Insights from a cross-sectional binational study comparing obesity among nonimmigrant Colombians in their home country and Colombian immigrants in the U.S.

BACKGROUND: Latinos in the United States (U.S.) represent a heterogeneous minority population disproportionally impacted by obesity. Colombians in the U.S. are routinely combined with other South Americans in most obesity studies. Moreover, most studies among Latino immigrants in the U.S. solely focus on factors in the destination context, which largely ignores the prevalence of obesity and contextual factors in their country of origin, and warrant transnational investigations. METHODS: Using 2013-17 data from the New York City Community Health Survey (NYC CHS, U.S.) and the National Survey of the Nutritional Situation (ENSIN, Colombia), Colombians that immigrated to the U.S. and are living in NYC (n = 503) were compared to nonimmigrant Colombians living in their home country (n = 98,829). Prevalence ratios (PR) for obesity (BMI ≥ 30 kg/m2) by place of residence were estimated using multivariable logistic regression adjusting for socio-demographic characteristics and daily consumption of sugar-sweetened beverages. RESULTS: The prevalence of obesity was 49% greater for immigrant Colombians living in NYC when compared to nonimmigrant Colombians living in in their home country (PR = 1.49; 95% CI 1.08, 2.07). Colombian immigrant men in NYC were 72% more likely to have obesity compared to nonimmigrant men living in their home country (PR = 1.72; 95% CI 1.03, 2.87). No significant differences were found in the adjusted models among women. CONCLUSIONS: Colombian immigrants in NYC exhibit a higher prevalence of obesity compared to their nonimmigrant counterparts back home and sex strengthens this relationship. More obesity research is needed to understand the immigration experience of Colombians in the U.S. and the underlying mechanisms for sex difference. Public health action focused on women in Colombia and both Colombian men and women immigrants in the U.S. is warranted to avert the long-term consequences of obesity.

Structural Community Governance: Importance for Community-Academic Research Partnerships.

Community based participatory research (CBPR) emphasizes democratic knowledge production and joint action between academics and communities to promote health equity through multilevel interventions. While much scholarship has expressed a commitment to collaboration between researchers and communities, effective methods of structural governance between community and academic stakeholders is under explored. We fill this gap by presenting a conceptual and empirical analysis describing multiple dimensions of structural governance in CBPR partnerships. First, we integrate public policy evidence on effective collaborative governance designs with the emerging literature in CBPR to create a conceptual model. Next, we utilize internet surveys of 179 federally funded community engaged research projects to construct and assess a measure of structural governance across multiple dimensions using confirmatory factor analysis. We explore whether antecedent factors such as the stage of the partnership and ethnic composition are associated with these dimensions and we examine associations for each of these components on positive perceptions of community involvement of research and collective empowerment. We develop a robust multidimensional measure of structural governance that is positively associated with perceptions of increased community involvement in research and collective empowerment.

Characteristics and Practices Within Research Partnerships for Health and Social Equity.

BACKGROUND: As federal research funding focuses more on academic/community collaborations to address health inequities, it is important to understand characteristics of these partnerships and how they work to achieve health equity outcomes. OBJECTIVES: This study built on previous National Institutes of Health-funded research to (a) describe partnership characteristics and processes of federally funded, community-based participatory research (CBPR) or community-engaged research projects; (b) explore characteristics of these projects by stage of funding; and (c) build on previous understanding of partnership promising practices. METHODS: Between fall 2016 and spring 2017, we completed a cross-sectional analysis and principal component analysis of online survey data from key informants of federally funded CBPR and community-engaged research projects. Respondents for 179 projects (53% response rate) described project characteristics (e.g., type of partner, stage of partnership, and population) and the use of promising practices (e.g., stewardship, advisory board roles, training topics) by stage of partnership. RESULTS: Projects involved community, healthcare, and government partners, with 49% of respondents reporting their project was in the early stage of funding. More projects focused on Black/African American populations, whereas principal investigators were mostly White. The more established a partnership (e.g., with multiple projects), the more likely it employed the promising practices of stewardship (i.e., community safeguards for approval), community advisory boards, and training on values and power. CONCLUSIONS: Community engagement is a developmental process with differences between early-stage and established CBPR partnerships. Engaging in active reflection and adopting promising partnering practices are important for CBPR partnerships working to improve health equity. The data provided in this study provide key indicators for reflection.

