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Naar S, Ellis D, Cunningham P, Pennar AL, Lam P, Brownstein NC, Bruzzese JM. Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents. Pediatrics 2018; 142:peds.2017-3737. [PMID: 30185428 PMCID: PMC6317763 DOI: 10.1542/peds.2017-3737] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5804911922001PEDS-VA_2017-3737Video Abstract BACKGROUND: African American adolescents appear to be the most at risk for asthma morbidity and mortality even compared with other minority groups, yet there are few successful interventions for this population that are used to target poorly controlled asthma. METHODS African American adolescents (age 12-16 years) with moderate-to-severe persistent asthma and ≥1 inpatient hospitalization or ≥2 emergency department visits in 12 months were randomly assigned to Multisystemic Therapy-Health Care or an attention control group (N = 167). Multisystemic Therapy-Health Care is a 6-month home- and community-based treatment that has been shown to improve illness management and health outcomes in high-risk adolescents by addressing the unique barriers for each individual family with cognitive behavioral interventions. The attention control condition was weekly family supportive counseling, which was also provided for 6 months in the home. The primary outcome was lung function (forced expiratory volume in 1 second [FEV1]) measured over 12 months of follow-up. RESULTS Linear mixed-effects models revealed that compared with adolescents in the comparison group, adolescents in the treatment group had significantly greater improvements in FEV1 secondary outcomes of adherence to controller medication, and the frequency of asthma symptoms. Adolescents in the treatment group had greater reductions in hospitalizations, but there were no differences in reductions in emergency department visits. CONCLUSIONS A comprehensive family- and community-based treatment significantly improved FEV1, medication adherence, asthma symptom frequency, and inpatient hospitalizations in African American adolescents with poorly controlled asthma. Further evaluation in effectiveness and implementation trials is warranted.
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Affiliation(s)
- Sylvie Naar
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavioral Research, College of Medicine, Florida State University, Tallahassee, Florida;
| | - Deborah Ellis
- Department of Family Medicine and Public Health
Services, School of Medicine, Wayne State University, Detroit, Michigan
| | - Phillippe Cunningham
- Department of Psychiatry and Behavioral Sciences,
Medical University of South Carolina, Charleston, South Carolina
| | - Amy L. Pennar
- Department of Family Medicine and Public Health
Services, School of Medicine, Wayne State University, Detroit, Michigan
| | - Phebe Lam
- Faculty of Arts, Humanities, and Social Sciences,
University of Windsor, Windsor, Canada; and
| | - Naomi C. Brownstein
- Department of Behavioral Sciences and Social
Medicine, Center for Translational Behavioral Research, College of Medicine,
Florida State University, Tallahassee, Florida
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Developing a Partnership for Change: The National Collaborative on Childhood Obesity Research. Am J Prev Med 2018; 54:465-474. [PMID: 29455760 PMCID: PMC5823267 DOI: 10.1016/j.amepre.2017.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/08/2017] [Accepted: 12/05/2017] [Indexed: 11/24/2022]
Abstract
Rising obesity rates in the U.S. over the past several decades, particularly among children and adolescents, led to an increased focus on research addressing obesity prevention and public- and private-sector initiatives on healthy eating and physical activity. Groups conducting prevention initiatives recognized that their ability to achieve and sustain cross-sector environmental, policy, and systems-level solutions was hampered by limited evidence in those areas. In 2007, the Centers for Disease Control and Prevention, NIH, and the Robert Wood Johnson Foundation began to discuss forming a partnership that could accelerate progress to prevent childhood obesity by coordinating research and evaluation agendas and collaboratively building an evidence base. This paper describes the formation, structure, and operations of the National Collaborative on Childhood Obesity Research, the resulting partnership between the Centers for Disease Control and Prevention, NIH, the Robert Wood Johnson Foundation, and since 2010, the U.S. Department of Agriculture. It includes a discussion of lessons learned from, and benefits of, this collaborative model.
