Browsing by Author "Obasi, Ezemenari M."
Now showing 1 - 11 of 11
- Results Per Page
- Sort Options
Item Anxiety Sensitivity and Fast-Food Ordering Habits Among African-American Adults(2020-09-29) Nitturi, VijayBackground: African American adults experience high rates of overweight/obesity, which is linked to chronic diseases and is exacerbated by fast-food consumption. Anxiety sensitivity, a relatively stable fear of anxiety-related sensations, has been linked to high caloric intake. Here, we examine whether anxiety sensitivity is associated with fast-food ordering habits within an African American convenience sample. Methods: Of 124 adults (79.4% women; Mage=49.3±11.6; 84.8% overweight/obese), 107 (86.3%) reported eating from a fast-food restaurant in the last month. Participants completed the Anxiety Sensitivity-Index 3, which has a total score and physical, cognitive, and social concerns subscales. Investigator-generated items were frequency of ordering “supersized” quantities of fast-food (e.g., cheeseburgers, fries), and healthy items (e.g., salads, oatmeal, yogurt), respectively, from “never” to “always.” Covariate-adjusted ordinal logistic regression models were used to assess relations between measures of interest. Results: Anxiety sensitivity (total and physical concerns) was associated with greater odds of more frequently ordering supersized unhealthy fast-food; and anxiety sensitivity (total and cognitive concerns) was associated with lower odds of more frequently ordering healthy items from fast-food restaurants. Conclusions: Results suggest that adults with greater anxiety sensitivity may engage in fast-food ordering habits that may contribute to the overweight/obesity epidemic. Future studies should replicate results and determine the potential for anxiety sensitivity-reduction interventions to affect dietary choices that contribute to overweight/obesity. This project was completed with contributions from Lorna H. McNeill from The University of Texas MD Anderson Cancer Center.Item The Association of Lesbian, Gay, and Bisexual Identity Facets with Smoking Dependence Motives(Nicotine & Tobacco Research, 2018-02-07) Smith, Nathan Grant; Winderman, Kate; King, Brooke; Obasi, Ezemenari M.; Reitzel, Lorraine R.Introduction: Lesbian, gay, and bisexual (LGB) adults have higher rates of smoking than heterosexual adults. LGB individuals face unique stressors, including challenges associated with having a LGB identity. The extent to which these unique stressors are related to dependence motives in LGB adult smokers, however, has not been previously explored. The current study was conducted to redress these gaps. Methods: Participants (N=52; Mage=42.8; 55.8% Black/African American) were recruited from the local community. Identity facets were measured by the Lesbian, Gay, and Bisexual Identity Scale (LGBIS). Dependence motives were measured by the Brief Wisconsin Inventory of Smoking Dependence Motives. Linear multiple regressions were calculated with the predictors of seven LGBIS subscales for primary and secondary dependence motives, respectively. Results: Primary dependence motives (core nicotine dependence features) were predicted by affirmation of LGB identity (β=.44). Secondary dependence motives (e.g., taste, cognitive/affective enhancement) were predicted by uncertainty of LGB identity (β=.43). Conclusions: LGB identity affirmation was associated with primary dependence motives, suggesting that a positive view of one’s sexual orientation is a risk factor for dependence. It may be that identity affirmation is related to stronger involvement with the LGB community, which has smoking-friendly norms. Identity uncertainty was associated with secondary dependence motives; this unique identity challenge may represent a stressor contributing to smoking dependence. Findings can help explain the higher rate of smoking in LGB populations and offer avenues to better tailor smoking cessation interventions.Item Autonomic Nervous System Reactivity and Addiction Vulnerability in the African American Community(2018-08) Cavanagh, Lucia; Obasi, Ezemenari M.; Reitzel, Lorraine R.; Coleman, M. Nicole; Smith, Nathan GrantBackground: African Americans experience disproportionate rates of morbidity and mortality with regard to drug use, but the mechanisms underlying this association remain poorly understood. Increasing evidence suggests that exposure to chronic stress and the subsequent activation of the physiological stress systems have been linked to the development of addiction. To date, no research exists that focuses on the influence of autonomic reactivity on prospective drug use among African American emerging