All alone: A qualitative study of home health aides' experiences during the COVID-19 pandemic in New York.

BACKGROUND: Despite their integral role, Home Health Aides (HHAs) are largely unrecognized as essential to implementing effective infection prevention and control practices in the home healthcare setting. We sought to understand the infection prevention and control needs and challenges associated with caring for patients during the pandemic from the perspective of HHAs. METHODS: From June to August 2020, data were collected from HHAs in the New York metropolitan area using semi-structured qualitative interviews by telephone; 12 HHAs were interviewed in Spanish. Audio-recorded interviews were transcribed, translated and analyzed using conventional content analysis. RESULTS: In total, 25 HHAs employed by 4 unique home care agencies participated. HHAs had a mean age of 49.8 (± 9.1), 24 (97%) female, 11 (44%) Black, 12 (48%) Hispanic. Three major themes related to the experience of HHA's working during the COVID-19 pandemic emerged: (1) all alone, (2) limited access to information and resources, and (3) dilemmas related to enhanced COVID-19 precautions. Hispanic HHAs with limited English proficiency faced additional difficulties related to communication. CONCLUSIONS: We found that HHA communication with nursing staff, plays a key role in infection control efforts in home care. Efforts to manage COVID-19 in home care should include improving communication between HHAs and nursing staff.

Sex and racial/ethnic differences in sleep quality and its relationship with body weight status among US college students.

Objective: To examine sex and racial/ethnic differences in sleep quality and the association between sleep quality and body weight status among US college students. Participants: A nationally representative sample (N = 324,767) of college students from 2011 to 2015. Methods: A secondary data analysis of cross-sectional data. Results: Women showed poorer sleep quality (nights per week getting enough sleep to feel rested) than men (4.00 versus 4.34 days; p < .001). In both men and women, compared with non-Hispanic whites, racial/ethnic minorities showed lower sleep quality (p < .001). Compared with normal weight participants, overweight participants had poorer sleep quality (p = .007) among men, and both overweight (p = .004) and obese participants (p < .001) had lower sleep quality among women. Conclusions: Understanding sex and racial/ethnic sleep differences and the association between sleep and body weight status is important for colleges to promote college students' healthy sleep.

Barbers as lay health advocates--developing a prostate cancer curriculum.

PURPOSE: The purpose of this study was to develop and test the efficacy of a prostate health curriculum designed to train African American and Afro Caribbean barbers to deliver prostate cancer control messages to their customers. PROCEDURES: The curriculum was drafted from information obtained from needs assessment surveys administered to barbers and customers from various barbershops in Brooklyn, New York. Focus groups were conducted to further inform the curriculum, which was pilot tested in training sessions. FINDINGS: The high incidence of late-stage diagnosis prostate cancer in African Americans has often been attributed to lack of screening. In surveys administered to 92 customers and 19 barbers, only 26% of customers and 42% of barbers reported having some knowledge of the prostate-specific antigen (PSA) screening test. More than 90% of the barbers expressed a willingness to obtain prostate cancer information to specifically share with their customers, and 83% of customers expressed an interest in obtaining prostate cancer information and willingness to receive that information from their barbers. Following the pilot training, barber knowledge of prostate cancer increased significantly (p < .0001). CONCLUSIONS: This pilot study suggests that there is a need for intervention programs that will raise awareness and increase prostate health knowledge and behavior in communities with elevated incidence of prostate cancer. The study further suggests that barbers are willing to use their leadership skills to educate and encourage their customers to engage in informed decision making.

Racial/ethnic differences in body weight perception among U.S. college students.

OBJECTIVE: To examine racial/ethnic differences in weight perception by sex among U.S. college students. PARTICIPANTS: a national sample (N = 70,267) of college students selected from 2- and 4-year postsecondary institutions (N = 62) during the Fall semester from 2011 to 2014. METHODS: This is a secondary data analysis using 4 years of American College Health Association-National College Health Assessment IIb data. Sex-stratified multinomial logistic regression was performed to investigate racial/ethnic differences in body weight perception. RESULTS: Compared with non-Hispanic whites, non-Hispanic black men and women were more likely to underestimate their body weight (p < .01). Asian men and women were more likely to overestimate their body weight than non-Hispanic whites (p < .001). CONCLUSIONS: Weight-related interventions should take into account racial/ethnic differences in body weight perception.

