A community based participatory approach to improving health in a Hispanic population

ABSTRACT: BACKGROUND: The Charlotte-Mecklenburg region has one of the fastest growing Hispanic communities in the country. This population has experienced disparities in health outcomes and diminished ability to access healthcare services. This city is home to an established practice-based research network (PBRN) that includes community representatives, health services researchers, and primary care providers. The aims of this project are: to use key principles of community-based participatory research (CBPR) within a practice-based research network (PBRN) to identify a single disease or condition that negatively affects the Charlotte Hispanic community; to develop a community-based intervention that positively impacts the chosen condition and improves overall community health; and to disseminate findings to all stakeholders. METHODS/DESIGN: This project is designed as CBPR. The CBPR process creates new social networks and connections between participants that can potentially alter patterns of healthcare utilization and other health-related behaviors. The first step is the development of equitable partnerships between community representatives, providers, and researchers. This process is central to the CBPR process and will occur at three levels -- community members trained as researchers and outreach workers, a community advisory board (CAB), and a community forum. Qualitative data on health issues facing the community -- and possible solutions -- will be collected at all three levels through focus groups, key informant interviews and surveys. The CAB will meet monthly to guide the project and oversee data collection, data analysis, participant recruitment, implementation of the community forum, and intervention deployment. The selection of the health condition and framework for the intervention will occur at the level of a community-wide forum. Outcomes of the study will be measured using indicators developed by the participants as well as geospatial modeling.On completion, this study will: determine the feasibility of the CBPR process to design interventions; demonstrate the feasibility of geographic models to monitor CBPR-derived interventions; and further establish mechanisms for implementation of the CBPR framework within a PBRN

Socioeconomic status, urbanicity and risk behaviors in Mexican youth: an analysis of three cross-sectional surveys

<p>Abstract</p> <p>Background</p> <p>The relationship between urbanicity and adolescent health is a critical issue for which little empirical evidence has been reported. Although an association has been suggested, a dichotomous rural versus urban comparison may not succeed in identifying differences between adolescent contexts. This study aims to assess the influence of locality size on risk behaviors in a national sample of young Mexicans living in low-income households, while considering the moderating effect of socioeconomic status (SES).</p> <p>Methods</p> <p>This is a secondary analysis of three national surveys of low-income households in Mexico in different settings: rural, semi-urban and urban areas. We analyzed risk behaviors in 15-21-year-olds and their potential relation to urbanicity. The risk behaviors explored were: tobacco and alcohol consumption, sexual initiation and condom use. The adolescents' localities of residence were classified according to the number of inhabitants in each locality. We used a logistical model to identify an association between locality size and risk behaviors, including an interaction term with SES.</p> <p>Results</p> <p>The final sample included 17,974 adolescents from 704 localities in Mexico. Locality size was associated with tobacco and alcohol consumption, showing a similar effect throughout all SES levels: the larger the size of the locality, the lower the risk of consuming tobacco or alcohol compared with rural settings. The effect of locality size on sexual behavior was more complex. The odds of adolescent condom use were higher in larger localities only among adolescents in the lowest SES levels. We found no statically significant association between locality size and sexual initiation.</p> <p>Conclusions</p> <p>The results suggest that in this sample of adolescents from low-income areas in Mexico, risk behaviors are related to locality size (number of inhabitants). Furthermore, for condom use, this relation is moderated by SES. Such heterogeneity suggests the need for more detailed analyses of both the effects of urbanicity on behavior, and the responses--which are also heterogeneous--required to address this situation.</p

Antisocial behavior and alcohol consumption by school adolescents Conducta antisocial y consumo de alcohol en adolescentes escolares Conduta anti-social e consumo de álcool em adolescentes escolares

