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; O'Meara, Louisa; Neel, Alisa Community Health Representative Workforce Assessment Phase II Journal Article 2021. @article{Sabo2021c, title = {Community Health Representative Workforce Assessment Phase II}, author = {Samantha Sabo and Louisa O'Meara and Alisa Neel}, url = {https://nau.edu/wp-content/uploads/sites/160/CHR-Workforce-Assessment-Phase-II-Report_Final_ReducedSize_0.pdf}, year = {2021}, date = {2021-08-01}, institution = {Northern Arizona Unversity}, organization = {Center for Health Equity Research}, abstract = {In 2018, the Community Health Representative (CHR) workforce celebrated their 50th year and serve as the oldest and only federally funded Community Health Worker (CHW) workforce in the United States. Since 2015, Tribal CHR Programs of Arizona have come together for annual CHR Policy Summit and Workforce Conferences to dialogue and plan for the unique issues and opportunities facing CHR workforce sustainability and advancement. Over time, the Policy Summit has resulted in an Arizona CHR Movement Coalition, which advocates for inclusion of CHRs in state and national level dialogue regarding workforce standardization, certification, training, supervision and financing.}, keywords = {}, pubstate = {published}, tppubtype = {article} } In 2018, the Community Health Representative (CHR) workforce celebrated their 50th year and serve as the oldest and only federally funded Community Health Worker (CHW) workforce in the United States. Since 2015, Tribal CHR Programs of Arizona have come together for annual CHR Policy Summit and Workforce Conferences to dialogue and plan for the unique issues and opportunities facing CHR workforce sustainability and advancement. Over time, the Policy Summit has resulted in an Arizona CHR Movement Coalition, which advocates for inclusion of CHRs in state and national level dialogue regarding workforce standardization, certification, training, supervision and financing. |
Schwartz, Anna L; Terry, Christopher M Returning to Sport: Female Athletes Living with and beyond Cancer Journal Article International Journal of Environmental Research and Public Health, 18 (15), 2021. @article{Schwartz2021, title = {Returning to Sport: Female Athletes Living with and beyond Cancer}, author = {Anna L. Schwartz and Christopher M. Terry}, url = {https://doi.org/10.3390/ijerph18158151}, doi = {10.3390/ijerph18158151}, year = {2021}, date = {2021-08-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {18}, number = {15}, abstract = {Many athletes living with and beyond cancer can continue to train and, in some cases, compete during treatment. Following cancer treatment, athletes can return to competitive sport but need to learn to adapt their physical strength and training to the lingering effects of cancer. It is critical for oncology healthcare providers to use the principles of assess, refer and advise to exercise oncology programs that are appropriate for the individual. Managing side effects of treatment is key to being able to train during and immediately following cancer treatment. Keen attention to fatigue is important at any point in the cancer spectrum to avoid overtraining and optimize the effects of training. Resources are introduced for providers to reference and direct patients to information for psychosocial support and instruction. The purpose of this paper is to present exercise considerations during and after cancer treatment for athletic cancer survivors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many athletes living with and beyond cancer can continue to train and, in some cases, compete during treatment. Following cancer treatment, athletes can return to competitive sport but need to learn to adapt their physical strength and training to the lingering effects of cancer. It is critical for oncology healthcare providers to use the principles of assess, refer and advise to exercise oncology programs that are appropriate for the individual. Managing side effects of treatment is key to being able to train during and immediately following cancer treatment. Keen attention to fatigue is important at any point in the cancer spectrum to avoid overtraining and optimize the effects of training. Resources are introduced for providers to reference and direct patients to information for psychosocial support and instruction. The purpose of this paper is to present exercise considerations during and after cancer treatment for athletic cancer survivors. |
Sabo, Samantha; O'Meara, Louisa; Russell, Kim; Hemstreet, Corey; Nashio, J T; Bender, Brook; Hamilton, Joyce; Begay, Mae-Gilene Community Health Representative Workforce: Meeting the Moment in American Indian Health Equity Journal Article Frontiers in Public Health, 9 , 2021. @article{Sabo2021, title = {Community Health Representative Workforce: Meeting the Moment in American Indian Health Equity}, author = {Samantha Sabo and Louisa O'Meara and Kim Russell and Corey Hemstreet and J. T. Nashio and Brook Bender and Joyce Hamilton and Mae-Gilene Begay}, url = {https://doi.org/10.3389/fpubh.2021.667926}, doi = {10.3389/fpubh.2021.667926}, year = {2021}, date = {2021-07-21}, journal = {Frontiers in Public Health}, volume = {9}, abstract = {In 2018, the Community Health Representative (CHR) workforce celebrated their 50th year and serve as the oldest and only federally funded Community Health Worker (CHW) workforce in the United States. CHRs are a highly trained, well-established standardized workforce serving the medical and social needs of American Indian communities. Nationally, the CHR workforce consists of ~1,700 CHRs, representing 264 Tribes. Of the 22 Tribes of Arizona, 19 Tribes operate a CHR Program and employ ~250 CHRs, equivalent to ~30% of the total CHW workforce in the state. Since 2015, Tribal CHR Programs of Arizona have come together for annual CHR Policy Summits to dialogue and plan for the unique issues and opportunities facing CHR workforce sustainability and advancement. Overtime, the Policy Summits have resulted in the Arizona CHR Workforce Movement, which advocates for inclusion of CHRs in state and national level dialogue regarding workforce standardization, certification, training, supervision, and financing. This community case study describes the impetus, collaborative process, and selected results of a 2019–2020 multi-phase CHR workforce assessment. Specifically, we highlight CHR core roles and competencies, contributions to the social determinant of health and well-being and the level to which CHRs are integrated within systems and teams. We offer recommendations for strengthening the workforce, increasing awareness of CHR roles and competencies, integrating CHRs within teams and systems, and mechanism for sustainability. }, keywords = {}, pubstate = {published}, tppubtype = {article} } In 2018, the Community Health Representative (CHR) workforce celebrated their 50th year and serve as the oldest and only federally funded Community Health Worker (CHW) workforce in the United States. CHRs are a highly trained, well-established standardized workforce serving the medical and social needs of American Indian communities. Nationally, the CHR workforce consists of ~1,700 CHRs, representing 264 Tribes. Of the 22 Tribes of Arizona, 19 Tribes operate a CHR Program and employ ~250 CHRs, equivalent to ~30% of the total CHW workforce in the state. Since 2015, Tribal CHR Programs of Arizona have come together for annual CHR Policy Summits to dialogue and plan for the unique issues and opportunities facing CHR workforce sustainability and advancement. Overtime, the Policy Summits have resulted in the Arizona CHR Workforce Movement, which advocates for inclusion of CHRs in state and national level dialogue regarding workforce standardization, certification, training, supervision, and financing. This community case study describes the impetus, collaborative process, and selected results of a 2019–2020 multi-phase CHR workforce assessment. Specifically, we highlight CHR core roles and competencies, contributions to the social determinant of health and well-being and the level to which CHRs are integrated within systems and teams. We offer recommendations for strengthening the workforce, increasing awareness of CHR roles and competencies, integrating CHRs within teams and systems, and mechanism for sustainability. |
Lee, Michele Sky; Day, Arden; Camplain, Carolyn; Papini, Natalie; Smith, Melinda; Compton-Gore, Kate; Gardner, Julia Remembering the “Who” and the “How” When Working with Tribal Communities Journal Article Harvard Public Health Review, 30 , 2021. @article{Lee2021, title = {Remembering the “Who” and the “How” When Working with Tribal Communities}, author = {Michele Sky Lee and Arden Day and Carolyn Camplain and Natalie Papini and Melinda Smith and Kate Compton-Gore and Julia Gardner}, url = {https://harvardpublichealthreview.org/30-article-lee./}, year = {2021}, date = {2021-07-01}, journal = {Harvard Public Health Review}, volume = {30}, abstract = {As doctoral students studying in the field of public health and working with tribal communities, we have had the opportunity to witness the unfolding effects of COVID-19 on diverse populations alongside our public health coursework steeped in theory and research. While in our classes, we examined COVID-19 through different social determinants of health lenses (Marmot & Allen, 2014). For example, the outbreak of COVID-19 necessitated an urgent response from public health officials, for which messages of social distancing and hand washing, among others, emerged. While this response was informed by public health officials, these messages were often detached from the complexity of social and environmental factors that are particularly germane to tribal communities. As a group of future public health leaders, we have observed this disconnect and believe the field of public health can strive to better recognize the social determinants of health relevant to tribal communities, including understanding “who” the communities are and “how” to work with communities towards public health solutions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } As doctoral students studying in the field of public health and working with tribal communities, we have had the opportunity to witness the unfolding effects of COVID-19 on diverse populations alongside our public health coursework steeped in theory and research. While in our classes, we examined COVID-19 through different social determinants of health lenses (Marmot & Allen, 2014). For example, the outbreak of COVID-19 necessitated an urgent response from public health officials, for which messages of social distancing and hand washing, among others, emerged. While this response was informed by public health officials, these messages were often detached from the complexity of social and environmental factors that are particularly germane to tribal communities. As a group of future public health leaders, we have observed this disconnect and believe the field of public health can strive to better recognize the social determinants of health relevant to tribal communities, including understanding “who” the communities are and “how” to work with communities towards public health solutions. |
Tippens, Julie A; Hatton-Bowers, Holly; Honomichl, Ryan; Wheeler, Lorey A; Miamidian, Helen M; Bash, Kirstie L; Smith, Michelle Howell C; Nyaoro, Dulo; Byrd, Joshua J; Packard, Samuel E; Teufel-Shone, Nicolette I Psychological distress prevalence and associated stressors and supports among urban-displaced Congolese adults in Kenya Journal Article American Journal of Orthopsychiatry, 91 (5), pp. 626–634, 2021. @article{Tippens2021, title = {Psychological distress prevalence and associated stressors and supports among urban-displaced Congolese adults in Kenya}, author = {Julie A. Tippens and Holly Hatton-Bowers and Ryan Honomichl and Lorey A. Wheeler and Helen M. Miamidian and Kirstie L. Bash and Michelle C. Howell Smith and Dulo Nyaoro and Joshua J Byrd and Samuel E. Packard and Nicolette I. Teufel-Shone}, url = {https://doi.org/10.1037/ort0000564}, doi = {10.1037/ort0000564}, year = {2021}, date = {2021-07-01}, journal = {American Journal of Orthopsychiatry}, volume = {91}, number = {5}, pages = {626–634}, abstract = {There is limited understanding of the prevalence of psychological distress and associated stressors and supports among displaced adults in low- and middle-income first asylum countries. Method: This article reports the findings of a cross-sectional study. We recruited 245 Congolese adults (18–80 years) residing in Nairobi, Kenya using snowball sampling. Data were collected using an interviewer-administered questionnaire consisting of sociodemographic characteristics, the Self-Reporting Questionnaire (SRQ-20), and a locally developed stressors and supports survey. We used multivariable logistic regression to examine associations among sociodemographic, stressor, and support variables and the likelihood of experiencing psychological distress. Results: More than half of the participants (52.8%) reported symptoms indicative of psychological distress. Factors associated with increased psychological distress included perceiving to have a useful role in one’s family or community, AOR = 1.85; 95% CI [1.1.17, 3.11], p = .012, feeling confused or not knowing what to do, AOR = 2.13; 95% CI [1.20, 4.6], p = .014, and feeling afraid to leave home for medical/health care to help with an illness, AOR = 1.57; 95% CI [1.17, 2.15], p < .01. Additionally, ethnic Banyamulenge Congolese adults without legal refugee status had an increased likelihood of experiencing psychological distress, AOR = .07; 95% CI [0, .74], p = .035. Conclusion: Future research is warranted to understand how to implement targeted mental health and psychosocial support (MHPSS) to improve urban-displaced adults’ sense of safety and belonging. Our findings suggest that legal refugee status is an important structural determinant of mental health, which should be considered in MHPSS practice and policy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } There is limited understanding of the prevalence of psychological distress and associated stressors and supports among displaced adults in low- and middle-income first asylum countries. Method: This article reports the findings of a cross-sectional study. We recruited 245 Congolese adults (18–80 years) residing in Nairobi, Kenya using snowball sampling. Data were collected using an interviewer-administered questionnaire consisting of sociodemographic characteristics, the Self-Reporting Questionnaire (SRQ-20), and a locally developed stressors and supports survey. We used multivariable logistic regression to examine associations among sociodemographic, stressor, and support variables and the likelihood of experiencing psychological distress. Results: More than half of the participants (52.8%) reported symptoms indicative of psychological distress. Factors associated with increased psychological distress included perceiving to have a useful role in one’s family or community, AOR = 1.85; 95% CI [1.1.17, 3.11], p = .012, feeling confused or not knowing what to do, AOR = 2.13; 95% CI [1.20, 4.6], p = .014, and feeling afraid to leave home for medical/health care to help with an illness, AOR = 1.57; 95% CI [1.17, 2.15], p < .01. Additionally, ethnic Banyamulenge Congolese adults without legal refugee status had an increased likelihood of experiencing psychological distress, AOR = .07; 95% CI [0, .74], p = .035. Conclusion: Future research is warranted to understand how to implement targeted mental health and psychosocial support (MHPSS) to improve urban-displaced adults’ sense of safety and belonging. Our findings suggest that legal refugee status is an important structural determinant of mental health, which should be considered in MHPSS practice and policy. |
Camplain, Ricky; Lininger, Monica R; Baldwin, Julie A; II, Robert Trotter T Cardiovascular Risk Factors among Individuals Incarcerated in an Arizona County Jail Journal Article International Journal of Environmental Research and Public Health , 18 (13), 2021. @article{Camplain2021, title = {Cardiovascular Risk Factors among Individuals Incarcerated in an Arizona County Jail}, author = {Ricky Camplain and Monica R. Lininger and Julie A. Baldwin and Robert T. Trotter II}, url = {https://doi.org/10.3390/ijerph18137007}, doi = {10.3390/ijerph18137007}, year = {2021}, date = {2021-06-30}, journal = {International Journal of Environmental Research and Public Health }, volume = {18}, number = {13}, abstract = {We aimed to estimate the prevalence of cardiovascular risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, alcohol consumption, and obesity among a sample of individuals incarcerated in an Arizona county jail and compare prevalence estimates to a matched non-institutionalized population. From 2017–2018, individuals housed at a county jail completed a cross-sectional health survey. We estimated the prevalence of hypertension, diabetes, cholesterol, overweight/obesity, cigarette smoking, binge drinking, and self-reported health among individuals incarcerated. We compared prevalence estimates of cardiovascular risk factors to a matched sample of 2017–2018 NHANES participants. Overall, 35.9%, 7.7%, and 17.8% of individuals incarcerated in jail self-reported hypertension, diabetes, and high cholesterol, respectively. Of individuals incarcerated, 59.6% were overweight or obese and 36.8% self-reported fair or poor general health. Over half of individuals incarcerated reported ever smoking cigarettes (72.3%) and binge drinking (60.7%). Compared to a matched sample of NHANES participants, individuals incarcerated in jail had a statistically higher prevalence of cigarette smoking and binge drinking. Screening of cardiovascular risk factors and providing preventive measures and interventions, such as healthy eating, physical activity, or pharmacological adherence interventions, while individuals are incarcerated may contribute to the prevention and management of cardiovascular risk factors and, eventually, cardiovascular disease.}, keywords = {}, pubstate = {published}, tppubtype = {article} } We aimed to estimate the prevalence of cardiovascular risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, alcohol consumption, and obesity among a sample of individuals incarcerated in an Arizona county jail and compare prevalence estimates to a matched non-institutionalized population. From 2017–2018, individuals housed at a county jail completed a cross-sectional health survey. We estimated the prevalence of hypertension, diabetes, cholesterol, overweight/obesity, cigarette smoking, binge drinking, and self-reported health among individuals incarcerated. We compared prevalence estimates of cardiovascular risk factors to a matched sample of 2017–2018 NHANES participants. Overall, 35.9%, 7.7%, and 17.8% of individuals incarcerated in jail self-reported hypertension, diabetes, and high cholesterol, respectively. Of individuals incarcerated, 59.6% were overweight or obese and 36.8% self-reported fair or poor general health. Over half of individuals incarcerated reported ever smoking cigarettes (72.3%) and binge drinking (60.7%). Compared to a matched sample of NHANES participants, individuals incarcerated in jail had a statistically higher prevalence of cigarette smoking and binge drinking. Screening of cardiovascular risk factors and providing preventive measures and interventions, such as healthy eating, physical activity, or pharmacological adherence interventions, while individuals are incarcerated may contribute to the prevention and management of cardiovascular risk factors and, eventually, cardiovascular disease. |
Akintobi, Tabia Henry; Sheikhattari, Payam; Shaffer, Emma; Evans, Christina L; Braun, Kathryn L; Sy, Angela U; Mancera, Bibiana; Campa, Adriana; Miller, Stephania T; Sarpong, Daniel; Holliday, Rhonda; Jimenez-Chavez, Julio; Khan, Shafiq; Hinton, Cimona; Sellars-Bates, Kimberly; Ajewole, Veronica; Teufel-Shone, Nicolette I International Journal of Environmental Research and Public Health , 18 (12), 2021. @article{Akintobi2021, title = {Community Engagement Practices at Research Centers in U.S. Minority Institutions: Priority Populations and Innovative Approaches to Advancing Health Disparities Research}, author = {Tabia Henry Akintobi and Payam Sheikhattari and Emma Shaffer and Christina L. Evans and Kathryn L. Braun and Angela U. Sy and Bibiana Mancera and Adriana Campa and Stephania T. Miller and Daniel Sarpong and Rhonda Holliday and Julio Jimenez-Chavez and Shafiq Khan and Cimona Hinton and Kimberly Sellars-Bates and Veronica Ajewole and Nicolette I. Teufel-Shone}, url = {https://doi.org/10.3390/ijerph18126675}, doi = {10.3390/ijerph18126675}, year = {2021}, date = {2021-06-21}, journal = {International Journal of Environmental Research and Public Health }, volume = {18}, number = {12}, abstract = {This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An overarching theme, building community together through trust and meaningful collaborations, emerged from the supporting themes and subthemes. The RCMI institutions and their CECs serve as models to circumvent the historical and current challenges to research in communities disproportionately affected by health disparities. Lessons learned from these cores may help other institutions who want to build community trust in and capacities for research that addresses community-related health concerns.}, keywords = {}, pubstate = {published}, tppubtype = {article} } This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An overarching theme, building community together through trust and meaningful collaborations, emerged from the supporting themes and subthemes. The RCMI institutions and their CECs serve as models to circumvent the historical and current challenges to research in communities disproportionately affected by health disparities. Lessons learned from these cores may help other institutions who want to build community trust in and capacities for research that addresses community-related health concerns. |
Jones, Christopher W; Morales, Crystal G; Eltiste, Sharon L; Yanchik-Slade, Francine E; Lee, Naomi R; Nilsson, Bradley L Capacity for increased surface area in the hydrophobic core of β-sheet peptide bilayer nanoribbons Journal Article Journal of Peptide Science, 27 , 2021. @article{Jones2021, title = {Capacity for increased surface area in the hydrophobic core of β-sheet peptide bilayer nanoribbons}, author = {Christopher W. Jones and Crystal G. Morales and Sharon L. Eltiste and Francine E. Yanchik-Slade and Naomi R. Lee and Bradley L. Nilsson}, url = {https://doi.org/10.1002/psc.3334}, doi = {10.1002/psc.3334}, year = {2021}, date = {2021-06-20}, journal = {Journal of Peptide Science}, volume = {27}, abstract = {Amphipathic peptides with amino acids arranged in alternating patterns of hydrophobic and hydrophilic residues efficiently self-assemble into β-sheet bilayer nanoribbons. Hydrophobic side chain functionality is effectively buried in the interior of the putative bilayer of these nanoribbons. This study investigates consequences on self-assembly of increasing the surface area of aromatic side chain groups that reside in the hydrophobic core of nanoribbons derived from Ac-(XKXE)2-NH2 peptides (X = hydrophobic residue). A series of Ac-(XKXE)2-NH2 peptides incorporating aromatic amino acids of increasing molecular volume and steric profile (X = phenylalanine [Phe], homophenylalanine [Hph], tryptophan [Trp], 1-naphthylalanine [1-Nal], 2-naphthylalanine [2-Nal], or biphenylalanine [Bip]) were assessed to determine substitution effects on self-assembly propensity and on morphology of the resulting nanoribbon structures. Additional studies were conducted to determine the effects of incorporating amino acids of differing steric profile in the hydrophobic core (Ac-X1KFEFKFE-NH2 and Ac-(X1,5KFE)-NH2 peptides, X = Trp or Bip). Spectroscopic analysis by circular dichroism (CD) and Fourier transform infrared (FT-IR) spectroscopy indicated β-sheet formation for all variants. Self-assembly rate increased with peptide hydrophobicity; increased molecular volume of the hydrophobic side chain groups did not appear to induce kinetic penalties on self-assembly rates. Transmission electron microscopy (TEM) imaging indicated variation in fibril morphology as a function of amino acid in the X positions. This study confirms that hydrophobicity of amphipathic Ac-(XKXE)2-NH2 peptides correlates to self-assembly propensity and that the hydrophobic core of the resulting nanoribbon bilayers has a significant capacity to accommodate sterically demanding functional groups. These findings provide insight that may be used to guide the exploitation of self-assembled amphipathic peptides as functional biomaterials.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Amphipathic peptides with amino acids arranged in alternating patterns of hydrophobic and hydrophilic residues efficiently self-assemble into β-sheet bilayer nanoribbons. Hydrophobic side chain functionality is effectively buried in the interior of the putative bilayer of these nanoribbons. This study investigates consequences on self-assembly of increasing the surface area of aromatic side chain groups that reside in the hydrophobic core of nanoribbons derived from Ac-(XKXE)2-NH2 peptides (X = hydrophobic residue). A series of Ac-(XKXE)2-NH2 peptides incorporating aromatic amino acids of increasing molecular volume and steric profile (X = phenylalanine [Phe], homophenylalanine [Hph], tryptophan [Trp], 1-naphthylalanine [1-Nal], 2-naphthylalanine [2-Nal], or biphenylalanine [Bip]) were assessed to determine substitution effects on self-assembly propensity and on morphology of the resulting nanoribbon structures. Additional studies were conducted to determine the effects of incorporating amino acids of differing steric profile in the hydrophobic core (Ac-X1KFEFKFE-NH2 and Ac-(X1,5KFE)-NH2 peptides, X = Trp or Bip). Spectroscopic analysis by circular dichroism (CD) and Fourier transform infrared (FT-IR) spectroscopy indicated β-sheet formation for all variants. Self-assembly rate increased with peptide hydrophobicity; increased molecular volume of the hydrophobic side chain groups did not appear to induce kinetic penalties on self-assembly rates. Transmission electron microscopy (TEM) imaging indicated variation in fibril morphology as a function of amino acid in the X positions. This study confirms that hydrophobicity of amphipathic Ac-(XKXE)2-NH2 peptides correlates to self-assembly propensity and that the hydrophobic core of the resulting nanoribbon bilayers has a significant capacity to accommodate sterically demanding functional groups. These findings provide insight that may be used to guide the exploitation of self-assembled amphipathic peptides as functional biomaterials. |
