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Although widely acknowledged as an important social determinant of health, until recently researchers and policymakers have primarily approached housing insecurity as an urban issue, obscuring the visibility of its impacts in rural contexts, including the ways in which housing insecurity intersects with other health and structural inequities facing rural populations. Working to address this gap in the existing literature, this paper explores the experiences of housing insecurity in a rural context by reporting on an analysis of 210 in-depth interviews with 153 adults between the ages of 18–35, living in California's rural North State, a relatively overlooked far northern region of the state comprised of 12 north central and north eastern counties. Using in-depth qualitative interview data, we conducted an exploratory pattern-level analysis of participants' narratives structured by four dimensions of housing insecurity defined in the literature (housing affordability, housing stability, housing conditions, and neighborhood context). Drawing attention to the pervasiveness of rural housing insecurity within our sample, this analysis highlights the unique ways in which rurality creates distinct experiences not currently captured in the existing literature. Further research is needed across different types of rural communities to better understand the various ways that housing insecurity affects the everyday lives and health of rural residents. By grounding research within the experiences of rural residents, we are better able to respond to the crisis of rural housing insecurity and develop solutions that are tailored to rural residents' unique needs. [ABSTRACT FROM AUTHOR]

Oklahoma's medical cannabis is some of the least restrictive in the US. Previous research suggests that American Indian/Alaska Native (AIAN) have higher rates of cannabis use than other racial or ethnic groups. The goals of this paper are, first, to look at cannabis use among high school students living on the Cherokee Nation Reservation before (2017) and after (2019) medical cannabis because legal in Oklahoma (2018) utilizing the Cherokee Nation Youth Risk Behavior Survey (CNYRBS). Second, to describe the socio-demographic characteristics of youth using cannabis in the Cherokee Nation Reservation. Data were retrieved from the 2017 and 2019 CNYRBS. The data for this study included 1,216 high school students who completed the 2017 and 1,476 who completed the 2019 CNYRBS. After removal of incomplete records, there were 2,602 students whose data was analyzed in this study. Data were weighted to be representative of public-school students attending grades 9–12 within Cherokee Nation Reservation. Despite the legalization of medical cannabis in Oklahoma in 2018, there was no change in cannabis use among youth between 2017 and 2019. There were variations in cannabis use based on demographic factors and other substance uses. AIAN individuals had higher odds of current cannabis use compared to non-Hispanic White students, but there were no differences based on ethnicity. Additionally, the use of cigarettes, e-cigarettes, alcohol, and illegal drugs were associated with increased odds of cannabis use among both current and former users compared to those who had never used it. There was no spike in use among youth at least immediately after the legalization of cannabis in the Cherokee Nation Reservation. There were socio-demographic as well as substance use disparities in the use of cannabis. [ABSTRACT FROM AUTHOR]

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an essential nutrition assistance program that has led to successful health outcomes and healthcare access. To alleviate discomfort associated with WIC shopping at stores, the Congress mandated the transition to electronic benefit transfer (EBT) card system from paper vouchers. This study aimed to explore the experiences of WIC recipients in using EBT cards in stores. WIC recipients from one WIC clinic in northern New Jersey (N = 220) participated in this study. An online survey was framed under the theory of planned behavior to probe their underlying behavioral, normative, and control beliefs of using EBT cards. Using content analyses, dominating themes of each belief were extracted. Participants composed of Hispanic (91.2%) with mean age of 31.68 (SD = 7.69). Most frequently mentioned advantages of using EBT cards were convenience and ease (34.3%) followed by fast and efficient (28.5%). Participants noted that most people would approve of using EBT cards (70%), especially those who receive the benefits and approve of the public assistance (16.7%). They stated that having improved store inventory and an increase in WIC-authorized stores (17.2%) would make the EBT cards use easy. The transition to EBT cars allowed purchase flexibility, alleviated stigma and the purchase process burdens, but the challenges associated with WIC app usage and store specific issues remained. These challenges should be addressed in future intervention to enable WIC recipients more engaged in using the EBT cards. [ABSTRACT FROM AUTHOR]

While severity of post-traumatic stress disorder (PTSD) symptoms and moral injury among civilians affected by armed conflicts is generally understudied, even less research exists on civilian populations during an active war. This paper reports a large-scale study that administered standard assessments of PTSD and moral injury severity, as well as rich demographic questionnaires, to nearly 1300 Ukrainian civilians during the ongoing Russian invasion. Analyses revealed an extremely high prevalence of severe PTSD symptoms and moral injury, relative to both proposed clinical cut-offs and to earlier measurements from a similar population. Further regression analyses identified risk factors and protective factors. Greater severity of PTSD symptoms was observed among women, older and forcibly displaced individuals, and individuals from geographic regions under Russian occupation. Higher education correlated with milder PTSD symptoms. Moral injury was particularly strong in younger individuals. The present study is one of the first to report a large scale set of psychological data collected from the civilian population of Ukraine during the ongoing Russian invasion. It is obvious from the scope and long-term nature of the atrocities that psychological treatment of the civilian population will be required both presently, while the hostilities are ongoing, and in the future. This data contributes to a detailed understanding of the psychological response to traumatic stress, including its overall prevalence and presence in specific demographically and geographically defined civilian groups. [ABSTRACT FROM AUTHOR]

Tobacco use is the leading cause of death in the United States and youth prevention is key to reducing tobacco use. American Indian/Alaska Native (AI/AN) individuals have a higher prevalence of tobacco use compared to other populations. This paper aims to evaluate the prevalence of tobacco products among youth within the Cherokee Nation reservation. Data from the 2019 Cherokee Nation Youth Risk Behavior Survey (YRBS) was used to analyze the prevalence of tobacco use (cigarettes, smokeless tobacco, electronic cigarettes, cigars, and ≥ 2 products) among students within Cherokee Nation. Weighted frequency and percentages were obtained for variables and 95% confidence intervals were computed using Taylor linearization variance estimators. Binary associations between variables were examined using the Rao-Scott Chi-square test. There were 1475 high students who participated in the 2019 Cherokee Nation YRBS. Males were more likely to report the use of smokeless tobacco and ≥ 2 products than females. Twelfth graders had a higher prevalence of reported e-cigarette use compared to lower grades. AI/AN students had a higher prevalence of current use of cigarettes and ≥ 2 products compared to other groups. The use of marijuana and alcohol was positively associated with the use of all tobacco products. Depression was also positively associated with the use of all products excluding smokeless tobacco. Grade, age, depression, and current use of other tobacco products, marijuana, and alcohol were associated with greater electronic cigarette intensity levels. Using the results, tribal and local organizations can promote evidence-based interventions that focus on reducing tobacco use among youth. [ABSTRACT FROM AUTHOR]

Public libraries in the United States (U.S.) are important sources of health information. Immigrants comprise a large portion of the U.S. population, and research suggests that public libraries help immigrants adjust to life in a new country. Public libraries help immigrants access information directly related to health and provide programs that have indirect impacts on health outcomes, including learning a new language and forging social ties. The purpose of this paper was to examine perspectives from librarians related to interactions with immigrant patrons and how their library supports them in this role. Public librarians (n = 205) from two selected U.S. states completed an online survey focusing on how comfortable they were in helping immigrants with inquiries related to health and the role of the public library in supporting librarians in this endeavor. Respondents generally reported high levels of comfort interacting with immigrants, although there was limited interaction on potentially sensitive topics (i.e., immigration, health). Library staff perceived that libraries overall were not effective in meeting the needs of immigrant populations and that librarians were infrequently offered professional training related to cultural competency and diversity. The findings echo previous studies that demonstrate the need for professional development to ensure that librarians are aware of library resources available to assist immigrant patrons. Findings from this study suggest opportunities for public health professionals and public librarians to collaborate to ensure the provision of reliable resources, health information, and referrals to community-based services. [ABSTRACT FROM AUTHOR]

