Identification of speckle-type POZ protein somatic mutations in African American prostate cancer

The speckle-type POZ protein （SPOP） is a tumor suppressor in prostate cancer （PCa）. SPOP somatic mutations have been reported in up to 15% of PCa of those of European descent. However, the genetic roles of SPOP in African American （AA）-PCa are currently unknown. We sequenced the SPOP gene to identify somatic mutations in 49 AA prostate tumors and identified three missense mutations （p.Y87C, p.F102S, and p.G111E） in five AA prostate tumors （10%） and one synonymous variant （p.11061） in one tumor. Intriguingly, all of mutations and variants clustered in exon six, and all of the mutations altered conserved amino acids. Moreover, two mutations （p.F102S and p.G111E） have only been identified in AA-PCa to date. Quantitative real-time polymerase chain reaction analysis showed a lower level of SPOP expression in tumors carrying SPOP mutations than their matched normal prostate tissues. In addition, SPOP mutations and novel variants were detected in 5 of 27 aggressive PCa and one of 22 less aggressive PCa （P 〈 0.05）. Further studies with increased sample size are needed to validate the clinicopathological significance of these SPOP mutations in AA-PCa.

Gastric intestinal metaplasia development in African American predominant United States population

BACKGROUND Gastric cancer significantly contributes to cancer mortality globally.Gastric intestinal metaplasia(GIM)is a stage in the Correa cascade and a premalignant lesion of gastric cancer.The natural history of GIM formation and progression over time is not fully understood.Currently,there are no clear guidelines on GIM surveillance or management in the United States.AIM To investigate factors associated with GIM development over time in African American-predominant study population.METHODS This is a retrospective longitudinal study in a single tertiary hospital in Washington DC.We retrieved upper esophagogastroduodenoscopies(EGDs)with gastric biopsies from the pathology department database from January 2015 to December 2020.Patients included in the study had undergone two or more EGDswith gastric biopsy.Patients with no GIM at baseline were followed up until they developed GIM or until the last available EGD.Exclusion criteria consisted of patients age<18,pregnancy,previous diagnosis of gastric cancer,and missing data including pathology results or endoscopy reports.The study population was divided into two groups based on GIM status.Univariate and multivariate Cox regression was used to estimate the hazard induced by patient demographics,EGD findings,and Helicobacter pylori(H.pylori)status on the GIM status.RESULTS Of 2375 patients who had at least 1 EGD with gastric biopsy,579 patients were included in the study.138 patients developed GIM during the study follow-up period of 1087 d on average,compared to 857 d in patients without GIM(P=0.247).The average age of GIM group was 64 years compared to 56 years in the non-GIM group(P<0.001).In the GIM group,adding one year to the age increases the risk for GIM formation by 4%(P<0.001).Over time,African Americans,Hispanic,and other ethnicities/races had an increased risk of GIM compared to Caucasians with a hazard ratio(HR)of 2.12(1.16,3.87),2.79(1.09,7.13),and 3.19(1.5,6.76)respectively.No gender difference was observed between the study populations.Gastritis was associated with an increased risk for GIM development with an HR of 1.62(1.07,2.44).On the other hand,H.pylori infection did not increase the risk for GIM.CONCLUSION An increase in age and non-Caucasian race/ethnicity are associated with an increased risk of GIM formation.The effect of H.pylori on GIM is limited in low prevalence areas.

COVID-19 among African Americans and Hispanics:Does gastrointestinal symptoms impact the outcome?