Sharma, Vinita; Levin, Bruce Lubotsky; Rahill, Guitele J; Baldwin, Julie A; Luitel, Aditi; Marhefka, Stephanie L Psychiatry Quarterly, 92 , pp. 1595–1609, 2021. @article{Sharma2021, title = {Post-earthquake Self-Reported Depressive Symptoms and Post-Traumatic Stress Disorder and their Correlates among College-Youths in Kathmandu, Nepal}, author = {Vinita Sharma and Bruce Lubotsky Levin and Guitele J. Rahill and Julie A. Baldwin and Aditi Luitel and Stephanie L. Marhefka }, url = {https://pubmed.ncbi.nlm.nih.gov/34109493/}, doi = {10.1007/s11126-021-09928-5}, year = {2021}, date = {2021-06-09}, journal = {Psychiatry Quarterly}, volume = {92}, pages = {1595–1609}, abstract = {Exposure to earthquake has previously been associated with adverse mental health outcomes, however, evidence is limited among youth in resource-limited settings. This study explored the association of retrospective extent of exposure on current day depressive symptoms and post-traumatic stress disorder (PTSD) symptoms among 125 youth attending a college in Kathmandu, Nepal. A self-administered survey including socio-demographic variables, scale for earthquake exposure and Nepali language validated standardized scales for depressive and PTSD symptoms was used. Prevalence estimates for depressive symptoms was 43.2% and PTSD symptoms was 19.2%. For each increasing unit of the extent of earthquake exposure, the odds of having depressive symptoms increased by a factor of 1.26 (p = 0.001) and PTSD symptoms increased by a factor of 1.26 (p = 0.002). Being in a complicated romantic relationship increased the odds of both depressive symptoms and PTSD symptoms. Exposure to earthquake is an important factor to consider while assessing depressive and PTSD symptoms among youth earthquake survivors in Kathmandu. It is important that programs or policies aimed at youth mental health concurrently address disaster exposures.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Exposure to earthquake has previously been associated with adverse mental health outcomes, however, evidence is limited among youth in resource-limited settings. This study explored the association of retrospective extent of exposure on current day depressive symptoms and post-traumatic stress disorder (PTSD) symptoms among 125 youth attending a college in Kathmandu, Nepal. A self-administered survey including socio-demographic variables, scale for earthquake exposure and Nepali language validated standardized scales for depressive and PTSD symptoms was used. Prevalence estimates for depressive symptoms was 43.2% and PTSD symptoms was 19.2%. For each increasing unit of the extent of earthquake exposure, the odds of having depressive symptoms increased by a factor of 1.26 (p = 0.001) and PTSD symptoms increased by a factor of 1.26 (p = 0.002). Being in a complicated romantic relationship increased the odds of both depressive symptoms and PTSD symptoms. Exposure to earthquake is an important factor to consider while assessing depressive and PTSD symptoms among youth earthquake survivors in Kathmandu. It is important that programs or policies aimed at youth mental health concurrently address disaster exposures. |
Sabo, Samantha; Wexler, Nancy; O'Meara, Louisa; Dreifuss, Heather; Soto, Yanitza; Redondo, Floribella; Carter, Heather; de Zapien, Jill Guernsey; Ingram, Maia Frontiers in Public Health, 9 , 2021. @article{Sabo2021b, title = {Organizational Readiness for Community Health Worker Workforce Integration Among Medicaid Contracted Health Plans and Provider Networks: An Arizona Case Study}, author = {Samantha Sabo and Nancy Wexler and Louisa O'Meara and Heather Dreifuss and Yanitza Soto and Floribella Redondo and Heather Carter and Jill Guernsey de Zapien and Maia Ingram}, url = {https://www.frontiersin.org/articles/10.3389/fpubh.2021.601908/full}, doi = {10.3389/fpubh.2021.601908}, year = {2021}, date = {2021-06-07}, journal = {Frontiers in Public Health}, volume = {9}, abstract = {Understanding and building organizational capacity for system change and the integration of the Community Health Worker (CHW) workforce within the health scare sector requires a supportive organizational culture among sector leaders and providers. The aim of this mixed-methods study was to assess organizational readiness for CHW workforce integration into Arizona Medicaid health systems and care teams. This collaborative effort was in direct response to emergent state and national CHW workforce policy opportunities, and the shifting health care landscape in Arizona – which merged behavior and physical health. Specifically, and in collaboration with a broad-based, statewide CHW workforce coalition, led by the CHW professional association, we assessed 245 licensed health care professionals with experience working with CHWs and 16 Medicaid-contracted health plan leadership. Our goal was to generate a baseline understanding of the knowledge, attitudes and beliefs these stakeholders held about the integration of CHWs into systems and teams. Our findings demonstrate a high level of organizational readiness and action toward integration of CHWs within the Arizona health care system and care teams. CHWs have emerged as a health care workforce able to enhance the patient experience of care, improve population health, reduce cost of care, and improve the experience of providing care among clinicians and staff.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Understanding and building organizational capacity for system change and the integration of the Community Health Worker (CHW) workforce within the health scare sector requires a supportive organizational culture among sector leaders and providers. The aim of this mixed-methods study was to assess organizational readiness for CHW workforce integration into Arizona Medicaid health systems and care teams. This collaborative effort was in direct response to emergent state and national CHW workforce policy opportunities, and the shifting health care landscape in Arizona – which merged behavior and physical health. Specifically, and in collaboration with a broad-based, statewide CHW workforce coalition, led by the CHW professional association, we assessed 245 licensed health care professionals with experience working with CHWs and 16 Medicaid-contracted health plan leadership. Our goal was to generate a baseline understanding of the knowledge, attitudes and beliefs these stakeholders held about the integration of CHWs into systems and teams. Our findings demonstrate a high level of organizational readiness and action toward integration of CHWs within the Arizona health care system and care teams. CHWs have emerged as a health care workforce able to enhance the patient experience of care, improve population health, reduce cost of care, and improve the experience of providing care among clinicians and staff. |
Eaves, Emery R; Barber, Jarrett; Whealy, Ryann; Clancey, Sara A; Wright, Rita; Cocking, Jill Hager; Spadafino, Joseph; Hepp, Crystal M Characterization of neonatal opioid withdrawal syndrome in Arizona from 2010-2017 Journal Article PLOS ONE, 16 (6), 2021. @article{Eaves2021, title = {Characterization of neonatal opioid withdrawal syndrome in Arizona from 2010-2017}, author = {Emery R. Eaves and Jarrett Barber and Ryann Whealy and Sara A. Clancey and Rita Wright and Jill Hager Cocking and Joseph Spadafino and Crystal M. Hepp }, url = {https://doi.org/10.1371/journal.pone.0248476}, doi = {10.1371/journal.pone.0248476}, year = {2021}, date = {2021-06-03}, journal = {PLOS ONE}, volume = {16}, number = {6}, abstract = {In this paper, we describe a population of mothers who are opioid dependent at the time of giving birth and neonates exposed to opioids in utero who experience withdrawal following birth. While there have been studies of national trends in this population, there remains a gap in studies of regional trends. Using data from the Arizona Department of Health Services Hospital Discharge Database, this study aimed to characterize the population of neonates with neonatal opioid withdrawal syndrome (NOWS) and mothers who were opioid dependent at the time of giving birth, in Arizona. We analyzed approximately 1.2 million electronic medical records from the Arizona Department of Health Services Hospital Discharge Database to identify patterns and disparities across socioeconomic, ethnic, racial, and/or geographic groupings. In addition, we identified comorbid conditions that are differentially associated with NOWS in neonates or opioid dependence in mothers. Our analysis was designed to assess whether indicators such as race/ethnicity, insurance payer, marital status, and comorbidities are related to the use of opioids while pregnant. Our findings suggest that women and neonates who are non-Hispanic White and economically disadvantaged, tend be part of our populations of interest more frequently than expected. Additionally, women who are opioid dependent at the time of giving birth are unmarried more often than expected, and we suggest that marital status could be a proxy for support. Finally, we identified comorbidities associated with neonates who have NOWS and mothers who are opioid dependent not previously reported. }, keywords = {}, pubstate = {published}, tppubtype = {article} } In this paper, we describe a population of mothers who are opioid dependent at the time of giving birth and neonates exposed to opioids in utero who experience withdrawal following birth. While there have been studies of national trends in this population, there remains a gap in studies of regional trends. Using data from the Arizona Department of Health Services Hospital Discharge Database, this study aimed to characterize the population of neonates with neonatal opioid withdrawal syndrome (NOWS) and mothers who were opioid dependent at the time of giving birth, in Arizona. We analyzed approximately 1.2 million electronic medical records from the Arizona Department of Health Services Hospital Discharge Database to identify patterns and disparities across socioeconomic, ethnic, racial, and/or geographic groupings. In addition, we identified comorbid conditions that are differentially associated with NOWS in neonates or opioid dependence in mothers. Our analysis was designed to assess whether indicators such as race/ethnicity, insurance payer, marital status, and comorbidities are related to the use of opioids while pregnant. Our findings suggest that women and neonates who are non-Hispanic White and economically disadvantaged, tend be part of our populations of interest more frequently than expected. Additionally, women who are opioid dependent at the time of giving birth are unmarried more often than expected, and we suggest that marital status could be a proxy for support. Finally, we identified comorbidities associated with neonates who have NOWS and mothers who are opioid dependent not previously reported. |
Crane, Jill M; Williamson, Heather J; Raley, Sheida K; Hagiwara, Mayumi; Lee, Chung Eun; Havercamp, Susan M Who Is Leading the Field in 2020?: AAIDD Students and Early Career Professionals Journal Article Intellectual and Developmental Disabilities, 59 (1), pp. 217-223, 2021. @article{Crane2021, title = {Who Is Leading the Field in 2020?: AAIDD Students and Early Career Professionals}, author = {Jill M Crane and Heather J Williamson and Sheida K Raley and Mayumi Hagiwara and Chung Eun Lee and Susan M Havercamp}, url = {https://pubmed.ncbi.nlm.nih.gov/34030179/}, doi = {10.1352/1934-9556-59.3.217}, year = {2021}, date = {2021-06-01}, journal = {Intellectual and Developmental Disabilities}, volume = {59}, number = {1}, pages = {217-223}, abstract = {The American Association on Intellectual and Developmental Disabilities (AAIDD) has been a leader in the field of intellectual and developmental disabilities since its founding in 1876. Today, student and early career professionals make up approximately 8.5% of the organization, with their engagement supported by the Student and Early Career Professional Interest Network (SECP). An article by Havercamp et al. (2003), "Who Will Lead the Field Beyond 2020?", recommended organizational changes that have been largely addressed in the years following by SECP. The present research replicates Havercamp et al.'s (2003) original survey of the organization's student and early career professionals, and results support the effectiveness of SECP as a welcoming platform from which students and early career professionals can establish themselves in the organization.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The American Association on Intellectual and Developmental Disabilities (AAIDD) has been a leader in the field of intellectual and developmental disabilities since its founding in 1876. Today, student and early career professionals make up approximately 8.5% of the organization, with their engagement supported by the Student and Early Career Professional Interest Network (SECP). An article by Havercamp et al. (2003), "Who Will Lead the Field Beyond 2020?", recommended organizational changes that have been largely addressed in the years following by SECP. The present research replicates Havercamp et al.'s (2003) original survey of the organization's student and early career professionals, and results support the effectiveness of SECP as a welcoming platform from which students and early career professionals can establish themselves in the organization. |
Abdul-Chani, Monical; Moreno, Christopher P; Reeder, Julia A; Zuckerman, Katherine; Lindly, Olivia Perceived community disability stigma in multicultural, low-income populations: Measure development and validation Journal Article Research in Developmental Disabilities, 115 , 2021. @article{Abdul-Chani2021, title = {Perceived community disability stigma in multicultural, low-income populations: Measure development and validation}, author = {Monical Abdul-Chani and Christopher P Moreno and Julia A Reeder and Katherine Zuckerman and Olivia Lindly}, url = {https://doi.org/10.1016/j.ridd.2021.103997}, doi = {10.1016/j.ridd.2021.103997}, year = {2021}, date = {2021-05-29}, journal = {Research in Developmental Disabilities}, volume = {115}, abstract = {Stigma and knowledge about disabilities differ across groups, impacting care. No validated measures of perceived community disability stigma exist for families in multicultural communities, at risk for disparities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Stigma and knowledge about disabilities differ across groups, impacting care. No validated measures of perceived community disability stigma exist for families in multicultural communities, at risk for disparities. |
Williamson, Heather J; Armin, Julie S; Stakely, Ellen; Nasimi, Bonny; Joseph, Darold H; Meyers, Jon; Baldwin, Julie A Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities Journal Article Annals of International Occupational Therapy, 4 (3), 2021. @article{Williamson2021, title = {Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities}, author = {Heather J. Williamson and Julie S. Armin and Ellen Stakely and Bonny Nasimi and Darold H. Joseph and Jon Meyers and Julie A. Baldwin}, url = {https://doi.org/10.3928/24761222-20201202-02}, doi = {10.3928/24761222-20201202-02}, year = {2021}, date = {2021-05-21}, journal = {Annals of International Occupational Therapy}, volume = {4}, number = {3}, abstract = {To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members :Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD. [Annals of International Occupational Therapy. 2021;4(3):e158–e165.]}, keywords = {}, pubstate = {published}, tppubtype = {article} } To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members :Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD. [Annals of International Occupational Therapy. 2021;4(3):e158–e165.] |
Kumar, Amit; Roy, Indrakshi; Karmarkar, Amol M; Erler, Kimberly S; Rudolph, James L; Baldwin, Julie A Shifting US Patterns of COVID-19 Mortality by Race and Ethnicity From June-December 2020 Journal Article Journal of American Medical Direct Association, 22 (5), pp. 966-970, 2021. @article{Kumar2021b, title = {Shifting US Patterns of COVID-19 Mortality by Race and Ethnicity From June-December 2020}, author = {Amit Kumar and Indrakshi Roy and Amol M Karmarkar and Kimberly S Erler and James L Rudolph and Julie A Baldwin}, url = {https://www.sciencedirect.com/science/article/abs/pii/S1525861021002553?via%3Dihub}, doi = {10.1016/j.jamda.2021.02.034}, year = {2021}, date = {2021-05-05}, journal = {Journal of American Medical Direct Association}, volume = {22}, number = {5}, pages = {966-970}, abstract = {The COVID-19 pandemic has disproportionately affected racial and ethnic minorities in the United States and has been devastating for residents of nursing homes (NHs). However, evidence on racial and ethnic disparities in COVID-19-related mortality rates within NHs and how that has changed over time has been limited. This study examines the impact of a high proportion of minority residents in NHs on COVID-19-related mortality rates over a 30-week period.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The COVID-19 pandemic has disproportionately affected racial and ethnic minorities in the United States and has been devastating for residents of nursing homes (NHs). However, evidence on racial and ethnic disparities in COVID-19-related mortality rates within NHs and how that has changed over time has been limited. This study examines the impact of a high proportion of minority residents in NHs on COVID-19-related mortality rates over a 30-week period. |
Pro, George; Schumacher, Krista; Hubach, Randolph; Zaller, Nickolas; Giano, Zachary; Camplain, Ricky; Camplain, Carolyn; Haberstroh, Shane; Baldwin, Julie A; Wheeler, Denna L US trends in mask wearing during the COVID-19 pandemic depend on rurality Journal Article Rural and Remote Health, 21 , 2021. @article{Pro2021, title = {US trends in mask wearing during the COVID-19 pandemic depend on rurality}, author = {George Pro and Krista Schumacher and Randolph Hubach and Nickolas Zaller and Zachary Giano and Ricky Camplain and Carolyn Camplain and Shane Haberstroh and Julie A Baldwin and Denna L Wheeler}, url = {https://doi.org/10.22605/RRH6596}, doi = {10.22605/RRH6596}, year = {2021}, date = {2021-05-04}, journal = {Rural and Remote Health}, volume = {21}, abstract = {Face masks are widely recommended as a COVID-19 prevention strategy. State mask mandates have generally reduced the spread of the disease, but decisions to wear a mask depend on many factors. Recent increases in case rates in rural areas following initial outbreaks in more densely populated areas highlight the need to focus on prevention and education. Messaging about disease risk has faced challenges in rural areas in the past. While surges in cases within some communities are likely an impetus for behavior change, rising case rates likely explain only part of mask-wearing decisions. The current study examined the relationship between county-level indicators of rurality and mask wearing in the USA. National data from the New York Times’ COVID-19 cross-sectional mask survey was used to identify the percentage of a county’s residents who reported always/frequently wearing a mask (2–14 July 2020). The New York Times’ COVID-19 data repository was used to calculate county-level daily case rates for the 2 weeks preceding the mask survey (15 June – 1 July 2020), and defined county rurality using the Index of Relative Rurality (n=3103 counties). Multivariate linear regression was used to predict mask wearing across levels of rurality. The model was adjusted for daily case rates and other relevant county-level confounders, including county-level indicators of age, race/ethnicity, gender, political partisanship, income inequality, and whether each county was subject to a statewide mask mandate. Large clusters of counties with high rurality and low mask wearing were observed in the Midwest, upper Midwest, and mountainous West. Holding daily case rates and other county characteristics constant, the predicted probability of wearing a mask decreased significantly as counties became more rural (β=–0.560; p<0.0001). Conclusion: Upticks in COVID-19 cases and deaths in rural areas are expected to continue, and localized outbreaks will likely occur indefinitely. The present findings highlight the need to better understand the mechanisms underlying perceptions of COVID-19 risk in rural areas. Dissemination of scientifically correct and consistent information is critical during national emergencies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Face masks are widely recommended as a COVID-19 prevention strategy. State mask mandates have generally reduced the spread of the disease, but decisions to wear a mask depend on many factors. Recent increases in case rates in rural areas following initial outbreaks in more densely populated areas highlight the need to focus on prevention and education. Messaging about disease risk has faced challenges in rural areas in the past. While surges in cases within some communities are likely an impetus for behavior change, rising case rates likely explain only part of mask-wearing decisions. The current study examined the relationship between county-level indicators of rurality and mask wearing in the USA. National data from the New York Times’ COVID-19 cross-sectional mask survey was used to identify the percentage of a county’s residents who reported always/frequently wearing a mask (2–14 July 2020). The New York Times’ COVID-19 data repository was used to calculate county-level daily case rates for the 2 weeks preceding the mask survey (15 June – 1 July 2020), and defined county rurality using the Index of Relative Rurality (n=3103 counties). Multivariate linear regression was used to predict mask wearing across levels of rurality. The model was adjusted for daily case rates and other relevant county-level confounders, including county-level indicators of age, race/ethnicity, gender, political partisanship, income inequality, and whether each county was subject to a statewide mask mandate. Large clusters of counties with high rurality and low mask wearing were observed in the Midwest, upper Midwest, and mountainous West. Holding daily case rates and other county characteristics constant, the predicted probability of wearing a mask decreased significantly as counties became more rural (β=–0.560; p<0.0001). Conclusion: Upticks in COVID-19 cases and deaths in rural areas are expected to continue, and localized outbreaks will likely occur indefinitely. The present findings highlight the need to better understand the mechanisms underlying perceptions of COVID-19 risk in rural areas. Dissemination of scientifically correct and consistent information is critical during national emergencies. |
Sabo, Samantha; Wightman, Patrick; McCue, Kelly; Butler, Matthew; Pilling, Vern; andMartín Celaya, Dulce Jimenez J; Rumann, Sara BMJ Open, 11 (6), 2021. @article{Sabo2021d, title = {Addressing maternal and child health equity through a community health worker home visiting intervention to reduce low birth weight: retrospective quasi-experimental study of the Arizona Health Start Programme}, author = {Samantha Sabo and Patrick Wightman and Kelly McCue and Matthew Butler and Vern Pilling and Dulce J Jimenez andMartín Celaya and Sara Rumann}, url = {http://dx.doi.org/10.1136/bmjopen-2020-045014}, doi = {10.1136/bmjopen-2020-045014}, year = {2021}, date = {2021-05-01}, journal = {BMJ Open}, volume = {11}, number = {6}, abstract = {To test if participation in the Health Start Programme, an Arizona statewide Community Health Worker (CHW) maternal and child health (MCH) home visiting programme, reduced rates of low birth weight (LBW), very LBW (VLBW), extremely LBW (ELBW) and preterm birth (PTB).}, keywords = {}, pubstate = {published}, tppubtype = {article} } To test if participation in the Health Start Programme, an Arizona statewide Community Health Worker (CHW) maternal and child health (MCH) home visiting programme, reduced rates of low birth weight (LBW), very LBW (VLBW), extremely LBW (ELBW) and preterm birth (PTB). |
s. Lane, Taylor; Sonderegger, Derek L; Holeva-Eklund, Whitney M; Brazendale, Keith; K.Behrens, Timothy; Howdeshell, Hiliary; Walka, Sherry; R.Cook, Jon; Heer, Hendrik D.de Seasonal Variability in Weight Gain Among American Indian, Black, White, and Hispanic Children: A 3.5-Year Study Journal Article American Journal of Preventive Medicine, 60 (5), pp. 658-665, 2021. @article{Lane2021, title = {Seasonal Variability in Weight Gain Among American Indian, Black, White, and Hispanic Children: A 3.5-Year Study}, author = {Taylor s. Lane and Derek L. Sonderegger and Whitney M. Holeva-Eklund and Keith Brazendale and Timothy K.Behrens and Hiliary Howdeshell and Sherry Walka and Jon R.Cook and Hendrik D.de Heer}, url = {https://doi.org/10.1016/j.amepre.2020.12.010}, doi = {10.1016/j.amepre.2020.12.010}, year = {2021}, date = {2021-05-01}, journal = {American Journal of Preventive Medicine}, volume = {60}, number = {5}, pages = {658-665}, abstract = {Several studies have reported that children gain more weight during the summer season. Despite high obesity rates, little research has included American Indian/Alaskan Native children, and few studies have been longitudinal. This observational study examines seasonal weight variability over 3.5 years among ethnically diverse children, including 2,184 American Indian/Alaskan Native children. Children gained significantly more weight during the summer season, with the strongest effects for children who were obese. American Indian/Alaskan Native children had less seasonal variability than White children, but higher overall obesity rates. These data underscore summer as a critical time for obesity prevention among children who are overweight/obese but suggest that seasonal patterns may vary for American Indian/Alaskan Native children.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Several studies have reported that children gain more weight during the summer season. Despite high obesity rates, little research has included American Indian/Alaskan Native children, and few studies have been longitudinal. This observational study examines seasonal weight variability over 3.5 years among ethnically diverse children, including 2,184 American Indian/Alaskan Native children. Children gained significantly more weight during the summer season, with the strongest effects for children who were obese. American Indian/Alaskan Native children had less seasonal variability than White children, but higher overall obesity rates. These data underscore summer as a critical time for obesity prevention among children who are overweight/obese but suggest that seasonal patterns may vary for American Indian/Alaskan Native children. |
Camplain, Ricky; Lopez, Nanette V; Cooper, Dan M; McKenzie, Thomas L; Zheng, Kai; Radom-Aizik, Shlomit Development of the systematic observation of COVID-19 mitigation (SOCOM): Assessing face covering and distancing in schools Journal Article Journal of Clinical and Translational Science, 5 (1), 2021. @article{Camplain2021b, title = {Development of the systematic observation of COVID-19 mitigation (SOCOM): Assessing face covering and distancing in schools}, author = {Ricky Camplain and Nanette V. Lopez and Dan M. Cooper and Thomas L. McKenzie and Kai Zheng and Shlomit Radom-Aizik}, url = {https://doi.org/10.1017/cts.2021.786}, doi = {10.1017/cts.2021.786}, year = {2021}, date = {2021-04-30}, journal = {Journal of Clinical and Translational Science}, volume = {5}, number = {1}, abstract = {During the COVID-19 pandemic, some K-12 schools resumed in-person classes with varying degrees of mitigation plans in the fall 2020. Physical distancing and face coverings can minimize SARS-CoV-2 spread, the virus that causes COVID-19. However, no research has focused on adherence to mitigation strategies during school days. Thus, we sought to develop a systematic observation protocol to capture COVID-19 mitigation strategy adherence in school environments: The Systematic Observation of COVID-19 Mitigation (SOCOM).}, keywords = {}, pubstate = {published}, tppubtype = {article} } During the COVID-19 pandemic, some K-12 schools resumed in-person classes with varying degrees of mitigation plans in the fall 2020. Physical distancing and face coverings can minimize SARS-CoV-2 spread, the virus that causes COVID-19. However, no research has focused on adherence to mitigation strategies during school days. Thus, we sought to develop a systematic observation protocol to capture COVID-19 mitigation strategy adherence in school environments: The Systematic Observation of COVID-19 Mitigation (SOCOM). |
