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Baquero B, Novak N, Sewell DK, Kava CM, Daniel-Ulloa J, Pham H, Askleson N, Ashida S, Laroche H, Maldonado Gonzalez A, Bucklin R, Haines H, Parker EA. Effectiveness of implementing evidence-based approaches to promote physical activity in a Midwestern micropolitan area using a quasi-experimental hybrid type I study design. BMC Public Health 2024; 24:1082. [PMID: 38637782 PMCID: PMC11027347 DOI: 10.1186/s12889-024-18523-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/04/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Much evidence-based physical activity (PA) interventions have been tested and implemented in urban contexts. However, studies that adapt, implement, and evaluate the effectiveness of these interventions in micropolitan rural contexts are needed. The study aimed to evaluate the effectiveness of the Active Ottumwa intervention to promote PA in a micropolitan community. METHODS Between 2013 - 2019, we implemented Active Ottumwa in a micropolitan setting, and subsequently implemented and evaluated its effectiveness using a Hybrid Type I design. In this paper, we describe the intervention's effectiveness in promoting PA. We collected PA data over 24 months from a cohort of community residents using accelerometers and PA data from two cross-sectional community surveys administered in 2013 and 2018, using the Global Physical Activity Questionnaire. RESULTS From the cohort, we found significant change in PA over 24 months (P = 0.03) corresponding to a 45-min daily decrease in sedentary activity, a daily increase of 35-min in light PA and 9 min in moderate-to-vigorous PA. There was a statistically significant (P = 0.01) increasing trend at the population-level in the moderate-to-vigorous composition of 7 min between the two cross-sectional assessments (95% CI: 0.1%-1.34%). CONCLUSIONS The study demonstrates that the adapted evidence-based PA interventions in a micropolitan context is effective.
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Affiliation(s)
- Barbara Baquero
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA.
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA.
| | - Nicole Novak
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Daniel K Sewell
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Christine M Kava
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Jason Daniel-Ulloa
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seatle, WA, USA
| | - Hanh Pham
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Natoshia Askleson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Helena Laroche
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Adriana Maldonado Gonzalez
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Rebecca Bucklin
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Heidi Haines
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
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Mohr NM, Okoro U, Harland KK, Fuller BM, Campbell K, Swanson MB, Wymore C, Faine B, Zepeski A, Parker EA, Mack L, Bell A, DeJong K, Mueller K, Chrischilles E, Carpenter CR, Wallace K, Jones MP, Ward MM. Outcomes Associated With Rural Emergency Department Provider-to-Provider Telehealth for Sepsis Care: A Multicenter Cohort Study. Ann Emerg Med 2023; 81:1-13. [PMID: 36253295 PMCID: PMC9780149 DOI: 10.1016/j.annemergmed.2022.07.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVE To test the hypothesis that provider-to-provider tele-emergency department care is associated with more 28-day hospital-free days and improved Surviving Sepsis Campaign (SSC) guideline adherence in rural emergency departments (EDs). METHODS Multicenter (n=23), propensity-matched, cohort study using medical records of patients with sepsis from rural hospitals in an established, on-demand, rural video tele-ED network in the upper Midwest between August 2016 and June 2019. The primary outcome was 28-day hospital-free days, with secondary outcomes of 28-day inhospital mortality and SSC guideline adherence. RESULTS A total of 1,191 patients were included in the analysis, with tele-ED used for 326 (27%). Tele-ED cases were more likely to be transferred to another hospital (88% versus 8%, difference 79%, 95% confidence interval [CI] 75% to 83%). After matching and regression adjustment, tele-ED cases did not have more 28-day hospital-free days (difference 0.07 days more for tele-ED, 95% CI -0.04 to 0.17) or 28-day inhospital mortality (adjusted odds ratio [aOR] 0.51, 95% CI 0.16 to 1.60). Adherence with both the SSC 3-hour bundle (aOR 0.59, 95% CI 0.28 to 1.22) and complete bundle (aOR 0.45, 95% CI 0.02 to 11.60) were similar. An a priori-defined subgroup of patients treated by advanced practice providers suggested that the mortality was lower in the cohort with tele-ED use (aOR 0.11, 95% CI 0.02 to 0.73) despite no significant difference in complete SSC bundle adherence (aOR 2.88, 95% CI 0.52 to 15.86). CONCLUSION Rural emergency department patients treated with provider-to-provider tele-ED care in a mature network appear to have similar clinical outcomes to those treated without.
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Affiliation(s)
- Nicholas M Mohr
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Division of Critical Care, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA.
| | - Uche Okoro
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Karisa K Harland
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Brian M Fuller
- Division of Critical Care, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO; Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO
| | - Kalyn Campbell
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Surgery, Hennepin County Medical Center, Minneapolis, MN
| | - Morgan B Swanson
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Cole Wymore
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Brett Faine
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Pharmaceutical Practice, College of Pharmacy, University of Iowa, Iowa City, IA
| | - Anne Zepeski
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA
| | - Luke Mack
- Avel eCare, Sioux Falls, SD; Department of Family Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD
| | | | | | - Keith Mueller
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA
| | | | | | - Kelli Wallace
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Michael P Jones
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA
| | - Marcia M Ward
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA
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Abstract
Rural health disparities have attracted increased national attention, compelling an expanded focus on rural health research. In this manuscript, we deconstruct the definitions and narratives of "rural" communities and suggest that a paradigm shift is needed that centers the complexity and strength of rural places. We discuss the relevance of health equity frameworks, implementation science, and community-engaged approaches to promote rural well-being. Focusing on rural in its own right will lead to intervention innovations and reinvention with implications beyond rural areas. We conclude with suggestions for research and practice to inspire renewed interest in partnering with rural communities to promote health equity. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- R A Afifi
- Department of Community and Behavioral Health, and Prevention Research Center for Rural Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States; ,
| | - E A Parker
- Department of Community and Behavioral Health, and Prevention Research Center for Rural Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States; ,
| | - G Dino
- Department of Social and Behavioral Sciences, and West Virginia Prevention Research Center, School of Public Health, West Virginia University, Morgantown, West Virginia, United States;
| | - D M Hall
- Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia, United States;
| | - B Ulin
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States;
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Wieland LS, Cramer H, Lauche R, Verstappen A, Parker EA, Pilkington K. Evidence on yoga for health: A bibliometric analysis of systematic reviews. Complement Ther Med 2021; 60:102746. [PMID: 34091028 PMCID: PMC8350934 DOI: 10.1016/j.ctim.2021.102746] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To support the research agenda in yoga for health by comprehensively identifying systematic reviews of yoga for health outcomes and conducting a bibliometric analysis to describe their publication characteristics and topic coverage. METHODS We searched 7 databases (MEDLINE/PubMed, Embase, PsycINFO, CINAHL, AMED, the Cochrane Database of Systematic Reviews, and PROSPERO) from their inception to November 2019 and 1 database (INDMED) from inception to January 2017. Two authors independently screened each record for inclusion and one author extracted publication characteristics and topics of included reviews. RESULTS We retrieved 2710 records and included 322 systematic reviews. 157 reviews were exclusively on yoga, and 165 were on yoga as one of a larger class of interventions (e.g., exercise). Most reviews were published in 2012 or later (260/322; 81 %). First/corresponding authors were from 32 different countries; three-quarters were from the USA, Germany, China, Australia, the UK or Canada (240/322; 75 %). Reviews were most frequently published in speciality journals (161/322; 50 %) complementary medicine journals (66/322; 20 %) or systematic review journals (59/322; 18 %). Almost all were present in MEDLINE (296/322; 92 %). Reviews were most often funded by government or non-profits (134/322; 42 %), unfunded (74/322; 23 %), or not explicit about funding (111/322; 34 %). Common health topics were psychiatric/cognitive (n = 56), cancer (n = 39) and musculoskeletal conditions (n = 36). Multiple reviews covered similar topics, particularly depression/anxiety (n = 18), breast cancer (n = 21), and low back pain (n = 16). CONCLUSIONS Further research should explore the overall quality of reporting and conduct of systematic reviews of yoga, the direction and certainty of specific conclusions, and duplication or gaps in review coverage of topics.
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Affiliation(s)
- L S Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - H Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany; National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Australia
| | - R Lauche
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Australia
| | - A Verstappen
- Global Alliance for Rheumatic and Congenital Hearts, Philadelphia, PA, USA
| | - E A Parker
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - K Pilkington
- School of Health and Care Professions, University of Portsmouth, UK
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Woods-Jaeger B, Daniel-Ulloa J, Kleven L, Bucklin R, Maldonado A, Gilbert PA, Parker EA, Baquero B. Building Leadership, Capacity, and Power to Advance Health Equity and Justice through Community-Engaged Research in the Midwest. Am J Community Psychol 2021; 67:195-204. [PMID: 33040375 DOI: 10.1002/ajcp.12462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Health Equity Advancement Lab (HEAL) at the University of Iowa College of Public Health began in 2012 to support students, researchers, and community members interested in tackling persistent health inequities through a community-based participatory research (CBPR) approach. Using concepts from critical consciousness theory, we developed an approach to building students', faculty members', and community partners' capacity to engage in CBPR to promote health equity that involved immersion in developing CBPR projects. Our paper describes the evolution of HEAL as a facilitating structure that provides a support network and engages diverse stakeholders in critical reflection as they participate in research to advance health equity, and resulting political efficacy and social action. We describe one HEAL-affiliated research project that employs a CBPR approach and has a strong focus on providing transformative learning experiences for students, faculty, and community members. We highlight challenges, successes, and lessons learned in the application of critical consciousness as a framework that engages diverse academic and community partners seeking to promote health equity. We argue that critical consciousness is a relevant theoretical framework to promote transformative learning among students, faculty, and community partners to promote health equity research in diverse communities.
