Adeline Nyamathi

University of California, Los Angeles, Los Ángeles, California, United States

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Publications (202)271.38 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Although hepatitis A virus (HAV) and hepatitis B virus (HBV) infections are vaccine-preventable diseases, few homeless parolees coming out of prisons and jails have received the hepatitis A and B vaccination series. The study focused on completion of the HAV and HBV vaccine series among homeless men on parole. The efficacy of three levels of peer coaching (PC) and nurse-delivered interventions was compared at 12-month follow-up: (a) intensive peer coaching and nurse case management (PC-NCM); (b) intensive PC intervention condition, with minimal nurse involvement; and (c) usual care (UC) intervention condition, which included minimal PC and nurse involvement. Furthermore, we assessed predictors of vaccine completion among this targeted sample. A randomized control trial was conducted with 600 recently paroled men to assess the impact of the three intervention conditions (PC-NCM vs. PC vs. UC) on reducing drug use and recidivism; of these, 345 seronegative, vaccine-eligible subjects were included in this analysis of completion of the Twinrix HAV/HBV vaccine. Logistic regression was added to assess predictors of completion of the HAV/HBV vaccine series and chi-square analysis to compare completion rates across the three levels of intervention. Vaccine completion rate for the intervention conditions were 75.4% (PC-NCM), 71.8% (PC), and 71.9% (UC; p = .78). Predictors of vaccine noncompletion included being Asian and Pacific Islander, experiencing high levels of hostility, positive social support, reporting a history of injection drug use, being released early from California prisons, and being admitted for psychiatric illness. Predictors of vaccine series completion included reporting having six or more friends, recent cocaine use, and staying in drug treatment for at least 90 days. Findings allow greater understanding of factors affecting vaccination completion in order to design more effective programs among the high-risk population of men recently released from prison and on parole.
    Nursing research 05/2015; 64(3):177-189. DOI:10.1097/NNR.0000000000000083 · 1.50 Impact Factor
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    ABSTRACT: This study was part of a randomized controlled trial designed to improve hepatitis knowledge and health promoting behaviors and subsequently decrease stimulant use and incarceration with 422 (G/B) homeless men between 18 and 46 years of age. Findings revealed that no significant program differences on incarceration in the 4 months following the intervention. However, younger participants (p = .010), and those with prior incarceration (p = .001) were at greater risk for incarceration at 4 months. An additional factor associated with incarceration at 4 months included living on the street for at least 1 week (p = .049).
    Community Mental Health Journal 01/2015; DOI:10.1007/s10597-014-9792-x · 1.03 Impact Factor
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    ABSTRACT: While there is an abundance of cancer survivorship research among various racial/ethnic groups, there is a paucity of research on survivors of African descent. To date, the meaning of survivorship has not been reported exclusively among African American breast cancer survivors (AABCS). The purpose was to describe and understand the meaning of survivorship among community-dwelling AABCS, mostly recruited from breast cancer support groups. Using a qualitative descriptive approach, an open-ended questionnaire explored the meaning of survivorship among 155 AABCS. An analysis of the content was performed. Among AABCS, survivorship meant having a strong spiritual base, thriving, being resilient, and being altruistic. The survivors self-identified with and embraced the term survivor. These results provide an important understanding of the perspectives and meaning of survivorship among AABCS and may assist in developing cancer survivorship care plans that are relevant, responsive, patient centered, and culturally appropriate. © The Author(s) 2014.
    Journal of Transcultural Nursing 12/2014; DOI:10.1177/1043659614561678 · 0.83 Impact Factor
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    ABSTRACT: Abstract Our study examined the relationships of biological and psychosocial predictors as contributing factors to the psychological functioning among breast cancer survivors. A sample of (N = 155) African American breast cancer survivors were recruited from California. A general linear model was utilized to examine the relationships. Biological and psychosocial risk factors were significant predictors for anxiety and depression. These predictors can be viewed as contributing factors to the psychological well-being of this cohort. Anxiety and depression are often under-recognized and subsequently under-treated in survivors. Understanding the predictors of depression and anxiety is necessary for incorporating a multidisciplinary approach to address this problem.
