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Kelly NR, Osa ML, Luther G, Guidinger C, Folger A, Williamson G, Esquivel J, Budd EL. Preliminary evaluation of a brief worksite intervention to reduce weight stigma and weight bias internalization. Eval Program Plann 2024; 104:102434. [PMID: 38615372 DOI: 10.1016/j.evalprogplan.2024.102434] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/20/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
Weight-based discrimination (WBD) is common and associated with reduced physical and emotional functioning. WBD is common in the workplace, yet no studies have evaluated a WBD intervention delivered in a worksite setting. This study evaluated the feasibility, acceptability, and preliminary effectiveness of a 3-hour, remote-delivered WBD intervention at a large public university. Six workshops including 94 participants (41.76 ± 9.37 y; 92.8% women) were delivered December 2020 through May 2021; 88.3% of participants enrolled in the study and 88.8% of enrolled participants completed pre- and post-intervention surveys. Participants strongly agreed the workshop contributed to a more inclusive work environment (M=4.98 ± 0.2; 1 =Strongly Disagree to 5 =Strongly Agree); and was highly needed (4.9 ± 0.3) and liked (4.8 ± 0.5). Qualitative feedback cited benefits of remote delivery in providing body size anonymity and wanting access to intervention materials and more time for discussion and action steps to reduce WBD. Participants experienced significant, medium reductions in explicit weight bias (ps < .001), significant, small reductions in weight bias internalization (p < .001), and statistically non-significant (p = .08), small-to-medium reductions in implicit bias. Targeting worksites as a delivery mechanism has the potential to reduce WBD, thereby improving the health and well-being of diverse employees and creating a more inclusive workspace.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA.
| | - Maggie L Osa
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Gabriella Luther
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Austin Folger
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Juliana Esquivel
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Elizabeth L Budd
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
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2
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Searcy JA, Cioffi CC, Tavalire HF, Budd EL, Cresko WA, DeGarmo DS, Leve LD. Reaching Latinx Communities with Algorithmic Optimization for SARS-CoV-2 Testing Locations. Prev Sci 2023; 24:1249-1260. [PMID: 36622480 PMCID: PMC9827438 DOI: 10.1007/s11121-022-01478-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 01/10/2023]
Abstract
The COVID-19 pandemic has disproportionately affected communities of color, including Latinx communities. Oregon Saludable: Juntos Podemos (OSJP) is a randomized clinical trial aimed at reducing this disparity by both increasing access to testing for SARS-CoV-2, the virus that causes COVID-19, for Oregon Latinx community members and studying the effectiveness of health and behavioral health interventions on turnout and health outcomes. OSJP established SARS-CoV-2 testing events at sites across Oregon. A critical early question was how to locate these sites to best serve Latinx community members. To propose sites in each participating county, we implemented an algorithmic approach solving a facilities location problem. This algorithm was based on minimizing driving time from Latinx population centers to SARS-CoV-2 testing locations. OSJP staff presented these proposed testing locations to community partners as a starting place for identifying final testing sites. Due to differences in geography, population distributions, and potential site accessibility, the study sites exhibited variation in how well the algorithmic optimization objectives could be satisfied. From this variation, we inferred the effects of the drive time optimization metric on the likelihood of Latinx community members utilizing SARS-CoV-2 testing services. After controlling for potential confounders, we found that minimizing the drive time optimization metric was strongly correlated with increased turnout among Latinx community members. This paper presents the algorithm and data sources used for site proposals and discusses challenges and opportunities for community-based health promotion research when translating algorithm proposals into action across a range of health outcomes.
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Affiliation(s)
- Jacob A Searcy
- Presidential Initiative in Data Science, University of Oregon, 203 Pacific Hall, Eugene, OR, 97403, USA.
| | - Camille C Cioffi
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | | | - Elizabeth L Budd
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - William A Cresko
- Presidential Initiative in Data Science, University of Oregon, 203 Pacific Hall, Eugene, OR, 97403, USA
- Institute of Ecology and Evolution, University of Oregon, Eugene, OR, USA
| | - David S DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Leslie D Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
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Castro E, Kelly NR, Budd EL. Healthcare provider-delivered healthy eating recommendations among U.S. Hispanic/Latino adults. Prev Med Rep 2023; 33:102216. [PMID: 37223558 PMCID: PMC10201819 DOI: 10.1016/j.pmedr.2023.102216] [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: 12/16/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/25/2023] Open
Abstract
U.S. Hispanic/Latino adults are at heightened risk for developing diet-related chronic diseases. Healthcare provider recommendations have shown to be effective for promoting health behavior change, but little is known about healthcare provider healthy eating recommendations among Hispanics/Latinos. To investigate the prevalence of and adherence to healthcare provider-delivered healthy eating recommendations among a U.S. sample of Hispanic/Latino adults, participants (N = 798; M = 39.6±15.1 years; 52% Mexican/Mexican American) were recruited via Qualtrics Panels to complete an online survey in January 2018. Most (61%) participants reported having ever received a healthcare provider-delivered dietary recommendation. Higher body mass index (AME = 0.015 [0.009, 0.021]) and having a chronic health condition (AME = 0.484 [0.398, 0.571]) were positively associated with receiving a dietary recommendation while age (AME = -0.004 [-0.007, -0.001]) and English proficiency (AME = -0.086 [-0.154, -0.018]) were negatively associated. Participants reported adhering regularly (49.7%) and sometimes (44.4%) to recommendations. There were no significant associations with patient characteristics and adherence to a healthcare provider-delivered dietary recommendation. Findings inform next steps toward increasing implementation of brief dietary counseling from healthcare providers to support prevention and management of chronic diseases among this under-studied population.
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Affiliation(s)
- Esmeralda Castro
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Elizabeth L. Budd
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
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Anda SD, Budd EL, Halvorson S, Mauricio AM, McWhirter EH, Cioffi CC, García JIR, Cresko WA, Leve LD, DeGarmo DS. Effects of a Health Education Intervention for COVID-19 Prevention in Latinx Communities: A Cluster-Randomized Controlled Trial. Am J Public Health 2022; 112:S923-S927. [PMID: 36446063 PMCID: PMC9707712 DOI: 10.2105/ajph.2022.307129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Accepted: 09/13/2022] [Indexed: 11/30/2022]
Abstract
To promote COVID-19 preventive attitudes and behaviors among Latinx individuals, researchers and community partners implemented a culturally tailored health education intervention across 12 Oregon counties from February 2021 through April 2022. We did not identify any significant intervention effects on preventive attitudes and behaviors but did observe significant decreases in psychological distress. Although Latinx individuals' preventive attitudes and behaviors were not associated with the health education intervention, findings suggest the intervention has value in promoting their well-being (ClinicalTrials.gov Identifier: NCT04793464). (Am J Public Health. 2022;112(S9):S923-S927. https://doi.org/10.2105/AJPH.2022.307129).