Black, Caroline Partner Emotional Support and Child Problem Behaviors: The Indirect Role of Harsh Parenting for Young Mothers and Their Children Journal Article Family Process, 2021. @article{Black2021, title = {Partner Emotional Support and Child Problem Behaviors: The Indirect Role of Harsh Parenting for Young Mothers and Their Children}, author = {Caroline Black}, url = {https://doi.org/10.1111/famp.12663}, doi = {10.1111/famp.12663}, year = {2021}, date = {2021-04-26}, journal = {Family Process}, abstract = {Emotionally supportive partners promote the well-being of teenage mothers and their children as they navigate sensitive developmental periods. Yet, having focused on young parents’ relationship dissolution, we know very little about benefits of partner supportiveness for the development of children’s psychological adjustment or processes that may explain this association. Using five waves of Fragile Families and Child Well-being Study data (N = 771) and parallel process latent growth curve modeling, this study tested whether trajectories of partner supportiveness (measured by maternal reports of fathers’ emotional support) directly mitigated trajectories of children’s externalizing and internalizing problem behaviors (measured by maternal reports of problem behaviors) and/or whether such effects were indirectly linked through lower levels of maternal harsh parenting (measured by observational ratings of mother-child interactions). Results suggest that higher levels of partner supportiveness at birth were associated with child externalizing and internalizing trajectories that started at lower levels and demonstrated slower improvements across time. Lower starting levels of maternal harsh parenting when children were three years old partially explained associations between partner supportiveness at birth and lower levels of child externalizing symptoms at age three. Lessons gleaned from this study are discussed in context of young families’ strengths and applied to practice-based settings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Emotionally supportive partners promote the well-being of teenage mothers and their children as they navigate sensitive developmental periods. Yet, having focused on young parents’ relationship dissolution, we know very little about benefits of partner supportiveness for the development of children’s psychological adjustment or processes that may explain this association. Using five waves of Fragile Families and Child Well-being Study data (N = 771) and parallel process latent growth curve modeling, this study tested whether trajectories of partner supportiveness (measured by maternal reports of fathers’ emotional support) directly mitigated trajectories of children’s externalizing and internalizing problem behaviors (measured by maternal reports of problem behaviors) and/or whether such effects were indirectly linked through lower levels of maternal harsh parenting (measured by observational ratings of mother-child interactions). Results suggest that higher levels of partner supportiveness at birth were associated with child externalizing and internalizing trajectories that started at lower levels and demonstrated slower improvements across time. Lower starting levels of maternal harsh parenting when children were three years old partially explained associations between partner supportiveness at birth and lower levels of child externalizing symptoms at age three. Lessons gleaned from this study are discussed in context of young families’ strengths and applied to practice-based settings. |
2017 |
MacFarlan, Shane J; Remiker, Mark Cultural multi-level selection and biological market theory explain the coupled dynamics of labor exchange cooperation and social support Journal Article Sustainability Science, 13 (1), pp. 59-70, 2017. @article{MacFarlan2017, title = {Cultural multi-level selection and biological market theory explain the coupled dynamics of labor exchange cooperation and social support}, author = {Shane J MacFarlan and Mark Remiker}, url = {https://link.springer.com/article/10.1007/s11625-017-0481-x}, year = {2017}, date = {2017-09-13}, journal = {Sustainability Science}, volume = {13}, number = {1}, pages = {59-70}, abstract = {Smallholders rely on labor exchange and social support networks; however, little is known about the cooperative dynamics of these interlinked systems. Whereas cultural multi-level selection (CLMS) predicts group membership and changes in the dominant level of selection modulates cooperation, biological market theory (BMT) posits market size fluctuations affect cooperation. We assess these predictions by examining two dimensions of labor exchange, competitive helping and labor reciprocity, and their downstream impacts on social support in a Dominican community between 2007 and 2010. First, we analyze within-community labor organization. Next, we analyze how international regulatory change and the 2008–2009 World Trade Collapse affected local labor organization and its impacts on competitive helping and labor reciprocity. Finally, we show how labor dynamics affected social support. Analyses reveal that (1) village labor initially involved two levels (labor contracting and labor exchange) and the presence of a structured group who maintained higher rates of reciprocal labor relative to non-group members; (2) changes in the international commodities market reduced labor contracting, the size of the labor exchange market, and the dominant level of selection, resulting in less competitive helping, lower rates of reciprocity for group members, and more cliquish social support; and (3) as the global market for bay oil ameliorated, labor organization shifted back to a pre-recession structure, resulting in a larger labor market with more competitive helping and higher rates of reciprocity amongst group members. We highlight the utility of an integrated CMLS and BMT framework for analyzing cooperative dynamics and socio-economic systems sustainability.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Smallholders rely on labor exchange and social support networks; however, little is known about the cooperative dynamics of these interlinked systems. Whereas cultural multi-level selection (CLMS) predicts group membership and changes in the dominant level of selection modulates cooperation, biological market theory (BMT) posits market size fluctuations affect cooperation. We assess these predictions by examining two dimensions of labor exchange, competitive helping and labor reciprocity, and their downstream impacts on social support in a Dominican community between 2007 and 2010. First, we analyze within-community labor organization. Next, we analyze how international regulatory change and the 2008–2009 World Trade Collapse affected local labor organization and its impacts on competitive helping and labor reciprocity. Finally, we show how labor dynamics affected social support. Analyses reveal that (1) village labor initially involved two levels (labor contracting and labor exchange) and the presence of a structured group who maintained higher rates of reciprocal labor relative to non-group members; (2) changes in the international commodities market reduced labor contracting, the size of the labor exchange market, and the dominant level of selection, resulting in less competitive helping, lower rates of reciprocity for group members, and more cliquish social support; and (3) as the global market for bay oil ameliorated, labor organization shifted back to a pre-recession structure, resulting in a larger labor market with more competitive helping and higher rates of reciprocity amongst group members. We highlight the utility of an integrated CMLS and BMT framework for analyzing cooperative dynamics and socio-economic systems sustainability. |
Hunter, Wynn G; Zafar, Yousuf S; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Barnett, Jamison A; Ubel, Peter A Discussing health care expenses in the oncology clinic: Analysis of cost conversations in outpatient encounters Journal Article Journal of Oncology Practice, 12 (11), pp. e944-e956, 2017. @article{Hunter2017, title = {Discussing health care expenses in the oncology clinic: Analysis of cost conversations in outpatient encounters}, author = {Wynn G Hunter and Yousuf S Zafar and Ashley Hesson and Kelly J Davis and Christine Kirby and Jamison A Barnett and Peter A Ubel}, url = {http://ascopubs.org/doi/abs/10.1200/JOP.2017.022855}, year = {2017}, date = {2017-08-23}, journal = {Journal of Oncology Practice}, volume = {12}, number = {11}, pages = {e944-e956}, abstract = {Purpose: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. Methods: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management. Encounters featured 677 patients with breast cancer visiting 56 oncologists nationwide from 2010 to 2013. Results: Cost conversations were identified in 22% of visits (95% CI, 19 to 25) and had a median duration of 33 seconds (interquartile range, 19 to 62). Fifty-nine percent of cost conversations were initiated by oncologists (95% CI, 51 to 67), who most commonly brought up costs for antineoplastic agents. By contrast, patients …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Purpose: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. Methods: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management. Encounters featured 677 patients with breast cancer visiting 56 oncologists nationwide from 2010 to 2013. Results: Cost conversations were identified in 22% of visits (95% CI, 19 to 25) and had a median duration of 33 seconds (interquartile range, 19 to 62). Fifty-nine percent of cost conversations were initiated by oncologists (95% CI, 51 to 67), who most commonly brought up costs for antineoplastic agents. By contrast, patients … |
Baldwin, Julie A; Williamson, Heather J; Eaves, Emery R; Levin, Bruce L; Burton, Donna L; Massey, Oliver T Broadening measures of success: Results of a behavioral health translational research training program Journal Article Implementation Science, 12 (92), 2017. @article{Baldwin2017b, title = {Broadening measures of success: Results of a behavioral health translational research training program}, author = {Julie A Baldwin and Heather J Williamson and Emery R Eaves and Bruce L Levin and Donna L Burton and Oliver T Massey}, url = {https://implementationscience.biomedcentral.com/articles/10.1186/s13012-017-0621-9}, year = {2017}, date = {2017-07-24}, journal = {Implementation Science}, volume = {12}, number = {92}, abstract = {Background While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects. Methods Semi-structured qualitative interviews with scholars, community mentors, and academic mentors were conducted regarding a translational research program to identify programmatic impacts. Interviews were transcribed and coded by the research team to identify salient themes related to programmatic outcomes. Results Results are framed using the Translational Research Impact Scale which is organized into three overarching domains of potential impact: (1) research-related impacts, (2) translational impacts, and (3) societal impacts. This evaluation demonstrates the program’s impact in all three domains of the TRIS evaluation framework. Graduate certificate participants (scholars) reported that gaining experience in applied behavioral health settings added useful skills and expertise to their present careers and increased their interest in pursuing translational research. Scholars also described benefits resulting from networks gained through participation in the program, including valuable ties between the university and community behavioral health organizations. Conclusions This evaluation of the outcomes of a graduate certificate program providing training in translational research highlights the need for more community-oriented and practice-based measures of success. Encouraging practitioner involvement in translational research is vital to translate knowledge into practice and to enable practice-based needs to inform research and policy. A more flexible approach to measuring programmatic success in research training programs can help bridge the knowledge translation gap.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects. Methods Semi-structured qualitative interviews with scholars, community mentors, and academic mentors were conducted regarding a translational research program to identify programmatic impacts. Interviews were transcribed and coded by the research team to identify salient themes related to programmatic outcomes. Results Results are framed using the Translational Research Impact Scale which is organized into three overarching domains of potential impact: (1) research-related impacts, (2) translational impacts, and (3) societal impacts. This evaluation demonstrates the program’s impact in all three domains of the TRIS evaluation framework. Graduate certificate participants (scholars) reported that gaining experience in applied behavioral health settings added useful skills and expertise to their present careers and increased their interest in pursuing translational research. Scholars also described benefits resulting from networks gained through participation in the program, including valuable ties between the university and community behavioral health organizations. Conclusions This evaluation of the outcomes of a graduate certificate program providing training in translational research highlights the need for more community-oriented and practice-based measures of success. Encouraging practitioner involvement in translational research is vital to translate knowledge into practice and to enable practice-based needs to inform research and policy. A more flexible approach to measuring programmatic success in research training programs can help bridge the knowledge translation gap. |
Williamson, Heather J; Contreras, Graciela M; Rodriguez, Erica S; Smith, Jennifer M; Perkins, Elizabeth A Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review Journal Article OTJR: Occupation, Participation and Health, 37 (4), pp. 227-236, 2017. @article{Williamson2017b, title = {Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review}, author = {Heather J Williamson and Graciela M Contreras and Erica S Rodriguez and Jennifer M Smith and Elizabeth A Perkins}, url = {http://journals.sagepub.com/doi/abs/10.1177/1539449217714148}, year = {2017}, date = {2017-07-13}, journal = {OTJR: Occupation, Participation and Health}, volume = {37}, number = {4}, pages = {227-236}, abstract = {Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study’s purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study’s purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment. |
Baldwin, Julie A; Williamson, Heather J; Eaves, Emery R; Levin, Bruce L; Burton, Donna L; Massey, Oliver T Broadening measures of success: results of a behavioral health translational research training program Journal Article Implementation Science, 12 (92), 2017. @article{Baldwin2017b, title = {Broadening measures of success: results of a behavioral health translational research training program}, author = {Julie A Baldwin and Heather J Williamson and Emery R Eaves and Bruce L Levin and Donna L Burton and Oliver T Massey}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5525239/}, year = {2017}, date = {2017-07-04}, journal = {Implementation Science}, volume = {12}, number = {92}, abstract = {Background: While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects. Methods: Semi-structured qualitative interviews with scholars, community mentors, and academic mentors were conducted regarding a translational research program to identify programmatic impacts. Interviews were transcribed and coded by the research team to identify salient themes related to programmatic outcomes. Results: Results are framed using the Translational Research Impact Scale which is organized into three overarching domains of potential impact: (1) research-related impacts, (2) translational impacts, and (3) societal impacts. This evaluation demonstrates the program’s impact in all three domains of the TRIS evaluation framework. Graduate certificate participants (scholars) reported that gaining experience in applied behavioral health settings added useful skills and expertise to their present careers and increased their interest in pursuing translational research. Scholars also described benefits resulting from networks gained through participation in the program, including valuable ties between the university and community behavioral health organizations. Conclusions: This evaluation of the outcomes of a graduate certificate program providing training in translational research highlights the need for more community-oriented and practice-based measures of success. Encouraging practitioner involvement in translational research is vital to translate knowledge into practice and to enable practice-based needs to inform research and policy. A more flexible approach to measuring programmatic success in research training programs can help bridge the knowledge translation gap}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background: While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects. Methods: Semi-structured qualitative interviews with scholars, community mentors, and academic mentors were conducted regarding a translational research program to identify programmatic impacts. Interviews were transcribed and coded by the research team to identify salient themes related to programmatic outcomes. Results: Results are framed using the Translational Research Impact Scale which is organized into three overarching domains of potential impact: (1) research-related impacts, (2) translational impacts, and (3) societal impacts. This evaluation demonstrates the program’s impact in all three domains of the TRIS evaluation framework. Graduate certificate participants (scholars) reported that gaining experience in applied behavioral health settings added useful skills and expertise to their present careers and increased their interest in pursuing translational research. Scholars also described benefits resulting from networks gained through participation in the program, including valuable ties between the university and community behavioral health organizations. Conclusions: This evaluation of the outcomes of a graduate certificate program providing training in translational research highlights the need for more community-oriented and practice-based measures of success. Encouraging practitioner involvement in translational research is vital to translate knowledge into practice and to enable practice-based needs to inform research and policy. A more flexible approach to measuring programmatic success in research training programs can help bridge the knowledge translation gap |
Sabo, Samantha; Flores, Melissa; Wennerström, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia Community health workers promote civic engagement and organizational capacity to impact policy Journal Article Journal of Community Health, 42 (6), pp. 1197-1203, 2017. @article{Sabo2017b, title = {Community health workers promote civic engagement and organizational capacity to impact policy}, author = {Samantha Sabo and Melissa Flores and Ashley Wennerström and Melanie L Bell and Lorena Verdugo and Scott Carvajal and Maia Ingram}, url = {https://link.springer.com/article/10.1007/s10900-017-0370-3}, year = {2017}, date = {2017-06-06}, journal = {Journal of Community Health}, volume = {42}, number = {6}, pages = {1197-1203}, abstract = {Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change. |
Brown, Gregory D; Hunter, Wynn G; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Barnett, Jamison A; Byelmac, Dmytro; Ubel, Peter A Discussing out-of-pocket expenses during clinical appointments: An observational study of patient-psychiatrist interactions Journal Article Psychiatric Services, 68 (6), pp. 610-617, 2017. @article{Brown2017, title = {Discussing out-of-pocket expenses during clinical appointments: An observational study of patient-psychiatrist interactions}, author = {Gregory D Brown and Wynn G Hunter and Ashley Hesson and Kelly J Davis and Christine Kirby and Jamison A Barnett and Dmytro Byelmac and Peter A Ubel}, url = {https://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.201600275}, year = {2017}, date = {2017-05-19}, journal = {Psychiatric Services}, volume = {68}, number = {6}, pages = {610-617}, abstract = {Objective: High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. Limited data characterize psychiatrist-patient conversations about health care costs. Methods: The authors conducted content analysis from 422 outpatient psychiatrist-patient visits for medication management of major depressive disorder in community-based private practices nationwide from 2010 to 2014. Results: Patients’ health care expenses were discussed in 38% of clinic visits (95% confidence interval [CI]= 33%–43%). Uninsured patients were significantly more likely to discuss expenses than were patients enrolled in private or public plans (64%, 44%, and 30%, respectively; p<.001). Sixty-nine percent of cost conversations lasted less than one minute …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective: High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. Limited data characterize psychiatrist-patient conversations about health care costs. Methods: The authors conducted content analysis from 422 outpatient psychiatrist-patient visits for medication management of major depressive disorder in community-based private practices nationwide from 2010 to 2014. Results: Patients’ health care expenses were discussed in 38% of clinic visits (95% confidence interval [CI]= 33%–43%). Uninsured patients were significantly more likely to discuss expenses than were patients enrolled in private or public plans (64%, 44%, and 30%, respectively; p<.001). Sixty-nine percent of cost conversations lasted less than one minute … |
Salinas-Miranda, Abraham; King, Lindsey M; Salihu, Hamisu M; Berry, Estrellita; Austin, Deborah; Nash, Susan; Scarborough, Kenneth; Best, Evangeline; Cox, Lillian; King, Georgette; Hepburn, Carrie; Burpee, Conchita; Richardson, Eugene; Ducket, Marlo; Briscoe, Richard; Baldwin, Julie A Exploring the life course perspective in maternal and child health through community-based participatory focus groups: Social risk assessment Journal Article Journal of Health Disparities Research and Practice, 10 (1), pp. 143-166, 2017. @article{Salinas-Miranda2017, title = {Exploring the life course perspective in maternal and child health through community-based participatory focus groups: Social risk assessment}, author = {Abraham Salinas-Miranda and Lindsey M King and Hamisu M Salihu and Estrellita Berry and Deborah Austin and Susan Nash and Kenneth Scarborough and Evangeline Best and Lillian Cox and Georgette King and Carrie Hepburn and Conchita Burpee and Eugene Richardson and Marlo Ducket and Richard Briscoe and Julie A Baldwin}, url = {https://digitalscholarship.unlv.edu/jhdrp/vol10/iss1/9/}, year = {2017}, date = {2017-04-20}, journal = {Journal of Health Disparities Research and Practice}, volume = {10}, number = {1}, pages = {143-166}, abstract = {Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas. Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain the experiences reported by the interviewees. A total of 78 residents participated in the focus groups. Children and adolescents’ health risks were childhood obesity, lack of physical activity, and low self-esteem. Women’s health risks were low self-esteem, low educational level, low health literacy, inadequate parenting skills, and financial problems. Risks during pregnancy included stress, low self-esteem, inadequate eating patterns, lack of physical activity, healthcare issues, lack of social support, and lack of father involvement during pregnancy. Multiple risk factors contribute to maternal and child health in low income communities in Tampa Bay. The intersection of risk factors in different life periods suggest possible pathways, cumulative, and latent effects, which must be considered in future longitudinal studies and when developing effective maternal and child health programs and policies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas. Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain the experiences reported by the interviewees. A total of 78 residents participated in the focus groups. Children and adolescents’ health risks were childhood obesity, lack of physical activity, and low self-esteem. Women’s health risks were low self-esteem, low educational level, low health literacy, inadequate parenting skills, and financial problems. Risks during pregnancy included stress, low self-esteem, inadequate eating patterns, lack of physical activity, healthcare issues, lack of social support, and lack of father involvement during pregnancy. Multiple risk factors contribute to maternal and child health in low income communities in Tampa Bay. The intersection of risk factors in different life periods suggest possible pathways, cumulative, and latent effects, which must be considered in future longitudinal studies and when developing effective maternal and child health programs and policies. |
Williamson, Heather J; Perkins, Elizabeth A; Levin, Bruce L; Baldwin, Julie A; Lulinski, Amie; Armstrong, Mary I; Massey, Oliver T Implementation of Medicaid managed long-term services and supports for adults with intellectual and/or developmental disabilities in Kansas Journal Article Intellectual and Developmental Disabilities, 55 (2), pp. 84-96, 2017. @article{Williamson2017b, title = {Implementation of Medicaid managed long-term services and supports for adults with intellectual and/or developmental disabilities in Kansas}, author = {Heather J Williamson and Elizabeth A Perkins and Bruce L Levin and Julie A Baldwin and Amie Lulinski and Mary I Armstrong and Oliver T Massey}, url = {http://www.aaiddjournals.org/doi/10.1352/1934-9556-55.2.84}, year = {2017}, date = {2017-04-01}, journal = {Intellectual and Developmental Disabilities}, volume = {55}, number = {2}, pages = {84-96}, abstract = {Many adults with intellectual and/or developmental disabilities (IDD) can access health and long-term services and supports (LTSS) through Medicaid. States are reforming their Medicaid LTSS programs from a fee-for-service model to a Medicaid managed LTSS (MLTSS) approach, anticipating improved quality of care and reduced costs, although there is limited evidence of MLTSS effectiveness. This study's objective was to contribute to the growing MLTSS research literature by describing MLTSS implementation in Kansas for adults with IDD. Thirty-one stakeholders completed in-depth semi-structured interviews, representing state or regional groups, service coordination providers, and family caregivers. Findings identify key aspects of the Centers for Medicare and Medicaid Services' new MLTSS regulations in the design and implementation of MLTSS programs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many adults with intellectual and/or developmental disabilities (IDD) can access health and long-term services and supports (LTSS) through Medicaid. States are reforming their Medicaid LTSS programs from a fee-for-service model to a Medicaid managed LTSS (MLTSS) approach, anticipating improved quality of care and reduced costs, although there is limited evidence of MLTSS effectiveness. This study's objective was to contribute to the growing MLTSS research literature by describing MLTSS implementation in Kansas for adults with IDD. Thirty-one stakeholders completed in-depth semi-structured interviews, representing state or regional groups, service coordination providers, and family caregivers. Findings identify key aspects of the Centers for Medicare and Medicaid Services' new MLTSS regulations in the design and implementation of MLTSS programs. |
