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Sachs AL, Coringrato E, Sprague N, Turbyfill A, Tillema S, Litt J. Rationale, Feasibility, and Acceptability of the Meeting in Nature Together (MINT) Program: A Novel Nature-Based Social Intervention for Loneliness Reduction with Teen Parents and Their Peers. Int J Environ Res Public Health 2022; 19:11059. [PMID: 36078775 PMCID: PMC9518349 DOI: 10.3390/ijerph191711059] [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] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Recently, there has been an increase in feelings of loneliness and mental health conditions among adolescents. Within this population, parenting teens are at an increased risk for these conditions. Outdoor experiences are shown to be an antidote to loneliness and a way to promote social connectedness by amplifying the processes for supporting social relationships. In 2020-2021, we piloted the 8-week Meeting in Nature Together program (MINT) at a charter school for pregnant and parenting teenagers in Colorado, USA. MINT aimed to promote relatedness and nature connection for students ages 14 to 19. MINT included online and in-person group meetings with educational content, creative activities, discussion, park excursions, mindfulness activities, journaling, and nature photography. Here, we ask, can a school-level nature-based social intervention reduce loneliness among pregnant and parenting teens by promoting and sustaining social connections? How acceptable is MINT to participants? Methods included audiovisual recording transcriptions, surveys, and observation field notes. Results suggest that MINT fostered social connections through a tailored nature-based intervention delivered to a typically isolated community in culturally sensitive, developmentally appropriate ways. MINT proved feasible and effective as participants reported high levels of satisfaction and interest in continuing to engage in activities promoted in MINT.
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Affiliation(s)
- Ashby Lavelle Sachs
- Environmental Studies Program, University of Colorado Boulder, Boulder, CO 80309, USA
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain
| | - Eva Coringrato
- Environmental Studies Program, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Nadav Sprague
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Angela Turbyfill
- Young Mother’s Clinic at the Children’s Hospital of Colorado, Aurora, CO 80045, USA
| | - Sarah Tillema
- Young Mother’s Clinic at the Children’s Hospital of Colorado, Aurora, CO 80045, USA
| | - Jill Litt
- Environmental Studies Program, University of Colorado Boulder, Boulder, CO 80309, USA
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain
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Chevance G, Fresán U, Hekler E, Edmondson D, Lloyd SJ, Ballester J, Litt J, Cvijanovic I, Araújo-Soares V, Bernard P. Thinking Health-related Behaviors in a Climate Change Context: A Narrative Review. Ann Behav Med 2022; 57:193-204. [PMID: 35861123 PMCID: PMC10074036 DOI: 10.1093/abm/kaac039] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Human activities have changed the environment so profoundly over the past two centuries that human-induced climate change is now posing serious health-related threats to current and future generations. Rapid action from all scientific fields, including behavioral medicine, is needed to contribute to both mitigation of, and adaption to, climate change. PURPOSE This article aims to identify potential bi-directional associations between climate change impacts and health-related behaviors, as well as a set of key actions for the behavioral medicine community. METHODS We synthesized the existing literature about (i) the impacts of rising temperatures, extreme weather events, air pollution, and rising sea level on individual behaviors (e.g., eating behaviors, physical activity, sleep, substance use, and preventive care) as well as the structural factors related to these behaviors (e.g., the food system); and (ii) the concurrent positive and negative roles that health-related behaviors can play in mitigation and adaptation to climate change. RESULTS Based on this literature review, we propose a first conceptual model of climate change and health-related behavior feedback loops. Key actions are proposed, with particular consideration for health equity implications of future behavioral interventions. Actions to bridge the fields of behavioral medicine and climate sciences are also discussed. CONCLUSIONS We contend that climate change is among the most urgent issues facing all scientists and should become a central priority for the behavioral medicine community.
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Affiliation(s)
| | | | - Eric Hekler
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, CA, USA.,Center for Wireless and Population Health Systems, Qualcomm Institute, UC San Diego, San Diego, CA, USA
| | - Donald Edmondson
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Jill Litt
- ISGlobal, Barcelona, Spain.,Environmental Studies, University of Colorado Boulder, CO, USA
| | | | - Vera Araújo-Soares
- Health Technology & Services Research, University of Twente, The Netherlands
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada.,Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
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Tharrey M, Sachs A, Perignon M, Simon C, Mejean C, Litt J, Darmon N. Correction to: Improving lifestyles sustainability through community gardening: results and lessons learnt from the JArDinS quasi-experimental study. BMC Public Health 2021; 21:15. [PMID: 33397306 PMCID: PMC7783970 DOI: 10.1186/s12889-020-10010-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Marion Tharrey
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France.
