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.

Examining the Association between Acculturation and Hypertension among Asian Americans in the Washington D.C. Metropolitan Area

Objective: To evaluate the association between Acculturation and hypertension among Asian Americans in the Washington, D.C. metropolitan area. Methods: A cross-sectional study was conducted of 600 Chinese, Korean, and Vietnamese adults. Logistic regression was used to investigate the relationship between acculturation variables (years in the U.S., self-rated acculturation, self-rated English fluency) and hypertension, determined from a mean of 3 blood pressure readings taken on site. Results: Compared to those who resided in the U.S. for 0-5 years, individuals who resided for 6-10 years were about 60% less likely to have hypertension (aOR= 0.36; 95% CI: 0.12, 1.05; p-value=0.06). No significant association was observed between self-rated identity and hypertension. Compared to those with poor English fluency, those who speak “so-so” English have increased odds of hypertension (aOR=1.57; 95%CI: 0.93, 2.64; p-value= 0.09). Disaggregated analysis was conducted for Asian American subgroups, which showed differences in trends of acculturation and hypertension. Conclusion: Findings suggest an association between acculturation and hypertension, guiding future studies to investigate further into these observed effects. Some subgroup differences were observed among Asian American subgroups, potentially suggesting a subgroup-focused intervention.

Maternal Age and Infant Mortality for White, Black, and Mexican Mothers in the United States

Funding for Open Access provided by the UMD Libraries Open Access Publishing Fund.

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.