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Yıldız M, Baysal HY. The effect of web-based and face-to-face training given to office workers on health beliefs and physical activity levels regarding obesity. Int J Nurs Pract 2024; 30:e13193. [PMID: 37658755 DOI: 10.1111/ijn.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/20/2023] [Accepted: 08/06/2023] [Indexed: 09/05/2023]
Abstract
AIM This study compared the effects of web-based and face-to-face education given to office workers on health beliefs and physical activity levels towards obesity. METHODS The research was conducted as a randomized controlled experimental study. The study population consisted of 768 office workers between February 2020 and April 2021, and the sample of the research consisted of 90 individuals selected from the population using the nonprobability sampling method. Clinical trial number of the study is NCT05591846. RESULTS A total of 90 people, including 30 people in each group, were included in the study. According to the obesity health belief model, a positive change was achieved in the beliefs of individuals about obesity; it was determined that there was a significant increase in the subdimensions of the importance of health, sensitivity, seriousness and perception of benefit and a decrease in the perception of obstacles (p < 0.05). After both education methods were given according to the health belief model, a positive change was achieved in the physical activity level of the individuals; it was determined that the physical activity level score increased significantly (p < 0.05). CONCLUSION It was determined that web-based and face-to-face education given to individuals had a positive effect on the obesity health belief model components and the levels of physical activity level.
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Affiliation(s)
- Metin Yıldız
- Department of Nursing, Sakarya University, Sakarya, Turkey
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2
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Bloor LE, Jendrusina AA, Rexer K. Broad and Adaptive Integrated Health Psychology Services: Engaging BIPOC Veterans in VA Healthcare. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09906-4. [PMID: 35978152 PMCID: PMC9385418 DOI: 10.1007/s10880-022-09906-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 11/28/2022]
Abstract
Clinical health psychologists provide adaptive, evidenced-based interventions that incorporate behavioral medicine and behavioral health strategies, with the potential to integrate broadly across the medical system. Veterans Affairs (VA) healthcare strives to meet the needs of an increasingly diverse patient population with complex behavioral health needs. This conceptual paper describes an example of health psychology at one VA healthcare system, with a focus on adaptive and culturally responsive services reaching Black, Indigenous and People of Color/Veterans of Color (BIPOC). The clinical health psychology services and cases described aim to reach Veterans who may not participate in, or benefit as fully from, traditional disease self-management or mental health services. The authors offer recommendations, to secure the value and sustainability of these integrated health psychology services, and hopefully contribute to addressing healthcare inequities.
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Affiliation(s)
- Lindsey E Bloor
- Department of Psychiatry, VA Ann Arbor Healthcare System, Michigan Medicine, Ann Arbor, MI, 48105, USA.
| | - Alexander A Jendrusina
- Department of Psychiatry, VA Ann Arbor Healthcare System, Michigan Medicine, Ann Arbor, MI, 48105, USA
| | - Kyle Rexer
- Department of Psychiatry, VA Ann Arbor Healthcare System, Michigan Medicine, Ann Arbor, MI, 48105, USA
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3
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Clements AD, Cyphers NA, Whittaker DL, Hamilton B, McCarty B. Using Trauma Informed Principles in Health Communication: Improving Faith/Science/Clinical Collaboration to Address Addiction. Front Psychol 2022; 12:781484. [PMID: 35002868 PMCID: PMC8727867 DOI: 10.3389/fpsyg.2021.781484] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Problematic substance use is a pressing global health problem, and dissemination and implementation of accurate health information regarding prevention, treatment, and recovery are vital. In many nations, especially the US, many people are involved in religious groups or faith communities, and this offers a potential route to positively affect health through health information dissemination in communities that may have limited health resources. Health information related to addiction will be used as the backdrop issue for this discussion, but many health arenas could be substituted. This article evaluates the utility of commonly used health communication theories for communicating health information about addiction in religious settings and identifies their shortcomings. A lack of trusting, equally contributing, bidirectional collaboration among representatives of the clinical/scientific community and religious/faith communities in the development and dissemination of health information is identified as a potential impediment to effectiveness. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) tenets of trauma-informed practice, although developed for one-on-one use with those who have experienced trauma or adversity, are presented as a much more broadly applicable framework to improve communication between groups such as organizations or communities. As an example, we focus on health communication within, with, and through religious groups and particularly within churches.
