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1.
J Nutr Educ Behav ; 54(8): 794-803, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35610157

RESUMO

OBJECTIVE: To describe the intervention and research methods of Project Dads in Nutrition Education, an intervention that adds nutrition and breastfeeding education to the existing Healthy Start program in Georgia for Black expecting mothers and fathers to improve nutrition literacy, health outcomes, and breastfeeding rates. DESIGN: This 2-year community-based participatory research study employs a cluster randomization factorial design. SETTING: Six Healthy Start program sites (3 intervention and 3 control sites) in Georgia counties with high infant and maternal mortality rates. PARTICIPANTS: Approximately 480 Black, expecting, Healthy Start program participants (20 couples [mother and father] and 40 single mothers from each site) will be enrolled over the study period. INTERVENTION(S): Project Dads in Nutrition Education will strengthen the capacity of the Georgia Healthy Start program to integrate an evidence-based nutrition education program, breastfeeding education, and father engagement into its routine services. MAIN OUTCOME MEASURE(S): Changes in prepost survey assessment of participants' nutrition literacy and eating behaviors; changes in prepost survey assessment of participants' breastfeeding knowledge, attitudes, intent, initiation, and duration; and health and food diary collected 3 times (ie, at baseline, 3 months, and 6 months after enrollment). ANALYSIS: Process evaluation throughout the study to document implementation. Generalized linear mixed modeling will be used to determine the impact of the intervention.


Assuntos
Aleitamento Materno , Mães , Pai , Feminino , Educação em Saúde , Promoção da Saúde/métodos , Humanos , Lactente , Masculino , Mães/educação
2.
J Community Health ; 46(1): 41-50, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32424500

RESUMO

African Americans in Atlanta, Georgia disproportionately reside in communities with limited access to healthy foods. Collaborations with local corner stores to provide healthy food options have been identified as an evidence-based intervention that could be used to increase food access. This paper describes the community-based participatory approach used to culturally-tailor a Healthy Corner Store Initiative (HCSI) in five Atlanta communities. A mixed method approach (qualitative/quantitative) was utilized. Spatial analysis and an environmental assessment were conducted to locate all corner stores in the partner communities that were listed in a business database. An environmental assessment was conducted at 34 corner stores using a structured log and checklist. Among them, 11 were selected and signed memorandums of understanding to implement the HCSI. A customer intercept survey was administered to 100 African American corner store customers at five of the healthy corner store sites. Descriptive statistics were used to analyze log/checklist and survey data. Corner store customers indicated that they typically purchase snacks, tobacco, and breads, but would purchase certain healthy foods, if offered. They also indicated that freshness of fruits and vegetables and positive relationships with corner store owners would influence healthy food purchases. Findings demonstrate that working collaboratively with community members, researchers and business owners is a critical step in nurturing trust, strengthening credibility, and building partnerships towards increased healthy food access and improved community health.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Participação da Comunidade/estatística & dados numéricos , Relações Comunidade-Instituição , Abastecimento de Alimentos/estatística & dados numéricos , Comércio/estatística & dados numéricos , Pesquisa Participativa Baseada na Comunidade , Comportamento do Consumidor/estatística & dados numéricos , Frutas , Georgia , Promoção da Saúde/métodos , Humanos , Áreas de Pobreza , Verduras
3.
Artigo em Inglês | MEDLINE | ID: mdl-33198272

RESUMO

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators' Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs' impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation Conceptual Framework and common metrics to allow for valid inter-institutional comparisons and consortium-wide evaluations. Stakeholders could ensure evaluation metrics are used to facilitate community impacts.


Assuntos
Academias e Institutos , Estudos de Avaliação como Assunto , Grupos Minoritários , Universidades , Academias e Institutos/organização & administração , Academias e Institutos/normas , Benchmarking , Humanos , Liderança , Universidades/organização & administração , Universidades/normas , Universidades/estatística & dados numéricos
4.
J Clin Transl Sci ; 5(1): e48, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-33948270