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Affiliation(s)
- Briana Woods-Jaeger
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Developmental and Behavioral Health, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jason Daniel-Ulloa
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- School of Nursing and Health Studies, University of Washington, Bothell, Bothell, WA, USA
| | - Lauren Kleven
- Department of Developmental and Behavioral Health, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Rebecca Bucklin
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Adriana Maldonado
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Barbara Baquero
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
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Mohr NM, Harland KK, Okoro UE, Fuller BM, Campbell K, Swanson MB, Simpson SQ, Parker EA, Mack LJ, Bell A, DeJong K, Faine B, Zepeski A, Mueller K, Chrischilles E, Carpenter CR, Jones MP, Ward MM. TELEmedicine as an intervention for sepsis in emergency departments: a multicenter, comparative effectiveness study (TELEvISED Study). J Comp Eff Res 2021; 10:77-91. [PMID: 33470848 DOI: 10.2217/cer-2020-0141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Sepsis is a life-threatening infection that affects over 1.7 million Americans annually. Low-volume rural hospitals have worse sepsis outcomes, and emergency department (ED)-based telemedicine (tele-ED) has been one promising strategy for improving rural sepsis care. The objective of this study is to evaluate the impact of tele-ED consultation on sepsis care and outcomes in rural ED patients. The TELEvISED study is a multicenter (n = 25) retrospective propensity-matched comparative effectiveness study of tele-ED care for rural sepsis patients in a mature tele-ED network. Telemedicine-exposed patients will be matched with non telemedicine patients using a propensity score to predict tele-ED use. The primary outcome is 28-day hospital free days, and secondary outcomes include adherence with guidelines, mortality and organ failure. ClinicalTrials.gov: NCT04441944.
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Affiliation(s)
- Nicholas M Mohr
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.,Division of Critical Care, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.,Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Karisa K Harland
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - Uche E Okoro
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - Brian M Fuller
- Division of Critical Care, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA.,Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Kalyn Campbell
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.,Department of Surgery, Hennepin County Medical Center, Minneapolis, MN 55415, USA
| | - Morgan B Swanson
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.,Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Stephen Q Simpson
- Department of Pulmonary, Critical Care, & Sleep Medicine, University of Kansas, Kansas City, KS 66160, USA.,Biomedical Advanced Research & Development Authority, US Department of Health & Human Services, Washington, DC 20201, USA
| | - Edith A Parker
- Department of Community & Behavioral Health, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Luke J Mack
- Avera eCARE, Sioux Falls, SD 57104, USA.,Department of Family Medicine, University of South Dakota School of Medicine, Sioux Falls, SD 57105, USA
| | | | | | - Brett Faine
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.,Department of Pharmacy Practice & Science, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA.,Department of Pharmaceutical Care, University of Iowa Hospitals & Clinics, Department of Health Management & Policy, Iowa City, IA 52242, USA
| | - Anne Zepeski
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.,Department of Pharmaceutical Care, University of Iowa Hospitals & Clinics, Department of Health Management & Policy, Iowa City, IA 52242, USA
| | - Keith Mueller
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Elizabeth Chrischilles
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Christopher R Carpenter
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Michael P Jones
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Marcia M Ward
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA 52242, USA
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Novak NL, Baquero B, Askelson NM, Diers L, Dunn B, Haines H, Afifi R, Parker EA. Health Equity in Midsize Rural Communities: Challenges and Opportunities in a Changing Rural America. Am J Public Health 2020; 110:1342-1343. [PMID: 32783728 DOI: 10.2105/ajph.2020.305824] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Nicole L Novak
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Barbara Baquero
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Natoshia M Askelson
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Lynelle Diers
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Brian Dunn
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Heidi Haines
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Rima Afifi
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Edith A Parker
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
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Parker EA, Baquero B, Daniel-Ulloa J, Diers L, Haines H, Kava CM, Hellige K, Hernandez H, Novak N. Establishing a Community-Based Participatory Research Partnership in a Rural Community in the Midwest. Prog Community Health Partnersh 2020; 13:201-208. [PMID: 31178455 DOI: 10.1353/cpr.2019.0020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Rural health disparities are well-documented. "New destination" communities in predominantly rural states have emerged in recent years, with immigrants moving into these communities for better opportunities. Few reports of community-based participatory partnerships with these communities have been previously described in the literature. OBJECTIVES We report on the formation and implementation of a community-academic partnership to reduce health disparities in a rural Midwestern community. METHODS We describe the creation of a partnership between the University of Iowa (UI) Prevention Research Center (PRC) and the Ottumwa, Iowa community. RESULTS We describe the partnership formation, activities, and results of the implementation of the partnership, and challenges encountered, including balancing attention to different health disparities populations and ensuring mechanisms for hearing from the different voices in the community. CONCLUSIONS Our experience suggests the importance and challenge of considering the multiple dimensions of health disparities in rural new destination Midwestern communities.
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Schwab-Reese LM, Parker EA, Peek-Asa C. The Interaction of Dopamine Genes and Financial Stressors to Predict Adulthood Intimate Partner Violence Perpetration. J Interpers Violence 2020; 35:1251-1268. [PMID: 29294665 DOI: 10.1177/0886260517696841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Three dopamine genes (DAT1, DRD2, and DRD4) have been associated with interpersonal delinquency, aggression, and violence when individuals experience adverse environmental exposures. Guided by the catalyst model of aggression, risk alleles identified in previous studies were hypothesized to be associated with intimate partner violence (IPV) perpetration in the presence of financial stressors, a possible environmental trigger. This hypothesis was tested using weighted, clustered logistic regression with data from the National Longitudinal Study of Adolescent to Adult Health. The direct effects DAT1, DRD2, and DRD4 on IPV perpetration, and the interaction of DAT1, DRD2, and DRD4 and financial stressors on IPV perpetration were assessed. Due to cell size, only White men and women were included in this analysis. Increasing number of financial stressors was associated with increased odds of IPV perpetration, regardless of DAT1, DRD2, and DRD4 alleles. As predicted, increasing number of financial stressors was more strongly associated with IPV perpetration among individuals with high-risk DAT1 alleles, than individuals with low-risk alleles. However, this relationship was inverted for DRD2. Although there was still a significant interaction between DRD2 and financial stressors, individuals with low-risk alleles had higher odds of IPV perpetration in the presence of financial stressors. A similar, nonsignificant relationship was found for DRD4. These findings indicate that these genes may interact differently with environmental exposures and types of violent behavior. In addition, the findings may, if replicated, suggest dopamine plays a different role in IPV perpetration compared with other forms of aggression and violence.
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Errett NA, Haynes EN, Wyland N, Everhart A, Pendergrast C, Parker EA. Assessing the national capacity for disaster research response (DR2) within the NIEHS Environmental Health Sciences Core Centers. Environ Health 2019; 18:61. [PMID: 31272453 PMCID: PMC6610905 DOI: 10.1186/s12940-019-0498-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/13/2019] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Disaster research response (DR2) is necessary to answer scientific questions about the environmental health impacts of disasters and the effectiveness of response and recovery strategies. This research explores the preparedness and capacity of National Institute of Environmental Health Sciences (NIEHS) P30 Core Centers (CCs) to conduct DR2 and engage with communities in the context of disasters. METHODS In early 2018, we conducted an online survey of CC Directors (n = 16, 69.5% response rate) to identify their DR2 relevant scientific assets, capabilities, and activities. Summary statistics were calculated. We also conducted in-depth, semi-structured interviews with 16 (69.5%) CC Community Engagement Core directors to identify facilitators and barriers of DR2 community engagement. Interview notes were coded and thematically analyzed. RESULTS Survey: While 56% of responding CCs reported prior participation in DR2 and preparedness to repurpose funding to support DR2, less than one third reported development of a disaster-specific data collection protocol, deployment plan, or concept of operations plan, participation in an exercise to test DR2 capacity, development of academic partnerships to conduct DR2, development of a process for fast-tracking institutional review board approvals for DR2, or maintenance of formal agreements with state, local, or community-based partner(s). A number of CCs reported developing or considering developing capacity in these areas. Barriers to, and tools and resources to enhance, CC engagement in DR2 were identified. Interviews: Four key components for community engaged DR2 were identified: pre-existing community relationships, responsive research that benefits communities, coordination among researchers, and coordination with community response partners. Several roles for, benefits of, and barriers to Community Engagement Rapid Response Teams (CERRT) were described. CONCLUSIONS CCs have significant scientific assets and community partnerships that can be leveraged for DR2; however, additional planning is necessary to ensure that these scientific assets and community partnerships are leveraged when disasters strike.
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Affiliation(s)
- Nicole A Errett
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, 1959 NE Pacific Street, Box 357234, Seattle, WA, 98195, USA.
| | - Erin N Haynes
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, USA
| | - Nancy Wyland
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Ali Everhart
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, 1959 NE Pacific Street, Box 357234, Seattle, WA, 98195, USA
| | - Claire Pendergrast
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, 1959 NE Pacific Street, Box 357234, Seattle, WA, 98195, USA
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
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Kava CM, Parker EA, Baquero B, Curry SJ, Gilbert PA, Sauder M, Sewell DK. Associations Between Organizational Culture, Workplace Health Climate, and Employee Smoking at Smaller Workplaces. Tob Use Insights 2019; 12:1179173X19835842. [PMID: 30906195 PMCID: PMC6421609 DOI: 10.1177/1179173x19835842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/09/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Smaller workplaces frequently employ low-wage earners, who have higher smoking rates. Organizational culture and workplace health climate are two characteristics that could influence employee smoking. The purpose of this study was to examine the associations between organizational culture, workplace health climate, and smoking among employees at small (20-99 employees) and very small (<20 employees) workplaces. We proposed the following hypotheses: a stronger clan culture will be associated with a better workplace health climate (HP1); a better workplace health climate will be associated with lower odds of current smoking (HP2); and there will be an association between workplace health climate and smoking intensity (HP3) and between workplace health climate and quit intention (HP4). Methods: Executives and employees completed separate online questionnaires. Data collection occurred between June and October 2017. We used regression and Fisher’s exact tests to answer study hypotheses. Results: Workplaces with stronger clan cultures had a better workplace health climate (b = 0.27, P < .05), providing support for HP1. A better workplace health climate was associated with lower odds of being a current smoker (odds ratio [OR] = 0.08; 95% confidence interval [CI]: 0.01, 0.53), providing support for HP2. No significant relationship existed between workplace health climate and smoking intensity (P = .50) or between workplace health climate and intention to quit smoking (P = .32); therefore, HP3 and HP4 were not supported. Conclusion: Certain culture types may inform an organization’s health climate. Despite a lower likelihood of current smoking in workplaces with better health climates, a better health climate may not be sufficient to produce changes in smoking behavior and intentions.
