Isabel C. Scarinci

University of Alabama at Birmingham

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Mona N. Fouad

University of Alabama

Sejong Bae

University of Alabama at Birmingham

Isabel Palacio

Central University Hospital of Asturias

Edward E. Partridge

University of Alabama at Birmingham

Sylvia Peral

University of Alabama at Birmingham

Lorna Bittencourt

University of Minnesota

Claudia M. Hardy

Glan Clwyd Hospital

Sharina D. Person

University of Massachusetts Chan Medical School

Regina Celina Cruz

Pontifícia Universidade Católica do Paraná

Philip E. Castle

National Cancer Institute

Cooperative Institutions

University of Alabama at Birmingham

197

University of Alabama

National Institutes of Health

Universidade Estadual de Londrina

National Cancer Institute

Harvard University

University of North Carolina at Chapel Hill

University of Michigan–Ann Arbor

University of Kansas

The University of Texas MD Anderson Cancer Center

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Smoking Attitudes and Practices among Low-Income African-Americans: Qualitative Assessment of Contributing Factors

American Journal of Health Promotion (2003)

Bettina M. Beech Isabel C. Scarinci

Purpose. Studies have shown that African-American adolescents are less likely to smoke cigarettes than white youth. National data suggest that this pattern changes in late adolescence and early adulthood. Specifically, African-American adults have a relatively high smoking prevalence rate when compared with other racial/ethnic groups. The purpose of this study was to qualitatively examine the sociocultural factors associated with smoking attitudes and practices among low-income African-American young adults. Design. Cross-sectional qualitative study. Settings. High schools, 2-year colleges, housing developments, and trade schools in New Orleans, Louisiana, and Memphis, Tennessee. Subjects. One hundred eighteen low-income African Americans between 18 and 35 years of age (65 men and 53 women). Measure/Procedure. Fourteen focus groups were conducted with the target population. Nonmonetary incentives were provided for each participant in the 1-hour sessions. The majority of focus group moderators were African-American females trained in focus group moderation. Participants were recruited through flyers and project liaisons at each field location. Results. Themes elicited from the focus groups were classified according to the PEN-3 model, and they included: lighting cigarettes for parents as a first experience with cigarettes, perceived stress relief benefits of smoking, use of cigarettes to extend the sensation of marijuana, and protective factors against smoking such as respect for parental rules. Conclusion. The results indicate that there are specific contextual and familial factors that can contribute to smoking initiation, maintenance, and cessation among low-income African-American young adults. Limitations of this study include the exploratory nature of focus groups and the relatively small sample size. Further studies are necessary to quantitatively examine the role of these factors on smoking patterns in this population.

10.4278/0890-1171-17.4.240

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Mudança de comportamento e cessação de uso de tabaco em mulheres: uma experiência com treinamento de Agentes Comunitárias de Saúde

Interação em Psicologia (2019)

Nádia Kienen Lorna Bittencourt Thaís Distéfano Wiltenburg Marcelle Teixeira Bertini Aline Fernanda de Campos

O conhecimento sobre mudanca de comportamento constitui importante ferramenta para auxiliar profissionais de saude a otimizar a eficacia das intervencoes com pacientes. Apesar das evidencias sobre a efetividade das atuacoes em saude de Agentes Comunitarios de Saude (ACS), esses ainda nao estao diretamente envolvidos nos programas de cessacao de uso de tabaco. Os objetivos deste estudo foram desenvolver e avaliar uma capacitacao de ACS para servirem de apoio a mulheres no processo de cessacao. A capacitacao foi elaborada em colaboracao com ACS, pacientes e profissionais de saude e enfocou no controle do tabaco e habilidades de mudanca do comportamento. Foram aplicados pre e pos-teste para avaliar o conhecimento sobre tabaco e mudanca de comportamento e percepcao sobre habilidades e confianca para promover mudancas de comportamento, sendo os dados analisados por meio do teste T pareado. Os resultados indicaram aquisicao de conhecimento e melhora na percepcao de habilidades e confianca para auxiliar mulheres no processo de cessacao (N=80; p<0,05). Esses dados confirmam que treinamento com enfoque em mudanca de comportamento pode ser util para ampliar o envolvimento de ACS com intervencoes na cessacao e, dada a generalidade das habilidades propostas na capacitacao, essas podem ser uteis para outras intervencoes em saude.

