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Lin T, Beckman W, Collie-Akers V. Guest Lectures: Increasing Student Knowledge of Health in All Policies by Using the Health Impact Checklist. CHIA 2022. [DOI: 10.18060/26687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lightner JS, McKinney L, Hoppe K, Ziegler N, Gardiner K, Clardy S, Prochnow T, Collie-Akers V. Community health improvement plan: Study protocol for Kansas City's intervention and implementation evaluation. Public Health in Practice 2022; 4:100340. [PMID: 36389257 PMCID: PMC9649945 DOI: 10.1016/j.puhip.2022.100340] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives Community health improvement plans (CHIPs) are foundational public health practice, yet no studies have been conducted to understand implementation of these plans. This evaluation study of the Kansas City CHIP aims to 1) identify implementation strategies used in the CHIP, 2) assess changes in implementation, service, and client outcomes, 3) assess contextual factors associated with implementation, and 4) understand social networks of coalitions who implement the Kansas City CHIP. Study design This study protocol uses a unique, mixed methods approach to evaluating process and outcomes of the Kansas City CHIP. This study is supported by Proctor's Model of Implementation, RE-10.13039/100003582AIM (reach, effectiveness, adoption, implementation, maintenance), and the practical, robust implementation and sustainability model (PRISM). Methods Staff and community members involved in implementing the Kansas City, Missouri CHIP will be invited to participate in an annual online survey, a series of focus groups, and quarterly implementation logs to assess implementation and sustainability. Results RE-AIM and PRISM constructs are the primary and secondary outcomes of interest. Results of this study will be available from the first year of implementation in 2023, with future results provided annually. Conclusions This project will fill a much-needed gap in the literature by understanding how large-scale coalitions implement projects that aim to improve population health and health equity. CHIPs have the potential to improve population health, yet few studies have been conducted on CHIPs, with no studies to date assessing outcomes. To support effective implementation and sustainability as well as improve public health outcomes, researchers need to evaluate CHIPs and develop models of implementation that can quickly be integrated into practice to improve populations’ health.
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Affiliation(s)
- Joseph S. Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
- Kansas City Health Commission, Kansas City Health Department, Kansas City, MO, USA
- Corresponding author. School of Nursing and Health Studies, University of Missouri-Kansas City, 2464 Charlotte St, 64108, Kansas City, MO, USA.
| | - Lana McKinney
- Kansas City Health Commission, Kansas City Health Department, Kansas City, MO, USA
- Wrights Hands Consulting, Kansas City, MO, USA
| | - Kate Hoppe
- Kansas City Health Commission, Kansas City Health Department, Kansas City, MO, USA
- CivicPoint Consulting, Kanas City, MO, USA
| | - Nancy Ziegler
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kelsey Gardiner
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
- Kansas City Health Commission, Kansas City Health Department, Kansas City, MO, USA
| | - Scott Clardy
- Kansas City Health Commission, Kansas City Health Department, Kansas City, MO, USA
| | - Tyler Prochnow
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Vicki Collie-Akers
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
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Schulz JA, Ramaswamy M, Collie-Akers V, Jordan S, Koon LM, Tryanski R. Understanding the Impact of an Integrated Crisis Team: A Qualitative Study of Emergency Department Staff. Community Ment Health J 2021; 57:1278-1287. [PMID: 33423187 DOI: 10.1007/s10597-020-00771-9] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022]
Abstract
Approximately one in eight visits to the Emergency Department (ED) in the United States are due to a behavioral health crisis. A Midwest community created an Integrated Crisis Team (ICT) as part of its county-wide effort to improve quality of care for people with mental health and/or substance use disorders. This ICT, which is embedded in the ED, ensured trained crisis clinicians were available in the ED, among other strategies. Semi-structured interviews were conducted with 15 staff members and a thematic analysis was used to assess ED staff members' perceptions of the impact of the ICT on staff and patient experience, and to identify barriers to implementation. Results indicated that the ICT facilitated a collaborative team effort in the ED and improved patient care in the ED. This evaluation informs key stakeholders about the importance of integrating a crisis team within an ED to better serve behavioral health patients.