    Journal of Psychosocial Oncology 07/2014; DOI:10.1080/07347332.2014.936650 · 1.04 Impact Factor
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    ABSTRACT: Introduction: A 2-day training program was developed to train Homoeopathy and Ayurveda practitioners to impart HIV/AIDS prevention messages to their clients. The purpose of the study was to evaluate the effectiveness of this training program based on train the trainer modality. Materials and Methods: Ten primary participants were enrolled in each one day and two day training program. Both the groups were instructed to impart further training to 10 participants each. The knowledge of and attitudes toward HIV/AIDS were measured in primary participants before and immediately after training and at the end of 3 months and in secondary participants before and immediately after training by a 21-item questionnaire. Results: In 1-day group, the pre-training and post-training assessments were completed by all the 10 participants, where as the 3 month assessment was completed by only seven participants. In this group, mean overall knowledge score was 15.9 which increased to 17 post training and reduced to 16.7, 3 months post training. In 2-day group, the pre-training and post training assessments were completed by 10 participants, where as the 3 month assessment was completed by nine participants. In this group, the pre-training score of 17.4 increased to 19.8 immediately after training and decreased to 18.4, 3 months after training. From the 1-day group and two day group, seven and nine participants respectively, conducted secondary trainings. In case of secondary trainees, the cognitive knowledge scores showed a statistically significant difference before and after trainings in both the groups. Conclusion: The training module on HIV/AIDS was useful in enhancing the knowledge of physicians of Homoeopathy and Ayurveda on cognitive and transmission related aspects of the disease and on its ethical, social and legal implications. With such training programs the homoeopathic and ayurvedic practitioners can play a vital role in prevention of HIV infection by undertaking appropriate patient education and counselling
    07/2014; 8(3):136-146. DOI:10.4103/0974-7168.141734
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    ABSTRACT: Abstract This cross-sectional study of 540 homeless ex-offenders exiting prisons and jails assessed sociodemographic, childhood and drug-related differences. Older ex-offenders from prison were more likely to have been married, come from a two-parent family and used crack while younger ex-offenders were more likely to have used methamphetamine. Older ex-offenders from jail were more likely to be African-American, have children, and report a history of crack and injection drug use, while those younger were more likely to have engaged in binge drinking and be in a gang. Our findings showcase the need to understand unique correlates of younger and older incarcerated populations.
    Journal of Addictive Diseases 05/2014; DOI:10.1080/10550887.2014.909694 · 1.46 Impact Factor
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    ABSTRACT: Gay and bisexual (G/B) homeless adults face multiple challenges in life which may place them at high risk for incarceration. Yet, little is known about this understudied population in terms of risk for incarceration. Baseline data collected from a longitudinal study between October 2009 and March 2012 in Hollywood, California, explored correlates of self-reported incarceration among G/B homeless stimulant-using adults (N = 353). Findings revealed older age, less education, having children, as well as a history of injection drug use and being born in the United States were positively associated with incarceration. Moreover, having poor social support and having received hepatitis information were also correlated with a history of incarceration. Our findings help us gain a greater awareness of homeless G/B adults who may be at greater risk for incarceration, which may be used by health care providers to design targeted interventions for this underserved population.
    Western Journal of Nursing Research 04/2014; 37(6). DOI:10.1177/0193945914530521 · 1.38 Impact Factor
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    ABSTRACT: High levels of hostility present a formidable challenge among homeless ex-offenders. This cross-sectional study assessed correlates of high levels of hostility using baseline data collected on recently-released male parolees (N=472; age 18-60) participating in a randomized trial focused on prevention of illicit drug use and recidivism. Predictors of high levels of hostility included greater depressive symptomatology, lower self-esteem, having a mother who was treated for alcohol/drugs, belonging to a gang, more tangible support, having used methamphetamine and having a history of cognitive difficulties. These findings highlight the need to understand predictors of hostility among recently released homeless men and how these predictors may relate to recidivism. Research implications are discussed as these findings will shape future nurse-led harm reduction and community-based interventions.
