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Tomayko, Emily J., Ronald J. Prince, Kate A. Cronin, Tassy Parker, Kyungmann Kim, Vernon M. Grant, Judith N. Sheche i Alexandra K. Adams. "Healthy Children, Strong Families 2: A randomized controlled trial of a healthy lifestyle intervention for American Indian families designed using community-based approaches". Clinical Trials 14, nr 2 (9.01.2017): 152–61. http://dx.doi.org/10.1177/1740774516685699.
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Background/Aims Few obesity prevention trials have focused on young children and their families in the home environment, particularly in underserved communities. Healthy Children, Strong Families 2 is a randomized controlled trial of a healthy lifestyle intervention for American Indian children and their families, a group at very high risk of obesity. The study design resulted from our long-standing engagement with American Indian communities, and few collaborations of this type resulting in the development and implementation of a randomized clinical trial have been described. Methods Healthy Children, Strong Families 2 is a lifestyle intervention targeting increased fruit and vegetable intake, decreased sugar intake, increased physical activity, decreased TV/screen time, and two less-studied risk factors: stress and sleep. Families with young children from five American Indian communities nationwide were randomly assigned to a healthy lifestyle intervention ( Wellness Journey) augmented with social support (Facebook and text messaging) or a child safety control group ( Safety Journey) for 1 year. After Year 1, families in the Safety Journey receive the Wellness Journey, and families in the Wellness Journey start the Safety Journey with continued wellness-focused social support based on communities’ request that all families receive the intervention. Primary (adult body mass index and child body mass index z-score) and secondary (health behaviors) outcomes are assessed after Year 1 with additional analyses planned after Year 2. Results To date, 450 adult/child dyads have been enrolled (100% target enrollment). Statistical analyses await trial completion in 2017. Lessons learned Conducting a community-partnered randomized controlled trial requires significant formative work, relationship building, and ongoing flexibility. At the communities’ request, the study involved minimal exclusion criteria, focused on wellness rather than obesity, and included an active control group and a design allowing all families to receive the intervention. This collective effort took additional time but was critical to secure community engagement. Hiring and retaining qualified local site coordinators was a challenge but was strongly related to successful recruitment and retention of study families. Local infrastructure has also been critical to project success. Other challenges included geographic dispersion of study communities and providing appropriate incentives to retain families in a 2-year study. Conclusion This multisite intervention addresses key gaps regarding family/home-based approaches for obesity prevention in American Indian communities. Healthy Children, Strong Families 2’s innovative aspects include substantial community input, inclusion of both traditional (diet/activity) and less-studied obesity risk factors (stress/sleep), measurement of both adult and child outcomes, social networking support for geographically dispersed households, and a community selected active control group. Our data will address a literature gap regarding multiple risk factors and their relationship to health outcomes in American Indian families.
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Warren-White, Nicolette, Patricia Moorman, Morris J. Dunn, Carol S. Mitchell, Ariel Fisher i Myron F. Floyd. "Southeast Raleigh Minority Faith-based Health Promotion Initiative". Californian Journal of Health Promotion 7, SI (15.09.2009): 87–98. http://dx.doi.org/10.32398/cjhp.v7isi.2003.
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Faith-based organizations are a powerful resource for addressing health issues within the African American community. In this paper, we describe two projects led by volunteer faith-based leaders and community residents who collaborated with public agencies to design programs to combat obesity. The first project, the Southeast Raleigh Community Garden Project, involved the construction of a community garden and the delivery of educational programs on healthy eating among youth. The second one, Project FACT (Faith-based groups Addressing health issues through Community outreach Together in the community), implemented church-based nutrition education programs and community walking programs led by church volunteers. The purpose of the two faith-based health promotion projects was to increase opportunities for physical activity and to encourage consumption of more fruits and vegetables. These projects resulted in the construction of a walking trail with the community garden as its destination, implementation of education programs to increase nutritional awareness, the initiation of multiple walking programs, and policy changes within the church to encourage a healthier lifestyle. The projects demonstrated the feasibility of collaboration among faith-based organizations, community residents and government agencies to promote physical activity and healthful eating among families by creating physical changes in the environment and implementing educational and walking programs in low income communities.
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Kopera-Frye, Karen, Ashley Graboski-Bauer i Ana Luisa Gonzalez-Marquez. "A COMMUNITY HEALTH EDUCATION PROGRAM TO ENCOURAGE EXERCISE AND PROPER NUTRITION IN LATINOS". Innovation in Aging 3, Supplement_1 (listopad 2019): S145. http://dx.doi.org/10.1093/geroni/igz038.522.
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Abstract New Mexico now has the 32nd highest adult obesity rate (28.8% for 2015). Thirty one percent of this obesity rate encompasses Latinos; rates are the highest among the 26-44 years age group. Obesity rates in NM for children aged 2-11 range from 11 – 14%. Healthy Kids New Mexico adopted the 5-2-1-0 challenge. (American Academy of Pediatrics) which refers to eating 5+ vegetables, reducing screen time to 2 hours, 1 hour+ daily activity, and daily water intake (H20). Therefore, project I’M HIP2’s main goal was to educate parents and children, within an intergenerational context, on improving diet and activity levels to reduce obesity. The Intergenerational Mentoring on Health Information Pathways 2 (I’M HIP2) program involved 74 Hispanic families including one target child, one parent, and one other relative, e.g., aunt or grandparent. Monthly educational sessions focused on physical activity and adapting meals to be healthy. Project outcomes included exercise frequency, Body Mass Index (BMI), and a knowledge quiz assessing healthy meal facts, exercise knowledge via a 10-item quiz; all assessments pre- and post-program. Paired t-test analyses revealed significant changes in knowledge quiz total scores (t 70 = 5.03, p < .0001), increased exercise frequency (t 72 = 2.106, p < .05); no significant change in BMI from pre- to post-assessments. The families reported overwhelmingly positive responses to how the program had changed their eating styles and activity levels. This study has implications for how we can harness this invaluable resource of the generations to affect health impacts on Hispanic families.
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Iscovich, José. "Introduction to the Post-Human Genome Project era, a target for interactions between polygenic and/or multiphenotypical components in cancer control in South America". Cadernos de Saúde Pública 14, suppl 3 (1998): S15—S23. http://dx.doi.org/10.1590/s0102-311x1998000700003.
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Epidemiological studies have suggested that the propensity to develop malignancy involves a complex mix of genetic and environmental determinants, however both older and innovative techniques display unresolved questions regarding etiology. Current barriers to achieving the potential benefit from this understanding are: 1) incomplete background on the various environmental and genetic factors involved in the carcinogenesis mechanism; 2) difficulties in accurately differentiating specific molecular subtypes and measuring the effective cellular exposure dose; and 3) difficulties in determining the multifactorial interaction between genetic and environmental factors. To extrapolate Human Genome Project research findings to the Post-Human Genome Project era, South America provides a large population and large-pedigree families, thus including genetically heterogeneous and less heterogeneous groups. An initial strategy might be to trace high risk populations and the respective exposures to which they are susceptible, such as: 1) migration, identifying rural migrant populations; 2) inherent susceptibility, studying "long term homogeneous populations" or large families living in similar rural environments; and 3) dissection of gene-environmental interaction.
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McCall, Kimberly, Keith McGregor, Shellie Layne i Raymond Jones. "264 Building Empowerment through FITness (BeFIT)". Journal of Clinical and Translational Science 8, s1 (kwiecień 2024): 79–80. http://dx.doi.org/10.1017/cts.2024.240.
