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1.
BMC Public Health ; 24(1): 1889, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39010017

RESUMO

BACKGROUND: Against the backdrop of the global public health crisis, the COVID-19 pandemic has exposed significant disparities in the supply and demand of risk information related to public health crises, posing severe challenges to risk governance in megacities. Shanghai, China, introduced community WeChat groups for community communication, effectively facilitating the dissemination and response of grassroots information and providing a new path for interactive governance in the community. METHODS: This study collected 1006 questionnaires from residents of 350 communities in Shanghai through an online survey between June 10 and July 10, 2022. Multiple linear regression analysis was conducted to examine the impact of different participants (including the community, core residents, and the combined community and core residents) on community risk communication, perceived communication quality, and dissemination themes related to COVID-19 on community communication satisfaction. Additionally, in-depth interviews were conducted with 20 core residents from different types of communities, focusing on the specific methods of risk communication through community WeChat groups and their ability to disseminate information, respond to, and solve problems. RESULTS: Perceived information coverage and perceived response efficiency are significantly positively correlated with communication satisfaction. Notably, the speed of community information response has the greatest impact on communication satisfaction. Regarding COVID-19-related information dissemination themes, "community outbreaks, supplies, nucleic acids, outbreak prevention measures, and scientific content" all have a significant impact on communication effectiveness, with "nucleic acid testing information" having the greatest impact. Although the statistical data indicate that the participation of core residents in risk communication does not significantly affect communication satisfaction, it seems to be related to the size of the community, and the interview results further validate this conclusion. CONCLUSION: In the future, grassroots communities should consider the affordances of social media, recognize the significant correlation between risk communication and grassroots trust, and formulate more detailed and targeted risk communication strategies. In particular, incorporating core residents into "semiformal" grassroots organizations can improve community service quality, thereby enhancing community resilience in the face of public health emergencies.


Assuntos
COVID-19 , Comunicação , Mídias Sociais , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , China/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Cidades , Disseminação de Informação/métodos , SARS-CoV-2 , Pandemias , Adulto Jovem , Idoso
2.
Clin Infect Dis ; 76(8): 1496-1499, 2023 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-36433715

RESUMO

The US Centers for Disease Control and Prevention (CDC) defines a county metric of coronavirus disease 2019 (COVID-19) community levels to inform public health measures. We find that the COVID-19 community levels vary frequently over time, which may not be optimal for decision making. Alternative metric formulations that do not compromise predictive ability are shown to reduce variability.


Assuntos
COVID-19 , Estados Unidos/epidemiologia , Humanos , SARS-CoV-2 , Saúde Pública , Centers for Disease Control and Prevention, U.S.
3.
Biol Blood Marrow Transplant ; 24(4): 877-879, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29292058

RESUMO

There is a critical need for tools to comprehensively describe disparities in hematopoietic cell transplant (HCT) recipients. We conducted a retrospective cohort study to evaluate a Community Risk Score (CRS) tool for this purpose. CRS included 10 community health indicators based on county or state of residence obtained from several secondary data sources and a composite score was assigned to each county (range 0 to 40), that was further categorized into six tiers (I to VI) with higher tiers indicating poor community health. CRS was assessed for 509 allogeneic and 1033 autologous HCT recipients from 2003 to 2013. Our cohort represented allogeneic and autologous HCT recipients from 300 and 431 unique ZIP codes from 99 and 125 counties in 15 and 16 states, although 86% and 90% patients were from Ohio, respectively. A greater proportion of patients had adverse individual community risk indicators in higher-risk tiers (P < .001 for trend for all). In multivariable analysis, clear trends toward association of CRS with outcomes were not observed. For autologous HCTs, Tier III has higher risks of relapse mortality (hazard ratio [HR] 2.2, P = .02) and all-cause mortality (HR 1.8, P = 0.03). In conclusion, CRS was able to categorize patients into groups representing greater levels of health care disparities. We did not see a clear association between CRS and transplant outcomes, although our cohort was limited to a relatively small group of counties. Community-based risk score model may serve as a tool for evaluating disparities in HCT recipients, but its validation in a nationally representative cohort of patients is needed.


