The relationship between health literacy and indicators of informed decision making for colorectal cancer screening among African Americans

African Americans are disproportionately affected by colorectal cancer (CRC) incidence and mortality. CRC early detection leads to better treatment outcomes and, depending on the screening test, can prevent the development of CRC. African Americans, however, are screened less often than Whites. Aspects of decision making (e.g., decisional conflict, decision self-efficacy) can impact decision making outcomes and may be influenced by social determinants of health, including health literacy. However the relationship between social determinants of health and indicators of decision making in this population is not fully understood. Additionally, individuals have a choice between different CRC screening tests and an individual’s desire to use a particular screening test may be associated with social determinants of health such as health literacy. This study aimed to examine the relationship between social determinants of health and indicators of decision making for CRC screening among African Americans. A total of 111 participants completed a baseline and 14-month follow-up survey assessing decisional conflict, decision self-efficacy, decisional preference (shared versus informed decision making), and CRC test preference. Health literacy was negatively associated with decisional conflict and positively associated with decision self-efficacy (ps < .05). Individuals who were unemployed or working part-time had significantly greater decisional conflict than individuals working full-time (ps < .05). Individuals with a first-degree family history of CRC had significantly lower decision self-efficacy than individuals without a family history (p < .05). Women were significantly more likely to prefer making a shared decision rather than an informed decision compared to men (p < .05). Lastly, previous CRC screening behavior was significantly associated with CRC test preference (e.g., individuals previously screened using colonoscopy were significantly more likely to prefer colonoscopy for their next screening test; ps < .05). These findings begin to identify social determinants of health (e.g., health literacy, employment) that are related to indicators of decision making for CRC among African Americans. Furthermore, these findings suggest further research is needed to better understand these relationships to help with the future development and improvement of interventions targeting decision making outcomes for CRC screening in this population.

BLACK SURVIVAL POLITICS: ORGANIZED MOBILIZATION STRATEGIES IN AFRICAN AMERICAN COMMUNITIES TO END THE HIV/AIDS EPIDEMIC

The purpose of this study is to examine organizational patterns of African American activism in response the HIV/AIDS epidemic. Given their political, economic, and social disenfranchisement, African Americans have historically developed protest and survival strategies to respond to the devaluation of their lives, health, and well-being. While Black protest strategies are typically regarded as oppositional and transformative, Black survival strategies have generally been conceptualized as accepting inequality. In the case of HIV/AIDS, African American religious and non-religious organizations were less likely to deploy protest strategies to ensure the survival and well-being of groups most at risk for HIV/AIDS—such as African American gay men and substance abusers. This study employs a multiple qualitative case study analysis of four African American organizations that were among the early mobilizers to respond to HIV/AIDS in Washington D.C. These organizations include two secular or community-based organizations and two Black churches or faith-based organizations. Given the association of HIV/AIDS with sexual sin and social deviance, I postulated that Black community-based organizations would be more responsive to the HIV/AIDS-related needs and interests of African Americans than their religious counterparts. More specifically, I expected that Black churches would be more conservative (i.e. maintain paternalistic heteronormative sexual standards) than the community-based organizations. Yet findings indicate that the Black churches in this study were more similar than different than the community-based organizations in their strategic responses to HIV/AIDS. Both the community-based organizations and Black churches drew upon three main strategies in ways that politicalize the struggle for Black survival—or what I regard as Black survival politics. First, Black survival strategies for HIV/AIDS include coalition building at the intersection of multiple systems of inequality, as well as on the levels of identity and community. Second, Black survival politics include altering aspects of religious norms and practices related to sex and sexuality. Third, Black survival politics relies on the resources of the government to provide HIV/AIDS related programs and initiatives that are, in large part, based on the gains made from collective action.

Three Hundred Years in Annapolis: Phase III Archaeological Investigations of the Anne Arundel County Courthouse Site (18AP63), Annapolis, Maryland