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OBJECTIVES/GOALS: Improving physical activity of African American women experiencing disproportionate health risks from sedentarism, educational and socio-environmental barriers. BeFit: Building Empowerment through Fitness is based on “What I Learned At Home” project, run by Women Under Construction Network, for residents of the Birmingham Housing Authority. METHODS/STUDY POPULATION: A qualitative study design to understand unique cultural context and challenges faced by African American women residing in the Birmingham Housing Authority, regarding physical activity engagement, including sedentarism. A needs assessment approach will help determine barriers, support systems, and social networks. Semi-structured, pre, mid, and post program focus groups will identify challenges and opportunities for health, such as diet and exercise, and will be analyzed by hand with a thematic analysis. The project framework uses exercise and home repair tools with a life-building/life repair curriculum to influence health, self-efficacy, and program engagement. The Study enrollment will include 50 women over two cohorts in a 12-week project. RESULTS/ANTICIPATED RESULTS: This research addresses the urgent health needs of African American women in low-income communities. These women face heightened health risks due to sedentary lifestyles, educational gaps, and socio-environmental barriers. This project targets the pronounced prevalence of allostatic burden in this population by applying a culturally sensitive, bottom-up approach. Our goal of incorporating healthy lifestyles to improve health in at-risk women and their families requires multiple projects. This project is a necessary first step in engaging with a community to identify local environmental circumstances and barriers to increasing the relevance of physical activity within the home. These barriers can then be addressed by adapting an exercise promotion program to the needs of this community. DISCUSSION/SIGNIFICANCE: Black women in under-resourced communities are more likely to be sedentary and have poor health. Exercise programs can be a powerful tool to address disparities and help prioritize health. The circumstances of women in public housing in Birmingham, AL, need community partners to adapt exercise engagement programs to meet environmental challenges.
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Topham, Glade L., Isaac J. Washburn, Laura Hubbs-Tait, Tay S. Kennedy, Julie M. Rutledge, Melanie C. Page, Taren Swindle, Lenka H. Shriver i Amanda W. Harrist. "The Families and Schools for Health Project: A Longitudinal Cluster Randomized Controlled Trial Targeting Children with Overweight and Obesity". International Journal of Environmental Research and Public Health 18, nr 16 (19.08.2021): 8744. http://dx.doi.org/10.3390/ijerph18168744.
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This cluster randomized controlled trial aimed at overweight and obese children compared three treatments. Two psychoeducation interventions for parents and children were conducted: Family Lifestyle (FL) focused on food and physical activity; Family Dynamics (FD) added parenting and healthy emotion management. A third Peer Group (PG) intervention taught social acceptance to children. Crossing interventions yielded four conditions: FL, FL + PG, FL + FD, and FL + FD + PG—compared with the control. Longitudinal BMI data were collected to determine if family- and peer-based psychosocial components enhanced the Family Lifestyle approach. Participants were 1st graders with BMI%ile >75 (n = 538: 278 boys, 260 girls). Schools were randomly assigned to condition after stratifying for community size and percent American Indian. Anthropometric data were collected pre- and post-intervention in 1st grade and annually through 4th grade. Using a two-level random intercept growth model, intervention status predicted differences in growth in BMI or BMI-M% over three years. Children with obesity who received the FL + FD + PG intervention had lower BMI gains compared to controls for both raw BMI (B = −0.05) and BMI-M% (B = −2.36). Interventions to simultaneously improve parent, child, and peer-group behaviors related to physical and socioemotional health offer promise for long-term positive impact on child obesity.
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Herbst, Rachel Becker, Amrik Singh Khalsa, Haley Schlottmann, Mary Kathleen Kerrey, Katherine Glass i Mary Carol Burkhardt. "Effective Implementation of Culturally Appropriate Tools in Addressing Overweight and Obesity in an Urban Underserved Early Childhood Population in Pediatric Primary Care". Clinical Pediatrics 58, nr 5 (6.03.2019): 511–20. http://dx.doi.org/10.1177/0009922819832088.
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Overweight and obese children are at an increased risk of remaining obese. The American Academy of Pediatrics recommends addressing healthy habits at well-child checks, but this poses challenges, especially in low-income populations. A clinical innovation project was designed to adapt recommendations in a busy urban clinic and consisted of motivational interviewing, culturally tailored tools, and standardizing documentation. A quasi-experimental design examined innovation outcomes. Of 137 overweight and obese children aged 24 to 66 months, providers’ documentation of weight during well-child check visits improved post-innovation ( P < .01), as did development of healthy habits goals ( P < .001). Families were more likely to return for visits post-innovation ( P = .01). A logistic regression analysis showed that adding body mass index to the problem list and establishing a specific follow-up timeframe most predicted follow-up visits to assess progress ( P < .001). Comprehensive innovations consisting of motivational interviewing, implementation of culturally tailored tools, and standardized documentation can enhance engagement in an urban clinic setting.
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Walters, Karina L., June LaMarr, Rona L. Levy, Cynthia Pearson, Teresa Maresca, Selina A. Mohammed, Jane M. Simoni i in. "Project həli?dxw/Healthy Hearts Across Generations: Development and Evaluation Design of a Tribally Based Cardiovascular Disease Prevention Intervention for American Indian Families". Journal of Primary Prevention 33, nr 4 (sierpień 2012): 197–207. http://dx.doi.org/10.1007/s10935-012-0274-z.
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Cook, Jocelynn, Kathy Unsworth i Katherine Flannigan. "Characterising fetal alcohol spectrum disorder in Canada: a national database protocol study". BMJ Open 11, nr 9 (wrzesień 2021): e046071. http://dx.doi.org/10.1136/bmjopen-2020-046071.
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IntroductionFetal alcohol spectrum disorder (FASD) is one of the most common neurodevelopmental disorders in North America. It is a complex disability, associated with challenges in cognitive, behavioural and socialemotional functioning, as well as an increased risk of physical and mental health comorbidities, and difficulties in daily living across the lifespan. Previous attempts to characterise the profile of this population have been hampered by differences in data collected across studies, regional discrepancies in terminology and definitions, and a lack of tools to integrate comprehensive datasets.Methods and analysisThe goals of this study are to use the Canadian National FASD Database, a national repository of FASD assessment-related information, to better understand the functional profile, comorbidities, intervention needs and difficulties in daily living experienced by individuals assessed for FASD across the lifespan. We will also examine what factors may be the most sensitive predictors of receiving an FASD diagnosis. Data will be analysed from over 3500 records collected between 2010 and 2021 (ongoing) from 26 FASD diagnostic clinics in seven provinces and territories. Data collection is ongoing, and analysis will be performed on a biannual basis to continue to hone our understanding of the profiles, needs and outcomes of individuals assessed for FASD in Canada. This research is critical for refining FASD assessment and diagnostic practice, enabling accurate and early identification of individuals with FASD, and connecting individuals with FASD and their families to comprehensive and effective services and resources to support healthy developmental trajectories.Ethics and disseminationEthics approval for the National FASD Database Project was obtained from the Ottawa Health Science Network Research Ethics Board. As new knowledge is gained from this project, findings will be disseminated through publications, presentations and feedback to participating clinics, with the ultimate goal of informing FASD research, practice and policy.
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Guo, Yuhao. "Comparison of Insurance Between China and the United States". Advances in Economics, Management and Political Sciences 22, nr 1 (13.09.2023): 48–54. http://dx.doi.org/10.54254/2754-1169/22/20230285.
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China has made enormous strides in economic development since the reform and opening up., while medicine and health care are relatively backward. Medical insurance is a very important social insurance project and an important institutional arrangement in the modern social security system. In addition to the common functions of social insurance, it also protects the physical and mental health of workers timely. It has special functions such as repairing labor capacity, reducing the economic burden of workers and their families, improving the physical fitness of the whole people, and promoting the healthy development of health services. Research question: which is better, Chinese insurance or American insurance. This paper analyzes the advantages of American insurance and the disadvantages of Chinese insurance through comparative research. This paper compares the coverage and protection, objects of insurance in China and the United States. By summing up the advantages of American insurance, it hopes that it can play a reference role in improving China's insurance. After analysis, this paper can draw the conclusion that the state needs to strengthen the people's awareness of maintenance, control the growth of medical expenses, and implement nationwide medical insurance.
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Ledoux, Tracey, Jessica Robinson, Tom Baranowski i Daniel P. O’Connor. "Teaching Parents About Responsive Feeding Through a Vicarious Learning Video: A Pilot Randomized Controlled Trial". Health Education & Behavior 45, nr 2 (9.06.2017): 229–37. http://dx.doi.org/10.1177/1090198117712332.
