Publications by authors named "Catherine M Waters"

28 Publications

  • Page 1 of 1

Earning the Trust of African American Communities to Increase Representation in Dementia Research.

Ethn Dis 2020 19;30(Suppl 2):719-734. Epub 2020 Nov 19.

Institute for Health & Aging; University of California San Francisco, CA.

Black/African American populations are underrepresented as participants in dementia research. A major barrier to participation of African American older adults in dementia research is a tendency to distrust research institutions owing to both historical and contemporary racism. Building on the Ford framework, the objective of our study was to examine factors that influence participation in dementia research among African American older adults and caregivers, with an emphasis on understanding factors related to trust. Data were collected during January 2019 and March 2020 from 10 focus groups with African American older adults (n=91), 5 focus groups with caregivers (n=44), and interviews with administrators of community-based organizations (n=11), and meetings with our Community Advisory Board. Inductive/deductive content analysis was used to identify themes. The results identified an overall tension between distrust of researchers and a compelling desire to engage in dementia research. This overarching theme was supported by six themes that provided insights about the multiple layers of distrust, as well as expectations about the appropriate conduct of researchers and academic institutions. Strong commitment to the community was identified as a priority. The findings suggest that a paradigm shift is needed to increase the representation of African Americans in dementia research. In this new paradigm, earning the trust of African American communities becomes a systemic endeavor, with academic, state, and national institutions deeply committed to earning the trust of African American communities and guiding researchers in this endeavor. The findings also generated actionable recommendations to help improve representation of African American older adults in dementia research.
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http://dx.doi.org/10.18865/ed.30.S2.719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683027PMC
November 2020

Two Different Buprenorphine Treatment Settings With Similar Retention Rates: Implications for Expanding Access to Treatment for Opioid Use Disorder.

J Am Psychiatr Nurses Assoc 2019 Jul/Aug;25(4):305-313. Epub 2018 Oct 8.

6 Catherine M. Waters, RN, PhD, FAAN, University of California, San Francisco, CA, USA.

There is considerable need for effective and accessible treatment for opioid use disorder. Our study explored differences in buprenorphine treatment retention and duration, with a focus on selected sociodemographic factors and treatment indicators, in two different settings: an office-based buprenorphine induction and stabilization clinic (OBIC) and a community-based primary care clinic (CPC). This nonexperimental retrospective chart review compared demographic information and buprenorphine treatment details, including treatment retention and duration. There were no statistically significant differences in buprenorphine treatment indicators between the OBIC and CPC groups, with two exceptions: the number of written buprenorphine prescriptions was significantly greater for the OBIC group, as was the number of filled buprenorphine prescriptions. Given similar treatment retention and duration in two different buprenorphine treatment settings, our findings suggest that access to buprenorphine treatment in standard integrated care settings can be supplemented by novel treatment structures such as the OBIC in order to increase access to care during the current opioid epidemic.
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http://dx.doi.org/10.1177/1078390318805562DOI Listing
September 2020

Experiences and Perceptions of Black Men Who Have Sex with Men About Acquiring HIV: A Qualitative Narrative Perspective.

J Assoc Nurses AIDS Care 2018 Sep - Oct;29(5):737-748. Epub 2018 Apr 25.

In the United States, Black men who have sex with men (MSM), between the ages of 18 and 34 years, have the highest rates of new HIV infections. The prevalence of HIV in this population is three to four times higher than their White MSM counterparts. Twelve Black MSM from the Bay Area, nine with HIV and three without HIV, were interviewed regarding their experiences and perceived risks of acquiring HIV. Narrative analysis revealed these themes: (a) tested regularly for HIV, (b) HIV knowledge varied before arriving in San Francisco, (c) condom use typically nonexistent when under the influence of alcohol and other drugs, (d) inability to negotiate sex and condom usage, and (e) sense of anticipation, resignation, and acceptance about acquiring HIV. Implications of this study highlight the need for Black MSM to have earlier HIV prevention education, including condom negotiation skills, particularly when under the influence of drugs and/or alcohol.
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http://dx.doi.org/10.1016/j.jana.2018.04.010DOI Listing
September 2019

Depression, Perceived Health, and Right-of-Return Hopefulness of Palestinian Refugees.

J Nurs Scholarsh 2018 03 29;50(2):163-171. Epub 2017 Nov 29.

Alpha Eta, Professor and Sally Bates Endowed Chair in Community Nursing and Health Disparities, Department of Community Health Systems, University of California, San Francisco, School of Nursing, San Francisco, CA, USA.

Purpose: Displacement is traumatic and often an unwanted social change that can lead to a loss of identity and socioeconomic, physical, and psychological livelihood. The purpose of the study was to describe the association of perceived health and right-of-return hopefulness to depressive symptom severity in Palestinian refugees, taking into consideration gender and poverty.

Design: The descriptive, correlational study was framed within a socioecological lens. Data collection occurred between October 2015 and November 2015 in Amman, Jordan, which hosts the most Palestinian refugees in the world. The participants in the sample (N = 177) had a mean age of 36.9 years.

