Impact of Housing and Infrastructure on handwashing in Peru.

BACKGROUND: The metropolitan area of Lima, Peru has a third of the nation's population living in slum dwellings that are hypothesized to contribute to inefficient household hygienic practices. The purpose of this study was to quantitatively assess which living conditions have the greatest impact on handwashing practices. METHODS: A cross-sectional epidemiological design of participants ≥16 y of age from San Juan de Miraflores, a slum on the outskirts of Lima, Peru, was used. Poisson regression was applied to assess the impact of living conditions on handwashing practices. RESULTS: We could not demonstrate a relationship between living conditions (home structure, overcrowding, water, grey water disposal) and reported handwashing. The reported lack of handwashing is associated with the number of children in the home (those with children <5 y of age were more likely not to report washing their hands) and length of stay in the slum in years. CONCLUSIONS: Living conditions play an important role in one's health, therefore improved study designs are needed to determine which strategies are likely to be the most effective in improving outcomes for slum dwellers.

Herbal Use and Medical Pluralism Among Latinos in Southern California.

Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet few patients disclose CAM use to medical doctors. Our objectives were to (1) assess Latino herbal use, (2) explore the most commonly used herbs for common ailments, and (3) examine patients' disclosure of herb use to their physicians. Self-administered questionnaires were collected from 318 Latino patients seeking treatment at community health centers. Descriptive statistical analysis was conducted to determine the frequency of stated objectives among the participants. Fisher's exact test was used to compare differences among CAM users and non-users. Most respondents (90%) reported using herbs. Less than a third (31%) of those herb users felt comfortable speaking English to their physician. A majority (74.8%) of the respondents utilizing herbs reported never disclosing their herbal use to their healthcare providers, and of those that did, majority (63%) were under the age of 36 years. Of those that disclosed their herbal use, only 31% perceived receiving a positive reaction about herbal use from their providers. Chamomile, cinnamon, Aloe vera, spearmint, and key lime were the top used herbs in this population. Herbal use disclosure reflects a greater sense of trust and communication between patient and provider. Therefore, a need exists to increase provider competency for patients using herbs in order to improve consistency of care and facilitate healthy patients and communities, especially among Spanish-speaking Latinos in Southern California.

Low-income women's conceptualizations of food craving and food addiction.

Food craving and food addiction have been proposed as targets for obesity focused interventions. However, individuals' conceptualizations of these constructs are not well understood and no studies have employed a qualitative approach. Therefore, we sought to understand how women conceptualize food craving and food addiction. Low-income women with preschool-aged children (2-5years old) participated in either a semi-structured individual interview or focus group in which they were asked about their conceptualization of eating behaviors among adults and children. All responses were audio-recorded and transcribed. Themes were identified using the constant comparative method of qualitative analysis. Identified themes revealed that the women perceived food craving to be common, less severe and to a degree more humorous than food addiction. It was not felt that food cravings were something to be guarded against or resisted. Food addiction was described in a very "matter of fact" manner and was believed to be identifiable through its behavioral features including a compulsive need to have certain foods all the time. A more detailed understanding of how the general population perceives food craving and food addiction may enable more refined measurement of these constructs with questionnaire measures in the future. In addition, interventions may be designed to use the language most consistent with participants' conceptualizations of these constructs.