Search

Background: Youth living with disabilities are at risk of experiencing poor health outcomes. Coordinated school health programs have an opportunity to help youth with disabilities and their families through health education, health services, and community engagement. The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) as a framework to analyze factors related to health conditions. We used the ICF to examine parental perceptions of health and function among students with disabilities living in rural and urban areas. Methods: We surveyed parents (N = 71) using the parent-report versions of the Pediatric Outcomes Data Collection Instrument and Child Health and Illness Profile. From this group, parents were asked to volunteer to participate in in-depth, individual interviews (N = 18). The interviews were audio-recorded and transcribed verbatim. Researchers used the ICF linking rules to analyze and code the transcriptions. Emergent themes were assigned numerical ICF codes. Results: There were more similarities than differences among rural and urban families. Children living with disabilities face significant environmental barriers regardless of context. Conclusions: Schools can facilitate education to improve the quality of life of parents and families of children with disabilities. School authorities should consider the many environmental barriers both urban and rural these families face in the community. The ICF can be used as a framework for program planning for community-based, health education for this population.

A growing number of college (postsecondary) students are in recovery from addiction to drugs or alcohol. In this article, we discuss the experiences of students returning to a university campus after long-term addiction treatment. We also explore the role of a Collegiate Recovery Program (CRP) in providing support, and in helping the students develop post-addiction identities that will sustain them. To do so, we draw on Goffman's ideas related to stigma, as well as conceptualizations of identity reconstruction as a practiced, lived experience. Students interviewed faced a double bind; they sought to escape the stigmatized identity of "addict," but could not identify as typical students because of their abstinence from alcohol and drugs. The CRP helped them manage the transition to student life, provided a safe haven on campus, and provided an alternate and positive identity: a student in recovery.

The study presents a perspective on the barriers encountered by children residing in a low-income rural community in Portal, GA. The purpose of this needs assessment (NA) is to identify educational challenges that youth in the community face. A sequential mixed method design was used. Intercept surveys were conducted followed by individual key informant interviews and a focus group. Survey data was entered into SPSS, and descriptive statistics were calculated. Audio recordings of the interviews were transcribed and uploaded into NVivo for content analysis. Overall, the results indicated a need for stronger infrastructure that better meets the needs of the youth, which can be done by engaging stakeholders in identifying and mobilizing community-based assets, thus creating local economic opportunities., Author(s): Moya L. Alfonso [sup.1] , Gayle Jackson [sup.2] , Alvin Jackson [sup.2] , Akrati Gupta [sup.3] , Shannon Antoine-Hardy [sup.3] , Maria I. Olivas [sup.3] Author Affiliations: (Aff1) 0000 [...]

Background: Fruit and vegetable consumption (FVC) is associated with a reduced risk of diabetes, obesity, cancer, and cardiovascular disease. Only one third of children aged 4-8?years consume the recommended 5 servings a day. Studies involving school-aged children (6-11?years) demonstrate that positive outcome expectancies can mediate FVC. There is a lack of similar studies involving preschool-aged (<5?years) children. The purpose of this study was to assess preschool children's knowledge and preference of fruits and vegetables, messages they recall hearing related to FVC, and how they perceive these messages. Methods: Children (N?=?192) were individually interviewed with a play-based picture card game followed by a mealtime environment reenactment open-ended interview. Fruit and vegetable messages were operationalized using Social Cognitive Theory (SCT). Descriptive statistics and associations are reported. Results: Each child recalled an average of 2.27 messages associated with FVC. Positive outcome expectancies, negative outcome expectancies, and prompts were most frequently recalled. Statistically significant differences in knowledge, preference, and messages were observed based on income. Conclusions: Children as young as age 4?years understand positive outcome expectancies. Experimental trials are warranted to determine if tailored expectancy messages mediate FVC among preschool children.

Objectives African American maternal caregiver support for prevention of childhood obesity may be a factor in implementing, monitoring, and sustaining children's positive health behaviors. However, little is known about how perceptions of childhood obesity risk factors and health complications influence caregivers' support of childhood obesity prevention strategies. The objective of this study was to determine if childhood obesity risk factors and health complications were associated with maternal caregivers' support for prevention initiatives. Methods A convenience sample of maternal caregivers (N = 129, ages 22-65 years) completed the childhood obesity perceptions (COP) survey. A linear regression was conducted to determine whether perceptions about childhood obesity risk factors and subsequent health complications influenced caregivers' support for prevention strategies. Results Caregivers' perceptions of childhood obesity risk factors were moderate (M = 3.4; SD = 0.64), as were their perceptions of obesity-related health complications (M = 3.3; SD = 0.75); however, they perceived a high level of support for prevention strategies (M = 4.2; SD = 0.74). In the regression model, only health complications were significantly associated with caregiver support ([beta] = 0.348; p < 0.004). Conclusions Childhood obesity prevention efforts should emphasize health complications by providing education and strategies that promote self-efficacy and outcome expectations among maternal caregivers., Author(s): Dayna S. Alexander [sup.1] [sup.2] , Moya L. Alfonso [sup.2] , Chunhua Cao [sup.3] , Alesha R. Wright [sup.2] Author Affiliations: (1) Division of Pharmaceutical Outcomes and Policy, UNC [...]

