Rural African American children living in poverty have a higher prevalence rate of mental health disorders than their urban counterparts. While access to mental health services is lacking in resource scarce rural communities, African American rural residents may also be the most likely to confront significant barriers to care and help-seeking. Studies of mental health help-seeking behavior among rural families are rare, even rarer are studies of African Americans living in these areas. To address this gap, the current study examined perceptions about help-seeking for adolescents with mental health problems among rural African American families. Data were obtained from African American mothers in rural Georgia to assess their perceptions of the mental health service system, help-seeking processes, and service experiences. A mixed-method approach was implemented, integrating a quantitative survey (n = 163) with qualitative interviews (subsample n = 21). Most of the mothers expressed confidence in mental health care providers' to help. Preferred sources of support, however, were family, church, and schools. Community stigma towards children with mental health problems and their families was a frequently endorsed perceived barrier to help-seeking. Although cultural mistrust was one of the two most frequently endorsed barriers in the survey, it did not emerge as a universal barrier to help-seeking for the mothers in this sample. Implications for research, policy, and practice include addressing family concerns about stigma, preferences for informal support and non-specialty services in addressing adolescents' mental health problems, and building community resources to enable all youth to participate in community life.

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Cancer health disparities among populations are the result of a combination of socioeconomic, environmental, behavioral, and biological factors, which affect cancer incidence, prevalence, mortality, survivorship, financial burden, and screening rates. The long-standing Meharry Medical College (MMC), Vanderbilt-Ingram Cancer Center (VICC), Tennessee State University (TSU) Cancer Partnership has built an exceptional cancer research and training environment to support the efforts of diverse investigators in addressing disparities. Over the past 20 years, collaborative partnership efforts across multiple disciplines have supported research into the determinants of cancer health disparities at a National Cancer Institute-designated comprehensive cancer center (VICC) along with enhancing research infrastructure and training at MMC and TSU, two institutions that serve predominantly underserved populations and underrepresented students. Moreover, the geographical placement of this partnership in Tennessee, a region with some of the highest cancer incidence and mortality in the United States, has provided an especially important opportunity to positively affect outcomes for cancer patients.

Persons who care for children and adolescents who are experiencing mental illness often incur a considerable burden as a result of their care work. Furthermore, caregivers living in rural areas often have increased difficulties as a result of longer travel times, lack of specialty services, and fewer community resources. While there is ample evidence documenting caregiver burden, it continues to go largely unaddressed by mental health care systems and economic and legal structures that might instead be altered to better support primary caregivers. In this article, we report the experiences of 42 rural primary caregivers for children and adolescents with mental health issues and apply a justice framework, informed by feminist care theory, to suggest possible alternatives for building mechanisms for caregiver support.

This pilot study explores an interprofessional, practice-based education initiative that placed students from four different professions (medicine, nursing, social work, and pharmacy) in a community health clinic ½ day per week for 8 months. The study was guided by two research questions: (1) How do clinic experiences contribute to students’ understanding of social determinants of health? (2) What factors influence the creation of an effective learning environment? To address these questions, we conducted a qualitative, ethnographic study that included participant observation, focus groups, and textual analysis. This study allowed us to explore the experiences of students and staff as they interacted in a community-based clinic setting. We found that the interprofessional, clinic-based experience improved students’ knowledge- and practice-based competencies in a variety of areas, including awareness of social determinants of health, skills in securing resources for patients with financial limitations, appreciation for health education and health promotion in clinical practice, and experience working interprofessionally. We observed that creating environments that support this kind of student learning requires time and effort on the part of the clinic staff. We discuss implications of these findings for supporting future interprofessional, practice-based health education initiatives.

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Background To identify individual and household characteristics associated with food security and dietary diversity in seven Haitian–Dominican bateyes. Methods A cross-sectional sample of 667 households were surveyed. Novel household food security scores were calculated from components of the Household Food Insecurity Assessment Scale, while the Food and Agricultural Organization’s Household Dietary Diversity Score was utilized to calculate individual dietary diversity scores. Multivariable analyses were performed using ordinal logistic regression models to estimate the association between these scores and the covariate variables. Secondary dietary diversity analyses were performed after removing non-nutritious food groups. Results Food security was significantly associated with being above the poverty line (OR 3.14, 95% CI 1.92 to 5.14), living in a rural batey (OR 1.44, 95% CI 1.02 to 2.03), receiving gifts and/or donations (OR 1.76, 95% CI 1.03 to 3.00) and having a salaried job (i.e., not being paid hourly; OR 1.67, 95% CI 1.05 to 2.64). Dietary diversity was significantly associated with living in a semi-urban batey (OR 1.70, 95% CI 1.26 to 2.30), living with a partner (OR 1.47, 95% CI 1.08 to 2.00), growing at least some of one’s own food (OR 1.62, 95% CI 1.17 to 2.23), and receiving gifts and/or donations (OR 1.72, 95% CI 1.08 to 2.73). Conclusions Food insecurity and low dietary diversity are highly prevalent in Haitian–Dominican bateyes. The inclusion of sweets and non-milk beverages in dietary diversity calculations appear to skew scores towards higher levels of diversity, despite limited nutritional gains.