Assuntos
Disparidades em Assistência à Saúde , Transplante de Células-Tronco Hematopoéticas , Modelos Biológicos , Mortalidade , Saúde Pública , Adolescente , Adulto , Idoso , Aloenxertos , Autoenxertos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco
4.
Aust N Z J Psychiatry ; 49(10): 869-86, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26416916

RESUMO

OBJECTIVE: Depression has been identified as a priority disorder among children and adolescents. While numerous reviews have examined the individual and family factors that contribute to child and adolescent depressive symptoms, less is known about community-level risk and protective factors. The aim of this study was to complete a systematic review to identify community risk and protective factors for depression in school-aged children (4-18 years). METHOD: The review adopted the procedures recommended by the Cochrane Non-Randomised Studies Methods Working Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify both observational and intervention study designs in both peer-reviewed and non-peer reviewed publications. RESULTS: A total of 21 studies met the inclusion criteria. Seventeen of the 18 community association studies and 2 of the 3 intervention studies reported one or more significant effects. Results indicated that community safety and community minority ethnicity and discrimination act as risk factors for depressive symptoms in school-aged children. Community disadvantage failed to achieve significance in meta-analytic results but findings suggest that the role of disadvantage may be influenced by other factors. Community connectedness was also not directly associated with depressive symptoms. CONCLUSION: There is evidence that a number of potentially modifiable community-level risk and protective factors influence child and adolescent depressive symptoms suggesting the importance of continuing research and intervention efforts at the community-level.


Assuntos
Depressão/etiologia , Características de Residência , Adolescente , Criança , Pré-Escolar , Humanos , Fatores de Proteção , Fatores de Risco
5.
Front Public Health ; 12: 1353890, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38818443

RESUMO

Objective: In this study, we aim to provide a comprehensive analysis of the effectiveness of the risk prevention and control mechanism within the grid management model for community risk prevention. We emphasize the importance of thoroughly examining the risk prevention and control mechanism to enhance risk management efforts in urban communities, particularly in response to unforeseen outbreaks such as COVID-19. Methods: Case studies are widely acknowledged as one of the most effective approaches to examine governance in China. In this study, the "Yuelu Model" serves as an illustrative example to demonstrate the application and effectiveness of grid management in community risk governance. To ensure the validity of the case study, it is imperative to adhere to the principle of representativeness. The collection of case data involves a combination of primary and secondary sources, and supplementary information is obtained through follow-up investigations conducted via WeChat, telephone, and other means, thereby enhancing the comprehensiveness and accuracy of the data. Results: Our analysis reveals significant findings regarding the impact of the grid management model, fulfilling a triple role as a "Social Safety Valve" in the management process: (1) Community stress reduction function, (2) Community alarm function, and (3) Community integration function. Furthermore, we explore the adaptability of the grid management mechanism in addressing community risks, highlighting its effectiveness and potential for broader application. Discussion: The findings of this study suggest that: Firstly, it is crucial to establish a shared information repository among different departments on a big data platform. Secondly, a dynamic government public information internal network should be established through collaborative efforts among multiple departments. Thirdly, implementing a regular (or periodic) early warning mechanism is essential. Lastly, the establishment of a high-quality talent team for power grid management is highly recommended. Our research provides valuable insights to enhance community risk governance.


Assuntos
COVID-19 , Gestão de Riscos , China , Humanos , COVID-19/prevenção & controle , SARS-CoV-2 , Estudos de Casos Organizacionais
6.
Burns ; 49(8): 1866-1878, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37838560

RESUMO

Quick, easy access to data-driven community risk assessment principles and to related community risk reduction activities can encourage fire departments to learn about, conduct, and complete district risk reduction practices. With the ultimate goal of creating web-based community risk assessment and community risk reduction resources, we first evaluated fire department needs. Over an eight-month period, a quantitative online survey was administered to officers from 45 unique fire departments in 44 Kentucky counties, with follow-up qualitative telephone interviews administered to 11 fire officials. Mixed-methods, sequential analysis of the data clarified the "what," "who," and "how" of risk analysis/reduction activities, noted what specific reduction activities departments used to prepare for and mitigate risk, and named specific facilitators and barriers to risk assessment and reduction. Respondents described data use for community risk assessment and for planning community risk reduction activities; how a lack of time, personnel, and funding impacts community risk assessment and community risk reduction activities; and how to involve both firefighters and the community in the process. Innovative solutions such as a website containing resources on how to assess community risk information along with resources such as community risk assessment/ reduction education, program planning, and tools, can assist departments to use community risk assessment data in the development of community risk reduction activities.


