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Assesses the role of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant Program. Objectives of the program; Indepth look at four areas that are central to the Kaiser Family Foundation's community health promotion strategy; Contributions which the program has made; Indications of the findings.

Introduction. Participation in the United States Census is critical for determining congressional representation and federal funding, but in every census there are groups systematically undercounted due to socioeconomic and demographic factors. Migrants and refugees are a group particularly threatened by being undercounted, including Hispanic migrant workers living in more rural areas. Methods and results. To gather information to promote migrant participation in the census, the Community Health Worker Coalition for Migrants and Refugees in Washington state conducted a systematic survey of 71 migrant workers in seven urban and suburban Washington communities. The results showed that while most participants had heard of the census, basic knowledge about the census was limited and people wanted more information. Conclusions and recommendations. A strong, coordinated outreach approach should be carried out to educate people in migrant communities about the census. This may involve one-on-one structured conversations, radio telenovelas, and community conversations organized by the trusted leaders. [ABSTRACT FROM AUTHOR]

Objectives: Oral health is one of the greatest unmet health needs of migrant farmworkers and many migrant workers lack basic oral health knowledge. This paper presents evaluation results for an oral health education program designed to both increase knowledge concerning oral health practices and to gain a better understanding of the knowledge, attitudes and behaviors regarding oral health among migrant workers. Methods: We used a pre-post uncontrolled design to assess the impact of the education program on participant knowledge about oral health practices. Changes in knowledge were assessed using a paper and pencil survey given to participants before the session began (pre) and at the end of the session (post). The pre-post survey was supplemented by qualitative information in the form of participant self-reported barriers and facilitators, and figure drawings illustrating their feelings about the state of their own oral health. Results: There were 311 participants in 12 workshops held in 2017 throughout Washington State. There were statistically significant increases in knowledge for all of the pre/post survey questions. Questions with particularly large improvements included: the results of having a mouth infection, factors causing oral health problems, and whether children in low-income families experience more tooth decay. Conclusions: An interactive, lay-led oral health education program can be an effective way to increase oral health knowledge in migrant populations. Recommendations for similar programs include using interactive approaches to engage participants, being open to learning and changing your own thinking, and using lay leaders for the education sessions. [ABSTRACT FROM AUTHOR]

A correction to the article "Population-Based Comparison of Biomarker Concentrations for Chemicals of Concern Among Latino-American and Non-Hispanic White Children," that was published online on July 3, 2014 issue is presented.

Differences in cultural and economic status may place ethnic subgroups of children at higher risk for exposure, leading to heightened health risks, and health inequities. Although Latino-Americans represent 22 % of all children in the United States, few studies have explored within-group differences in their exposure to toxicants. Using socio-demographic and biomarker data from the National Health and Nutrition Examination Survey from 1999 to 2008, we characterized determinants of health and estimated geometric means of environmental contaminant biomarkers (blood concentrations of lead and mercury, serum concentrations of dichlorodiphenyldichloroethylene [ p,p′-DDE] and cotinine, and urinary metabolites of organophosphate [OP] pesticides and polycyclic aromatic hydrocarbons [PAHs]) among 4,257 Mexican American (MA), 677 Other Latino-American (OL), and 3,370 Non-Hispanic White (NHW) children. MAs had the lowest levels of health insurance coverage and regular access to health care, and largest household size compared to NHWs and OLs. MAs had higher levels of p,p′-DDE, lead, and cadmium while OLs had higher estimates of mercury relative to other groups. MAs had higher urinary metabolite concentrations of 2-hydroxynaphthalene; otherwise MAs and OLs had lower concentrations of PAHs. NHWs had higher levels of cotinine and dimethylthiophosphate. For other OP metabolites, differences among groups were less clear. Lead and p,p′-DDE exposure differences likely reflect later and less regulatory control of these chemicals in Latin America. Additionally, poor quality housing with lead paint is more common in economically disadvantaged subpopulations. Dietary habits are possible sources of differential cadmium, mercury, and organophosphate exposure. Cotinine exposure differences by income and U.S.- vs. foreign-born may represent increased acculturation. These results, coupled with additional research on exposure sources may contribute to refinement of environmental health promotion programs for the fast-growing Latino-American population. [ABSTRACT FROM AUTHOR]

