Public Health Education and Promotion Commons^™

Using Photovoice As A Tool For Community Engagement To Assess The Environment And Explore Environmental Health Disparities, Heather M. Brandt, Venice E. Haynes, Lashanta J. Rice, Dayna Campbell, Edith Williams, *Sacoby Wilson, Saundra H. Glover

Journal of Health Disparities Research and Practice

Photovoice was used as a participatory research method to document perceived local environmental hazards, pollution sources, and potential impact on health among community members to address environmental health disparities. A convenience sample of 16 adults in Orangeburg, South Carolina participated in Photovoice. Photos depicted positive and negative implications of the environment across seven themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive and negative photos demonstrated a high level of interest among community members in considering how the environment influences health and health disparities.

Race And “Hotspots” Of Preventable Hospitalizations, Caryn N. Bell, Janice V. Bowie, Roland J. Thorpe Jr.

Journal of Health Disparities Research and Practice

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH …

Chuukese Migrant Women In Guam: Perceptions Of Barriers To Health Care, Margaret Hattori-Uchima

Asian/Pacific Island Nursing Journal

This descriptive qualitative study examined perceived barriers to health care among Chuukese migrant women in Guam and explored which factors influenced health-seeking behaviors. Study participants recommended interventions which may reduce those perceived barriers. Since the Compact of Free Association with the United States was enacted in 1985, there has been a dramatic rise in the numbers of Chuukese migrating to Guam. This migration is anticipated to continue with more migrants needing health care, education, and social services. Little is known about their perceptions of barriers to health care services or the cultural, social, economic, and other factors that influence their …

Priority Hypertension Management Strategies For At-Risk African Americans As Perceived By Medical Clinicians And Academic Scholars, Shirley M. Timmons, Lu Shi, Amin Khademi

Journal of Health Disparities Research and Practice

African American adults, in the United States (US), bear the greatest burden of high blood pressure (HBP)--a primary risk factor for cardiovascular disease and premature death. Current research does not adequately inform the design of multi-level interventions that work to control HBP in this at-risk population. The purpose of this study was to uncover information about priority strategies recommended for HBP control in African American adults. Research questions are 1) what are factors that reduce or manage HBP in at-risk African Americans and 2) what factors are important to the design and implementation of successful HBP interventions in at-risk African …

Prenatal Care Providers’ Perspectives And Practices: Informed Consent For Hiv Screening Among Latinas With Limited English Proficiency In South Carolina, Edena G. Meetze

Journal of Health Disparities Research and Practice

Abstract

The rapid increase in Latinos in South Carolina that has occurred within the past 15 years is associated with both in-migrationand high birth rates. Limited ethnic-specific data and communication barriers betweenLatinas with limited English proficiency have contributed to difficulties in assessing theprovision of recommended routine prenatal HIV screening among this vulnerablepopulation. This qualitative descriptive study examined providers' perceptions andpractices related to obtaining informed consent for routine HIV screening for pregnantLatinas with limited English proficiency. Findings indicate the need for focused educational interventionswith providers and patients and implementation of culturally and linguistically tailoredpractice guidelines to improve patient understanding and acceptance …

Gender And Racial/Ethnic Disparities: Cumulative Screening Of Health Risk Indicators In 20-50 Year Olds In The United States, Alissa Cordner, Adrien A. Wilkie, Timothy J. Wade, Edward E. Hudgens, Rebecca J. Birch, Jane E. Gallagher

Journal of Health Disparities Research and Practice

This study explored potential gender and racial/ethnic disparities in overall health risk related to 24 health risk indicators selected across six domains: socioeconomic, health status and health care, lifestyle, nutritional, clinical, and environmental. Using the 2003-2006 National Health and Nutrition Examination Surveys (NHANES), it evaluated cross-sectional data for 5,024 adults in the United States. Logistic regression models were developed to estimate prevalence odds ratios (PORs) adjusted for smoking, health insurance status, and age. Analyses evaluated disparities associated with 24 indicator variables of health risk, comparing females to males and four racial/ethnic groups to non-Hispanic Whites. Non-Hispanic Blacks and Mexican Americans …

Knowledge And Beliefs About Cancer In African American Population, Rabindra P. Gautam Dhs, Deven Shah Phd, Eric Matthews Phd