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Affiliation(s)
- Christine M Kava
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA.,Health Promotion Research Center, University of Washington, Seattle, WA, USA
| | - Edith A Parker
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Barbara Baquero
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Susan J Curry
- Department of Health Management and Policy, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Paul A Gilbert
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Michael Sauder
- Department of Sociology, The University of Iowa, Iowa City, IA, USA
| | - Daniel K Sewell
- Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, IA, USA
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Kava CM, Parker EA, Baquero B, Curry SJ, Gilbert PA, Sauder M, Sewell DK. Organizational culture and the adoption of anti-smoking initiatives at small to very small workplaces: An organizational level analysis. Tob Prev Cessat 2018; 4:39. [PMID: 32411865 PMCID: PMC7205048 DOI: 10.18332/tpc/100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/26/2018] [Accepted: 11/29/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Many workplaces have adopted anti-smoking initiatives to reduce smoking behavior, but small workplaces are less likely to adopt these initiatives. One factor that could influence adoption is organizational culture, defined as the values and assumptions shared by members of an organization. The aim of this study was to examine the types of organizational culture associated with smoking policy strength and adoption of smoking cessation activities at small (20–99 employees) and very small (<20 employees) workplaces. Two study hypotheses were made: An increase in clan culture (characterized by participation in decision-making and human resources development) will be associated with an increase in smoking policy strength (H1) and higher odds of having cessation activities in the workplace (H2). METHODS Between June and October 2017, executives and employees coming from small and very small workplaces participated in separate surveys. Executives answered questions about their workplace’s anti-smoking initiatives, while employees completed a 12-item questionnaire about organizational culture. We aggregated employee data to perform linear and logistic regression at the organizational level. RESULTS Organizational culture was not significantly associated with smoking policy strength, therefore H1 was not supported. Counter to H2, an increase in clan culture was associated with lower odds of offering smoking cessation activities (OR=0.06; 95% CI: 0.01–0.58). CONCLUSIONS We did not find support for the hypothesized relationships. External factors and additional cultural characteristics may explain study findings. Continued research on culture and ways to improve tobacco control within smaller workplaces is needed.
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Affiliation(s)
- Christine M Kava
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Barbara Baquero
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Susan J Curry
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa, United States
| | - Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Michael Sauder
- Department of Sociology, University of Iowa, Iowa, United States
| | - Daniel K Sewell
- Department of Biostatistics, University of Iowa College of Public Health, Iowa, United States
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Kava CM, Parker EA, Baquero B, Curry SJ, Gilbert PA, Sauder M, Sewell DK. A qualitative assessment of the smoking policies and cessation activities at smaller workplaces. BMC Public Health 2018; 18:1094. [PMID: 30185177 PMCID: PMC6125884 DOI: 10.1186/s12889-018-6001-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/29/2018] [Indexed: 12/02/2022] Open
Abstract
Background To reduce the negative consequences of smoking, workplaces have adopted and implemented anti-smoking initiatives. Compared to large workplaces, less research exists about these initiatives at smaller workplaces, which are more likely to hire low-wage workers with higher rates of smoking. The purpose of this study was to describe and compare the smoking policies and smoking cessation activities at small (20–99 employees) and very small (< 20 employees) workplaces. Methods Thirty-two key informants coming from small and very small workplaces in Iowa completed qualitative telephone interviews. Data collection occurred between October 2016 and February 2017. Participants gave descriptions of the anti-smoking initiatives at their workplace. Additional interview topics included questions on enforcement, reasons for adoption, and barriers and facilitators to adoption and implementation. The data were analyzed using counts and content and thematic analysis. Results Workplace smoking policies were nearly universal (n = 31, 97%), and most workplaces (n = 21, 66%) offered activities to help employees quit smoking. Reasons for adoption included the Iowa Smokefree Air Act, to improve employee health, and organizational benefits (e.g., reduced insurance costs). Few challenges existed to adoption and implementation. Commonly cited facilitators included the Iowa Smokefree Air Act, no issues with compliance, and support from others. Compared to small workplaces, very small workplaces offered cessation activities less often and had fewer tobacco policy restrictions. Conclusions This study showed well-established tobacco control efforts in small workplaces, but very small workplaces lagged behind. To reduce potential health disparities in smoking, future research and intervention efforts in tobacco control should focus on very small workplaces.
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Affiliation(s)
- Christine M Kava
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA. .,Health Promotion Research Center, University of Washington, Box 354804, 1107 NE 45th St., Suite 200, Seattle, WA, 98105, USA.
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Barbara Baquero
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Susan J Curry
- Department of Health Management and Policy, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Michael Sauder
- Department of Sociology, University of Iowa, 140 Seashore Hall, Iowa City, IA, 52242, USA
| | - Daniel K Sewell
- Department of Biostatistics, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
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Baquero B, Kava CM, Ashida S, Daniel-Ulloa J, Laroche HH, Haines H, Bucklin R, Maldonado A, Coronado Garcia M, Berto S, Sewell D, Novak N, Janz K, Gates C, Parker EA. Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community. Int J Environ Res Public Health 2018; 15:ijerph15050917. [PMID: 29734709 PMCID: PMC5981956 DOI: 10.3390/ijerph15050917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/26/2018] [Accepted: 04/30/2018] [Indexed: 11/16/2022]
Abstract
Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity.
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Affiliation(s)
- Barbara Baquero
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Christine M Kava
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Sato Ashida
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Jason Daniel-Ulloa
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Helena H Laroche
- Department of Internal Medicine, University of Iowa Carver College of Medicine, 451 Newton Rd., Iowa City, IA 52242, USA.
| | - Heidi Haines
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Rebecca Bucklin
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Adriana Maldonado
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Mayra Coronado Garcia
- Department of Biostatistics, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Sandy Berto
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Dan Sewell
- Department of Biostatistics, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Nicole Novak
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Kathleen Janz
- Department of Health and Human Physiology, University of Iowa College of Liberal Arts and Sciences, 240 Schaeffer Hall, Iowa City, IA 52242, USA.
| | - Claudia Gates
- Community Advisory Board representative, Ottumwa Prevention Research Center office, 205 E. Main St., Ottumwa, IA 52556, USA.
| | - Edith A Parker
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
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Gilbert PA, Laroche HH, Wallace RB, Parker EA, Curry SJ. Extending Work on Rural Health Disparities: A Commentary on Matthews and Colleagues' Report. J Rural Health 2017; 34:119-121. [PMID: 28397970 DOI: 10.1111/jrh.12241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Helena H Laroche
- Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Susan J Curry
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa
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Schwab-Reese LM, Parker EA, Peek-Asa C. Interactions of adolescent social experiences and dopamine genes to predict physical intimate partner violence perpetration. PLoS One 2017; 12:e0172840. [PMID: 28264032 PMCID: PMC5338787 DOI: 10.1371/journal.pone.0172840] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/08/2017] [Indexed: 12/05/2022] Open
Abstract
Objectives We examined the interactions between three dopamine gene alleles (DAT1, DRD2, DRD4) previously associated with violent behavior and two components of the adolescent environment (exposure to violence, school social environment) to predict adulthood physical intimate partner violence (IPV) perpetration among white men and women. Methods We used data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health, a cohort study following individuals from adolescence to adulthood. Based on the prior literature, we categorized participants as at risk for each of the three dopamine genes using this coding scheme: two 10-R alleles for DAT1; at least one A-1 allele for DRD2; at least one 7-R or 8-R allele for DRD4. Adolescent exposure to violence and school social environment was measured in 1994 and 1995 when participants were in high school or middle school. Intimate partner violence perpetration was measured in 2008 when participants were 24 to 32 years old. We used simple and multivariable logistic regression models, including interactions of genes and the adolescent environments for the analysis. Results Presence of risk alleles was not independently associated with IPV perpetration but increasing exposure to violence and disconnection from the school social environment was associated with physical IPV perpetration. The effects of these adolescent experiences on physical IPV perpetration varied by dopamine risk allele status. Among individuals with non-risk dopamine alleles, increased exposure to violence during adolescence and perception of disconnection from the school environment were significantly associated with increased odds of physical IPV perpetration, but individuals with high risk alleles, overall, did not experience the same increase. Conclusion Our results suggested the effects of adolescent environment on adulthood physical IPV perpetration varied by genetic factors. This analysis did not find a direct link between risk alleles and violence, but contributes to growing research indicating that if genetic factors contribute to perpetration, this relationship is likely complicated and the result of interactions with other factors.
