Current literature poorly defines the specific ways trained peer supporter influences health care behaviors. This study attempts to identify the key defining features of a culturally appropriate peer support program for African Americans with type 2 diabetes by exploring participants experiences related to assistance with daily disease management, emotional support, linkage to clinic care and community resources, and ongoing support. We used a qualitative interpretive descriptive approach to collect data through semi-structured interviews from 20 African Americans with type 2 diabetes participating in a peer support program. Interviews captured participants' background and experiences with the peer supporter and evaluated the cultural appropriateness of the peer support intervention. Data was coded deductively using predetermined codes found in the peer support literature and inductively to identify emergent themes. Three specific themes were identified namely [1] healthy behaviors [2] frequent telephonic contact and [3] emotional support as a by-product of other support activities. These findings mirror the broader literature on what constitutes culturally appropriate peer support programs for ethnic minorities. We recommend the inclusion of culturally appropriate peer support program to complement diabetes management as targeted plan for improvement in clinical care and ultimately, diabetes outcome.

Purpose: Rates of sexually transmitted infections among adolescents remain high in the United States and Botswana. Mobile phone density rates in Botswana exceed those of the United States. Yet, in both countries, safer sex information continues to be delivered primarily via face-to-face curricula such as Becoming a Responsible Teen and Living as a Safe Teen . While social media shows promise as a medium for delivering risk-reduction information to youth, few studies have been conducted in either country to assess its effectiveness. This study examines adolescents in both countries, their mobile phone and social media usage, and their perceptions of safer sex interventions delivered via social media. Design and methods: Three focus groups were conducted with 28 adolescents 13–18 years of age who lived in the United States (n=14) and Botswana (n=14). Data analysis was ongoing, which informed the data collection process. After the first group, no additional revisions were made to the focus group protocol. An abridged method of analyzing the data was employed. Results: Adolescents in all groups discussed peer pressure and connectedness with mobile phones and social media and had general knowledge of STIs and HIV. The adolescents agreed that adaptation of risk reduction interventions for mobile phone and social media delivery was warranted, and they shared ideas for adaptation. Practice implications: Our findings provide a starting point for researchers interested in developing a social media intervention with global implications for sexual health promotion.

Severe under-representation of Black women academic nurse leaders persists in United States higher education, and a major research gap still exists regarding experiences of these leaders, and facilitators of and barriers to their success. Our objective was to examine how race and gender influence how Black women academic nurse leaders’ function in their leadership positions, how they are perceived by their peers, and how their perception of race, gender, class, and power influences diversity, equity, and inclusion initiatives in the workplace. Critical race theory was used as a guiding theory, and the study design involved narrative inquiry followed by thematic analysis. Four overarching themes with four sub-themes were revealed: (a) Paying a personal price for authenticity, (b) Being the only one is hard even when you are in charge, (c) The illusion of diversity and inclusion while trying to survive, and (d) Focusing on building and sustaining diversity, equity, and inclusion. Implications for nursing education including instituting training for faculty in anti-racist pedagogy and requiring nursing programs to meet inclusivity metrics for approval and accreditation.

Objective. The objective of this study was to investigate the extent stroke survivors who attended an herbal center knew of stroke risk factors and whether significant sex differences existed. Study Design. This was a cross-sectional study conducted from January to June 2018 at Bebe Herbal Center, and it involved two well-trained assistants who interviewed 149 first-time stroke survivors after consent and ethical approval were obtained. The survivors self-reported their knowledge, attitude, and beliefs on risk factors before and after stroke. Statistical Analyses. Means of continuous variables were compared using Student’s unpaired t -test, while categorical variables between males and the females were analyzed using Pearson’s chi-square test. P < 0.05 was taken as significant. Results. Mean age of men ( 64.81 ± 1.24   yrs ) was significantly higher than that of women ( 61.39 ± 1.42   yrs ) ( F = 0.096 , t = 1.79 , df = 147 ; P < 0.05 ). More men than women were 60 years and above while more women than men were below 60 years. Pearson’s chi-square test showed significant association of sex with education ( χ 2 = 12.31 ; df = 3 , P < 0.006 ), occupation ( χ 2 = 23.65 ; df = 4 , P < 0.001 ), alcohol intake ( χ 2 = 24.23 ; df = 1 ; P < 0.001 ), and smoking ( χ 2 = 9.823 ; df = 1 ; P < 0.001 ). The commonest risk factor suffered was hypertension (73.1%), followed by alcohol intake (59.1%), smoking (31.5%), and diabetes mellitus (26.7%); these affected men more than women. Male survivors unaware of their hypertensive status were more likely to have stroke than females, and age had a significant effect on the likelihood of developing a stroke; the same was occupation. Conclusions. These survivors suffered mainly from hypertension, triggered by psychosocial problems and diabetes mellitus; their stroke seemed fueled by unrecognized hypertension, unrecognized diabetes mellitus, ignorance of hyperlipidemia, and wide-scale belief in witchcraft as risk factor. Awareness programs in the third world should take these observations into consideration.

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