NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
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Sabo, Samantha; Lee, Alison Elizabeth Frontiers in Public Health, 3 (155), 2015. @article{Sabo2015b, title = {The Spillover of US Immigration Policy on Citizens and Permanent Residents of Mexican Descent: How Internalizing "Illegality" Impacts Public Health in the Borderlands}, author = {Samantha Sabo and Alison Elizabeth Lee}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26125018}, doi = {10.3389/fpubh.2015.00155}, year = {2015}, date = {2015-06-11}, journal = {Frontiers in Public Health}, volume = {3}, number = {155}, abstract = {BACKGROUND: The militarization of the US-Mexico border region exacerbates the process of "Othering" Latino immigrants - as "illegal aliens." The internalization of "illegality" can manifest as a sense of "undeservingness" of legal protection in the population and be detrimental on a biopsychological level. OBJECTIVE: We explore the impacts of "illegality" among a population of US citizen and permanent resident farmworkers of Mexican descent. We do so through the lens of immigration enforcement-related stress and the ability to file formal complaints of discrimination and mistreatment perpetrated by local immigration enforcement agents, including local police authorized to enforce immigration law. METHODS: Drawing from cross-sectional data gathered through the National Institute of Occupation Safety and Health, "Challenges to Farmworker Health at the US-Mexico Border" study, a community-based participatory research project conducted at the Arizona-Sonora border, we compared Arizona resident farmworkers (N = 349) to Mexico-based farmworkers (N = 140) or Transnational farmworkers who cross the US-Mexico border daily or weekly to work in US agriculture. RESULTS: Both samples of farmworkers experience significant levels of stress in anticipation of encounters with immigration officials. Fear was cited as the greatest factor preventing individuals from reporting immigration abuses. The groups varied slightly in the relative weight attributed to different types of fear. CONCLUSION: The militarization of the border has consequences for individuals who are not the target of immigration enforcement. These spillover effects cause harm to farmworkers in multiple ways. Multi-institutional and community-centered systems for reporting immigration-related victimization is required. Applied participatory research with affected communities can mitigate the public health effects of state-sponsored immigration discrimination and violence among US citizen and permanent residents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: The militarization of the US-Mexico border region exacerbates the process of "Othering" Latino immigrants - as "illegal aliens." The internalization of "illegality" can manifest as a sense of "undeservingness" of legal protection in the population and be detrimental on a biopsychological level. OBJECTIVE: We explore the impacts of "illegality" among a population of US citizen and permanent resident farmworkers of Mexican descent. We do so through the lens of immigration enforcement-related stress and the ability to file formal complaints of discrimination and mistreatment perpetrated by local immigration enforcement agents, including local police authorized to enforce immigration law. METHODS: Drawing from cross-sectional data gathered through the National Institute of Occupation Safety and Health, "Challenges to Farmworker Health at the US-Mexico Border" study, a community-based participatory research project conducted at the Arizona-Sonora border, we compared Arizona resident farmworkers (N = 349) to Mexico-based farmworkers (N = 140) or Transnational farmworkers who cross the US-Mexico border daily or weekly to work in US agriculture. RESULTS: Both samples of farmworkers experience significant levels of stress in anticipation of encounters with immigration officials. Fear was cited as the greatest factor preventing individuals from reporting immigration abuses. The groups varied slightly in the relative weight attributed to different types of fear. CONCLUSION: The militarization of the border has consequences for individuals who are not the target of immigration enforcement. These spillover effects cause harm to farmworkers in multiple ways. Multi-institutional and community-centered systems for reporting immigration-related victimization is required. Applied participatory research with affected communities can mitigate the public health effects of state-sponsored immigration discrimination and violence among US citizen and permanent residents. |
Eaves, Emery R; Nichter, Mark; Ritenbaugh, Cheryl; Sutherland, Elizabeth; Dworkin, Samuel F Works of Illness and the Challenges of Social Risk and the Specter of Pain in the Lived Experience of TMD Journal Article Medical Anthropology Quarterly, 29 (2), pp. 157-177, 2015. @article{Eaves2015b, title = {Works of Illness and the Challenges of Social Risk and the Specter of Pain in the Lived Experience of TMD}, author = {Emery R Eaves and Mark Nichter and Cheryl Ritenbaugh and Elizabeth Sutherland and Samuel F Dworkin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25331799}, doi = {10.1111/maq.12146}, year = {2015}, date = {2015-06-01}, journal = {Medical Anthropology Quarterly}, volume = {29}, number = {2}, pages = {157-177}, abstract = {Temporomandibular Disorders (TMD) represent a particular form of chronic pain that, while not outwardly debilitating, profoundly impacts interactions as fundamental to human existence as smiling, laughing, speaking, eating, and intimacy. Our analysis, informed by an expanded "works of illness" assessment, draws attention to work surrounding social and physical risk. We refer to these as the work of stoicism and the work of vigilance and identify double binds created in contexts that call for both. Conflicting authorial stances in informants' narratives are shown to be essential in maintaining a positive identity in the face of illness. While earlier ethnographic studies report TMD sufferers' experience of stigma and search for diagnosis and legitimacy, we present a group of individuals who have accepted diagnosis at face value and soldier through pain as a fundamental aspect of their identity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Temporomandibular Disorders (TMD) represent a particular form of chronic pain that, while not outwardly debilitating, profoundly impacts interactions as fundamental to human existence as smiling, laughing, speaking, eating, and intimacy. Our analysis, informed by an expanded "works of illness" assessment, draws attention to work surrounding social and physical risk. We refer to these as the work of stoicism and the work of vigilance and identify double binds created in contexts that call for both. Conflicting authorial stances in informants' narratives are shown to be essential in maintaining a positive identity in the face of illness. While earlier ethnographic studies report TMD sufferers' experience of stigma and search for diagnosis and legitimacy, we present a group of individuals who have accepted diagnosis at face value and soldier through pain as a fundamental aspect of their identity. |
Klaus, Kimberly; Baldwin, Julie A; Izurieta, Ricardo; Naik, Eknath; Seme, Assefa; Corvin, Jaime; Sinke, Abiy Hiruye; Enquselassie, Fikre REDUCING PMTCT ATTRITION: PERSPECTIVES OF HIV+ WOMEN ON THE PREVENTION OF MOTHER-TO-CHILD HIV SERVICES IN ADDIS ABABA, ETHIOPIA Journal Article Ethiopian Medical Journal, 53 (2), pp. 91-104, 2015. @article{Klaus2015, title = {REDUCING PMTCT ATTRITION: PERSPECTIVES OF HIV+ WOMEN ON THE PREVENTION OF MOTHER-TO-CHILD HIV SERVICES IN ADDIS ABABA, ETHIOPIA}, author = {Kimberly Klaus and Julie A Baldwin and Ricardo Izurieta and Eknath Naik and Assefa Seme and Jaime Corvin and Abiy Hiruye Sinke and Fikre Enquselassie}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26591297}, year = {2015}, date = {2015-04-01}, journal = {Ethiopian Medical Journal}, volume = {53}, number = {2}, pages = {91-104}, abstract = {BACKGROUND: Only 41% of eligible Ethiopian women completed (PMTCT) therapy in 2012, with MTCT rate of 20%. OBJECTIVE: This study elicited the perspectives of HIV positive mothers on the situation and the unique beliefs, attitudes, cultural norms and individuals who have influence over them during their pregnancy. METHODS: The mixed-methods parent study included community level surveys, focus groups and in-depth individual interviews of HIV positive women with a child at least one year of age in Addis Ababa, Ethiopia: only focus group and interview data are presented here. All tools were completed in Amharic with English translation. RESULTS: 23 women completed in-depth interviews; 27 participated within 4 focus groups. The greatest barriers to PMTCT completion were: feelings of hopelessness and carelessness, lack of understanding of the efficacy of ARV, and negative religious influences. The advice to improve PMTCT