Martinez-Hume, Anna C; Baker, Allison M; Bell, Hannah S; Montemayor, Isabel; Elwell, Kristan; Hunt, Linda M "They Treat you a Different Way:" Public Insurance, Stigma, and the Challenge to Quality Health Care Journal Article Culture, Medicine, and Psychiatry, 41 (1), pp. 161-180, 2017. @article{Martinez-Hume2017, title = {"They Treat you a Different Way:" Public Insurance, Stigma, and the Challenge to Quality Health Care}, author = {Anna C Martinez-Hume and Allison M Baker and Hannah S Bell and Isabel Montemayor and Kristan Elwell and Linda M Hunt}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28025774}, year = {2017}, date = {2017-03-01}, journal = {Culture, Medicine, and Psychiatry}, volume = {41}, number = {1}, pages = {161-180}, abstract = {Under the Affordable Care Act, Medicaid Expansion programs are extending Medicaid eligibility and increasing access to care. However, stigma associated with public insurance coverage may importantly affect the nature and content of the health care beneficiaries receive. In this paper, we examine the health care stigma experiences described by a group of low-income public insurance beneficiaries. They perceive stigma as manifest in poor quality care and negative interpersonal interactions in the health care setting. Using an intersectional approach, we found that the stigma of public insurance was compounded with other sources of stigma including socioeconomic status, race, gender, and illness status. Experiences of stigma had important implications for how subjects evaluated the quality of care, their decisions impacting continuity of care, and their reported ability to access health care. We argue that stigma challenges the quality of care provided under public insurance and is thus a public health issue that should be addressed in Medicaid policy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Under the Affordable Care Act, Medicaid Expansion programs are extending Medicaid eligibility and increasing access to care. However, stigma associated with public insurance coverage may importantly affect the nature and content of the health care beneficiaries receive. In this paper, we examine the health care stigma experiences described by a group of low-income public insurance beneficiaries. They perceive stigma as manifest in poor quality care and negative interpersonal interactions in the health care setting. Using an intersectional approach, we found that the stigma of public insurance was compounded with other sources of stigma including socioeconomic status, race, gender, and illness status. Experiences of stigma had important implications for how subjects evaluated the quality of care, their decisions impacting continuity of care, and their reported ability to access health care. We argue that stigma challenges the quality of care provided under public insurance and is thus a public health issue that should be addressed in Medicaid policy. |
Panzera, Anthony D; Bryant, Carol A; Hawkins, Fran; Goff, Rhonda; Napier, Ashley; Schneider, Tali; Kirby, Russell S; Coulter, Martha L; Sappenfield, William M; Baldwin, Julie A; O'Rourke, Kathleen Mapping a WIC Mother's Journey: A preliminary analysis Journal Article Social Marketing Quarterly, 23 (2), pp. 1-17, 2017. @article{Panzera2017, title = {Mapping a WIC Mother's Journey: A preliminary analysis}, author = {Anthony D Panzera and Carol A Bryant and Fran Hawkins and Rhonda Goff and Ashley Napier and Tali Schneider and Russell S Kirby and Martha L Coulter and William M Sappenfield and Julie A Baldwin and Kathleen O'Rourke}, url = {http://journals.sagepub.com/doi/full/10.1177/1524500417692526}, year = {2017}, date = {2017-02-21}, journal = {Social Marketing Quarterly}, volume = {23}, number = {2}, pages = {1-17}, abstract = {While the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides numerous benefits to many enrolled families across the United States, including access to nutritious foods, some recent drops in maternal participation in Kentucky resulted from failures to retrieve those benefits. We explored perceived benefits of and encountered barriers to food benefit retrieval. Journey mapping included direct observations of client appointments, clinic lobby areas, and a shopping experience and was augmented with focus groups conducted in two urban and two rural areas. Major touchpoints before WIC appointments, during those appointments at clinics, and after appointments when redeeming food benefits were identified. Across touchpoints, mothers identified childcare, transportation issues, long waits, confusion regarding eligibility, problems scheduling appointments, and stigma as barriers to their ability to retrieve food instruments. Despite these barriers mothers value the benefits of WIC, especially access to healthy foods, infant formula, and nutrition education. This work demonstrates a method by which WIC mothers’ experiences shed light on client service shortfalls and possible opportunities to improve client services.}, keywords = {}, pubstate = {published}, tppubtype = {article} } While the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides numerous benefits to many enrolled families across the United States, including access to nutritious foods, some recent drops in maternal participation in Kentucky resulted from failures to retrieve those benefits. We explored perceived benefits of and encountered barriers to food benefit retrieval. Journey mapping included direct observations of client appointments, clinic lobby areas, and a shopping experience and was augmented with focus groups conducted in two urban and two rural areas. Major touchpoints before WIC appointments, during those appointments at clinics, and after appointments when redeeming food benefits were identified. Across touchpoints, mothers identified childcare, transportation issues, long waits, confusion regarding eligibility, problems scheduling appointments, and stigma as barriers to their ability to retrieve food instruments. Despite these barriers mothers value the benefits of WIC, especially access to healthy foods, infant formula, and nutrition education. This work demonstrates a method by which WIC mothers’ experiences shed light on client service shortfalls and possible opportunities to improve client services. |
Camplain, Ricky; Kucharska-Newton, Anna; Cuthbertson, Carmen C; Wright, Jacqueline D; Alonso, Alvaro; Heiss, Gerardo Pharmacoepidemiology and Drug Safety, 26 (4), pp. 421-428, 2017. @article{Camplain2017c, title = {Misclassification of incident hospitalized and outpatient heart failure in administrative claims data: the Atherosclerosis Risk in Communities (ARIC) study.}, author = {Ricky Camplain and Anna Kucharska-Newton and Carmen C Cuthbertson and Jacqueline D Wright and Alvaro Alonso and Gerardo Heiss}, url = {http://onlinelibrary.wiley.com/doi/10.1002/pds.4162/abstract;jsessionid=84471AF98391D8C41703CB2E376B34F1.f04t01}, year = {2017}, date = {2017-01-25}, journal = {Pharmacoepidemiology and Drug Safety}, volume = {26}, number = {4}, pages = {421-428}, abstract = {PURPOSE: The aim of this study was to quantify the influence of the length of the look-back period on misclassification of heart failure (HF) incidence in Medicare claims available for participants of a population-based cohort. METHODS: Atherosclerosis Risk in Communities participants with ≥3 years of continuous fee-for-service Medicare enrollment from 2000 to 2012 was assigned an index date 36 months after enrollment separating the time-in-observation period into the look-back and the incidence periods. Incident HF events were identified using ICD-9-CM code algorithms as the first observed hospitalization claim or the second of two HF outpatient claims occurring within 12 months. Using 36 months as a referent, the look-back period was reduced by 6-month increments. For each look-back period, we calculated the incidence rate, percent of prevalent HF events misclassified as incident, and loss in sample size. RESULTS: We identified 9568 Atherosclerosis Risk in Communities participants at risk for HF. For hospitalized and outpatient HF, the number of events misclassified as incident increased, and the total number of incident events decreased with increased length of the look-back period. The incident rate (per 1000 person years) decreased with increased length of the look-back period from 6 to 36 months and had a greater impact on outpatient HF; for example, from 11.2 to 10.6 for ICD-9-CM 428.xx hospitalization in the primary position and 10.5 to 7.9 for outpatient HF. CONCLUSION: Our estimates can be used to optimize trade-offs between the degree of misclassification and number of events in the estimation of incident HF from administrative claims data, as pertinent to different study questions. Copyright © 2017 John Wiley & Sons, Ltd.}, keywords = {}, pubstate = {published}, tppubtype = {article} } PURPOSE: The aim of this study was to quantify the influence of the length of the look-back period on misclassification of heart failure (HF) incidence in Medicare claims available for participants of a population-based cohort. METHODS: Atherosclerosis Risk in Communities participants with ≥3 years of continuous fee-for-service Medicare enrollment from 2000 to 2012 was assigned an index date 36 months after enrollment separating the time-in-observation period into the look-back and the incidence periods. Incident HF events were identified using ICD-9-CM code algorithms as the first observed hospitalization claim or the second of two HF outpatient claims occurring within 12 months. Using 36 months as a referent, the look-back period was reduced by 6-month increments. For each look-back period, we calculated the incidence rate, percent of prevalent HF events misclassified as incident, and loss in sample size. RESULTS: We identified 9568 Atherosclerosis Risk in Communities participants at risk for HF. For hospitalized and outpatient HF, the number of events misclassified as incident increased, and the total number of incident events decreased with increased length of the look-back period. The incident rate (per 1000 person years) decreased with increased length of the look-back period from 6 to 36 months and had a greater impact on outpatient HF; for example, from 11.2 to 10.6 for ICD-9-CM 428.xx hospitalization in the primary position and 10.5 to 7.9 for outpatient HF. CONCLUSION: Our estimates can be used to optimize trade-offs between the degree of misclassification and number of events in the estimation of incident HF from administrative claims data, as pertinent to different study questions. Copyright © 2017 John Wiley & Sons, Ltd. |
Davis, Jenna L; McGinnis, Kara E; Walsh, Margaret L; Williams, Coni; Sneed, Kevin B; Baldwin, Julie A; Green, Lee B An Innovative Approach for Community Engagement: Using an Audience Response System Journal Article Journal of Health Disparities Research and Practice, 5 (2), pp. 1, 2017. @article{Davis2017, title = {An Innovative Approach for Community Engagement: Using an Audience Response System}, author = {Jenna L Davis and Kara E McGinnis and Margaret L Walsh and Coni Williams and Kevin B Sneed and Julie A Baldwin and Lee B Green}, url = {https://www.ncbi.nlm.nih.gov/pubmed/23302776}, year = {2017}, date = {2017-01-01}, journal = {Journal of Health Disparities Research and Practice}, volume = {5}, number = {2}, pages = {1}, abstract = {Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge and technology among all population groups. ARS was implemented at a community town hall event sponsored by a National Institute on Minority Health and Health Disparities Exploratory Center of Excellence, the Center for Equal Health. Participants appreciated being able to see how everyone else answered and felt included in the research process. ARS is beneficial because the community can answer truthfully and provides instant research results. Additionally, researchers can collect large amounts of data quickly, in a non-threatening way while tracking individual responses anonymously. Audience Response Systems proved to be an effective tool for successfully accomplishing community-based participatory research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge and technology among all population groups. ARS was implemented at a community town hall event sponsored by a National Institute on Minority Health and Health Disparities Exploratory Center of Excellence, the Center for Equal Health. Participants appreciated being able to see how everyone else answered and felt included in the research process. ARS is beneficial because the community can answer truthfully and provides instant research results. Additionally, researchers can collect large amounts of data quickly, in a non-threatening way while tracking individual responses anonymously. Audience Response Systems proved to be an effective tool for successfully accomplishing community-based participatory research. |
2016 |
Williamson, Heather J; Perkins, Elizabeth A; Acosta, Annie; Fitzgerald, Maureen; Agrawal, Jui; Massey, Oliver T Journal of Policy and Practice in Intellectual Disabilities, 13 (4), pp. 287-296, 2016. @article{Williamson2016, title = {Family Caregivers of Individuals with Intellectual and Developmental Disabilities: Experiences with Medicaid Managed Care Long-Term Services and Supports in the United States}, author = {Heather J Williamson and Elizabeth A Perkins and Annie Acosta and Maureen Fitzgerald and Jui Agrawal and Oliver T Massey}, url = {http://onlinelibrary.wiley.com/doi/10.1111/jppi.12198/abstract}, year = {2016}, date = {2016-12-01}, journal = {Journal of Policy and Practice in Intellectual Disabilities}, volume = {13}, number = {4}, pages = {287-296}, abstract = {A majority of individuals with intellectual and developmental disabilities need the support of a family caregiver. In the USA, more states are transitioning to a managed care model to provide long-term services and supports (LTSS) and family caregivers are vital partners in the successful management of LTSS. This study's purpose is to illustrate the lived experience of receiving LTSS in a managed care model from the family caregiver perspective. In-depth semi-structured interviews were completed with 16 caregivers in four states with Medicaid managed LTSS (MLTSS). The themes include the importance of the family caregiver as supported and active partners in the provision of MLTSS, the family caregiver experiences with care coordination and access to services in MLTSS, and the family caregivers’ overall impression of MLTSS. Results indicate caregiver advocacy is critical to coordinating needed MLTSS and family support services help caregiver's maintain their vital role in the MLTSS system. Access to services and care coordination in MTLSS varies depending on state of residence. Some caregivers experienced less flexibility in the provision of services and supports and limited access to services making it more complicated for them to feel supported in their caregiving role. Care coordination in MLTSS was largely seen as paperwork processing function. Family caregivers can provide a wealth of knowledge from lived experiences on best practices for MLTSS. Given the move to more home and community-based services, the role of the family caregiver as an active partners in MLTSS will remain the reality for many individuals with IDD. Family caregivers are a key component in MLTSS and more needs to be done to encourage their involvement in the design and oversight of MLTSS. More research is needed to explore best practices for effective stakeholder engagement in the provision of MLTSS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } A majority of individuals with intellectual and developmental disabilities need the support of a family caregiver. In the USA, more states are transitioning to a managed care model to provide long-term services and supports (LTSS) and family caregivers are vital partners in the successful management of LTSS. This study's purpose is to illustrate the lived experience of receiving LTSS in a managed care model from the family caregiver perspective. In-depth semi-structured interviews were completed with 16 caregivers in four states with Medicaid managed LTSS (MLTSS). The themes include the importance of the family caregiver as supported and active partners in the provision of MLTSS, the family caregiver experiences with care coordination and access to services in MLTSS, and the family caregivers’ overall impression of MLTSS. Results indicate caregiver advocacy is critical to coordinating needed MLTSS and family support services help caregiver's maintain their vital role in the MLTSS system. Access to services and care coordination in MTLSS varies depending on state of residence. Some caregivers experienced less flexibility in the provision of services and supports and limited access to services making it more complicated for them to feel supported in their caregiving role. Care coordination in MLTSS was largely seen as paperwork processing function. Family caregivers can provide a wealth of knowledge from lived experiences on best practices for MLTSS. Given the move to more home and community-based services, the role of the family caregiver as an active partners in MLTSS will remain the reality for many individuals with IDD. Family caregivers are a key component in MLTSS and more needs to be done to encourage their involvement in the design and oversight of MLTSS. More research is needed to explore best practices for effective stakeholder engagement in the provision of MLTSS. |
Fleischhacker, Sheila; Roberts, Erica; Camplain, Ricky; Evenson, Kelly R; Gittelsohn, Joel Journal of Racial and Ethnic Health Disparities, 3 (4), pp. 608-624, 2016. @article{Fleischhacker2016, title = {Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives}, author = {Sheila Fleischhacker and Erica Roberts and Ricky Camplain and Kelly R Evenson and Joel Gittelsohn}, url = {https://link.springer.com/article/10.1007%2Fs40615-015-0180-1}, year = {2016}, date = {2016-12-01}, journal = {Journal of Racial and Ethnic Health Disparities}, volume = {3}, number = {4}, pages = {608-624}, abstract = {Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth. |
Hunter, Wynn G; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A Patient-physician discussions about costs: Definitions and impact on cost conversation incidence estimates Journal Article BMC Health Services Research, 16 (1), pp. 108, 2016. @article{Hunter2016b, title = {Patient-physician discussions about costs: Definitions and impact on cost conversation incidence estimates}, author = {Wynn G Hunter and Ashley Hesson and Kelly J Davis and Christine Kirby and Lillie D Williamson and Jamison A Barnett and Peter A Ubel}, url = {https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1353-2}, year = {2016}, date = {2016-12-01}, journal = {BMC Health Services Research}, volume = {16}, number = {1}, pages = {108}, abstract = {Nearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations are unclear, and rigorous definitions are lacking. We sought to develop a novel set of cost conversation definitions, and determine the impact of definitional variation on cost conversation incidence in three clinical settings. Retrospective, mixed-methods analysis of transcribed dialogue from 1,755 outpatient encounters for routine clinical management of breast cancer, rheumatoid arthritis, and depression, occurring between 2010–2014. We developed cost conversation definitions using summative content analysis. Transcripts were evaluated independently by at least two members of our multi-disciplinary team to determine cost conversation incidence using each definition. Incidence estimates were compared using Pearson’s Chi-Square Tests. Three cost conversation definitions emerged from our analysis: (a) Out-of-Pocket (OoP) Cost -- discussion of the patient’s OoP costs for a healthcare service; (b) Cost/Coverage -- discussion of the patient’s OoP costs or insurance coverage; (c) Cost of Illness-- discussion of financial costs or insurance coverage related to health or healthcare. These definitions were hierarchical; OoP Cost was a subset of Cost/Coverage, which was a subset of Cost of Illness. In each clinical setting, we observed significant variation in the incidence of cost conversations when using different definitions; breast oncology: 16, 22, 24 % of clinic visits contained cost conversation (OOP Cost, Cost …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Nearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations are unclear, and rigorous definitions are lacking. We sought to develop a novel set of cost conversation definitions, and determine the impact of definitional variation on cost conversation incidence in three clinical settings. Retrospective, mixed-methods analysis of transcribed dialogue from 1,755 outpatient encounters for routine clinical management of breast cancer, rheumatoid arthritis, and depression, occurring between 2010–2014. We developed cost conversation definitions using summative content analysis. Transcripts were evaluated independently by at least two members of our multi-disciplinary team to determine cost conversation incidence using each definition. Incidence estimates were compared using Pearson’s Chi-Square Tests. Three cost conversation definitions emerged from our analysis: (a) Out-of-Pocket (OoP) Cost -- discussion of the patient’s OoP costs for a healthcare service; (b) Cost/Coverage -- discussion of the patient’s OoP costs or insurance coverage; (c) Cost of Illness-- discussion of financial costs or insurance coverage related to health or healthcare. These definitions were hierarchical; OoP Cost was a subset of Cost/Coverage, which was a subset of Cost of Illness. In each clinical setting, we observed significant variation in the incidence of cost conversations when using different definitions; breast oncology: 16, 22, 24 % of clinic visits contained cost conversation (OOP Cost, Cost … |
Eaves, Emery R; Nichter, Mark; Howerter, Amy; Floden, Lysbeth; Ritenbaugh, Cheryl; Gordon, Judith S; MPH2, Myra Muramoto L Printed Educational Materials' Impact on Tobacco Cessation Brief Interventions in CAM Practice: Patient and Practitioner Experiences Journal Article Health Promotion Practice, 17 (6), pp. 862-870, 2016. @article{Eaves2016, title = {Printed Educational Materials' Impact on Tobacco Cessation Brief Interventions in CAM Practice: Patient and Practitioner Experiences}, author = {Emery R Eaves and Mark Nichter and Amy Howerter and Lysbeth Floden and Cheryl Ritenbaugh and Judith S Gordon and Myra Muramoto L MPH2}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27591225}, year = {2016}, date = {2016-11-01}, journal = {Health Promotion Practice}, volume = {17}, number = {6}, pages = {862-870}, abstract = {Printed educational materials (PEMs) have long demonstrated their usefulness as economical and effective media for health communication. In this article, we evaluate the impact of targeted tobacco cessation PEMS for use along with a brief intervention training designed for three types of complementary and alternative medicine (CAM) practitioners: chiropractic, acupuncture, and massage. We describe how PEMs in CAM practitioners' offices were perceived and used by practitioners and by patients. Semistructured qualitative interviews were conducted with 53 practitioners and 38 of their patients. This analysis specifically focused on developing and distributing project-related posters and pamphlets in CAM practice. Our findings indicate that materials (1) legitimated tobacco-related expertise among CAM practitioners and tobacco-related conversations as part of routine CAM practice, (2) increased practitioners' willingness to approach the topic of tobacco with patients, (3) created an effective way to communicate tobacco-related information and broaden the reach of brief intervention initiatives, and (4) were given to patients who were not willing to engage in direct discussion of tobacco use with practitioners.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Printed educational materials (PEMs) have long demonstrated their usefulness as economical and effective media for health communication. In this article, we evaluate the impact of targeted tobacco cessation PEMS for use along with a brief intervention training designed for three types of complementary and alternative medicine (CAM) practitioners: chiropractic, acupuncture, and massage. We describe how PEMs in CAM practitioners' offices were perceived and used by practitioners and by patients. Semistructured qualitative interviews were conducted with 53 practitioners and 38 of their patients. This analysis specifically focused on developing and distributing project-related posters and pamphlets in CAM practice. Our findings indicate that materials (1) legitimated tobacco-related expertise among CAM practitioners and tobacco-related conversations as part of routine CAM practice, (2) increased practitioners' willingness to approach the topic of tobacco with patients, (3) created an effective way to communicate tobacco-related information and broaden the reach of brief intervention initiatives, and (4) were given to patients who were not willing to engage in direct discussion of tobacco use with practitioners. |
Chief, Carmenlita; Sabo, Samantha; Clark, Hershel; Henderson, Patricia Nez; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott J Tobacco Control, 25 , pp. 19-25, 2016. @article{Chief2016, title = {Breathing clean air is Są’áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centered approach to understanding commercial smoke-free policy among the Diné (Navajo People)}, author = {Carmenlita Chief and Samantha Sabo and Hershel Clark and Patricia Nez Henderson and Alfred Yazzie and Jacqueline Nahee and Scott J Leischow}, url = {http://dx.doi.org/10.1136/tobaccocontrol-2016-053081}, year = {2016}, date = {2016-10-03}, journal = {Tobacco Control}, volume = {25}, pages = {19-25}, abstract = {Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective: We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centered approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective: We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centered approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people. |
