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DeNunzio M, Miller M, Chase M, Kraak V, Serrano E, Misyak S. A Scoping Review of the Community Health Worker Model Used for Food Systems Interventions Within the United States. Am J Health Promot 2023; 37:401-419. [PMID: 36112805 DOI: 10.1177/08901171221125451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To document and analyze the food systems interventions delivered by community health workers (CHW) serving as educators within the United States (U.S.). DATA SOURCE Ten databases (ie, Agricola, CAB Abstracts, CINAHL, ERIC, Proquest Social Science and Education, Proquest Theses and Dissertations, PubMed, Scopus, SocIndex, Web of Science) and gray-literature repositories were searched for publications between 2005-2020. STUDY INCLUSION AND EXCLUSION CRITERIA English-language and U.S. studies included with CHW as educators or facilitators for food systems interventions. Food systems defined as processes of production, processing, distribution, marketing, access, preparation, consumption, and disposal of food products. Studies excluded for clinical settings; non-adult CHWs; CHWs with medical or public health credentials; and programming guides, reviews, and commentaries. DATA EXTRACTION Variables included CHW and intervention description, priority population, food system processes, and targeted and unexpected outcomes. DATA SYNTHESIS Data were analyzed by the lead investigator and described narratively. RESULTS Of 43 records, CHWs educated for consumption (n = 38), preparation (n = 33), and food access (n = 22) to improve health of priority populations. Community health workers educated for the highest number of food system processes in garden-based interventions. Programs reached many underserved racial and socioeconomic populations. CONCLUSIONS The CHW model has been used to educate in interventions for all food systems processes and reached many diverse underserved audiences. Future work must explore garden-based food systems education and CHWs as community change agents.
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Affiliation(s)
- Maria DeNunzio
- Department of Human Nutrition, Foods, and Exercise, 1757Virginia Tech, Blacksburg, VA, USA
| | - Makenzie Miller
- 4366Louisiana State University AgCenter, Baton Rouge, LA, USA
| | - Melissa Chase
- Department of Food Science and Technology, 118724Virginia Tech, Blacksburg, VA, USA
| | - Vivica Kraak
- Department of Human Nutrition, Foods, and Exercise, 1757Virginia Tech, Blacksburg, VA, USA
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, 1757Virginia Tech, Blacksburg, VA, USA
| | - Sarah Misyak
- Department of Human Nutrition, Foods, and Exercise, 1757Virginia Tech, Blacksburg, VA, USA
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Duea SR, Zimmerman EB, Vaughn LM, Dias S, Harris J. A Guide to Selecting Participatory Research Methods Based on Project and Partnership Goals. JOURNAL OF PARTICIPATORY RESEARCH METHODS 2022; 3. [PMID: 35799626 PMCID: PMC9258244 DOI: 10.35844/001c.32605] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Participatory research engages community stakeholders in the research process, from problem identification and developing the research question, to dissemination of results. There is increasing recognition in the field of health research that community-engaged methods can be used throughout the research process. The volume of guidance for engaging communities and conducting participatory research has grown steadily in the past 40+ years, in many countries and contexts. Further, some institutions now require stakeholder engagement in research as a condition of funding. Interest in collaborating in the research process is also growing among patients and the public. This article provides an overview for selecting participatory research methods based on project and partnerships goals.
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Affiliation(s)
| | | | - Lisa M. Vaughn
- Cincinnati Children's Hospital Medical Center/University of Cincinnati
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Pullyblank K, Atav S. Enrollment and Completion Characteristics for Novel Remote Delivery Modes of the Self-Management Programs during the COVID-19 Pandemic: An Exploratory Analysis (Preprint). JMIR Form Res 2022; 6:e38357. [DOI: 10.2196/38357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 11/23/2022] Open
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Wagner J, Bermudez-Millan A, Buckley T, Buxton OM, Feinn R, Kong S, Kuoch T, Nahmod NG, Scully M. A randomized trial to decrease risk for diabetes among Cambodian Americans with depression: Intervention development, baseline characteristics and process outcomes. Contemp Clin Trials 2021; 106:106427. [PMID: 33957272 PMCID: PMC8312406 DOI: 10.1016/j.cct.2021.106427] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/26/2021] [Accepted: 05/01/2021] [Indexed: 11/29/2022]
Abstract
Background: Depression and antidepressant medications are associated with increased risk for type 2 diabetes. It is not known if diabetes can be prevented in the setting of depression. Cambodian Americans have high rates of both depression and diabetes. This paper reports intervention development, experimental design, baseline characteristics, and process outcomes of diabetes prevention interventions for Cambodian Americans with depression, “Diabetes Risk Reduction through Eat, Walk, Sleep and Medication Therapy Management” (DREAM). Methods: Participants were aged 35–75, Khmer speaking, at high risk for developing diabetes, and met criteria for likely depression by either a) antidepressant medication and/or b) elevated depressive symptoms at two time-points during a study eligibility period. Treatment arms were: 1) community health educator (CHE) delivered lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus pharmacist/CHE-delivered medication therapy management (EWS + MTM), and, 3) social services (SS; control). Results: 188 participants were randomized. Treatment fidelity was high (98% checklist adherence) and on a scale from 0 to 3, participants reported high EWS treatment satisfaction (M = 2.9, SD = 0.2), group cohesion (M = 2.9, SD = 0.3), and therapeutic alliance to CHEs (M = 2.9, SD = 0.2) and to pharmacists (2.9, SD = 0.3). Attendance was challenging but highly successful; in EWS, 99% attended ≥ one session and 86% completed ≥ 24 sessions, M = 27.3 (SD = 3.7) sessions. Of those randomized to EWS + MTM, 98% attended at least one MTM session and 77%) completed ≥ 4 sessions. Retention was high, 95% at 12-month and 96% at 15-month assessments. Conclusions: The interventions were successfully implemented. Lessons learned and suggestions for future trials are offered. ClinicalTrials.gov identifier: NCT02502929
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Affiliation(s)
- Julie Wagner
- UConn Schools of Medicine and Dental Medicine, USA.