adherence most frequently offered included increasing PLWHIV peer support and improving and extending current HIV educational efforts. Participants recommended that PLWHIV mothers be utilized in all PMTCT planning and interventions in the future. CONCLUSION: Maintaining the motivation to adhere to the entire PMTCT cascade requires that a PLWHIV mother understands the validity of the steps she is taking and receives support for the many challenges she faces. Engaging PLWHIV peers as active members of the health care workforce and expanding their use as educators and counselors is important. Health officials can consider these findings to develop innovative and effective PMTCT interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Only 41% of eligible Ethiopian women completed (PMTCT) therapy in 2012, with MTCT rate of 20%. OBJECTIVE: This study elicited the perspectives of HIV positive mothers on the situation and the unique beliefs, attitudes, cultural norms and individuals who have influence over them during their pregnancy. METHODS: The mixed-methods parent study included community level surveys, focus groups and in-depth individual interviews of HIV positive women with a child at least one year of age in Addis Ababa, Ethiopia: only focus group and interview data are presented here. All tools were completed in Amharic with English translation. RESULTS: 23 women completed in-depth interviews; 27 participated within 4 focus groups. The greatest barriers to PMTCT completion were: feelings of hopelessness and carelessness, lack of understanding of the efficacy of ARV, and negative religious influences. The advice to improve PMTCT adherence most frequently offered included increasing PLWHIV peer support and improving and extending current HIV educational efforts. Participants recommended that PLWHIV mothers be utilized in all PMTCT planning and interventions in the future. CONCLUSION: Maintaining the motivation to adhere to the entire PMTCT cascade requires that a PLWHIV mother understands the validity of the steps she is taking and receives support for the many challenges she faces. Engaging PLWHIV peers as active members of the health care workforce and expanding their use as educators and counselors is important. Health officials can consider these findings to develop innovative and effective PMTCT interventions. |
Ingram, Maia; Sabo, Samantha; Gomez, Sofia; Piper, Rosalinda; de Zapien, Jill Guernsey; Reinschmidt, Kerstin M; Schachter, Ken A; Carvajal, Scott C Progress in Community Health Partnerships: Research, Education, and Action, 9 (1), pp. 49-56, 2015. @article{Ingram2015, title = {Taking a community-based participatory research approach in the development of methods to measure a community health worker community advocacy intervention}, author = {Maia Ingram and Samantha Sabo and Sofia Gomez and Rosalinda Piper and Jill Guernsey de Zapien and Kerstin M Reinschmidt and Ken A Schachter and Scott C Carvajal}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25981424}, doi = {10.1353/cpr.2015.0001}, year = {2015}, date = {2015-04-01}, journal = {Progress in Community Health Partnerships: Research, Education, and Action}, volume = {9}, number = {1}, pages = {49-56}, abstract = {BACKGROUND: Public health advocacy is by necessity responsive to shifting sociopolitical climates, and thus a challenge of advocacy research is that the intervention must by definition be adaptive. Moving beyond the classification of advocacy efforts to measurable indicators and outcomes of policy, therefore, requires a dynamic research approach. OBJECTIVES: The purposes of this article are to (1) describe use of the CBPR approach in the development and measurement of a community health worker (CHW) intervention designed to engage community members in public health advocacy and (2) provide a model for application of this approach in advocacy interventions addressing community-level systems and environmental change. METHODS: The Kingdon three streams model of policy change provided a theoretical framework for the intervention. Research and community partners collaboratively identified and documented intervention data. We describe five research methods used to monitor and measure CHW advocacy activities that both emerged from and influenced intervention activities. DISCUSSION: Encounter forms provided a longitudinal perspective of how CHWs engaged in advocacy activities in the three streams. Strategy maps defined desired advocacy outcomes and health benefits. Technical assistance notes identified and documented intermediate outcomes. Focus group and interview data reflected CHW efforts to engage community members in advocacy and the development of community leaders. APPLICATION OF LESSONS LEARNED: We provide a model for application of key principles of CPBR that are vital to effectively capturing the overarching and nuanced aspects of public health advocacy work in dynamic political and organizational environments.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Public health advocacy is by necessity responsive to shifting sociopolitical climates, and thus a challenge of advocacy research is that the intervention must by definition be adaptive. Moving beyond the classification of advocacy efforts to measurable indicators and outcomes of policy, therefore, requires a dynamic research approach. OBJECTIVES: The purposes of this article are to (1) describe use of the CBPR approach in the development and measurement of a community health worker (CHW) intervention designed to engage community members in public health advocacy and (2) provide a model for application of this approach in advocacy interventions addressing community-level systems and environmental change. METHODS: The Kingdon three streams model of policy change provided a theoretical framework for the intervention. Research and community partners collaboratively identified and documented intervention data. We describe five research methods used to monitor and measure CHW advocacy activities that both emerged from and influenced intervention activities. DISCUSSION: Encounter forms provided a longitudinal perspective of how CHWs engaged in advocacy activities in the three streams. Strategy maps defined desired advocacy outcomes and health benefits. Technical assistance notes identified and documented intermediate outcomes. Focus group and interview data reflected CHW efforts to engage community members in advocacy and the development of community leaders. APPLICATION OF LESSONS LEARNED: We provide a model for application of key principles of CPBR that are vital to effectively capturing the overarching and nuanced aspects of public health advocacy work in dynamic political and organizational environments. |
Sabo, Samantha; de Zapien, Jill; Teufel-Shone, Nicolette; Rosales, Cecilia; Bergsma, Lynda; Taren, Douglas Service learning: a vehicle for building health equity and eliminating health disparities Journal Article American Journal of Public health, 105 (S1), pp. S38-S43, 2015. @article{Sabo2015c, title = {Service learning: a vehicle for building health equity and eliminating health disparities}, author = {Samantha Sabo and Jill de Zapien and Nicolette Teufel-Shone and Cecilia Rosales and Lynda Bergsma and Douglas Taren}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25706014}, doi = {10.2105/AJPH.2014.302364}, year = {2015}, date = {2015-03-01}, journal = {American Journal of Public health}, volume = {105}, number = {S1}, pages = {S38-S43}, abstract = {Service learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection on the broader social, economic, and political contexts of health. We describe the elements and impact of five distinct week-long intensive SL courses focused on the context of urban, rural, border, and indigenous health contexts. Students involved in these SL courses demonstrated a commitment to community-engaged scholarship and practice in both their student and professional lives. SL is directly in line with the core public health value of social justice and serves as a venue to strengthen community-campus partnerships in addressing health disparities through sustained collaboration and action in vulnerable communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Service learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection on the broader social, economic, and political contexts of health. We describe the elements and impact of five distinct week-long intensive SL courses focused on the context of urban, rural, border, and indigenous health contexts. Students involved in these SL courses demonstrated a commitment to community-engaged scholarship and practice in both their student and professional lives. SL is directly in line with the core public health value of social justice and serves as a venue to strengthen community-campus partnerships in addressing health disparities through sustained collaboration and action in vulnerable communities. |
