The development and incorporation of interventions to promote health promotion behaviors should include readiness for change, health literacy, BMI, and education, especially among urban Black women in order to reduce critical health disparities. Community-based and culturally relevant strategies in promoting health that are integrated into existing lifestyles and designed to impact readiness for change will have the greatest impact on reducing health disparities both in the United States and in countries experiencing rapid urbanization. For example, healthy eating behaviors or increased physical activity may be best adopted when integrated into existing community-based spiritual or cultural events via trusted community leaders. Replication of this study in other populations of Black women will improve the generalizability of this study, both in the United States and globally. However, the addition of other demographic variables, such as a history of chronic conditions, military service, domestic or other violence, spirituality, and the availability of community resources, would strengthen the results in future studies.

Therapeutic temperature modulation, which incorporates mild hypothermia and maintenance of normothermia, is being used to manage patients resuscitated after cardiac arrest. Methods of modulating temperature include intravenous infusion of cold fluids and surface or endovascular cooling. During this therapy, the shiver response is activated as a defense mechanism in response to an altered set-point temperature and causes metabolic and hemodynamic stress for patients. Recognition of shivering according to objective and subjective assessments is vital for early detection of the condition. Once shivering is detected, treatment is imperative to avoid deleterious effects. The Bedside Shivering Assessment Scale can be used to determine the efficacy of interventions intended to blunt thermoregulatory defenses and can provide continual evaluation of patients’ responses to the interventions. Nurses’ knowledge and understanding of the harmful effects of shivering are important to effect care and prevent injury associated with uncontrolled shivering.

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Health-promotion behaviors among urban Black women are the forefront of US health policy regarding health disparities. This cross-sectional study explored factors such as health literacy, self-efficacy, and readiness for change with health-promotion behaviors of urban Black women. Although these variables are relevant, urban Black women have identified that spirituality and history of domestic violence were also relevant. The sample consists of 152 participants from outpatient clinics, community events, and grocery stores in one Northeastern US city. The anonymous online survey contained the following Instruments: Newest Vital Sign, New General Self-efficacy Scale, Health Risk Instrument, Daily Spiritual Assessment Scale, FAST Survey, and Health-Promoting Lifestyle Profile II. Univariate statistics and bivariate/simultaneous linear regression identified significant relationships between health-promotion behaviors and the following: eeadiness for change, self-efficacy, and spirituality. Participants who engaged in health-promotion behaviors were ready to change, but these behaviors were negatively associated with spirituality, self-efficacy, and a history of domestic violence.

Problem: Black women have been shown to experience higher rates of morbidity and mortality as a result of stroke, cardiovascular disease, hypertension, diabetes and overweight and obesity than women of other races/ethnicities. Creating an understanding of the various factors that impact individual health promotion behaviors to reduce risk, such as health literacy, self-efficacy and readiness to change will support effective interventions to reduce health care disparities in this vulnerable population. Method: 132 urban Black women in Midtown Manhattan in the service region of an academic medical center with a diverse population was chosen for this descriptive correlative study. Participants completed a questionnaire containing a demographic profile and survey instruments measuring health literacy, self-efficacy and readiness for change, and a detailed report of current health promotion behaviors. Results: Black urban women between 30 - 64 y (M = 45, SD = 9.72) participated. 72.6% completed high school, 25% had achieved a college degree. Pearson correlation showed positive correlation at the 0.01 level (2-tailed) between health literacy (r2 = .25), self-efficacy (r2 = .31) and readiness for change (r2 = .44) to health promotion behaviors. Self-efficacy was positively related to participation church organizations (r2 = .31) and a high body mass index (BMI) (F=25, p<.001). Participation in church organization was inversely related to high health literacy (r2 = .41). Among women scoring high in self-efficacy and low in health literacy, BMI scores averaged higher (BMI=35.2) than those with high health literacy scores (BMI=30.2). Conditions such as hypertension, diabetes, respiratory disorders and stroke were more prevalent if health literacy scores were low and self-efficacy was high. Women with low health literacy were less likely to seek medical care with a health care provider, take prescribed medications or receive routine preventative health care. Conclusion: Future research interventions geared to reduce health care disparities in Black women may be more effective in reducing modifiable conditions if performed in collaboration with community church organizations rather than from a health care provider alone.