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Affiliation(s)
- Laura M. Schwab-Reese
- Department of Community & Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
- * E-mail:
| | - Edith A. Parker
- Department of Community & Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
| | - Corinne Peek-Asa
- Department of Occupational & Environmental, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
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Daniel-Ulloa J, Gilbert PA, Parker EA. Human Papillomavirus Vaccination in the United States: Uneven Uptake by Gender, Race/Ethnicity, and Sexual Orientation. Am J Public Health 2016; 106:746-7. [PMID: 26890185 DOI: 10.2105/ajph.2015.303039] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess national differences in human papillomavirus (HPV) vaccine uptake among young adults in the United States by gender, race/ethnicity, and sexual orientation. METHODS We tested group differences in initiation and completion of the HPV vaccine series (i.e., 3 doses) by Rao-Scott χ(2) test among 6444 respondents aged 18 to 30 years from the 2013 National Health Interview Survey. RESULTS Among men, 5% reported receiving the HPV vaccine, with no differences in uptake by race/ethnicity or sexual orientation. By contrast, 30% of the women reported receiving the HPV vaccine, with women of color having lower odds of initiating and completing the vaccine series compared with White women. CONCLUSIONS In the United States, HPV vaccine rates are lagging in men and show disparities among women. Increasing HPV vaccine uptake and series completion among women of color and all men may provide considerable long-term public health benefits.
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Affiliation(s)
- Jason Daniel-Ulloa
- The authors are with University of Iowa, College of Public Health; and University of Iowa Prevention Research Center, Cancer Prevention and Control Research Network, Iowa City
| | - Paul A Gilbert
- The authors are with University of Iowa, College of Public Health; and University of Iowa Prevention Research Center, Cancer Prevention and Control Research Network, Iowa City
| | - Edith A Parker
- The authors are with University of Iowa, College of Public Health; and University of Iowa Prevention Research Center, Cancer Prevention and Control Research Network, Iowa City
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White-Newsome JL, McCormick S, Sampson N, Buxton MA, O'Neill MS, Gronlund CJ, Catalano L, Conlon KC, Parker EA. Strategies to reduce the harmful effects of extreme heat events: a four-city study. Int J Environ Res Public Health 2014; 11:1960-88. [PMID: 24531122 PMCID: PMC3945579 DOI: 10.3390/ijerph110201960] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/04/2014] [Accepted: 02/06/2014] [Indexed: 11/26/2022]
Abstract
Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted 73 semi-structured interviews with government and non-governmental organization leaders representing public health, general social services, emergency management, meteorology, and the environmental planning sectors in Detroit, MI; New York City, NY; Philadelphia, PA and Phoenix, AZ-cities selected for their diverse demographics, climates, and climate adaptation strategies. We identified activities these leaders used to reduce the harmful effects of heat for residents in their city, as well as the obstacles they faced and the approaches they used to evaluate these efforts. Local leaders provided a description of how local context (e.g., climate, governance and city structure) impacted heat preparedness. Despite the differences among study cities, political will and resource access were critical to driving heat-health related programming. Upon completion of our interviews, we convened leaders in each city to discuss these findings and their ongoing efforts through day-long workshops. Our findings and the recommendations that emerged from these workshops could inform other local or national efforts towards preventing heat-related morbidity and mortality.
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Affiliation(s)
| | - Sabrina McCormick
- George Washington University School of Public Health and Health Services, 2100 M Street, NW, suite 203, Washington, DC 20037, USA.
| | - Natalie Sampson
- Department of Health Behavior Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Miatta A Buxton
- Department of Epidemiology, University Of Michigan School Of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Marie S O'Neill
- Department of Epidemiology, University Of Michigan School Of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Carina J Gronlund
- Department of Epidemiology, University Of Michigan School Of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Linda Catalano
- Department of Sociology, City University of New York-Queens College, 65-30 Kissena Blvd, Flushing, NY 11367, USA.
| | - Kathryn C Conlon
- National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307, USA.
| | - Edith A Parker
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, N432A CPHB, 105 River Street, Iowa City, IA 52242, USA.
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Sampson NR, Parker EA, Cheezum RR, Lewis TC, O'Toole A, Zuniga A, Patton J, Robbins TG, Keirns CC. "I wouldn't look at it as stress": conceptualizations of caregiver stress among low-income families of children with asthma. J Health Care Poor Underserved 2013; 24:275-88. [PMID: 23377734 DOI: 10.1353/hpu.2013.0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Low-income caregivers of children with asthma experience multiple stressors, likely worsening family health. As part of Community Action Against Asthma's community-based participatory research partnership, researchers conducted 40 qualitative semi-structured interviews and quantitative surveys with low-income caregivers of children with asthma in Detroit, Michigan. Participants described daily childhood asthma experiences and completed scales including the Peds Quality of Life Family Impact Module and Zarit Burden Caregiver Scale. Quantitative scale findings suggested participants are moderately stressed or affected by their child's illness. While there was some accordance between qualitative and quantitative findings, qualitative findings additionally captured many relevant life stressors, seemingly overlooked or conflated in scale responses. Many participants described asthma as part of childrearing, rather than as a stressor or burden. Findings encourage improvement of clinical, psychometric assessments used to measure and address stressors that shape health for many families with children with asthma.
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Affiliation(s)
- Natalie R Sampson
- Department of Health Behavior Health Education at the University of Michigan School of Public Health (UM-SPH), Ann Arbor, MI 48109, USA
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Yonas MA, Garrettson M, Gielen A, Parker EA. Integrating principles of community-based participatory research (CBPR) with the injury prevention and control agenda. Inj Prev 2013; 19:149. [PMID: 23513036 PMCID: PMC4880993 DOI: 10.1136/injuryprev-2013-040788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Michael A Yonas
- Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Sampson NR, Gronlund CJ, Buxton MA, Catalano L, White-Newsome JL, Conlon KC, O'Neill MS, McCormick S, Parker EA. Staying cool in a changing climate: Reaching vulnerable populations during heat events. Glob Environ Change 2013; 23:475-484. [PMID: 29375195 PMCID: PMC5784212 DOI: 10.1016/j.gloenvcha.2012.12.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The frequency and intensity of hot weather events are expected to increase globally, threatening human health, especially among the elderly, poor, and chronically ill. Current literature indicates that emergency preparedness plans, heat health warning systems, and related interventions may not be reaching or supporting behavior change among those most vulnerable in heat events. Using a qualitative multiple case study design, we comprehensively examined practices of these populations to stay cool during hot weather ("cooling behaviors") in four U.S. cities with documented racial/ethnic and socio-economic disparities and diverse heat preparedness strategies: Phoenix, Arizona; Detroit, Michigan; New York City, New York; and Philadelphia, Pennsylvania. Based on semi-structured in-depth interviews we conducted with 173 community members and organizational leaders during 2009-2010, we assessed why vulnerable populations do or do not participate in health-promoting behaviors at home or in their community during heat events, inquiring about perceptions of heat-related threats and vulnerability and the role of social support. While vulnerable populations often recognize heat's potential health threats, many overlook or disassociate from risk factors or rely on experiences living in or visiting warmer climates as a protective factor. Many adopt basic cooling behaviors, but unknowingly harmful behaviors such as improper use of fans and heating and cooling systems are also adopted. Decision-making related to commonly promoted behaviors such as air conditioner use and cooling center attendance is complex, and these resources are often inaccessible financially, physically, or culturally. Interviewees expressed how interpersonal, intergenerational relationships are generally but not always protective, where peer relationships are a valuable mechanism for facilitating cooling behaviors among the elderly during heat events. To prevent disparities in heat morbidity and mortality in an increasingly changing climate, we note the implications of local context, and we broadly inform heat preparedness plans, interventions, and messages by sharing the perspectives and words of community members representing vulnerable populations and leaders who work most closely with them.
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Affiliation(s)
- Natalie R Sampson
- Department of Health Behavior Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, U.S.A
| | - Carina J Gronlund
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, U.S.A
| | - Miatta A Buxton
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, U.S.A
| | - Linda Catalano
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, U.S.A
| | | | - Kathryn C Conlon
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, U.S.A
| | - Marie S O'Neill
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, U.S.A
| | - Sabrina McCormick
- George Washington University School of Public Health and Health Services, 2100 M St., NW, Suite 203, Washington, DC 20037, U.S.A
| | - Edith A Parker
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, S161 CPHB, 105 River St., Iowa City, IA, 52242, U.S.A
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Wallace AS, Sussman AL, Anthoney M, Parker EA. From intervention to innovation: applying a formal implementation strategy in community primary care. Nurs Res Pract 2013; 2013:605757. [PMID: 23606957 PMCID: PMC3625572 DOI: 10.1155/2013/605757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 02/18/2013] [Indexed: 11/30/2022] Open
Abstract
Objective. To describe a comprehensive strategy for implementing an effective diabetes self-management support intervention incorporating goal-setting and followup support in community health clinics (CHCs) serving vulnerable patients. Methods. The Replicating Effective Programs (REP) framework was applied to develop an intervention strategy. In order to create a strategy consistent with the REP framework, four CHCs engaged in an iterative process involving key-informant interviews with clinic staff, ongoing involvement of clinic staff facilitating translational efforts, feedback from national experts, and an instructional designer. Results. Moving through the REP process resulted in an implementation strategy that aims to facilitate commitment, communication, and change at the clinic level, as well as means of providing interactive, time-limited education about patient behavior change and support to health care providers. Conclusion. The REP offered a useful framework for providing guidance toward the development of a strategy to implement a diabetes self-management intervention in CHCs serving medically underserved and underrepresented patient populations.
