Carmen Samuel-hodge - Academia.edu (original) (raw)

Papers by Carmen Samuel-hodge

Carolina Digital Repository (University of North Carolina at Chapel Hill), 2014

The FASEB Journal, Apr 1, 2013

American Journal of Health Promotion, Apr 13, 2022

Purpose To examine the relationship between the multiple caregiver role and its perceived barrier... more Purpose To examine the relationship between the multiple caregiver role and its perceived barriers to self-care on behavioral adherence in a weight loss intervention. Design A secondary analysis of data from a behavioral weight loss intervention. Setting The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Subjects Eighty-one Black women with overweight/obesity (age = 48.4 ± 10.9 years [M ± SD], BMI = 36.4 ± 4.5 kg/m2 [M ± SD]). Measures Identification with the multiple caregiver role and barriers was assessed with the Multiple Caregiving Measurement Instrument. Weight was measured with a digital scale and height with a stadiometer. The Block food frequency questionnaire evaluated dietary intake. Moderate-to-vigorous physical activity (MVPA) was measured objectively with an accelerometer. Study adherence was measured by session attendance, self-weighing, and self-monitoring (diet and physical activity) frequency. Analysis Generalized linear models were used to examine the relationship between the multiple caregiver scales and the outcomes of interest, controlling for study arm, cohort, and income. Chi-square tests tested correlations. Results Greater identification with the multiple caregiver role was associated with decreased session attendance (β = −.56 [SE = .27], P < .05) and a trend towards weight gain (β = .36, [SE = .19], P = .07). Greater multiple caregiver barriers score predicted a decrease in fruit/vegetable intake (β = −.17 [SE = .07], P < .05). All regression results are unstandardized. Negative correlations between multiple caregiver barriers and MVPA ( r = −.24, P = .06) and daily self-weighing ( r = −.19, P = .10) approached significance. Conclusions Participants’ identification with multiple caregiving role and barriers can reduce adherence, behavior and weight change. Interventions to address Black women’s multiple roles and barriers during weight loss are needed to maximize outcomes.

Carolina Digital Repository (University of North Carolina at Chapel Hill), 2013

Carolina Digital Repository (University of North Carolina at Chapel Hill), 2015

Objective-This study explored the criterion-related validity and test-retest reliability of the m... more Objective-This study explored the criterion-related validity and test-retest reliability of the modified RESIDential Enviroment (RESIDE) physical activity questionnaire and whether the instrument's validity varied by body mass index (BMI), education, race/ethnicity, or employment status. Design-Validation study using baseline data collected for randomized trial of a weight loss intervention. Method-Participants recruited from health departments wore an ActiGraph accelerometer and self-reported non-occupational walking, moderate and vigorous physical activity on the modified RESIDE questionnaire. We assessed validity (n=152) using Spearman correlation coefficients (SCC), and reliability (n=57) using intraclass correlation coefficients (ICC). Results-When compared to steps, moderate physical activity, and bouts of moderate/vigorous physical activity measured by accelerometer, these questionnaire measures showed fair evidence

Carolina Digital Repository (University of North Carolina at Chapel Hill), 2010

Introduction Cardiovascular disease is the leading cause of deaths and illnesses in US adults, an... more Introduction Cardiovascular disease is the leading cause of deaths and illnesses in US adults, and the prevalence is disproportionately high in underserved populations. In this study, we assessed respondents' understanding of context-specific differences in knowledge and perceptions of disease, risk, and prevention in 6 underserved communities, with the longer-term goal of developing appropriate interventions. Methods Thirty-nine small-group sessions and 14 interviews yielded data from 318 adults. Each site's researchers coded, analyzed, and extracted key themes from local data. Investigators from all sites synthesized results and identified common themes and differences. Results Themes clustered in 3 areas (barriers to cardiovascular health, constraints related to multiple roles, and suggestions for effective communications and programs). Barriers spanned individual, social and cultural, and environmental levels; women in particular cited multiple roles (eg, competing demands, lack of self-care). Programmatic suggestions included the following: personal, interactive, social context; information in language that people use; activities built around cultural values and interests; and community orientation. In addition, respondents preferred health-related information from trusted groups (eg, AARP), health care providers (but with noticeable differences of opinion), family and friends, and printed materials. Conclusion Interventions to decrease barriers to cardiovascular health are needed; these strategies should include family and community context, small groups, interactive methods, culturally sensitive materials, and trusted information sources. New-immigrant communities need culturally and linguistically tailored education before receiving more substantive interventions.

Preventive Medicine, Jul 1, 2021

The projected three-fold increase in diabetes burden by 2060 in the United States will affect cer... more The projected three-fold increase in diabetes burden by 2060 in the United States will affect certain race and gender groups disproportionately. The objective of this mixed-methods study was to assess differences in prediabetes screening and clinician response to prediabetes by patient race and gender. We utilized data from 18,742 patients seen between 11/1/15 and 4/30/17 who met criteria for blood glucose screening by the 2015 US Preventive Service Task Force recommendation and had at least one visit to a primary care practice within a large, academic health system located in North Carolina. We utilized generalized estimating equations with logistic regression to assess race and gender differences in two outcomes: prediabetes screening and clinician response to prediabetes. We conducted twenty in-depth interviews (October 2018–May 2019) with physicians to assess their approach to screening for and treating prediabetes.Black patients had 11% higher odds (95% CI:1.02–1.20) of being screened for prediabetes than White patients. Men had 19% higher odds (95% CI:1.09–1.30) of being screened for prediabetes than women. There were no significant differences in clinician response to prediabetes by patient race or gender. Qualitatively, physicians reported a non-systematic approach to prediabetes screening and follow-up care related to: 1) System-level barriers to screening and treatment; 2) Implicit bias; 3) Patient factors; and 4) Physician preferences for prediabetes treatment. Targeted risk-based screening for prediabetes along with increased treatment for prediabetes are critical for preventing diabetes and reducing diabetes-related disparities.