Standardizing a process to engage African Americans in health research: the Community Research Outreach Workers' Network (CROWN).

BACKGROUND: Recruiting African Americans into health research studies has proven to be challenging. Barriers to research study participation exist at the individual, research, and community levels. Additionally, a gap may exist where research opportunities do not reach potential participants in many African-American communities and/or research investigators may not have access to pathways that allow for them to connect with potential research participants. OBJECTIVES: Few studies have been published regarding an engagement strategy that utilizes volunteer research registries and community review boards to link registrants to health research. Therefore, the aims of this Community Research Outreach Workers' Network (CROWN) pilot project were to (1) create a community outreach-generated registry of African Americans interested in participating in health research and (2) develop a community research review board that serves to advise research investigators on conducting culturally engaging research. METHODS: The Uniformed Services University Center for Health Disparities (USUCHD) served as an administrative coordinating center that provided resources and support to a community research review board that determined if research investigators could recruit participants from the CROWN registry. RESULTS: The CROWN board reviewed five research studies and provided feedback to research investigators. In turn, 71 people who were recruited into research studies reported that they heard about the study through CROWN. CONCLUSIONS: Outcomes from this pilot project suggest that the CROWN model is an effective strategy that can be used to engage African Americans in health research.

Training community health workers to be advocates for health promotion: efforts taken by a community-based organization to reduce health disparities in cardiovascular disease.

Compared to white adults, blacks are less likely to be aware of their cardiovascular risk factors and are less likely to respond appropriately to signs and symptoms of a myocardial infarction or stroke. This fact highlights the need for better dissemination of health information about cardiovascular disease among communities of color. Community health workers (CHWs) are important resources for disseminating health information. Recognizing this important role of CHWs, the Greater Southern Brooklyn Health Coalition and its community and academic partners developed a workshop designed to educate CHWs about the risk factors, signs and symptoms of cardiovascular disease. The purpose of this workshop was to educate CHWs so that they themselves could be better informed and thus, be in a better position to educate their respective clients. The resulting workshop, Taking Action Against Cardiovascular Disease in Our Communities: A Training for Service Providers, was a half-day workshop attended by 70 CHWs from various community service organizations. Approximately 97% of attendees said that the workshop met their expectations. More than half said they learned the signs and symptoms of cardiovascular disease and about 90% said that they received clear and concrete information that they could use with their clients. These evaluations also provided critiques regarding aspects of the workshop that could be improved upon and other information which will be used as a formative tool in developing future educational initiatives. In conclusion, this workshop demonstrated that it was feasible to develop effective community programs targeted at educating CHWs about cardiovascular disease.

Os barbeiros como defensores leigos da saúde: desenvolvendo um currículo de câncer de próstata / Barbers as a Lay Health Advocates: Developing a Prostate Cancer Curriculum

O objetivo do estudo foi desenvolver e testar a eficácia de um currículo de câncer de próstata projetado para treinar barbeiros afroamericanos e afrocaribenhos a passarem mensagens de controle do câncer e próstata a seus clientes. O projeto resultou em um currículo que era viável e bem recebido no cenário das barbearias. O estudo sugere que os barbeiros estão dispostos a usar suas habilidades de liderança para educar e incentivar seus clientes a se envolver na tomada de decisão bem informada com relação à saúde. Além disso, os clientes também manifestaram grande interesse (83%) em ouvir seus barbeiros sobre câncer de próstata. Os barbeiros que participaram dos grupos focais ficaram interessados em obter o máximo de informação possível sobre o câncer de próstata e expressaram a importância de educar os clientes sobre o tema. O aumento do conhecimento dos barbeiros sobre o câncer de próstata após o treinamento é encorajador.