Pachter, Lee M; Weller, Susan C; Baer, Roberta D; de Garcia, Javier Garcia Alba E; Glazer, Mark; Trotter, Robert; Klein, Robert E; Gonzalez, Eduardo Culture and Dehydration: A Comparative Study of Caída de la Mollera (Fallen Fontanel) in Three Latino Populations Journal Article Journal of Immigrant and Minority Health, 18 (5), pp. 1066-1075, 2016. @article{Pachter2016, title = {Culture and Dehydration: A Comparative Study of Caída de la Mollera (Fallen Fontanel) in Three Latino Populations}, author = {Lee M Pachter and Susan C Weller and Roberta D Baer and Javier Garcia Alba E de Garcia and Mark Glazer and Robert Trotter and Robert E Klein and Eduardo Gonzalez}, url = {https://link.springer.com/article/10.1007/s10903-015-0259-0}, doi = {10.1007/s10903-015-0259-0}, year = {2016}, date = {2016-10-01}, journal = {Journal of Immigrant and Minority Health}, volume = {18}, number = {5}, pages = {1066-1075}, abstract = {A sunken soft-spot or fontanel is a sign for dehydration in infants. Around the world, folk illnesses, such as caída de la mollera in some Latin American cultures, often incorporate this sign as a hallmark of illness, but may or may not incorporate re-hydration therapies in treatment strategies. This report describes a study of lay descriptions of causes, symptoms, and treatments for caída de la mollera in three diverse Latin American populations. A mixed-methods approach was used. Representative community-based samples were interviewed in rural Guatemala, Guadalajara, Mexico, and Edinburgh, Texas, with a 132 item questionnaire on the causes, susceptibility, symptoms, and therapies for caída de la mollera. Cultural consensus analysis was used to estimate community beliefs about caída. Interviews conducted in rural Guatemala (n = 60), urban Mexico (n = 62), and rural Texas on the Mexican border (n = 61) indicated consistency in thematic elements within and among these three diverse communities. The high degree of consistency in the illness explanatory models indicated shared beliefs about caída de la mollera in each of the communities and a core model shared across communities. However, an important aspect of the community beliefs was that rehydration therapies were not widely endorsed. The consistency in explanatory models in such diverse communities, as well as the high degree of recognition and experience with this illness, may facilitate communication between community members, and health care providers/public health intervention planners to increase use of rehydration therapies for caída de la mollera. Recommendations for culturally informed and respectful approaches to clinical communication are provided.}, keywords = {}, pubstate = {published}, tppubtype = {article} } A sunken soft-spot or fontanel is a sign for dehydration in infants. Around the world, folk illnesses, such as caída de la mollera in some Latin American cultures, often incorporate this sign as a hallmark of illness, but may or may not incorporate re-hydration therapies in treatment strategies. This report describes a study of lay descriptions of causes, symptoms, and treatments for caída de la mollera in three diverse Latin American populations. A mixed-methods approach was used. Representative community-based samples were interviewed in rural Guatemala, Guadalajara, Mexico, and Edinburgh, Texas, with a 132 item questionnaire on the causes, susceptibility, symptoms, and therapies for caída de la mollera. Cultural consensus analysis was used to estimate community beliefs about caída. Interviews conducted in rural Guatemala (n = 60), urban Mexico (n = 62), and rural Texas on the Mexican border (n = 61) indicated consistency in thematic elements within and among these three diverse communities. The high degree of consistency in the illness explanatory models indicated shared beliefs about caída de la mollera in each of the communities and a core model shared across communities. However, an important aspect of the community beliefs was that rehydration therapies were not widely endorsed. The consistency in explanatory models in such diverse communities, as well as the high degree of recognition and experience with this illness, may facilitate communication between community members, and health care providers/public health intervention planners to increase use of rehydration therapies for caída de la mollera. Recommendations for culturally informed and respectful approaches to clinical communication are provided. |
Hunter, Wynn G; Zhang, Cecilia Z; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A Medical Decision Making, 36 (7), pp. 900-910, 2016. @article{Hunter2016b, title = {What strategies do physicians and patients discuss to reduce out-of-pocket costs? Analysis of cost-saving strategies in 1,755 outpatient clinic visits}, author = {Wynn G Hunter and Cecilia Z Zhang and Ashley Hesson and Kelly J Davis and Christine Kirby and Lillie D Williamson and Jamison A Barnett and Peter A Ubel}, url = {http://journals.sagepub.com/doi/10.1177/0272989X15626384}, doi = {10.1177/0272989X15626384}, year = {2016}, date = {2016-10-01}, journal = {Medical Decision Making}, volume = {36}, number = {7}, pages = {900-910}, abstract = {Background. More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. Objective. We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs. Design. Retrospective analysis of dialogue from 1,755 outpatient visits in community-based practices nationwide from 2010 to 2014. The study population included 677 patients with breast cancer, 422 with depression, and 656 with rheumatoid arthritis visiting 56 oncologists, 36 psychiatrists, and 26 rheumatologists, respectively. Results. Thirty percent of visits contained cost conversations (95% confidence interval [CI], 28 to 32). Forty-four percent of cost conversations involved discussion of cost-saving strategies (95% CI, 40 to 48; median …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background. More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. Objective. We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs. Design. Retrospective analysis of dialogue from 1,755 outpatient visits in community-based practices nationwide from 2010 to 2014. The study population included 677 patients with breast cancer, 422 with depression, and 656 with rheumatoid arthritis visiting 56 oncologists, 36 psychiatrists, and 26 rheumatologists, respectively. Results. Thirty percent of visits contained cost conversations (95% confidence interval [CI], 28 to 32). Forty-four percent of cost conversations involved discussion of cost-saving strategies (95% CI, 40 to 48; median … |
Elwell, Kristan Facilitators and barriers to treatment adherence within PMTCT programs in Malawi Journal Article AIDS Care, 28 (8), pp. 971-975, 2016. @article{Elwell2016, title = {Facilitators and barriers to treatment adherence within PMTCT programs in Malawi}, author = {Kristan Elwell}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26984065}, doi = {10.1080/09540121.2016.1153586}, year = {2016}, date = {2016-08-01}, journal = {AIDS Care}, volume = {28}, number = {8}, pages = {971-975}, abstract = {In Malawi, an innovative prevention of mother-to-child transmission (PMTCT) of HIV program, Option B+, has greatly expanded access to antiretroviral treatment at no cost to women and their exposed infants. However, many women continue to experience social, cultural, and structural barriers impeding their ability to consistently access medical treatment. Understanding these women's perspectives may make programs more responsive to patients' needs. This qualitative study sought to explore factors influencing women's adherence within PMTCT programs in southern Malawi. Participants were current PMTCT patients (the first cohort following national implementation of Option B+), healthcare providers, community leaders, and patients who had dropped out of the program ("defaulters"). Qualitative interviews and focus groups were conducted to investigate barriers and facilitators to continued participation within PMTCT programs. Data were analyzed using content analysis. Barriers identified included fears of HIV disclosure to husbands, community-based HIV/AIDS stigma, and poor interactions with some health workers. Facilitators included the improved survival of PMTCT patients in recent years and the desire to remain healthy to care for one's children. This research highlights important sociocultural factors affecting adherence within HIV/AIDS treatment programs in Malawi. Recommendations to improve access to medical care for PMTCT patients include integrated services to increase attention to confidentiality and minimize stigma, shared HIV testing and counseling for couples to minimize conflict in gender-unequal relationships, and peer-led support groups to provide social support from other women with the shared experience of an HIV-positive serostatus.}, keywords = {}, pubstate = {published}, tppubtype = {article} } In Malawi, an innovative prevention of mother-to-child transmission (PMTCT) of HIV program, Option B+, has greatly expanded access to antiretroviral treatment at no cost to women and their exposed infants. However, many women continue to experience social, cultural, and structural barriers impeding their ability to consistently access medical treatment. Understanding these women's perspectives may make programs more responsive to patients' needs. This qualitative study sought to explore factors influencing women's adherence within PMTCT programs in southern Malawi. Participants were current PMTCT patients (the first cohort following national implementation of Option B+), healthcare providers, community leaders, and patients who had dropped out of the program ("defaulters"). Qualitative interviews and focus groups were conducted to investigate barriers and facilitators to continued participation within PMTCT programs. Data were analyzed using content analysis. Barriers identified included fears of HIV disclosure to husbands, community-based HIV/AIDS stigma, and poor interactions with some health workers. Facilitators included the improved survival of PMTCT patients in recent years and the desire to remain healthy to care for one's children. This research highlights important sociocultural factors affecting adherence within HIV/AIDS treatment programs in Malawi. Recommendations to improve access to medical care for PMTCT patients include integrated services to increase attention to confidentiality and minimize stigma, shared HIV testing and counseling for couples to minimize conflict in gender-unequal relationships, and peer-led support groups to provide social support from other women with the shared experience of an HIV-positive serostatus. |
Bleck, Jennifer; DeBate, Rita; Levin, Bruce Lubotsky; Baldwin, Julie A Underlying mechanisms and trajectory of comorbid ADHD and eating disorders: Proposing an integrative systems framework for informing research Journal Article International Journal of Mental Health and Addiction, 14 (4), pp. 449-458, 2016. @article{Bleck2016, title = {Underlying mechanisms and trajectory of comorbid ADHD and eating disorders: Proposing an integrative systems framework for informing research}, author = {Jennifer Bleck and Rita DeBate and Bruce Lubotsky Levin and Julie A Baldwin}, url = {https://link.springer.com/article/10.1007/s11469-015-9593-7}, doi = {10.1007/s11469-015-9593-7}, year = {2016}, date = {2016-08-01}, journal = {International Journal of Mental Health and Addiction}, volume = {14}, number = {4}, pages = {449-458}, abstract = {ADHD and eating disorders are both significant public health issues. Emerging evidence suggests that ADHD and eating disorders may be comorbid resulting in increased severity of associated health issues. Although several hypotheses have been proposed with respect to the underlying mechanisms of the comorbidity, there is a need for a conceptual model, which presents the simultaneous investigation of the trajectory of onset and multiple hypotheses. The current paper proposes an innovative conceptual model that can be used to simultaneously explore hypothesized underlying mechanisms by triangulating current literature with aspects of the biopsychosocial model, life course approach, Risk Regulator Framework, research domain criteria matrix, and the person-environment transaction theory. Designated within the model are proposed pathways that serve to describe how various psychosocial and psychiatric risk regulators and genetic risk factors combine to influence the comorbidity across the lifespan. The proposed conceptual model can provide the foundation for further research regarding comorbid ADHD and eating disorders in addition to translation for use among other comorbid conditions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } ADHD and eating disorders are both significant public health issues. Emerging evidence suggests that ADHD and eating disorders may be comorbid resulting in increased severity of associated health issues. Although several hypotheses have been proposed with respect to the underlying mechanisms of the comorbidity, there is a need for a conceptual model, which presents the simultaneous investigation of the trajectory of onset and multiple hypotheses. The current paper proposes an innovative conceptual model that can be used to simultaneously explore hypothesized underlying mechanisms by triangulating current literature with aspects of the biopsychosocial model, life course approach, Risk Regulator Framework, research domain criteria matrix, and the person-environment transaction theory. Designated within the model are proposed pathways that serve to describe how various psychosocial and psychiatric risk regulators and genetic risk factors combine to influence the comorbidity across the lifespan. The proposed conceptual model can provide the foundation for further research regarding comorbid ADHD and eating disorders in addition to translation for use among other comorbid conditions. |
Cragun, Deborah; Pal, Tuya; Vadaparampil, Susan T; Baldwin, Julie A; Hampel, Heather; DeBate, Rita D Qualitative Comparative Analysis: A Hybrid Method for Identifying Factors Associated with Program Effectiveness Journal Article Journal of Mixed Methods Research, 10 (3), pp. 251-272, 2016, ISBN: 1558-6898. @article{Cragun2016, title = {Qualitative Comparative Analysis: A Hybrid Method for Identifying Factors Associated with Program Effectiveness}, author = {Deborah Cragun and Tuya Pal and Susan T Vadaparampil and Julie A Baldwin and Heather Hampel and Rita D DeBate}, url = {http://journals.sagepub.com/doi/abs/10.1177/1558689815572023}, isbn = {1558-6898}, year = {2016}, date = {2016-07-01}, journal = {Journal of Mixed Methods Research}, volume = {10}, number = {3}, pages = {251-272}, abstract = {Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. On searching PubMed and the Journal of Mixed Methods Research, this review identified 30 original research studies that used QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from 15 institutions that implemented universal tumor screening programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective universal tumor screening programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. On searching PubMed and the Journal of Mixed Methods Research, this review identified 30 original research studies that used QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from 15 institutions that implemented universal tumor screening programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective universal tumor screening programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen. |
Wheldon, Christopher W; Daley, Ellen M; Walsh-Buhi, Eric R; Baldwin, Julie A; Nyitray, Alan G; Giuliano, Anna R An Integrative Theoretical Framework for HPV Vaccine Promotion Among Male Sexual Minorities Journal Article American Journal of Men's Health, pp. 1-12, 2016. @article{Wheldon2016, title = {An Integrative Theoretical Framework for HPV Vaccine Promotion Among Male Sexual Minorities}, author = {Christopher W Wheldon and Ellen M Daley and Eric R Walsh-Buhi and Julie A Baldwin and Alan G Nyitray and Anna R Giuliano}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27272241}, doi = {10.1177/1557988316652937}, year = {2016}, date = {2016-06-06}, journal = {American Journal of Men's Health}, pages = {1-12}, abstract = {The objective of the current study was to quantify the behavioral intentions of young adult male sexual minorities (MSM) to initiate human papillomavirus (HPV) vaccination and test an integrative model of HPV vaccine decision making. Participants were 575 MSM who were residing in the United States and were between ages 18 and 26 years. Standard direct and indirect measures of attitudes, perceived norms, and perceived behavioral control were employed to explain variation in behavioral intention. Additional background factors-such as concealment of one's sexual identity, suspicion of health care provider competence in LGBT health issues, perceived threat, and information orientation-were also included in the model. The final model fit the data well and identified a set of salient attitudinal and control beliefs as the strongest determinants of intention (R2 = .38). Perceived threat and information orientation were positively correlated with HPV-related beliefs. Perceived threat was higher among men infected with HIV and lower among men in monogamous relationships. Self-efficacy, as an indirect measure of perceived behavioral control, was inversely related to the general tendency to conceal aspects of one's sexual orientation and a suspicion of health care providers. Bisexual identified men were more likely to conceal their sexual orientation and be more suspicious of health care providers. In this study, a number of modifiable determinants of HPV vaccine intentions-both psychosocial and environmental-were identified and have implications for targeted and tailored behavioral interventions to promote HPV vaccination among MSM.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The objective of the current study was to quantify the behavioral intentions of young adult male sexual minorities (MSM) to initiate human papillomavirus (HPV) vaccination and test an integrative model of HPV vaccine decision making. Participants were 575 MSM who were residing in the United States and were between ages 18 and 26 years. Standard direct and indirect measures of attitudes, perceived norms, and perceived behavioral control were employed to explain variation in behavioral intention. Additional background factors-such as concealment of one's sexual identity, suspicion of health care provider competence in LGBT health issues, perceived threat, and information orientation-were also included in the model. The final model fit the data well and identified a set of salient attitudinal and control beliefs as the strongest determinants of intention (R2 = .38). Perceived threat and information orientation were positively correlated with HPV-related beliefs. Perceived threat was higher among men infected with HIV and lower among men in monogamous relationships. Self-efficacy, as an indirect measure of perceived behavioral control, was inversely related to the general tendency to conceal aspects of one's sexual orientation and a suspicion of health care providers. Bisexual identified men were more likely to conceal their sexual orientation and be more suspicious of health care providers. In this study, a number of modifiable determinants of HPV vaccine intentions-both psychosocial and environmental-were identified and have implications for targeted and tailored behavioral interventions to promote HPV vaccination among MSM. |
Green, Robert C; Goddard, Katrina AB; Jarvik, Gail P; Amendola, Laura M; ..., ; Kirby, Christine Clinical sequencing exploratory research consortium: Accelerating evidence-based practice of genomic medicine Journal Article The American Journal of Human Genetics, 98 (6), pp. 1051-1066, 2016. @article{Green2016, title = {Clinical sequencing exploratory research consortium: Accelerating evidence-based practice of genomic medicine}, author = {Robert C Green and Katrina AB Goddard and Gail P Jarvik and Laura M Amendola and ... and Christine Kirby}, url = {https://www.sciencedirect.com/science/article/pii/S0002929716301069}, doi = {https://doi.org/10.1016/j.ajhg.2016.04.011}, year = {2016}, date = {2016-06-02}, journal = {The American Journal of Human Genetics}, volume = {98}, number = {6}, pages = {1051-1066}, abstract = {Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools … |
Maness, Sarah B; Buhi, Eric R; Daley, Ellen M; Baldwin, Julie A; Kromrey, Jeffrey D Social Determinants of Health and Adolescent Pregnancy: An Analysis From the National Longitudinal Study of Adolescent to Adult Health Journal Article Journal of Adolescent Health, 58 (6), pp. 636-643, 2016. @article{Maness2016, title = {Social Determinants of Health and Adolescent Pregnancy: An Analysis From the National Longitudinal Study of Adolescent to Adult Health}, author = {Sarah B Maness and Eric R Buhi and Ellen M Daley and Julie A Baldwin and Jeffrey D Kromrey}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27020277}, doi = {10.1016/j.jadohealth.2016.02.006}, year = {2016}, date = {2016-06-01}, journal = {Journal of Adolescent Health}, volume = {58}, number = {6}, pages = {636-643}, abstract = {PURPOSE: Although rates of adolescent pregnancy are at an all-time low in the United States, racial/ethnic and geographic disparities persist. This research used National Longitudinal Study of Adolescent to Adult Health (Add Health) data to analyze empirical relationships between social determinants of health (SDoH) and adolescent pregnancy. Examining relationships between the SDoH and adolescent pregnancy provides support for funding priorities and interventions that expand on the current focus on individual and interpersonal-level factors. METHODS: On the basis of the Healthy People 2020 Social Determinants of Health Framework, the identification of proxy measures for SDoH within the Add Health study allowed for an analysis of relationships to adolescent pregnancy (N = 9,204). Logistic regression examined associations between adolescent pregnancy and each measure of SDoH. RESULTS: Results indicated that 6 of 17 measures of SDoH had an empirical relationship with adolescent pregnancy. Measures negatively associated with adolescent pregnancy included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, reporting litter or trash in the neighborhood environment as a big problem, and living in a two-parent home. CONCLUSIONS: Findings from this study support the need for increased research and intervention focus in SDoH related to areas of education and social and community context. Results of this study provide information for the allocation of resources to best address SDoH that show a link with adolescent pregnancy. Areas of future research can further explore the areas in which SDoH show a relationship with adolescent pregnancy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } PURPOSE: Although rates of adolescent pregnancy are at an all-time low in the United States, racial/ethnic and geographic disparities persist. This research used National Longitudinal Study of Adolescent to Adult Health (Add Health) data to analyze empirical relationships between social determinants of health (SDoH) and adolescent pregnancy. Examining relationships between the SDoH and adolescent pregnancy provides support for funding priorities and interventions that expand on the current focus on individual and interpersonal-level factors. METHODS: On the basis of the Healthy People 2020 Social Determinants of Health Framework, the identification of proxy measures for SDoH within the Add Health study allowed for an analysis of relationships to adolescent pregnancy (N = 9,204). Logistic regression examined associations between adolescent pregnancy and each measure of SDoH. RESULTS: Results indicated that 6 of 17 measures of SDoH had an empirical relationship with adolescent pregnancy. Measures negatively associated with adolescent pregnancy included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, reporting litter or trash in the neighborhood environment as a big problem, and living in a two-parent home. CONCLUSIONS: Findings from this study support the need for increased research and intervention focus in SDoH related to areas of education and social and community context. Results of this study provide information for the allocation of resources to best address SDoH that show a link with adolescent pregnancy. Areas of future research can further explore the areas in which SDoH show a relationship with adolescent pregnancy. |
Evenson, Kelly R; Brown, David R; Pearce, Emily; Camplain, Ricky; Jernigan, Jan; Epping, Jacqueline; Shepard, Dennis M; Dorn, Joan M Evaluation of the Physical Activity and Public Health Course for Practitioners Journal Article Research Quarterly for Exercise and Sport, 87 (2), pp. 207-213, 2016. @article{Evenson2016, title = {Evaluation of the Physical Activity and Public Health Course for Practitioners}, author = {Kelly R Evenson and David R Brown and Emily Pearce and Ricky Camplain and Jan Jernigan and Jacqueline Epping and Dennis M Shepard and Joan M Dorn}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946847/}, doi = {10.1080/02701367.2016.1146942}, year = {2016}, date = {2016-06-01}, journal = {Research Quarterly for Exercise and Sport}, volume = {87}, number = {2}, pages = {207-213}, abstract = {From 1996 to 2013, a 6-day Physical Activity and Public Health Course for Practitioners has been offered yearly in the United States. An evaluation was conducted to assess the impact of the course on building public health capacity for physical activity and on shaping the physical activity and public health careers of fellows since taking the courses. METHOD: An evaluation quantified time that fellows spent in different course offerings and surveyed fellows. RESULTS: From 1996 to 2012, 410 fellows attended the course, and in 2013, 186 participated in the Web-based survey (56% response rate). The number of fellows attending the course ranged from 15 to 33 yearly. From 1996 to 2012, the course averaged 38 hr of instructional time that included topics on interventions and environment/policy work to increase physical activity, program evaluation, public health research, and health disparities. The course included consultations, collaborative work, and field-based experiences. Fellows who participated in the survey agreed that the course had a positive impact on the physical activity research or practice work they did (98%), met their expectations (96%), helped them with research/practice collaborations with other physical activity professionals (96%), assisted them in conducting higher-quality interventions/programs (95%), helped increase their professional networking in the field (93%), and had a positive impact on other work they did (91%). Following the course, 66% and 56% had further contact with faculty and other fellows, respectively. CONCLUSION: The Physical Activity and Public Health Course for Practitioners made important contributions toward building the capacity of physical activity and public health practitioners.}, keywords = {}, pubstate = {published}, tppubtype = {article} } From 1996 to 2013, a 6-day Physical Activity and Public Health Course for Practitioners has been offered yearly in the United States. An evaluation was conducted to assess the impact of the course on building public health capacity for physical activity and on shaping the physical activity and public health careers of fellows since taking the courses. METHOD: An evaluation quantified time that fellows spent in different course offerings and surveyed fellows. RESULTS: From 1996 to 2012, 410 fellows attended the course, and in 2013, 186 participated in the Web-based survey (56% response rate). The number of fellows attending the course ranged from 15 to 33 yearly. From 1996 to 2012, the course averaged 38 hr of instructional time that included topics on interventions and environment/policy work to increase physical activity, program evaluation, public health research, and health disparities. The course included consultations, collaborative work, and field-based experiences. Fellows who participated in the survey agreed that the course had a positive impact on the physical activity research or practice work they did (98%), met their expectations (96%), helped them with research/practice collaborations with other physical activity professionals (96%), assisted them in conducting higher-quality interventions/programs (95%), helped increase their professional networking in the field (93%), and had a positive impact on other work they did (91%). Following the course, 66% and 56% had further contact with faculty and other fellows, respectively. CONCLUSION: The Physical Activity and Public Health Course for Practitioners made important contributions toward building the capacity of physical activity and public health practitioners. |