Assuntos
Queimaduras , Humanos , Kentucky , Inquéritos e Questionários , Desenvolvimento de Programas , Medição de Risco
7.
J Clin Med ; 12(3)2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-36769854

RESUMO

The relative contributions of occupational and community sources of COVID-19 among health-care workers (HCWs) are still subject to debate. In a cohort study at a 2814-bed tertiary medical center (five hospitals) in the Paris area of France, we assessed the proportion of hospital-acquired cases among staff and identified risk factors. Between May 2020 and June 2021, HCWs were invited to complete a questionnaire on their COVID-19 risk factors. RT-PCR and serology test results were retrieved from the virology department. Mixed-effects logistic regression was used to account for clustering by hospital. The prevalence of COVID-19 was 15.6% (n = 213/1369 respondents) overall, 29.7% in the geriatric hospitals, and 56.8% of the infections were hospital-acquired. On multivariable analyses adjusted for COVID-19 incidence and contact in the community, a significantly higher risk was identified for staff providing patient care (especially nursing assistants), staff from radiology/functional assessment units and stretcher services, and staff working on wards with COVID-19 clusters among patients or HCWs. The likelihood of infection was greater in geriatric wards than in intensive care units. The presence of significant occupational risk factors after adjustment for community exposure is suggestive of a high in-hospital risk and emphasizes the need for stronger preventive measures-especially in geriatric settings. Clinicaltrials.gov NCT04386759.

8.
Viruses ; 15(7)2023 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-37515269

RESUMO

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), challenged public health systems worldwide. Individuals in low-income countries/regions are still at individual and community risk concerning inequality, sanitation, and economic conditions. Besides, during the pandemic, the transmission in municipalities and communities in the countryside and less developed regions kept viral spread and required structured and strengthened clinical and laboratory surveillance. Here, we present an observational, analytic, cross-sectional study conducted using secondary data from the Laboratório de Farmacogenômica e Epidemiologia Molecular (LAFEM)-Universidade Estadual de Santa Cruz (UESC), to evaluate individual and community factors associated to SARS-CoV-2 infection in outpatients from different cities from Southern Region of Bahia State, in Brazil. The data were collected between June 2021 and May 2022. The SARS-CoV-2 positivity by RT-qPCR was correlated with low socio-economic indicators, including the Human development index (HDIc) and Average worker salary (AWSc). Besides, in general, females were less likely to test positive for SARS-CoV-2 (OR = 0.752; CI 95% 0.663-0.853; p < 0.0001), while brown individuals had more positivity for infection (p < 0.0001). In addition, those who had clinical symptoms were more likely to test positive for SARS-CoV-2 (OR = 6.000; CI 95% 4.932-7.299; p < 0.0001). Although dry cough, headache, and fever were the most frequent, loss of taste (OR = 5.574; CI 95% 4.334-7.186) and loss of smell (OR = 6.327; CI 95% 4.899-8.144) presented higher odds ratio to be positive to SARS-CoV-2 by RT-qPCR. Nonetheless, the distribution of these characteristics was not homogenous among the different cities, especially for age and gender. The dynamic of SARS-CoV-2 positivity differed between cities and the total population and reinforces the hypothesis that control strategies for prevention needed to be developed based on both individual and community risk levels to mitigate harm to individuals and the health system.


Assuntos
COVID-19 , Feminino , Humanos , Brasil/epidemiologia , Cidades/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Pandemias , SARS-CoV-2/genética
9.
J Infect Public Health ; 15(2): 261-269, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35065359

RESUMO

INTRODUCTION: To mitigate morbidity, mortality, and impacts of COVID-19 on health, it was essential to implement a comprehensive framework for COVID-19 control and prevention. A well-recognized tool from the field of injury prevention known as the Haddon matrix was utilized. The matrix states that any accident is affected by the host, agent, and environment. Another well-recognized tool used by the national fire protection association known as the Community risk reduction tool (CRR). The (CRR) tool utilizes the Five E's of Community Risk Reduction. AIM OF THE STUDY: To describe the risk factors that increase the susceptibility and the severity of COVID-19 infection based on the Haddon matrix and the proposed prevention strategies by the CRR tool by using the combined model. METHODOLOGY: We reviewed the literature to assess known factors contributing to COVID-19 susceptibility, infection, and severity of infection. We then used the Haddon matrix to structure, separating human factors from technical and environmental details and timing. We then used the community risk reduction (CRR) model to set all responses and control measures for each element obtained from the Haddon matrix tool. Subsequently, we incorporated both tools to develop the combined model. CONCLUSION: we proposed and implemented a combined model that utilizes the CRR model as the systematic strategy for the more theoretical framework of Haddon's matrix. Combining both models was practical and helpful in planning the preparedness and control of the COVID-19 pandemic in Saudi Arabia that can be generalized to national and international levels.