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Abel WM, DeHaven MJ. An interactive technology enhanced coaching intervention for Black women with hypertension: Randomized controlled trial study protocol. Res Nurs Health 2021; 44:24-36. [PMID: 33319386 PMCID: PMC7905978 DOI: 10.1002/nur.22090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/11/2020] [Accepted: 11/28/2020] [Indexed: 12/21/2022]
Abstract
In the United States, hypertension (HTN) is the leading risk factor for cardiovascular disease, and a more significant health problem for Blacks compared with other racial/ethnic groups. The prevalence of HTN in Black women is among the highest in the world, underscoring the need for effective prevention and management approaches for blood pressure (BP) control. We developed a two-arm randomized controlled trial repeated measures design study for improving HTN self-management among Black women. The study tests whether the Chronic Disease Self-Management Program (CDSMP) combined with interactive technology-enhanced coaching, can improve BP control and adherence to treatment (e.g., medication-taking, physical activity, calorie intake, and weight management) compared with the CDSMP alone. Repeated measurements were conducted at 3, 6, and 9 months. A sample of 90 community-dwelling Black women with uncontrolled Stage 1 HTN (BP ≥ 130/80) were enrolled, completed CDSMP training, and randomized. This study will contribute to our understanding of novel methods to empower Black women to increase their active involvement in self-care management of HTN.
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Affiliation(s)
- Willie M. Abel
- School of Nursing, The University of North Carolina at Charlotte
| | - Mark J. DeHaven
- Department of Public Health Sciences, The University of North Carolina at Charlotte
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Mayer VL, Vangeepuram N, Fei K, Hanlen-Rosado EA, Arniella G, Negron R, Fox A, Lorig K, Horowitz CR. Outcomes of a Weight Loss Intervention to Prevent Diabetes Among Low-Income Residents of East Harlem, New York. HEALTH EDUCATION & BEHAVIOR 2019; 46:1073-1082. [PMID: 31441328 PMCID: PMC6908807 DOI: 10.1177/1090198119868232] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
There is a need for diabetes prevention efforts targeting vulnerable populations. Our community-academic partnership, the East Harlem Partnership for Diabetes Prevention, conducted a randomized controlled trial to study the impact of peer led diabetes prevention workshops on weight and diabetes risk among an economically and racially diverse population in East Harlem, New York. We recruited overweight/obese adults from more than 50 community sites and conducted oral glucose tolerance testing and completed other clinical assessments and a health and lifestyle survey. We randomized prediabetic participants to intervention or delayed intervention groups. Intervention participants attended eight 90-minute peer-led workshop sessions at community sites. Participants in both groups returned for follow-up assessments 6 months after randomization. The main outcomes were the proportion of participants who achieved 5% weight loss, percentage weight loss, and change in the probability of developing diabetes over the next 7.5 years according to the San Antonio Diabetes Prediction Model. We enrolled 402 participants who were mainly female (85%), Latino (73%) or Black (23%), foreign born (64%), and non-English speaking (58%). At 6 months, the intervention group lost a greater percentage of their baseline weight, had significantly lower rise in HbA1c (glycated hemoglobin), decreased risk of diabetes, larger decreases in fat and fiber intake, improved confidence in nutrition label reading, and decrease in sedentary behavior as compared with the control group. Thus, in partnership with community stakeholders, we created an effective low-resource program that was less intensive than previously studied programs by incorporating strategies to engage and affect our priority population.
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Affiliation(s)
| | | | - Kezhen Fei
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Ashley Fox
- Rockefeller College of Public Affairs and Policy, University at Albany, State University of New York, Albany, NY, USA
| | - Kate Lorig
- Self-Management Resource Center, Palo Alto, CA, USA
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Chambers EC, Gonzalez JS, Marquez ME, Parsons A, Rehm CD. The Reach of an Urban Hospital System-Based Diabetes Prevention Program: Patient Engagement and Weight Loss Characteristics. THE DIABETES EDUCATOR 2019; 45:616-628. [PMID: 31608798 PMCID: PMC7328524 DOI: 10.1177/0145721719880503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. METHODS Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. RESULTS Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPP participants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. CONCLUSION This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.
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Affiliation(s)
- Earle C Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Jeffrey S Gonzalez
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, New York
- The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, New York
| | - Melinda E Marquez
- Office of Community and Population Health, Montefiore Health System, Bronx, New York
| | - Amanda Parsons
- Office of Community and Population Health, Montefiore Health System, Bronx, New York
| | - Colin D Rehm
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Office of Community and Population Health, Montefiore Health System, Bronx, New York
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Kim SE, Castro Sweet CM, Cho E, Tsai J, Cousineau MR. Evaluation of a Digital Diabetes Prevention Program Adapted for Low-Income Patients, 2016-2018. Prev Chronic Dis 2019; 16:E155. [PMID: 31775010 PMCID: PMC6896833 DOI: 10.5888/pcd16.190156] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION We examined the effects of a digitally delivered, type 2 diabetes mellitus prevention program (DPP) for a low-income population. METHODS We conducted a nonrandomized clinical trial with matched controls. The intervention group was offered a digital DPP, a web-based and mobile-based program including 52 weeks of participation in an educational curriculum, health coaching, and peer support. RESULTS A total of 227 participants enrolled. At baseline, 34.6 was the mean body mass index, and 5.8 was the mean HbA1c. For the intervention group, mean weight loss was 4.4% at the 12-month follow-up. CONCLUSION The modified DPP successfully engaged participants and resulted in weight loss. Low-income patients with prediabetes benefitted from a digitally delivered diabetes intervention. This prevention method should be accessible to a low-income population.
