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Little is known about health limitations and service utilization among the Native Hawaiian and Pacific Islander (NHPI) children with developmental disabilities (DDs) due to limited data. Our study examined the prevalence of DDs, health limitations, services used, and the unmet needs of NHPI children aged 3 to 17 years using cross-sectional data from the 2014 NHPI National Health Interview Survey. Results showed that prevalence of DDs among NHPI children was lower than American children of other races. DDs were negatively associated with health and functioning of NHPI children. There is a need to promote understanding of DDs among NHPI families and to inform public policy makers to identify appropriate intervention services for NHPI children.

Introduction: During the COVID-19 pandemic, health care shifted to virtual interactions with health professionals. The aim of this study was to examine the determinants of telehealth use in a nationally representative sample of the United States adult population. Methods: The study used data from the 2020 National Health Interview Survey of 17,582 respondents aged ≥18. Andersen's model of health services utilization was employed to examine predisposing, enabling, and needs factors associated with past-year telehealth use. Multivariable logistic regression was conducted to examine statistical associations. Results: 32.5% of adults (n = 6402; mean age 51.6, SE = 0.4) reported telehealth use. Predisposing factors: Women and married/partnered adults and those with higher levels of education had greater odds of using telehealth. Adults living in Midwest and South and adults living in medium-small and non-metropolitan areas had decreased odds of using telehealth. Enabling factors: Income and having a usual source of care were positively associated with telehealth use. A negative association was found for those with no insurance and telehealth use, whereas a positive association was found for military insurance. Needs factors: Odds of using telehealth were increased for adults who had well-visits and ER visits in the past 12 months. Mental health services quadrupled the odds of telehealth use. Odds of using telehealth increased with each additional chronic disease, including COVID-19. Conclusion: There are disparities in telehealth use according to sex, education, rurality, access to care, and health needs. Tackling these disparities is pivotal to ensure barriers to telehealth use are not exacerbated post-pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes self-management education (DSME) programs that engage the families of patients with diabetes have shown to be effective in improving diabetes-related outcomes of the patients. The health effects of these 'family models' of DSME on participating family members are rarely studied. Opportunity exists for the participating family members to benefit from the healthy lifestyle recommendations offered through such programs. Method: Using data from a randomized controlled trial to assess the effect of family DSME compared to standard DSME among Marshallese adults with Type 2 diabetes, this study examined baseline to 12-month changes in Ale, body mass index (BMI), food consumption, and physical activity among participating family members, comparing outcomes of family members based on attended at least 1 (n = 98) versus attended no (n = 44) DSME sessions. Results: Overall, family member attendance was low. There were no differences in the level of change from baseline to 12 months for A1c, BMI, food consumption, and physical activity between groups. After controlling for attendance and sociodemographic measures, lowering of BMI was the only significant predictor of not having an A1c level indicative of diabetes at 12 months. Discussion: Future research on family DSME should consider ways to improve family member attendance; have them set their own health improvement goals; and integrate healthy lifestyle education, such as healthy eating and being physically active, along with the DSME core content to create an added benefit of diabetes prevention for participating family members. The limitations of this study and recommendations for future research are provided. Keywords: diabetes, Marshallese, family support, diabetes self-management education, Type 2 diabetes (T2D) is a chronic disease affecting 8.5% of adults globally (World Health Organization, 2016). Poorly managed T2D can lead to kidney and nerve damage, amputation, and death. [...]

Background: Limited access to fitness programs for rural older adults make lay or volunteer delivery approaches potentially desirable to extend reach. However, factors affecting adoption of such approaches are not well explored. Purpose: This study sought to identify barriers and facilitators affecting adoption of a volunteer lay delivery approach for the community-based StrongWomen strength training program conducted through rural county Extension offices. Methods: Educators implementing the program, identified as adopters (n = 6) and nonadopters (n = 13) of the lay delivery approach, participated in semistructured interviews, which were recorded, transcribed, and coded. The socialecological model (SEM) as an organizing framework revealed barriers and facilitators at the intrapersonal, interpersonal, institutional, and community levels. Results: Barriers included lack of appropriate facilities, limited time, passive leader recruitment approaches, volunteer training proximity, and perceived lack of confidence among potential volunteers. Retired or part-time employment status, education level, comfort in leadership positions, communication of need for volunteers, and active recruitment approach were facilitators. Discussion: Barriers and facilitators can be attributed to differences in educator approaches, participant characteristics, and institutional and community factors. Translation to Health Education Practice: Identification of modifiable factors promoting or inhibiting adoption of lay-led approaches may assist others seeking to implement similar delivery strategies to extend reach.

This article describes findings from a qualitative study of volunteer leaders in the StrongWomen strength training program in Arkansas. The study explored reasons volunteers initially agreed to serve, perceptions of volunteer role, and motivations for continuing to lead strength training groups long-term. Findings suggest a combination of factors supporting volunteer engagement: personal benefit of program, desire to continue program combined with a personal invitation to volunteer extended by the agent, desire to support a co-leader, and exercise and social support needs met through volunteer service. Motivations of Extension health program volunteers are important to address to maximize program impact.