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Salud America! Developing a National Latino Childhood Obesity Research Agenda.
No full textU.S. childhood obesity has reached epidemic proportions, with one third of children overweight or obese. Latino children have some of the highest obesity rates, a concern because they are part of the youngest and fastest-growing U.S. minority group. Unfortunately, scarce research data on Latinos hinders the development and implementation of evidence-based, culturally appropriate childhood obesity interventions. In response, the Salud America! network conducted a national Delphi survey among researchers and stakeholders to identify research priorities to address Latino childhood obesity and compare differences by occupation and race or ethnicity. The resulting first-ever National Latino Childhood Obesity Research Agenda provides a framework to stimulate research and collaboration among investigators, providers, and communities, and inform policy makers about the epidemic's seriousness and specific needs for priority funding. The agenda ranks family as the main ecological level to prevent Latino childhood obesity--followed by community, school, society, and individual-and ranks top research priorities in each level
Life in a Food Desert
No full textCarolyn Aidman, of Emory's Urban Health Initiative, explains the concept of a "food desert" and talks about the burden it places on residents of disadvantaged urban areas, both in terms of money and health. Aidman also outlines measures aimed at increasing access to healthy food. The Healthy Food Financing Initiative defines a "food desert" as "a low-income census tract where a substantial number or share of residents has low access to a supermarket or large grocery store.
HIV Screening and Access to Care: Exploring the Impact of Policies on Access to and Provision of HIV Care
No full textWith the widespread use of highly active anti-retroviral treatment (HAART), HIV has become a chronic, rather than a fatal, disease. But for their treatment to succeed, patients require uninterrupted care from a health care provider and uninterrupted access to anti-HIV medications. The IOM identifies federal, state, and private health insurance policies that inhibit HIV-positive individuals from initiating or continuing their care
Evaluation of a Tailored Approach for Tobacco Dependence Treatment for American Indians
No full textPurpose. Evaluate a tailored approach for tobacco dependence treatment for American Indians.
Design. A single-group design evaluation of a culturally specific curriculum for tobacco dependence treatment was implemented. Baseline assessment, program utilization, and 90-day follow-up interview data were analyzed.
Setting. Fond du Lac Reservation in rural Minnesota and Mashkiki Waakaaigan Pharmacy in Minneapolis, Minnesota.
Subjects. American Indian adults (N = 317).
Intervention. Four 1-hour individual or group sessions of behavioral counseling paired with pharmacotherapy.
Measures. Demographic variables, program satisfaction, and tobacco use behaviors.
Analysis. Descriptive statistics; for abstinence, a smoking = missing analysis was used, assuming all nonrespondents were still smoking.
Results. Sixty-three percent of participants completed the program. The 90-day follow-up response rate was 47%. Of those who completed, 47% reported abstinence at the 90-day follow-up. Missing = smoking analysis yielded a 21.8% quit rate. Continuing smokers cut their daily smoking by half from 17 to eight cigarettes, 88% reported an increase in self-efficacy for their next quit, and 44% planned to quit within 30 days.
Conclusion. Evidence-based tobacco dependence treatment programs tailored to be culturally specific have the potential to significantly affect the burden of tobacco-related disparities among American Indian
Motivating Latino Smokers to Quit: Does Type of Social Support Matter?
No full textPurpose. Social support may help smokers quit and buffer against factors that hinder quitting. The study's aims are to examine which types of social support are effective for quitting smoking among Latino smokers and whether social support buffers the effects of depressed mood on smoking cessation.
Design, Setting, Subjects. Participants were Latino smokers with children with asthma (N = 131, mean age = 37 years, 73% female). They did not have to want to quit smoking to participate. Smoking status was biochemically verified at a 3-month follow-up.
Measures. Social support was assessed as whether or not the participant had a significant other, level of perceived general support (Interpersonal Support Evaluation List) and level of perceived partner support for smoking cessation (Partner Interaction Questionnaire). Depressed mood was assessed with the Center for Epidemiological Studies–Depression scale.
Analysis. Hierarchical logistic regression.
Results. Thirty percent of those with a partner quit smoking versus 14.3% of those without a partner. 43.5% of those with high levels of perceived positive partner support quit smoking vs. 17.4% of those with low levels. There was a significant interaction between whether or not a smoker had a partner and depressed mood on quitting: among those not partnered, quit rates were higher among those with low levels of depressed mood (37%) than among those with high levels of depressed mood (9%; odds ratio = 1.147, 95% confidence interval = 1.031–1.276, p < .02). Among those partnered, quit rates were not significantly different between those with high vs. low levels of depressed mood.
