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1.  Self-reported racial discrimination, response to unfair treatment, and coronary calcification in asymptomatic adults - the North Texas Healthy Heart study 
BMC Public Health  2010;10:285.
Background
Accruing evidence supports the hypothesis that psychosocial factors are related to cardiovascular disease. However, a limited number of studies have investigated the pathophysiologic pathways through which these associations occur. The purpose of this study was to assess whether experiences of self-reported racial discrimination and reactions to unfair treatment were associated with coronary artery calcification (CAC), an indicator of subclinical coronary heart disease (CHD).
Methods
This cross-sectional study recruited 571 subjects (45 years and older) who were asymptomatic of CHD from Fort Worth, Texas from 2006 to 2008. Subjects completed a questionnaire, a multi-slice computed tomography scan to assess for CAC presence (measured as Agatston score >0), and serum chemistries. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between self-reported discrimination and CAC. Results were stratified by response to unfair treatment as it was found to significantly modify the relationship between discrimination and CAC.
Results
Among those who passively responded to unfair treatment, the odds of having CAC present were approximately 3 times higher for those experiencing discrimination (OR, 2.95; 95% CI, 1.19-7.32) after adjusting for age, gender, race/ethnicity, education, body mass index, hyperlipidemia, smoking status, hypertension, diabetes, and first degree relative with heart disease.
Conclusions
This is the first multi-racial/ethnic study to find racial discrimination associated with CAC, which differs based on how one responds to unfair treatment.
doi:10.1186/1471-2458-10-285
PMCID: PMC2887822  PMID: 20507602
2.  Acculturation and self-reported health among Hispanics using a socio-behavioral model: the North Texas Healthy Heart Study 
BMC Public Health  2010;10:53.
Background
Acculturation is a continuous, firsthand contact with other cultures functioning at both group and individual levels and is reflected in our culturally diverse society, calling for a greater understanding of the environmental and cultural impact on health. Self-reported health (SRH), a robust and well validated predictor of future mortality for all racial/ethnic groups, has been differentially reported by Hispanics compared to whites, especially based on their acculturation status. This study investigated the relationship between acculturation and SRH among Hispanics. An adapted Andersen framework was used to develop logistic regression models to assess for an association between acculturation and general health status.
Methods
Hispanic participants (n = 135), as part of the North Texas Healthy Heart Study, were administered standardized questionnaires on acculturation, psychosocial measures which included sense of control, stress, depression and social support and a single item SRH measure. In addition, physiological measurements and demographic characteristics including age, gender, body mass index, medical history, and socioeconomic status were also obtained.
Results
Bivariate analyses found Mexican-oriented participants 3.16 times more likely to report fair/poor SRH compared to Anglo-oriented Hispanics. Acculturation was also associated with SRH in multiple regression models controlling for enabling, need, and predisposing factors together (OR: 3.53, 95% CI: 1.04, 11.97).
Conclusions
Acculturation status was associated with SRH after accounting for other underlying factors. Medical and public health professionals should promote the use of acculturation measures in order to better understand its role in Hispanic behaviors, health outcomes and health care use. Such research findings will contribute to the design of culturally sensitive prevention and treatment strategies for diverse and immigrant populations.
doi:10.1186/1471-2458-10-53
PMCID: PMC2843663  PMID: 20122263
3.  Recommendations for primary care physicians to improve HPV vaccination rates during clinical encounters 
The availability of the human papillomavirus (HPV) vaccine has positioned primary care physicians to play an active role in ensuring its successful implementation. However, physicians must be aware of common knowledge, attitudes, and belief barriers associated with HPV and the vaccine that are often encountered during clinical visits. This editorial provides primary care physicians an overview of these barriers and realistic recommendations utilizing the "5A's" – Awareness, Assess, Address, Acceptability, and Activate. This mnemonic can help facilitate a physician's systematic approach to increasing HPV vaccination rates during the clinical encounter.
doi:10.1186/1750-4732-2-10
PMCID: PMC2577681  PMID: 18947420
4.  Sense of control and diabetes mellitus among U.S. adults: A cross-sectional analysis 
Background
Little is known about the influence of psychosocial factors on diabetes mellitus. The aim of this study was to improve understanding of the association between two psychosocial factors- sense of control and social support- and diabetes mellitus.
Methods
The authors analyzed data from 2,592 U.S. households in the 1995 survey of the Aging, Status, and the Sense of Control study. Logistic regression analyses were conducted to examine whether sense of personal control and social support were associated with DM and whether gender, race, and Hispanic ethnicity modified these associations.
Results
After adjusting for age, obesity, and socioeconomic position, a one point increase in sense of control (i.e., a stronger sense of control) was associated a significant reduction in risk of diabetes mellitus (odds ratio = 0.67, 95% confidence interval: 0.47, 0.95). A weak social support system was associated with a non-significant risk of diabetes (odds ratio = 1.32, 95% confidence interval: 0.93, 1.89). No effect modification was detected.
Conclusion
Sense of control deserves greater attention as a predictor of diabetes mellitus. Further studies of the contribution of psychosocial factors to diabetes mellitus should assess the temporal nature of this relationship.
doi:10.1186/1751-0759-1-19
PMCID: PMC2151060  PMID: 17971217

Results 1-4 (4)