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Affiliation(s)
- Andrea D Clements
- Department of Psychology, College of Arts and Sciences, East Tennessee State University, Johnson City, TN, United States.,Uplift Appalachia, Johnson City, TN, United States.,Ballad Health Strong BRAIN Institute, East Tennessee State University, Johnson City, TN, United States
| | - Natalie A Cyphers
- Division of Nursing, DeSales University, Center Valley, PA, United States
| | | | - Bridget Hamilton
- Center for Nursing Research, College of Nursing, East Tennessee State University, Johnson City, TN, United States
| | - Brett McCarty
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States.,Divinity School, Duke University, Durham, NC, United States
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4
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Hornbuckle LM, Barroso CS, Rauer A, Jones CS, Winters-Stone KM. "It was just for us": qualitative evaluation of an exercise intervention for African-American couples. BMC Public Health 2021; 21:838. [PMID: 33933048 PMCID: PMC8087875 DOI: 10.1186/s12889-021-10659-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background Promoting long-term exercise adherence should be a key focus for health and fitness professionals working to reduce obesity and cardiometabolic health disparities, and all-cause mortality in inactive African-American (AA) adults. Data have suggested that romantic partners can improve long-term exercise adherence and that this dyadic approach should be examined in exercise interventions. Therefore, the purpose of this study was to conduct a qualitative evaluation of a pilot exercise intervention conducted in older AA couples. Methods Two semi-structured focus groups were utilized to compare participants’ perceptions of and experiences during the pilot intervention across two randomly assigned treatment conditions (exercising together with partner [ET; n = 8] versus exercising separately [ES: n = 6]). Participants (mean age: 64.7 ± 6.8 years) of a previous 12-week pilot exercise intervention (walking ≥3 days/week, 30 min/day plus supervised resistance training 2 days/week) were interviewed. Verbatim transcripts were coded using an open coding approach. Results Three key themes (intervention value/benefits, intervention difficulties, and suggested improvements) emerged. Although all couples identified health and relationship benefits of the intervention, some differences surfaced within themes across the two intervention groups. Conclusions Overall, these qualitative data suggest that couples had a positive experience while participating in the pilot study. In addition, key learning points to improve the intervention were identified including a more gradual transition to independent exercise, more flexibility training, and the incorporation of tangential education. These data will help investigators continue to develop the intervention, which is ultimately designed to promote long-term exercise adherence to reduce cardiometabolic health disparities in the AA community.
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Affiliation(s)
- Lyndsey M Hornbuckle
- Department of Kinesiology, Recreation, & Sport Studies, University of Tennessee, 322 HPER Building, 1914 Andy Holt Avenue, Knoxville, USA.
| | - Cristina S Barroso
- Department of Public Health, University of Tennessee, 390 HPER Building, 1914 Andy Holt Avenue, Knoxville, USA
| | - Amy Rauer
- Department of Child & Family Studies, University of Tennessee, 115 Jesse Harris Building, 1215 W. Cumberland Avenue, Knoxville, USA
| | - Chloe S Jones
- Department of Kinesiology, Recreation, & Sport Studies, University of Tennessee, 322 HPER Building, 1914 Andy Holt Avenue, Knoxville, USA
| | - Kerri M Winters-Stone
- School of Nursing and Knight Cancer Institute, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
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5
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Galvin AE, Friedman DB, Hébert JR. Focus on disability-free life expectancy: implications for health-related quality of life. Qual Life Res 2021; 30:2187-2195. [PMID: 33733432 PMCID: PMC7970769 DOI: 10.1007/s11136-021-02809-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 10/31/2022]
Abstract
BACKGROUND Since the end of the industrial revolution, advances in public health and clinical medicine have contributed to dramatic decreases in infant and childhood mortality, improvements in health-related quality of life (HRQoL), increases in overall life expectancy (LE), and rectangularization of survival curves. OBJECTIVES In this article, we focus on disability that has occurred with the overall lengthening of LE in many populations and the implications this has for decreased HRQoL. METHODS We utilize the concept of rectangularization of population survival to depict the rising prevalence of disability associated with increased LE, especially among racial and ethnic minorities and people of low socioeconomic status (SES) and relate this to HRQoL. RESULTS Disability-free life expectancy (DFLE) and healthy life expectancy (HLE) are defined in terms of HRQoL. Specific attention is focused on disability experienced by disparate populations around the globe. By focusing on disparities in DFLE, and the need to expand LE to include HLE as a central component of HRQoL, this work provides an important counterpoint to the attention that has been paid to LE disparities according to race, gender, ethnicity, education, and SES. DISCUSSION By calling attention to those factors that appear to be the most important drivers of the differences in quality and length of DFLE between different groups (i.e., the components of the social gradient, exposure to chronic stress, systemic inflammation, and the psychological and biological mechanisms associated with the gut-brain axis) and, by logical extension, HRQoL, we hope to promote research in this arena with the ultimate goal of improving DFLE, HLE, and overall HRQoL, especially in disparate populations around the globe.
