay discounting task. Overt discrimination had a stronger negative effect on perceived acceptance (basic psychological need satisfaction and interpersonal vulnerability) than covert discrimination. Only overt discrimination had an indirect effect through basic psychological need satisfaction to risky behavioral intentions. However, experiencing either covert or overt discrimination had indirect effects through basic psychological need satisfaction on ability to delay gratification while waiting for a condom. These results link racial-ethnic discrimination to yet another negative outcome, risky sexual behavior, and demonstrate the differential effects of both covert and overt discrimination on POC’s well-being. Addressing both covert and overt racial-ethnic discrimination is crucial in reducing social disconnection and health-risk behaviors among POC.Item Perceptions of Body Size and Desire to Be Thinner among Hispanice Mother-Daughter Dyads(2020-05) Scherer, Rhonda; Olvera, Norma E.; Schwartz, Jonathan P.; Carmack, Chakema C.; Fan, WeihuaBackground: Overweight/obesity is a major health problem among children and adolescents in the United States. Hispanic girls are more likely to be overweight compared to their Caucasian counterparts, with 26% Hispanic girls versus 14% Caucasian girls being classified as overweight (Centers for Disease Control and Prevention [CDCP], 2018). Among adolescents, an association between obesity and body size disturbances has been identified (Evans et al., 2013). Maternal attitudes about their own body size and that of their daughters may play an important role in the development of daughters’ body image (Duchin et al., 2016). Yet, few studies have investigated the relationship between Hispanic mothers perceived-ideal body size including the moderation effect of maternal acculturation. Purpose: This study aimed to assess: 1) comparisons between Hispanic mothers’ and daughters’ perceived and ideal body size; 2) comparisons between Hispanic mothers’ desire to be thinner for themselves, mothers’ desire for their daughters to be thinner, and daughters’ self-desire to be thinner; and 3) assess the moderation role of acculturation in predicting daughters’ desire to be thinner. The following hypotheses were proposed: 1) Hispanic daughters will endorse smaller figure sizes as ideal compared to their mother’s selection of ideal figures for their daughters; 2) Hispanic daughters’ desire to be thinner will be positively associated with maternal desire to be thinner; 3) Hispanic daughters acculturation will moderate the association between maternal acculturation and daughters’ desire to be thinner; 4) Hispanic maternal acculturation will be moderating the association between daughters’ acculturation and daughter’s desire to be thinner. Method: The sample consisted of archival data collected at baseline from different cohorts of Hispanic mother-daughter pairs (N=112 pairs) who participated in a healthy lifestyle summer intervention known as BOUNCE (Behavior Opportunities Uniting Nutrition, Counseling, and Exercise). Data collection occurred during the summers of 2009, 2010, 2012 and 2017. Analysis consisted of a paired samples t-test to assess the relationship between mother’s and daughter’s ideal views on body size. A Pearson’s correlation analysis was conducted to test whether or not there was a significant relationship between mothers and daughters desire to be thinner. Finally, a blocked logistic regression analysis with moderation was conducted to assess the relationship between acculturation and mother and daughters desire to be thinner. Results: A paired samples t-test revealed that daughters selected a significantly smaller ideal body size figure than their mothers selected for their daughters t (111) =3.81, p=.000. No significant relationship between daughters desire to be thinner and mother’s desire to be thinner for their daughters was found r(111)=-0.047, p=.62. Though daughter’s acculturation was found not to be a significant predictor of daughter’s desire to be thinner, β =-.56, p=.39, daughter’s adiposity (BMI) was associated with the daughter’s desire to be thinner, β =.288, p=.001. Mother’s acculturation was not a significant predictor (β = -.53, p=.251) of the of the daughter’s desire to be thinner. Similarly, a blocked logistic regression determined that mother’s desire to be thinner was not significant β =-.459, p=.296 nor was mother’s acculturation β =.302, p=.649 with daughter’s desire to be thinner. Conclusion: Overall, findings from this study revealed that daughters selected a significantly smaller figure for themselves than their mother’s selected for them. No relationship was observed between acculturation and desire to be thinner.Item Promoting Safer Sexual Behavior on the HBCU Campus through a Focus on Ethnic Identity(2018-10-18) Crump, DontrayBecause HIV disparity exists in African American populations, condom use is of public health significance. The present study was to identify whether ethnic identity is useful in predicting condom use among emerging adults attending a historically Black college/university (HBCU). Participants