School of Public Health
Permanent URI for this communityhttp://hdl.handle.net/1903/1633
The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
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Item Exploring the Politics and Radical Health Activism Strategies of Black-Led Grassroots Organizations in Washington, D.C.(2023) Fox, Imani; Simon-Rusinowitz, Lori; White, Kellee; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Black communities in Washington, DC have long experienced health inequities due to a history of inequitable social policies and inadequate access to health-related resources (Jackson, 2017). Critical, academic scholars and social justice activists implicate the political economy and racial oppression as a root cause of health inequities in the country. Black grassroots organizations demonstrate a history of political and social resistance to oppressive health and social systems, defending their right to health and autonomy, known as radical health activism (Nelson, 2011). Despite rich accounts of Black-led health interventions, their contributions to public health practice and frameworks have not been widely reviewed in public health discourse. Using informant interviews and descriptive study analysis, the health politics and subsequent health intervention strategies of Black grassroots organizations in Washington, D.C were examined. The 3 core themes that emerged from this study were health politics, radical health intervention strategies, and successes and challenges.Item “STARTED FROM THE BOTTOM, NOW WE’RE…WHERE?”” A QUALITATIVE ANALYSIS OF STRESS AND COPING AMONG HIGHLY EDUCATED BLACK WOMEN(2021) Ellick, Kecia Lurie; Lewin, Amy B; Roy, Kevin M; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Rationale: Black women suffer disproportionate rates of stress-related diseases including heart disease, diabetes, cancer, maternal mortality, and depression. Education is promoted as a protective factor against these outcomes. An increasing number of Black women are leveraging advanced degrees to secure leadership positions in education, law, science, and technology. Yet, highly educated, middle-class Black women experience the same deleterious health outcomes, at the same rates, as Black women living in poverty. This suggests that neither education nor its correlates protect Black women from harmful outcomes. It further suggests that, for Black women, the cost of social mobility afforded by advanced education may result in diminishing returns by reproducing and reinforcing social inequalities that inform and exacerbate negative experiences.Purpose: The purpose of this study was to explore the experiences of highly educated Black women during their prime work, partnering, and reproductive years. This study examined the strategies that highly educated Black women employed to cope with stressors perceived while navigating, negotiating, and performing multiple roles, social identities, and responsibilities in their personal and professional lives. Methods: Data was collected from a sample of Black, middle-class women living in Georgia, ages 28 - 49, with doctorate degrees (n = 24, Mage = 40.2) via in-person, semi-structured interviews. Following a constructivist grounded theory approach, a triadic scheme of open, axial, and selective coding will be performed to uncover emergent themes from women’s narratives. Findings: Evaluation of the data revealed three central themes that serve as the main findings of this study and answer the study questions about how highly educated Black women experience and cope with stress: 1) redefining of the strong Black woman, 2) prioritization of self-care practices and, 3) unapologetic authenticity. Discussion: This study explored the heterogeneity of Black women and contributes to the body literature focused on the interactive effects of race, gender, and class. It provides empirical data on the ways in which Black women experience, perceive, and respond to stress and highlights the ways in which Black women take proactive approaches to protect their health and well-being.Item EXAMINING RACISM AS A RISK FACTOR FOR UTERINE FIBROIDS AMONG AFRICAN AMERICAN WOMEN(2020) Porter, Shyneice; Mittal, Mona; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Uterine fibroids are a common gynecological condition among women. African American women, however, are particularly susceptible to developing fibroids; in fact, approximately 80-90% of African American women are diagnosed with the condition by age 50. Left untreated, these benign tumors can reduce fertility and increase the risk of pregnancy complications. Despite the high prevalence of uterine fibroids among African American women and the detrimental effects they may have on reproductive health, little is known about the risk factors associated with fibroid development among this demographic. To address this gap in the literature, the proposed study used data collected from 699 African American women in the southern region of the United States. This study was guided by an adapted racism and health framework as well as an expanded ABC-X model that includes elements of the mundane extreme environmental stress theory. Structural equation modeling was used to examine the relationship between perceived and internalized racism, the interaction between the two racism variables, and uterine fibroid diagnosis among African American women. The study also investigated depressive symptomology and body mass index as mediators of the proposed relationships. Results revealed a direct effect between perceived racism and the likelihood of a uterine fibroid diagnosis (β = .172, SE = .05, p < .001, OR = 1.19 [95% CI = 1.08, 1.31]). There was not a direct effect, however, between internalized racism and fibroid diagnosis, or the racism interaction variable and fibroid diagnosis. Perceived racism (β = .214, SE = .03, p < .001), internalized racism (β = .108, SE = .04, p < .01), and the racism interaction term (β = .067, SE = .03, p < .05) were positively and significantly associated with depressive symptomology. There was no evidence of full or partial mediation through the proposed mediators. The present study is among the first to examine two forms of racism as critical psychosocial risk factors for an adverse reproductive health outcome that differentially impacts African American women. The findings have important implications for clinical practice and policy that may aid in the effort to address racial disparities related to uterine fibroid development.Item IDENTIFYING BARRIERS AND FACILITATORS OF LEISURE TIME PHYSICAL ACTIVITY THROUGH THE EXPERIENCES OF 16-18 YEAR OLD AFRICAN AMERICAN/BLACK GIRLS: A GROUNDED THEORY STUDY(2020) Zeeger, Tracy; Gold, Robert S; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Among older adolescent African American/Black girls, obesity rates continue to rise between the ninth and 12th grades, whereas among white females, rates decline. Contributing to these high rates is the lack of leisure-time physical activity (LTPA) among youth. Nationwide, 95% of older adolescents (ages 16-18) are not meeting federal guidelines for physical activity. Older adolescent African American/Black girls are less likely to report LTPA when compared to their peers. Current approaches are not adequately addressing reduced LTPA among African American/Black older adolescent girls, requiring a return to the population affected to better understand this problem. To address this need, the current grounded theory dissertation study aimed to develop a grounded theory model of barriers and facilitators to LTPA among older adolescent African American/Black girls. Enrolled in the study were 16 African American/Black girls (N=16) aged 16-18 (M=16.7) years. Nine participants were classified as exercisers and seven as non-exercisers. All participants attended high school in Prince George’s County, Maryland. Each participant took part in an in-depth individual qualitative interview, conducted at a private, quiet location of their choice. Using constructivist grounded theory methods (CGT), analysis of the interview data occurred across four phases: open, focused, axial, and theoretical coding. CGT analysis resulted in a behavioral process theory explaining barriers and facilitators of LTPA among African American/Black older adolescent girls, grounded in youths’ own experiences. The theory, anchored by the core category of Choosing to Engage in LTPA, has five related categories: Being Autonomously Motivated, Perceiving Control Over Time, Knowing About Exercise, Experiencing the Influence of Others, and Receiving Messages About One’s Body. Each theoretical category includes multiple properties and dimensions, such as understanding the benefits of LTPA outside of weight loss, believing exercise is fun, and having confidence in the ability to exercise. Multiple influences across family, community, and societal systems shaped participants’ attitudes and beliefs. The results of this study contribute to a growing body of research on physical activity among older adolescents. These findings can inform the development and testing of feasibility in an afterschool LTPA intervention, as well as school physical education curriculum and policy.Item "Triggered": How the exposure to or experiences with Police are affecting Black Women's psychological functioning(2018) Madison, Jordan Ashley; Mittal, Mona; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Interactions between the Black community and the police have gained national attention recently. There is emerging literature on how being a victim and/or being exposed to these deaths and other incidents of police brutality is affecting the Black community. This study used qualitative interviews to explore the relationship between the exposure to and interactions with police and Black women’s psychological functioning and to further the understanding of coping strategies being used by Black women (n=5) to deal with this stressor. Results indicated that Black women feel fear, hyper-vigilance, and the randomness of negative interactions with the police. They reported using prayer, activism, and avoidance as ways to cope and discussed needing therapists to normalize therapy, as well as acknowledge and understand their experiences. Findings have the potential to address a significant gap in literature and can inform the development of trauma-informed programs for Black women.Item THE SYNDEMIC EFFECT OF PSYCHOSOCIAL AND STRUCTURAL FACTORS ON HIV TESTING AMONG BLACK MEN AND THE MODERATING EFFECT OF SEXUAL IDENTITY(2018) Turpin, Rodman Emory; Dyer, Typhanye; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Black populations experience the highest incidence and prevalence of HIV in the United States. It has been posited that numerous structural and psychosocial factors contribute to HIV disparities among Black populations, these factors can have an adverse effect on healthcare utilization, including HIV testing. Given the burden of HIV rates among Black men, especially Black gay and bisexual men, it is important to consider possible barriers to HIV testing in this population. Syndemic theory posits a mutually reinforcement of social and structural conditions that cumulatively affects disease outcomes. While syndemic theory has been applied to HIV acquisition, this framework has not been utilized for HIV testing. We tested for a syndemic of depression, poverty, and a lack of healthcare access impacting HIV testing and tested sexual identity as a moderator of healthcare access in a nationally representative sample of Black men. Participants with 2 or 3 syndemic factors were significantly more likely to have never been HIV tested compared to those with 0 or 1 (49.2% to 31.7%). Having 