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Affiliation(s)
- Sue E Kim
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, SSB 2001 North Soto St, Ste 318C, Los Angeles, CA 90033.
| | | | - Edward Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jennifer Tsai
- Omada Health, Incorporated, San Francisco, California
| | - Michael R Cousineau
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, Los Angeles, California
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Harris J, Haltbakk J, Dunning T, Austrheim G, Kirkevold M, Johnson M, Graue M. How patient and community involvement in diabetes research influences health outcomes: A realist review. Health Expect 2019; 22:907-920. [PMID: 31286639 PMCID: PMC6803418 DOI: 10.1111/hex.12935] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient and public involvement in diabetes research is an international requirement, but little is known about the relationship between the process of involvement and health outcomes. OBJECTIVE This realist review identifies who benefits from different types of involvement across different contexts and circumstances. Search strategies Medline, CINAHL and EMBASE were searched to identify interventions using targeted, embedded or collaborative involvement to reduce risk and promote self-management of diabetes. People at risk/with diabetes, providers and community organizations with an interest in addressing diabetes were included. There were no limitations on date, language or study type. DATA EXTRACTION AND SYNTHESIS Data were extracted from 29 projects using elements from involvement frameworks. A conceptual analysis of involvement types was used to complete the synthesis. MAIN RESULTS Projects used targeted (4), embedded (8) and collaborative (17) involvement. Productive interaction facilitated over a sufficient period of time enabled people to set priorities for research. Partnerships that committed to collaboration increased awareness of diabetes risk and mobilized people to co-design and co-deliver diabetes interventions. Cultural adaptation increased relevance and acceptance of the intervention because they trusted local delivery approaches. Local implementation produced high levels of recruitment and retention, which project teams associated with achieving diabetes health outcomes. DISCUSSION AND CONCLUSIONS Achieving understanding of community context, developing trusting relationships across sectors and developing productive partnerships were prerequisites for designing research that was feasible and locally relevant. The proportion of diabetes studies incorporating these elements is surprisingly low. Barriers to resourcing partnerships need to be systematically addressed.
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Affiliation(s)
- Janet Harris
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUK
| | - Johannes Haltbakk
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Trisha Dunning
- Centre for Quality and Patient Safety ResearchDeakin University and Barwon Health PartnershipGeelongVictoriaAustralia
| | | | - Marit Kirkevold
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
- Department of Nursing Science, Institute of Health and SocietyUniversity of OsloOsloNorway
| | - Maxine Johnson
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUK
| | - Marit Graue
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
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Evaluation of a digital diabetes prevention program adapted for the Medicaid population: Study design and methods for a non-randomized, controlled trial. Contemp Clin Trials Commun 2018; 10:161-168. [PMID: 30035241 PMCID: PMC6052649 DOI: 10.1016/j.conctc.2018.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 11/23/2022] Open
Abstract
Previous studies have shown that lifestyle modification can successfully prevent or delay development of type 2 diabetes. This trial aimed to test if an underserved, low-income population would engage in a digital diabetes prevention program and successfully achieve lifestyle changes to reduce their risk of type 2 diabetes. Participants were recruited from three health care facilities serving low-income populations. The inclusion criteria were: a recent blood test indicating prediabetes, body mass index (BMI) > 24 kg/m2, age 18-75 years, not pregnant, not insured, Medicaid insured or Medicaid-eligible, internet or smartphone access, and comfort reading and writing in English or Spanish. A total of 230 participants were enrolled and started the intervention. Participants' average age was 48 years, average BMI = 34.8, average initial HbA1c = 5.8, 81% were female, and 45% were Spanish speaking. Eighty percent had Medicaid insurance, 18% were uninsured, and 2% were insured by a medical safety net plan. Participants completed a health assessment including measured anthropometrics, HbA1c test, and self-report questionnaires at baseline, 6 and 12 months. The 52-week digital diabetes prevention program included weekly educational curriculum, human health coaching, connected tracking tools, and peer support from a virtual group. Qualitative data on implementation was collected with semi-structured interviews with key informants to understand the barriers, keys to success, and best practices in the adoption of the program within the clinical setting. This paper describes the study design and methodology of a digital diabetes prevention program and early lessons learned related to recruitment, enrollment, and data collection.
