Family & Community Health最新文献

Formerly incarcerated individuals have poorer oral health and less frequent dental care utilization than the general population. However, prior work has overlooked the relationship between prior incarceration and disparities in dental insurance coverage. Using data from the Health and Retirement Study (n = 11,638), findings from multiple logistic regression analyses demonstrate that formerly incarcerated older adults are significantly less likely to have dental insurance coverage (odds ratio [OR] = 0.745, 95% confidence interval [CI] = 0.608, 0.912). After accounting for the income-to-poverty ratio, this association was no longer statistically significant. Analyses using the Karlson-Holm-Breen method demonstrated that approximately 45% of the association between prior incarceration and dental insurance is explained by the income-to-poverty ratio. These findings suggest the need for policies to expand affordable dental coverage for formerly incarcerated older adults.

Heart failure (HF) is a chronic disease with increasing prevalence, with rural communities having HF worse outcomes and higher mortality. The aim of this systematic review is to consolidate and evaluate existing evidence for the outpatient management of chronic HF in rural-dwelling adults. A librarian assisted in the design and implementation of the search strategy. Overall, 14 studies met criteria and were included in this review, with 5 overarching strategies identified. Despite the overall differences in outcomes for those with HF living in rural communities, there remains a lack of randomized trial evidence to inform outpatient care management strategies.

Background: Despite vaccination being one of the most effective ways to mitigate the impact of vaccine-preventable diseases, immunization coverage is low among rural and minoritized populations. Vaccine hesitancy, which increased during the COVID-19 pandemic, contributes to low immunization coverage despite higher prevalence of and increased risk for severe illness due to vaccine-preventable diseases among rural minoritized adults.

Objective: Public health efforts to reduce vaccine hesitancy among rural Black Americans require understanding the factors that contribute to vaccine confidence and vaccine uptake. This study identifies how multilevel factors influence vaccine confidence and uptake among rural Black American adults in 3 Northeast Florida counties.

Methods: Four focus groups (N = 34) were conducted, audio-recorded, transcribed, and open-coded in MAXQDA 2022. The social ecological model was used to guide analysis and provide insight into contextual factors influencing vaccine knowledge and confidence, and trust in vaccines.

Results: Results show that multilevel variables influence vaccine confidence among rural Black Americans. Social factors, specifically social networks, shape an individual's perception of vaccines at all levels of the social ecological model.

Conclusion: Public health interventions to increase vaccine uptake among rural Black adults should focus on social networks to enhance the credibility of the information provided by experts.

Background: Community-engaged approaches to health interventions can improve program feasibility and suitability, reduce attrition, and improve health outcomes. The current paper (1) describes the community-engaged development and delivery of an infant obesity prevention program, and (2) presents program feasibility and acceptability data.

Methods: Healthy Eating for My Infant (HEMI) was developed using a multiphase approach with community stakeholders, including a qualitative needs assessment, action planning, and feedback from community stakeholders. Healthy Eating for My Infant addressed nutrition/feeding education, behavior-change techniques, and mental health/stress as related to infant feeding through 6 home visits with health behavior coaches and family support peers and text messaging support with other program mothers. Fifteen mother-infant dyads enrolled in a home visiting program serving primarily families from marginalized backgrounds were randomized to receive HEMI in a small feasibility trial.

Results: Delivery of HEMI was feasible with high retention (86.7%) and session completion (84.0%). Families reported high acceptability of the program; health behavior coaches and family support peers delivering the program perceived that HEMI was helpful for families and that families felt heard and supported.

Conclusion: Healthy Eating for My Infant serves as an example of a multiphase community-engaged approach to develop future programs targeting health behavior change among children and families from marginalized backgrounds.

Background: Parents are the agent of change in their child's lifestyle choices; therefore, actively involving them in promoting healthy lifestyle behaviors is essential. Our study concurrently analyzed 3 forms of parent-reported parental social support (modeling, instrumental support, and encouragement) to determine which factor has a greater impact, if any, is associated with their child's physical activity (PA) levels. Additionally, this paper investigated parent-reported accuracy of parental perceptions of child's PA levels and examined whether these perceptions influence their social support toward PA.

Methods: This is a secondary analysis of cross-sectional data from the 2019-2020 Texas SPAN survey of second-grade children and their parents.

Results: Parents who were physically active with their second-grade child most or all of the time had over 2 times the odds or over 3 times the odds, respectively, of their children meeting adequate PA levels. Latinx/Hispanic parents had 33% lower odds of their children participating in adequate PA levels compared to white parents. We found no significant associations for the other types of social support.

Conclusion: This study underscores the significance of involving parents in promoting PA among children, particularly through the provision of instrumental and direct support mechanisms. Culturally sensitive interventions that address parental perceptions and promote support may improve PA among Latinx/Hispanic children. The results emphasize the importance of prioritizing instrumental support over mere encouragement and underscore the necessity of addressing parental misperceptions through educational materials and programs.

Background and objectives: While several studies have described short-term increases in fathers' reports of household labor during the pandemic, few have reported on longer-term trends. We estimated the association between recalled changes in household responsibilities due to the COVID-19 pandemic and current health-related parental responsibility.