Methods: Participants responded to the Patient Health Questionnaire for depressive symptom severity, the RAND-36 perceived health item, and a statement about hopefulness to return to Palestine. Descriptive, correlation, and logistic and linear regression analyses were computed.

Findings: Results showed that 43% of participants had moderate to severe depressive symptoms, 42% lived in poverty, and 20% had fair or poor health; yet, 60% were hopeful about returning to Palestine. Participants who had better perceived health and right-of-return hopefulness were less likely to have symptoms of major depression. Perceived health was the only factor-not gender, poverty, or right-of-return hopefulness-that explained the variance in depressive symptoms.

Conclusions: Palestinian adult refugees in Jordan exhibited symptoms of major depression that were associated with poorer perceived health and less hopefulness about repatriation to Palestine.

Clinical Relevance: Nurses with community or mental health specialization can play a major role by systematically screening refugees for depression using worldwide, evidence-based tools and by advocating for policies that can improve the health and living conditions of refugees.
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http://dx.doi.org/10.1111/jnu.12363DOI Listing
March 2018

Nativity, Chronic Health Conditions, and Health Behaviors in Filipino Americans.

J Transcult Nurs 2018 05 11;29(3):249-257. Epub 2017 Apr 11.

1 University of California, San Francisco, CA, USA.

Introduction: Nearly half of Americans have a chronic health condition related to unhealthful behavior. One in four Americans is an immigrant; yet immigrants' health has been studied little, particularly among Asian American subpopulations.

Methodology: Years lived in United States, hypertension, diabetes, smoking, walking, adiposity, and fruit/vegetable variables in the 2011-2012 California Health Interview Survey were analyzed to examine the influence of nativity on chronic health conditions and health behaviors in 555 adult Filipinos, the second largest Asian American immigrant subpopulation.

Results: Recent and long-term immigrant Filipinos had higher odds of having hypertension and diabetes, but lower odds of smoking and overweight/obesity compared with second-generation Filipinos.

Discussion: Being born in the United States may be protective against chronic health conditions, but not for healthful behaviors among Filipinos. Chronic disease prevention and health promotion strategies should consider nativity/length of residence, which may be a more consequential health determinant than other immigration and acculturation characteristics.
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http://dx.doi.org/10.1177/1043659617703164DOI Listing
May 2018

Cardiometabolic risks, lifestyle health behaviors and heart disease in Filipino Americans.

Eur J Cardiovasc Nurs 2017 Aug 1;16(6):522-529. Epub 2017 Feb 1.

University of California, San Francisco School of Nursing, Department of Community Health Systems, San Francisco, CA, USA.

Background: Cardiovascular disease is the leading cause of death among all racial and ethnic populations in the USA. Cardiovascular risks and cardioprotective factors have been disparately estimated among Asian American subpopulations.

Aims: The study's purpose was to describe the cardiometabolic risks and lifestyle health behaviors associated with cardiovascular disease, considering age and gender, in Filipinos, the second largest Asian American population.

Methods: Secondary analysis was conducted of behavioral (smoking, walking, body mass index and soda, fast food and fruit/vegetable consumption), cardiometabolic (hypertension and diabetes) and heart disease variables in the 2011-2012 California Health Interview Survey. The metropolitan sample of Filipino American adults included 57.3% women and had a mean age of 47.9 ± 18.3 years ( n = 555).

Results: Among the sample, 7.4% had heart disease, 38.9% had hypertension, 16.6% had diabetes, 12.4% smoked cigarettes, 83.2% were insufficiently active, 54.2% were overweight/obese, 21.8% routinely ate fast food, 13.2% routinely drank soda and 90.3% did not meet the fruit/vegetable consumption recommendation. Age (unadjusted odds ratio [OR] = 1.0, p < 0.0001), hypertension (unadjusted OR = 4.8, p < 0.0001) and diabetes (unadjusted OR = 3.3, p = 0.001) were associated with heart disease. Hypertension was the single greatest heart disease risk, controlling for diabetes, age and gender (adjusted OR = 3.1, p = 0.006).

Conclusions: Primary and secondary prevention and treatment of hypertension should be paramount, along with promotion of glucose control, regular moderate-intensity physical activity, weight management and increased fruit and vegetable consumption in the Filipino American population. A multidisciplinary, chronic care model that is population-specific, emphasizes integrated, comprehensive care and provides linkages between primary healthcare and community resources is recommended for practice.
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http://dx.doi.org/10.1177/1474515117697886DOI Listing
August 2017

A Community Based Program for Family Caregivers for Post Stroke Survivors in Thailand.

Asian Nurs Res (Korean Soc Nurs Sci) 2017 Jun 26;11(2):150-157. Epub 2017 Jun 26.

Department of Community Health, School of Nursing Faculty, University of California, San Francisco (UCSF), USA.