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Vangeepuram N, Mayer V, Fei K, Hanlen-Rosado E, Andrade C, Wright S, Horowitz C. Smartphone ownership and perspectives on health apps among a vulnerable population in East Harlem, New York. Mhealth 2018; 4:31. [PMID: 30221166 PMCID: PMC6131491 DOI: 10.21037/mhealth.2018.07.02] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 07/16/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Individuals from low-income and racial/ethnic minority backgrounds have traditionally had less access to mobile health (mHealth) technologies, but there is evidence that this gap has been rapidly narrowing. Given the increase in access to mobile technologies recently seen in vulnerable populations, mHealth has been championed as a strategy for improving population health and reducing health disparities. However, members of low-income and racial/ethnic minority populations have had a limited role in the development and implementation of mHealth interventions designed to impact them. METHODS We used community-based participatory research (CBPR), a research approach that is frequently employed to help reach communities that are disproportionately affected by illness but are difficult to engage. Our community-academic collaboration, the East Harlem Partnership for Diabetes Prevention, sought to create a mobile technology platform that would allow adults in East Harlem, New York to improve their own health and promote the health of the broader community. As a first step, we developed and conducted a survey of community residents to better understand access to, usage of, and attitudes towards mobile technologies among diverse, low-income adults. We administered the cross-sectional survey to a convenience sample of adults who utilized a variety of community-based organizations in East Harlem. We examined frequencies for each survey item and then used chi-square tests (or Fisher's exact tests) and multivariate logistic regression to evaluate relationships between these outcomes and sociodemographic factors. RESULTS We approached 154 people, of whom 104 (68%) agreed to participate. The majority of respondents were of Black and/or Hispanic/Latino descent with a mean age of 37 years. Our sample displayed a high percentage of smartphone ownership (82% of the participants reported that they owned a cell phone, and 88% of owners reported that their cell phone was a smartphone). We found lower rates of ownership among individuals who were older, self-identified as Latino, insured by Medicare, and had a household income of less than $30,000 per year. Multivariate logistic regression showed that after adjusting for age, gender and race, those with at least a high school education were seven times more likely to use health apps than those with less than a high school education (OR 6.8, 95% CI: 1.7-27.1). Participants expressed interest in health promoting apps that provide interactive, individualized diet, exercise and weight loss tools and offer information about local health resources and events. CONCLUSIONS Despite some notable disparities, our study results suggest that the digital divide is narrowing in the East Harlem community with relatively high rates of smartphone ownership and use, even among individuals from low-income, low education backgrounds and those without health insurance. Based on study results, our partnership developed an app supporting healthy lifestyle and diabetes prevention tailored to the East Harlem community.
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Affiliation(s)
- Nita Vangeepuram
- Departments of Pediatrics and Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Victoria Mayer
- Departments of Pediatrics and Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kezhen Fei
- Departments of Pediatrics and Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emily Hanlen-Rosado
- Departments of Pediatrics and Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cesar Andrade
- Departments of Pediatrics and Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shari Wright
- Departments of Pediatrics and Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carol Horowitz
- Departments of Pediatrics and Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Rastogi S, Pandey N, Sachdev K. Linking Prameha etiology with diabetes mellitus: Inferences from a matched case-control study. Ayu 2018; 39:139-145. [PMID: 31000990 PMCID: PMC6454911 DOI: 10.4103/ayu.ayu_106_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Diabetes is one of the most rapidly increasing disease in the contemporary context. Its rapid global rise indicates that its cause are possibly closely associated with the routine lifestyle and eating habits. Diabetes is also possibly the medical condition, which presents with a preclinical phase having a possibility of reversal if its possible causes can be seriously understood and eliminated. Experiences of diabetes management so far had not been very promising either in prevention of its incidence or spread and prevention of its complications. Aims and Objective: In this case, preventing diabetes by attempting to identify the risk factors and then proposing the ways to avoid them could be a most pragmatic way forward. Material and Methods: This study has attempted to associate Ayurvedic causes of Prameha with diabetes in a matched case–control manner (n = 24) and has shown the high association of diabetes with a few relatively less known causes such as stress (odds ratio [OR]: 7.86:1), anger (OR: 5.9:1), and excessive exposure to high ambient temperature (OR: 4.6:1). Results: Among the causative factors showing a high OR, stress and anger were particularly found statistically significant (P = 0.0173 and 0.0145, respectively). Conclusion: On the basis of these results, this can be proposed that if such studies are done on larger basis and possibly in a prospective cohort manner, it can open a completely new area of identifying the risk factors to diabetes. Such revealing knowledge will not only help us knowing about diabetes better but also definitely help us to prevent diabetes to a large extent.
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Affiliation(s)
- Sanjeev Rastogi
- Department of Kaya Chikitsa, State Ayurvedic College and Hospital, Lucknow University, Lucknow, Uttar Pradesh
| | - Nripendra Pandey
- Department of Swasthavritta, Patanjali Ayurved College, Patanjali Yogpeeth, Haridwar, Uttarakhand, India
| | - Kamal Sachdev
- Department of Kaya Chikitsa, State Ayurvedic College and Hospital, Lucknow University, Lucknow, Uttar Pradesh
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Hill J, Peer N, Oldenburg B, Kengne AP. Roles, responsibilities and characteristics of lay community health workers involved in diabetes prevention programmes: A systematic review. PLoS One 2017; 12:e0189069. [PMID: 29216263 PMCID: PMC5720739 DOI: 10.1371/journal.pone.0189069] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/17/2017] [Indexed: 01/16/2023] Open
Abstract
AIM To examine the characteristics of community health workers (CHWs) involved in diabetes prevention programmes (DPPs) and their contributions to expected outcomes. METHODS Electronic databases including PubMed-MEDLINE, EBSCOHost, and SCOPUS/EMBASE were searched for studies published between January 2000 and March 2016. All studies that used CHWs to implement DPP in ≥18-year-old participants without diabetes but at high risk for developing the condition, irrespective of the study design, setting or outcomes measured, were included. Results were synthesized narratively. RESULTS Forty papers of 30 studies were identified. Studies were mainly community-based and conducted in minority populations in USA. Sample sizes ranged from 20 participants in a single community to 2369 participants in 46 communities. Although CHWs were generally from the local community, their qualifications, work experience and training received differed across studies. Overall the training was culturally sensitive and/or appropriate, covering topics such as the importance of good nutrition and the benefits of increased physical activity, communication and leadership. CHWs delivered a variety of interventions and also screened or recruited participants. The shared culture and language between CHWs and participants likely contributed to better programme implementation and successful outcomes. CONCLUSIONS The complexity of DPPs and the diverse CHW roles preclude attributing specific outcomes to CHW involvement. Nevertheless, documenting potential CHW roles and the relevant training required may optimise CHW contributions and facilitate their involvement in DPPs in the future.