BACKGROUND The coronavirus disease 2019(COVID-19)disproportionately affected African Americans(AA)and Hispanics(HSP).AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal(GI)symptoms,laboratory values and comorbidities METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020.We assessed the symptoms,including the GI manifestations,comorbidities,and mortality,using logistic regression analysis.RESULTS Of these 386 COVID-19 positive patients,257(63.7%)were AAs,102(25.3%)HSP,and 26(6.45%)Whites.There were 257(63.7%)AA,102(25.3%)HSP,26(6.45%)Whites.The mean age was 55.6 years(SD=18.5).However,the mean age of HSP was the lowest(43.7 years vs 61.2 for Whites vs 60 for AAs).The mortality rate was highest among the AAs(20.6%)and lowest among HSP(6.9%).Patients with shortness of breath(SOB)(OR2=3.64,CI=1.73-7.65)and elevated AST(OR2=8.01,CI=3.79-16.9)elevated Procalcitonin(OR2=8.27,CI=3.95-17.3),AST(OR2=8.01,CI=3.79-16.9),ferritin(OR2=2.69,CI=1.24-5.82),and Lymphopenia(OR2=2.77,CI=1.41-5.45)had a high mortality rate.Cough and fever were common but unrelated to the outcome.Hypertension and diabetes mellitus were the most common comorbidities.Glucocorticoid treatment was associated with higher mortality(OR2=5.40,CI=2.72-10.7).Diarrhea was prevalent(18.8%),and GI symptoms did not affect the outcome.CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities.Age is the most important factor along with SOB in determining the mortality rate.Overall,elevated liver enzymes,ferritin,procalcitonin and C-reactive protein were associated with poor prognosis.GI symptoms did not affect the outcome.Glucocorticoids should be used judiciously,considering the poor outcomes associated with it.Attention should also be paid to monitor liver function during COVID-19,especially in AA and HSP patients with higher disease severity.

Prognostic value of left atrial size in hypertensive African Americans undergoing stress echocardiography

BACKGROUND Left atrial(LA)enlargement is a marker of increased risk in the general population undergoing stress echocardiography.African American(AA)patients with hypertension are known to have less atrial remodeling than whites with hypertension.The prognostic impact of LA enlargement in AA with hypertension undergoing stress echocardiography is uncertain.AIM To investigate the prognostic value of LA size in hypertensive AA patients undergoing stress echocardiography.METHODS This retrospective outcomes study enrolled 583 consecutive hypertensive AA patients who underwent stress echocardiography over a 2.5-year period.Clinical characteristics including cardiovascular risk factors,stress and echocardiographic data were collected from the electronic health record of a large community hospital.Treadmill exercise and Dobutamine protocols were conducted based on standard practices.Patients were followed for all-cause mortality.The optimal cutoff value of antero-posterior LA diameter for mortality was assessed by receiver operating characteristic analysis.Cox regression was used to determine variables associated with outcome.RESULTS The mean age was 57±12 years.LA dilatation was present in 9%(54)of patients(LA anteroposterior≥2.4 cm/m^(2)).There were 85 deaths(15%)during 4.5±1.7 years of follow-up.LA diameter indexed for body surface area had an area under the curve of 0.72±0.03(optimal cut-point of 2.05 cm/m^(2)).Variables independently associated with mortality included age[P=0.004,hazard ratio(HR)1.34(1.10-1.64)],tobacco use[P=0.001,HR 2.59(1.51-4.44)],left ventricular hypertrophy[P=0.001,HR 2.14(1.35-3.39)],Dobutamine stress[P=0.003,HR 2.12(1.29-3.47)],heart failure history[P=0.031,HR 1.76(1.05-2.94)],LA diameter≥2.05 cm/m^(2)[P=0.027,HR 1.73(1.06-2.82)],and an abnormal stress echocardiogram[P=0.033,HR 1.67(1.04-2.68)].LA diameter as a continuous variable was also independently associated with mortality but LA size≥2.40 cm/m^(2) was not.CONCLUSION LA enlargement is infrequent in hypertensive AA patients when traditional reference values are used.LA enlargement is independently associated with mortality when a lower than“normal”threshold(≥2.05 cm/m^(2))is used.

