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Lori Carter-Edwards

Publications and source records attributed to Lori Carter-Edwards.

11 recordsLinked to original sources
PubMed2005

Perceptions of participation in an observational epidemiologic study of cancer among African Americans.

PURPOSE: Recruitment and retention of African Americans in cancer research studies has become increasingly important. However, little is known about factors bearing on recruitment and retention in etiologic observational studies of cancer. We assessed perceptions and attitudes of African Americans towards participation in an observational epidemiologic study of cancer, and attitudes toward the data collection process. METHODS: Five focus groups, each lasting approximately 2 hours, were conducted. Participants were comprised of men and women between 41-65 years of age. A total of 35 adults from three rural and two urban counties in North Carolina participated. Data were analyzed using NVivo software. RESULTS: Four key themes emerged on the perception of participation and retention in an epidemiologic study of cancer: (1) fear of cancer prognosis; (2) conflicts between mistrust and trust in researchers; (3) comprehension of prospective study purpose, structure, and participation strategies; and (4) the necessity for and obligation to provide feedback. CONCLUSION: Results indicate that African Americans would be willing to participate in epidemiologic studies to identify etiologic risk factors for cancer. However, culturally appropriate efforts to thoroughly inform them of study process and progress are deemed essential for successful recruitment and retention.

Adult↗
PubMed2005

Familial roles of older African-American women with type 2 diabetes: testing of a new multiple caregiving measure.

OBJECTIVE: This study describes the development and validation of a new multiple caregiving (MC) measure and examines how familial caregiving relates to family composition and psychosocial factors among older African-American women with type 2 diabetes. RESEARCH DESIGN AND METHODS: The study sample included 345 African-American women with type 2 diabetes who participated in two lifestyle behavior interventions. A new 12-item survey of caregiving perceptions was tested for internal reliability and construct validity of two empirically defined scales (MC-role and MC-barriers). Multiple caregiving (MC) constructs were validated by using baseline measures of diabetes quality of life, social support, stress, diabetes competence, and self-care barriers. Correlational, analysis of variance, and multivariate analyses were used to examine the associations among familial MC variables and psychosocial and household factors. RESULTS: Surveys were completed by 299 (87%) participants who were an average of 60 years of age, with 10 years of diagnosed diabetes and 11 years of education. Both MC-role and MC-barriers scores were positively associated with putting the family's needs first, difficulty saying "no" to family, and the number of adults living in the household. MC-barriers were associated negatively with quality of life, and positively with stress, barriers to diabetes self-care, and negative perceptions of diabetes competence. In a multivariate model, age and difficulty saying "no" to family seeking help were significant independent predictors of MC-barriers. CONCLUSIONS: Findings suggest that a better understanding of African-American women with diabetes in the context of family and caregiving roles may be important to identifying culturally meaningful strategies to improve self-care behaviors.

Adaptation, Psychological↗
PubMed2004

Disparities in lipid management for African Americans and Caucasians with coronary artery disease: a national cross-sectional study.

BACKGROUND: Individuals with coronary artery disease are at high risk for adverse health outcomes. This risk can be diminished by aggressive lipid management, but adherence to lipid management guidelines is far from ideal and substantial racial disparities in care have been reported. Lipid treatment and goal attainment information is not readily available for large patient populations seen in the fee-for-service setting. As a result, national programs to improve lipid management in this setting may focus on lipid testing as an indicator of lipid management. We describe the detection, treatment, and control of dyslipdemia for African Americans and Caucasians with coronary artery disease to evaluate whether public health programs focusing on lipid testing can eliminate racial disparities in lipid management. METHODS: Physicians and medical practices with high numbers of prescriptions for coronary artery disease medications were invited to participate in the Quality Assurance Program. Medical records were reviewed from a random sample of patients with coronary artery disease seen from 1995 through 1998. Data related to the detection, treatment, and control of dyslipidemia were abstracted from the medical record and evaluated in cross-sectional stratified and logistic regression analyses using generalized estimation equations. RESULTS: Data from the medical records of 1,046 African Americans and 22,077 Caucasians seen in outpatient medical practices in 23 states were analyzed. African-American patients were younger, more likely to be women and to have diabetes, heart failure, and hypertension. The low density lipoprotein cholesterol (LDL-C) testing rate for Caucasian men was over 1.4 times higher than that for African-American women and about 1.3 times higher than that for African-American men. Almost 60% of tested Caucasian men and less than half of tested African Americans were prescribed lipid-lowering drugs. Tested and treated Caucasian men had the highest LDL-C goal attainment (35%) and African-American men the lowest (21%). CONCLUSIONS: Although increased lipid testing is clearly needed for African Americans, improvements in treatment and control are also necessary to eliminate racial disparities in lipid management. Disparities in treatment and goal attainment must be better understood and reflected in policy to improve the health of underserved populations.

Adult↗
PubMed2003

Lipid testing among patients with diabetes who receive diabetes care from primary care physicians.

