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Koonmen LA, Lennie TA, Hieronymus LB, Rayens MK, Ickes M, Miller JL, Mudd-Martin G. COVID-19 Impact Predicts Diabetes Distress Among Individuals With Type 2 Diabetes. Sci Diabetes Self Manag Care 2023; 49:392-400. [PMID: 37658648 DOI: 10.1177/26350106231196300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
PURPOSE The purpose of this study was to determine whether COVID-19 impact and Diabetes Self-Management Education and Support (DSMES) service attendance predicted diabetes distress among individuals with type 2 diabetes during the pandemic. METHODS Eighty-six adults with type 2 diabetes who either attended (n = 29) or did not previously attend (n = 57) DSMES services completed a cross-sectional survey. Participants' mean age was 57 ± 12.3 years, 50% were female, and 71.3% were diagnosed with diabetes >5 years. The Coronavirus Impact Scale was used to measure impact of the pandemic on daily life. The Diabetes Distress Scale was used to measure distress overall and within 4 subscales (emotional burden, interpersonal distress, physician-related distress, regimen distress). Separate multiple linear regressions were conducted for each outcome, controlling for age, sex, marital status, financial status, and time since diabetes diagnosis. RESULTS Higher COVID-19 impact predicted higher diabetes-related distress for all subscales and overall. Only the subscale for interpersonal distress was predicted by DSMES attendance, which decreased with DSMES attendance. CONCLUSION This study identifies a link between the effects of the COVID-19 pandemic and diabetes distress. The findings highlight the negative impact of the pandemic on diabetes distress and the importance of DSMES services for diabetes-related distress. Interventions are needed to reduce psychological distress among this population during public health crises.
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Affiliation(s)
- Leigh Anne Koonmen
- Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Michigan
| | - Terry A Lennie
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | | | - Mary Kay Rayens
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Melinda Ickes
- College of Education, College of Nursing, University of Kentucky, Lexington, Kentucky
| | | | - Gia Mudd-Martin
- College of Nursing, University of Kentucky, Lexington, Kentucky
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Heaton B, Muzzi A, Gebel C, Bernstein J, Garcia RI. Recruitment and Enrollment of Low-income, Minority Residents of Urban Public Housing into Research. J Community Health 2023; 48:741-751. [PMID: 37005967 PMCID: PMC10067510 DOI: 10.1007/s10900-023-01212-w] [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] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
Research participation among vulnerable populations is often limited by the same socioeconomic factors that contribute to poor health. Identifying best practices for inclusion is critical to addressing health disparities. Urban public housing communities bear a disproportionate burden of chronic disease and may represent an opportunity to directly engage historically vulnerable populations in research designed to ultimately reduce that burden. We used mixed-method data to analyze recruitment effectiveness among a random sample of households (N = 380) across two public housing developments in Boston, MA who were approached for participation in a pre-COVID oral health study. Quantitative data from detailed recruitment tracking methods was analyzed to assess the relative efficiency of the methods employed. Field journals of study staff were qualitatively analyzed to identify community-specific recruitment barriers and facilitators. The participation rate among randomly sampled households was 28.6% (N = 131), with participation from primarily Hispanic (59.5%) or Black (26%) residents. Door-to-door knocking with response yielded the highest participation (44.8%), followed by responses to informational study flyers (31%). Primary barriers to enrollment included references to unemployment and employment variations, shift work, childcare responsibilities, time demands, and managing multiple appointments and social services. This study finds active, door-to-door knocking and return visits resolved barriers to participation, and reduced safety concerns and historic distrust. It's time to consider how best to adapt effective pre-COVID recruitment practices for utilization under current and future exposure conditions as effective recruitment of populations such as urban public housing residents into research is only becoming more important.
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Affiliation(s)
- Brenda Heaton
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Avenue, 3rd Floor, Rm 329, Boston, MA, USA.
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Alicia Muzzi
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Avenue, 3rd Floor, Rm 329, Boston, MA, USA
| | - Christina Gebel
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Avenue, 3rd Floor, Rm 329, Boston, MA, USA
| | - Judith Bernstein
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Raul I Garcia
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Avenue, 3rd Floor, Rm 329, Boston, MA, USA
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3
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Low assets predict persistent depression through living difficulties amid large-scale disasters: A cohort study. J Affect Disord 2022; 315:282-290. [PMID: 35872246 PMCID: PMC9304334 DOI: 10.1016/j.jad.2022.07.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/18/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND In face of large-scale disasters, persons with fewer assets are at greater risk of persistent poorer mental health than persons with more assets. Everyday daily routine disruptions and financial hardship could mediate this association. METHODS This prospective population-representative study in Hong Kong aimed to investigate the relation between assets during the acute phase of COVID-19 (February-August 2020, T1) and persistent probable depression from T1 to March-August 2021 (T2), as well as the mediating effects of daily routine disruptions and financial hardship on the assets-depression association. RESULTS Low assets at T1 prospectively related to persistent probable depression from T1 to T2. Primary routine disruptions (i.e., healthy eating and sleep) at T1 and financial hardship at T2 were found to fully mediate the association between T1 assets and persistent probable depression. LIMITATIONS Persistent probable depression reported on the PHQ-9 should be further verified with clinical diagnoses/interviews. CONCLUSIONS The COVID-19 pandemic was accompanied by a global economic downturn. Persons who have fewer assets could be at greater risk of depression during this period. Our findings suggest a need to provide behavioral and financial assistance to persons with fewer assets in the short run and a need to ensure that everyone has adequate assets to mitigate the mental health consequences of the COVID-19 pandemic in the long run.