10.5380/psi.v11i11.56430

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Increased disparities associated with black women and abnormal cervical cancer screening follow-up

Gynecologic Oncology Reports (2022)

Teresa Boitano Peter Ketch Julia G. Maier Christine T. O. Nguyen Warner K. Huh

To determine whether race and ethnicity impacts patient adherence to follow-up for colposcopy after abnormal cervical cancer screening.This retrospective chart review included women that were randomly selected from patients presenting to our colposcopy clinic from 1/2019 to 12/2019. Inclusion criteria were females age ≥21 years-old and appropriate referral for colposcopy. Patients were grouped into three categories: (1) ADHERENT to follow-up if they came to their first scheduled appointment; (2) DELAYED if they presented more than three months from their original referral (usually missing 1-3 appointments); and (3) NOT ADHERENT if they did not show for their appointment after referral. Analysis was performed using SPSS v.26.284 women met inclusion criteria for the study. The majority of women were Black (65.2 %) followed by non-Hispanic Whites (20.0 %) and Latinx (14.8 %). Overall, 39.1 % were ADHERENT, 18.6 % were DELAYED, and 42.3 % were NOT ADHERENT. When compared with non-Hispanic White women, there was a significant difference between race/ethnicity and timing of follow-up (p = 0.03). Blacks were more likely to be NOT ADHERENT (45.9 %; p = 0.03), and Latinx and Blacks were the most likely to be DELAYED (35.7 % and 21.1 %; p = 0.03). Private insurance patients were more likely to be ADHERENT for care compared with un-/underinsured patients (78.9 vs 27.8 %, p = 0.0001).There is inadequate follow-up after abnormal cervical cancer screening across all races/ethnicities; however, lack of adherence is higher in Black patients. Moreover, 25% of Hispanic and Black women present in a delayed fashion. Culturally relevant assessments and interventions are needed to understand and address these gaps.

Underinsured

Medical record

10.1016/j.gore.2022.101041

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Prevalence of high-risk behaviors and obesity among low-income patients attending primary care clinics in Louisiana.

PubMed (1999)

Phillip J. Brantley Isabel C. Scarinci Cindy L. Carmack Edwin D. Boudreaux Richard H. Streiffer

This study examined the prevalence of the most prominent high-risk behaviors that contribute to mortality in the United States (i.e., sedentary lifestyle, cigarette smoking, and high dietary fat intake) and obesity among low-income patients attending primary care clinics in Louisiana. The sample consisted of 1,132 patients attending primary care clinics that were randomly selected and administered a demographic questionnaire, the 1994 Behavioral Risk Factor Surveillance System, and the Eating Patterns Questionnaire. Participants consisted predominantly of African-American (67.7%), uninsured (73.3%), low-income, middle-aged females. Prevalence of high-risk behaviors included sedentary lifestyle (47.1%), cigarette smoking (26.2%), and high dietary fat intake (61.3%). Prevalence of obesity was 63.5%. In conclusion, low-income patients attending primary care clinics in Louisiana display a high frequency of important high-risk behaviors that contribute to mortality in this country. Obesity is also extremely prevalent in this population. Clinical implications and directions for future studies are discussed.

High income countries

Sedentary lifestyle

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Pictorial health warnings on cigarette packs and the impact on women

Revista de Saúde Pública (2013)

Lorna Bittencourt Sharina D. Person Regina Celina Cruz Isabel C. Scarinci

OBJECTIVE : To analyze the association between the pictorial graphic health warnings on cigarette packs and their impact on intention to quit smoking among women. METHODS : Population-based cross-sectional study among 265 women daily smokers in the State of Paraná in 2010. The sample size was calculated using cluster sampling. Participants were asked whether they had seen any pictorial graphic health warnings in the past 30 days, whether these warnings made them think about quitting, and intensity of these thoughts. The data was analyzed using logistic regression and the independent variables included age, educational attainment, whether they had children, whether they had attempted to quit smoking in the past 12 months, age of smoking initiation, number of cigarettes smoked per day, their town of residence, and how soon after waking do they smoke their first cigarette. RESULTS : Participants (91.7%) reported seeing the pictorial graphic health warnings in the past 30 days. Women with elementary education or below and women with some/complete high school education were more likely to think about quitting smoking after seeing the pictorial graphic health warningsthan women with higher education (OR = 4.85; p = 0.0028 and OR = 2.91; p = 0.05), respectively). Women who attempted to quit smoking in the past 12 months were more likely to think about quitting than women who had not (OR = 2.49; p = 0.001). Quit attempts within the last 12 months were associated with intensity of these thoughts (OR = 2.2; p = 0.03). CONCLUSIONS : Results show an association between pictorial graphic health warnings and intent to quit smoking among women with warnings having a greater impact among women with less education and who had attempted to quit smoking within the past year. Tobacco control strategies should be implemented across all groups of women regardless of their educational attainment.

