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The widespread adoption of science-based prevention requires local infrastructures for prevention service delivery. Communities That Care (CTC) is a tested prevention service delivery system that enables a local coalition of community stakeholders to use a science-based approach to prevention and improve the behavioral health of young people. This paper uses data from the Community Youth Development Study (CYDS), a community-randomized trial of CTC, to examine the extent to which better internal team functioning of CTC coalitions increases the community-wide adoption of science-based prevention within 12 communities, relative to 12 matched comparison communities. Specifically, this paper examines the potential of both a direct relationship between coalition functioning and the community-wide adoption of science-based prevention and a direct relationship between functioning and the coalition capacities that ultimately enable the adoption of science-based prevention. Findings indicate no evidence of a direct relationship between four dimensions of coalition functioning and the community-wide adoption of a science-based approach to prevention, but suggest a relationship between coalition functioning and coalition capacities (building new member skills and establishing external linkages with existing community organizations) that enable science-based prevention. [ABSTRACT FROM AUTHOR]

This paper discusses characteristics that are associated with enhanced maternal and child health (MCH) epidemiology functioning in state health agencies. The concept of the 'MCH Epidemiology Effort' is introduced as 'the epidemiologic work carried out by multiple units and agencies aimed at informing program planning and policy development on behalf of women, children and families.' This concept focuses attention on MCH epidemiology functioning at the organizational level rather than on individual MCH epidemiologists. The analysis used data from all 50 states and the District of Columbia. Each state participated in a telephone interview and submitted material that demonstrated the breadth, depth, and capacity of its MCH Epidemiology Effort. Several organizations, including the Council for State and Territorial Epidemiologists, the Health Resources and Services Administration/Maternal and Child Health Bureau, and the Centers for Disease Control and Prevention provided additional secondary data. The outcome for analysis was a three-category measure of MCH epidemiology functioning. The findings are consistent with, and add specificity to, those from prior assessments. In a multivariable model, agenda-setting by consensus, involvement of external stakeholders, the total of doctorally trained staff, and accessing CDC assignees or other staff were all significantly related to higher level MCH epidemiology functioning (ORs of 6.1, 6.6, 2.5, and 6.4, respectively; P < 0.05). Organizational visibility of the MCH Epidemiology Effort and a data environment marked by routine data-sharing and data integration were marginally related. We provide recommendations for action at the state and federal level for advancing evidence-based decision-making in maternal and child health. [ABSTRACT FROM AUTHOR]

The objective of this study is to document the health profile of 252 African-American grandparents raising their grandchildren solo, compared with 1552 African-American single parents. The 2012 Behavior Risk Factor Surveillance System is used to compare the specific physical and mental health profiles of these two family groups. The findings suggest solo grandparents have prevalence of many health conditions, including arthritis (50.3 %), diabetes (20.1 %), heart attack (16.6 %) and coronary heart disease (16.6 %). Logistic regression analyses suggest that solo grandparents have much higher odds of several chronic health disorders in comparison with single parents, but this difference is largely explained by age. Although solo grandparents have good access to health care insurance and primary care providers, a substantial percentage (44 %) rate their health as fair or poor. Practice interventions to address African American solo grandparents' health needs are discussed. [ABSTRACT FROM AUTHOR]

The Latino population in the US is projected to grow substantially in the years ahead. Although often referred to as a single group, Latinos are not homogeneous. This article, based mainly on a national telephone survey of 1,478 Latino adults, examines the perspectives of six Latino heritage groups on the health care issues they face. The six groups differ in their reported health care experiences in: the types facilities they use in getting medical care, their ratings of the quality of care they receive, their experiences with discrimination in getting quality care, the level of confidence they have in being able to pay for a major illness. One thing the heritage groups agree on is that diabetes is the biggest health problem facing their families. Community health leaders, particularly at the state level, need to focus on the specific Latino groups in their state or area and their unique situations. [ABSTRACT FROM AUTHOR]