included 255 African American college students recruited from a HBCU in the south. Participants were surveyed on attitudes toward condom use, subjective norms about condom use, self-efficacy to use condoms, and ethnic identity. Logistic regression was used to construct a model of condom use behavior. Results indicated that ethnic identity and self-efficacy to use condoms were significant predictors of condom use (p<.05). However, self-efficacy and ethnic identity, together, were the strongest predictors of condom use. Additionally, participants who scored high on ethnic identity were 1.6 times more likely to use condoms than those who scored low on ethnic identity. Likewise, participants who scored high on ethnic identity and self-efficacy, together, were 2.8 times more likely to use condoms. These results imply that a focus on ethnic identity and cultural belonging may be worthwhile additions to university interventions and public health programs aiming to increase condom use behavior to reduce HIV/STIs on predominantly African American college campuses.Item Refining STI Risk Prevention Messages That Yield Strong Intentions(2017-10-12) Coleman, TaylorThe present study was a baseline illustration of pro-condom beliefs that may be amenable to minimal change through intervention, while engendering a sizeable impact on strong intentions. Intentions were related to actual condom use more so for participants who “strongly agreed” with condom use cognition. Future research might benefit by focusing on identifying messages related to strong intentions to use condoms for college students who already intend to use condoms.Item The Bisexual+ Umbrella: Within-Group Variation and the Role of Sexual Minority Stress on Mental Health(2023-12) DeLucia, Renae; Smith, Nathan Grant; Carmack, Chakema C.; de Dios, Marcel A.; Fan, Weihua; Winderman, Katherine E.Background: Bisexual and other non-monosexual (e.g., pansexual) individuals report disproportionately poor mental and behavioral health outcomes. These disparities are attributable to minority stress. Minority stress experiences may look different based on someone’s gender and sexual orientation identity. Within the bisexual umbrella, there are many identities (e.g., pansexual, queer, omnisexual), and emerging research indicates there may be within-group differences in the bisexual+ population based on gender and sexual identity labels. Purpose: This project will explore how gender, sexual orientation identity, and sexual minority stress relate to mental and behavioral health outcomes among bisexual adults. Methods: Manuscript 1 examined how sexual minority stress relates to body dissatisfaction and the mediating role of body-image-related coping and internalization of body image norms. In a sample of bisexual adults, structural equation modeling was used to examine predictors of body image in line with Mason et al.’s (2018) proposed model of disordered eating and body image concern. Manuscript 2 focused on bisexual men and the relationship between sexual minority stress and heavy alcohol use, as moderated by sexual orientation identity. Logistic regression was used to test the relationship between sexual minority stress and heavy alcohol use among bisexual men, controlling for sexual orientation concealment and outness. Manuscript 3 explored the impact of provider bias against bisexual individuals on bisexual individuals’ mental health treatment seeking. A mediation analysis was conducted using the PROCESS macro for SPSS. Using 10,000 bootstrapped samples, the 95% confidence interval of the indirect effect of outness on help-seeking intentions through both provider anti-bisexual experiences and provider microaffirmations was examined. Results: In Manuscript 1, the SEM model showed a good fit and significant paths between bisexual minority stress, body image norms, body-image related coping, and body image esteem. There was no evidence of mediation. In Manuscript 2, sexual minority stress, sexual orientation concealment, and outness were not significant predictors of heavy drinking. Finally, Manuscript 3 indicated a significant impact of anti-bisexual experiences from providers on treatment seeking in the future. Conclusion: This research responds to a call for more research centering bisexuality and bisexual samples, who are often overlooked or combined with other sexual orientation identity groups. For example, bisexual men are underrepresented in research, and the current findings contribute to a slowly growing knowledge base of this population. This research also provides insight into nuances and diversity within the bisexual community around gender and sexual orientation identity. Clinicians working with clients who present with these, and other mental health outcomes will benefit from learning more about what may contribute to the health disparities facing the bisexual+ community.Item Treatment Decision Making in African American Women Diagnosed with Triple Negative Breast Cancer(2022-08) Ewane, Ewune; Obasi, Ezemenari M.; Miggins, Makesha V.; Carmack, Chakema C.; Correa-Fernández, Virmarie; Reitzel, Lorraine R.Background: Breast cancer