Purpose: The purpose of this study was to evaluate the effectiveness of the post-stroke care program within the community setting in Thailand.

Methods: This quasi-experimental study was a nonequivalent control group pre-test and post-test design. A total of 62 pairs of post-stroke patients and their family caregivers were recruited to the study (31 pairs per group). The intervention consisted of a four-week program that included distributing pertinent information, providing skill practice during post-stroke care sessions and utilizing strategies to enhance motivation and behavioral skills of family caregivers based on the information-motivation-behavioral skills model. The family caregivers' post-stroke care skills were evaluated. The patients' activities of daily living (ADLs) and complications were evaluated at baseline and immediately and 2-month post-intervention. Statistical analysis included chi-square test, Fisher's exact test, independent t-test, and two-way repeated measures' analysis of variance.

Results: After participating in the program, family caregivers in the experimental group significantly improved their post-stroke care knowledge and skills as compared to those in the control group (F = 585.81, p < .001). ADLs among post-stroke patients in the experimental group significantly increased over time and were higher than those in the control group (F = 46.01, p < .001). Moreover, complications among patients in the experimental group were less than those in the control group.

Conclusions: The post-stroke care program improved family caregivers' post-stroke care skills which resulted in improved functional status and decreased complications among post-stroke patients.
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http://dx.doi.org/10.1016/j.anr.2017.05.009DOI Listing
June 2017

Health-related quality of life of Palestinian refugees inside and outside camps in Jordan.

Nurs Outlook 2017 Jul - Aug;65(4):436-443. Epub 2017 May 26.

Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, CA. Electronic address:

Background: Jordan hosts more Palestinian refugees than any country in the world. Conditions under which people in a community live influence their health-related quality of life (HRQOL).

Purpose: The purpose of this descriptive comparative cross-sectional study was to compare HRQOL of Palestinian refugees in Jordan who live inside camps with those who live outside camps.

Methods: Participants, recruited from inside the Baqa'a camp (n = 86) and the surrounding Abu Nsair community (n = 91), completed the World Health Organization Quality of Life Brief questionnaire.

Findings: There were disparities in education and social relations and environment HRQOL related to income and residency, but not gender, among refugees.

Conclusion: Refugees living inside camps, particularly if poorer, fared worse than refugees living outside camps. Enhanced programs and policies may be needed to improve HRQOL, education, and socioeconomics for camp refugees. Nursing's perspective on refugee health could make an important contribution to humanitarian efforts and health diplomacy.
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http://dx.doi.org/10.1016/j.outlook.2017.05.007DOI Listing
September 2017

Infant Feeding Decision-Making and the Influences of Social Support Persons Among First-Time African American Mothers.

Matern Child Health J 2017 04;21(4):863-872

Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, USA.

Background While breast milk is considered the gold standard of infant feeding, a majority of African American mothers are not exclusively breastfeeding their newborn infants. Objective The overall goal of this critical ethnographic research study was to describe infant feeding perceptions and experiences of African American mothers and their support persons. Methods Twenty-two participants (14 pregnant women and eight support persons) were recruited from public health programs and community based organizations in northern California. Data were collected through field observations, demographic questionnaires, and multiple in-person interviews. Thematic analysis was used to identify key themes. Results Half of the mothers noted an intention to exclusively breastfeed during the antepartum period. However, few mothers exclusively breastfed during the postpartum period. Many participants expressed guilt and shame for not being able to accomplish their antepartum goals. Life experiences and stressors, lack of breastfeeding role models, limited experiences with breastfeeding and lactation, and changes to the family dynamic played a major role in the infant feeding decision making process and breastfeeding duration. Conclusions for Practice Our observations suggest that while exclusivity goals were not being met, a considerable proportion of African American women were breastfeeding. Future interventions geared towards this population should include social media interventions, messaging around combination feeding, and increased education for identified social support persons. Public health measures aimed at reducing the current infant feeding inequities would benefit by also incorporating more culturally inclusive messaging around breastfeeding and lactation.
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http://dx.doi.org/10.1007/s10995-016-2167-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329142PMC
April 2017

Factors influencing health behaviors among active duty Air Force personnel.

Nurs Outlook 2016 Sep-Oct;64(5):440-9. Epub 2016 May 18.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA.

Background: Individual health behaviors affect whether U.S. Air Force (USAF) service members are fit and ready to deploy.

Purpose: The purpose of this study was to understand health behaviors of USAF members to guide future interventions to reduce cardiovascular risks.

Methods: A qualitative descriptive study was conducted with a purposive sample of 24 active duty USAF participants. Conventional content analysis was used to derive data-driven themes that were compared with the Health Promotion Model (HPM).

Discussion: Participants defined health in a multifactorial way that covered physical, emotional, and spiritual dimensions. The three themes that contributed to participants' health behaviors addressed: "who I am," "what works for me," and the USAF culture. There was a poor fit between findings as expressed by these participants and the HPM.

