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Serrano N, Schmidt L, Eyler AA, Brownson RC. Perspectives From Public Health Practitioners and Advocates on Community Development for Active Living: What are the Lasting Impacts? Am J Health Promot 2024; 38:80-89. [PMID: 37612243 PMCID: PMC10748458 DOI: 10.1177/08901171231198403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE Evidence suggests differential impacts of community development, including gentrification and displacement. Public health practitioners and advocates are key stakeholders involved in the community development process related to active living, yet little is known about their perceptions of its impacts. We explored the perspectives of relevant leaders of public health departments and key community and advocacy organizations on community development, gentrification, and displacement. APPROACH Purposive key informant interviews. SETTING CDC State Physical Activity and Nutrition (SPAN) funding recipients. PARTICIPANTS CDC SPAN recipient leadership (n = 10 of 16) and advocacy organizations they partnered with (n = 7 of 16). METHOD Interviews were recorded, transcribed, coded, and thematically analyzed with direct quotes representing key themes. RESULTS Both groups felt community development held important benefits, specifically by creating healthy living opportunities, but also potentially leading to the displacement of long-time residents. Practitioners reported the benefits were for all community members, whereas advocates noted the benefits were seen in those with privilege, and the consequences were disproportionately seen in disadvantaged communities. Both mentioned the importance and difficulty of getting diverse representation for community engagement. CONCLUSIONS Learning how key stakeholders perceive and navigate the community development process can help inform recommendations for better equity in active living community improvements. More work is needed to further elucidate best practices for health and social equity in the community development process.
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Affiliation(s)
- Natalicio Serrano
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laurel Schmidt
- Office of Educational Innovation and Evaluation, Kansas State University, Manhattan, KS, USA
| | - Amy A. Eyler
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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Gao X, Berkowitz RL, Michaels EK, Mujahid MS. Traveling Together: A Road Map for Researching Neighborhood Effects on Population Health and Health Inequities. Am J Epidemiol 2023; 192:1731-1742. [PMID: 37246316 DOI: 10.1093/aje/kwad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/12/2023] [Accepted: 05/24/2023] [Indexed: 05/30/2023] Open
Abstract
As evidence of the relationship between place and health mounts, more epidemiologists and clinical science researchers are becoming interested in incorporating place-based measures and analyses into their examination of population health and health inequities. Given the extensive literature on place and health, it can be challenging for researchers new to this area to develop neighborhood-effects research questions and apply the appropriate measures and methods. This paper provides a road map for guiding health researchers through the conceptual and methodological stages of incorporating various dimensions of place into their quantitative health research. Synthesizing across reviews, commentaries, and empirical investigations, the road map consists of 4 broad stages for considering place and health: 1) why?: articulating the motivation for assessing place and health and grounding the motivation in theory; 2) what?: identifying the relevant place-based characteristics and specifying their link to health to build a conceptual framework; 3) how?: determining how to operationalize the conceptual framework by defining, measuring, and assessing place-based characteristics and quantifying their effect on health; and 4) now what?: discussing the implications of neighborhood research findings for future research, policy, and practice. This road map supports efforts to develop conceptually and analytically rigorous neighborhood research projects.
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Zhang Y, Liu M, Wang J, Han K, Han F, Wang B, Xie S, Yuan C, Zhao M, Li S, Wang J. Bibliometric analysis of the association between drinking water pollution and bladder cancer. Front Oncol 2023; 13:1170700. [PMID: 37456244 PMCID: PMC10346845 DOI: 10.3389/fonc.2023.1170700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Background Bladder cancer has become an increasingly intractable health problem worldwide. Long-term drinking water pollution is known to promote its occurrence. This study aimed to analyze the research status, hot spots, and future trends of drinking water pollution and bladder cancer through extensive bibliometric examination to provide reference data for better prevention and management of bladder cancer. Methods The Scopus database developed by Elsevier was browsed for articles that met the predefined criteria using the search terms related to drinking water and bladder cancer. Included articles were further evaluated by year of publication, subject category, institution, article type, source journal, authors, co-authorship networks, and text mining of titles by R software packages tm, ggplot2 and VOSviewer software. Results In total, 687 articles were selected after a comprehensive literature search by the Scopus database, including 491 research articles, 98 review articles, 26 conference papers, 23 letters and 49 other documents. The total number of articles published showed an upward trend. The United States has the largest number of published articles (345 articles), institutions (7/10) and funding sponsors (top 5). The journal with the most publications was Environmental Health Perspectives, with 46 published. The highest number of citations up to 2330 times for a single article published in 2007 on the journal of Mutation Research. Professor Cantor K.P. was the highest number of publications with 35 articles and Smith A.H. was the most cited author with the number of citations reaching 6987 times overall and 225 times per article. The most frequent keywords excluding the search subject were "arsenic", "chlorination", "trihalomethane", and "disease agents". Conclusion This study is the first systematic bibliometric study of the literature publications on drinking water pollution and bladder cancer. It offers an overall and intuitive understanding of this topic in the past few years, and points out a clear direction research hotspots and reveals the trends for further in-depth study in future.
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Affiliation(s)
- Ying Zhang
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan, China
- Center for Single-Cell Omics and Tumor Liquid Biopsy, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Mei Liu
- Department of Laboratory Medicine, Wuhan Hankou Hospital, Wuhan, China
| | - Jiajun Wang
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Kexin Han
- Center for Single-Cell Omics and Tumor Liquid Biopsy, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fuyu Han
- Center for Single-Cell Omics and Tumor Liquid Biopsy, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bicheng Wang
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Si Xie
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunhui Yuan
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingdeng Zhao
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan, China
| | - Shuo Li
- Center for Single-Cell Omics and Tumor Liquid Biopsy, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jun Wang
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Mui Y, Headrick G, Chien J, Pollack C, Saleem HT. Revisiting revitalization: exploring how structural determinants moderate pathways between neighborhood change and health. Int J Equity Health 2022; 21:165. [DOI: 10.1186/s12939-022-01771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/16/2022] [Accepted: 09/27/2022] [Indexed: 11/19/2022] Open
Abstract
AbstractVacant housing can produce many issues that affect residents’ quality of life, especially in historically segregated communities of color. To address these challenges, local governments invest in strategic, place-based revitalization initiatives focused on the regeneration of vacant housing. Yet, the outcomes of these efforts remain contested. To maximize health benefits of revitalization investments, a more nuanced understanding of pathways between neighborhood changes and residents’ responses, adaptations, and ability to thrive is necessary, though, remains largely absent in the literature. Using the Vacants to Value initiative in Baltimore, MD as a case study, we explore (1) how health manifests among certain groups in the context of vacant housing revitalization; (2) how vacant housing and its regeneration engender social and cultural environmental change i.e., gentrification; and (3) what structural determinants (cultural norms, policies, institutions, and practices) contribute to the distribution of material resources and benefits of revitalization. Results suggest that vacant housing revitalization requires more than just physical remedies to maximize health. Our findings demonstrate how vacant housing revitalization influences the physical environment, social environment, and structural determinants of material resources and community engagement that can ultimately impact residents’ physical, mental, and social health. This study recommends that because housing disparities are rooted in structural inequalities, how policies, practices, and processes moderate pathways for residents to adapt and benefit from neighborhood changes is consequential for health and health equity. Establishing shared governance structures is a promising approach to foster equitable decision-making and outcomes. Going forward in urban regeneration, pathways to retain and strengthen the social environment while revitalizing the physical environment may be promising to achieve healthy communities.
