The Alabama Coalition for a Healthier Black Belt: A Proof of Concept Project

Savage, Robert M.; Dillon, Jacqueline; Hammel, Jacinda C.; Lewis, Tonia C.; Johnson, Natasha C.; Barlow, Lafon M.; Brooms, Molly M.; Moore, Patricia M.; Parker, Henry E.; Rodney, Kanini Z.

doi:10.1007/s10597-012-9488-z

Cited by 8 publications

(5 citation statements)

References 5 publications

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“…However, it is possible that selection bias contributed to a greater representation of parents with low stigma beliefs. Also, mental health stigma reduction efforts in the U.S. have increased in recent years, including for adults in the target county (Savage et al, 2013), which may have contributed to reduced stigma in the general community.…”

Section: Discussionmentioning

confidence: 99%

Bridging the gap: A pilot study of a lay health worker model to decrease child mental health stigma and promote parents’ professional help-seeking for Black/African American children.

Chakawa¹

2023

Psychological Services

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Unmet mental health needs among children in the United States (U.S.) are at a critical status (Kimball & Miller, 2015;Perou et al., 2013), with less than half of children receiving needed care (Whitney & Peterson, 2019). Unmet mental health needs are especially pronounced for racial/ethnic minority children, including Black/African American children (Alegria et al., 2010;Cokley et al., 2014), whose rates of suicide among those aged 5-11 years has increased in the past two decades (Bridge et al., 2015). Culturally responsive strategies that build on common mental health help-seeking pathways for Black/African American families are needed to improve access to care. The Bridging the Gap pilot project described in this paper used an innovative lay health worker model embedded in faith-based networks to target child mental health stigma and promote professional help-seeking among 65 Black/African American parents of children 5-12 years old. A single-group, pretest, posttest, follow-up (PPF) design (with double pretest and double follow-up) was used to structure the delivery of the pilot program and data collection. Child mental health stigma significantly decreased after the intervention portion of the program but help-seeking attitudes stayed constant. Thirteen parents had children with clinically significant mental health needs. Of the eight parents reached for follow-up, five sought child mental health services based on individualized recommendations and the rest endorsed intentions to follow through on service recommendations. Parents endorsed satisfaction with the program and several program evaluation themes were identified through qualitative data. Recommendations and future directions are discussed. Impact StatementBlack/African American children have disproportionately high unmet mental health care needs. The help-seeking pathway for Black/African American families often includes faith-based networks. Establishing culturally responsive lay health worker models within faith-based networks may help address racial/ethnic disparities in care by reducing mental health stigma and helping connect Black/ African American children with mental health needs to evidence-based services.

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Section: Discussionmentioning

confidence: 99%

Bridging the gap: A pilot study of a lay health worker model to decrease child mental health stigma and promote parents’ professional help-seeking for Black/African American children.

Chakawa¹

2023

Psychological Services

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“…This highlights the importance of researchers partnering with key community stakeholders in designing and testing their interventions. Savage et al (2013) 39 provides an example of a large-scale project involving the partnership of non-profit organizations, churches, community mental health centers, a state department of mental health, and a university in order to increase mental health service utilization and reduce mental illness stigma in a rural, predominantly African American region of Alabama. While resource-intensive, such partnerships may influence the design of stigma reduction interventions such that they may be more feasibly implemented in a variety of community settings.…”

