The Impact of Psychosocial, Clinical, and Neighborhood Factors on Inflammatory Outcomes Among African American Women

Inflammatory-related chronic diseases are disparagingly prevalent among African Americans in the United States, particularly in the Southeastern region. Access to community gardens shows promise in mitigating chronic disease outcomes, despite multiple barriers to physical activity and diet among underserved populations. We seek to determine if psychosocial or clinical factors mediate the association between the treatment effect of a healthy lifestyle intervention and inflammatory biomarker levels among African American women, respectively. We also seek to analyze the relationship between residing in a food desert/swamp and inflammatory biomarker levels, while gaining a qualitative perspective about community garden access among African American women. Quantitative data was obtained from the Sistas Inspiring Sistas Through Activity and Support (SISTAS) trial (N = 337), where we received biological, anthropometric, and demographic measures. Qualitative information came from key informative interviews (n = 15) to gain insight on the views of healthy food access among residents in county level-designated food deserts or swamps. We computed descriptive statistics using frequencies or means and standard deviations (STD) and conducted mediation analyses to evaluate if depression, percent body fat, or diastolic blood pressure mediates the effect of the association between participation in the SISTAS intervention and c-reactive protein (CRP) and interleukin-6 (IL6) levels. We also performed a mixed methods analysis to observe the impact of residing in a food desert or food swamp on CRP and IL6 levels, and then receive common themes on community garden access among SISTAS participants. We found that depression, percent body fat, nor diastolic blood pressure mediated the effect of the treatment assignment of the SISTAS trial on CRP or IL-6, respectively. We also did not find a significantly increased risk of high CRP or IL-6 levels among women residing in food deserts or food swamps. Common themes from the key informative interviews included self-efficacy for the utilization of personal or community gardening. Other psychosocial and clinical factors should be analyzed for future mediation analyses, and unique resources such as community gardens also need to be considered for use in healthy lifestyle interventions to combat inflammatory-related health disparities among underserved populations

Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD): Methodology for a Population-Based Study of Black, Hispanic and White Patients with Ovarian Cancer

INTRODUCTION: Less than 40% of patients with ovarian cancer (OC) in the USA receive stage-appropriate guideline-adherent surgery and chemotherapy. Black patients with cancer report greater depression, pain and fatigue than white patients. Lack of access to healthcare likely contributes to low treatment rates and racial differences in outcomes. The Ovarian Cancer Epidemiology, Healthcare Access and Disparities study aims to characterise healthcare access (HCA) across five specific dimensions-Availability, Affordability, Accessibility, Accommodation and Acceptability-among black, Hispanic and white patients with OC, evaluate the impact of HCA on quality of treatment, supportive care and survival, and explore biological mechanisms that may contribute to OC disparities. METHODS AND ANALYSIS: We will use the Surveillance Epidemiology and Ends Results dataset linked with Medicare claims data from 9744 patients with OC ages 65 years and older. We will recruit 1641 patients with OC (413 black, 299 Hispanic and 929 white) from cancer registries in nine US states. We will examine HCA dimensions in relation to three main outcomes: (1) receipt of quality, guideline adherent initial treatment and supportive care, (2) quality of life based on patient-reported outcomes and (3) survival. We will obtain saliva and vaginal microbiome samples to examine prognostic biomarkers. We will use hierarchical regression models to estimate the impact of HCA dimensions across patient, neighbourhood, provider and hospital levels, with random effects to account for clustering. Multilevel structural equation models will estimate the total, direct and indirect effects of race on treatment mediated through HCA dimensions. ETHICS AND DISSEMINATION: Result dissemination will occur through presentations at national meetings and in collaboration with collaborators, community partners and colleagues across othercancer centres. We will disclose findings to key stakeholders, including scientists, providers and community members. This study has been approved by the Duke Institutional Review Board (Pro00101872). Safety considerations include protection of patient privacy. All disseminated data will be deidentified and summarised

2016 AAPP Monograph Series: African American Professors Program

The African American Professors Program (AAPP) at the University of South Carolina is honored to publish this fifteenth edition of its annual monograph series. AAPP recognizes the significance of offering scholars a venue through which to engage actively in research and to publish their refereed papers. Parallel with the publication of their manuscripts is the opportunity to gain visibility among colleagues throughout postsecondary institutions at national and international levels. Scholars who have contributed papers for this monograph are acknowledged for embracing the value of including this responsibility within their academic milieu. Writing across disciplines adds to the intellectual diversity of these manuscripts. From neophytes to quite experienced individuals, the chapters have been researched and written in depth. Founded in 1997 through the Department of Educational Leadership and Policies in the College of Education, AAPP was designed originally to address the under-representation of African American professors on college and university campuses. Its mission is to expand the pool of these professors in critical academic and research areas. Sponsored historically by the University of South Carolina, the W.K. Kellogg Foundation, and the South Carolina General Assembly, the program recruits doctoral students for disciplines in which African Americans currently are underrepresented among faculty in higher education. The continuation of this monograph series is seen as responding to a window of opportunity to be sensitive to academic expectation of graduates as they pursue career placement and, at the same time, to allow for the dissemination of products of scholarship to a broader community. The importance of this series has been voiced by one of our 2002 AAPP graduates, Dr. Shundelle LaTjuan Dogan, formerly an Administrative Fellow at Harvard University, a Program Officer for the Southern Education Foundation, and a Program Officer for the Arthur M. Blank Foundation in Atlanta, Georgia. She is currently a Corporate Citizenship and Corporate Affairs Manager for IBM-International Business Machines in Atlanta, Georgia and has written the Foreword for the 2014 monograph. Dr. Dogan wrote: One thing in particular that I want to thank you for is having the African American Professors Program scholars publish articles for the monograph. I have to admit that writing the articles seemed like extra work at the time. However, in my recent interview process, organizations have asked me for samples of my writing. Including an article from a published monograph helped to make my portfolio much more impressive. You were \u27right on target\u27 in having us do the monograph series. (AAPP 2003 Monograph, p. xi) The African American Professors Program continues the tradition as a promoter of international scholarship in higher education evidenced through the inspiration from this group of interdisciplinary manuscripts. I hope that you will envision these published papers to serve as an invaluable contribution to your own professional development and career enhancement. John McFadden, PhD The Benjamin Elijah Mays Distinguished Professor Emeritus Director, African American Professors Program University of South Carolinahttps://scholarcommons.sc.edu/mcfadden_monographs/1003/thumbnail.jp

Development and Psychometric Evaluation of Healthcare Access Measures among Women with Ovarian Cancer

Several proposed theoretical frameworks have defined the complex nature of healthcare access (HCA) [...