Trotter, Robert; Laurila, Kelly; Alberts, David; Huenneke, Laura F Evaluation and Program Planning, 48 (1), pp. 10-20, 2015. @article{Trotter2015, title = {A diagnostic evaluation model for complex research partnerships with community engagement: The partnership for Native American Cancer Prevention (NACP) model}, author = {Robert Trotter and Kelly Laurila and David Alberts and Laura F Huenneke}, url = {http://www.sciencedirect.com/science/article/pii/S0149718914000974}, year = {2015}, date = {2015-02-28}, journal = {Evaluation and Program Planning}, volume = {48}, number = {1}, pages = {10-20}, abstract = {Complex community oriented health care prevention and intervention partnerships fail or only partially succeed at alarming rates. In light of the current rapid expansion of critically needed programs targeted at health disparities in minority populations, we have designed and are testing an “logic model plus” evaluation model that combines classic logic model and query based evaluation designs (CDC, NIH, Kellogg Foundation) with advances in community engaged designs derived from industry–university partnership models. These approaches support the application of a “near real time” feedback system (diagnosis and intervention) based on organizational theory, social network theory, and logic model metrics directed at partnership dynamics, combined with logic model metrics.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Complex community oriented health care prevention and intervention partnerships fail or only partially succeed at alarming rates. In light of the current rapid expansion of critically needed programs targeted at health disparities in minority populations, we have designed and are testing an “logic model plus” evaluation model that combines classic logic model and query based evaluation designs (CDC, NIH, Kellogg Foundation) with advances in community engaged designs derived from industry–university partnership models. These approaches support the application of a “near real time” feedback system (diagnosis and intervention) based on organizational theory, social network theory, and logic model metrics directed at partnership dynamics, combined with logic model metrics. |
Eaves, Emery R; Sherman, Karen J; Ritenbaugh, Cheryl; Hsu, Clarissa; Nichter, Mark; Turner, Judith A; Cherkin, Daniel C A qualitative study of changes in expectations over time among patients with chronic low back pain seeking four CAM therapies Journal Article BMC Complementary and Alternative Medicine, 15 (1), pp. 12, 2015. @article{Eaves2015c, title = {A qualitative study of changes in expectations over time among patients with chronic low back pain seeking four CAM therapies}, author = {Emery R Eaves and Karen J Sherman and Cheryl Ritenbaugh and Clarissa Hsu and Mark Nichter and Judith A Turner and Daniel C Cherkin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25652396}, doi = {10.1186/s12906-015-0531-9}, year = {2015}, date = {2015-02-05}, journal = {BMC Complementary and Alternative Medicine}, volume = {15}, number = {1}, pages = {12}, abstract = {BACKGROUND: The relationship between patient expectations about a treatment and the treatment outcomes, particularly for Complementary and Alternative Medicine (CAM) therapies, is not well understood. Using qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies, we examined how participants' expectations of treatment changed over the course of a therapy. METHODS: We conducted semi-structured qualitative interviews with 64 participants initiating one of four CAM therapies (yoga, chiropractic, acupuncture, massage) for chronic low back pain. Participants just starting treatment were interviewed up to three times over a period of 3 months. Interviews were transcribed verbatim and analyzed using a qualitative mixed methods approach incorporating immersion/crystallization and matrix analysis for a decontexualization and recontextualization approach to understand changes in thematic emphasis over time. RESULTS: Pre-treatment expectations consisted of conjecture about whether or not the CAM therapy could relieve pain and improve participation in meaningful activities. Expectations tended to shift over the course of treatment to be more inclusive of broader lifestyle factors, the need for long-term pain management strategies and attention to long-term quality of life and wellness. Although a shift toward greater acceptance of chronic pain and the need for strategies to keep pain from flaring was observed across participants regardless of therapy, participants varied in their assessments of whether increased awareness of the need for ongoing self-care and maintenance strategies was considered a "positive outcome". Regardless of how participants evaluated the outcome of treatment, participants from all four therapies reported increased awareness, acceptance of the chronic nature of pain, and attention to the need to take responsibility for their own health. CONCLUSIONS: The shift in treatment expectations to greater acceptance of pain and the need for continued self-care suggests that future research should explore how CAM practitioners can capitalize on these shifts to encourage feelings of empowerment rather than disappointment surrounding realizations of the need for continued engagement with self-care.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: The relationship between patient expectations about a treatment and the treatment outcomes, particularly for Complementary and Alternative Medicine (CAM) therapies, is not well understood. Using qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies, we examined how participants' expectations of treatment changed over the course of a therapy. METHODS: We conducted semi-structured qualitative interviews with 64 participants initiating one of four CAM therapies (yoga, chiropractic, acupuncture, massage) for chronic low back pain. Participants just starting treatment were interviewed up to three times over a period of 3 months. Interviews were transcribed verbatim and analyzed using a qualitative mixed methods approach incorporating immersion/crystallization and matrix analysis for a decontexualization and recontextualization approach to understand changes in thematic emphasis over time. RESULTS: Pre-treatment expectations consisted of conjecture about whether or not the CAM therapy could relieve pain and improve participation in meaningful activities. Expectations tended to shift over the course of treatment to be more inclusive of broader lifestyle factors, the need for long-term pain management strategies and attention to long-term quality of life and wellness. Although a shift toward greater acceptance of chronic pain and the need for strategies to keep pain from flaring was observed across participants regardless of therapy, participants varied in their assessments of whether increased awareness of the need for ongoing self-care and maintenance strategies was considered a "positive outcome". Regardless of how participants evaluated the outcome of treatment, participants from all four therapies reported increased awareness, acceptance of the chronic nature of pain, and attention to the need to take responsibility for their own health. CONCLUSIONS: The shift in treatment expectations to greater acceptance of pain and the need for continued self-care suggests that future research should explore how CAM practitioners can capitalize on these shifts to encourage feelings of empowerment rather than disappointment surrounding realizations of the need for continued engagement with self-care. |
Teufel-Shone, Nicolette; Jiang, Luohua; Beals, Janette; Henderson, William G; Zhang, Lijing; Acton, Kelly J; Roubideaux, Yvette; Manson, Spero M Ethnicity and Health, 20 (4), pp. 327-340, 2015. @article{Teufel-Shone2015b, title = {Demographic characteristics and food choices of participants in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project}, author = {Nicolette Teufel-Shone and Luohua Jiang and Janette Beals and William G Henderson and Lijing Zhang and Kelly J Acton and Yvette Roubideaux and Spero M Manson}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24954106}, doi = {10.1080/13557858.2014.921890}, year = {2015}, date = {2015-01-01}, journal = {Ethnicity and Health}, volume = {20}, number = {4}, pages = {327-340}, abstract = {OBJECTIVE: American Indians and Alaska Natives (AI/ANs) suffer a disproportionate burden of diabetes. Identifying food choices of AI/ANs at risk of type 2 diabetes, living in both rural and urban settings, is critical to the development of culturally relevant, evidence-based education strategies designed to reduce morbidity and mortality in this population. DESIGN: At baseline, 3135 AI/AN adults participating in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project (SDPI-DP) completed a socio-demographic survey and a 27-item food frequency questionnaire (FFQ). The primary dietary behavior goal of SDPI-DP education sessions and lifestyle coaching is changes in food choices, i.e., increased fruits, vegetables and whole grains, decreased high sugar beverages, red meat, and processed foods. Subsequently, program assessment focuses on changes in food types. Foods were delineated using a 'healthy' and 'unhealthy' classification as defined by the educators advising participants. Urban and rural differences were examined using χ(2) tests and two sample t-tests. Multiple linear regressions and linear mixed models were used to assess the association between socio-demographic factors and food choice. RESULTS: Retired participants, those living in urban areas and with high income and education selected healthy foods most frequently. Young males, those with low income and education consumed unhealthy foods most frequently. Selection of unhealthy foods did not differ by urban and rural setting. CONCLUSIONS: The ubiquitous nature of unhealthy food choices makes them hard to avoid. Food choice differences by gender, age, income, and setting suggest that nutrition education should more effectively target and meets the needs of young AI/AN males.