    Journal of Offender Rehabilitation 02/2014; 53(2):95-115. DOI:10.1080/10509674.2013.868388
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    ABSTRACT: Homeless men exiting California State jails and prisons are a heterogeneous community with varied childhood, incarceration and drug use histories. This cross-sectional study assessed whether homeless men who were discharged from either jail or prison into a residential substance abuse treatment program, differed in terms of methamphetamine and heroin use. This study utilized baseline data collected on 540 recently paroled men randomized to one of three programs that assessed the impact of a peer coaching intervention on subsequent drug use and reincarceration. We found that younger ex-offenders exiting prisons and jails were more likely to have used methamphetamine alone, whereas African–American ex-offenders were less likely to have used methamphetamine alone when compared to other ethnic groups. Further, ex-offenders exiting jails and self-reporting use of heroin only at baseline were significantly more likely than their counterparts to have been removed from home before age 18 years. For men exiting jails, there was an association between lower self-esteem and having used methamphetamine but not heroin. However, having used both heroin and methamphetamine was associated with both violent crime and cognitive problems in both jail and prison samples. Our findings showcase the need to understand unique correlates of both heroin and methamphetamine as they relate to jail and prison populations.
    Addiction Research and Theory 01/2014; 22(6). DOI:10.3109/16066359.2013.877453 · 1.03 Impact Factor
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    ABSTRACT: Frailty is a public health issue that is experienced by homeless and other vulnerable populations; to date, a frailty framework has not been proposed to guide researchers who study hard-to-reach populations. The Frailty Framework among Vulnerable Populations has been developed from empirical research and consultation with frailty experts in an effort to characterize antecedents, that is, situational, health-related, behavioral, resource, biological, and environmental factors that contribute to physical, psychological, and social frailty domains and impact adverse outcomes. As vulnerable populations continue to age, a greater understanding of frailty will enable the development of nursing interventions.
    ANS. Advances in nursing science 01/2014; 37(1):70-81. DOI:10.1097/ANS.0000000000000013 · 0.87 Impact Factor
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    ABSTRACT: The current study focuses on the relationships among a trauma history, a substance use history, chronic homelessness, and the mediating role of recent emotional distress in predicting drug treatment participation among adult homeless people. We explored the predictors of participation in substance abuse treatment because enrolling and retaining clients in substance abuse treatment programs is always a challenge particularly among homeless people. Participants were 853 homeless adults from Los Angeles, California. Using structural equation models, findings indicated that trauma history, substance use history and chronicity of homelessness were associated, and were significant predictors of greater recent emotional distress. The most notable result was that recent emotional distress predicted less participation in current substance abuse treatment (both formal and self-help) whereas a substance use history alone predicted significantly more participation in treatment. Implications concerning treatment engagement and difficulties in obtaining appropriate dual-diagnosis services for homeless mentally distressed individuals are discussed.
    Journal of substance abuse treatment 10/2013; 46(3). DOI:10.1016/j.jsat.2013.10.008 · 2.90 Impact Factor
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    ABSTRACT: Homeless urbanites are a heterogeneous population with unique health and social service needs. The study examined situational, behavioral, health-related and resource indicators in terms of their direct impact on frailty, hypothesized as a latent variable. Using structural equation modeling (SEM), a model was tested with 150 homeless men and women, ages 40–73, from three homeless day center drop-in sites on Skid Row and one residential drug treatment (RDT) facility that works with homeless parolees and probationers. In bivariate analyses with the latent construct frailty, months homeless (p < 0.01), female gender (p < 0.05), education (p < 0.05), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), health care utilization (p < 0.01), and falls (p < 0.001) were significantly associated with frailty. In the final path model, significant predictors of frailty included educational attainment (p < 0.01), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), and falls (p < 0.01). These findings will serve as a foundation for future nurse-led, community-based initiatives that focus on key predictors of frailty among the homeless and the development of interventions.
