Delaware journal of public health最新文献

Objectives: To evaluate the accessibility and usability of parks and playgrounds in New Castle County, Delaware, for people with disabilities, with a particular focus on identifying environmental barriers that may impede access to these public spaces and potentially affect physical activity (PA) participation for the chronic disease prevention and mitigation.

Methods: Using a cross-sectional observational design, teams of trained University of Delaware students utilized the Community Health Inclusion Index (CHII) Tool to assess the accessibility of ten suburban and urban parks and playgrounds from April to November 2023. The tool evaluated various elements of public spaces, including public transit, parking, pathways and multi-use trails, entrances, playground equipment, and health promotional materials. Descriptive statistics were calculated for the accessibility and usability of each element.

Results: Significant barriers to accessibility and usability were identified. Over half of the sites lacked nearby public transit stops, and many trails and playgrounds were not fully accessible to people with disabilities. While some areas demonstrated good accessibility, such as well-maintained pathways and appropriately designed crosswalks, barriers like uneven surfaces, insufficient curb cuts, and inadequate van-accessible parking spaces were common. Most playgrounds lacked equitable play equipment, with less than half having ground materials suitable for mobility devices.

Conclusions: The study underscores the need for substantial improvements in the design, construction, and maintenance of Delaware parks and playgrounds to better support people with disabilities. Enhancing accessibility is crucial for promoting PA participation. The findings support the development of inclusive recreational and PA environments, aligning with the Americans with Disabilities Act, to reduce chronic disease health disparities faced by people with disabilities.

Policy implications: This study highlights the need for revised policy measures to enhance park accessibility, advocating for infrastructure improvements and inclusive designs to ensure equitable recreation and physical activity opportunities for people with disabilities.

The Lieutenant Governor's Challenge 2.0, Wellness Award Initiative, is an opportunity for everyone to drive change and to elevate the well-being, productivity, and prosperity among communities in Delaware. The 2.0 reference is rooted in the mission of former Lieutenant Governor, and now Governor, John Carney to address physical activity and fitness levels of youth and adults. The Lieutenant Governor's Challenge 2.0 presents the opportunity to unite the entire state in an ongoing effort to create an overall healthier population. Mobilizing communities to get healthier, promote better health outcomes, and lower health care costs are the goals of this statewide initiative.

Although influenza (flu) and COVID-19 vaccines are highly recommended for healthcare workers, it is known that vaccination rates are suboptimal in healthcare settings. There is a need to optimize vaccination rates among healthcare workers as there are direct correlations to increased patient safety and protection of staff from healthcare associated infections. Our health care organization employed some novel strategies to increase the uptake of both flu and COVID-19 vaccinations by identifying and addressing common barriers. Barriers were identified through team meetings, review of previous years' vaccination trends, and historical information. Strategies to overcome these barriers included dissemination of information through various team meetings; identifying peer vaccination champions among specific groups that had historically low vaccination rates; creating a sense of urgency with weekly announcements regarding vaccinations; and computer screensavers with graphics promoting vaccinations. We believed education was key to success. Our focus was not only on the vaccination rates, but also on compliance which is defined as either getting the vaccine or submitting a declination after completing an education module. These efforts resulted in the organization achieving more than 95% compliance for both vaccinations. Our vaccination uptake rates for influenza were greater than 85% and updated COVID-19 vaccination rates were around 42%. We believe that the grass-root level work initiated for this year's campaign was one of the drivers for our success and some aspects could be replicated for vaccinating the public as well.