RESUMO

INTRODUCTION: The Clinical and Translational Science Awards (CTSA) program of the National Center for Advancing Translational Sciences (NCATS) seeks to improve population health by accelerating the translation of scientific discoveries in the laboratory and clinic into practices for the community. CTSAs achieve this goal, in part, through their pilot project programs that fund promising early career investigators and innovative early-stage research projects across the translational research spectrum. However, there have been few reports on individual pilot projects and their impacts on the investigators who receive them and no studies on the long-term impact and outcomes of pilot projects. METHODS: The Georgia CTSA funded 183 pilot projects from 2007 to 2015. We used a structured evaluation framework, the payback framework, to document the outcomes of 16 purposefully-selected pilot projects supported by the Georgia CTSA. We used a case study approach including bibliometric analyses of publications associated with the selected projects, document review, and investigator interviews. RESULTS: These pilot projects had positive impact based on outcomes in five "payback categories": (1) knowledge; (2) research targeting, capacity building, and absorption; (3) policy and product development; (4) health benefits; and (5) broader economic benefits. CONCLUSIONS: Results could inform our understanding of the diversity and breadth of outcomes resulting from Georgia CTSA-supported research and provide a framework for evaluating long-term pilot project outcomes across CTSAs.

5.
Eval Health Prof ; 43(3): 169-179, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-30917690

RESUMO

The Clinical and Translational Science Awards (CTSA) program sponsors an array of innovative, collaborative research. This study uses complementary bibliometric approaches to assess the scope, influence, and interdisciplinary collaboration of publications supported by single CTSA hubs and those supported by multiple hubs. Authors identified articles acknowledging CTSA support and assessed the disciplinary scope of research areas represented in that publication portfolio, their citation influence, interdisciplinary overlap among research categories, and characteristics of publications supported by multihub collaborations. Since 2006, CTSA hubs supported 69,436 articles published in 4,927 journals and 189 research areas. The portfolio is well distributed across diverse research areas with above-average citation influence. Most supported publications involved clinical/health sciences, for example, neurology and pediatrics; life sciences, for example, neuroscience and immunology; or a combination of the two. Publications supported by multihub collaborations had distinct content emphasis, stronger citation influence, and greater interdisciplinary overlap. This study characterizes the CTSA consortium's contributions to clinical and translational science, identifies content areas of strength, and provides evidence for the success of multihub collaborations. These methods lay the foundation for future investigation of the best policies and priorities for fostering translational science and allow hubs to understand their progress benchmarked against the larger consortium.


Assuntos
Comunicação Interdisciplinar , National Institutes of Health (U.S.)/estatística & dados numéricos , Apoio à Pesquisa como Assunto/estatística & dados numéricos , Pesquisa Translacional Biomédica/estatística & dados numéricos , Bibliometria , Comportamento Cooperativo , Humanos , Fator de Impacto de Revistas , Publicações Periódicas como Assunto/normas , Publicações Periódicas como Assunto/estatística & dados numéricos , Estados Unidos
6.
Ethn Dis ; 29(Suppl 2): 329-342, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308601

RESUMO

Health disparities have persisted despite decades of efforts to eliminate them at the national, regional, state and local levels. Policies have been a driving force in creating and exacerbating health disparities, but they can also play a major role in eliminating disparities. Research evidence and input from affected community-level stakeholders are critical components of evidence-based health policy that will advance health equity. The Transdisciplinary Collaborative Center (TCC) for Health Disparities Research at Morehouse School of Medicine consists of five subprojects focused on studying and informing health equity policy related to maternal-child health, mental health, health information technology, diabetes, and leadership/workforce development. This article describes a "health equity lens" as defined, operationalized and applied by the TCC to inform health policy development, implementation, and analysis. Prioritizing health equity in laws and organizational policies provides an upstream foundation for ensuring that the laws are implemented at the midstream and downstream levels to advance health equity.


Assuntos
Equidade em Saúde/organização & administração , Política de Saúde/legislação & jurisprudência , Liderança , Formulação de Políticas , Humanos , Estados Unidos
7.
Ethn Dis ; 29(Suppl 2): 377-384, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308609

