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Biomedical subjects

S A James

Publications and source records attributed to S A James.

At least 73 records · Page 4Linked to original sources
PubMed1989

A Social Environment Inventory for the pediatric office.

Exposure to psychosocial stressors is associated with deleterious physical and mental health outcomes among children and adults, as well as with school-related and behavioral problems among children. However, research and intervention in this area have been hampered by the lack of a valid measurement tool to assess exposure to stressors among mothers. This paper reports on the development and testing of a self-administered questionnaire for use in the pediatric setting to assess maternal exposure to stressors. The questionnaire was developed to facilitate the early identification of mothers exposed to high levels of stressors, since exposure to stressors often precedes the onset of problems. Early identification of mothers and children, in the pediatric office, could facilitate the prevention of various behavioral, school, and other problems among children.

Child↗
PubMed1987

Socioeconomic status, John Henryism, and hypertension in blacks and whites.

The joint influence of socioeconomic status and John Henryism on risk for elevated blood pressure was examined in a biracial, community sample of 820 adults, aged 21-50 years, who resided in Edgecombe County, North Carolina, and were interviewed in 1983. John Henryism refers to a strong personality predisposition to cope actively with psychosocial environmental stressors. In keeping with an earlier finding for black men, it was hypothesized that the inverse association between socioeconomic status and blood pressure would be stronger for persons who scored high on John Henryism than for persons who scored low. Using race-specific definitions of socioeconomic status, the study found support for the hypothesis among blacks. At low levels of John Henryism, socioeconomic status differences in hypertension prevalence were small (1.6%), whereas at high levels of John Henryism, low socioeconomic status blacks were nearly three times as likely to be hypertensive as higher status blacks (31.4% vs. 11.5%, p = 0.02 for the socioeconomic status X John Henryism interaction term). The findings for systolic and diastolic blood pressures were in a similar direction but did not reach statistical significance. The study hypothesis was not supported among whites. Analyses of the correlates of John Henryism as well as the blood pressure findings are discussed in terms of the different socioeconomic circumstances that characterize the lives of blacks and whites in this rural, southern community.

Adult↗
PubMed1987

Effects of race and marginally elevated blood pressure on responses to stress.

A total of 228 men, aged 18 to 22 years (109 black and 119 white), underwent monitoring of heart rate (HR) and systolic (SBP) and diastolic blood pressure (DBP) responses during several stressor conditions and a 30-minute posttask rest period. Stressors included the cold pressor test and three reaction-time tasks: noncompetitive, competitive, and competitive plus money incentive. Substantial within-subject variations in blood pressure and heart rate were induced, varying from 119/70 to 148/94 mm Hg and from 63 to 91 beats/min on the average. Men (25 black and 39 white) with marginal SBP elevations during initial casual determinations had higher SBP under all conditions compared with men whose casual SBP levels were normal, and they also showed greater elevations over baseline levels in heart rate, SBP, and DBP during the stressors and the initial casual determination. Black and white subjects did not differ in their blood pressures at baseline or during the initial casual determinations, although blacks had slightly lower heart rates. Blacks did show greater SBP elevations over baseline levels than whites during the stressors, primarily because the blacks with marginally elevated SBP showed substantially greater stress-induced increases than whites with marginally elevated SBP. This enhanced pressor response to stress in blacks with marginal blood pressure elevations may be due to higher vascular resistance during enhanced sympathetic activity and could contribute to the higher incidence of hypertension among blacks.

Adult↗
PubMed1987

Psychosocial precursors of hypertension: a review of the epidemiologic evidence.

