Health promoting ideas and actions generated by community engagement in an underserved Swedish area

Background

For an intervention to contribute to decreased health gaps, people living in underserved areas must participate in the research-to-action process during the development of the intervention.

Methods for increased engagement and participation have been developed within the community-based participatory research (CBPR) paradigm. Group Level Assessment (GLA) is a qualitative, participatory methodology that is designed for a large group to generate and evaluate relevant needs and priorities within a lens of action for positive social change. Influence of researchers is tuned down in favour of partnership and impact from the community. Ideally, the process results in participant-driven data and relevant action plans. The aim was to apply GLA to generate reflections on the situation in the community, aligning towards action for change.

Methods

We applied GLA together with people living in Gårdsten, an underserved Swedish suburb where obesity, caries and other illnesses are prevalent. Residents were recruited by posters and post cards at a community center and by snowball sampling. In total, 47 residents attended at least one of eight GLA sessions held over a five-month time period. The majority were women. Outcomes were reflections, suggestions and actions for change.

Results

Themes were: resident pride of the area, the importance of communication and of places to meet, a feeling of being abandoned by society, and a desire for more collaboration between schools and parents. Immediate results were a language café and inquiries from the community about information regarding teeth, food and health. When the results were presented for stakeholders in a report and an exhibition, new collaborations were founded and old were refreshed.

Conclusions

GLA helped residents identify what they thought valuable and relevant concerning health issues and supported them in taking actions to achieve change.

Key messages

Participatory processes that directly engage community residents can result in fruitful discussions and actions. Methodologies like GLA that support such processes may contribute to closing the health gap.

Natural variation in the expression of ORGANIC CATION TRANSPORTER 1 affects root length responses to cadaverine in Arabidopsis

Polyamines, including cadaverine, are organic cations that affect numerous biological processes including transcription, translation, cell signalling, and ion channel activity. They often function in biotic and abiotic stress responses in plants. Because little is known about how plants respond to cadaverine, a quantitative natural variation approach was used to identify genetic factors that contribute to this response. Here it is shown that Arabidopsis thaliana accessions have varying root length responses to exogenous cadaverine: Cape Verde Islands (Cvi) was one of the most resistant accessions tested, whereas Landsberg erecta (Ler) was one of the most sensitive. Recombinant inbred lines, near isogenic lines, and a microarray were used to show that variation in ORGANIC CATION TRANSPORTER 1 (OCT1) is at least partially responsible for this difference. OCT1 expression was higher in Cvi than in Ler, and oct1 mutants were more sensitive to cadaverine than wild-type plants. In oct1 mutants transformed with an ectopic copy of OCT1 originating from either Cvi or Ler, the expression level of the transgene, not its accession, correlated with the cadaverine response. These results suggest that decreased OCT1 expression confers cadaverine sensitivity in some accessions.

Parental expectations regarding discussions on psychosocial topics during pediatric office visits

Parents from urban (n=67) and suburban (n=76) primary care settings responded to a survey determining the extent to which 9 common psychosocial concerns have affected their children. Parents also reported their expectations of their pediatrician to discuss such topics during a health care visit. Within both settings, discipline was the most frequently experienced (41%), commonly discussed (34.3%), and frequently expected (75.4%) topic to be discussed. The frequency of discussions on psychosocial topics was less than half that of the actual reported occurrence of the psychosocial concern. When discussions on psychosocial topics did occur, however, most parents (87.3%) perceived pediatricians as helpful.

Brief report: learning to parent: a survey of parents in an urban pediatric primary care clinic

OBJECTIVE

To survey parents bringing children to an urban pediatric primary care clinic about (1) how they learned parenting skills, (2) role of the clinic in teaching parenting, (3) helpfulness of information sources, and (4) preferred modalities for teaching.

METHODS

A total of 108 adults completed an oral survey in clinic, consisting of open-ended questions, yes/no endorsements, Likert ratings, and demographic questions.

RESULTS

The majority reported learning to parent from their families or "by just doing it." Talking with professionals was rated as very helpful. Most had parenting questions. Almost half wanted information regarding specific developmental/behavioral issues, while only 8% wanted medical information. Most felt they could talk with clinic professionals about concerns but fewer had done so. Modality preferences were reported.

CONCLUSIONS

Inner-city parents value working with primary care providers to improve knowledge of developmental/behavioral issues. Results have implications for the anticipatory guidance process, content of information provided, and the training of pediatric healthcare providers. We determined preferences for information delivery.