}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: American Indians and Alaska Natives (AI/ANs) suffer a disproportionate burden of diabetes. Identifying food choices of AI/ANs at risk of type 2 diabetes, living in both rural and urban settings, is critical to the development of culturally relevant, evidence-based education strategies designed to reduce morbidity and mortality in this population. DESIGN: At baseline, 3135 AI/AN adults participating in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project (SDPI-DP) completed a socio-demographic survey and a 27-item food frequency questionnaire (FFQ). The primary dietary behavior goal of SDPI-DP education sessions and lifestyle coaching is changes in food choices, i.e., increased fruits, vegetables and whole grains, decreased high sugar beverages, red meat, and processed foods. Subsequently, program assessment focuses on changes in food types. Foods were delineated using a 'healthy' and 'unhealthy' classification as defined by the educators advising participants. Urban and rural differences were examined using χ(2) tests and two sample t-tests. Multiple linear regressions and linear mixed models were used to assess the association between socio-demographic factors and food choice. RESULTS: Retired participants, those living in urban areas and with high income and education selected healthy foods most frequently. Young males, those with low income and education consumed unhealthy foods most frequently. Selection of unhealthy foods did not differ by urban and rural setting. CONCLUSIONS: The ubiquitous nature of unhealthy food choices makes them hard to avoid. Food choice differences by gender, age, income, and setting suggest that nutrition education should more effectively target and meets the needs of young AI/AN males. |
Cragun, Deborah; DeBate, Rita D; Vadaparampil, Susan T; Baldwin, Julie A; Hampel, Heather; Pal, Tuya Genetics in Medicine, 16 (10), pp. 773-782, 2014. @article{Cragun2014, title = {Comparing universal Lynch syndrome tumor-screening programs to evaluate associations between implementation strategies and patient follow-through}, author = {Deborah Cragun and Rita D DeBate and Susan T Vadaparampil and Julie A Baldwin and Heather Hampel and Tuya Pal}, url = {https://www.nature.com/gim/journal/v16/n10/full/gim201431a.html}, doi = {10.1038/gim.2014.31}, year = {2014}, date = {2014-10-01}, journal = {Genetics in Medicine}, volume = {16}, number = {10}, pages = {773-782}, abstract = {PURPOSE: Universal tumor screening (UTS) for all colorectal cancer patients can improve the identification of Lynch syndrome, the most common cause of hereditary colorectal cancer. This multiple-case study explored how variability in UTS procedures influenced patient follow-through (PF) with germ-line testing after a screen-positive result. METHODS: Data were obtained through Web-based surveys and telephone interviews with institutional informants. Institutions were categorized as Low-PF (≤10% underwent germ-line testing), Medium-PF (11-40%), or High-PF (>40%). To identify implementation procedures (i.e., conditions) unique to High-PF institutions, qualitative comparative analysis was performed. RESULTS: Twenty-one informants from 15 institutions completed surveys and/or interviews. Conditions present among all five High-PF institutions included the following: (i) disclosure of screen-positive results to patients by genetic counselors; and (ii) genetic counselors either facilitate physician referrals to genetics professionals or eliminate the need for referrals. Although both of these High-PF conditions were present among two Medium-PF institutions, automatic reflex testing was lacking and difficulty contacting screen-positive patients was a barrier. The three remaining Medium-PF and five Low-PF institutions lacked the conditions found in High-PF institutions. CONCLUSION: METHODS for streamlining UTS procedures, incorporating a high level of involvement of genetic counselors in tracking and communication of results and in reducing barriers to patient contact, are reviewed within a broader discussion on maximizing the effectiveness and public health impact of UTS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } PURPOSE: Universal tumor screening (UTS) for all colorectal cancer patients can improve the identification of Lynch syndrome, the most common cause of hereditary colorectal cancer. This multiple-case study explored how variability in UTS procedures influenced patient follow-through (PF) with germ-line testing after a screen-positive result. METHODS: Data were obtained through Web-based surveys and telephone interviews with institutional informants. Institutions were categorized as Low-PF (≤10% underwent germ-line testing), Medium-PF (11-40%), or High-PF (>40%). To identify implementation procedures (i.e., conditions) unique to High-PF institutions, qualitative comparative analysis was performed. RESULTS: Twenty-one informants from 15 institutions completed surveys and/or interviews. Conditions present among all five High-PF institutions included the following: (i) disclosure of screen-positive results to patients by genetic counselors; and (ii) genetic counselors either facilitate physician referrals to genetics professionals or eliminate the need for referrals. Although both of these High-PF conditions were present among two Medium-PF institutions, automatic reflex testing was lacking and difficulty contacting screen-positive patients was a barrier. The three remaining Medium-PF and five Low-PF institutions lacked the conditions found in High-PF institutions. CONCLUSION: METHODS for streamlining UTS procedures, incorporating a high level of involvement of genetic counselors in tracking and communication of results and in reducing barriers to patient contact, are reviewed within a broader discussion on maximizing the effectiveness and public health impact of UTS. |
August, Euna M; Daley, Ellen; Kromrey, Jeffrey; Baldwin, Julie A; Romero-Daza, Nancy; Salmeron, Jorge; Lazcano-Ponce, Eduardo; Villa, Luisa L; Bryant, Carol A; Giuliano, Anna R Age-related variation in sexual behaviours among heterosexual men residing in Brazil, Mexico and the USA Journal Article Journal of Family Planning and Reproductive Health Care, 40 (4), pp. 261-269, 2014. @article{August2014, title = {Age-related variation in sexual behaviours among heterosexual men residing in Brazil, Mexico and the USA}, author = {Euna M August and Ellen Daley and Jeffrey Kromrey and Julie A Baldwin and Nancy Romero-Daza and Jorge Salmeron and Eduardo Lazcano-Ponce and Luisa L Villa and Carol A Bryant and Anna R Giuliano}, url = {http://jfprhc.bmj.com/content/40/4/261}, doi = {10.1136/jfprhc-2012-100564}, year = {2014}, date = {2014-10-01}, journal = {Journal of Family Planning and Reproductive Health Care}, volume = {40}, number = {4}, pages = {261-269}, abstract = {OBJECTIVE: To compare the prevalence of demographic characteristics and sexual behaviours across age groups and to estimate their significance in predicting sexual risk factors by age cohort. METHODS: This cohort study examined sexually transmitted infection (STI) prevalence among heterosexual men in Brazil, Mexico and the USA (N=3047). Participants completed a sexual risk factor questionnaire and were tested for chlamydia, gonorrhoea, syphilis and genital herpes. We examined sexual risk in the study population through a composite measure of STI positivity by age cohort (young: 18-30 years; middle-aged: 31-44 years; older: 45-70 years). Multivariable logistic regression models were used to generate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS: We found that STI positivity varied significantly by age group among heterosexual men by a number of covariates. In younger men, having more advanced education had a protective effect (16 years: AOR=0.37, 95% CI 0.15- 0.92), whereas higher numbers of sexual partners elevated the risk for STIs (20-49 partners: AOR=2.06, 95% CI 1.04-4.06; ≥ 50 partners: AOR=4.33, 95% CI 1.74-10.76). Middle-aged men who were black (AOR=1.64, 95% CI 