Assuntos
COVID-19 , Humanos , Pandemias/prevenção & controle , Fatores de Risco , Comportamento de Redução do Risco , SARS-CoV-2
10.
Front Public Health ; 10: 957576, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36062122

RESUMO

Introduction: To mitigate morbidity, mortality, and impacts of heat-related illnesses (HRIs) on health, it was vital to implement a comprehensive framework for HRI prevention and control. A recognized tool from the field of trauma prevention known as the Haddon matrix was applied. The matrix states that any event is affected by three factors: host, agent, and environment. In addition, another recognized tool known as the combined model was used in this study. The combined model is a three-dimensional model that includes the idea for the three axes of Haddon's matrix with the methodology of the community risk reduction (CRR) model. Aim of the study: To identify the environmental and individual risk factors of HRIs based on the Haddon matrix and the recommended prevention strategies by the CRR tool by using the combined model. Methodology: An extensive literature review was conducted to assess all the risk factors associated with HRI, as well as preventive measures. Then the Haddon matrix was used to structure, separating human factors from technical and environmental details and timing. After that, the combined model was used to set all responses and mitigation measures for each element obtained from the Haddon matrix tool. Conclusion: Projected increases in heat stress over the globe require the formulation and implementation of evidence-based HRI mitigation and preventive measures. In this study, we implemented the combined model that was utilized as a systematic strategy for the more theoretical framework of Haddon's matrix. Using the Haddon matrix to determine the HRI risk factors and the combined model to mitigate its impact was practical and helpful in planning, preparedness, and mitigating the HRIs during Hajj, provided a broad approach equivalent to the Swiss cheese model, and would facilitate an informed decision.


Assuntos
Eventos de Massa , Humanos , Morbidade , Fatores de Risco
11.
Clin Epidemiol Glob Health ; 9: 204-215, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32901227

RESUMO

OBJECTIVES: COVID-19 Pandemic has brought a threatening challenge to the world and as well as for Indian society and economy. In India, it has become a public health disaster and its' intensity increasing continuously. For the disaster risk reduction, and capacity building against the COVID-19 pandemic understanding of the relationship between socio-environmental conditions with the pandemic is very necessary. The objective of the present work is to construct a socio-environmental vulnerability index of the potential risk of community spread of COVID-19 using socio-economic and environmental variables. METHODOLOGY: In this, cross-sectional study principal component analyses have been used to drive SoEVI. 4 uncorrelated sub-index has been extracted from 16 sub-indicators which reflects 59% of the variance. Aggregation of 4 Sub-Index has been done to obtain the final vulnerability Index. RESULTS: Results show that there is spatial variability in vulnerability based on environmental and socio-economic conditions. Districts of north and central India found more vulnerable then south India. Statistical significance has been tested using regression analysis, positive relation has been found between vulnerability index and confirmed and active cases. CONCLUSION: The vulnerability index has highlighted environmentaly and socioeconomicallybackward districts. These areas will suffer more critical problems against COVID-19 pandemic for their socio-environmental problem.

12.
SAGE Open Med ; 9: 20503121211036132, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34377473

RESUMO

BACKGROUND: COVID-19 brought significant challenges to public health. It changed the view of global health and safety, trust in the healthcare system, and clients' willingness to seek healthcare. To contain the course of the COVID-19 pandemic and its detrimental effects, understanding peoples' health behavior, especially healthcare-seeking, and determining the community risk perception is very important. Thus, this study aimed to determine the health-seeking behavior, community's risk perception to COVID-19 pandemics, and factors influencing the community risk perception in Harari regional state, Ethiopia. METHODS: Community-based cross-sectional study was conducted from 5 to 30 February 2021. A total of 1320 adult (>18 years) participants were selected using systematic random sampling. The data were collected using an online kobo collect toolbox and analyzed using descriptive statistical tests. Chi-square test and multiple binary logistic regression were applied to examine the difference between variables. A p-value < 0.05 was considered to be of statistical significance. RESULTS: The study included 1296 respondents >18 years old. The overall prevalence of willingness to seek healthcare in the study area was 35.6% (95% CI: 33%-38.3.0%). The mean cumulative score of risk perception was 30.5 (SD ± 7.25) with the minimum and maximum score of 13 and 63, respectively. A total of 656 (50.6%) of the participants had low-risk perceptions concerning COVID-19. The study found a statistically significant association between risk perception and sociodemographic characteristics (age, educational status, and income), and knowledge of the respondents. CONCLUSION: The overall prevalence of willingness to seek healthcare was 35.6%. Healthcare intervention aimed to contain the COVID-19 pandemic should consider the factors associated with the study area. Similarly, the study found a low-risk perception among the community that needs critical action to manage the COVID-19 pandemic and to protect the community as a whole. Thus, it is necessary to improve community risk perception through health education.

