Jennifer Rienks PhD (c) 1 Geraldine Oliva, MD, MPH1 Virginia Smyly, MPH, CHES 2 Linda Mack Burch, MPH 1 Judith Hager Belfiori, MPH, MA1

1
Jennifer Rienks PhD (c) 1 Geraldine Oliva, MD,
MPH1Virginia Smyly, MPH, CHES 2Linda Mack
Burch, MPH 1Judith Hager Belfiori, MPH, MA1
Development of a Scale for Measuring African
American Neighborhood Social Cohesion and
Personal and Environmental Factors Associated
with Perceptions of Low Cohesion

1) University of California, San Francisco,
Family Health Outcomes Project, 3333 California
Street, Suite 365, San Francisco, CA 94118 2) San
Francisco Department of Public Health Community
Health Education Section, 30 Van Ness Avenue,
Suite 2300, San Francisco, CA 94102
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Background

• San Francisco Health Depart., with funding from
  the Centers for Disease Control REACH 2010
  initiative, created the SevenPrinciples Project
  to address personal and social environment
  factors thought to be related to the much higher
  rate of infant mortality experienced by African
  American babies compare to white babies. The
  Family Health Outcomes Project at the UCSF is
  working to evaluate project efforts. This study
  was conducted at part of the evaluation.

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Objectives

• To measure African American perceptions of
  factors in the social environment that may be
  related to infant health outcomes
• To create a reliable scale to measure African
  American neighborhood social cohesion

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Methods

• 15-minute telephone survey conducted with African
  Americans in four multi-ethnic neighborhood
• Survey items address feeling of sense of
  belonging or community, frequency of
  participation in social and community activities,
  barriers to participation, volunteer activities
  and social cohesion
• Social cohesion items taken from Saguaro
  Seminars Social Capital Community Benchmark
  Survey and modified to be specific to about
  cohesion among African Americans

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Results

• 993 people identified as eligible to participate
• 163 refused to participate and 26 terminated
  interview before completed
• Overall refusal rate 19
• N 804
• 71 of respondents self-define as African
  Americans, 22 as Black, and 6.7 as African
  American and other

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Demographics
Male 37.2
Female 62.8
18 to 25 years old 12.0
26 to 39 years old 16.3
40 to 54 years old 31.5
55 to 64 years old 40.0
Did not graduate high school 10.3
High school degree or GED 26.4
Attend tech. or voc. school 5.8
Some College 29.4
College degree 18.3
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Social Cohesion Scale

• Summing together responses in Table 1. creates a
  scale of African American Neighborhood Social
  Cohesion
• Cronbachs alpha .79, indicating good
  reliability
• Dichotomous variable made to distinguish between
  those reporting high and moderate levels of
  social cohesion (61.5) vs. low levels of cohesion

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Logistic Regression Results

• Logistic regression modeling was done using low
  cohesion as an outcome variable and the variables
  listed in Table 2. as predictor variables
• Hosmer and Lemeshow Goodness-of-fit Test
  indicated good fit between expected and predicted
  values (X2 2.27, df 8, pgt.97)
• Variables in model account for 13 of
  unstandardized variance and 18 of standardized
  variance

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Logistic Regression Results (cont.)

• Respondents reporting lower levels of social
  cohesion also more likely to be under 40, less
  socially active, less knowledgeable about the
  importance of getting good prenatal care to avoid
  SIDS, less likely to believe they have something
  of value to give to the community, less likely to
  say that concerns for safety NOT a barrier to
  being involved in the community, less likely to
  volunteer for art/cultural organizations, and
  less likely to reside in the Excelsior/Ingleside
  neighborhood compare to the other 3 study
  neighborhoods.

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Conclusion and Implications

• A tailored African American neighborhood social
  cohesion tool can provide important information
  for better understanding the impact of social
  environment factors on negative perinatal
  outcomes in African Americans.
• Such a measure can also be useful as a control
  variable when evaluating the impact of community
  interventions, as prior levels of cohesiveness
  may play a role in the success or failure of an
  intervention.