Obstacles to food security, food pantry use, and educational success among university students: a mixed methods approach.

Purpose. This study contrasts views of university students with very low or high food security scores with respect to: obstacles to healthy eating, food pantry use, and managing dietary and educational needs. Method. Comments on open-ended survey questions (n = 1374) were counted, compared, and thematically analyzed to discern differences between the two student groups. Results. Cost concerns were paramount among students with very low food security scores. Students with very low food security experienced significant challenges in reconciling dietary needs and long-term educational goals; this was not problematic among students with high food security. Students from both very low and high food security groups mostly expressed an openness to the campus food pantry, though stigma associated with its use remained a deterrent. Conclusion. While all students face similar challenges to healthy eating, food security status substantially shapes dietary health and the management of dietary and educational needs.

University student food insecurity and academic performance.

Objective: Characterize the prevalence and dimensions of student food insecurity and the associations with academic performance. Participants: An online survey was distributed (November 2017) to 13,897 undergraduates at a midsized, New Jersey Public University; 2,055 (15%) responded. Methods: Demographic, behavioral, and food security data from University IT services, and the survey were combined in a single dataset. The USDA food security index was adapted to assess food insecurity. Results: Forty-eight percent of students were food insecure. Odds were higher for: women, African Americans, Hispanics, students with partial or no meal plan, commuters, and students receiving financial assistance. Food insecurity increased the odds of being among the lower 10% GPA and reduced the odds of being among the upper 10% GPA. Conclusions: Food insecurity among university students is high and is associated with academic performance. Understanding the mechanisms underlying this relationship is essential to design programs to address this problem.

A 40-Day Journey to Better Health: Utilizing the DanielFast to Improve Health Outcomes in Urban Church-Based Settings.

Background: As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chronic disease prevention among underserved groups, particularly in urban settings. This research study evaluated Philadelphia area Keystone First members and church participants enrolled in a group health education program to determine the impact of the Daniel Fast on physical health and the adoption of healthy behaviors. Methods: Participants attended six-weekly health education sessions in two participating churches, and were provided with a digital healthy eating platform. Results: There was a statistically significant decrease from baseline to post assessment for weight, waist circumference and cholesterol. Participants reported a significant improvement in their overall well-being, social and physical functioning, vitality and mental health. Conclusion: Results of this study demonstrate that dietary recommendations and comprehensive group health education delivered in churches and reinforced on a digital platform can improve physical health, knowledge and psychosocial outcomes.

Participatory implementation science to increase the impact of evidence-based cancer prevention and control.

It is critical to accelerate the integration of evidence-based programs, practices, and strategies for cancer prevention and control into clinical, community, and public health settings. While it is clear that effective translation of existing knowledge into practice can reduce cancer burden, it is less clear how best to achieve this. This gap is addressed by the rapidly growing field of implementation science. Given that context influences and is influenced by implementation efforts, engaging stakeholders in the co-production of knowledge and solutions offers an opportunity to increase the likelihood that implementation efforts are useful, scalable, and sustainable in real-world settings. We argue that a participatory implementation science approach is critical, as it supports iterative, ongoing engagement between stakeholders and researchers to improve the pathway between research and practice, create system change, and address health disparities and health equity. This article highlights the utility of participatory implementation science for cancer prevention and control research and addresses (a) the spectrum of participatory research approaches that may be of use, (b) benefits of participatory implementation science, and

Understanding Patients' Perspectives on Opt-Out, Incentivized, and Mandatory HIV Testing.