Conclusions. This paper is the first to examine multiple sources of support for smoking cessation in Latino smokers; partner support and the presence of a significant other are associated with quitting smoking
The GoodNEWS (Genes, Nutrition, Exercise, Wellness, and Spiritual Growth) Trial: A community-based participatory research (CBPR) trial with African-American church congregations for reducing cardiovascular disease risk factors — recruitment, measurement, and randomization
No full textIntroduction
Although cardiovascular diseases (CVD) are the leading cause of death among Americans, significant disparities persist in CVD prevalence, morbidity, and mortality based on race and ethnicity. However, few studies have examined risk factor reduction among the poor and ethnic minorities.
Methods
Community-based participatory research (CBPR) study using a cluster randomized design — African-American church congregations are the units of randomization and individuals within the congregations are the units of analysis. Outcome variables include dietary change (Diet History Questionnaire), level of physical activity (7-Day Physical Activity Recall), lipoprotein levels, blood pressure, fasting glucose, and hemoglobin A1c.
Results
Eighteen (18) church congregations were randomized to either a health maintenance intervention or a control condition. Complete data were obtained on 392 African-American individuals, 18 to 70 years of age, predominantly employed women with more than a high school diploma. Treatment and intervention groups were similar at baseline on saturated fat intake, metabolic equivalent of tasks (METS) per day, and other risk factors for CVD.
Conclusions
The GoodNEWS trial successfully recruited and evaluated CVD-related risk among African-American participants using a CBPR approach. Several logistical challenges resulted in extending the recruitment, preliminary training, and measurement periods. The challenges were overcome with the assistance of a local community consultant and a professional event planner. Our experience supports the need for incorporating non-traditional community-based staff into the design and operational plan of CBPR trials
Breast cancer screening and ethnicity in the United States: implications for health disparities research
No full textEthnic and racial minority women within the U.S. are less likely to use breast cancer screening (BCS) procedures than non-Latina White women, and are more likely to be diagnosed with cancer at later stages of disease. Previous studies examining Latina rates of screening and disease have used aggregated populations for comparison, possibly attenuating important ethnic healthcare disparities and yielding misleading findings. The purpose of this study was to examine if ethnicity matters in understanding current estimates of BCS patterns among U.S. women; to test if healthcare disparities in BCS are present, and if any ethnic/racial groups are primarily affected. The authors used multivariate multinomial regression to examine self-reported mammogram and clinical breast exam in the 2007 full-year U.S. Medical Expenditure Panel Survey. Mexican origin women reported the lowest rates of past-year mammograms and clinical breast examination. Factors enabling healthcare moderated the group’s lower likelihood of mammograms and clinical breast examination. Some breast cancer screening parity appears to have been achieved in 2007 for Black and some Latina groups; however, those rates lag behind for the largest Latino ethnic group, Mexican. Factors enabling healthcare access, such as education, income and insurance, attenuated the BCS inequalities found for Mexican origin women. Findings suggest that successful efforts to reduce BCS disparities be strategically redirected to include women of Mexican origin in addition to other underserved populations
Collecting Race, Ethnicity, and Language Data to Identify and Reduce Health Disparities: Perceptions of Health Plan Enrollees
No full textAbstract available at publisher's website
State of Health Equity Movement, 2011 Update Part B: Catalog of Activities DRA Project Report No. 11-02
Get PDFState of Health Equity Movement, 2011 Update
Part B: Catalog of Activities
DRA Project Report No. 11-0
THE SUSTAINING RELEVANCE OF W. E. B. DU BOIS TO HEALTH DISPARITIES RESEARCH
No full textWilliam Edward Burghardt Du Bois is considered one of the most prolific and brilliant scholars of our time. While his contributions to civil rights, sociology, history, African American studies, and urban studies are universally recognized, his legacy in the public health and epidemiology discourses is not as widely acknowledged by contemporary health researchers. His seminal work The Philadelphia Negro: A Social Study (1899) and his report “The Health and Physique of the Negro American” (1906) may be considered early harbingers in general of public health—and more specifically, social epidemiology—research. During the late nineteenth and early twentieth centuries, Black and White differences in mortality and morbidity were largely attributed to notions of biological racial inferiority. Efforts by Du Bois to challenge these predominant notions resulted in the systematic empirical investigation of social factors contributing to Black health risk and health disparities. More than one hundred years after Du Bois’s pioneering scholarship, racial0ethnic and social disparities remain a central challenge for public health and medical professionals. Given the persistence of health disparities and the increasing focus on neighborhood social and physical environments as fundamental factors contributing to health inequalities, this paper seeks to historically situate Du Bois’s scholarship, describe the methodological and conceptual
significance of his seminal studies, and articulate the importance of incorporating Du Bois’s legacy to advance the next generation of racial0ethnic health inequality research