Background: National quality measures set goals for diabetes management. Hispanic populations are higher risk for diabetes and associated complications, especially low-income communities. Research suggests free clinics provide suboptimal diabetes management. Our quality improvement project aims to improve diabetes management in the Hispanic free clinic population. Methods: Clínica Latina's volunteer medical students and physicians serve predominantly uninsured Spanish-speaking patients. Established diabetes patients that attended clinic during the study were included. Data was collected regarding patients' diabetes care for two months, then analyzed compared to quality metrics. We implemented paper checklists and electronic medical record (EMR) smart phrases for volunteers to utilize in managing diabetes. Results: 32 patients were included in the study. At baseline, 78% had an A1C check in the past 3 months, 81% were on a statin. In the past year, 81% had a lipid panel, 19% had an eye exam, 63% had a diabetic foot exam, 53% had a urine microalbumin-creatinine screening. After interventions, 97% had an A1C check, 93% were on a statin, 91% had a lipid panel, 31% had an eye exam, 75% had a foot exam, 63% had a urine microalbumin-creatinine. Patients with an LDL < 100 increased from 62 to 66%. The mean A1C did not statistically significantly change. Volunteer smart phrase utilization increased from 37 to 59.1%. Conclusion: We implemented a checklist and EMR smart phrase to optimize diabetes management in a student-run Hispanic free clinic, which improved quality metrics. Low-resource clinics serving Spanish-speaking populations may benefit from similar interventions to improve diabetic care. [ABSTRACT FROM AUTHOR]

This paper analyses community knowledge, perceptions, and experiences of effectiveness of healthcare service provision on malaria prevention/treatment in two disease-endemic villages of the Okavango Delta panhandle in northern Botswana. A stratified random sampling of 355 households was conducted in October–November 2015. Follow-up retrospective cohort interviews were undertaken in August 2016 from 79 households that reported malaria incidences during the household survey. Data were also collected from 16 key informant interviews and 2 focus group discussions participants. Descriptive statistics and content analyses were used to summarise quantitative and qualitative data, respectively. Results indicate that communities in the study sites had positive perceptions about efficiency of health services based on availability, accessibility and utilization, adequacy of prevention and treatment interventions. Local health clinics were crucial information channels used by respondents. Additionally, factors related to acceptability, availability and accessibility are likely to contribute to perceived effectiveness of the interventions provided by healthcare service providers. Affirmation of efficiency health service provision against malaria has public health implications for adherence to treatment/prevention and participation in community health education campaigns and program implementation in the Okavango Delta region. [ABSTRACT FROM AUTHOR]

While health care-associated financial burdens among uninsured individuals are well described, few studies have systematically characterized the array of financial and logistical complications faced by insured individuals with low household incomes. In this mixed methods paper, we conducted 6 focus groups with a total of 55 residents and analyzed programmatic administrative records to characterize the specific financial and logistic barriers faced by residents living in public housing in East and Central Harlem, New York City (NYC). Participants included individuals who enrolled in a municipal community health worker (CHW) program designed to close equity gaps in health and social outcomes. Dedicated health advocates (HAs) were explicitly paired with CHWs to provide health insurance and health care navigational assistance. We describe the needs of 150 residents with reported financial barriers to care, as well as the navigational and advocacy strategies taken by HAs to address them. Finally, we outline state-level policy recommendations to help ameliorate the problems experienced by participants. The model of paired CHW–HAs may be helpful in addressing financial barriers for insured populations with low household income and reducing health disparities in other communities. [ABSTRACT FROM AUTHOR]

Our goal was to identify strategies aimed at increasing Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment and participation rates. The WIC program provides many health benefits for pregnant women, mothers, and children. WIC offers nutrition education, formula, fruits and vegetables, and other food to pregnant and postpartum women and their children until they reach the age of five. Despite the availability of this program nationwide, enrollment and participation rates remain low across the country. Several states have tried various interventions to combat this deficiency of engagement with the goal of increasing WIC enrollment and participation. We conducted a scoping review to identify articles based on pre-specified inclusion and exclusion criteria. Two reviewers independently identified and screened articles. Subsequently, three reviewers independently extracted study details and outcomes related to WIC enrollment and participation rate changes. We included 14 studies reporting on 12 interventions from 3945 citations reviewed. Seven of these were published papers, while the others were final reports of USDA WIC Special Grant Projects. All the observed interventions had some success increasing WIC participation. Virtual interventions demonstrated the most success based on preliminary evidence. Successful interventions showed percentage gains in enrollment close to 8% and changes in participation over 9%. Overall, the literature surrounding WIC enrollment interventions reveal a mixed impact on improving participation. Many successful interventions involve an online or virtual engagement component which can provide educational resources on WIC benefits, nutrition, and living a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Mexican Americans are at increased risk for obesity upon immigration to the U.S., increasing their risk for diabetes, cardiovascular disease, and cancer. Our pilot individual lifestyle intervention culturally tailored for Mexican Americans, COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), showed promising results. This paper presents outcomes from the group-based version of COMIDA. 129 overweight/obese Mexican Americans were enrolled in 'Group COMIDA'. Participants' weight (primary outcome), dietary intake and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Seventeen percent of participants experienced 5% weight loss at follow-up. Post-intervention, participants consumed more fruit and vegetables and fewer sweets and fried foods. A group-based, culturally adapted lifestyle intervention may be a more cost-effective approach than individual interventions to improve dietary behavior among underserved populations, though additional modifications may be considered to increase the intervention's effectiveness in promoting significant weight loss. [ABSTRACT FROM AUTHOR]

Electronic cigarette use among adolescents has increased in the past decade. Little is known about the perception and use of e-cigarettes in Vietnam, especially among young people. This study examines the perceptions and use of electronic cigarettes among young adults in Vietnam. The study uses data from a survey of adult tobacco consumption among adults at the provincial level in 2020, which was funded and managed by the Vietnam Tobacco Control Fund—Ministry of Health. Data were collected from 34 provinces and cities throughout Vietnam and managed using REDCap software. The survey engaged 80,166 participants, of which 9478 were young adults aged 15–24 were selected and reported in this paper. The results show that, at the time of the survey, 2.4% of young Vietnamese adults were smoking e-cigarettes. Many survey participants cited more than one reason for smoking e-cigarettes. These reasons included preferring the taste of e-cigarettes (64.0%), disliking the odour of other cigarettes (46.2%), following the example of family members (44.9%), and believing e-cigarettes threatened fewer health risks (39.1%). Almost half of the e-cigarette users wanted to quit (48%). E-cigarette use was associated with males living in urban areas who are aware of the Law on Prevention and Control of Tobacco Harms. The findings of this study provide evidential data that support public health policies aimed at reducing and ceasing e-cigarette use among young people. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused unprecedented disruption in all activities, especially those related to group gatherings. During the lockdown period, faith-based organizations, which are resources for both religious and health promotion activities, had to develop alternative strategies to meet those goals. The purpose of this paper is to describe the sustainability of M.I.C.A.H. Project HEAL, a partnership between an academic medical center and faith-based organizations in underserved communities in New York City, during the initial pandemic lockdown period. The use of virtual platforms facilitated Community Health Advisors (CHAs) in 13 organizations to conduct 47 health education workshops, reaching over 800 participants. Reliance on virtual platforms continued after in person gatherings were permitted. These data further support the benefits of academic partnerships with faith-based organizations to provide timely health information during a public health crisis. [ABSTRACT FROM AUTHOR]