1.10-2.42) and divorced/separated/widowed (AOR=1.91, 95% CI 1.21-3.02) had an increased risk for a positive STI test. Among older men, a younger age at first vaginal sexual encounter (AOR=3.75, 95% CI 1.45-9.74) and a history of exchanging sex for money or drugs heightened STI risk (AOR=2.30, 95% CI 1.0-5.04). CONCLUSIONS: These findings demonstrate that age-related life experiences among heterosexual men influence sexual risk and STI transmission. This topic warrants further investigation to support the development and implementation of targeted interventions that may potentially reduce adverse sexual health outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: To compare the prevalence of demographic characteristics and sexual behaviours across age groups and to estimate their significance in predicting sexual risk factors by age cohort. METHODS: This cohort study examined sexually transmitted infection (STI) prevalence among heterosexual men in Brazil, Mexico and the USA (N=3047). Participants completed a sexual risk factor questionnaire and were tested for chlamydia, gonorrhoea, syphilis and genital herpes. We examined sexual risk in the study population through a composite measure of STI positivity by age cohort (young: 18-30 years; middle-aged: 31-44 years; older: 45-70 years). Multivariable logistic regression models were used to generate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS: We found that STI positivity varied significantly by age group among heterosexual men by a number of covariates. In younger men, having more advanced education had a protective effect (16 years: AOR=0.37, 95% CI 0.15- 0.92), whereas higher numbers of sexual partners elevated the risk for STIs (20-49 partners: AOR=2.06, 95% CI 1.04-4.06; ≥ 50 partners: AOR=4.33, 95% CI 1.74-10.76). Middle-aged men who were black (AOR=1.64, 95% CI 1.10-2.42) and divorced/separated/widowed (AOR=1.91, 95% CI 1.21-3.02) had an increased risk for a positive STI test. Among older men, a younger age at first vaginal sexual encounter (AOR=3.75, 95% CI 1.45-9.74) and a history of exchanging sex for money or drugs heightened STI risk (AOR=2.30, 95% CI 1.0-5.04). CONCLUSIONS: These findings demonstrate that age-related life experiences among heterosexual men influence sexual risk and STI transmission. This topic warrants further investigation to support the development and implementation of targeted interventions that may potentially reduce adverse sexual health outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. |
Teufel-Shone, Nicolette; Gamber, Michelle; Watahomigie, Helen; Siyuja, Jr T J; Crozier, Laurie; Irwin, Sandra L Preventing Chronic Disease, 11 (E166), 2014. @article{Teufel-Shone2014, title = {Using a participatory research approach in a school-based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002-2006}, author = {Nicolette Teufel-Shone and Michelle Gamber and Helen Watahomigie and Jr T. J. Siyuja and Laurie Crozier and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25254984}, doi = {10.5888/pcd11.130397}, year = {2014}, date = {2014-09-25}, journal = {Preventing Chronic Disease}, volume = {11}, number = {E166}, abstract = {INTRODUCTION: In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. METHODS: During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. RESULTS: Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. CONCLUSION: Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth.}, keywords = {}, pubstate = {published}, tppubtype = {article} } INTRODUCTION: In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. METHODS: During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. RESULTS: Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. CONCLUSION: Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth. |
McGinnis, Kara; Montiel-Ishino, Alejandro F; Standifer, Maisha Kambon; Wathington, Deanna; Goldsmith, Johnetta; Baldwin, Julie A Photonovels: an innovative approach to address health disparities and sustainability Journal Article Journal of Cancer Education, 29 (3), pp. 441-448, 2014. @article{McGinnis2014, title = {Photonovels: an innovative approach to address health disparities and sustainability}, author = {Kara McGinnis and Alejandro F Montiel-Ishino and Maisha Kambon Standifer and Deanna Wathington and Johnetta Goldsmith and Julie A Baldwin}, url = {https://link.springer.com/article/10.1007%2Fs13187-014-0607-0}, doi = {10.1007/s13187-014-0607-0}, year = {2014}, date = {2014-09-01}, journal = {Journal of Cancer Education}, volume = {29}, number = {3}, pages = {441-448}, abstract = {Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay. |
Eaves, Emery R; Ritenbaugh, Cheryl; Nichter, Mark; Hopkins, Allison L; Sherman, Karen J EXPLORE: The Journal of Science and Healing, 10 (4), pp. 225-232, 2014. @article{Eaves2014, title = {Modes of hoping: understanding hope and expectation in the context of a clinical trial of complementary and alternative medicine for chronic pain}, author = {Emery R Eaves and Cheryl Ritenbaugh and Mark Nichter and Allison L Hopkins and Karen J Sherman}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25037665}, doi = {10.1016/j.explore.2014.04.004}, year = {2014}, date = {2014-08-01}, journal = {EXPLORE: The Journal of Science and Healing}, volume = {10}, number = {4}, pages = {225-232}, abstract = {This article explores the role of hope in participants' assessments of their expectations, experiences and treatment outcomes. Data analysis focused on semi-structured, open-ended interviews with 44 participants, interviewed 3-5 times each over the course of a study evaluating Traditional Chinese Medicine (TCM) for temporomandibular disorders (TMD), a form of chronic orofacial pain. Transcripts were coded and analyzed using qualitative and ethnographic methods. A "Modes of Hoping" (Webb, 2007)(1) framework informed our analysis. Five modes of hoping emerged from participant narratives: Realistic Hope, Wishful Hope, Utopian Hope, Technoscience Hope, and Transcendent Hope. Using this framework, hope is demonstrated as exerting a profound influence over how participants assess and report their expectations. This suggests that researchers interested in measuring expectations and understanding their role in treatment outcomes should consider hope as exercising a multi-faceted and dynamic influence on participants' reporting of expectations and their experience and evaluation of treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } This article explores the role of hope in participants' assessments of their expectations, experiences and treatment outcomes. Data analysis focused on semi-structured, open-ended interviews with 44 participants, interviewed 3-5 times each over the course of a study evaluating Traditional Chinese Medicine (TCM) for temporomandibular disorders (TMD), a form of chronic orofacial pain. Transcripts were coded and analyzed using qualitative and ethnographic methods. A "Modes of Hoping" (Webb, 2007)(1) framework informed our analysis. Five modes of hoping emerged from participant narratives: Realistic Hope, Wishful Hope, Utopian Hope, Technoscience Hope, and Transcendent Hope. Using this framework, hope is demonstrated as exerting a profound influence over how participants assess and report their expectations. This suggests that researchers interested in measuring expectations and understanding their role in treatment outcomes should consider hope as exercising a multi-faceted and dynamic influence on participants' reporting of expectations and their experience and evaluation of treatment. |
Hsu, Clarissa; Sherman, Karen J; Eaves, Emery R; Turner, Judith A; Cherkin, Daniel C; Cromp, DeAnn; Schafer, Lisa; Ritenbaugh, Cheryl BMC Complementary and Alternative Medicine, 14 (1), pp. 276-286, 2014. @article{Hsu2014, title = {New perspectives on patient expectations of treatment outcomes: results from qualitative interviews with patients seeking complementary and alternative medicine treatments for chronic low back pain.