BackgroundSocial needs may affect cancer survivors' health‐related quality of life (HRQOL) above and beyond sociodemographic and cancer‐related factors. The purpose of this study was to estimate associations between social needs and HRQOL.MethodsResults included data from 1754 participants in the Detroit Research on Cancer Survivors cohort, a population‐based study of African American survivors of breast, colorectal, lung, and prostate cancer. Social needs included items related to food insecurity, utility shutoffs, housing instability, not getting health care because of cost or a lack of transportation, and perceptions of neighborhood safety. HRQOL was measured with the validated Functional Assessment of Cancer Therapy–General (FACT‐G). Linear regression models controlled for demographic, socioeconomic, and cancer‐related factors.ResultsMore than one‐third of the survivors (36.3%) reported social needs including 17.1% of survivors reported 2 or more. The prevalence of social needs ranged from 14.8% for food insecurity to 8.9% for utility shutoffs. FACT‐G score differences associated with social needs were –12.2 (95% confidence interval [CI] to –15.2 to –9.3) for not getting care because of a lack of transportation, –11.3 (95% CI, –14.2 to –8.4) for housing instability, –10.1 (95% CI, –12.7 to –7.4) for food insecurity, –9.8 (95% CI, –12.7 to –6.9) for feeling unsafe in the neighborhood, –8.6 (95% CI, –11.7 to –5.4) for utility shutoffs, and –6.7 (95% CI, –9.2 to –4.1) for not getting care because of cost.ConclusionsSocial needs were common in this cohort of African American cancer survivors and were associated with clinically significant differences in HRQOL. Clinical oncology care and survivorship care planning may present opportunities to screen for and address social needs to mitigate their impact on survivors' HRQOL.
Religious leaders, particularly African-American pastors, are believed to play a key role in addressing health disparities. Despite the role African-American pastors may play in improving health, there is limited research on pastoral influence. The purpose of this study was to examine African-American pastors' perceptions of their influence in their churches and communities. In-depth interviews were conducted with 30 African-American pastors and analyzed using a grounded theory approach. Three themes emerged: the historical role of the church; influence as contextual, with pastors using comparisons with other pastors to describe their ability to be influential; and a reciprocal relationship existing such that pastors are influenced by factors such as God and their community while these factors also aid them in influencing others. A conceptual model of pastoral influence was created using data from this study and others to highlight factors that influence pastors, potential outcomes and moderators as well as the reciprocal nature of pastoral influence.
The objective of this study was to examine sources (friends, family, church members, and pastors) and type (positive or negative) of social support and their association with eating and physical activity behaviors. Study participants consisted of 41 African-American adults (78% female), with an average age of 43.5 years (standard deviation = 15.7). Participants were recruited from churches in southwest, Ohio. Mean comparisons showed family members, and friends had the highest positive and negative social support scores for healthy eating and physical activity. Pastors and church members received the lowest social support scores related to these behaviors. Using a linear regression analysis, social support in the form of physical activity rewards from family members was positively associated with fruit and vegetable consumption after adjusting for gender, age, education level, and church location. Based on these findings, future research should continue examining how different social support sources and types influence physical activity and healthy eating behaviors among African-Americans.
Purpose: Clergy have influence on the health of congregations and communities yet struggle with health behaviors. Interventions tailored to their occupation-specific demands and unique needs may provide a solution. Qualitative methods were used to identify opportunities and resources for the development of an effective obesity-related program for clergy. Approach: Ninety-minute focus groups were held with clergy (3 groups) and spouses (3 separate groups). Discussion explored: Program target(s); Opportunities and barriers that influence diet, physical activity, and stress-reduction practices; Empowering and culturally relevant health promotion strategies. Setting: All study activities took place in Memphis, TN. Participants: Eighteen clergy and fourteen spouses participated. All clergy were male, all spouses were female. Method: Previous research with clergy informed the interview guide and the PEN-3 framework aided in organizing the coding of clergy and spouse focus groups. Focus groups were audio recorded and transcripts analyzed using NVivo® 12. Results: Themes included: 1) Intervention targets—clergy, spouses, congregations; 2) Opportunities and barriers—making time, establishing boundaries, church traditions, individuals who support and hinder behavior change; 3) Intervention strategies—tools for healthy eating, goal setting, camaraderie, combining face-to-face with eHealth modalities. Conclusion: The relationship between clergy, spouse, and congregation make it important for obesity-related programs to target the unique needs of both clergy and spouses. Strategies should focus on healthy eating and personal connections no matter the modality used.
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