While surveillance on a global scale has been showing a decline in tobacco smoking in the past decade, rates in the Eastern Mediterranean Region (EMR) remained stable with some countries showing rising trends. This study aimed to analyze the landscape of tobacco research in the EMR, present data on publication trends, and identify research gaps and opportunities to guide future tobacco research in the region. We conducted a scoping review of tobacco research in seven countries from January 2000 to December 2013. Three hundred and forty eight studies were identified, the majority of which were published in international journals and in English language. There was an increase in publications over time, with a significant positive linear trend (p = 0.03). Descriptive cross-sectional and case–control studies were the most common study designs (67.0%), and only 8% were longitudinal studies. Papers that reported, in part or solely, on waterpipe tobacco smoking (WTS) constituted 25.6% of the total publication pool. Tobacco consumption was treated as an exposure variable in half of the papers and mostly in relation to cancer and cardiovascular diseases, as an outcome measure in 37.7%, and as a confounding variable in 14.7% of the papers. Studies that examined associations of tobacco with other behaviors (5.3%) were lacking. The scarcity of high-evidence tobacco research in the EMR, together with the relatively deficient data on WTS and associations with other factors warrant the need for discussions on research priority setting and guidance on funding allocations in the region. [ABSTRACT FROM AUTHOR]

Bicycling holds promise as a healthy and sustainable means of transportation and physical activity. Despite the growing interest in community-based environmental approaches to promoting physical activity, bikeability has received relatively little attention. This paper provides a scoping review of the instruments developed to measure bikeability along with practice-based analyses of the tools related to user expertise, estimated cost, and required time to implement. The review summarizes the literature, identifies research gaps, and informs stakeholders with articles from EBSCO and transportation databases published after 2003 when the previous bikeability instrument review paper was published. Data extraction included the tool name, data collection method, study location, data collection scale, type of measure, and description. Two reviewers independently reviewed articles included in the full text review, and the inter-rater agreement exceeded 90%. The database search yielded 388 unique articles, and 17 met the inclusion/exclusion criteria. Most of the studies, 11 of 17, were applied to settings outside of the U.S. Five studies employed a self-report survey, and five studies examined bikeability using geospatial data, like GIS. Seven studies used a direct observation audit tool—one specifically using a mobile app and another using virtual observation techniques with Google Street View. Bikeability tools are useful for assessing communities and their supports for bicycling. Our primary finding is that advances in technology over the past two decades have driven innovative and useful methodologies, in a variety of disciplines, for assessing the environment, but more consensus is needed to provide a universal definition of bikeability. [ABSTRACT FROM AUTHOR]

The increase in depression during the COVID-19 pandemic underscores the importance of systematic approaches to identify individuals with mental health concerns. Primary care is often underutilized for depression screening, and it is not clear how practices can successfully increase screening rates. This study describes a quality improvement initiative to increase depression screening in five Family Medicine clinics. The initiative included four Plan-Do-Study-Act cycles that resulted in implementing a standardized workflow for depression screening, collaborative efforts with health information technology to prompt providers to perform screening via the medical record, delivering educational materials for providers and clinic staff and conducting follow-up education. Between September 2020 and April 2021 there were 23,745 clinic encounters with adult patients that were analyzed to determine whether patients were up-to-date on depression screening following their visit. A multi-level logistic regression model was constructed to determine the changes in likelihood of a patient being up-to-date on screening over the study period, while controlling for patient demographics and comorbidities. The average proportion of up-to-date patients increased from 61.03% in September 2020 to 82.33% in April 2021. Patients aged 65+ and patients with comorbidities were more likely to be up-to-date on screening; patients with telemedicine visits had lower odds of being up-to-date on depression screening. Overall, this paper describes a feasible, effective intervention to increase depression screening in a primary care setting. Additionally, we discuss lessons learned and recommendations to inform the design of future interventions. [ABSTRACT FROM AUTHOR]

In 2017, Public Health 3.0 was introduced, providing recommendations that expand traditional public department functions and programs. Operationalizing the framework requires that local health departments invest in the requisite professional skills to respond to their community's needs. The purpose of this paper is to determine the professional skills that are most important for local health departments to respond to large public health issues and challenges that are having a major impact on their communities. The study used a cross-sectional assessment of the education and training needs of local public health departments in Nebraska following the principles of practice-based systems research. The assessment was designed to assess the training and education needs of local health department staff members. The questions measured the perceived importance of and respondent's capacity across 57 core competencies for public health professionals modified from the Council on Linkages Between Academia and Public Health Practice. A total of 104 staff members from seven local health departments were requested to complete the assessment and 100% of the individuals responded to and completed the assessment. Twenty-eight skills were identified as the most important skills needed for local health departments. The skills were themed and categorized into four domains. (1) Data, Evaluation, and Quality Improvement, (2) Community Engagement and Facilitation, (3) Systems Thinking and Leadership, and (4) Policy and Advocacy. The results from this analysis provide direction to strengthen and transform the public health system into one that is connected, responsive, and nimble. Additionally, it also highlighted a glaring omission that Equity, Diversity, and Inclusion should be included as the fifth domain. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has exposed the difficulty of the US public health system to respond effectively to vulnerable subpopulations, causing disproportionate rates of morbidity and mortality. New York Haredi-Orthodox Jewish communities represent a group that have been heavily impacted by Covid-19. Little research has examined their experience or perceptions toward Covid-19 and vaccines. We conducted a cross-sectional, observational study to explore the experience of Covid-19 among Haredim. Paper surveys were self-administered between December 2020 and January 2021 in Haredi neighborhood pediatricians' offices in Brooklyn, New York. Of 102 respondents, 43% reported either a positive SARS-CoV-2 viral or antibody test. Participants trusted their physicians, Orthodox medical organizations, and rabbinic leaders for medical information. Knowledge of Covid-19 transmission and risk was good (69% answered ≥ 4/6 questions correctly). Only 12% of respondents would accept a Covid-19 vaccine, 41% were undecided and 47% were strongly hesitant. Independent predictors of strong vaccine hesitancy included believing natural infection to be better than vaccination for developing immunity (adjusted odds ratio [aOR] 4.28; 95% confidence interval [CI] 1.23–14.86), agreement that prior infection provides a path toward resuming communal life (aOR 4.10; 95% CI 1.22–13.77), and pandemic-related loss of trust in physicians (aOR 5.01; 95% CI 1.05–23.96). The primary disseminators of health information for self-protective religious communities should be stakeholders who understand these groups' unique health needs. In communities with significant Covid-19 experience, vaccination messaging may need to be tailored toward protecting infection-naïve individuals and boosting natural immunity against emerging variants. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic has required health services to rapidly respond to the needs of people diagnosed with the virus. Over 80% of people diagnosed with COVID-19 experience a mild illness and there is a need for community management to support these people in their home. In this paper we present, a telephone based COVID-19 community monitoring service developed in an Australian public health network, and we describe the rapid implementation of the service and the demographic and clinical characteristics of those enrolled. A retrospective mixed methods evaluation of the COVID-19 community monitoring service using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Eight hundred and fifty COVID-19 positive patients were enrolled, 54% female, 45% male, mean age 34 years SD 17. Four hundred and nine (48%) patients were born outside Australia. Among the 850 patients, 305 (36%) were classified as having a high risk of serious illness from COVID-19. The most prevalent risk factors were cardiovascular disease (37%), lung disease (30%) and age over 60 years (26%). The most common reported ongoing symptoms were fatigue (55%), breathing issues (26%) and mental health issues such as low mood (19%). There were no deaths in patients that participated in the service. The process of risk stratification undertaken with telephone triage was effective in determining risk of prolonged illness from COVID-19. Telephone monitoring by trained health professionals has a strong potential in the effective management of patients with a mild COVID-19 illness. [ABSTRACT FROM AUTHOR]