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The American Academy of Pediatrics and World Health Organization recommend responsive feeding (RF) to promote healthy eating behaviors in early childhood. This project developed and tested a vicarious learning video to teach parents RF practices. A RF vicarious learning video was developed using community-based participatory research methods. Fifty parents of preschoolers were randomly assigned to watch Happier Meals or a control video about education. Knowledge and beliefs about RF practices were measured 1 week before and immediately after intervention. Experimental group participants also completed measures of narrative engagement and video acceptability. Seventy-four percent of the sample was White, 90% had at least a college degree, 96% were married, and 88% made >$50,000/year. RF knowledge increased ( p = .03) and positive beliefs about some unresponsive feeding practices decreased ( ps < .05) more among experimental than control parents. Knowledge and belief changes were associated with video engagement ( ps < .05). Parents perceived Happier Meals as highly relevant, applicable, and informative. Community-based participatory research methods were instrumental in developing this vicarious learning video, with preliminary evidence of effectiveness in teaching parents about RF. Happier Meals is freely available for parents or community health workers to use when working with families to promote healthy eating behaviors in early childhood.
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Garcia, Catherine, i Su-I. Hou. "LEVERAGING COMMUNITY-BASED KNOWLEDGE TO ADDRESS THE NEEDS OF OLDER ADULTS FROM RACIAL/ETHNIC MINORITY POPULATIONS". Innovation in Aging 6, Supplement_1 (1.11.2022): 60. http://dx.doi.org/10.1093/geroni/igac059.237.
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Abstract Racially and ethnically minoritized older adults constitute the fastest-growing demographic in the United States. Yet, they are largely underrepresented in population-based studies of aging despite NIH policies encouraging inclusion since the mid-1980s. The resulting and continued exclusion of racially and ethnically diverse populations in aging research limits efforts to elucidate and better understand the determinants of health and healthy aging to improve the lives of minoritized older adults, their families, and/or communities. To enhance the inclusion of racially and ethnically minoritized older adults in recruitment, survey development, analysis, and dissemination efforts, this symposium focuses on leveraging community-based knowledge that centers the lived experiences of community members that are needed to improve health outcomes and equitable changes, especially with the ongoing COVID-19 pandemic. The first paper in this symposium highlights how Community-Based Participatory Advocacy is used in the Dine community, which includes working with indigenous older adults and decolonizing methodologies to facilitate community healing. The second paper focuses on developing culturally informed instruments to collect data on dementia care needs and resources among African immigrants. A third paper focuses on critical lessons learned in Project RAMA that provided crucial insights for a new initiative focused on Hispanic immigrant families affected by rheumatoid arthritis in Washington, DC, including recruiting through embedded community clinics and integrating community needs into the study design. The final paper discusses the meaningful inclusion of Asian American older adults regarding their demographic diversity and prioritizing engagement of community members and community-based organizations in the survey research process.
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Holt, Heidi, i Blythe S. Winchester. "INTEREST GROUP SESSION—INDIGENOUS PEOPLES: REVEALING THE HEALTHY BRAIN INITIATIVE’S ROAD MAP FOR INDIAN COUNTRY: OPPORTUNITIES FOR ENGAGEMENT". Innovation in Aging 3, Supplement_1 (listopad 2019): SS365. http://dx.doi.org/10.1093/geroni/igz038.1334.
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Abstract This landmark document, The Healthy Brain Initiative: Road Map for Indian Country, is the first-ever public health guide focused on dementia in American Indian/Alaska Native (AI/AN) communities. It is intended as a tool for leaders of the 573 federally recognized Indian tribes, as well as state-recognized tribes, to engage their communities in this important issue. Early in the development of the HBI Public Health Road Map for Dementia, CDC recognized strategies that may work for state and local public health agencies likely would need to be tailored by native communities due to culture and unique contexts. This Road Map for Indian Country (Road Map) can be used to support a dialogue within a Native community about how to promote wellness across the lifespan and best support older adults with dementia, their families, and caregivers. The panel will consist of 5 presenters and 1 discussant. Bill Benson, International Association of Indigenous Aging, will discuss the background and need for the project. Molly French, the Alzheimer’s Association, will describe the process used to create the Road Map. Heidi Holt, CDC, will describe the content and goals of the Road Map. Kelsey Donnellan, Association for State and Territorial Health Officials (ASTHO), will present key Indian Country products and Messages that accompany the Road Map. Lisa McGuire will present relevant Behavioral Risk Factor Data, including data specific to the AI/AN population. The discussant will wrap up the panel and provide unique insights as to the use and future for this important document.
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Holton, John K., i Kathryn Harding. "Healthy Families America®". Journal of Prevention & Intervention in the Community 34, nr 1-2 (23.08.2007): 13–38. http://dx.doi.org/10.1300/j005v34n01_02.
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Harding, Kathryn, Joseph Galano, Joanne Martin, Lee Huntington i Cynthia J. Schellenbach. "Healthy Families America® Effectiveness". Journal of Prevention & Intervention in the Community 34, nr 1-2 (23.08.2007): 149–79. http://dx.doi.org/10.1300/j005v34n01_08.
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Aquino, Sheiladen, Thomas Sauter, Lucy Marland i Amber McCollum. "Integrated Swallowing, Nutrition and Medication Management in Care Homes using Telehealth". International Journal of Integrated Care 23, S1 (28.12.2023): 491. http://dx.doi.org/10.5334/ijic.icic23526.
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Pressures from the pandemic have increased waiting times and highlighted the disjointed community services, particularly for vulnerable care home residents significantly affected by Covid-19 (Nawaz and Tulunay-Ugur, 2018). Currently, nearly half a million people live in care homes in the UK. Up to 50% of these residents suffer from swallowing difficulties that can potentially exacerbate symptoms of malnutrition, dehydration, aspiration pneumonia, non-adherence to medication and unwarranted hospital admission ( Chen et al., 2020; Munson, 2022). Digital technologies for swallowing difficulties are effective in improving clinical outcomes for residents in care homes as it has the potential to provide multidisciplinary integrated care to individuals with complex health needs (Pownall et al., 2019).
The project has three aims (1) to provide multidisciplinary training to care home staff to manage risks while health services are recovering after the pandemic, (2) co-design with an efficient integrated clinical pathway with multiple stakeholders, (3) to provide multidisciplinary integrated swallowing, nutrition and medication management to care home residents.
The training process includes an understanding of learners' needs and expectations, the development of immersive training modules, and the provision of hybrid training sessions. To improve the efficiency of care, this project also co-designed an integrated clinical pathway with the stakeholders. Process pathways were created with all the stakeholders to ensure these are both efficient and fit for purpose. The expected length of time was negotiated during the pathway development, as well as roles and accountability. This project used video conferencing to conduct integrated multidisciplinary care to care home residents. Care home staff are with the residents, while clinicians are based in the hospital clinics. Patient families are also invited to attend and participate in the holistic anticipatory care plans.
The project developed a single point of access with one referral to access the three professionals responsible for providing holistic care for residents with swallowing, nutrition and medication issues. Training assessment showed improved competency and confidence. Care home staff felt involved as they communicated the frustration of making multiple referrals, coordinating and attending separate waiting lists and appointments from each profession. The integrated video consultations by the multidisciplinary team were able to improve individual experiences, maximise clinical outcomes, reduce cost, and provide equity of care for marginalised community groups while ensuring staff wellbeing.
The project showed the potential of providing remote integrated swallowing, nutrition and medication management to care home residents to enrich community resources and build capacity to meet increasing demands.
Chen, S. et al. (2020) "Prevalence and risk factors of dysphagia among nursing home residents in eastern China: a cross-sectional study", BMC Geriatrics. BMC Geriatrics, 20(1), pp. 1–11. doi: 10.1186/s12877-020-01752-z.
Munson, S. (2022) ""Care home stats: number of settings, population & workforce"", Carehome.co.uk. Available at: https://www.carehome.co.uk/advice/care-home-stats-number-of-settings-population-workforce.
Nawaz, S. and Tulunay-Ugur, O. E. (2018) "Dysphagia in the older patient", Otolaryngologic Clinics of North America. Elsevier, 51(4), pp. 769–777.