| | - Ashby Sachs
- University of Colorado Boulder, Boulder, CO, USA
| | - Marlène Perignon
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
| | - Chantal Simon
- CarMen Laboratory, INSERM 1060, INRA 1397, University of Lyon, F-69600, Oullins, France
| | - Caroline Mejean
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
| | - Jill Litt
- University of Colorado Boulder, Boulder, CO, USA.,ISGlobal, Barcelona, Spain
| | - Nicole Darmon
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
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Tharrey M, Sachs A, Perignon M, Simon C, Mejean C, Litt J, Darmon N. Improving lifestyles sustainability through community gardening: results and lessons learnt from the JArDinS quasi-experimental study. BMC Public Health 2020; 20:1798. [PMID: 33243204 PMCID: PMC7690132 DOI: 10.1186/s12889-020-09836-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 08/05/2020] [Accepted: 11/04/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Despite an increasing number of studies highlighting the health benefits of community gardening, the literature is limited by cross-sectional designs. The "JArDinS" quasi-experimental study aimed to assess the impact of community garden participation on the adoption of more sustainable lifestyles among French adults. METHODS Individuals entering a community garden in Montpellier (France) in 2018 (n = 66) were compared with pairwise matched individuals with no experience in community gardening (n = 66). Nutritional quality, environmental impact and cost of monthly household food supplies, level of physical activity measured by accelerometers, as well as mental and social well-being, sensitivity to food waste, and connection with nature were evaluated at baseline (t0) and 12 months later (t1) to explore sustainability of lifestyles in social/health, environmental and economic dimensions. Linear mixed models were used to determine the independent effect of community gardening on investigated lifestyles components. In-depth interviews were conducted at t1 with 15 gardeners to better understand changes that may have occurred in gardeners' lives during the first year of gardening. RESULTS At t0, gardeners had lower education level, lower BMI and their household reported lower percentage of meals consumed outside of the home compared to non-gardeners (p < 0.05). Participating in the community garden had no significant impact, in spite of sufficient statistical power, on fruit and vegetables supplies (main outcome), nor on physical activity parameters, nor on others of the social/health, environmental and economic lifestyles components investigated. Qualitative interviews suggested the existence of pre-established health and environmental consciousness in some gardeners and revealed several barriers to the participation such as lack of time, lack of gardening knowledge, physical difficulty of gardening, health problems and conflicts with other gardeners. CONCLUSIONS The health benefits of community gardening previously reported by cross-sectional studies might be confounded by selection bias. The JArDinS study highlights the need to identify solutions to overcome barriers related to community garden participation when designing relevant public health interventions for the promotion of sustainable lifestyles. TRIAL REGISTRATION The study was registered at clinicaltrials.gov as NCT03694782 . Date of registration: 3rd October 2018, retrospectively registered.
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Affiliation(s)
- Marion Tharrey
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France.
| | - Ashby Sachs
- University of Colorado Boulder, Boulder, CO, USA
| | - Marlène Perignon
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
| | - Chantal Simon
- CarMen Laboratory, INSERM 1060, INRA 1397, University of Lyon, F-69600, Oullins, France
| | - Caroline Mejean
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
| | - Jill Litt
- University of Colorado Boulder, Boulder, CO, USA.,ISGlobal, Barcelona, Spain
| | - Nicole Darmon
- MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
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Gascon M, Harrall KK, Beavers AW, Glueck DH, Stanislawski MA, Alaimo K, Villalobos A, Hebert JR, Dexter K, Li K, Litt J. Feasibility of collection and analysis of microbiome data in a longitudinal randomized trial of community gardening. Future Microbiol 2020; 15:633-648. [PMID: 32495698 DOI: 10.2217/fmb-2019-0195] [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] [Indexed: 12/21/2022] Open
Abstract
Aim: We explored the feasibility of collecting and analyzing human microbiome data in a longitudinal randomized controlled trial of community gardening. Methods & materials: Participants were randomly assigned to gardening (N = 8) or control (N = 8). Participants provided stool, mouth, hand and forehead microbiome samples at six timepoints. Analyses combined mixed models with Qiita output. Results: Participant satisfaction was high, with 75% of participants completing evaluations. While no microbial effects were statistically significant due to small sample size, the analysis pipeline utility was tested. Conclusion: Longitudinal collection and analysis of microbiome data in a community gardening randomized controlled trial is feasible. The analysis pipeline will be useful in larger studies for assessment of the pathway between microbiota, gardening and health outcomes.
