Initiation of cannabis use typically follows alcohol use, but the reverse order does occur and is more common for African-Americans (AAs) than European-Americans (EAs). The aim of this study was to test for differences in the order of initiation of cannabis and alcohol use between AA and EA women and to determine whether order and ethnicity contribute independently to risk for rapid progression to cannabis-related problems.

Data were drawn from structured psychiatric interviews of 4102 women (mean age = 21.6 years), 3787 from an all-female twin study and 315 from a high-risk family study; 18.1% self-identified as AA, 81.9% as EA. Ethnicity and order of initiation of cannabis and alcohol use were modeled as predictors of transition time from first use to onset of cannabis use disorder symptom(s) using Cox proportional hazards regression analyses.

AA women were nearly three times as likely as EA women to initiate cannabis use before alcohol use. Using cannabis before alcohol [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.08–1.93] and AA ethnicity (HR 1.59, 95% CI 1.13–2.24) were both associated with rapid progression from first use to cannabis symptom onset even after accounting for age at initiation and psychiatric risk factors.

The findings indicate that AA women are at greater risk for rapid development of cannabis-related problems than EA women and that this risk is even higher when cannabis use is initiated before alcohol use. Prevention programs should be tailored to the various patterns of cannabis use and relative contributions of risk factors to the development of cannabis-related problems in different ethnic groups.

This study examined general and cancer-related stressors of depression that are unique to African-American cancer patients.

The study used cohort design and mixed methods. Seventy-four breast and prostate cancer survivors including 34 depressed and 23 non-depressed African-Americans and 17 depressed whites were interviewed. Qualitative data analysis identified themes. The thematic codes were converted to a SPSS data set numerically. The Fisher's exact test was performed to examine group differences in the experience of stress.

Significantly more depressed African-Americans experienced a dramatic reaction to a cancer diagnosis (p = 0.03) or had concerns about functional decline (p = 0.01), arguments with relatives or friends (p = 0.02), and unemployment status (p = 0.03) than did non-depressed African-Americans, who reacted to the cancer diagnosis as a matter of reality (p = 0.02). Significantly more depressed African-Americans talked about feeling shocked by a cancer diagnosis (p = 0.04) and being unable to do things that they used to do (p = 0.02) than did depressed whites. Qualitative analysis shed light on the extent of such group differences.

Distress from the initial cancer diagnosis and functional decline were likely to have triggered or worsened depression in African-American cancer patients. This study highlighted racial differences in this aspect. It is critical to screen African-American cancer patients for depression at two critical junctures: immediately after the disclosure of a cancer diagnosis and at the onset of functional decline. This will enhance the chance of prompt diagnosis and treatment of depression in this underserved population.

The objective of the present study was to assess whether weight status, nutrient intake and dietary adequacy were associated with breakfast consumption patterns.

A representative sample of the US population was used in a secondary analysis of nutrient intake/diet quality and weight status by breakfast consumption patterns.

The 1999–2002 National Health and Nutrition Examination Survey (NHANES).

The study sample included African-American (AA) children aged 1–12 years (n 1389).

Forty-five per cent of children aged 1–5 years and 38 % of those aged 6–12 years consumed ready-to-eat cereal (RTEC) at breakfast; while 7·4 % and 16·9 % in those age groups skipped breakfast, respectively. The lowest mean BMI (P ≤ 0·05) and mean waist circumference (P ≤ 0·05) was found in children 1–12 years of age who consumed RTEC at breakfast compared with other consumption groups. RTEC breakfast consumers had the highest mean intakes of vitamins A, B6 and B12, thiamine, riboflavin, niacin, folate, Ca, Fe and Zn (P ≤ 0·05) and the highest Mean Adequacy Ratio (P ≤ 0·05). RTEC breakfast consumers also had the highest intake of carbohydrates and total sugars, and the lowest intakes of total fat (P ≤ 0·05).

Consuming RTEC at breakfast was associated with improved weight and nutrient adequacy in AA children. AA children in all breakfast categories still had mean intakes of most nutrients below recommended levels. The implications are that consuming a breakfast meal should be encouraged in these children, and that RTEC at breakfast provides important nutrients and may help promote a healthy weight.

To examine associations of various psychosocial factors with fruit and vegetable intake in African-American adults.

A cross-sectional survey of a population-based sample of 658 African-Americans, aged 18–70 years, in North Carolina. Information was collected on diet-related psychosocial (predisposing, reinforcing and enabling) factors based on the PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation) planning framework; demographic, lifestyle and behavioural characteristics, and fruit and vegetable intake.

The mean participant age was 43.9 years (standard deviation 11.6), 57% were female and 76% were overweight/obese. Participants expressed healthy beliefs regarding many of, but not all, the psychosocial factors. For example, although half of the respondents believed it is important to eat a diet high in fruits/vegetables, only 26% knew that ≥ 5 daily servings are recommended. The strongest associations of the psychosocial factors with fruit/vegetable intake were for predisposing factors (e.g. belief in the importance of a high fruit/vegetable diet and knowledge of fruit/vegetable recommendations) and one reinforcing factor (social support), with differences between the healthiest and least healthy responses of 0.5–1.0 servings per day. There was evidence of effect modification by gender in associations between psychosocial factors and fruit/vegetable consumption (e.g. self-efficacy was only significant in women), with higher intakes and generally healthier responses to the psychosocial variables in women than men.

Interventions to increase fruit/vegetable intake in African-Americans may be more effective if they focus primarily on predisposing factors, such as knowledge, self-efficacy and attitudes, but not to the exclusion of reinforcing and enabling factors. The psychosocial factors that are targeted may also need to be somewhat different for African-American men and women.

A food-frequency questionnaire (FFQ) was developed to assess habitual dietary intake in the Southern Community Cohort Study (SCCS), a prospective epidemiological study to analyse disparities in cancer and other chronic diseases between African-Americans and Whites.

Frequency and portion size estimates were obtained for each of 104 foods. Daily intakes of 13 food groups, energy and 18 nutrients were computed. Each participant's rank and quintile classification of nutrient intakes was determined with and without the use of the subject's reported portion size.

The sample was obtained from the SCCS pilot study conducted in Tennessee, Mississippi and Florida, and consisted of 209 adults, 54% African-American, with a mean (standard deviation) age of 57.1 (12.5) years.

Correlations between the ranks from the two methods of estimation were high, ranging from 0.66 to 0.94 for food groups and 0.81 to 0.94 for nutrients. Pearson correlations were similarly high for food groups and nutrients. Concordance in exact quintile rank across the nutrient indices ranged from 52 to 70%, rising to 90–99% for concordance within adjacent quintiles.

To reduce the respondents' burden and to increase data completeness, the assignment of a uniform portion size when scoring the SCCS FFQ was considered acceptable.