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Davenport TE, Griech SF, Deamer KE, Gale LR. Beyond "Exercise as Medicine" in Physical Therapy: Toward the Promotion of Exercise as a Public Good. Phys Ther 2022; 102:6618282. [PMID: 35778932 DOI: 10.1093/ptj/pzac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 04/11/2022] [Accepted: 06/20/2022] [Indexed: 11/12/2022]
Abstract
Physical therapists are uniquely positioned through their knowledge and skills to help people become more physically active, which may reduce the consequences of physical inactivity for health-related quality of life and the global economy. The "Exercise Is Medicine" campaign was introduced in 2007. It holds that exercise may be prescribed like a medicine. Although this analogy doubtlessly has promoted innumerable life-changing conversations between clinicians and patients, there are important shortcomings to considering physical activity and exercise as medicine. In the United States, many of these shortcomings relate to how medical services are provided and remunerated. Medical care is provided in the context of exclusive groups, which are established by insurance, preferred service populations, or other characteristics that determine a basis for providing care. Exclusivity means that medical care is frequently provided in a type of club. The club structure of medical care jeopardizes the ability of nonmembers to benefit. Medical care clubs based on payment create an environment in which nonpaying customers may not benefit in the same manner as paying customers from approaches that consider exercise prescribed as medicine. This clinical perspective reviews the characteristics of exercise as a good, focusing on how it is prescribed by physical therapists. It discusses how physical therapists may become involved in the process of making exercise a public good by reducing its exclusivity. Multiple levels of involvement are recommended at the societal, community, and individual levels. These involvements may be guided by an existing construct proposed by the World Health Organization, which would bring the global physical therapy profession into a common alignment. This Perspective concludes with a discussion that anticipates the shortcomings of conceptualizing exercise as a public good to be addressed in future service delivery models.
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Affiliation(s)
- Todd E Davenport
- Department of Physical Therapy, School of Health Sciences, University of the Pacific, Stockton, California, USA
| | - Sean F Griech
- Department of Physical Therapy, DeSales University, Center Valley, Pennsylvania, USA
| | | | - Lewis R Gale
- Eberhardt School of Business, University of the Pacific, Stockton, California, USA
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Osokpo OH, Lewis LM, Ikeaba U, Chittams J, Barg FK, Riegel BJ. Self-Care of African Immigrant Adults with Chronic Illness. Clin Nurs Res 2022; 31:413-425. [PMID: 34726102 PMCID: PMC8951348 DOI: 10.1177/10547738211056168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This cross-sectional study aims to describe the self-care of adult African immigrants in the US with chronic illness and explore the relationship between acculturation and self-care. A total of 88 African immigrants with chronic illness were enrolled. Self-care was measured with the Self Care of Chronic Illness Inventory v3 and the Self-Care Self-Efficacy scale. Scores are standardized 0 to 100 with scores >70 considered adequate. Acculturation was measured using a modified standardized acculturation instrument and predefined acculturation proxies. The self-care scores showed adequate self-care, with the mean scores of 78.6, 77.9, and 75.6 for self-care maintenance, monitoring, and management. Self-care self-efficacy mean score was 81.3. Acculturation was not significantly associated with self-care. Self-care self-efficacy was a strong determinant of self-care maintenance (p < .0001), monitoring (p < .0001), and management (p < .0001). The perception of inadequate income was a significant determinant of poor self-care management (p = .03). Self-care self-efficacy and perceived income adequacy were better determinants of self-care than acculturation.
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Affiliation(s)
- Onome H. Osokpo
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Lisa M. Lewis
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Uchechukwu Ikeaba
- West Chester University of Pennsylvania, 25 University Avenue, West Chester, PA 19383
| | - Jesse Chittams
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Frances K. Barg
- University of Pennsylvania Perelman School of Medicine, 915 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Barbara J. Riegel
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
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Acculturation Strategies and Pap Screening Uptake among Sub-Saharan African Immigrants (SAIs). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413204. [PMID: 34948811 PMCID: PMC8700989 DOI: 10.3390/ijerph182413204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
Although regular cervical cancer screening can prevent cervical cancer, screening utilization remains low among immigrant population including sub-Saharan African immigrants (SAIs). Acculturation is a complex process, which can lead to adoption of positive or negative health behaviors from the dominant culture. Acculturation strategies are the varying ways in which individuals seek to go about their acculturation by either maintaining or rejecting their own cultural values ip or accepting or rejecting the host culture’s cultural values. Cervical cancer screening behaviors among SAI women may be influenced by their acculturation strategies. We conducted a secondary analysis of data to examine the relationship between acculturation strategies and Pap screening among 99 SAI women recruited from community settings. Data were collected on Pap screening behavior and acculturation strategy. Traditionalists and Integrationists were the dominant acculturation strategies; 32.3% women were Traditionalists and 67.7% Integrationists. From the logistic regression models, Integrationists had seven times the odds of having ever been screened compared to Traditionalists (OR = 7.08, 95% CI = 1.54–28.91). Cervical cancer screening interventions should prioritize Traditionalists for cancer screening. Acculturation strategies may be used to tailor cancer prevention and control for SAIs. More research among a larger SAI women sample is warranted to further our understanding of Pap screening patterns and acculturation strategies.