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Affiliation(s)
- Andrea S. Wallace
- The University of Iowa College of Nursing, 330 CNB, 50 Newton Road, Iowa City, IA 52242, USA
| | - Andrew L. Sussman
- Department of Family and Community Medicine, The University of New Mexico School of Medicine, USA
| | - Mark Anthoney
- Department of Information and Technology Services, The University of Iowa, USA
| | - Edith A. Parker
- Department of Community and Behavioral Health, The University of Iowa College of Public Health, USA
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Lewis TC, Robins TG, Mentz GB, Zhang X, Mukherjee B, Lin X, Keeler GJ, Dvonch JT, Yip FY, O'Neill MS, Parker EA, Israel BA, Max PT, Reyes A. Air pollution and respiratory symptoms among children with asthma: vulnerability by corticosteroid use and residence area. Sci Total Environ 2013; 448:48-55. [PMID: 23273373 PMCID: PMC4327853 DOI: 10.1016/j.scitotenv.2012.11.070] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 10/31/2012] [Accepted: 11/19/2012] [Indexed: 05/10/2023]
Abstract
RATIONALE Information on how ambient air pollution affects susceptible populations is needed to ensure protective air quality standards. OBJECTIVES To estimate the effect of community-level ambient particulate matter (PM) and ozone (O) on respiratory symptoms among primarily African-American and Latino, lower-income asthmatic children living in Detroit, Michigan and to evaluate factors associated with heterogeneity in observed health effects. METHODS A cohort of 298 children with asthma was studied prospectively from 1999 to 2002. For 14days each season over 11 seasons, children completed a respiratory symptom diary. Simultaneously, ambient pollutant concentrations were measured at two community-level monitoring sites. Logistic regression models using generalized estimating equations were fit for each respiratory symptom in single pollutant models, looking for interactions by area or by corticosteroid use, a marker of more severe asthma. Exposures of interest were: daily concentrations of PM<10μm, <2.5μm, and between 10 and 2.5μm in aerodynamic diameter (PM, PM, and PM respectively), the daily 8-hour maximum concentration of O (8HrPeak), and the daily 1-hour maximum concentration of O (1HrPeak). RESULTS Outdoor PM, PM, 8HrPeak, and 1HrPeak O concentrations were associated with increased odds of respiratory symptoms, particularly among children using corticosteroid medication and among children living in the southwest community of Detroit. Similar patterns of associations were not seen with PM. CONCLUSIONS PM and O at levels near or below annual standard levels are associated with negative health impact in this population of asthmatic children. Variation in effects within the city of Detroit and among the subgroup using steroids emphasizes the importance of spatially refined exposure assessment and the need for further studies to elucidate mechanisms and effective risk reduction interventions.
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Affiliation(s)
- Toby C Lewis
- Department of Pediatrics, Division of Pulmonology, University of Michigan Medical School, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5212, United States.
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24
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Cheezum RR, Parker EA, Sampson NR, Lewis TC, O'Toole A, Patton J, Robins TG, Keirns CC. Nightwatch: Sleep Disruption of Caregivers of Children With Asthma in Detroit. ACTA ACUST UNITED AC 2013; 4:217-225. [PMID: 25419470 DOI: 10.1177/2150129713478635] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Caregiving for ill loved ones can affect sleep quality and quantity. Insufficient sleep has been associated with worse physical and mental health outcomes, and it is known to affect work performance and ability to accomplish necessary tasks. While some research has looked at the sleep of caregivers of loved ones with chronic illness and found that they experience poorer sleep, little is known about the impact of caring for a child with asthma on the caregiver's sleep and the ways in which their sleep may be affected. Community Action Against Asthma, a community-based participatory research partnership, conducted interviews with semistructured and open-ended questions with 40 caregivers of children with asthma who live in Detroit. Findings showed that caregivers regularly experience poor quality sleep because of sleeping lightly in order to listen for the child's symptoms, wake multiple times to check on the child because of worry, and provide care for child when he or she experiences symptoms in the middle of the night. Results of the Epworth Sleepiness Scale indicate that 12.5% of caregivers received a score of 16 or more, the score on the scale used to indicate likely presence of a sleep disorder, and 42.5% had a score of 10 or more, indicating excessive sleepiness. Sleep disturbance in caregivers is an underrecognized consequence of childhood asthma, with implications for providers caring for children with asthma.
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Affiliation(s)
- Rebecca R Cheezum
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
| | - Edith A Parker
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
| | - Natalie R Sampson
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
| | - Toby C Lewis
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
| | - Ashley O'Toole
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
| | - Jean Patton
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
| | - Thomas G Robins
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
| | - Carla C Keirns
- School of Health Sciences, Oakland University, Rochester, Michigan (RRC); the College of Public Health, the University of Iowa, Iowa City, Iowa (EAP); Health Behavior and Health Education Department (NRS, AO, JP) and Department of Environmental Health Sciences (TCL, TGR), University of Michigan, Ann Arbor, Michigan; and the Department of Preventive Medicine, Stony Brook University, Stony Brook, New York (CCK)
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Zikmund-Fisher BJ, Turkelson A, Franzblau A, Diebol JK, Allerton LA, Parker EA. The effect of misunderstanding the chemical properties of environmental contaminants on exposure beliefs: a case involving dioxins. Sci Total Environ 2013; 447:293-300. [PMID: 23391895 PMCID: PMC3652325 DOI: 10.1016/j.scitotenv.2013.01.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 01/09/2013] [Accepted: 01/09/2013] [Indexed: 06/01/2023]
Abstract
Chemical properties of contaminants lead them to behave in particular ways in the environment and hence have specific pathways to human exposure. If residents of affected communities lack awareness of these properties, however, they could make incorrect assumptions about where and how exposure occurs. We conducted a mailed survey of 904 residents of Midland and Saginaw counties in Michigan, USA to assess to what degree residents of a community with known dioxin contamination appear to understand the hydrophobic nature of dioxins and the implications of that fact on different potential exposure pathways. Participants assessed whether various statements about dioxins were true, including multiple statements assessing beliefs about dioxins in different types of water. Participants also stated whether they believed different exposure pathways were currently significant sources of dioxin exposure in this community. A majority of residents believed that dioxins can be found in river water that has been filtered to completely remove all particulates, well water, and even city tap water, beliefs which are incongruous with the hydrophobic nature of dioxins. Mistrust of government and personal concern about dioxins predicted greater beliefs about dioxins in water. In turn, holding more beliefs about dioxins in water predicted beliefs that drinking and touching water are currently significant exposure pathways for dioxins. Ensuring that community residents' mental models accurately reflect the chemical properties of different contaminants can be important to helping them to adjust their risk perceptions and potentially their risk mitigation behaviors accordingly.
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Affiliation(s)
- Brian J. Zikmund-Fisher
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Risk Science Center, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Angela Turkelson
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Alfred Franzblau
- Risk Science Center, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Julia K. Diebol
- Risk Science Center, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Lindsay A. Allerton
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Edith A. Parker
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA
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Sampson NR, Parker EA, Cheezum RR, Lewis TC, O'Toole A, Patton J, Zuniga A, Robins TG, Keirns CC. A life course perspective on stress and health among caregivers of children with asthma in Detroit. Fam Community Health 2013; 36:51-62. [PMID: 23168346 PMCID: PMC3984896 DOI: 10.1097/fch.0b013e31826d7620] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Low-income caregivers raising children with asthma experience many obstacles to their own health, including stress. To understand and describe their daily experiences, researchers conducted 40 qualitative interviews supplemented with descriptive quantitative surveys in Detroit, Michigan, as part of a community-based participatory research partnership of Community Action Against Asthma. Prevalence of chronic illness is noticeably higher among participants than the general US population. Caregivers identified stress processes that may influence disproportionate health outcomes and risk-related behaviors over their lifetime. Applying a life course perspective, findings suggest that public health interventions should address family-level comorbidities, increase instrumental social support, and acknowledge practical coping mechanisms.
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Affiliation(s)
- Natalie R Sampson
- Department of Health Behavior Health Education, University of Michigan, Ann Arbor, MI, USA.
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27
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White-Newsome JL, Sánchez BN, Jolliet O, Zhang Z, Parker EA, Dvonch JT, O'Neill MS. Climate change and health: indoor heat exposure in vulnerable populations. Environ Res 2012; 112:20-7. [PMID: 22071034 PMCID: PMC4352572 DOI: 10.1016/j.envres.2011.10.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 09/30/2011] [Accepted: 10/18/2011] [Indexed: 05/18/2023]
Abstract
INTRODUCTION Climate change is increasing the frequency of heat waves and hot weather in many urban environments. Older people are more vulnerable to heat exposure but spend most of their time indoors. Few published studies have addressed indoor heat exposure in residences occupied by an elderly population. The purpose of this study is to explore the relationship between outdoor and indoor temperatures in homes occupied by the elderly and determine other predictors of indoor temperature. MATERIALS AND METHODS We collected hourly indoor temperature measurements of 30 different homes; outdoor temperature, dewpoint temperature, and solar radiation data during summer 2009 in Detroit, MI. We used mixed linear regression to model indoor temperatures' responsiveness to weather, housing and environmental characteristics, and evaluated our ability to predict indoor heat exposures based on outdoor conditions. RESULTS Average maximum indoor temperature for all locations was 34.85°C, 13.8°C higher than average maximum outdoor temperature. Indoor temperatures of single family homes constructed of vinyl paneling or wood siding were more sensitive than brick homes to outdoor temperature changes and internal heat gains. Outdoor temperature, solar radiation, and dewpoint temperature predicted 38% of the variability of indoor temperatures. CONCLUSIONS Indoor exposures to heat in Detroit exceed the comfort range among elderly occupants, and can be predicted using outdoor temperatures, characteristics of the housing stock and surroundings to improve heat exposure assessment for epidemiological investigations. Weatherizing homes and modifying home surroundings could mitigate indoor heat exposure among the elderly.