Physical education teachers can champion their profession through marketing the importance of physical activity to children and families in the communities they serve. Social marketing, a consumer-based approach to behavior change, is an excellent choice for physical education teachers who want to "sell" physical activity to their "audiences". This article describes how teachers can apply the concept of social marketing to advocate for what they do.

Objective: We assessed changes in the frequency of self-reported physical activity (PA) among tween girls exposed and not exposed to the VERB [TM] Summer Scorecard (VSS) intervention in Lexington, Kentucky, during 2004, 2006, and 2007. Methods: Girls who reported 0-1 day per week of PA were classi?ed as having "little or no" PA. Girls who reported 2-3 days of PA were classi?ed as "low" PA performers; 4-5 days of PA were labeled as "moderate" performers; and 6-7 days of PA were identi?ed as "high" performers. Logit regression analysis of survey data from girls identi?ed trends in PA frequency across time. Results: In 2004, participant girls were more likely than girls unfamiliar with VSS (reference group girls) to report "high" frequency of PA (OR = 1.44, CI = 1.18, 1.70). In 2006, participants were statistically less likely than reference group girls to report "low" frequency of PA (OR = 1.75, CI = 1.33, 2.21). In 2007, VSS participants were consistently more likely to report "moderate" frequency (OR = 1.56, CI = 1.35, 1.77) and "high" frequency of PA (OR = 1.44, CI = 1.24, 1.64) than reference group girls. Conclusion: An innovative, community-driven intervention demonstrated promise for increasing PA among tween girls. VSS may have transportability to other communities to help reverse the secular trend of declining PA for this population segment. (Contains 2 tables.)

Background: Self-injury has been described as a "silent school crisis," reflecting insufficient knowledge, confusion, lack of effective interventions, and the tendency for adults and youth to shy away from dealing directly with the issue. This purpose of this study was to identify distinct subgroups of youth who may be at increased risk of or reduced risk of nonsuicidal self-injury (NSSI). Methods: The middle-school Youth Risk Behavior Survey was administered in 8 district public middle schools in a large, southeastern county in Florida. A final sample size of 1748, representing approximately 92% of participants who self-reported attendance at 1 of the 8 middle schools (N = 1907) and 74% of the 2350 surveys originally distributed, was used in this study. Chi-squared automatic interaction detection (CHAID) was used to identify distinct segments at risk for or protected from NSSI. Results: CHAID analyses suggested large groups of youth at risk for (and not at risk) having ever tried self-injury including suicidal tendencies, substance use, low belief in life possibilities, and exposure to peer self-injury. Protective factors identified included having low to zero levels of suicidal tendencies, high belief in life possibilities, lack of substance use, and not being a victim of bullying. Conclusion: Engaging adolescents in prevention programs at early stage can reduce the chances of suicidal behavior as well as physical injury. Schools should take the lead in advocating for the development of evidence-based interventions that are capable of addressing factors that contribute to self-injury at multiple levels of youth's environments. (Contains 3 figures and 6 tables.)

Background: Although the potential health benefits of farmers markets have been discussed for years, there is a dearth of literature to aid health educators in advocating for the development of local farmers markets. Purpose: The purpose of this manuscript is to present a case study of a rural farmers market in southeast Georgia with emphasis on operational procedures and customer satisfaction. Methods: A mini-ethnography was conducted over a seven-week period using participant observation, document review and brief interviews. Results: Observational results suggested the farmers market operates smoothly and has resulted in high levels of customer satisfaction. Challenges should be addressed, including the seasonal nature of farming and attracting those who are not already motivated to eat healthy. Innovative strategies for reaching consumers throughout the year include taking farmers markets online. Discussion: An ecological approach such as farmers markets, which reach of hundreds of rural customers each week, represents a legitimate population-based approach to addressing obesity. Translation to Health Education Practice: By working with communities to develop local farmers markets, health educators in rural communities can help increase local capacity for healthier lifestyles.

Creating community-based opportunities for youth to be physically active is challenging for many municipalities. A Lexington, Kentucky community coalition designed and piloted a physical activity program, "VERB[TM] summer scorecard (VSS)", leveraging the brand equity of the national VERB[TM]--It's What You Do! campaign. Key elements of VSS subsequently were adopted in Sarasota County, FL. This study identified characteristics of Sarasota's VSS participants and non-participants. Students in Grades 5-8 from six randomly selected public schools completed a survey assessing VSS participation, physical activity level, psychosocial variables, parental support for physical activity and demographics. Logistic regression showed that VSS participants were more likely to be from Grades 5 to 6 versus Grades 7 and 8 [odds ratio (OR) = 6.055] and perceive high versus low parental support for physical activity (OR = 4.627). Moreover, for each unit rise in self-efficacy, the odds of VSS participation rose by 1.839. Chi-squared automatic interaction detector (CHAID) analysis suggested an interaction effect between grade and school socioeconomic status (SES), with a large proportion of seventh and eighth graders from high SES schools being non-participants (76.6%). A VSS-style program can be expected to be more effective with tweens who are younger, in a middle SES school, having high self-efficacy and high parental support for physical activity.