adults. Purpose: The present study aimed to: (1) investigate the association between ANS reactivity and prospective drug use among a sample of African American emerging adults (18-25 years old) in the southwestern U.S.; (2) characterize the impact of chronic environmental stress exposure on regulatory mechanisms of the ANS; and (3) identify socially- and culturally-specific risk and resilience factors associated with physiological stress reactivity in this population. Methods: Participants (N = 277) were assessed across three different time points over a period of four-months. They completed measures of self-reported chronic and race-related stress exposure, behavioral and emotional coping styles, and past 90-day marijuana and alcohol use. They also underwent a laboratory-based stressor to derive measures of autonomic reactivity to acute stress, including heart rate (HR), heart rate variability (HRV), and skin conductance levels (SCL). Results: Higher SCL reactivity to acute stress was associated with higher rates of subsequent alcohol and marijuana use at 90-day follow-up. There was no significant association between autonomic reactivity and chronic, nor race-related stress exposure. However, there was a significant interaction effect, such that active coping moderated the relationship between race-related stress exposure and HRV reactivity to acute stress. Conclusions: These results highlight the role of ANS (dys)regulation as a putative link between environmental stress exposure and subsequent drug use vulnerability among African American emerging adults.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 Implementation of a Comprehensive Tobacco Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed(2020-09-29) Taing, MatthewAlthough there have been substantial decreases in the prevalence of cigarette smoking in the last two decades, these overall population estimates often fail to account for subpopulations, such as individuals who are homeless or vulnerably housed, that have disproportionately high smoking rates. Despite this, clinicians do not commonly address tobacco use among individuals who are homeless. Tobacco-free workplace programs, like TTTF, are evidence-based, tobacco control initiatives that may be effective in increasing capacity to address tobacco use within homeless-serving community agencies by addressing known clinician barriers to intervention by providing education, specialized training, and resources to promote and assist quit attempts. Here, we examine the outcomes of TTTF’s implementation within 4 agencies that provide housing or other services to individuals who are homeless or vulnerably housed. Pre- and post-implementation data were collected from clinicians (N=68) to assess changes in training receipt, knowledge, and intervention behaviors. Results indicated significant gains in clinicians’ receipt of training in 9 (of 9) target areas (ps≤0.0042) and a 53% knowledge gain (ps<0.0001). From pre- to post-implementation, there were mean increases in the use of the 5A’s (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with significant gains seen over time in assisting residents/clients to quit, arranging follow-ups, and providing or referring for non-nicotine medications (ps≤0.0491). Overall, TTTF improved clinicians’ capacity to address tobacco use among homeless and vulnerably housed individuals and may serve as a model for tobacco control efforts in similar agencies. This project was completed with contributions from Bryce Kyburz, Teresa Williams, and Kathleen Casey from Integral Care at Austin.Item Instructional video for collecting saliva samples (Video instructivo para recolectar muestras de saliva)(2019) Yip, MaggieThe Stress and Spit Study aims to measure differences in stress between and within Latino undocumented and documented immigrant families. Although family stress can lead to serious health problems such as mental health disorders or substance use issues, little is known about stress within Latino immigrant parent-U.S. born adolescent dyads. Stress can be measured through self-reported surveys or through biological markers, such as cortisol. The use of surveys is beneficial to understanding associations between different types of stress. However, measuring cortisol levels through the collection of participants’ saliva samples can more accurately examine chronic stress and stress regulation within vulnerable families. To collect saliva samples, instructional videos were created in both English and Spanish to meet the needs of the study population. Alongside the UH Instructional Design team, three HOUSTON Academy students, consisting of one English speaker, one Spanish