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Affiliation(s)
- Stephanie De Anda
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - Elizabeth L Budd
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - Sven Halvorson
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - Anne Marie Mauricio
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - Ellen Hawley McWhirter
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - Camille C Cioffi
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - Jorge I Ramírez García
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - William A Cresko
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - Leslie D Leve
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
| | - David S DeGarmo
- Stephanie De Anda is with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elizabeth L. Budd is with the Department of Counseling Psychology and Human Services, University of Oregon. Sven Halvorson, Anne Marie Mauricio, Camille C. Cioffi, Jorge I. Ramírez García, and David S. DeGarmo are with the Prevention Science Institute, University of Oregon. Ellen Hawley McWhirter and Leslie D. Leve are with the Department of Counseling Psychology and Human Services, University of Oregon. William A. Cresko is with the Institute of Ecology and Evolution, University of Oregon
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Budd EL, McWhirter EH, De Anda S, Mauricio AM, Mueller MV, Cioffi CC, Nash A, Van Brocklin K, Yarris K, Jackson A, Terral H, García JIR, Cresko WA, DeGarmo DS, Leve LD. Development and design of a culturally tailored intervention to address COVID-19 disparities among Oregon's Latinx communities: A community case study. Front Public Health 2022; 10:962862. [PMID: 36211681 PMCID: PMC9541743 DOI: 10.3389/fpubh.2022.962862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/06/2022] [Accepted: 09/05/2022] [Indexed: 02/05/2023] Open
Abstract
Background Latinx communities are disproportionately affected by COVID-19 compared with non-Latinx White communities in Oregon and much of the United States. The COVID-19 pandemic presents a critical and urgent need to reach Latinx communities with innovative, culturally tailored outreach and health promotion interventions to reduce viral transmission and address disparities. The aims of this case study are to (1) outline the collaborative development of a culturally and trauma-informed COVID-19 preventive intervention for Latinx communities; (2) describe essential intervention elements; and (3) summarize strengths and lessons learned for future applications. Methods Between June 2020 and January 2021, a multidisciplinary team of researchers and Latinx-serving partners engaged in the following intervention development activities: a scientific literature review, a survey of 67 Latinx residents attending public testing events, interviews with 13 leaders of community-based organizations serving Latinx residents, and bi-weekly consultations with the project's Public Health and Community Services Team and a regional Community and Scientific Advisory Board. After launching the intervention in the field in February 2021, bi-weekly meetings with interventionists continuously informed minor iterative refinements through present day. Results The resulting intervention, Promotores de Salud, includes outreach and brief health education. Bilingual, trauma-informed trainings and materials reflect the lived experiences, cultural values, needs, and concerns of Latinx communities. Interventionists (21 Promotores) were Latinx residents from nine Oregon counties where the intervention was delivered. Conclusions Sharing development and intervention details with public health researchers and practitioners facilitates intervention uptake and replication to optimize the public health effect in Oregon's Latinx communities and beyond.
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Affiliation(s)
- Elizabeth L. Budd
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States,Prevention Science Institute, University of Oregon, Eugene, OR, United States,*Correspondence: Elizabeth L. Budd
| | - Ellen Hawley McWhirter
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Stephanie De Anda
- Prevention Science Institute, University of Oregon, Eugene, OR, United States,Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, United States
| | - Anne Marie Mauricio
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Maryanne V. Mueller
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States,Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Camille C. Cioffi
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Ashley Nash
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Kelsey Van Brocklin
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Kristin Yarris
- Department of Global Studies, Center for Global Health, University of Oregon, Eugene, OR, United States
| | - Arriell Jackson
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Heather Terral
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States,Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | | | | | - William A. Cresko
- Institute of Ecology and Evolution, University of Oregon, Eugene, OR, United States,Presidential Initiative in Data Science, University of Oregon, Eugene, OR, United States
| | - David S. DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States,Prevention Science Institute, University of Oregon, Eugene, OR, United States
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DeGarmo DS, De Anda S, Cioffi CC, Tavalire HF, Searcy JA, Budd EL, Hawley McWhirter E, Mauricio AM, Halvorson S, Beck EA, Fernandes L, Currey MC, Ramírez García J, Cresko WA, Leve LD. Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities: A Cluster Randomized Trial. JAMA Netw Open 2022; 5:e2216796. [PMID: 35708690 PMCID: PMC9204550 DOI: 10.1001/jamanetworkopen.2022.16796] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/22/2022] [Indexed: 02/05/2023] Open
Abstract
Importance Latinx individuals have been disproportionately affected during the COVID-19 pandemic caused by the spread of SARS-CoV-2. It is imperative to evaluate newly developed preventive interventions to assess their effect on COVID-19 health disparities. Objective To examine the effectiveness of a culturally tailored outreach intervention designed to increase SARS-CoV-2 testing rates among Latinx populations. Design, Setting, and Participants In this cluster randomized trial performed from February 1 to August 31, 2021, in community settings in 9 Oregon counties, 38 sites were randomized a priori (19 to the community health promoters intervention and 19 to outreach as usual wait-listed controls). Thirty-three sites were activated. A total of 394 SARS-CoV-2 testing events were held and 1851 diagnostic samples collected, of which 919 were from Latinx persons. Interventions A culturally informed outreach program was developed that made use of promotores de salud (community health promoters) to increase Latinx SARS-CoV-2 testing. Strategies addressed barriers by disseminating information on testing events in English and Spanish, mitigating misinformation, and increasing trust. Main Outcomes and Measures The primary outcomes were the count of sample tests from Latinx persons and the sampled proportion of the Latinx populace. Site-level covariates included census tract Latinx populace, nativity (number of US-born individuals per 100 population), median age, and income inequality. Time-varying covariates included number of new weekly SARS-CoV-2-positive cases and percentage of vaccine coverage at the county level. Results A total of 15 clusters (sites) were randomized to the control group and 18 to the community health promoters group. A total of 1851 test samples were collected, of which 995 (53.8%) were from female participants and 919 (49.6%) were from Latinx individuals. The intervention tested 3.84 (95% CI, 2.47-5.97) times more Latinx individuals per event than controls (incident rate ratio, 0.79; 95% CI, 0.46-1.34; Cohen d = 0.74; P < .001). The intervention was associated with a 0.28 increase in the proportion of Latinx populace being tested compared with control sites for the dependent variable scaled as the proportion of the Latinx populace ×100, or a 0.003 proportion of the raw populace count. The use of a standardized scaling of the proportion of Latinx individuals showed that the relative percentage increase was 0.53 (95% CI, 0.21-0.86) in the intervention sites compared with controls, representing a medium effect size. Conclusions and Relevance To our knowledge, this was the first randomized evaluation of an outreach intervention designed to increase SARS-CoV-2 testing among Latinx populations. Findings could be used to implement strategies to reduce other health disparities experienced by these groups. Trial Registration ClinicalTrials.gov Identifier: NCT04793464.
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Affiliation(s)
- David S. DeGarmo
- Prevention Science Institute, University of Oregon, Eugene
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Stephanie De Anda
- Prevention Science Institute, University of Oregon, Eugene
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | | | | | - Jacob A. Searcy
- Presidential Initiative in Data Science, University of Oregon, Eugene
| | - Elizabeth L. Budd
- Prevention Science Institute, University of Oregon, Eugene
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | | | | | - Sven Halvorson
- Prevention Science Institute, University of Oregon, Eugene
| | - Emily A. Beck
- Presidential Initiative in Data Science, University of Oregon, Eugene
- Institute of Ecology and Evolution, University of Oregon, Eugene
| | | | - Mark C. Currey
- Institute of Ecology and Evolution, University of Oregon, Eugene
| | - Jorge Ramírez García
- Prevention Science Institute, University of Oregon, Eugene
- Oregon Research Institute, Eugene
| | - William A. Cresko
- Presidential Initiative in Data Science, University of Oregon, Eugene
- Institute of Ecology and Evolution, University of Oregon, Eugene
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene
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Trevino SD, Kelly NR, Budd EL, Giuliani NR. Parent Gender Affects the Influence of Parent Emotional Eating and Feeding Practices on Child Emotional Eating. Front Psychol 2021; 12:654237. [PMID: 34566746 PMCID: PMC8460857 DOI: 10.3389/fpsyg.2021.654237] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/13/2021] [Indexed: 01/15/2023] Open
Abstract
Extant research supports a direct association between parent's own emotional eating and their child's emotional eating, and demonstrates correlations among parent emotional eating, feeding practices, and child emotional eating. However, the majority of this work focuses on the separate influences of these factors. The current study aims to add to the literature by simultaneously examining the indirect effects of three major parental feeding practices (i.e., emotion regulation, instrumental, and restrictive feeding) in the association between parent emotional eating and child emotional eating, and exploring how these indirect effects vary based on parent gender. Parents (86 fathers, 324 mothers) of an elementary school-age child (M = 8.35, SD = 2.29, range = 5-13) completed an online survey through Qualtrics Panels. Results suggested that restrictive feeding partially accounted for the association between parent and child emotional eating in the combined sample of mothers and fathers. Exploratory analyses revealed that the indirect effects of parental feeding practices in the association between parent emotional eating and child emotional eating varied based on parent gender. Among mothers, restrictive feeding was the only feeding practice that partially accounted for the association between maternal and child emotional eating, whereas all three feeding practices fully accounted for the association between father and child emotional eating. As the bulk of the literature on parent emotional eating and feeding has solely focused on mothers, these findings offer insight into how feeding practices may differentially function in the relation between parent emotional eating and child emotional eating for mothers versus fathers.