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Affiliation(s)
- Jonathan A Schulz
- Department of Applied Behavioral Science, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS, 66045, USA.
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Vicki Collie-Akers
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Sonia Jordan
- Lawrence-Douglas County Public Health, 200 Maine Suite B, Lawrence, KS, 66044, USA
| | - Lyndsie M Koon
- Life Span Institute, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS, 66045, USA
| | - Robert Tryanski
- Lawrence-Douglas County Public Health, 200 Maine Suite B, Lawrence, KS, 66044, USA
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Collie-Akers V, Landry S, Ehule NJ, Pecha D, Beltran MM, Gilbert C, Abresch C. Enhancing the Capacity of Local Health Departments to Address Birth Equity: The Institute for Equity in Birth Outcomes. Matern Child Health J 2021; 25:1010-1018. [PMID: 33929652 PMCID: PMC8184551 DOI: 10.1007/s10995-021-03135-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Significant and persistent racial and ethnic disparities exist related to infant mortality and other birth outcomes. Few models exist that aim to prepare organizations to implement essential features, such as community engagement or intervening on social determinants of health. METHODS Between 2013 and 2015, teams from seven local health departments participated in the Institute for Equity in Birth Outcomes (EI) with the goals of building capacity and implementing changes to address equity in birth outcomes. Four of the teams enrolled in the first cohort (2013-2015), and three enrolled in cohort two (2014-2015). To examine the EI effort and its impact on capacity and implementation of changes, two types of assessments were completed. Capacities of the teams in specific key areas were assessed using "Best Change Process" instruments at the completion of participation in the EI. Teams also documented on an ongoing basis implementation of interventions. The data were analyzed using descriptive statistics and Pearson Correlation tests. RESULTS Best Change Process capacity scores were higher in the first cohort than in the second and were highly correlated with implementation of changes (Pearson's Correlation = 0.838, p = 0.037). Collectively, the teams implemented about 32 new programs, policies, practices, and systems changes aimed at addressing equity in birth outcomes. Most interventions were based on scientific recommendations and local epidemiologic data. DISCUSSION The results of the study suggest the EI is a promising approach that may result in strong capacity and ability to implement interventions aimed at addressing equity in birth outcomes.
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Affiliation(s)
- Vicki Collie-Akers
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1008, Kansas City, KS 66160 USA
| | - Sarah Landry
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1008, Kansas City, KS 66160 USA
| | - N. Jessica Ehule
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
| | - Denise Pecha
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
| | | | - Carol Gilbert
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
| | - Chad Abresch
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
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Webb KL, Hewawatharana SC, Au LE, Collie-Akers V, Strauss W, Landgraf A, Nagaraja J, Wilson DK, Sagatov R, Kao J, Loria CM, Fawcett S, Ritchie LD. Objectives of community policies and programs associated with more healthful dietary intakes among children: findings from the Healthy Communities Study. Pediatr Obes 2018; 13 Suppl 1:103-112. [PMID: 29923334 PMCID: PMC6197901 DOI: 10.1111/ijpo.12424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 03/15/2018] [Accepted: 04/04/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Rational planning of community policies and programs (CPPs) to prevent obesity requires an understanding of CPP objectives associated with dietary behaviours. OBJECTIVE The objective of the study is to identify objectives of CPPs associated with healthful dietary behaviours. METHODS An observational study identified 4026 nutrition CPPs occurring in 130 communities in the prior 6 years. Dietary intakes of fruits and vegetables, added sugar and sugar-sweetened beverages, among others, were reported among 5138 children 4-15 years of age from the communities, using a Dietary Screener Questionnaire with children age 9 years and older (parent assisted) or parent proxies for younger children. CPPs were documented through key informant interviews and characterized by their intensity, count, and objectives including target dietary behaviour and food environment change strategy. Associations between dietary intakes and CPP objectives were assessed using hierarchical statistical models. RESULTS CPPs with the highest intensity scores that targeted fast food or fat intake or provided smaller portions were associated with greater fruit and vegetable intake (0.21, 0.19, 0.23 cup equivalents/day respectively with p values <0.01, 0.04, 0.03). CPPs with the highest intensity scores that restricted the availability of less healthful foods were associated with lower child intakes of total added sugar (-1.08 tsp/day, p < 0.01) and sugar from sugar-sweetened beverages (-1.63 tsp/day, p = 0.04). Similar associations were observed between CPP count and dietary outcomes. No other significant associations were found between CPP target behaviours or environmental strategies and dietary intakes/behaviours. CONCLUSION CPPs that targeted decreases in intakes of less healthful foods and/or aimed to modify the availability of less healthful foods and portions were associated with healthier child dietary behaviours.