}, author = {Clarissa Hsu and Karen J Sherman and Emery R Eaves and Judith A Turner and Daniel C Cherkin and DeAnn Cromp and Lisa Schafer and Cheryl Ritenbaugh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25077732}, doi = {10.1186/1472-6882-14-276}, year = {2014}, date = {2014-07-30}, journal = {BMC Complementary and Alternative Medicine}, volume = {14}, number = {1}, pages = {276-286}, abstract = {BACKGROUND: Positive patient expectations are often believed to be associated with greater benefits from complementary and alternative medicine (CAM) treatments. However, clinical studies of CAM treatments for chronic pain have not consistently supported this assumption, possibly because of differences in definitions and measures of expectations. The goal of this qualitative paper is to provide new perspectives on the outcome expectations of patients prior to receiving CAM therapies for chronic low back pain. METHODS: We conducted semi-structured interviews with 64 individuals receiving massage, chiropractic, acupuncture or yoga for chronic low back pain. Interviews were recorded and transcribed. Transcripts were analyzed by a team of experienced qualitative researchers using an immersion/crystallization approach to coding and analysis. RESULTS: Overall, participants' expectations of treatment outcomes tended to cluster in four key domains: pain relief, improved function (including an increase in ability to engage in meaningful activities), improved physical fitness, and improved overall well-being (including mental well-being). Typically, patients had modest expectations for outcomes from treatment. Furthermore, outcome expectations were complex on several levels. First, the concept of expectations overlapped with several related concepts; in particular, hopes. Participants sometimes used expectations and hopes interchangeably and at other times made clear distinctions between these two terms depending on context. A related finding was that participants were cautious about stating that they expected positive outcomes. Finally, participants articulated strong interrelationships among the four key domains and often discussed how changes in one domain might affect other domains. CONCLUSIONS: Overall, these findings contribute to a growing body of literature exploring the role of expectations in patient outcomes. This paper provides important guidance that may help refine the way treatment expectations are studied in the future. In particular, participants' statements indicate that standardized measures of patient expectations should include items that capture hesitancy to articulate overly optimistic outcomes as well as interrelationships among different outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Positive patient expectations are often believed to be associated with greater benefits from complementary and alternative medicine (CAM) treatments. However, clinical studies of CAM treatments for chronic pain have not consistently supported this assumption, possibly because of differences in definitions and measures of expectations. The goal of this qualitative paper is to provide new perspectives on the outcome expectations of patients prior to receiving CAM therapies for chronic low back pain. METHODS: We conducted semi-structured interviews with 64 individuals receiving massage, chiropractic, acupuncture or yoga for chronic low back pain. Interviews were recorded and transcribed. Transcripts were analyzed by a team of experienced qualitative researchers using an immersion/crystallization approach to coding and analysis. RESULTS: Overall, participants' expectations of treatment outcomes tended to cluster in four key domains: pain relief, improved function (including an increase in ability to engage in meaningful activities), improved physical fitness, and improved overall well-being (including mental well-being). Typically, patients had modest expectations for outcomes from treatment. Furthermore, outcome expectations were complex on several levels. First, the concept of expectations overlapped with several related concepts; in particular, hopes. Participants sometimes used expectations and hopes interchangeably and at other times made clear distinctions between these two terms depending on context. A related finding was that participants were cautious about stating that they expected positive outcomes. Finally, participants articulated strong interrelationships among the four key domains and often discussed how changes in one domain might affect other domains. CONCLUSIONS: Overall, these findings contribute to a growing body of literature exploring the role of expectations in patient outcomes. This paper provides important guidance that may help refine the way treatment expectations are studied in the future. In particular, participants' statements indicate that standardized measures of patient expectations should include items that capture hesitancy to articulate overly optimistic outcomes as well as interrelationships among different outcomes. |
Weller, Susan C; Baer, Roberta D; de Garcia, Javier Garcia Alba; Glazer, Mark; Trotter, Robert; Rocha, Ana Salcedo L; Klein, Robert E; Pachter, Lee M Variation and Persistence in Latin American Beliefs About Evil Eye Journal Article Cross-Cultural Research, 29 (2), pp. 174-203, 2014. @article{Weller2014, title = {Variation and Persistence in Latin American Beliefs About Evil Eye}, author = {Susan C Weller and Roberta D Baer and Javier Garcia Alba de Garcia and Mark Glazer and Robert Trotter and Ana Salcedo L Rocha and Robert E Klein and Lee M Pachter}, url = {http://journals.sagepub.com/doi/abs/10.1177/1069397114539268}, doi = {10.1177/1069397114539268}, year = {2014}, date = {2014-07-24}, journal = {Cross-Cultural Research}, volume = {29}, number = {2}, pages = {174-203}, abstract = {In a comparative study of evil eye (mal de ojo), we demonstrate a methodology appropriate for the study of cultural transmission of beliefs. We studied four diverse populations with historical links to Spain: Puerto Ricans in Connecticut, Mexican Americans in south Texas, Mexicans in Guadalajara, and rural Guatemalans. Using agreement on ideas or themes about evil eye within and across sites, we identify specific ideas that may have persisted through time. The relevance of specific themes was estimated with a cultural consensus analysis. Mal de ojo was widely recognized in each community and higher community prevalence was associated with higher agreement on reported causes, symptoms, and treatments. Each community exhibited a distinct model for ojo, although models were highly similar between sites. Agreement among individuals and across communities suggests a pan-regional description for mal de ojo and possible content of older versions of these beliefs in Latin America.}, keywords = {}, pubstate = {published}, tppubtype = {article} } In a comparative study of evil eye (mal de ojo), we demonstrate a methodology appropriate for the study of cultural transmission of beliefs. We studied four diverse populations with historical links to Spain: Puerto Ricans in Connecticut, Mexican Americans in south Texas, Mexicans in Guadalajara, and rural Guatemalans. Using agreement on ideas or themes about evil eye within and across sites, we identify specific ideas that may have persisted through time. The relevance of specific themes was estimated with a cultural consensus analysis. Mal de ojo was widely recognized in each community and higher community prevalence was associated with higher agreement on reported causes, symptoms, and treatments. Each community exhibited a distinct model for ojo, although models were highly similar between sites. Agreement among individuals and across communities suggests a pan-regional description for mal de ojo and possible content of older versions of these beliefs in Latin America. |
Sabo, Samantha; Shaw, Susan; Ingram, Maia; Teufel-Shone, Nicolette; Carvajal, Scott; de Zapien, Jill Guernsey; Rosales, Cecilia; Redondo, Flor; Garcia, Gina; Rubio-Goldsmith, Raquel Everyday violence, structural racism and mistreatment at the US-Mexico border Journal Article Social Science and Medicine, 109 , pp. 66-74, 2014. @article{Sabo2014, title = {Everyday violence, structural racism and mistreatment at the US-Mexico border}, author = {Samantha Sabo and Susan Shaw and Maia Ingram and Nicolette Teufel-Shone and Scott Carvajal and Jill Guernsey de Zapien and Cecilia Rosales and Flor Redondo and Gina Garcia and Raquel Rubio-Goldsmith}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24705336}, doi = {10.1016/j.socscimed.2014.02.005}, year = {2014}, date = {2014-05-01}, journal = {Social Science and Medicine}, volume = {109}, pages = {66-74}, abstract = {Immigration laws that militarize communities may exacerbate ethno-racial health disparities. We aimed to document the prevalence of and ways in which immigration enforcement policy and militarization of the US-Mexico border is experienced as everyday violence. Militarization is defined as the saturation of and pervasive encounters with immigration officials including local police enacting immigration and border enforcement policy with military style tactics and weapons. Data were drawn from a random household sample of US citizen and permanent residents of Mexican descent in the Arizona border region (2006-2008). Qualitative and quantitative data documented the frequency and nature of immigration related profiling, mistreatment and resistance to institutionalized victimization. Participants described living and working in a highly militarized environment, wherein immigration-related profiling and mistreatment were common immigration law enforcement practices. Approximately 25% of respondents described an immigration-related mistreatment episode, of which 62% were personally victimized. Nearly 75% of episodes occurred in a community location rather than at a US port of entry. Participant mistreatment narratives suggest the normalization of immigration-related mistreatment among the population. Given border security remains at the core of immigration reform debates, it is imperative that scholars advance the understanding of the public health impact of such enforcement policies on the daily lives of Mexican-origin US permanent residents, and their non-immigrant US citizen co-ethnics. Immigration policy that sanctions institutional practices of discrimination, such as ethno-racial profiling and mistreatment, are forms of structural racism and everyday violence. Metrics and systems for monitoring immigration and border enforcement policies and institutional practices deleterious to the health of US citizens and residents should be established.