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Affiliation(s)
- Shaina D. Trevino
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, United States,*Correspondence: Shaina D. Trevino,
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Elizabeth L. Budd
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Nicole R. Giuliani
- Department of Special Education and Clinical Sciences, Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Budd EL, Giuliani NR, Kelly NR. Perceived Neighborhood Crime Safety Moderates the Association Between Racial Discrimination Stress and Chronic Health Conditions Among Hispanic/Latino Adults. Front Public Health 2021; 9:585157. [PMID: 33659230 PMCID: PMC7917115 DOI: 10.3389/fpubh.2021.585157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition. Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability. Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = -0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = -0.004, 95% CI [-0.01, -0.00]). Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.
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Affiliation(s)
- Elizabeth L. Budd
- Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Nicole R. Giuliani
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
- Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, United States
| | - Nichole R. Kelly
- Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Budd EL, Nixon CT, Hymel AM, Tanner-Smith EE. The impact of afterschool program attendance on academic outcomes of middle school students. J Community Psychol 2020; 48:2439-2456. [PMID: 33032386 DOI: 10.1002/jcop.22416] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 06/11/2023]
Abstract
This evaluation examined the effects of afterschool programs-supported by an afterschool system intermediary organization (ASIO)-on middle school students' academic performance and examined how those effects varied by student characteristics and program engagement. In this longitudinal, quasi-experimental matched comparison group evaluation, propensity score matching was used to create demographically balanced samples of ASIO-supported afterschool program participants and nonparticipants. Students enrolled in the afterschool programs did not differ from non-participants in growth over time on most academic outcomes. Students attending the afterschool programs showed less growth on certain state test scores compared to nonparticipants. Student demographic characteristics did not consistently influence participant outcomes. Among program participants only, students who were enrolled more than 1 year demonstrated a 7-percentile-point increase in state test scores per year of program engagement. There was no consistent evidence that ASIO-supported afterschool program participation was associated with improved student academic outcomes. However, study results support increased emphasis on afterschool program retention, given that longer duration of participation in the afterschool programs was associated with more growth on multiple academic outcomes.
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Affiliation(s)
- Elizabeth L Budd
- Counseling Psychology and Human Services Department, College of Education, Prevention Science Institute, University of Oregon, Eugene, Oregon
| | - Carol T Nixon
- Spokane Mining Research Division, National Institute for Safety and Health, Centers for Disease Control and Prevention, Spokane, Washington
| | - Alicia M Hymel
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Emily E Tanner-Smith
- Counseling Psychology and Human Services Department, College of Education, Prevention Science Institute, University of Oregon, Eugene, Oregon
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10
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Ashiru-Oredope D, Budd EL, Doble A, Cramp E, Hendrick A, Hopkins S. Development and implementation of a national antimicrobial stewardship surveillance system, with open access data sharing. J Hosp Infect 2020; 107:16-22. [PMID: 33122043 DOI: 10.1016/j.jhin.2020.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Public Health England (PHE) developed an antimicrobial stewardship (AMS) surveillance system and conducted a national pilot to test the feasibility of centrally collecting data from AMS audits performed by NHS hospital trusts. The system was simplified, focusing on requirements of the NHS AMR CQUIN (Commissioning for Quality and Innovation; a financial incentive quality improvement scheme). AIM To present results and user feedback from the national pilot, and results from using the AMS surveillance system as part of the AMR CQUIN. METHODS An AMS surveillance system was developed and a national pilot conducted in which 33 NHS trusts submitted data and feedback on system utilization. The system was refined based on feedback and deployed nationally to collect AMS data for the 2016-17 AMR CQUIN. FINDINGS Most trusts participating in the pilot collected data on documentation of indication (90%). Fewer collected data on documenting review decisions at 48-72 h (36%). On average 83% of patients had an indication documented, whereas 71% had formal documentation of 48-72 h review. AMR CQUIN data were submitted by 88% of trusts for at least one quarter of 2016-17. Approximately 92% of prescriptions had an indication documented and 87.5% of prescriptions had evidence of review within 72 h; these increased by 7 and 10 percentage points respectively between the first and final quarters. CONCLUSION The AMS surveillance system allowed AMS audit data from NHS trusts in England to be collected centrally. PHE publishes these data openly online, on PHE Fingertips portal, a national public health data portal. The reported data highlight improvement in the percentage of antibiotic prescriptions with evidence of a documented review within 72 h.
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Affiliation(s)
- D Ashiru-Oredope
- HCAI & AMR Division, National Infection Service, Public Health England, London, UK.
| | - E L Budd
- HCAI & AMR Division, National Infection Service, Public Health England, London, UK
| | - A Doble
- HCAI & AMR Division, National Infection Service, Public Health England, London, UK
| | - E Cramp
- Patient Safety Team, NHS Improvement, London, UK(1)
| | - A Hendrick
- HCAI & AMR Division, National Infection Service, Public Health England, London, UK
| | - S Hopkins
- HCAI & AMR Division, National Infection Service, Public Health England, London, UK
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11
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Budd EL, Franz DJ, Kelly NR, Giuliani NR. Oregon Parents' Perceptions of the Supportiveness of the School Environment for Their Children's Health Behaviors. J Nutr Educ Behav 2020; 52:975-981. [PMID: 32171670 DOI: 10.1016/j.jneb.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To describe Oregon parents' perceptions of their children's school regarding health behaviors; examine how perceptions vary by parent, child, and community characteristics; and identify recommendations for improving school environments. METHODS Oregon parents with an elementary school-aged child completed an electronic survey. RESULTS Over 90% of parents (n = 814) described their child's school as supportive of healthy eating and physical activity. Parents who ate ≥5 fruits/vegetables per day more often perceived their children's school as unsupportive of healthy eating (P < 0.001) and physical activity (P < 0.05) relative to others. Parents of children eligible for free/reduced-price lunch more often perceived the school as unsupportive of physical activity (P < 0.05) relative to others. Parental recommendations included improving school meals and providing short physical activity breaks. CONCLUSIONS AND IMPLICATIONS Parents' suggested school improvements can inform school wellness committees' and administrators' quality-improvement efforts and, in turn, better support children's healthy behaviors.