3 syndemic factors was associated with greater prevalence of never having been HIV tested (aPR=1.46, 95% CI 1.09, 1.95). Gay/bisexual identity moderated the association between health insurance and ever having been HIV tested in adjusted models (aPR=4.36; 95% CI 1.40, 13.62), with not having health insurance being associated with HIV testing among gay/bisexual participants only (aPR=4.84, 95% CI 1.19, 19.70). Using latent class analysis, four syndemic classes were identified as significant predictors of having never been HIV tested. In adjusted log-binomial models, compared to the class with the lowest proportion of syndemic factors, the highest prevalence of never having been HIV tested was among the class with the highest proportions of syndemic component factors (aPR=2.27, 95% CI 1.83, 2.82). Overall, there is evidence of a syndemic of depression, poverty, and a lack of healthcare access that negatively affects HIV testing among Black men, with a lack of healthcare access being a significantly greater barrier to HIV testing among gay/bisexual men compared to heterosexual men.Item African American Couples' Provider Role Attitudes as a Function of Income, Relative Income, Education, and Age(2018) Walton, Tariiq Omari; Epstein, Norman B.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigated characteristics that are associated with the provider role attitudes of African Americans being seen for couple therapy at a university-based family therapy clinic in a major metropolitan region, the Center for Healthy Families at the University of Maryland, College Park. It was predicted that income, relative income, education, age, and gender would be associated with the degree of traditional provider role attitudes of members of African American couples being treated at the CHF between 2000 and 2015. Contrary to the predictions, no relationship between education, age, and relative income and the provider role attitudes of the study’s participants was found. However, the results did show a significant relationship between gender and income and provider role attitudes. The implications for future research and clinical applications are discussed.Item BLACK, MALE, AND HIGH-ACHIEVING: AN EXAMINATION OF A RISK FACTOR AND CULTURAL RESOURCES FOR BLACK MALE ACADEMIC ACHIEVEMENT(2016) Davis, BreAnna; Smith Bynum, Mia; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Black boys are confronted with unique educational circumstances. They are often misdiagnosed and misplaced into special education programs (Bush-Daniels, 2008; Patton, 1998; Terman et al., 1996). Additionally, they are less likely to be enrolled in gifted and talented programs, even if their former achievements reflect their aptitude to succeed (Black Alliance for Educational Options, n.d.; Moore & Flowers, 2012). Given these statistics, a considerable emphasis has been placed on the causes and the consequences of low/under achievement for this population. As a result, the experiences of Black males who are achieving have been greatly neglected. Moreover, little is known about the factors that facilitate academic achievement among high-achieving Black boys. In an effort to bring the heterogenic nature of schooling experiences for Black boys to light, the present study examined the influence risk and protective factors had on the academic experiences of high-achieving Black boys. Grounded in the risk and resilience framework and the Integrative Model for the Study of Minority Youth Development, this study explored whether the high-achieving Black high school boys in this sample (n =88) reported experiencing discrimination (i.e. academic-based) and how this academic-based discrimination related to their 1) academic performance (i.e. GPA), 2) perceptions of math ability, and 3) race-based academic self-concept. In addition to exploring how academic-based discrimination was linked to academic achievement, this study examined how cultural resources such as racial socialization messages and racial identity related to academic achievement. Specifically, cultural socialization, preparation for bias, egalitarianism, private regard and public regard were evaluated alongside the three academic outcomes under study. Finally, the study explored whether aspects of racial socialization or racial identity buffered the effects of discrimination on any of the outcomes. Interestingly, the race/ethnicity of the student mattered for how students perceived their math ability. The risk factor academic-based discrimination was linked to academic performance. Cultural resources cultural socialization, preparation for bias, and private regard were linked to various academic outcomes of interest. There was only one significant moderating effect: a high private regard buffered the relationship between academic-based discrimination and race-based academic self-concept. Limitations and implications of this study are discussed.Item RACIAL SOCIALIZATION AS A PREDICTOR OF ADOLESCENT RACIAL IDENTITY: IS GENDER A MODERATOR?(2012) Davis, BreAnna; Smith Bynum, Mia; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The current study examined the role of gender in the relationship between racial socialization and racial identity among 133 African American adolescents (44% boys, 56% girls). Two dimensions of racial socialization, cultural socialization and preparation for coping with racial bias were evaluated alongside two dimensions of racial identity (centrality and private regard). Results revealed that messages focused on cultural pride and alertness to discrimination were both linked to private regard. Surprisingly, none of the messages predicted racial centrality. Against expectations, gender did not moderate relationships between racial socialization and racial identity. Considerations for the development and use of gendered racial socialization measures are provided.