    Archives of gerontology and geriatrics 10/2013; 58(2):248-56. DOI:10.1016/j.archger.2013.09.005 · 1.53 Impact Factor
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    ABSTRACT: Homeless men on parole are a hard-to-reach population with significant community reintegration challenges. This cross-sectional study describes sociodemographic, cognitive, psychosocial, and drug-related correlates of alcohol and methamphetamine use in 157 homeless male parolees (age range 18-60) enrolled in a substance abuse treatment center in Los Angeles, California. Logistic regression results revealed that being African American and older were negatively related to methamphetamine use, whereas being older and more hostile were related to riskier alcohol abuse. Findings from this study provide a greater understanding of correlates of methamphetamine and alcohol--two of the most detrimental forms of substances abused among currently homeless parolees.
    Journal of Addictive Diseases 10/2013; 32(4):365-76. DOI:10.1080/10550887.2013.849973 · 1.46 Impact Factor
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    ABSTRACT: Objectives: Researchers have proposed biological (inflammation) and psychological (depression) factors as potential mechanisms for poorer outcomes and readmissions in heart failure (HF) patients. However, studies investigating the link between inflammation and depressive symptoms in these patients are few. We examined the relationships between levels of the inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and soluble tumor necrosis factor receptor 2 (sTNR2) and depressive symptoms in HF outpatients. Method: 55 patients (74.5% men; 60% Whites; mean age 71.6 ± 11.3 years) with New York Heart Association Class II, III, or IV HF (49%, 47%, and 4%, respectively) and mean ejection fraction (EF) 29.9 ± 7.1% completed the Patient Health Questionnaire (PHQ)-9 as a measure of depressive symptoms. We also obtained height, weight, and CRP, IL-6, and sTNFR2 levels. We used multivariate regressions to assess the predictive value of PHQ-9 scores on each inflammatory marker. Results: 22 (40%) participants reported depressive symptoms (PHQ-9 score ≥ 5). After controlling for age, gender, body mass index, HF etiology, EF, and statin use, we found significant relationships between levels of both sTNFR2 (β = .35, p = .01) and IL-6 (β = .30, p = .04), but not CRP (β = -.96, p = .52), and depression scores. Conclusion: Our findings add to a growing body of evidence supporting the proposition that heightened inflammation explains the effect depression has on HF. Health care providers should screen for depression in HF patients, as they may be at higher risk of augmented inflammation and poor outcomes.
    Biological Research for Nursing 07/2013; 16(3). DOI:10.1177/1099800413496454 · 1.34 Impact Factor
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    ABSTRACT: Frailty, a relatively unexplored concept among vulnerable populations, may be a significant issue for homeless adults. This cross-sectional study assessed correlates of frailty among middle age and older homeless adults (N = 150, 40-73). A Pearson (r) bivariate correlation revealed a weak relationship between frailty and being female (r = .230, p < .01). Significant moderate negative correlations were found between frailty and resilience (r = -.395, p < .01), social support (r = -.377, p < .01), and nutrition (r = -.652, p < .01). Furthermore, Spearman's rho (rs) bivariate correlations revealed a moderate positive relationship between frailty and health care utilization (rs = .444, p < .01). A stepwise backward linear regression analysis was conducted and in the final model, age, gender, health care utilization, nutrition, and resilience were significantly related to frailty. Over the next two decades, there is an anticipated increase in the number of homeless adults which will necessitate a greater understanding of the needs of this hard-to-reach population.
    Western Journal of Nursing Research 05/2013; 35(9). DOI:10.1177/0193945913487608 · 1.38 Impact Factor
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    ABSTRACT: Homeless adults have high rates of hepatitis C virus infection (HCV) and low levels of HCV knowledge. This study reports results of an interdisciplinary, community-based intervention using stakeholder cooperation, case management, risk factor identification, and modification of dysfunctional psychosocial factors to increase HCV knowledge among homeless adults (N = 747). Data are from a randomized quasi-experimental study, with the major goal of evaluating the effectiveness of a Nurse Case Managed Intervention compared to a Standard Intervention, encouraging completion of a three-series hepatitis A/hepatitis B vaccination program. Increased HCV knowledge was measured with an 18-item questionnaire discerning risk factors for HCV and common misconceptions about individuals with HCV. A significant increase in HCV knowledge resulted regardless of intervention format. Receiving the Nurse Case Managed Intervention predicted greatest gain in HCV knowledge (p < 0.000). Successfully engaging key stakeholders, outreach workers, community organizations, and homeless people themselves proved most efficacious in increasing HCV knowledge.