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Fleischhacker S, Roberts E, Camplain R, Evenson KR, Gittelsohn J. Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives. J Racial Ethn Health Disparities 2016; 3:608-624. [PMID: 27294756 PMCID: PMC4911341 DOI: 10.1007/s40615-015-0180-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/13/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
Abstract
Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.
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Affiliation(s)
- Sheila Fleischhacker
- Senior Public Health & Science Policy Advisor, Office of Nutrition Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Two Democracy Plaza, Room 635, 6707 Democracy Boulevard MSC 5461, Bethesda, Maryland 20892-5461, – office 301-594-7440, mobile – 301-640-1396, fax – 301-480-3768
| | - Erica Roberts
- Doctoral Candidate, University of Maryland School of Public Health, Department of Behavioral and Community Health, 7923 Eastern Ave, Apt 1001, Silver Spring, MD 20910, voice – 410-236-7016
| | - Ricky Camplain
- Doctoral Student, University of North Carolina, Gillings School of Global Public Health, Department of Epidemiology, 137 East Franklin Street, Suite 303A, Chapel Hill, NC 27514, voice – 505-658-5262
| | - Kelly R. Evenson
- Research Professor of Epidemiology, University of North Carolina, Gillings School of Global Public Health, Department of Epidemiology, 137 E Franklin Street, Suite 306, Chapel Hill, NC 27514, voice – 919-966-4187
| | - Joel Gittelsohn
- Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, 615 N. Wolfe Street, Rm W2041, Baltimore, MD 21205, voice – 410-955-3927
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La valoración antropométrica en el contexto de la escuela como medida para detectar y prevenir efectos a largo plazo de la obesidad y del sobrepeso en niños en edad escolar. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2016.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Holden K, Akintobi T, Hopkins J, Belton A, McGregor B, Blanks S, Wrenn G. Community Engaged Leadership to Advance Health Equity and Build Healthier Communities. SOCIAL SCIENCES (BASEL, SWITZERLAND) 2016; 5:2. [PMID: 27713839 PMCID: PMC5048675 DOI: 10.3390/socsci5010002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Health is a human right. Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential. Addressing the multi-faceted health needs of ethnically and culturally diverse individuals in the United States is a complex issue that requires inventive strategies to reduce risk factors and buttress protective factors to promote greater well-being among individuals, families, and communities. With growing diversity concerning various ethnicities and nationalities; and with significant changes in the constellation of multiple of risk factors that can influence health outcomes, it is imperative that we delineate strategic efforts that encourage better access to primary care, focused community-based programs, multi-disciplinary clinical and translational research methodologies, and health policy advocacy initiatives that may improve individuals' longevity and quality of life.
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Affiliation(s)
- Kisha Holden
- Department of Psychiatry & Behavioral Science, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
- Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
| | - Tabia Akintobi
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
- Prevention Research Center, Morehouse School of Medicine, 720Westview Drive, Atlanta, GA 30310, USA
| | - Jammie Hopkins
- Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
| | - Allyson Belton
- Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
| | - Brian McGregor
- Department of Psychiatry & Behavioral Science, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
- Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
| | - Starla Blanks
- Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
| | - Glenda Wrenn
- Department of Psychiatry & Behavioral Science, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
- Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA
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Oggioni C, Cena H, Wells JCK, Lara J, Celis-Morales C, Siervo M. Association between worldwide dietary and lifestyle patterns with total cholesterol concentrations and DALYs for infectious and cardiovascular diseases: an ecological analysis. J Epidemiol Glob Health 2015; 5:315-25. [PMID: 25747186 PMCID: PMC7320501 DOI: 10.1016/j.jegh.2015.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 12/03/2022] Open
Abstract
Global dietary and lifestyle trends are primary risk factors for communicable and non-communicable diseases. An ecological analysis was conducted to examine the association of global dietary and lifestyle patterns with total cholesterol concentrations. This study also investigated whether total cholesterol modified the association between dietary and lifestyle habits with disability-adjusted-life-years-lost (DALYs) for infectious and cardiovascular diseases (CVDs). Country-specific mean total cholesterol concentrations and DALYs for infectious and CVDs were obtained. Data were then matched to country-specific food and energy availability for consumption and information on obesity, physical inactivity, urbanization, gross domestic product (GDP), life expectancy and smoking. Stepwise multiple regression models were developed to identify significant predictors of total cholesterol concentrations and DALYs for infectious and CVDs. Life expectancy and egg and meat consumption were significantly associated with cholesterol concentrations. DALYs for infectious diseases were associated with smoking, life expectancy and per capita GDP. Smoking was the only predictor of DALYs for CVDs. The improvement of socio-demographic conditions and economic growth is likely to reduce the burden of communicable diseases in developing countries. A concurring increase in non-communicable diseases is expected, and these results have, yet again, identified smoking as a primary risk factor for CVDs.