RESUMO

Rulemaking is one of the most important ways the federal government makes public policy. It frequently has significant impact on individuals, communities, and organizations. Yet, few of those directly affected are familiar with the rulemaking process, and even fewer understand how it works. This article describes a case study of the Transdisciplinary Collaborative Center for Health Disparities Research Health Information Technology (TCC HIT) Policy Project's approach to health-policy engagement using: 1) social media; and 2) a webinar to educate stakeholders on the rulemaking process and increase their level of meaningful engagement with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) proposed rule public comment submission. The webinar "Paying for Quality: What Is the Impact on Health Equity" was promoted through Twitter and held in June 2016. In total, we posted 19 tweets using two distinct hashtags (#MACRA4Equity, #MACRA2Equity) to raise awareness of the upcoming MACRA proposed rule and its possible effects on health equity. Overall, 252 individuals registered for the webinar, and more than half participated (n=133). Most (67%) registrants reported that health policy was not the primary focus of their current position. Based on information provided in the webinar, 95% agreed that their understanding of the topic improved. By the end of the webinar, 44% of participants indicated that they planned to submit public comments for MACRA, a 12% increase compared with those who planned to submit at the time of registration. The TCC health-policy engagement strategy demonstrates the feasibility of engaging a diverse audience around health policy issues, particularly those who are not typically engaged in policy work.


Assuntos
Guias como Assunto , Política de Saúde/tendências , Pesquisa sobre Serviços de Saúde/métodos , Disparidades em Assistência à Saúde/organização & administração , Informática Médica/tendências , Mídias Sociais , Humanos , Medicare , Estados Unidos
8.
Ethn Dis ; 29(Suppl 2): 385-392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308610

RESUMO

This article describes the participatory evaluation framework for the Transdisciplinary Collaborative Center for Health Disparities Research (TCC) funded by the National Institute of Minority Health and Health Disparities. In collaboration with TCC stakeholders, logic models, the McKinlay model, and process and outcome evaluation plans, including quantitative and qualitative methods, have been developed and used to document the impact of the TCC. The McKinlay model, a widely used comprehensive health model for eliminating health disparities, was also tailored to document the outcomes of the TCC. The process and outcome evaluation plans for the TCC guide continuous improvement and the achievement of its specific aims. The evaluation of the TCC occurred between 2012 and 2019 and involved key stakeholders in TCC research and programming. Several challenges exist for implementing an evaluation plan of a health equity-focused policy research center. However, we learned several lessons that will ensure progress toward specific aims and will help the TCC serve as a model for similar programs and centers.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Equidade em Saúde/organização & administração , Disparidades nos Níveis de Saúde , Comunicação Interdisciplinar , Saúde das Minorias , Comportamento Cooperativo , Humanos
9.
Ethn Dis ; 29(Suppl 2): 393-404, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308611

RESUMO

Objective: We describe the implementation, clinical outcomes and participant perspectives for e-Healthystrides©. Setting: Three independent ambulatory clinics and an historic African American (AA) church. Participants: Adults with diagnosed diabetes mellitus type 2. Intervention: e-Healthystrides© health coach facilitated intervention. Primary outcome: Acquisition of three new self-management behaviors. Secondary outcomes: Blood pressure, blood glucose, A1c, attrition rate and participant perspectives of e-Healthystrides©. Methods: A convergent parallel mixed method design was used in both pilot studies. Results: Two hundred and sixty-four participants, aged ~62±16 years, enrolled. Attrition at 52 weeks varied 50%-90% by site. Low engagement users were defined mainly by anxiety with putting health information online. The primary outcome was achieved in 36% of our participants, with the top 3 self-management behaviors acquired being: reducing risk (24.5%); healthy eating (23.7%); and monitoring (16.4%). Problem solving had the lowest rate of achievement (.91%). Blood pressure improved significantly at all sites at 12 weeks and at clinics A,B,C at 52 weeks. Blood glucose improved at 12 weeks: clinic A (P=.0001), B (P=.003), C (P=.001) and D (P=.03); but, at 52 weeks, only clinics A (P=<.0001) and B (P=.0001). Participants felt empowered by features of e-Healthystrides©. Engagement with health coaches and peers was highly valued. Conclusions: e-Healthystrides© is effective for self-management behavior change. Participants showed the best success with healthy coping, healthy eating, and monitoring behaviors. They felt empowered by access to health information and valued interaction with coaches and peers. Our findings support strong relational/social network strategy with a role for coaches as guides (apomediaries) who facilitate skill acquisition using technology.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/reabilitação , Equidade em Saúde/organização & administração , Informática Médica/métodos , Autocuidado/métodos , Idoso , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo Associado , Projetos Piloto
10.
Am J Mens Health ; 13(2): 1557988319834843, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30836815

