Bridging research and policy to address childhood obesity among border Hispanics: a pilot study.

BACKGROUND: Mexican-American children are disproportionately affected by obesity compared to other population groups. Although national guidelines recommend using environmental and policy approaches to address this public health issue, the majority of Mexican-American children do not meet physical activity recommendations. PURPOSE: To describe a knowledge transfer process involving local decision makers to address childhood obesity and physical activity needs among low-income, Mexican-American children and to examine environmental policy recommendations generated in this process. METHODS: This pilot study employed a qualitative research design that included the dissemination of primary research data to local decision makers in the Texas-Mexico border region. Stakeholders attending public meetings were briefed about a research project reporting on the physical activity needs of Mexican-American children from impoverished neighborhoods known as colonias. Seventy-four stakeholders responded to an unstructured questionnaire and proposed policy recommendations. Data were collected January-April 2011 and analyzed July-September 2011. Data were analyzed using a content analysis technique. RESULTS: Four policy themes emerged from the data: (1) establishing sustainable community-based health programs; (2) improving neighborhood infrastructure and safety; (3) increasing access to parks; and (4) supporting community organizations to disseminate health education to parents and children. CONCLUSIONS: Knowledge transfer processes planned and facilitated by researchers at public meetings with local decision makers are effective methods to influence policy development related to childhood obesity.

Health-related quality of life among Latinos with multiple sclerosis.

This study identifies characteristics associated with health-related quality of life (HRQOL) among Latinos with multiple sclerosis (MS). Data were collected from 99 Latinos with MS, with multiple linear regression models utilized to analyze these data. Marital status, MS symptoms, depressive symptoms, treatment at MS clinics, and satisfaction with insurance coverage of MS-related care were significantly linked with physical HRQOL. Marital status, employment, access to MS-focused care, and need for mental health care were significantly associated with mental health dimensions of HRQOL. Identifying characteristics associated with better HRQOL among Latinos with MS should facilitate approaches that address the health needs of this community.

Personal and cultural influences on diabetes self-care behaviors among older Hispanics born in the U.S. and Mexico.

Older Hispanics are disproportionately affected by diabetes, but little is known about predictors of diabetes self-care among this group. This study compared the magnitude of three self-care behaviors (diet, physical activity (PA), and glucose monitoring) among older Hispanics with type 2 diabetes born in the United States (n = 59) to those born in Mexico (n = 179), and investigated the influence of personal and health indicators on each self-care behavior. Findings were based on data drawn from convenience sample data collected with a questionnaire. Self-care behaviors were moderately practiced (39.5-45.8 %) with no significant differences by nativity. Mexico-born seniors were less linguistically acculturated (P < 0.001). Being female (OR = 2.41) and PA levels (OR = 2.62) were significantly associated with diet. Being female (OR = 3.24), more educated (OR = 3.73), U.S.-born (OR = 2.84), and receiving diabetes education (OR = 3.67) were associated with PA. Diabetes education (OR = 2.41) was associated with glucose monitoring. Although acculturation influenced only PA and no other behaviors, personal and cultural factors require further investigation to design diabetes management strategies for Hispanic seniors at the border region.

The impact of asthma health education for parents of children attending head start centers.

Parents of children who attend Head Start Centers are key participants in the health promotion and care of their own children. This non-randomized, longitudinal study aimed to test the effectiveness of an educational intervention based on the asthma and healthy homes curriculum targeting parents of Head Start children with or without an asthma diagnosis. One hundred and fifteen parents of children in Head Start Centers received an educational intervention at their corresponding sites, additionally pre- and post-test surveys were administered to measure educational intervention outcomes. A follow-up survey was conducted 6 months after the educational intervention was offered. Results showed a statistically significant increase in asthma and healthy home-knowledge (p < 0.001) in several areas. At 6 months post-intervention (54.4 %) (61 participants) were contacted and 98.4 % of made changes in their households as a result of their training. This study suggests that education can improve knowledge and change behaviors for the well-being of the residents of that household.

A pilot study of Latinos with multiple sclerosis: demographic, disease, mental health, and psychosocial characteristics.