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Affiliation(s)
- Mireia Gascon
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Kylie K Harrall
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 800455, USA
| | - Alyssa W Beavers
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 488246, USA
| | - Deborah H Glueck
- Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO 800457, USA
| | - Maggie A Stanislawski
- Department of Epidemiology, University of Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO 800458, USA
| | - Katherine Alaimo
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 488246, USA
| | - Angel Villalobos
- Environmental Studies, University of Colorado Boulder, Boulder, CO 488246, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Colombia, SC 8030310, USA
| | - Kelsey Dexter
- Department of Endocrinology, University of Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO 2920811, USA
| | - Kaigang Li
- Department of Health & Exercise Science, Colorado State University, CO 8004512, USA
| | - Jill Litt
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Environmental Studies, University of Colorado Boulder, Boulder, CO 488246, USA
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Zijlema WL, Christian H, Triguero-Mas M, Cirach M, van den Berg M, Maas J, Gidlow CJ, Kruize H, Wendel-Vos W, Andrušaitytė S, Grazuleviciene R, Litt J, Nieuwenhuijsen MJ. Dog ownership, the natural outdoor environment and health: a cross-sectional study. BMJ Open 2019; 9:e023000. [PMID: 31138578 PMCID: PMC6549751 DOI: 10.1136/bmjopen-2018-023000] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Dog owners walking their dog in natural outdoor environments (NOE) may benefit from the physical activity facilitated by dog walking and from time spent in nature. However, it is unclear whether dog owners receive additional health benefits associated with having access to NOE above the physical activity benefit of walking with their dog. We investigated associations between dog ownership, walking, time spent in NOE and health and whether these associations differed among those with good and poor access to NOE and those living in green and less green areas. DESIGN Cross-sectional study. SETTING The Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe project. PARTICIPANTS n=3586 adults from Barcelona (Spain), Doetinchem (the Netherlands), Kaunas (Lithuania) and Stoke-on-Trent (UK). DATA COLLECTION AND ANALYSIS We calculated access to NOE with land maps and residential surrounding greenness with satellite data. Leisure time walking, time spent in NOE and general and mental health status were measured using validated questionnaires. Associations were estimated using multilevel analysis with a random intercept defined at the neighbourhood level. RESULTS Dog ownership was associated with higher rates of leisure time walking and time spending in NOE (OR 2.17, 95% CI 1.86 to 2.54 and 2.37, 95% CI 2.02 to 2.79, respectively). These associations were stronger in those living within 300 m of a NOE and in greener areas. No consistent associations were found between dog ownership and perceived general or mental health status. CONCLUSIONS Compared with non-dog owners, dog owners walked more and spent more time in NOE, especially those living within 300 m of a NOE and in greener areas. The health implications of these relationships should be further investigated. In a largely physically inactive society, dog walking in NOE may be a simple way of promoting physical activity and health.
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Affiliation(s)
- Wilma L Zijlema
- Instituto de Salud Global Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Hayley Christian
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Margarita Triguero-Mas
- Instituto de Salud Global Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Cirach
- Instituto de Salud Global Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Magdalena van den Berg
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Jolanda Maas
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Christopher J Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent, UK
| | - Hanneke Kruize
- Centre of Environmental Health Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Wanda Wendel-Vos
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Sandra Andrušaitytė
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | | | - Jill Litt
- Instituto de Salud Global Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Environmental Studies Program, University of Colorado Boulder, Boulder, Colorado, USA
| | - Mark J Nieuwenhuijsen
- Instituto de Salud Global Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Thomson E, Li K, Pimentel R, Beavers A, Burr K, Litt J. A Feasibility RCT. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000516934.87302.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Litt J, Varda D, Reed H, Retrum J, Tabak R, Gustat J, O'Hara Tompkins N. How to Identify Success Among Networks That Promote Active Living. Am J Public Health 2015; 105:2298-305. [PMID: 26378863 DOI: 10.2105/ajph.2015.302828] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated organization- and network-level factors that influence organizations' perceived success. This is important for managing interorganizational networks, which can mobilize communities to address complex health issues such as physical activity, and for achieving change. METHODS In 2011, we used structured interview and network survey data from 22 states in the United States to estimate multilevel random-intercept models to understand organization- and network-level factors that explain perceived network success. RESULTS A total of 53 of 59 "whole networks" met the criteria for inclusion in the analysis (89.8%). Coordinators identified 559 organizations, with 3 to 12 organizations from each network taking the online survey (response rate = 69.7%; range = 33%-100%). Occupying a leadership position (P < .01), the amount of time with the network (P < .05), and support from community leaders (P < .05) emerged as correlates of perceived success. CONCLUSIONS Organizations' perceptions of success can influence decisions about continuing involvement and investment in networks designed to promote environment and policy change for active living. Understanding these factors can help leaders manage complex networks that involve diverse memberships, varied interests, and competing community-level priorities.
