Results are presented of enrolling HIV+ active-injection drug users (IDUs) into a peer-driven intervention (PDI) to improve their adherence to medical care. Using respondent-driven sampling (RDS), which evolved out of the PDI model, the... more
Results are presented of enrolling HIV+ active-injection drug users (IDUs) into a peer-driven intervention (PDI) to improve their adherence to medical care. Using respondent-driven sampling (RDS), which evolved out of the PDI model, the authors recruited and tested 1,097 IDUs, of whom 145 were confirmed to be HIV+. Despite promises of confidentiality, increased social supports, and direct cash rewards for participating, only 78 (54%) of the HIV+ IDUs enrolled in the subsequent adherence study. Correlates of participation as well as interviews with respondents who declined participating are presented. The seemingly negative findings have important implications for future adherence studies. RDS provided a powerful mechanism for recruiting HIV+ IDUs. But selection biases were revealed to favor sicker yet more socially connected respondents, which resulted in more conservative outcomes with regard to social supports and positive health-seeking behaviors. The analysis may help streamline future efforts using the PDI, which harnesses IDUs' abilities to help one another, by underscoring some of the mechanism's limitations.
The dopaminergic system is implicated in depressive disorders and research has also shown that dopamine constricts lexical/semantic networks by reducing spreading activation. Hence, depression, which is linked to reductions of dopamine,... more
The dopaminergic system is implicated in depressive disorders and research has also shown that dopamine constricts lexical/semantic networks by reducing spreading activation. Hence, depression, which is linked to reductions of dopamine, may be associated with increased spreading activation. However, research has generally found no effects of depression on spreading activation, using semantic priming paradigms. We used a different paradigm to investigate the relationship between depression and spreading activation, one based on word frequencies. Our sample included 97 undergraduates who completed the BDI-II and the Controlled Oral Word Association test as well as the Animal Naming test. The results indicated that the group scoring within the depressed ranged evidenced greater spreading activation as compared to those who scored within the normal range on the BDI-II. The implications of these results as they relate to creativity in depression is discussed.► Depressed participants average COWAT word frequency was (M = 126.68, SD = 81.70). ► Nondepressed participants average COWAT word frequency was (M = 170.91, SD = 92.45). ► Hence, depression associated with greater spreading activation. ► Results may help to explain increased creativity in depressed individuals.
Alzheimer's disease (AD) is known to be associated with disruption in semantic networks. Previous studies examining changes in spreading activation in AD have used a lexical decision task paradigm. We have used a paradigm based on average... more
Alzheimer's disease (AD) is known to be associated with disruption in semantic networks. Previous studies examining changes in spreading activation in AD have used a lexical decision task paradigm. We have used a paradigm based on average word frequencies obtained from the words generated on the Controlled Oral Word Association Test (COWAT) and the Animal Naming (AN) test. The COWAT and AN tests were administered to a group of 25 patients with AD and 20 control participants. We predicted that the patients with AD would have higher average word frequencies on the COWAT and AN tests than the control participants. The results indicated that the AD group generated words with a higher average word frequency on the AN test but a lower average word frequency on the COWAT. The reasons for the discrepancy in average word frequencies on the AN test and COWAT are discussed.
BackgroundWhile studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and... more
BackgroundWhile studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effects of antiretroviral therapy. We examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women.MethodsIn this prospective observational study, data were obtained from 135 HIV-positive women from eight antenatal clinics in the rural Nyanza Province of Kenya at their first antenatal visit (prior to testing HIV-positive for the first time) and subsequently at 6 weeks after g...
The Southeastern U.S. Collaborative Center of Excellence in the Elimination of Disparities Legacy Grant Program provides funding to increase community-based organizations' capacity to implement evidence-based breast and cervical cancer... more
The Southeastern U.S. Collaborative Center of Excellence in the Elimination of Disparities Legacy Grant Program provides funding to increase community-based organizations' capacity to implement evidence-based breast and cervical cancer interventions for African American women. This article describes the development of the grant process, summarizes Legacy grantee outcomes, and discusses lessons learned.
Risky sexual behavior among African-American youth increases risks for sexually transmitted diseases and unintended pregnancy. This article describes a community-academic partnership to assess The 2 HYPE Abstinence Club, a program... more
Risky sexual behavior among African-American youth increases risks for sexually transmitted diseases and unintended pregnancy. This article describes a community-academic partnership to assess The 2 HYPE Abstinence Club, a program combining abstinence education with stress management and creative arts promotion for African-American youth ages 12–18. Bi-directional learning and communication systems were established to facilitate culturally relevant evaluation approaches, quality assurance in data collection, and action-based protocols for on-going improvement. Assessment tools included self-administered surveys and focus groups to gauge intervention effectiveness and perceptions regarding abstinence, sexual peer norms and intervention characteristics. Statistically significant increases in the understanding of abstinence benefits and sexual activity risks were observed and youth identified goal-setting and refusal skills as most important program components. Youth-instructor relationships and the integration of hip-hop were reasons cited for sustained participation. This assessment partnership represents a rapport with minority youth and a participatory evaluation approach adding programmatic and evidence-based value to intervention efforts.
The Southeastern U.S. Collaborative Center of Excellence in the Elimination of Disparities Legacy Grant Program provides funding to increase community-based organizations' capacity to implement evidence-based breast and cervical cancer... more
The Southeastern U.S. Collaborative Center of Excellence in the Elimination of Disparities Legacy Grant Program provides funding to increase community-based organizations' capacity to implement evidence-based breast and cervical cancer interventions for African American women. This article describes the development of the grant process, summarizes Legacy grantee outcomes, and discusses lessons learned.