Pownall, S. et al. (2019) "The development of a digital dysphagia guide with care homes: Co-production and evaluation of a nutrition support tool", Geriatrics (Switzerland), 4(3). doi: 10.3390/geriatrics4030048.
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Galano, Joseph, i Cynthia J. Schellenbach. "Healthy Families America® Research Practice Network". Journal of Prevention & Intervention in the Community 34, nr 1-2 (23.08.2007): 39–66. http://dx.doi.org/10.1300/j005v34n01_03.
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Friedman, Lori, i Lisa Schreiber. "Healthy Families America® State Systems Development". Journal of Prevention & Intervention in the Community 34, nr 1-2 (23.08.2007): 67–87. http://dx.doi.org/10.1300/j005v34n01_04.
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Malovic, Aida, Rowena Rossiter i Glynis Murphy. "Keep Safe: the development of a manualised group CBT intervention for adolescents with ID who display harmful sexual behaviours". Journal of Intellectual Disabilities and Offending Behaviour 9, nr 1 (12.03.2018): 49–58. http://dx.doi.org/10.1108/jidob-10-2017-0023.
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Purpose The purpose of this paper is to focus on the development of Keep Safe, a manualised group intervention for adolescents with intellectual disabilities (ID) who display harmful sexual behaviour (HSB) as the initial phase of a feasibility study. National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. Aims included taking account of adolescents’ and families’ needs, motivations and practical commitments, integrating best- practice and being accessible and appropriate across different types of services. Design/methodology/approach Keep Safe development progressed from the practitioner/researcher collaborative young sex offender treatment services collaborative-ID through a project team, Keep Safe development group, comprising a range of practitioners with a variety of clinical expertise across services and an Advisory Group of people with ID. An expert-consensus methodology based on the Delphi method was used. The iterative process for the manual draws on the slim practice-based evidence from UK, New Zealand, North America and Australia. Findings Keep Safe comprises six modules distributed through 36 term-time young people’s sessions, alongside 16 concurrent parental/ carer sessions (some joint). The main focus of Keep Safe is to enhance well-being and reduce harm. Four initial sites volunteered as feasibility leads, and two more were added as recruitment was more difficult than foreseen. Originality/value National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. This study is innovative and valuable given the recognition that research and practice is significantly lacking in this area.
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O'Mahony, Sean, Patricia Marthone, Gabriella Santoro, Clare Horn, Sandy Selikson, Tia Powell, Hannah Lipman i in. "Preliminary Report of a Pilot Tele-Health Palliative Care and Bioethics Program for Residents in Skilled Nursing Facilities". Palliative Care: Research and Treatment 3 (styczeń 2009): PCRT.S3296. http://dx.doi.org/10.4137/pcrt.s3296.
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Currently about 25% of Americans die in nursing homes, many with poorly controlled pain and other symptoms, with minimal provisions for psychosocial support. New models are necessary to lessen structural and process barriers to give effective end-of-life care in nursing homes. Objectives 1) To extend hospital-based Bioethics Consultation Services (BCS) and Palliative Care Services (PCS) at Montefiore Medical Center (MMC) in the Bronx to two local Skilled Nursing Facilities (SNFs), Morningside House Aging in America (MSH) using direct face-to-face consultations and Beth Abraham Health Systems (BAHS) via video consultations (VC); 2) Achieve improvements in quality of life and comfort for elderly residents and their families; 2a) Improve the level of practice and increase staff satisfaction with palliative care content-related knowledge and bioethical analysis. Methods We report preliminary findings of this two group quasi experimental project with results of pre- and post-tests rating content-related knowledge in aspects of end-of-life care for staff. Select pre-test and post-test questions were given to physicians and other staff, but were re-configured for, registered and licensed practice nurses, social workers, and certified nursing assistants from the End-of-Life Physician Education Resource Center (EPERC). Patient, family, and staff ratings of the quality of palliative care were measured with a Palliative Outcomes Scale (POS) one week prior to and post consultation. Results 72 staff attended in-services; 53 completed pre-tests and 49 post-tests. Overall knowledge scores increased for 9 of the 16 items that were analyzed. There were improvements in knowledge scores in 12 of 16 items tested for staff content related knowledge which were statistically significant in regard to management of cancer pain from 63.8% to 81.5% (p = 0.03) and a trend to significance for assessment and management of delirium from 31.6% to 61.9% (p = 0.073). Seventy five POS surveys were completed from 13 video-conferenced Palliative Care consultations and 14 direct face-to-face consultations from March 2008 to January 2009. There were improvements in ratings for some aspects of quality of care on the POS. Patient and staff aggregate response scores for the POS were significantly improved between baseline and follow-up (Wilcoxon signed-rank test p = 0.0143 and p = 0.005) at the videoconsultation site and for family and staff at the face-to-face consultation site (Wilcoxon signed-rank test p = 0.0016 and p = 0.0012). Conclusion Preliminary evidence suggests that use of real time videoconferencing to connect hospital-based Bioethics and Palliative Care clinicians with patients, families, and staff in Skilled Nursing Facilities may enhance some aspects of end-of-life care for their residents, as well as content related knowledge in core aspects of end-of-life care for interdisciplinary groups of staff or caregivers.
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Daro, Deborah A., i Kathryn A. Harding. "Healthy Families America: Using Research to Enhance Practice". Future of Children 9, nr 1 (1999): 152. http://dx.doi.org/10.2307/1602726.
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St. George, Sara M., Dawn K. Wilson, Tyler McDaniel i Kassandra A. Alia. "Process Evaluation of the Project SHINE Intervention for African American Families". Health Promotion Practice 17, nr 4 (15.04.2016): 557–68. http://dx.doi.org/10.1177/1524839916635977.
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Heard-Garris, Nia, Tianyi Yu, Gene Brody, Edith Chen, Katherine B. Ehrlich i Gregory E. Miller. "Racial Discrimination and Metabolic Syndrome in Young Black Adults". JAMA Network Open 7, nr 4 (18.04.2024): e245288. http://dx.doi.org/10.1001/jamanetworkopen.2024.5288.
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ImportanceMetabolic syndrome (MetS) is a common health condition that predisposes individuals to cardiovascular disease (CVD) and disproportionately affects Black and other racially and ethnically minoritized people. Concurrently, Black individuals also report more exposure to racial discrimination compared with White individuals; however, the role of discrimination in the development of MetS over time and associated mediators in these pathways remain underexplored.ObjectiveTo evaluate the association between racial discrimination and MetS in rural Black individuals transitioning from late adolescence into early adulthood and to identify potential mediating pathways.Design, Setting, and ParticipantsThis longitudinal cohort study included Black adolescents enrolled in the Strong African American Families Healthy Adults (SHAPE) Project between June 2009 and May 2021. Families resided in rural counties of Georgia, where poverty rates are among the highest in the nation. Analyses included 322 of the 500 participants who originally enrolled in SHAPE and who were eligible to participate. Guardians provided information about socioeconomic disadvantage. Analyses were conducted in April 2023.ExposuresYouths reported exposure to racial discrimination annually from ages 19 to 21 years.Main Outcomes and MeasuresMetS was the main health outcome and was measured at ages 25 and 31 years. MetS was diagnosed according to the International Diabetes Federation guidelines, which requires central adiposity (ie, waist circumference ≥94 cm for males and ≥80 cm for females) and at least 2 of the 4 additional components: signs of early hypertension (ie, systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg); elevated triglyceride levels (ie, &gt;150 mg/dL); elevated fasting glucose level (ie, ≥100 mg/dL); or lowered high-density lipoprotein levels (ie, &lt;40 mg/dL in men and &lt;50 mg/dL in women). At age 25 years, markers of inflammatory activity (ie, soluble urokinase plasminogen activator receptor [suPAR]) and sleep problems were collected to consider as potential mediators.ResultsIn 322 participants (210 [65.2%] female) ages 19 to 21 years, more frequent exposure to racial discrimination was associated with higher suPAR levels (b = 0.006; 95% CI, 0.001-0.011; P = .01) and more sleep problems at age 25 years (b = 0.062; 95% CI, 0.028-0.097; P &lt; .001) as well as a 9.5% higher risk of MetS diagnosis at age 31 years (odds ratio [OR], 1.10; 95% CI, 1.01-1.20; P = .03). Both suPAR (b = 0.015; 95% CI, 0.002-0.037) and sleep problems (b = 0.020; 95% CI, 0.002-0.047) at age 25 years were significant indirect pathways. No significant interactions between sex and discrimination emerged.Conclusions and RelevanceThis study suggests that racial discrimination in late adolescence is associated with MetS among Black young adults through biobehavioral pathways. Thus, health interventions for MetS in Black adults will need to contend with sleep behaviors and inflammatory intermediaries as well as address and reduce exposure to racial discrimination to narrow disparities and promote health equity.