Interventions which facilitate physical activity of youth are vital for promoting community health and reducing obesity. This study assessed the results of a community-driven program, VERB[TM] Summer Scorecard, as knowledge of exposure to and awareness of community-based interventions for physical activity among youth could inform design and implementation of such interventions. A total of 2,215 youth ages 8 to 12 years responded to a survey about physical activity. Ordinal logistic regression suggested that youth who participated in this program were 1.73 times (95%CI= 1.41, 2.11) more likely to report high physical activity than nonparticipating youth 9 mo. after the intervention's first full-scale application. The program appeared to appeal more to girls than boys. Such results are encouraging for use in communities. DOI 10.2466/06.10.11.14.PMS.111.4.240-248

The social cognitive theory (SCT) has been used to explain and promote childhood obesity prevention behaviors. We examined whether the SCT concepts predicted outcome expectations of childhood obesity among the children of African American caregivers. Caregivers (n = 128) completed the childhood obesity perceptions paper-based survey. A multiple linear regression was conducted to determine the direct effects of moral disengagement, environment, self-efficacy, and behavioral capability on outcome expectations (p <.05). A mediation analysis using a bootstrapping bias correction method was used to test whether self-efficacy and behavioral capability mediated the effect of moral disengagement and environment on outcome expectations. Caregivers reported high levels of moral disengagement (M = 4.13; standard deviation [ SD ] = 0.70) and self-efficacy (M = 4.26; SD = 0.64) and moderate levels of behavioral capability (M = 2.83; SD = 0.75) and environment (M = 2.92; SD = 0.74). Findings indicated the hypothesized relationships in the SCT were not fully supported. In addition, the indirect effects of environment on outcome expectations were not statistically significantly mediated by behavioral capability. This research warrants more attention in testing the SCT concepts for the development of childhood obesity prevention efforts that prioritize African American families in rural communities. [ABSTRACT FROM AUTHOR]

This study examined the feasibility and efficacy of Salud es Vida-a promotora-led, Spanish language educational group session on cervical cancer screening (Pap tests)-self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014-2015. Hispanic/Latina immigrant women aged 21-65 years and overdue for a Pap test were included as intervention (N = 38) and control (N = 52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Twelve (32 %) intervention group participants received the Pap test compared to 10 (19 %) control group participants (p = 0.178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < 0.001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. The group intervention approach was associated with increased cervical cancer knowledge but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population. [ABSTRACT FROM AUTHOR]

Presents an abstract of the study "Involving Youth in Research: When Should We? How Should We?," by Moya L. Alfonso, which was discussed during the University of South Florida College of Public Health's 13th Annual Social Marketing in Public Health Conference in June 2003.

Introduction: An increasing number of grandparents in rural USA are serving as primary caregivers for their grandchildren because of parental incarceration, addiction, joblessness, or illness. Low-income, African American women from the South are overrepresented in this growing population. There is a paucity of research exploring the challenges faced by rural grandparent caregivers, and past studies have not explicitly addressed the potential consequences of rural grandparent caregiving for health. The purpose of this qualitative study was to explore grandparent caregiving among rural, low-income, African American grandmothers in a community in the American South, and to identify challenges to health that arose in that context. McLeroy's social ecological model (SEM) was used to examine these challenges at multiple levels of influence., Methods: This qualitative interview-based study was conducted in a high-poverty community in rural Georgia. In-depth interviews were conducted with African American grandparent caregivers and key informants from local community-based organizations. A key informant assisted in identifying initial interview participants, and then snowball sampling was used to recruit additional participants. Interview questions were grouped under five domains (intrapersonal, interpersonal, community, organizational, and policy), according to the levels of the SEM. Iterative content analysis of interview transcripts was utilized. Transcripts were coded to identify text segments related to each domain of the SEM, which were grouped together for analysis by domain. Reflexive memo-writing aided in development of themes, and data quality was assessed using Lincoln and Guba's trustworthiness criteria., Results: Rural African American grandparent caregivers faced a range of challenges to health. Direct physical challenges included chronic pain that interfered with sleep and daily functioning, mobility issues exacerbated by child care, and the pressure of managing their own medical conditions as well as their grandchildren's. Financial scarcity added to their vulnerability to poor health outcomes, especially when caregivers would forego purchase of medications or visits to the doctor because of expenses related to their grandchildren. In addition, lack of child care made health appointments and hospitalizations logistically difficult. Emotional strain was common as grandparent caregivers struggled to protect their grandchildren in communities where rates of drug use, HIV, and incarceration were high. Caregivers worried about their mortality and the related consequences for their grandchildren. Chronic stress, which is linked to a number of poor health outcomes, was self-reported by most rural grandparent caregivers., Conclusions: In this study, the challenges of rural grandparent caregiving among African American women posed multiple threats to health and wellbeing. Further research is needed, in different rural contexts and with different caregiver populations, to more thoroughly examine the health risks of grandparent caregiving. In addition, the development of multi-faceted interventions and programs will be critical to meeting the needs of rural grandparent caregivers. A few models for such programs exist, although resource shortfalls have often limited their impact.