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1.
Am J Ind Med ; 67(8): 723-731, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38770904

RESUMEN

INTRODUCTION: Worker trust in employer-provided occupational health services has not been explored in essential industries, such as meatpacking. The purpose of this study was to describe workplace health culture and trust in the occupational health office and highlight meatpacking workers' experiences with the occupational health office. METHODS: Meatpacking workers were surveyed between February 2021 and October 2022. Descriptive statistics and nonparametric tests were used to explore trust across demographic variables, including workplace health culture. Thematic analysis was used to examine the short-answer qualitative data. RESULTS: Among workers who completed surveys (n = 731), health culture was rated low (M = 1.3 (0.73); possible range 0-3). Trust in the occupational health office was also rated low (M = 8.2 (5.06); possible range 0-20). Workers' descriptions of interactions with the occupational health office were mostly unfavorable (287 negative opinion units; 97 positive opinion units) and primarily focused on quality of care, communication, the supervisor as gatekeeper to health services, and the prioritization of company interests. CONCLUSION: Meatpacking worker health may be improved by building worker trust in the occupational health office. Suggested strategies include enhanced communication, protection of confidentiality, prioritization of worker well-being, and promotion of a stronger health culture in plants and throughout the industry. Supporting workers without a regular healthcare provider to establish a relationship with a primary care provider of their choice is also recommended.


Asunto(s)
Salud Laboral , Confianza , Lugar de Trabajo , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Lugar de Trabajo/psicología , Encuestas y Cuestionarios , Cultura Organizacional , Servicios de Salud del Trabajador , Industria de Procesamiento de Alimentos , Adulto Joven , Investigación Cualitativa
2.
J Cancer Educ ; 38(5): 1767-1776, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37466902

RESUMEN

Nationally and in Nebraska, African Americans (AA) and Hispanics have lower colorectal cancer (CRC) screening rates compared to non-Hispanic Whites. We aimed to obtain perspectives from AA and Hispanic cancer survivors and caregivers in Nebraska about CRC screening to improve outreach efforts. Data from four virtual focus groups (AA female, AA male, Hispanic rural, and Hispanic urban) conducted between April-August 2021 were analyzed using a directed content approach based on the Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model. Most of the 19 participants were female (84%) and survivors (58%). Across groups, awareness of colonoscopy was high, but awareness of fecal testing needed to be higher, with confusion about different types of fecal tests. Predisposing factors were trust in the health system; awareness of CRC screening; machismo; fear of cancer; embarrassment with screening methods; and negative perceptions of CRC screening. Enabling factors included provider recommendations, healthcare access, and insurance. Reinforcing factors included prioritizing personal health and having a support system. Suggestions to improve screening included increasing healthcare access (free or low-cost care), increasing provider diversity, health education using various methods and media, and enhancing grassroots health promotion efforts. Lack of awareness, accessibility issues, attitudes and perceptions of CRC and CRC screening, trust, and cultural and linguistic concerns are major issues that need to be addressed to reduce CRC screening disparities among AA and Hispanic adults.


Asunto(s)
Negro o Afroamericano , Neoplasias Colorrectales , Adulto , Femenino , Humanos , Masculino , Colonoscopía , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/prevención & control , Detección Precoz del Cáncer , Conocimientos, Actitudes y Práctica en Salud , Tamizaje Masivo , Nebraska , Hispánicos o Latinos
3.
Health Promot Pract ; : 15248399231216728, 2023 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-38102812

RESUMEN

Hispanic/Latino individuals across the lifespan generally do not engage in enough physical activity. Intergenerational programming is an innovative solution that could improve opportunities for physical activity across the lifespan in a culturally relevant manner; however, few studies have explored perceptions of intergenerational physical activity programming among Hispanic/Latino communities. This pre-implementation study aimed to: (a) explore the perceived benefits, barriers, and facilitators of physical activity among an intergenerational sample of Hispanic/Latino community members and stakeholders and (b) assess interest in intergenerational physical activity programming. This qualitative study consisted of a total of eight focus groups (N = 45 participants): Hispanic/Latino youth (2 groups), their parents (2 groups), older Hispanic/Latino adults (3 groups), and community stakeholders who work with older adults (1 group). We used thematic analysis techniques integrating the Framework Method to compare and contrast perspectives between participant groups. We found that all groups identified physical, mental, and/or social benefits to physical activity. Primary barriers included limited physical accessibility, environmental considerations, and time constraints. Primary facilitators included physical accessibility, programming format, environmental supports, and social support. Overall, there was general interest in intergenerational physical activity programming across all groups. Practitioners are encouraged to: (a) be aware of how different age groups may view and respond to program context, fit, and communications; (b) reflect on their capacity for high-quality implementation, and (c) weigh the costs and benefits of various programming decisions. Findings can be used to design culturally, linguistically, and contextually relevant intergenerational physical activity programming and to promote health equity.

