Factors Associated with Arkansans’ First Use of Telehealth during the COVID-19 Pandemic

Objective. To examine the factors associated with the first use of telehealth during the COVID-19 pandemic using Andersen’s Model of Healthcare Utilization. Andersen’s Model of Healthcare Utilization allowed the categorization of the independent variables into the following: (1) predisposing factors, including sociodemographic variables and health beliefs; (2) enabling factors, including socioeconomic status and access to care; and (3) need for care, including preexisting or newly diagnosed conditions and reasons to seek out care or to utilize a new mode of care. Methods. Potential respondents (n = 4,077) were identified for recruitment from a volunteer registry in Arkansas. Recruitment emails provided a study description, the opportunity to verify meeting the study’s inclusion criteria and to consent for participation, and a link to follow to complete the survey online. The online survey responses were collected between July and August of 2020 (n = 1,137). Results. Telehealth utilization included two categories: (1) utilizers reported the first use of telehealth services during the pandemic, and (2) nonutilizers reported they had never used telehealth. Lower odds of reporting telehealth utilization during the pandemic were associated with race (Black; OR = 0:57, CI [0.33, 0.96]) and education (high School or less; OR = 0:45, CI [0.25, 0.83]). Higher odds of reporting telehealth utilization included having more than one provider (OR = 2:33, CI [1.30, 4.18]), more physical (OR = 1:12, CI [1.00, 1.25]) and mental (OR 1.53, CI [1.24, 1.88]) health conditions, and changes in healthcare delivery during the pandemic (OR = 3:49, CI [2.78, 4.38]). Conclusions. The results illustrate that disparities exist in Arkansans’ utilization of telehealth services during the pandemic. Future research should explore the disparities in telehealth utilization and how telehealth may be used to address disparities in care for Black Arkansans and those with low socioeconomic status

Association between Diagnosed Anxiety and Depression and Exposure to Life Stressors during the COVID-19 Pandemic

Research suggests that mental health disorders heighten the risk of exposure to life stressors. Drawing on a sample of 754 adults from a survey distributed at six primary care clinics, we examine whether adults who reported ever being diagnosed with depression or anxiety were more likely to experience an employment disruption, a housing disruption, and/or report more COVID-19-related stressors during the COVID-19 pandemic. Individuals who reported ever being diagnosed with depression reported a greater burden (B=.75) of COVID-19-related stressors. Those who reported ever being diagnosed with anxiety had higher odds of experiencing an employment disruption (OR=1.90) and a housing disruption (OR=2.92) and reported about one (B=.97) additional COVID-19-related stressor. Our results suggest that the COVID-19 pandemic may have deepened existing mental health disparities by exposing those with a depression or anxiety diagnosis to additional life stressors

Results of a Rural Traffic Calming Event to Promote Physical Activity

This article describes how community need was addressed through a traffic calming pop-up event in rural Arkansas. The event was conducted on routes connecting a neighborhood, two schools, and a municipal park. A brief survey assessed safety concerns of parents and/or guardians related to children walking or biking to school. Prior to the event, parents/guardians reported it was not safe for their children to walk or bike to school; however, the majority agreed the event made the area safer. Small-scale traffic calming events can provide evidence to stakeholders that built environment changes are an important childhood obesity prevention strategy in rural Extension work

Prevalence and Associations between Food Insecurity and Overweight/Obesity among Native Hawaiian and Pacific Islander Adolescents

Abstract Objective: This study estimates the prevalence of, and associations between, family food insecurity and overweight/obesity among Native Hawaiian and Pacific Islander (NHPI) adolescents and explores sociodemographic factors which might have a moderation effect on the association. Design: Cross-sectional study using 2014 NHPI-National Health Interview Survey (NHIS) data reported by a parent or guardian. Family-level food security was assessed by the United States (US) Department of Agriculture 10-item questionnaire. BMI for age and sex >=85th and 95th percentiles defined overweight and obesity, respectively, according to US Centers for Disease Control and Prevention criteria. Setting: The US, including all 50 states and the District of Columbia. Participants: 383 NHPI adolescents aged 12-17 in the US. Results: A third (33.5%) of NHPI adolescents aged 12-17 were overweight (19.1%) or obese (14.4%); 8.1% had low food security; and 8.5% had very low food security. Mean family food security score was 1.06, which corresponds to marginal food security. We found no association between family food insecurity and adolescent overweight/obesity or between any other covariates and overweight/obesity, except for family Supplemental Nutrition Assistance Program (SNAP) participation. Odds of being overweight/obese were 77% lower for adolescents in families participating in SNAP (OR: 0.23, 95% CI: 0.08-0.64, p=0.007). The association between SNAP participation and lower odds of overweight/obesity was particularly pronounced for adolescent girls in food insecure families. Conclusions: The association between SNAP participation and lower odds of overweight/obesity suggests potential benefit of research to determine whether interventions to increase SNAP enrollment would improve NHPI adolescents’ health outcomes