Journal of General Internal Medicine, Apr 7, 2021

Background In 2015, the US Preventive Services Task Force (USPSTF) revised clinical recommendatio... more Background In 2015, the US Preventive Services Task Force (USPSTF) revised clinical recommendations to more broadly recommend abnormal blood glucose screening and more clearly recommend referral to behavioral interventions for adults with prediabetes. Objective To assess the effects of the 2015 USPSTF recommendation changes on abnormal blood glucose screening and referral to behavioral interventions, and to examine physicians’ perceptions of the revised recommendation. Design We utilized a sequential, dependent mixed-methods triangulation design. Participants A total of 33,444 patients meeting USPSTF abnormal blood glucose screening criteria within 15 health system–affiliated primary care practices and 20 primary care physicians in North Carolina. Main Measures We assessed monthly abnormal blood glucose screening rate and monthly referral rate to behavioral interventions. To estimate trend changes in outcomes, we used segmented linear regression analysis of interrupted time-series data. We gathered physicians’ perspectives on the 2015 USPSTF abnormal blood glucose recommendation including awareness of, agreement with, adoption of, and adherence to the recommendation. To analyze qualitative data, we used directed content analysis. Key Results There was a slight significant change in trend in abnormal blood glucose screening rates post-recommendation. There was a slight, statistically significant decrease in referral rates to behavioral interventions post-recommendation. Physicians were generally unaware of the revisions to the 2015 USPSTF abnormal blood glucose recommendation; however, once the recommendations were described, physicians agreed with the screening recommendation but felt that the behavioral intervention referral recommendation was hard to implement. Conclusion The 2015 USPSTF abnormal blood glucose guideline had little to no effect on abnormal blood glucose screening or referral to behavioral interventions in North Carolina practices. Potential interventions to improve these rates could include clinical decision tools embedded in the electronic health record and better referral systems for community-based diabetes prevention programs.

Carolina Digital Repository (University of North Carolina at Chapel Hill), 2011

Research Square (Research Square), Jun 19, 2019

JMIR Research Protocols, Feb 26, 2016

Frontiers in Health Services, Nov 23, 2022

the implementation strategies' reach, acceptability, and feasibility, with mixed findings on fide... more the implementation strategies' reach, acceptability, and feasibility, with mixed findings on fidelity. Strategies were only moderately successful at building delivery system capacity to implement Med-South. Conclusions: This paper describes the multiphase approach used to plan for Med-South scale-up, including the methods used to tailor two-levels of implementation strategies by identifying and targeting multilevel determinants.

Medical Clinics of North America

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity

Background Although studies have traced the impact of COVID-19 on those with eating disorders, li... more Background Although studies have traced the impact of COVID-19 on those with eating disorders, little is known about the specific impact of the pandemic on Black American women who report disordered eating behaviors and are at risk for eating disorders. Thus, the purpose of this study is to investigate the impact of COVID-19 on Black women who binge-eat. Methods We recruited a purposive sample during the first wave of COVID-19 from the southeastern United States. Participants identified as Black women, reported binge-eating episodes in the last 28 days, and agreed to participate in a semistructured interview. Prior to the interview, participants were administered a socio-demographic survey and the Eating Disorder Examination-Questionnaire. Interviews were transcribed verbatim and analyzed independently using qualitative content analysis and open coding to identify relevant codes and themes. Results On average, participants (N = 20) were 43.05 ± 16.2 years of age and reported 5.6 ± 5.7 binge-eating episodes in the last 28 days. We identified six themes to describe participants' experiences managing their eating behavior during COVID-19: (1) food as a coping strategy; (2) lack of control around food; (3) increased time in a triggering environment (e.g., being at home with an easy availability of food); (4) lack of structure and routine; (5) challenges with limited food availability; and (6) positive impact of the pandemic. Conclusion In this study, Black women reported challenges managing their eating behavior during COVID-19. Results could inform the development and tailoring of treatments for Black women reporting disordered eating behaviors. Level of Evidence Level V, qualitative interviews.

American Journal of Health Promotion

Purpose To evaluate the implementation and effectiveness of the Carolina Heart Alliance Networkin... more Purpose To evaluate the implementation and effectiveness of the Carolina Heart Alliance Networking for Greater Equity (CHANGE) Program, an adapted evidence-based cardiovascular disease risk reduction intervention delivered by Community Health Workers (CHW) to rural adults. Design Hybrid implementation-effectiveness study with a pre–post design. Setting North Carolina Federally Qualified Health Center and local health department in a rural, medically underserved area. Sample Participants (n = 255) included 87% Non-Hispanic Black with a mean age of 57 years; 84% had diagnosed hypertension, 55% had diabetes, and 65% had hypercholesterolemia. Intervention A CHW-delivered, low-intensity, 4-month behavioral lifestyle intervention promoting a southern-style Mediterranean dietary pattern and physical activity. Measures We measured number and representativeness of participants reached and retained, intervention delivery fidelity, weight, blood pressure, and self-reported dietary and physical...