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Sadler RC, Felton JW, Rabinowitz JA, Powell TW, Latimore A, Tandon D. Inequitable Housing Practices and Youth Internalizing Symptoms: Mediation Via Perceptions of Neighborhood Cohesion. URBAN PLANNING 2022; 7:153-166. [PMID: 37033410 PMCID: PMC10081151 DOI: 10.17645/up.v7i4.5410] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Disordered urban environments negatively impact mental health symptoms and disorders. While many aspects of the built environment have been studied, one influence may come from inequitable, discriminatory housing practices such as redlining, blockbusting, and gentrification. The patterns of disinvestment and reinvestment that follow may be an underlying mechanism predicting poor mental health. In this study, we examine pathways between such practices and internalizing symptoms (i.e., anxiety and depression) among a sample of African American youth in Baltimore, Maryland, considering moderation and mediation pathways including neighborhood social cohesion and sex. In our direct models, the inequitable housing practices were not significant predictors of social cohesion. In our sex moderation model, however, we find negative influences on social cohesion: for girls from gentrification, and for boys from blockbusting. Our moderated mediation model shows that girls in gentrifying neighborhoods who experience lower social cohesion have higher levels of internalizing symptoms. Likewise for boys, living in a formerly blockbusted neighborhood generates poorer social cohesion, which in turn drives higher rates of internalizing symptoms. A key implication of this work is that, in addition to standard measures of the contemporary built environment, considering other invisible patterns related to discriminatory and inequitable housing practices is important in understanding the types of neighborhoods where anxiety and depression are more prevalent. And while some recent work has discussed the importance of considering phenomena like redlining in considering long-term trajectories of neighborhoods, other patterns such as blockbusting and gentrification may be equally important.
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Affiliation(s)
- Richard C. Sadler
- Division of Public Health, Michigan State University, USA
- Department of Family Medicine, Michigan State University, USA
| | - Julia W. Felton
- Center for Health Policy & Health Services Research, Henry Ford Health System, USA
| | - Jill A. Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Terrinieka W. Powell
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Amanda Latimore
- Johns Hopkins Bloomberg School of Public Health, USA
- Center for Addiction Research and Effective Solutions, USA
| | - Darius Tandon
- Center for Community Health, Northwestern University Feinberg School of Medicine, USA
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Wang S, Yung EHK, Cerin E, Yu Y, Yu P. Older People's Usage Pattern, Satisfaction with Community Facility and Well-Being in Urban Old Districts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10297. [PMID: 36011933 PMCID: PMC9408318 DOI: 10.3390/ijerph191610297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Community facilities are an important element that supports older people's daily life and promotes their well-being. However, there is a dearth of comprehensive studies on the effect of planning and design of different types of community facilities on older people's usage patterns and satisfaction. This study aims to provide a framework to explore the relationship among the planning of community facilities, older people's usage and satisfaction level and well-being for different types of community facilities. Both spatial analysis and questionnaire survey (n = 497) methods are employed in this study. This study finds that commercial (89.34%), municipal (83.10%) and leisure (88.13%) facilities are most commonly used by older people. This study suggests that older people's frequency of visiting community facilities is mainly affected by the purpose of visiting a community facility. Planning and design quality of the community facility are found to be significantly associated with older people's satisfaction level with using a community facility. In addition, older people's higher satisfaction level and usage level of community facilities could increase their physical and psychological well-being. The findings of this study not only contribute to the knowledge gap of older people's usage and satisfaction with using community facilities but also suggest that planners should aim toward a better distribution of community facilities to improve older adults' well-being.
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Affiliation(s)
- Siqiang Wang
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hong Kong, China
| | - Esther Hiu Kwan Yung
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Yifan Yu
- College of Architecture and Urban Planning, Tongji University, Shanghai 200092, China
| | - Peiheng Yu
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hong Kong, China
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Morey BN, Chang RC, Thomas KB, Tulua 'A, Penaia C, Tran VD, Pierson N, Greer JC, Bydalek M, Ponce N. No Equity without Data Equity: Data Reporting Gaps for Native Hawaiians and Pacific Islanders as Structural Racism. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2022; 47:159-200. [PMID: 34522960 PMCID: PMC10959240 DOI: 10.1215/03616878-9517177] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Data on the health and social determinants for Native Hawaiians and Pacific Islanders (NHPIs) in the United States are hidden, because data are often not collected or are reported in aggregate with other racial/ethnic groups despite decades of calls to disaggregate NHPI data. As a form of structural racism, data omissions contribute to systemic problems such as inability to advocate, lack of resources, and limitations on political power. The authors conducted a data audit to determine how US federal agencies are collecting and reporting disaggregated NHPI data. Using the COVID-19 pandemic as a case study, they reviewed how states are reporting NHPI cases and deaths. They then used California's neighborhood equity metric-the California Healthy Places Index (HPI)-to calculate the extent of NHPI underrepresentation in communities targeted for COVID-19 resources in that state. Their analysis shows that while collection and reporting of NHPI data nationally has improved, federal data gaps remain. States are vastly underreporting: more than half of states are not reporting NHPI COVID-19 case and death data. The HPI, used to inform political decisions about allocation of resources to combat COVID-19 in at-risk neighborhoods, underrepresents NHPIs. The authors make recommendations for improving NHPI data equity to achieve health equity and social justice.
