Disparities in obesity among rural and urban residents in a health disparate region

BACKGROUND: The burden of obesity and obesity-related conditions is not borne equally and disparities in prevalence are well documented for low-income, minority and rural adults in the United States. The current literature on rural versus urban disparities is largely derived from national surveillance data which may not reflect regional nuances. There is little practical research that supports the reality of local service providers such as county health departments that may serve both urban and rural residents in a given area. Conducted through a community-academic partnership, the primary aim of this study is to quantify the current levels of obesity (BMI), fruit and vegetable (FV) intake and physical activity (PA) in a predominately rural health disparate region. Secondary aims are to determine if a gradient exists within the region in which rural residents have poorer outcomes on these indicators compared to urban residents. METHODS: Conducted as part of a larger ongoing community-based participatory research (CBPR) initiative, data were gathered through a random digit dial telephone survey using previously validated measures (n = 784). Linear, logistic and quantile regression models are used to determine if residency (i.e. rural, urban) predicts outcomes of FV intake, PA and BMI. RESULTS: The majority (72%) of respondents were overweight (BMI = 29 ± 6 kg/m(2)), with 29% being obese. Only 9% of residents met recommendations for FV intake and 38% met recommendations for PA. Statistically significant gradients between urban and rural and race exist at the upper end of the BMI distribution. In other words, the severity of obesity is worse among black compared to white and for urban residents compared to rural residents. CONCLUSIONS: These results will be used by the community-academic partnership to guide the development of culturally relevant and sustainable interventions to increase PA, increase FV intake and reduce obesity within this health disparate region. In particular, local stakeholders may wish to address disparities in BMI by allocating resources to the vulnerable groups identified

A study of gender, self-perception, and mathematics: The 2020 England, Wales, and Northern Ireland PISA Field Trial

Contrasts between female and male participation in mathematics, while not a new concern, remain important. Normatively it is a question of social justice: if females are disproportionately excluded due to conscious or unconscious decisions, these need to be addressed. Pragmatically it is an economic issue: failure to engage females in STEM subjects may impact national economic heath (Smith, 2014). While there has been positive news in the UK recently – 2019 was the first year more females than males took STEM A-levels – females continue to enrol in mathematics at substantially lower rates than males (Ofqual, 2020), and while some work has been done to address this, it has had little measurable impact (MEI, 2016). This paper offers an overview of factors which are known to impact this issue via the 2020 England, Wales, and Northern Ireland PISA Field Trial. It does this by focusing on the following five areas (Smith, 2014). Self-assessment The FT shows a statistically significant disproportion of females do not believe mathematics is easy for them (contrary to males) despite there being no clear statistical relationship between this and their actual maths grades. This is problematic as A-Level mathematics continues to be a demanding subject taken by a ‘clever core’ (Matthews & Pepper, 2007), and failure to recognise oneself as part of this core may limit perceived options. Enjoyment Students are more likely to continue studying mathematics if they have positive emotional responses to it (Mujtaba & Reiss, 2013). The FT, however, shows females enjoy mathematics less than their male peers. It is ranked as their least favourite subject, even amongst nearly 40% of the females who reported mathematics as easy. Additionally, a significant proportion of females report being more frequently upset in class, and ten times as many females than males report anxiety “all or almost all of the time” while in class. Interest While causes of interest in mathematics are numerous (Thoman, 2014; Tripney, 2010), interest is itself a prerequisite for females choosing to study it (Brown, 2008). However, females more frequently report a lack of interest during mathematics lessons and are statistically less interested in pursuing a career involving mathematical and adjacent skills

Environmental perceptions and objective walking trail audits inform a community-based participatory research walking intervention

<p>Abstract</p> <p>Background</p> <p>Given the documented physical activity disparities that exist among low-income minority communities and the increased focused on socio-ecological approaches to address physical inactivity, efforts aimed at understanding the built environment to support physical activity are needed. This community-based participatory research (CBPR) project investigates walking trails perceptions in a high minority southern community and objectively examines walking trails. The primary aim is to explore if perceived and objective audit variables predict meeting recommendations for walking and physical activity, MET/minutes/week of physical activity, and frequency of trail use.</p> <p>Methods</p> <p>A proportional sampling plan was used to survey community residents in this cross-sectional study. Previously validated instruments were pilot tested and appropriately adapted and included the short version of the validated International Physical Activity Questionnaire, trail use, and perceptions of walking trails. Walking trails were assessed using the valid and reliable Path Environmental Audit Tool which assesses four content areas including: design features, amenities, maintenance, and pedestrian safety from traffic. Analyses included Chi-square, one-way ANOVA's, multiple linear regression, and multiple logistic models.</p> <p>Results</p> <p>Numerous (n = 21) high quality walking trails were available. Across trails, there were very few indicators of incivilities and safety features rated relatively high. Among the 372 respondents, trail use significantly predicted meeting recommendations for walking and physical activity, and MET/minutes/week. While controlling for other variables, significant predictors of trail use included proximity to trails, as well as perceptions of walking trail safety, trail amenities, and neighborhood pedestrian safety. Furthermore, while controlling for education, gender, and income; for every one time per week increase in using walking trails, the odds for meeting walking recommendations increased 1.27 times, and the odds for meeting PA recommendation increased 3.54 times. Perceived and objective audit variables did not predict meeting physical activity recommendations.</p> <p>Conclusions</p> <p>To improve physical activity levels, intervention efforts are needed to maximize the use of existing trails, as well as improve residents' perceptions related to incivilities, safety, conditions of trail, and amenities of the walking trails. This study provides important insights for informing development of the CBPR walking intervention and informing local recreational and environmental policies in this southern community.</p