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Immigration laws that militarize communities may exacerbate ethno-racial health disparities. We aimed to document the prevalence of and ways in which immigration enforcement policy and militarization of the US-Mexico border is experienced as everyday violence. Militarization is defined as the saturation of and pervasive encounters with immigration officials including local police enacting immigration and border enforcement policy with military style tactics and weapons. Data were drawn from a random household sample of US citizen and permanent residents of Mexican descent in the Arizona border region (2006-2008). Qualitative and quantitative data documented the frequency and nature of immigration related profiling, mistreatment and resistance to institutionalized victimization. Participants described living and working in a highly militarized environment, wherein immigration-related profiling and mistreatment were common immigration law enforcement practices. Approximately 25% of respondents described an immigration-related mistreatment episode, of which 62% were personally victimized. Nearly 75% of episodes occurred in a community location rather than at a US port of entry. Participant mistreatment narratives suggest the normalization of immigration-related mistreatment among the population. Given border security remains at the core of immigration reform debates, it is imperative that scholars advance the understanding of the public health impact of such enforcement policies on the daily lives of Mexican-origin US permanent residents, and their non-immigrant US citizen co-ethnics. Immigration policy that sanctions institutional practices of discrimination, such as ethno-racial profiling and mistreatment, are forms of structural racism and everyday violence. Metrics and systems for monitoring immigration and border enforcement policies and institutional practices deleterious to the health of US citizens and residents should be established. |
Ingram, Maia; Schachter, Ken A; Sabo, Samantha; Reinschmidt, Kerstin M; Gomez, Sofia; Zapien, Jill Guernsey De; Carvajal, Scott C A community health worker intervention to address the social determinants of health through policy change Journal Article The Journal of primary Prevention, 35 (2), pp. 119-123, 2014. @article{Ingram2014, title = {A community health worker intervention to address the social determinants of health through policy change}, author = {Maia Ingram and Ken A Schachter and Samantha Sabo and Kerstin M Reinschmidt and Sofia Gomez and Jill Guernsey De Zapien and Scott C Carvajal}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24363179}, doi = {10.1007/s10935-013-0335-y}, year = {2014}, date = {2014-04-01}, journal = {The Journal of primary Prevention}, volume = {35}, number = {2}, pages = {119-123}, abstract = {Public policy that seeks to achieve sustainable improvements in the social determinants of health, such as income, education, housing, food security and neighborhood conditions, can create positive and sustainable health effects. This paper describes preliminary results of Acción para la Salud, a public health intervention in which Community health workers (CHWs) from five health agencies engaged their community in the process of making positive systems and environmental changes. Academic-community partners trained Acción CHWs in community advocacy and provided ongoing technical assistance in developing strategic advocacy plans. The CHWs documented community advocacy activities through encounter forms in which they identified problems, formulated solutions, and described systems and policy change efforts. Strategy maps described the steps of the advocacy plans. Findings demonstrate that CHWs worked to initiate discussions about underlying social determinants and environment-related factors that impact health, and identified solutions to improve neighborhood conditions, create community opportunities, and increase access to services.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Public policy that seeks to achieve sustainable improvements in the social determinants of health, such as income, education, housing, food security and neighborhood conditions, can create positive and sustainable health effects. This paper describes preliminary results of Acción para la Salud, a public health intervention in which Community health workers (CHWs) from five health agencies engaged their community in the process of making positive systems and environmental changes. Academic-community partners trained Acción CHWs in community advocacy and provided ongoing technical assistance in developing strategic advocacy plans. The CHWs documented community advocacy activities through encounter forms in which they identified problems, formulated solutions, and described systems and policy change efforts. Strategy maps described the steps of the advocacy plans. Findings demonstrate that CHWs worked to initiate discussions about underlying social determinants and environment-related factors that impact health, and identified solutions to improve neighborhood conditions, create community opportunities, and increase access to services. |
Williamson, Heather J; Perkins, Elizabeth A Family caregivers of adults with intellectual and developmental disabilities: outcomes associated with U.S. services and supports Journal Article Intellectual and Developmental Disabilities, 52 (2), pp. 147-159, 2014. @article{Williamson2014, title = {Family caregivers of adults with intellectual and developmental disabilities: outcomes associated with U.S. services and supports}, author = {Heather J Williamson and Elizabeth A Perkins}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24725113}, doi = {10.1352/1934-9556-52.2.147}, year = {2014}, date = {2014-04-01}, journal = {Intellectual and Developmental Disabilities}, volume = {52}, number = {2}, pages = {147-159}, abstract = {Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver outcomes and their association with existing services and supports for family caregivers of adults with IDD. Twenty-four articles were compiled using the PubMed, Web of Knowledge, PsychInfo, and CINAHL databases. Studies report economic, mental, and physical health outcomes from caregiving roles. The need for comprehensive caregiver assessment is discussed. Understanding and responding to the changing needs of family caregivers is vital to the U.S. disability service system to effectively prioritize formal resources and services.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver outcomes and their association with existing services and supports for family caregivers of adults with IDD. Twenty-four articles were compiled using the PubMed, Web of Knowledge, PsychInfo, and CINAHL databases. Studies report economic, mental, and physical health outcomes from caregiving roles. The need for comprehensive caregiver assessment is discussed. Understanding and responding to the changing needs of family caregivers is vital to the U.S. disability service system to effectively prioritize formal resources and services. |