    The Journal of Behavioral Health Services & Research 04/2013; 41(1). DOI:10.1007/s11414-013-9333-3 · 1.03 Impact Factor
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    ABSTRACT: Purpose:To understand correlates of health and unmet health care needs among four vulnerable populations; namely, homeless men on parole, middle age to older homeless men and women at risk for frailty, adverse childhood events among American Indians, and early bonding needs and childbirth readiness among methamphetamine (MA)-using women. Rationale:The challenges experienced by the most vulnerable of populations in terms of meeting health care needs and continuing to thrive despite adversities are stunning. Substantial needs of these populations are compounded by the combination of situational, behavioral, psychosocial, and physiological risk factors which affect health and social outcomes. Methods:Quantitative methods have been utilized to explore health care and social service needs among four vulnerable populations. As part of a randomized controlled trial, baseline data were collected related to homeless adults and hostility. A cross- sectional design was used to examine correlates of frailty among homeless adults. Among American Indians, health registries were used to conduct random household surveys among adults to determine impact of adverse childhood events and a qualitative design assessed challenges experienced by MA-using mothers. Results:Homeless men on parole (N=472) faced a multiplicity of challenges in terms of reintegrating into society. Middle age to older homeless men and women (N=150) present with risk factors for frailty which include, physical functioning, comorbid conditions and nutrition. Among American Indians (N=457), adverse childhood events may precipitate chronic illnesses and suicide ideation. Further, among MA-using women (N=8), voices of women made challenges experienced and needs clearly known Implications:Across the lifespan, there exist substantial challenges and unmet need experienced, leading to health disparities. For homeless men on parole, encouragement of completion of drug treatment, and access to mental healthcare may reduce hostility, recidivism and substance use. Among homeless men and women, risk factors for frailty include comorbid conditions, poorer nutrition and physical functioning. For American Indians, identifying adverse events is essential in order to develop culturally-sound interventions. Likewise, among MA-using women, recognizing challenges faced by women who are ready to parent a child was made known. Funding: NIH/NINR T32 NR007077 Vulnerable Populations/Health Disparities
    2014 Western Institute of Nursing Annual Communicating Nursing Research Conference; 04/2013
  • Adeline Nyamathi, Benissa Salem
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    ABSTRACT: Purpose/Aims: Homeless men on parole are a hard to reach population who have significant challenges when attempting to reintegrate into the community. The purpose of our study was to examine hostility among homeless men on parole in an effort to reduce substance use and recidivism. Background: The United States hosts the largest population of men and women behind bars, outranking the rest of the world. High levels of hostility present a formidable challenge among homeless ex-offenders; in particular three quarters are rearrested within three years. With the current day crisis, California can no longer house its large inmate population, and as parolees reenter the community, many must cope with significant stressors. One of these stressors is hostility. Methods: Guided by the Comprehensive Health Seeking and Coping Paradigm, this cross-sectional study assessed correlates of high levels of hostility using baseline data from a randomized control intervention with recently-released homeless men on parole (n = 472; age 18-60). After informed consent was provided, a structured instrument was administered by research staff containing the following highly reliable and valid instruments: coping behaviors, childhood family relationships, depressive symptoms, emotional well-being, social support, self-esteem, drug and alcohol use and hostility. Staged logistic regression analysis was conducted to identify correlates of high levels of hostility. Results: Predictors of high levels of hostility included greater depressive symptomatology (p<.001), lower self-esteem (p<.021), having a mother who was treated for alcohol/drugs (p<.001), belonging to a gang (p<.001), more tangible support (p<.037), having used methamphetamine (p<.001) and having a history of cognitive difficulties (p<.028).
