Translating Hemoglobin A1c Scores across an Ethnically Diverse Population: Is the Language Consistent across All Races?

Hemoglobin A1c testing is an accepted measure of how well the blood glucose level has been controlled in the recent past (six to eight weeks) among individuals with diabetes. The purpose of this study was to evaluate the relationship between hemoglobin A1c (HbA1c) and blood glucose in an ethnically diverse population in a clinical setting. A cross-sectional research design was employed to explore associations between these two diabetes control measures in a sample of African American, White and Hispanic patients receiving diabetes treatment and follow-up in an outpatient clinic in Tallahassee, Florida. Data collection included a questionnaire, medical examinations, and lab results. Although we found a significant association between the glucose level and the HbA1c levels, the A1c value did not predict the mean glucose value as closely as previously found in less diverse groups. These findings suggest there is need for further study of these two variables among minority groups

Normalization of Stressors among African American College and Graduate Students: Looking through a Cultural Lens

Introduction: Obtaining higher education increases the amount of stressors physically, mentally, and emotionally. College is more than parties, pledging, and freedom from authoritative figures. For many young adults, it is the time to learn independence, responsibility, and roads to success. Today’s students are making life-altering decisions under the influences and pressures of society. Coping with stress is just one of the challenges students will endure while in college. Stressors are often considered normal, and students may not immediately recognize certain stressors as being problematic. They may also fail to identity and differentiate between eustress and distress. Purpose: This exploratory study defines the role of stress in coping mechanisms (healthy and unhealthy decision making) as it relates to African American college students’ success (ability to strive academically) at Historically Black College and University (HBCU) and Predominantly White Institutions (PWI). Methodology: A mixed method research design was applied to determine the effects of culture on stressors and coping mechanisms of African American college and graduate students at Florida Agricultural and Mechanical University (FAMU) and Florida State University (FSU). The Transactional Model of Stress and Coping framework was utilized to evaluate the processes of coping with stressful events. To ensure rigor and validity, the study was segmented into two phases, qualitative (Phase I) and quantitative (Phase II). Phase I consisted of the primary researcher transcribed 17 interviews. A second researcher reviewed and coded for themes. Phase II consisted of 300 student respondents to the College Student’s Stressful Event Checklist (CSSEC) and the Brief COPE (COPE) surveys. Descriptive statistical analyses were conducted for each variable using quantitative software, SPSS Statistics. A comprehensive analysis was conducted to identify new or merging themes bases on the research questions. Results: African American college and graduate students perceived both their susceptibility and severity to stress to result in negative outcomes (problems or health issues). The problems were categorized as maladaptive (overeating, smoking marijuana and drinking alcohol) and non-maladaptive (prayer, meditation, and exercising) behaviors. The health issues experienced, are listed as the following but not limited to: Unwanted pressure, feeling overwhelmed, tired, embarrassed, and symptoms of Irritable Bowel Syndrome (IBS). As an individuals’ perception of susceptibility and severity increased in regards to demographics so did their level of stress (CSSEC scoring). Although there was almost an even split about culture being an influence, it played a factor in normalizing stress. A positive relationship was discovered between a student’s academic matriculation (classification) and their amount of coping (COPE score). Discussion/Conclusion: The findings from phase I were consistent with Lazarus and Folkman’s Transactional Model of Stress and Coping and the importance of evaluating harm, threat, and challenges among African American college students. Students perceived both their susceptibility and severity as high due to the pressures of life and past experiences. Students perceived expressions to stress as maladaptive and non-maladaptive behaviors. Students also responded to adaptation with actual style of coping mechanisms. The findings from phase II shows a positive relationship between an individual’s classification and the amount of coping mechanisms developed. All four hypotheses were accepted. As students matriculate throughout school (classification) they will adopt coping mechanisms. Stressors may also become more common and easier to normalize; however, adaptation will allow for coping mechanisms to augment from other stressful events. Students utilized the revision of goals and spiritualty as a meaning-based coping mechanisms. The cultural lens influences the coping styles of students within their particular way of life, traditions, and beliefs. As a preventative measure, it is essential to seek counseling services that will assist in obtaining effective ways of coping and possibly healing past issues. Further, exploration of stigma and discrimination among those who self-identify as being a racial/ethnicity or gender/sexual identity minorities in both Historically Black College and Universities and Predominantly White Institutions