4.
J Gen Intern Med ; 37(10): 2496-2504, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35411530

RESUMEN

BACKGROUND: While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level. OBJECTIVE: We examined whether experienced and perceived racial discrimination were associated with mental or behavioral health outcomes during the pandemic. DESIGN: In October 2020, we conducted a national survey with minorities oversampled that covered respondents' sociodemographic background and health-related information. PARTICIPANTS: A total of 2709 participants responded to the survey (response rate: 4.2%). MAIN MEASURES: The exposure variables included (1) experienced and encountered racial discrimination, (2) experienced racial and ethnic cyberbullying, and (3) perceived racial bias. Mental health outcomes were measured by psychological distress and self-rated happiness. Measures for behavioral health included sleep quality, change in cigarette smoking, and change in alcohol consumption. Weighted logistic regressions were performed to estimate the associations between the exposure variables and the outcomes, controlling for age, gender, race and ethnicity, educational attainment, household income, eligibility to vote, political party, COVID-19 infection, and geographic region. Separate regressions were performed in the six racial and ethnic subgroups: non-Hispanic White, non-Hispanic Black, Hispanic, East Asian, South Asian, and Southeast Asian respondents. KEY RESULTS: Experienced racial discrimination was associated with higher likelihood of psychological distress (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [95% CI]: 1.34-3.55). Experienced racial discrimination (AOR = 2.31, 95% CI: 1.34-3.99) and perceived racial bias (AOR = 1.05, 95% CI: 1.00-1.09) were both associated with increased cigarette smoking. The associations between racial discrimination and mental distress and substance use were most salient among Black, East Asian, South Asian, and Hispanic respondents. CONCLUSIONS: Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic.


Asunto(s)
COVID-19 , Racismo , Humanos , Salud Mental , Pandemias , Grupos Raciales , Estados Unidos/epidemiología
5.
Am J Ind Med ; 65(11): 898-912, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35880742

RESUMEN

INTRODUCTION: Agriculture, forestry, and fishing industry (AgFF) workers often work extremely long hours during peak production seasons, resulting in sleep deprivation and fatigue. The National Occupational Research Agenda has classified fatigue as a "significant safety issue" and area of concern for many industry sectors, including AgFF. This review explores current research and practice in AgFF and proposes next steps. METHODS: We conducted a scoping literature review to examine the extent and nature of research in this area. Article inclusion criteria included peer-reviewed journal articles written in English; published after 1989; covering AgFF workers in high-income countries; with data on working hours/schedules and sleep related to safety and health. RESULTS: Limited research has addressed long hours and sleep deprivation among AgFF workers. We identified 8350 articles for title and abstract review. Among those, 407 underwent full-text review and 96 met all inclusion criteria (67% agriculture, 25% fishing/seafood processing, 8% forestry). The literature provided some evidence fatigue contributes to fatalities, injuries, and illnesses in AgFF. Older, new, young, foreign-born, and female workers, as well as those who work in small organizations or longer hours (40+) may be at higher risk for fatigue-related injury and illness. Few studies have developed or evaluated interventions to control risks. DISCUSSION: Given that fatigue is a factor in injury and illness for this sector, future AgFF surveillance and research should increase efforts to capture fatigue and sleep data, directly investigate the role of long hours and nonstandard work schedules in the sector, and most importantly, create practical interventions to manage fatigue.


