Taking Neighborhood Health to Heart (TNH2H): building a community-based participatory data system.

BACKGROUND: Healthy People 2020 calls for increased monitoring of local health and health disparities, but successful models of designing and implementing data collection systems for this purpose are lacking. COMMUNITY CONTEXT: We describe the process, methods, and outcomes of a community-based participatory research initiative, Taking Neighborhood Health to Heart, designed to collect and disseminate comprehensive health data from 5 diverse urban neighborhoods in Denver, Colorado. METHODS: Since its beginning in 2006, this initiative has involved community members in collection of individual health surveys from 1,146 households; audits of sidewalks, buildings, and other built environment features in 412 neighborhood blocks; audits of availability, price, and quality of fresh produce in 69 local stores; and audits of conditions and amenities in 20 local parks. Community members and researchers share, interpret, and disseminate these data through a joint data review and dissemination committee. OUTCOME: Through our community-based data collection system, Taking Neighborhood Health to Heart has been able to collect, analyze, and disseminate locally relevant data on people and neighborhoods to monitor heath and health disparities. INTERPRETATION: Since 2006, the initiative has sustained its focus on community-based participatory research that targets collection and dissemination of local health data. We have used this information to identify salient health issues and advocate for neighborhood programs, policies, and environmental changes to built and social features of neighborhoods that have historically led to unequal opportunities and social disadvantage.

Evaluating the performance of sampling plans to detect hypoglycin A in ackee fruit shipments imported into the United States.

Hypoglycin A (HGA) is a toxic amino acid that is naturally produced in unripe ackee fruit. In 1973, the U.S. Food and Drug Administration (FDA) placed a worldwide import alert on ackee fruit, which banned the product from entering the United States. The FDA has considered establishing a regulatory limit for HGA and lifting the ban, which will require development of a monitoring program. The establishment of a regulatory limit for HGA requires the development of a scientifically based sampling plan to detect HGA in ackee fruit imported into the United States. Thirty-three lots of ackee fruit were sampled according to an experimental protocol in which 10 samples, i.e., ten 19 oz cans, were randomly taken from each lot and analyzed for HGA by using liquid chromatography. The total variance was partitioned into sampling and analytical variance components, which were found to be a function of the HGA concentration. Regression equations were developed to predict the total, sampling, and analytical variances as a function of HGA concentration. The observed HGA distribution among the test results for the 10 HGA samples was compared with the normal and lognormal distributions. A computer model based on the lognormal distribution was developed to predict the performance of sampling plan designs to detect HGA in ackee fruit shipments. The performance of several sampling plan designs was evaluated to demonstrate how to manipulate sample size and accept/reject limits to reduce misclassification of ackee fruit lots.

Understanding Social Isolation Among Urban Aging Adults: Informing Occupation-Based Approaches.

Socially isolated aging adults are at risk of poor health and well-being. Occupational therapy can help address this issue; however, information is needed to guide such work. National surveys characterize social isolation in populations of aging adults but fail to provide meaningful information at a community level. The objective of this study is to describe multiple dimensions of social isolation and related factors among aging adults in diverse urban neighborhoods. Community-based participatory research involving a door-to-door survey of adults 50 years and older was used. Participants ( N = 161) reported social isolation in terms of small social networks (24%) and wanting more social engagement (43%). Participants aged 50 to 64 years reported the highest levels of isolation in most dimensions. Low income, poor health, lack of transportation, and infrequent information access appeared linked to social isolation. Occupational therapists can address social isolation in similar urban communities through policy and practice that facilitate social engagement and network building.

Liquid chromatographic analysis of vitamin B6 in reconstituted infant formula: collaborative study.

A liquid chromatographic (LC) method was validated for the determination of total vitamin B6 in infant formula. Total vitamin B6 was quantified by converting the phosphorylated and free vitamers into pyridoxine. Pyridoxine was determined by ion pair reversed-phase LC with fluorescence detection. The method was subjected to an AOAC collaborative study involving a factory-manufactured, milk- and soy-based infant formula. Each was spiked at 3 concentrations in the range of 0-1 microg/g and sent as blind duplicate to participant laboratories. Nine laboratories returned valid data which were statistically analyzed for outliers and precision parameters. The repeatability relative standard deviation (RSD(r)) ranges were 2.0-4.0 and 3.5-5.9% for fortified milk- and soy-based formulas, respectively. The reproducibility relative standard deviation (RSD(R)) ranges were 8.2-8.4 and 6.7-11.2% for fortified milk- and soy-based formulas, respectively. HORRAT values ranged from 0.42 to 0.53, indicating that the precision of the method is acceptable. The mean RSD(r):RSD(R) values were 0.60 and 0.55 for milk- and soy-based formulas, respectively. As expected, RSDs for the unfortified samples were higher, but their HORRAT values (0.81 and 2.06) helped define a realistic limit of quantitation as 0.05 microg/g. Recovery data were quantitative and varied between 81.4 and 98.0% (mean = 89.8%) for each of 6 spiked materials.

Method validation study of hypoglycin A determination in ackee fruit.

A study was conducted to validate the performance characteristics of a published method entitled "Reversed-Phase Liquid Chromatographic Detection of Hypoglycin A in Canned Ackee Fruit Sample." Hypoglycin A (HG-A) was extracted from ackee fruit with 80% ethanol-water, centrifuged, and filtered; the sample extract then was reacted with phenylisothiocyanate. HG-A was separated by reversed-phase chromatography as the phenylthiocarbamyl derivative and detected at the low nanogram level using a UV detector at 254 nm. A study was conducted to determine recovery of HG-A added to a control ackee fruit sample. A control sample containing a low level of HG-A was spiked with 403.2, 201.6, 96.8, and 48.4 microg HG-A/g ackee fruit, respectively. Twelve replicates were analyzed for each spike level. The mean percent recovery +/- standard deviation for spike levels 403.2, 201.6, 96.8, and 48.4 microg HG-A/g were 94.37 +/- 1.27, 99.12 +/- 2.09, 107.95 +/- 5.42, and 129.18 +/- 15.32%, respectively. The percent coefficient of variation (%CV) for spike levels 403.2, 201.6, 96.8, and 48.4 microg HG-A/g were 1.35, 2.11, 5.02, and 11.86%, respectively. The recovery data indicate that HG-A can be recovered from ackee fruit with excellent accuracy and precision. Precision data obtained from replicate assays of ackee fruit naturally contaminated with low, medium, and high HG-A levels is presented.