Conclusion: Although these findings were derived from a sample of USAF participants, the findings have implications for members of other military services. The findings also have relevance for nurses and other providers within the civilian work environments who can promote health and wellness by integrating a client's personal history into a plan for developing and sustaining a healthy lifestyle.
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http://dx.doi.org/10.1016/j.outlook.2016.05.004DOI Listing
May 2017

Breastfeeding and use of social media among first-time African American mothers.

J Obstet Gynecol Neonatal Nurs 2015 Mar-Apr;44(2):268-78. Epub 2015 Feb 24.

Objective: To describe the use of social media during the antepartum and postpartum periods among first-time African American mothers and their support persons.

Design: A qualitative critical ethnographic research design within the contexts of family life course development theory and Black feminist theory.

Setting: Participants were recruited from community-based, public health, and home visiting programs.

Participants: A purposive sample was recruited, consisting of 14 pregnant African American women and eight support persons.

Methods: Pregnant and postpartum African American women and their support persons were interviewed separately during the antepartum and postpartum periods. Data were analyzed thematically.

Results: Participants frequently used social media for education and social support and searched the Internet for perinatal and parenting information. Most participants reported using at least one mobile application during their pregnancies and after giving birth. Social media were typically accessed through smartphones and/or computers using different websites and applications. Although participants gleaned considerable information about infant development from these applications, they had difficulty finding and recalling information about infant feeding.

Conclusion: Social media are an important vehicle to disseminate infant feeding information; however, they are not currently being used to full potential. Our findings suggest that future interventions geared toward African American mothers and their support persons should include social media approaches. The way individuals gather, receive, and interpret information is dynamic. The increasing popularity and use of social media platforms offers the opportunity to create more innovative, targeted mobile health interventions for infant feeding and breastfeeding promotion.
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http://dx.doi.org/10.1111/1552-6909.12552DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359664PMC
December 2015

How community trust was gained by an NGO in Malawi, Central Africa, to mitigate the impact of HIV/AIDS.

J Transcult Nurs 2013 Jul 22;24(3):263-70. Epub 2013 Apr 22.

University of California, San Francisco, CA 94143-0608, USA.

Trust is valuable social capital that is essential for effective partnerships to improve a community's health. Yet, how to establish trust in culturally diverse communities is elusive for many researchers, practitioners, and agencies. The purpose of this qualitative study was to obtain perspectives of individuals working for a nongovernmental organization (NGO) about gaining community trust in Malawi in order to mitigate the impact of HIV/AIDS. Twenty-six interviews were conducted over 12 months. Content analysis revealed the relationship between NGO staff and the community is crucial to gaining community trust. Gender, social context, and religious factors influence the establishment of trust within the relationship, but NGO assumptions about the community can erode community trust. Nurses and other health professionals working with the NGOs can help create conditions to build trust in an ethically and culturally sensitive manner whereby communities can develop processes to address their own health concerns.
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http://dx.doi.org/10.1177/1043659613482002DOI Listing
July 2013

Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research.

Res Nurs Health 2013 Aug 19;36(4):359-72. Epub 2013 Apr 19.

Department of Family Health Care Nursing, University of California San Francisco, 2 Koret Way, Box 0606, San Francisco, CA 94143-0606, USA.

Chinese Americans demonstrate greater prevalence of diabetes than non-Hispanic whites and find standard diabetes care disregards their cultural health beliefs. Academic researchers and Chinatown agencies collaborated to culturally adapt and test an efficacious cognitive-behavioral intervention using community-based participatory research. Using a delayed-treatment repeated-measures design, 145 adult Chinese immigrants with Type 2 diabetes completed treatment. Immediate benefits of treatment were evident in the improvement (p < .05) in diabetes self-efficacy, diabetes knowledge, bicultural efficacy, family emotional and instrumental support, diabetes quality of life, and diabetes distress. Prolonged benefits were evident in all changed variables 2 months post-intervention. The CBPR approach enabled the development of a culturally acceptable, efficacious behavioral intervention, and provides a model for working with communities that demonstrate health disparities.
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http://dx.doi.org/10.1002/nur.21543DOI Listing
August 2013

Socially disempowered women as the key to addressing change in Malawi: how do they do it?

Health Care Women Int 2013 ;34(2):103-21

Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, CA 94143, USA.

Malawi women are in the ironic juxtaposition of being socially disempowered while, at the same time, thought to hold the key to shaping an effective community response to the HIV crisis. Based on this juxtaposition, a descriptive, qualitative study was conducted in Malawi and the United States where 26 participants from nongovernmental organizations (NGOs) and community-based organizations (CBOs) discussed the roles of Malawi women. Interviews were audiotaped, transcribed, and analyzed. We identified an improvement in women's economic status as the strongest factor in reducing gender inequities. Through providing stipends for rural Malawi women, one NGO created unintended changes in gender roles.
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http://dx.doi.org/10.1080/07399332.2011.630116DOI Listing
March 2013

Coronary heart disease risk estimation in asymptomatic adults.