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Di Noia J, Gellermann W. Use of the Spectroscopy-Based Veggie Meter ® to Objectively Assess Fruit and Vegetable Intake in Low-Income Adults. Nutrients 2021; 13:2270. [PMID: 34209048 PMCID: PMC8308249 DOI: 10.3390/nu13072270] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 12/20/2022] Open
Abstract
Reflection spectroscopy is an emerging approach for noninvasively assessing dermal carotenoids as a biomarker of fruit and vegetable (FV) intake. This study sought to profile and identify determinants of scores from a reflection spectroscopy device (the Veggie Meter (VM)®) among 297 urban, primarily Hispanic low-income adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The repeatability of the scores and bi- and multivariate relationships between VM scores, self-reported FV intake measured by a brief screener, and participant characteristics were examined. The mean VM score was 270 (range 0-695); 3- and 6-month test-retest correlations were positive and strong (r = 0.79 and 0.55, respectively). VM scores were negatively associated with body mass index (BMI; r = -0.22) and were higher among participants of Ecuadorian, Dominican, and Mexican Hispanic origin relative to those of Puerto Rican origin; foreign- vs. US-born participants, breastfeeding vs. non-breastfeeding participants, nonsmokers vs. smokers, and participants who consumed three or more cups of FV/day relative to those who consumed less than three cups of FV/day. Foreign-born nativity, consumption of three or more cups of FV/day, and smaller body size were determinants of increased VM scores. Although replication studies are needed to confirm these findings, investigators working with similar populations are encouraged to use the VM to longitudinally track FV intake and to target determinants of the scores in observational and intervention studies of FV intake as measured by the VM.
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Affiliation(s)
- Jennifer Di Noia
- Department of Sociology, William Paterson University, Wayne, NJ 07470, USA
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Freije SL, Holmes JA, Rachidi S, Ellsworth SG, Zellars RC, Lautenschlaeger T. Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution. Future Oncol 2020; 16:2635-2643. [PMID: 32976060 DOI: 10.2217/fon-2020-0425] [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: 11/21/2022] Open
Abstract
Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African-American race (odds ratio [OR] 1.33; 95% CI: 1.17-1.51), Medicaid insurance (OR 1.59; 1.36-1.87), no insurance (OR 1.66; 1.32-2.10) and rural residence (OR 1.78; 1.49-2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.
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Affiliation(s)
- Samantha L Freije
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Jordan A Holmes
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Saleh Rachidi
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Department of Dermatology, Johns Hopkins Medicine, Baltimore, MD 21287, USA
| | - Susannah G Ellsworth
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Richard C Zellars
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Tim Lautenschlaeger
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Sabbath EL, Hashimoto D, Boden LI, Dennerlein JT, Williams JAR, Hopcia K, Orechia T, Tripodis Y, Stoddard A, Sorensen G. Cohort profile: The Boston Hospital Workers Health Study (BHWHS). Int J Epidemiol 2019; 47:1739-1740g. [PMID: 30107500 DOI: 10.1093/ije/dyy164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
- Erika L Sabbath
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Dean Hashimoto
- Partners HealthCare, Boston, MA, USA.,School of Law, Boston College, Newton, MA, USA
| | - Leslie I Boden
- School of Public Health, Boston University, Boston, MA, USA
| | - Jack T Dennerlein
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | | | | | | | | | - Anne Stoddard
- Centre for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Glorian Sorensen
- Centre for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Escobedo P, Gonzalez KD, Kuhlberg J, Calanche M‘L, Baezconde-Garbanati L, Contreras R, Bluthenthal R. Community Needs Assessment among Latino Families in an Urban Public Housing Development. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2019. [DOI: 10.1177/0739986319845103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies examining the health of public housing residents are limited. In response, community-based participatory research principles were used to develop an intervention aimed at improving health outcomes related to multifactorial risk behaviors among Latino families living in a low-income neighborhood. A two-part needs assessment was completed to guide the intervention: interviews with parents ( n = 10) and a group model building (GMB) workshop with youth and parents ( n = 40) to explore the parent-youth dynamic. Interviews indicated that poverty, youth disobedience, and inadequate communication between parents and youth led to parental stress. During the workshop, balancing and reinforcing feedback loops involving Communication, Trust, and Respect between youth and parents were identified. Based on these findings and collaboration with a community advisory board, a bilingual, mindfulness-based meditation intervention was designed to address community needs: positive parent-child interaction emphasizing trust and communication, stress reduction, and family well-being.