Wheldon, Christopher W; Daley, Ellen M; Buhi, Eric R; Baldwin, Julie A; Nyitray, Alan G; Giuliano, Anna R HPV vaccine decision-making among young men who have sex with men. Health Education Journal Journal Article Health Education Journal, 76 (1), pp. 52-65, 2016. @article{Wheldon2016b, title = {HPV vaccine decision-making among young men who have sex with men. Health Education Journal}, author = {Christopher W Wheldon and Ellen M Daley and Eric R Buhi and Julie A Baldwin and Alan G Nyitray and Anna R Giuliano}, url = {http://journals.sagepub.com/doi/full/10.1177/0017896916647988}, doi = {10.1177/0017896916647988}, year = {2016}, date = {2016-05-31}, journal = {Health Education Journal}, volume = {76}, number = {1}, pages = {52-65}, abstract = {Objective: Human papilloma virus (HPV) vaccination is recommended for all men who have sex with men (MSM) in the USA until the age of 26 years. Despite this recommendation, vaccine uptake remains low. The purpose of this study was to (1) describe salient beliefs related to HPV vaccination among young MSM; (2) determine factors that underlie these beliefs; and (3) describe a model for HPV vaccine decision-making. Design: Qualitative descriptive study. Setting: Central Florida, USA. Methods: Semi-structured interviews (N = 22). Results: The majority of respondents had heard of the HPV vaccine, but generally perceived HPV as a women’s health issue. Salient behavioural beliefs about HPV vaccination described physical (such as lowering risk and promoting overall health) and psychological benefits (such as protecting sex partners and providing peace of mind). There was some concern regarding the risks of vaccination including contracting HPV from the vaccine, not knowing if it would be effective, and side effects. Normative influences on decision-making were minimal. Availability, cost and convenience were among the most salient external control factors discussed. Issues surrounding disclosure of sexual orientation, as well as the competence and sensitivity of healthcare providers in dealing with issues of sexuality, were key factors in HPV-related beliefs. Conclusion: Addressing the specific beliefs and concerns expressed by MSM can help to improve the effectiveness of health education interventions promoting vaccination.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective: Human papilloma virus (HPV) vaccination is recommended for all men who have sex with men (MSM) in the USA until the age of 26 years. Despite this recommendation, vaccine uptake remains low. The purpose of this study was to (1) describe salient beliefs related to HPV vaccination among young MSM; (2) determine factors that underlie these beliefs; and (3) describe a model for HPV vaccine decision-making. Design: Qualitative descriptive study. Setting: Central Florida, USA. Methods: Semi-structured interviews (N = 22). Results: The majority of respondents had heard of the HPV vaccine, but generally perceived HPV as a women’s health issue. Salient behavioural beliefs about HPV vaccination described physical (such as lowering risk and promoting overall health) and psychological benefits (such as protecting sex partners and providing peace of mind). There was some concern regarding the risks of vaccination including contracting HPV from the vaccine, not knowing if it would be effective, and side effects. Normative influences on decision-making were minimal. Availability, cost and convenience were among the most salient external control factors discussed. Issues surrounding disclosure of sexual orientation, as well as the competence and sensitivity of healthcare providers in dealing with issues of sexuality, were key factors in HPV-related beliefs. Conclusion: Addressing the specific beliefs and concerns expressed by MSM can help to improve the effectiveness of health education interventions promoting vaccination. |
Young, Belinda-Rose; Desmarais, Sarah L; Baldwin, Julie A; Chandler, Rasheeta Sexual Coercion Practices Among Undergraduate Male Recreational Athletes, Intercollegiate Athletes, and Non-Athletes Journal Article Violence Against Women, 23 (7), pp. 795-812, 2016. @article{Young2016, title = {Sexual Coercion Practices Among Undergraduate Male Recreational Athletes, Intercollegiate Athletes, and Non-Athletes}, author = {Belinda-Rose Young and Sarah L Desmarais and Julie A Baldwin and Rasheeta Chandler}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27247201}, doi = {10.1177/1077801216651339}, year = {2016}, date = {2016-05-30}, journal = {Violence Against Women}, volume = {23}, number = {7}, pages = {795-812}, abstract = {Prior research shows that male intercollegiate athletes are at risk for perpetrating sexual violence. Whether this risk extends to male recreational athletes has not been explored. This study assessed associations between attitudes toward women, rape myth acceptance, and prevalence of sexual coercion among 379 male, undergraduate recreational and intercollegiate athletes and non-athletes. Our analyses showed significant differences between the responses of athletes and non-athletes for all dependent variables, and intercollegiate and recreational athletes on attitudes toward women and the prevalence of sexual coercion. Controlling for rape myth acceptance and traditional gender role attitudes eliminated differences between athletes and non-athletes in prevalence of sexual coercion.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Prior research shows that male intercollegiate athletes are at risk for perpetrating sexual violence. Whether this risk extends to male recreational athletes has not been explored. This study assessed associations between attitudes toward women, rape myth acceptance, and prevalence of sexual coercion among 379 male, undergraduate recreational and intercollegiate athletes and non-athletes. Our analyses showed significant differences between the responses of athletes and non-athletes for all dependent variables, and intercollegiate and recreational athletes on attitudes toward women and the prevalence of sexual coercion. Controlling for rape myth acceptance and traditional gender role attitudes eliminated differences between athletes and non-athletes in prevalence of sexual coercion. |
Meyer, Michelle L; Tanaka, Hirofumi; Palta, Priya; Patel, Mehul D; Camplain, Ricky; Couper, David; Cheng, Susan; Qunaibet, Ada Al; Poon, Anna K; Heiss, Gerardo Response to “Repeatability of Different Segmental Pulse Wave Velocity Measurements” Journal Article American Journal of Hypertension, 29 (7), pp. 890-890, 2016. @article{Meyer2016, title = {Response to “Repeatability of Different Segmental Pulse Wave Velocity Measurements”}, author = {Michelle L Meyer and Hirofumi Tanaka and Priya Palta and Mehul D Patel and Ricky Camplain and David Couper and Susan Cheng and Ada Al Qunaibet and Anna K Poon and Gerardo Heiss}, url = {https://academic.oup.com/ajh/article-lookup/doi/10.1093/ajh/hpw051}, doi = {10.1093/ajh/hpw051}, year = {2016}, date = {2016-05-11}, journal = {American Journal of Hypertension}, volume = {29}, number = {7}, pages = {890-890}, abstract = {To the Editor: We appreciate the thoughtful comments by Papaioannou and colleagues 1 regarding our recently published article “Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study.” 2 Numerous methods are used to evaluate repeatability of measurements and those chosen are influenced by the study question. Our interest was to examine the sources of variability in repeated measures at 2 time points using the intraclass correlation coefficient and SE of measurement. Repeatability could also be evaluated using the SD of differences and Bland–Altman method. The latter relies on a visual evaluation of plots to assess bias and whether the magnitude of differences between pairs of measures varies across the range of the mean. Since we used 1 device to obtain all measurements, we cannot speak to measurement-specific bias (other than from the literature).}, keywords = {}, pubstate = {published}, tppubtype = {article} } To the Editor: We appreciate the thoughtful comments by Papaioannou and colleagues 1 regarding our recently published article “Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study.” 2 Numerous methods are used to evaluate repeatability of measurements and those chosen are influenced by the study question. Our interest was to examine the sources of variability in repeated measures at 2 time points using the intraclass correlation coefficient and SE of measurement. Repeatability could also be evaluated using the SD of differences and Bland–Altman method. The latter relies on a visual evaluation of plots to assess bias and whether the magnitude of differences between pairs of measures varies across the range of the mean. Since we used 1 device to obtain all measurements, we cannot speak to measurement-specific bias (other than from the literature). |
Burton, Donna L; Lubotsky, Bruce; Massey, LevinTom; Baldwin, Julie A; Williamson, Heather J Innovative Graduate Research Education for Advancement of Implementation Science in Adolescent Behavioral Health Journal Article Journal of Behavioral Health Services and Research, 43 (2), pp. 172-186, 2016. @article{Burton2016, title = {Innovative Graduate Research Education for Advancement of Implementation Science in Adolescent Behavioral Health}, author = {Donna L Burton and Bruce Lubotsky and LevinTom Massey and Julie A Baldwin and Heather J Williamson}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26746638}, doi = {10.1007/s11414-015-9494-3}, year = {2016}, date = {2016-04-01}, journal = {Journal of Behavioral Health Services and Research}, volume = {43}, number = {2}, pages = {172-186}, abstract = {An innovative approach to research education that integrates the theory and principles of implementation science, participatory research, and service learning in the area of adolescent behavioral health is presented. Qualitative interviews and surveys of program participants have been conducted to assess the program's curricula, service-learning partnerships, student (scholar) satisfaction, and views of community partnerships and academic mentors. The Institute has experienced the successful completion of its first and second cohorts and enrollment of a third cohort of scholars. Community partners are utilizing results of service-learning projects to influence agency operations. Institute scholars have identified research and service learning experiences as key factors in the decision to apply to the Institute graduate certificate program. The availability of tuition support is identified as valuable but not ranked as the most important reason for scholar interest in the program. Academic mentors report positive relationships with community agencies. Future iterations of the program will expand options for distance learning and alternatives to traditional graduate education for community-based scholars. Community partner agency capacity for participation is expected to change over time. Methods are being identified to both sustain existing partnerships and develop new community partnership relationships.}, keywords = {}, pubstate = {published}, tppubtype = {article} } An innovative approach to research education that integrates the theory and principles of implementation science, participatory research, and service learning in the area of adolescent behavioral health is presented. Qualitative interviews and surveys of program participants have been conducted to assess the program's curricula, service-learning partnerships, student (scholar) satisfaction, and views of community partnerships and academic mentors. The Institute has experienced the successful completion of its first and second cohorts and enrollment of a third cohort of scholars. Community partners are utilizing results of service-learning projects to influence agency operations. Institute scholars have identified research and service learning experiences as key factors in the decision to apply to the Institute graduate certificate program. The availability of tuition support is identified as valuable but not ranked as the most important reason for scholar interest in the program. Academic mentors report positive relationships with community agencies. Future iterations of the program will expand options for distance learning and alternatives to traditional graduate education for community-based scholars. Community partner agency capacity for participation is expected to change over time. Methods are being identified to both sustain existing partnerships and develop new community partnership relationships. |
Meyer, Michelle L; Tanaka, Hirofumi; Palta, Priya; Patel, Mehul D; Camplain, Ricky; Couper, David; Cheng, Susan; Qunaibet, Ada Al; Poon, Anna K; Heiss, Gerardo Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study Journal Article American Journal of Hypertension, 29 (4), pp. 470-475, 2016. @article{Meyer2016b, title = {Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study}, author = {Michelle L Meyer and Hirofumi Tanaka and Priya Palta and Mehul D Patel and Ricky Camplain and David Couper and Susan Cheng and Ada Al Qunaibet and Anna K Poon and Gerardo Heiss}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850900/}, doi = {10.1093/ajh/hpv127}, year = {2016}, date = {2016-04-01}, journal = {American Journal of Hypertension}, volume = {29}, number = {4}, pages = {470-475}, abstract = {BACKGROUND Arterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared. METHODS Participants (n = 79; mean age 75.7 years; USA) from a repeatability study nested within the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011–2013) underwent 2 standardized visits, 4–8 weeks apart. Trained technicians obtained 2 PWV measurements at each visit using the VP-1000 Plus system. We calculated the intraclass correlation coefficient (ICC), SE of measurement, and minimal detectable change (MDC95; 95% confidence interval) and difference (MDD). RESULTS The ICCs and 95% confidence intervals (95% CIs) were 0.70 (0.59, 0.81) for cfPWV, 0.84 (0.78, 0.90) for baPWV, and 0.69 (0.59, 0.79) for faPWV. The MDC95 between repeat measures within an individual was 411.0cm/s for cfPWV, 370.6cm/s for baPWV, and 301.4cm/s for faPWV. The MDD for 2 independent samples of 100 per group was 139.3cm/s for cfPWV, 172.3cm/s for baPWV, and 100.4cm/s for faPWV. CONCLUSIONS Repeatability was acceptable for all PWV measures in a multicenter, population-based study of older adults and supports its use in epidemiologic studies. Quantifying PWV measurement variation is critical for applications to risk assessment and stratification and eventual translation to clinical practice.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND Arterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared. METHODS Participants (n = 79; mean age 75.7 years; USA) from a repeatability study nested within the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011–2013) underwent 2 standardized visits, 4–8 weeks apart. Trained technicians obtained 2 PWV measurements at each visit using the VP-1000 Plus system. We calculated the intraclass correlation coefficient (ICC), SE of measurement, and minimal detectable change (MDC95; 95% confidence interval) and difference (MDD). RESULTS The ICCs and 95% confidence intervals (95% CIs) were 0.70 (0.59, 0.81) for cfPWV, 0.84 (0.78, 0.90) for baPWV, and 0.69 (0.59, 0.79) for faPWV. The MDC95 between repeat measures within an individual was 411.0cm/s for cfPWV, 370.6cm/s for baPWV, and 301.4cm/s for faPWV. The MDD for 2 independent samples of 100 per group was 139.3cm/s for cfPWV, 172.3cm/s for baPWV, and 100.4cm/s for faPWV. CONCLUSIONS Repeatability was acceptable for all PWV measures in a multicenter, population-based study of older adults and supports its use in epidemiologic studies. Quantifying PWV measurement variation is critical for applications to risk assessment and stratification and eventual translation to clinical practice. |
Ubel, Peter A; Zhang, Cecilia J; Hesson, Ashley; Davis, Kelly J; Kirby, Christine; Barnett, Jamison; Hunter, Wynn G Study of physician and patient communication identifies missed opportunities to help reduce patients' out-of-pocket spending Journal Article Health Affairs, 35 (4), pp. 654-661, 2016. @article{Ubel2016, title = {Study of physician and patient communication identifies missed opportunities to help reduce patients' out-of-pocket spending}, author = {Peter A Ubel and Cecilia J Zhang and Ashley Hesson and Kelly J Davis and Christine Kirby and Jamison Barnett and Wynn G Hunter}, url = {https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2015.1280}, doi = {10.1377/hlthaff.2015.1280}, year = {2016}, date = {2016-04-01}, journal = {Health Affairs}, volume = {35}, number = {4}, pages = {654-661}, abstract = {Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in the way of helping patients navigate out-of-pocket spending. Some behaviors reflected a failure to fully engage with patients’ financial concerns, from never acknowledging such concerns to dismissing them too quickly. Other behaviors reflected a failure to resolve uncertainty about out-of-pocket expenses or reliance on temporary solutions without making long-term plans to reduce spending. Many of these failures resulted from systemic barriers to health care spending conversations, such as a lack of price transparency. For consumer health care markets to work as …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in the way of helping patients navigate out-of-pocket spending. Some behaviors reflected a failure to fully engage with patients’ financial concerns, from never acknowledging such concerns to dismissing them too quickly. Other behaviors reflected a failure to resolve uncertainty about out-of-pocket expenses or reliance on temporary solutions without making long-term plans to reduce spending. Many of these failures resulted from systemic barriers to health care spending conversations, such as a lack of price transparency. For consumer health care markets to work as … |
Ortega, María Isabel; Sabo, Samantha; Gallegos, Patricia Aranda; Zapien, Jill Eileen Guernsey De; Zapien, Antonio; Abril, Gloria Elena Portillo; Rosales, Cecilia Agribusiness, Corporate Social Responsibility, and Health of Agricultural Migrant Workers Journal Article Frontiers in Public Health, 4 (54), pp. 1-10, 2016. @article{Ortega2016, title = {Agribusiness, Corporate Social Responsibility, and Health of Agricultural Migrant Workers}, author = {María Isabel Ortega and Samantha Sabo and Patricia Aranda Gallegos and Jill Eileen Guernsey De Zapien and Antonio Zapien and Gloria Elena Portillo Abril and Cecilia Rosales}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27066471}, doi = {10.3389/fpubh.2016.00054}, year = {2016}, date = {2016-03-29}, journal = {Frontiers in Public Health}, volume = {4}, number = {54}, pages = {1-10}, abstract = {BACKGROUND: Living conditions and health of migrant farmworkers could benefit from a health promotion model based on corporate social responsibility (CSR). OBJECTIVE: To understand how Mexican agribusiness owners and general managers view and practice CSR. METHODS: We interviewed 8 agribusiness owners/managers and 233 farmworkers using open-ended interviews and gathered anthropometrical data of 133 children from farmworkers families. To guide our analysis and discussion, we followed the two-dimension model of CSR proposed by Quazi and O'Brien. RESULTS: According to interviewee responses, mean percentage of agreement with CSR concept was 77.4%, with a range of 54-85.7%. Main health-related issues among farmworkers were infectious diseases, crowding, and access to health-care services; there were acute cases of undernutrition among farmworkers' children and diets were of poor quality. DISCUSSION: Agribusiness owners and managers understand and practice CSR according to a wide and modern view, which contradicts with farmworkers' living conditions and health. Quazi and O'Brien model should consider the social context, in which it is analyzed, and the social manifestations of community development as a tool for further analysis on the perceptions and actions of entrepreneurs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Living conditions and health of migrant farmworkers could benefit from a health promotion model based on corporate social responsibility (CSR). OBJECTIVE: To understand how Mexican agribusiness owners and general managers view and practice CSR. METHODS: We interviewed 8 agribusiness owners/managers and 233 farmworkers using open-ended interviews and gathered anthropometrical data of 133 children from farmworkers families. To guide our analysis and discussion, we followed the two-dimension model of CSR proposed by Quazi and O'Brien. RESULTS: According to interviewee responses, mean percentage of agreement with CSR concept was 77.4%, with a range of 54-85.7%. Main health-related issues among farmworkers were infectious diseases, crowding, and access to health-care services; there were acute cases of undernutrition among farmworkers' children and diets were of poor quality. DISCUSSION: Agribusiness owners and managers understand and practice CSR according to a wide and modern view, which contradicts with farmworkers' living conditions and health. Quazi and O'Brien model should consider the social context, in which it is analyzed, and the social manifestations of community development as a tool for further analysis on the perceptions and actions of entrepreneurs. |
Eaves, Emery R; Nichter, Mark; Ritenbaugh, Cheryl Ways of Hoping: Navigating the Paradox of Hope and Despair in Chronic Pain Journal Article Culture, Medicine, and Psychiatry, 40 (1), pp. 35-58, 2016. @article{Eaves2016b, title = {Ways of Hoping: Navigating the Paradox of Hope and Despair in Chronic Pain}, author = {Emery R Eaves and Mark Nichter and Cheryl Ritenbaugh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26194780}, doi = {10.1007/s11013-015-9465-4}, year = {2016}, date = {2016-03-01}, journal = {Culture, Medicine, and Psychiatry}, volume = {40}, number = {1}, pages = {35-58}, abstract = {In this paper, we explore hope in the context of living with chronic pain. Individuals with chronic pain from temporomandibular disorder(s) were interviewed four to five times over the course of their 18-month participation in a clinical trial investigating the effectiveness of Traditional Chinese Medicine. We sought to understand shifts in participants' descriptions of expectations and hopefulness, particularly with regard to the work involved in counterbalancing positive thinking with buffers against disappointment. We found hope to be a dynamic and multifaceted mindset as distinct from being a single entity to be measured. Drawing upon Polanyi's concept of tacit knowing, we explore how different ways of hoping emerge and index one another in participant narratives. We offer a working typology of hope and raise as an issue the manner in which the paradox of hope--hoping enough to carry on while keeping hopes in check to avoid the ever-present possibility of despair--complicates simplistic notions of the relationship between positive thinking and the placebo response.}, keywords = {}, pubstate = {published}, tppubtype = {article} } In this paper, we explore hope in the context of living with chronic pain. Individuals with chronic pain from temporomandibular disorder(s) were interviewed four to five times over the course of their 18-month participation in a clinical trial investigating the effectiveness of Traditional Chinese Medicine. We sought to understand shifts in participants' descriptions of expectations and hopefulness, particularly with regard to the work involved in counterbalancing positive thinking with buffers against disappointment. We found hope to be a dynamic and multifaceted mindset as distinct from being a single entity to be measured. Drawing upon Polanyi's concept of tacit knowing, we explore how different ways of hoping emerge and index one another in participant narratives. We offer a working typology of hope and raise as an issue the manner in which the paradox of hope--hoping enough to carry on while keeping hopes in check to avoid the ever-present possibility of despair--complicates simplistic notions of the relationship between positive thinking and the placebo response. |