Migrant and seasonal farmworkers face many health risks with limited access to health care and promotion services. This study explored whether fear of deportation (as a barrier), and church attendance (as an enabling factor), were associated with medical and dental care use among Mexican-origin farmworkers. Interviews were conducted with 179 farmworkers who attended mobile services provided by a local federally-qualified health center (FQHC) in partnership with area churches, during the 2007 agricultural season. The majority of respondents (87 %) were afraid of being deported, and many (74 %) attended church. Although about half of participants reported poor/fair physical (49 %) and dental (58 %) health, only 37 % of farmworkers used medical care and 20 % used dental care during the previous year. Fear of deportation was not associated with use of medical or dental care; while church attendance was associated with use of dental care. Findings suggest that despite high prevalence of fear of deportation, support by FQHCs and churches may enable farmworkers to access health care services. [ABSTRACT FROM AUTHOR]

We examined indicators of health status and healthcare utilization according to immigration status to assess the ‘healthy immigrant effect’ for Chinese adults. Data for Chinese in Taiwan ( n = 15,549) were from the 2001 Taiwan National Health Interview Survey (NHIS). Data for U.S.-born Chinese ( n = 964) and Chinese Immigrants in the U.S. ( n = 253) were from the 1998–2004 U.S. NHIS. We used multivariate logistic regression to estimate the adjusted odds of perceived poor health, having ever smoked, and past year emergency room visits according to immigration status. For Chinese immigrants, more years in the U.S. were associated with lower odds of reporting poor health (OR = 0.4; 95% CI = 0.2–0.8) and past-year emergency room use (OR = 0.5; 95% CI = 0.3–0.9). Compared with recent Chinese immigrants (<5 years in U.S.), Chinese in Taiwan had higher odds of reporting poor health (OR = 6.2; 95% CI = 3.2–12.1) and having ever smoked (OR = 1.6; 95% CI = 1.1–2.5). Our results suggest that those who migrate have better health profiles than those who do not migrate. However, recent Chinese immigrants were not significantly different than U.S.-born Chinese. [ABSTRACT FROM AUTHOR]

This study examines whether having designated case management staff facilitates delivery of comprehensive medical and psychosocial services in substance abuse treatment programs. A multilevel, prospective cohort study of 2829 clients admitted to selected substance abuse treatment programs was used to study clients from long-term residential, outpatient, and methadone treatment modalities. Program directors reported whether the program had staff designated as case managers. After treatment discharge, clients reported their receipt of 9 supplemental services during the treatment episode. In multivariate models controlling for multiple program-level and client-level factors, program-level availability of designated case managers increased client-level receipt of only 2 of 9 services, and exerted no effect on service comprehensiveness, compared to programs that did not have designated case managers. These findings do not support the common practice of designating case management staff as a means to facilitate comprehensive services delivery in addiction treatment programs. [ABSTRACT FROM AUTHOR]

Background: This study aimed to develop and provide a psychometric and feasibility pilot evaluation of the Heart Failure (HF) Symptom Tracker (HFaST), a new patient-reported tool designed to facilitate communication between patients and health care providers (HCPs) in routine clinical care. The HFaST enables patients to identify worsening HF symptoms, with a long-term goal of preventing hospitalizations or emergency room visits. Methods: The HFaST was developed drawing on evidence from the literature, qualitatively with cognitive interviews (12 patient/caregiver and 8 HCPs), and evaluated quantitatively (psychometric, feasibility assessment). The HFaST was administered for 7 consecutive days to 100 individuals diagnosed with HF during a multisite, non-interventional US pilot study. Health care providers then completed a survey assessing the feasibility and importance of the HFaST in clinical practice. Qualitative development included a literature review and cognitive interviews with patients, caregivers, and HCPs. The psychometric properties of the HFaST were evaluated using classical test theory methods. Descriptive statistics provided insight into HCPs' perceptions of the feasibility of using the HFaST in clinical practice. Results: A preliminary set of 40 items was developed for the symptom tracker and iteratively reduced to 10 items based on the qualitative phase. Test-retest reliability (weighted kappa 0.71–0.97), discriminating validity, and construct validity of the HFaST were acceptable. HCPs rated the HFaST as a good (70%) or excellent (30%) means of tracking HF symptoms. Six HFaST items were ultimately retained, covering concepts of fatigue, shortness of breath (3 items), swelling, and rapid weight gain. Conclusions: The 6-item HFaST is an easy-to-use tool designed to raise patients' awareness of HF symptoms and facilitate communication with HCPs. Future research should evaluate HFaST implementation in clinical practice and effectiveness as an intervention to potentially prevent hospitalizations and emergency room visits. [ABSTRACT FROM AUTHOR]