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Affiliation(s)
- Elizabeth L Budd
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR; Prevention Science Institute, University of Oregon, Eugene, OR.
| | - Daschel J Franz
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR; Prevention Science Institute, University of Oregon, Eugene, OR
| | - Nicole R Giuliani
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR; Prevention Science Institute, University of Oregon, Eugene, OR; Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR
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12
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Tavalire HF, Budd EL, Natsuaki MN, Neiderhiser JM, Reiss D, Shaw DS, Ganiban JM, Leve LD. Using a sibling-adoption design to parse genetic and environmental influences on children's body mass index (BMI). PLoS One 2020; 15:e0236261. [PMID: 32687510 PMCID: PMC7371159 DOI: 10.1371/journal.pone.0236261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/21/2019] [Accepted: 07/01/2020] [Indexed: 12/13/2022] Open
Abstract
Dietary and physical activity behaviors formed early in life can increase risk for childhood obesity and have continued negative consequences for lifelong health. Previous research has highlighted the importance of both genetic and environmental (e.g., cultural environment or parental lifestyle) contributions to obesity risk, although these studies typically involve genetically-related individuals residing in the same household, where genetic similarity and rearing environment are inextricably linked. Here we utilize a sibling-adoption design to independently estimate genetic and environmental contributions to obesity risk in childhood and describe how these influences might vary as children age. As part of a prospective adoption study, the current investigation used data from biological siblings reared either apart or together, and nonbiological siblings reared together to estimate the contributions of genetics and environment to body mass indices (BMI) in a large cohort of children (N = 711). We used a variance partitioning model to allocate variation in BMI to that which is due to shared genetics, common environment, or unique environment in this cohort during middle childhood and adolescence. We found 63% of the total variance in BMI could be attributed to heritable factors in middle childhood sibling pairs (age 5-11.99; 95% CI [0.41,0.85]). Additionally, we observed that common environment explained 31% of variation in BMI in this group (95% CI [0.11,0.5]), with unique environment and error explaining the remaining variance. We failed to detect an influence of genetics or common environment in older sibling pairs (12-18) or pairs spanning childhood and adolescence (large sibling age difference), but home type (adoptive versus birth) was an important predictor of BMI in adolescence. The presence of strong common environment effects during childhood suggests that early interventions at the family level in middle childhood could be effective in mitigating obesity risk in later childhood and adolescence.
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Affiliation(s)
- Hannah F. Tavalire
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Instutite of Ecology and Evolution, University of Oregon, Eugene, Oregon, United States of America
| | - Elizabeth L. Budd
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Counseling Psychology and Human Services Department, College of Education, University of Oregon, Eugene, Oregon, United States of America
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, California, United States of America
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - David Reiss
- Child Study Center, Yale University, New Haven, Connecticut, United States of America
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jody M. Ganiban
- Department of Psychology, George Washington University, Washington, DC, United States of America
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Counseling Psychology and Human Services Department, College of Education, University of Oregon, Eugene, Oregon, United States of America
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13
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Budd EL, Ying X, Stamatakis KA, deRuyter AJ, Wang Z, Sung P, Pettman T, Armstrong R, Reis R, Brownson RC. Developing a Survey Tool to Assess Implementation of Evidence-Based Chronic Disease Prevention in Public Health Settings Across Four Countries. Front Public Health 2019; 7:152. [PMID: 31245349 PMCID: PMC6579827 DOI: 10.3389/fpubh.2019.00152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 05/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Understanding the contextual factors that influence the dissemination and implementation of evidence-based chronic disease prevention (EBCDP) interventions in public health settings across countries could inform strategies to support the dissemination and implementation of EBCDP interventions globally and more effectively prevent chronic diseases. A survey tool to use across diverse countries is lacking. This study describes the development and reliability testing of a survey tool to assess the stage of dissemination, multi-level contextual factors, and individual and agency characteristics that influence the dissemination and implementation of EBCDP interventions in Australia, Brazil, China, and the United States. Methods: Development of the 26-question survey included, a narrative literature review of extant measures in EBCDP; qualitative interviews with 50 chronic disease prevention practitioners in Australia, Brazil, China, and the United States; review by an expert panel of researchers in EBCDP; and test-retest reliability assessment. Results: A convenience sample of practitioners working in chronic disease prevention in each country completed the survey twice (N = 165). Overall, this tool produced good to moderately reliable responses. Generally, reliability of responses was higher among practitioners from Australia and the United States than China and Brazil. Conclusions: Reliability findings inform the adaptation and further development of this tool. Revisions to four questions are recommended before use in China and revisions to two questions before use in Brazil. This survey tool can contribute toward an improved understanding of the contextual factors that public health practitioners in Australia, Brazil, China, and the United States face in their daily chronic disease prevention work related to the dissemination and implementation of EBCDP interventions. This understanding is necessary for the creation of multi-level strategies and policies that promote evidence-based decision-making and effective prevention of chronic diseases on a more global scale.
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Affiliation(s)
- Elizabeth L. Budd
- Prevention Science Institute, College of Education, University of Oregon, Eugene, OR, United States
| | - Xiangji Ying
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Katherine A. Stamatakis
- College for Public Health and Social Justice, St. Louis University, St. Louis, MO, United States
| | - Anna J. deRuyter
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Zhaoxin Wang
- Tongji University School of Medicine, Shanghai, China
| | - Pauline Sung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, China
| | - Tahna Pettman
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca Armstrong
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rodrigo Reis
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
- School of Health and Biosciences, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Ross C. Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
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14
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Furtado KS, Budd EL, Armstrong R, Pettman T, Reis R, Sung-Chan P, Wang Z, Brownson RC. A cross-country study of mis-implementation in public health practice. BMC Public Health 2019; 19:270. [PMID: 30841888 PMCID: PMC6404329 DOI: 10.1186/s12889-019-6591-x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 02/25/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Mis-implementation (i.e., the premature termination or inappropriate continuation of public health programs) contributes to the misallocation of limited public health resources and the sub-optimal response to the growing global burden of chronic disease. This study seeks to describe the occurrence of mis-implementation in four countries of differing sizes, wealth, and experience with evidence-based chronic disease prevention (EBCDP). METHODS A cross-sectional study of 400 local public health practitioners in Australia, Brazil, China, and the United States was conducted from November 2015 to April 2016. Online survey questions focused on how often mis-termination and mis-continuation occur and the most common reasons programs end and continue. RESULTS We found significant differences in knowledge of EBCDP across countries with upwards of 75% of participants from Australia (n = 91/121) and the United States (n = 83/101) reporting being moderately to extremely knowledgeable compared with roughly 60% (n = 47/76) from Brazil and 20% (n = 21/102) from China (p < 0.05). Far greater proportions of participants from China thought effective programs were never mis-terminated (12.2% (n = 12/102) vs. 1% (n = 2/121) in Australia, 2.6% (n = 2/76) in Brazil, and 1.0% (n = 1/101) in the United States; p < 0.05) or were unable to estimate how frequently this happened (45.9% (n = 47/102) vs. 7.1% (n = 7/101) in the United States, 10.5% (n = 8/76) in Brazil, and 1.7% (n = 2/121) in Australia; p < 0.05). The plurality of participants from Australia (58.0%, n = 70/121) and the United States (36.8%, n = 37/101) reported that programs often mis-continued whereas most participants from Brazil (60.5%, n = 46/76) and one third (n = 37/102) of participants from China believed this happened only sometimes (p < 0.05). The availability of funding and support from political authorities, agency leadership, and the general public were common reasons programs continued and ended across all countries. A program's effectiveness or evidence-base-or lack thereof-were rarely reasons for program continuation and termination. CONCLUSIONS Decisions about continuing or ending a program were often seen as a function of program popularity and funding availability as opposed to effectiveness. Policies and practices pertaining to programmatic decision-making should be improved in light of these findings. Future studies are needed to understand and minimize the individual, organizational, and political-level drivers of mis-implementation.
