African American youth are affected disproportionately by sexually transmitted infections (STIs), human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and teenage pregnancy when compared to other racial groups. This paper evaluates the effectiveness of the To Help Young People Establish (2 HYPE) Abstinence Club, a behavioral intervention designed to promote delayed sexual activity among African American youth ages 12–18 in Atlanta, Georgia. The intervention included 20 h of curriculum and creative arts instruction. Pre- and post-intervention survey data collected from 2008–2010 were analyzed to determine the effectiveness of the intervention. Intervention (n = 651) and comparison (n = 112) groups were compared through analysis of variance and multivariate logistic regression models. There was a statistically significant increase in intervention youth who were thinking about being abstinent (p = 0.0005). Those who had not been engaged in sexual activity were two times more likely to plan abstinence compared to participants that had been previously sexually active previously (odds ratio 2.41; 95% confidence interval 1.62, 3.60). Significant results hold implications for subsequent community-based participatory research and practice that broadens the understanding of the relevance of marriage, as just one among other life success milestones that may hold more importance to African American youth in positioning the value of delayed and responsible sexual activity towards effective STIs, HIV/AIDS, and teen pregnancy risk reduction interventions.

The results indicate that gender, income, marital status, and perceived health status were associated with self-reported depression among cancer survivors aged ≥18 years in the United States.

Background: "Food desert" is a term used to describe lowincome communities without access to healthy, fresh food within a one-mile radius of their residence. The limited access to healthy foods in urban African-American communities may be a critical factor in the development of nutritional disorders and associated chronic disease in this vulnerable population. Research has shown that community gardens are a promising intervention for addressing food quality and access issues. This study aimed to assess whether improving the local food environment through community gardens can increase accessibility to healthy foods in Metropolitan Atlanta communities assumed to be food deserts. Methods: A systematic literature review was conducted to identify best practices of community garden projects in order to address food deserts in metropolitan cities. Next, a windshield survey was conducted in the Adamsville community in metropolitan Atlanta, Georgia to determine if a food desert was present, and to provide an analysis of the local food environment. Results: Twenty-nine articles were reviewed and eight best practices were identified as effective strategies in metropolitan cities. We found that community gardens had only minimal impact on food access issues in urban communities due to seasonal accessibility and low yield. The windshield survey revealed that the Adamsville community was not a food desert because it had access to healthy foods within a half-mile radius. Conclusion: While the literature review revealed that community gardens had a minimal impact on food access in urban communities, food policy advocacy and supermarket tax incentives were identified as effective ways to promote healthy community development.

Background The Centers for Disease Control and Prevention (CDC) estimates that 14 percent of persons infected with HIV in the United States (US) are unaware of their infection and many of the estimated 50,000 new HIV infections each year are transmitted by people who do not know that they are HIV-positive. HIV testing is an important component of HIV prevention. This study examined predictors of self-reported HIV testing among persons 18 years and over in the US. Methods Data from the 2012 BRFSS were utilized. We used univariate analysis to calculate relative frequencies for gender, race or ethnicity, age, education, income, marital status, region of residence, and having engaged in HIV/AIDS risky behaviors to characterize the overall sample. We conducted bivariate analysis for an initial assessment of factors independently associated with HIV testing. Multivariable logistic regression models were used to obtain the Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (95% CIs) for factors associated with getting tested for HIV. Analyses were conducted using SAS version 9.2. Results Of the 439,327 respondents, 30% had been tested for HIV. Of those who had been tested for HIV, 59% were female; 41% were two or more races and 47% were between 18–44 years of age. The majority (39%) of the respondents were college graduates. Over one-third (31%) of the participants who had been tested had annual household incomes which were less than $25,000. Half (50%) were married and 24% of the respondents were from the Western region of the US. Five percent of the respondents reported that they had engaged in HIV/AIDS risky behaviors. Factors associated with lower odds of getting tested included being Asian (AOR=0.56; 95% CI=0.41, 0.78); Native Hawaiian or Other Pacific Islander (AOR=0.42; 95% CI=0.18, 0.90); and having an income between $25,000 to $49,000 (AOR=0.82; 95% CI=0.78–0.87); $50,000 to $74,999 (AOR=0.86; 95% CI=0.79–0.93); or $75,000 or more (AOR=0.87; 95% CI=0.81–0.94). Also, respondents from the Midwest (AOR=0.78; 95% CI=0.73, 0.83) and the West (AOR=0.88; 95% CI=0.83, 0.93) were less likely to get tested for HIV. Our adjusted analyses also showed that being non-Hispanic Black or African American, Hispanic or Latino, identifying as having two or more races, and being American Indian or Alaska Native increased the likelihood of getting tested for HIV. Having engaged in HIV/AIDS risky behaviors had significantly higher odds of being tested for HIV (AOR=2.45; 95% CI=2.19, 2.74). Conclusion Our findings suggest that the HIV/AIDS prevention education and training programs in the US that have focused on traditionally classified high-risk populations have been effective. Findings from this study uncover an interesting paradox, which suggests that populations with higher incomes have been overlooked in efforts to combat HIV/AIDS. Our results suggest that these populations are at greatest risk of not knowing their HIV status and are therefore most likely to unknowingly contribute to the number of new HIV infections...

Objective It is estimated that 41 million American adults 18 and older experience poor physical or mental health which limits their ability to engage in their daily activities. The objective of this study was to assess the prevalence of and factors associated with ≥14activity limitation days (ALD) due to poor physical or mental health as self-reported by persons aged 18 years and over in the United States (U.S). Methods Using the 2012 Behavioral Risk Factors Surveillance System (BRFSS), persons over the age of 18 in the U.S. were examined to assess the prevalence of and factors associated with ≥ 14ALD due to poor physical or mental health. The BRFSS is administered on a continuous basis by telephone using random-digit dial sampling methods. A clustering sample design was used to account for differences in the probability of selection and non-response in order to accurately derive US and state-based population estimates. The design consists of a probability sample of all households with telephones in the state. Analyses were conducted using SAS 9.2. Results Of the 104,257 participants included in the analyses, 40% reported having ≥14 ALD due to poor physical or mental health. After adjusting for demographic and socioeconomic factors, males (AOR1.17, 95% CI: 1.14–1.21), those with high school or less education (AOR: 1.42, 95% CI: 1.37–1.21), those who were separated (AOR: 1.23; 95% CI=1.14–1.32), divorced (AOR: 1.10; 95% CI=1.06–1.15), those from the Southern Black Belt States (AOR1.14, 95% CI: 1.10–1.20), and those from the remainder of the Southern region of the U.S. (AOR1.14, 95% CI: 1.08–1.21) were significantly more likely to report ≥14ALD due to poor physical or mental health. Conclusion The prevalence of ≥14ALD due to poor physical or mental health among the study population was associated with sociodemographic and region of residence factors. These findings highlight the need for prevention strategies specifically for populations who might be more at risk for ALD due to social determinants of health.