Nurs Res 2012 Jan-Feb;61(1):66-9

Department of Physiological Nursing, University of California San Francisco, San Francisco, CA, USA.

Background: Accurate estimation of coronary heart disease (CHD) risk is requisite for effective primary prevention of the disease. The Framingham Risk Score is the most commonly used method for estimating 10-year risk for CHD in asymptomatic individuals. Further noninvasive tests of atherosclerosis are widely available and may be added to enhance risk estimation. However, the ability to combine different test results explicitly in a quantitative way is limited, and a substantial gap remains in identification of those at high risk for future CHD.

Objectives: The aims of this paper are to present information about and examples of how to estimate 10-year risk of developing CHD with the Framingham Risk Score and to demonstrate how to combine two different test results with Bayes' theorem.

Method: Bayes' theorem of conditional probability is presented as a method by which to combine two different test results in a quantitative way to better identify high-risk asymptomatic individuals.

Discussion: Applying Bayes' theorem will help nurses to better estimate CHD risk, leading to optimal intervention plans. This method of refining risk estimation is especially useful for individuals who would fall into an intermediate-risk category based on the Framingham Risk Score.
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http://dx.doi.org/10.1097/NNR.0b013e31823b1429DOI Listing
February 2012

Rural adolescent health: the importance of prevention services in the rural community.

J Rural Health 2011 23;27(1):60-71. Epub 2010 Aug 23.

Division of Nursing, California State University, Sacramento, California 95819-6096, USA.

Context: Adolescence is a pivotal developmental period for the establishment of positive health and health practices. However, developmentally propelled risk behaviors coinciding with barriers to health services may increase the propensity for untoward health outcomes in adolescence. In addition, the sociocultural context of the rural environment can present challenges to the health of adolescents. Limited data on rural adolescent health, particularly among population subgroups, hinder the ability to adequately advocate for adolescent health prevention services.

Methods: A secondary analysis of the 2005 California Health Interview Survey Adolescent questionnaire was conducted. Selected survey items corresponding to the Healthy Youth 2010 objectives were analyzed for 663 adolescents aged 12-17 residing in rural regions of California. Adolescent subgroup analysis included race/ethnicity, age, and poverty level.

Findings: Adolescent health issues of particular concern in this study include sexual health, substance use, mental health, and risk factors for obesity. Predictably, risk behaviors increase with the age of the adolescent. Minority and poor youth demonstrate the greatest vulnerability to untoward health outcomes.

Conclusion: Significant risk behaviors and health concerns exist among the rural adolescent population, particularly among poor and minority youth, arguing for the creation and preservation of prevention services for youth in the rural community. Future research using alternative sampling methodologies may be necessary to adequately represent the higher-risk adolescent in the rural community. More data are needed on vulnerable adolescent populations in the rural community in order to adequately advocate for prevention services.
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http://dx.doi.org/10.1111/j.1748-0361.2010.00319.xDOI Listing
April 2011

Increasing community capacity to reduce tobacco-related health disparities in African American communities.

Public Health Nurs 2010 Nov-Dec;27(6):552-60. Epub 2010 Sep 22.

College of Nursing, Nebraska Medical Center, University of Nebraska Medical Center, Omaha, Nebraska 69198-5330, USA.

Objective: The purpose of this study was to understand the processes and interactions that African American tobacco control organizations use to engage African American communities in tobacco control efforts.

Design And Sample: The study used grounded theory methods to interpret participant's perspectives on tobacco control. The study sample consisted of African American tobacco control program directors from African American tobacco control organizations throughout the United States.

Measures: Data collection involved 1 interview per participant using a semistructured interview at a location selected by the participant. Each interview lasted approximately 30-90 min.

Results: The results showed that organizations used specific strategies to involve African Americans in tobacco control. The tobacco control organizations built community capacity using 3 processes: developing relationships and partnerships, raising awareness, and creating collective power.

Conclusion: Contextual, cultural processes, and historical references used by African American tobacco control organizations provide insight into how to engage African American communities in tobacco control efforts and achieve tobacco-related health parity. Public health professionals and nurses should be aware of these and other strategies that may increase the involvement of African American communities in tobacco control.
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http://dx.doi.org/10.1111/j.1525-1446.2010.00882.xDOI Listing
March 2011

Conceptualizing physical activity behavior of older Korean-Americans: an integration of Korean culture and social cognitive theory.

Nurs Outlook 2008 Nov-Dec;56(6):322-9

College of Natural Sciences, School of Nursing, Hoseo University, 165 Sechul-ri, Baebang-myun, Asan, Chungnam, Republic of Korea.