RESUMO

The prostate-specific antigen (PSA) screening recommendation endorses the opportunity for men to make an informed decision about whether or not to screen. This entails speaking with a provider to discuss the potential advantages, disadvantages, and uncertainties about the PSA screening test. The purpose of this study was to examine (a) the reported level of being informed about the PSA test by race and (b) the association between the receipt of the PSA test and participants reporting that they were informed about the test. U.S. adult males (ages 40-74 years) were identified from the 2015 Behavioral Risk Factors Surveillance System (BRFSS; n = 3,877). Chi-square analysis assessed bivariate differences among men who received different levels of PSA screening information. Binomial logistic regression models assessed the relationship of race/ethnicity and the receipt of the PSA test on being informed about the PSA test. Over half (54.3%) of the sample had a PSA test and most (72.0%) reported that they did not receive information about both the advantages and disadvantages (being informed) of the PSA test. Black men (40.3%) were significantly most likely to report being informed ( p < .001), and 61.3% reported receipt of a recommendation from their provider ( p < .001). White men (63.1%) were significantly more likely to report receiving the PSA test. Findings indicate that more men reported receiving the PSA test than men who reported being informed about it. Future research and interventions should strive for men of all racial and ethnic backgrounds to be informed about the PSA test before making a decision.


Assuntos
Sistema de Vigilância de Fator de Risco Comportamental , Tomada de Decisões , Etnicidade/estatística & dados numéricos , Fidelidade a Diretrizes/estatística & dados numéricos , Antígeno Prostático Específico/análise , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
11.
Ethn Dis ; 29(Suppl 1): 135-144, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30906162

RESUMO

The Research Centers in Minority Institutions (RCMI) program was established by the US Congress to support the development of biomedical research infrastructure at minority-serving institutions granting doctoral degrees in the health professions or in a health-related science. RCMI institutions also conduct research on diseases that disproportionately affect racial and ethnic minorities (ie, African Americans/Blacks, American Indians and Alaska Natives, Hispanics, Native Hawaiians and Other Pacific Islanders), those of low socioeconomic status, and rural persons. Quantitative metrics, including the numbers of doctoral science degrees granted to underrepresented students, NIH peer-reviewed research funding, peer-reviewed publications, and numbers of racial and ethnic minorities participating in sponsored research, demonstrate that RCMI grantee institutions have made substantial progress toward the intent of the Congressional legislation, as well as the NIH/NIMHD-linked goals of addressing workforce diversity and health disparities. Despite this progress, nationally, many challenges remain, including persistent disparities in research and career development awards to minority investigators. The continuing underrepresentation of minority investigators in NIH-sponsored research across multiple disease areas is of concern, in the face of unrelenting national health inequities. With the collaborative network support by the RCMI Translational Research Network (RTRN), the RCMI community is uniquely positioned to address these challenges through its community engagement and strategic partnerships with non-RCMI institutions. Funding agencies can play an important role by incentivizing such collaborations, and incorporating metrics for research funding that address underrepresented populations, workforce diversity and health equity.


Assuntos
Pesquisa Comportamental , Pesquisa Biomédica , Grupos Minoritários , Saúde das Minorias , Pesquisa Translacional Biomédica , Pesquisa Comportamental/métodos , Pesquisa Comportamental/organização & administração , Pesquisa Biomédica/métodos , Pesquisa Biomédica/organização & administração , Diversidade Cultural , Etnicidade/educação , Etnicidade/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Grupos Minoritários/educação , Grupos Minoritários/estatística & dados numéricos , Saúde das Minorias/educação , Saúde das Minorias/etnologia , Pesquisadores , Apoio à Pesquisa como Assunto , Pesquisa Translacional Biomédica/métodos , Pesquisa Translacional Biomédica/organização & administração , Estados Unidos , Recursos Humanos
12.
Trans Am Clin Climatol Assoc ; 129: 215-234, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30166716

RESUMO

Health 360x is a mobile health application and social platform that integrates self-monitoring and decision support for preventive health. We studied 240 diabetic patients in primary care practices and a church community in metropolitan Atlanta. Health coaches were trained on the Health 360x curriculum, which was adapted from the American Association of Diabetes Educators. Participants worked with the health coaches to set goals for diabetes self-management. The intervention included weekly coaching for 12 weeks and online peer networking. Outcome variables included blood pressure, physical activity, and blood glucose that showed significant improvement at 12 weeks and 12 months compared to baseline. Focus group testing revealed that references for empowerment and engagement were associated with positive clinical outcomes. Barriers to adoption and use of the technology were inability to use the internet and concern about privacy and security of health data. Future efforts will integrate a multidisciplinary training dashboard with considerable attention to education on security features including data encryption and sign-on verification.