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Affiliation(s)
- Ashley E Galvin
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA.,Pediatric Hematology-Oncology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02215, USA
| | - Daniela B Friedman
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.,Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - James R Hébert
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA. .,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA.
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6
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Hébert JR. Reducing Racial Disparities in Surviving Gastrointestinal Cancer Will Require Looking Beyond the Fact That African-Americans Have Low Rates of Surgery. Cancer Epidemiol Biomarkers Prev 2021; 30:438-440. [PMID: 33857014 DOI: 10.1158/1055-9965.epi-20-1808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/16/2022] Open
Abstract
This article by Bliton and colleagues in this issue of the journal concludes that disproportionately low surgery rates among Black patients contribute to the known survival disparity between Blacks and Whites. Using data from the National Cancer Database (NCDB), they were able to address the implicit hypothesis that the measured outcome disparities are partly attributable to failure to deliver surgical care equitably. As with most good research on difficult and complex topics, it also raises interesting and provocative questions about the role of race in poor survival among African-American patients with gastrointestinal cancer. The main limitation of the NCDB is its inability to account for individual-level factors. Those things related to health behaviors, such as diet, physical activity, and tobacco use, but that also include characteristics of the built environment, comprehensive access to care measures, clinical decision-making, racial discrimination and other forms of psychosocial stress, and environmental contamination, would influence both the likelihood of getting cancer and the probability of having aggressive disease with poor prognosis. These factors also may be related to clinical decision-making. Suggestions are made to design studies and collect data that would help to inform future investigations to deepen our understanding of racial disparities in cancer survival.See related article by Bliton et al., p. 529.
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Affiliation(s)
- James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
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7
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Goldstein E, Benton SF, Barrett B. Health Risk Behaviors and Resilience Among Low-Income, Black Primary Care Patients: Qualitative Findings From a Trauma-Informed Primary Care Intervention Study. FAMILY & COMMUNITY HEALTH 2020; 43:187-199. [PMID: 32324650 PMCID: PMC7988480 DOI: 10.1097/fch.0000000000000260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study describes an intervention with low-income, Black primary care patients and their experience in changing a health risk behavior. Participant themes, including behavioral coping, personal values, accomplishments and strengths, barriers and strategies, and social support, are understood in relationship to health behavior theories. Two structured interviews were conducted 1 month apart. Content analysis was used to analyze responses from 40 participants. Participants were well equipped with resilience-based coping, self-efficacies, and informal social networks despite economic and social disadvantages. Findings from this study have the potential to improve behavioral health coping and reduce racial inequities in health prevalent for this population.
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Affiliation(s)
- Ellen Goldstein
- Department of Family Medicine and Community Health, University of Wisconsin-Madison
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Golman M, Luu A, Ricks N, Norris V, Nguyen S. Engaging Church Leaders in the Reduction of Teen Birth Rate in High-Risk Areas. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 41:125-132. [PMID: 32228139 DOI: 10.1177/0272684x20915378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Involving faith-based organizations in community health promotion has gained widespread interest and has been a successful approach in addressing various health disparities in vulnerable communities. However, there is comparatively little evidence regarding sexual health promotion among faith-based organizations. Some agencies have responded to the challenge of reducing teen pregnancy with broad-based initiatives involving many different sectors of the community including faith-based organizations. Focus groups with key church leaders (n = 25) from zip codes with identified birth rates of 95 or higher were conducted to explore their perception of teen pregnancy among their communities. Purposive and snowball sampling were utilized. Recruitment was conducted through calls, email, and flyers. This study identified the barriers that church leaders encounter in their efforts to address teen pregnancy in their communities. Common themes that emerged include church education, parent support and communication, cultural barriers, availability of resources, awareness of services, and the need for comprehensive sexual education. Findings and recommendations to help those working in the faith community overcome identified barriers are addressed. Recent decreases in teen birth rates should not lead to complacency; rather they should inspire public health practitioners to do more, especially when some communities have not experienced the same success. Collaborating with faith-based organizations is one method to consider when considering community prevention efforts.
