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Family & Community Health

Yi-Ling Lin, Judith Ortiz, Celeste Boor
The purpose of this study was to examine the impact of Medicare Shared Savings Program Accountable Care Organizations (SSP ACOs), along with other factors, on diabetes-related hospitalization rates for rural older adults. Using an early year of the SSP ACO program, we conducted multiple linear regressions to examine the effect of ACO participation on African American and white older adults. In neither model was ACO affiliation found to have a statistically significant impact on diabetes-related hospitalization rates...
October 2018: Family & Community Health
Kenneth J Fawcett, Raymond K Neff, Christina M Freese Decker, Josephine E Faber
Utilizing a nurse/community health worker team model, a Midwest institution's community health care division developed a 12-month managed care program for underserved individuals diagnosed with heart failure and/or diabetes. A study of 277 patients was conducted to determine whether this model could be utilized in rural settings. The program was evaluated using the Institute for Healthcare Improvement's Triple Aim criteria; HEDIS measures and other health indicators quantified each patient's performance. Study participants showed improved outcomes and a reduction in the total cost of care...
October 2018: Family & Community Health
Adam Hege, Lanae Ball, Richard W Christiana, Conner Wallace, Cami Hubbard, Danielle Truesdale, Jennifer Hege, Howard Fleming
Recent evidence highlights health disparities among rural communities. The purpose of this study was to learn from members of 2 Appalachia communities in North Carolina about barriers to health and well-being. Researchers conducted 3 focus groups (n = 24), which were coded and analyzed by a team of researchers to identify themes. Researchers identified 5 themes: (1) poverty/lack of economic opportunity; (2) access to health care and health resources; (3) social/mental health challenges; (4) food insecurity/hunger; and (5) youth/older adults being most vulnerable to health disparities...
October 2018: Family & Community Health
Ai Yue, Nianrui Zhang, Xueyang Liu, Lei Tang, Renfu Luo, Meredith Yang, Scott Rozelle, Alexis Medina
The overall goal of this study is to examine whether infant feeding practices differ between mothers and grandmothers in rural China. We randomly sampled 1383 caregivers of infants aged 18 to 30 months living in 351 villages across 174 townships in nationally designated poverty counties in rural areas. Results show that a high fraction of caregivers of 18- to 30-month-old children living in low-income areas of rural China do not regularly engage in positive infant feeding practices. Only 30% of children in our sample achieved adequate dietary diversity...
October 2018: Family & Community Health
Mary Lehman Held, Lisa C Lindley
This study examined how country of origin (Mexico or Guatemala) correlates with prenatal care utilization among unauthorized Latina immigrants, who encounter disparate access to health care. Logistic regression and negative binomial regression analyses were used to examine prenatal care adequacy and number of visits among a sample of 4188 unauthorized Latina immigrants. Findings suggest that originating from Guatemala predicted increased likelihood of inadequate prenatal care and fewer prenatal care visits...
October 2018: Family & Community Health
Samantha Teixeira, Anita Zuberi
Despite the knowledge that children in low-income neighborhoods are particularly vulnerable to asthma, few studies of child asthma focus on variation among low-income neighborhoods. We examined the relationship between child asthma and features associated with neighborhood poverty including safety, social cohesion, informal social control, collective efficacy, and disorder, across a sample of children from low-income neighborhoods (N = 3010; 2005-2007). Results show that the relationship between asthma and poverty is accounted for by family-level characteristics, but informal social control remains significantly and positively related to asthma after accounting for family-level characteristics...
October 2018: Family & Community Health
David O Fakunle, Raimee Eck, Adam J Milam, Roland J Thorpe, Debra M Furr-Holden
There is limited research on e-cigarette availability despite increased use. E-cigarette availability within Baltimore alcohol outlets was analyzed for disparities among residential neighborhoods. Data were obtained via field surveys of alcohol outlets, and then spatially merged with sociodemographic data; 18.8% of alcohol outlets had any e-cigarette availability. Regression models showed greater odds ratios for e-cigarette availability when cigarettes, cigars, or hookah paraphernalia were sold, and lower odds ratios when alcohol outlets had an on-site consumption license...
October 2018: Family & Community Health
LaToya J OʼNeal, Lori Brand Bateman, Theolishia Smith, Yufeng Li, Chen Dai, Theresa A Wynn, Mona N Fouad
Understanding obesity-related health disparities among low-income African Americans in the south requires further research investigating the range of factors influencing health behaviors. This study sought to examine the relationship between meeting the minimum recommendation for moderate physical activity and multilevel, including policy, systems, and environmental, strategies thought to influence health behaviors. We utilize preintervention community survey data from a sample of 256 low-income, predominantly, African Americans in 3 southeastern cities...
October 2018: Family & Community Health
Marino A Bruce, Derek M Griffith, Roland J Thorpe
No abstract text is available yet for this article.
October 2018: Family & Community Health
Joseph Ramsey, Brandii Mayes
A prenatal, evidenced-based education program was implemented in 7 rural counties and provided by trained staff at the Texas Department of State Health Services. This was implemented to address health disparities, in regard to birth outcomes, in rural minorities of Southeast Texas. The participants were given a preassessment (N = 382) and a postassessment (N = 326) of relevant health knowledge and a follow-up assessment (N = 149) to document the outcomes of their birth as well as health practices they were employing as new parents...
July 2018: Family & Community Health
Susan J Andreae, Lynn J Andreae, Andrea L Cherrington, Marquita Lewis, Ethel Johnson, Debra Clark, Monika M Safford
Cognitive behavioral therapy (CBT) programs have the potential to improve quality of life in individuals with chronic pain and diabetes. Rural communities often lack the infrastructure necessary to implement such programs. CBT traditionally requires trained therapists, who are rarely available in these areas. An alternative may be programs delivered by community health workers (CHWs). We present an iterative developmental approach that combined program adaptation, pretesting, and CHW training processes for a CBT-based diabetes self-care program for individuals living with diabetes and chronic pain...