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Affiliation(s)
- Karishma S. Furtado
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
| | | | - Rebecca Armstrong
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, 3010 Australia
| | - Tahna Pettman
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, 3010 Australia
| | - Rodrigo Reis
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
| | - Pauline Sung-Chan
- Hong Kong University of Science & Technology, Clear Water Bay, Kowloon, Hong Kong
| | | | - Ross C. Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine; Washington University in St. Louis, St. Louis, MO 63130 USA
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15
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DeRuyter AJ, Ying X, Budd EL, Furtado K, Reis R, Wang Z, Sung-Chan P, Armstrong R, Pettman T, Becker L, Mui T, Shi J, Saunders T, Brownson RC. Comparing Knowledge, Accessibility, and Use of Evidence-Based Chronic Disease Prevention Processes Across Four Countries. Front Public Health 2018; 6:214. [PMID: 30140668 PMCID: PMC6095058 DOI: 10.3389/fpubh.2018.00214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/10/2018] [Indexed: 12/23/2022] Open
Abstract
Background: Evidence-based chronic disease prevention (EBCDP) effectively reduces incidence rates of many chronic diseases, but contextual factors influence the implementation of EBCDP worldwide. This study aims to examine the following contextual factors across four countries: knowledge, access, and use of chronic disease prevention processes. Methods: In this cross-sectional study, public health practitioners (N = 400) from Australia (n = 121), Brazil (n = 76), China (n = 102), and the United States (n = 101) completed a 26-question survey on EBCDP. One-way ANOVA and Pearson's Chi-Square tests were used to assess differences in contextual factors of interest by country. Results: Practitioners in China reported less knowledge of EBCDP processes (p < 0.001) and less use of repositories of evidence-based interventions, than those from other countries (p < 0.001). Academic journals were the most frequently used method for accessing information about evidence-based interventions across countries. When selecting interventions, Brazilian and Chinese practitioners were more likely to consider implementation ease while the Australian and United States practitioners were more likely to consider effectiveness (p < 0.001). Conclusions: These findings can help inform and improve within and across country strategies for implementing EBCDP interventions.
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Affiliation(s)
- Anna J. DeRuyter
- Prevention Research Center in St. Louis, Brown School of Social Work and Public Health, Washington University in St. Louis, St. Louis, MO, United States
| | - Xiangji Ying
- Prevention Research Center in St. Louis, Brown School of Social Work and Public Health, Washington University in St. Louis, St. Louis, MO, United States
| | - Elizabeth L. Budd
- Counseling Psychology and Human Services, Prevention Science Institute, College of Education, University of Oregon, Eugene, OR, United States
| | - Karishma Furtado
- Prevention Research Center in St. Louis, Brown School of Social Work and Public Health, Washington University in St. Louis, St. Louis, MO, United States
| | - Rodrigo Reis
- Prevention Research Center in St. Louis, Brown School of Social Work and Public Health, Washington University in St. Louis, St. Louis, MO, United States
| | - Zhaoxin Wang
- School of Medicine, Tongji University, Shanghai, China
| | - Pauline Sung-Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom Kowloon, Hong Kong
| | - Rebecca Armstrong
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Tahna Pettman
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Leonardo Becker
- Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Tabitha Mui
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jianwei Shi
- School of Medicine, Tongji University, Shanghai, China
| | - Tahnee Saunders
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School of Social Work and Public Health, Washington University in St. Louis, St. Louis, MO, United States
- Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
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16
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Budd EL, McQueen A, Eyler AA, Haire-Joshu D, Auslander WF, Brownson RC. The role of physical activity enjoyment in the pathways from the social and physical environments to physical activity of early adolescent girls. Prev Med 2018; 111:6-13. [PMID: 29447926 PMCID: PMC5985153 DOI: 10.1016/j.ypmed.2018.02.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 11/25/2022]
Abstract
Most girls experience a notable decline in physical activity (PA) in early adolescence, increasing their risk for harmful health outcomes. Enjoyment for PA (i.e., positive feelings toward PA) is a determinant of PA among girls during adolescence and sustained PA throughout adulthood. Previous studies recommended increasing girls' PA enjoyment in order to increase their PA, but did not include environmental-level strategies for how families, schools, or communities do this. To gain insight on such strategies, this study examines the role of PA enjoyment as a mediator of social and physical environments to moderate-to-vigorous intensity PA of early adolescent girls. Cross-sectional, secondary analyses, using structural equation modeling, were conducted on a U.S. national dataset of 1721 sixth grade girls from the Trial of Activity for Adolescent Girls in 2003. Mediation model fit parameters included χ2 (292, N = 1721) = 947.73 p < 0.001, CFI = 0.95, RMSEA = 0.04 (90% CI = 0.03, 0.04), and SRMR = 0.037 suggesting overall good fit. There were no indirect effects on PA through PA enjoyment from the social or physical environmental factors. To PA, there were significant direct effects only from social support from friends (β = 0.15, CI = 0.09, 0.22). To PA enjoyment, there were significant direct effects from social support from family (β = 0.15, CI = 0.08, 0.23), school climate (teachers β = 0.15, CI = 0.10, 0.21 and boys β = 0.15, CI = 0.09, 0.20), and neighborhood environment (β = 0.10, CI = 0.04, 0.17). The findings of this study identified several direct effects of the social and physical environment on PA enjoyment that can begin to inform environmental-level strategies for increasing PA enjoyment among early adolescent girls.
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Affiliation(s)
- Elizabeth L Budd
- College of Education, University of Oregon, 5251 University of Oregon, HEDCO Building, Eugene, OR 97403, USA.
| | - Amy McQueen
- Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130, USA.
| | - Amy A Eyler
- Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130, USA.
| | - Debra Haire-Joshu
- Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130, USA.
| | - Wendy F Auslander
- Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130, USA.
| | - Ross C Brownson
- Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130, USA; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63130, USA.
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17
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Budd EL, deRuyter AJ, Wang Z, Sung-Chan P, Ying X, Furtado KS, Pettman T, Armstrong R, Reis RS, Shi J, Mui T, Saunders T, Becker L, Brownson RC. A qualitative exploration of contextual factors that influence dissemination and implementation of evidence-based chronic disease prevention across four countries. BMC Health Serv Res 2018; 18:233. [PMID: 29609621 PMCID: PMC5880066 DOI: 10.1186/s12913-018-3054-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 03/22/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Little is known about the contextual factors affecting the uptake of evidence-based chronic disease interventions in the United States and in other countries. This study sought to better understand the contextual similarities and differences influencing the dissemination and implementation of evidence-based chronic disease prevention (EBCDP) in Australia, Brazil, China, and the United States. METHODS Between February and July 2015, investigators in each country conducted qualitative, semi-structured interviews (total N = 50) with chronic disease prevention practitioners, using interview guides that covered multiple domains (e.g., use of and access to EBCDP interventions, barriers and facilitators to the implementation of EBCDP interventions). RESULTS Practitioners across the four countries reported only a few programmatic areas in which repositories of EBCDP interventions were used within their workplace. Across countries, academic journals were the most frequently cited channels for accessing EBCDP interventions, though peers were commonly cited as the most useful. Lack of time and heavy workload were salient personal barriers among practitioners in Australia and the United States, while lack of expertise in developing and implementing EBCDP interventions was more pertinent among practitioners from Brazil and China. Practitioners in all four countries described an organizational culture that was unsupportive of EBCDP. Practitioners in Brazil, China and the United States cited an inadequate number of staff support to implement EBCDP interventions. A few practitioners in Australia and China cited lack of access to evidence. Partnerships were emphasized as key facilitators to implementing EBCDP interventions across all countries. CONCLUSIONS This study is novel in its cross-country qualitative exploration of multilevel constructs of EBCDP dissemination and implementation. The interviews produced rich findings about many contextual similarities and differences with EBCDP that can inform both cross-country and country-specific research and practice to address barriers and improve EBCDP implementation among the four countries long-term.