Journal of Health Disparities Research and Practice

Cancer is the second most common cause of death in the United States, taking the lives of one in four Americans each year (American Cancer Society [ACS], 2015). A total of 1,658,370 new cancer cases and 589,430 deaths from cancer were projected to occur in the United States in 2015 (ACS, 2015). In 2013, approximately 176,630 new cancer cases and 64,880 deaths from cancer were projected to occur in African American communities. The majority of diagnoses were cancers of the prostate, lung, colon, rectum, breast, and colorectal region (ACS, 2013). For most cancers, African Americans have the highest death rate, …

Exploring Sexual And Behavioral Health Inequities Among College Students: A Need For Lgb-Specific Risk Reduction, Todd M. Sabato

Journal of Health Disparities Research and Practice

Many studies have examined differences in sexual behavior based upon self-identified sexual orientation, with results often indicating that those with same-sex partners engage in greater risk behaviors than those with opposite sex partners. However, few of those studies consisted of large, national sample studies. To address that gap, the present study examined the relationship between sexual orientation and both behavioral and sexual health outcomes in a national sample of U.S. college students. The Fall 2012 through Spring 2014 American College Health Association National College Health Assessment was used to examine behavioral and sexual health related responses from self-identified heterosexual, gay, …

Healthcare Reform In Latino Rhode Island: Perspectives Of Spanish Speakers And Insurance Navigators, Haiyan Ramírez Batlle, Roberta E. Goldman, Amed Logroño, Joseph A. Diaz

Journal of Health Disparities Research and Practice

Latinos have the highest uninsurance rates of any ethnic or racial group in the US despite recent health insurance expansion reform. In addition to immigration and language barriers, health literacy and attitudes may impact coverage disparities. Focus groups with Spanish-speaking community members and semi-structured interviews with health insurance navigators were conducted to explore knowledge, awareness, and attitudes towards healthcare reform among Latinos in Rhode Island. Sessions were audio recorded, transcribed, and analyzed employing standard qualitative methods. Thirty-two focus group participants and six navigators were enrolled in the study. Spanish-speaking participants demonstrated limited knowledge of the cost implications of the Medicaid …

Child-Mediated Health Communication: A Conceptual Framework For Increasing Stroke Literacy In Hard To Reach Populations, Olajide Williams, Ellyn Leighton-Herrmann, Mindy F. Hecht, Alexandra Desorbo, William Gerin, Monique Hedmann, Rachel Shelton, Benjamin Tolchin, James Noble

Journal of Health Disparities Research and Practice

Effectively engaging economically-disadvantaged ethnic minority communities for promoting health has proved to be challenging for a variety of reasons, including factors related to healthcare access, literacy, inadequate or ineffective cultural appropriateness of materials, and the relatively low priority for health due to competing demands related to economic hardship. We have developed a framework of Child-Mediated Health Communication (CMHC), which focuses on children as channels for carrying out health promotion interventions to parents and other caregivers. CMHC is an innovative, alternative strategy for engaging this underserved population, where traditional methods of health promotion have not been successful. We discuss the theoretical …

Identifying Outcomes And Gaps Impacting Tobacco Control And Prevention In African American Communities, Leah M. Ranney, Hannah M. Baker, Delmonte Jefferson, Adam O. Goldstein

Journal of Health Disparities Research and Practice

Great racial disparities exist in smoking and related health outcomes in the United States. African American (AA) smokers start smoking later and smoke less than white smokers but are less likely to quit. In 2008, the CDC’s Office on Smoking and Health funded the National African American Tobacco Prevention Network (NAATPN) to focus tobacco control leadership, expertise and promotion in the AA community. In 2012, NAATPN sought to determine significant outcomes of tobacco control efforts impacting Black and AA communities by conducting a qualitative document search and series of interviews with experts in the field. Thirteen identified outcomes were categorized …

Connecting Culturally And Spiritually To Healthy Eating: A Community Assessment With Native Hawaiians, Mary Frances Oneha, Joan Dodgson, Mabel Ho`Oipo Decambra, Carol Titcomb, Rachelle Enos, Sandie Morimoto-Ching