Assuntos
Diabetes Mellitus/terapia , Aplicativos Móveis , Assistência Centrada no Paciente/métodos , Autocuidado/métodos , Telemedicina/métodos , Idoso , Biomarcadores/sangue , Glicemia/metabolismo , Pressão Sanguínea , Serviços de Saúde Comunitária , Aconselhamento , Técnicas de Apoio para a Decisão , Diabetes Mellitus/sangue , Diabetes Mellitus/fisiopatologia , Diabetes Mellitus/psicologia , Exercício Físico , Feminino , Georgia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Participação do Paciente , Atenção Primária à Saúde , Resultado do Tratamento
13.
Artigo em Inglês | MEDLINE | ID: mdl-30154351

RESUMO

The Learning and Action in Community Health project was implemented to gather preliminary data needed to inform community-engaged educational approaches to increase clinical research participation among racial minorities. The Health Belief Model was the theoretical framework utilized to develop the intervention and assessment tools. An educational session about clinical research and biorepository participation was designed using clinicaltrials.gov information and administered to adult, African American community residents (n = 60) in Atlanta, Georgia. Pre- and post-tests were collected and analyzed to assess changes in participants' knowledge, perceptions, and willingness to participate in clinical studies and biorepositories. There were statistically significant changes in knowledge about joining a clinical study (p < 0.001) and registry or biorepository (p < 0.001). There was no statistically significant change in willingness to participate in clinical research or biorepositories after the educational session. Focus groups were conducted to gather feedback on the educational session and perceived barriers and benefits to participating in clinical research. Perceived benefits were improving health, receiving incentives, early detection of health issues, and access to care. Perceived barriers included fear, lack of knowledge, historical mistrust of research, and time constraints. Results have implications for subsequent community-engaged approaches to increasing minority participation in clinical research.


Assuntos
Negro ou Afro-Americano , Conhecimentos, Atitudes e Prática em Saúde , Sujeitos da Pesquisa , Voluntários , Adulto , Medo , Feminino , Grupos Focais , Georgia , Humanos , Aprendizagem , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Motivação , Percepção , Médicos , Saúde Pública
14.
Prev Chronic Dis ; 15: E17, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29389312

RESUMO

INTRODUCTION: Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. METHODS: We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. RESULTS: We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. CONCLUSION: This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes.


Assuntos
Ambiente Construído/estatística & dados numéricos , Doenças Cardiovasculares/mortalidade , Disparidades nos Níveis de Saúde , Características de Residência/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Doenças Cardiovasculares/etnologia , Estudos Transversais , Abastecimento de Alimentos , Georgia/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Modelos Logísticos , Mortalidade Prematura , Avaliação de Resultados em Cuidados de Saúde , Fatores Socioeconômicos
15.
Acad Med ; 93(8): 1162-1170, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29298181

RESUMO

PURPOSE: The authors evaluated publication and citation patterns for articles supported by Clinical and Translational Science Awards (CTSA) hub investment over the first decade of the CTSA program. The aim was to elucidate a pivotal step in the translational process by providing an account of how time, hub maturity, and hub attributes were related to productivity and influence in the academic literature. METHOD: In 2017, the authors collected bibliometric data from PubMed, Web of Science InCites, and National Institutes of Health (NIH) iCite for articles citing any CTSA hub grants published from hub inception through 2016. They compiled data on publication and citation rates and indices of relative citation impact aggregated by hub funding year cohort. They compared hub-level bibliometric activity by multi- versus single-institution structure and total monetary award sums, compiled from NIH RePORTER. RESULTS: From 2006-2016, CTSA hubs supported over 66,000 publications, with publication rates accelerating as hubs matured. These publications accumulated over 1.2 million citations, with some articles cited over 1,000 times. Indices of relative citation impact indicated CTSA-supported publications were cited more than twice as often as expected for articles of their publication years and disciplines. Multi-institutional hubs and those awarded higher grant sums exhibited significantly higher publication and citation activity. CONCLUSIONS: The CTSA program is yielding a robust and growing body of influential research findings with consistently high indices of relative citation impact. Preliminary evidence suggests multi-institutional collaborations and more monetary resources are associated with elevated bibliometric activity and, therefore, may be worth their investment.