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Affiliation(s)
- Karen L Webb
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland and Berkeley offices
| | - Sridharshi C Hewawatharana
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland and Berkeley offices
| | - Lauren E Au
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland and Berkeley offices
| | - Vicki Collie-Akers
- Center for Community Health and Development, University of Kansas, Lawrence, Kansas
| | | | | | | | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | | | - Janice Kao
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland and Berkeley offices
| | | | - Stephen Fawcett
- Center for Community Health and Development, University of Kansas, Lawrence, Kansas
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland and Berkeley offices
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Sagatov RD, John LV, Gregoriou M, Arteaga SS, Weber S, Payn B, Strauss W, Weinstein N, Collie-Akers V. Recruitment outcomes, challenges and lessons learned: the Healthy Communities Study. Pediatr Obes 2018; 13 Suppl 1:27-35. [PMID: 30209890 PMCID: PMC6424514 DOI: 10.1111/ijpo.12455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 07/15/2017] [Revised: 05/11/2018] [Accepted: 05/30/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Healthy Communities Study (HCS) was a national study of community programs and policies that aimed to address childhood obesity; it necessitated recruitment of a large sample of children from communities throughout the United States. OBJECTIVE The HCS aimed to complete visits with an average of 45 children and 12 key informants from at least 120 communities, diverse with respect to region of the country, urbanicity, socioeconomic status, race, ethnicity and intensity of community programs and policies that aim to address childhood obesity. METHODS Purchased address lists were utilized to select households for recruitment during Wave 1 of the study, and recruitment of families through schools was employed for Wave 2. RESULTS The HCS successfully obtained approval from 149 school districts and 478 schools in 130 communities, recruited 5138 families, and interviewed 1421 key informants to allow for characterization of overall intensity of obesity prevention/treatment efforts in each community. CONCLUSIONS Lessons learned are presented. Future studies should plan for inclusion of the following in development of recruitment strategies: literature review, formative research, pilot testing, and ongoing monitoring and adjustment.
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Affiliation(s)
| | | | | | - S. Sonia Arteaga
- National Institutes of Health, National Heart, Lung and Blood Institute, Bethesda, MD
| | | | - Betsy Payn
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle, WA
| | - Warren Strauss
- W.J. Strauss, Health Analytics Hub, LLC – Lewis Center, OH, USA
| | | | - Vicki Collie-Akers
- Work Group for Health and Community Development, University of Kansas, Lawrence, KS
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Ritchie LD, Woodward-Lopez G, Au LE, Loria CM, Collie-Akers V, Wilson DK, Frongillo EA, Strauss WJ, Sagatov RD, Landgraf AJ, Nagaraja J, Nicastro HL, Nebeling LC, Webb K. Associations of community programs and policies with children's dietary intakes: the Healthy Communities Study. Pediatr Obes 2018; 13 Suppl 1:14-26. [PMID: 29992795 PMCID: PMC6197888 DOI: 10.1111/ijpo.12440] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 05/04/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The impact of community-based obesity prevention efforts on child nutrition has not been adequately studied. OBJECTIVE Examine relationships between number, type and intensity of community programs and policies (CPPs) and child nutrition. METHODS An observational study of 5138 children (grades K-8) in 130 U.S. communities was conducted in 2013-2015. CPPs were identified by 10-14 key informant interviews per community. CPPs were characterized based on: count, intensity, number of different strategies used and number of different behaviours targeted. Scores for the prior 6 years were calculated separately for CPPs that addressed primarily nutrition, primarily physical activity (PA) or total combined. Child intakes were calculated from a dietary screener and dietary behaviours were based on survey responses. Multi-level statistical models assessed associations between CPP indices and nutrition measures, adjusting for child and community-level covariates. RESULTS Implementing more types of strategies across all CPPs was related to lower intakes of total added sugar (when CPPs addressed primarily PA), sugar-sweetened beverages (for nutrition and PA CPPs) and energy-dense foods of minimal nutritional value (for total CPPs). Addressing more behaviours was related to higher intakes of fruit and vegetables (for nutrition and total CPPs) and fibre (total CPPs). Higher count and intensity (PA and total CPPs) were related to more consumption of lower fat compared with higher fat milk. A higher count (PA CPPs) was related to fewer energy-dense foods and whole grains. No other relationships were significant at P < 0.05. CONCLUSION Multiple characteristics of CPPs to prevent obesity appear important to improve children's diets.