The paper contributes to unravelling the perceptions of urban commercial drivers regarding their vulnerability to catching the SARS-CoV-2 virus while at work. It further examines how the perception of vulnerability influences personal use of face masks by drivers, as well as on their insistence on appropriate masking behaviour by other persons on-board public transport. Overcrowding and unsanitary conditions in informal public transport in Africa could facilitate the spread of the corona virus. However, the use of face masks, among other enhanced mitigation measures significantly contain and minimize the spread of the virus. Primary data, obtained through surveys at five major public transport terminals in Accra, was analysed and interpreted using the Health Belief Model as an explanatory framework. Results indicate that most drivers have a high vulnerability perception to Covid-19. It further emerged that older drivers, in particular, consistently wore face masks and insisted on other persons in their commercial vehicles to follow suit. Socio-demographic factors, and the need to ensure one's personal safety and those of loved ones were critical determinants of face mask use among surveyed drivers. The study thus recommends that public awareness campaigns should strategically focus attention on the younger generation of drivers (i.e. 18–39 years) who perceived themselves to be immune to the SARS-CoV-2 virus. Also, the collaborative efforts of state and non-state actors, like the transport operator unions, must be further strengthened if the gains made so far against Covid-19 is to be sustained. [ABSTRACT FROM AUTHOR]

The use of Electronic cigarettes (E-cigarettes) has considerably expanded especially among adults. This paper highlights the behavior regarding E-cigarettes uses among adult males in Jordan. Moreover, we studied the electronic cigarette devices, the electronic cigarette liquids used in them, and the health-related complaints associated with e-smoking. Among smokers, we studied the association between E-cigarette use and their interest in smoking cessation. A questionnaire-based study regarding electronic cigarette prevalence and awareness among Jordanian individuals was conducted with a total sample size of 1536 participants. The questionnaire was distributed using Facebook and WhatsApp social groups. In this study, we included data of a total of 254 adult male participants after excluding non-E-cigarettes smokers, female smokers, and male smokers younger than 18 years old from the previously published study (Electronic Cigarettes Prevalence and Awareness among Jordanian Individuals) to describe electronic smoking behavior among adult males in Jordan. We described smoking behavior, electronic smoking technologies and materials, source of knowledge, and believe regarding electronic smoking among participants. A total of 254 E-cigarette smokers have participated in this study. 104 participants (40.9%) were found to smoke both traditional and electronic cigarettes, 111 (43.7%) quit traditional cigarette smoking and switched to E-cigarettes, and 39 (15.3%) individuals are exclusively e-smokers. More than half of the participants (n = 144; 56.7%) believe E-smoking is not addictive, and 213 (83.8%) suppose that the overall health effects attributable to E-smoking are less severe and not as serious as those related to traditional smoking. The use of E-cigarettes increased both nationally and globally in the past few years and is considered an emerging modality of smoking among non-smokers. Social media and other internet websites are the main sources of knowledge regarding E-cigarettes. Health-related issues and addiction are thought to be less than traditional smoking in considerable percentages of E-smokers. A more comprehensive conception of E-smoking patterns in Jordan is required to approach this phenomenon. Health authorities in collaboration with governmental policymakers are obligate to adopt strict recommendations to control the promotion of E-smoking through social media and other internet websites to limit its distribution among people especially youths. [ABSTRACT FROM AUTHOR]

Hispanics are the largest U.S. immigrant group and Mexican Americans are the largest U.S. Hispanic population. Hispanics, particularly Mexican Americans, are among the highest risk groups for obesity, placing them at increased risk for cardiovascular disease and certain types of cancer. Obesity lifestyle interventions incorporating Motivational Interviewing techniques and specific adaptations for the population of interest can have a significant impact on reducing health risks. This paper presents a community-engaged, culturally-sensitive nutrition and dietary counseling intervention conducted between 2016 and 2018 at the Consulate General of Mexico in New York City and reports preliminary findings regarding participant satisfaction and self-reported changes in eating and exercise habits. In addition, it describes the community and academic partners' roles and processes in program development, discusses strengths and challenges posed by a multi-sector partnership and describes adaptations made using the Behavioral Model for Vulnerable Populations to increase the program's sustainability and potential for scalability. [ABSTRACT FROM AUTHOR]

The provision of care to older persons can impose significant burden on those providing care, burdens influenced by care recipient characteristic, caregiver attributes and availability of social support. This paper focuses on identifying relationships between caregiver burden and the socio-demographic, health and functional status attributes of care recipients age 60 years and older in Jamaica. A nationally representative cross-sectional study was done among persons providing non-institutional care for a single person 60 years and older. Data were obtained from a total of 180 caregivers from the four geographic health regions of Jamaica using the Zarit Burden Interview and a 44-question structured questionnaire. Associations between caregiver burden and socio-demographic, health and functional status of care recipients were examined and logistic regression applied to ascertain independent predictors of caregiver burden. The results revealed statistically significant relationships between caregiver burden and care recipients' receipt of conditional cash transfer grants and the ability to toilet independently. In multivariate analysis, ability to toilet remained a significant predictor of caregiver burden—Caregivers who had care recipients who were able to toilet independently were 71% less likely to have mild to severe caregiver burden compared to those who had care recipients that were not able to toilet (OR 0.29; 95% CI 0.14–0.57). Families, health care providers, social workers, state actors and caregivers should take this into account as they develop strategies to mitigate associated caregiver burden. [ABSTRACT FROM AUTHOR]

African Americans in Atlanta, Georgia disproportionately reside in communities with limited access to healthy foods. Collaborations with local corner stores to provide healthy food options have been identified as an evidence-based intervention that could be used to increase food access. This paper describes the community-based participatory approach used to culturally-tailor a Healthy Corner Store Initiative (HCSI) in five Atlanta communities. A mixed method approach (qualitative/quantitative) was utilized. Spatial analysis and an environmental assessment were conducted to locate all corner stores in the partner communities that were listed in a business database. An environmental assessment was conducted at 34 corner stores using a structured log and checklist. Among them, 11 were selected and signed memorandums of understanding to implement the HCSI. A customer intercept survey was administered to 100 African American corner store customers at five of the healthy corner store sites. Descriptive statistics were used to analyze log/checklist and survey data. Corner store customers indicated that they typically purchase snacks, tobacco, and breads, but would purchase certain healthy foods, if offered. They also indicated that freshness of fruits and vegetables and positive relationships with corner store owners would influence healthy food purchases. Findings demonstrate that working collaboratively with community members, researchers and business owners is a critical step in nurturing trust, strengthening credibility, and building partnerships towards increased healthy food access and improved community health. [ABSTRACT FROM AUTHOR]

