Celebrating the strengths of black youth: increasing self-esteem and implications for prevention.

The purpose of this study was to test the impact of a preventive intervention program, celebrating the strengths of black youth (CSBY), on African American children's self-esteem, racial identity, and parental racial socialization messages. CSBY consisted of 10 in-person group sessions in which small groups of middle school students met two trained group leaders. Parents were invited to attend three of the 10 group sessions. African American children between the ages of 7 and 10 were randomly assigned to either a treatment (TX; n = 33) or waitlist control (WLC; n = 40) group. Pre- and post-measures were completed to capture treatment effects. Analyses revealed that treatment group participants had higher levels of self-esteem post intervention than WLC group participants. In addition, treatment group parents were more likely to communicate egalitarian messages to their children post intervention than WLC parents. The advantages of a cultural heritage, strengths-based preventive intervention for African American youth and suggestions for future research are discussed.

Food Insecurity in the Rural South in the Wake of the COVID-19 Pandemic.

Food insecurity in rural communities in the Southern US continues to grow, especially in the wake of the COVID-19 pandemic. Understanding the characteristics of food-insecure individuals and families in this region is critical for developing creative strategies for eliminating this health disparity issue. A food insecurity survey was given to attendees at food-security events held in several counties in one Southern US state. A descriptive analysis of food insecurity in this region is presented, and recommendations for addressing food insecurity among underserved and disadvantaged populations are suggested.

Community Engagement Practices at Research Centers in U.S. Minority Institutions: Priority Populations and Innovative Approaches to Advancing Health Disparities Research.

This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An overarching theme, building community together through trust and meaningful collaborations, emerged from the supporting themes and subthemes. The RCMI institutions and their CECs serve as models to circumvent the historical and current challenges to research in communities disproportionately affected by health disparities. Lessons learned from these cores may help other institutions who want to build community trust in and capacities for research that addresses community-related health concerns.

Improving the use of evidence in health impact assessment.

OBJECTIVE: Health impact assessment (HIA) has been proposed as one mechanism that can inform decision-making by public policy-makers. However, HIA methodology has been criticized for a lack of rigour in its use of evidence. The aim of this work was to formulate, develop and test a practical guide to reviewing publicly available evidence for use in HIA. The term evidence includes all scientific assessments, whether research studies in peer-reviewed journals or previous HIAs. METHODS: The formulation and development of the guide involved substantial background research, qualitative research with the target audience, substantial consultations with potential users and other stakeholders, a pilot study to explore content, format and usability, and peer review. Finally, the guide was tested in practice by invited volunteers who used it to appraise existing HIA evidence reviews. FINDINGS: During development, a wealth of data was generated on how the guide might be applied in practice, on terminology, on ensuring clarity of the text and on additional resources needed. The final guide provides advice on reviewing quantitative and qualitative research in plain language and is suitable for those working in public health but who may not have experience in reviewing evidence. During testing, it enabled users to discriminate between satisfactory and unsatisfactory evidence reviews. By late 2009, 1700 printed and 2500 downloaded copies of the guide had been distributed. CONCLUSION: Substantive and iterative consultation, though time-consuming, was pivotal to producing a simple, systematic and accessible guide to reviewing publicly available research evidence for use in HIA.

Rural Community Engagement for Health Disparities Research: The Unique Role of Historically Black Colleges and Universities (HBCUs).

Reducing health disparities in rural communities of color remains a national concern. Efforts to reduce health disparities often center on community engagement, which is historically the strategy used to provide rural minority populations with support to access and utilize health information and services. Historically Black Colleges and Universities (HBCUs), with their origins derived from social injustices and discrimination, are uniquely positioned to conduct this type of engagement. We present the "Research with Care" project, a long-standing positive working relationship between North Carolina Central University (NCCU) and rural Halifax County, North Carolina, demonstrating an effective campus-community partnership. The importance of readiness to implement Community-based Participatory Research (CBPR) principles is underscored. As demonstrated by the NCCU-Halifax partnership, we recommend leveraging the positive associations of the HBCU brand identity as a method of building and sustaining meaningful relationships with rural Black communities. This underscores the role and value of HBCUs in the health disparities research arena and should be communicated and embraced.

Family income and its relation to preschool children's adjustment for families in the NICHD Study of Early Child Care.

The current study examines relations of mean-level estimates, linear changes, and instability in income and family processes to child outcomes and addresses whether income, through its impact on family functioning, matters more for children living in poverty. Temporal changes and instability in family processes, but not income, predicted children's adjustment. Cross-sectional mediational analyses indicated that for families living at the poverty threshold, family processes fully mediated the effect of average income over the study period on social behavior but only partially mediated its effect on cognitive-linguistic development. The strength of these associations diminished as average income exceeded the poverty threshold. That is, income had a greater impact on the family functioning and development of poor children than of nonpoor children.

Appropriate utilization of semi-quantitative analysis in salivary scintigraphy.