13.
Soc Sci Med ; 279: 113985, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33990072

RESUMO

This study examined the relationship between community risk factors (drug outlets density and crime hot spots) and family factors on the risk behaviours (drugs consumption and delinquent behaviour) of male adolescent Mexican students. Results were obtained based on data bank analysis and direct collection of information regarding family factors and risk behaviours of adolescents attending school. Spatial and statistical analysis was performed. The final sample was composed of 1450 male adolescents, from 11 secondary and high schools located in marginal and violent areas of Mexico. Spatial analysis revealed that when considering only the prevalence of the risk behaviours of the adolescents, the area of highest risk was the northwestern area of the city. However, after performing conjunct analysis of all evaluated variables using density point risk (aside from confirming that the northwestern area is still the one with the greatest risk), results indicated that the southern area has a high-density point risk. All densities of the variables showed a statistically significant positive association (p < 0.05). However, the results of the structural equation model indicated than only the family factors influenced the risk behaviours of adolescents (p < 0.05). The spatial distribution of the risk behaviours in male adolescent students and community risk variables surrounding the area where schools are located allows for the description of patterns and hotspot detection that facilitate the prioritization of where interventions must be directed. Besides, the interventions should target family factors.


Assuntos
Comportamento do Adolescente , Preparações Farmacêuticas , Adolescente , Crime , Humanos , Masculino , México/epidemiologia , Instituições Acadêmicas , Estudantes
14.
Trop Med Health ; 47: 1, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30787669

RESUMO

BACKGROUND: Myanmar has similar agro-based ecology and environmental risks as others in the Greater Mekong sub-region leading to the broad array of helminthic infections. Basic health staff (BHS) from the public sector forms a key stakeholder group in deworming interventions. The study aimed to ascertain the prevalence and determinants of multiple species helminth infections to promote township-level integrated interventions. METHODS: A cross-sectional implementation research study in 2017 covered randomly selected 240 households in four villages of Shwegyin Township. Trained interviewers administered the pre-tested structured questionnaire to either the household head or the assigned person concerning their knowledge, perceptions, practices, food habits, and deworming experience. Concomitantly, the research team collected a single stool sample from each of 698 participants (age range of 8 months to 87 years) from 93% (224/240) of eligible households and examined by Kato-Katz smear microscopy. Eventually, 16 BHS joined the interactive dialogue session based on research evidence and knowledge translated for further validation. RESULTS: The estimated prevalence of at least one helminth infection was 24% [168/698; 95% CI 21.0-27.0]. Apart from the soil-transmitted helminths (14%), zoonotic helminths especially Taenia spp. (0.7%) and Schistosoma spp. (3%) were detected. Almost half of the seasonally mobile gold panning workers (12/25; 48%) and 46% of pre-school-age children had helminth infections. Community risk groups at riverside villages had significantly higher multiple species helminth infection than those from inland villages (AOR = 10.9; 95% CI 4.9-24.2). Gold panning workers had higher infection rates than other categories (AOR = 2.5; 95% CI 0.6-9.5) but not significant. In flood-prone areas, householders failed to follow the guidelines to construct/re-construct specific type of sanitary latrines and challenges remained in disseminating health messages for community engagement. The innovative ideas recapitulated by BHS included the integration of health talks during the sessions for small agricultural loans and to harness advocacy with water, sanitation, and hygiene interventions. CONCLUSIONS: The emerging evidence of neglected zoonotic helminths required attention to introduce the periodic mopping-up and the "selective deworming plan" for vulnerable groups to cover the missed targets. Further multidisciplinary research to confirm the intermediate hosts and vectors of zoonotic helminths in the environment is essential for surveillance and response.

