Public Housing for the Elderly : The Relationship of Selected Physical Standards to Resident Satisfaction

A major area of recent interest to the elderly is housing. One of the reasons housing has become a major concern is because housing represents much more than a physical structure in our society. Housing is a subject of highly charged emotional content with many strong feelings attached. The housing environment seems to have considerable control over they way in which individuals perceive themselves and over others perception of them. The design of buildings can have an important effect on the persons who live and move around in them. In the United States there has been experimentation with a variety of housing for the elderly. A few of these options are high rises, retirement communities, nursing homes, hospitals and various types of public housing. So far there has been limited research on the effects of these residences on the elderly. Information on the effects of housing on the elderly would seem to be critical at this stage. Investing large amounts of money in housing, when it is not known whether the units are fulfilling their purpose would seem to be a great mistake. If present units are found not to be meeting elderly housing needs, the problems and alternatives for their solution should be explored before large numbers are built. The purpose of this research was to critique some of the physical characteristics of subsidized housing designed particularly for the elderly. More specifically, the objectives of the study were to: 1. Identify from literature certain physical standards of subsidized housing for the elderly considered critical to their well-being. 2. Determine the extent to which elderly subsidized housing meets the physical standards identified in the literature review. 3. Determine elderly resident’s satisfaction with the physical characteristics of their subsidized housing. 4. Investigate the influence of selected personal characteristics on housing satisfaction. 5. Ascertain the relationship between physical standards and the housing satisfaction of elderly residents

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

An Exploration of Dietary Acculturation in Hispanic Males Residing in Mississippi

The purpose of this research was to explore dietary acculturation in Hispanic males in the context of the Operant Theory of Acculturation. This was a qualitative study using grounded theory to guide methodological procedures. Semi-structured interviews, a focus group, the Acculturation-Rating Scale for Mexican-Americans-II and the Marginality Scale, and photovoice with follow-up interviews were used to explore dietary acculturation in the participant sample. Thirty-five first- and second-generation Hispanic males residing in Mississippi were recruited and categorized into one of three different bidimensional acculturation groups as determined by the Acculturation-Rating Scale for Mexican-Americans-II and the Marginality Scale. Main dietary influencing themes identified were intrapersonal and environmental dietary factors. The subthemes included values, attitudes, beliefs, knowledge, and preference for the intrapersonal factors and availability; living structure; accessibility; food preparation skill; and time for the environmental factors. The factors are not mutually exclusive and show the complexity of the dietary acculturation process. This research can be used to guide future research and inform nutrition intervention development for this population

Improvements in Blood Pressure Among Undiagnosed Hypertensive Participants in a Community-Based Lifestyle Intervention, Mississippi, 2010

Introduction Effective strategies are needed to reach and treat people who lack awareness of or have uncontrolled hypertension. We used data from a community-based participatory research initiative, Hub City Steps, to quantify the prevalence of undiagnosed hypertension and determine the relationship between hypertension status at baseline and postintervention improvements in blood pressure and health-related quality of life. Methods Hub City Steps was a 6-month preintervention–postintervention lifestyle intervention targeting hypertension risk factors. Outcome measures were collected at baseline, 3 months, and 6 months. Generalized linear mixed models were used to test for effects by time and hypertension status. Results Of the enrolled sample (N = 269), most were overweight or obese (91%), African American (94%), and women (85%). When considering hypertension status, 42% had self-reported diagnosis of hypertension (self-reported subgroup; 84% with antihypertensive medication use); 36% had no self-reported medical history of hypertension, but when blood pressure was measured they had a clinical diagnosis of prehypertension or hypertension (undiagnosed subgroup); and 22% had no self-reported or clinical hypertension diagnosis (no hypertension subgroup). From baseline to 6 months, systolic blood pressure significantly improved for participants with self-reported hypertension [8.2 (SD, 18.2) mm Hg] and undiagnosed hypertension [12.3 (SD, 16.3) mm Hg], with undiagnosed participants experiencing the greatest improvements (P \u3c .001). Effects remained significant after controlling for covariates. Health-related quality of life significantly improved for all 3 hypertension subgroups, with no apparent subgroup differences. Conclusion This study reveals advantages of a culturally appropriate community-based participatory research initiative to reach those with undetected hypertension and effectively improve blood pressure status and health-related quality of life

HUB City Steps: Methods and Early Findings From a Community-Based Participatory Research Trial to Reduce Blood Pressure Among African Americans

Background: Community-based participatory research (CBPR) has been recognized as an important approach to develop and execute health interventions among marginalized populations, and a key strategy to translate research into practice to help reduce health disparities. Despite growing interest in the CBPR approach, CBPR initiatives rarely use experimental or other rigorous research designs to evaluate health outcomes. This behavioral study describes the conceptual frameworks, methods, and early findings related to the reach, adoption, implementation, and effectiveness on primary blood pressure outcomes. Methods: The CBPR, social support, and motivational interviewing frameworks are applied to test treatment effects of a two-phased CBPR walking intervention, including a 6-month active intervention quasi experimental phase and 12-month maintenance randomized controlled trial phase to test dose effects of motivational interviewing. A community advisory board helped develop and execute the culturally-appropriate intervention components which included social support walking groups led by peer coaches, pedometer diary selfmonitoring, monthly diet and physical activity education sessions, and individualized motivational interviewing sessions. Although the study is on-going, three month data is available and reported. Analyses include descriptive statistics and paired t tests. Results: Of 269 enrolled participants, most were African American (94%) females (85%) with a mean age of 43.8 (SD = 12.1) years. Across the 3 months, 90% of all possible pedometer diaries were submitted. Attendance at the monthly education sessions was approximately 33%. At the 3-month follow-up 227 (84%) participants were retained. From baseline to 3-months, systolic BP [126.0 (SD = 19.1) to 120.3 (SD = 17.9) mmHg; p \u3c 0.001] and diastolic BP [83. 2 (SD = 12.3) to 80.2 (SD = 11.6) mmHg; p \u3c 0.001] were significantly reduced. Conclusions: This CBPR study highlights implementation factors and signifies the community’s active participation in the development and execution of this study. Reach and representativeness of enrolled participants are discussed. Adherence to pedometer diary self-monitoring was better than education session participation. Significant decreases in the primary blood pressure outcomes demonstrate early effectiveness. Importantly, future analyses will evaluate long-term effectiveness of this CBPR behavioral intervention on health outcomes, and help inform the translational capabilities of CBPR efforts