Asian/Pacific Island Nursing Journal

Many of the chronic illnesses disproportionately experienced by Native Hawaiians are directly related to poor diets and long-standing obesity beginning in childhood. We report on the findings of in-depth key informant interviews (N = 14) that took place in two Native Hawaiian communities as part of a larger, community-based participatory research study that included a community assessment through individual interviews and focused group discussions, and a pilot intervention targeting pregnant women, their infants, and families. Four categories emerged from the qualitative analysis of interview transcripts that described an understanding of “healthy eating”: family roles and responsibilities, aspects of community …

Assessing Feasibility And Readiness To Address Obesity Through Policy In American Indian Reservations, Valarie Blue Bird Jernigan, Gail Boe, Carolyn Noonan, Leslie Carroll, Dedra Buchwald

Journal of Health Disparities Research and Practice

The Institute of Medicine and Centers for Disease Control and Prevention (CDC) have identified policy and environmental strategies as critical to the prevention and control of obesity. However such strategies are rare in American Indian communities despite significant obesity-related disparities. Tribal policymaking processes differ by tribal nation and are often poorly understood by researchers and public health practitioners, hindering the dissemination, implementation, and successful scale-up of evidence-base obesity strategies in tribal communities. To address these gaps in knowledge we surveyed 138 diverse stakeholders in two American Indian reservations to assess the feasibility of and readiness to implement CDC-recommended obesity policy …

Brighter Sights: Using Photovoice For A Process Evaluation Of A Food Co-Op Style Nutrition Intervention, Margaret P. Raber, Kimberly Kay Lopez, Mike Pomeroy, Avni Mody, Christine Markham, Shreela V. Sharma

Journal of Health Disparities Research and Practice

Access to healthy food is a critical factor impacting childhood obesity. Brighter Bites is a school-based program that addresses the issue of fresh food access among low-income families living in food deserts using a food co-op model. The aim of this study is to evaluate initial parent participant reactions to the ongoing Brighter Bites program using Photovoice. A predominately Hispanic, economically disadvantaged, urban school was chosen as the site for the Photovoice project. A total of seven Brighter Bites parent participants were enrolled and six completed the study. The participants developed research questions, took documentary photographs, completed a group analysis …

Feasibility Of A Community-Based Sickle Cell Trait Testing And Counseling Program, Ashley Housten, Regina Abel, Terianne Lindsey, Allison King

Journal of Health Disparities Research and Practice

Background: Sickle cell trait (SCT) screening is required at birth in the United States; however, adults rarely know their SCT status prior to having children.

Purpose: Assess feasibility of a community-based SCT education and testing intervention.

Methods: Participants were recruited from eight community sites to complete an educational program and offered a hemoglobin analysis. A genetic counselor met individually with participants to discuss lab results.

Results: Between July 14, 2010 and May 31, 2012, 637 participants completed the educational program. Five hundred seventy (89.5%) provided a blood sample, and 61 (10.9%) had SCT or other hemoglobinopathies. The genetic counselor met …

Development Of A Capacity Building Program For Village Health Volunteers To Support Self-Management In A High Risk Population For Diabetes In A Rural Community In Northeast Thailand, Pakinee Srisarakham, Kwanjai Amnatsatsue, Patcharaporn Kerdmongkol, Prasit Leerapan

Asian/Pacific Island Nursing Journal

Similar to other parts of the world, the prevalence of type 2 diabetes mellitus (T2DM) in the Asia-Pacific Region has rapidly increased during the last few decades. The purposes of this pilot study were to determine the feasibility and the effects of a capacity building program for Village Health Volunteers (VHVs) to support self-management in a T2DM high risk population from a rural subdistrict in Northeast Thailand. Both quantitative and qualitative data were collected using surveys, focus group discussions, and in-depth interviews. Data were analyzed and used to develop a 12-week capacity building program for VHVs. This program was then …

Addressing Health Disparities Among Homeless In Alachua County Through Community-Based Participatory Research., Meron Hirpa, Omar Iqbal, Haider Ali, Sama I. Ilyas, Nabeel Iqbal, Jeena A. Kar, Tiffany Splatt, Brendan Shortley, Nancy Hardt