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Affiliation(s)
- Jill Litt
- Jill Litt and Hannah Reed are with Colorado School of Public Health, Aurora. Danielle Varda and Jessica Retrum are with University of Colorado, School of Public Affairs, Denver. Rachel Tabak is with Prevention Research Center, Brown School of Social Work, Washington University in St Louis, St Louis, MO. Jeanette Gustat is with Department of Epidemiology, Prevention Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Nancy O'Hara Tompkins is with West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown
| | - Danielle Varda
- Jill Litt and Hannah Reed are with Colorado School of Public Health, Aurora. Danielle Varda and Jessica Retrum are with University of Colorado, School of Public Affairs, Denver. Rachel Tabak is with Prevention Research Center, Brown School of Social Work, Washington University in St Louis, St Louis, MO. Jeanette Gustat is with Department of Epidemiology, Prevention Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Nancy O'Hara Tompkins is with West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown
| | - Hannah Reed
- Jill Litt and Hannah Reed are with Colorado School of Public Health, Aurora. Danielle Varda and Jessica Retrum are with University of Colorado, School of Public Affairs, Denver. Rachel Tabak is with Prevention Research Center, Brown School of Social Work, Washington University in St Louis, St Louis, MO. Jeanette Gustat is with Department of Epidemiology, Prevention Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Nancy O'Hara Tompkins is with West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown
| | - Jessica Retrum
- Jill Litt and Hannah Reed are with Colorado School of Public Health, Aurora. Danielle Varda and Jessica Retrum are with University of Colorado, School of Public Affairs, Denver. Rachel Tabak is with Prevention Research Center, Brown School of Social Work, Washington University in St Louis, St Louis, MO. Jeanette Gustat is with Department of Epidemiology, Prevention Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Nancy O'Hara Tompkins is with West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown
| | - Rachel Tabak
- Jill Litt and Hannah Reed are with Colorado School of Public Health, Aurora. Danielle Varda and Jessica Retrum are with University of Colorado, School of Public Affairs, Denver. Rachel Tabak is with Prevention Research Center, Brown School of Social Work, Washington University in St Louis, St Louis, MO. Jeanette Gustat is with Department of Epidemiology, Prevention Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Nancy O'Hara Tompkins is with West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown
| | - Jeanette Gustat
- Jill Litt and Hannah Reed are with Colorado School of Public Health, Aurora. Danielle Varda and Jessica Retrum are with University of Colorado, School of Public Affairs, Denver. Rachel Tabak is with Prevention Research Center, Brown School of Social Work, Washington University in St Louis, St Louis, MO. Jeanette Gustat is with Department of Epidemiology, Prevention Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Nancy O'Hara Tompkins is with West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown
| | - Nancy O'Hara Tompkins
- Jill Litt and Hannah Reed are with Colorado School of Public Health, Aurora. Danielle Varda and Jessica Retrum are with University of Colorado, School of Public Affairs, Denver. Rachel Tabak is with Prevention Research Center, Brown School of Social Work, Washington University in St Louis, St Louis, MO. Jeanette Gustat is with Department of Epidemiology, Prevention Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Nancy O'Hara Tompkins is with West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown
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Gustat J, O'Malley K, Hu T, Tabak RG, Goins KV, Valko C, Litt J, Eyler A. Support for physical activity policies and perceptions of work and neighborhood environments: variance by BMI and activity status at the county and individual levels. Am J Health Promot 2015; 28:S33-43. [PMID: 24380463 DOI: 10.4278/ajhp.130430-quan-216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine support for local policies encouraging physical activity and perceived neighborhood environment characteristics by physical activity and weight status of respondents across U.S. counties. DESIGN We used a random-digit-dial, computer-assisted telephone interview (CATI) to conduct a cross-sectional telephone questionnaire in selected U.S. counties in 2011. SETTING Counties with high prevalences of obesity and sedentary behavior (HH; n = 884) and counties with low prevalences of obesity and sedentary behavior (LL; n = 171) were selected nationally. SUBJECTS Adult respondents from HH (n = 642) and LL (n = 566) counties. MEASURES Questions were asked of respondents, pertaining to support for physical activity policies in various settings, neighborhood features, time spent in physical activity and sedentary behaviors, self-reported weight and height, and personal demographic information. ANALYSIS Means and frequencies were calculated; bivariable and multivariable linear and logistic regression models, developed. Models were adjusted for individual characteristics and county HH/LL status. RESULTS Respondents in LL counties perceived their neighborhood and work environments to be more supportive of healthy behaviors and were more supportive of local physical activity policies than respondents in HH counties (p < .001 for all). Positive neighborhood environment perceptions were related to reduced body mass index, increased physical activity, and decreased sedentary behavior. CONCLUSION Policy support and neighborhood environments are associated with behaviors. Results can inform targeting policy agendas to facilitate the improvement of environments (community, work, and school) to be more supportive of physical activity.
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Lemon SC, Goins KV, Schneider KL, Brownson RC, Valko CA, Evenson KR, Eyler AA, Heinrich KM, Litt J, Lyn R, Reed HL, Tompkins NO, Maddock J. Municipal Officials' Participation in Built Environment Policy Development in the United States. Am J Health Promot 2014; 30:42-9. [PMID: 25372234 DOI: 10.4278/ajhp.131021-quan-536] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study examined municipal officials' participation in built environment policy initiatives focused on land use design, transportation, and parks and recreation. DESIGN Web-based cross-sectional survey. SETTING Eighty-three municipalities with 50,000 or more residents in eight states. SUBJECTS Four hundred fifty-three elected and appointed municipal officials. MEASURES Outcomes included self-reported participation in land use design, transportation, and parks and recreation policy to increase physical activity. Independent variables included respondent position; perceptions of importance, barriers, and beliefs regarding physical activity and community design and layout; and physical activity partnership participation. ANALYSIS Multivariable logistic regression models. RESULTS Compared to other positions, public health officials had lower participation in land use design (78.3% vs. 29.0%), transportation (78.1% vs. 42.1%), and parks and recreation (67.1% vs. 26.3%) policy. Perceived limited staff was negatively associated with participation in each policy initiative. Perceptions of the extent to which physical activity was considered in community design and physical activity partnership participation were positively associated with participation in each. Perceived lack of collaboration was associated with less land use design and transportation policy participation, and awareness that community design affects physical activity was associated with more participation. Perceived lack of political will was associated with less parks and recreation policy participation. CONCLUSION Public health officials are underrepresented in built environment policy initiatives. Improving collaborations may improve municipal officials' policy participation.