Adolescence is a vulnerable period and facilitates the start of risk behaviors, for instance the use of drugs. This study aims to describe the differences between antisocial behavior and alcohol consumption according to gender, age and education; as well as to discover the relation between antisocial behavior and alcohol consumption in 1,221 school adolescents from Monterrey - Nuevo Leon, Mexico. The findings reveal differences in antisocial behavior according to gender. Evidences showed that 41.3% of the students had consumed alcohol at sometime in their lives, and that differences exist in alcohol consumption according to age and education. Finally, the study found positive and significant relations between antisocial behavior and alcohol consumption (r s = .272, p <.001).<br>La adolescencia se convierte en una etapa de vulnerabilidad y facilitador para el inicio de conductas de riesgo como es el consumo de drogas. Los objetivos del presente estudio fueron: describir las diferencias de la conducta antisocial y consumo de alcohol según sexo, edad y escolaridad; conocer la relación existente de la conducta antisocial con el consumo de alcohol en 1221 adolescentes escolares de Monterrey, Nuevo Léon, México, en relación a los hallazgos encontrados se presentan diferencias de la conducta antisocial por sexo; se destaca que 41.3% de los estudiantes consumieron alcohol alguna vez en su vida, y existen diferencias de consumo de alcohol por edad y escolaridad. Finalmente se encontró relación positiva y significativa de la conducta antisocial con el consumo de alcohol (r s=.272, p<.001).<br>A adolescência se apresenta como uma etapa de vulnerabilidade e facilitadora para o início de condutas de risco como o consumo de drogas. Os objetivos do presente estudo foram: descrever as diferenças entre sexo, idade e escolaridade na conduta anti-social e o consumo de álcool e conhecer a relação existente entre a conduta anti-social e o consumo de álcool em 1221 adolescentes escolares de Monterrey, Nuevo León, México. De acordo com os resultados obtidos foram observadas diferenças na conduta anti-social por sexo. Destaca-se que 41,3% dos estudantes consumiram álcool em algum momento da vida, e houve diferenças de consumo de álcool por idade e escolaridade. Finalmente, encontrou-se uma relação positiva e significativa entre a conduta anti-social e o consumo de álcool (r s=,272, p<,001)

Ambiente familiar e consumo de álcool e tabaco entre adolescentes Familiar environment and use of alcohol and tobacco among teenagers

OBJETIVO: Analisar a influência do ambiente familiar em relação ao uso de álcool e tabaco pelos adolescentes. MÉTODOS: Trata-se de estudo descritivo, elaborado a partir da análise e aprofundamento da categoria referente ao uso de drogas lícitas e a influência familiar, presente em um questionário semiestruturado, contendo ao todo 25 questões sobre o uso álcool e tabaco, realizado junto a 1.533 adolescentes de ambos os sexos, tendo por critérios de inclusão: adolescentes entre dez e 20 anos de idade, matriculados e frequentando regularmente a sexta, a sétima ou a oitava séries do ensino fundamental e o primeiro, o segundo ou o terceiro anos do ensino médio das escolas estaduais situadas nas regiões de Santo Eduardo e Santa Emília, no município de Embu, no período matutino, e que aceitaram participar das oficinas de prevenção e promoção da saúde realizadas pelo Projeto Corporalidade e Promoção da Saúde. A análise estatística foi aplicada por meio do teste do qui-quadrado, ao nível de significância p<0,05, tendo como medida de risco a aplicação do Odds Ratio, com intervalo de confiança de 95%. RESULTADOS: Os dados demonstraram que 66% dos adolescentes que não experimentaram bebidas alcoólicas não possuem familiares que bebem frequentemente (p<0,001) e 84% dos que são fumantes apresentam familiares que fumam (p<0,001). CONCLUSÕES: O ambiente familiar induz e facilita o uso de álcool e tabaco por adolescentes, tornando-se fundamental a utilização deste conhecimento na elaboração de projetos de prevenção e educação em saúde.<br>OBJECTIVE: To analyze the influence of the family environment in relation to alcohol and tobacco use among adolescents. METHODS: This was a descriptive study consisting of in-depth analysis on the topic of family influence related to legal drug use. A semi-structured questionnaire containing 25 questions on alcohol and tobacco use was completed by 1,533 adolescents of both genders. Inclusion criteria were: adolescents aged ten to 20 years who were regularly attending morning classes in the sixth, seventh or eighth years of elementary education or in the first, second or third years of high school education at state schools in two regions of the municipality of Embu, São Paulo, Brazil. Subjects agreed to participate in preventive health promotion workshops of the Corporality and Health Promotion Project. Statistical analysis applied odds ratio, with a 95% confidence interval and chi-square test, being significant p<0.05. RESULTS: 66% of the adolescents who had not tried alcoholic drinks did not have any family members who were frequent drinkers (p<0.001) and 84% of those who smoked had family members who were smokers (p<0.001). CONCLUSIONS: The family environment induces and facilitates alcohol and tobacco use. It is extremely important to use this knowledge to design preventive health education projects