People can live longer and healthier lives by engaging in physical activity (PA). The purpose of this article is to assess the social cognitive theory (SCT) in relation to its relevance to produce cultural-specific directions for gerontological nursing practice in order to guide the design of PA interventions for Korean-American elders. SCT is compared to the Korean cultural, social, and health belief system and is analyzed and evaluated based on 3 criteria: assumptions of the theory, completeness and consistency, and essence of nursing. Within the Korean culture, as presumed in the SCT and the nursing paradigm, health-promoting behavior, such as PA, is conceptualized as the desire for a higher level of health rather than a fear of disease as is proposed by other health behavior theories. SCT with the integration of Korean culture recognizes cultural, developmental, societal, and other external constraints that may help in formulating interventions and better understanding of the limits faced by older Korean-Americans (OKAs) in their pursuit of routine PA.
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http://dx.doi.org/10.1016/j.outlook.2008.09.001DOI Listing
March 2009

Meeting a primary care challenge in the United States: chronic illness care.

Contemp Nurse 2007 Aug;26(1):94-103

Adult Nurse Practitioner Program, Department of Community Health Systems, University of California, San Francisco, CA, USA.

Leading health care experts in the United States have stated that the greatest primary care challenge today is meeting the complex needs of patients with chronic illness/long-term conditions or impairment.To address this challenge, there is a need for health care system redesign that requires a multidisciplinary team approach, including active participation from professional nurses. In particular, it is essential for advanced practice nurses to provide leadership in health systems design for which they are specifically trained and experienced. In this article, the primary care challenge related to chronic illness care management is addressed. Future implications for community-based, chronic illness care delivery and the education of future health care providers with a focus on advanced practice nurses will also be discussed.
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http://dx.doi.org/10.5172/conu.2007.26.1.94DOI Listing
August 2007

Receptor tyrosine kinase-G-protein coupled receptor complex signaling in mammalian cells.

Adv Enzyme Regul 2007 6;47:271-80. Epub 2007 Mar 6.

Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, University of Strathclyde, 27 Taylor St, Glasgow G4 0NR, UK.

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http://dx.doi.org/10.1016/j.advenzreg.2006.12.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446785PMC
November 2007

Protean agonism of the lysophosphatidic acid receptor-1 with Ki16425 reduces nerve growth factor-induced neurite outgrowth in pheochromocytoma 12 cells.

J Neurochem 2006 Sep;98(6):1920-9

Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, University of Strathclyde, Glasgow, UK.

We report here a novel role for the constitutively active lysophosphatidic acid receptor-1 (LPA(1)) receptor in providing Gbetagamma subunits for use by the Trk A receptor. This enhances the ability of nerve growth factor (NGF) to promote signalling and cell response. These conclusions were based on three lines of evidence. Firstly, the LPA(1) receptor was co-immunoprecipitated with the Trk A receptor from lysates, suggesting that these proteins form a complex. Secondly, Ki16425, a selective protean agonist of the LPA(1) receptor, decreased constitutive basal and LPA-induced LPA(1) receptor-stimulated GTPgammaS binding. Ki16425 reduced the LPA-induced activation of p42/p44 mitogen activated protein kinase (MAPK), while acting as a weak stimulator of p42/p44 MAPK on its own, properties typical of a protean agonist. Significantly, Ki16425 also reduced the NGF-induced stimulation of p42/p44 MAPK and inhibited NGF-stimulated neurite outgrowth. Thirdly, the over-expression of the C-terminal GRK-2 peptide, which sequesters Gbetagamma subunits, reduced the NGF-induced activation of p42/p44 MAPK. In contrast, the stimulation of PC12 cells with LPA leads to a predominant G(i)alpha2-mediated Trk A-independent activation of p42/p44 MAPK, where Gbetagamma subunits play a diminished role. These findings suggest a novel role for the constitutively active LPA(1) receptor in regulating NGF-induced neuronal differentiation.
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http://dx.doi.org/10.1111/j.1471-4159.2006.04009.xDOI Listing
September 2006

Integrin signalling regulates the nuclear localization and function of the lysophosphatidic acid receptor-1 (LPA1) in mammalian cells.

Biochem J 2006 Aug;398(1):55-62

Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, University of Strathclyde, 27 Taylor St, Glasgow, G4 0NR, UK.

We show that LPA1 (lysophosphatidic acid receptor-1) is constitutively localized in the nucleus of mammalian cells. LPA1 also traffics from cell membranes to the nucleus in response to LPA (lysophosphatidic acid). Several lines of evidence suggest an important role for cell-matrix interaction in regulating the constitutive nuclear localization of LPA1. First, the RGDS peptide, which blocks cell matrix-induced integrin clustering and cytoskeletal rearrangement, reduced the number of cells containing LPA1 in the nucleus. Secondly, a higher proportion of cells contained nuclear LPA1 when adhesion on fibronectin-coated glass was compared with adherence to polylysine-coated glass. Thirdly, pre-treatment of cells with the Rho kinase inhibitor (Y27632) or the myosin light chain kinase inhibitor (ML9) reduced the number of cells containing nuclear LPA1. The addition of LPA and/or Ki16425 (which binds to LPA1) to isolated nuclei containing LPA1 induced the phosphorylation of several proteins with molecular masses of 34, 32, 14 and 11 kDa. These findings demonstrate that trafficking of LPA1 to the nucleus is influenced by cell-matrix interactions and that nuclear LPA1 may be involved in regulating intranuclear protein phosphorylation and signalling.
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http://dx.doi.org/10.1042/BJ20060155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525019PMC
August 2006

Change in perceived psychosocial status following a 12-week Tai Chi exercise programme.