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Affiliation(s)
- Jalonne L. White-Newsome
- University of Michigan School of Public Health, Environmental Health Sciences Department, 109 S. Observatory, SPH II, Rm. M6314, Ann Arbor, MI 48109, USA
- Corresponding author. Present address: Union of Concerned Scientists, 1825 K St., N.W. Suite 800, Washington, DC 20006, USA. Fax: + 202 223 6162. (J.L. White-Newsome)
| | - Brisa N. Sánchez
- University of Michigan School of Public Health, Biostatistics Department, M4164 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
- Fax: +734 763 2215. (B.N. Sánchez)
| | - Olivier Jolliet
- University of Michigan School of Public Health, Environmental Health Sciences Department, 6622 SPH tower, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
- Fax: +734 763 8095. (O. Jolliet)
| | - Zhenzhen Zhang
- University of Michigan School of Public Health, Biostatistics Department, M4164 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | - Edith A. Parker
- University of Michigan School of Public Health, Health Behavior and Health Education Department, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | - J. Timothy Dvonch
- University of Michigan School of Public Health, Environmental Health Sciences Department, 1415 Washington Heights, 6642 SPH Tower, Ann Arbor, MI 48109, USA
- Fax: +734 936 7283. (J. Timothy Dvonch), (M.S. O'Neill)
| | - Marie S. O'Neill
- University of Michigan School of Public Health, Environmental Health Sciences Department, 6631 SPH Tower, 1415 Washington Heights, Ann Arbor, MI 48109, USA
- Fax: +734 936 7283. (J. Timothy Dvonch), (M.S. O'Neill)
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White-Newsome JL, Sánchez BN, Parker EA, Dvonch JT, Zhang Z, O'Neill MS. Assessing heat-adaptive behaviors among older, urban-dwelling adults. Maturitas 2011; 70:85-91. [PMID: 21782363 DOI: 10.1016/j.maturitas.2011.06.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 06/24/2011] [Accepted: 06/25/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Health studies have shown that the elderly are at a greater risk to extreme heat. The frequency and intensity of summer heat waves will continue to increase as a result of climate change. It is important that we understand the environmental and structural factors that increase heat vulnerability, as well as examine the behaviors used by the elderly to adapt to hot indoor temperatures. STUDY DESIGN From June 1 to August 31, 2009, residents in 29 homes in Detroit, MI, kept an hourly log of eight heat-adaptive behaviors: opening windows/doors, turning fans or the air conditioner on, changing clothes, taking a shower, going to the basement, the porch/yard, or leaving the house. Percentages of hourly behavior were calculated, overall and stratified by housing type and percent surface imperviousness. The frequency of behavior use, as a result of indoor and outdoor predetermined temperature intervals was compared to a reference temperature range of 21.1-23.8°C. RESULTS The use of all adaptive behaviors, except going to the porch or yard, was significantly associated with indoor temperature. Non-mechanical adaptations such as changing clothes, taking showers, and going outside or to the basement were rarely used. Residents living in high-rises and highly impervious areas reported a higher use of adaptive behaviors. The odds of leaving the house significantly increased as outdoor temperature increased. CONCLUSIONS These findings suggest that the full range of heat adaptation measures may be underused by the elderly and public health interventions need to focus on outreach to these populations.
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Affiliation(s)
- Jalonne L White-Newsome
- University of Michigan School of Public Health, Environmental Health Sciences Department, Ann Arbor, MI 48109, USA.
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Haile R, Padilla MB, Parker EA. 'Stuck in the quagmire of an HIV ghetto': the meaning of stigma in the lives of older black gay and bisexual men living with HIV in New York City. Cult Health Sex 2011; 13:429-42. [PMID: 21229421 PMCID: PMC3053418 DOI: 10.1080/13691058.2010.537769] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In this paper, we analyse the life history narratives of 10 poor gay and bisexual Black men over the age of 50 living with HIV/AIDS in New York City, focusing on experiences of stigma. Three overarching themes are identified. First, participants described the ways in which stigma marks them as 'just one more body' within social and medical institutions, emphasising the dehumanisation they experience in these settings. Second, respondents described the process of 'knowing your place' within social hierarchies as a means through which they are rendered tolerable. Finally, interviewees described the dynamics of stigma as all-consuming, relegating them to the 'quagmire of an HIV ghetto'. These findings emphasise that despite advances in treatment and an aging population of persons living with HIV, entrenched social stigmas continue to endanger the well-being of Black men who have sex with men.
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Affiliation(s)
- Rahwa Haile
- HIV Center for Clinical and Behavioural Studies, Columbia University and NY State of Psychiatric Institute, New York, USA.
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Wong NT, Zimmerman MA, Parker EA. A typology of youth participation and empowerment for child and adolescent health promotion. Am J Community Psychol 2010; 46:100-14. [PMID: 20549334 DOI: 10.1007/s10464-010-9330-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Research suggests that increasing egalitarian relations between young people and adults is optimal for healthy development; however, the empirical assessment of shared control in youth-adult partnerships is emerging, and the field still requires careful observation, identification, categorization and labeling. Thus, our objective is to offer a conceptual typology that identifies degrees of youth-adult participation while considering the development potential within each type. We use an empowerment framework, rooted in evidence-based findings, to identify five types of youth participation: (1) Vessel, (2) Symbolic, (3) Pluralistic, (4) Independent and (5) Autonomous. The typology is constructed as a heuristic device to provide researchers, practitioners and policy-makers with a common language for articulating degrees of youth participation for optimal child and adolescent health promotion.
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Parker EA, Chung LK, Israel BA, Reyes A, Wilkins D. Community organizing network for environmental health: using a community health development approach to increase community capacity around reduction of environmental triggers. J Prim Prev 2010; 31:41-58. [PMID: 20306137 DOI: 10.1007/s10935-010-0207-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Community Organizing Network for Environmental Health (CONEH), a project of Community Action Against Asthma, used a community health development approach to improve children's asthma-related health through increasing the community's capacity to reduce physical and social environmental triggers for asthma. Three community organizers were hired to work with community groups and residents in neighborhoods in Detroit on the priority areas of air quality, housing, and citizen involvement in the environmental project and policy decision-making. As part of the evaluation of the CONEH project, 20 one-on-one semi-structured, in-depth interviews were conducted between August and November 2005 involving steering committee members, staff members, and key community organization staff and/or community members. Using data from the evaluation of the CONEH project, this article identifies the dimensions of community capacity that were enhanced as part of a CBPR community health development approach to reducing physical and social environmental triggers associated with childhood asthma and the factors that facilitated or inhibited the enhancement of community capacity.
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Affiliation(s)
- Edith A Parker
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
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Houle CR, Caldwell CH, Conrad FG, Joiner TA, Parker EA, Clark NM. Blowing the whistle: what do African American adolescents with asthma and their caregivers understand by "wheeze?". J Asthma 2010; 47:26-32. [PMID: 20100017 DOI: 10.3109/02770900903395218] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To investigate what African American adolescents with asthma and their caregivers understand by "wheeze". METHODS Caregivers (n = 35) and adolescents (n = 35) were each asked to describe what they understood by "wheeze". Respondents were also shown a video clip of an adolescent wheezing and asked: a) to describe the breathing of the adolescent in the video; and, b) whether the adolescent respondent's breathing had ever been similar to the video-presented symptoms. RESULTS Most caregivers described wheeze in terms of sound alone (61.8%) while the majority of adolescents described wheeze as something that is felt (55.8%). Few caregivers and adolescents (5.8% each) included "whistling" in their descriptions of "wheeze". Most caregivers and adolescents used the word "wheeze" when describing the video clip, but nearly one-quarter of the caregivers and one-third of the adolescents felt that the adolescent's breathing was never similar to the video. CONCLUSION Caregiver and adolescents descriptions of wheeze are different from each other and both may be different from clinical definitions of the term. Study findings have implications for the ways in which questions about "wheeze" are framed and interpreted.
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Affiliation(s)
- Christy R Houle
- Center for Managing Chronic Disease, The University of Michigan, Ann Arbor, Michigan, USA.
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Valerio MA, Stevens EA, Parker EA. DIARIES AND ASTHMA MANAGEMENT: A QUALITATIVE EXAMINATION OF THEIR USE, EXPECTATIONS, AND POTENTIAL. Chest 2008. [DOI: 10.1378/chest.134.4_meetingabstracts.p8002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Valerio MA, Parker EA, Couper MP, Connell CM, Janz NK. Demographic and clinical characteristics predictive of asthma diary use among women. J Asthma 2008; 45:357-61. [PMID: 18569227 DOI: 10.1080/02770900801956405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Current asthma guidelines encourage the use of an asthma diary for patients whose symptoms are not under control, who are being introduced to new treatments, or who need help in identifying environmental or occupational exposures. Despite the potential benefit of diaries in asthma management, gaps in the understanding of their use exist. Our objective was to identify demographic and clinical characteristics predictive of diary use by women with asthma as women patients predominate in asthma among adults and have higher rates of associated asthma management problems. METHODS Demographic and clinical characteristics associated with the use of a structured asthma diary were examined using data collected from 424 women with asthma over 18 years of age taking part in a randomized controlled study. Data were analyzed using chi-square statistics and logistic regression. Data reported are for women randomized to the intervention arm (N = 424) who were assigned the diary as part of the educational intervention. RESULTS Older age (OR = 1.614; p < 0.05) and higher education (OR = 1.835; p < 0.05) were associated with diary use. More severe asthma (OR = 0.479; p < 0.01) and a history of smoking (OR = 0.495; p < 0.05) were associated with nonuse of the diary. CONCLUSIONS Both demographic and clinical characteristics are associated with asthma diary use. Clinicians and researchers should anticipate potential differences in use of an asthma diary according to demographic and/or clinical characteristics of female patients.