Methods: Father-mother dyads with young children (n = 253) completed surveys. We used Actor-Partner Interdependence Models to estimate the association between recalled household responsibility change during the pandemic and current health-related parental responsibility.

Results: Recalled increases in household responsibility during the pandemic were associated with higher current health-related parental responsibility among fathers (β= 0.05, SE = 0.03), though not mothers.

Conclusions: The pandemic may have catalyzed increases in father responsibility and facilitated a shift towards more egalitarian household labor divisions. Findings pose design implications for parenting interventions; for example, programs may shift from mother-focused to family-systems approaches, include content that reflect more egalitarian care, and incorporate curricula that address fathers' increasing responsibilities.

Key nutritional behaviors during the first 1000 days of development (pregnancy to age 2) can affect a child's risks for obesity and related negative health conditions. Because social disadvantage can pose substantial barriers to engaging in healthy lifestyle behaviors and increase obesity risk, it's particularly important to help families facing such circumstances support optimal early nutrition. Although some studies have found relevant health messaging to be effective, little previous research has focused on the mechanisms underlying successful messaging. The current study involved semi-structured interviews with pregnant women (n = 8) and mothers of children aged 0-24 months (n = 27) who were members of minoritized socio-economic or racial or ethnic groups with relatively high rates of childhood obesity. Study goals included developing an enhanced understanding of caregiver decision-making and potential obstacles to engaging in recommended behaviors to support optimal early nutrition, as well as identifying likely mechanisms underlying caregiver responses. Thematic analysis identified multiple determinants of caregiver responses related to internal or psychological factors, environmental obstacles, and individual needs. Findings may have implications for future health-focused messaging campaigns aimed at pregnant women and caregivers of young children, particularly for groups at greatest risk for childhood obesity.

Background and objectives: Vasectomy is a highly effective outpatient procedure for permanent contraception that is allowable as a contraceptive method with Title X funds. However, there is limited published knowledge on vasectomies in publicly funded agencies. We sought to understand and document vasectomy services in Title X-funded health centers, including barriers and facilitators to providing those services.

Study design: The study team held qualitative interviews with 22 organizations who received Title X funding. Through an iterative thematic analysis, our team coded the data to produce findings illustrating the landscape of vasectomy service provision in Title X family planning health centers.

Results: Our analysis revealed barriers and facilitators to providing vasectomy services in Title X settings centered on 5 areas: provision of care, finance, supplies, training, and marketing.

Conclusions: These findings highlight some common barriers experienced by clinics and organizations funded by Title X, as well as the facilitators and ways in which barriers are mitigated. By adopting successful strategies to facilitate vasectomy services and mitigate barriers, Title X-funded clinics can meet potential increases in demand for vasectomy services and ensure equitable access to uninsured and underinsured individuals.

Objective: Social Determinants of Health (SDH) are grouped into domains to explain collective impact on different outcomes. The purpose of this study is to examine if SDH items group together to create new domains.

Methods: A retrospective, cross-sectional study was conducted utilizing data from the Future Families and Child Wellbeing Study (FFCWS) N=4,898. Nine SDH items were assessed: neighborhood safety, walkability, personal importance of race/ethnicity, sexual orientation/gender identity, religiosity, spirituality, personal satisfaction, poverty level, and people's willingness to help others.

Analysis: Factor structure was explored and confirmed using an exploratory factor analysis (EFA; n = 2,449) and confirmatory factor analysis (CFA; n = 2,449), respectively.

Results: The final EFA used eight items, in which three factors/domains were identified: Spirituality, Social Place, and Personal Characteristics. Four of the items, neighborhood safety, walkability, neighbors' willingness to help (p<.00), and participant's poverty level loaded onto the Social Place domain. Social Place was found to have strong model fit using the CFA, χ2(2) = 2.504, p = 0.29, SRMR = .01, RMSEA = .01 (90% CI: .0 to .04), CFI = 0.99, TLI = .99.

Conclusions: Collectively, findings from this study provide evidence that can expand SDH research, identifying a four-item measure for place. (200/200).

Purpose: Combining the Integrated Behavioral Model (IBM) and Social Network Analysis (SNA), this study explored individual and interpersonal-level factors related to adults meeting physical activity (PA) recommendations.

Methods: 250 adults (66.8% women, 70.1% non-Hispanic white, age = 38.65 ± 12.93) recruited through local events and social media completed online surveys. Logistic regression analysis assessed factors related to meeting PA recommendations, including demographic characteristics, barriers to PA, injunctive norms, perceived behavioral control, intention, and descriptive norms measured via SNA.

Results: 40.6% (n = 99) of participants met minimum PA recommendations. Higher perceived behavioral control (OR = 1.47, P < .001), intention (OR = 1.16, P = .01), having more female network members (OR = 1.02, P = .04) and more network members who were active with the participant (OR = 1.03, P < .001) were associated with increased odds of meeting PA recommendations. Network density scores (OR = .04, P < .01), decreased the odds of meeting PA recommendations.

Conclusions: Our findings highlight the importance of a person's immediate social context, more so than global social norms, on their PA behavior. In addition to increasing individual-level perceived behavioral control and intentions, efforts aimed at promoting PA should focus on leveraging aspects of social networks that translate to direct social influence on individual behavior. This study affirms SNA as a useful way to assess descriptive norms defined in the IBM.