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Affiliation(s)
| | | | | | - 'Alisi Tulua
- Native Hawaiian and Pacific Islander Data Policy Lab
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8
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Mentias A, Desai MY, Vaughan-Sarrazin MS, Rao S, Morris AA, Hall JL, Menon V, Hockenberry J, Sims M, Fonarow GC, Girotra S, Pandey A. Community-Level Economic Distress, Race, and Risk of Adverse Outcomes After Heart Failure Hospitalization Among Medicare Beneficiaries. Circulation 2022; 145:110-121. [PMID: 34743555 PMCID: PMC9172990 DOI: 10.1161/circulationaha.121.057756] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Socioeconomic disadvantage is a strong determinant of adverse outcomes in patients with heart failure. However, the contribution of community-level economic distress to adverse outcomes in heart failure may differ across races and ethnicities. METHODS Patients of self-reported Black, White, and Hispanic race and ethnicity hospitalized with heart failure between 2014 and 2019 were identified from the Medicare MedPAR Part A 100% Files. We used patient-level residential ZIP code to quantify community-level economic distress on the basis of the Distressed Community Index (quintile 5: economically distressed versus quintiles 1-4: nondistressed). The association of continuous and categorical measures (distressed versus nondistressed) of Distressed Community Index with 30-day, 6-month, and 1-year risk-adjusted mortality, readmission burden, and home time were assessed separately by race and ethnicity groups. RESULTS The study included 1 611 586 White (13.2% economically distressed), 205 840 Black (50.6% economically distressed), and 89 199 Hispanic (27.3% economically distressed) patients. Among White patients, living in economically distressed (versus nondistressed) communities was significantly associated with a higher risk of adverse outcomes at 30-day and 1-year follow-up. Among Black and Hispanic patients, the risk of adverse outcomes associated with living in distressed versus nondistressed communities was not meaningfully different at 30 days and became more prominent by 1-year follow-up. Similarly, in the restricted cubic spline analysis, a stronger and more graded association was observed between Distressed Community Index score and risk of adverse outcomes in White patients (versus Black and Hispanic patients). Furthermore, the association between community-level economic distress and risk of adverse outcomes for Black patients differed in rural versus urban areas. Living in economically distressed communities was significantly associated with a higher risk of mortality and lower home time at 1-year follow-up in rural areas but not urban areas. CONCLUSIONS The association between community-level economic distress and risk of adverse outcomes differs across race and ethnic groups, with a stronger association noted in White patients at short- and long-term follow-up. Among Black patients, the association of community-level economic distress with a higher risk of adverse outcomes is less evident in the short term and is more robust and significant in the long-term follow-up and rural areas.
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Affiliation(s)
- Amgad Mentias
- Heart, Thoracic and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Milind Y. Desai
- Heart, Thoracic and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Mary S Vaughan-Sarrazin
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, IA
- Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA
| | - Shreya Rao
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | | | - Jennifer L. Hall
- Institute for Precision Cardiovascular Medicine, American Heart Association, Dallas, TX
| | - Venu Menon
- Heart, Thoracic and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Jason Hockenberry
- Department of Public Health (Health Policy), Yale School of Public Health, New Haven, CT
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Gregg C. Fonarow
- Division of Cardiology, Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA
| | - Saket Girotra
- Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA
- Division of Cardiovascular Diseases, Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
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Envisioning Happy Places for All: A Systematic Review of the Impact of Transformations in the Urban Environment on the Wellbeing of Vulnerable Groups. SUSTAINABILITY 2021. [DOI: 10.3390/su13148086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Urban planning and design can impact mental health, but it is unclear how ever-growing and changing cities can sustain the psychological wellbeing of vulnerable groups, who are among the most mentally sensitive to spatial inequalities. This systematic review synthesised quantitative and qualitative studies on urban design interventions and their impact on wellbeing in vulnerable groups. Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we searched five online databases from inception to May 2020. A total of 10 papers were included. We found mixed evidence of benefits for wellbeing linked to urban regeneration projects or focused interventions (green spaces, transport, security). Interventions that were centred around participation, sustainable living, and quality of design (e.g., perceived sense of safety) were associated with increased residential satisfaction and wellbeing, particularly among low-income communities and women. Risk of bias was low to medium, but there was high methodological heterogeneity; studies were mainly from Western countries, and none of the included studies investigated the experiences of people with disabilities, migrants, or racial minorities. This review highlights the importance of inclusive and sustainable design interventions to create happy places for all strata of society, although further investigation is warranted.
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Huang Y, Liu H, Masum M. Adverse Childhood Experiences and Physical and Mental Health of Adults: Assessing the Mediating Role of Cumulative Life Course Poverty. Am J Health Promot 2020; 35:637-647. [PMID: 33356410 DOI: 10.1177/0890117120982407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Research has linked adverse childhood experiences (ACEs) to a host of negative health outcomes in adulthood. However, most existing studies focused on traumatic ACEs and used samples collected from a specific geographic unit (e.g., region, city, or state). This study examines the association between non-traumatic ACEs and health outcomes (i.e., self-rated health and psychological well-being) in adulthood, and assesses the extent to which the cumulative life course poverty accounts for these associations between ACEs and health. DATA SOURCE Public and de-identified data from Panel Study of Income Dynamics (PSID) (1968-2013) and its Childhood Retrospective Circumstances Study (CRCS) (2014) (N = 7,126) were used. Episode and severity of childhood adversities of respondents were determined by using comprehensive retrospective circumstance measures. METHODS Multivariate regression models were used to analyze the associations between ACEs and adult health. Mediation analysis was employed to assess the extent to which the associations were explained by cumulative life course poverty. Data analysis was carried out in 2019 using STATA 15. RESULTS We found that episode and severity of ACEs were associated with increased risk of poor health and psychological distress. Compared to individuals with no ACEs, one unit increase in the ACE index is associated with 8 and 18 percent increase in the risk of poor health and psychological distress, respectively. A small proportion (4%) of the impact of early adversities on health is attributable to the proportion of adult lifetime spent in poverty. CONCLUSIONS Non-traumatic ACEs are associated with increased risk for poor health and psychological distress. Life course cumulative experience in poverty accounts for a small portion of the associations. Providing support to prevent ACEs may have long-term health benefits.
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Affiliation(s)
- Ying Huang
- Department of Demography, 12346University of Texas at San Antonio, San Antonio, TX, USA
| | - Han Liu
- Department of Sociology, 1084University at Albany, State University of New York, New York, NY, USA
| | - Muntasir Masum
- Department of Demography, 12346University of Texas at San Antonio, San Antonio, TX, USA
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11
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Li Y, Hyder A, Southerland LT, Hammond G, Porr A, Miller HJ. 311 service requests as indicators of neighborhood distress and opioid use disorder. Sci Rep 2020; 10:19579. [PMID: 33177583 PMCID: PMC7658248 DOI: 10.1038/s41598-020-76685-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/30/2020] [Indexed: 01/19/2023] Open
Abstract
Opioid use disorder and overdose deaths is a public health crisis in the United States, and there is increasing recognition that its etiology is rooted in part by social determinants such as poverty, isolation and social upheaval. Limiting research and policy interventions is the low temporal and spatial resolution of publicly available administrative data such as census data. We explore the use of municipal service requests (also known as "311" requests) as high resolution spatial and temporal indicators of neighborhood social distress and opioid misuse. We analyze the spatial associations between georeferenced opioid overdose event (OOE) data from emergency medical service responders and 311 service request data from the City of Columbus, OH, USA for the time period 2008-2017. We find 10 out of 21 types of 311 requests spatially associate with OOEs and also characterize neighborhoods with lower socio-economic status in the city, both consistently over time. We also demonstrate that the 311 indicators are capable of predicting OOE hotspots at the neighborhood-level: our results show code violation, public health, and street lighting were the top three accurate predictors with predictive accuracy as 0.92, 0.89 and 0.83, respectively. Since 311 requests are publicly available with high spatial and temporal resolution, they can be effective as opioid overdose surveillance indicators for basic research and applied policy.
