Is Timing of Enrollment Associated with Birth Outcomes? Findings from a Healthy Start Program in Kansas.

Objective The Sedgwick County Healthy Babies Healthy Start (HBHS) program provides community-based services (including care coordination, interconception care and home visiting) aimed at reducing racial/ethnic disparities in poor birth outcomes. The purpose of this study is to assess the effectiveness of the Sedgwick County HBHS program by comparing the birth outcomes of program participants who enrolled prenatally and those who did not participate while pregnant. Methods In this retrospective cohort study, we used data drawn from the Sedgwick County HBHS program. The sample included 280 clients who were enrolled in the Sedgwick County HBHS program between September 2014 and December 2015. We performed logistic regression analyses to assess the associations between enrollee type (prenatal enrollee vs. interconceptional enrollee) and birth outcomes (low birth weight, preterm birth). Results The majority of the sample consisted of racial/ethnic minority women (32.1% non-Hispanic black, 31.8% Hispanic). After adjusting for covariates, women who enrolled in the Sedgwick County HBHS program prenatally were less likely than women who were not enrolled during pregnancy to have a preterm birth (OR 0.19, [CI 08, 0.43]) and deliver a low birth weight infant (OR 0.31, [CI 0.10, 0.97]). Conclusions for Practice Women, particularly minority women, who participate in the HBHS program experienced better birth outcomes than women who did not participate in the program during pregnancy. However, findings also suggest that interconceptional enrollees may stand to benefit from continued participation in the program.

College Students Opinions on Gun Violence.

Gun violence and control issues have become serious public health problems. This study gathered the opinions from 419 college students from a Midwestern University. Participants were asked about beliefs about purchasing assault weapons, beliefs about bringing handguns to college campuses and beliefs about contributing factors that lead to gun violence. Participants completed surveys online. The findings showed that overall 54 % of respondents believed that military assault weapons should be banned and 53 % agree that teachers should be allowed to carry a registered handgun on campus. There were statistically significant differences between males and females on these issues. For instance, females believed military assault weapons and high capacity magazines should be banned more than 1.9 times (p = .004) p < .05 compared to male students. On the other hand, female students were more likely to believe that school teachers should be allowed to carry registered handguns on school campuses more than 1.55 times (p = .046) p < .05 compared to their male student counterparts. There were no statistically significant differences between ethnic groups. The top four contributing factors that students believed led to gun violence were decline in parenting and family values (17 %), gang involvement (14 %), bullying (13.8 %) and guns being easy to obtain (13.8 %). Limitations and implications for policy work are discussed.

Breast Cancer Treatment Experiences of Witness Project of Kansas Participants.

BACKGROUND: African American women continue to die at a higher rate than White women from breast cancer. Kansas has a high death rate among African American women. Their voices needed to be heard. OBJECTIVES: This exploratory study will ask the following questions: 1) Were African American and White women having different breast cancer treatment experiences with their health care providers? And 2) How satisfied were they with their treatment? METHOD: A total of 15 breast cancer survivors were recruited to participate in this qualitative research study. We conducted focus groups in two communities in the Midwest. Forty percent of the sample was White women, 53% of the sample was African American women and 7% of the sample was Hispanic/Latina. RESULTS: Overall six themes emerged. Generally both African American women and White women were satisfied with their health care; both felt they were treated equally by health care professionals. However, they felt that health care professionals should pay more attention to their significant others and to continue to educate young women about early detection. CONCLUSIONS: As a result of the focus groups a gap in services emerged in educating the patient's partners about what is needed for their significant others and what role partners play in the recovery process.

Youth empowerment implementation project evaluation results: A program designed to improve the health and well-being of low-income African-American adolescents.

Adolescent obesity is a major health issue facing today's youth. This may be the first generation to have a lower life expectancy than their parents. The Youth Empowerment Implementation Project's (YEIP) goal was to increase fruit and vegetable intake, lower junk food consumption, and increase physical activity among low-income African-American youth living in the Midwest. Thirty middle school aged youth participated in an evidenced-based program (i.e., Botvin's Life Skills Training) and were engaged in health education and physical activities. The results from baseline to follow-up demonstrated a reduction in junk food intake for participants and an increase in fruit and vegetable intake but not for physical activity. The health behaviors of participants improved for three out of four indicators following the intervention. Limitations, future research, and implications for future programs are also discussed.

Exploring the Experience of Life Stress Among Black Women with a History of Fetal or Infant Death: a Phenomenological Study.

INTRODUCTION: Disparate birth outcomes among Black women continue to be a major public health problem. Whereas prior research has investigated the influence of stress on Black women's birth outcomes, few studies have explored how stress is experienced among Black women across the life course. The objectives of this study were to describe the experience of stress across the life course among Black women who reported a history of fetal or infant death and to identify stressful life events (SLE) that may not be represented in the widely used SLE inventory. METHODS: Using phenomenological, qualitative research design, in-depth interviews were conducted with six Black women in Kansas who experienced a fetal or infant death. RESULTS: Analyses revealed that participants experienced multiple, co-occurring stressors over the course of their lives and experienced a proliferation of stress emerging in early life and persisting into adulthood. Among the types of stressors cited by participants, history of sexual assault (trauma-related stressor) was a key stressful life event that is not currently reflected in the SLE inventory. CONCLUSION: Our findings highlight the importance of using a life-course perspective to gain a contextual understanding of the experiences of stress among Black women, particularly those with a history of adverse birth outcomes. Further research investigating Black women's experiences of stress and the mechanisms by which stress impacts their health could inform efforts to reduce disparities in birth outcomes. An additional focus on the experience and impact of trauma-related stress on Black women's birth outcomes may also be warranted.

How can immunization coverage in urban counties be improved? A pilot study of a Kansas county.

Vaccination coverage is sometimes lower in urban counties compared with their rural counterparts. Increasing private health providers' participation in the Vaccines for Children (VFC) program and in centralized immunization data collections systems or registries are 2 recommended strategies for increasing urban and statewide vaccination coverage. The purpose of this pilot study was to examine perceived barriers to providing immunization services in a group of private health clinics in an urban county and to obtain the clinics' recommendations for improvement. A survey was developed and mailed to a sample of 57 health clinics obtained from a medical roster. The response rate was 65%. Several clinic- and patient-related barriers to immunization were identified. The most prevalent clinic-related barriers that providers reported were patient noncompliance (73%) and clinic scheduling problems (14%). In terms of patient-related barriers, the most frequently cited were patients' work schedules (41%) and unawareness of the importance of immunization (41%). The data also suggested misconceptions and lack of information among providers pertaining to the VFC program and the immunization registry. The information obtained from this pilot study may assist researchers, practitioners, policy makers, and others in their efforts to improve immunization coverage as it pertains to private health providers and their role in these efforts. Implications for further studies and education initiatives are addressed.