Objective: Social support may be associated with improved diet and physical activity—determinants of overweight and obesity. Wellness programs increasingly target worksites. The aim was to evaluate the relationship between worksite social support and dietary behaviors, physical activity, and body mass index (BMI). Method: Baseline data were obtained on 2878 employees from 2005 to 2007 from 34 worksites through Promoting Activity and Changes in Eating, a group-randomized weight reduction intervention in Greater Seattle. Worksite social support, diet, physical activity, and BMI were assessed via self-reported questionnaire. Principal component analysis was applied to workgroup questions. To adjust for design effects, random effects models were employed. Results: No associations were found with worksite social support and BMI, or with many obesogenic behaviors. However, individuals with higher worksite social support had 14.3% higher (95% CI: 5.6%–23.7%) mean physical activity score and 4% higher (95% CI: 1%–7%) mean fruit and vegetable intake compared to individuals with one-unit lower support. Conclusion: Our findings do not support a conclusive relationship between higher worksite social support and obesogenic behaviors, with the exception of physical activity and fruit and vegetable intake. Future studies are needed to confirm these relationships and evaluate how worksite social support impacts trial outcomes. [Copyright &y& Elsevier]

Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente's Community Health Initiative--a community-based obesity prevention effort. This article focuses on the first Photovoice project implemented in three communities in Colorado. Photovoice themes related to healthy eating and active living include a lack of access to healthy food choices in stores and schools, unsafe street crossings and sidewalks, and the need to re develop certain areas to encourage safe recreation. The involvement of policy leaders in the project combined with several dissemination activities has contributed to healthier food offerings in schools and neighborhoods and city planning efforts that emphasize walkability and access to healthy food, and park revitalization. [ABSTRACT FROM AUTHOR]

The article presents a study on the effects of a lifestyle-based weight management program on employee health and amount of prescription drug use. The study involves the participation of five hundred sixteen employees from three companies in a weight-management program. After one year the employees were examined and results showed that there was a decrease in average body weight and waist circumference. Positive results were also found in relation to blood pressure, self-esteem, and depression. The average number of prescription drugs taken also decreased.

Increasing rates of childhood overweight have been linked to the rising energy density of the diet. We sought to provide temporal profiles of dietary energy density (DED) in a nationally representative sample of U.S. children and adolescents < or = 19 y old and to describe associations between DED and predictors of overweight. We used a subset of data from the 1994-1996, 1998 Continuing Survey of Food Intake for Individuals (CSFII) and a multivariate regression model to determine independent associations between DED and socioeconomic and demographic variables after controlling for covariates. In this cross-sectional data set, DED was positively associated with total energy intakes and varied with both age and gender. DED increased from birth, peaked at 7-8 y of age, and then declined. Boys consumed more energy-dense diets than girls. Among children < or = 4 y old, higher DED was associated in the regression model with lower household incomes and with enrollment in the food stamp program. Among adolescents 12-19 y old, higher DED was associated with being African-American. In contrast, lower DED among children < or = 11 y old was associated with being Asian or Hispanic and with total daily consumption of fluid milk. The quality of the diet for young children, as indexed by high DED, may be adversely affected by limited household economic resources. Although food insecurity and WIC enrollment were not associated with DED in this study sample, milk consumption in children < or = 4 y old was associated with lower DED. [ABSTRACT FROM AUTHOR]

Evaluates patient satisfaction with occupational medical care in California. Implication of patient satisfaction for quality of medical care; Factors influencing patient satisfaction; Requirements in the assessment of patient satisfaction.