Gloves can serve as barriers to decrease the transfer of microorganisms from hands to food. Glove changing by food vendors is particularly important when handling paper currency, as bills can carry and transmit microbes from person to person. The purpose of this study was two-fold: (1) To ascertain the extent to which gloves are changed after monetary transactions in food vendors at a major mall in New Jersey; and (2) to document the level of bacterial contamination and the presence of coliform bacteria on paper currency handled by these vendors. This study was conducted with two phases: Phase 1, in which 10 min of observation of food workers was completed followed by a monetary sample collection and testing, and Phase 2, in which 1 h of observations were conducted. During Phase 1, gloves were changed after 4 (2.3%) of the 174 transactions. All the dollar bills collected from all 17 vendors during Phase 1 exhibited bacterial contamination. The number of CFUs ranged from 1.18 × 10 to 1.13 × 10, and bills collected from 6 of the 17 vendors (35.3%) tested positive for coliform bacteria. In Phase 2, gloves were changed after 3.35% of the 1193 transactions observed. This study makes the critical connection between the lack of compliance by food workers with the health code, and the contaminated money they may be handling while dispensing food. [ABSTRACT FROM AUTHOR]

Traditional medicine is widespread in Ghana, with 80% of Ghanaians relying on its methods for primary health care. This paper argues that integrating traditional and biomedical health systems expands the reach and improves outcomes of community health care. Moving beyond literature, it stresses the importance of trust-relationships between healers and biomedical staff. Insights are based on qualitative research conducted in Ghana's Northern Region (2013-2014). Five challenges to integration emerged out of the data: a lack of understanding of traditional medicine, discrimination, high turnover of biomedical staff, declining interest in healing as a profession, and equipment scarcity. Besides challenges, opportunities for integration exist, including the extensive infrastructure of traditional medicine, openness to collaboration, and grassroots initiatives. Contemplating challenges and opportunities this paper provides recommendations for integration, including: identify/select healers, promote best practices, institute appropriate forms of appreciation/recognition of healers, provide aid and equipment, use communication campaigns to promote integration and steer attitudinal change towards healers among biomedical staff. Most crucial, we argue successful implementation of these recommendations depends on a concerted investment in relationships between healers and biomedical staff. [ABSTRACT FROM AUTHOR]

Volunteers and voluntary organizations can connect preventative health care programs to communities and may play an important role in addressing the health needs of older adults. Despite this, tensions may exist in the structures that drive volunteers and voluntary organizations representing immigrant communities to provide unpaid labour to augment and supplement health care services. Furthermore, organizational challenges may exist for community agencies relying on volunteers to sustain a health screening and education program. The intervention program was led by one voluntary agency specifically for South Asian communities in partnership with the university and five local organizations. This paper draws on volunteer surveys (n = 22) and key informant interviews (n = 12) to detail volunteer experiences providing this intervention. Volunteers were university students and other community volunteers. A total of 810 adults participated in the intervention within the Greater Toronto Area, Ontario, Canada between October 2014 and June 2016. We found that volunteers often used their experience as a 'stepping stone' position to other education or work. They also gained from the knowledge and used it to educate themselves and their family members and friends. This paper provides a critical reflection on the role of volunteers in a preventative and educational healthcare intervention program for older adults from the South Asian community. Tensions exist when relying on volunteer labour for the implementation of preventative community health care programming and must be explored to ensure program sustainability as well as equity within the health care system. [ABSTRACT FROM AUTHOR]

This paper describes incidental exposure to alcohol in advertisements on buses in Manhattan, New York City. From April to July 2019, researchers observed advertisements on all bus lines in Manhattan and coded the content of these advertisements, including the kinds of products and services advertised and whether alcoholic beverages or images were present. Despite a ban on direct alcohol beverage advertising within the Metropolitan Transit Authority in 2017 (and expanded in 2019), almost one in five of the 136 advertisements observed (n = 25) included incidental exposure to images of alcohol portrayed in a favorable way and/or associated with well-known movie stars and television personalities. Advertisements on city buses are unlike any other, as they traverse the city streets and create considerable exposure to residents, including youth. This study demonstrates that banning advertisements for alcohol will not necessarily restrict favorable images containing alcohol and that youth continue to be exposed to these images. [ABSTRACT FROM AUTHOR]

Falls are the fifth leading cause of death and are one of the main causes of hospitalization. The literature about falls prevalence among older adults living in rural/remote communities in South America is scarce. To compare falls prevalence among the elderly in the Andes, Peru, and in the rural area of the municipality of Rio Grande, Rio Grande do Sul state, Brazil. Two separate cross-sectional studies were conducted in Peru, Andes (N = 413), and Brazil, Rio Grande, Rio Grande do Sul state (N = 1029). We stratified all data analysis according to location (Andes/Rio Grande). Characteristics of the samples were compared and the chi square test for proportions was used. Falls prevalence was then calculated for each independent variable and crude and adjusted prevalence ratios were estimated using Poisson Regression with robust variance. Falls prevalence in the last year was much higher in the Andes (64.1%) than in Rio Grande (25.3%). For most characteristics assessed, falls prevalence in Peru was at least double that found in Rio Grande. According to the adjusted analysis for the Andes, age (80 or more), being married, divorced and alcohol intake were significantly associated with falls. In Rio Grande, female gender and being in the 70–79 and 80 or more age ranges were associated with falls as well as those who self-rated their health as poor. This paper contributes to knowledge about falls prevalence among the elderly from rural and remote communities in two South American countries. Longitudinal multicentre studies with standardized methodologies are recommended. [ABSTRACT FROM AUTHOR]

Over the past few decades, a community-based approach was seen to be the "gold standard" for health promotion and disease prevention, especially in the field of socially deprived neighborhoods in urban areas. Up to the beginning of the 2000s, earlier reviews provide valuable information on activities in this context. However, in their conclusions they were limited to North America and Europe. Therefore, we conducted a systematic literature review on community-based health promotion and prevention programs worldwide. The Pubmed and PsycINFO databases were screened for relevant articles published between January 2002 and December 2018, revealing 101 potentially eligible publications out of 3646 hits. After a systematic review process including searching the reference lists, 32 papers met the inclusion criteria and were included in the review. Twenty-four (75.0%) articles reported improvements in at least one health behavior, health service access, health literacy, and/or a range of health status outcomes. Large-scale community-based health promotion programs, however, often resulted in limited or missing population-wide changes. Possible reasons are methodological limitations, concurrent context effects, and limitations of the interventions used. Our results confirm that community-based interventions are promising for health promotion and disease prevention but so far their potential is not fully realized. For the future, such interventions should aim at proximal outcomes and invest in community capacity building. [ABSTRACT FROM AUTHOR]