During the summer of 1994, Archaeology in Annapolis conducted archaeological investigations of the city block bounded by Franklin, South and Cathedral Streets in the city of Annapolis. This Phase III excavation was conducted as a means to identify subsurface cultural resources in the impact area associated with the proposed construction of the Anne Arundel County Courthouse addition. This impact area included both the upper and lower parking lots used by Courthouse employees. Investigations were conducted in the form of mechanical trenching and hand excavated units. Excavations in the upper lot area yielded significant information concerning the interior area of the block. Known as Bellis Court, this series of rowhouses was constructed in the late nineteenth century and was used as rental properties by African-Americans. The dwellings remained until the middle of the twentieth century when they were demolished in preparation for the construction of a Courthouse addition. Portions of the foundation of a house owned by William H. Bellis in the 1870s were also exposed in this area. Construction of this house was begun by William Nicholson around 1730 and completed by Daniel Dulany in 1732/33. It was demolished in 1896 by James Munroe, a Trustee for Bellis. Excavations in the upper lot also revealed the remains of a late seventeenth/early eighteenth century wood-lined cellar, believed to be part of the earliest known structure on Lot 58. After an initially rapid deposition of fill around 1828, this cellar was gradually covered with soil throughout the remainder of the nineteenth century. The fill deposit in the cellar feature yielded a mixed assemblage of artifacts that included sherds of early materials such as North Devon gravel-tempered earthenware, North Devon sgraffito and Northem Italian slipware, along with creamware, pearlware and whiteware. In the lower parking lot, numerous artifacts were recovered from yard scatter associated with the houses that at one time fronted along Cathedral Street and were occupied by African- Americans. An assemblage of late seventeenth century/early eighteenth century materials and several slag deposits from an early forge were recovered from this second area of study. The materials associated with the forge, including portions of a crucible, provided evidence of some of the earliest industry in Annapolis. Investigations in both the upper and lower parking lots added to the knowledge of the changing landscape within the project area, including a prevalence of open space in early periods, a surprising survival of impermanent structures, and a gradual regrading and filling of the block with houses and interior courts. Excavations at the Anne Arundel County Courthouse proved this to be a multi-component site, rich in cultural resources from Annapolis' Early Settlement Period through its Modern Period (as specified by Maryland's Comprehensive Historic Preservation Plan (Weissman 1986)). This report provides detailed interpretations of the archaeological findings of these Phase III investigations.

Archaeological Investigation at Slayton House, 18AP74, Annapolis, Maryland

Archaeological investigation at the Slayton House site in Annapolis revealed evidence of occupation of the lot since the early 18th century. The intact late 18th century ground surfaces on which John Ridout built the row houses, and subsequent changes in the landscape and use of the yard as work space in the 19th century were discovered. There was ample visible evidence of the early 20th century landscape and use of the yard as a pleasure garden when excavation was started. Deposits inside the house were quite disturbed, but there was evidence of the work done by the African Americans who lived there. A number of artifacts were found which may indicate the slaves and free African Americans were practicing African-related folk beliefs. No further investigations are recommended for the site. However, if severe or deep ground-disturbing activities were to take place on the property, they should be monitored by a qualified archaeologist.

Ledroit Park, A Portrait In Black And White: A Study Of Historic Districts, Social Change, And The Process Of Neighborhood Placemaking

This research examines the process of placemaking in LeDroit Park, a residential Washington, DC, neighborhood with a historic district at its core. Unpacking the entwined physical and social evolution of the small community within the context of the Nation’s Capital, this analysis provides insight into the role of urban design and development as well as historic designation on shaping collective identity. Initially planned and designed in 1873 as a gated suburb just beyond the formal L’Enfant-designed city boundary, LeDroit Park was intended as a retreat for middle and upper-class European Americans from the growing density and social diversity of the city. With a mixture of large romantic revival mansions and smaller frame cottages set on grassy plots evocative of an idealized rural village, the physical design was intentionally inwardly-focused. This feeling of refuge was underscored with a physical fence that surrounded the development, intended to prevent African Americans from nearby Howard University and the surrounding neighborhood, from using the community’s private streets to access the City of Washington. Within two decades of its founding, LeDroit Park was incorporated into the District of Columbia, the surrounding fence was demolished, and the neighborhood was racially integrated. Due to increasingly stringent segregation laws and customs in the city, this period of integration lasted less than twenty years, and LeDroit Park developed into an elite African American enclave, using the urban design as a bulwark against the indignities of a segregated city. Throughout the 20th century housing infill and construction increased density, yet the neighborhood never lost the feeling of security derived from the neighborhood plan. Highlighting the architecture and street design, neighbors successfully received historic district designation in 1974 in order to halt campus expansion. After a stalemate that lasted two decades, the neighborhood began another period of transformation, both racial and socio-economic, catalyzed by a multi-pronged investment program led by Howard University. Through interviews with long-term and new community members, this investigation asserts that the 140-year development history, including recent physical interventions, is integral to placemaking, shaping the material character as well as the social identity of residents.