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Williams, Ishan, Noelle Fields, Ling Xu i Fayron Epps. "THE FAITH CARE FAMILY PROJECT: A PILOT STUDY PROTOCOL". Innovation in Aging 7, Supplement_1 (1.12.2023): 326. http://dx.doi.org/10.1093/geroni/igad104.1086.
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Abstract The use of lay providers/trained volunteers, to address ADRD caregiver needs may provide a scalable and culturally congruent approach for bridging gaps in ADRD care, particularly for African American families. Research examining the church as a platform for raising awareness about ADRD suggests that churches are well-suited to providing support and services to families affected by ADRD. This research protocol describes the development and testing of the Faith Care Family Project (FCF), a lay provider intervention for African American family caregivers in a church setting to address caregiver burden, coping skills, and social support. Guided by the revised sociocultural stress and coping model, an explanatory sequential mixed methods design will be utilized to test the efficacy of the FCF intervention with a sample of 18 church volunteer-family caregiver dyads. Specifically, the study addresses four aims: 1) How do church members and pastors perceive the key components of the FCF and what are their recommendations for implementation? 2) Do the church volunteers gain knowledge of ADRD after the 6-hour, FCF training? 3) Do family caregivers report more knowledge of dementia, less caregiver stress and improved well-being, more social support, and better coping skills after they participate in the FCF? and 4) What are the experiences of participants with the FCF? Data are collected at baseline, mid-intervention, post- intervention, 3 months-post intervention and through qualitative interviews. These evaluation activities will allow us to determine the applicability of the FCF as an effective, lay provider intervention for African American ADRD family caregivers.
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Whipple, E. E., i J. D. Whyte. "Evaluation of a Healthy Families America (HFA) Programme: A Deeper Understanding". British Journal of Social Work 40, nr 2 (19.01.2009): 407–25. http://dx.doi.org/10.1093/bjsw/bcn177.
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Spruill, Ida J. "Enhancing recruitment of African-American families into genetic research: lessons learned from Project SuGar". Journal of Community Genetics 1, nr 3 (wrzesień 2010): 125–32. http://dx.doi.org/10.1007/s12687-010-0017-x.
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NEWACHECK, PAUL W. "Improving Access to Health Care for Children, Youth, and Pregnant Women". Pediatrics 86, nr 4 (1.10.1990): 626–35. http://dx.doi.org/10.1542/peds.86.4.626.
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Twenty-five years ago it seemed that America was on the verge of universal health care coverage.1 A large and growing number of workers and their dependents had gained employer-based health insurance coverage.2 Medicaid and Medicare were enacted to serve the needs of those who did not work—notably the poor and the elderly. Direct service programs, such as community health centers, maternal and infant care projects, and children and youth projects, were also established in the mid-1960s to serve low-income families. At the time, it appeared that this pluralistic approach to financing health care was leading to universal access to health care.
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Johnson, Meghan L., Sue Butts-Dion, Meera Menon, Kelly Edwards i Scott D. Berns. "Promoting social emotional development during the paediatric well-child visit: a demonstration project". BMJ Open Quality 10, nr 2 (czerwiec 2021): e001392. http://dx.doi.org/10.1136/bmjoq-2021-001392.
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Supporting social emotional development, beginning at birth, can improve lifelong health. The American Academy of Paediatrics recommends 12 well-child visits between birth and age 3 years. Each well-child visit provides a unique opportunity to interact with and support families to promote social emotional development of children. Eighteen US paediatric practices joined a learning community to use improvement science to test and implement evidence-informed strategies that nurture parent–child relationships and promote the social emotional development of young children.Quality improvement methods were used to integrate 11 strategies into well-child visits between birth and age 3 years and measure the improvements with a set of outcome, process and balancing measures. Participation among the 18 paediatric practices was high with 72% of teams attending monthly webinars and 97% of teams attending the three learning sessions. Over 12 months, the percentage of children receiving age-appropriate social emotional development screens at participating practices’ well-child visits increased from a baseline median of 83% to 93%.Current paediatric practice in the USA focuses primarily on cognitive and physical development, and paediatric providers are less familiar with established practices to screen for social emotional development and promote the caregiver–child relationship. This project suggests that improvement methods show promise in increasing the number of children who receive age-appropriate social emotional development screens or assessments at well-child visits.
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Epps, Fayron. "Using Advisory Boards to Develop a Faith-Based Toolbox to Support African American Families Facing Dementia". Innovation in Aging 5, Supplement_1 (1.12.2021): 316. http://dx.doi.org/10.1093/geroni/igab046.1233.
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Abstract For this project, we are designing and testing the feasibility of employing components of a Faith-based Home Activity Toolbox (Faith-HAT). The goal of this NIH stage 1 intervention development project is to go beyond the four walls of the church to find ways to meet the spiritual needs of persons living with moderate and severe dementia “where they are” to help them remain religiously and spiritually engaged. This mixed-methods project is designed in 2 phases: (a) developing a prototype Faith-HAT and (b) testing the feasibility and exploring preliminary effectiveness. To successfully conduct this project, we have included a community advisory board of church leaders, caregivers, and persons living with dementia as members of the research design team to advise on the design and implementation of the Faith-HAT. Brainstorming workshops with the board are used to ensure the research is meeting the needs of the African American families affected by dementia.
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Ibrahimi, Sahra, Korede K. Yusuf, Deepa Dongarwar, Sitratullah Olawunmi Maiyegun, Chioma Ikedionwu i Hamisu M. Salihu. "COVID-19 Devastation of African American Families: Impact on Mental Health and the Consequence of Systemic Racism". International Journal of Maternal and Child Health and AIDS (IJMA) 9, nr 3 (16.09.2020): 390–93. http://dx.doi.org/10.21106/ijma.408.
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African Americans are bearing a disproportionate burden of morbidity and mortality due to COVID-19 pandemic. To our knowledge, no previous study has delineated inequities potentially incentivized by systemic racism, and whether synergistic effects impose an abnormally high burden of social determinants of mental health on African American families in the era of COVID-19 pandemic. We applied the social ecological model (SEM) to portray inequities induced by systemic racism that impact the mental health of African American families. In our model, we identified systemic racism to be the primary operator of mental health disparity, which disproportionately affects African American families at all levels of the SEM. Programs tailored towards reducing the disproportionate detrimental effects of COVID-19 on the mental health of African Americans need to be culturally appropriate and consider the nuances of systemic racism, discrimination, and other institutionalized biases.
Key words: • African American • COVID-19 • Mental health • Systemic racism • Social determinants of mental health
Copyright © 2020 Ibrahimi et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.
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Kifer, Abbi. "In-Home Cooking Project Increases Healthy Behaviors among Low-Income Families". Journal of Nutrition Education and Behavior 43, nr 4 (lipiec 2011): S33. http://dx.doi.org/10.1016/j.jneb.2011.03.100.
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Bennett, Kellie S., David A. Hay, Jan Piek, Jillian Pearsall-Jones, Florence Levy i Neilson Martin. "The Australian Twin ADHD Project: Current Status and Future Directions". Twin Research and Human Genetics 9, nr 6 (1.12.2006): 718–26. http://dx.doi.org/10.1375/twin.9.6.718.