In this study the authors present results from a survey of 99 Latinos with multiple sclerosis (MS), including demographic, disease, and mental health characteristics. Four in 10 respondents reported depressive symptoms; half thought they had more worries than other people due to their MS; and about 29 % thought they needed mental health care in the past year. Whereas 76 % of respondents were highly satisfied with their access to MS-focused care, only 61% were highly satisfied with their access to mental health care. These findings highlight the role of mental health and social services in the comprehensive care needed by Latinos with MS.

Comparisons of Latinos, African Americans, and Caucasians with multiple sclerosis.

OBJECTIVE: Identify racial/ethnic differences among people with multiple sclerosis (MS) in demographics, MS disease characteristics, and health services received. PARTICIPANTS: We analyzed enrollment data from the Registry of the North American Research Committee on Multiple Sclerosis (NARCOMS) Project to compare 26,967 Caucasians, 715 Latinos, and 1,313 African Americans with MS. DESIGN: Racial/ethnic analyses of NARCOMS data focused on descriptive characteristics, using ANOVA and chi-square tests to identify significant differences in means and frequencies among Caucasians, Latinos, and African Americans. RESULTS: We identified significant racial/ethnic differences in demographics, MS disease characteristics, and treatments. Caucasians were older when first MS symptoms were experienced (30.1 years) and at MS diagnosis (37.4 years) than Latinos (28.6 years and 34.5 years) or African Americans (29.8 years and 35.8 years). Larger proportions of Latinos reported normal function for mobility and bladder/bowel function compared to Caucasians. Larger proportions of Latinos (44.2 percent) and African Americans (45.8 percent) reported at least mild depression compared to only 38.7 percent of Caucasians. Larger proportions of Latinos never received mental health care or care from rehabilitation specialists than Caucasians or African Americans. A larger proportion of African Americans had never been treated by a neurologist specializing in MS and a smaller proportion of African Americans received care at a MS clinic than Caucasians or Latinos. CONCLUSIONS: Our findings highlight the need for future analyses to determine if age, disease duration, MS symptoms, and disability levels provide additional insights into racial/ethic differences in the use of MS-related providers.

Multi-criteria assessment of county public health capability disparities.

OBJECTIVE: This paper proposes an analytical approach to the assessment of geographic population health disparities that are measured as the consolidation of public health related indicators into geographic-specific scores, and are representative of the level of public health capability within counties in the state of Mississippi. STUDY DESIGN: A multi-criteria decision model was employed to develop an additive scoring system that assigns a numerical score of public health capability disparities for a geographical area (county). METHODS: Routinely collected indicators were used to measure each county's current public health related concerns. These indicators include access, risks, health care quality, and outcomes data. Public health experts rated and ranked indicators to generate indicator weight. RESULTS: A county score was developed to rank Mississippi counties based on relative public health capability. This scoring system depicts population health disparities among Mississippi counties. CONCLUSIONS: The model is useful and ideal for establishing expectations and benchmarks for reduction or equalization of disparities. This information can be used to manage geographic population health disparities by guiding policy formulation and implementation.

Awareness of the National Standards for Culturally and Linguistically Appropriate Services at an academic health center.

The study's objectives were to (a) determine the level of familiarity of faculty and students at an academic health center with the National Standards for Culturally and Linguistically Appropriate Services (CLAS), (b) identify faculty's and students' interest and preferred method of learning Medical Spanish, and (c) determine their aptitude for working with medical interpreters. A survey was developed, piloted, and sent via e-mail to all faculty members (n = 1,025) and students (n = 1,956) currently affiliated with or enrolled at the Medical College of Georgia. Reminder e-mails were sent after 2 weeks, and responses were accepted for 1 month. The total response rate for faculty members was 29% (300/1,025), and that for students was 44% (871/1,956). Nearly 22% of the responding faculty and 23% of the responding students reported that they were less than familiar with the National Standards for CLAS. Both faculty (46%) and students (70%) were willing to spend time learning Medical Spanish. Web-based instruction was the preferred educational delivery mode for those who completed the survey; however, 18% of faculty and 5% of students strongly disagreed with this point. When questioned about how often interpreters services are used, the rates for faculty and students ranged from 34% to 39%. These results suggest that a void exists in understanding the National Standards for CLAS and that there are varying levels of willingness to learn medical Spanish.