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Moran KE, Ommerborn MJ, Blackshear CT, Sims M, Clark CR. Financial Stress and Risk of Coronary Heart Disease in the Jackson Heart Study. Am J Prev Med 2019; 56:224-231. [PMID: 30661571 DOI: 10.1016/j.amepre.2018.09.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Financial hardship is associated with coronary heart disease risk factors, and may disproportionately affect some African American groups. This study examines whether stress because of financial hardship is associated with incident coronary heart disease in African Americans. METHODS The Jackson Heart Study is a longitudinal cohort study of cardiovascular disease risks in African Americans in the Jackson, Mississippi metropolitan statistical area. Participant enrollment began in 2000. Analyses were performed in 2017 and included adjudicated endpoints through December 2012. Financial stress was assessed from the Jackson Heart Study Weekly Stress Inventory and categorized into four levels: (1) did not experience financial stress, (2) no stress, (3) mild stress, and (4) moderate to high stress. Incident coronary heart disease was defined as the first event of definite or probable myocardial infarction, definite fatal myocardial infarction, definite fatal coronary heart disease, or cardiac procedure. There were 2,256 individuals in this analysis. RESULTS Participants with moderate to high (versus no) financial stress were more likely to have incident coronary heart disease events after controlling for demographics, SES, access to care, and traditional clinical risk factors (hazard ratio=2.42, 95% CI=1.13, 5.17). The association between financial stress and coronary heart disease was no longer statistically significant in a model adjusting for three specific risk factors: depression, smoking status, and diabetes (hazard ratio=1.99, 95% CI=0.91, 4.39). CONCLUSIONS Financial stress may be an unrecognized risk factor for coronary heart disease for African Americans. Additional research should examine these associations in intervention studies that address perceived stress, in addition to other coronary heart disease risk factors, in patients experiencing financial stress.
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Affiliation(s)
- Kaitlyn E Moran
- Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, Massachusetts
| | - Mark J Ommerborn
- Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, Massachusetts
| | - Chad T Blackshear
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi; Jackson Heart Study, Jackson State University, Jackson, Mississippi
| | - Mario Sims
- Jackson Heart Study, Jackson State University, Jackson, Mississippi; Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Cheryl R Clark
- Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
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Peters SE, Grant MP, Rodgers J, Manjourides J, Okechukwu CA, Dennerlein JT. A Cluster Randomized Controlled Trial of a Total Worker Health ® Intervention on Commercial Construction Sites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112354. [PMID: 30366387 PMCID: PMC6265748 DOI: 10.3390/ijerph15112354] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 01/17/2023]
Abstract
This study evaluated the efficacy of an integrated Total Worker Health® program, “All the Right Moves”, designed to target the conditions of work and workers’ health behaviors through an ergonomics program combined with a worksite-based health promotion Health Week intervention. A matched-pair cluster randomized controlled trial was conducted on ten worksites (five intervention (n = 324); five control sites (n = 283)). Worker surveys were collected at all sites pre- and post- exposure at one- and six-months. Linear and logistic regression models evaluated the effect of the intervention on pain and injury, dietary and physical activity behaviors, smoking, ergonomic practices, and work limitations. Worker focus groups and manager interviews supplemented the evaluation. After controlling for matched intervention and control pairs as well as covariates, at one-month following the ergonomics program we observed a significant improvement in ergonomic practices (B = 0.20, p = 0.002), and a reduction in incidences of pain and injury (OR = 0.58, p = 0.012) in the intervention group. At six months, we observed differences in favor of the intervention group for a reduction in physically demanding work (B = −0.25, p = 0.008), increased recreational physical activity (B = 35.2, p = 0.026) and higher consumption of fruits and vegetables (B = 0.87, p = 0.008). Process evaluation revealed barriers to intervention implementation fidelity and uptake, including a fissured multiemployer worksite, the itinerant nature of workers, competing production pressures, management support, and inclement weather. The All the Right Moves program had a positive impact at the individual level on the worksites with the program. For the longer term, the multi-organizational structure in the construction work environment needs to be considered to facilitate more upstream, long-term changes.
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Affiliation(s)
- Susan E Peters
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Michael P Grant
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Justin Rodgers
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
| | - Justin Manjourides
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
| | - Cassandra A Okechukwu
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Jack T Dennerlein
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
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Henshaw M, Borrelli B, Gregorich S, Heaton B, Tooley E, Santo W, Cheng N, Rasmussen M, Helman S, Shain S, Garcia R. Randomized Trial of Motivational Interviewing to Prevent Early Childhood Caries in Public Housing. JDR Clin Trans Res 2018; 3:353-365. [PMID: 30238060 PMCID: PMC6139579 DOI: 10.1177/2380084418794377] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Caries experience among preschool-age children has remained relatively unchanged for the past 2 decades, despite recently documented decreases in untreated decay. OBJECTIVES In a community-based cluster-randomized controlled trial, a motivational interviewing (MI) intervention administered to primary caregivers was hypothesized to reduce caries increment over 2 y as compared with controls, among children aged 0 to 5 y at baseline living in public housing. METHODS Public housing residents, who served as interventionists, were trained in MI with a focus on early childhood caries prevention. All 26 eligible public housing developments were randomized to either control (quarterly clinical examinations, fluoride varnish applications, toothbrush/toothpaste, and educational brochures) or intervention (same procedures as control plus MI counseling). Quarterly MI sessions were delivered in English or Spanish over 2 y, audio recorded, and assessed for treatment fidelity. The primary outcome was the increment in dmfs (decayed, missing, and filled tooth surfaces) as assessed by clinical examination at baseline, 12 mo, and 24 mo. Secondary outcomes included caregiver oral health knowledge and child oral health behaviors (child toothbrushing and sugar-sweetened beverage intake). Baseline characteristics were compared between groups and adjusted for housing-site clusters. Longitudinal outcomes were analyzed with mixed models. RESULTS A total of 1,065 children (49% female, 55% non-White, 61% Hispanic, 89% below poverty level, n = 686 control) and their caregivers were enrolled. During 2 y of follow-up, the mean dmfs increment increased in both groups; however, there were no statistically significant group differences at 24 mo or group × time interactions. The mean increase in intervention caregivers' knowledge was significantly greater than that of control, F(2, 1,593) = 3.48, P = 0.0310, but there were no significant intervention effects on caregiver-reported child sugar-sweetened beverage intake or child toothbrushing. CONCLUSION MI counseling plus intensive caries prevention activities resulted in knowledge increases but did not improve oral health behaviors or caries increment (ClinicalTrials.gov NCT01205971). KNOWLEDGE TRANSFER STATEMENT When viewed in light of the findings from the companion Pine Ridge study and other recent MI studies, the results of this study suggest that when the complex disease of early childhood caries is addressed in high-risk populations, MI is not effective, and alternative approaches are warranted.