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Affiliation(s)
- Mandy Golman
- School of Health Promotion and Kinesiology, Texas Woman's University
| | - Amy Luu
- Medical School, University of Texas Southwestern Medical Center
| | - Nila Ricks
- Social Work Program, Texas Woman's University
| | - Vanessa Norris
- Medical School, University of Texas Southwestern Medical Center
| | - Sarah Nguyen
- Medical School, University of Texas Southwestern Medical Center
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9
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Abbott LS, Slate EH. Improving Cardiovascular Disease Knowledge among Rural Participants: The Results of a Cluster Randomized Trial. Healthcare (Basel) 2018; 6:healthcare6030071. [PMID: 29941776 PMCID: PMC6164969 DOI: 10.3390/healthcare6030071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 01/14/2023] Open
Abstract
Cardiovascular disease (CVD) is a major cause of death and disability, especially among people living in the rural, southern United States. Rural African Americans are often diagnosed with CVD earlier in life, and they bear a disproportionate burden of CVD risk factors, morbidity, and mortality. Health equity among historically underserved, rural populations can potentially be attained through culturally relevant interventions that teach people skills to stay well and avoid CVD-related risk and diagnoses. The purpose of this secondary analysis was to determine the effect of an evidence-based intervention on cardiovascular health knowledge and the stages of change toward the action and maintenance phases. The pre-test-post-test data were obtained during a cluster randomized trial involving twelve rural churches that were randomized to intervention (n = 6) and control (n = 6) groups. Participants (n = 115) in the intervention group received a cardiovascular health intervention, and those (n = 114) in the control group could receive the intervention following the study’s completion. The data were analyzed using a linear mixed model to compare group differences from pre-test to post-test. The cardiovascular health promotion intervention significantly improved cardiovascular health knowledge and was associated with advancements in the stages of change toward the action and maintenance phases.
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Affiliation(s)
- Laurie S Abbott
- College of Nursing, Florida State University, Tallahassee, FL 32306-4310, USA.
| | - Elizabeth H Slate
- Department of Statistics, Florida State University, Tallahassee, FL 32306-4310, USA.
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10
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Lemacks JL, James RE, Abbott L, Choi H, Parker A, Bryant A, Ralston PA, Rigsby AG, Gilner P. The Church Bridge Project: An Academic-Community Perspective of a Church-Based Weight Management Pilot Intervention among Young Adult African Americans. Prog Community Health Partnersh 2018; 12:23-34. [PMID: 29755046 PMCID: PMC6767920 DOI: 10.1353/cpr.2018.0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Churches are effective community partners and settings to address weight management among African Americans. There is limited information on the use of churches to reach young adult populations and church collaborations with primary care clinics. OBJECTIVES The Church Bridge Project represents a community-academic partnership that presents the recruitment process of a church-based weight management intervention and describes baseline data of participants recruited from churches and primary care providers. We also discuss research contributions, challenges and limitations, study applicability, and practice implications from an academic and community perspective. METHODS Church leaders were involved in the entire research process. The theory-driven intervention included 12 diabetes prevention program-adapted education and motivational interviewing (MI)-guided sessions. Participants were recruited through primary care providers and church leaders. Demographics, medical and weight history, stage of change for weight loss, social support, and self-efficacy for diet and physical activity, weight, and girth circumferences were measured. Baseline descriptive data were analyzed. RESULTS Of 64 potential participants, 42 (65.6%) were enrolled in the study and 16 (25.0%) completed baseline data collection. No participants were recruited through primary care providers. Recruited participants were similar to the target population except for being all obese and mostly female. The mean ± SD age of participants was 34.31 ± 8.86 years with most reporting having more than a high school education (n = 14 [87.5%]), individual yearly income of less than $59,000 (n = 12 [75.0%]), and been married or living with a partner (n = 9 [56.3%]). Most reported a history of hypertension and an immediate family history of diabetes and hypertension. Most participants were classified as class III obesity. CONCLUSIONS Young adults and primary care providers are difficult to engage in church-based interventions. Church leaders were comfortable with a collaborate model for decision making, but not an empower model. Churches remain a successful method to reach African Americans; however, more research is needed to motivate young adults to participate in health intervention research.