BACKGROUND: Currently, widespread HIV testing is the best preventive action against further spread of the HIV epidemic. However, over 40% of the U.S. population has never been tested for HIV and 25% of those with HIV have never been tested. To increase testing rates, in 2006 the CDC advised healthcare settings to conduct testing on an opt-out basis. METHODS: Qualitative, semi-structured interviews with ten seropositive patients and ten seronegative were conducted to address the lack of studies investigating patients' acceptance of and attitude towards this and more novel testing models, e.g. incentivized or anonymous mandatory testing. Participants were asked about their HIV testing history and attitudes towards opt-out, incentivized, and mandatory anonymous HIV testing. RESULTS: Major themes were identified using grounded theory data analysis. All participants were receptive to opt-out testing, and saw the removal of separate written consent as beneficial as long as patients were given the opportunity to consent in some form. CONCLUSION: Ultimately, both mandatory and opt-out testing were equally indicated by participants as being the most effective testing model at increasing testing rates. A firm understanding of patients' perspectives allows for development of effective HIV testing initiatives that are patient-sensitive and can substantially reduce HIV infection rates.

Social cognitions, distress, and leadership self-efficacy: associations with aggression for high-risk minority youth.

Urban ethnic minority youth are often exposed to high levels of aggression and violence. As such, many aggression intervention programs that have been designed with suburban nonethnic minority youth have been used or slightly adapted in order to try and meet the needs of high-risk urban youth. The current study contributes to the literature base by examining how well a range of social-cognitive, emotional distress and victimization, and prosocial factors are related to youth aggression in a sample of urban youth. This study utilized data gathered from 109 9- to 15-year-old youth (36.7% male; 84.4% African American) and their parents or caregivers. A series of hierarchical multiple regressions were fit predicting youth aggression from social-cognitive variables, victimization and distress, and prosocial variables, controlling for youth gender and age. Each set of variables explained a significant and unique amount of the variance in youth aggressive behavior. The full model including all predictors accounted for 41% of the variance in aggression. Models suggest that youth with stronger beliefs supportive of violence, youth who experience more overt victimization, and youth who experience greater distress in overtly aggressive situations are likely to be more aggressive. In contrast, youth with higher self-esteem and youth who endorse greater leadership efficacy are likely to be less aggressive. Contrary to hypotheses, hostile attributional bias and knowledge of social information processing, experience of relational victimization, distress in relationally aggressive situations, and community engagement were not associated with aggression. Our study is one of the first to address these important questions for low-income, predominately ethnic minority urban youth, and it has clear implications for adapting aggression prevention programs to be culturally sensitive for urban African American youth.

Digital animation as a method to disseminate research findings to the community using a community-based participatory approach.

Community-based participatory research (CBPR) has garnered increasing interest over the previous two decades as researchers have tackled increasingly complex health problems. In academia, professional presentations and articles are major ways that research is disseminated. However, dissemination of research findings to the people and communities who participated in the research is many times forgotten. In addition, little scholarly literature is focused on creative dissemination of research findings to the community using CBPR methods. We seek to fill this gap in the literature by providing an exemplar of research dissemination and partnership strategies that were used to complete this project. In this paper, we present a novel approach to the dissemination of research findings to our targeted communities through digital animation. We also provide the foundational thinking and specific steps that were taken to select this specific dissemination product development and distribution strategy.

Methods for linking community views to measureable outcomes in a youth violence prevention program.

BACKGROUND: All parties in community-academic partnerships have a vested interest prevention program success. Markers of success that reflect community's experiences of programmatic prevention success are not always measurable, but critically speak to community-defined needs. OBJECTIVE: The purpose of this manuscript was to (1) describe our systematic process for linking locally relevant community views (community-defined indicators) to measurable outcomes in the context of a youth violence prevention program and (2) discuss lessons learned, next steps, and recommendations for others trying to replicate a similar process. METHODS: A research team composed of both academic and community researchers conducted a systematic process of matching community-defined indicators of youth violence prevention programmatic success to standardized youth survey items being administered in the course of a program evaluation. The research team of three community partners and five academic partners considered 43 community-defined indicators and 208 items from the youth surveys being utilized within the context of a community-based aggression prevention program. At the end of the matching process, 92 youth survey items were identified and agreed upon as potential matches to 11 of the community-defined indicators. CONCLUSIONS: We applied rigorous action steps to match community-defined indicators to survey data collected in the youth violence prevention intervention. We learned important lessons that inform recommendations for others interested in such endeavors. The process used to derive and assess community-defined indicators of success emphasized the principles of community-based participatory research (CBPR) and use of existing and available data to reduce participant burden.