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Belansky ES, Cutforth N, Gilbert L, Litt J, Reed H, Scarbro S, Marshall JA. Local Wellness Policy 5 years later: is it making a difference for students in low-income, rural Colorado elementary schools? Prev Chronic Dis 2013; 10:E184. [PMID: 24199737 PMCID: PMC3820520 DOI: 10.5888/pcd10.130002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [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: 11/10/2022] Open
Abstract
INTRODUCTION The federally mandated Local Wellness Policy (LWP) was intended to promote student health in schools. This study assesses the 5-year effects of the LWP on the health practices of rural elementary schools in Colorado. METHODS One year before and 5 years after the LWP mandate, a survey was administered to a random sample of principals, physical education (PE) teachers, and food-service managers in 45 rural, low-income elementary schools in Colorado. Response rates were 71% in 2005 and 89% in 2011. RESULTS Minutes for PE and recess did not increase, nor did offerings of fresh fruits and vegetables. More schools adopted policies prohibiting teachers from taking recess away as punishment (9.7% in 2005 vs 38.5% in 2011, P = .02) or for making up missed instructional time, class work, or tests in other subjects (3.2% in 2005 vs 28.2% in 2011, P = .03). More schools scheduled recess before lunch (22.6% in 2005 vs 46.2% in 2011, P = .04) and developed policies for vending machines (42.9% in 2005 vs 85.7% in 2011, P = .01) and parties (21.4% in 2005 vs 57.9% in 2011, P = .004). CONCLUSION Changes in school practices are modest, and arguably the important school practices such as increased PE and recess time and increased offerings of fruits and vegetables in the lunch line have not changed in the 5 years since the mandate went into effect. Further investigation is needed to identify the knowledge, skills, and attitudes as well as financial and physical resources required for school administrators to make changes in school practices.
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Affiliation(s)
- Elaine S Belansky
- Community and Behavioral Health, Associate Director, Rocky Mountain Prevention Research Center, Colorado School of Public Health, University of Colorado Denver, 13001 East 17th Place, Campus Box C-245, Aurora, CO 80045. E-mail:
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Harris M, Litt J, Russell G, Mazza D, Lloyd J, Zwar N, Taylor R, Van Driel M, Del Mar C, Krastev Y, Parker S, Smith J. P179 Facilitating Implementation Of Guidelines For The Prevention Of Vascular Disease In General Practice. BMJ Qual Saf 2013. [DOI: 10.1136/bmjqs-2013-002293.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lyn R, Aytur S, Davis TA, Eyler AA, Evenson KR, Chriqui JF, Cradock AL, Goins KV, Litt J, Brownson RC. Policy, systems, and environmental approaches for obesity prevention: a framework to inform local and state action. J Public Health Manag Pract 2013; 19:S23-33. [PMID: 23529052 PMCID: PMC4943076 DOI: 10.1097/phh.0b013e3182841709] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [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] [Indexed: 11/26/2022]
Abstract
The public health literature has not fully explored the complexities of the policy process as they relate to public health practice and obesity prevention. We conducted a review of the literature across the policy science and public health fields, distilled key theories of policy making, and developed a framework to inform policy, systems, and environmental change efforts on obesity prevention. Beginning with a conceptual description, we focus on understanding three domains of the policy process: the problem domain, the policy domain, and the political domain. We identify key activities in the policy process including the following: (a) assessing the social and political environment; (b) engaging, educating and collaborating with key individuals and groups; (c) identifying and framing the problem; (d) utilizing available evidence; (e) identifying policy solutions; and (f) building public support and political will. The article provides policy change resources and case studies to guide and support local and state efforts around obesity prevention.
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Affiliation(s)
- Rodney Lyn
- Division of Health Management and Policy, Institute of Public Health, Georgia State University, Atlanta, Georgia 30302, USA.