Asunto(s)
Agricultura Forestal , Privación de Sueño , Agricultura , Fatiga/etiología , Femenino , Humanos , Caza , Sueño
6.
J Community Health ; 47(1): 79-86, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34387813

RESUMEN

In 2017, Public Health 3.0 was introduced, providing recommendations that expand traditional public department functions and programs. Operationalizing the framework requires that local health departments invest in the requisite professional skills to respond to their community's needs. The purpose of this paper is to determine the professional skills that are most important for local health departments to respond to large public health issues and challenges that are having a major impact on their communities. The study used a cross-sectional assessment of the education and training needs of local public health departments in Nebraska following the principles of practice-based systems research. The assessment was designed to assess the training and education needs of local health department staff members. The questions measured the perceived importance of and respondent's capacity across 57 core competencies for public health professionals modified from the Council on Linkages Between Academia and Public Health Practice. A total of 104 staff members from seven local health departments were requested to complete the assessment and 100% of the individuals responded to and completed the assessment. Twenty-eight skills were identified as the most important skills needed for local health departments. The skills were themed and categorized into four domains. (1) Data, Evaluation, and Quality Improvement, (2) Community Engagement and Facilitation, (3) Systems Thinking and Leadership, and (4) Policy and Advocacy. The results from this analysis provide direction to strengthen and transform the public health system into one that is connected, responsive, and nimble. Additionally, it also highlighted a glaring omission that Equity, Diversity, and Inclusion should be included as the fifth domain.


Asunto(s)
Práctica de Salud Pública , Salud Pública , Estudios Transversales , Personal de Salud , Humanos , Evaluación de Resultado en la Atención de Salud , Salud Pública/educación
7.
J Cardiovasc Nurs ; 37(5): 439-445, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35020706

RESUMEN

BACKGROUND: Hispanic/Latino adults have high rates of hypertension, obesity, and type II diabetes. Mobile health technologies (mHealth) are effective in supporting self-management of lifestyle behaviors; however, the effectiveness in rural Hispanic/Latino adults is unclear. OBJECTIVE: A pilot 12-week self-management mHealth intervention in rural Hispanic/Latino adults with cardiometabolic risk was conducted. METHODS: A randomized, 2-group (intervention and enhanced usual care) design was used to test the use of the MyFitnessPal app, a smart scale, and text messages to support daily self-monitoring of weight, food intake, and steps. RESULTS: Seventy participants enrolled. The intervention group had greater improvement in body mass index ( P = .052) and waist circumference ( P = .043) at 12 weeks and a trend toward greater fitness at 12 and 24 weeks. Both groups improved hemoglobin A 1c level at 12 and 24 weeks. CONCLUSIONS: mHealth using MyFitnessPal, smart scale, and text messages may be effective for improving aspects of cardiometabolic health in rural Hispanic/Latino adults.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipertensión , Telemedicina , Diabetes Mellitus Tipo 2/prevención & control , Hispánicos o Latinos , Humanos , Hipertensión/prevención & control , Proyectos Piloto
8.
Emerg Infect Dis ; 27(4): 1032-1038, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33591249

RESUMEN

The coronavirus disease (COVID-19) pandemic has severely impacted the meat processing industry in the United States. We sought to detail demographics and outcomes of severe acute respiratory syndrome coronavirus 2 infections among workers in Nebraska meat processing facilities and determine the effects of initiating universal mask policies and installing physical barriers at 13 meat processing facilities. During April 1-July 31, 2020, COVID-19 was diagnosed in 5,002 Nebraska meat processing workers (attack rate 19%). After initiating both universal masking and physical barrier interventions, 8/13 facilities showed a statistically significant reduction in COVID-19 incidence in <10 days. Characteristics and incidence of confirmed cases aligned with many nationwide trends becoming apparent during this pandemic: specifically, high attack rates among meat processing industry workers, disproportionately high risk of adverse outcomes among ethnic and racial minority groups and men, and effectiveness of using multiple prevention and control interventions to reduce disease transmission.


Asunto(s)
COVID-19 , Transmisión de Enfermedad Infecciosa/prevención & control , Industria de Procesamiento de Alimentos , Control de Infecciones , Industria para Empaquetado de Carne , Adulto , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/transmisión , Femenino , Industria de Procesamiento de Alimentos/métodos , Industria de Procesamiento de Alimentos/organización & administración , Industria de Procesamiento de Alimentos/tendencias , Humanos , Incidencia , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Masculino , Industria para Empaquetado de Carne/métodos , Industria para Empaquetado de Carne/organización & administración , Industria para Empaquetado de Carne/tendencias , Salud de las Minorías/estadística & datos numéricos , Nebraska/epidemiología , Salud Laboral/normas , Evaluación de Resultado en la Atención de Salud , Equipo de Protección Personal/normas , Medición de Riesgo , SARS-CoV-2/aislamiento & purificación , Lugar de Trabajo/normas
9.
Am J Public Health ; 111(11): 2050-2058, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34554815