What’s Next for Tobacco Control Efforts? Health Equity Related Lessons Learned from a National Qualitative Study on Tobacco Control and Prevention

Context: Despite gains in the tobacco prevention and control movement, tobacco products remain a threat, with specific populations at greater risk. Objective: The purpose of this paper is to examine the role that leaders in the tobacco prevention and control movement have played in progress achieved to date and identify recommendations for the future using a health equity framework. The purpose of this paper is to examine the role that leading organizations in the tobacco prevention and control movement have played in progress achieved to date, identify future recommendations within the context of current public health priorities (e.g., obesity prevention), and explore potential for tobacco prevention and control using a health equity framework. Design: Qualitative key informant interviews were conducted with representatives from four key tobacco prevention and control organizations and their partners. Setting: Interviews were conducted on-site at tobacco prevention and control organization offices or by telephone. Participants: Key informant interviews (n=87) were conducted during July-December of 2017. Main outcome measures: Interviewees describe their work in providing technical assistance to leading public health and policy efforts in tobacco prevention and control. Interviews were transcribed verbatim and coded for meaning units. This analysis was conducted November 2017-January 2018. This study was determined exempt from review by the University of Nebraska Medical Center Institutional Review Board. Results: Three overarching themes emerged from our analysis: (1) maintaining tobacco prevention and control as a public health issue, (2) the importance of health equity in tobacco prevention and control work, and (3) planning for the next generation of tobacco prevention and control advocates. Certain populations remain untouched by broad public health approaches to reduce tobacco use. Conclusions: Tailored, focused, and comprehensive approaches to address health equity in tobacco prevention and control work across specific communities are needed. Adopting a health equity lens across public health priority areas (e.g., obesity, opioids, and tobacco prevention and control) could reduce prevalence among vulnerable groups for multiple conditions

Evaluating the Feasibility of a Gardening and Nutrition Intervention with a Matched Contact-Control Physical Activity Intervention Targeting Youth

The study reported here involved Cooperative Extension as a key research partner and was guided by a community-based participatory research approach and a feasibility study framework. The research objective was to assess four indicators of feasibility (i.e., acceptability, demand, implementation, and limited-effectiveness) of a gardening and nutrition program delivered at three youth community sites as compared to a matched contact-control physical activity intervention delivered at three different youth community sites. Conducted in a medically underserved region, the mixed-methods, quasi-experimental study revealed numerous opportunities for and barriers to increasing youths\u27 willingness to try fruits and vegetables and increasing physical activity among youths

Abdominal cancer symptoms: evaluation of the impact of a regional public awareness campaign.

Objective: A regional ‘Be Clear on Cancer’ (BCoC) campaign developed by Public Health England aimed to promote public awareness of key abdominal cancer symptoms in people aged 50 years and over. Methods: Data were analysed for metrics at different stages in the patient care pathway including public awareness, GP attendance and referrals, to cancer diagnosis. Results: There was significantly higher recognition of the BCoC abdominal campaign in the campaign region compared to the control area (Post Campaign/Control, n = 401/406; 35% vs. 24%, p [less than] 0.05). The campaign significantly improved knowledge of ‘bloating’ as a symptom (p = 0.03) compared to pre-campaign levels. GP attendances for abdominal symptoms increased significantly by 5.8% (p = 0. 03), although the actual increase per practice was small (average 16.8 visits per week in 2016 to 17.7 in 2017). Urgent GP referrals for suspected abdominal cancer increased by 7.6%, compared to a non-significant change (0.05%) in the control area. For specific abdominal cancers, the number diagnosed were similar to or higher than the median in the campaign area but not in the control area in people aged 50 and over: colorectal (additional n = 61 cancers), pancreatic (additional n = 102) and stomach cancers (additional n = 17). Conclusions: This campaign had a modest impact on public awareness of abdominal cancer symptoms, GP attendances and cancers diagnosed

The Influence of Health Literacy on Reach, Retention, and Success in a Worksite Weight Loss Program

To examine if employee health literacy (HL) status moderated reach, retention, and weight outcomes in a worksite weight loss program

Who participates in internet-based worksite weight loss programs?

<p>Abstract</p> <p>Background</p> <p>The reach and representativeness are seldom examined in worksite weight loss studies. This paper describes and illustrates a method for directly assessing the reach and representativeness of a internet-based worksite weight loss program.</p> <p>Methods</p> <p>A brief health survey (BHS) was administered, between January 2008 and November 2009, to employees at 19 worksites in Southwest Virginia. The BHS included demographic, behavioral, and health questions. All employees were blinded to the existence of a future weight loss program until the completion of the BHS.</p> <p>Results</p> <p>The BHS has a participation rate of 66 percent and the subsequent weight loss program has a participation rate of 30 percent. Employees from higher income households, with higher education levels and health literacy proficiency were significantly more likely to participate in the program (p's < .01).</p> <p>Conclusions</p> <p>Worksite weight loss programs should include targeted marketing strategies to engage employees with lower income, education, and health literacy.</p