Globally, young people in sub-Saharan Africa continue to be the population at the greatest risk for sexually transmitted infections (STIs) such as HIV and AIDS, Syphilis, and Gonorrhoea. Research has shown significant relationship between young peoples risky sexual behaviours and their vulnerability to these STIs. The study examined risky sexual behaviours among the youth in Ghana and Kenya in relation to socio-demographic characteristics. The paper uses data from the 2014 Demographic and Health Surveys of Ghana and Kenya. Young people between the ages of 15 to 24 years who were not married or living with a man/woman were included in the study. They comprised 2545 females and 1437 males from Ghana and 3546 females and 4317 males from Kenya. Descriptive analyses and binary logistic regression estimation technique were used to analyse the data. While awareness of AIDS was universal among the youth of both countries, utilisation of condoms on last penetrative sex was low. Risky sexual behaviour among young people was significantly associated with age, level of education, wealth status and religion. Among males and females in Ghana, the odds of sexual risk taking behaviour were higher among those who were employed than those who were unemployed. The reverse of this, however, occurred in Kenya, where males and females who were employed were less likely to engage in risky sexual behaviours than their counterparts who were unemployed. Our findings underscore the need for the relevant stakeholders in the two countries; Ministries of Health, Ghana/KenyaHealth Service, and NGOs concerned with sexual and reproductive health of young people, to intensify education on consistent and proper use of condoms and, position condom use as an acceptable behaviour especially among young people who are sexually active; with multiple partners and who may have STIs. Health literacy, which is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services to make appropriate health decisions, should be given priority. The governments of the two countries, especially Kenya, should promote youth entrepreneurship to reduce unemployment and strengthen job creation as a way of ensuring that young people engage on productive economic activities. With productive economic activities, females for instance may not have to engage in transactional multiple sexual relationships which is risky and, therefore, predisposes them to STIs such as gonorrhoea and HIV. [ABSTRACT FROM AUTHOR]

Having children compels parents to examine their vaccine beliefs, particularly if they are vaccine-hesitant or refuse all vaccines. Presently, little is known about the specific ways in which having children influences the vaccine beliefs of parents. This research examined how having children changed the attitudes of Australian vaccine-hesitant and vaccine-refusing parents towards childhood vaccination. We asked 904 Australian parents who believed that having children changed their attitudes to vaccination to describe these changes. Parents' responses were inductively, iteratively coded and thematically analysed. Themes were compared between parents who believed all vaccines should be refused, parents with varying degrees of vaccine hesitancy, and parents who were fully vaccine-accepting. Low numbers of responses from fully vaccine-accepting parents meant that this paper focused on mostly vaccine-hesitant and vaccine-refusing vaccine parents. Five themes were identified. Having children prompted all parents to learn about vaccine choices. Hesitant and refusing parents' interpreted vaccine choices through a lens of distrust of pharmaceutical companies and regulatory bodies overseeing vaccine safety. The distrust fuelled parents' fears about vaccination risks, such as side effects. Parents became concerned about the scheduled timing of vaccinations, particularly of the Hepatitis B vaccine. Parents among the three groups that believed some or all vaccines should be refused reported that a vaccine permanently injured their child. This research contributes to understanding how having children affects the vaccine attitudes among vaccine-hesitant and vaccine-refusing parents. Greater support for parents with negative vaccination experiences may prevent hesitant attitudes. The vaccination schedule needs to be communicated to parents better. [ABSTRACT FROM AUTHOR]

Longitudinal data are needed to investigate chronic disease causation and improve prevention efforts for Alaska Native and American Indian (ANAI) people. This paper describes the methods used to conduct follow-up data collection of a longitudinal cohort that enrolled ANAI adults between 2004 and 2006 in south central Alaska. The follow-up study re-examined ANAI participants in a large, urban centre in south central Alaska between 2015 and 2017. Computerized surveys were used to collect self-reported health, lifestyle, physical activity, and diet data. Clinical measurements included blood pressure, fasting blood glucose and lipid panel, urine albumin/creatinine, height, weight, and waist and hip circumference. Participants were provided individual results at the conclusion of their visit. A total of 1320 south central Alaska study participants completed the baseline visit. Study staff attempted to contact all living cohort members for inclusion in the follow-up study. More than 11,000 attempted contacts were made. Of the 637 available for participation, 388 completed the follow-up visit. The proportion of women increased from baseline to follow-up examinations (67 vs. 72%, p < 0.01). Self-reported health status of being married or living as married (46% vs. 39%, p < 0.01), and those reporting being employed or self-employed (55% vs. 47%, p < 0.01) were higher at follow-up when compared to baseline. Almost all participants at follow-up (97%) agreed to long-term storage of biological specimens for future study. Despite demographic differences between the follow-up and baseline cohorts, longitudinal data collected will provide novel insight on chronic disease development and prevention for ANAI people as well as other populations. [ABSTRACT FROM AUTHOR]

This paper examines the epidemiology of nonfatal firearm violence (NFFV) on the Westside of Chicago over three finite time periods: 2005–2008, 2009–2012, and 2013–2016. The trend analysis will look at any significant changes over the time periods and describe the demographic characteristics of NFFV. A descriptive analysis of Mount Sinai Hospital (MSH) Emergency Department (ED) data was conducted. NFFV patients were identified by specific firearm ICD-9 primary eCode injury categories: accident, assault, legal intervention, undetermined intent, suicide or self-inflicted injury, and legal intervention. The Pearson Chi-square test was conducted to statistically compare the categorical frequencies of the Chicago metropolitan region of injury, cause of firearm related injury, and place of injury by time period. There were a total of 3962 nonfatal hospitalizations at MSH between the three time periods due to gun violence related injuries. Overall, nonfatal hospitalizations were most frequent for those between age groups 16–24 (52.5%). The number of nonfatal hospitalizations decreased with increasing age for the age groups 35–44 (9.7%), 45–54 (3.2%), and > 54 (1.2%). There were significantly more nonfatal hospitalizations in males (n = 3649) than females (n = 312) across the three time periods. However, there was a 74.7% increase in female nonfatal hospitalizations from 2009–2012 to 2013–2016. There were significant racial differences in nonfatal hospitalizations between the three time periods. NFFV continues to be problem on the Westside of Chicago, particularly for young, Black men. The incidence of gun violence however has not changed significantly between 2005 and 2016. [ABSTRACT FROM AUTHOR]

Barriers to health care access and utilization are likely to be perceived differently for receivers and providers of health care. This paper compares and contrasts perspectives of lay community members, volunteer community health advisors (CHA), and health care providers related to structural and interpersonal barriers to health care seeking and provision among African American adults experiencing health disparities in the rural Mississippi Delta. Sixty-four Delta residents (24 males, 40 females) participated in nine focus groups organized by role and gender. The constant comparative method was used to identify themes and subthemes from the focus group transcripts. Barriers were broadly categorized as structural and interpersonal with all groups noting structural barriers including poverty, lack of health insurance, and rurality. All groups identified common interpersonal barriers of gender socialization of African American males, and prevention being a low priority. Differences emerged in perceptions of interpersonal barriers between community members and healthcare providers. Community members and CHA fears of serious medical diagnosis, stigma, medical distrust, and racism emerged as factors inhibiting health care utilization. All groups were critical of insurance/regulatory constraints with providers viewing medical guidelines at times restricting their ability to provide quality treatment while community members and CHA viewed providers as receiving compensation for prescribing medications without regard to potential side-effects. These findings shed light on barriers perceived similarly and differently across these stakeholder groups, and offer directions for ongoing research, outreach, clinical work, and health care policy. [ABSTRACT FROM AUTHOR]