J Adv Nurs 2006 May;54(3):313-29

Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, California 94305-5705, USA.

Aim: This paper reports a study to examine change in psychosocial status following a 12-week Tai Chi exercise intervention among ethnic Chinese people with cardiovascular disease risk factors living in the United States of America.

Background: Regular participation in physical activity is associated with protection against cardioavascular disease, and improvements in physical and psychological health. Increasing amounts of scientific evidence suggests that mind-body exercise, such as Tai Chi, are related to improvements in mental health, emotional well-being, and stress reduction. No prior study has examined the effect of a Tai Chi exercise intervention on psychosocial status among people with cardiovascular disease risk factors.

Methods: This was a quasi-experimental study. Participants attended a 60-minute Tai Chi exercise class three times per week for 12 weeks. Data were collected at baseline, 6 and 12 weeks following the intervention. Psychosocial status was assessed using Chinese versions of Cohen's Perceived Stress Scale, Profile of Mood States, Multidimensional Scale of Perceived Social Support, and Tai Chi exercise self-efficacy.

Results: A total of 39 participants, on average 66-year-old (+/-8.3), married (85%), Cantonese-speaking (97%), immigrants participated. The majority were women (69%), with < or =12 years education (87%). Statistically significant improvements in all measures of psychosocial status were found (P < or = 0.05) following the intervention. Improvement in mood state (eta2 = 0.12), and reduction in perceived stress (eta2 = 0.13) were found. In addition, Tai Chi exercise statistically significantly increased self-efficacy to overcome barriers to Tai Chi (eta2 = 0.19), confidence to perform Tai Chi (eta2 = 0.27), and perceived social support (eta2 = 0.12).

Conclusions: Tai Chi was a culturally appropriate mind-body exercise for these older adults, with statistically significant psychosocial benefits observed over 12-weeks. Further research examining Tai Chi exercise using a randomized clinical trial design with an attention-control group may reduce potential confounding effects, while exploring potential mechanisms underlying the relaxation response associated with mind-body exercise. In addition, future studies with people with other chronic illnesses in all ethnic groups are recommended to determine if similar benefits can be achieved.
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http://dx.doi.org/10.1111/j.1365-2648.2006.03809.xDOI Listing
May 2006

Cell migration activated by platelet-derived growth factor receptor is blocked by an inverse agonist of the sphingosine 1-phosphate receptor-1.

FASEB J 2006 Mar 30;20(3):509-11. Epub 2005 Nov 30.

Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, University of Strathclyde, Glasgow, UK.

We have previously identified a novel complex between the platelet-derived growth factor (PDGF)beta receptor and the sphingosine 1-phosphate receptor-1 (S1P1). The complex permits the utilization of active G-protein subunits (made available by constitutively active S1P1 receptor) by the PDGFbeta receptor kinase to transmit signals to p42/p44 MAPK in response to PDGF. Therefore, an inverse agonist of the S1P1 receptor is predicted to reduce signal transduction from PDGFbeta receptor tyrosine kinase by blocking the constitutive activity of the G-protein coupled receptor. SB649146 is a novel inverse agonist of the S1P1 receptor. First, SB649146 displaced the S1P1 receptor agonist dihydrosphingosine 1-phosphate from membranes expressing the recombinant S1P1 receptor. Second, SB649146 reduced basal recombinant S1P1 receptor-induced GTPgammaS binding and S1P-induced GTPgammaS binding in membranes. Third, SB649146 blocked the S1P-induced activation of p42/p44 MAPK in airway smooth muscle cells, a response that is mediated by the S1P1 receptor. We now report that inverse agonism of the S1P1 receptor with SB649146 reduced the endocytosis of the PDGFbeta receptor-S1P1 receptor complex and the stimulation of p42/p44 MAPK and cell migration in response to PDGF. These findings are the first to report that a GPCR inverse-agonist reduces growth factor-induced receptor tyrosine kinase signaling, fundamentally broadening their mechanism of action. The data obtained with SB649146 also suggest that the constitutively active endogenous S1P1 receptor enhances PDGF-induced cell migration.
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http://dx.doi.org/10.1096/fj.05-4810fjeDOI Listing
March 2006

The effect of RGS12 on PDGFbeta receptor signalling to p42/p44 mitogen activated protein kinase in mammalian cells.

Cell Signal 2006 Jul 7;18(7):971-81. Epub 2005 Oct 7.

Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, University of Strathclyde, 27 Taylor St, Glasgow, G4 0NR, UK.