is the most diagnosed cancer in women across the globe. Women diagnosed with Triple Negative Breast Cancer (TNBC) have the highest mortality rate compared to other subtypes of breast cancer. After diagnosis, considerable attention is extended to decisions regarding treatment. These efforts include, but are not limited to, immediate emotional and mental management, resource availability, belief in treatment outcomes, and consideration of short and long-term quality of life outcomes. Treatment decision making (TDM) communicates how patients understand and attribute worth to their treatment options in relation to salient aspects of their interpersonal processing to the treatment staff. Research suggests African American/Black women diagnosed with breast cancer are more likely to engage in behavior contradictory to medical advice such as treatment delay or premature termination. In addition, African American/Black women are most susceptible to negative outcomes along the breast cancer continuum, including younger diagnosis compared to the national average and poor survival outcomes. Despite the devasting consolidation of diagnosis susceptibility, consequential health behavior and poor health outcomes, little attention has been extended to understand TDM in African American/Black women to identify influential determinants. Purpose: The purpose of the present study was to investigate current TNBC treatment acceptance rates and identify determinants of initial treatment intention and final treatment decision in African American/Black women. Methods: Thirty-three African American/Black women recently diagnosed with TNBC were recruited from an academic National Cancer Institute designated cancer center. The volunteer patients completed a two-part, time-specific online self-report assessment battery that measured the components of the Theory of Planned Behavior and a semi-structured interview within an online focus group. Logistic regression and the Constant Comparative Method of the Grounded Theory were utilized to identify the mechanisms of TDM in African American/Black women diagnosed with TNBC. Results: The ages of the volunteer participants ranged from 30 – 69 years of age and most were diagnosed at Stage 3 (85%). Most of the women were employed (71%), with private insurance (85%), and endorsed family history of cancer (77%). All volunteer participants selected the treatment recommendation as their final treatment decision. Thematic findings from the online focus groups identified four influential factors within their TDM process: health advocacy behavior (self-discovery of breast tumor, favorable research participation, and treatment recommendation agreeance), application of faith (religion, MDACC reputation, lack of caregiver influence), historical influences (family cancer history, environmental stressors), and ultimate deciding factor. Conclusion: African American/Black women may be agreeable to receipt of care of and treatment recommendations from treatment institutions that employ patient-centered communication strategies regarding trust in the treatment institution. Furthermore, TDM recommendations and guidelines should consider inclusion of external factors such as trust in treatment institution and interpersonal exposure to cancer experiences.Item Understanding How to Address Cervical Cancer Disparities in African American and Hispanic Populations(2020-09-29) Serrano, KarinaCervical cancer rates have decreased significantly compared to previous years, however African American and Hispanic women face higher mortality rates than other racial groups. In 2016 the Texas Cancer Registry showed that Hispanic women had the highest incidence rate of late-stage cervical cancer and Non-Hispanic Blacks had the highest mortality rate. The Human Papilloma Virus, HPV, is a casual link in creating cervical cancer precursor lesions. HPV does not carry symptoms; therefore, comorbidities progress the infection and cancer is detected at an older age. The higher mortality rates in minority populations are due to screenings that detect late-stage cervical cancer. HPV vaccinations and Pap smear screenings are best used to avoid cervical cancer. Within the Houston area, predominantly African American and Hispanic communities have similar socioeconomic status, which alludes to similar health outcomes. This study focuses on understanding successful intervention elements that have the potential to decrease cervical cancer morbidity and mortality in African American and Hispanic women. In addition, research analyses of evidence-based interventions were synthesized to understand which study works best to address parental concerns, cultural beliefs, pap test knowledge, and completion of the HPV vaccination series. Many women did not receive a Pap smear within the recommended CDC guidelines of 3 years. Studies explained that the low adolescent uptake of HPV vaccinations are due to parental concerns of perceived sexual activity. Interventions that were culturally tailored and maintained partnerships with local institutions were successful in creating a positive impact on health beliefs and behaviors.