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Affiliation(s)
- M.M. Henshaw
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - B. Borrelli
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - S.E. Gregorich
- University of California, San Francisco, San Francisco, CA, USA
| | - B. Heaton
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | | | - W. Santo
- University of California, San Francisco, San Francisco, CA, USA
| | - N.F. Cheng
- University of California, San Francisco, San Francisco, CA, USA
| | - M. Rasmussen
- University of California, San Francisco, San Francisco, CA, USA
| | - S. Helman
- University of California, San Francisco, San Francisco, CA, USA
| | - S. Shain
- University of California, San Francisco, San Francisco, CA, USA
| | - R.I. Garcia
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
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Bradford VA, Quinn EL, Walkinshaw LP, Rocha A, Chan NL, Saelens BE, Johnson DB. Fruit and vegetable access programs and consumption in low-income communities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1498819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Victoria A. Bradford
- University of Washington Department of Health Services, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Emilee L. Quinn
- University of Washington Department of Health Services, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Lina P. Walkinshaw
- University of Washington Department of Health Services, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Anita Rocha
- Data Manager and Research Analyst, SSW: West Coast Poverty Center, University of Washington, Seattle, Washington, USA
| | - Nadine L. Chan
- Assessment, Policy Development, and Evaluation Unit Public Health, Seattle, King County, Washington, USA
- Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
| | - Brian E. Saelens
- Pediatrics and Psychiatry & Behavioral Sciences, University of Washington and Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Donna B. Johnson
- University of Washington School of Public Health, Nutritional Sciences Program, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
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Garbers S, Hunersen K, Nechitilo M, Fisch M, Bell DL, Byrne MW, Gold MA. Healthy Weight and Cardiovascular Health Promotion Interventions for Adolescent and Young Adult Males of Color: A Systematic Review. Am J Mens Health 2018; 12:1328-1351. [PMID: 29808765 PMCID: PMC6142141 DOI: 10.1177/1557988318777923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease is the leading cause of mortality in the United States, accounting for one fourth of deaths. Higher rates of obesity put Hispanic and Black men at increased risk. The American Heart Association cites diet quality, physical activity, and body weight as alterations responsive to health promotion intervention. Prevention strategies need to begin in adolescence and the emerging adulthood years to impact cumulative risk factors. A scoping review identified search terms and this was followed by a systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases for articles published in English from January 1, 2002, through May 11, 2017. This review explores community-based content, delivery, recruitment, or retention strategies used with young men of color aged 15 to 24 years. Of 17 articles describing 16 individual interventions and 1 describing multiple interventions (with samples ranging from 37 to 4,800), 13 reported significant results in one or more domains. No studies specifically targeted the needs of young men and only three had more than 50% male participants. There was a gap in studies that addressed young men in the ages of interest with most interventions reaching participants aged 11 to 19 years. Cultural tailoring was addressed through recruitment setting, interventionist characteristics, community involvement, and theoretical frameworks such as motivational interviewing that allow individual goal setting. Because young men seek access to preventive health services less than young women, it is suggested that interventions that are community based or use push technology (send information directly to the user) be increased.
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Affiliation(s)
- Samantha Garbers
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kara Hunersen
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Marylynn Fisch
- 2 Columbia University College of Physicians and Surgeons, New York, USA
| | - David L Bell
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
| | | | - Melanie A Gold
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
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Noonan D, Hartman AM, Briggs J, Biederman DJ. Collaborating with Public Housing Residents and Staff to Improve Health: A Mixed-Methods Analysis. J Community Health Nurs 2017; 34:203-213. [PMID: 29023160 DOI: 10.1080/07370016.2017.1369810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study described the health behaviors and barriers and facilitators of those behaviors in elderly and/or disabled residents of public housing. A mixed-methods design was used. Residents (N = 88) completed a survey with validated measures of health behaviors. A sub-sample (N = 16) participated in three focus groups. Residents scored worse than population norms on the majority of behaviors measured. Qualitative results framed in an ecological model indicated the majority of facilitators and barriers to health behaviors were perceived as occurring at the intrapersonal and interpersonal levels. Interventions to promote health should consider the unique barriers and facilitators to health behaviors among residents.