Cervical cancer adversely impacts African American communities. While disparities in incidence remain unclear, communities continue to use forums to increase cervical cancer education. The purpose of this paper is to examine the efficacy of using community forums to increase human papillomavirus vaccine (HPVV) and cervical cancer knowledge in African American communities. This study is a one-group pretest–posttest study design using a 17-item questionnaire to collect data from 412 participants in diverse communities. Our analyses revealed perceived knowledge increased significantly after the forums for African American participants. For African Americans, perceived knowledge prior to the forums was explained by gender, access to care, and trust in clinical trials. After the forum, perceived knowledge was associated with access to care and trust in vaccines. Participants who had health insurance reported higher perceived HPV and cervical cancer knowledge and greater trust in vaccines. This study found community forums that address the cultural and historical context of research mistreatment related to HPVV development and include diverse racial/ethnic representation of stakeholders may be a useful strategy to increase HPVV, and cervical cancer knowledge in African American communities. [ABSTRACT FROM AUTHOR]

Community health workers in developing countries usually perform house calls in degraded and violent territories. Thus, in this paper we study the effects of urban violence in the performance of CHWs in poorly developed territories, in order to understand the challenges of delivering care to dangerous communities in developing countries. We conducted telephone surveys for 5 months in 2017, within a systematic sample of 2.000 CHWs based on clinics distributed along the health regions of the city of Rio de Janeiro, Brazil. We completed 766 interviews, approximately 40% of the sample, 86% man and 14% women. Most participants are 30 to 39 years old (35%), followed by 27% of 40 to 49 years old participants. As CHWs work on the sharp end of the healthcare system, responsible for outreaching, community education, counseling, and social support, our study presents contributions to government and management levels on working conditions inside communities, constraints in assistance, and difficulties in implementing primary care policies. [ABSTRACT FROM AUTHOR]

Many countries have guidelines that recommend safety practices for infant sleep. However, it is not known whether guidelines between countries are similar or different. The purpose of this paper is to compare national public health infant sleep safety guidelines among highly developed countries. Criteria for inclusion were: countries defined by United Nations as "very high human development," guideline related to infant sleep position and safety practices, evidence of it being a national guideline, and published in English. Guidelines from nine countries met inclusion criteria, and data were extracted across 13 categories. All guidelines recommended the supine sleep position and avoidance of smoke exposure. While most guidelines addressed the remaining 11 categories, specific recommendations varied among guidelines. These findings can inform the broad context of SIDS reduction work, offer opportunities for collaboration among countries, and promote multi-country and global conversations about how research evidence is translated into recommendations for practice. [ABSTRACT FROM AUTHOR]

Nebraska has one of the highest numbers of refugees per capita in the U.S. A high number of Somalis have resettled in Nebraska due to job opportunities and the low cost of living. In this paper, we report the process and the results of a cervical and breast cancer education program for Somali women conducted through a collaboration among public health, academia, and community entities. The curriculum was built to be suitable for the literacy level and cultural values of this community. Topics include female reproductive anatomy; breast and cervical cancer knowledge and screening; hepatitis C and liver cancer; and preparing for a health screening visit. Two community members trained as lay health workers conducted a pilot and an actual education session. The 2-day education program was attended by 52 women. Qualitative data showed the intervention to be promising for this and other African refugee populations. [ABSTRACT FROM AUTHOR]

Comprehensive cancer centers are an important community resource for cancer prevention education in their catchment areas. Colorectal cancer remains one of the most commonly diagnosed cancers in the United States, making prevention a priority. Colorectal cancer prevention targets include lifestyle modifications that are influenced by cultural norms, such as diet change, physical activity and screening behavior. Cancer centers must tailor prevention efforts to multiethnic catchment areas. This paper describes the development and feasibility of a comprehensive cancer center’s approach to community-based colorectal cancer prevention in Houston, Texas, specifically targeting Hispanic and Asian populations. Sites were recruited through a city-wide network of partnerships between the community relations department in the hospital and community organizations. The program consisted of three workshop-style classes per community site. Each class had a similar overall structure, but cultural and site-specific adaptations were made for each group. A total of 33 classes were taught at nine distinct community sites to 1054 participants over 9 months. This program structure may be adapted for the future dissemination of other cancer prevention tools to communities in the area. [ABSTRACT FROM AUTHOR]

HIV affects an estimated 1.2 million individuals in the United States and is disproportionately concentrated among African Americans, Latinos, and people of multiple races. Post-exposure prophylaxis (PEP) substantially decreases HIV transmission when started within 72 h after exposure, but problems of accessibility have hindered its widespread usage in communities at risk for HIV infection. Pharmacy-initiated PEP access was first permitted in New York City in 2017, allowing pharmacists to provide a 7-day supply of PEP without a prescription for consumers at high risk for HIV infection. It was expected that the broad reach and accessibility of community pharmacies would increase timely access to PEP for all individuals, especially those who already face significant barriers to accessing the healthcare system. Since then, eleven other states have followed suit and expanded the scope of outpatient pharmacy practice in order to increase the availability of HIV PEP but prescribing laws in over 75% of the US have not been changed. Much of the existing literature on HIV prevention focuses on PrEP access barriers with limited information on PEP access in the US. In this paper, we review the current status of pharmacist-initiated PEP in the US as part of the End the HIV Epidemic (EHE) initiative. [ABSTRACT FROM AUTHOR]

Urban food swamps are typically situated in low-income, minority communities and contribute to overweight and obesity. Changing the food landscape in low income and underserved communities is one strategy to combat the negative health consequences associated with the lack of access to healthy food resources and an abundance of unhealthy food venues. In this paper, we describe Proyecto MercadoFRESCO (Fresh Market Project), a corner store intervention project in East Los Angeles and Boyle Heights in California that used a multi-level approach with a broad range of community, business, and academic partners. These are two neighboring, predominantly Latino communities that have high rates of overweight and obesity. Located in these two communities are approximately 150 corner stores. The project used a community-engaged approach to select, recruit, and convert four corner stores, so that they could become healthy community assets in order to improve residents' access to and awareness of fresh and affordable fruits and vegetables in their immediate neighborhoods. We describe the study framework for the multi-level intervention, which includes having multiple stakeholders, expertise in corner store operations, community and youth engagement strategies, and social marketing campaigns. We also describe the evaluation and survey methodology to determine community and patron impact of the intervention. This paper provides a framework useful to a variety of public health stakeholders for implementing a community-engaged corner store conversion, particularly in an urban food swamp. [ABSTRACT FROM AUTHOR]

Falls are common events that threaten the independence and health of older adults. Studies have found a wide range of fall statistics in different ethnic and racial groups throughout the world. These studies suggest that fall rates may differ between different racial and ethnic groups. Studies also suggest that the location of falls, circumstances of falls, and particular behaviors may also be different by population. Also migration to new locations may alter an individual's fall risk. However, there are few studies that directly compare ethnic and racial differences in falls statistics or examine how known fall risk factors change based on race and ethnicity. This paper reviews the existing literature on how falls may differ between different racial and ethnic groups, highlights gaps in the literature, and explores directions for future research. The focus of this paper is community dwelling older adults and immigrant populations in the United States. [ABSTRACT FROM AUTHOR]

Nurses play a critical role in delivering care to elderly people at primary health care level but there is no synthesis of research knowledge to guide community nursing practice in Japan. This review aims to identify nurse-led interventions that have been found to improve elder health at village level; the barriers and constraints that service providers face when delivering care to the elderly; and the experiences of elderly people and their caregivers. The electronic databases such as MEDLINE, CINAHL and Google Scholar were searched to retrieve peer-reviewed primary research literature. A narrative synthesis of the findings sections of the papers was applied to identify key themes. These themes are: socioculturally appropriate care; health improvements; barriers and constraints to care delivery and; experience of the elderly and families. Seven papers were included in the review. The synthesis identified that nurse-led health care for the elderly in rural Japan can be effective when it is targeted and culturally sensitive. The studies highlight a number of barriers to the provision of care. There is a need for further research to examine the issues affecting access to rural nursing care including health system factors, as well as the needs of the elderly and families themselves. Such studies will better inform the delivery of programs, reduce inequity and provide socio-culturally appropriate care to improve the well-being of the elderly. [ABSTRACT FROM AUTHOR]