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Affiliation(s)
- Jillian Hill
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- * E-mail:
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Brian Oldenburg
- Melbourne School of Public Health and Global Health, University of Melbourne, Melbourne, Australia
| | - Andre Pascale Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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Yu J, Fei K, Fox A, Negron R, Horowitz C. Stress eating and sleep disturbance as mediators in the relationship between depression and obesity in low-income, minority women. Obes Res Clin Pract 2016; 10:283-90. [PMID: 26324859 PMCID: PMC4769965 DOI: 10.1016/j.orcp.2015.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 07/15/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to explore potential mediators of the relationship between depression and obesity in a sample of low-income, minority women. Data were extracted from a sample of 535 women enrolled in a weight loss intervention for the prevention of type 2 diabetes. Using a non-parametric bootstrapping procedure, the potential mediation effects of stress eating and sleep disturbance on the relationship between depression and obesity were tested. Results of a single mediation model indicated that depressive symptomatology was significantly associated with obesity (β=0.800, SE=0.290, p=0.006), and that stress eating (β=0.166, 95% CI [0.046, 0.328]) and sleep disturbance (β=1.032, 95% CI [0.612, 1.427]) were significant independent mediators of this relationship. Sleep disturbance remained a significant mediator in a combined mediation model (β=1.009, 95% CI [0.653, 1.399]). Findings add to the growing literature on the psychosocial factors implicated in the link between depression and obesity, particularly among disadvantaged populations. Future longitudinal research should aim to establish causal pathways between obesity, stress eating, sleep disturbance, and depression.
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Affiliation(s)
- Jessica Yu
- Institute for Health, Health Care Policy, and Aging Research, Rutgers - The State University of New Jersey, New Brunswick, NJ, United States; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Kezhen Fei
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ashley Fox
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Rennie Negron
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Carol Horowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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15
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Horowitz CR, Abul-Husn NS, Ellis S, Ramos MA, Negron R, Suprun M, Zinberg RE, Sabin T, Hauser D, Calman N, Bagiella E, Bottinger EP. Determining the effects and challenges of incorporating genetic testing into primary care management of hypertensive patients with African ancestry. Contemp Clin Trials 2016; 47:101-8. [PMID: 26747051 PMCID: PMC4818169 DOI: 10.1016/j.cct.2015.12.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/21/2015] [Accepted: 12/28/2015] [Indexed: 12/11/2022]
Abstract
People of African ancestry (Blacks) have increased risk of kidney failure due to numerous socioeconomic, environmental, and clinical factors. Two variants in the APOL1 gene are now thought to account for much of the racial disparity associated with hypertensive kidney failure in Blacks. However, this knowledge has not been translated into clinical care to help improve patient outcomes and address disparities. GUARDD is a randomized trial to evaluate the effects and challenges of incorporating genetic risk information into primary care. Hypertensive, non-diabetic, adults with self-reported African ancestry, without kidney dysfunction, are recruited from diverse clinical settings and randomized to undergo APOL1 genetic testing at baseline (intervention) or at one year (waitlist control). Providers are educated about genomics and APOL1. Guided by a genetic counselor, trained staff return APOL1 results to patients and provide low-literacy educational materials. Real-time clinical decision support tools alert clinicians of their patients' APOL1 results and associated risk status at the point of care. Our academic-community-clinical partnership designed a study to generate information about the impact of genetic risk information on patient care (blood pressure and renal surveillance) and on patient and provider knowledge, attitudes, beliefs, and behaviors. GUARDD will help establish the effective implementation of APOL1 risk-informed management of hypertensive patients at high risk of CKD, and will provide a robust framework for future endeavors to implement genomic medicine in diverse clinical practices. It will also add to the important dialog about factors that contribute to and may help eliminate racial disparities in kidney disease.
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Affiliation(s)
- C R Horowitz
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA; Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA; The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Annenberg Building, 18th Floor, Room 18-16, New York, NY 10029, USA.
| | - N S Abul-Husn
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Annenberg Building, 18th Floor, Room 18-16, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1022, New York, NY 10029, USA.
| | - S Ellis
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Annenberg Building, 18th Floor, Room 18-16, New York, NY 10029, USA.
| | - M A Ramos
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA; Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA.
| | - R Negron
- Yale Institute for Network Science, Yale University, 17 Hillhouse Avenue, P.O. Box 208263, New Haven, CT 06520, USA.
| | - M Suprun
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA.
| | - R E Zinberg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1022, New York, NY 10029, USA.
| | - T Sabin
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA.
| | - D Hauser
- Institute for Family Health, 16 East 16th Street, New York, NY 10003, USA.
| | - N Calman
- Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA; Institute for Family Health, 16 East 16th Street, New York, NY 10003, USA.
| | - E Bagiella
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA.
| | - E P Bottinger
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Annenberg Building, 18th Floor, Room 18-16, New York, NY 10029, USA; Berlin Institute of Health, Berlin, Germany.