Poverty Status and Clustering of Cardiometabolic Risk Factors and Metabolic Syndrome among African Americans: Results from the National Health and Nutritional Examination Survey 2001-2006

Background: African Americans (AA) are disproportionally affected by cardiovascular disease as compared to other racial-ethnic groups. Exposure to adverse socioeconomic conditions may partially explain disparities in risk factors and prevalence and cardiovascular diseases for AA. We aim to study the impact of poverty status on metabolic syndrome (MetS) and its components among African Americans. Methods: We used data from the National Health and Nutritional Examination Survey (NHANES) cycles 2001-2006. We defined MetS using the Joint Scientific Definition as the presence of any 3/5 components: elevated blood pressure (BP), elevated triglycerides (TGL), lower high-density lipoprotein cholesterol (LDL), elevated fasting plasma glucose (FPG), and elevated waist circumference (WC). Poverty to income ratio (PIR) was categorized as below poverty (<1), above poverty (1 - 3) and high income (>3) groups. We used multivariable survey-weighted logistic regression models to study the impact of poverty status of prevalence of MetS and its components among AA men and women. Results: Overall, the average aggregate prevalence of MetS among AA sample was 22% in our study with prevalence being 25% for women and 18% among men (p < 0.001). In regression models, among women, living below poverty (PIR < 1) was associated with a higher prevalence/odds of having metabolic syndrome compared to those living in the high-income group (PIR > 3) (OR = 1.57, 95%CI = 1.00 - 2.46, p = 0.05) with no association observed among men (OR (PIR < 1 vs PIR >= 1) = 0.70, 95%CI = 0.43 - 1.19, p = 0.13). Further, similar associations were observed for individual components among women including: elevated waist circumference (OR = 2.04, 95%CI = 1.37, 3.01, p < 0.001), elevated triglycerides (OR = 1.85, 95%CI = 1.02 - 3.36, p = 0.04), reduced HDL (OR = 2.04, 95%CI = 1.15, 3.60, p = 0.02) and elevated blood pressure (OR = 2.16, 95%CI = 1.34 - 3.49, p = 0.002) as compared to women in high income group (PIR > 3). No association of poverty status with MetS and its components were observed among AA men. Clustering of factors identified key groups that define MetS among women included WC. Conclusion: African American women living below poverty have a higher likelihood of having MetS and 4 of 5 individual components. Clustering of these factors differ across men and women and should be further explored as tools for clinical management. Main Points: 1) Metabolic syndrome remains an important public health burden among African Americans and shows disparities by socioeconomic status;2) Women living below poverty were more likely to have MetS and associated components as compared to women living above poverty;3) Clustering of components gave us snapshot of factors that should be considered to develop gender specific targeted health interventions for MetS among African Americans.

Elderly African Americans Insights on the COVID-19 Pandemic: An Exploratory Study of Risk Perception and Personal, Social, and Cultural Factors

This exploratory study examined elderly African Americans attitudes on the COVID-19 pandemic by identifying their perceptions of risk based personal, social, and cultural factors. It seeks to understand their insights toward public health pandemic response initiatives and other efforts to mitigate COVID-19 outbreak response measures impacting elderly African Americans, including policies, interventions, and public information/communication. The effectiveness of pandemic response measures and community caregiving support for the elderly African Americans was examined as well. Respondents in this study were a convenient sample of 60 residents predominantly in a Midwestern metropolitan area. Respondents were eligible for study participation if 1) there were 60 years and over and, 2) African American or people of African descent. A mixed research method design comprising focus groups and online survey was used to collect the data for the study. The respondents characterized the impact of the coronavirus as a personal, family, and community loss (e.g., less socially engaged and burdensome). An overwhelming majority (98.3%) expressed no worries about getting health care if they or their family members needed it. A sizable number of respondents expressed the need for all to be tested to help prevent the spread of the virus.