Muramoto, Myra L; Howerter, Amy; Eaves, Emery R; Hall, John R; Buller, David B; Gordon, Judith S JMIR Research Protocols, 5 (1), pp. e2, 2016. @article{Muramoto2016, title = {Online Tobacco Cessation Training and Competency Assessment for Complementary and Alternative Medicine (CAM) Practitioners: Protocol for the CAM Reach Web Study}, author = {Myra L Muramoto and Amy Howerter and Emery R Eaves and John R Hall and David B Buller and Judith S Gordon}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26740468}, doi = {10.2196/resprot.5061}, year = {2016}, date = {2016-01-06}, journal = {JMIR Research Protocols}, volume = {5}, number = {1}, pages = {e2}, abstract = {BACKGROUND: Complementary and alternative medicine (CAM) practitioners, such as chiropractors, acupuncturists, and massage therapists, are a growing presence in the US health care landscape and already provide health and wellness care to significant numbers of patients who use tobacco. For decades, conventional biomedical practitioners have received training to provide evidence-based tobacco cessation brief interventions (BIs) and referrals to cessation services as part of routine clinical care, whereas CAM practitioners have been largely overlooked for BI training. Web-based training has clear potential to meet large-scale training dissemination needs. However, despite the exploding use of Web-based training for health professionals, Web-based evaluation of clinical skills competency remains underdeveloped. OBJECTIVE: In pursuit of a long-term goal of helping CAM practitioners integrate evidence-based practices from US Public Health Service Tobacco Dependence Treatment Guideline into routine clinical care, this pilot protocol aims to develop and test a Web-based tobacco cessation training program tailored for CAM practitioners. METHODS: In preparation for a larger trial to examine the effect of training on CAM practitioner clinical practice behaviors around tobacco cessation, this developmental study will (1) adapt an existing in-person tobacco cessation BI training program that is specifically tailored for CAM therapists for delivery via the Internet; (2) develop a novel, Web-based tool to assess CAM practitioner competence in tobacco cessation BI skills, and conduct a pilot validation study comparing the competency assessment tool to live video role plays with a standardized patient; (3) pilot test the Web-based training with 120 CAM practitioners (40 acupuncturists, 40 chiropractors, 40 massage therapists) for usability, accessibility, acceptability, and effects on practitioner knowledge, self-efficacy, and competency with tobacco cessation; and (4) conduct qualitative and quantitative formative research on factors influencing practitioner tobacco cessation clinical behaviors (eg, practice environment, peer social influence, and insurance reimbursement). RESULTS: Web-training and competency assessment tool development and study enrollment and training activities are complete (N=203 practitioners enrolled). Training completion rates were lower than expected (36.9%, 75/203), necessitating over enrollment to ensure a sufficient number of training completers. Follow-up data collection is in progress. Data analysis will begin immediately after data collection is complete. CONCLUSIONS: To realize CAM practitioners' potential to promote tobacco cessation and use of evidence-based treatments, there is a need to know more about the facilitative and inhibitory factors influencing CAM practitioner tobacco intervention behaviors (eg, social influence and insurance reimbursement). Given marked differences between conventional and CAM practitioners, extant knowledge about factors influencing conventional practitioner adoption of tobacco cessation behaviors cannot be confidently extrapolated to CAM practitioners. The potential impact of this study is to expand tobacco cessation and health promotion infrastructure in a new group of health practitioners who can help combat the continuing epidemic of tobacco use.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Complementary and alternative medicine (CAM) practitioners, such as chiropractors, acupuncturists, and massage therapists, are a growing presence in the US health care landscape and already provide health and wellness care to significant numbers of patients who use tobacco. For decades, conventional biomedical practitioners have received training to provide evidence-based tobacco cessation brief interventions (BIs) and referrals to cessation services as part of routine clinical care, whereas CAM practitioners have been largely overlooked for BI training. Web-based training has clear potential to meet large-scale training dissemination needs. However, despite the exploding use of Web-based training for health professionals, Web-based evaluation of clinical skills competency remains underdeveloped. OBJECTIVE: In pursuit of a long-term goal of helping CAM practitioners integrate evidence-based practices from US Public Health Service Tobacco Dependence Treatment Guideline into routine clinical care, this pilot protocol aims to develop and test a Web-based tobacco cessation training program tailored for CAM practitioners. METHODS: In preparation for a larger trial to examine the effect of training on CAM practitioner clinical practice behaviors around tobacco cessation, this developmental study will (1) adapt an existing in-person tobacco cessation BI training program that is specifically tailored for CAM therapists for delivery via the Internet; (2) develop a novel, Web-based tool to assess CAM practitioner competence in tobacco cessation BI skills, and conduct a pilot validation study comparing the competency assessment tool to live video role plays with a standardized patient; (3) pilot test the Web-based training with 120 CAM practitioners (40 acupuncturists, 40 chiropractors, 40 massage therapists) for usability, accessibility, acceptability, and effects on practitioner knowledge, self-efficacy, and competency with tobacco cessation; and (4) conduct qualitative and quantitative formative research on factors influencing practitioner tobacco cessation clinical behaviors (eg, practice environment, peer social influence, and insurance reimbursement). RESULTS: Web-training and competency assessment tool development and study enrollment and training activities are complete (N=203 practitioners enrolled). Training completion rates were lower than expected (36.9%, 75/203), necessitating over enrollment to ensure a sufficient number of training completers. Follow-up data collection is in progress. Data analysis will begin immediately after data collection is complete. CONCLUSIONS: To realize CAM practitioners' potential to promote tobacco cessation and use of evidence-based treatments, there is a need to know more about the facilitative and inhibitory factors influencing CAM practitioner tobacco intervention behaviors (eg, social influence and insurance reimbursement). Given marked differences between conventional and CAM practitioners, extant knowledge about factors influencing conventional practitioner adoption of tobacco cessation behaviors cannot be confidently extrapolated to CAM practitioners. The potential impact of this study is to expand tobacco cessation and health promotion infrastructure in a new group of health practitioners who can help combat the continuing epidemic of tobacco use. |
Williamson, Heather J; Young, Belinda-Rose; Murray, Nichole; Burton, Donna L; Levin, Bruce Lubotsky; Massey, Oliver Tom; Baldwin, Julie A Community-university partnerships for research and practice: Application of an interactive and contextual model of collaboration Journal Article Journal of Higher Education Outreach and Engagement, 20 (2), pp. 55-84, 2016, ISSN: 1534-6104. @article{Williamson2016b, title = {Community-university partnerships for research and practice: Application of an interactive and contextual model of collaboration}, author = {Heather J Williamson and Belinda-Rose Young and Nichole Murray and Donna L Burton and Bruce Lubotsky Levin and Oliver Tom Massey and Julie A Baldwin}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295659/}, issn = {1534-6104}, year = {2016}, date = {2016-01-01}, journal = {Journal of Higher Education Outreach and Engagement}, volume = {20}, number = {2}, pages = {55-84}, abstract = {Community–university partnerships are frequently used to enhance translational research efforts while benefiting the community. However, challenges remain in evaluating such efforts. This article discusses the utility of applying the contextual and interactive model of community–university collaboration to a translational research education program, the Institute for Translational Research in adolescent Behavioral Health, to guide programmatic efforts and future evaluations. Institute stakeholders from academia and the community completed in-depth interviews querying their expectations and experiences in this collaboration. Key quotes and themes were extracted and analyzed based on the constructs within the 3 phases of the model. The findings note specific themes for future valuations. Overall, the contextual and interactive model of community–university collaboration proved a useful framework to guide the process evaluation of the Institute. Findings suggest possible strategies for the successful development, evaluation, and sustainability of community–university partnerships.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community–university partnerships are frequently used to enhance translational research efforts while benefiting the community. However, challenges remain in evaluating such efforts. This article discusses the utility of applying the contextual and interactive model of community–university collaboration to a translational research education program, the Institute for Translational Research in adolescent Behavioral Health, to guide programmatic efforts and future evaluations. Institute stakeholders from academia and the community completed in-depth interviews querying their expectations and experiences in this collaboration. Key quotes and themes were extracted and analyzed based on the constructs within the 3 phases of the model. The findings note specific themes for future valuations. Overall, the contextual and interactive model of community–university collaboration proved a useful framework to guide the process evaluation of the Institute. Findings suggest possible strategies for the successful development, evaluation, and sustainability of community–university partnerships. |
2015 |
Camplain, Ricky; Meyer, Michelle L; Tanaka, Hirofumi; Palta, Priya; Agarwal, Sunil K; Aguilar, David; Butler, Kenneth R; Heiss, Gerardo Smoking Behaviors and Arterial Stiffness Measured by Pulse Wave Velocity in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study Journal Article American Journal of Hypertension, 29 (11), pp. 1268-1275, 2015, ISBN: 0895-7061. @article{Camplain2015, title = {Smoking Behaviors and Arterial Stiffness Measured by Pulse Wave Velocity in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study}, author = {Ricky Camplain and Michelle L Meyer and Hirofumi Tanaka and Priya Palta and Sunil K Agarwal and David Aguilar and Kenneth R Butler and Gerardo Heiss}, url = {https://academic.oup.com/ajh/article-lookup/doi/10.1093/ajh/hpv189}, doi = {10.1093/ajh/hpv189}, isbn = {0895-7061}, year = {2015}, date = {2015-12-10}, journal = {American Journal of Hypertension}, volume = {29}, number = {11}, pages = {1268-1275}, abstract = {BACKGROUND Though smoking is strongly associated with peripheral vascular disease and arteriosclerosis, smoking’s association with arterial stiffness has been inconsistent and mostly limited to a single arterial segment. We examined the relationship between smoking behaviors with arterial stiffness in multiple arterial segments among community dwelling older adults. METHODS The cross-sectional relationship between smoking behavior with carotid-femoral (cfPWV) and femoral-ankle pulse wave velocity (faPWV) was examined in 5,002 men and women, separately, of the Atherosclerosis Risk in Communities (ARIC) cohort study. Brachial-ankle PWV was also assessed and presented in Supplementary Material. Heckman selection models were used to control for selective attrition and death in the ARIC cohort. RESULTS In women, faPWV was lower in current smokers compared to never smokers (−66.0cm/s; 95% confidence interval (95% CI): −94.6, −37.4), and was 1.0cm/s lower (95% CI: −1.8, −0.2) for every additional year a woman smoked, after adjustment for confounders. Among women, cfPWV was not associated with smoking status or cigarette pack-years. Additionally, no associations of smoking status and cigarette pack-years with PWV were observed among men. Years since smoking cessation was not associated with PWV in either gender. CONCLUSION Both smoking status and cumulative smoking exposure were associated with lower peripheral arterial stiffness among women, but not among men. We did not observe an association between central arterial stiffness and smoking status in either gender. The profound and well-documented adverse effects of cigarette smoking on the vasculature may not include a sustained stiffening of the arteries measured at older age.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND Though smoking is strongly associated with peripheral vascular disease and arteriosclerosis, smoking’s association with arterial stiffness has been inconsistent and mostly limited to a single arterial segment. We examined the relationship between smoking behaviors with arterial stiffness in multiple arterial segments among community dwelling older adults. METHODS The cross-sectional relationship between smoking behavior with carotid-femoral (cfPWV) and femoral-ankle pulse wave velocity (faPWV) was examined in 5,002 men and women, separately, of the Atherosclerosis Risk in Communities (ARIC) cohort study. Brachial-ankle PWV was also assessed and presented in Supplementary Material. Heckman selection models were used to control for selective attrition and death in the ARIC cohort. RESULTS In women, faPWV was lower in current smokers compared to never smokers (−66.0cm/s; 95% confidence interval (95% CI): −94.6, −37.4), and was 1.0cm/s lower (95% CI: −1.8, −0.2) for every additional year a woman smoked, after adjustment for confounders. Among women, cfPWV was not associated with smoking status or cigarette pack-years. Additionally, no associations of smoking status and cigarette pack-years with PWV were observed among men. Years since smoking cessation was not associated with PWV in either gender. CONCLUSION Both smoking status and cumulative smoking exposure were associated with lower peripheral arterial stiffness among women, but not among men. We did not observe an association between central arterial stiffness and smoking status in either gender. The profound and well-documented adverse effects of cigarette smoking on the vasculature may not include a sustained stiffening of the arteries measured at older age. |
Laurila, Kelly; Ingram, Jani C; Briehl, Margaret M; Trotter, Robert Weaving the Web: Evaluation Strategies to Help Native-American Undergraduate Research Training Programs Navigate Students to Success Journal Article CURQ on the Web, 35 (3), pp. 4-11, 2015. @article{Laurila2015, title = {Weaving the Web: Evaluation Strategies to Help Native-American Undergraduate Research Training Programs Navigate Students to Success}, author = {Kelly Laurila and Jani C Ingram and Margaret M Briehl and Robert Trotter}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671630/}, year = {2015}, date = {2015-12-07}, journal = {CURQ on the Web}, volume = {35}, number = {3}, pages = {4-11}, abstract = {Native-American cultures are characterized by strong connections to community, family, and the land. These connections are integrated into Native-American education, resulting in curricula that are different from those in Western educational systems. Differences between Native-American and Western cultures create challenges for those educated in Native-American education systems when they pursue postsecondary education in Western cultures. The under-representation of Native-Americans among those earning degrees reflects both extremely low enrollment rates and generally poor retention rates for Native-American college students (UA 2009). Obstacles for Native-American students include inadequate academic preparation, cultural differences, vague constructs of educational or vocational goals, insufficient financial aid, and social isolation (McClellan et al. 2005). Engaging Native-American students in research is one strategy for overcoming these obstacles and improving their college experience. Here we describe a research-based training program focused on Native-American undergraduates, the evaluation model and process used to evaluate this program, and the paradigm-shifting insights that emerged from the evaluation data.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Native-American cultures are characterized by strong connections to community, family, and the land. These connections are integrated into Native-American education, resulting in curricula that are different from those in Western educational systems. Differences between Native-American and Western cultures create challenges for those educated in Native-American education systems when they pursue postsecondary education in Western cultures. The under-representation of Native-Americans among those earning degrees reflects both extremely low enrollment rates and generally poor retention rates for Native-American college students (UA 2009). Obstacles for Native-American students include inadequate academic preparation, cultural differences, vague constructs of educational or vocational goals, insufficient financial aid, and social isolation (McClellan et al. 2005). Engaging Native-American students in research is one strategy for overcoming these obstacles and improving their college experience. Here we describe a research-based training program focused on Native-American undergraduates, the evaluation model and process used to evaluate this program, and the paradigm-shifting insights that emerged from the evaluation data. |
Eaves, Emery R "Just Advil": Harm reduction and identity construction in the consumption of over-the-counter medication for chronic pain Journal Article Social Science and Medicine, 146 , pp. 147-154, 2015. @article{Eaves2015, title = {"Just Advil": Harm reduction and identity construction in the consumption of over-the-counter medication for chronic pain}, author = {Emery R Eaves}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26517291}, doi = {10.1016/j.socscimed.2015.10.033}, year = {2015}, date = {2015-12-01}, journal = {Social Science and Medicine}, volume = {146}, pages = {147-154}, abstract = {Direct-to-consumer marketing has sparked ongoing debate concerning whether ads empower consumers to be agents of their own care or shift greater control to the pharmaceutical industry. Ads for over-the-counter (OTC) medications in particular portend to offer simple, harmless solutions for meeting the demands of social life. Rather than join the longstanding debate between consumer agency and social control in pharmaceutical advertising, I approach self-medication with over-the-counter (OTC) analgesics using Harm Reduction as a framework. From this perspective, consumption of OTC analgesics by chronic pain sufferers is a means of seeking some level of relief while also avoiding the stigma associated with prescription pain medication. Qualitative methods are used to analyze data from two sources: (1) semi-structured qualitative interviews with 95 participants in a trial examining the effectiveness of Traditional Chinese Medicine for Temporomandibular Disorders (TMD) from 2006 to 2011 in Tucson, AZ and Portland, OR; and (2) print, online, and television advertisements for three major brands of OTC pain medication. Participants described their use of OTC medications as minimal, responsible, and justified by the severity of their pain. OTC medication advertising, while ostensibly ambiguous and targeting all forms of pain, effectively lends support to the consumption of these medications as part of the self-projects of chronic pain sufferers, allowing them to reconcile conflicting demands for pain relief while being stoic and maintaining a positive moral identity. Describing OTC medication as "just over-the-counter" or "not real pain medication," sufferers engage in ideological harm reduction, distinguishing themselves from "those people who like taking pain medication" while still seeking relief. Justifying one's use of OTC medication as minimal and "normal," regardless of intake, avoids association with the addictive potential of prescription pain medications and aligns the identity of the chronic pain sufferer with a culturally sanctioned identity as stoic bearer of pain.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Direct-to-consumer marketing has sparked ongoing debate concerning whether ads empower consumers to be agents of their own care or shift greater control to the pharmaceutical industry. Ads for over-the-counter (OTC) medications in particular portend to offer simple, harmless solutions for meeting the demands of social life. Rather than join the longstanding debate between consumer agency and social control in pharmaceutical advertising, I approach self-medication with over-the-counter (OTC) analgesics using Harm Reduction as a framework. From this perspective, consumption of OTC analgesics by chronic pain sufferers is a means of seeking some level of relief while also avoiding the stigma associated with prescription pain medication. Qualitative methods are used to analyze data from two sources: (1) semi-structured qualitative interviews with 95 participants in a trial examining the effectiveness of Traditional Chinese Medicine for Temporomandibular Disorders (TMD) from 2006 to 2011 in Tucson, AZ and Portland, OR; and (2) print, online, and television advertisements for three major brands of OTC pain medication. Participants described their use of OTC medications as minimal, responsible, and justified by the severity of their pain. OTC medication advertising, while ostensibly ambiguous and targeting all forms of pain, effectively lends support to the consumption of these medications as part of the self-projects of chronic pain sufferers, allowing them to reconcile conflicting demands for pain relief while being stoic and maintaining a positive moral identity. Describing OTC medication as "just over-the-counter" or "not real pain medication," sufferers engage in ideological harm reduction, distinguishing themselves from "those people who like taking pain medication" while still seeking relief. Justifying one's use of OTC medication as minimal and "normal," regardless of intake, avoids association with the addictive potential of prescription pain medications and aligns the identity of the chronic pain sufferer with a culturally sanctioned identity as stoic bearer of pain. |
Young, Belinda-Rose; Williamson, Heather J; Burton, Donna L; Massey, Oliver Thomas; Levin, Bruce Lubotsky; Baldwin, Julie A Challenges and Benefits in Designing and Implementing a Team-Based Research Mentorship Experience in Translational Research Journal Article Pedagogy in Health Promotion, 1 (4), pp. 233-246, 2015. @article{Young2015, title = {Challenges and Benefits in Designing and Implementing a Team-Based Research Mentorship Experience in Translational Research}, author = {Belinda-Rose Young and Heather J Williamson and Donna L Burton and Oliver Thomas Massey and Bruce Lubotsky Levin and Julie A Baldwin}, url = {http://journals.sagepub.com/doi/10.1177/2373379915600174}, doi = {10.1177/2373379915600174}, year = {2015}, date = {2015-12-01}, journal = {Pedagogy in Health Promotion}, volume = {1}, number = {4}, pages = {233-246}, abstract = {BACKGROUND: Translational research seeks to build bridges between research and practice to address public health issues efficiently and effectively. The purpose of this paper was to evaluate a newly formed Institute that provided graduate students and adolescent behavioral health community professionals with a translational research service-learning opportunity through the creation of a community-university mentoring partnership. Goals of the team-based research mentorship approach included: 1) providing students the skills for implementing translational research; 2) providing research opportunities for community agencies to enhance operations and to encourage ongoing research involvement; and 3) developing relationships between university faculty and community agency professionals for further research collaborations. METHODS: The Institute used the National Institute on Drug Abuse's Mentoring Mosaic to select a diverse group of Community and Academic Mentors. The research mentorship experience of the initial cohort was evaluated based upon the Research Mentorship Conceptual Framework and Self-Assessment Tool. RESULTS: As a direct result of the research mentorship, outcomes for the Academic and Community Mentors and Scholars (i.e., those seeking a graduate certificate) included improved working relationships/networking and research experience. Through experiential learning, Scholars also discovered career trajectory clarity, the need for community collaboration in research, opportunities for continuing professional development, a greater understanding of public health competencies and how they align with community-based research, and skill development in best practices for translational research. CONCLUSION: The team mentoring approach is a form of pedagogy that holds promise to enhance translational research and community-based research efforts while developing public health competencies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Translational research seeks to build bridges between research and practice to address public health issues efficiently and effectively. The purpose of this paper was to evaluate a newly formed Institute that provided graduate students and adolescent behavioral health community professionals with a translational research service-learning opportunity through the creation of a community-university mentoring partnership. Goals of the team-based research mentorship approach included: 1) providing students the skills for implementing translational research; 2) providing research opportunities for community agencies to enhance operations and to encourage ongoing research involvement; and 3) developing relationships between university faculty and community agency professionals for further research collaborations. METHODS: The Institute used the National Institute on Drug Abuse's Mentoring Mosaic to select a diverse group of Community and Academic Mentors. The research mentorship experience of the initial cohort was evaluated based upon the Research Mentorship Conceptual Framework and Self-Assessment Tool. RESULTS: As a direct result of the research mentorship, outcomes for the Academic and Community Mentors and Scholars (i.e., those seeking a graduate certificate) included improved working relationships/networking and research experience. Through experiential learning, Scholars also discovered career trajectory clarity, the need for community collaboration in research, opportunities for continuing professional development, a greater understanding of public health competencies and how they align with community-based research, and skill development in best practices for translational research. CONCLUSION: The team mentoring approach is a form of pedagogy that holds promise to enhance translational research and community-based research efforts while developing public health competencies. |
Williamson, Heather J Research Brief: Implementation of KanCare for Adults with Intellectual and/or Developmental Disabilities Technical Report University of South Florida 2015. @techreport{Williamson2015, title = {Research Brief: Implementation of KanCare for Adults with Intellectual and/or Developmental Disabilities}, author = {Heather J Williamson}, url = {https://www.researchgate.net/publication/283488751_Research_Brief_Implementation_of_KanCare_for_Adults_with_Intellectual_andor_Developmental_Disabilities}, doi = {10.13140/RG.2.1.1135.8162}, year = {2015}, date = {2015-11-04}, institution = {University of South Florida}, abstract = {he state of Kansas reformed their Medicaid program to Medicaid Managed Long-Term Services and Supports (MLTSS) in 2013, titled KanCare (KanCare, 2015). In KanCare, adults with intellectual and/or developmental disabilities (IDD) select one of three private for profit Managed Care Organizations (MCOs), which then coordinate all needed LTSS, behavioral health, ** and health services. Adults with IDD began receiving health care through KanCare in January 2013 and LTSS were included beginning February 2014. The purpose of this research study was to describe the current implementation of KanCare for adults with IDD and their family caregivers. Study aims included: 1) To understand the rationale behind and what actually happened with MLTSS implementation for adults with IDD in Kansas; 2) To understand how service coordination providers and family caregivers perceived care coordination and access to services for adults with IDD in MLTSS; and 3) To understand how family caregivers and their roles were recognized in MLTSS for adults with IDD. Research Brief: Implementation of KanCare... (PDF Download Available). Available from: https://www.researchgate.net/publication/283488751_Research_Brief_Implementation_of_KanCare_for_Adults_with_Intellectual_andor_Developmental_Disabilities [accessed Jun 07 2018].}, keywords = {}, pubstate = {published}, tppubtype = {techreport} } he state of Kansas reformed their Medicaid program to Medicaid Managed Long-Term Services and Supports (MLTSS) in 2013, titled KanCare (KanCare, 2015). In KanCare, adults with intellectual and/or developmental disabilities (IDD) select one of three private for profit Managed Care Organizations (MCOs), which then coordinate all needed LTSS, behavioral health, ** and health services. Adults with IDD began receiving health care through KanCare in January 2013 and LTSS were included beginning February 2014. The purpose of this research study was to describe the current implementation of KanCare for adults with IDD and their family caregivers. Study aims included: 1) To understand the rationale behind and what actually happened with MLTSS implementation for adults with IDD in Kansas; 2) To understand how service coordination providers and family caregivers perceived care coordination and access to services for adults with IDD in MLTSS; and 3) To understand how family caregivers and their roles were recognized in MLTSS for adults with IDD. Research Brief: Implementation of KanCare... (PDF Download Available). Available from: https://www.researchgate.net/publication/283488751_Research_Brief_Implementation_of_KanCare_for_Adults_with_Intellectual_andor_Developmental_Disabilities [accessed Jun 07 2018]. |