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AbstractThis article describes the Australian Twin Attention-deficit/hyperactivity disorder (ADHD) Project (ATAP), the results of research conducted using this database and plans for future studies. Information has been actively collected from Australian families with twin children since 1991 for the ATAP database. The value of assessing siblings as well as twins is emphasized. Much work has gone into continuing the involvement of families in the study though this does become more difficult when twins reach maturity. The main focus of the project is ADHD in children and adolescents plus comorbid conditions including conduct disorder, oppositional defiant disorder, and generalized anxiety disorder. A major challenge has been how to retain continuity in the assessments, while at the same time covering changes in psychiatric classification, such as the move to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994). Changes in the scale can affect the reports of twin similarity. Over the years, these twins have become part of other twin studies and future plans include linking different twin databases to investigate the relationships between childhood behavior and adult conditions. Recruitment, assessment and retention of twin families require a major commitment but create a significant resource for collaboration in areas outside the original aim.
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Whipple, Ellen E., i Laura L. Nathans. "Evaluation of a Rural Healthy Families America (HFA) Program: The Importance of Context". Families in Society: The Journal of Contemporary Social Services 86, nr 1 (styczeń 2005): 71–82. http://dx.doi.org/10.1606/1044-3894.1879.
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Baker, Zachary, i Katherine Supiano. "ADDRESSING THE NEEDS OF AFRICAN AMERICAN BEREAVED DEMENTIA CAREGIVERS". Innovation in Aging 7, Supplement_1 (1.12.2023): 9. http://dx.doi.org/10.1093/geroni/igad104.0028.
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Abstract Within the next 10 years there will be at least 9 million NEWLY Bereaved Dementia Caregivers, disproportionately affecting African American families due, in part, to dementia prevalence that is twice that of White counterparts. Up to 26% of Bereaved Dementia Caregivers experience pathologically prolonged or exacerbated grief, often referred to as complicated grief or prolonged grief disorder: 2.5x the rate of other chronic disease care contexts, like cancer. The present project used an asset-based approach to assess the needs and resources of African American Bereaved Dementia Caregivers. This project was conducted with community members and university members serving as Co-Principal Investigators. Community PIs lead a grassroots organization that has served Bereaved Dementia Caregivers since 2016. The University PI leads a research team devoted to understanding and improving the experience of Bereaved Dementia Caregivers. The present symposium will discuss the challenges and opportunities offered by this unique collaboration and insights gleaned by a project designed to serve doubly underrepresented groups: African American Bereaved Dementia Caregivers (who sometimes call themselves the “ultra-invisible”). Because this was a project funded through grant dollars, we will also discuss actionable insights that we hope may help others develop fruitful academic-community partnerships. Finally, we will share recruitment strategies for speaking with minoritized populations and insights from engaging gleaned through conversations with African American Bereaved Dementia Caregivers.
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Scott, Dorothy. "New directions for trust funding: Strengthening families and communities". Children Australia 22, nr 1 (1997): 4–5. http://dx.doi.org/10.1017/s1035077200008026.
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Some leading philanthropic trusts and foundations in Australia, like those in North America, are increasingly interested in moving away from a reactive funding model in which they merely respond to requests for funding to a more proactive model in which they develop, in collaboration with those in the field, the broad parameters of innovative programs they wish to support, and then invite agencies to make expressions of interest in relation to these program dimensions.Selected programs need to be committed to evaluation and prepared to help disseminate their innovations and experiences to the field. It is this last step, from innovation to dissemination, which has often not been taken in the past, resulting in lost opportunities for valuable and cutting edge pilot projects to make an impact on practice and policy.
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Stearns, Jodie A., Paul J. Veugelers, Tara-Leigh McHugh, Chris Sprysak i John C. Spence. "The Use of a Nonrefundable Tax Credit to Increase Children’s Participation in Physical Activity in Alberta, Canada". Journal of Physical Activity and Health 18, nr 9 (1.09.2021): 1067–73. http://dx.doi.org/10.1123/jpah.2020-0217.
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Background: Potential income disparities were examined in the (1) awareness and uptake of the Children’s Fitness Tax Credit (CFTC), and (2) physical activity (PA) of children from families who did and did not claim the credit in Alberta, Canada in 2012 and 2014. Methods: Secondary analyses of 3 cross-sectional data sets of grade 5 students (10–11 y) were performed, including Alberta Project Promoting healthy Living for Everyone Schools 2012 (N = 1037), and Raising healthy Eating and Active Living Kids Alberta 2012 (N = 2676), and 2014 (N = 3125). Parents reported whether they claimed the CFTC in the previous year, their education and household income, and their child’s gender and PA. Children self-reported their PA from the previous 7 days. In Alberta Project Promoting healthy Living for Everyone Schools, children also wore pedometers. Analyses adjusted for clustering within schools and demographic factors. Results: Higher income families (≥$50,000/y) were more likely to be aware of and to have claimed the CFTC compared with low-income families (<$50,000/y). The CFTC was associated with organized PA with larger associations for higher-income families (odds ratio = 9.03–9.32, Ps < .001) compared with lower-income families (odds ratio = 3.27–4.05, Ps < .01). No associations existed for overall PA or pedometer steps with the CFTC. Conclusions: Income disparities exist in the awareness, uptake, and potential impact of the CFTC. Tax credits are not effective in promoting overall PA.
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Kaehler, Laura. "The Healthy Families America Initiative: Integrating Research, Theory, and Practice, edited by J. Galano". Journal of Trauma & Dissociation 10, nr 3 (7.07.2009): 368–70. http://dx.doi.org/10.1080/15299730902956903.
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Kang-Yi, Christina D., Roy Richard Grinker, Rinad Beidas, Aneeza Agha, Rachel Russell, Sandeep B. Shah, Kathleen Shea i David S. Mandell. "Influence of Community-Level Cultural Beliefs about Autism on Families’ and Professionals’ Care for Children". Transcultural Psychiatry 55, nr 5 (4.07.2018): 623–47. http://dx.doi.org/10.1177/1363461518779831.
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This qualitative study aimed to understand how community-level cultural beliefs affect families’ and professionals’ care for children with autism and developmental delays in immigrant communities, as a first step towards promoting early identification and access to early intervention services. The study was part of the larger New York City (NYC) Korean Community Autism Project, which was designed to identify strategies to increase awareness of autism and reduce delays in treatment seeking within the NYC Korean-American community. Our study elicited early childcare workers’ and church leaders’ beliefs about autism and developmental disorders and, in particular, early intervention. We also elicited responses to newly developed outreach materials targeting this community. An inductive approach was used to identify concepts and categories associated with autism. Our study confirmed that discomfort, stigma and discrimination are the prevailing community attitudes toward autism and developmental disorders in the Korean-American community. Families’ and professionals’ understanding of autism and their care for children are affected by these community beliefs. Approaching immigrant communities with general information about child development and education rather than directly talking about autism and developmental disorders is likely to engage more families and professionals in need for diagnostic evaluation and early intervention for autism.
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Harjusola-Webb, Sanna, Michelle Gatmaitan i Ashley Lyons. "Empowering families : the early intervention in natural environments professional development community of practice project in Ohio". Social welfare : interdisciplinary approach 3, nr 1 (28.06.2013): 42–55. http://dx.doi.org/10.15388/sw.2013.28218.
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This paper describes a model of professional development for Early Intervention based on an ongoing project taking place in a Midwestern state in the United States of America. The Project framework is presented as a model for high-quality professional development in Early Intervention by combining a) content including evidencebased practices and recommended practices from national professional organizations; b) university-community-family partnerships, an invaluable component without which the Project would not be possible; and c) tools for effective communication, collaboration, and coaching to support adult learning. As the Project is ongoing, research and program evaluation data are not reported in this paper. However, implications for young children and families, early intervention practitioners and stakeholders, and professional development in both the authors’ local context and the wider global context are discussed.
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Arantes, Ive Mariana Guissoni, Cícero José Da Silva, Natália Gislene Silva Salvador, Anselmo Afonso Golynski, Ênio Eduardo Basílio, Danilo Silva De Oliveira, Valentine Virginia Matheus i Eduardo Cardoso da Silva Assunção. "Horta comunitária – produção de hortaliças para segurança alimentar de famílias com vulnerabilidade social". Caderno Pedagógico 21, nr 1 (24.01.2024): 2218–25. http://dx.doi.org/10.54033/cadpedv21n1-114.