July 2018: Family & Community Health
Carolyn M Tucker, Julia Roncoroni, Guillermo M Wippold, Michael Marsiske, Delphia J Flenar, Kristin Hultgren
Health Self-Empowerment Theory asserts that 5 controllable psychological variables predict engagement in health-promoting behaviors. This study tests the theoretical integrity of Health Self-Empowerment Theory and its usefulness in predicting health-promoting behaviors and body mass index. Results from surveying 189 predominantly low-income, overweight/obese, and culturally diverse adults showed that most Health Self-Empowerment Theory variables were positively correlated. Structural equation modeling showed that 4 variables significantly predicted engagement in health-promoting behaviors, which mediated the relationships between body mass index and (a) motivation, (b) health self-efficacy, and (c) self-praise...
July 2018: Family & Community Health
Morgan E Cooley, Heather M Thompson, Heather Murray
Medically and economically vulnerable adults experience various challenges that can impact their health. Within this vulnerable population, there may be individuals who are even more vulnerable, those who have a history of involvement with the foster care system. The purpose of this study was to evaluate the difference of reported health-related problems between adults with previous foster care experience and other vulnerable adults. Physical, mental, and relational health was evaluated in this study. Practice and policy implications for mental health and medical professionals are discussed...
July 2018: Family & Community Health
Ana Laura Fonseca, Jill Koyama, Emily A Butler
Many Americans are in poor health. This is acute for racial/ethnic minorities compared with the Non-Hispanic white population. A grounded theory approach was used to analyze semistructured qualitative interviews to identify perceptions of family-of-origin lifestyle choices in same-race and interracial couples. Several central themes emerged from the data including influence of family-of-origin eating patterns, lack of family-of-origin importance for physical activity, and romantic partner influence in eating and exercise...
July 2018: Family & Community Health
Molly A Martin, Melissa Gutierrez Kapheim, Kim Erwin, Stacy Ignoffo, Kate McMahon, Amy OʼRourke, Lynn B Gerald, Meredith Barrett, Valerie G Press, Houshang Darabi, Jerry A Krishnan
We conducted a needs assessment to develop an evidence-based, locally tailored asthma care implementation plan for high-risk children with asthma in Chicago. Our team of health policy experts, clinicians, researchers, and designers included extensive stakeholder engagement (N = 162) in a mixed-methods community needs assessment. Results showed the lines of communication and collaboration across sectors were weak; caregivers were the only consistent force and could not always manage this burden. A series of recommendations for interventions and how to implement and measure them were generated...
July 2018: Family & Community Health
Lori J Silveira, Susan B Fleck, Nancy Sonnenfeld, Jill Manna, Lijing Zhang, Kimberly B Irby, Jane E Brock
Everyone with Diabetes Counts (EDC) is a national disparities reduction program funded by the Centers for Medicare & Medicaid Services to improve outcomes in the underserved minority, diverse, and rural populations. This analysis evaluates West Virginia's pilot program of diabetes self-management education (DSME), one component of EDC. We frequency-matched 422 DSME completers to 1688 others by demographics and enrollment from Medicare fee-for service claims. We estimated savings associated with reduced hospitalizations in multivariable negative binomial models...
July 2018: Family & Community Health
Pamela Wadsworth, Catherine Kothari, Grace Lubwama, Cathy L Brown, Jennifer Frank Benton
Intimate partner violence (IPV) predicts poor health for victims and their children, but little is known about the perspective of victims. This study reports the perspectives of adult female IPV victims about the impact of IPV on their health and barriers of health care access for themselves and their children. The majority rated their health as good to excellent (69%). However, 83.5% indicated that IPV negatively affected their health; 53.5% had unmet health care needs. Mental health care was the most common unmet need for women; children's unmet needs were immunizations and preventive care...
April 2018: Family & Community Health
Christine A Limbers, Ashley Teasdale
The purpose of the present study was to evaluate generic and pediatric parenting stress in an international sample of fathers of children with type 1 diabetes. Two-hundred forty-nine fathers of children ages 2 to 10 years with type 1 diabetes completed the Parenting Stress Index, Pediatric Inventory for Parents, Dads' Active Disease Support Scale (DADS), Self-Care Inventory, and a demographic/disease-related questionnaire online. More frequency of pediatric parenting stress was associated with greater general parenting stress (r = -0...
April 2018: Family & Community Health
Satı Demir
The purpose of this study is to examine expressed emotion and the relationship between expressed emotion and suicide probability in psychiatric outpatients (N = 350). Patients who did not receive support from anyone scored higher on the Level of Expressed Emotion (LEE) Scale than those who were supported by family, friends, or their physician provider. Scores by patients, who selected their spouse as a key person, scored higher on the LEE than those who chose one of their children. Spouses on the LEE were often depicted as being more intrusive, reactive, and intolerant when compared with their children...
April 2018: Family & Community Health
Lynette Hamlin
This study examined whether the closure of several inpatient obstetric units in rural New Hampshire affected birth outcomes. It is a secondary analysis of birth certificate data from 2005 through 2012 and includes 5881 births. There were no changes in perinatal outcomes. When examining outcomes based on distance travelled to place of birth, controlling for closures, women who traveled greater than 30 miles had fewer prenatal visits and lower birth weight and gestational age infants. Community services that provide prenatal care and/or home visiting are even more important when obstetric units are not available in the community...
April 2018: Family & Community Health
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