HUB City Steps: A 6-Month Lifestyle Intervention Improves Blood Pressure among a Primarily African-American Community

The effectiveness of community-based participatory research (CBPR) efforts to address the disproportionate burden of hypertension among African Americans remains largely untested. The objective of this 6-month, noncontrolled, pre-/post-experimental intervention was to examine the effectiveness of a CBPR intervention in achieving improvements in blood pressure, anthropometric measures, biological measures, and diet. Conducted in 2010, this multicomponent lifestyle intervention included motivational enhancement, social support provided by peer coaches, pedometer diary self-monitoring, and monthly nutrition and physical activity education sessions. Of 269 enrolled participants, 94% were African American and 85% were female. Statistical analysis included generalized linear mixed models using maximum likelihood estimation. From baseline to 6 months, blood pressure decreased significantly: mean (±standard deviation) systolic blood pressure decreased from 126.0±19.1 to 119.6±15.8 mm Hg, P=0.0002; mean diastolic blood pressure decreased from 83.2±12.3 to 78.6±11.1 mm Hg, P

HUB City Steps: A 6-Month Lifestyle Intervention Improves Blood Pressure among a Primarily African-American Community

The effectiveness of community-based participatory research (CBPR) efforts to address the disproportionate burden of hypertension among African Americans remains largely untested. The objective of this 6-month, noncontrolled, pre-/post-experimental intervention was to examine the effectiveness of a CBPR intervention in achieving improvements in blood pressure, anthropometric measures, biological measures, and diet. Conducted in 2010, this multicomponent lifestyle intervention included motivational enhancement, social support provided by peer coaches, pedometer diary self-monitoring, and monthly nutrition and physical activity education sessions. Of 269 enrolled participants, 94% were African American and 85% were female. Statistical analysis included generalized linear mixed models using maximum likelihood estimation. From baseline to 6 months, blood pressure decreased significantly: mean (±standard deviation) systolic blood pressure decreased from 126.0±19.1 to 119.6±15.8 mm Hg, P=0.0002; mean diastolic blood pressure decreased from 83.2±12.3 to 78.6±11.1 mm Hg, P

Meaningful Messages: Adults in the Lower Mississippi Delta Provide Cultural Insight into Strategies for Promoting the MyPyramid

Objective: To explore cultural perceptions of the MyPyramid key messages and identify factors that may impact adoption of these recommendations. Methods: Systematic content analysis of transcripts from in-depth, structured interviews with 23 adults, primarily African American females, residing in the Lower Mississippi Delta. Results: When asked to identify good reasons to follow the MyPyramid key messages, nonspecific references to improved health were most prevalent (n = 130); however, participants also acknowledged the importance of getting vitamins and nutrients (n = 81), and the impact food choices have on health conditions (n = 77) and organ systems (n = 65). Individual-level factors (n = 211), Such as dislike for food items and tradition or customs, far outnumbered environmental-level factors (n = 48), Such as cost and availability, as perceived reasons preventing community members from adhering to the key messages. The most frequently mentioned suggestion for helping community members cat according to the MyPyramid were to raise awareness (n = 93), provide information (n = 65), and improve the taste of or provide opportunity to taste (n = 49). Conclusions and Implications: This study captured participants\u27 Cultural perspectives of the MyPyramid key messages. Results indicate that both social marketing campaigns and intervention efforts focused on individual-level factors arc needed to promote the MyPyramid in this disadvantaged Delta region

Does a Six-Month Pedometer Intervention Improve Physical Activity and Health Among Vulnerable African Americans? A Feasibility Study

Background: Race/ethnic-specific physical activity patterns and biological responses to physical activity is one of the most understudied, yet critical aspects related to the development and adoption of physical activity recommendations. Methods: In this 6-month community walking intervention targeting African Americans, participants wore a pedometer and maintained a pedometer diary for the study duration. Outcome measures included height, weight, percent body fat, waist circumference, blood pressure, lipids and glucose. ANOVA, Pearson Correlations, and Kruskal-Wallis tests were used to examine changes in steps/day over each month of the intervention and explore associations among pedometer-determined physical activity and anthropometric/biological change scores from month 1 to 6. Results: The 83 participants were primarily African American (98%) women (94%). There was a significant increase in the average step/day beginning with 6665 (SD =3,396) during month I and increasing to 9232 (SD = 3670) steps/day during month 6 (F = 4.5, P \u3c .0001). Associations among step counts and anthropometric/biological change scores were not significant. Conclusions: While this intervention resulted in significant increases in steps/day; it exemplifies that physical activity standards may be unachievable for some vulnerable, minority communities. Methodological considerations for exploring associations between changes in pedometer-determined step counts and anthropometric/biological outcomes are emphasized through this study