Neighborhood and Individual-Level Risk Factors for Term Low Birth Weight: An Examination of Cross-Level Interactions in Los Angeles County, California

This paper examines the association between term low birth weight (TLBW) and individual-level exposure to NO2 and whether this association differs by neighborhood-level physical and social factors. Data consisted of birth records (n=97,200), measures of neighborhood-level social disadvantage, racial and ethnic segregation, and greenness. Unconditional logistic regressions revealed that exposure to high NO2 levels in the third trimester is compatible with a weak positive association with TLBW after adjusting for maternal age, birthplace, race/ethnicity, smoking; infant sex; parity; and prenatal care payment type (aOR= 1.02, 95%CI=0.95, 1.09). To examine the presence of interaction, the model was re-run for each neighborhood covariate to include a product term. Evidence of a negative interaction between NO2 and greenness was found. The odds of TLBW when NO2 is high and greenness is low was lower compared to when NO2 is low and greenness is high, corresponding to a point estimate of 1.00 (95%CI: 0.74 1.34) when exposure to high NO2 levels is stratified at low NDVI

Investigating Perceptions of Teachers and School Nurses on Child and Adolescent Oral Health in Los Angeles County.

This study reports the results of focus groups with school nurses and teachers from elementary, middle, and high schools to explore their perceptions of child and adolescent oral health. Participants included 14 school nurses and 15 teachers (83% female; 31% Hispanic; 21% White; 21% Asian; 14% African American; and 13% Others). Respondents were recruited from Los Angeles County schools and scheduled by school level for six one-hour focus groups using Zoom. Audio recordings were transcribed, reviewed, and saved with anonymization of speaker identities. NVivo software (QSR International, Melbourne, Australia) was used to facilitate content analysis and identify key themes. The nurses' rate of "Oral Health Education" comments statistically exceeded that of teachers, while teachers had higher rates for "Parental Involvement" and "Mutual Perception" comments. "Need for Care" was perceived to be more prevalent in immigrants to the United States based on student behaviors and complaints. "Access to Care" was seen as primarily the nurses' responsibilities. Strong relationships between community clinics and schools were viewed by some as integral to students achieving good oral health. The results suggest dimensions and questions important to item development for oral health surveys of children and parents to address screening, management, program assessment, and policy planning