Journal of Health Disparities Research and Practice

Introduction. In states such as Florida that did not expand Medicaid, a large number of economically disadvantaged individuals do not qualify for subsidies to buy health insurance through the Affordable Care Act (ACA) ². This leaves the health needs of Florida’s homeless population largely unaddressed. Nearly 48.1% of Alachua County’s homeless population has disabling conditions ¹⁶. This confirms a pressing need to understand the homeless population's healthcare needs, knowledge, and barriers in accessing healthcare. Methods. We used a Community-Based Participatory Research model in conducting health fairs and needs assessment surveys, incentivizing participation, and providing education about existing resources. …

Physical Activity Among Older American Indians And Alaska Natives, David Hodgins, Linda Larkey, Barbara E. Ainsworth, Colleen Keller

Journal of Health Disparities Research and Practice

Introduction: Life style behaviors contribute to poor health among older Americans Indians/Alaska Native (AI/AN) in the United States, with low levels of physical activity (PA) particularly tied to the chronic disease profile of this population. Searched reviews of physical activity among AI/ANs are limited in assessing prevalence and correlates to PA among older adults > 40 years.

Methods: A literature search of reported physical activity studies among older AI/AN was assessed for prevalence and predictive factors associated with levels of physical activity.

Results: Fourteen studies were included in this review that either specifically quantified the amount of physical activity among older …

Blood Pressure Control For African American Parents And Children: Feasibility And Initial Outcomes Of A Faith-Based Intervention Pilot Study, Penny A. Ralston Ph.D., Tammye Farmer M.S., Iris Young-Clark Ph.D., Catherine Coccia Ph.D., R.D.

Journal of Health Disparities Research and Practice

The overall purpose was to determine the feasibility and initial outcomes of a faith-based intervention to improve blood pressure (BP) control in African American (AA) parents/guardians and their children, using a pre/post without control group design. Sample included AA parents and children (n=17) from three churches in North Florida. Health behaviors (daily servings of fruits/vegetables [F/V], minutes of physical activity [PA]) and physical health (BMI, systolic BP and diastolic SB) were examined. Data were analyzed using descriptive statistics, paired t-tests, and correlations. Feasibility outcomes showed high attendance (91% children, 88% parents) and completion (100%) rates. F/V significantly increased at post-test …

Perceptions Of Renal Disease Risk Among African Americans: A Review Of The Literature, Casey L. Migliore, Julie Barroso, Allison Vorderstrasse

Journal of Health Disparities Research and Practice

African Americans are disproportionately at risk for renal disease, especially those with type 2 diabetes (McDonough et al., 2011). Despite this disease disparity, the literature lacks research on renal disease awareness and risk perceptions among African Americans with type 2 diabetes. Therefore, a literature review guided by the Common Sense Model was conducted to review and synthesize the literature on African Americans’ awareness of renal disease and existing risk perceptions, capturing sociocultural factors in the African American community that could influence the development of those risk perceptions. The literature identified an overall lack of knowledge about renal disease risk factors, …

A Public Health-Based Approach To German Gaming Regulation, Knut Walter, Gerhard Buehringer

International Conference on Gambling & Risk Taking

The current situation of the German gambling market can be characterized by an unrelated framework of different legal systems, different regulatory authorities and different control principles, and has led to (1) an increasing number of court decisions and information requests by European Commission questioning parts of that regulatory system, (2) public tolerance of illicit gambling, and consequently (3) a lack of consumer protection.

Taking RENO Model 1.0 and 2.0 seriously, a new and comprehensive regulatory framework based on common consumer protection standards for all types of gambling – land-based and online, state-owned and private operated – has been developed and …

Developing Capacity, Skills, And Tobacco Control Networks To Address Tobacco-Related Disparities: Leadership And Advocacy Institute To Advance Minnesota’S Parity For Priority Populations (Laampp), Linda M. Bosma, Raffaele Vacca, Raymond G. Boyle, Jaime L. Martinez, Rod Lew

Journal of Health Disparities Research and Practice

Priority populations disproportionately experience tobacco-related disparities, despite population level declines in tobacco use. The Leadership and Advocacy Institute to Advance Minnesota’s Parity for Priority Populations (LAAMPP) recruits and trains African immigrants/African Americans, Asian Americans/Pacific Islanders, American Indians, Chicano/Latinos, and LGBTQ community members to develop leaders to address tobacco harms in their communities. This paper describes and evaluates the LAAMPP Institute, and discusses lessons learned through the Institute and future directions for community-based tobacco-control efforts.

