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1.  C-Reactive Protein Levels in African Americans: A Diet and Lifestyle Randomized Community Trial 
Chronic Inflammation is linked to poor lifestyle behaviors and a variety of chronic diseases that are prevalent among African Americans, especially in the southeastern U.S.
The goal of the study was to test the effect of a community-based diet, physical activity, and stress reduction intervention conducted in 2009–2012 on reducing serum C-reactive protein (CRP) in overweight and obese African-American adults.
An RCT intervention was designed jointly by members of African-American churches and academic researchers. In late 2012, regression (i.e., mixed) models were fit that included both intention-to-treat and post hoc analyses conducted to identify important predictors of intervention success. Outcomes were assessed at 3 months and 1 year.
At baseline, the 159 individuals who were recruited in 13 churches and had evaluable outcome data were, on average, obese (BMI=33.1 [±7.1]) and had a mean CRP level of 3.7 (±3.9) mg/L. Reductions were observed in waist-to-hip ratio at 3 months (2%, p=0.03) and 1 year (5%, p<0.01). In female participants attending ≥60% of intervention classes, there was a significant decrease in CRP at 3 months of 0.8 mg/L (p=0.05), but no change after 1 year. No differences were noted in BMI or interleukin-6.
In overweight/obese, but otherwise “healthy,” African-American church members with very high baseline CRP levels, this intervention produced significant reductions in CRP at 3 and 12 months, and in waist-to-hip ratio, which is an important anthropometric predictor of overall risk of inflammation and downstream health effects.
Trial registration
This study is registered at NCT01760902.
PMCID: PMC3779347  PMID: 24050419
2.  Intersection of identities. Food, role, and the African–American pastor☆ 
Appetite  2013;67:44-52.
African–American pastors can foster health-related innovations as gatekeepers and advocates within their churches. Personal experiences with food and health likely influence their support of such programs. Identities or meanings attached to societal roles have been shown to motivate individuals’ attitudes and behaviors. Understanding role and eating identities of African–American pastors may have important implications for participation in faith-based health promotion programs. This study aimed to describe the eating and pastoral identities of African–American pastors, explore intersections between these identities, and highlight implications for nutrition programs. In-depth interviews with 30 African–American pastors were audio-recorded and transcribed verbatim. Data were analyzed using theory-guided and grounded-theory approaches. Pastors described affinity across one or more dimensions including healthy, picky, meat, and over-eater identities. In describing themselves as pastors, the dimensions pastor’s heart, teacher, motivator, and role model emerged. Pastors who described themselves as healthy eaters were more likely to see themselves as role models. Pastors with healthier eating identities and more complex pastoral identities described greater support for health programming while unhealthy, picky, and over-eaters did not. These findings provide guidance for understanding eating and role identities among pastors and should be considered when designing and implementing faith-based programs.
PMCID: PMC3758249  PMID: 23538172
Identity; Diet; Role; Faith-based programs; African American; Pastors
3.  Urbanicity Affects Blood Pressure and Heart Rate Reactivity to a Speech Stressor in Cameroon 
Ethnicity & disease  2010;20(3):251-256.
To examine the interactive influence of urbanicity on cardiovascular reactivity to speech stressors among 103 urban and 93 rural Cameroonians.
Heart rate, systolic, and diastolic blood pressure (HR, SBP, and DBP) changes from baseline were assessed during a speech preparation period, speech stressor task, and post-speech recovery period.
After adjusting for income, age, BMI, and sex, urban subjects showed greater diastolic reactivity to the pre-speech and speech conditions than to recovery. Urban subjects also showed greater reactivity to the speech stressor than to other conditions. Urban subjects showed greater HR reactivity to the speech stressor. Rural subjects showed greater diastolic reactivity to the pre-speech and speech stressor and less recovery.
Urbanicity affects blood pressure and heart rate differently for urban and rural Cameroonians. It also affects recovery from stressors. More exploration into the influence of urbanization on hypertension risk factors in developing countries is warranted. (Ethn Dis. 2010;20:251–256)
PMCID: PMC3773215  PMID: 20828098
Heart Rate; Blood Pressure; Urban; Cameroon
4.  Creating a Cadre of Junior Investigators to Address the Challenges of Cancer-Related Health Disparities: Lessons Learned from the Community Networks Program 
Community-based participatory research (CBPR) initiatives such as the National Cancer Institute’s Community Networks Program (CNP) (2005–2010) often emphasize training of junior investigators from underrepresented backgrounds to address health disparities. From July to October 2010, a convenience sample of 80 participants from the 25 CNP national sites completed our 45-item, web-based survey on the training and mentoring of junior investigators. This study assessed the academic productivity and CBPR-related experiences of the CNP junior investigators (n=37). Those from underrepresented backgrounds reported giving more presentations in non-academic settings (9 vs. 4 in last 5 years, p=0.01), having more co-authored publications (8 vs. 3 in last 5 years, p=0.01), and spending more time on CBPR-related activities than their non-underrepresented counterparts. Regardless of background, junior investigators shared similar levels of satisfaction with their mentors and CBPR experiences. This study provides support for the success of the CNP’s training program, especially effort directed at underrepresented investigators.
PMCID: PMC3407323  PMID: 22528636
5.  Circadian Disruption, Per3, and Human Cytokine Secretion 
Integrative cancer therapies  2009;8(4):329-336.
Circadian disruption has been linked with inflammation, an established cancer risk factor. Per3 clock gene polymorphisms have also been associated with circadian disruption and with increased cancer risk. Patients completed a questionnaire and provided a blood sample prior to undergoing a colonoscopy (n = 70). Adjusted mean serum cytokine concentrations (IL-6, TNF-alpha, gamma-INF, IL-I ra, IL-I-beta, VEGF) were compared among patients with high and low scores for fatigue (Multidimensional Fatigue Inventory), depressive symptoms (Beck Depression Inventory II), or sleep disruption (Pittsburgh Sleep Quality Index), or among patients with different Per3 clock gene variants. Poor sleep was associated with elevated VEGF, and fatigue-related reduced activity was associated with elevated TNF-alpha concentrations. Participants with the 4/5 or 5/5 Per3 variable tandem repeat sequence had elevated IL-6 concentrations compared to those with the 4/4 genotype. Biological processes linking circadian disruption with cancer remain to be elucidated. Increased inflammatory cytokine secretion may playa role.
PMCID: PMC2959170  PMID: 19926609
circadian rhythm; clock gene; cytokine; inflammation
6.  Interdisciplinary, Translational, and Community-Based Participatory Research 
Preventing cancer, downstaging disease at diagnosis, and reducing mortality require that relevant research findings be translated across scientific disciplines and into clinical and public health practice. Interdisciplinary research focuses on using the languages of different scientific disciplines to share techniques and philosophical perspectives to enhance discovery and development of innovations; (i.e., from the “left end” of the research continuum). Community-based participatory research (CBPR), whose relevance often is relegated to the “right end” (i.e., delivery and dissemination) of the research continuum, represents an important means for understanding how many cancers are caused as well as for ensuring that basic science research findings affect cancer outcomes in materially important ways. Effective interdisciplinary research and CBPR both require an ability to communicate effectively across groups that often start out neither understanding each other’s worldviews nor even speaking the same language. Both demand an ability and willingness to treat individuals from other communities with respect and understanding. We describe the similarities between CBPR and both translational and interdisciplinary research, and then illustrate our points using squamous cell carcinoma of the esophagus as an example of how to deepen understanding and increase relevance by applying techniques of CBPR and interdisciplinary engagement.
PMCID: PMC2679168  PMID: 19336548

Results 1-6 (6)