This article provides a selective overview of epidemiologic studies on the relationship between psychosocial factors and blood pressure elevation. The review focuses on English-language reports published since 1975 and emphasizes two broad areas of research: changes in mean blood pressures of third world populations undergoing modernization, and psychosocial correlates of elevated blood pressure in low socioeconomic status (SES) and black populations within the continental United States. The recent modernization studies provide additional evidence that rapid sociocultural change is associated with increased prevalence of hypertension. To account for these effects, several studies have advanced the general thesis that modernization impacts traditional value systems of third world populations in ways that frequently engender discrepancies between their newly acquired aspirations for a Western lifestyle and their socioeconomic resources to successfully pursue that lifestyle. There is overlap between this formulation and recent investigations of hypertension in low SES and black populations in the United States. The report concludes with a discussion of epidemiologic studies of anger and hypertension, emphasizing some of the complexities that characterize this area of research.

Adaptation, Psychological↗
PubMed1986

Social support and hypertension among blacks and whites in a rural, southern community.

The association between social support and the prevalence of hypertension was examined in a randomly selected, biracial sample of 2,030 adult residents of Edgecombe County, North Carolina, who were surveyed in 1980. Two types of support, instrumental and emotional, were measured and evaluated in the 2,009 individuals for whom complete data were available. Blacks were more likely to have low levels of both kinds of social support. Low emotional support was unrelated to the prevalence of hypertension. In unadjusted analyses, low instrumental support was associated with increased hypertension for both races. After controlling for other correlates of blood pressure, the association no longer held for whites (odds ratio (OR) = 1.1), but remained statistically significant for blacks (OR = 1.5, 95 per cent confidence interval = 1.1-2.0). Further analyses revealed that these results were specific to low income blacks (OR = 1.7). These findings are consistent with the results of ecologic studies of social ties and hypertension-related mortality in North Carolina.

Adult↗
PubMed1985

Patient exposition and physician explanation in initial medical interviews and outcomes of clinic visits.

To replicate an earlier study and explore associations between verbal behaviors in patient-physician interactions and outcomes of care, 102 visits to a medicine walk-in clinic were tape-recorded, transcribed, and coded according to the Verbal Response Mode (VRM) system. Questionnaires given before and after the clinic visit and telephone interviews 1 week and 4 weeks after the visit were used to measure patient satisfaction, compliance, and change in symptoms. Data were collected on patients' sociodemographic characteristics, illness characteristics, and health beliefs. Two verbal exchanges were examined: in the medical history, the Patient Exposition exchange, which was measured as the frequency with which patients make statements about their illnesses in their own words; and in the conclusion, the Physician Explanation exchange, which was measured as the percentage of physician statements that are factual. These verbal indexes showed correlations with patient satisfaction, thus replicating the earlier study, but no significant correlations with compliance. Analysis of variance showed that the association between verbal exchanges and patient satisfaction remained after controlling for physician differences and for patient age, education, and belief in the controllability of the illness.

Adult↗
PubMed1985

Community coverage in a rural, church-based, hypertension screening program in Edgecombe County, North Carolina.

In a rural, church-based hypertension program in Edgecombe County, North Carolina, screening of the congregations was complemented by a community outreach component targeted at 18-60 year old males, a group at higher risk for untreated hypertension. Compared with its estimated frequency in the community, untreated hypertension was as common in the church congregations and somewhat less prevalent than expected among outreach screenees.

Adolescent↗
PubMed1985

The Edgecombe County High Blood Pressure Control Program: III. Social support, social stressors, and treatment dropout.

In a hypertension prevalence survey of a stratified random sample of 1,000 households, 2,030 adults (aged 18 years and over) were interviewed and information on psychosocial variables collected. Among 359 hypertensives, there was a consistent relationship between indicators of difficulty in the social environment and dropout from treatment in women. Compared to those who remained in treatment, women who dropped out can be characterized as having less social support on the job, having less perceived spouse approval (if married), having a lower level of perceived access to supportive resources, and being more likely to report feeling pushed most or all of the time if they are homemakers. Relationships between indicators of social support and dropout from treatment in men were found only with support on the job, and for White men, with perceived friend approval.

Adult↗
PubMed1984

John Henryism and blood pressure differences among black men. II. The role of occupational stressors.