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Eyler A, Baldwin J, Carnoske C, Nickelson J, Troped P, Steinman L, Pluto D, Litt J, Evenson K, Terpstra J, Brownson R, Schmid T. Parental Involvement in Active Transport to School Initiatives. American Journal of Health Education 2013. [DOI: 10.1080/19325037.2008.10599029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Amy Eyler
- a School of Public Health , Saint Louis University , 3545 Lafayette Ave., St. Louis , MO , 63104
| | - Julie Baldwin
- b Community and Family Health , University of South Florida , Tampa , FL
| | | | | | - Philip Troped
- e Department of Health and Kinesiology , Purdue University , West Lafayette , IN
| | - Lesley Steinman
- f Prevention Research Center , University of Washington , Seattle , WA
| | | | - Jill Litt
- h Health Sciences Center , University of Colorado , Denver , CO
| | - Kelly Evenson
- i Department of Epidemiology , University of North Carolina , Chapel Hill , NC
| | | | | | - Thomas Schmid
- l Division of Nutrition, Physical Activity, and Obesity , National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Promotion , Atlanta , GA
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Berrian AM, O'Keeffe J, White PW, Norris J, Litt J, More SJ, Olea-Popelka FJ. Risk of bovine tuberculosis for cattle sold out from herds during 2005 in Ireland. Vet Rec 2012; 170:620. [DOI: 10.1136/vr.100674] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A. M. Berrian
- College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO USA
| | - J. O'Keeffe
- Centre of Veterinary Epidemiology and Risk Analysis; UCD School of Veterinary Medicine; University College Dublin, Belfield; Ireland
- the Department of Agriculture, Food and the Marine; Dublin Ireland
| | - P. W. White
- Centre of Veterinary Epidemiology and Risk Analysis; UCD School of Veterinary Medicine; University College Dublin, Belfield; Ireland
| | - J. Norris
- Colorado School of Public Health; University of Colorado; Denver CO USA
| | - J. Litt
- Colorado School of Public Health; University of Colorado; Denver CO USA
| | - S. J. More
- Centre of Veterinary Epidemiology and Risk Analysis; UCD School of Veterinary Medicine; University College Dublin, Belfield; Ireland
| | - F. J. Olea-Popelka
- College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO USA
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Homan G, Litt J, Norman RJ. The FAST study: Fertility ASsessment and advice Targeting lifestyle choices and behaviours: a pilot study. Hum Reprod 2012; 27:2396-404. [DOI: 10.1093/humrep/des176] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Diguiseppi C, Goss CW, Dao L, Allshouse A, Bardwell RA, Hendrikson E, Miller SL, Litt J. Safety practices in relation to home ownership among urban Mexican immigrant families. J Community Health 2011; 37:165-75. [PMID: 21739295 DOI: 10.1007/s10900-011-9432-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
UNLABELLED We examined home safety hazards, comparing renter- to owner-occupied housing among urban, immigrant Mexican families. METHODS Interviews and home inspections were conducted among urban, Spanish-speaking immigrant families with children. We estimated weighted hazard prevalence and used logistic regression to compare owner- and renter-occupied homes. Of 313 eligible households, 250 (80%) enrolled. Respondents were predominantly Mexican-born (99%), low income (72.6%) and lower education (92.3%). Most homes had fire, burn, fall, poisoning, electrocution and fire escape hazards, including high tap water temperatures (76.4%; 95% CI: 69.0, 83.7%), no working smoke alarms (60.0%; 51.3, 68.8%), slippery bathtub/shower surfaces (58.7%; 49.9, 67.5%), blocked fire escape routes (55.9%; 47.2, 64.5%) and child-accessible medications (71.0%; 60.1, 81.3%). After adjustment for sociodemographics, fire escape (OR = 8.8; 95% CI: 2.8, 27.7), carbon monoxide poisoning (OR = 2.9; 1.4, 6.2) and drowning (OR = 3.5; 1.3, 9.4) hazards were more likely in owner- than renter-occupied homes. Housing age and type explained most differences. Many urban, immigrant Spanish-speaking families live in unsafe homes. For this population, housing safety programs should be targeted based on housing age and type rather than tenure.
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Affiliation(s)
- Carolyn Diguiseppi
- Department of Epidemiology, Preventive Medicine Residency Program, Colorado School of Public Health, University of Colorado, Aurora, CO 80045, USA.
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Belansky ES, Cutforth N, Delong E, Litt J, Gilbert L, Scarbro S, Beatty B, Romaniello C, Brink L, Marshall JA. Early effects of the federally mandated Local Wellness Policy on school nutrition environments appear modest in Colorado's rural, low-income elementary schools. ACTA ACUST UNITED AC 2010; 110:1712-7. [PMID: 21034885 DOI: 10.1016/j.jada.2010.08.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 05/14/2010] [Indexed: 11/15/2022]
Abstract
To increase opportunities for healthy eating and physical activity, US school districts participating in the National School Lunch Program were required to create a Local Wellness Policy (LWP) by June 2006. The What's Working project described the initial influence of this mandate on nutrition environments and policies. In 2005 and 2007 (before and after the mandate went into effect), a survey about school features related to nutrition and physical activity was sent to a random sample of 45 low-income, rural elementary foodservice managers and principals. Schools averaged 204 students, 27% Hispanic. Districts' LWPs were coded for strength and comprehensiveness. In addition, key informant interviews were conducted with foodservice managers almost 2 years after the LWP went into effect. Three improvements were observed: increases in the percent of schools with policies stipulating predominantly healthy items be offered in classroom parties (21.4% in 2005 vs 48.7% in 2007), daily fresh fruit offerings in the lunchroom (0.80 choices in 2005 vs 1.15 choices in 2007), and the percent of schools using skinless poultry (27% in 2005 vs 59% in 2007). LWPs were weakly worded and rarely addressed energy content. Nutrition guideline elements most commonly addressed included vending machines, school stores, and à la carte food offerings. Seveny-three percent of foodservice managers were familiar with their district's LWP but did not perceive it changed lunchroom practices. Although LWPs offer a framework to support opportunities for healthy eating, few evidence-based practices were implemented as a direct result of the mandate. Schools need more information about evidence-based practices, as well as technical and financial assistance for implementation.