Healthy families Brooklyn: working with health advocates to develop a health promotion program for residents living in New York City housing authority developments.

Decreasing health disparities must increase access to care, improve health education and ease navigating the health care system. Community Health Workers (CHW) take on these tasks in professional and culturally competent manners. The Healthy Families Brooklyn (HFB) Program serves residents in two public housing developments in Brooklyn, NY. Healthy Families Advocates (HFA), a type of CHW, are at the core of HFB. Curriculum development for, training of and services provided by the 10 HFA over 19 months are described. Pre and post knowledge assessments of HFAs are analyzed. Data from HFA surveys regarding training were analyzed using grounded theory methods. HFA served 172 unique clients at 222 visits. Services offered include accessing public benefits, health education, and connection to hospitals. There was a significant increase between pre and post assessment knowledge scores (P < 0.01). Taking temperature, building trust, and communicating care and connection emerged as themes related to interpersonal skills used by the HFA. The HFA are committed to moving clients forward in their health knowledge and behaviors. Themes from the HFA survey closely mirrored the HFA training curriculum. Lessons learned pertaining to training needs, data collection, and supervision are explored. The HFB program is a model way of working in communities in New York City and expansion with faith-based groups and other housing development communities is underway. Engaging communities to improve access, screening, prevention and treatment is paramount to the nation's health and the success of the 2010 Affordable Care Act. CHW's role in this mission is integral.

Using community-based participatory research to develop the PARTNERS youth violence prevention program.

BACKGROUND: School-based violence prevention programs have shown promise for reducing aggression and increasing children's prosocial behaviors. Prevention interventions within the context of urban after-school programs provide a unique opportunity for academic researchers and community stakeholders to collaborate in the creation of meaningful and sustainable violence prevention initiatives. OBJECTIVES: This paper describes the development of a collaborative between academic researchers and community leaders to design a youth violence prevention/leadership promotion program (PARTNERS Program) for urban adolescents. Employing a community-based participatory research (CBPR) model, this project addresses the needs of urban youth, their families, and their community. METHODS: Multiple strategies were used to engage community members in the development and implementation of the PARTNERS Program. These included focus groups, pilot testing the program in an after-school venue, and conducting organizational assessments of after-school sites as potential locations for the intervention. RESULTS: Community members and academic researchers successfully worked together in all stages of the project development. Community feedback helped the PARTNERS team redesign the proposed implementation and evaluation of the PARTNERS Program such that the revised study design allows for all sites to obtain the intervention over time and increases the possibility of building community capacity and sustainability of programs. CONCLUSION: Despite several challenges inherent to CBPR, the current study provides a number of lessons learned for the continued development of relationships and trust among researchers and community members, with particular attention to balancing the demand for systematic implementation of community-based interventions while being responsive to the immediate needs of the community.

Psychosocial factors and health perceptions in parents and children who are overweight or obese.

This study examined the relationships among weight status (BMI), health perceptions, and psychosocial characteristics in children, parents, and parent-child dyads. A convenient sample of 114 parent-child dyads participated. All children were overweight or obese. Parents and children completed questionnaires by self-report or interview. Questionnaires included the Parenting Stress Index-Short Form (PSI), the Parents' Stage of Change (SOC) Questionnaire, and the Pediatric Quality of Life Inventory (PedsQL). Child's mean age was 10.34 years (s.d. = 1.87), mean BMI was 28.13 kg/m(2) (s.d. = 5.46), and mean BMI z-score was 2.17 (s.d. = 0.38). Parent mean age was 37.28 years (s.d. = 12.66) and mean BMI was 34.07 kg/m(2) (s.d. = 8.18). Most parents (68.5%) reported that they and their children (70.7%) were African American and many (44.3%) reported that they and their children were Hispanic. Significant correlations included: child health perceptions and child BMI (r = 0.309, P < 0.001) and parent perception of weight and parent BMI (r = 0.691, P < 0.001). For parent-child dyads, one correlation approached significance (child health perceptions and parent stage of change (r = -0.269, P < 0.01). Findings suggest that characteristics of parent-child dyads may be important considerations in the management of childhood obesity.