Walsh, Margaret L; Baldwin, Julie A AMERICAN INDIAN SUBSTANCE ABUSE PREVENTION EFFORTS: A REVIEW OF PROGRAMS, 2003-2013 Journal Article American Indian and Alaska Native Mental Health Research, 22 (2), pp. 41-68, 2015. @article{Walsh2015, title = {AMERICAN INDIAN SUBSTANCE ABUSE PREVENTION EFFORTS: A REVIEW OF PROGRAMS, 2003-2013}, author = {Margaret L Walsh and Julie A Baldwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26053884}, doi = {10.5820/aian.2202.2015.41}, year = {2015}, date = {2015-11-02}, journal = {American Indian and Alaska Native Mental Health Research}, volume = {22}, number = {2}, pages = {41-68}, abstract = {The purpose of the review was to assess substance abuse prevention (SAP) efforts in American Indian and Alaska Native (AI/AN) communities from 2003-2013. In the past, many SAP programs were unable to meet the unique cultural needs of AI/AN communities adequately. It has been suggested that a disconnect may exist between the theories that are used to guide development of prevention programs in AI/AN communities and culturally appropriate theoretical constructs of AI/AN worldviews. To explore this possible disconnect further, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to assess a total of 18 articles (N = 31 programs) on program location and method, participant characteristics, described program cultural elements, use of theory, program outcomes, program measures, and future recommendations. Results indicated that SAP programs in AI/AN communities vary widely in their use of theory, implementation strategies, view and definition of cultural constructs, overall evaluational rigor, and reporting methods. Future research is needed to integrate appropriate theory and cultural elements into SAP programs to tie them to measurable outcomes for AI/AN communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The purpose of the review was to assess substance abuse prevention (SAP) efforts in American Indian and Alaska Native (AI/AN) communities from 2003-2013. In the past, many SAP programs were unable to meet the unique cultural needs of AI/AN communities adequately. It has been suggested that a disconnect may exist between the theories that are used to guide development of prevention programs in AI/AN communities and culturally appropriate theoretical constructs of AI/AN worldviews. To explore this possible disconnect further, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to assess a total of 18 articles (N = 31 programs) on program location and method, participant characteristics, described program cultural elements, use of theory, program outcomes, program measures, and future recommendations. Results indicated that SAP programs in AI/AN communities vary widely in their use of theory, implementation strategies, view and definition of cultural constructs, overall evaluational rigor, and reporting methods. Future research is needed to integrate appropriate theory and cultural elements into SAP programs to tie them to measurable outcomes for AI/AN communities. |
Teufel-Shone, Nicolette; Cordova-Marks, Felina; Susanyatame, Gloria; Teufel-Shone, Louis; Irwin, Sandra L Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program Journal Article Journal of Community Health, 43 (5), pp. 891-898, 2015. @article{Teufel-Shone2015, title = {Documenting Cancer Information Seeking Behavior and Risk Perception in the Hualapai Indian Community to Inform a Community Health Program}, author = {Nicolette Teufel-Shone and Felina Cordova-Marks and Gloria Susanyatame and Louis Teufel-Shone and Sandra L Irwin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25791877}, doi = {10.1007/s10900-015-0009-1}, year = {2015}, date = {2015-10-01}, journal = {Journal of Community Health}, volume = {43}, number = {5}, pages = {891-898}, abstract = {Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Cancer incidence among American Indians (AIs) is low, yet their 5-year relative survival rate is the second lowest of all U.S. populations. Culturally relevant cancer prevention education is key to achieve health equity. This collaborative project of the Hualapai Tribe and University of Arizona modified the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS) to yield a more culturally relevant cancer information survey to document the health seeking behaviors and perceptions of cancer risks and preventability of AI adults residing in the Hualapai Indian community. A team of health care providers, educators and cancer survivors (six native and three non-natives) completed the adaptation. Four trained native surveyors administered the survey using a random household survey design. The Hualapai HINTS was well accepted (<5% refusal rate) and was completed by 205 adults (20.5% of all adult residents). Respondents reported a preference for and a trust in verbal cancer information and communication with health care professionals (77.1% preference; 57.4% trust) and at workshops (75.2% preference; 45.5% trust). Respondents were aware of some health behaviors associated with a reduced cancer risk, e.g., avoid tobacco use and need for screening. Respondents were less well informed about the role of diet and exercise. These findings were used to inform local cancer prevention education efforts and to develop a series of monthly workshops that engaged local health professionals to reinforce and discuss pathways of the primary role of lifestyle related factors, specifically diet and exercise in reducing cancer risk. |
Salinas-Miranda, Abraham A; Salemi, Jason L; King, Lindsey M; Baldwin, Julie A; Berry, Estrellita “Lo”; Austin, Deborah A; Scarborough, Kenneth; Spooner, Kiara K; Zoorob, Roger J; Salihu, Hamisu M Adverse childhood experiences and health-related quality of life in adulthood: revelations from a community needs assessment Journal Article Health and Quality of Life Outcomes, 13 (123), pp. 1-12, 2015. @article{Salinas-Miranda2015, title = {Adverse childhood experiences and health-related quality of life in adulthood: revelations from a community needs assessment}, author = {Abraham A Salinas-Miranda and Jason L Salemi and Lindsey M King and Julie A Baldwin and Estrellita “Lo” Berry and Deborah A Austin and Kenneth Scarborough and Kiara K Spooner and Roger J Zoorob and Hamisu M Salihu}, url = {https://hqlo.biomedcentral.com/articles/10.1186/s12955-015-0323-4}, doi = {10.1186/s12955-015-0323-4}, year = {2015}, date = {2015-08-11}, journal = {Health and Quality of Life Outcomes}, volume = {13}, number = {123}, pages = {1-12}, abstract = {Adverse childhood experiences (ACE) have been previously linked to quality of life, health conditions, and life expectancy in adulthood. Less is known about the potential mechanisms which mediate these associations. This study examined how ACE influences adult health-related quality of life (HRQoL) in a low-income community in Florida. METHODS: A community-based participatory needs assessment was conducted from November 2013 to March 2014 with 201 residents of Tampa, Florida, USA. HRQoL was measured by an excessive number of unhealthy days experienced during the previous 30-day window. Mediation analyses for dichotomous outcomes were conducted with logistic regression. Bootstrapped confidence intervals were generated for both total and specific indirect effects. RESULTS: Most participants reported 'good to excellent health' (76%) and about a fourth reported 'fair to poor health' (24%). The mean of total unhealthy days was 9 days per month (SD ± 10.5). Controlling for demographic and neighborhood covariates, excessive unhealthy days was associated with ACE (AOR = 1.23; 95% CI: 1.06, 1.43), perceived stress (AOR = 1.07; 95% CI: 1.03, 1.10), and sleep disturbance (AOR = 8.86; 3.61, 21.77). Mediated effects were significant for stress (β = 0.08) and sleep disturbances (β = 0.11) as they related to the relationship between ACE and excessive unhealthy days. CONCLUSION: ACE is linked to adult HRQoL. Stress and sleep disturbances may represent later consequences of childhood adversity that modulate adult quality of life.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Adverse childhood experiences (ACE) have been previously linked to quality of life, health conditions, and life expectancy in adulthood. Less is known about the potential mechanisms which mediate these associations. This study examined how ACE influences adult health-related quality of life (HRQoL) in a low-income community in Florida. METHODS: A community-based participatory needs assessment was conducted from November 2013 to March 2014 with 201 residents of Tampa, Florida, USA. HRQoL was measured by an excessive number of unhealthy days experienced during the previous 30-day window. Mediation analyses for dichotomous outcomes were conducted with logistic regression. Bootstrapped confidence intervals were generated for both total and specific indirect effects. RESULTS: Most participants reported 'good to excellent health' (76%) and about a fourth reported 'fair to poor health' (24%). The mean of total unhealthy days was 9 days per month (SD ± 10.5). Controlling for demographic and neighborhood covariates, excessive unhealthy days was associated with ACE (AOR = 1.23; 95% CI: 1.06, 1.43), perceived stress (AOR = 1.07; 95% CI: 1.03, 1.10), and sleep disturbance (AOR = 8.86; 3.61, 21.77). Mediated effects were significant for stress (β = 0.08) and sleep disturbances (β = 0.11) as they related to the relationship between ACE and excessive unhealthy days. CONCLUSION: ACE is linked to adult HRQoL. Stress and sleep disturbances may represent later consequences of childhood adversity that modulate adult quality of life. |
Reinschmidt, Kerstin M; Ingram, Maia; Schachter, Kenneth; Sabo, Samantha; Verdugo, Lorena; Carvajal, Scott The Journal of Ambulatory Care Management, 38 (3), pp. 244-253, 2015. @article{Reinschmidt2015, title = {The Impact of Integrating Community Advocacy Into Community Health Worker Roles on Health-Focused Organizations and Community Health Workers in Southern Arizona}, author = {Kerstin M Reinschmidt and Maia Ingram and Kenneth Schachter and Samantha Sabo and Lorena Verdugo and Scott Carvajal}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26049654}, doi = {10.1097/JAC.0000000000000092}, year = {2015}, date = {2015-08-01}, journal = {The Journal of Ambulatory Care Management}, volume = {38}, number = {3}, pages = {244-253}, abstract = {Organizational environments may encourage community health workers (CHWs) to engage community members in improving their communities. We conducted open-ended interviews and focus groups to explore how participation in the Acción intervention, which trained CHWs in community advocacy, affected organizational capacity to support their CHWs. Supervisors described improved organizational recognition and trust of CHWs. Organizational leaders reported organizational benefits and increased appreciation of CHW leadership. Both expressed increased interest in future advocacy trainings. Limiting factors included organizational mission, CHW position descriptions, and funding. Findings indicate that, with training and funding, CHW community advocacy can be integrated into organizations with congruent missions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Organizational environments may encourage community health workers (CHWs) to engage community members in improving their communities. We conducted open-ended interviews and focus groups to explore how participation in the Acción intervention, which trained CHWs in community advocacy, affected organizational capacity to support their CHWs. Supervisors described improved organizational recognition and trust of CHWs. Organizational leaders reported organizational benefits and increased appreciation of CHW leadership. Both expressed increased interest in future advocacy trainings. Limiting factors included organizational mission, CHW position descriptions, and funding. Findings indicate that, with training and funding, CHW community advocacy can be integrated into organizations with congruent missions. |
Sabo, Samantha; Wennerstrom, Ashley; Phillips, David; Haywoord, Catherine; Redondo, Floribella; Bell, Melanie L; Ingram, Maia Community Health Worker Professional Advocacy: Voices of Action from the 2014 National Community Health Worker Advocacy Survey Journal Article The Journal of Ambulatory Care Management, 38 (2), pp. 225-235, 2015. @article{Sabo2015, title = {Community Health Worker Professional Advocacy: Voices of Action from the 2014 National Community Health Worker Advocacy Survey}, author = {Samantha Sabo and Ashley Wennerstrom and David Phillips and Catherine Haywoord and Floribella Redondo and Melanie L Bell and Maia Ingram}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26049652}, doi = {10.1097/JAC.0000000000000089}, year = {2015}, date = {2015-08-01}, journal = {The Journal of Ambulatory Care Management}, volume = {38}, number = {2}, pages = {225-235}, abstract = {This mixed-methods study explores community health worker (CHW) engagement in professional advocacy. Data from the National Community Health Worker Advocacy Survey (n = 1661) assessed the relationship between CHW professional advocacy and CHW demographics, and work characteristics. Qualitative data articulated the quality of professional advocacy efforts. Approximately, 30% of CHW respondents advocated for professional advancement or collaborated with other CHWs to advance the workforce. Advocacy was more prevalent among CHWs affiliated with a professional network. CHW advocacy targeted recognition of the field, appropriate training and compensation, and sustainable funding. CHW professional advocacy is imperative to advancement of the field.}, keywords = {}, pubstate = {published}, tppubtype = {article} } This mixed-methods study explores community health worker (CHW) engagement in professional advocacy. Data from the National Community Health Worker Advocacy Survey (n = 1661) assessed the relationship between CHW professional advocacy and CHW demographics, and work characteristics. Qualitative data articulated the quality of professional advocacy efforts. Approximately, 30% of CHW respondents advocated for professional advancement or collaborated with other CHWs to advance the workforce. Advocacy was more prevalent among CHWs affiliated with a professional network. CHW advocacy targeted recognition of the field, appropriate training and compensation, and sustainable funding. CHW professional advocacy is imperative to advancement of the field. |
Evenson, Kelly R; Dorn, Joan M; Camplain, Ricky; Pate, Russell R; Brown, David R Evaluation of the Physical Activity and Public Health Course for Researchers Journal Article Journal of Physical Activity and Health, 12 (8), pp. 1052-1060, 2015, ISBN: 1543-3080. @article{Evenson2015, title = {Evaluation of the Physical Activity and Public Health Course for Researchers}, author = {Kelly R Evenson and Joan M Dorn and Ricky Camplain and Russell R Pate and David R Brown}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949596/}, doi = {10.1123/jpah.2014-0284}, isbn = {1543-3080}, year = {2015}, date = {2015-08-01}, journal = {Journal of Physical Activity and Health}, volume = {12}, number = {8}, pages = {1052-1060}, abstract = {Background Since 1995, an 8-day Physical Activity and Public Health Course for Researchers has been offered yearly in the United States. Methods In 2013, an evaluation quantified time that fellows spent in different course offerings, surveyed fellows on course impact, documented grant funding, and identified fellow participation on leading physical activity-related journals. Results The number of fellows that attended the course ranged from 20–35/year. Fellows who participated in the web survey (n=322) agreed that the course: met their expectations (99%), had a positive impact on the physical activity research or practice work they did (98%), and helped increase their professional networking in the field (93%). Following the course, 73% of fellows had further contact with course faculty and 71% had further contact with other fellows. From the National Institutes of Health, 117 grants were awarded to 82 fellows (21% of eligible fellows). Out of 14 journals reviewed, 11 had at least one fellow on their staff as editor, associate editor, or editorial board member. Conclusion The Physical Activity and Public Health Course for Researchers helps address a training need by providing instruction and building capacity in the US and abroad for conducting research on physical activity and public health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Since 1995, an 8-day Physical Activity and Public Health Course for Researchers has been offered yearly in the United States. Methods In 2013, an evaluation quantified time that fellows spent in different course offerings, surveyed fellows on course impact, documented grant funding, and identified fellow participation on leading physical activity-related journals. Results The number of fellows that attended the course ranged from 20–35/year. Fellows who participated in the web survey (n=322) agreed that the course: met their expectations (99%), had a positive impact on the physical activity research or practice work they did (98%), and helped increase their professional networking in the field (93%). Following the course, 73% of fellows had further contact with course faculty and 71% had further contact with other fellows. From the National Institutes of Health, 117 grants were awarded to 82 fellows (21% of eligible fellows). Out of 14 journals reviewed, 11 had at least one fellow on their staff as editor, associate editor, or editorial board member. Conclusion The Physical Activity and Public Health Course for Researchers helps address a training need by providing instruction and building capacity in the US and abroad for conducting research on physical activity and public health. |
Xing, Dongyuan; Huang, Yangxin; Chen, Henian; Zhu, Yiliang; Dagne, Getachew A; Baldwin, Julie A Bayesian inference for two-part mixed-effects model using skew distributions, with application to longitudinal semicontinuous alcohol data Journal Article Statistical Methods in Medical Research, pp. 1-19, 2015. @article{Xing2015, title = {Bayesian inference for two-part mixed-effects model using skew distributions, with application to longitudinal semicontinuous alcohol data}, author = {Dongyuan Xing and Yangxin Huang and Henian Chen and Yiliang Zhu and Getachew A Dagne and Julie A Baldwin}, url = {http://journals.sagepub.com/doi/10.1177/0962280215590284}, doi = {10.1177/0962280215590284}, year = {2015}, date = {2015-07-19}, journal = {Statistical Methods in Medical Research}, pages = {1-19}, abstract = {Semicontinuous data featured with an excessive proportion of zeros and right-skewed continuous positive values arise frequently in practice. One example would be the substance abuse/dependence symptoms data for which a substantial proportion of subjects investigated may report zero. Two-part mixed-effects models have been developed to analyze repeated measures of semicontinuous data from longitudinal studies. In this paper, we propose a flexible two-part mixed-effects model with skew distributions for correlated semicontinuous alcohol data under the framework of a Bayesian approach. The proposed model specification consists of two mixed-effects models linked by the correlated random effects: (i) a model on the occurrence of positive values using a generalized logistic mixed-effects model (Part I); and (ii) a model on the intensity of positive values using a linear mixed-effects model where the model errors follow skew distributions including skew-t and skew-normal distributions (Part II). The proposed method is illustrated with an alcohol abuse/dependence symptoms data from a longitudinal observational study, and the analytic results are reported by comparing potential models under different random-effects structures. Simulation studies are conducted to assess the performance of the proposed models and method.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Semicontinuous data featured with an excessive proportion of zeros and right-skewed continuous positive values arise frequently in practice. One example would be the substance abuse/dependence symptoms data for which a substantial proportion of subjects investigated may report zero. Two-part mixed-effects models have been developed to analyze repeated measures of semicontinuous data from longitudinal studies. In this paper, we propose a flexible two-part mixed-effects model with skew distributions for correlated semicontinuous alcohol data under the framework of a Bayesian approach. The proposed model specification consists of two mixed-effects models linked by the correlated random effects: (i) a model on the occurrence of positive values using a generalized logistic mixed-effects model (Part I); and (ii) a model on the intensity of positive values using a linear mixed-effects model where the model errors follow skew distributions including skew-t and skew-normal distributions (Part II). The proposed method is illustrated with an alcohol abuse/dependence symptoms data from a longitudinal observational study, and the analytic results are reported by comparing potential models under different random-effects structures. Simulation studies are conducted to assess the performance of the proposed models and method. |
Valdez, Elizabeth Salerno; Valdez, Luis A; Sabo, Samantha Frontiers in Public Health, 3 (163), pp. 1-8, 2015. @article{Valdez2015, title = {Structural Vulnerability Among Migrating Women and Children Fleeing Central America and Mexico: The Public Health Impact of "Humanitarian Parole"}, author = {Elizabeth Salerno Valdez and Luis A Valdez and Samantha Sabo}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26157791}, doi = {10.3389/fpubh.2015.00163}, year = {2015}, date = {2015-06-24}, journal = {Frontiers in Public Health}, volume = {3}, number = {163}, pages = {1-8}, abstract = {Since October 2013, US Customs and Border Patrol has apprehended 15,979 families on the Southwest Border of the US. Daily, migrating women and children from Mexico and Central America that qualify for humanitarian parole are released from immigration detention to a humanitarian aid organization in Southern Arizona. After several days in detention facilities, these families arrive tired, hungry, dehydrated, and with minimal direction regarding their final destination, and adherence to the parameters of their parole. Project helping hands (PHHs) utilizes a network of volunteers to provide the women and children with food, water, clothing, hygiene products, hospitality, and legal orientation. The aim of this assessment was to document the experiences of families granted humanitarian parole through the lens of structural vulnerability. Here, we apply qualitative methods to elicit PHH lead volunteer perspectives regarding the migration experience of migrating families. Using inductive analysis, we found six major themes emerged from the qualitative data: reasons for leaving, experience on the journey, dehumanization in detention, family separation, vulnerability, and resiliency. These findings elucidate the different physical and psychological distresses that migrating families from Mexico and Central America experience before, during and after their arrival at the US-Mexico border. We posit that these distresses are a result of, or exacerbated by, structural vulnerability. Structural vulnerability has life-long health implications for a sub-population of young mothers and their children. The number of migrating families who have experienced traumatic events before and during their migration experience continues to expand and thus warrants consideration of mental health surveillance and intervention efforts for these families. More public health research is needed to better understand and combat the health challenges of this growing population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Since October 2013, US Customs and Border Patrol has apprehended 15,979 families on the Southwest Border of the US. Daily, migrating women and children from Mexico and Central America that qualify for humanitarian parole are released from immigration detention to a humanitarian aid organization in Southern Arizona. After several days in detention facilities, these families arrive tired, hungry, dehydrated, and with minimal direction regarding their final destination, and adherence to the parameters of their parole. Project helping hands (PHHs) utilizes a network of volunteers to provide the women and children with food, water, clothing, hygiene products, hospitality, and legal orientation. The aim of this assessment was to document the experiences of families granted humanitarian parole through the lens of structural vulnerability. Here, we apply qualitative methods to elicit PHH lead volunteer perspectives regarding the migration experience of migrating families. Using inductive analysis, we found six major themes emerged from the qualitative data: reasons for leaving, experience on the journey, dehumanization in detention, family separation, vulnerability, and resiliency. These findings elucidate the different physical and psychological distresses that migrating families from Mexico and Central America experience before, during and after their arrival at the US-Mexico border. We posit that these distresses are a result of, or exacerbated by, structural vulnerability. Structural vulnerability has life-long health implications for a sub-population of young mothers and their children. The number of migrating families who have experienced traumatic events before and during their migration experience continues to expand and thus warrants consideration of mental health surveillance and intervention efforts for these families. More public health research is needed to better understand and combat the health challenges of this growing population. |