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Affiliation(s)
- Melissa A Valerio
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Valerio MA, Janz NK, Parker EA, Connell CM, Couper MP. WOMEN WITH ASTHMA: WHO USES AN ASTHMA DIARY AND HOW HELPFUL IS IT? Chest 2007. [DOI: 10.1378/chest.132.4_meetingabstracts.450b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Parker EA, Israel BA, Robins TG, Mentz G, Brakefield-Caldwell W, Ramirez E, Edgren KK, Salinas M, Lewis TC. Evaluation of Community Action Against Asthma: a community health worker intervention to improve children's asthma-related health by reducing household environmental triggers for asthma. Health Educ Behav 2007; 35:376-95. [PMID: 17761540 PMCID: PMC4676080 DOI: 10.1177/1090198106290622] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the evaluation of a community-based participatory research (CBPR) community health worker (CHW) intervention to improve children's asthma-related health by reducing household environmental triggers for asthma. After randomization to an intervention or control group, 298 households in Detroit, Michigan, with a child, aged 7 to 11, with persistent asthma symptoms participated. The intervention was effective in increasing some of the measures of lung function (daily nadir Forced Expiratory Volume at one second [p = .03] and daily nadir Peak Flow [p = .02]), reducing the frequency of two symptoms ("cough that won't go away," "coughing with exercise"), reducing the proportion of children requiring unscheduled medical visits and reporting inadequate use of asthma controller medication, reducing caregiver report of depressive symptoms, reducing concentrations of dog allergen in the dust, and increasing some behaviors related to reducing indoor environmental triggers. The results suggest a CHW environmental intervention can improve children's asthma-related health, although the pathway for improvement is complex.
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Affiliation(s)
- Edith A Parker
- School of Public Health, Ann Arbor, Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
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Abstract
Previous studies of the GH-IGF system gene expression in growth plate using immunohistochemistry and in situ hybridization have yielded conflicting results. We therefore studied the spatial and temporal patterns of mRNA expression of the GH-IGF system in the rat proximal tibial growth plate quantitatively. Growth plates were microdissected into individual zones. RNA was extracted, reverse transcribed and analyzed by real-time PCR. In 1-week-old animals, IGF-I mRNA expression was minimal in growth plate compared with perichondrium, metaphyseal bone, muscle, and liver (70-, 130-, 215-, and 400-fold less). In contrast, IGF-II mRNA was expressed at higher levels than in bone and liver (65- and 2-fold). IGF-II expression was higher in the proliferative and resting zones compared with the hypertrophic zone (P < 0.001). GH receptor and type 1 and 2 IGF receptors were expressed throughout the growth plate. Expression of IGF-binding proteins (IGFBPs)-1 through -6 mRNA was low throughout the growth plate compared with perichondrium and bone. With increasing age (3-, 6-, 9-, and 12-week castrated rats), IGF-I mRNA levels increased in the proliferative zone (PZ) but remained at least tenfold lower than levels in perichondrium and bone. IGF-II mRNA decreased dramatically in PZ (780-fold; P < 0.001) whereas, type 2 IGF receptor and IGFBP-1, IGFBP-2, IGFBP-3, and IGFBP-4 increased significantly with age in growth plate and/or surrounding perichondrium and bone. These data suggest that IGF-I protein in the growth plate is not produced primarily by the chondrocytes themselves. Instead, it derives from surrounding perichondrium and bone. In addition, the decrease in growth velocity that occurs with age may be caused, in part, by decreasing expression of IGF-II and increasing expression of type 2 IGF receptor and multiple IGFBPs.
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Affiliation(s)
- E A Parker
- Developmental Endocrinology Branch, National Institutes of Health, National Institute of Child Health and Human Development, Building 10/CRC, Rm 1-3330, MSC 1103, 10 Center drive, Bethesda, Maryland 20892, USA
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Abstract
The use of qualitative methods can provide an in-depth understanding of the issues and barriers related to community health and can help to inform the planning of health promotion programs and interventions. Although there are many examples in the literature that describe the application of quantitative data to program planning, few articles explicitly describe the application of qualitative data, such as data gathered using focus groups, in-depth interviews, and windshield tours, in program planning. Using the East Side Village Health Worker Partnership in Detroit, Michigan, as a case study example, this article explains the methods of incorporating qualitative data into each stage of program planning and development, including community assessment, development of goals and objectives, implementation of activities, and program evaluation.
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Edgren KK, Parker EA, Israel BA, Lewis TC, Salinas MA, Robins TG, Hill YR. Community involvement in the conduct of a health education intervention and research project: Community Action Against Asthma. Health Promot Pract 2005; 6:263-9. [PMID: 16020621 DOI: 10.1177/1524839903260696] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is a need for more guidance on how to implement community-based participatory research, particularly on the roles of community members, throughout the process. This article focuses on how a Steering Committee, composed of representatives from community-based organizations, a local health department, an integrated health care system, and academia from the University of Michigan, participated in the design and implementation of a children's asthma study in Detroit, Michigan: Community Action Against Asthma. In addition, this article focuses on the role of community members as data collectors, examining a variety of sophisticated data collection roles. A description and analysis of how community members shaped and participated in the project, the lessons learned, and recommendations for practitioners are also presented.
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Israel BA, Parker EA, Rowe Z, Salvatore A, Minkler M, López J, Butz A, Mosley A, Coates L, Lambert G, Potito PA, Brenner B, Rivera M, Romero H, Thompson B, Coronado G, Halstead S. Community-based participatory research: lessons learned from the Centers for Children's Environmental Health and Disease Prevention Research. Environ Health Perspect 2005; 113:1463-71. [PMID: 16203263 PMCID: PMC1281296 DOI: 10.1289/ehp.7675] [Citation(s) in RCA: 322] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2004] [Accepted: 06/13/2005] [Indexed: 05/04/2023]
Abstract
Over the past several decades there has been growing evidence of the increase in incidence rates, morbidity, and mortality for a number of health problems experienced by children. The causation and aggravation of these problems are complex and multifactorial. The burden of these health problems and environmental exposures is borne disproportionately by children from low-income communities and communities of color. Researchers and funding institutions have called for increased attention to the complex issues that affect the health of children living in marginalized communities--and communities more broadly--and have suggested greater community involvement in processes that shape research and intervention approaches, for example, through community-based participatory research (CBPR) partnerships among academic, health services, public health, and community-based organizations. Centers for Children's Environmental Health and Disease Prevention Research (Children's Centers) funded by the National Institute of Environmental Health Sciences and U.S. Environmental Protection Agency were required to include a CBPR project. The purpose of this article is to provide a definition and set of CBPR principles, to describe the rationale for and major benefits of using this approach, to draw on the experiences of six of the Children's Centers in using CBPR, and to provide lessons learned and recommendations for how to successfully establish and maintain CBPR partnerships aimed at enhancing our understanding and addressing the multiple determinants of children's health.
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Affiliation(s)
- Barbara A Israel
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Schulz AJ, Israel BA, Zenk SN, Parker EA, Lichtenstein R, Shellman-Weir S, Klem ABL. Psychosocial stress and social support as mediators of relationships between income, length of residence and depressive symptoms among African American women on Detroit's eastside. Soc Sci Med 2005; 62:510-22. [PMID: 16081196 DOI: 10.1016/j.socscimed.2005.06.028] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2004] [Accepted: 06/03/2005] [Indexed: 01/22/2023]
Abstract
Patterns of mental health are clearly associated with life circumstances, including educational and economic opportunities, access to safe and supportive neighborhoods, socially structured exposures to stressors and to supportive relationships. In this article, we examine the social and economic correlates of depressive symptoms among African American women residing within a predominantly African American urban neighborhood in Detroit, USA, with relatively few economic resources. We identify distinct stressors associated with financial strain, neighborhood social disorder (concern about police responsiveness, safety stress), and experiences of discrimination. We test the extent to which each of these stressors mediates relationships between household income, length of residence in the neighborhood, social support and depressive symptoms. Our results suggest that for women in this racially segregated area with a high concentration of poverty, relationships between household income and symptoms of depression are partially mediated by financial stress and social support, but that stressors associated with neighborhood disorder and discrimination influence depressive symptoms independent of household income. Furthermore, we find that length of residence in the neighborhood is negatively associated with financial stress and positively associated with police stress and social support, with no significant net effect on symptoms of depression. We conclude that higher household income may help reduce symptoms of depression by reducing financial stress and strengthening social support even within neighborhoods with high concentrations of poverty. However, increased household income does not protect African American women residing in a high poverty community from distress associated with neighborhood disorder or experiences of discrimination.
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Affiliation(s)
- Amy J Schulz
- University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor, 48109-2029, USA.
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Lewis TC, Robins TG, Dvonch JT, Keeler GJ, Yip FY, Mentz GB, Lin X, Parker EA, Israel BA, Gonzalez L, Hill Y. Air pollution-associated changes in lung function among asthmatic children in Detroit. Environ Health Perspect 2005; 113:1068-75. [PMID: 16079081 PMCID: PMC1280351 DOI: 10.1289/ehp.7533] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2004] [Accepted: 05/05/2005] [Indexed: 05/03/2023]
Abstract
In a longitudinal cohort study of primary-school-age children with asthma in Detroit, Michigan, we examined relationships between lung function and ambient levels of particulate matter < or = 10 microm and < or = 2.5 microm in diameter (PM10 and PM2.5) and ozone at varying lag intervals using generalized estimating equations. Models considered effect modification by maintenance corticosteroid (CS) use and by the presence of an upper respiratory infection (URI) as recorded in a daily diary among 86 children who participated in six 2-week seasonal assessments from winter 2001 through spring 2002. Participants were predominantly African American from families with low income, and > 75% were categorized as having persistent asthma. In both single-pollutant and two-pollutant models, many regressions demonstrated associations between higher exposure to ambient pollutants and poorer lung function (increased diurnal variability and decreased lowest daily values for forced expiratory volume in 1 sec) among children using CSs but not among those not using CSs, and among children reporting URI symptoms but not among those who did not report URIs. Our findings suggest that levels of air pollutants in Detroit, which are above the current National Ambient Air Quality Standards, adversely affect lung function of susceptible asthmatic children.
