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2. Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK
- Collection:
- Black Caribbean Literature (BCL)
- Contributers:
- Edge,Dawn (Author) and MacKian,Sara C. (Author)
- Format:
- Journal Article
- Publication Date:
- 2010
- Location:
- African American Research Center, Library, University of Illinois at Urbana-Champaign
- Journal Title:
- Ethnicity & health
- Journal Title Details:
- 15(1) : 93-111
- Notes:
- Background. Perinatal depression among Black Caribbean women in the UK remains an intriguingly under-researched topic. Despite high levels of known psychosocial risks, Black Caribbeans remain relatively invisible among those seeking/receiving help for depression during and after pregnancy. Methods. In-depth interviews were undertaken with a purposive sample of twelve Black Caribbean women selected from a larger sample (n=101) to examine prevalence and psychosocial risks for perinatal depression among this ethnic group. The study also sought to explore women's models of help-seeking. During analysis, the context in which help-seeking/giving is mediated emerged as a key issue. We explore the nature of these encounters thereby opening up the possibility of finding common ground between service users and providers for enabling women to receive the care and support they need. Findings. Whether or not women configure depressive feelings as 'symptoms' requiring external validation and intervention is a reflection both of the social embeddedness of those individuals and of how 'help-givers' perceive them and their particular needs. We suggest that the ways in which help-seeking/giving are commonly conceptualised might offer at least a partial explanation for apparently low levels of diagnosed perinatal depression among Black Caribbean women. Conclusions. Popular approaches to health seeking behaviours within health promotion and practice focus on individuals as the fulcrum for change, tending to overlook their embeddedness within 'reflexive communities'. This might serve to reinforce the invisibility of Black Caribbean women both in mainstream mental health services and associated research. Alternative approaches may be required to achieve government targets to reduce inequalities in access, care, and treatment and to deliver more responsive and culturally-appropriate mental health services.
3. Perceptions of Racism in Children and Youth (PRaCY): properties of a self-report instrument for research on children's health and development
- Collection:
- Black Caribbean Literature (BCL)
- Contributers:
- Pachter,Lee M. (Author), Szalacha,Laura A. (Author), Bernstein,Bruce A. (Author), and Coll,Cynthia Garcia (Author)
- Format:
- Journal Article
- Publication Date:
- 2010
- Location:
- African American Research Center, Library, University of Illinois at Urbana-Champaign
- Journal Title:
- Ethnicity & health
- Journal Title Details:
- 15(1) : 33-46
- Notes:
- Experiences of racial discrimination have been demonstrated to be related to racial and ethnic disparities in mental and physical health and healthcare. There has been little study, however, of the relationship between racism and health in children, and few psychometrically valid and reliable instruments to measure Perceptions of Racism in Children and Youth (PRaCY) exist. This paper reports on the development and testing of such an instrument, the PRaCY. Development of the instrument began with open-ended qualitative interviews, from which a proto-questionnaire was created. The questionnaire gathered information on the prevalence, attribution, emotional responses, and coping responses to 23 situations identified by participants in the qualitative phase. The proto-questionnaire was administered to 277 children between the ages of 8 and 18 years (38% Latino/a, 31% African-American, 19% multiracial/multicultural, 7% West Indian/Caribbean, and 5% Other). Item analysis resulted in two developmentally appropriate 10-item instruments (one for ages 7-13, another for ages 14-18). Internal consistency reliability was strong (alpha=0.78 for both versions of the instrument). Confirmatory factor analysis demonstrated good fit for both versions (younger-Comparative Fit Index (CFI): 0.967, Root Mean Square Error of Approximation (RMSEA): 0.047; older-CFI: 0.934, RMSEA: 0.056). Differential item functioning analyses demonstrated no group-specific biases in item response. PRaCY scores were appropriately associated with higher depressive symptom scores and elevated anxiety scores in the younger sample. Results indicate that the PRaCY is a valid and reliable instrument that measures perceptions of racism and discrimination in children and youth aged 8-18 from diverse racial/ethnic backgrounds.
4. Prescribing in general practice for people with coronary heart disease; equity by age, sex, ethnic group and deprivation
- Collection:
- Black Caribbean Literature (BCL)
- Contributers:
- Mathur,Rohini (Author), Badrick,Ellena (Author), Boomla,Kambiz (Author), Bremner,Stephen (Author), Hull,Sally (Author), and Robson,John (Author)
- Format:
- Journal Article
- Publication Date:
- 2011
- Location:
- African American Research Center, Library, University of Illinois at Urbana-Champaign
- Journal Title:
- Ethnicity & health
- Journal Title Details:
- 16(2) : 107-123
- Notes:
- Objective. Differences in drug prescribing for coronary heart disease have previously been identified by age, sex and ethnic group. Set in the UK, our study utilises routinely collected data from 98 general practices serving a socially diverse population in inner East London, to examine differences in prescribing rates among patients aged 35 years and over with coronary heart disease. Design. 10,933 patients aged 35 years or more, with recorded coronary heart disease, from 98 practices in two Primary Care Trusts (PCT) in East London during 2009/2010 were included for this cross-sectional study. Multivariable logistic regression was used to assess the odds of prescribing for recommended coronary heart disease drugs by age, sex, ethnicity, social deprivation, co-morbidity and recorded reasons for not prescribing. Results. Women are prescribed fewer recommended coronary heart disease drugs than men; Black African/Caribbean patients are prescribed fewer lipid modifying drugs and other cardiovascular drugs than White patients. Patients over age 84 are prescribed fewer lipid modifying drugs and beta blockers than patients aged 45-54. South Asian patients had the highest levels of prescribing and higher prevalence of coronary heart disease and diabetes co-morbidity. No difference in prescribing rates by social deprivation was found. Discussion. Overall levels of prescribing are high but small differences between sex and ethnic groups remain and prescribing may be inequitable for women, for Black/African Caribbeans and at older ages. These differences were not explained by recorded intolerance, contraindications or declining treatment.