The mixed-methods evaluation included qualitative key informant interviews with LAAMPP Fellows and community and project contacts, a Skills Assessment Tool, project case studies, and a social …

Social Determinants Of Late Stage Hiv Diagnosis And Its Distributions Among African Americans And Latinos: A Critical Literature Review, Alison M. Chopel, Meredith Minkler, Amani Nuru-Jeter, Megan Dunbar

Journal of Health Disparities Research and Practice

ABSTRACT

This critical literature review was conducted to identify both individual- and environmental-level social determinants of health using an ecological framework as a way to contextualize risk for, and distributions of, late HIV diagnosis among African Americans and Latinos in the United States.

Background: Late diagnosis, defined as a diagnosis of AIDS simultaneously with or within one year of an initial HIV diagnosis,¹ disproportionately affects African American and Latino communities;^2,3 disparities in this health problem thus represent a preventable inequity. Such disparities affect not only late diagnosed individuals but also population levels of HIV incidence, as transmission is …

Adapting And Piloting An Evidence-~Based Hiv/Aids And Teen Pregnancy Prevention Intervention For Native American Teens, Murlynn Crystal Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Native American youth are at disproportionate risk for HIV infection. Native Americans represent about 1.7% of the U.S. population, yet they rank fifth in HIV/AIDS diagnosis nationwide (U.S. Census, 2012; CDCd 2013). Native Americans with HIV/AIDS are more likely to be younger than non-Native Americans with the disease. There are limited evidence-based HIV/AIDS and teen pregnancy prevention interventions that have been developed, adapted, and/or evaluated for Native American teens. The purpose of this study was to adapt an existing evidence-based HIV/AIDS and teen pregnancy prevention intervention into a culturally responsive intervention curriculum for Native teens. Methods: There were three …

A Comparison Of Beliefs And Attitudes About Body Image, Eating And Weight Between Incarcerated And Non-~Incarcerated Females, Anne R. Lindsay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract

Incarceration and substance abuse are two of the largest public health issues in America. While the U.S. makes up only 5% of the world’s population, it accounts for 25% of its prisoners. Incarceration affects more than 2.2 million individuals who will eventually return to their families and communities with ongoing family, social and health issues. Women in prison are a particularly vulnerable and underserved population, generally of low education and socio-economic status and although they account for a small percent of the prison population, many are mothers of young children who are likely to become incarcerated themselves. Substance abuse …

Factors Associated With Colorectal Cancer Screening Among Younger African American Men: A Systematic Review, Charles R. Rogers, Patricia Goodson, Margaret Foster

Journal of Health Disparities Research and Practice

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men’s intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men’s screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies’ methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

The Complexities Of Childhood Obesity: A Qualitative Study Among Mexican American Mothers, Erica T. Sosa, E. Lisako Mckyer, Buzz Pruitt, Patricia Goodson, Linda Castillo

Journal of Health Disparities Research and Practice

Introduction: Mothers play an important role in preventing childhood obesity; however, might differ in how they define healthy weight and the associated consequences. Due to the lack of research investigating how Mexican American mothers perceive childhood obesity, the purpose of this paper is to qualitatively assess Mexican-American mothers’ perceptions regarding childhood obesity, its causes and consequences.

Methods: Three focus groups, two in Spanish and one in English, were conducted with 23 mothers in Bryan, TX. Thematic analysis was performed by three researchers independently using sentences as the unit of meaning.

Findings: Mexican American mothers believed that a …

The Feasibility Of Delivering A Home-Based Motivational Exercise Program To African-American Breast Cancer Survivors, Denise Spector, Claudio Battaglini

Journal of Health Disparities Research and Practice

Most African-American breast cancer survivors do not meet current exercise recommendations for cancer survivors, which include both aerobic and strength-training exercises. This pilot study tested the feasibility of delivering a home-based exercise intervention to African-American breast cancer survivors. Sedentary African-American breast cancer survivors were recruited for a 16-week motivational home-based progressive aerobic and strength-training exercise pilot study. Participants completed weekly exercise logs and received weekly phone calls. To assess feasibility, we evaluated recruitment, retention, and adherence rates, as well as participant acceptance and safety. 17 women enrolled; 13 completed the intervention (76%). Participants had moderately-high adherence (70%) to walking goals, …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …