Social determinants of health among African–American men

http://dx.doi.org/10.1016/j.jomh.2009.12.00

Utilization of a Community-based Participatory Approach to Design and Implement a Peer-led Parenting Pilot Intervention to Influence Child Nutritional and Physical Activity Behaviors

Parents and primary child guardians within the household play critical roles in shaping their children’s nutritional and physical activity behaviors, which are among the individual-level determinants of childhood obesity and other chronic conditions. There are well-established correlations between race, socioeconomic status and the risk for obesity calling for both contextually- and individual-centered interventions that are community-driven. The Using Quality Parenting (UQP) pilot intervention was a peer-led, parenting education intervention developed in collaboration with community residents in Atlanta, Georgia to influence child nutritional and physical activity behaviors in African American low socioeconomic status communities. A community-based participatory research (CBPR) framework was used to conduct a mixed-methods needs assessment designed to the UQP curriculum. The UQP program targeted parents of children ages 6-14. The overarching aim was to increase quality parenting and address community identified child obesity disparities and inequities in early and middle childhood. The topics pertaining to parenting to children’s health/well-being addressed by the UQP included nutrition, physical activity, socio-emotional development, positive parenting, coping skills, child advocacy, and community development. Analyses were conducted using PSAW 18 statistical software. Descriptive statistics, including frequencies, means, standard deviations, and ranges for the individual survey items were conducted. A t-test was performed comparing pre- and post-program participation. A repeated measure analysis of variance was conducted on the items that demonstrated a significant t-test. The analytic sample was composed of 46 African American parents, with over 50% of the sample earning an annual household income of $25,000 or less. Participating parents reported significantly higher levels of water consumption for their children post-program in comparison to pre-test reports (p = .010). Additionally, based on t-test analyses, parents reported that their children consumed significantly higher levels of proteins, grains, fruits and vegetables at each meal, post-program (p=0.03). These findings highlight the potential efficacy of community-informed, parent-led interventions in improving health disparities and related outcomes for children

Psychosocial, socio-cultural, and environmental influences on mental health help-seeking among African-American men

http://dx.doi.org/10.1016/j.jomh.2012.03.00

African American students’ use of personal technologies in the university classroom

Despite positive impacts of the Internet on engagement of university students, higher-education professionals have increasingly expressed concerns about students’ problematic Internet use (PIU) in the classroom. While it has been a growing burden on instructors to handle disruptive student behaviors associated specifically with PIU and the resulting interpersonal conflicts with students in the classroom, no study has investigated how students’ PIU in the classroom contributes to such student-instructor interpersonal conflicts. This study examined African American students’ PIU in the university classroom and the resulting student-instructor interpersonal conflicts. A total of 322 African American students completed a cross-sectional survey during class that assessed interpersonal conflicts, PIU, depression, resilience, and socio-demographics. Hierarchical binary logistic regression analysis revealed employment and resilience predicted students’ PIU in the classroom, while PIU levels predicted interpersonal conflicts. Universities should develop interventions that reduce PIU and enhance resilience, especially among working African American students

Missed Policy Opportunities to Advance Health Equity by Recording Demographic Data in Electronic Health Records

The science of eliminating health disparities is complex and dependent on demographic data. The Health Information Technology for Economic and Clinical Health Act (HITECH) encourages the adoption of electronic health records and requires basic demographic data collection; however, current data generated are insufficient to address known health disparities in vulnerable populations, including individuals from diverse racial and ethnic backgrounds, with disabilities, and with diverse sexual identities. We conducted an administrative history of HITECH and identified gaps between the policy objective and required measure. We identified 20 opportunities for change and 5 changes, 2 of which required the collection of less data. Until health care demographic data collection requirements are consistent with public health requirements, the national goal of eliminating health disparities cannot be realized

Improving Service Coordination and Reducing Mental Health Disparities Through Adoption of Electronic Health Records.

Despite widespread support for removing barriers to the use of electronic health records (EHRs) in behavioral health care, adoption of EHRs in behavioral health settings lags behind adoption in other areas of health care. The authors discuss barriers to use of EHRs among behavioral health care practitioners, suggest solutions to overcome these barriers, and describe the potential benefits of EHRs to reduce behavioral health care disparities. Thoughtful and comprehensive strategies will be needed to design EHR systems that address concerns about policy, practice, costs, and stigma and that protect patients privacy and confidentiality. However, these goals must not detract from continuing to challenge the notion that behavioral health and general medical health should be treated as separate and distinct. Ultimately, utilization of EHRs among behavioral health care providers will improve the coordination of services and overall patient care, which is essential to reducing mental health disparities

Reducing Health Disparities and Improving Health Equity in Saint Lucia

St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157), and health care providers/clinic administrators (n = 42), were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations

Improving Service Coordination and Reducing Mental Health Disparities Through Adoption of Electronic Health Records

Despite widespread support for removing barriers to the use of electronic health records (EHRs) in behavioral health care, adoption of EHRs in behavioral health settings lags behind adoption in other areas of health care. The authors discuss barriers to use of EHRs among behavioral health care practitioners, suggest solutions to overcome these barriers, and describe the potential benefits of EHRs to reduce behavioral health care disparities. Thoughtful and comprehensive strategies will be needed to design EHR systems that address concerns about policy, practice, costs, and stigma and that protect patients’ privacy and confidentiality. However, these goals must not detract from continuing to challenge the notion that behavioral health and general medical health should be treated as separate and distinct. Ultimately, utilization of EHRs among behavioral health care providers will improve the coordination of services and overall patient care, which is essential to reducing mental health disparities