Educational Attainment

Cross-sectional study

Quit smoking

10.1590/s0034-89102013000901123

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Citations (12)

Weight Status and High Blood Pressure Among Low-Income African American Men

Carolina Digital Repository (University of North Carolina at Chapel Hill) (2011)

Marino A. Bruce Bettina M. Beech Christopher L. Edwards Mario Sims Isabel C. Scarinci

10.17615/8qmk-2a34

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Child Health Needs of Rural Alabama Latino Families

Journal of Community Health Nursing (2007)

Lynda Law Harrison Isabel C. Scarinci

Abstract Abstract This article presents findings from a study 1 This study was funded by pilot study Grant U50OH07551–05 from the National Institute of Occupational Safety and Health through the Southern Agromedicine Institute at East Carolina University. that used focus group methodology to identify perceptions of Latino parents living in rural Alabama related to their children's health needs. Sixteen focus groups were held with a total of 89 parents (54 mothers and 35 fathers). The groups were led by native Spanish speakers, and group meetings were tape recorded. The main themes that emerged related to (a) what children need to be healthy, (b) common children's health problems, (c) what we do when children are ill, (d) barriers to receiving health care, (e) parenting issues and concerns, (f) experiences with children's schools, and (g) services needed. The findings can be used to guide the development of culturally appropriate, community-based programs to address the priority health needs of the growing Latino community in rural areas of the United States.

Needs assessment

Special Needs

10.1207/s15327655jchn2401_3

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Pain Threshold Levels and Coping Strategies Among Patients Who Have Chest Pain and Normal Coronary Arteries

Medical Clinics of North America (1991)

Laurence A. Bradley Isabel C. Scarinci Joel E. Richter

Heartburn

Esophagitis

Esophageal Disorder

10.1016/s0025-7125(16)30407-2

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Citations (35)

The National Cancer Institute’s Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned

Carolina Digital Repository (University of North Carolina at Chapel Hill) (2015)

Kathryn L. Braun Susan Stewart Claudia R. Baquet Lisa Berry‐Bobovski Daniel J. Blumenthal

10.17615/2ptr-wj17

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Congruence of Readiness to Change, Self-Efficacy, and Decisional Balance for Physical Activity and Dietary Fat Reduction

American Journal of Health Promotion (2003)

Edwin D. Boudreaux Karen B. Wood Dan Mehan Isabel C. Scarinci Cindy L. Carmack Taylor

Purpose. The current study examines the relations between decisional balance and self-efficacy variables on stage of change between the behaviors of avoiding dietary fat and increasing exercise. Design. A cross-sectional design was used. Setting. The current study took place in public primary care clinics from four sites across Louisiana. Clinics were associated with teaching hospitals and located in urban and rural areas. Subjects. Subjects included 515 adult outpatients, 60% African-American, 81% women, and 43% married. The age ranged from 18 to 87 years old, and the mean age was 45 (SD = 14). Patients were predominantly low-income (mean household income of $490 per month) and uninsured (71%). Measures. Standard questionnaires were given to assess stage of change, decisional balance, and self-efficacy for exercise and dietary fat reduction. Results. Although the χ 2 analysis revealed that dietary fat and exercise stage of change were significantly related, Pearson χ 2 (df = 16) = 74.30, p < .001, 35% of the sample was stage incongruent between behaviors (e.g., a significant percentage of exercise maintainers were precon-templators for reducing dietary fat). Only 27% of the sample was in the same stage for both behaviors. Correlations and multivariate analyses of variance (MANOVAs) indicated that relationships between behaviors were similar to those found previously within behaviors; however, the effect sizes were markedly attenuated. Conclusions. These results have implications for healthcare providers working with weight management. Accurate assessment of readiness for change for both exercise and dietary fat consumption is critical. For many patients, readiness for change differs dramatically between the two behaviors, and interventions may need to be tailored more precisely. Providers may need to use more active, behaviorally focused interventions for the more advanced behavior while simultaneously implementing more cognitively focused interventions for the less advanced one.

Self-Efficacy

10.4278/0890-1171-17.5.329

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Citations (48)