Assuntos
Bibliometria , National Institutes of Health (U.S.)/tendências , Publicações/normas , Pesquisa Translacional Biomédica/normas , Distinções e Prêmios , Comportamento Cooperativo , Humanos , National Institutes of Health (U.S.)/organização & administração , Publicações/tendências , Projetos de Pesquisa/tendências , Pesquisa Translacional Biomédica/tendências , Estados Unidos
16.
Am J Mens Health ; 12(2): 326-337, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-27008993

RESUMO

Despite improvements in oral health status in the United States, pronounced racial/ethnic disparities exist. Black men are less likely to visit the dentist, are twice as likely to experience tooth decay, and have a significantly lower 5-year oral cancer survival rate when compared to White men. The Minority Men's Oral Health Dental Access Program employed a community-based participatory research approach to examine the oral health barriers and opportunities for intervention among Black men in a low-income, urban neighborhood. A cross-sectional study design was implemented through a self-administered survey completed among 154 Black males. The majority reported not having dental insurance (68.8%). Most frequently cited oral health care barriers were lack of dental insurance and not being able to afford dental care. Attitudes related to the significance of dental care centered on cancer prevention and feeling comfortable with one's smile. The impact of oral health on daily life centered on social interaction, with men citing insecurities associated with eating, talking, and smiling due to embarrassment with how their teeth/mouth looked to others. Multivariate logistic regression revealed that those who had difficulty finding dental care were 4.81 times (odds ratio = 4.65, 95% confidence interval [1.80, 12.85]) more likely to report no dental insurance, and 2.73 times (odds ratio = 3.72; 95% confidence interval [1.12, 6.70]) more likely to report poor oral health. Community-based participatory approaches include assessment of neighborhood residents affected by the health issue to frame interventions that resonate and are more effective. Social, physical, and infrastructural factors may emerge, requiring a multilevel approach.


Assuntos
Negro ou Afro-Americano , Assistência Odontológica/estatística & dados numéricos , Saúde Bucal , Pobreza , População Urbana , Adulto , Pesquisa Participativa Baseada na Comunidade , Estudos Transversais , Pesquisas sobre Atenção à Saúde , Humanos , Modelos Logísticos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde
17.
Am J Public Health ; 107(S1): S104-S110, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28661811

RESUMO

OBJECTIVES: To describe the Minority Men's Oral Health Dental Access Program (MOHDAP) intervention and report participants' outcomes and satisfaction. METHODS: MOHDAP was designed to increase the oral health knowledge of low-income, African American men in Atlanta, GA, in 2013. A community-based participatory approach and needs assessment guided the intervention development, which consisted of 3 educational modules delivered over a 2-day period. All participants (n = 45; mean age = 50 years) were African American men. We assessed changes in oral health knowledge and attitudes at baseline and postintervention via survey. RESULTS: After the intervention, the percentage of correct responses to questions about gingivitis increased by 24.2% (P = .01), about use of a hard (instead of a soft) toothbrush increased by 42.2% (P < .01), and knowledge of ways to prevent gum diseases increased by 16.0% (P = .03). The percentage agreeing with erroneous statements decreased 11.3% (P = .02) regarding oral health-related fatalism and oral health self-care and 17.4% (P = .05) regarding saving front versus back teeth. CONCLUSIONS: Community-based oral health educational interventions designed for African American men may reduce oral health disparities among this population.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Saúde Bucal/educação , Pobreza , Pesquisa Participativa Baseada na Comunidade/métodos , Georgia , Promoção da Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Saúde das Minorias , Autocuidado , Inquéritos e Questionários
18.
Vaccine ; 35(20): 2661-2667, 2017 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-28396210