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Abstract
Designing and implementing effective lifestyle modification strategies remains one of the great challenges in diabetes care. Historically, programs have focused on individual behavior change with little or no attempt to integrate change within the broader social framework or community context. However, these contextual factors have been shown to be associated with poor diabetes outcomes, particularly in low-income minority populations. Recent evidence suggests that one way to address these disparities is to match patient needs to existing community resources. Not only does this position patients to more quickly adapt behavior in a practical way, but this also refers patients back to their local communities where a support mechanism is in place to sustain healthy behavior. Technology offers a new and promising platform for connecting patients to meaningful resources (also referred to as "assets"). This paper summarizes several noteworthy innovations that use technology as a practical bridge between healthcare and community-based resources that promote diabetes self-care.
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Affiliation(s)
- Elizabeth L. Tung
- Section of General Internal Medicine, Chicago Center of Diabetes Translation Research, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637, USA
| | - Monica E. Peek
- Section of General Internal Medicine, Chicago Center of Diabetes Translation Research, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637, USA
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Koniak-Griffin D, Brecht ML, Takayanagi S, Villegas J, Melendrez M, Balcázar H. A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: feasibility and outcomes of a randomized controlled trial. Int J Nurs Stud 2015; 52:75-87. [PMID: 25307195 PMCID: PMC4277872 DOI: 10.1016/j.ijnurstu.2014.09.005] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 08/07/2014] [Accepted: 09/12/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Low-income Latinas (Hispanics) face risk for cardiovascular disease due to high rates of overweight/obesity, sedentary lifestyle, and other factors. Limited access to health care and language barriers may prevent delivery of health promotion messages. Targeted approaches, including the integration of community health workers, may be required to promote healthy lifestyle and prevent chronic disease in underserved ethnic minority groups. The term commonly used to refer to female community health workers in Latino communities is "promotora(s)." OBJECTIVES This study evaluates the outcomes and feasibility of a promotora-led lifestyle behavior intervention for overweight, immigrant Latinas. METHODS A community prevention model was employed in planning and implementing this study. A randomized controlled trial design was used. A Community Advisory Board provided expertise in evaluating feasibility of study implementation in the community and other important guidance. The sample was comprised of 223 women aged 35-64 years, predominantly with low income and ≤8th grade education. The culturally tailored Lifestyle Behavior Intervention included group education (8 classes based upon Su Corazon, Su Vida), followed by 4 months of individual teaching and coaching (home visits and telephone calls). The control group received a comparable length educational program and follow-up contacts. Evaluations were conducted at baseline and at 6 and 9 months using a dietary habits questionnaire, accelerometer readings of physical activity, and clinical measures (body mass index, weight, waist circumference, blood pressure, lipids, blood glucose). Data were collected between January 2010 and August 2012. RESULTS Women in the intervention group improved significantly in dietary habits, waist circumference, and physical activity in comparison to those in the control group. A treatment dosage effect was observed for weight and waist circumference. Knowledge about heart disease increased. High attendance at classes and participation in the individual teaching and counseling sessions and high retention rates support the feasibility and acceptability of the promotora-led lifestyle behavior intervention. CONCLUSIONS Our findings demonstrate that lifestyle behaviors and other risk factors of overweight Latina women may be improved through a promotora-led lifestyle behavior intervention. Feasibility of implementing this intervention in community settings and engaging promotoras as facilitators is supported.
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Affiliation(s)
- Deborah Koniak-Griffin
- Audrienne H. Moseley Endowed Chair, Women's Health Research, School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mary-Lynn Brecht
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Sumiko Takayanagi
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Juan Villegas
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Marylee Melendrez
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Héctor Balcázar
- Regional Dean, El Paso Regional Campus, and Professor, Division of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health at Houston, El Paso, TX, United States
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18
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Dickson-Gomez J, Corbett AM, Bodnar G, Zuniga MO, Guevara CE, Rodriguez K, Navas V. Context and group dynamics in a CBPR-developed HIV prevention intervention. Health Promot Int 2014; 31:93-105. [PMID: 25070835 DOI: 10.1093/heapro/dau058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This paper will explore in detail the effects of context and group dynamics on the development of a multi-level community-based HIV prevention intervention for crack cocaine users in the San Salvador Metropolitan Area, El Salvador. Community partners included residents from marginal communities, service providers from the historic center of San Salvador and research staff from a non-profit organization. The community contexts from which partners came varied considerably and affected structural group dynamics, i.e. who was identified as community partners, their research and organizational capacity, and their ability to represent their communities, with participants from marginal communities most likely to hold community leadership positions and be residents, and those from the center of San Salvador most likely to work in religious organizations dedicated to HIV prevention or feeding indigent drug users. These differences also affected the intervention priorities of different partners. The context of communities changed over time, particularly levels of violence, and affected group dynamics and the intervention developed. Finally, strategies were needed to elicit input from stakeholders under-represented in the community advisory board, in particular active crack users, in order to check the feasibility of the proposed intervention and revise it as necessary. Because El Salvador is a very different context than that in which most CBPR studies have been conducted, our results reveal important contextual factors and their effects on partnerships not often considered in the literature.
