Target population involvement in urban ciclovias: a preliminary evaluation of St. Louis Open Streets

Ciclovias are active street events when roads are open to walkers, cyclists, and families and closed to automobiles. Over 70 cities in the USA have implemented ciclovias to promote physical activity. The authors evaluated four events during 2010 to determine what activities participants perform and who is attending. For two ciclovia events in St. Louis, Missouri, observation reports of activities, gender, and age of 1,452 participants were collected, and 82 adults were interviewed via direct approach. The survey covered six domains: physical activity, travel to event, sense of community, marketing, economic impact, and demographics. Each event occurred within the city, along multiple streets. Domains were selected from Ciclovia Recreativa developed by Ciclovia Bogota, Pan American Health Organization, and CDC. Additional questions addressed city-specific goals and matched similar evaluations in other cities.Over 50%of participants met CDC-defined weekly minute thresholds for physical activity. Participants, primarily (980 %) middle class, college educated, and white, were not representative of the majority minority city population, which has high rates of poverty, and low percentage of college graduates. Cities must work with residents to increase low-income minority population participation in ciclovia-based physical activity

Open streets initiatives in the U.S. : Closed to traffic, open to physical activity

Background: The ciclovía, or open streets concept, is a community level physical activity promotion strategy where streets are closed to motorized traffic and open for individuals to engage in PA. This paper presents an overview of such initiatives in the U.S. to understand their potential in PA promotion, comparing event and city characteristics. Methods: We searched ciclovía and open streets initiatives held in 2011 in the U.S. using internet searches, publication databases, social media, and personal contacts. We extracted data on the each initiative’s frequency, route length, attendance, evaluation procedures, and sociodemographic characteristics of host cities. Results: Our search yielded 47 U.S. cities with open streets in 2011. Cities were diverse in sociodemographic characteristics. Route lengths ranged from a few blocks to 51 miles and event frequency ranged from annual to monthly. Reporting number of participants for events was sporadic. Few events conducted formal evaluations. Conclusion: The number of U.S. cities hosting open streets is increasing. The sociodemographics of the host cities suggest a potential to increase physical activity in populations at risk for developing chronic diseases through these initiatives. However, further evaluation is required. Identifying successful promotion and evaluation tactics would boost the health promotion potential of these initiatives

Advancing Community Engaged Approaches to Identifying Structural Drivers of Racial Bias in Health Diagnostic Algorithms

Much attention and concern has been raised recently about bias and the use of machine learning algorithms in healthcare, especially as it relates to perpetuating racial discrimination and health disparities. Following an initial system dynamics workshop at the Data for Black Lives II conference hosted at MIT in January of 2019, a group of conference participants interested in building capabilities to use system dynamics to understand complex societal issues convened monthly to explore issues related to racial bias in AI and implications for health disparities through qualitative and simulation modeling. In this paper we present results and insights from the modeling process and highlight the importance of centering the discussion of data and healthcare on people and their experiences with healthcare and science, and recognizing the societal context where the algorithm is operating. Collective memory of community trauma, through deaths attributed to poor healthcare, and negative experiences with healthcare are endogenous drivers of seeking treatment and experiencing effective care, which impact the availability and quality of data for algorithms. These drivers have drastically disparate initial conditions for different racial groups and point to limited impact of focusing solely on improving diagnostic algorithms for achieving better health outcomes for some groups.Comment: 2020 International System Dynamics Conference, Honorable Mention Award, 28 pages, 8 figure

Means, Intent, Lethality, Behaviors, and Psychiatric Diagnosis in Latina Adolescent Suicide Attempters

This article describes the means, intent, lethality, behavioral profiles, and psychiatric diagnoses of adolescent Latina suicide attempters. From a large, mixed-method project studying the sociocultural processes of Latina suicide attempts, we selected 76 participants for this report. In addition to quantitative research data, medical records were available for all 76 participants, as was qualitative data from in-depth interviews for 34 of them. Using the qualitative and quantitative research data, we explored intent and behavioral profiles of the suicidal adolescents. Medical records provided additional information about the means the adolescents used in their attempts, and about their psychiatric diagnoses. The lethality of suicide attempts was coded using the Lethality of Suicide Attempt Rating Scale (LSARS) and the Lethality of Suicide Attempt Rating Scale—Updated (LSARS-II). Findings showed that Latina adolescent suicide attempts are low in lethality. Consistent with the literature, most adolescents reported that they attempted by using means available in their homes (cutting and overdosing with medications were the predominant methods). Interesting discrepancies emerged when comparing adolescents’ self-reported behavioral profiles with clinicians’ psychiatric diagnoses. This report has implications for diagnosis and treatment approaches for both inpatient and outpatient service providers