Correlates and Covariates of Type 2 Diabetes in an African American Population in the Washington DC Area

In the United States, type 2 diabetes mellitus (T2DM) disproportionately affects the African American (AA) community, which has not been systematically included in molecular studies of underlying mechanisms. As part of a gene expression study, we recruited cases with T2DM and matched, unaffected controls at an urban hospital in Washington, DC, with a majority AA population. Here we describe the profile of socio-demographic, behavioral, and health-related associations of the study population. Self-reported data were collected from cases with T2DM (N = 77) and age- and gender-matched controls (N = 80), ages 45 - 65 years. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). As expected, obesity, hypertension, and cardiovascular disease were more prevalent in cases than in controls. Tobacco smoking and working alongside other tobacco smokers were also associated with T2DM. After adjusting for covariates, current tobacco smoking remained statistically associated with the disease (OR per half pack of cigarettes 1.43, 95% CI 1.04 - 1.95;p-value 0.027). HbA1c levels were elevated in T2DM cases who smoked more than a pack of cigarettes daily. These associations highlight the comorbid burdens of T2DM in an AA urban community setting and identify tobacco control as an unmet need for future prevention and control efforts.

Perceptions and Receipt of Cancer Screening among African Americans: A Community Networks Program Project

Objective: Minority groups constitute one of the nation’s highest cancer risk groups. Historically, these groups have not been adequately informed about cancer, its prevention and/or treatment. The purpose of this study was to examine participants’ receipt of cancer screening and to explore perceptions of barriers to and facilitators of cancer screening. Methods: A two-part study design consisting of a survey and focus group was conducted among African Americans residents of neighborhoods geographically defined as low-income areas of Chattanooga, Memphis, and Nashville in the state of Tennessee. The survey was administered to 1071 participants, and 12 focus groups were conducted with a total of 112 participants, with both sets of participants being residents of similarly defined underserved communities served by the community health centers. Results: Overall, 51% of surveyed respondents were females;the majority (75%) had a yearly income of less than $25,000;and 67% reported 12 years of education or less. Most surveyed respondents had a family history of cancer. More than 30% and 64% of male respondents over 50 years old did not receive prostate cancer and colorectal cancer screening, respectively;58% of women 50 years and older were not screened for colorectal cancer;28% of women over 40 years old did not receive breast cancer screening. Barriers to cancer screening included: lack of information about cancer screening and treatments, cost of cancer treatment and fear. The need for more information about cancer and cancer treatment, as well as the involvement of churches to increase cancer screening awareness was identified as facilitators. Conclusion: This study provides information into the structural and psychological barriers in cancer screening. It describes the self-reported prevalence/frequency of screening among men and women in our target population, and the associated facilitators to screening.

Comparison of reflux esophagitis and its complications between African Americans and non-Hispanic whites

AIM: To determine the effect of ethnicity on the severity of reflux esophagitis (RE) and its complications. METHODS: A retrospective search of the endoscopy database at the University of Florida Health Science Center/Jacksonville for all cases of reflux esophagitis and its complications from January 1 to March 31, 2001 was performed. Inclusion criteria were endoscopic evidence of esophagitis using the LA classif ication, reflux related complications and self-reported ethnicity. The data obtained included esophagitis grade, presence of a hiatal hernia, esophageal ulcer, stricture and Barrett's esophagus, and endoscopy indication. RESULTS: The search identified 259 patients with RE or its complications, of which 171 were non-Hispanic whites and 88 were African Americans. The mean ages and male/female ratios were similar in the two groups. RE grade, esophageal ulcer, stricture and hiatal hernia frequency were likewise similar in the groups. Barrett's esophagus was present more often in non-Hispanic whites than in African Americans (15.8% vs 4.5%; P < 0.01). Heartburn was a more frequent indication for endoscopy in non-Hispanic whites with erosive esophagitis than in African Americans (28.1% vs 7.9%; P < 0.001). CONCLUSION: Distribution of RE grade and frequency of reflux-related esophageal ulcer, stricture andhiatal hernia are similar in non-Hispanic whites and African Americans. Heartburn was more frequently and nausea/vomiting less frequently reported as the primary endoscopic indication in non-Hispanic whites compared with African Americans with erosive esophagitis or its complications. African Americans have a decreased prevalence of Barrett's esophagus compared with non-Hispanic whites.