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Affiliation(s)
- Lorrene D. Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - Gail Woodward-Lopez
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - Lauren E. Au
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | | | - Vicki Collie-Akers
- Work Group for Community Development, University of Kansas, Lawrence, Kansas
| | - Dawn K. Wilson
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | | | | | | | | | | | | | - Karen Webb
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - on behalf of the Healthy Communities Study Team
- For complete list of members of the Healthy Communities Study Team, see Strauss WJ, Nagaraja J, Landgraf AJ, et al. The longitudinal relationship between community programs and policies to prevent childhood obesity and BMI in children: The Healthy Communities Study. Pediatr Obes 2018; ##: ##-##
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Fawcett S, Torres J, Jones L, Moffett M, Bradford K, Mantilla MR, Cupertino AP, de Los Rios JB, Collie-Akers V. Assuring Health Access and Culturally Competent Health Services Through the Latino Health for All Coalition. Health Promot Pract 2018; 19:765-774. [PMID: 29991288 DOI: 10.1177/1524839918781525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although the importance of health care access is widely acknowledged, less is known about how partnerships can help assure access to quality health services for those experiencing health inequities. This report describes implementation of collaborative efforts through the Health Access Committee of the Latino Health for All Coalition (Wyandotte County/Kansas City, Kansas) to address its three goal areas (1) improving cultural competence through organizational change, (2) improving access to quality health services through access to diabetes prevention services, and (3) improving access and linkage to care via enrollment in health insurance. Using community-based participatory approaches, we documented and reflected on the pattern of activities facilitated by the coalition and its partners for each goal area over a 1-year period. This case report outlines strategies, activities, and lessons learned by coalition partners. This article offers practical guidance about how to structure and implement a coalition that provides technical support for increasing health care access and cultural competency.
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Affiliation(s)
| | | | - Lucia Jones
- 3 Community Health Council of Wyandotte County, Kansas City, KS, USA
| | - Molly Moffett
- 3 Community Health Council of Wyandotte County, Kansas City, KS, USA
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Colvin JD, Bettenhausen JL, Anderson-Carpenter KD, Collie-Akers V, Chung PJ. Caregiver Opinion of In-Hospital Screening for Unmet Social Needs by Pediatric Residents. Acad Pediatr 2016; 16:161-7. [PMID: 26946270 PMCID: PMC4794116 DOI: 10.1016/j.acap.2015.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 08/20/2014] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Child health is strongly influenced by social determinants. Little is known about the opinions of primary caregivers regarding the physicians' role in addressing social needs. Our objective was to examine caregivers' opinions about that role and any associations between those opinions, previous exposure to screening for needs by pediatric residents, and socioeconomic status (SES). METHODS Cross-sectional survey study of caregivers of hospitalized children. The survey collected information on caregiver opinion regarding their ability to ask physicians for help with social needs, whether physicians know how to help with those needs, and whether physicians should ask about social needs. The chi square test was used to identify associations between caregiver opinions, prior screening by a resident at admission, and SES (determined by census tract median household income). RESULTS Surveys were completed by 143 caregivers (79% participation). Most respondents agreed that they could ask their physician for help (54.5%), that their physician knows how to help (64.3%), and that physicians should ask about social needs (71.3%). Previously screened caregivers had more favorable opinions about asking for help (76.2% vs 45.5%, P < .01), whether their physician knows how to help (81.0% vs 57.4%, P = .02), and physician screening for unmet needs (85.7% vs 65.3%, P = .03). There were no SES differences in opinion. CONCLUSIONS Caregivers have favorable opinions of the physician's role in addressing the social determinants of health, especially after being screened. Physicians should be confident in the acceptability of screening families for social needs.