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Affiliation(s)
- Elizabeth L. Budd
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
- Prevention Science Institute, College of Education, University of Oregon, 5261 University of Oregon, Eugene, OR 97403 USA
| | - Anna J. deRuyter
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
| | - Zhaoxin Wang
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, No .1239 Siping Road, Yangpu District, Shanghai, China
| | - Pauline Sung-Chan
- The Hong Kong Polytechnic University, GH 410 Department of Applied Social Sciences, Hung Hom Kowloon, China
| | - Xiangji Ying
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
| | - Karishma S. Furtado
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
| | - Tahna Pettman
- Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Victoria, 3010 Australia
| | - Rebecca Armstrong
- Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Victoria, 3010 Australia
| | - Rodrigo S. Reis
- Pontifical Catholic University of Parana, Curitiba, Rua Imaculada Conceicao, 1155, Prado Velho, 80215901 Brazil
| | - Jianwei Shi
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, No .1239 Siping Road, Yangpu District, Shanghai, China
| | - Tabitha Mui
- The Hong Kong Polytechnic University, GH 410 Department of Applied Social Sciences, Hung Hom Kowloon, China
| | - Tahnee Saunders
- Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Victoria, 3010 Australia
| | - Leonardo Becker
- Pontifical Catholic University of Parana, Curitiba, Rua Imaculada Conceicao, 1155, Prado Velho, 80215901 Brazil
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196, St. Louis, MO 63130 USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63130 USA
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Furtado KS, Budd EL, Ying X, deRuyter AJ, Armstrong RL, Pettman TL, Reis RS, Sung-Chan P, Wang Z, Saunders T, Becker LA, Shi J, Mui LST, Brownson RC. Exploring political influences on evidence-based non-communicable disease prevention across four countries. Health Educ Res 2018; 33:89-103. [PMID: 29547975 PMCID: PMC6279167 DOI: 10.1093/her/cyy005] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 02/05/2017] [Accepted: 02/06/2018] [Indexed: 06/08/2023]
Abstract
Implementation of evidence-based practices can improve efficiency and effectiveness of public health efforts. Few studies have explored the political contextual factors that impact implementation of evidence-based non-communicable disease prevention (EBNCDP). This study aimed to do so in Australia, Brazil, China and the United States. Investigators conducted 10-13 qualitative, semi-structured interviews of public health practitioners working in functionally similar public health organizations in each country (total N = 50). Study participants were identified through purposive sampling and interviews were structured around an interview guide covering six domains related to EBNCDP. Interviewees from all four countries identified funding as the primary politically-influenced barrier to implementing EBNCDP. Similarly widespread barriers included government funding priorities that shift based on who is in power and the difficulty of convincing policy-makers and funders that non-communicable disease prevention is a wise investment of political capital. Policymakers who are not evidence-driven was another common barrier even in the United States and Australia, where EBNCDP is more established. Findings suggest that political contextual factors influence EBNCDP and vary to an extent by country, though certain factors seem to be universal. This can aid public health practitioners, political leaders, and policymakers in advocating for conditions and policies that encourage evidence-based practice.
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Affiliation(s)
- Karishma S Furtado
- Prevention Research Center in St. Louis, Brown School, Washington University, One Brookings Drive, St. Louis, MO 63130, USA
| | - Elizabeth L Budd
- College of Education, University of Oregon, 5261 University of Oregon, Eugene, OR 97403, USA
| | - Xiangji Ying
- T. H. Chan School of Public Health, Harvard University, Massachusetts Hall, Cambridge, MA 02138, USA
| | - Anna J deRuyter
- Prevention Research Center in St. Louis, Brown School, Washington University, One Brookings Drive, St. Louis, MO 63130, USA
| | - Rebecca L Armstrong
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Tahna L Pettman
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Rodrigo S Reis
- Prevention Research Center in St. Louis, Brown School, Washington University, One Brookings Drive, St. Louis, MO 63130, USA
| | | | | | - Tahnee Saunders
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Leonardo A Becker
- Federal University of Parana, Street Coração de Maria, 92, Curitiba, Brazil
| | | | | | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University, One Brookings Drive, St. Louis, MO 63130, USA
- Department of Surgery, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, MO 63110, USA
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Kelly NR, Smith TM, Hall GCN, Guidinger C, Williamson G, Budd EL, Giuliani NR. Perceptions of general and postpresidential election discrimination are associated with loss of control eating among racially/ethnically diverse young men. Int J Eat Disord 2018; 51:28-38. [PMID: 29149497 DOI: 10.1002/eat.22803] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the association between young men's perceived experiences with discrimination, both general and following the 2016 presidential election, and their loss of control (LOC) eating. The degree to which men identified with their ethnic identity was evaluated as a moderator. METHOD The sample included 798 men (18-30 years; M = 24.0 ± 3.6) who identified as African American (n = 261), Asian/Asian American (n = 266), or Hispanic/Latino (n = 271). Participants completed an online survey of items assessing demographic characteristics; perceived discrimination; perceptions of race-related discrimination following the 2016 U.S. presidential election; ethnic identity; and LOC eating. RESULTS After adjusting for income, education, generational status and body mass index, perceived discrimination was positively associated with LOC eating frequency in African American and Hispanic/Latino men (ps < .01). Ethnic identity was inversely associated with LOC eating frequency in Hispanic/Latino men (p < .001). In Asian/Asian American men, perceived discrimination was only associated with more LOC eating among those with a low ethnic identity (p < .001). Higher levels of perceived discrimination following the presidential election were uniquely associated with more frequent LOC eating (p < .01) only among Asian/Asian American men who were not born in the United States or whose parents were not born in the United States. DISCUSSION LOC eating may partially explain known associations between discrimination and heightened risk for obesity and chronic diseases among African American and Hispanic/Latino men. Asian/Asian American men's LOC eating may be linked to postpresidential election and general experiences with racial discrimination, particularly if they report a low sense of belonging to their ethnic group.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregan
| | - Tasia M Smith
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregan
| | | | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregan
| | - Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregan
| | - Elizabeth L Budd
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregan
| | - Nicole R Giuliani
- The Prevention Science Institute, University of Oregon, Eugene, Oregan.,Special Education and Clinical Sciences, University of Oregon, Eugene, Oregan
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Gerke D, Budd EL, Plax K. Measurement Noninvariance of Safer Sex Self-Efficacy Between Heterosexual and Sexual Minority Black Youth. J Soc Social Work Res 2016; 7:569-584. [PMID: 27617061 PMCID: PMC5014365 DOI: 10.1086/688047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Black and lesbian, gay, bisexual, or questioning (LGBQ) youth in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs). Although self-efficacy is strongly, positively associated with safer sex behaviors, no studies have examined the validity of a safer sex self-efficacy scale used by many federally funded HIV/STD prevention programs. This study aims to test factor validity of the Sexual Self-Efficacy Scale by using confirmatory factor analysis (CFA) to determine if scale validity varies between heterosexual and LGBQ Black youth. METHOD The study uses cross-sectional data collected through baseline surveys with 226 Black youth (15 to 24 years) enrolled in community-based HIV-prevention programs. Participants use a 4-point Likert-type scale to report their confidence in performing 6 healthy sexual behaviors. CFAs are conducted on 2 factor structures of the scale. Using the best-fitting model, the scale is tested for measurement invariance between the 2 groups. RESULTS A single-factor model with correlated errors of condom-specific items fits the sample well and, when tested with the heterosexual group, the model demonstrates good fit. However, when tested with the LGBQ group, the same model yields poor fit, indicating factorial noninvariance between the groups. CONCLUSIONS The Sexual Self-Efficacy Scale does not perform equally well among Black heterosexual and LGBQ youth. Study findings suggest additional research is needed to inform development of measures for safer sex self-efficacy among Black LGBQ youth to ensure validity of conceptual understanding and to accurately assess effectiveness of HIV/STD prevention interventions among this population.