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Affiliation(s)
- Devon Noonan
- a School of Nursing, Duke University , Durham , North Carolina
| | | | - Joyce Briggs
- b Durham Housing Authority , Durham , North Carolina
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17
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Lam CN, Goldenson NI, Burner E, Unger JB. Cultural buffering as a protective factor against electronic cigarette use among Hispanic emergency department patients. Addict Behav 2016; 63:155-60. [PMID: 27513593 DOI: 10.1016/j.addbeh.2016.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 07/21/2016] [Accepted: 07/30/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Hispanics in the U.S. historically use tobacco at lower rates than other racial and ethnic groups. Cultural buffering, the process by which aspects of traditional Hispanic culture delay the adoption of unhealthy behaviors, is believed to be a protective factor against tobacco use. Electronic cigarettes (e-cigarettes) are a new tobacco product that have not been extensively studied, and it is unknown if cultural factors that protect against tobacco use will buffer against e-cigarette use among the Hispanic population. METHODS This cross-sectional study was conducted at the emergency department (ED) in a safety-net hospital in 2014. Patients visiting the ED participated in a survey assessing demographics and substance use. Cultural buffering was operationalized as participants' primary language spoken at home. Multivariate logistic regression and generalized estimating equations examined the association between Hispanic cultural buffering and e-cigarette ever-use. RESULTS Of the 1476 Hispanic ED patients (age: 46.6M±14.5SD, 49.3% male), 7.6% reported e-cigarette ever-use and 11.1% reported current combustible cigarette use. In adjusted models, Spanish speakers were half as likely to report e-cigarette ever-use (O.R.: 0.54, 95% C.I.: 0.34-0.84, p=0.007), compared with English speakers. Combustible cigarette use remained the most significant factor associated with e-cigarette ever-use (O.R.: 9.28, 95% C.I.:7.44-11.56, p<0.001). In higher-income neighborhoods, English speakers reported e-cigarette ever-use at higher rates than Spanish speakers (28.2% vs. 5.9%, p<0.001). CONCLUSIONS Cultural buffering was protective against e-cigarette ever-use, especially in higher-income neighborhoods. These results support research on culturally-sensitive prevention programs for new and emerging tobacco products in Hispanic communities.
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Affiliation(s)
- Chun Nok Lam
- Department of Emergency Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
| | - Nicholas I Goldenson
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Elizabeth Burner
- Department of Emergency Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
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18
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Airagnes G, Lemogne C, Hoertel N, Goldberg M, Limosin F, Zins M. Childhood adversity and depressive symptoms following retirement in the Gazel cohort. J Psychiatr Res 2016; 82:80-90. [PMID: 27471842 DOI: 10.1016/j.jpsychires.2016.07.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Only a few studies have examined whether specific moderators may impact the magnitude of the relationship between retirement and depression. The aim of this study was to examine the potential moderating role of adverse childhood life events (ACLE) on changes in depressive symptoms following retirement in the GAZEL cohort. METHODS 9242 participants, followed up since 1989, completed the Center of Epidemiologic Studies Depression scale (CESD) every three years and were asked in 2004 to answer an ACLE questionnaire. Subjects were classed according to 6 clusters by Two-Step Cluster Analysis (no ACLE: cluster 1; increasing material deprivation: clusters 2 to 4; history of early separation: cluster 5 and history of conflicts or violence: cluster 6), and then stratified for sex. Analyses were based on general linear models with the CESD variation between, before and after retirement as dependent variable. All results were adjusted according to age, marital status, occupational status, alcohol consumption, self-rated health and CESD score before retirement. RESULTS The association between exposure to ACLE and changes in depressive symptoms following retirement was significant in both men (F = 6.929; p < 0.001; eta(2) = 0.005) and women (F = 6.890; p < 0.001; eta(2) = 0.016). Exposure to early separation or history of conflicts or violence during childhood was associated with less improvement in both men and women, whereas early exposure to material deprivation only affected results in men. CONCLUSIONS Programs aimed at facilitating retirement transition may focus on subjects at risk of not experiencing the expected benefits of retirement, which is the case for those with a history of ACLE.
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Affiliation(s)
- Guillaume Airagnes
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France.
