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Background: Latinos are currently the largest and fastest growing racial/ethnic group in the United States and have the lowest rates nationally of regular sources of primary care. The changing demographics of Latino populations have significant implications for the future health of the nation, particularly with respect to chronic disease. Community-based agencies and clinics alike have a long history of engaging community health workers (CHWs) to provide a broad range of tangible and emotional support strategies for Latinos with chronic diseases. In this paper, we present the protocol for a community intervention designed to evaluate the impact of CHWs in a Community-Clinical Linkage model to address chronic disease through innovative utilization of electronic health records (EHRs) and application of mixed methodologies. Linking Individual Needs to Community and Clinical Services (LINKS) is a 3-year, prospective matched observational study designed to examine the feasibility and impact of CHW-led Community-Clinical Linkages in reducing chronic disease risk and promoting emotional well-being among Latinos living in three U.S.-Mexico border communities.Methods: The primary aim of LINKS is to create Community-Clinical Linkages between three community health centers and their respective county health departments in southern Arizona. Our primary analysis is to examine the impact of the intervention 6 to 12-months post program entry. We will assess chronic disease risk factors documented in the EHRs of participants versus matched non-participants. By using a prospective matched observational study design with EHRs, we have access to numerous potential comparators to evaluate the intervention effects. Secondary analyses include modeling within-group changes of extended research-collected measures. This approach enhances the overall evaluation with rich data on physical and emotional well-being and health behaviors of study participants that EHR systems do not collect in routine clinical practice.Discussion: The LINKS intervention has practical implications for the development of Community-Clinical Linkage models. The collaborative and participatory approach in LINKS illustrates an innovative evaluation framework utilizing EHRs and mixed methods research-generated data collection.Trial Registration: This study protocol was retrospectively registered, approved, and made available on Clinicaltrials.gov by NCT03787485 as of December 20, 2018. [ABSTRACT FROM AUTHOR]

Background: Understanding the social lives of South Asian immigrants in the United States (U.S) and their influence on health can inform interpersonal and community-level health interventions for this growing community. This paper describe the rationale, survey design, measurement, and network properties of 700 South Asian individuals in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) social networks ancillary study.Methods: MASALA is a community-based cohort, established in 2010, to understand risk factors for cardiovascular disease among South Asians living in the U.S. Survey data collection on personal social networks occurred between 2014 and 2017. Network measurements included size, composition, density, and organizational affiliations. Data on participants' self-rated health and social support functions and health-related discussions among network members were also collected.Results: Participants' age ranged from 44 to 84 (average 59 years), and 57% were men. South Asians had large (size=5.6, SD=2.6), kin-centered (proportion kin=0.71, SD=0.28), and dense networks. Affiliation with religious and spiritual organizations was perceived as beneficial to health. Emotional closeness with network members was positively associated with participants' self-rated health (p-value <0.001), and networks with higher density and more kin were significantly associated with health-related discussions.Discussion: The MASALA networks study advances research on the cultural patterning of social relationships and sources of social support in South Asians living in the U.S. Future analyses will examine how personal social networks and organizational affiliations influence South Asians' health behaviors and outcomes.Trial Registration: ClinicalTrials.gov identifier: NCT02268513. [ABSTRACT FROM AUTHOR]

Background: Youth's physical activity (PA) may change across developmental periods. Although previous studies have observed a decline in levels of PA during adolescence, few studies have explored trends in PA during the transition from adolescence to young adulthood and what factors may impact the transitional change. The purpose of this study was to examine changes and predictors of change over time in PA from 10(th) grade to post-high school.Methods: The NEXT Generation Health Study recruited a nationally-representative cohort of US 10(th)-graders, and administered longitudinal surveys in four waves (years) to follow up the participants to their first year after high school. Using transition models, the self-reported outcomes, moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) each of which was repeatedly measured by one question, were modelled in association with wave-4 environmental-status variables and time-varying covariates.Results: There was a continuous decline in the proportion of respondents who met or exceeded the minimum recommended level for either MVPA (from 55.97 to 34.33 %) or VPA (from 65.96 to 54.90 %) from W1 to W4. Higher scores of peer PA, family support and VPA planning were prospectively associated with higher likelihood of meeting the MVPA/VPA recommendations. At wave 4, compared to those not working, attending 4-year colleges, or living on campus, participants working full/part time, not attending school or attending community-college level schools, and living at home or in own place were more likely to engage in MVPA.Conclusions: Peer PA, family support, self-regulatory skills, and environmental status after high school are critical factors that can promote MVPA/VPA among adolescents and emerging adults. [ABSTRACT FROM AUTHOR]

Background: Dietary behaviors are influenced by many individual and environmental factors. This study explores how dietary fat intake in high-risk midlife adults living in the rural south is influenced by three behavior settings, i.e. in the home, at work, and at church.Methods: Self-report data were collected from rural African American or Caucasian adults age 40-70 at three time points at baseline, 6, and 12 months post baseline. Multilevel analyses investigated the impact of determinants of fat intake over time.Results: Home and work environments varied significantly over time in regard to healthy eating while church environments remained stable. Age, gender, and self-efficacy for healthy eating were individual factors associated with fat intake. In the home, presence of more high fat items, a time-varying variable, was significant. In the work environment, having access to healthy foods as well as healthy eating programs has positive impact as did hearing healthy eating messages and availability of healthy foods at church.Conclusions: Understanding stability and variability of dietary fat intake from a social ecologic perspective will aid in identifying targets of change for intervention. Understanding which components of key behavior settings are dynamic and which are relatively stable will help to disentangle the complexity of multi-level determinants of dietary behavior. [ABSTRACT FROM AUTHOR]

Background: Physical activity is associated with the reduction of several chronic conditions in adults. Additionally, physical activity is extremely important for children for their development and cognitive functioning and also to create a physically active lifestyle that continues into adulthood. Despite the known benefits of physical activity, only one in five adults are achieving the public health recommendations of 150 minutes of moderate-to-vigorous physical activity per week and only 13 % of boys and 6 % of girls between the ages of 5 and 17 years are meeting the guidelines of 60 minutes per day. This study aims to evaluate whether a planning condition improves adherence to regular physical activity compared to an education-only control condition among families. Families are eligible if there is at least one child between the ages of 6 and 12 years who is not meeting the Canadian Physical Activity Guidelines.Methods/design: A six-month longitudinal randomized controlled trial will be used to compare the two conditions. Materials will be delivered at baseline with 'booster' sessions at six weeks and three months. Participants will be assessed at baseline and at six months with a fitness test, as well as questionnaires and accelerometery at baseline, six weeks, three months and six months. A total of 137 families have been recruited thus far from Greater Victoria. This study is ongoing and recruitment will continue until December 2015 with the target goal of reaching 160 families.Discussion: This protocol describes the implementation of a randomized controlled trial that utilizes planning strategies to try and increase physical activity among families. Research findings could be useful in public health in providing effective strategies to families to help decrease sedentary lifestyles. Additionally, findings may help to inform future interventions aimed at increasing physical activity among families.Trial Registration: This trial was registered on June 5, 2012 with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health. The registration ID is NCT01882192. [ABSTRACT FROM AUTHOR]