The National Childrens Study: Recruitment Outcomes Using the Provider-Based Recruitment Approach

In 2009, the National Children’s Study (NCS) Vanguard Study tested the feasibility of household-based recruitment and participant enrollment using a birth-rate probability sample. In 2010, the NCS Program Office launched 3 additional recruitment approaches. We tested whether provider-based recruitment could improve recruitment outcomes compared with household-based recruitment

Development and evaluation of a community-engaged research training program: Building capacity of Marshallese stakeholders and academic researchers to conduct health research

Pacific Islanders are a growing, yet understudied population who suffer from high rates of chronic diseases such as obesity and diabetes. Given the historical trauma experienced by Pacific Islanders, community-based participatory research (CBPR) is an appropriate way to conduct research focused on reducing the health disparities observed in this population. This paper presents the process of engaging the Marshallese community to design, conduct, and evaluate a community-engaged research training program. The goal of the program was to build the capacity of both academic researchers and community stakeholders to conduct CBPR for the purpose of addressing health disparities identified and prioritized by the Marshallese community. The program included both didactic training and experiential mentored research components delivered over a period of two years. Eleven Marshallese community stakeholders and eleven academic researchers participated in the program. Results indicated that the program successfully increased participants’ knowledge regarding the CBPR process. Groups of participants have completed exploratory research projects based on the topics identified by the community. The evaluation adds important insights to the current CBPR training literature and can inform future CBPR trainings. Keywords community-basead participatory research, community-engaged research, Pacific Islanders, minority health, health disparities, interprofessional trainin

Capacity Building for a New Multicenter Network Within the ECHO IDeA States Pediatric Clinical Trials Network

Introduction: Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN. Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research capacity for pediatrician scientists and team members. The inventory findings were utilized by the ISPCTN Data Coordinating and Operations Center to construct training modules covering 3 broad domains: Faculty/coordinator development; Infrastructure; Trials/Research concept development. Results: Key lessons learned reveal substantial participation in the training modules, the importance of an inventory to guide the development of trainings, and recognizing local barriers to clinical trials research. Conclusions: Research networks that seek to implement successfully completed trials need to build capacity across and within the sites engaged. Our findings indicate that building research capacity is a multi-faceted endeavor, but likely necessary for sustainability of a unique network addressing high impact pediatric health problems. The ISPCTN emphasis on building and enhancing site capacity, including pediatrician scientists and team members, is critical to successful trial implementation/completion and the production of findings that enhance the lives of children and families

Parents’ and Guardians’ Intentions to Vaccinate Children against COVID-19

A cross-sectional survey design was used to assess Arkansas parents’/guardians’ intentions to vaccinate their child against COVID-19. Parents/guardians whose oldest child was age 0–11 years (n = 171) or 12–17 years (n = 198) were recruited between 12 July and 30 July 2021 through random digit dialing. Among parents/guardians with an age-eligible child, age 12–17, 19% reported their child had been vaccinated, and 34% reported they would have their child vaccinated right away. Among parents/guardians with a child aged 0–11, 33% of parents/guardians reported they would have their child vaccinated right away. Twenty-eight percent (28%) of parents/guardians whose oldest child was 12–17 and 26% of parents/guardians whose oldest child was 0–11 reported they would only have their child vaccinated if their school required it; otherwise, they would definitely not vaccinate them. For both groups, parents’/guardians’ education, COVID-19 vaccination status, and COVID-19 vaccine hesitancy were significantly associated with intentions to vaccinate their child. More than a third of parents/guardians whose child was eligible for vaccination at the time of the survey reported they intended to have them vaccinated right away; however, they had not vaccinated their child more than two months after approval. This finding raises questions about the remaining barriers constraining some parents/guardians from vaccinating their child