speaker, and one actor, assisted with creating the videos. The videos were then published to YouTube and are shown to participants during data collection events. Currently, research assistants have been scheduling a day and time to retrieve the saliva samples and collection diaries from participants within 48 hours of completion. Samples will be kept in a freezer at UH prior to cortisol analysis. This data can potentially be used to inform psychosocial intervention and prevention programs for Latino immigrant families. This project was completed with contributions from Geselle Zuniga from Texas Southern University and Laura Gonzalez from Rice University.Item Mental Health Help-Seeking in South Asian American Muslims: The Role of Cultural Beliefs, Attitudes, and Knowledge(2018-08) Damani-Khoja, Nadia; Smith, Nathan Grant; Nutt, Roberta L.; Hassett, Kristen S.; Obasi, Ezemenari M.Background: Islam is one of the fastest growing religions in the U.S. It is imperative for mental health researchers and clinicians to learn about group differences among South Asian American Muslims to avoid misconceptions and stereotypes. Purpose: This study examined if there are differences in (a) cultural beliefs, attitudes, and knowledge and familiarity towards formal mental health help between three South Asian Muslim groups—Sunni, Shia, and Ismaili—controlling for the effects of age and generational status; (b) cultural beliefs, attitudes, and knowledge and familiarity between men and women; and (c) preferences towards seeking formal (physicians, mental health professionals) versus informal (family, friends, and religious leaders) mental health resources based on Muslim group. Method: Participants included 252 South Asian American Muslims. Measures included demographics, the Cultural Beliefs about Mental Health Problems scale, the Attitudes Towards Seeking Formal Mental Health Services scale, the Knowledge About and Familiarity with Formal Mental Health Services scale, and an author-generated measure of preferences towards formal versus informal mental health resources. Results: A one-way between-groups MANCOVA, controlling for age and generational status, was conducted. Sunnis endorsed the most traditional cultural beliefs, compared to Shias and Ismailis. Shias endorsed the least positive attitudes and the least knowledge and familiarity, compared to both Sunnis and Ismailis. Women endorsed more positive attitudes and knowledge and familiarity than men but there were no significant differences for cultural beliefs. Shias preferred reaching out to informal support first while both Sunnis and Ismailis preferred reaching out to formal support. Conclusion: Results suggest that mental health help seeking in South Asian American Muslims is complex, especially when it comes to cultural beliefs, and can have implications for engagement in seeking formal services. Clinical implications are discussed and suggestions for future research provided.Item Physiological Determinants of Chronic Stress in Relation to Substance Use and Neighborhood Crime(2018-10-18) Smith, ChristineBackground: African Americans (AAs) are more likely to report greater levels of perceived stress (PSS) and are susceptible to suffering from chronic stress and the related negative outcomes due to poorer environments that they live in and daily stressors they experience due to racism, discrimination, socioeconomic status, and neighborhood crime. Methods: Participants (N=241; Mage=20.43, 72.03% female) were administered measures including self-reported neighborhood violence, substance use, and PSS. Study procedures included the provision of seven saliva samples for cortisol analysis (at wakeup, 30 and 90 minutes post-wakeup, 1:00PM, 2:30PM, 4:00PM, and pre-bedtime). Five measures of the repeated measures of cortisol awakening response (CAR) were computed for each individual. The measures using Area Under the cortisol Curve (i.e., AUC0, AUC1, and AUC7) were calculated by the trapezoid formula. Results: PSS was significantly negatively related to AUC0 (p=0.020) and Cortisolmean (p=0.017), while daily alcohol use was positively correlated with AUC7 (p=0.046). The results of multiple regression analyses showed that PSS was a significant negative predictor for AUC0 (p=0.020) and Cortisolmean (p=0.017), daily drinking amount was a significant positive predictor (p=0.040) for AUC7 after controlling for age and sex. Discussion: As levels of PSS increased, the AUC and overall cortisol levels decreased. This association suggests those who experience high levels of PSS likely become ‘resilient’ to their environmental stressors that influence increased cortisol production. In addition, daily