Advancing system and policy changes for social and racial justice: comparing a Rural and Urban Community-Based Participatory Research Partnership in the U.S.

BACKGROUND: The paper examines the role of community-based participatory research (CBPR) within the context of social justice literature and practice. METHODS: Two CBPR case studies addressing health inequities related to Type 2 Diabetes and Cardiovascular disease were selected from a national cross-site study assessing effective academic-community research partnerships. One CBPR partnership works with African Americans in rural Pemiscot County, Missouri and the other CBPR partnership works with African American and Latinos in urban South Bronx, New York City. Data collection included semi-structured key informant interviews and focus groups. Analysis focused on partnerships' context/history and their use of multiple justice-oriented strategies to achieve systemic and policy changes in order to address social determinants of health in their communities. RESULTS: Community context and history shaped each partnership's strategies to address social determinants. Four social justice approaches (identity/recognition, procedural, distributive, and structural justice) used by both partnerships were identified. These social justice approaches were employed to address underlying causes of inequitable distribution of resources and power structures, while remaining within a scientific research framework. CONCLUSION: CBPR can bridge the role of science with civic engagement and political participation, empowering community members to become political agents who integrate evidence into their social justice organizing strategies.

Physical activity, fruit and vegetable intake, and health-related quality of life among older Chinese, Hispanics, and Blacks in New York City.

OBJECTIVES: We explored the relationship between health-related quality of life (HRQOL) and adequate physical activity (PA) and fruit and vegetable (F&V) intake among racial/ethnic minority groups aged 60 years or older living in New York City (NYC). METHODS: Survey data from 2009 to 2012 targeted minority groups in NYC ethnic enclaves; we analyzed 3594 individuals (Blacks, Hispanics, and Chinese) aged 60 years or older. Descriptive statistics were run; unadjusted and adjusted logistic regression evaluated the relationship of HRQOL with PA and F&V intake. RESULTS: Hispanics were most likely to engage in sufficient PA and eat recommended F&Vs and had significantly worse HRQOL. After multivariable adjustment, significant associations were found between PA and self-reported health, activity limitation and physical health days for all groups, and PA and mental health days for Hispanics. Significant associations were found between F&V intake and physical health days for Hispanics and F&V intake and self-reported health for Chinese. CONCLUSIONS: Findings indicated variations between HRQOL and PA by racial/ethnic subgroup. Despite being highly insured, recommendations for PA and F&V intake were not met. There is a need to promote healthy living behaviors among aging NYC racial/ethnic populations.

Disparities in diabetes management in Asian Americans in New York City compared with other racial/ethnic minority groups.

We examined diabetes management practices among Hispanics, Blacks, and 3 Asian American subgroups in New York City. Compared with Blacks and Hispanics, all 3 Asian American subgroups had lower average rates of diabetes management practices. Compared with Blacks, Chinese and Koreans were significantly less likely to participate in all diabetes management behaviors and practices, whereas Asian Indians were significantly less likely to perform feet checks or undergo an eye examination. Results demonstrated the need for health care provider interventions and training to support diabetes management among Asian Americans.

Corner Store Purchases in a Low-Income Urban Community in NYC.