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Affiliation(s)
- Toby C Lewis
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
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Becker AB, Israel BA, Schulz AJ, Parker EA, Klem L. Age differences in health effects of stressors and perceived control among urban African American women. J Urban Health 2005; 82:122-41. [PMID: 15738329 PMCID: PMC3456625 DOI: 10.1093/jurban/jti014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2005] [Indexed: 11/12/2022]
Abstract
A conceptual model of the stress process has been useful in examining relationships among a variety of stressors, health status, and protective factors that modify the health-stress relationship. The model can contribute to an understanding of variations in health among people living in urban environments experiencing high degrees of stress. This study examines social contextual stressors in the neighborhood, health outcomes, and perceived control at multiple levels beyond the individual as a protective factor, among a random sample (N = 679) of predominantly low-income African American women who reside on Detroit's east side. Findings suggest that although stress has a consistently negative impact on health, perceived control may buffer against the deleterious effects of stress. The buffering role of perceived control, however, depends on age, the type of stressor examined, and the context or level at which perceived control is assessed (e.g., organizational, neighborhood, beyond the neighborhood). For young women, perceived control was found to be health protective. Among older women, perceived control in the face of stressors was inversely related to health. These findings suggest the need for health and social service programs and policy change strategies to both increase the actual influence and control of women living in low-income urban communities and to reduce the specific social contextual stressors they experience.
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Affiliation(s)
- A B Becker
- Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA.
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Abstract
The field of environmental health promotion gained new prominence in recent years as awareness of physical environmental stressors and exposures increased in communities across the country and the world. Although many theories and conceptual models are used routinely to guide health promotion and health education interventions, they are rarely applied to environmental health issues. This article examine show health promotion theories and models can be applied in designing interventions to reduce exposure to environmental health hazards. Using the Community Action Against Asthma (CAAA) project as an example, this article describes the application of these theories and models to an intervention aimed at reducing environmental triggers for childhood asthma. Drawing on the multiple theories and models described, a composite ecological stress process model is presented, and its implications for environmental health promotion discussed.
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Affiliation(s)
- Edith A Parker
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
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Lewis TC, Robins TG, Joseph CLM, Parker EA, Israel BA, Rowe Z, Edgren KK, Salinas MA, Martinez ME, Brown RW. Identification of gaps in the diagnosis and treatment of childhood asthma using a community-based participatory research approach. J Urban Health 2004; 81:472-88. [PMID: 15273269 PMCID: PMC3455945 DOI: 10.1093/jurban/jth131] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The goal of this investigation was to use a community-based participatory research approach to develop, pilot test, and administer an asthma screening questionnaire to identify children with asthma and asthma symptoms in a community setting. This study was conducted as the recruitment effort for Community Action Against Asthma, a randomized trial of a household intervention to reduce exposure to environmental triggers of asthma and was not designed as a classic prevalence study. An asthma screening questionnaire was mailed and/or hand delivered to parents of 9,627 children, aged 5 to 11 years, in two geographic areas of Detroit, Michigan, with predominantly African American and Hispanic populations. Additional questionnaires were distributed via community networking. Measurements included parent report of their child's frequency of respiratory symptoms, presence of physician diagnosis of asthma, and frequency of doctor-prescribed asthma medication usage. Among the 3,067 completed questionnaires, 1,570 (51.2% of returned surveys, 16.3% of eligible population) were consistent with asthma of any severity and 398 (12.9% of returned surveys, 4.1% of eligible population) met criteria for moderate-to-severe asthma. Among those meeting criteria for moderate-to-severe asthma, over 30% had not been diagnosed by a physician, over one half were not taking daily asthma medication, and one quarter had not taken any physician-prescribed asthma medication in the past year. Screening surveys conducted within the context of a community-based participatory research partnership can identify large numbers of children with undiagnosed and/or undertreated moderate-to-severe asthma. These children are likely to benefit from interventions to reduce morbidity and improve quality of life.
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Affiliation(s)
- Toby C Lewis
- Department of Pediatrics and Communicable Diseases, University of Michigan School of Medicine, Ann Arbor, MI, USA.
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Niedzinski EJ, Chen YJ, Olson DC, Parker EA, Park H, Udove JA, Scollay R, McMahon BM, Bennett MJ. Enhanced systemic transgene expression after nonviral salivary gland transfection using a novel endonuclease inhibitor/DNA formulation. Gene Ther 2004; 10:2133-8. [PMID: 14625568 DOI: 10.1038/sj.gt.3302125] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Gene transfer to the major salivary glands is an attractive method for the systemic delivery of therapeutic proteins. To date, nonviral gene transfer to these glands has resulted in inadequate systemic protein concentrations. We believe that identification of the barriers responsible for this inefficient transfection will enable the development of enhanced nonviral gene transfer in salivary glands and other tissues. One potential barrier is the degradation of plasmid DNA by endonucleases. To test this hypothesis, we coadministered two endonuclease inhibitors ((zinc and aurintricarboxylic acid (ATA)) with plasmid DNA, containing the secreted alkaline phosphatase gene (SEAP), to the submandibular glands of rats. The effect of zinc and ATA on SEAP expression, tissue accumulation of plasmid DNA, and plasmid DNA stability was then characterized. We observed that mixtures containing zinc/DNA, ATA/DNA, and zinc/ATA/DNA significantly enhanced both systemic transgene expression and the amount of plasmid DNA associated with treated tissues. The relative endonuclease inhibitory activity of zinc, ATA, and zinc/ATA correlated with the observed effects on transfection efficacy. The use of zinc/ATA enhanced the efficacy of salivary gland transfection by at least 1000-fold versus DNA alone. Importantly, this improved performance resulted in robust systemic secretion of an exogenous protein (SEAP), thus demonstrating the potential this nonviral gene transfer technology has as a method to treat systemic protein deficiencies.
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Parker EA, Israel BA, Williams M, Brakefield-Caldwell W, Lewis TC, Robins T, Ramirez E, Rowe Z, Keeler G. Community action against asthma: examining the partnership process of a community-based participatory research project. J Gen Intern Med 2003; 18:558-67. [PMID: 12848839 PMCID: PMC1494884 DOI: 10.1046/j.1525-1497.2003.20322.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Community Action Against Asthma (CAAA) is a community-based participatory research (CBPR) project that assesses the effects of outdoor and indoor air quality on exacerbation of asthma in children, and tests household- and neighborhood-level interventions to reduce exposure to environmental asthma triggers. Representatives of community-based organizations, academia, an integrated health system, and the local health department work in partnership on CAAA's Steering Committee (SC) to design and implement the project. OBJECTIVE To conduct a process evaluation of the CAAA community-academic partnership. DESIGN In-depth interviews containing open-ended questions were conducted with SC members. Analysis included established methods for qualitative data, including focused coding and constant comparison methods. SETTING Community setting in Detroit, Michigan. PARTICIPANTS Twenty-three members of the CAAA SC. MEASUREMENTS Common themes identified by SC members relating to the partnership's ability to achieve project goals and the successes and challenges facing the partnership itself. MAIN RESULTS Identified partnership accomplishments included: successful implementation of a complex project, identification of children with previously undiagnosed asthma, and diverse participation and community influence in SC decisions. Challenges included ensuring all partners' influence in decision-making, the need to adjust to "a different way of doing things" in CBPR, constraints and costs of doing CBPR felt by all partners, ongoing need for communication and maintaining trust, and balancing the needs of science and the community through intervention. CONCLUSIONS CBPR can enhance and facilitate basic research, but care must be given to trust issues, governance issues, organizational culture, and costs of participation for all organizations involved.
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Affiliation(s)
- Edith A Parker
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI 48109-2029, USA.
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Becker AB, Israel BA, Schulz AJ, Parker EA, Klem L. Predictors of perceived control among African American women in Detroit: exploring empowerment as a multilevel construct. Health Educ Behav 2002; 29:699-715. [PMID: 12456130 DOI: 10.1177/109019802237939] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Efforts to enhance empowerment toward the aim of improved health require an understanding of factors that contribute to perceived control at multiple levels, as a dimension of empowerment. In this article, the authors examine hypothesized predictors of perceived control at multiple levels among urban, African American women. Variables that predict perceived control include greater participation in change-related action; level of activity within respondents' most important organizations; and attempts made by those organizations to influence public officials, businesses, and other groups. Results suggest that (1) perceived control is a context-specific, multilevel construct; (2) citizen participation is an important factor in control and influence at multiple levels; and (3) organizations that are involved within neighborhoods and in the broader community can help to increase control and influence at multiple levels in marginalized communities. Implications for health education practice and research are discussed.
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Affiliation(s)
- Adam B Becker
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
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Schulz AJ, Israel BA, Parker EA, Lockett M, Hill Y, Wills R. The East Side Village Health Worker Partnership: integrating research with action to reduce health disparities. Public Health Rep 2002. [PMID: 12196614 DOI: 10.1016/s0033-3549(04)50087-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
This article describes the work of the East Side Village Health Worker Partnership as a case study of an initiative that seeks to reduce the disproportionate health risks experienced by residents of Detroit's east side. The Partnership is a community-based participatory research and intervention collaboration among academia, public health practitioners, and the east side Detroit community. The Partnership is guided by a steering committee that is actively involved in all aspects of the research, intervention, and dissemination process, made up of representatives of five community-based organizations, residents of Detroit's east side, the local health department, a managed care provider, and an academic institution. The major goal of the East Side Village Health Worker Partnership is to address the social determinants of health on Detroit's east side, using a lay health advisor intervention approach. Data collected from 1996 to 2001 are used here to describe improvements in research methods, practice activities, and community relationships that emerged through this academic-practice-community linkage.
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Affiliation(s)
- A J Schulz
- School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI 48109, USA.
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Israel BA, Farquhar SA, Schulz AJ, James SA, Parker EA. The Relationship Between Social Support, Stress, and Health Among Women on Detroit’s East Side. Health Education & Behavior 2002. [DOI: 10.1177/1090198102029003006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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