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Higashi RT, Craddock Lee SJ, Pezzia C, Quirk L, Leonard T, Pruitt SL. Family and Social Context Contributes to the Interplay of Economic Insecurity, Food Insecurity, and Health. ANNALS OF ANTHROPOLOGICAL PRACTICE 2017; 41:67-77. [PMID: 30233917 DOI: 10.1111/napa.12114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In this study, we show how household health, economic instability, and food insecurity are inextricably linked; disruptions in individual health or income create cumulative and interdependent challenges faced by multiple household members. Drawing upon semi-structured focus groups with English- and Spanish-speaking clients of an urban food pantry, we demonstrate: (1) the impact of economic scarcity on health, (2) the impact of one household member's health on the health and food security of all household members, and (3) food sharing behaviors among family and social networks, including multi-generational families and non-kin individuals. We identify the gap between household-level assessments of food insecurity and individual-level health reports, which may obscure poor health among other household members. Understanding the social and family context of health and food insecurity may inform future interventions that address the interrelated challenges of diverse and disadvantaged households and communities.
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Affiliation(s)
- Robin T Higashi
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066
| | - Simon J Craddock Lee
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75235
| | - Carla Pezzia
- University of Dallas, 1845 East Northgate Drive, Irving, TX 75062
| | - Lisa Quirk
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066
| | - Tammy Leonard
- University of Dallas, 1845 East Northgate Drive, Irving, TX 75062
| | - Sandi L Pruitt
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75235
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12
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Zhou YE, Jackson CD, Oates VJ, Davis GW, Davis C, Takizala ZM, Akatue RA, Williams K, Liu J, Hébert JR, Patel KA, Buchowski MS, Schlundt DG, Hargreaves MK. Refining a Church-Based Lifestyle Intervention Targeting African-American Adults at Risk for Cardiometabolic Diseases: A Pilot Study. ACTA ACUST UNITED AC 2017; 7:96-114. [PMID: 33457107 DOI: 10.4236/ojepi.2017.72009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P < 0.001). The baseline PSS score was positively associated with baseline adiposity levels (e.g., weight, β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.
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Affiliation(s)
- Yuan E Zhou
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Cynthia D Jackson
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Veronica J Oates
- Department of Family and Consumer Sciences, Tennessee State University, Nashville, TN, USA
| | - Gerald W Davis
- Ralph H Boston Wellness Center, Tennessee State University, Nashville, TN, USA
| | | | - Zudi-Mwak Takizala
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Richmond A Akatue
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Konya Williams
- Participant and Clinical Interactions Resources, Meharry Medical College, Nashville, TN, USA
| | - Jianguo Liu
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA
| | - Kushal A Patel
- Department of Public Health, Tennessee State University, Nashville, USA
| | | | - David G Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Lucke-Wold B, Shawley S, Ingels JS, Stewart J, Misra R. A Critical Examination of the Use of Trained Health Coaches to Decrease the Metabolic Syndrome for Participants of a Community-Based Diabetes Prevention and Management Program. JOURNAL OF HEALTHCARE COMMUNICATIONS 2016; 1. [PMID: 27857997 PMCID: PMC5110146 DOI: 10.4172/2472-1654.100038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The epidemic of obesity and diabetes in the United States poses major challenge to the prevention and management of chronic diseases. Furthermore, when this is viewed in other components of the metabolic syndrome (i.e., the burden of high cholesterol and hypertension), the prevalence of the metabolic syndrome continues to rise in the USA continued challenge is how to deal with this epidemic from a medical and public health standpoint. Community Based Participatory Research (CBPR) is a unique approach and offers a novel perspective for answering this challenge. A critical set of goals for CBPR is to address health disparities and social inequalities while getting community members engaged in all aspects of the research process. Utilizing the West Virginia Diabetes Prevention and Management Program and trained Health Coaches as a model, we discuss topics of consideration related to CBPR, involving trained health coaches, optimizing early adoption of healthy lifestyle behaviors, and enhancing participation. Through careful project planning and design, questions regarding disparities increasing susceptibility and preventive efforts within the community can be addressed successfully. These topics are part of a broader integration of theories such as participatory research, community engagement, and outcomes measurement. The understanding of the pathophysiology and epidemiology of the metabolic syndrome can help frame an appropriate strategy for establishing long-term community-wide changes that promote health. In order to continue to improve investigations for preventing the metabolic syndrome, it will be necessary to have aggressive efforts at the individual and population level for developing culturally sensitive programs that start early and are sustainable in practical environments such as the workplace. In this comprehensive review, we will discuss practical considerations related to project design, implementation, and how to measure effectiveness in regards to reducing the burden of the metabolic syndrome.
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Affiliation(s)
| | | | | | | | - Ranjita Misra
- West Virginia University, Morgantown, West Virginia, USA
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