We assessed purchases made, motivations for shopping, and frequency of shopping at four New York City corner stores (bodegas). Surveys and purchase inventories (n = 779) were collected from consumers at four bodegas in Bronx, NY. We use Chi square tests to compare types of consumers, items purchased and characteristics of purchases based on how frequently the consumer shops at the specific store and the time of day the purchase was made. Most consumers shopped at the bodega because it was close to their home (52 %). The majority (68 %) reported shopping at the bodega at least once per day. The five most commonly purchased items were sugary beverages, (29.27 %), sugary snacks (22.34 %), coffee, (13.99 %), sandwiches, (13.09 %) and non-baked potato chips (12.2 %). Nearly 60 % of bodega customers reported their purchase to be healthy. Most of the participants shopped at the bodega frequently, valued its convenient location, and purchased unhealthy items. Work is needed to discover ways to encourage healthier choices at these stores.

Graphical analysis of agent-based opinion formation models.

Agent-based models of opinion formation are becoming increasingly complex, because of their size and of the embedding of several individual psychological traits of the agents, aimed at realistically capturing the multifaceted aspects of social interaction. Therefore, the characterisation of the model properties mostly relies on simulation-based numerical approaches: more techniques are needed to analyse, contrast, and compare the properties of different models. We propose a novel graphical technique, which relies on the Agreement Plot to visualise the evolution of opinion distributions over time, that allows us to unveil behavioural patterns and capabilities of agent-based opinion formation models. Our proposed approach can be used to characterise the relation between global properties of the model evolution and the model features (initial opinion distributions, agent parameters, underlying digraphs), and is here showcased through its application to both seminal and recently proposed opinion formation models.

South-to-South parental migration patterns and excess weight among children: Insights from a national cross-sectional study in Colombia.

BACKGROUND: Evidence from Latin America suggests that children embedded in South-to-North migrant networks (i.e. relatives who live abroad, typically in the United States) are at increased risk of excess weight. It is unclear if the same findings apply to children embedded in Latin American intraregional migration or South-to-South migration networks. OBJECTIVE: To compare excess weight among Colombian children embedded in South-to-South migration networks (n = 334) to children with non-migrant parents (n = 4272) using Colombia's 2015 National Survey of the Nutritional Situation. METHODS: Prevalence ratios (PRs) for excess weight (BMI z-score ≥1) by parent migration history were estimated using weighted multivariable logistic regression adjusting for demographics, child behaviours, community and household indicators, including household food insecurity. RESULTS: Most migrant parents returned to Colombia from Venezuela (84%) and reported higher household food insecurity rates than non-migrant parents (59% versus 32%). Models excluding household food insecurity showed that excess weight among children with migrant parents was 51% lower (PR = 0.49; 95% CI 0.25, 0.98) than among children with non-migrant parents. After adjustment for household food insecurity, no statistically significant differences were found. CONCLUSION: Colombian children with return migrant parents from Venezuela experienced less excess weight than children with non-migrant parents, but higher rates of food insecurity in migrant households might partially explain this difference. This study calls attention to two serious public health concerns for Colombian children-those who have excess weight and those who lack sufficient food, particularly among migrant returnees (a situation that may have worsened since the COVID-19 pandemic).

Long-term reparative effects of mesenchymal stem cell therapy following neonatal hyperoxia-induced lung injury.

BACKGROUND: Mesenchymal stem cell (MSC) therapy may prevent neonatal hyperoxia-induced lung injury (HILI). There are, however, no clear data on the therapeutic efficacy of MSC therapy in established HILI, the duration of the reparative effects, and the exact mechanisms of repair. The main objective of this study was to evaluate whether the long-term reparative effects of a single intratracheal (IT) dose of MSCs or MSC-conditioned medium (CM) are comparable in established HILI. METHODS: Newborn rats exposed to normoxia or hyperoxia from postnatal day (P)2)-P16 were randomized to receive IT MSCs, IT CM, or IT placebo (PL) on P9. Alveolarization and angiogenesis were evaluated at P16, P30, and P100. RESULTS: At all time periods, there were marked improvements in alveolar and vascular development in hyperoxic pups treated with MSCs or CM as compared with PL. This was associated with decreased expression of inflammatory mediators and an upregulation of angiogenic factors. Of note, at P100, the improvements were more substantial with MSCs as compared with CM. CONCLUSION: These data suggest that acute effects of MSC therapy in HILI are mainly paracrine mediated; however, optimum long-term improvement following HILI requires treatment with the MSCs themselves or potentially repetitive administration of CM.