We have previously shown that the PDGFbeta receptor uses a classical GPCR-mediated pathway in order to induce efficient activation of p42/p44 MAPK in response to PDGF. We therefore, considered the possibility that GTPase accelerating proteins (RGS proteins), which regulate GPCR signalling, modulate PDGFbeta receptor-mediated signal transmission. Several lines of evidence were obtained to support functional interaction between the PDGFbeta receptor and RGS12 in HEK 293 and airway smooth muscle cells. Firstly, the over-expression of the RGS12 PDZ/PTB domain N-terminus or RGS12 PTB domain reduced the PDGF-induced activation of p42/p44 MAPK. Secondly, the RGS12 PDZ/PTB domain N-terminus and RGS12 PDZ domain can form a complex with the PDGFbeta receptor. Therefore, the results presented here provide the first evidence to support the concept that the PDZ/PTB domain N-terminus and/or the PTB domain of RGS12 may modulate PDGFbeta receptor signalling. In airway smooth muscle cells, over-expressed recombinant RGS12 and the isolated PDZ/PTB domain N-terminus co-localised with PDGFbeta receptor in cytoplasmic vesicles. To provide additional evidence for a role of the PDZ/PTB domain N-terminus, we used RGS14. RGS14 has the same C-terminal domain architecture of an RGS box, tandem Ras-binding domains (RBDs) and GoLoco motif as RGS12, but lacks the PDZ/PTB domain N-terminus. In this regard, RGS14 exhibited a different sub-cellular distribution compared with RGS12, being diffusely distributed in ASM cells. These findings suggest that RGS12 via its PDZ/PTB domain N-terminus may regulate trafficking of the PDGFbeta receptor in ASM cells.
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http://dx.doi.org/10.1016/j.cellsig.2005.08.003DOI Listing
July 2006

c-Src is involved in regulating signal transmission from PDGFbeta receptor-GPCR(s) complexes in mammalian cells.

Cell Signal 2005 Feb;17(2):263-77

Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, University of Strathclyde, 27 Taylor St., Glasgow G4 ONR, UK.

We have reported that the platelet-derived growth factor receptor-beta (PDGFbeta) forms a novel signaling complex with G protein-coupled receptors (GPCR) (e.g. S1P(1) receptor) that enables more efficient activation of p42/p44 mitogen-activated protein kinase (MAPK) in response to PDGF and sphingosine 1-phosphate (S1P). We now demonstrate that c-Src participates in regulating the endocytosis of PDGFbeta receptor-GPCR complexes in response to PDGF. This leads to association of cytoplasmic p42/p44 MAPK with the receptor complex in endocytic vesicles. c-Src is regulated by G protein betagamma subunits and can interact with beta-arrestin. Indeed, the PDGF-dependent activation of p42/p44 MAPK was reduced by over-expression of the C-terminal domain of GRK2 (sequesters Gbetagamma subunits), the clathrin-binding domain of beta-arrestin and by inhibitors of c-Src and clathrin-mediated endocytosis. Moreover, PDGF and S1P induce the recruitment of c-Src to the PDGFbeta receptor-S1P(1) receptor complex. This leads to a G protein/c-Src-dependent tyrosine phosphorylation of Gab1 and accumulation of dynamin II at the plasma membrane, a step required for endocytosis of the PDGFbeta receptor-GPCR complex. These findings provide important information concerning the molecular organisation of novel receptor tyrosine kinase (RTK)-GPCR signal relays in mammalian cells.
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http://dx.doi.org/10.1016/j.cellsig.2004.07.011DOI Listing
February 2005

Parental influence on models of primary prevention of cardiovascular disease in children.

Eur J Cardiovasc Nurs 2003 Dec;2(4):311-22

Institute for Health Policy Studies, University of California, 3333 California, Suite 265, San Francisco, CA 94143-0936, USA.

Background: Lifestyle behaviors such as overeating and physical inactivity contribute significantly to CVD, the leading cause of morbidity and mortality among adults globally. CVD risk factors that begin in children often track into adulthood. Parents are believed to influence the health behaviors of their children.

Objective: To review the literature on parental influence on children's health beliefs and behaviors, particularly eating and exercise behaviors as indicators of CV health, school-based CVD risk reduction programs, and racial/ethnic, gender and socioeconomic considerations for models of primary prevention of CVD in children.

Methods: Seventeen studies that included parents as either a source of information, change agent or participant in a CVD risk reduction intervention were identified searching the Medline, CINAHL and PsycINFO databases from 1980 through 2002.

Results: Children's lifestyle health beliefs and behaviors are significantly influenced by positive parental modeling and involvement in exercise and healthy eating; parental influence on children's behavior lasts beyond adolescence; parents are effective teachers of health habits at home when prompted by health educators; and parental influences vary by ethnicity/race, socioeconomics and gender.

Conclusions: A broader base of knowledge that is socioculturally sensitive must be developed about what parents and children believe is healthy, how parents model beliefs and behaviors for their children, and how to build self-efficacy for positive health behaviors.
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http://dx.doi.org/10.1016/S1474-5151(03)00072-0DOI Listing
December 2003