Community-academic partnerships: lessons learned from replicating a salon-based health education and promotion program.

BACKGROUND: We present a model of a community-academic partnership formed to replicate a unique salon-based health education and promotion program among African-American and Latino communities in Philadelphia. OBJECTIVES: The purpose of this article is to describe the partnership principles established and lessons learned in replicating the salon-based program that sought to develop a cadre of community-academic partners and build community-based organizations' (CBOs) capacity to implement and evaluate the program. METHODS: As the lead organization, the Arthur Ashe Institute for Urban Health (AAIUH), formed a partnership with two CBOs, three universities, and 17 salons. Guiding principles were established to manage the large collaborative and ensure success. LESSONS LEARNED: By embracing a common mission and principles of understanding, co-learning, building capacity and sharing responsibility and recognition, this partnership was able to achieve positive outcomes. Challenges faced were related to replication, CBO infrastructure, data management capacity, and other process issues. CONCLUSIONS: Despite challenges, we created and sustained an enduring partnership and brought positive change to the community. Lessons learned highlight issues to examine before furthering this work such as fostering trust and building meaningful relationships.

The impact of nurse case management home visitation on birth outcomes in African-American women.

UNLABELLED: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Uniformed Services University of the Health Sciences, Department of the Navy, Department of Defense or the U. S. government. Dr. Wells is a military service member (employee of the U.S. government). This work was prepared as a part of her official duties. Title 17, USC Section 101 defines a U.S. government work as a work prepared by a military service member or employee of the U.S. government as part of the person's official duties. Despite substantial reductions in U.S. infant mortality rates, racial disparities persist, with black Americans experiencing 2.4 times the rate of their white counterparts. Low birthweight and preterm delivery contribute to this disparity. METHODS: To examine the association between antepartum nurse case management home visitation and the occurrence of low birthweight and preterm deliveries in African-American women in Montgomery County, MD, a retrospective cohort study was conducted using existing data from 109 mothers who were enrolled in the Black Babies Start More Infants Living Equally Healthy (SMILE) program. Logistic regression analysis was used. RESULTS: Women who received antepartum home visits were 0.37 (CI 0.15-0.94) times less likely to experience preterm delivery than women who did not receive antepartum home visits. The effect of antepartum home visits on preterm delivery was independent of level of prenatal care, negative life events and number of prior live births. There was no significant association between antepartum home visits and low birthweight. CONCLUSION: Antepartum home visits appeared to be protective against preterm delivery and could contribute to reducing racial disparities in infant mortality. Further study is needed to understand and replicate specific program components that may contribute to improved birth outcomes in African-American women.

Church-based obesity treatment for African-American women improves adherence.

This study compared adherence to Behavioral Choice Treatment (BCT), a 12-week obesity treatment program that promotes weight loss and exercise, among 22 Caucasian-American and 10 African-American overweight women in a university setting to 10 African-American overweight women in a church setting. Behavioral Choice Treatment (BCT) promotes moderate behavior change that can be comfortably and therefore permanently maintained. Participants obtained feedback from computerized eating diaries and kept exercise logs. Results indicated that both university groups exhibited comparable eating pathology at pre- and post-treatment and comparable weight loss, despite the African-American sample attending fewer sessions. The African-American church group exhibited less disordered eating attitudes, less interpersonal distrust (eg, reluctance to form close relationships or sense of alienation) at pre-treatment, and experienced significantly greater weight loss than either university group. All groups lost weight and maintained these losses at 12-month follow-up. Preliminary results suggest treatment setting may play an important role in treatment adherence and sample characteristics.