Introduction: As a means of conceptualizing population health, the County Health Rankings & Roadmaps program developed a methodology to rank counties within each state on Health Outcomes and Health Factors. We built on this framework by introducing an additional application that utilized national percentile scores and population size weighting to compare counties on a national, rather than a state, level. Methods: We created national percentile scores for 3078 US counties and used population size weighting in our calculations so that values for counties with larger populations would be weighted more heavily than values for counties with smaller populations. Results: We demonstrated how this application can be used to 1) compare counties nationally, 2) examine clustering and variability among counties, and 3) compare the health of states and regions. To underscore its utility, we included an example application by Kaiser Permanente. As a form of method validation, the results of this application are in line with other ranking systems (eg, US News and World Report and United Health Foundation; p = 0.39 to 0.91, p < 0.001). Discussion: This application can be used by communities and organizations that may be interested in comparing the health of counties, service areas, and regions in which they operate. We included additional considerations and highlighted some limitations for those interested in utilizing this application. Conclusion: By comparing counties nationally and utilizing population size weighting, community partners can focus on areas that may be of greatest need in moving toward a national Culture of Health. [ABSTRACT FROM AUTHOR]

Background: Interest is growing in interventions to address social needs in clinical settings. However, little is known about patients' perceptions and experiences with these interventions.Objective: To evaluate patients' experiences and patient-reported outcomes of a primary care-based intervention to help patients connect with community resources using trained volunteer advocates.Design: Qualitative telephone interviews with patients who had worked with the volunteer advocates. Sample and recruitment targets were equally distributed between patients who had at least one reported success in meeting an identified need and those who had no reported needs met, based on the database used to document patient encounters.Participants: One hundred two patients.Interventions: Patients at the study clinic were periodically screened for social needs. If needs were identified, they were referred to a trained volunteer advocate who further assessed their needs, provided them with resource referrals, and followed up with them on whether their need was met.Approach: Thematic analysis was used to code the data.Key Results: Interviewed patients appreciated the services offered, especially the follow-up. Patients' ability to access the resource to which they were referred was enhanced by assistance with filling out forms, calling community resources, and other types of navigation. Patients also reported that interacting with the advocates made them feel listened to and cared for, which they perceived as noteworthy in their lives.Conclusions: This patient-reported information provides key insights into a human-centered intervention in a clinical environment. Our findings highlight what works in clinical interventions addressing social needs and provide outcomes that are difficult to measure using existing quantitative metrics. Patients experienced the intervention as a therapeutic relationship/working alliance, a type of care that correlates with positive outcomes such as treatment adherence and quality of life. These insights will help design more patient-centered approaches to providing holistic patient care. [ABSTRACT FROM AUTHOR]

Improving community health "from the ground up" entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an "inter-sector" enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public's Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative's five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served. [ABSTRACT FROM AUTHOR]

The article presents a study that evaluates the quality and process of care indicators available in administrative workers' compensation in the U.S. As part of the study, quality and process of care indicators for nurse practitioners and primary care physicians back injury claims from Washington State were compared using direct standardization and logistic regression. The researchers concluded that the process of care indicators were highly associated with the duration of work disability and have potential for further development to assess and promote quality improvement.

Background: The U.S. population of former prison inmates is large and growing. The period immediately after release may be challenging for former inmates and may involve substantial health risks. We studied the risk of death among former inmates soon after their release from Washington State prisons. Methods: We conducted a retrospective cohort study of all inmates released from the Washington State Department of Corrections from July 1999 through December 2003. Prison records were linked to the National Death Index. Data for comparison with Washington State residents were obtained from the Wide-ranging OnLine Data for Epidemiologic Research system of the Centers for Disease Control and Prevention. Mortality rates among former inmates were compared with those among other state residents with the use of indirect standardization and adjustment for age, sex, and race. Results: Of 30,237 released inmates, 443 died during a mean follow-up period of 1.9 years. The overall mortality rate was 777 deaths per 100,000 person-years. The adjusted risk of death among former inmates was 3.5 times that among other state residents (95% confidence interval [CI], 3.2 to 3.8). During the first 2 weeks after release, the risk of death among former inmates was 12.7 (95% CI, 9.2 to 17.4) times that among other state residents, with a markedly elevated relative risk of death from drug overdose (129; 95% CI, 89 to 186). The leading causes of death among former inmates were drug overdose, cardiovascular disease, homicide, and suicide. Conclusions: Former prison inmates were at high risk for death after release from prison, particularly during the first 2 weeks. Interventions are necessary to reduce the risk of death after release from prison. N Engl J Med 2007;356:157-65. [ABSTRACT FROM AUTHOR]