Center for Epidemiological Studies (CES) Depression Scale results for surveys of homeless, community-wide and selected distressed samples are compared. Nearly four times the percentage of homeless fit the criterion for clinical caseness... more
Center for Epidemiological Studies (CES) Depression Scale results for surveys of homeless, community-wide and selected distressed samples are compared. Nearly four times the percentage of homeless fit the criterion for clinical caseness (a score of 16+) compared to the general population (74 to 19 percent). None of the distressed samples exhibited a higher rate except psychiatric patients diagnosed as acutely depressive. High rates of depression have implications for social policies directed toward homelessness. (Am J
The topic of euthanasia has been a matter of public debate for several decades. Although empirical research should inform policy, scale measurement is lacking. After analyzing shortcomings of previous work, we offer a systematically... more
The topic of euthanasia has been a matter of public debate for several decades. Although empirical research should inform policy, scale measurement is lacking. After analyzing shortcomings of previous work, we offer a systematically designed scale to measure attitudes toward euthanasia. We attempt to encompass previously unspecified dimensions of the phenomenon that are central to the euthanasia debate. The results of our pretest show that our attitude towards euthanasia (ATE) scale is both reliable and valid. We delineate active and passive euthanasia, no chance for recovery and severe pain, and patient's autonomy and doctor's authority. We argue that isolating these factors provides a more robust scale capable of better analyzing sample variance. Internal consistency is established with Cronbach's alpha = .871. Construct external consistency is established by correlating the scale with other predictors such as race and spirituality. 229
This article examines racial differences in attitudes toward euthanasia. Many researchers assert distrust of medicine as a substantive explanation for less favorable attitudes toward euthanasia among African Americans, although... more
This article examines racial differences in attitudes toward euthanasia. Many researchers assert distrust of medicine as a substantive explanation for less favorable attitudes toward euthanasia among African Americans, although quantitative measurement has been unsuccessful in showing this. In this article, spiritual meaning, perceived capacity for discrimination (distrust), individual experiences with physicians, and access to healthcare are hypothesized as intervening variables in the relationship between race and attitudes toward euthanasia. With a distinction between individual and collective experiences with discrimination we use path analysis to test previous assertions that African American distrust of medicine leads to more negative attitudes toward euthanasia. Results indicate that while African Americans exhibit higher levels of distrust of medicine, this is not related to attitudes toward euthanasia, which seem predominantly to be a spiritual matter. Our findings have implications for legislative policy, treatment interventions, doctor-patient relations, and sociological understanding of the interaction of race, spirituality, experience, and attitudes.
A Weberian lifestyles approach is employed to examine differences in quality of life among the homeless. Using a systematic random sample of 161 homeless people in a mid-sized, Southern metropolitan area, the study focuses on the impact... more
A Weberian lifestyles approach is employed to examine differences in quality of life among the homeless. Using a systematic random sample of 161 homeless people in a mid-sized, Southern metropolitan area, the study focuses on the impact of life chances and social choices on aspects of quality of life in this severely challenged population. Regression results show that a number of life chance and social choice variables affect general and domain-specific well-being. While chances and choices both contribute to these aspects of quality of life, there is only modest evidence of a mediating effect. With the exception of depressive symptoms, life chances appear to play a more important role in quality of life differences than life choices. The specific life chance and choice factors influencing aspects of quality of life vary with each separate well-being outcome. The implications of these findings for general sociology and homeless social policy are explored.
i ACKNOWLEDGEMENTS This research was funded by grants from the Office of Development, City of Birmingham (James Fenstermaker, Director) and Jefferson County's Office of Planning and Community Development (Dr. Frederick L. Hamilton). We... more
i ACKNOWLEDGEMENTS This research was funded by grants from the Office of Development, City of Birmingham (James Fenstermaker, Director) and Jefferson County's Office of Planning and Community Development (Dr. Frederick L. Hamilton). We are grateful for this support.
The association between exposure to violence and symptoms of mental health problems among 161 homeless adults in a mid-sized Southern metropolitan area was examined. Results indicated a significant relationship between witnessing violence... more
The association between exposure to violence and symptoms of mental health problems among 161 homeless adults in a mid-sized Southern metropolitan area was examined. Results indicated a significant relationship between witnessing violence and the reporting of mental health symptoms; no relationship was found between criminal victimization and symptom reporting. Implications for clinical practice and social policy are discussed.
We use a life course approach to guide an investigation of relationships and health at the nexus of race and gender. We consider childhood as a sensitive period in the life course, during which significant adversity may launch chains of... more
We use a life course approach to guide an investigation of relationships and health at the nexus of race and gender. We consider childhood as a sensitive period in the life course, during which significant adversity may launch chains of disadvantage in relationships throughout the life course that then have cumulative effects on health over time. Data from a nationally representative panel study (Americans’ Changing Lives, N=3,477) reveal substantial disparities between black and white adults, especially pronounced among men, in the quality of close relationships and in the consequences of these relationships for health. Greater childhood adversity helps to explain why black men have worse health than white men, and some of this effect appears to operate through childhood adversity’s enduring influence on relationship strain in adulthood. Stress that occurs in adulthood plays a greater role than childhood adversity in explaining racial disparities in health among women.
