This study examined differences in kin and nonkin networks among African Americans, Caribbean Blacks (Black Caribbeans), and non‐Hispanic Whites. Data are taken from the National Survey of American Life, a nationally representative study of African Americans, Black Caribbeans, and non‐Hispanic Whites. Selected measures of informal support from family, friendship, fictive kin, and congregation/church networks were utilized. African Americans were more involved in congregation networks, whereas non‐Hispanic Whites were more involved in friendship networks. African Americans were more likely to give support to extended family members and to have daily interaction with family members. African Americans and Black Caribbeans had larger fictive kin networks than non‐Hispanic Whites, but non‐Hispanic Whites with fictive kin received support from them more frequently than African Americans and Black Caribbeans. The discussion notes the importance of examining kin and nonkin networks, as well as investigating ethnic differences within the Black American population.
Objectives This study examined the influence of church and family based social support on depressive symptoms and serious psychological distress among older African Americans. Methods The analysis is based on the National Survey of American Life (NSAL). Church and family based informal social support correlates of depressive symptoms (CES-D) and serious psychological distress (K6) were examined. Data from 686 African Americans aged 55 years or older who attend religious services at least a few times a year are used in this analysis. Results Multivariate analysis found that social support from church members was significantly and inversely associated with depressive symptoms and psychological distress. Frequency of negative interactions with church members was positively associated with depressive symptoms and psychological distress. Social support from church members remained significant but negative interaction from church members did not remain significant when controlling for indicators of family social support. Among this sample of church goers, emotional support from family was a protective factor and negative interaction with family was a risk factor for depressive symptoms and psychological distress. Conclusions This is the first investigation of the relationship between church and family based social support and depressive symptoms and psychological distress among a national sample of older African Americans. Overall, the findings indicate that social support from church networks was protective against depressive symptoms and psychological distress. This finding remained significant when controlling for indicators of family social support.
This study examined whether training provided to adults age 60+ would increase the use of information and communication technologies (ICTs), such as email and the Internet, and influence participants' social support and mental health. Participants were randomly assigned to an experimental (n=45) or a control group (n=38). The experimental group participated in a six-month training program. Data were collected before, during, and after training on outcomes related to computer use, social support, and mental health. Mixed regression models were used for multivariate analyses. Compared to the control group, the experimental group reported greater self-efficacy in executing computer-related tasks and used more ICTs, perceived greater social support from friends, and reported significantly higher quality of life. Computer self-efficacy had both a direct and indirect effect on ICT use, but not on other variables. With appropriate training, older adults want to and can learn the skills needed to use ICTs. Older adults with ICT skills can access online sources of information regarding Medicare Part D options and utilize patient portals associated with electronic medical records. Agencies may develop services that build upon this technology sophistication, but policies also will need to address issues of access to equipment and high-speed Internet service.
Objectives-This study examined the religious correlates of psychiatric disorders. Design-The analysis is based on the National Survey of American Life (NSAL). The AfricanAmerican sample of the NSAL is a national representative sample of households with at least one African American adult 18 years or over. This study utilizes the older African American sub-sample (n=837).Methods-Religious correlates of selected measures of lifetime DSM-IV psychiatric disorders (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress, major depressive disorder, dysthymia, bipolar I & II disorders, alcohol abuse/dependence, and drug abuse/dependence) were examined.Participants-Data from 837 African Americans aged 55 years or older are used in this analysis. Measurement-The DSM-IV World Mental Health Composite International Diagnostic Interview(WMH-CIDI) was used to assess mental disorders. Measures of functional status (i.e., mobility and self-care) were assessed using the World Health Organization Disability Assessment ScheduleSecond Version (WHODAS-II). Measures of organizational, non-organizational and subjective religious involvement, number of doctor diagnosed physical health conditions, and demographic factors were assessed.Results-Multivariate analysis found that religious service attendance was significantly and inversely associated with the odds of having a lifetime mood disorder.Conclusions-This is the first study to investigate the relationship between religious participation and serious mental disorders among a national sample of older African Americans. The inverse relationship between religious service attendance and mood disorders is discussed. Implications for mental health treatment underscore the importance of assessing religious orientations to render more culturally sensitive care. Over the last several years, increasing attention has been devoted to examining religious correlates of mental health among various groups of the population (1-4). This literature includes focused epidemiologic studies; large-scale general surveys of the population; smaller, geographically-situated community studies; and research conducted within clinical settings (5-11). This extensive body of research is characterized by differences in theoretical orientations and conceptualizations and measurement of religious involvement and mental health, as well as in research methods, study samples and analytic approaches. Despite these differences, the data overall indicate largely positive associations between various forms of religious involvement (e.g., service attendance, private prayer, religious coping) and diverse indicators of mental health and well-being (i.e., life satisfaction and happiness) and lower rates of depression, suicide, anxiety disorders and other psychiatric outcomes among religious adherents (2). Associations between religious participation and psychiatric disorders likely vary across populations, with particularly robust findings for vu...
This study utilized data from the National Survey of American Life to investigate the use of professional services and informal support among African American and Caribbean black men with a lifetime mood, anxiety, or substance use disorder. Thirty-three percent used both professional services and informal support, 14% relied on professional services only, 24% used informal support only, and 29% did not seek help. African American men were more likely than to rely on informal support alone. Having co-occurring mental and substance disorders, experiencing an episode in the past 12 months, and having more people in the informal network increased the likelihood of using professional services and informal supports. Marital status, age, and socioeconomic status were also significantly related to help-seeking. The results suggests potential unmet need. However, the reliance on informal support also suggests a strong protective role that informal networks play in the lives of black men.