Policymakers are exploring ways to expand access to doula care to address persistent inequities in maternal and infant health across the United States. Doulas are non-medical professionals who provide physical, emotional, and informational support to birthing people before, during and after childbirth. Growing evidence supports the role of doulas in improved birth outcomes. Delaware is among several states moving towards Medicaid reimbursement for doula care to serve those most at risk. Objective: To gain an in-depth understanding of key stakeholders' knowledge, attitudes, beliefs and experiences regarding doula training and certification, relationships among providers, and other potential needs related to infrastructure to identify areas of agreement and inform policy change in the state of Delaware. Methods: We conducted focus groups with 11 doulas and key-informant interviews with 12 licensed providers practicing in Delaware, including six nurses, four physicians and two certified nurse midwives. Qualitative data was collected via Zoom (video conferencing) between September 2022 and April 2023. Results: Analysis revealed themes related to training, credentials and competencies of doulas, including cultural competence; logistical, administrative, and financial considerations for policy and practice change; and the whole care team-relationships between doulas and medical partners, and opportunities for growth. Conclusions: Doulas and licensed providers agree on key elements of doula training, the value of certification, the need for financial support, and the importance of relationship-building across the care team. Policy implications: Areas of agreement among stakeholders provide a foundation for state leaders to move forward to ensure the delivery of the most accessible, high quality, and culturally competent doula care for birthing people in Delaware.

Adults with intellectual disabilities (ID) experience age-related diseases, such as diabetes, hypertension, cardiovascular disease, and obesity much earlier than their typical peers. Therefore, health promotion is essential in this population.¹ This population tends to live sedentary lives; exercise needs to be a focus. Exercise positively impacts survival rates for those with ID.² Motivation and support are vital factors to successfully incorporate exercise into their lives. Prevalent barriers are a lack of access to health promotion programs, support, and transportation. Creating virtual programming with exercise and support can fill this gap. The implementation of a 6-week virtual exercise/dance program with music as a motivator Doctor of Nursing Practice (DNP) project, enabled adults with ID to participate in physical activity resulting in improved cardiovascular and muscular fitness using Standing Long Jump (SLJ) and 6 Minute Walk Test (6MWT) as measures. No improvement was noted in Body Mass Index measurements.

Chronic Disease, Health Equity, & COVID-19 ("Advancing Healthy Lifestyles" or "AHL") is a statewide initiative launched in January 2021 by the Delaware Department of Health and Social Services, Division of Public Health (DPH). DPH's Physical Activity, Nutrition and Obesity Prevention Program (PANO) introduced the initiative as Coronavirus 2019 (COVID-19) swept through the state, exacerbating health burdens already faced by many Delawareans. The PANO Program provides administrative staff support to the Delaware Cancer Consortium's Cancer Risk Reduction Committee (CRRC). In December 2019, the CRRC launched the Healthy Lifestyles Subcommittee (HLSC) in response to Governor John Carney's request to develop actionable policy recommendations to positively influence healthy lifestyles in Delaware. The HLSC efforts led to the recommendation of 14 policy recommendations for action in three population health strategic focus areas: 1) birth to age 18; 2) employee health and wellness; and 3) community wellness. The AHL initiative builds from the work of the HLSC and promotes the use of policy, systems, and environmental change (PSE) strategies to reduce obesity and other chronic conditions among Delawareans across the lifespan. Ideally, the AHL initiative is categorized into three component strategies: school, community, and workplace. This article highlights both completed and ongoing projects under the AHL Initiative that aim to address the burden of obesity in Delaware.

This study aimed to assess the prevalence of chronic disease risk factors among college students, particularly within a minority-serving institution in Delaware, to inform targeted prevention efforts. A quantitative cross-sectional research design was employed, administering surveys to 457 students at Delaware State University over a three-year period. Surveys assessed tobacco use, physical activity, and dietary habits. Descriptive statistics were used to analyze the data. The majority of respondents were people of color (83%) and female (74%). Significant findings included 24.1% reporting trying tobacco cigarettes, 4.9% smoking in the last 30 days, and 37.2% trying e-cigarettes, with 11.8% vaping in the last month. Regarding physical activity, 65.6% reported being active for 120+ minutes per week, while only 5.7% consumed four or more servings of vegetables daily. Behavioral disparities were observed, with more males reporting tobacco use but also higher engagement in physical activity compared to females. Nutritional intake was inadequate for both genders. Convenience sampling may limit generalizability, highlighting the need for larger, randomized studies. Colleges are pivotal settings for promoting healthy behaviors and addressing chronic disease burdens. Integrated approaches involving education, policy changes, and community engagement are crucial. Investing in health promotion programs is essential for cultivating a healthier future population. This study underscores the importance of preventive measures and equitable access to resources for addressing chronic disease risk factors among college students.