Probabilistic analysis of agent-based opinion formation models.

When agent-based models are developed to capture opinion formation in large-scale populations, the opinion update equations often need to embed several complex psychological traits. The resulting models are more realistic, but also challenging to assess analytically, and hence numerical analysis techniques have an increasing importance in their study. Here, we propose the Qualitative Outcome Likelihood (QOL) analysis, a novel probabilistic analysis technique aimed to unravel behavioural patterns and properties of agent-based opinion formation models, and to characterise possible outcomes when only limited information is available. The QOL analysis reveals which qualitative categories of opinion distributions a model can produce, brings to light their relation to model features such as initial conditions, agent parameters and underlying digraph, and allows us to compare the behaviour of different opinion formation models. We exemplify the proposed technique by applying it to four opinion formation models: the classical Friedkin-Johnsen model and Bounded Confidence model, as well as the recently proposed Backfire Effect and Biased Assimilation model and Classification-based model.

Antagonism of CXCR7 attenuates chronic hypoxia-induced pulmonary hypertension.

INTRODUCTION: Chemokines may directly participate in the pathogenesis of neonatal chronic hypoxia-induced pulmonary hypertension (PH). Although stromal-derived factor-1 (SDF-1) has been shown to be involved in PH, the role of its most recently discovered receptor, chemokine receptor type 7 (CXCR7), remains unclear. We sought to determine whether antagonism of the CXCR7 receptor would decrease pulmonary vascular remodeling in newborn mice exposed to chronic hypoxia by decreasing pulmonary vascular cell proliferation. METHODS: Neonatal mice were exposed to hypoxia (fractional inspired oxygen concentration = 0.12) or room air (RA) for 2 wk. After 1 wk of exposure, mice received daily injections of placebo or a CXCR7 antagonist (CCX771) from postnatal day 7 (P7) to P14. Right ventricular systolic pressure (RVSP), the ratio of the weight of the right ventricle to left ventricle + septum (RV/LV + S), and pulmonary vascular cell proliferation and remodeling were determined at P14. RESULTS: As compared with mice exposed to RA, hypoxia placebo mice had a significant increase in the lung protein expression of CXCR7. Although hypoxic placebo-treated mice had a significant increase in RVSP, RV/LV+S, and pulmonary vascular cell proliferation and remodeling, the administration of CCX771 markedly decreased these changes. DISCUSSION: These results indicate that antagonism of CXCR7 may be a potent strategy to decrease PH and vascular remodeling.

A framework to analyze opinion formation models.

Comparing model predictions with real data is crucial to improve and validate a model. For opinion formation models, validation based on real data is uncommon and difficult to obtain, also due to the lack of systematic approaches for a meaningful comparison. We introduce a framework to assess opinion formation models, which can be used to determine the qualitative outcomes that an opinion formation model can produce, and compare model predictions with real data. The proposed approach relies on a histogram-based classification algorithm, and on transition tables. The algorithm classifies an opinion distribution as perfect consensus, consensus, polarization, clustering, or dissensus; these qualitative categories were identified from World Values Survey data. The transition tables capture the qualitative evolution of the opinion distribution between an initial and a final time. We compute the real transition tables based on World Values Survey data from different years, as well as the predicted transition tables produced by the French-DeGroot, Weighted-Median, Bounded Confidence, and Quantum Game models, and we compare them. Our results provide insight into the evolution of real-life opinions and highlight key directions to improve opinion formation models.

Prevalence of self-reported obesity among diverse Latino adult populations in New York City, 2013-2017.