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Affiliation(s)
- Yuchen Li
- Department of Geography, The Ohio State University, Columbus, OH, USA
- Center for Urban and Regional Analysis, The Ohio State University, Columbus, OH, USA
| | - Ayaz Hyder
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | | | | | - Adam Porr
- Center for Urban and Regional Analysis, The Ohio State University, Columbus, OH, USA
| | - Harvey J Miller
- Department of Geography, The Ohio State University, Columbus, OH, USA.
- Center for Urban and Regional Analysis, The Ohio State University, Columbus, OH, USA.
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Chisolm DJ, Jones C, Root ED, Dolce M, Kelleher KJ. A Community Development Program and Reduction in High-Cost Health Care Use. Pediatrics 2020; 146:peds.2019-4053. [PMID: 32636235 DOI: 10.1542/peds.2019-4053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2020] [Indexed: 11/24/2022] Open
Abstract
Adverse housing and neighborhood conditions influence child health. The Healthy Neighborhoods Healthy Families community development initiative was established in 2008 to address housing, education, employment, and other neighborhood-level, child health-influencing factors on the south side of Columbus, Ohio, with the goal of improving child health and well-being. In this article, we discuss the path from advocacy to outcomes analysis in this initiative and assess changes in high-cost health care use by children in the target area over the first decade of implementation. Change in health care use was measured by using a difference-in-differences approach comparing emergency department visits, inpatient stays, and inpatient length of stay in the intervention neighborhood and a propensity score-matched, pooled comparator neighborhood in the same city. The baseline and follow-up periods were August 2008 to July 2010 and August 2015 to July 2017, respectively. Findings from this analysis reveal that compared to 2 pooled comparison neighborhoods, the intervention neighborhood trended, nonsignificantly, toward greater decreases in inpatient stays and emergency department visits and smaller increases in length of stays. These results suggest that our community development activities may be influencing health care use outcomes, but in the early years of the intervention relative changes are modest and are variable based on the definition of the intervention and comparator neighborhoods. Lessons learned in expanding from advocacy to analysis include the importance of building multidisciplinary teams that can apply novel approaches to analysis, moderating expectations, and retaining focus on the broader social context.
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Affiliation(s)
- Deena J Chisolm
- Department of Pediatrics, College of Medicine and .,The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Claire Jones
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio.,Department of Geography, College of Arts and Sciences, The Ohio State University, Columbus, Ohio; and
| | - Elisabeth D Root
- Department of Geography, College of Arts and Sciences, The Ohio State University, Columbus, Ohio; and
| | - Millie Dolce
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Kelly J Kelleher
- Department of Pediatrics, College of Medicine and.,The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
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Petteway RJ. Intergenerational photovoice perspectives of place and health in public housing: Participatory coding, theming, and mapping in/of the "structure struggle". Health Place 2019; 60:102229. [PMID: 31778845 DOI: 10.1016/j.healthplace.2019.102229] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 08/07/2019] [Accepted: 09/20/2019] [Indexed: 11/29/2022]
Abstract
This paper details an intergenerational photovoice project exploring spatial and perceptual differences of "place" and health among adult and youth public housing residents in a small urban rustbelt city in the Midwestern United States. It specifically highlights the value of fully participatory photovoice processes-participatory narrative-coding and digital web-based photo-mapping-in furthering conceptual and analytical understanding of "place" and health. Results indicate the critical import of accounting for non-residential locations (i.e. activity spaces), and the significance of engaging the generationally- and spatially-specific social and physical landscapes of residents' lived "place" to improve health opportunities within place-based strategies involving public housing.
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Affiliation(s)
- Ryan J Petteway
- University of California, Berkeley School of Public Health, USA(2).
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Stluka S, McCormack LA, Burdette L, Dvorak S, Knight N, Lindvall R, Pierce L, Schoch J, Walkling P. Gardening for Health: Using Garden Coordinators and Volunteers to Implement Rural School and Community Gardens. Prev Chronic Dis 2019; 16:E156. [PMID: 31775009 PMCID: PMC6896830 DOI: 10.5888/pcd16.190117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Gardens provide access to healthy food, increase access to nutrition and physical activity opportunities, and are a focal point for community interventions. We used a gardening intervention to improve local access to and consumption of fruits and vegetables and as an integral part of overall efforts of local wellness coalitions. Seasonal garden coordinators were hired, and action plans included goals for nutrition and physical activity education programs and youth and adult engagement. The characteristics of each garden (size, items planted, number of volunteers) and pre- and post-intervention surveys were used to understand how the gardens affected communities. Thirteen gardens were planted, and volunteers provided 18,136 hours; adults from the community reported an increased awareness of garden benefits. The community garden intervention provided opportunities for collaboration with a variety of schools, community organizations, and city and tribal organizations, thereby increasing the sustainability of the intervention.
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Affiliation(s)
- Suzanne Stluka
- Montana State University Extension, 224 Culbertson Hall, PO Box 172230, Bozeman, MT 59717-2040.
| | - Lacey A McCormack
- Health and Nutritional Sciences Department, South Dakota State University, Brookings, South Dakota
| | - Linda Burdette
- Undergraduate Nursing, South Dakota State University, Brookings, South Dakota
| | - Samantha Dvorak
- Extension, South Dakota State University, Brookings, South Dakota
| | - Nathania Knight
- Extension, South Dakota State University, Brookings, South Dakota
| | - Rachel Lindvall
- Extension, South Dakota State University, Brookings, South Dakota
| | - Lauren Pierce
- Extension, South Dakota State University, Brookings, South Dakota
| | - Jason Schoch
- Extension, South Dakota State University, Brookings, South Dakota
| | - Prairey Walkling
- Extension, South Dakota State University, Brookings, South Dakota
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McIntire RK, Romney MC, Alonzo G, Hutt J, Bartolome L, Wood G, Klein G, Goldfarb NI. Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health. Prev Chronic Dis 2019; 16:E95. [PMID: 31344336 PMCID: PMC6716388 DOI: 10.5888/pcd16.180631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities. Methods We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel linear modeling to explore relationships between community health and 3 outcome variables: emergency department (ED) use, hospital use, and paid claims. Business leaders reviewed findings and offered insights on preparedness to invest in community health improvement. Results Poorer community health was associated with high use of ED services, after controlling for age and sex. After including a summary measure of racial composition at the zip code region level, the relationship between community health and ED use became nonsignificant. No significant relationships between community health and hospitalizations or paid claims were identified. Business leaders expressed interest in further understanding health needs of communities where their employees live. Conclusion The health of communities in which adult employees and dependents live was associated with ED use, but similar relationships were not seen for hospitalizations or paid claims. This finding suggests a need for more primary care access. Despite limited quantitative evidence, business leaders expressed interest in guidance on investing in community health improvement.