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Affiliation(s)
- Jeffrey D. Colvin
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108
| | - Jessica L. Bettenhausen
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108
| | - Kaston D. Anderson-Carpenter
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, 11075 Santa Monica Blvd Suite 100, Los Angeles, CA 90025
| | - Vicki Collie-Akers
- Work Group for Community Health and Development, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045
| | - Paul J. Chung
- Departments of Pediatrics and Health Policy & Management, University of California, Los Angeles, 10833 LeConte Ave, Los Angeles, CA 90095,RAND Health, The RAND Corporation, 1776 Main Street, Santa Monica, CA 90401,Children’s Discovery & Innovation Institute, Mattel Children’s Hospital UCLA, 10833 LeConte Ave, Los Angeles, CA 90095
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Colvin JD, Bettenhausen JL, Anderson-Carpenter KD, Collie-Akers V, Plencner L, Krager M, Nelson B, Donnelly S, Simmons J, Higinio V, Chung PJ. Multiple Behavior Change Intervention to Improve Detection of Unmet Social Needs and Resulting Resource Referrals. Acad Pediatr 2016; 16:168-74. [PMID: 26183003 PMCID: PMC4712125 DOI: 10.1016/j.acap.2015.06.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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: 02/25/2015] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. METHODS During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use. RESULTS A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P < .001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% confidence interval 0.87-0.99) and sensitivity was 0.63 (95% confidence interval 0.50-0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months). CONCLUSIONS A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs.
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Affiliation(s)
- Jeffrey D. Colvin
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108
| | - Jessica L. Bettenhausen
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108
| | - Kaston D. Anderson-Carpenter
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, 11075 Santa Monica Blvd Suite 100, Los Angeles, CA 90025
| | - Vicki Collie-Akers
- Work Group for Community Health and Development, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045
| | - Laura Plencner
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108
| | - Molly Krager
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108
| | - Brooke Nelson
- Department of Social Work, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108
| | - Sara Donnelly
- Department of Social Work, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108
| | - Julia Simmons
- Department of Pediatrics, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108
| | - Valeria Higinio
- Turner House Children’s Clinic, 21 North 12 St Suite 300, Kansas City, KS 66102
| | - Paul J. Chung
- Departments of Pediatrics and Health Policy & Management, University of California, Los Angeles, 10833 LeConte Ave, Los Angeles, CA 90095,RAND Health, The RAND Corporation, 1776 Main Street, Santa Monica, CA 90401,Children’s Discovery & Innovation Institute, Mattel Children’s Hospital UCLA, 10833 LeConte Ave, Los Angeles, CA 90095
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Colvin JD, Collie-Akers V, Schunn C, Moon RY. In reply to the letters from Smith et al and Bartick et al. Pediatrics 2014; 134:e1778-9. [PMID: 25452646 DOI: 10.1542/peds.2014-2794d] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Colvin JD, Collie-Akers V, Schunn C, Moon RY. In reply to the letter from Dr Cutz. Pediatrics 2014; 134:e1779-80. [PMID: 25452647 DOI: 10.1542/peds.2014-2794e] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
OBJECTIVE Sudden infant death syndrome and other sleep-related causes of infant mortality have several known risk factors. Less is known about the association of those risk factors at different times during infancy. Our objective was to determine any associations between risk factors for sleep-related deaths at different ages. METHODS A cross-sectional study of sleep-related infant deaths from 24 states during 2004-2012 contained in the National Center for the Review and Prevention of Child Deaths Case Reporting System, a database of death reports from state child death review teams. The main exposure was age, divided into younger (0-3 months) and older (4 months to 364 days) infants. The primary outcomes were bed-sharing, objects in the sleep environment, location (eg, adult bed), and position (eg, prone). RESULTS A total of 8207 deaths were analyzed. Younger victims were more likely bed-sharing (73.8% vs. 58.9%, P < .001) and sleeping in an adult bed/on a person (51.6% vs. 43.8%, P < .001). A higher percentage of older victims had an object in the sleep environment (39.4% vs. 33.5%, P < .001) and changed position from side/back to prone (18.4% vs. 13.8%, P < .001). Multivariable regression confirmed these associations. CONCLUSIONS Risk factors for sleep-related infant deaths may be different for different age groups. The predominant risk factor for younger infants is bed-sharing, whereas rolling into objects in the sleep area is the predominant risk factor for older infants. Parents should be warned about the dangers of these specific risk factors appropriate to their infant's age.