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The Horta Comunitária extension project aims to produce vegetables to guarantee food security to families in social vulnerability situation, improving student training and development of the Olericulture sector in Morrinhos-Goiás. The project is developed in Morrinhos, at Colégio Estadual Silvio Gomes de Melo Filho (-17º 43’ 52.76” S, 49º 7’ 54.66” W, altitude: 771 m) in partnership with local entities and regional companies. The project’s management is responsibility of the teachers, employees and scholarship students and volunteers from the Intituto Federal Goiano Campus – Morrinhos, which are responsible for all producting stages, harvesting and distribution of the vegetables produced. The project has achieved significant results in training students, rural producers and assisting families in social vulnerability, as it provides them healthy and quality food.
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Sviridoff, Mitchell, i William Ryan. "Community-Centered Family Service". Families in Society: The Journal of Contemporary Social Services 78, nr 2 (kwiecień 1997): 128–39. http://dx.doi.org/10.1606/1044-3894.753.
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The authors discuss proposals for actions that Family Service America and its member agencies can take to help create strong communities that in turn will support healthy families. The authors explore and evaluate the family service landscape and recommend various community-building strategies that family service agencies can implement and in which they can participate.
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Benke, Carrie, Sandra Bailey, Galen Eldridge, Wesley Lynch, Jill Martz i Lynn Paul. "4-Health: A Programmatic Evaluation of a Parent-Based Childhood Obesity Prevention Program". Journal of Youth Development 8, nr 3 (1.12.2013): 32–45. http://dx.doi.org/10.5195/jyd.2013.83.
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The 4-Health Project promotes healthy lifestyles for rural families with an overall goal of reducing or preventing childhood obesity. 4-Health is an integrated research and educational outreach program delivered by agents located in Montana State University Extension offices throughout the state. The collaborative project was developed to provide healthy living programs focusing on the areas of parenting and family communication, body image, food and nutrition, and physical activity to rural parents of 8-12 year old children participating in Montana’s 4-H Youth Development programs. Evaluation outcomes of the 4-Health Educational (experimental) program and the Healthy Living Information (control) program both showed increases in participants’ knowledge, attitudes, and behaviors related to healthy living, with those participating in the 4-Health Educational program making greater gains.
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Kopera-Frye, Karen, Ashley Graboski-Bauer i Ana Luisa Gonzalez-Marquez. "Intergenerational Mentoring on Health Promotion to Improve Healthy Lifestyles Among Latino Families". Innovation in Aging 4, Supplement_1 (1.12.2020): 336. http://dx.doi.org/10.1093/geroni/igaa057.1077.
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Abstract New Mexico now has the 32nd highest adult obesity rate; approximately one-third are Latinos. Obesity rates in NM for children aged 2-11 years range from 11 – 14%. Mentoring as a health promotion or intervention strategy has become widespread. However, few programs have focused on several generations reciprocally influencing each other in healthy behaviors. Project I’M HIP (Intergenerational Mentoring Health Information Pathways)’s goals included: Providing an innovative, multigenerational educational program to promote greater maternal, child, and grandparent well-being, healthier lifestyle behaviors, and support continued healthy home environments by empowering the families with knowledge. Three cohorts of 30 families (1 parent, 1 child, 1 grandparent/other relative) were recruited for Program I’M HIP. This Program utilized culturally sensitive Evidence-Based Programs (EBPs). Monthly educational sessions focused on physical activity and adapting meals to be healthy. Project outcomes included exercise frequency, Body Mass Index (BMI), and a knowledge quiz assessing healthy meal facts, exercise knowledge via a 10-item quiz; all assessments pre- and post-program. Program outcomes included: 100% of the parents shared at least 1 fact on nutrition or exercise with other relatives, thus affecting another household; paired t-test analyses revealed significant changes in knowledge quiz total scores (t 70 = 5.03, p < .0001), increased exercise frequency (t 72 = 2.106, p < .05); no significant change in BMI from pre- to post-assessments; and children corrected their parents on proper diet; all demonstrating the reciprocal mentoring effects of parent, child, and other relative on health behaviors.
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Wegner, L. M. "FC06-05 - 2005–2010 American academy of pediatrics task force on mental health". European Psychiatry 26, S2 (marzec 2011): 1844. http://dx.doi.org/10.1016/s0924-9338(11)73548-9.
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IntroductionChildren and adolescents experience significant emotional disorders and the prevalence of these conditions is notable. In 1999, the U.S. Surgeon General's report on children's mental health listed the following prevalence data: Anxiety disorders 13.0%; Mood disorders 6.2%; Disruptive disorders 10.3%; Substance use disorders 2%; Any Disorder: 20.9%* (*Children age 9–17 with mental or addictive disorders, combined MECA sample, 6-month prevalence.) However, there is an acknowledged dearth of pediatric mental health care professionals in the U.S. and among those professionals available, geographic and reimbursement limitations restrict access to the care available for many children and adolescents.ObjectivesPrimary health care providers are being encouraged to provide some of the identification and care management to offset this access problem.AimsExpand clinical skills of providers, develop tools for planning at state and local level, educate public about importance of early screening and diagnosis.MethodsIn 2005, the American Academy of Pediatrics convened a Task Force of members and consultants to develop recommendations and paradigms for melding physical health care and mental/behavioral care in the primary practice medical home for children and adolescents.ResultsThis project concluded in 2010 with six published papers and appendices detailing increased identification of pediatric mental health conditions, methods for primary care providers working collaboratively with families and mental health specialists, algorithms for decisions and actions, and payment mechanisms supporting parity between mental and physical care in the US third party payer system.ConclusionsPaper presents the major recommendations and outcomes from this 5 year project.
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Frank, Gail C., Selena T. Nguyen Rodriguez, Mara Bird, Melawhy Garcia, Natalia Gatdula, Erika Centinaje, Mayra Rascón i Britt Rios-Ellis. "Primary Outcomes of a Healthy Lifestyle Interventions for Latino Families". Californian Journal of Health Promotion 18, nr 1 (25.06.2020): 29–38. http://dx.doi.org/10.32398/cjhp.v18i1.2452.
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Latinos, especially children, are disproportionately affected by obesity. Sanos y Fuertes is a community-based, participatory research project that created a culturally resonant, bilingual, healthy lifestyle intervention for Latinos in California. Results of the program for families are presented. Methods: The sample consisted of 390 Latino families with at least one 2 to 8-year-old child. Confidential, self-report, paper-and-pencil surveys and objective anthropometrics were assessed. Paired sample t-tests evaluated changes between baseline-to-follow-up assessments. Results: A significant decrease was observed in children’s percent body fat, but not in adults. Improvements were found in adult knowledge, frequency of food label use and serving MyPlate portions. Adult frequency of breakfast, fruit, and vegetable intake increased, while frequency of sugary beverage intake decreased. Concomitant increases in parent-reported frequencies of children’s intake of breakfast, fruits, and vegetables were observed along with a less frequent intake of sugary beverage. Conclusion: Sanos y Fuertes is a promising, short-term healthy lifestyle education program which may lower obesity risk among Latino families. Replication in a randomized controlled trial is needed to establish its effectiveness among diverse Latino populations.
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McKee, Grace B., Laiene Olabarrieta-Landa, Paula K. Pérez-Delgadillo, Ricardo Valdivia-Tangarife, Teresita Villaseñor-Cabrera, Daniela Ramos-Usuga, Paul B. Perrin i Juan Carlos Arango-Lasprilla. "Longitudinal Growth Curve Trajectories of Family Dynamics after Pediatric Traumatic Brain Injury in Mexico". International Journal of Environmental Research and Public Health 17, nr 22 (17.11.2020): 8508. http://dx.doi.org/10.3390/ijerph17228508.