Gut microbiome profiling and colorectal cancer in African Americans and Caucasian Americans

AIM To determine whether and to what extent the gut microbiome is involved in regulating racial disparity in colorectal cancer(CRC). METHODS All patients were recruited and experiments were performed in accordance with the relevant guidelines and regulations by the Institutional Review Boards (IRB), committees of the John D. Dingell VAMC and Wayne State University guidelines. African American (AA) and Caucasian American (CA) patients were scheduled for an outpatient screening for colonoscopy, and no active malignancy volunteer patients were doubly consented, initially by the gastroenterologist and later by the study coordinator, for participation in the study. The gut microbial communities in colonic effluents from AAs and CAs were examined using 16 sRNA profiling, and bacterial identifications were validated by performing SYBR-based Real Time PCR. For metagenomic analysis to characterize the microbial communities, multiple software/tools were used, including Metastats and R statistical software.RESULTS It is generally accepted that the incidence and mortality of CRC is higher in AAs than in CAs. However, the reason for this disparity is not well understood. We hypothesize that the gut microbiome plays a role in regulating this disparity. Indeed, we found significant differences in species richness and diversity between AAs and CAs. Bacteroidetes was more abundant in AAs than in CAs. In particular, the pro-inflammatory bacteria Fusobacterium nucleatum and Enterobacter species were significantly higher in AAs, whereas probiotic Akkermansia muciniphila and Bifidobacterium were higher in CAs. The polyphyletic Clostridia class showed a divergent pattern, with Clostridium XI elevated in AAs, and Clostridium IV, known for its beneficial function, higher in CAs. Lastly, the AA group had decreased microbial diversity overall in comparison to the CA group. In summary, there were significant differences in pro-inflammatory bacteria and microbial diversity between AA and CA, which may help explain the CRC disparity between groups.CONCLUSION Our current investigation, for the first time, demonstrates microbial dysbiosis between AAs and CAs, which could contribute to the racial disparity of CRC.

African Americans,hypertension and the renin angiotensin system

African Americans have exceptionally high rates of hypertension and hypertension related complications. It is commonly reported that the blood pressure lowering efficacy of renin angiotensin system(RAS) inhibitors is attenuated in African Americans due to a greater likelihood of having a low renin profile. Therefore these agents are often not recommended as initial therapy in African Americans with hypertension. However, the high prevalence of comorbid conditions, such as diabetes, cardiovascular and chronic kidney disease makes treatment with RAS inhibitors more compelling. Despite lower circulating renin levels and a less significant fall in blood pressure in response to RAS inhibitors in African Americans, numerous clinical trials support the efficacy of RAS inhibitors to improve clinical outcomes in this population, especially in those with hypertension and risk factors for cardiovascular and related diseases. Here, we discuss the rationale of RAS blockade as part of a comprehensive approach to attenuate the high rates of premature morbidity and mortality associated with hypertension among African Americans.

A comprehensive cardiovascular disease lifestyle treatment controlled trial among high-risk African Americans

Background: The purpose of this study was to assess the effects of a comprehensive lifestyle intervention on modifiable cardiovascular risk factors among high-risk African Americans. Methods: The study included a randomized treatment/controlled intervention trial among 136 African Americans residing in Atlanta, GA who were overweight and had elevated blood pressure. The treatment group was exposed to 3-months of a multi-component intervention and the control to an abbreviated 6-week intervention after the completion of the treatment group’s intervention. The main outcomes included mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean waist circumference, mean body mass index (BMI), mean number of times exercise per week, mean number of servings of fruits and vegetables per day, and mean level of daily stress. Data were collected at baseline and at 6-month follow-up. Separate linear regressions were used with an established significance level of P P P = 0.002). Conclusion: These results show that a comprehensive lifestyle intervention can improve cardiovascular risk factor profile among high risk African Americans. Caregivers should encourage patients to participate in such programs and public health policymakers should allocate resources to community based health oriented organizations to implement comprehensive lifestyle program.

Developmental assets and age of first sexual intercourse among adolescent African American males in Mobile, Alabama

Background and Aims: Younger age at first sexual intercourse is associated with a variety of adverse health outcomes. We aimed to gain a clearer understanding of a wide range of individual, family and social factors that may influence sexual behavior of children and adolescents. Specifically, we examined the relationships of developmental assets with age of first sexual intercourse among a large sample (n = 1061) of adolescent African American males living in low-income neighborhoods in Mobile, Alabama. Methods: Using the Developmental Asset Model as a theoretical guide, we selected variables from adolescent survey data and conducted logistic regression analysis to determine predictors of early age of first sexual intercourse. Results: Nearly one half (49%) of the male survey participants reported that they first had sexual intercourse at the age of 12 or younger. The total number of assets was the strongest predictor of later age (13 years old or later) of first sexual intercourse (OR 1.49, 95% CI = 1.09, 2.04), followed by decision-making skills (OR 1.40, 95% CI = 1.04, 1.86), and positive view of the future (OR 1.36, 95% CI = 1.02, 1.74). Conclusion: There are several developmental assets related to the age of first sexual intercourse. This study found support for the Developmental Asset Model as a framework for promoting sexual and overall adolescent health. Recommendations for asset-building among this population are discussed.

Stress intervention and disease in African American lupus patients: The balancing lupus experiences with stress strategies (BLESS) study

Very little is known about the impact of psychosocial stress on underlying biological mechanisms in African American lupus patients, although African American women display the highest rates of lupus. Due to the exposure of African Americans to a unique trajectory of stressors throughout the life course, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group. To begin to fill this research void, an evidence-based self-management program was piloted among a cohort of African American lupus patients participating in a SLE database project at the Medical University of South Carolina (MUSC). To assess disease activity, during each clinic visit, a history is obtained, and physical examination, phlebotomy, and urine collection are performed. SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) scores are assessed at each visit. Disease data corresponding with data collection timeframes for each participant were extracted from the MUSC SLE Database to assess the effectiveness of the program. Several differences were observed between the intervention and control groups on symptoms pertaining to lupus activity, and many of these differences had large effect sizes. Our findings can be rapidly translated into improved delivery of health care and targeted trials/interventions with relevance to health disparities, and if widely implemented, morbidities and mortality related to lupus could be drastically reduced in African-Americans.

Qualitative Study among African American Parents to Inform an Intervention to Promote Adoption of the Dietary Guidelines for Americans Food and Physical Activity Recommendations

This qualitative study was conducted to enable the research team to culturally tailor an intervention to increase adherence to Dietary Guidelines for Americans (DGA) in African American parents and their children living in Lower Mississippi Delta (LMD) communities. Focus group results guided the planning of an obesity prevention intervention utilizing the We Can! (Ways to Enhance Children’s Activity and Nutrition) obesity prevention program. Main outcome measure was perceptions of approaches to use in culturally tailoring a nutrition and physical activity intervention. Six focus group sessions were conducted with 86 African American adults to identify cultural concerns, intervention strategies in two Louisiana parishes in the LMD. Focus groups discussions were audio recorded, transcribed, and analyzed to identify recurring trends and patterns among focus groups. Major themes that emerged included cultural influences on food habits and physical activity, challenges of meeting the DGA and the CDC physical activity guidelines, facilitators and barriers to adhering to healthy food and physical activity guidelines and program development. Wider acceptance and use of the DGA recommendations are needed by LMD populations, leading to reduced prevalence of overweight and obesity and parallel reductions in the prevalence of chronic diseases. Interventions are needed that will enhance adherence to the DGA particularly for diverse subpopulations in the U.S. This study provides important insights for culturally tailoring an intervention to promote adoption of the DGA in two low-income African American Delta communities.

An intervention to reduce psychosocial and biological indicators of stress in African American lupus patients: The balancing lupus experiences with stress strategies study

Objective: Very little is known about the impact of psychosocial stress on African American lupus patients. Due to the exposure of African Americans to a unique trajectory of stressors throughout life, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group. Methods: The Balancing Lupus Experiences with Stress Strategies (BLESS) study piloted the validated “Better Choices, Better Health” Chronic Disease Self-Management Program (CDSMP) in 30 African-American lupus patients participating in the SLE Clinic Database Project at the Medical University of South Carolina (MUSC). Measures of psychosocial and biological indicators of stress were collected in all of the patients in each of the study conditions before and after intervention activities, as well as four months’ post-intervention, to assess the effectiveness of the program in reducing perceived and biological indicators of stress. Results: Participation in the workshops had large effects upon depression (d = 1.63 and d = 1.68), social/role activities limitations (d =1.15), health distress (d = 1.13 and d = 0.78), fatigue (d = 1.03), pain (d = 0.96), and lupus self-efficacy (d = 0.85). Neither the differences in cortisol or DHEA levels pre- and post-intervention were found to be significantly different between intervention participants and controls. Conclusion: The intervention workshops acted to reduce perceived stress and improve quality of life. Our findings imply that comparable, if not more significant gains in relevant health indicators are possible in African American patients when provided the opportunity to participate in CDSMP’s.

Effect of Medical Advice for Diet on Diabetes Self-Management and Glycemic Control for Haitian and African Americans with Type 2 Diabetes

Adequate care of type 2 diabetes is reflected by the individual’s adherence to dietary guidance;yet, few patients are engaged in diabetes self-care at the recommended level, regardless of race/ethnicity. Few studies on the effect of dietary medical advice on diabetes self-management (DSM) and glycemic control have been conducted on Haitian and African American adults with type 2 diabetes. These relationships were assessed in total of 254 Blacks with type 2 diabetes (Haitian Americans = 129;African Americans = 125) recruited from Miami-Dade and Broward Counties, Florida by community outreach methods. Although dietary advice received was not significantly different between the two Black ethnicities, given advice “to follow a diet” as a predictor of “using food groups” was significant for Haitian Americans, but not for African Americans. Haitian Americans who were advised to follow a diet were approximately 3 times more likely to sometimes or often use food groups (or exchange lists) in planning meals. Less than optimal glycemic control (A1C > 7.2) was inversely related to DSM for African Americans;but the relationship was not significant for Haitian Americans. A one unit increase in DSM score decreased the odds ratio point estimate of having less than optimal glycemic control (A1C > 7.2%) by a factor of 0.94 in African Americans. These results suggest that medical advice for diet plans may not be communicated effectively for DSM for some races/ethnicities. Research aimed at uncovering the enablers and barriers of diet management specific to Black ethnicities with type 2 diabetes is recommended.

The Unmet Needs of African American Women with Breast Cancer

Breast cancer is the most common cancer in women and treatment includes various combinations of surgery, chemotherapy, and/or hormone therapy. The multimodal treatment of breast cancer improves survival outcomes, but it also contributes to a prolonged period of medical intervention with associated physical and emotional consequences. However, we know less about the specific clinical experiences of African American (AA) women during treatment for breast cancer and in survivorship. The studies that have addressed the issue of breast cancer in AA women have focused primarily on early detection and epidemiological variables such a screening, mortality and staging at diagnosis. In our study, in-depth semi-structured phone interviews were conducted to explore the clinical experiences, concerns and needs of AA women who had survived breast cancer. The AA women reported that their physicians did not provide adequate disease and treatment information;did not discuss clinical trials with them;and did not offer access to support services.

Use of Multiple Intelligence Modalities to Convey Genetic and Genomic Concepts in African American College Biology Students

Correct conceptualizations of genetics and genomics are central to understand many aspects of the STEM disciplines as they provide the foundational building blocks for later work in the life sciences. Our study of 435 African American college students investigated the use of culturally- relevant memes transmitted using multiple intelligence (MI) modalities to convey core genetic and genomic information as an alternative to the traditional teaching approaches. We observed that this approach appears to optimize the transmission and retention of core genetics concepts, identify and correct misconceptions, and serve as a conduit to increased African American (AA) access to further studies in STEM disciplines. A review of the relevant literature and specific examples of our interventions and their MI links are provided.