Familism and family environment among suicidal Latinas: Three family types

This study examined the relationship between familism and family environment type as well as the relationship between family environment type and suicide attempts among Latina youth. Latina teen attempters (n=109) and non-attempters (n=107) were recruited from the NYC area. Latent class analysis revealed three family environment types: tight-knit; intermediate-knit; and loose-knit. Tight-knit families (high cohesion and low conflict) were significantly less likely to have teens that attempted suicide as compared to intermediate-knit families or loose-knit families. Moreover, familism increased the odds of being in the tight-knit family vs. the loose-knit family and the odds of being in the tight-knit family vs. the intermediate-knit. Results suggest that familism may protect against suicide behavior among Latinas via its influence on family environment

Familism and family environment among suicidal Latinas: Three family types

This study examined the relationship between familism and family environment type as well as the relationship between family environment type and suicide attempts among Latina youth. Latina teen attempters (n=109) and non-attempters (n=107) were recruited from the NYC area. Latent class analysis revealed three family environment types: tight-knit; intermediate-knit; and loose-knit. Tight-knit families (high cohesion and low conflict) were significantly less likely to have teens that attempted suicide as compared to intermediate-knit families or loose-knit families. Moreover, familism increased the odds of being in the tight-knit family vs. the loose-knit family and the odds of being in the tight-knit family vs. the intermediate-knit. Results suggest that familism may protect against suicide behavior among Latinas via its influence on family environment

Family relationships and Latina teen suicide attempts: Reciprocity, asymmetry, and detachment

Using qualitative data collected from adolescent Latinas and their parents, this article describes ways in which family relationships are organized within low-income Latino families (n = 24) with and without a daughter who attempted suicide. Based on a family-level analysis approach, we present a framework that categorizes relationships as reciprocal, asymmetrical, or detached. Clear differences are identified: Families of nonattempters primarily cluster in reciprocal families, whereas families with an adolescent suicide attempter exhibit characteristics of asymmetrical or detached families. Our results highlight the need for detailed clinical attention to family communication patterns, especially in Latino families. Clinicians may reduce the likelihood of an attempt or repeated attempts by raising mutual, reciprocal exchanges of words and support between parents and daughter

Family relationships and Latina teen suicide attempts: Reciprocity, asymmetry, and detachment

Using qualitative data collected from adolescent Latinas and their parents, this article describes ways in which family relationships are organized within low-income Latino families (n = 24) with and without a daughter who attempted suicide. Based on a family-level analysis approach, we present a framework that categorizes relationships as reciprocal, asymmetrical, or detached. Clear differences are identified: Families of nonattempters primarily cluster in reciprocal families, whereas families with an adolescent suicide attempter exhibit characteristics of asymmetrical or detached families. Our results highlight the need for detailed clinical attention to family communication patterns, especially in Latino families. Clinicians may reduce the likelihood of an attempt or repeated attempts by raising mutual, reciprocal exchanges of words and support between parents and daughter

Mental illness, poverty and stigma in India: a case-control study

Objective: To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mentalillness(PSMI) in Delhi, India, controlling for gender, age and caste. Design: Matching case(hospital)–control(population) study. Setting:University Hospital (cases) and National Capital Region (controls),India. Participants: A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophreniaor affective disorders were recruited and 647 individuals of same age,sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Main outcome measures: Higher risk of poverty due to stigma among PSMI. Results :38.5% of PSMI compared with 22.2%of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma(OR 2.60,95%CI 1.27 to 5.31) ,scheduled castes/scheduled tribes/other backward castes(2.39,1.39 to 4.08),mental illness (2.07,1.25 to 3.41)and female gender(1.87,1.36 to 2.58).A significant interaction between stigma,mental illness and gender or caste indicates female PSMI or PSMI from ‘lower castes’ were more likely to be poor due to stigma than male controls(p\u3c0.001)or controls from other castes(p\u3c0.001). Conclusions: Public stigma and multidimensional poverty linked to SMI are pervasive and intertwined.In particular for low caste and women,it is a strong predictor of poverty.Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty,increasing the burden for the family. Mental health professionals need to be aware of and address these issues

Walking on the Border: Walkability and Socioeconomic Placement in El Paso, Texas

This study has two aims: To explore walkability; andTo examine the relationship between walkability and SEP across census block groups in El Paso, Texas. Physical inactivity and related chronic diseases are higher for Latinos than other racial/ethnic groups in the U.S. Socioeconomic placement (SEP) and the built environment are determinants of physical activity. Walkability is a measure of the built environment that indicates how conducive an area is to walking for leisure, access to services, and travel to work. No study has examined walkability and its correlates in a U.S./Mexico border community with a large population of Latinos and high prevalence of obesity and diabetes.https://openscholarship.wustl.edu/gis_poster/1130/thumbnail.jp