RESUMEN

Objectives To evaluate disparities in youth e-cigarette use patterns and flavor use by race/ethnicity over time. Methods We used data from the US 2014-2019 National Youth Tobacco Survey (NYTS) to examine trends in dual use (co-use of e-cigarettes and cigarettes or other tobacco products), occasional (≤ 5 days) versus frequent use (≥ 20 days) in the past 30 days, and flavor use among current (past-30-day) e-cigarette users (n = 13 178) across racial/ethnic groups (non-Hispanic Whites, non-Hispanic Blacks, Hispanics/Latinos, and non-Hispanic others). Results Among current e-cigarette users, dual use and occasional use decreased significantly from 2014 to 2019 across racial and ethnic groups except for non-Hispanic Blacks; frequent use and flavored e-cigarette use increased among non-Hispanic Whites, Hispanics/Latinos, and non-Hispanic others but not among non-Hispanic Blacks. In 2019, non-Hispanic Black e-cigarette users were more likely to report dual use (adjusted odds ratio [AOR] = 2.2; 95% confidence interval [CI] = 1.5, 3.2; P < .001) and occasional use of e-cigarettes (AOR = 3.7; 95% CI = 2.3, 5.9; P < .001) but less likely to report frequent use (AOR = 0.2; 95% CI = 0.1, 0.4; P < .001) and flavored e-cigarette use (AOR = 0.4; 95% CI = 0.3, 0.5; P < .001) than their White peers. Conclusions Youth e-cigarette use patterns differed considerably across racial/ethnic groups, and tailored strategies to address disparities in e-cigarette use are needed. (Am J Public Health. 2021;111(11):2050-2058. https://doi.org/10.2105/AJPH.2021.306448).


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Estados Unidos
10.
Am J Ind Med ; 64(2): 84-96, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33284493

RESUMEN

BACKGROUND: Meatpacking is dangerous, dirty, and demanding (3-D) work-much of which is done by immigrant workers. It is characterized by high rates of occupational injuries and illnesses due to the speed of the production line, repetitive motions, and other inherent exposures. The purpose of this qualitative study was to explore perceptions of safety culture among Hispanic/Latino meatpacking workers in the Midwest. METHODS: Five focus groups with a total of 28 participants were conducted between March 2019 and February 2020 with Hispanic/Latino meatpacking workers in Nebraska. Workers were asked about the type of work performed, how the work was physically done, and perceptions of health risks and exposures. Thematic analysis was used to build a description of safety culture within the meatpacking industry. RESULTS: Three main themes were found: (1) workers depicted a culture where companies cared more about production than people; (2) workers felt powerless in improving their situation; and (3) workers noted that the work was precarious, both dangerous and one where much of the responsibility for safety was shifted to the individual workers. CONCLUSIONS: The meatpacking industry has a poor safety culture. Safety culture within the industry may be improved by ensuring that organizational values and artifacts are aligned with safety by addressing the critical role of supervisors, providing culturally and linguistically appropriate consistent safety training and messaging to the workforce, and enforcing and strengthening safety regulations.


Asunto(s)
Emigrantes e Inmigrantes/psicología , Hispánicos o Latinos/psicología , Industria para Empaquetado de Carne , Administración de la Seguridad , Lugar de Trabajo/psicología , Adulto , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Nebraska , Exposición Profesional , Investigación Cualitativa , Trabajo/psicología , Adulto Joven
11.
J Cancer Educ ; 36(5): 996-1004, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-32162283

RESUMEN

American Indians residing in the Northern Plains region of the Indian Health Service experience some of the most severe cancer-related health disparities. We investigated ways in which the community climate among an American Indian population in an urban community in the Northern Plains region influences community readiness to address cancer. A Community Readiness Assessment, following the Community Readiness Model, conducted semi-structured interviews with eight educators, eight students, and eight community leaders from the American Indian community in Omaha's urban American Indian population and established the Northern Plains region community at a low level of readiness to address cancer. This study reports on a subsequent qualitative study that analyzed all 24 interview transcriptions for emergent themes to help understand the prevailing attitude of the community toward cancer. A synthesis of six emergent themes revealed that the community's perceptions of high levels of severity and barriers, paired with perceptions of low levels of susceptibility and benefits, lead to low levels of self-efficacy, all of which are reflected in minimal cues to action and little effort to address cancer. These findings, interpreted through the lens of the Health Belief Model, can inform the development of more community-based, comprehensive, and culturally appropriate approaches to address the multilevel determinants of health behaviors in relation to cancer among American Indians in the Northern Plains region.