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Affiliation(s)
| | - Martha C Romney
- Jefferson College of Population Health, Philadelphia, Pennsylvania
| | - Greg Alonzo
- Gallagher Benefit Services, Princeton, New Jersey
| | - Jill Hutt
- Greater Philadelphia Business Coalition on Health, Philadelphia, Pennsylvania
| | - Lauren Bartolome
- Jefferson College of Population Health, Philadelphia, Pennsylvania
| | | | - Gary Klein
- Public Health Management Corporation, Philadelphia, Pennsylvania
| | - Neil I Goldfarb
- Greater Philadelphia Business Coalition on Health, 123 South Broad St, Suite 1235, Philadelphia, PA 19109.
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Resnick B, Galik E, Boltz M, Vigne E, Holmes S, Fix S, Zhu S, Lewis R. Testing of the Function Focused Environment Assessment and the Function Focused Policy Assessment in Assisted Living. JOURNAL OF HOUSING FOR THE ELDERLY 2019; 33:153-172. [PMID: 32038064 PMCID: PMC7006224 DOI: 10.1080/02763893.2018.1534180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study tested two new instruments, the Function Focused Environment Assessment (FF-EA) and the Function Focused Policy Assessment (FF-PA). The measures were developed for clinical evaluation of AL settings to help optimize function and physical activity among residents. A total of 106 AL settings and 242 residents were included. There was evidence of item reliability (0.92) and interrater reliability (kappa=0.40, p=.015; percent agreement 85%) of FF-EA and item reliability (0.89) and interrater reliability (kappa=0.48, p=.001, percent agreement 82%) of the FF-PA, and support for validity of both measures based on INFIT and OUTFIT statistics and hypothesis testing.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Elizabeth Galik
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Marie Boltz
- Pennsylvania State University, College of Nursing, 201 Nursing Sciences Building, University Park, PA 16802
| | - Erin Vigne
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Sarah Holmes
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Steven Fix
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Shijun Zhu
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Regina Lewis
- The Pennsylvania State University, College of Nursing, 303 B Nursing Sciences Building, University Park, PA 16802
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Young JL, Hawthorne DJ. Integrating Health and Community Development for Health Equity: Philanthropic Investments in Baltimore City, 2010–2017. Health Equity 2019; 3:134-137. [PMID: 31289771 PMCID: PMC6608684 DOI: 10.1089/heq.2018.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Achieving health equity requires addressing the social determinants of health, which philanthropy has supported through community development grants. This study analyzes health topics that have been integrated into community development grants. Methods: Community development grants from 2010 to 2017 were analyzed for health topics in Baltimore, MD. Results: Food and nutrition, chronic disease, reproductive health, adolescent health, violence prevention, health care access, and infectious disease were the least common health topics in community development grants. Conclusion: To support health equity efforts, funders should consider a broader range of health issues to integrate into community development investments.
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Affiliation(s)
- Jessica L. Young
- Department of Health Studies, American University, Washington, District of Columbia
| | - David J. Hawthorne
- Department of Health Studies, American University, Washington, District of Columbia
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Petteway RJ, Mujahid M, Allen A, Morello-Frosch R. The body language of place: A new method for mapping intergenerational "geographies of embodiment" in place-health research. Soc Sci Med 2019; 223:51-63. [PMID: 30708171 DOI: 10.1016/j.socscimed.2019.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/23/2018] [Accepted: 01/15/2019] [Indexed: 01/19/2023]
Abstract
Research on place and health has grown rapidly in recent years, including examining the physiological embodiment of place-based exposures. While this research continues to improve understanding of why place matters, there is particular need for work capable of revealing: 1) which places matter, i.e. spatially-specific notions of "place"); 2) how these places matter-processes and mechanisms of the physiological embodiment of place; and 3) potential intergenerational and life stage differences in place-embodiment experiences/perceptions. The research presented here seeks to make contributions in each of these areas through developing the "geographies of embodiment" concept. Drawing from a multi-method intergenerational community-based participatory research project examining place and health, the research presented here specifically highlights X-Ray Mapping as a new methodology to elucidate subjective notions of place-embodiment within place-health research. Participants were recruited as parent-child dyads and trained in four participatory research methods, including X-Ray Mapping. Participants used X-Ray Mapping and a multimedia-enabled web-based mapping platform to map their "geographies of embodiment". X-Ray Mapping results revealed that 49% of youth place-embodiment locations were spatially outside of their residential census tract-with 75% of positive place-embodiment locations outside, and 66% of negative place-embodiment locations inside. Overall, 67% of youth and adult positive place-embodiment locations were outside of their residential census tract. Through mapping "geographies of embodiment" via participatory methods like X-Ray Mapping, we can gain greater insight into what is embodied (i.e. specific experiences/exposures), and where (i.e. spatially-specific). These gains could improve development of quantitative place-health metrics and enhance efforts to uncover/intervene on the "pathways of embodiment"-specifically, those elements of local social, political, economic, and environmental contexts that constitute expressions of social inequality.
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Affiliation(s)
- Ryan J Petteway
- Portland State University, OHSU-PSU School of Public Health Department of Community Health, 506 SW Mill St, Suite 450, Portland, OR 97201 USA.
| | - Mahasin Mujahid
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, Berkeley CA 94720-7358, USA
| | - Amani Allen
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, Berkeley CA 94720-7358, USA; University of California, Berkeley School of Public Health Division of Community Health Sciences, University Hall, Berkeley, CA 94720-7360, USA
| | - Rachel Morello-Frosch
- University of California, Berkeley School of Public Health Division of Community Health Sciences, University Hall, Berkeley, CA 94720-7360, USA; University of California, College of Natural Resources Department of Environmental Science, Policy, & Management 130 Mulford, Berkeley, CA, 94720, USA
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Rammah A, Walker Whitworth K, Han I, Chan W, Jimenez MD, Strom SS, Bondy ML, Symanski E. A Mixed-Methods Study to Examine the Role of Psychosocial Stress and Air Pollution on Hypertension in Mexican-Origin Hispanics. J Racial Ethn Health Disparities 2019; 6:12-21. [PMID: 29679333 PMCID: PMC6347581 DOI: 10.1007/s40615-018-0490-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Independent and combined effects of air pollution and psychosocial stressors on hypertension, a risk factor for cardiovascular disease, among Hispanics are not well studied. METHODS We administered a pilot-tested questionnaire on individual- and neighborhood-level psychosocial stressors, developed with community input, to nearly 2500 individuals from the MD Anderson Cancer Center cohort of Mexican-Americans. We used data from local air quality monitors to estimate individual exposures to ozone (O3) and fine particulate matter (PM2.5) for the 12-month period preceding enrollment using inverse distance interpolation. We applied logistic regression models to examine relationships between exposures to psychosocial stressors and air pollution with prevalent hypertension and used stratified analyses to examine the interacting effects of these two exposures on hypertension. RESULTS: There was a positive association between prevalent hypertension and a high frequency of feeling anxious or depressed (prevalence odds ratio (POR) = 1.36, 95% CI [1.06-1.75]) and experiencing aches and pains (POR = 1.29, 95% CI [1.01-1.64]). The odds of having hypertension were also elevated among those worrying about their own health (POR = 1.65, 95% CI [1.30-2.06]) or about not having enough money (POR = 1.27, 95% CI [1.01-1.6]). We observed an inverse association between O3 and hypertension. There was no interaction between psychosocial stressors and O3 on hypertension. CONCLUSION Our findings add to the evidence of a positive association between individual and family stressors on hypertension among Hispanics and other racial/ethnic groups. Contrary to previous studies reporting positive associations, our results suggest that long-term exposure to O3 may be inversely related to prevalent hypertension.