AIM: The purpose of this case-control study was to determine whether semi-quantitative indices derived from salivary time-activity curves (TACs) are useful in the diagnosis and management of xerostomia. METHODS: Twenty-six healthy volunteers and 83 consecutive patients with xerostomia, including a subset of 40 patients with Sjogren's syndrome, underwent sequential salivary scintigraphy (SSS). Semi-quantitative analysis of the TACs was performed, deriving six different indices, previously cited in the literature, for each patient. These reflected trapping and uptake, stimulated excretion, or stimulated and unstimulated oral radioactivity. The indices were the percentage uptake, uptake ratios, maximum accumulation, pre-stimulatory oral radioactivity index, post-stimulatory oral radioactivity index and ejection fraction. RESULTS: Reduced parotid activity relative to submandibular activity, expressed as the P : S ratio, was able to distinguish abnormal from normal salivary function, and a parotid ejection fraction of greater than 50% also indicated normal parotid function. The other parameters showed no statistically significant difference between controls and patients. Individual variation in all indices served to widen the reference limits obtained from controls to the extent that they overlapped with those from the xerostomic population. CONCLUSIONS: This finding, together with previous work indicating that uptake parameters are only sensitive to differences exceeding 25% of the gland mass, the possibility that xerostomia may result from qualitative as well as quantitative changes in saliva and the probability that immune factors decrease neurosecretory circuits without affecting acinar mass, suggest that those indices derived from salivary TACs that directly reflect trapping and uptake are not useful in the detection of salivary gland disease.

Development of social-emotional competence in boys of color: a cross-sectional cohort analysis from pre-K to second grade.

This article explores the development of psychosocial competence in boys of color (BOC; 226 African Americans and 109 Latinos). Changes in competence were assessed over 2 years in cohorts of low-income BOC beginning in pre-K, kindergarten, or first grade. Psycho-social competence was assessed in terms of self-regulation, interpersonal skills, and positive relationships with peers and teachers. Psycho-social and academic competence in literacy and math were assessed in prekindergarten through second grade using teacher reports, child reports, and normed measures. One-year follow-up data were available on measures of psycho-social competence. BOC evidenced high levels of psycho-social competence, especially on self-regulation, which was related to both math and reading achievement. Teachers and children held similarly favorable views of their relationships, but teacher ratings of peer relationships of BOC were less positive. Although emotional self-regulation was stable, declines were observed in self-regulation of attention, quality of peer relationships, teacher-rated closeness, and satisfaction with life at school, especially over the transition from pre-K to primary school.

NICE guidance on long-term sickness and incapacity.

Long-term sickness absence and incapacity benefits (disability pension) rates have increased across industrialised countries. Effective measures are needed to support return to work. The recommendations of this guidance were informed by the most appropriate available evidence of effectiveness and cost-effectiveness. Public health evidence was provided by research using a variety of study designs that attempted to determine the outcome of a particular intervention by evaluating status before and after the intervention had been effected, and was not limited to randomised control trials. Where the evidence base was depleted or underdeveloped, expert witnesses were called to give their opinion on the best available evidence and emerging interventions. The process enabled challenge and contestability from stakeholder groups at different points as the guidance was developed. Forty-five heterogeneous studies were included in the review of interventions to reduce long-term sickness absence and transitions from short-term to long-term absence (mainly covering the former and also mainly examining musculoskeletal conditions). The analysis of evidence was restricted to descriptive synthesis. Three general themes emerged from an analysis of the studies that were more likely to report positive results: early interventions; multidisciplinary approaches; and interventions with a workplace component. Two further reviews were undertaken, one on interventions to reduce the re-occurrence of sickness absence, which identified seven studies on lower back pain, and concluded that early intervention and direct workplace input are important factors. The final evidence review focused on six studies of interventions for those in receipt of incapacity benefit. The evidence was that work-focused interviews coupled with access to tailored support are effective and cost-effective interventions. Practitioners should consider the impact of interventions and management options on work ability for patients of working age. Work ability should be considered a key outcome for future intervention studies.

Evaluation as a key part of health impact assessment: the English experience.

Health impact assessment (HIA) is an approach that has experienced increased activity and wide support within England. This is reflected in the large number of HIAs being undertaken at local and regional levels, by the advocacy of HIA in many national policy documents, and by the setting up of specialized HIA posts and centres. To continue this level of support, and to justify any increase, the approach of HIA must show whether and how the HIA approach informs the decision-making process and, in particular, whether it improves health and reduces health inequalities. The first steps in answering these questions have been taken by the partial evaluation of some completed HIAs within England. A description of these evaluations is presented. Work is also progressing on promising practice guidance for practitioners on the topic of evaluating HIAs. The further development of evaluation within HIA is required, at both a practitioner and research level, and provides an exciting opportunity for people and groups to advance the evidence base for HIA, while also proving its place as an effective public health intervention.