Judith C. Barker

Bio: Judith C. Barker is an academic researcher from University of California, San Francisco. The author has contributed to research in topics: Population & Early childhood caries. The author has an hindex of 35, co-authored 126 publications receiving 3636 citations. Previous affiliations of Judith C. Barker include Harvard University & University of California.

Theorizing Social Context: Rethinking Behavioral Theory

Abstract: Major behavioral theories focus on proximal influences on behavior that are considered to be predominantly cognitive characteristics of the individual largely uninfluenced by social context. Social ecological models integrate multiple levels of influence on health behavior and are noted for emphasizing the interdependence of environmental settings and life domains. This theory-based article explains how social context is conceptualized in the social sciences and how the social science conceptualization differs from and can broaden the analytic approach to health behavior. The authors use qualitative data from the Behavioral Constructs and Culture in Cancer Screening study to illustrate our conceptualization of social context. We conclude that the incorporation into health behavior theory of a multidimensional socioculturally oriented, theoretical approach to social context is critical to understand and redress health disparities in multicultural societies like the United States.

Practice constraints, behavioral problems, and dementia care: primary care physicians' perspectives.

Abstract: Objectives To examine how practice constraints contribute to barriers in the health care of persons with dementia and their families, particularly with respect to behavioral aspects of care.

Cultural factors and children's oral health care: a qualitative study of carers of young children

Abstract: Objective: This qualitative study sought to identify cultural beliefs, practices and experiences that influence access to preventive oral health care for young children from different racial and ethnic groups. Methods: Four to six focus groups in each of the African–American, Chinese, Latino and Filipino communities in San Francisco, California were included in the study. Participants were carers of children aged 1–5 years. The 22 groups (n = 177 participants) were stratified by carer's age and, except in the African–American community, by whether US or non-US born. Sessions were conducted in different languages as needed. Results: Lack of knowledge and beliefs about primary teeth created barriers to early preventive care in all groups. In Chinese groups more than others, health beliefs regarding disease causation and prevention influenced access to preventive dental care. In all groups, multiple family carers, especially elders, influenced access to preventive care. Dental fear, whether derived from prevailing community beliefs or personal negative dental experiences, greatly influenced attitudes regarding accessing preventive care. Conclusion: There are both similarities and differences between racial/ethnic groups in how cultural beliefs and experiences influence young children's access to dental care and how it might be improved.

Stigmatizing a "normal" condition: urinary incontinence in late life.

Abstract: The geriatric medical literature presents a perspective on urinary incontinence in the elderly that is sharply divergent from the realities of medical and lay responses to incontinence. This contrast raises questions about the cultural significance of urinary incontinence. The geriatric literature reveals a consensus that urinary incontinence, a major health problem among the elderly, is treatable and frequently reversible. The elderly and their health care providers, however, not only see incontinence as an inevitable, irreversible, and normal part of growing old but also consider it a sign of incompetence. This linkage of incontinence with incompetence forces elderly people to adopt several strategies for managing their incontinence so as not to compromise their competence in the eyes of others. Incontinence is a cultural symbol for the increasing dependencies of old age, dependencies that are much feared and resented in U.S. society, where tremendous emphasis is placed on independence even into advanced old age.

Reexamining the relationships among dementia, stigma, and aging in immigrant Chinese and Vietnamese family caregivers.

Abstract: Prior literature emphasizes that Asian Americans with dementia may be particularly vulnerable to the stigma of chronic and severe mental illness. However, there is a dearth of empirical research to support this claim. This study examines the relationship of stigma and dementia in 32 qualitative interviews with Chinese and Vietnamese family caregivers. Stigma was a common theme in the interviews (91%). Further analysis revealed two sources: the stigma of chronic and severe mental illness and a stigma reflecting negative stereotypes of aging or the aged. Chinese and Vietnamese cultural views of normal aging are not unitary but accommodate different trajectories of aging, some more and some less desired. When applied to persons with dementia, a "normalized" but negative trajectory of aging carried with it significant stigma that was distinct from but in addition to the stigma of chronic and severe mental illness. Older Chinese and Vietnamese with dementia are thus at risk of experiencing multiple stigmas that include but go beyond the stigma associated with chronic and severe mental illness.

Habits of the Heart: Individualism and Commitment in American Life

Abstract: Meanwhile, the authors' antidote to the American sicknessa quest for democratic community that draws on our diverse civic and religious traditionshas contributed to a vigorous scholarly and popular debate. Attention has been focused on forms of social organization, be it civil society, democratic communitarianism, or associative democracy, that can humanize the market and the administrative state. In their new Introduction the authors relate the argument of their book both to the current realities of American society and to the growing debate about the country's future. With this new edition one of the most influential books of recent times takes on a new immediacy.\

The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding

Abstract: At a time when lesbian, gay, bisexual, and transgender individuals—often referred to under the umbrella acronym LGBT—are becoming more visible in society and more socially acknowledged, clinicians and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs. Furthermore, the experiences of LGBT individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location, and age, any of which can have an effect on health-related concerns and needs. While some research about the health of LGBT populations has been conducted, researchers still have a great deal to learn. To help assess the state of the science, the National Institutes of Health (NIH) asked the Institute of Medicine (IOM) to assess current knowledge of the health status of lesbian, gay, bisexual, and transgender populations; to identify research gaps and opportunities; and to outline a research agenda to help NIH focus its research in this area. A committee of experts was convened by the IOM to consider this task, and its findings are presented in its report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.

Shape of the relapse curve and long-term abstinence among untreated smokers

Abstract: Objective To describe the relapse curve and rate of long-term prolonged abstinence among smokers who try to quit without treatment. Method Systematic literature review. Data sources Cochrane Reviews, Dissertation Abstracts, Excerpt Medica, Medline, Psych Abstracts and US Center for Disease Control databases plus bibliographies of articles and requests of scientists. Study selection Prospective studies of self-quitters or studies that included a no-treatment control group. Data extraction Two reviewers independently extracted data in a non-blind manner. Data synthesis The number of studies was too small and the data too heterogeneous for meta-analysis or other statistical techniques. Results There is a paucity of studies reporting relapse curves of self-quitters. The existing eight relapse curves from two studies of self-quitters and five no-treatment control groups indicate most relapse occurs in the first 8 days. These relapse curves were heterogeneous even when the final outcome was made similar. In terms of prolonged abstinence rates, a prior summary of 10 self-quitting studies, two other studies of self-quitters and three no-treatment control groups indicate 3–5% of self-quitters achieve prolonged abstinence for 6–12 month after a given quit attempt. Conclusions More reports of relapse curves of self-quitters are needed. Smoking cessation interventions should focus on the first week of abstinence. Interventions that produce abstinence rates of 5–10% may be effective. Cessation studies should report relapse curves.