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Affiliation(s)
- Amal Rammah
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
- Southwest Center for Occupational and Environmental Health (SWCOEH), The UTHealth School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
| | - Kristina Walker Whitworth
- Southwest Center for Occupational and Environmental Health (SWCOEH), The UTHealth School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
- Epidemiology, Human Genetics and Environmental Sciences, The UTHealth School of Public Health, San Antonio Regional Campus, 7411 John Smith Drive, San Antonio, TX, 78229, USA
| | - Inkyu Han
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
- Southwest Center for Occupational and Environmental Health (SWCOEH), The UTHealth School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
| | - Wenyaw Chan
- Department of Biostatistics, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
| | - Maria D Jimenez
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
- Southwest Center for Occupational and Environmental Health (SWCOEH), The UTHealth School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA
| | - Sara S Strom
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, 1155 Pressler, Unit 1340, Duncan Building (CPB) 4th floor, Houston, TX, 77030, USA
| | - Melissa L Bondy
- Department of Medicine, Epidemiology and Population Science, Baylor College of Medicine, One Baylor Plaza, Suite 422A, Houston, TX, 77030, USA
| | - Elaine Symanski
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA.
- Southwest Center for Occupational and Environmental Health (SWCOEH), The UTHealth School of Public Health, 1200 Herman Pressler Street, Houston, TX, 77030, USA.
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20
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Kim MM, Cheney A, Black A, Thorpe RJ, Cene CW, Dave GJ, Schaal J, Vassar S, Ruktanonchai C, Frerichs L, Young T, Jones J, Burke J, Varma D, Striley C, Cottler L, Brown A, Sullivan G, Corbie-Smith G. Trust in Community-Engaged Research Partnerships: A Methodological Overview of Designing a Multisite Clinical and Translational Science Awards (CTSA) Initiative. Eval Health Prof 2019; 43:180-192. [PMID: 30612444 DOI: 10.1177/0163278718819719] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Community-engaged research (CEnR) builds on the strengths of the Clinical and Translational Science Awards (CTSA) framework to address health in underserved and minority communities. There is a paucity of studies that identify the process from which trust develops in CEnR partnerships. This study responds to the need for empirical investigation of building and maintaining trust from a multistakeholder perspective. We conducted a multi-institutional pilot study using concept mapping with to better understand how trust, a critical outcome of CEnR partnerships, can act as "social capital." Concept mapping was used to collect data from the three stakeholder groups: community, health-care, and academic research partners across three CTSAs. Concept mapping is a mixed-methods approach that allows participants to brainstorm and identify factors that contribute to a concept and describe ways in which those factors relate to each other. This study offers important insights on developing an initial set of trust measures that can be used across CTSAs to understand differences and similarities in conceptualization of trust among key stakeholder groups, track changes in public trust in research, identify both positive and negative aspects of trust, identify characteristics that maintain trust, and inform the direction for future research.
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Affiliation(s)
- Mimi M Kim
- Center for Biobehavioral Health Disparities Research, Duke University, Durham, NC, USA
| | - Ann Cheney
- Center for Healthy Communities, University of California, Riverside, CA, USA
| | - Anita Black
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Crystal Wiley Cene
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Guarav J Dave
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Schaal
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stefanie Vassar
- Department of Medicine, Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Corrine Ruktanonchai
- College of Public Health and Health Professions and College of Medicine, University of Florida, FL, USA
| | - Leah Frerichs
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tiffany Young
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Jones
- Health Policy Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jessica Burke
- Health Policy Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Deepthi Varma
- College of Public Health and Health Professions and College of Medicine, University of Florida, FL, USA
| | - Catherine Striley
- College of Public Health and Health Professions and College of Medicine, University of Florida, FL, USA
| | - Linda Cottler
- College of Public Health and Health Professions and College of Medicine, University of Florida, FL, USA
| | - Arleen Brown
- Department of Medicine, Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Greer Sullivan
- Center for Healthy Communities, University of California, Riverside, CA, USA
| | - Giselle Corbie-Smith
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Roy B, Riley C, Sears L, Rula EY. Collective Well-Being to Improve Population Health Outcomes: An Actionable Conceptual Model and Review of the Literature. Am J Health Promot 2018; 32:1800-1813. [PMID: 30079743 DOI: 10.1177/0890117118791993] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To propose collective well-being as a holistic measure of the overall "health" of a community. To define collective well-being as a group-level construct measured across 5 domains (vitality, opportunity, connectedness, contribution, and inspiration) and introduce an actionable model that demonstrates how community characteristics affect collective well-being. To review the literature describing each domain's association with health outcomes and community characteristics' associations with collective well-being. METHODS We came to consensus on topics describing each component of our conceptual model. Because "well-being" is not indexed in MEDLINE, we performed topic-specific database searches and examined bibliographies of papers retrieved. We excluded articles that were limited to narrow subtopics or studies within small subpopulations. Preference was given to quasi-experimental or randomized studies, systematic reviews, or meta-analyses. Consensus was reached on inclusion or exclusion of all articles. RESULTS Reviewed literature supported each of the proposed domains as important aspects of collective well-being and as determinants of individual or community health. Evidence suggests a broad range of community characteristics support collective well-being. CONCLUSIONS The health and quality of life of a community may be improved by focusing efforts on community characteristics that support key aspects of well-being. Future work should develop a unified measure of collective well-being to evaluate the relative impact of specific efforts on the collective well-being of communities.