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Affiliation(s)
- C Oggioni
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne NE4 5PL, UK; Department of Public Health, Neuroscience, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, via Bassi 21, 27100 Pavia, Italy
| | - H Cena
- Department of Public Health, Neuroscience, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, via Bassi 21, 27100 Pavia, Italy
| | - J C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - J Lara
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne NE4 5PL, UK
| | - C Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne NE4 5PL, UK
| | - M Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne NE4 5PL, UK.
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Abstract
Diseases once associated with older adulthood, type 2 diabetes and cardiovascular disease, are increasingly diagnosed in children and adolescents. Interventions designed to assist adults in modifying dietary and physical activity habits have been shown to help prevent the development of type 2 diabetes and cardiovascular disease in adults. Given the unfortunate rise in both of these diseases in pediatric populations, it is increasingly important to begin prevention efforts in childhood or prenatally. There is strong empirical support for utilizing lifestyle interventions to prevent these diseases in adults; it is not clear whether the same holds true for pediatric populations. The present review examines lifestyle management efforts to prevent type 2 diabetes and cardiovascular disease in children across socioecological levels. Recommendations are made for expanding the traditional focus of lifestyle interventions from dietary and physical activity behaviors to target additional risks for these diseases such as smoking and depression in youth.
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Affiliation(s)
- Dorothy J. Van Buren
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 South Euclid, St. Louis, MO 63110 USA
| | - Tiffany L. Tibbs
- School of Advanced Studies and College of Social Sciences, University of Phoenix, 3157 E. Elwood St., Phoenix, AZ 85034 USA
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Brandert K, McCarthy C, Grimm B, Svoboda C, Palm D, Stimpson JP. A model for training public health workers in health policy: the Nebraska Health Policy Academy. Prev Chronic Dis 2014; 11:E82. [PMID: 24831286 PMCID: PMC4023675 DOI: 10.5888/pcd11.140108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
There is growing recognition that health goals are more likely to be achieved and sustained if programs are complemented by appropriate changes in the policies, systems, and environments that shape their communities. However, the knowledge, skills, and abilities needed to create and implement policy are among the major needs identified by practitioners at both the state and local levels. This article describes the structure and content of the Nebraska Health Policy Academy (the Academy), a 9-month program developed to meet the demand for this training. The Academy is a competency-based training program that aims to increase the capacity of Nebraska's state and local public health staff and their community partners to use public health policy and law as a public health tool. Our initiative allows for participation across a large, sparsely populated state; is grounded in adult learning theory; introduces the key principles and practices of policy, systems, and environmental change; and is offered free of charge to the state's public health workforce. Challenges and lessons learned when offering workforce development on public health policy efforts are discussed.
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Affiliation(s)
- Kathleen Brandert
- University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska
| | - Claudine McCarthy
- University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska
| | - Brandon Grimm
- University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska
| | - Colleen Svoboda
- State of Nebraska, Department of Health and Human Services, Lincoln, Nebraska
| | - David Palm
- State of Nebraska, Department of Health and Human Services, Lincoln, Nebraska
| | - Jim P Stimpson
- Center for Health Policy, and Associate Professor and Graduate Program Director, Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE 68198-4350. E-mail:
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