Asunto(s)
Indígenas Norteamericanos , Neoplasias , Conductas Relacionadas con la Salud , Humanos , Salud Pública , Indio Americano o Nativo de Alaska
12.
Telemed J E Health ; 26(5): 621-628, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31411552

RESUMEN

Background: Evidence-based guidelines for the management of type 2 diabetes (T2D) consist of blood glucose monitoring, medication adherence, and lifestyle modifications that may particularly benefit from reminders, consultation, education, and behavioral reinforcements through remote patient monitoring (RPM). Objectives: To identify predictors of weight loss and to examine the association between weight loss and hemoglobin A1C (HbA1C) outcomes for T2D patients who were enrolled in an RPM program for diabetes management. Materials and Methods: The study applied logistic and ordinary least-squares regression models to examine the relationship between baseline characteristics and the likelihood of weight loss during the RPM, and how the magnitude of weight loss was related to changes in HbA1C outcomes for 1,103 T2D patients who went through 3 months of RPM from 2014 to 2017. Results: Older patients were 3% more likely to have weight loss (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05), whereas patients with higher baseline HbA1C had 9% reduced odds (OR, 0.91; 95% CI, 0.85-0.97) of experiencing weight loss. For every pound of weight lost, there was a 0.02-point (95% CI, 0.01-0.03) reduction on the HbA1C measured at the end of the RPM. Moreover, compared with those who had weight loss of ≤3%, participants who had lost 5-7%, or >7% of their baseline weight had a 0.37- and 0.58-point reduction in HbA1C, respectively. Conclusions: This study revealed a notable relationship between weight loss and positive HbA1C outcomes for T2D patients in an RPM-facilitated diabetes management program, which pointed to the potential of integrating evidence-based lifestyle modification programs into future telemedicine programs to improve diabetes management outcomes.


Asunto(s)
Glucemia , Diabetes Mellitus Tipo 2 , Pérdida de Peso , Glucemia/metabolismo , Automonitorización de la Glucosa Sanguínea , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/terapia , Hemoglobina Glucada/metabolismo , Humanos , Monitoreo Fisiológico
13.
Respir Res ; 19(1): 166, 2018 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-30176916

RESUMEN

BACKGROUND: Agriculture workers are exposed to microbial component- and particulate matter-enriched organic dust aerosols. Whereas it is clear that exposure to these aerosols can lead to lung inflammation, it is not known how inflammatory responses are resolved in some individuals while others develop chronic lung disease. Interleukin (IL)-10 is an immunomodulatory cytokine that is recognized as a potent anti-inflammatory and pro-resolving factor. The objective of this study was to determine whether there is a relationship of systemic IL-10 and proinflammatory responses and/or respiratory health effects in humans with prior agriculture exposure. METHODS: This is a cross sectional study of 625 veterans with > 2 years of farming experience. Whole blood was stimulated with or without organic dust and measured for IL-6, TNFα and IL-10. Participants underwent spirometry and respiratory symptoms were assessed by questionnaire. RESULTS: We found that baseline IL-10 concentration from the whole blood assay was inversely associated with ΔTNF-α (r = - 0.63) and ΔIL-6 (r = - 0.37) levels. Results remained highly significant in the linear regression model after adjusting for age, sex, BMI, race, education, smoking status, and white blood cell count (ΔTNF-α, p < 0.0001; ΔIL-6, p < 0.0001). We found no association between chronic cough (p = 0.18), chronic phlegm (p = 0.31) and chronic bronchitis (p = 0.06) and baseline IL-10 levels using univariate logistic regression models. However, we did find that higher FEV1/FVC was significantly associated with increased baseline IL-10 concentration. CONCLUSIONS: Collectively, these studies support a potential role for IL-10 in modulating an inflammatory response and lung function in agriculture-exposed persons.