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Affiliation(s)
- Brita Roy
- 1 Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Carley Riley
- 2 Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,3 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Arcaya MC, Schnake-Mahl A, Binet A, Simpson S, Church MS, Gavin V, Coleman B, Levine S, Nielsen A, Carroll L, Ursprung S, Wood B, Reeves H, Keppard B, Sportiche N, Partirdge J, Figueora J, Frakt A, Alfonzo M, Abreu D, Abreu T, Ambroise T, Andrade E, Barrientos E, Baty A, Baty C, Benner K, Bennett C, Blanchette A, Bongiovanni R, Cardile O, Corchado C, Dixon C, Dodson C, Dominguez J, Durena M, Fiestas Y, Genty J, Graffam N, Gonzalez A, Grigsby E, Hayden P, Alvado SH, Hernandez Z, Hodes I, Johnson J, Keefe K, Latimer K, Levine S, Logg C, Martinez N, Mboup K, McPhorson D, Meacham S, Mohammed D, Moss E, Nielsen A, O'Brien K, Owens L, Partridge J, Johnson LP, Power MB, Rebelo T, Remy R, Roderigues G, Sabtow Q, Sanchez C, Seeder A, Sepulveda R, Sportiche N, Ursprung S, West E, Winters L, Wood B, Youmans T. Community change and resident needs: Designing a Participatory Action Research study in Metropolitan Boston. Health Place 2018; 52:221-230. [PMID: 30015179 DOI: 10.1016/j.healthplace.2018.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/18/2018] [Accepted: 05/31/2018] [Indexed: 10/28/2022]
Abstract
The health implications of urban development, particularly in rapidly changing, low-income urban neighborhoods, are poorly understood. We describe the Healthy Neighborhoods Study (HNS), a Participatory Action Research study examining the relationship between neighborhood change and population health in nine Massachusetts neighborhoods. Baseline data from the HNS survey show that social factors, specifically income insecurity, food insecurity, social support, experiencing discrimination, expecting to move, connectedness to the neighborhood, and local housing construction that participants believed would improve their lives, identified by a network of 45 Resident Researchers exhibited robust associations with self-rated and mental health. Resident-derived insights into relationships between neighborhoods and health may provide a powerful mechanism for residents to drive change in their communities.
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Affiliation(s)
- Mariana C Arcaya
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
| | - Alina Schnake-Mahl
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
| | - Andrew Binet
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
| | - Shannon Simpson
- Dudley Street Neighborhood Initiative, 550 Dudley St, Roxbury, MA 02119, USA.
| | | | - Vedette Gavin
- Conservation Law Foundation, 62 Summer St, Boston, MA 02110, USA.
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Beck AF, Huang B, Wheeler K, Lawson NR, Kahn RS, Riley CL. The Child Opportunity Index and Disparities in Pediatric Asthma Hospitalizations Across One Ohio Metropolitan Area, 2011-2013. J Pediatr 2017; 190:200-206.e1. [PMID: 29144247 PMCID: PMC5708858 DOI: 10.1016/j.jpeds.2017.08.007] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/30/2017] [Accepted: 08/03/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To determine whether the Child Opportunity Index (COI), a nationally available measure of relative educational, health/environmental, and social/economic opportunity across census tracts within metropolitan areas, is associated with population- and patient-level asthma morbidity. STUDY DESIGN This population-based retrospective cohort study was conducted between 2011 and 2013 in a southwest Ohio county. Participants included all children aged 1-16 years with hospitalizations or emergency department visits for asthma or wheezing at a major pediatric hospital. Patients were identified using discharge diagnosis codes and geocoded to their home census tract. The primary population-level outcome was census tract asthma hospitalization rate. The primary patient-level outcome was rehospitalization within 12 months of the index hospitalization. Census tract opportunity was characterized using the COI and its educational, health/environmental, and social/economic domains. RESULTS Across 222 in-county census tracts, there were 2539 geocoded hospitalizations. The median asthma-related hospitalization rate was 5.0 per 1000 children per year (IQR, 1.9-8.9). Median hospitalization rates in very low, low, moderate, high, and very high opportunity tracts were 9.1, 7.6, 4.6, 2.1, and 1.8 per 1000, respectively (P < .0001). The social/economic domain had the most variables significantly associated with the outcome at the population level. The adjusted patient-level analyses showed that the COI was not significantly associated with a patient's risk of rehospitalization within 12 months. CONCLUSIONS The COI was associated with population-level asthma morbidity. The details provided by the COI may inform interventions aimed at increasing opportunity and reducing morbidity across regions.
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Affiliation(s)
- Andrew F. Beck
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, U.S.A,Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Bin Huang
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | | | - Nikki R. Lawson
- University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Robert S. Kahn
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Carley L. Riley
- Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, U.S.A
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Woolf SH. Progress In Achieving Health Equity Requires Attention To Root Causes. Health Aff (Millwood) 2017; 36:984-991. [DOI: 10.1377/hlthaff.2017.0197] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Steven H. Woolf
- Steven H. Woolf ( ) is director of the Center on Society and Health at Virginia Commonwealth University, in Richmond
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Urban Place and Health Equity: Critical Issues and Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020117. [PMID: 28134756 PMCID: PMC5334671 DOI: 10.3390/ijerph14020117] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 11/23/2022]
Abstract
Urban places and health equity are two of the most challenging concepts for 21st century environmental health. More people live in cities than at any other time in human history and health inequities are increasing. Health inequities are avoidable differences in the social, environmental and political conditions that shape morbidity and mortality, and disproportionately burden the poor, racial, ethnic and religious minorities and migrants. By linking urban place and health inequities, research and action brings into sharp relief the challenges of achieving urban environmental justice. This article briefly reviews the complex definitions of urban places and how they can shape health equity in cities. I suggest that a more relational or integrated approach to defining urban places and acting on health equity can complement other approaches and improve the ability of public health to meet 21st century challenges. I close with suggestions for research and practice that might focus environmental public health on healthy urban place making. The practices include community driven map making, Health in All Policies (HiAP), promoting urban ecosystem services for health, and participatory and integrated approaches to urban slum upgrading. I conclude that if the global community is serious about the sustainable development goals (SDGs), greater attention must be paid to understanding and acting to improve urban places, living conditions and the social and economic conditions that can promote health equity.
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Cruden G, Kelleher K, Kellam S, Brown CH. Increasing the Delivery of Preventive Health Services in Public Education. Am J Prev Med 2016; 51:S158-67. [PMID: 27542653 PMCID: PMC5505174 DOI: 10.1016/j.amepre.2016.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/16/2016] [Accepted: 07/05/2016] [Indexed: 11/19/2022]
Abstract
The delivery of prevention services to children and adolescents through traditional healthcare settings is challenging for a variety of reasons. Parent- and community-focused services are typically not reimbursable in traditional medical settings, and personal healthcare services are often designed for acute and chronic medical treatment rather than prevention. To provide preventive services in a setting that reaches the widest population, those interested in public health and prevention often turn to school settings. This paper proposes that an equitable, efficient manner in which to promote health across the life course is to integrate efforts from public health, primary care, and public education through the delivery of preventive healthcare services, in particular, in the education system. Such an integration of systems will require a concerted effort on the part of various stakeholders, as well as a shared vision to promote child health via community and institutional stakeholder partnerships. This paper includes (1) examination of some key system features necessary for delivery of preventive services that improve child outcomes; (2) a review of the features of some common models of school health services for their relevance to prevention services; and (3) policy and implementation strategy recommendations to further the delivery of preventive services in schools. These recommendations include the development of common metrics for health outcomes reporting, facilitated data sharing of these metrics, shared organization incentives for integration, and improved reimbursement and funding opportunities.
