Validation of the detroit area study discrimination scale in a community sample of older African American adults: The Pittsburgh healthy heart project

This study examined the construct validity of the Detroit Area Study Discrimination Questionnaire (DAS-DQ) in 49 healthy African American adults, with respect to its association with global measures and daily experiences of psychological demand. Daily experiences of psychological demand were obtained using ecological momentary assessment (EMA) methods. Everyday Mistreatment, as measured by the DAS-DQ, was significantly related to global reports of perceived stress and depression but was unrelated to measures of hostility and social desirability. Everyday Mistreatment was significantly related to average EMA score measures of Negative Affect and Social Conflict but was unrelated to daily experiences of Task Demand or Decisional Control. Negative Affect mediated the relation between Everyday Mistreatment and global reports of perceived stress. In contrast, Lifetime History of Discrimination, as measured by the DAS-DQ, was unrelated to global measures or daily experiences of stress. Thus, this study lends support to the construct validity of the DAS-DQ

Cardiovascular Reactivity and Left Ventricular Mass: An Integrative Review

Left ventricular hypertrophy has been shown to be an independent predictor of risk for cardiovascular morbidity and mortality. Behavioral scientists have focused on how hemodynamic factors influenced by psychosocial stress may be associated with left ventricular mass (LVM). We reviewed existing studies examining stress-related cardiovascular reactivity (CVR) and LVM, with a goal of examining the moderating role of population (age and hypertensive status) and methodological factors (task type, sample size, and study design) explaining the observed results. Twenty-one studies met the criteria for this review. Results showed only a modestly consistent relationship between CVR and LVM. Forty-three percent of the studies reported 1 or more significant results linking systolic blood pressure reactivity with LVM, and 14% of the studies showed that diastolic blood pressure reactivity was significantly related to LVM. Hypertensive status, task type, and sample size did not play a major role in moderating the relationship between LVM and CVR. A somewhat larger percentage of positive results was shown in prospective and adult studies. The association between CVR and LVM may be real, although the effect size is modest, and we discuss methodological strategies for enhancing statistical power in future investigations. Additional sampling factors (e.g., race, gender) may also impact this relationship. Finally, greater attention is warranted to the role of the psychosocial environment, as this may interact with reactivity to influence LVM

The effect of a supervised exercise trial on exercise adherence among African American men: A pilot study

Objective: The objective of this pilot study was to determine the effect of a supervised short-term exercise trial on exercise adherence in a sample of African American males. Methods: We observed exercise adherence rates among a group of African American men in response to an exercise intervention. Exercise adherence was determined by dividing the total number of actual sessions attended by the total number of possible sessions (12 sessions). A participant was classified as an adherer if they completed 9 out of 12 exercise sessions (75%). Results: Seventy-one percent of the study participants (12/17) completed at least 75% of the study sessions and therefore adhered to the study protocol. Among the adherers, 7 out of 12 (58%) had adherence rates of 100%. Five participants withdrew from the exercise group due to lack of time and lack of interest. Conclusion: Exercise adherence rates among African-American men in this study were favorable during this supervised exercise intervention and were comparable to adherence rates observed in other supervised exercise interventions. Recommendations based on this pilot study are provided to reduce participant withdrawal and to inform future large-scale studies

The effect of a randomized controlled physical activity trial on health related quality of life in metabolically unhealthy African-American women: FIERCE STUDY

Purpose: African-American women (AAW) are more likely to be metabolically unhealthy than White women (WW). Metabolic syndrome (MetS) is associated with increased breast cancer risk and mortality from breast cancer is greater in AAW compared to WW. Data show MetS affects health-related quality of life (HRQoL). Exercise studies report improvements in MetS, however, no study to date has examined HRQoL in metabolically unhealthy AAW enrolled in an exercise trial. Methods: This report examined the effect of a 6-month, 3-arm (supervised exercise, home-based exercise, control) randomized exercise controlled trial on HRQoL among 213 obese, metabolically unhealthy, postmenopausal AAW at high risk for breast cancer. Results: Certain baseline participant characteristics were related to baseline HRQoL dimensions. The “exercise group” (supervised group combined with the home-based group) showed significantly greater improvement in health change scores (M = 13.6, SD = 3.1) compared to the control group (M = 0.7, SD = 4.4) (p = 0.02) over the 6-month study period. There were no significant differences in HRQoL change scores between the 3 study groups, however, although non-significant, data indicated most HRQoL change scores were more favorable in the supervised group. Conclusion: While significant improvement occurred in health change scores in the combined supervised and home-based group compared to the control group, we did not observe any significant differences on HRQoL change scores between all three study groups. However, while non-significant, there was a trend for more favorable HRQoL change scores in the supervised group versus the home-based and control groups. Additional research is needed to further explore this topic