Faithful Genres: Rhetorics of the Civil Rights Mass Meeting

“Faithful Genres” examines how African Americans adapted the genres of the black church during the civil rights movement. Civil rights mass meetings, as the movement’s so-called “energy machine” and “heartbeat,” serve as the project’s central site of inquiry for these meetings were themselves adaptations of the genre of the black church service. The mass meetings served as the space to draw people into the movement, encourage people toward further activism, and testify to anyone watching that the African American community was working toward desegregation, voting rights, and racial equality. In Martin Luther King, Jr.’s words, “Through these meetings we were able to generate the power and depth which finally galvanized the entire Negro community.” In these weekly or sometimes even nightly meetings, participants inhabited the familiar genres of the black church, song, prayer, and testimony. As they did, they remade these genres to respond directly to white supremacy and to enact the changes they sought to create. While scholars have studied the speeches men and women such as King, Ralph Abernathy, and Fannie Lou Hamer delivered at meetings (Wilson; Selby; Holmes; Brooks), scholars have yet to examine how civil rights mass meetings functioned through a range of genres and rhetors. My study addresses this absence and invigorates this discussion to demonstrate how the other meeting genres beyond the speech—song, prayer, and testimony—functioned to create energy, sustenance, and motivation for activists. Examining these collectively enacted genres, I show how rhetors adapted song, prayer, and testimony toward strategic interventions. I also examine how activists took these same genres up outside the meetings to circulate them in broader contexts for new audiences. By recovering and defining the mass meeting as a flexible repertoire of genres and then examining the redeployment of meeting genres outside the meeting, “Faithful Genres” contributes to histories of civil rights and African American rhetorics, genre studies, and histories of religious rhetorics.

Contested Play and Clean Water: McMillan Park, Race, and the Built Environment in Washington, D.C., 1900-1941

This study focuses on the intersection of the politics and culture of open public space with race relations in the United States from 1900 to 1941. The history of McMillan Park in Washington, D.C. serves as a lens to examine these themes. Ultimately, the park’s history, as documented in newspapers, interviews, reports, and photographs, reveals how white residents attempted to protect their dominance in a racial hierarchy through the control of both the physical and cultural elements of public recreation space. White use of discrimination through seemingly neutral desires to protect health, safety, and property values, establishes a congruence with their defense of residential property. Without similar access to legal methods, African Americans acted through direct action in gaps of governmental control. Their use of this space demonstrates how African-American residents of Washington and the United States contested their race, recreation, and spatial privileges in the pre-World War II era.

Breaking through the Margins: Pushing Sociopolitical Boundaries Through Historic Preservation

“Breaking through the Margins: Pushing Sociopolitical Boundaries Through Historic Preservation” explores the ways in which contemporary grassroots organizations are adapting historic preservation methods to protect African American heritage in communities that are on the brink of erasure. This project emerges from an eighteen-month longitudinal study of three African American preservation organizations—one in College Park, Maryland and two in Houston, Texas—where gentrification or suburban sprawl has all but decimated the physical landscape of their communities. Grassroots preservationists in Lakeland (College Park, Maryland), St. John Baptist Church (Missouri City, Texas), and Freedmen’s Town (Houston, Texas) are involved in pushing back against preservation practices that do not, or tend not, to take into consideration the narratives of African American communities. I argue, these organizations practice a form of preservation that provides immediate and lasting effects for communities hovering at the margins. This dissertation seeks to outline some of the major methodological approaches taken by Lakeland, St. John, and Freedmen’s Town. The preservation efforts put forth by the grassroots organizations in these communities faithfully work to remind us that history without preservation is lost. In taking on the critical work of pursuing social justice, these grassroots organizations are breaking through the margins of society using historic preservation as their medium.

Ready for Transition: Factors that facilitate transfer to undergraduate engineering programs among Black African and American students

This study examines the factors facilitating the transfer admission of students broadly classified as Black from a single community college into a selective engineering college. The work aims to further research on STEM preparation and performance for students of color, as well as scholarship on increasing access to four-year institutions from two-year schools. Factors illuminating Underrepresented Racial and Ethnic Minority (URM) student pathways through Science, Technology, Engineering, and Mathematics (STEM) degree programs have often been examined through large-scale quantitative studies. However, this qualitative study complements quantitative data through demographic questionnaires, as well as semi-structured individual and group. The backgrounds and voices of diverse Black transfer students in four-year engineering degree programs were captured through these methods. Major findings from this research include evidence that community college faculty, peer networks, and family members facilitated transfer. Other results distinguish Black African from Black American transfers; included in these distinctions are depictions of different K-12 schooling experiences and differences in how participants self-identified. The findings that result from this research build upon the few studies that account for expanded dimensions of student diversity within the Black population. Among other demographic data, participants’ countries of birth and years of migration to the U.S. (if applicable) are included. Interviews reveal participants’ perceptions of factors impacting their educational trajectories in STEM and subsequent ability to transfer into a competitive undergraduate engineering program. This study is inclusive of, and reveals an important shifting demographic within the United States of America, Black Africans, who represent one of the fastest-growing segments of the immigrant population.