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Affiliation(s)
- Julia Dickson-Gomez
- Medical College of Wisconsin, Center for AIDS Intervention Research, Milwaukee, WI, USA
| | | | - Gloria Bodnar
- Fundación Antidrogas de El Salvador, Santa Tecla, El Salvador
| | | | | | - Karla Rodriguez
- Universidad Centroamericana Jose Simeon Cañas, San Salvador, El Salvador
| | - Verónica Navas
- Fundación Antidrogas de El Salvador, Santa Tecla, El Salvador
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Tapp H, White L, Steuerwald M, Dulin M. Use of community-based participatory research in primary care to improve healthcare outcomes and disparities in care. J Comp Eff Res 2014; 2:405-19. [PMID: 24236682 DOI: 10.2217/cer.13.45] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Community-based participatory research (CBPR) has emerged to bridge the gap between research and primary-care practice through community engagement and social action to increase health equity. It is widely acknowledged that access to high-quality primary care services is important to the overall health of a community. Here, CBPR studies in a primary care setting are reviewed to assess the use of CBPR associated with common health problems seen in primary care such as access to care and disparities in chronic disease management across vulnerable populations. CBPR involves building relationships with local communities, determining areas of need and establishing priorities for health concerns. Studies showing improved access to care for a Hispanic population, reduced asthma symptoms and weight loss are highlighted.
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Affiliation(s)
- Hazel Tapp
- Carolinas HealthCare System, PO Box 32861, NC, USA
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20
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Odulana A, Kim MM, Green M, Taylor Y, Howard DL, Godley P, Corbie-Smith G. Participating in research: attitudes within the African American church. JOURNAL OF RELIGION AND HEALTH 2014; 53:373-81. [PMID: 22886179 PMCID: PMC4419576 DOI: 10.1007/s10943-012-9637-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We assessed associations between pastor and congregant characteristics and congregant attitudes about research participation among African American churches. Respondents shared their attitudes regarding how willing, ready, and confident they were about research participation. The outcome measure, the index of research preparedness, summed responses across the domains of willingness, readiness, and confidence. Pastor age and pastor educational attainment were independently associated with a congregants' higher index of research preparedness. Young and educated pastors were significantly associated with congregant attitudes about participation preparedness, a finding that highlights the importance of the pastor regarding congregant research participation decisions.
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Affiliation(s)
- Adebowale Odulana
- Division of General Medicine & Clinical Epidemiology and Division of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, 5034 Old Clinic, CB 7100, Chapel Hill, NC, 27599, USA,
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21
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Cotter AP, Durant N, Agne AA, Cherrington AL. Internet interventions to support lifestyle modification for diabetes management: a systematic review of the evidence. J Diabetes Complications 2014; 28:243-51. [PMID: 24332469 PMCID: PMC3943472 DOI: 10.1016/j.jdiacomp.2013.07.003] [Citation(s) in RCA: 147] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 07/26/2013] [Accepted: 07/26/2013] [Indexed: 01/15/2023]
Abstract
BACKGROUND The Internet presents a widely accessible, 24-h means to promote chronic disease management. The objective of this review is to identify studies that used Internet based interventions to promote lifestyle modification among adults with type 2 diabetes. METHODS We searched PubMed using the terms: [internet, computer, phone, smartphone, mhealth, mobile health, web based, telehealth, social media, text messages] combined with [diabetes management and diabetes control] through January 2013. Studies were included if they described an Internet intervention, targeted adults with type 2 diabetes, focused on lifestyle modification, and included an evaluation component with behavioral outcomes. RESULTS Of the 2803 papers identified, nine met inclusion criteria. Two studies demonstrated improvements in diet and/or physical activity and two studies demonstrated improvements in glycemic control comparing web-based intervention with control. Successful studies were theory-based, included interactive components with tracking and personalized feedback, and provided opportunities for peer support. Website utilization declined over time in all studies that reported on it. Few studies focused on high risk, underserved populations. CONCLUSION Web-based strategies provide a viable option for facilitating diabetes self-management. Future research is needed on the use of web-based interventions in underserved communities and studies examining website utilization patterns and engagement over time.
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Affiliation(s)
| | | | - April A Agne
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham
| | - Andrea L Cherrington
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham.
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22
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Tapp H, White L, Steuerwald M, Dulin M. Use of community-based participatory research in primary care to improve healthcare outcomes and disparities in care. J Comp Eff Res 2013. [PMID: 24236682 PMCID: PMC4042315 DOI: 10.2217/cer.13.45,] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Community-based participatory research (CBPR) has emerged to bridge the gap between research and primary-care practice through community engagement and social action to increase health equity. It is widely acknowledged that access to high-quality primary care services is important to the overall health of a community. Here, CBPR studies in a primary care setting are reviewed to assess the use of CBPR associated with common health problems seen in primary care such as access to care and disparities in chronic disease management across vulnerable populations. CBPR involves building relationships with local communities, determining areas of need and establishing priorities for health concerns. Studies showing improved access to care for a Hispanic population, reduced asthma symptoms and weight loss are highlighted.
