Nadine Barrett

Many women do not get mammography screenings at the intervals recommended for early detection and treatment of breast cancer. The Guide to Community Preventive Services (Community Guide) recommends a range of evidence-based strategies to improve mammography rates. However, nurses and others working in community-based settings make only limited use of these strategies. We report on a dissemination intervention that partnered the University of North Carolina with the Susan G. Komen Triangle Affiliate to disseminate Community Guide breast cancer screening strategies to community organizations. The intervention was guided by social marketing and diffusion of innovation theory and was designed to provide evidence and support via Komen's existing relationships with grantee organizations. The present study reports the findings from a formative evaluation of the intervention, which included a content analysis of 46 grant applications pre- and post intervention and focus groups with 20 grant recipients.

Although national methadone treatment trends have improved substantially from 1988 to 2001, current research has found that African Americans still receive lower dosages of methadone treatment than their white and Hispanic counterparts, which has significant public health concerns. We sought to empirically examine whether the degree of cultural competency within an outpatient substance abuse treatment (OSAT) organization has influence on the methadone dosage levels received by African Americans in 1995 and in 2005. The 1995 and 2005 National Drug Abuse Treatment System Survey (NDATSS) provided a nationally-representative, stratified sample of 618 and 566 OSAT organizations, respectively, of which 121 and 140 affiliated methadone maintenance treatment programs, respectively, were analyzed. The organizations' director and clinical supervisor were surveyed. Fixed-effects linear regression models were fitted with measures of cultural competency, client, and organizational characteristics to assess methadone dosage levels. Culturally-competent units have smaller numbers of methadone clients, greater percentages of clients who receive methadone dosages of less than 40 mg/d, smaller percentages of clients who receive methadone dosages of 80 mg/d or more, and provide a larger number of therapeutic and ancillary services during treatment than non-culturally-competent units. OSAT units with more African Americans are significantly more likely to have clients who receive dosages of less than 40 mg/d and are significantly less likely to have clients who receive dosages of 80 mg/d or more. There is no racial difference among culturally-competent unit clients who receive dosages of less than 40 mg/d, between 40 and 59 mg/d, between 60 and 79 mg/d, and 80 mg/d or more. However, among non-culturally-competent units, a racial difference exists among African Americans and other clients who receive these various dosage levels. Research indicating that African Americans receive lower dosages of methadone than their White and Hispanic counterparts may now be explained by whether these clients receive treatment in culturally competent organizations, rather than solely by arguments related to organizational differences in resources, experience and training of staff, staff bias and/or racism. Culturally competent organizations may seek a method of treatment that dissuades "replacing one drug for another," while simultaneously treating the root cause of the addiction through the provision of comprehensive therapeutic and ancillary support services. Further research is needed to determine if cultural competency results in better substance abuse treatment outcomes for African Americans. © Springer Science+Business Media, LLC 2009.

This Community Health Assessment covers the 13 County Catchment Area of Susan G. Komen NC Triangle Affiliate and is designed to ensure strategic initiatives reach the most vulnerable populations in the Greater Triangle and eastern NC to increase breast cancer outreach, education, screening, and treatment for underserved populations in the region. The report is a comprehensive overview of primary and secondary data describing the current state of breast cancer incidence and mortality and the challenges associated with access to care in urban and rural counties in the Greater Triangle.

There has been very little research on why individuals hold different attitudes toward Social Security. In this article we integrate social location theory and political predisposition theory to provide a framework of explanation and test these theories using a unique sample from the 1998 General Social Survey. Our multivariate results reveal that social structural positions along the lines of race, gender, class and age play a more important role than political predispositions in explain-ing individual differences in support for the current Social Security system against privatisation. Political party affiliation also partly contributes to variation in support for Social Security, but political ideology does not have a significant effect. Our results suggest that with regard to support for Social Security, primary consideration must rest on social structural positions. Racial minorities, women, the poor and the elderly tend to dislike a drastic change in the current Social Security system, and Social Security reform ought to pay attention to their concerns. Our robust finding of a positive relationship between age and support for Social Security also challenges much of the established knowledge, pointing to an intergenerational discord over Social Security. It is also important to differentiate among social welfare programmes in order to uncover the real determinants of public attitudes towards them. © 2006 The Author(s), Journal compilation © 2006 Blackwell Publishing Ltd and the International Journal of Social Welfare.

BACKGROUND: Certain cultural, folk, and religious beliefs that are more common among African Americans (AAs) have been associated with later-stage breast cancer. It is unknown if these beliefs are similarly associated with delays in diagnosis of ovarian cancer. METHODS: Data from a multicenter case-control study of ovarian cancer in AA women were used to examine associations between cultural/folk beliefs and religious practices and stage at diagnosis and symptom duration before diagnosis. Associations between cultural/folk beliefs or religious practices and stage at diagnosis were assessed with logistic regression analyses, and associations with symptom duration with linear regression analyses. RESULTS: Agreement with several of the cultural/folk belief statements was high (e.g., 40% agreed that "if a person prays about cancer, God will heal it without medical treatments"), and ∼90% of women expressed moderate to high levels of religiosity/spirituality. Higher levels of religiosity/spirituality were associated with a twofold increase in the odds of stage III-IV ovarian cancer, whereas agreement with the cultural/folk belief statements was not associated with stage. Symptom duration before diagnosis was not consistently associated with cultural/folk beliefs or religiosity/spirituality. CONCLUSIONS: Women who reported stronger religious beliefs or practices had increased odds of higher stage ovarian cancer. Inaccurate cultural/folk beliefs about cancer treament were not associated with stage; however, these beliefs were highly prevalent in our population and could impact patient treatment decisions. Our findings suggest opportunities for health education interventions, especially working with churches, and improved doctor-patient communication.