Preliminary Validation of the "Plausibility of Intraracial Marriage Scale": A Study of Upwardly Mobile African American Women

Like many Americans, African American women often view marriage as an important life goal; however, it is likely that many also view it as one that is out of reach (Dixon, 2009; Wallace, 2014). The present study sought to address this issue by developing a new measure to assess African American women’s experiences in this regard in hopes of shedding light on how it impacts their dating and mating experiences. A total of 251 heterosexual African American women who were either enrolled in college or who had completed some form of postsecondary education completed an online survey assessing a variety of topics including their attitudes and emotions regarding a shortage of marriageable men, their standards to marry, and their willingness to date interracially. Results from this study established preliminary construct validity for a new scale assessing African American women’s attitudes and emotions about the shortage of “marriageable” African American men.

Aging African American Women and the Impact of Positive Psychological Factors on Quality of Life

Aging African-American women are disproportionately affected by negative health outcomes and mortality. Life stress has strong associations with these health outcomes. The purpose of this research was to understand how aging African American women manage stress. Specifically, the effects of coping, optimism, resilience, and religiousness as it relates to quality of life were examined. This cross-sectional exploratory study used a self-administered questionnaire and examined quality of life in 182 African-American women who were 65 years of age or older living in senior residential centers in Baltimore using convenience sampling. The age range for these women was 65 to 94 years with a mean of 71.8 years (SD = 5.6). The majority (53.1%) of participants completed high school, with 23 percent (N = 42) obtaining college degrees and 19 percent (N = 35) holding advanced degrees. Nearly 58 percent of participants were widowed and 81 percent were retired. In addition to demographics, the questionnaire included the following reliable and valid survey instruments: The Brief Cope Scale (Carver, Scheier, & Weintraub, 1989), Optimism Questionnaire (Scheier, Carver, & Bridges, 1994), Resilience Survey (Wagnild & Young, 1987), Religiousness Assessment (Koenig, 1997), and Quality of Life Questionnaire (Cummins, 1996). Results revealed that the positive psychological factors examined were positively associated with and significant predictors of quality of life. The bivariate correlations indicated that of the six coping dimensions measured in this study, planning (r=.68) was the most positively associated with quality of life. Optimism (r=.33), resilience (=.48), and religiousness (r=.30) were also significantly correlated with quality of life. In the linear regression model, again the coping dimension of planning was the best predictor of quality of life (beta = .75, p <.001). Optimism (beta = .31, p <.001), resilience (beta = .34, p, .001) and religiousness (beta = .17, p <.01) were also significant predictors of quality of life. It appears as if positive psychology plays an important role in improving quality of life among aging African-American women.

Final Archaeological Investigations at the Maynard-Burgess House (18AP64): An 1850-1980 African-American Household in Annapolis, Maryland

The Maynard-Burgess House was excavated by Archaeology in Annapolis from Fall, 1990 to Summer, 1992. The still-standing house is located at 163 Duke of Gloucester Street in Annapolis' Historic District and is today being restored by Port of Annapolis, Incorporated. Archaeological testing and excavation of the site was developed alongside architectural analyses and archival research as the initial phase of the home's restoration. The Maynard-Burgess House was continuously occupied by two African-American families, the Maynards and the Burgesses, from the 1850s until the late 1980s. The main block of the house was built between 1850 and 1858 by the household of John T. Maynard, a free African American born in 1810,and his wife Maria Spencer Maynard. Maynard descendants lived in the home until it was foreclosed in 1908 and subsequently sold to the family of Willis and Mary Burgess in 1915. Willis had been a boarder in the home in 1880, and his sister Martha Ready had married John and Maria's son John Henry. Burgess descendants lived at the home until its sale in 1990.

African-American Composers for the Concert Saxophone: A Look at Three Prolific Composers

African-American composers within the field of classical music have made very profound contributions to the literature. In the field of chamber music, Scott Joplin, William Grant Still, Adolphus Hailstork and other composers illustrious composers have created an established and well-documented body of repertoire for many orchestral wind instruments. The saxophone repertoire, however, has not been developed as fully due to its limited tradition as an orchestral instrument and its prominence in the tradition of jazz and popular music. African-American composers in particular appear to be significantly under-represented within the standard concert saxophone literature. My personal experiences with saxophone repertoire in academic settings, solo recitals, conferences and in surveys of standard repertoire from nationally-recognized saxophone teachers support this assertion. There are many African-American composers who have made substantial contributions to the body of repertoire for the concert saxophone. This dissertation examines the works of three prolific African-American composers for the concert saxophone; Dr. Yusef A. Lateef, Andrew N. White III, and Dr. David N. Baker. All have composed more than five separate works featuring the concert saxophone. This project comprises three recitals, each dedicated to one of the three composers selected for this dissertation. Each recital presented will present their compositions featuring the saxophone as a soloist with various types of accompaniment. The project also includes newly-created piano reductions of Dr. David Baker's works for saxophone and orchestra made collaboratively with Baker and arranger John Leszczynski.