In predominately immigrant neighborhoods, the nuances of immigrant life in the ethnic enclave have important, yet underappreciated impact on community health. The complexities of immigrant experiences are essential to unpacking and addressing the impact of acculturative processes on observed racial, ethnic, and class-based health disparities in the United States. These insights because they are largely unexplored are best captured qualitatively through academic-community research partnership. We established the participatory mixed method Little Village participatory community health assessment (CHA) to explore community health in an ethnic enclave. In this paper, we share findings from our qualitative component exploring: how do Residents in a Predominately Immigrant Neighborhood Perceive Community Health Needs and Assets in Little Village. Three major themes emerged: rich, health promoting community assets inherent in the ethnic enclave; cumulative chronic stress impacting the mental health of families and intra-familial strain; and, work and occupation as important but underappreciated community health determinants in an immigrant neighborhood. These nuanced findings enhanced our community health assessment and contributed to the development of two additional tailored CHA methods, a community member-administered Community Health Survey, and an oral history component that provided deeper insight on the community’s health needs and assets, and a focus for action on work as a social determinant of health at the community level. Conducting trusted community-driven health assessments that are adaptive and flexible to capture authentic needs and assets are critical, given health consequences of the new anti-immigrant rhetoric and growing socio-political tensions and fear in immigrant neighborhoods in the United States. [ABSTRACT FROM AUTHOR]

The United States (US) federal government allocates hundreds of billions of dollars to provide resources to Americans with disabilities, older adults, and the poor. The American Community Survey (ACS) influences the distribution of those resources. The specific aim of the project is to introduce health researchers to Public Use Microdata Sample file from 2009 to 2011. The overall goal of our paper is to promote the use of ACS data relevant to disability status. This study provides prevalence estimates of three disability related items for the population at or over the age of 15 years who reside in one of the continental states. When population weights are applied to the 7,198,221 individuals in the sample under analysis, they are said to represent 239,641,088 of their counterparts in the US population. Detailed tabulations by state (provided as Microsoft Excel® spreadsheets in ACS output) clearly show disability prevalence varies from state-to-state. Because analyses of the ACS data have the ability to influence resources aiding individuals with physical mobility challenges, its use should be promoted. Particular attention should be given to monetary allocations which will improve accessibility of the existing built environment for the individuals with mobility impairment. [ABSTRACT FROM AUTHOR]

A large body of research documents the relationship between health and place, including the positive association between neighborhood cohesion and health. However, very little research has examined neighborhood cohesion by sexual orientation. This paper addresses that gap by examining differences in perceived neighborhood cohesion by sexual orientation. We use data from the 2016 National Health Interview Survey (n = 28,164 respondents aged 18 years and older) to examine bivariate differences by sexual orientation in four measures of neighborhood cohesion. We then use ordered logistic regression models to assess the relationship between sexual orientation and a scaled measure of neighborhood cohesion, adjusting for socio-demographic characteristics, living arrangements, health status, region, and neighborhood tenure. We find that lesbian, gay, and bisexual (LGB) adults are less likely to say that they live in a close-knit neighborhood (54.6 vs. 65.6%, p < 0.001), they can count on their neighbors (74.7 vs. 83.1%, p < 0.001), they trust their neighbors (75.5 vs. 83.7%, p < 0.001), or people in their neighborhood help each other out (72.9 vs. 83.1%, p < 0.001), compared to heterosexual adults. Even after controlling for socio-demographic factors, neighborhood cohesion scores are lower for LGB adults compared to heterosexual adults (odds ratio of better perceived neighborhood cohesion for sexual minorities: 0.70, p < 0.001). Overall, LGB adults report worse neighborhood cohesion across multiple measures, even after adjusting for individual characteristics and neighborhood tenure. Because living in a cohesive neighborhood is associated with better health outcomes, future research, community-level initiatives, and public policy efforts should focus on creating welcoming neighborhood environments for sexual minorities. [ABSTRACT FROM AUTHOR]

This paper examines health care utilization among indigenous immigrants from Oaxaca, Mexico, who have settled in a farmworker community in southern California. In 2016, two trained Spanish-Mixteco and Spanish- Zapoteco bi-lingual interviewers conducted in-depth interviews with 44 indigenous women residing in Oxnard, California on issues that affect health care utilization. Interviews were conducted in Mixteco, Zapoteco and Spanish and were coded to identify structural, cultural, and provider-related barriers to health care utilization. Five bi-lingual Spanish-Mixteco indigenous interpreters employed at local clinics were also interviewed. Many women reported lack of health insurance, inability to pay, language barriers, long waiting times, rushed encounters with providers, and seeking western medical care only after home remedies did not work. However, several women were able to access routine health care services, often with support from indigenous interpreters employed at clinics. Interviews with five interpreters found that they provided assistance with interpretation during medical encounters and appointment making. They also educated patients about upcoming exams, identified low-cost services and insurance programs available to patients, assisted with paperwork and occasionally educated physicians on behalf of their patients. In addition to addressing barriers to health care access our findings suggest the importance of identifying and leveraging community assets, such as indigenous navigators, when developing programs for such underserved communities. Our findings can inform best practice in settings that provide health care to indigenous populations and may also apply to settings that provide health care to other immigrant communities that have very limited familiarity and contact with western health care. [ABSTRACT FROM AUTHOR]

Physically demanding work carried out during long workdays affects women's health. In rural and agrarian societies, women perform a variety of domestic and productive tasks, often from dawn to dusk, with little or no leisure time. This paper presents the results of a survey of indigenous women in six rural communities in the Ecuadorian highlands. It was conducted to measure the amount of time women spend on physically demanding work in the context of food security, parity outcomes, and access to prenatal health care. The findings demonstrate that these women work very long workdays and also experience food insecurity and poor access to prenatal health care. [ABSTRACT FROM AUTHOR]

The use and motivations for use of energy drinks (EDs) in college students has been documented in the literature. Many college students identify academic reasons, such as a need to study more, as a motivation for ED use. However, research has not determined if users who claim academic motivations actually study more than those who claim other motivations. A sample of 692 undergraduate students at a large, private university completed a paper survey that inquired about demographics, ED use, motivations for ED use, sleep quality, and average amount of time spent sleeping and studying per week. Descriptive statistics were used to analyze demographics, and analysis of variance was used to compare ED users with different motivations to amount of time spent sleeping and studying per week. Regression analysis was also used to determine if ED use could be predicted by any of the other variables. Increased ED consumption was predicted by being male (B = −0.394, p < .001) and having a decreased sleep quality (B = 0.586, p < .001). Reported study hours by subjects who claimed academic reasons as motivation for ED use were not significantly different in comparison to ED users who claimed other motivations. In our sample, ED users who reported academic reasons as motivations for use did not report significantly more study hours per week when compared to those who claimed other motivations. This demonstrates a disconnect between reported motivations for energy drink use and outcomes that are expected to be associated with those motivations. [ABSTRACT FROM AUTHOR]