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Affiliation(s)
- Elaine S Belansky
- Department of Community and Behavioral Health, Rocky Mountain Prevention Research Center, Colorado School of Public Health, University of Colorado Denver, 13001 E 17th Pl, Campus Box C-245, Aurora, CO 80045, USA.
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Herce HD, Garcia AE, Litt J, Kane RS, Martin P, Enrique N, Rebolledo A, Milesi V. Arginine-rich peptides destabilize the plasma membrane, consistent with a pore formation translocation mechanism of cell-penetrating peptides. Biophys J 2009; 97:1917-25. [PMID: 19804722 DOI: 10.1016/j.bpj.2009.05.066] [Citation(s) in RCA: 206] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 05/22/2009] [Accepted: 05/29/2009] [Indexed: 10/20/2022] Open
Abstract
Recent molecular-dynamics simulations have suggested that the arginine-rich HIV Tat peptides translocate by destabilizing and inducing transient pores in phospholipid bilayers. In this pathway for peptide translocation, Arg residues play a fundamental role not only in the binding of the peptide to the surface of the membrane, but also in the destabilization and nucleation of transient pores across the bilayer. Here we present a molecular-dynamics simulation of a peptide composed of nine Args (Arg-9) that shows that this peptide follows the same translocation pathway previously found for the Tat peptide. We test experimentally the hypothesis that transient pores open by measuring ionic currents across phospholipid bilayers and cell membranes through the pores induced by Arg-9 peptides. We find that Arg-9 peptides, in the presence of an electrostatic potential gradient, induce ionic currents across planar phospholipid bilayers, as well as in cultured osteosarcoma cells and human smooth muscle cells. Our results suggest that the mechanism of action of Arg-9 peptides involves the creation of transient pores in lipid bilayers and cell membranes.
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Affiliation(s)
- H D Herce
- Department of Physics, Rensselaer Polytechnic Institute, Troy, New York, USA
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Litt J, Tran N, Malecki KC, Neff R, Resnick B, Burke T. Identifying priority health conditions, environmental data, and infrastructure needs: a synopsis of the Pew Environmental Health tracking project. Environ Health Perspect 2004; 112:1414-8. [PMID: 15471735 PMCID: PMC1247570 DOI: 10.1289/ehp.7147] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [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: 04/01/2004] [Accepted: 08/03/2004] [Indexed: 05/18/2023]
Abstract
In this article we describe the methodologic approaches of the Pew Environmental Health Commission at the Johns Hopkins Bloomberg School of Public Health used to identify priority environmental health conditions and develop recommendations to establish a national environmental public health tracking network. We present the results of a survey of public health and environmental practitioners to uncover state and local health tracking needs and priorities. We describe the steps that combined the findings from the state and local health tracking survey and a review of the state of the science on environmental impacts on health to identify priority health end points. Through an examination of national health and health care databases, we then describe trends and public health effects of those diseases that may be linked to the environment. Based on this analysis, respiratory diseases and neurologic diseases are recommended as priorities for tracking. Specific end points recommended for tracking include asthma and chronic respiratory diseases, and chronic neurodegenerative diseases such as multiple sclerosis. Based on trends in reported prevalence, consideration should also be given to developmental disabilities, reproductive disorders, and endocrine/metabolic disorders. Strengthening of current efforts to track cancer and birth defects should also be included as components of a nationwide health tracking network. Finally, we present the recommendations for environmental public health tracking. These recommendations provided the groundwork for the development of the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Progam that now includes 21 states, three cities, and three academic centers throughout the nation.
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Affiliation(s)
- Jill Litt
- University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometrics, Denver, Colorado, USA
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Weir R, Brunton C, Jennings L, Smith L, Litt J. Knowledge and attitudes about influenza vaccination: a New Zealand study of primary care practitioners and elderly people. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.ics.2004.02.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Willis E, Condon J, Litt J. Factors impacting on shared care working relationships between practice nurses and general practitioners: a literature review. Contemp Nurse 2000; 9:120-31. [PMID: 11855000 DOI: 10.5172/conu.2000.9.2.120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Practice nurses have worked in general practice for many years yet little is known or published in Australia about their work. Recent health care reforms in Australia, particularly the establishment of the Divisions of General Practice and various best-practice innovations linked to the National GP Strategy have seen an increase in the role of practice nurses. Despite this GPs in Australia are cautious about the role of practice nurses. Much of this caution arises from reform in general practice in Britain particularly the establishment of fund-holding for general practice. This article reviews the literature on practice nurses in Britain and Australia within the framework of the health reforms in general practice in both countries.