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Affiliation(s)
- Donald Gerke
- George Warren Brown School of Social Work, Washington University in St. Louis
| | | | - Kathryn Plax
- Washington University School of Medicine in St. Louis
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21
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Ashiru-Oredope D, Budd EL, Bhattacharya A, Din N, McNulty CAM, Micallef C, Ladenheim D, Beech E, Murdan S, Hopkins S. Implementation of antimicrobial stewardship interventions recommended by national toolkits in primary and secondary healthcare sectors in England: TARGET and Start Smart Then Focus. J Antimicrob Chemother 2016; 71:1408-14. [PMID: 26869693 DOI: 10.1093/jac/dkv492] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 12/22/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To assess and compare the implementation of antimicrobial stewardship (AMS) interventions recommended within the national AMS toolkits, TARGET and Start Smart Then Focus, in English primary and secondary healthcare settings in 2014, to determine the prevalence of cross-sector engagement to drive AMS interventions and to propose next steps to improve implementation of AMS. METHODS Electronic surveys were circulated to all 211 clinical commissioning groups (CCGs; primary sector) and to 146 (out of the 159) acute trusts (secondary sector) in England. Response rates were 39% and 63% for the primary and secondary sectors, respectively. RESULTS The majority of CCGs and acute trusts reported reviewing national AMS toolkits formally or informally (60% and 87%, respectively). However, only 13% of CCGs and 46% of acute trusts had developed an action plan for the implementation of these toolkits. Only 5% of CCGs had antimicrobial pharmacists in post; however, the role of specialist antimicrobial pharmacists continued to remain embedded within acute trusts, with 83% of responding trusts having an antimicrobial pharmacist at a senior grade. CONCLUSIONS The majority of healthcare organizations review national AMS toolkits; however, implementation of the toolkits, through the development of action plans to deliver AMS interventions, requires improvement. For the first time, we report the extent of cross-sector and multidisciplinary collaboration to deliver AMS interventions in both primary and secondary care sectors in England. Results highlight that further qualitative and quantitative work is required to explore mutual benefits and promote best practice. Antimicrobial pharmacists remain leaders for implementing AMS interventions across both primary and secondary healthcare sectors.
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Affiliation(s)
- D Ashiru-Oredope
- Antimicrobial Resistance Programme, Public Health England, London, UK
| | - E L Budd
- Antimicrobial Resistance Programme, Public Health England, London, UK
| | - A Bhattacharya
- Antimicrobial Resistance Programme, Public Health England, London, UK
| | - N Din
- Department of Pharmaceutics, UCL School of Pharmacy, UCL, London, UK
| | - C A M McNulty
- Primary Care Unit, Public Health England, Gloucester Royal Hospital, Gloucester, UK
| | - C Micallef
- Pharmacy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK National Institute for Health Research Health Protection Research Unit, Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London, UK
| | - D Ladenheim
- Pharmacy Department, East & North Herts NHS Trust, Hertford, UK
| | - E Beech
- NHS Bath and North East Somerset Clinical Commissioning Group, Bath, UK NHS England Patient Safety Domain 5, London, UK
| | - S Murdan
- Department of Pharmaceutics, UCL School of Pharmacy, UCL, London, UK
| | - S Hopkins
- Antimicrobial Resistance Programme, Public Health England, London, UK
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Budd EL, Aaron Hipp J, Geary N, Dodson EA. Racial differences in parental perceptions of the neighborhood as predictors of children's physical activity and sedentary behavior. Prev Med Rep 2016; 2:397-402. [PMID: 26844096 PMCID: PMC4721463 DOI: 10.1016/j.pmedr.2015.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 11/30/2022] Open
Abstract
Objective Most U.S. children engage in insufficient physical activity (PA) and spend too much time in sedentary behaviors (SBs), leading to increased risk of obesity and chronic disease. Evidence remains inconsistent on relationships between parental perceptions of the neighborhood and children's PA and SB. This study examines parental neighborhood perceptions, stratified by race, as predictors of children's PA and SB. Methods Relationships were tested with regressions stratified by parental race. The sample included 196 parents, residing in St. Louis, Missouri with a child at home. Participants responded to a mailed survey in 2012. Parental neighborhood perceptions were examined by mean composite scores and individual items. Results For parents of all races, perceived barriers negatively predicted the number of days in a week children engaged in ≥ 60 min of PA. Examining parental neighborhood perceptions by individual item, the perception that drivers exceed neighborhood speed limits was a positive predictor of their children's SB only among white parents. Only among minority-race parents was perceived neighborhood crime rate a positive predictor of their children's SB. Conclusions While predictors of children's PA did not differ widely, several distinct predictors of children's SB by parental race lend support toward further examination of this topic. We examine parental neighborhood perceptions by race and children's behaviors. For all parents, perceived barriers negatively predict children's activity. For white parents, speeding cars positively predict children's sedentary behavior. For minority-race parents, crime positively predicts children's sedentary behavior. Results could inform tailored strategies for reducing children's sedentary behavior.
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Affiliation(s)
- Elizabeth L Budd
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA
| | - J Aaron Hipp
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA
| | - Nora Geary
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA
| | - Elizabeth A Dodson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA
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Haire-Joshu DL, Schwarz CD, Peskoe SB, Budd EL, Brownson RC, Joshu CE. A group randomized controlled trial integrating obesity prevention and control for postpartum adolescents in a home visiting program. Int J Behav Nutr Phys Act 2015; 12:88. [PMID: 26112041 PMCID: PMC4499890 DOI: 10.1186/s12966-015-0247-8] [Citation(s) in RCA: 23] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 06/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence represents a critical period for the development of overweight that tracks into adulthood. This risk is significantly heightened for adolescents that become pregnant, many of whom experience postpartum weight retention. The aim of this study was to evaluate Balance Adolescent Lifestyle Activities and Nutrition Choices for Energy (BALANCE), a multicomponent obesity prevention intervention targeting postpartum adolescents participating in a national home visiting child development-parent education program. METHODS A group randomized, nested cohort design was used with 1325 adolescents, 694 intervention and 490 control, (mean age = 17.8 years, 52 % underrepresented minorities) located across 30 states. Participatory methods were used to integrate lifestyle behavior change strategies within standard parent education practice. Content targeted replacement of high-risk obesogenic patterns (e.g. sweetened drink and high fat snack consumption, sedentary activity) with positive behaviors (e.g. water intake, fruit and vegetables, increased walking). Parent educators delivered BALANCE through home visits, school based classroom-group meetings, and website activities. Control adolescents received standard child development information. Phase I included baseline to posttest (12 months); Phase II included baseline to follow-up (24 months). RESULTS When compared to the control group, BALANCE adolescents who were ≥12 weeks postpartum were 89 % more likely (p = 0.02) to maintain a normal BMI or improve an overweight/obese BMI by 12 months; this change was not sustained at 24 months. When compared to the control group, BALANCE adolescents significantly improved fruit and vegetable intake (p = .03). In stratified analyses, water intake improved among younger BALANCE teens (p = .001) and overweight/obese BALANCE teens (p = .05) when compared to control counterparts. There were no significant differences between groups in sweetened drink and snack consumption or walking. CONCLUSION Prevention of postpartum weight retention yields immediate health benefits for the adolescent mother and may prevent the early development or progression of maternal obesity, which contributes to the intergenerational transmission of obesity to her offspring. Implementing BALANCE through a national home visiting organization may hold promise for promoting positive lifestyle behaviors associated with interruption of the progression of maternal obesity. TRIAL REGISTRATION Clinical Trials Registry NCT01617486 .
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Affiliation(s)
- Debra L Haire-Joshu
- Washington University in St. Louis, The Brown School of Social Work and Public Health, and The School of Medicine, 1 Brookings Dr, St. Louis, MO, 63130, USA.
| | - Cynthia D Schwarz
- Washington University in St. Louis, The Brown School of Social Work and Public Health, and The School of Medicine, 1 Brookings Dr, St. Louis, MO, 63130, USA.
| | - Sarah B Peskoe
- Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Elizabeth L Budd
- Washington University in St. Louis, The Brown School of Social Work and Public Health, and The School of Medicine, 1 Brookings Dr, St. Louis, MO, 63130, USA.
| | - Ross C Brownson
- Washington University in St. Louis, The Brown School of Social Work and Public Health, and The School of Medicine, 1 Brookings Dr, St. Louis, MO, 63130, USA.
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21218, USA.