In this study, the effects of psychosocial job stressors on the resting blood pressure (BP) of 112 black male workers were examined. The subjects resided in a rural, poor, predominantly black community in eastern North Carolina. The job stressors included unemployment, lack of job security, lack of job success, the perception that wages earned were too low for the work performed (and inhibited anger about unfair wages), and the perception that being black had hindered chances for achieving job success. The effect-modifying influence of on-the-job social support, and John Henryism, on several of these relationships was also examined. For systolic blood pressure, a main effect was observed for job security, and an interaction effect was observed for employment status and time of day of interview. For diastolic blood pressure, significant interactions were observed for job success and John Henryism, and for job success and the perception that being black had hindered chances for achieving job success. These findings further clarify under what conditions John Henryism may be associated with higher BPs in this sample of black men. These findings also shed light on the emotional pathways through which selected job stressors may influence resting BPs in these men.

Adaptation, Psychological↗
PubMed1984

Socioeconomic influences on coronary heart disease in black populations.

It is likely that socioeconomic factors exert important influences on coronary heart disease (CHD) morbidity and mortality for U.S. blacks. Careful and comprehensive studies are needed to clarify the pathways through which low socioeconomic status exerts its influence on susceptibility to CHD. In addition, policy-oriented research is needed to clarify to what extent reduced access to medical care contributes to excessive CHD mortality in black Americans.

Black or African American↗
PubMed1984

Coronary heart disease in black Americans: suggestions for research on psychosocial factors.

Despite the fact that coronary heart disease (CHD) is the leading cause of death among U.S. blacks, virtually no information exists on the contribution of psychosocial factors to CHD risk in this population. Studies conducted on U.S. whites suggest that type A behavior may be positively associated with risk for CHD. Other studies on whites suggest that occupational stressors, socioeconomic status, and social mobility may also be important. Studies that examine the contribution of these factors to CHD risk in the black population are needed. Moreover, recent changes in the socioeconomic profile of the U.S. black population present an unusual opportunity to study the role of psychosocial variables in CHD among black Americans. Some of the theoretical and measurement issues that investigators may face in conducting such research are discussed, and some specific suggestions for research are offered.

Adult↗
PubMed1984

Differences in use of health services by children according to race. Relative importance of cultural and system-related factors.

Black children make substantially less use of health services than do their white counterparts, despite their demonstrably poorer health status. This relationship is true regardless of income. Various authors have suggested that such differences are due to system-related barriers to access to care by black children. Alternatively, others have noted that blacks have cultural patterns related to health and illness, and these culturally determined beliefs and behaviors may account for the observed differences. The present study compared use of health services by black and white children within a system of care that has sought to decrease barriers to access to care by black children. Within this system, black and white children used health services in a similar fashion, suggesting that system-related factors that assure equity of access to health services may be more important than client-related cultural factors, or that these cultural factors may be overcome.

Adolescent↗
PubMed1984

The Edgecombe County High Blood Pressure Control Program: I. Correlates of uncontrolled hypertension at baseline.

To guide the planning of a multifacetted hypertension control program in Edgecombe County, North Carolina, a baseline survey of a stratified (by township) random sample of 1,000 households was conducted. All adults (greater than or equal to 18 years) were interviewed and had their blood pressures (BP) measured. Five hundred thirty-nine individuals, 27 per cent of the survey population, had diastolic BP greater than or equal to 90 mm Hg or were receiving anti-hypertensive drug therapy. The 539 hypertensives were divided into seven subgroups reflecting successive stages in the control of hypertension based on the awareness, treatment, and control of their hypertension. Unaware hypertensives were further subdivided into three groups according to the recency of their last BP check, and those aware but untreated were subdivided by whether they had previously received treatment. The seven subgroups of hypertensives were compared, separately for women and men, with respect to sociodemographic characteristics, health behaviors, and health status. In general, the progression from undetected hypertension to treatment and control appeared to be associated with being older, female, and White. This progression was further associated with greater educational levels and higher family incomes among women and increasing self-reported morbidity among men. The implications for intervention of these and other described associations are discussed.

Adolescent↗