OBJECTIVE: To identify factors related to lipid testing among patients with diabetes who receive diabetes care from primary care physicians. RESEARCH DESIGN AND METHODS: North Carolina Medicare claims were used to identify individuals with diabetes who received diabetes care from primary care physicians. Lipid testing was related to sociodemographic characteristics, comorbid conditions, physician specialty, and mortality. RESULTS: Based on Medicare claims from July 1997 through June 1999, 13,660 diabetic North Carolina residents with Medicare, 65-75 years of age, had received HbA(1c) testing from a single primary care physician during at least three of four consecutive 6-month time intervals. During these 2 years, 31% had no lipid profile and 24% had only one lipid profile. Caucasians were 1.6 times more likely than African Americans to receive lipid profiles. Patients not receiving state Medicare assistance were 1.4 times more likely to have a lipid profile than the presumably lower-income patients receiving assistance. Patients with stroke and heart failure were less likely to receive lipid profiles. Those with no lipid profile were almost twice as likely to die from cardiovascular disease than those with at least two lipid profiles. CONCLUSIONS: Adherence to lipid testing recommendations by primary care physicians for elderly patients with diabetes has much room for improvement. The most vulnerable patients (African Americans, the economically disadvantaged, and the medically complex) are the least likely to receive lipid testing.

Age Factors↗
PubMed2003

A new model for developing and executing culturally appropriate behavior modification clinical trials for African Americans.

Past clinical trials addressing behavior modification for cardiovascular disease (CVD) prevention have not been culturally appropriate for African Americans. This supposition is borne out by the continued challenges researchers face not only in recruiting and retaining African Americans in clinical trials, but also in achieving the desired outcomes among this population. Investigators have limited resources to develop culturally appropriate CVD prevention trials. The scientific literature reveals 2 models for implementing culturally appropriate interventions applicable to CVD prevention among African Americans; however, these models are not easily applied to the clinical trial setting. We propose a new model for developing a culturally appropriate clinical trial. The clinical trial is a function of the investigator's cultural framework, meaning that an investigator will have more difficulty designing clinical trials appropriate for use with cultures other than his or her own, a definite limitation when attempting to effectively reach diverse populations. Differences between the cultural frameworks of most clinical trials and African Americans' cultural frameworks lead to intrinsic biases, limiting the ability of African Americans to achieve the desired outcomes for any particular trial. An African-American participant's degree of immersion in traditional African-American culture, or acculturation, influences the magnitude of these biases. Investigators must be aware of, and attempt to mitigate, such biases so that the trial's potential for success is equitable across ethnic groups. In addition, investigators must understand how to effectively address relevant biases of African Americans without challenging their ethnic identity. Steps to decrease biases are described.

Black or African American↗
PubMed2002

Church rosters: is this a viable mechanism for effectively recruiting African Americans for a community-based survey?

OBJECTIVES: The purpose of this report is to describe the process, results, and implications in the phone recruitment of African Americans through church rosters for a survey of diet-and blood pressure-related awareness and hypertension prevalence. DESIGN: The survey was conducted using a non-probability sample of churches and a random selection of participants from church rosters. Recruitment strategies included frequent contact with pastors and church representatives, presentations, standard and tailored recruitment approaches, and bi-annual progress reports. Church representatives provided the rosters and assisted in arranging interviews, which were conducted at church or the participants' homes. RESULTS: Of 742 randomly selected, 315 (42.4%) were ineligible because of an unavailable or unreachable number, a move, discontinued church membership, death, or other reasons. Of the 344 eligible, 45.8% participated, 30.2% refused, 4.4% agreed to participate but did not, and 19.6% were incompletes (called less than three times before recruitment was terminated). Among participants, 70.4% were female, 58.2% had completed college, and the age range was 19-91 years. The survey's sample size goal of 196 was met. CONCLUSIONS: In this study population, over 45% who were eligible participated. Rapport established with church representatives and congregations was critical to the sampling process. Using church rosters can be a low-cost, effective recruitment tool. However, key factors to consider when recruiting African Americans in this manner include: trust, study eligibility criteria, roster accuracy, and time, and generalizability.

Adolescent↗
PubMed2002

Diet- and blood pressure-related knowledge, attitudes, and hypertension prevalence among African Americans: the KDBP Study. Knowledge of Diet and Blood Pressure.