Asunto(s)
Agricultura/tendencias , Citocinas/sangre , Polvo , Interleucina-10/sangre , Enfermedades Pulmonares/sangre , Exposición Profesional/efectos adversos , Anciano , Biomarcadores/sangre , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Mediadores de Inflamación/sangre , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Pruebas de Función Respiratoria/métodos
15.
Tob Control ; 26(6): 703-708, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-28119499

RESUMEN

AIM: To examine the association between neighbourhood exposure to point-of-sale (POS) cigarette price promotions and financial stress among smokers in a Midwestern metropolitan area in the USA. METHODS: Survey data from 888 smokers provided information on sociodemographic and smoking related variables. Financial stress was measured with the question: 'In the last six months, because of lack of money, was there a time when you were unable to buy food or pay any important bills on time, such as electricity, telephone, credit card, rent or your mortgage? (Yes/No).' Using audit data from 504 tobacco retailers, we estimated a score of POS price promotions for each respondent by summing the different types of promotion in each store in their neighbourhood, as defined by a 1-km roadway buffer. RESULTS: Adjusted results provided strong support for an association between higher scores of neighbourhood POS cigarette price promotions and a higher probability of financial stress (p=0.007). CONCLUSION: Exposure to POS cigarette price promotions is associated with financial stress. This finding, coupled with previous reports that smokers with financial stress are less likely to attempt to quit or succeed in quitting smoking, suggests that POS cigarette price promotions may act as an impediment to smoking cessation.


Asunto(s)
Comercio/economía , Fumadores/psicología , Fumar/economía , Productos de Tabaco/economía , Adolescente , Adulto , Publicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nebraska , Características de la Residencia , Fumadores/estadística & datos numéricos , Cese del Hábito de Fumar/economía , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Adulto Joven
16.
J Cancer Educ ; 31(4): 666-672, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-26194778

RESUMEN

Breast cancer is the most common cause of cancer death among Hispanic women in the USA. Throughout the country, Hispanic immigrants face many barriers to achieving optimal breast health. Three focus groups were conducted to explore challenges and opportunities in access to breast health services and information among recent Hispanic immigrant women in Lancaster Country, Nebraska. Respondents perceived breast cancer as a serious issue and were concerned about it, but there were few cues to action to improve health given the limited information and access to services available to low-income Spanish-speaking individuals in the community. Results highlighted the need for culturally and linguistically appropriate health education and services, accessibility and promotion of low-cost screening and treatment services, and inclusive policies to promote preventative healthcare services for all women regardless of immigration status. Health is more than just clinical care, and therefore, it is important to understand the contextual and cultural factors that have resulted in low screening rates and develop methods to address these them. Failure to address these aspects of social determinants of health could hamper efforts to improve breast health and reduce disparities.


Asunto(s)
Neoplasias de la Mama/prevención & control , Emigrantes e Inmigrantes/psicología , Conocimientos, Actitudes y Práctica en Salud , Servicios de Salud/estadística & datos numéricos , Hispánicos o Latinos/psicología , Educación del Paciente como Asunto , Adulto , Anciano , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/epidemiología , Barreras de Comunicación , Femenino , Humanos , Persona de Mediana Edad , Nebraska/epidemiología , Investigación Cualitativa , Adulto Joven
17.
J Immigr Minor Health ; 26(3): 554-568, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38180583

RESUMEN

Racial and ethnic minority populations experience poorer cancer outcomes compared to non-Hispanic White populations, but qualitative studies have typically focused on single subpopulations. We explored experiences, perceptions, and attitudes toward cancer care services across the care continuum from screening through treatment among African American and Hispanic residents of Nebraska to identify unique needs for education, community outreach, and quality improvement. We conducted four focus groups (N = 19), April-August 2021 with people who were aged 30 or older and who self-identified as African American or Hispanic and as cancer survivors or caregivers. Sessions followed a structured facilitation guide, were audio recorded and transcribed, and were analyzed with a directed content analysis approach. Historical, cultural, and socioeconomic factors often led to delayed cancer care, such as general disuse of healthcare until symptoms were severe due to mistrust and cost of missing work. Obstacles to care included financial barriers, transportation, lack of support groups, and language-appropriate services (for Hispanic groups). Knowledge of cancer and cancer prevention varied widely; we identified a need for better community education about cancer within the urban Hispanic community. Participants had positive experiences and a sense of hope from the cancer care team. African American and Hispanic participants shared many similar perspectives about cancer care. Our results are being used in collaboration with national and regional cancer support organizations to expand their reach in communities of color, but structural and cultural barriers still need to be addressed.