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Affiliation(s)
- Gracelyn Cruden
- Department of Health Policy and Management, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina; Center for Prevention Implementation Methodology (Ce-PIM), Northwestern University, Chicago, Illinois.
| | - Kelly Kelleher
- Departments of Pediatrics, Psychiatry, and Public Health, Ohio State University, Columbus, Ohio; The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Sheppard Kellam
- Center for Prevention Implementation Methodology (Ce-PIM), Northwestern University, Chicago, Illinois; Department of Mental Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - C Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Woolf SH, Zimmerman E, Haley A, Krist AH. Authentic Engagement Of Patients And Communities Can Transform Research, Practice, And Policy. Health Aff (Millwood) 2016; 35:590-4. [PMID: 27044956 PMCID: PMC4868544 DOI: 10.1377/hlthaff.2015.1512] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The engagement of patients and the public is increasingly important in the design and conduct of research. Some researchers still cling to the outdated notion that laypeople cannot contribute meaningfully to science; for some, "community engagement" is another term for recruiting patients for trials. Authentic engagement encompasses far more, involving stakeholders as full partners in all phases of research, as research funders increasingly require. Such engagement, although challenging, can enhance the quality and impact of studies on many levels, from ensuring that data are relevant to users' needs to elevating the moral plane of research by showing respect to patients and vulnerable populations. We share examples from our work, including the engagement of patients in a study of cancer screening decisions and the engagement of inner-city residents in addressing social determinants of health. These engagement principles are of growing relevance to health systems and policy makers responsible for population health.
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Affiliation(s)
- Steven H Woolf
- Steven H. Woolf is director of the Center on Society and Health and a professor in the Department of Family Medicine and Population Health at Virginia Commonwealth University, in Richmond
| | - Emily Zimmerman
- Emily Zimmerman is a senior researcher at the Center on Society and Health and an associate professor in the Department of Family Medicine and Population Health, Virginia Commonwealth University
| | - Amber Haley
- Amber Haley is a research epidemiologist at the Center on Society and Health in the Department of Family Medicine and Population Health, Virginia Commonwealth University
| | - Alex H Krist
- Alex H. Krist is an associate professor in the Department of Family Medicine and Population Health, Virginia Commonwealth University
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Carvalho MS, Coeli CM, Chor D, Pinheiro RS, da Fonseca MDJM, de Sá Carvalho LC. The Challenge of Cardiovascular Diseases and Diabetes to Public Health: A Study Based on Qualitative Systemic Approach. PLoS One 2015; 10:e0132216. [PMID: 26171854 PMCID: PMC4501838 DOI: 10.1371/journal.pone.0132216] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 06/08/2015] [Indexed: 01/02/2023] Open
Abstract
The most common modeling approaches to understanding incidence, prevalence and control of chronic diseases in populations, such as statistical regression models, are limited when it comes to dealing with the complexity of those problems. Those complex adaptive systems have characteristics such as emerging properties, self-organization and feedbacks, which structure the system stability and resistance to changes. Recently, system science approaches have been proposed to deal with the range, complexity, and multifactor nature of those public health problems. In this paper we applied a multilevel systemic approach to create an integrated, coherent, and increasingly precise conceptual framework, capable of aggregating different partial or specialized studies, based on the challenges of the Longitudinal Study of Adult Health - ELSA-Brasil. The failure to control blood pressure found in several of the study's subjects was discussed, based on the proposed model, analyzing different loops, time lags, and feedback that influence this outcome in a population with high educational level, with reasonably good health services access. We were able to identify the internal circularities and cycles that generate the system's resistance to change. We believe that this study can contribute to propose some new possibilities of the research agenda and to the discussion of integrated actions in the field of public health.
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Affiliation(s)
- Marilia Sá Carvalho
- Scientific Computing Program, Oswaldo Cruz Foundation, Antiga Residência Oficial, Rio de Janeiro, RJ, Brazil
- * E-mail:
| | - Claudia Medina Coeli
- Institute for Studies in Collective Health. Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Dóra Chor
- Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Rejane Sobrino Pinheiro
- Institute for Studies in Collective Health. Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Valentijn PP, Vrijhoef HJM, Ruwaard D, Boesveld I, Arends RY, Bruijnzeels MA. Towards an international taxonomy of integrated primary care: a Delphi consensus approach. BMC FAMILY PRACTICE 2015; 16:64. [PMID: 25998142 PMCID: PMC4446832 DOI: 10.1186/s12875-015-0278-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/06/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Developing integrated service models in a primary care setting is considered an essential strategy for establishing a sustainable and affordable health care system. The Rainbow Model of Integrated Care (RMIC) describes the theoretical foundations of integrated primary care. The aim of this study is to refine the RMIC by developing a consensus-based taxonomy of key features. METHODS First, the appropriateness of previously identified key features was retested by conducting an international Delphi study that was built on the results of a previous national Delphi study. Second, categorisation of the features among the RMIC integrated care domains was assessed in a second international Delphi study. Finally, a taxonomy was constructed by the researchers based on the results of the three Delphi studies. RESULTS The final taxonomy consists of 21 key features distributed over eight integration domains which are organised into three main categories: scope (person-focused vs. population-based), type (clinical, professional, organisational and system) and enablers (functional vs. normative) of an integrated primary care service model. CONCLUSIONS The taxonomy provides a crucial differentiation that clarifies and supports implementation, policy formulation and research regarding the organisation of integrated primary care. Further research is needed to develop instruments based on the taxonomy that can reveal the realm of integrated primary care in practice.
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Affiliation(s)
- Pim P Valentijn
- Jan van Es Institute, Netherlands Expert Centre Integrated Primary Care, Wisselweg 33, CB 1314, Almere, The Netherlands.
- Scientific Centre for Care and Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands.
| | - Hubertus J M Vrijhoef
- Scientific Centre for Care and Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
- Department of Patient and Care, University Hospital Maastricht, Maastricht, The Netherlands.
| | - Dirk Ruwaard
- Department of Health Services Research, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Inge Boesveld
- Jan van Es Institute, Netherlands Expert Centre Integrated Primary Care, Wisselweg 33, CB 1314, Almere, The Netherlands.
| | - Rosa Y Arends
- Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands.
| | - Marc A Bruijnzeels
- Jan van Es Institute, Netherlands Expert Centre Integrated Primary Care, Wisselweg 33, CB 1314, Almere, The Netherlands.
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