Background: To test whether access to home-based social worker–led case management (SWCM) program or SWCM program combined with a website providing stroke-related information improves patient-reported outcomes in patients with stroke, relative to usual care. Methods and Results: The MISTT (Michigan Stroke Transitions Trial), an open (unblinded) 3-group parallel-design clinical trial, randomized 265 acute patients with stroke to 3 treatment groups: Usual Care (group-1), SWCM (group-2), and SWCM+MISTT website (group-3). Patients were discharged directly home or returned home within 4 weeks of discharge to a rehabilitation facility. The SWCM program provided in-home and phone-based case management services. The website provided patient-orientated information covering stroke education, prevention, recovery, and community resources. Both interventions were provided for up to 90 days. Outcomes data were collected by telephone at 7 and 90 days. Primary patient-reported outcomes included Patient-Reported Outcomes Measurement Information System Global-10 Quality-of-Life (Physical and Mental Health subscales) and the Patient Activation Measure. Treatment efficacy was determined by comparing the change in mean response (90 days minus 7 days) between the 3 treatment groups using a group-by-time interaction. Subjects were aged 66 years on average, 49% were female, 21% nonwhite, and 86% had ischemic stroke. There were statistically significant changes in Patient-Reported Outcomes Measurement Information System Physical Health ( P =0.003) and Patient Activation Measure ( P =0.042), but not Patient-Reported Outcomes Measurement Information System Mental Health ( P =0.56). The mean change in Patient-Reported Outcomes Measurement Information System Physical Health scores for group-3 (SWCM+MISTT Website) was significantly higher than both group-2 (SWCM; difference, +2.4; 95% CI, 0.46–4.34; P =0.02) and group-1 (usual care; difference, +3.4; 95% CI, 1.41–5.33; P <0.001). The mean change in Patient Activation Measure scores for group-3 was significantly higher than group-2 (+6.7; 95% CI, 1.26–12.08; P =0.02) and marginally higher than group-1 (+5.0; 95% CI, −0.47 to 10.52; P =0.07). Conclusions: An intervention that combined SWCM with access to online stroke-related information produced greater gains in patient-reported physical health and activation compared with usual care or case management alone. There was no intervention effect on mental health. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02653170.
Objectives-This study investigated the use of professional services and informal support among African Americans and Caribbean Blacks with a lifetime mood, anxiety, or substance disorder.Methods-Data were from the National Survey of American Life (NSAL). Multinomial logistic regression was utilized to test the use of professional services only, informal support only, both, or no help at all. Analyses controlled for sociodemographic characteristics, disorder-related variables, and family network variables.Results-The analytic sample included 1,096 African Americans and 372 Caribbean Blacks. Fortyone percent used both professional services and informal support, 14% relied on professional services only, 23% used informal support only, and 22% did not receive help. There were no significant differences in help-seeking between African Americans and Caribbean Blacks. Having co-occurring mental and substance disorders, a severe 12-month disorder, more people in the informal helper network, and being female increased the likelihood of receiving help from both professional services and informal supports. When men did receive help they were more likely to rely on informal helpers. Marital status, age, and socioeconomic status were also significantly related to help-seeking.
This study examined use of ministers for assistance with a serious personal problem within a nationally representative sample of African Americans (National Survey of American Life-2001Life- -2003. Different perspectives on the use of ministers-social stratification, religious socialization, and clinical/problem-oriented approach-were proposed and tested using logistic regression analyses with demographic, religious involvement, and problem type factors as predictors. Study findings supported religious socialization and clinical/problem-oriented explanations indicating that persons who are heavily invested in religious pursuits and organizations (i.e., women, frequent attenders) are more likely than their counterparts to use ministerial assistance. Contrary to expectations from the social stratification perspective, positive income and education effects indicated that higher status individuals were more likely to report use of ministers. Finally, problems involving bereavement are especially suited for assistance from ministers owing to their inherent nature (e.g., questions of ultimate meaning) and the extensive array of ministerial support and church resources that are available to address the issue. Keywords ministers; African American men and women; National Survey of American Life; logistic regression; socioemotional support; religious socialization; social stratification; clinical/problemoriented approachCorrespondence concerning this article should be addressed to Linda Chatters, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI 48109. Electronic mail may be sent to chatters@umich.edu. Nyasha Grayman is now at Goucher College. NIH Public Access Author ManuscriptAm J Orthopsychiatry. Author manuscript; available in PMC 2012 January 1. The U.S. Department of Health and Human Services (DHHS, 2001) reports that relative to Whites, ethnic and racial minority groups "have less access to and availability of care, and tend to receive poorer quality mental health services" (p. 5). These disparities in access and availability have resulted in unaddressed psychological needs (DHHS, 2001) and have raised compelling questions about the contexts in which African Americans can and do receive mental health care. Scholars have noted consistently that African Americans are less likely than members of other racial and ethnic groups to access or use formal mental health services including psychologists and psychiatrists (Alvidrez, 1999;Barrio, Yamada, Hough, Hawthorne, Garcia, & Jeste, 2003; DHHS, 2001;Padgett, Patrick, & Burns, 1994;Snowden, 2001;Wang et al., 2005). Further, when African Americans do access mental health services, it is in primary care contexts (e.g., emergency rooms) and from sources (e.g., emergency room physicians) that are not explicitly intended to provide such services (DHHS, 2001;Neighbors et al., 2007;Snowden, 1999). African American men are more likely to access mental health care through pathways such as the justice system (Takeuchi & Cheung, 1998). A...
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