15.
J Nutr Sci ; 8: e30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31523425

RESUMO

The risk of undernutrition in older community-dwelling adults increases when they are no longer able to shop or cook themselves. Home-delivered products could then possibly prevent them from becoming undernourished. This single-blind randomised trial tested the effectiveness of home-delivered protein-rich ready-made meals and dairy products in reaching the recommended intake of 1·2 g protein/kg body weight (BW) per d and ≥25 g of protein per meal. Community-dwelling older adults (n 98; mean age 80·4 (sd 6·8) years) switched from self-prepared to home-delivered hot meals and dairy products for 28 d. The intervention group received ready-made meals and dairy products high in protein; the control group received products lower in protein. Dietary intake was measured at baseline, after 2 weeks (T1), and after 4 weeks (T2). Multilevel analyses (providing one combined outcome for T1 and T2) and logistic regressions were performed. Average baseline protein intake was 1·09 (se 0·05) g protein/kg BW per d in the intervention group and 0·99 (se 0·05) g protein/kg BW per d in the control group. During the trial, protein intake of the intervention group was 1·12 (se 0·05) g protein/kg BW per d compared with 0·87 (se 0·03) g protein/kg BW per d in the control group (between-group differences P < 0·05). More participants of the intervention group reached the threshold of ≥25 g protein at dinner compared with the control group (intervention T1: 84·8 %, T2: 88·4 % v. control T1: 42·9 %, T2: 40·5 %; P < 0·05), but not at breakfast and lunch. Our findings suggest that switching from self-prepared meals to ready-made meals carries the risk of a decreasing protein intake, unless extra attention is given to protein-rich choices.


Assuntos
Laticínios , Proteínas Alimentares , Vida Independente , Refeições , Idoso , Idoso de 80 Anos ou mais , Desjejum , Culinária , Ingestão de Alimentos , Ingestão de Energia , Feminino , Humanos , Almoço , Masculino , Método Simples-Cego
16.
Child Obes ; 13(6): 479-489, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28759255

RESUMO

BACKGROUND: Childhood obesity is associated with increased risk of long-term health consequences. Despite the wealth of research, prevalence rates are still high, particularly among lower-income groups. Little is known about variations in risk of overweight/obesity across income gradients and the adolescent developmental stage. This study examines the association between distal community factors and adolescent weight status across income gradients and whether this association is moderated by age. METHODS: Using a nationally representative sample of 33,096 adolescents drawn from the National Survey of Children's Health (NSCH), this study assesses how age interacts with community factors and weight (overweight/obese vs. normal weight) after controlling for individual-level factors (gender, race/ethnicity, household composition, parental employment, education) in subsamples stratified by income quartile (according to federal poverty guidelines). Community factors include community risk (comprising community safety, school safety, neighborhood cohesion, and detracting neighborhood elements) and four neighborhood amenities (sidewalks, parks, recreation centers, libraries). RESULTS: Adolescents with low community risk in quartiles 1 and 3 had lower odds of overweight/obesity (by 32% and 35%, respectively) compared with the high community risk group. Age interacted with access to recreational centers in quartile 1 and sidewalks in quartile 4, indicating a decrease in odds of overweight/obesity (by 17% and 9%, respectively) with access to these amenities as youth age. CONCLUSIONS: Findings suggest that predictors of overweight/obesity can be diverse within income groups, and future research and interventions should address distinct features of each community. This includes reducing detracting elements and enhancing amenities and cohesion in lower quartiles, as well as improving walkability in the highest quartile.


Assuntos
Desenvolvimento Infantil , Sobrepeso/economia , Sobrepeso/epidemiologia , Obesidade Infantil/economia , Obesidade Infantil/epidemiologia , Características de Residência/estatística & dados numéricos , Meio Social , Adolescente , Criança , Etnicidade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Sobrepeso/etiologia , Obesidade Infantil/etiologia , Prevalência , Fatores Socioeconômicos , Estados Unidos/epidemiologia
18.
J Empir Res Hum Res Ethics ; 10(5): 488-95, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26527370

RESUMO

Community-based participatory research (CBPR) is challenging to research ethics committees (RECs). We reviewed the REC preparedness when reviewing CBPR projects. We searched the MEDLINE database and included qualitative studies of CBPR researchers or REC members about their experiences with RECs. The search yielded 107 studies, of which 10 met our criteria. Barriers were that the community is not prepared to conduct research, the reluctance of RECs to work outside the university, the difficulty RECs have understanding CBPR, and that REC forms evaluate individual rather than community risk. Facilitators were having a CBPR expert as an REC member and educating RECs. Therefore, RECs are not prepared to evaluate CBPR projects leading to unnecessary delays in the approval process.


Assuntos
Atitude , Pesquisa Participativa Baseada na Comunidade/ética , Revisão Ética , Comitês de Ética em Pesquisa , Competência Profissional , Características de Residência , Relações Comunidade-Instituição , Compreensão , Humanos , Pesquisa Qualitativa , Pesquisadores
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