RESUMO

INTRODUCTION: Black and Hispanic men are diagnosed with more HPV-related cancers and at later stages compared to other racial/ethnic groups. Physician communication with men about HPV vaccination may be beneficial to increasing HPV vaccinations and decreasing HPV transmission. The purpose of this study was to examine HPV and HPV vaccine awareness among men by race, and the association between trust in cancer information from physicians and ever hearing about HPV and the HPV vaccine. METHODS: U.S. adult males (age 18+) were identified from the 2014 Health Information National Trends Survey (HINTS) (n=1203). Binomial logistic regression models assessed the influences of race/ethnicity and trust of cancer information from physicians on men having heard of HPV and the HPV vaccination. RESULTS: Approximately 50% of the sample had never heard of HPV and 53% had never heard of the vaccine. Black men were less likely to know that HPV is sexually transmitted compared to White and Hispanic men (p<0.001). Hispanic and Black men were less likely to have heard about the HPV vaccine when compared to White men (p<0.001). Additionally, Hispanic men were less likely to trust a doctor about cancer information compared to White and Black men (p<0.001). CONCLUSION: Findings highlight the lack of awareness about HPV among men. Furthermore, statistically significant racial/ethnic differences were found in HPV vaccine knowledge and trust in receiving cancer information from physicians. Future interventions should include community-based approaches and improved physicians' HPV-related communication to increase knowledge and uptake of the HPV vaccine.


Assuntos
Conscientização , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias/prevenção & controle , Infecções por Papillomavirus/complicações , Vacinas contra Papillomavirus/imunologia , Relações Médico-Paciente , Confiança , Adulto , Idoso , Estudos Transversais , Etnicidade , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Infecções por Papillomavirus/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Médicos , Estados Unidos
19.
J Ga Public Health Assoc ; 5(3): 212-219, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27275021

RESUMO

BACKGROUND: Among children, there are substantial ethno-racial minority disparities across a broad range of health-related behaviors, experiences, and outcomes. Addressing these disparities is important, as childhood and adolescence establish health trajectories that extend throughout life. METHODS: The current study employed a community-based participatory research approach to gain community insight on child health priorities and to frame an intervention aimed at improving the health of minority children. Eight focus groups were conducted among seventy-five African American parents in a Southeastern city. The current study was guided by an ecological theoretical framework. RESULTS: Although the focus of this investigation was on community identification of child health priorities, participants cited, as root determinants, contextual factors, which included lack of healthy food options, lack of spaces for physical activity, and community violence. These co-occurring factors were related to limited engagement in outdoor activities and physical activity, increased obesity, and poor mental health and coping. Poor parenting was cited as the most substantial barrier to improving child health outcomes, and quality parenting was identified as the most important issue to address for community programs focused on promoting the health and success of children. For improving health outcomes for children in their neighborhoods, establishment of positive social capital and constructive activities were also cited. CONCLUSIONS: These results reinforce social determinants of health as influences on child health outcomes and describe how community engagement can address potential solutions through interventions that resonate with program participants.

20.
Health Promot Pract ; 17(5): 751-9, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27216874

RESUMO

African Americans comprise nearly half of people in the United States living with the human immunodeficiency virus (HIV) but compose one tenth of the population. Infection rate among young African American adults is 11 times that of Whites. The Color It Real Program was a seven-session, weekly administered, age-specific, and culturally tailored intervention designed to provide HIV education and address behavioral motivations (risk awareness, decisional balance exercises, partner negotiation, and attitudes) associated with HIV risk among African Americans ages 18 to 24 years in Atlanta, Georgia. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 88) and control (n = 52) groups completing a 45-item survey. When controlling for gender and education, repeated measures analysis of variance revealed that the intervention group had significant increases in HIV transmission knowledge (F = 4.84, p = .0305), condom use, and intentions to use condoms (F = 4.38, p = .0385). Risky sexual behavior means did not significantly differ between groups (F = 1.44, p = .2331). Results indicate the value of culturally tailored educational strategies toward improved HIV knowledge and adoption of risk reduction strategies. Future studies investigating the differential impact of programs by gender and sexual orientation are also critical. Continued innovation and tailoring of risk reduction strategies for minority young adults will contribute to reducing HIV incidence and prevalence over the life course.


Assuntos
Negro ou Afro-Americano , Preservativos/estatística & dados numéricos , Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Educação em Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Síndrome da Imunodeficiência Adquirida/etnologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Adolescente , Competência Cultural , Feminino , Georgia , Humanos , Masculino , Fatores de Risco , Sexo Seguro , Estados Unidos , Adulto Jovem
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