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Affiliation(s)
- Jeffrey D Colvin
- Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri;Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;
| | - Vicki Collie-Akers
- Work Group for Community Health and Development, University of Kansas, Lawrence, Kansas
| | | | - Rachel Y Moon
- Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, District of Columbia; andDepartment of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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14
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Fawcett SB, Schultz JA, Holt CM, Collie-Akers V, Watson-Thompson J. Participatory research and capacity building for community health and development. J Prev Interv Community 2014; 41:139-41. [PMID: 23751057 DOI: 10.1080/10852352.2013.788340] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This report describes engagement of the Work Group for Community Health and Development at the University of Kansas in pursuing its mission of collaborative research, teaching, and public service. In research, this team uses capabilities for community measurement to help discover factors and conditions that affect community change and improvement. In teaching and training, it prepares new generations of leadership for collaborative research and community practice. As part of its public service mission, the team serves as home base for the Community Tool Box, the largest Web resource of its kind for community building. This work reflects the two-fold aim of engaged scholarship: to contribute to understanding about what affects community health and development and to apply that knowledge to assure conditions that promote well-being for all those living in our communities.
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Affiliation(s)
- Stephen B Fawcett
- Work Group for Community Health and Development, University of Kansas, Lawrence, KS 66045, USA.
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15
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Fawcett SB, Collie-Akers V, Schultz JA, Cupertino P. Community-Based Participatory Research Within the Latino Health for All Coalition. J Prev Interv Community 2013; 41:142-54. [DOI: 10.1080/10852352.2013.788341] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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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16
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Anderson-Carpenter KD, Collie-Akers V, Colvin JD, Cronin K. The Role of Advocacy in Occasioning Community and Organizational Change in a Medical–Legal Partnership. J Prev Interv Community 2013; 41:167-75. [DOI: 10.1080/10852352.2013.788343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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17
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Abstract
Health disparities, differences in health status, and mortality among different groups have challenged the public health commitment to health for all. African Americans and Latinos have historically experienced greater prevalence and mortality from many chronic diseases than Whites. Community mobilization is a promising approach to addressing health disparities. The Kansas City—Chronic Disease Coalition (KC-CDC), a REACH 2010 initiative, aimed to engage neighborhoods and faith organization in changing conditions to reduce risk for cardiovascular disease and diabetes. Using a time series design replicated with each of these two sectors, we examined the effects of a microgrant strategy and a resource distribution strategy on the coalition's facilitation of community change. Results indicate that both strategies increased the implementation of community change by neighborhood and faith organizations, with higher rates of change for the microgrant strategy. This study holds important implications for public health practitioners working with neighborhood and faith-based organizations to address health disparities.
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Affiliation(s)
- Vicki Collie-Akers
- University of Kansas Work Group for Community Health
and Development in Lawrence, Kansas
| | - Jerry A. Schultz
- University of Kansas Work Group for Community Health
and Development in Lawrence, Kansas
| | - Valorie Carson
- United Community Services of Johnson County in Lenexa,
Kansas
| | - Stephen B. Fawcett
- University of Kansas Work Group for Community Health
and Development in Lawrence, Kansas
| | - Marianne Ronan
- Kansas City-Chronic Disease Coalition in Kansas City,
Missouri
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