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Pediatric traumatic brain injury (TBI) represents a serious public health concern. Family members are often caregivers for children with TBI, which can result in a significant strain on familial relationships. Research is needed to examine aspects of family functioning in the context of recovery post-TBI, especially in Latin America, where cultural norms may reinforce caregiving by family members, but where resources for these caregivers may be scarce. This study examined caregiver-reported family satisfaction, communication, cohesion, and flexibility at three time points in the year post-injury for 46 families of a child with TBI in comparison to healthy control families. Families experiencing pediatric TBI were recruited from a large hospital in Guadalajara, Mexico, while healthy controls were recruited from a local educational center. Results from multilevel growth curve models demonstrated that caregivers of children with a TBI reported significantly worse family functioning than controls at each assessment. Families experiencing pediatric TBI were unable to attain the level of functioning of controls during the time span studied, suggesting that these families are likely to experience long-term disruptions in family functioning. The current study highlights the need for family-level intervention programs to target functioning for families affected by pediatric TBI who are at risk for difficulties within a rehabilitation context.
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Pereira, Sara, Carla Santos, Peter T. Katzmarzyk i José Maia. "Familial Resemblance in Body Shape and Composition, Metabolic Syndrome, Physical Activity and Physical Fitness: A Summary of Research in Portuguese Families and Siblings". Twin Research and Human Genetics 22, nr 6 (6.08.2019): 651–59. http://dx.doi.org/10.1017/thg.2019.46.
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AbstractWe report a summary of Portuguese families and siblings research under the umbrella of the Portuguese Healthy Family Project. Families lived in mainland Portugal, as well as in the Azores and Madeira islands. All samples comprise children and adolescents (9–20 years) and their parents (27–57 years). Recruitment procedures and phenotypes were detailed. Familial resemblance in body shape and composition, metabolic syndrome, physical fitness, physical activity and sedentary behaviors are presented, as well as future research avenues.
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Cabal-Escandón, Victoria-Eugenia. "Developments and Challenges in Advanced Practice Nursing". Revista Colombiana de Enfermería 18, nr 2 (31.08.2019): e007. http://dx.doi.org/10.18270/rce.v18i2.2663.
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Advanced Practice Nursing (APN) emerged as a response to the need for professionals capable of giving care to patients, thereby improving the quality of healthcare; the results obtained by implementing APNs in healthcare teams confirm that APNs can be implemented in the healthcare of patients of all ages and with varied health situations (1).
Levels of development in APN are very diverse in distinct countries, in the legal aspect as well as in the roles that a nurse with this level of training can fulfill. The International Council of Nurses (ICN) counts around seventy countries as being preoccupied with introducing clear function for APNs (20); nonetheless, literature describes the main progress in this sense occurring in Canada, Australia, Ireland, Finland, the United Kingdom, and the United States, although in the last ten years significant advances have been identifies in Belgium, Germany, Switzerland, Thailand, Singapore, Korea, and Africa (3, 4).
In Latin-American, progress in this initiative is embryonic: the role that a APN can fulfill has not been sufficiently disseminated and the implementation of this strategy has been limited by healthcare policies in many countries or by the opposition to APNs by professionals in other areas who are reacting to misinformation or to fear of usurpation of certain functions by APNs. However, in primary care, APNs have been incorporated into healthcare teams, and research shows positive results for the expansion of coverage and reduction of healthcare costs, in both rural areas and urban centers (1, 5).
Thanks to these advances, in 2000 the ICN supported the creation of the International Nurse Practitioner/Advanced Practice Nursing Network (INP/APNN) with the objective of favoring dialogue, advancing the installation of APNs in the countries, facilitating the interchange of knowledge, determining the limits in the expansion of the role of nurses, and defining the guidelines for the formation of human resources at this level. Likewise, the World Health Organization and the Pan-American Health Organization (PAHO) have worked with universities and nursing associations in Latin America and the Caribbean to, through context analyses, propose implementation of APNs (5).
During August 2018, the 10th Conference of the International Nursing Council convened in Rotterdam with the goal of exploring the role of APNs in the transformation of healthcare (6). With the participation of more than fifty countries, the council established a global panorama of the situation and of the challenges nursing faces as an active participant and agent for achieving universal health coverage. An important conclusion drawn from the event is the recognition given by all participating countries to APNs for allowing significant advancement of strategies for primary healthcare and the achievement of goals related with universal health coverage and sustainable development: the guarantee of a healthy life and the promotion of wellness for everyone at every age (4, 5).
These propositions imply a process and the need for countries to work towards the expansion of nursing roles, which requires the promotion of a collective project that unites different sectors involved in the formation of human talent, on one hand, that the offering of health services on the other. Likewise, administrators of education and health policy along with associations involved in the nursing discipline need to contribute to the analyses of strategies for implementing a sustainable and efficient health system that allows universal access to health (1, 4, 7).
In this context, APNs are understood to have undergone master or doctorate level training that develops scientific knowledge, clinical expertise, leadership, political formation, communicational capacity, and education for the patient, family, and community groups. Therefore, the professional is enabled to take ethical decisions, work autonomously, interact in intra- and interdisciplinary groups, and understand that ANP’s work will be determined by the unique environment, healthcare structure, and legislation of different countries.
In accord with Morán-Peña (8), the International Nursing Council states that APNs are characterized by an autonomous practice that allows the implementation of tools like: valuation, diagnostic reasoning, decision making for the handling of cases, plan development, implementation and evaluation of programs as part of consultation services, and being the first point of contact in the healthcare system. This implies that an ANP will have competencies to participate in the elaboration of public policy as well as on teams dedicated to care for individuals, families, groups, and communities in disease prevention, health promotion, treatment, recuperation, and palliative care (7, 9, 10).
Consequently, working on the implementation of the EPA can possibly lead to transformation of healthcare systems in the clinical area, improvement in the access to primary healthcare, and in the design and development of investigation projects whose results can be applied in practice; in short, it would affect the quality and effectiveness of healthcare at different levels and allow the urgent and much needed evolution of healthcare systems (11).
With this perspective, the fundamental question is whether sufficient political interest exist for the development of APN’s roles, the definition of APN’s limits, the adaption of the existing structure, the establishment of guidelines for educational programs, and the application of expert knowledge, among other aspects, in benefit of health coverage, healthcare quality, and the establishment of a sustainable healthcare system.
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Bass, Lessie, i Mary S. Jackson. "A Study of Drug Abusing African-American Pregnant Women". Journal of Drug Issues 27, nr 3 (lipiec 1997): 659–71. http://dx.doi.org/10.1177/002204269702700312.
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Many studies have focused on pregnant women who have used crack cocaine and other drugs during pregnancy, but few studies have conducted interviews with the women either during pregnancy or after delivery while undergoing residential care and the recovery process to determine what they feel their program needs are in an effort to ensure successful treatment. This exploratory study was undertaken specifically to consider not only drug-use patterns and sexual risk behaviors, but primarily to consider what characteristics the women felt would make drug treatment intervention strategies more effective for them and their families, including the significant other in their lives. Interviews were conducted at three residential treatment facilities for women as well as at home, after program discharge. Eighty-three women participated in this project, which was both quantitative and qualitative. There is discussion of the nurturing program that should be considered for use with this population.
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Morin, Nancy R., Luc Brouillet i Geoffrey A. Levin. "Flora of North America North of Mexico". Rodriguésia 66, nr 4 (2015): 973–81. http://dx.doi.org/10.1590/2175-7860201566416.
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Abstract The Flora of North America north of Mexico treats all native and naturalized vascular plants and bryophytes in Canada, Greenland, St. Pierre et Miquelon, and the continental United States including the Florida Keys and Aleutian Islands (approximately 18 million square kilometers). It provides accepted names, literature citations, basionyms, synonyms, morphological descriptions, habitat, geographical distribution, conservation or weed status, and a discussion of taxonomic issues for approximately 20,000 species. Of the total 30 volumes anticipated, 18 have been published and one is in press, treating 2021 genera and 12,393 species. For the remaining volumes, 763 genera and 5,008 species have been submitted, and 82 of the 144 families have been submitted in full. Completion is anticipated by the end of 2017. The project is managed by the Flora of North America Association. Content from published volumes is available through eFloras and JSTOR and has been provided to the World Flora informatics team.