| | - Cédric Lemogne
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Nicolas Hoertel
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Marcel Goldberg
- Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
| | - Frédéric Limosin
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Marie Zins
- Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
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19
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Camacho-Rivera M, Rosenbaum E, Yama C, Chambers E. Low-Income Housing Rental Assistance, Perceptions of Neighborhood Food Environment, and Dietary Patterns among Latino Adults: the AHOME Study. J Racial Ethn Health Disparities 2016; 4:346-353. [PMID: 27129854 DOI: 10.1007/s40615-016-0234-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 04/04/2016] [Accepted: 04/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Federal rental assistance programs, in the form of the traditional public housing program and the Housing Choice Voucher Program (HCVP-formerly known as Section 8), are designed to reduce the economic rental burden for low-income residents. While residents using federal housing vouchers, which allow low-income residents in public housing to move out of public housing to rent-subsidized homes, have been found to be have better cardiovascular outcomes compared to the cardiovascular outcomes of low-income public housing residents, the mechanisms explaining these associations remains an understudied area. PURPOSE The aim of this study is to assess whether residents participating in HCVP or unassisted residents had greater access to healthy foods such as fruits and vegetables, and less access to unhealthy foods such as fast food and sugar sweetened beverages, when compared to residents living in public housing (referent group). METHODS The Affordable Housing as an Obesity Mediating Environment (AHOME) study is a cross-sectional study of Latinos residing in low-income housing in the Bronx, NY (n = 362). Participants were interviewed to assess food patterns and perceptions of neighborhood environment. RESULTS The analytic sample was primarily female (74.5 %) with a mean age of 46.4 years (SD = 14.68). Residents participating in HCVP had similar availability of fruits and vegetables in the home compared to residents receiving no assistance or public housing residents. HCVP participants consumed more fast food (β = 0.34; CI = 0.10-0.58) but had similar sugar sweetened beverage consumption compared to public housing residents. Unassisted residents had more fast food consumption (β = 0.25; CI = 0.01-0.49) but less sugar sweetened beverage consumption (β = -0.52; CI = -0.76--0.28) than public housing residents. Perceptions of neighborhood food environment were not significantly associated with dietary patterns. CONCLUSION This study shows variability in consumption of sugar sweetened beverage consumption and fast food consumption, but not in availability of fruits and vegetables, across residents participating in HCVP, public housing residents, and unassisted residents. Evaluating the health benefits associated with low-income housing mobility programs, such as HCVP, requires examining how housing may influence dietary patterns above and beyond an individual's socioeconomic position.
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Affiliation(s)
- Marlene Camacho-Rivera
- Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education/CUNY School of Medicine, 160 Convent Avenue, New York, NY, 10031, USA.
| | - Emily Rosenbaum
- Department of Sociology and Anthropology, Fordham University, Bronx, NY, USA
| | - Cecile Yama
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Earle Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
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20
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Sorensen G, Nagler EM, Hashimoto D, Dennerlein JT, Theron J, Stoddard AM, Buxton OM, Wallace L, Kenwood C, Nelson CC, Tamers SL, Grant MP, Wagner G. Implementing an Integrated Health Protection/Health Promotion Intervention in the Hospital Setting: Lessons Learned From the Be Well, Work Well Study. J Occup Environ Med 2016; 58:185-94. [PMID: 26849263 PMCID: PMC4746007 DOI: 10.1097/jom.0000000000000592] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study reports findings from a proof-of-concept trial designed to examine the feasibility and estimates the efficacy of the "Be Well, Work Well" workplace intervention. METHODS The intervention included consultation for nurse managers to implement changes on patient-care units and educational programming for patient-care staff to facilitate improvements in safety and health behaviors. We used a mixed-methods approach to evaluate feasibility and efficacy. RESULTS Using findings from process tracking and qualitative research, we observed challenges to implementing the intervention due to the physical demands, time constraints, and psychological strains of patient care. Using survey data, we found no significant intervention effects. CONCLUSIONS Beyond educating individual workers, systemwide initiatives that respond to conditions of work might be needed to transform the workplace culture and broader milieu in support of worker health and safety.
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Affiliation(s)
- Glorian Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eve M. Nagler
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Dean Hashimoto
- Partners HealthCare System, Boston, MA
- Boston College Law School, Newton Centre, MA
- Harvard Medical School, Boston, MA
| | - Jack T. Dennerlein
- Harvard T.H. Chan School of Public Health, Boston, MA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA
| | - Julie Theron
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
| | | | - Orfeu M. Buxton
- Harvard Medical School, Boston, MA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Lorraine Wallace
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Sara L. Tamers
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington DC*
| | | | - Gregory Wagner
- Harvard T.H. Chan School of Public Health, Boston, MA
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington DC*
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21
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Tucker-Seeley RD, Selk S, Adams I, Allen JD, Sorensen G. Tobacco use among low-income housing residents: does hardship motivate quit attempts? Cancer Causes Control 2015; 26:1699-707. [PMID: 26376892 PMCID: PMC4694626 DOI: 10.1007/s10552-015-0662-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 09/03/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to examine material hardship among smokers to determine whether such hardship was positively associated with current attempts to quit tobacco use. METHODS We analyzed cross-sectional data from the Health in Common (HIC) study, an observational study to investigate social and physical determinants of cancer risk-related behaviors among residents of low-income housing in three cities in the Boston metropolitan area. In this study, three indicators of hardship were used: food hardship, financial hardship, and material hardship (food and financial hardship combined). Logistic regression models were used to obtain the odds of currently trying to quit among current smokers in the HIC (n = 170) across hardship types experienced, adjusting for sociodemographic and psychosocial factors. RESULTS Fully adjusted models revealed no statistically significant association between trying to quit tobacco use and indicators of material hardship: food hardship and financial hardship present (OR 1.33 (0.42-4.2); food hardship and no financial hardship OR 3.83 (0.97-15.13); and financial hardship but no food hardship OR 0.5 (0.1-2.39). CONCLUSIONS These findings suggest that even in the presence of material hardship, low-income housing resident tobacco users are not more likely to quit tobacco use; therefore, cessation efforts focused on the financial benefits of quitting may be insufficient to motivate quit attempts among low-income smokers.
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Affiliation(s)
- R D Tucker-Seeley
- Center for Community-Based Research, Dana Farber Cancer Institute, 450 Brookline Ave, LW 747, Boston, MA, 02215, USA.
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - S Selk
- Center for Community-Based Research, Dana Farber Cancer Institute, 450 Brookline Ave, LW 747, Boston, MA, 02215, USA
| | - I Adams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J D Allen
- Department of Public Health and Community Medicine, Tufts University, Boston, MA, USA
| | - G Sorensen
- Center for Community-Based Research, Dana Farber Cancer Institute, 450 Brookline Ave, LW 747, Boston, MA, 02215, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Anbari K, Mostafavi SM, Ghanadi K. Health Promoting Behaviors in Women of Khorramabad City in Western Iran in 2013. WOMEN’S HEALTH BULLETIN 2014. [DOI: 10.17795/whb-22162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mudd-Martin G, Rayens MK, Lennie TA, Chung ML, Gokun Y, Wiggins AT, Biddle MJ, Bailey AL, Novak MJ, Casey BR, Moser DK. Fatalism moderates the relationship between family history of cardiovascular disease and engagement in health-promoting behaviors among at-risk rural Kentuckians. J Rural Health 2014; 31:206-16. [PMID: 25252080 DOI: 10.1111/jrh.12094] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE In rural communities that experience high rates of cardiovascular disease (CVD) morbidity and mortality, family history education may enhance risk awareness and support engagement in healthy behaviors but could also engender fatalism. This study was conducted to assess if the relationship between family history and adherence to healthy lifestyle behaviors is moderated by fatalism. METHODS Baseline data were obtained from 1,027 adult participants in the HeartHealth in Rural Kentucky study. Multiple linear regression was used to determine whether fatalism moderated the relationship between high-risk family history of CVD and adherence to healthy lifestyle behaviors, controlling for sociodemographic variables and CVD risk factors. The relationship between family history and healthy behaviors was assessed for subgroups of participants divided according to the upper and lower quartiles of fatalism score. FINDINGS The relationship between high-risk family history of CVD and adherence to healthy behaviors was moderated by fatalism. Among those with the highest quartile of fatalism scores, high-risk family history predicted greater adherence to healthy behaviors, while among those in the lowest quartile, and among those with the middle 50% of fatalism scores, there was no association between family history and healthy behavior scores. CONCLUSIONS Family history education can provide people at increased risk for CVD important information to guide health practices. This may be particularly relevant for those with a high degree of fatalistic thinking. In rural communities with limited health resources, family history education, combined with assessment of fatalism, may support better targeted interventions to enhance engagement in healthy behaviors.
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Affiliation(s)
- Gia Mudd-Martin
- College of Nursing, University of Kentucky, Lexington, Kentucky
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Robles B, Smith LV, Ponce M, Piron J, Kuo T. The influence of gender and self-efficacy on healthy eating in a low-income urban population affected by structural changes to the food environment. J Obes 2014; 2014:908391. [PMID: 24800064 PMCID: PMC3985319 DOI: 10.1155/2014/908391] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/09/2014] [Indexed: 11/17/2022] Open
Abstract
Although U.S. obesity prevention efforts have begun to implement a variety of system and environmental change strategies to address the underlying socioecological barriers to healthy eating, factors which can impede or facilitate community acceptance of such interventions are often poorly understood. This is due, in part, to the paucity of subpopulation health data that are available to help guide local planning and decision-making. We contribute to this gap in practice by examining area-specific health data for a population targeted by federally funded nutrition interventions in Los Angeles County. Using data from a local health assessment that collected information on sociodemographics, self-reported health behaviors, and objectively measured height, weight, and blood pressure for a subset of low-income adults (n = 720), we compared health risks and predictors of healthy eating across at-risk groups using multivariable modeling analyses. Our main findings indicate being a woman and having high self-efficacy in reading Nutrition Facts labels were strong predictors of healthy eating (P < 0.05). These findings suggest that intervening with women may help increase the reach of these nutrition interventions, and that improving self-efficacy in healthy eating through public education and/or by other means can help prime at-risk groups to accept and take advantage of these food environment changes.
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Affiliation(s)
- Brenda Robles
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Boulevard, 8th Floor, Los Angeles, CA 90010, USA
| | - Lisa V. Smith
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 North Figueroa Street, Room 127, Los Angeles, CA 90012, USA
- Department of Epidemiology, UCLA Jonathan and Karin Fielding School of Public Health, Box 951772, 71-254 CHS, Los Angeles, CA 90095-1772, USA
| | - Mirna Ponce
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Boulevard, 8th Floor, Los Angeles, CA 90010, USA
| | - Jennifer Piron
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 North Figueroa Street, Room 127, Los Angeles, CA 90012, USA
| | - Tony Kuo
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Boulevard, 8th Floor, Los Angeles, CA 90010, USA
- Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Boulevard, Suite 1800, Los Angeles, CA 90024-4142, USA
- *Tony Kuo:
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