No abstract

The objective of this study was to investigate the effectiveness of using decision support instruments (DSI) to assist African-American (AA) men in making a prostate cancer (CaP) screening decision. This nonrandomized pretest-posttest comparison study assessed two DSI that were either culturally tailored or culturally nonspecific. CaP knowledge, intention to screen, and preferences were assessed before and after exposure to DSI using a convenience sample of 120 AA men aged 40 years and above. Participants interested in screening were referred to healthcare providers through a community-based patient navigator to obtain prostate-specific antigen (PSA) testing. We followed up 3 months after to determine if participants screened for CaP. CaP knowledge increased following exposure to both DSI in equivalent proportions. While similar proportions of men ultimately intended on having a PSA test following both DSI, bivariate analysis revealed that the culturally tailored DSI demonstrated a statistically significant increase in intention to screen. Participants' degree of certainty in their decision-making process with regard to CaP screening increased following the culturally tailored DSI (p < .001). The majority of participants planned on discussing CaP screening with a healthcare provider upon completion of the study. Barbershop-based health education can change the knowledge, preferences, intentions, and behaviors of this at-risk population. At 3 months follow-up, half (n = 58) of the participants underwent PSA testing, which led to the diagnosis of CaP in one participant. Community-led interventions for CaP, such as cluster-randomized designs in barbershops, are needed to better assess the efficacy of DSI in community settings.

Background Obesity, a major risk factor for hypertension, diabetes, and other chronic diseases is influenced by a person’s local environmental setting. Accessibility to supermarkets has been shown to influence nutritional behaviors and obesity rates; however the specific local environmental conditions and behavioral mechanisms at work in this process remain unclear. Purpose To determine how individual fruit and vegetable consumption behavior was influenced by a distance decay based gravity model of neighborhood geographic accessibility to supermarkets, across neighborhoods in Los Angeles County, independent of other factors that are known to influence nutritional behaviors. Methods A distance decay based accessibility model (gravity model) was specified for a large sample (n=7,514) of urban residents. The associations between their fruit and vegetable consumption patterns and their local accessibility to supermarkets were explored, while controlling for covariates known to influence eating behaviors. Results Significant variation in geographic accessibility and nutritional behavior existed by age, gender, race and ethnicity, education, marital status, poverty status, neighborhood safety and knowledge of nutritional guidelines. Logistic regression showed an independent effect of geographic accessibility to supermarkets, even after the inclusion of known controlling factors. Conclusion A basic gravity model was an effective predictor of fruit and vegetable consumption in an urban population, setting the stage for inclusion of supply and demand parameters, and the ability to estimate local directions and magnitudes of the factors that contribute to the differential obesity rates found in United States urban areas. This knowledge will facilitate more targeted interventions that can help eliminate health disparities.

Acceptance of amniocentesis in the Hispanic and African American population in our prenatal diagnostic center is significantly lower than what has previously been reported in the literature for Caucasians and reported in California statewide prenatal diagnostic center data for non-MS-AFP. There was a significant decline in amniocentesis acceptance from 1995 to 2001. Our incidence of fetal abnormalities was higher than reported in California statewide data.

No abstract