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Affiliation(s)
- Hazel Tapp
- Carolinas HealthCare System, PO Box 32861, NC, USA
- Author for correspondence:
| | - Lauren White
- Carolinas HealthCare System, PO Box 32861, NC, USA
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23
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Abstract
Emerging research suggests that sedentary behavior, sometimes measured as screen time, may be an important correlate of depression. Physical activity, while not the direct opposite of sedentary behavior, has also been associated with depression (albeit inversely). Although low-income and minority populations may experience greater levels of depression, little research has focused on the relationships between screen time or physical activity and depression in low-income, minority populations in the United States. This study used logistic regression to assess relationships among depression, daily screen time, and weekly physical activity and the interaction between screen time and physical activity in a cross-sectional sample of 535 overweight or obese minority women in East Harlem, New York. Sixteen percent of participants were at risk for depression, which was significantly higher than national averages. Results suggested that engaging in high levels of daily screen time was associated with increased depression risk, even after controlling for physical activity and demographic variables. Neither physical activity nor the interaction between screen time and physical activity were associated with depression risk. Obesity was significantly associated with depression risk in all models, even when accounting for sedentary behavior and physical activity. Daily screen time may be an important risk factor for depression in minority women in the United States. The lack of association between physical activity and depression did not support past research and may have been due to the physical activity measure or the fact that physical activity may not be an important risk factor for depression in minority women.
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Affiliation(s)
- Jessica Y. Breland
- Department of Psychology, Rutgers, The State University of New Jersey, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, 112 Paterson Street, New Brunswick, NJ 08901, USA
| | - Ashley M. Fox
- Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA
| | - Carol R. Horowitz
- Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA
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24
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Lee EC, Simon EP, Nickerson J, Brenner B, Talavera S, Goytia C, Arniella G, Horowitz CR. Shared governance in building community capacity: A case study of sleep apnea. INTERNATIONAL PUBLIC HEALTH JOURNAL 2013; 5:99-104. [PMID: 25621099 PMCID: PMC4302721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
East Harlem has the highest diabetes mortality rate in New York City, NY. Using Community Based Participatory Research principles, the East Harlem Partnership for Diabetes Prevention-a community- academic partnership-formed to build community capacity with a goal to address health disparities in East Harlem. As part of prevention efforts, community partners chose to study the prevalence of obstructive sleep apnea and its relationship to pre-diabetes and progression to diabetes. However, community partners insisted any study of sleep apnea go beyond simple assessment to ensure the largely uninsured, minority population enrolled also have access to state of the art diagnosis and treatment. Through compromise and collaboration, the partnership developed a culturally appropriate and scientifically rigorous method to diagnose and treat sleep apnea as part of a novel research program.
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Affiliation(s)
- Euny C Lee
- Departments of Health Evidence and Policy and Preventive Medicine, Mount Sinai School of Medicine, New York, United States of America
| | - Ellen P. Simon
- Union Settlement Association, New York, United States of America
| | - Jillian Nickerson
- Departments of Health Evidence and Policy and Preventive Medicine, Mount Sinai School of Medicine, New York, United States of America
| | - Barbara Brenner
- Departments of Health Evidence and Policy and Preventive Medicine, Mount Sinai School of Medicine, New York, United States of America
| | - Sandra Talavera
- East Harlem Partnership for Diabetes Prevention and Senior Health Partners, New York, United States of America
| | - Crispin Goytia
- East Harlem Partnership for Diabetes Prevention and Centers for Community and Academic Research Partnerships, Mount Sinai CONDUITS, New York, United States of America
| | - Guedy Arniella
- Institute for Family Health, Family Health Center at North General, 1879 Madison Ave, New York, United States of America
| | - Carol R. Horowitz
- Departments of Health Evidence and Policy and Preventive Medicine, Mount Sinai School of Medicine, New York, United States of America
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25
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Friedman EA. Optimizing care in diabetes: a quixotic challenge. Diabetes Care 2012; 35:1204-5. [PMID: 22619287 PMCID: PMC3357255 DOI: 10.2337/dc12-0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Eli A Friedman
- Division of Renal Disease, Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
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26
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Johnson J, Ross L, Iwanenko W, Schiffert J, Sen A. Are podcasts effective at educating African American men about diabetes? Am J Mens Health 2012; 6:365-7. [PMID: 22516566 DOI: 10.1177/1557988312444717] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Education is a critical component of the National Blueprint to eliminate racial disparities in diabetes. Research indicates that traditional methods of diabetes education has had limited effectiveness with minority populations and suggests that different educational approaches be explored. The purpose of the research was to explore the effectiveness of an emergent technology (podcast) for use in educating inner-city, African American men about diabetes prevention. Thirty African American men participated in self-administered, pretest-posttest surveys in August 2009. Surveys collected information on demographic characteristics, perceptions of diabetes, and diabetes knowledge. Paired samples t test was computed to evaluate pretest-posttest changes in overall knowledge. McNemar or binomial tests were computed to evaluate pretest-posttest knowledge changes on each of the 15 individual knowledge items. Diabetes knowledge scores for the sample increased from 8.27 at pretest to 10.47 at posttest (p = .001). Posttest knowledge scores increased for 77% of men, stayed the same for 13%, and decreased for 10%. Men who listened to the podcast correctly answered 40% more knowledge questions on their posttest assessments. Results from this exploratory study suggest that podcasts are useful for helping inner-city, African American men recall diabetes prevention information. Additional research is recommended with larger randomly selected samples using more rigorous research designs.
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Affiliation(s)
- Jarrett Johnson
- Roswell Park Cancer Institute, Office of Cancer Health Disparities, Elm & Carlton Streets, Buffalo, NY 14263, USA.
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27
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Pagoto S. The current state of lifestyle intervention implementation research: where do we go next? Transl Behav Med 2011; 1:401-5. [PMID: 24073065 PMCID: PMC3717623 DOI: 10.1007/s13142-011-0071-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Sherry Pagoto
- University of Massachusetts Medical School, Worcester, MA USA
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