Cardiovascular reactivity in Zimbabwe

Objective. In this study, we examined the effects of residency and gender on cardiovascular reactivity to a speech stressor in 50 rural Zimbabweans (24 males, 26 females) and 47 urban Zimbabweans (25 males and 22 females). Methods. Participants were engaged in 4 periods: pre-task rest period, speech preparatory period, speaking task period, and the final recovery period. During each period, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed. Results. There was a significant interaction between area of residence and period for SBP and HR. Urban residents exhibited greater SBP and HR during the speaking phase of the speech task than did rural residents. However, rural residents displayed more exaggerated HR reactivity during the speech preparatory phase as compared to the urban residents. No gender differences were observed on blood pressure or heart rate reactivity. Conclusion. In conclusion, the more exaggerated SBP and HR reactivity to the speaking phase among urban residents as compared to rural residents may be influenced by factors associated with urbanization

An assessment of the CES-D scale factor structure in black women: The Black Women\u27s Health Study

This study investigates the dimensional structure of the Center for Epidemiologic Studies Depression (CES-D) scale in US Black women with and without history of cancer via single-group and multi-group analyses. The CES-D questionnaire was administered in 1999 to 50,774 black women who are participants in the Black Women\u27s Health Study (BWHS). For our analysis, we utilized a group of 690 women with a history of at least one of the three types of cancer (breast cancer, colon cancer or lung cancer) and an age-matched group of 1,380 healthy women with no history of any cancer or other chronic conditions including myocardial infarctions, stroke, angina, diabetes, lupus, and sarcoidosis. Three a priori hypothesized models were tested via confirmatory factor analysis: single-, three- and four-factor structures. The four-factor model provided the best fit and remained largely invariant across the groups when tested via multi-group comparisons. Two internal consistency measures of the scale (Cronbach\u27s α coefficient and split-half coefficient) were also shown to be satisfactory. We concluded that the CES-D scale is appropriate for use in black women regardless of their cancer status. © 2008 Elsevier Ltd. All rights reserved

CES-D four-factor structure is confirmed, but not invariant, in a large cohort of African American women

This study examined the factor structure of the Centers for Epidemiologic Studies Depression Scale (CES-D) in a sample of 40,403 African American women participating in the Black Women\u27s Health Study (BWHS). To examine within group differences in the structural characteristics of the CES-D, women were stratified by age (\u3c 60 vs. ≥ 60 years). Confirmatory factor analysis indicated that a four-factor solution was a good fit for the data in both groups. The four factors extracted (depressed, somatic, positive, and interpersonal) matched findings from previous studies in other populations. Although item loadings were identical for 19 of 20 items, when equality restrictions were placed on factor loadings, the factors were not shown to be equivalent across groups. The only observed difference in item loadings was that the item people disliked me loaded higher on the interpersonal factor for younger women than older women. The variance/covariance matrix differed between groups. The correlations between the depressed and somatic factors were identical for the two age groups. However, correlations among the other factors were weaker among older women. We conclude that four-factor structure of the CES-D is supported for African American women, but the relationships among the factors vary with age. © 2006 Elsevier Ireland Ltd. All rights reserved

Effect of exercise on metabolic syndrome in black women by family history and predicted risk of breast cancer: The FIERCE Study

Background: This study examined the effects of supervised and home-based exercise interventions on changes in metabolic syndrome (MetS) according to breast cancer risk (high vs low) in black women enrolled in the Focused Intervention on Exercise to Reduce Cancer (FIERCE) trial. Methods: Postmenopausal, obese, metabolically unhealthy black women, 45 to 65 years old, were randomized to supervised aerobic exercise (73 women), home-based walking-based exercise (69 women), or a control arm (71 women). Participants in the exercise arms underwent a 6-month intervention with study assessments conducted at the baseline and 6 months. The primary outcome measure was MetS (fasting glucose, waist circumference, blood pressure, serum triglycerides, and high-density lipoprotein [HDL]). The intervention effects on MetS, stratified by breast cancer risk as measured by the family history of breast cancer and model-based projected breast cancer risk, were examined with intent-to-treat analyses using generalized estimating equation models. Results: Among women with a family history of breast cancer, the exercise arms had lower mean MetS z scores, which suggested an improvement in the metabolic profile, than controls at 6 months (controls, + 0.55; home-based arm, –0.97, P \u3c.01; supervised arm, –0.89, P \u3c.01). Stratified analyses by projected breast cancer risk suggested similar but statistically nonsignificant findings, with those at high risk having more favorable changes in the MetS z score in the exercise arms versus the control arm. These changes were primarily attributable to changes in blood pressure, triglycerides, and HDL. Conclusions: Short-term aerobic activity regimens may improve the metabolic profile and thereby reduce breast cancer risk in obese, metabolically unhealthy black women at high risk for cancer. © 2018 American Cancer Society