    2014 Western Institute of Nursing Annual Communicating Nursing Research Conference; 04/2013
  • Benissa E. Salem, Adeline Nyamathi
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    ABSTRACT: Purpose: To explore gender differences in terms of health and other covariates among middle age and older homeless men and women residing in Los Angeles. Background: Demographic trends suggest that homeless adults are aging and expected to double within three decades. Gender differences among homeless men and women are important to explore as there may be unique areas to target with nurse led community-based health initiatives. Methods: The Frailty Framework among Homeless and Other Vulnerable Populations guided inclusion of variables in this study (N = 150; age 40-73). Quantitative methods were used to explore gender differences in terms of age, length of time homeless, grip strength, nutrition, comorbid conditions, physical functioning, depressive symptomology, drug use and dependency, social support, resilience, and frailty. Descriptive statistics and frequencies were used to explore general differences and independent samples t-tests were used to determine differences among covariates. Results: Data reveal that the mean age was 52.4 (SD 6.80). Slightly over half of the participants (59.3%) were over the age of 50 and gender was equally distributed. The majority were African American (63.3%), followed by Caucasian (12%), Hispanic/Latino (10.7%) and other groups (14%). Significant differences were found between gender and length of time homeless, comorbid conditions, physical functioning, drug use, grip strength, and frailty. Compared to men, women had a higher number of comorbid conditions (p<.05), lower physical functioning scores (p<.05), and lower grip strength (p<.001). Women were more likely to be pre frail and frail when compared to men. Implications: Women are significantly more likely to have comorbid conditions, poorer physical functioning, grip strength and frailty. These findings serve as an impetus and a foundation for understanding gender differences which will undoubtedly inform future nurse-led health promotion interventions.
    2014 Western Institute of Nursing Annual Communicating Nursing Research Conference; 04/2013
  • Janelle F. Palacios, Adeline Nyamathi, Amy Levi
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    ABSTRACT: Purpose: The purpose of this presentation is to describe the findings from a qualitative interpretive phenomenological study that aimed to understand the lived experience of fatherhood among young American Indian men. Background: While much attention has been given to young mothers, little is understood of the young father’s (aged 21 and younger) experience, and rarely have studies addressed the experiences of young American Indian fathers. In general, young fathers aspire to be providers and engage with their children, though they face a number of obstacles. Method: In a collaborative resarch partnership with a Western tribe, a convenience sample, comprised of 10 self-identified American Indian young fathers aged 21 and younger, was recruited and interviewed according to a semi-structured interview guide. Interviews were digitally recorded and transcribed verbatim. Interpretive phenomenology, as presented by Benner, with the use of thematic analysis, exemplars and paradigm cases was used to identify themes. Each interview was repeatedly read for a global understanding and a summary was written to create a paradigm case. Similarities and comparisons were made across paradigm cases by means of thematic analysis, a tool to help identify meaningful patterns and concerns. Finally, exemplars were selected to demonstrate a particular salient situation or meaning. Results: Learning of their impending fatherhood was a time of ambivalence and elation. While extended families provided much support, they were also a source of stress which at times was complicated by their relationship with their child’s mother. Despite some obstacles, young fathers remained optimistic of their future and their child’s future. Implications: Young fatherhood is a time wherein positive fathering practices may be instituted, as this is a time they may be open for related education and skill development. It may also be a time wrought with stress, and knowledge of good communication skills may benefit young fathers in establishing supportive relationships with their family, friends, partners, and children.
    2014 Western Institute of Nursing Annual Communicating Nursing Research Conference; 04/2013

Publication Stats

3k Citations
271.38 Total Impact Points

Institutions

  • 1988–2015
    • University of California, Los Angeles
      • • School of Nursing
      • • Department of Psychology
      Los Ángeles, California, United States
  • 2013
    • San Diego State University
      San Diego, California, United States
  • 2007
    • University of Greifswald
      • Institute of Epidemiology and Social Medicine
      Griefswald, Mecklenburg-Vorpommern, Germany
    • University of North Dakota
      Grand Forks, North Dakota, United States
    • Cambridge Health Alliance
      Cambridge, Massachusetts, United States
  • 2006–2007
    • Western University of Health Sciences
      • College of Graduate Nursing
      Pomona, CA, United States
  • 1990
    • CSU Mentor
      Long Beach, California, United States