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Adlakha D, Budd EL, Gernes R, Sequeira S, Hipp JA. Corrigendum: Use of Emerging Technologies to Assess Differences in Outdoor Physical Activity in St. Louis, Missouri. Front Public Health 2015; 3:41. [PMID: 25853115 PMCID: PMC4360572 DOI: 10.3389/fpubh.2015.00041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/16/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Deepti Adlakha
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
- *Correspondence:
| | - Elizabeth L. Budd
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Rebecca Gernes
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Sonia Sequeira
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - James A. Hipp
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
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Adlakha D, Budd EL, Gernes R, Sequeira S, Hipp JA. Use of emerging technologies to assess differences in outdoor physical activity in st. Louis, missouri. Front Public Health 2014; 2:41. [PMID: 24904908 PMCID: PMC4033201 DOI: 10.3389/fpubh.2014.00041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 04/28/2014] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Abundant evidence shows that regular physical activity (PA) is an effective strategy for preventing obesity in people of diverse socioeconomic status (SES) and racial groups. The proportion of PA performed in parks and how this differs by proximate neighborhood SES has not been thoroughly investigated. The present project analyzes online public web data feeds to assess differences in outdoor PA by neighborhood SES in St. Louis, MO, USA. METHODS First, running and walking routes submitted by users of the website MapMyRun.com were downloaded. The website enables participants to plan, map, record, and share their exercise routes and outdoor activities like runs, walks, and hikes in an online database. Next, the routes were visually illustrated using geographic information systems. Thereafter, using park data and 2010 Missouri census poverty data, the odds of running and walking routes traversing a low-SES neighborhood, and traversing a park in a low-SES neighborhood were examined in comparison to the odds of routes traversing higher-SES neighborhoods and higher-SES parks. RESULTS RESULTS show that a majority of running and walking routes occur in or at least traverse through a park. However, this finding does not hold when comparing low-SES neighborhoods to higher-SES neighborhoods in St. Louis. The odds of running in a park in a low-SES neighborhood were 54% lower than running in a park in a higher-SES neighborhood (OR = 0.46, CI = 0.17-1.23). The odds of walking in a park in a low-SES neighborhood were 17% lower than walking in a park in a higher-SES neighborhood (OR = 0.83, CI = 0.26-2.61). CONCLUSION The novel methods of this study include the use of inexpensive, unobtrusive, and publicly available web data feeds to examine PA in parks and differences by neighborhood SES. Emerging technologies like MapMyRun.com present significant advantages to enhance tracking of user-defined PA across large geographic and temporal settings.
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Affiliation(s)
- Deepti Adlakha
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Elizabeth L. Budd
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Rebecca Gernes
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Sonia Sequeira
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - James A. Hipp
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
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Budd EL, Schwarz C, Yount BW, Haire-Joshu D. Factors influencing the implementation of school wellness policies in the United States, 2009. Prev Chronic Dis 2012; 9:E118. [PMID: 22742592 PMCID: PMC3457767 DOI: 10.5888/pcd9.110296] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction The quality of school wellness policy implementation varies among schools in the United States. The objective of this study was to characterize the school wellness policy environment nationally and identify factors influencing the quality and effectiveness of policy implementation. Methods We invited school administrators from 300 high schools to complete a questionnaire; 112 administrators responded. We performed a 2-step cluster analysis to help identify factors influencing the implementation of school wellness policies. Results Eighty-two percent of schools reported making staff aware of policy requirements; 77% established a wellness committee or task force, 73% developed administrative procedures, and 56% trained staff for policy implementation. Most commonly reported challenges to implementation were lack of time or coordination of policy team (37% of respondents) and lack of monetary resources (33%). The core domains least likely to be implemented were communication and promotion (63% of respondents) and evaluation (54%). Cluster 1, represented mostly by schools that have taken action toward implementing policies, had higher implementation and effectiveness ratings than Cluster 2, which was defined by taking fewer actions toward policy implementation. In Cluster 1, accountability was also associated with high ratings of implementation quality and effectiveness. Conclusion The development of organizational capacity may be critical to ensuring an environment that promotes high-quality policy implementation. Assessing, preventing, and addressing challenges; establishing clear definitions and goals; and requiring accountability for enacting policy across all core domains are critical to ensuring high-quality implementation.
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Affiliation(s)
- Elizabeth L Budd
- George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Dr, St. Louis, MO 63130, USA.
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Haire-Joshu D, Yount BW, Budd EL, Schwarz C, Schermbeck R, Green S, Elliott M. The quality of school wellness policies and energy-balance behaviors of adolescent mothers. Prev Chronic Dis 2011; 8:A34. [PMID: 21324248 PMCID: PMC3073427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION In this study, we 1) compared the quality of school wellness policies among schools participating in Moms for a Healthy Balance (BALANCE), a school- and home-based weight loss study conducted with postpartum adolescents in 27 states; and 2) assessed the relationship between policy quality with energy-balance behaviors and body mass index z scores of postpartum adolescents. METHODS As a part of BALANCE, we collected data on high-calorie food and beverage consumption, minutes spent walking, and height and weight for 647 participants. The School Wellness Policy Coding Tool was used to assess the strength and comprehensiveness of school district wellness policies from 251 schools attended by participating adolescent mothers. RESULTS Schools averaged low scores for wellness policy comprehensiveness and strength. When compared with participants in schools with the lowest policy comprehensiveness scores, adolescent mothers in schools with the highest scores reported consuming significantly fewer daily calories from sweetened beverages while reporting higher consumption of water (P = .04 and P = .01, respectively). School wellness policy strength was associated with lower BMI z scores among adolescent mothers (P = .01). CONCLUSION School wellness policies associated with BALANCE may be limited in their ability to promote a healthy school environment. Future studies are needed to evaluate the effect of the strength and comprehensiveness of policy language on energy balance in high-risk postpartum adolescents. Evidence from this work can provide additional guidance to federal or state government in mandating not only policy content, but also systematic evaluation.
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Affiliation(s)
- Debra Haire-Joshu
- Center for Obesity Prevention and Policy Research, George Warren Brown School of Social Work and School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA.
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Haire-Joshu D, Schwarz C, Budd EL, Yount BW, Lapka C. Postpartum teens' breakfast consumption is associated with snack and beverage intake and body mass index. J Am Diet Assoc 2011; 111:124-30. [PMID: 21185974 PMCID: PMC3033661 DOI: 10.1016/j.jada.2010.10.009] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 07/27/2010] [Indexed: 11/16/2022]
Abstract
Addressing high-risk dietary patterns among postpartum teens may help reduce weight retention and prevent intergenerational obesity. The objective of this study was to describe the relationship between breakfast consumption and outcomes of snack and beverage intake and body mass index (BMI) among postpartum teens. During 2007-2009, 1,330 postpartum teens across 27 states participated in a cross-sectional, baseline assessment of a group-randomized, nested cohort study. Participants were enrolled in the Parents as Teachers Teen Program and completed a 7-day recall of breakfast, snack, and beverage consumption. BMI was calculated from heights and weights obtained by on-site staff. Sample descriptives were compared across breakfast consumption frequency groupings by one-way analysis of variance tests or χ² tests. General linear models assessed relationships between breakfast consumption and measures of snack and sweetened beverage intake, water consumption, and BMI-for-age percentile. Almost half (42%) of the sample consumed breakfast fewer than 2 days per week. Those who ate breakfast 6 to 7 days/week consumed 1,197 fewer kilocalories per week from sweet and salty snacks, 1,337 fewer kilocalories per week from sweetened drinks, and had a lower BMI compared to those who ate breakfast fewer than 2 days per week (P < 0.05). Consumption of fruit, vegetables, milk, water, and cereal as a snack were higher among regular breakfast consumers (P < 0.05). Although breakfast consumption among postpartum teens is low, those who regularly consume breakfast had healthier snacking behaviors and weight. Interventions are needed to encourage breakfast consumption among teen mothers.
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