Asunto(s)
Negro o Afroamericano , Supervivientes de Cáncer , Cuidadores , Grupos Focales , Hispánicos o Latinos , Humanos , Nebraska , Hispánicos o Latinos/psicología , Masculino , Femenino , Negro o Afroamericano/psicología , Persona de Mediana Edad , Supervivientes de Cáncer/psicología , Cuidadores/psicología , Adulto , Anciano , Factores Socioeconómicos , Neoplasias/etnología , Neoplasias/terapia , Investigación Cualitativa , Accesibilidad a los Servicios de Salud , Conocimientos, Actitudes y Práctica en Salud/etnología
18.
J Agromedicine ; 28(1): 81-85, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36284467

RESUMEN

Agricultural employers have faced extreme challenges in recruiting and retaining an adequate workforce. Various societal changes have made hiring local workers into agricultural jobs difficult. Therefore, there is a growing reliance on foreign workers and visa programs to meet labor demands. One such program, the TN visa, can be an effective and useful tool for recruiting professional labor for livestock operations, and many agricultural employers have already seen its value. It is likely that the use of the TN program will continue to grow in the future. However, there is opportunity for misuse and abuse of the TN program because there are few administrative rules and limited oversight. We offer recommendations to improve the TN program and the well-being of TN professionals including additional oversight of the program, transparency in recruiting and contracting workers, educating TN workers about U.S. labor rights, ensuring fair pay, and allowing a path to work authorization for TN workers' spouses and children who accompany them in the U.S. Clearly, sustainable solutions to the farm labor shortage are needed. As a field, we need to better understand workforce recruitment and retention concerns as well as mechanisms being used to address such concerns and their impact on workers' health, safety, and well-being.


Asunto(s)
Ganado , Salud Laboral , Humanos , Niño , Animales , Agricultura , Granjas , Recursos Humanos
19.
J Child Fam Stud ; 32(2): 530-543, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36788948

RESUMEN

Parenting programs are an important tool that can provide support for parents and families and improve family functioning. This concurrent nested QUANT + qual mixed methods study sought to better understand parenting education program participation and examine format, delivery, and content preferences for parenting programs among Latino parents in Nebraska. Results from a statewide survey (N = 173) indicated that 31.4% of parents in the sample had participated in a parenting program. Significant predictors of participation in parenting education programs included being unmarried, not working full-time, having a higher income, and having excellent or very good health. Major barriers to participation included lack of information about available programs and logistical concerns. Focus group participants discussed key program design concerns which included: (1) cultural clashes related to acculturation gaps between parents and children; (2) cultural relevance of programming; (3) logistical considerations; and (4) the inclusion of technology to enhance parenting. Overall, participants were particularly interested in group-based learning, flexible scheduling, and improving the cultural relevance of programs. Implications for program design and outreach to improve Latino parents' access and willingness to participate in parenting education programs are presented. Future research should explore the effectiveness of parenting program implementation and dissemination with Latino parents in rural communities, if there are differences in the benefits of parenting programs by Latino subgroup or level of acculturation, and assess the impact of near-peers in the delivery of parenting programs with Latinos.

20.
Artículo en Inglés | MEDLINE | ID: mdl-36834054

RESUMEN

Based on the Ecological Stress-Based Model of Immigrant Worker Safety and Health, we hypothesized that occupational stress and physical safety would be negatively linked to workers' depression, which in turn, would increase family conflict and decrease youth prosocial behaviors. A total of 242 Latino immigrant cattle feedyard workers from Nebraska and Kansas (90.9% male; M age = 37.7 years) answered questions assessing depression, occupational stress, whether they had ever been injured at work, familial conflict, and youth prosocial behaviors. All four indirect relations among occupational stress and injury and the outcomes (family conflict and youth prosocial behaviors) via depressive symptomatology were significant. Additionally, ever injured was negatively related to youth prosocial behaviors and occupational stress was positively related to youth prosocial behaviors. The findings support our model and suggest that increased stress and work-related injuries on cattle feedyards are linked to mental health problems, which in turn, is linked to more conflict experienced at home and less youth prosocial behaviors. Feedyard employers should focus on improving safety culture including providing robust training in the workplace. Practical implications to improve availability and access to mental and behavioral health resources to mitigate negative family outcomes are provided.


Asunto(s)
Traumatismos Ocupacionales , Estrés Laboral , Animales , Bovinos , Femenino , Humanos , Masculino , Hispánicos o Latinos/psicología , Administración de la Seguridad , Adulto , Salud Mental , Estrés Psicológico , Conducta Social
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