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Affiliation(s)
- E Willis
- School of Nursing, Flinders University of South Australia
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Condon J, Willis E, Litt J. The role of the practice nurse. An exploratory study. Aust Fam Physician 2000; 29:272-7. [PMID: 10785995] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AIM There is little research on the role of the practice nurse in Australia. However, there is some evidence that practice nurses are no longer primarily receptionists, but rather function as nurses. This article reports on a small qualitative study that set out to identify areas of effective shared care between general practitioners and practice nurses. METHOD Semistructured interviews were conducted with general practitioners and practice nurses in eight general practices. A general practitioner who did not employ a practice nurse and a general practitioner and two nurse practitioners at a Community Health Centre were also interviewed. RESULTS It was found that general practitioners and practice nurses have established effective working relationships that enhance patient care. Shared care was not found, except to some extent in the area of wound care. CONCLUSION Most GPs and practice nurses interviewed believed that the current funding model, requiring GPs to sight all patients before a fee can be claimed, restricts the potential use of practice nurses' expertise, for example with patients returning for routine blood tests or blood pressure monitoring, or wound dressing. A change to the current model would have implications for the education and accreditation of practice nurses.
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Affiliation(s)
- J Condon
- Department of Nursing Inquiry and Practice, School of Nursing, Flinders University, South Australia
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Litt J. Putting prevention into practice: just do it. Aust Fam Physician 1999; 28 Suppl 1:S1-2. [PMID: 9988918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Farfel M, Brophy M, Litt J, Rooney B, Orlova A. HELD STUDY OF LEAD HAZARD REDUCTION MEASURES IN THE BALTIMORE CLINICAL CENTER OF THE TREATMENT OF LEAD-EXPOSED CHILDREN (TLC)-CLINICAL TRIAL. Epidemiology 1998. [DOI: 10.1097/00001648-199807001-00474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Crack mothers-particularly African American and Latina women-have been constructed as maternal villains who actively and permanently damage their offspring. Many women have been arrested or lost parental rights to their children because of child neglect charges. Despite this panic, recent medical and legal research indicates that reports of damage to the fetus have been greatly exaggerated. This article examines the ongoing questions in medical publications about crack babies. The authors connect the search for biological markers of cocaine use during pregnancy to a new cultural conception of a bio-underclass. The conclusion considers medical developments and controversies in the broader context of class and racial divisions and reproductive politics in the United States.
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Affiliation(s)
- J Litt
- Department of Sociology, Iowa State University, Ames 50011, USA.
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Beilby J, Steven I, Coates J, Coffey G, Litt J, Wagner C. Comparison of South Australian city and country general practitioners as regards reported asthma management. Med J Aust 1993; 159:710. [PMID: 8232023 DOI: 10.5694/j.1326-5377.1993.tb138098.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Abstract
This study aimed to assess perceptions of continuity of care by patients from different socioeconomic areas using focus group interviews augmented by postal replies. Patients were randomly selected from two contrasting primary medical care locations: a middle class suburb and a less affluent suburb in Adelaide, South Australia. The Ethnograph was used to analyse the content of the interviews and postal responses. Analysis used the framework described by Curtis and Rogers in the USA and Freeman in the UK. The response rate was much lower from the lower socioeconomic group (5% focus group; 20% when postal replies included). They emphasized access factors and importance of records, and alleged situations where they were taken too casually and their problems were not dealt with. Those from the middle class area (response rate 25%) emphasized interpersonal ('art of care') factors and were more likely to use their presenting problem as a criterion to decide whether they needed to postpone the problem to a time when they could see their personal doctor. Focus groups can be useful evaluation tools in general practice, but oversampling of lower socioeconomic groups is needed. Continuity of care should be considered as an aid to consistent quality of care, rather than its essence. Well controlled intervention-outcome studies in different types of practice organization in differing socioeconomic situations will increase our understanding of continuity of care.
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Affiliation(s)
- S T Liaw
- Department of Primary Health Care, Flinders University, Bedford Park, Australia
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Litt J. An invitation to research. Aust Fam Physician 1988; 17:838. [PMID: 3240147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Suhadolc T, Copps B, Erling T, Chung EF, Litt J, Kerr M, Frank J. More on hemoccult. Can Fam Physician 1983; 29:643. [PMID: 21283444 PMCID: PMC2154158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Kay S, Schneider V, Litt J. Choriocarcinoma of the mesosalpinx masquerading as congestive heart failure: ultrastructural observations of the tumor. Int J Gynecol Pathol 1983; 2:72-87. [PMID: 6347924 DOI: 10.1097/00004347-198301000-00007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A 45-year-old woman suffered from hypertension and congestive heart failure for 5 months. She was found to have a choriocarcinoma of the left mesosalpinx. The final event was, in all probability, a massive pulmonary tumor embolus which occurred shortly after removal of the uterus and adnexae. The tumor was studied by immunohistochemical methods as well as ultrastructurally, and the findings are illustrated and described.
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Aston D, Atkinson M, Ball A, Brookes G, Bussey P, Cake B, Clarke D, Connell K, Duerdoth I, Ellison R, Flynn P, Galbraith W, Hampson P, Ibbotson M, Hughes-Jones R, Kemp M, Lafferty G, Lane J, Litt J, Mercer D, Newton D, Raine C, Roberts J, Smith K, Storr K, Thompson R, Waite A. The 25–70 GeV tagged photon facility at CERN. ACTA ACUST UNITED AC 1982. [DOI: 10.1016/0167-5087(82)90319-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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