Despite attempts to raise awareness of the effect lifestyle factors such as diet have on health, little is known about the results of such efforts among populations at highest risk for hypertension (HTN). The Knowledge of Diet and Blood Pressure (KDBP) Study investigated the relationship between diet- and blood pressure-related knowledge and HTN prevalence, and attitudes among a church-based population of African Americans. One hundred ninety-six adults were randomly selected from 6 churches in an urban area of North Carolina. After study criteria and missing data exclusions, the study sample comprised 179 individuals. A knowledge index assessed awareness of: the definition of HTN; its risk and prognostic factors; risk-preventing and risk-promoting nutrition; and related nutritional recommendations (score range: 0-100, 100 = most knowledgeable). Health attitudes were assessed primarily through Likert-type questions. HTN was defined as SBP > or = 140 mm Hg, DBP > or = 90 mm Hg, or anti hypertensive medication use. The mean SBP and DBP were 135.4 +/- 21.6 mm Hg and 78.8 +/- 15.7 mm Hg, respectively, and 55.9% of participants had HTN. The mean knowledge score was 76.1 (+/- 10.6). There was no statistically significant difference in mean knowledge score by HTN status (known HTN: 76.9 [+/- 11.31); unknown HTN (ie, the participant was unaware of the presence of HTN): 76.1 (+/- 9.3); no HTN: 75.3 (+/- 10.4), P = .665). Attitudes were not significantly related to knowledge and HTN prevalence, despite apparent trends. However, logistic regression analyses revealed that age, occupation, and church site were significant correlates of this relationship. Further exploration of attitudes and socioeconomic factors in assessing health awareness and HTN prevalence in this population is recommended.

Adult↗
PubMed2002

Mid-life African-American women with type 2 diabetes: influence on work and the multicaregiver role.

PURPOSE: Few studies have examined the multicaregiver role, including the work role, of African-American women and the influence of that role on diabetes self-management and the ability to cope with type 2 diabetes. Therefore, the purpose of this study was to explore the perceptions of work and the multicaregiver role of a group of such women to more clearly identify the influence of these factors on diabetic self-management and personal coping. METHODS: Focus group methodology was used to collect data from 12 mid-life African-American women. After data inspection, the research team extracted themes related to work and the multicaregiver role. Identification of relationships among and between themes helped delineate explanations of data and refine questions for future research. FINDINGS: Focus group analysis of participant responses elicited 4 themes. Family as core represented the participant's role as leader of her household. Work as survival defined the stresses of work and the physical and psychosocial responses to not working due to the social and economic costs of diabetes. Participants also identified pressures of balancing work and family responsibilities due to diabetes, a theme of impaired role function. The final theme, inner-strengthening, defined participants' methods of self-preservation through introspection and spiritual behaviors. CONCLUSIONS: Despite their identification of physical and psychosocial struggles with diabetes, participants did not think of diabetes as a life-long illness because it affected their ability to remain at "the head of the table," to continue engaging in paid work outside the home, and to provide for their families. Historical, social, political, and economic factors supported the themes of the study and provide a foundation for further research and healthcare delivery system changes focused on improving the lives of these women and their families, who are facing the challenges of chronic illness.

Adaptation, Psychological↗
PubMedDate not supplied

"They care but don't understand": family support of African American women with type 2 diabetes.

PURPOSE: This study evaluated the relationship between perceived social support among African American women with type 2 diabetes and diabetes self-management. METHODS: The sample included 12 African American female patients at a diabetes clinic in the southeastern United States. Focus group participants responded to questions related to social support and its influence on diabetes management. RESULTS: Support comes particularly from family, but also friends and/or healthcare providers. The dual challenges of diabetes management and multicaregiving were an expected theme from the sessions. A unique emerging theme, however, was the women's perception of a lack of understanding of their needs by members of their social networks. Participants believed that those who provide support claim they care and try to be helpful but provide minimal physical assistance or emotional understanding of their needs, which could vary daily. Those who provide informational support seem to care but misunderstand the type of information actually needed and how best to deliver it. CONCLUSIONS: Healthcare providers can help improve communication with these women by actively seeking to meet their support needs and educating families so that provisional support is more meaningful and diabetes management more attainable.

Black People↗
PubMedDate not supplied

Key attributes of health ministries in African American churches: an exploratory survey.

BACKGROUND: Church leaders are considered instrumental in the successful implementation of church-based health programs. However it is unknown which program attributes they perceive as important and which program attributes exist in their congregations. OBJECTIVE: To explore the perceived importance and existence of health ministry-related attributes in predominately African American churches. METHODS: Cross-sectional survey, with a convenience sample of 98 registered church leaders attending a conference on health and spirituality in Raleigh, NC. Attendees were asked to complete a brief survey assessing perceived importance (very important vs. somewhat or not important) and existence (yes vs. no) of 20, health ministry-related attributes in their churches. Percent perceived as very important, percent existence, and their differences were assessed for each attribute. RESULTS: Seventy-two (73.5%) of the attendees completed the survey. Attributes perceived as very important were: displaying health information in churches (73.6%); hosting health fairs for church members (73.2%); pastoral, church-based Internet access (70.8%); willingness to receive foundation funding for activities (66.7%); and incorporating health messages in Sunday bulletins (65.3%). For each of these program attributes, there was a gap between the proportion rating them "very important" and existence of the attribute in their own congregations (range diff in %: -8.3 to -22.2). LIMITATIONS: Lack of generalizability due to sample selection and homogeneity. CONCLUSIONS: Among leaders surveyed, despite perceived importance, attributes did not exist for all. Future studies should evaluate whether attributes considered important by church leadership parallel an increase in the development and maintenance of health program activities, and are associated with congregation health behaviors and health outcomes.

Black or African American↗