Marhefka, Stephanie L; Buhi, Eric R; Baldwin, Julie A; Chen, Henian; Johnson, Ayesha; Lynn, Vickie; Glueckauf, Robert Telemedicine Journal and E-health, 20 (2), pp. 128-134, 2014. @article{Marhefka2014, title = {Effectiveness of healthy relationships video-group-A videoconferencing group intervention for women living with HIV: preliminary findings from a randomized controlled trial}, author = {Stephanie L Marhefka and Eric R Buhi and Julie A Baldwin and Henian Chen and Ayesha Johnson and Vickie Lynn and Robert Glueckauf}, url = {http://online.liebertpub.com/doi/full/10.1089/tmj.2013.0072}, doi = {10.1089/tmj.2013.0072}, year = {2014}, date = {2014-02-01}, journal = {Telemedicine Journal and E-health}, volume = {20}, number = {2}, pages = {128-134}, abstract = {INTRODUCTION: Expanded access to efficacious interventions is needed for women living with human immunodeficiency virus (WLH) in the United States. Availability of "prevention with (human immunodeficiency virus [HIV)] positives" interventions in rural/remote and low HIV prevalence areas remains limited, leaving WLH in these communities few options for receiving effective behavioral interventions such as Healthy Relationships (HR). Offering such programs via videoconferencing groups (VGs) may expand access. This analysis tests the effectiveness of HR-VG (versus wait-list control) for reducing sexual risk behavior among WLH and explores intervention satisfaction. SUBJECTS AND METHODS: In this randomized controlled trial unprotected vaginal/anal sex occasions over the prior 3 months reported at the 6-month follow-up were compared across randomization groups through zero-inflated Poisson regression modeling, controlling for unprotected sex at baseline. Seventy-one WLH were randomized and completed the baseline assessment (n=36 intervention and n=35 control); 59 (83% in each group) had follow-up data. RESULTS: Among those who engaged in unprotected sex at 6-month follow-up, intervention participants had approximately seven fewer unprotected occasions than control participants (95% confidence interval 5.43-7.43). Intervention participants reported high levels of satisfaction with HR-VG; 84% reported being "very satisfied" overall. CONCLUSIONS: This study found promising evidence for effective dissemination of HIV risk reduction interventions via VGs. Important next steps will be to determine whether VGs are effective with other subpopulations of people living with HIV (i.e., men and non-English speakers) and to assess cost-effectiveness. Possibilities for using VGs to expand access to other psychosocial and behavioral interventions and reduce stigma are discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } INTRODUCTION: Expanded access to efficacious interventions is needed for women living with human immunodeficiency virus (WLH) in the United States. Availability of "prevention with (human immunodeficiency virus [HIV)] positives" interventions in rural/remote and low HIV prevalence areas remains limited, leaving WLH in these communities few options for receiving effective behavioral interventions such as Healthy Relationships (HR). Offering such programs via videoconferencing groups (VGs) may expand access. This analysis tests the effectiveness of HR-VG (versus wait-list control) for reducing sexual risk behavior among WLH and explores intervention satisfaction. SUBJECTS AND METHODS: In this randomized controlled trial unprotected vaginal/anal sex occasions over the prior 3 months reported at the 6-month follow-up were compared across randomization groups through zero-inflated Poisson regression modeling, controlling for unprotected sex at baseline. Seventy-one WLH were randomized and completed the baseline assessment (n=36 intervention and n=35 control); 59 (83% in each group) had follow-up data. RESULTS: Among those who engaged in unprotected sex at 6-month follow-up, intervention participants had approximately seven fewer unprotected occasions than control participants (95% confidence interval 5.43-7.43). Intervention participants reported high levels of satisfaction with HR-VG; 84% reported being "very satisfied" overall. CONCLUSIONS: This study found promising evidence for effective dissemination of HIV risk reduction interventions via VGs. Important next steps will be to determine whether VGs are effective with other subpopulations of people living with HIV (i.e., men and non-English speakers) and to assess cost-effectiveness. Possibilities for using VGs to expand access to other psychosocial and behavioral interventions and reduce stigma are discussed. |
Sherman, Karen J; Eaves, Emery R; Ritenbaugh, Cheryl; Hsu, Clarissa; Cherkin, Daniel C; Turner, Judith A Cognitive interviews guide design of a new CAM patient expectations questionnaire Journal Article BMC Complementary and Alternative Medicine, 14 (1), pp. 39, 2014. @article{Sherman2014, title = {Cognitive interviews guide design of a new CAM patient expectations questionnaire}, author = {Karen J Sherman and Emery R Eaves and Cheryl Ritenbaugh and Clarissa Hsu and Daniel C Cherkin and Judith A Turner}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24460709}, doi = {10.1186/1472-6882-14-39}, year = {2014}, date = {2014-01-25}, journal = {BMC Complementary and Alternative Medicine}, volume = {14}, number = {1}, pages = {39}, abstract = {BACKGROUND: No consistent relationship exists between pre-treatment expectations and therapeutic benefit from various complementary and alternative medicine (CAM) therapies in clinical trials. However, many different expectancy measures have been used in those studies, with no validated questionnaires clearly focused on CAM and pain. We undertook cognitive interviews as part of a process to develop and validate such a questionnaire. METHODS: We reviewed questions about expectations of benefits of acupuncture, chiropractic, massage, or yoga for pain. Components of the questions - verbs, nouns, response options, terms and phrases describing back pain - were identified. Using seven different cognitive interview scripts, we conducted 39 interviews to evaluate how individuals with chronic low back pain understood these individual components in the context of expectancy questions for a therapy they had not yet received. Chosen items were those with the greatest agreement and least confusion among participants, and were closest to the meanings intended by the investigators. RESULTS: The questionnaire drafted for psychometric evaluation had 18 items covering various domains of expectancy. "Back pain" was the most consistently interpreted descriptor for this condition. The most understandable response options were 0-10 scales, a structure used throughout the questionnaire, with 0 always indicating no change, and 10 anchored with an absolute descriptor such as "complete relief". The use of words to describe midpoints was found to be confusing. The word "expect" held different and shifting meanings for participants. Thus paired items comparing "hope" and "realistically expect" were chosen to evaluate 5 different aspects of treatment expectations (back pain; back dysfunction and global effects; impact of back pain on specific areas of life; sleep, mood, and energy; coping). "Impact of back pain" on various areas of life was found to be a consistently meaningful concept, and more global than "interference". CONCLUSIONS: Cognitive interviews identified wordings with considerable agreement among both participants and investigators. Some items widely used in clinical studies had different meanings to participants than investigators, or were confusing to participants. The final 18-item questionnaire is undergoing psychometric evaluation with goals of streamlining as well as identifying best items for use when questionnaire length is constrained.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: No consistent relationship exists between pre-treatment expectations and therapeutic benefit from various complementary and alternative medicine (CAM) therapies in clinical trials. However, many different expectancy measures have been used in those studies, with no validated questionnaires clearly focused on CAM and pain. We undertook cognitive interviews as part of a process to develop and validate such a questionnaire. METHODS: We reviewed questions about expectations of benefits of acupuncture, chiropractic, massage, or yoga for pain. Components of the questions - verbs, nouns, response options, terms and phrases describing back pain - were identified. Using seven different cognitive interview scripts, we conducted 39 interviews to evaluate how individuals with chronic low back pain understood these individual components in the context of expectancy questions for a therapy they had not yet received. Chosen items were those with the greatest agreement and least confusion among participants, and were closest to the meanings intended by the investigators. RESULTS: The questionnaire drafted for psychometric evaluation had 18 items covering various domains of expectancy. "Back pain" was the most consistently interpreted descriptor for this condition. The most understandable response options were 0-10 scales, a structure used throughout the questionnaire, with 0 always indicating no change, and 10 anchored with an absolute descriptor such as "complete relief". The use of words to describe midpoints was found to be confusing. The word "expect" held different and shifting meanings for participants. Thus paired items comparing "hope" and "realistically expect" were chosen to evaluate 5 different aspects of treatment expectations (back pain; back dysfunction and global effects; impact of back pain on specific areas of life; sleep, mood, and energy; coping). "Impact of back pain" on various areas of life was found to be a consistently meaningful concept, and more global than "interference". CONCLUSIONS: Cognitive interviews identified wordings with considerable agreement among both participants and investigators. Some items widely used in clinical studies had different meanings to participants than investigators, or were confusing to participants. The final 18-item questionnaire is undergoing psychometric evaluation with goals of streamlining as well as identifying best items for use when questionnaire length is constrained. |
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