INTRODUCTION: Latinos in the United States represent a heterogeneous population disproportionally impacted by obesity. Yet, the prevalence of obesity by specific Latino group is unclear. Using the New York City Community Health Survey (2013-2017), this study compared self-reported obesity in the city's largest Latino adult populations (Puerto Ricans, Mexicans, Dominicans, Ecuadorians, and Colombians). METHODS: Age-standardized prevalence using the 2000 Census and prevalence ratios (PRs) for self-reported obesity (BMI ≥30 kg/m2) by country of origin were estimated using weighted multivariable logistic regression adjusting for socio-demographic characteristics, health status, and behaviors. RESULTS: Obesity prevalence among Mexicans (36.8%; 95% CI [31.5, 42.4]) and Puerto Ricans (36.3%; 95% CI [31.7, 41.3]) was significantly higher than that among Colombians (23.8%; 95% CI [18.8, 29.5]), Ecuadorians (24.2%; 95% CI [20.7, 28.1]), and Dominicans (27.0%; 95% CI [25.0, 29.1]). After adjusting for covariates, compared to Mexicans, the PRs of obesity remained significantly lower for Colombians (PR = 0.80; 95% CI [0.64, 1.00]), Ecuadorians (PR = 0.72; 95% CI [0.61, 0.86]) and Dominicans (PR = 0.75; 95% CI [0.65, 0.85]). There was no significant difference between Mexicans and Puerto Ricans. CONCLUSION: Obesity prevalence differs by country of origin, suggesting that clustering of Latinos in public health research may obscure unique risks among specific groups. Despite group differences, all Latino groups exhibit high prevalence of obesity and warrant renewed efforts tailored to the specific context and culture of each group to prevent and reduce obesity.

Toll-like receptor 4-deficient mice are resistant to chronic hypoxia-induced pulmonary hypertension.

Current data suggest that Toll-like receptor 4 (TLR4), a key molecule in the innate immune response, may also be activated following tissue injury. Activation of this receptor is known to induce the production of several proinflammatory cytokines. Given that pulmonary inflammation has been shown to be a key contributor to chronic hypoxia-induced pulmonary vascular remodeling, the authors hypothesized that TLR4-deficient mice would be less susceptible to pulmonary hypertension (PH) as compared to mice with intact TLR4. TLR4-deficient and TLR4-intact strains of inbred mice were exposed to 4, 8, and 16 weeks of hypoxia (0.10 FiO(2)) or normoxia (0.21 FiO(2)) in a normobaric chamber. After chronic hypoxic exposure, TLR4-intact mice developed significant PH evidenced by increased right ventricular systolic pressure, right ventricular hypertrophy, and pulmonary artery medial thickening. In contrast, TLR4-deficient mice had no significant change in any of these parameters and this was associated with decreased pulmonary vascular inflammatory response as compared to the TLR4-intact mice. These results suggest that TLR4 deficiency may decrease the susceptibility to developing PH by attenuating the pulmonary vascular inflammatory response to chronic hypoxia.

Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program.

PURPOSE: The purpose of this study was to evaluate Fine, Fit, and Fabulous (FFF), a faith-based diabetes prevention program for black and Latino congregants at churches in low-income New York City neighborhoods. FFF includes nutrition education and fitness activities while incorporating Bible-based teachings that encourage healthy lifestyles. METHODS: FFF is a 12-week, bilingual program developed by the Bronx Health REACH coalition, a Centers for Disease Control and Prevention-funded Center of Excellence for the Elimination of Disparities. This program has been implemented in 15 Bronx and Harlem churches, engaging a primarily black and Latino overweight and obese urban population. Pre-post surveys, nutrition tests, and weight logs were collected to assess knowledge, attitudes, and behaviors regarding healthy eating and physical activity. RESULTS: Participants (n = 183) reported statistically significant improvements in knowledge and healthy behaviors from baseline. Increased numbers of participants reported exercising in the past 30 days, eating fruit daily, being able to judge portion sizes, and reading food labels. Statistically significant numbers reported that they ate less fast food and were less likely to overeat at follow-up. The average weight loss across churches was 4.38 lbs or 2% of participants' initial body weight. Significant differences were observed when stratifying by race/ethnicity. CONCLUSION: Evaluation results show FFF's success at engaging overweight adults in behavior changes related to healthy eating and exercise. FFF demonstrates the potential of faith-based health interventions to address obesity and diabetes risk in high-need communities of color.