Section: Discussionmentioning

confidence: 99%

A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States

Rivera¹,

Zhang²,

Mohr³

et al. 2021

J Ment Health Clin Psychol

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Among African Americans, the chronicity and severity of mental illness correlates with worse health outcomes and widens health disparities. Stigma related to mental illness compounds mental health disparities by creating barriers to help-seeking behavior. We examine the current tools designed to reduce mental illness stigma and promote improved mental health outcomes among African Americans. The authors reviewed the current evidence in the literature for such stigma reduction interventions. The review team developed a focused search across four databases: PubMed, Embase, Scopus, and APA PsycINFO. Initial searches identified 120 articles, from which six studies were included as reporting on mental illness stigma reduction interventions among African Americans. We describe these four quantitative and two qualitative studies. There have been various interventions used among African Americans to reduce mental illness stigma, and the level of efficacy and effectiveness is not well studied. Our review demonstrated a need for more robust studies to yield strong evidence on effectiveness among stigma reduction interventions in this target population. The evidence does support tailoring intervention studies to this population. Effectively engaging and partnering with key stakeholders, including schools, community organizations, and faith-based institutions enhances the acceptance and delivery of stigma reduction interventions.

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“…The socio‐economic status of our study sample may also have contributed to the present results. All participants in Encourage resided in the Alabama counties collectively referred to as the ‘Black Belt,’ a region with limited healthcare resources and high rates of unemployment and poverty . In the study by Bair et al .…”

Section: Discussionmentioning

confidence: 99%

Association of pain with HbA_1c in a predominantly black population of community‐dwelling adults with diabetes: a cross‐sectional analysis

et al. 2013

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Aims To assess the relationship between pain and HbA1c levels in a predominantly black population with diabetes, and to determine whether self-management behaviours (exercise and diet) and symptoms of depression mediate this relationship. Methods We analysed cross-sectional data from 417 community-dwelling individuals with diabetes in rural Alabama, USA. Binary logistic regression was used to analyse the relationship between pain and HbA1c levels, defined as relatively good [≤ 64 mmol/mol (≤ 8.0%)] and relatively poor [> 64 mmol/mol (> 8.0%)], after adjusting for sociodemographics, insulin use, medication count, cigarette smoking history and body mass index (BMI). We examined the mediating roles of exercise, diet, and symptoms of depression using bootstrapping. Results Participants were primarily black (86.6%), female (76.1%) and reported an annual income of ≤$20,000 (52.7%). Their mean (SD) age was 59.6 (12.8) years. The majority of the participants reported moderate to extreme pain (71.5%). Participants reporting pain were more than twice as likely to have HbA1c levels > 64 mmol/mol (8.0%) in the fully adjusted model (odds ratio 2.33 [95% CI 1.28–4.24]; P < 0.05). Diet significantly mediated the relationship between pain and HbA1c control (β = 0.06; 95% CI: 0.01–0.17), but only in the unadjusted model. Exercise and symptoms of depression were not significant mediators. Conclusions A significant independent relationship between pain and HbA1c control was found in this mainly black population, which was not explained by self-management behaviours or symptoms of depression. Future research is needed to delineate the mechanism by which pain influences HbA1c control, especially among black people with diabetes on low incomes.

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The Alabama Coalition for a Healthier Black Belt: A Proof of Concept Project

Cited by 8 publications

References 5 publications

Bridging the gap: A pilot study of a lay health worker model to decrease child mental health stigma and promote parents’ professional help-seeking for Black/African American children.

Bridging the gap: A pilot study of a lay health worker model to decrease child mental health stigma and promote parents’ professional help-seeking for Black/African American children.

A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States

Association of pain with HbA_1c in a predominantly black population of community‐dwelling adults with diabetes: a cross‐sectional analysis

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The Alabama Coalition for a Healthier Black Belt: A Proof of Concept Project

Cited by 8 publications

References 5 publications

Bridging the gap: A pilot study of a lay health worker model to decrease child mental health stigma and promote parents’ professional help-seeking for Black/African American children.

Bridging the gap: A pilot study of a lay health worker model to decrease child mental health stigma and promote parents’ professional help-seeking for Black/African American children.

A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States

Association of pain with HbA1c in a predominantly black population of community‐dwelling adults with diabetes: a cross‐sectional analysis

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Resources

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Association of pain with HbA_1c in a predominantly black population of community‐dwelling adults with diabetes: a cross‐sectional analysis