alcohol use was associated with an increase in pre-bedtime cortisol levels, suggesting that excessive alcohol consumption, likely near the individuals’ bedtime, influences stress symptomology and cortisol production.Item Quantifying the Effect of Vitamin D Deficiency and Alcohol Exposure on Immune Response to Mycobacterium Infection(2019-05) Gough, Maya; May, Elebeoba E.; Graviss, Edward A.; Obasi, Ezemenari M.; Mohan, Chandra; Zhang, YingchunThe goal of the May Multiscale Immunobiology Design, Algorithms, & Simulation (MIDAS) Lab is to develop dynamic empirical and simulation-based models of host-pathogen interactions to further our understanding of the mechanisms guiding immunologic response. Previous studies on the role of vitamin D3 and its modulation of host response have shown increased anti-inflammatory cytokines and effector substrates during innate immune response; however, many of these studies investigated only single, often dissimilar, levels of infection[1]–[8]. There is currently not a well-established model of macrophage immune modulation by vitamin D3 and the data regarding the kinetics of this process are scarce. There remains a need for more quantitative data on the dynamic impact of vitamin D3 on host response to infection [3], [5]. The majority of studies collected samples and investigate the host response at a single, usually end-stage, time point versus quantifying vitamin D3’s modulation of the host response throughout the study. Furthermore, minimal consideration has been given to the potential immune modulatory effects of the vehicle and biochemical process through which vitamin D3 is delivered [3], [9]. This results in a lack of empirical dynamic data that takes into consideration state of host prior to and during infection/treatment. The objective of our lab’s research is to develop in vitro, ex vivo, and in silico models that can capture host state, quantifying and expounding on the mechanistic differences in immunologic response due to host state. The focus of my doctoral research is the investigation of host vitamin D3 deficiency in conjunction with adolescent immune response and alcohol exposure. This research will provide insight into the ramifications of age-related vitamin D3 deficiency and its effect on the outcome of mycobacterium infection, as well as, the combined effects of vitamin D3 deficiency and alcohol exposure on infection outcome. This platform can be expanded upon in the future to aid in the identification of immunomodulator associated therapies to enhance host immune response to TB.Item Racial and Gender Discrimination among Black Women: an Examination of Health Locus of Control as a Moderator of Maladaptive Eating Behaviors(2015-12) Huddleston, Cashuna T.; Smith, Nathan Grant; Horn, Catherine L.; Obasi, Ezemenari M.; Evans-Hudnall, Gina L.Many factors may contribute to the higher prevalence of overweight and obesity for Black women. Associations between discrimination and health behaviors have been identified (Laitinen, Ek, & Sovio, 2002; Oliver & Wardle, 1999). Stress as a result of racial and gender discrimination may lead to changes in health behaviors such as maladaptive eating habits as a coping response; these behaviors may ultimately have an influence on Black women’s health. In addition, major substantive questions remain about the conditions that moderate the effects of discrimination on health behaviors among Black women. Thus, this study examined two questions: (a) Is there a relationship between discrimination (i.e., racial and gender) and dietary behavior (e.g., low-fat eating and snacking on sweets)? and (b) Is the relationship between discrimination and dietary behaviors moderated by health locus of control orientation (e.g., internal and matter of chance)? Two hundred and twenty-seven participants were recruited and data were collected online. It was expected that discrimination and health locus of control would each contribute significantly to dietary behaviors in this sample of women. Moderated regressions were used to test the study hypotheses. Bivariate correlations results revealed that internal HLOC was positively associated with low-fat eating behavior; chance HLOC was positively associated with snacking on sweets eating behavior; and racial discrimination was positively associated with snacking on sweets eating behaviors. Results also indicated that internal HLOC and chance HLOC served as moderators in the relationship between racial and gender discrimination and snacking on sweets eating behaviors but not for low-fat eating behaviors. Implications for future research are discussed.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.