A community mobilizes to end medical apartheid.

PROBLEM: People of color suffer worse health outcomes than their White counterparts due, in part, to limited access to high-quality specialty care. PURPOSE: This article describes the events that led to the Bronx Health REACH coalition's decision to file a civil rights complaint with the New York State Office of the Attorney General alleging that three academic medical centers in New York City discriminated on the basis of payer status and race in violation of Title VI of the Civil Rights Act of 1964, the Hill-Burton Act, New York State regulations, and New York City Human Rights Law. KEY POINTS: Although the problem has not yet been resolved, the related community mobilization efforts have raised public awareness about the impact of disparate care, strengthened the coalition's commitment to achieve health equality, and garnered support among many city and state legislators. CONCLUSION: Community groups and professionals with relevant expertise can tackle complex systemic problems, but they must be prepared for a long and difficult fight.

Stirring up the mud: using a community-based participatory approach to address health disparities through a faith-based initiative.

This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institutionalization and sustainability.

Brainstem amino acid neurotransmitters and ventilatory response to hypoxia in piglets.

The ventilatory response to hypoxia is influenced by the balance between inhibitory (GABA, glycine, and taurine) and excitatory (glutamate and aspartate) brainstem amino acid (AA) neurotransmitters. To assess the effects of AA in the nucleus tractus solitarius (NTS) on the ventilatory response to hypoxia at 1 and 2 wk of age, inhibitory and excitatory AA were sampled by microdialysis in unanesthetized and chronically instrumented piglets. Microdialysis samples from the NTS area were collected at 5-min intervals and minute ventilation (VE), arterial blood pressure (ABP), and arterial blood gases (ABG) were measured while the animals were in quiet sleep. A biphasic ventilatory response to hypoxia was observed in wk 1 and 2, but the decrease in VE at 10 and 15 min was more marked in wk 1. This was associated with an increase in inhibitory AA during hypoxia in wk 1. Excitatory AA levels were elevated during hypoxia in wk 1 and 2. Changes in ABP, pH, and ABG during hypoxia were not different between weeks. These data suggest that the larger depression in the ventilatory response to hypoxia observed in younger piglets is mediated by predominance of the inhibitory AA neurotransmitters, GABA, glycine, and taurine, in the NTS.

The effect of pentoxifylline on the pulmonary response to high tidal volume ventilation in rats.

BACKGROUND: Volume-induced lung injury is associated with lung inflammation. Pentoxifylline inhibits cytokine release and modulates neutrophil function. OBJECTIVE: To evaluate the efficacy of pentoxifylline in the attenuation of lung inflammation induced by high tidal volume ventilation. DESIGN: Adult rats were randomly assigned to receive saline as placebo or pentoxifylline (100mg/kg over 30 min, followed by 50mg/kg/h) before and during 4h of high tidal volume ventilation (20 ml/kg). Bronchoalveolar fluid inflammatory mediators were measured at baseline and after 4h of ventilation. Lung tissue myeloperoxidase activity and wet/dry lung weight were assessed upon completion of the study. RESULTS: Bronchoalveolar tumor necrosis factor-alpha (pentoxifylline vs. placebo; 192+/-61 vs. 543+/-99 pg/ml; p<0.007) and thromboxane B(2) (262+/-26 vs. 418+/-49 pg/ml; p<0.02) concentrations, lung myeloperoxidase activity (0.5+/-0.1 vs. 1.2+/-0.2U/mg; p<0.003) and wet/dry weight (6.1+/-0.2 vs. 7.1+/-0.3; p<0.01) were all significantly lower in the pentoxifylline-treated group. CONCLUSION: Pentoxifylline was effective in reducing inflammatory lung injury associated with high tidal volume ventilation.