Oral health is one of the greatest unmet health needs of migrant farmworkers and many migrant workers lack basic oral health knowledge. This paper presents evaluation results for an oral health ...education program designed to both increase knowledge concerning oral health practices and to gain a better understanding of the knowledge, attitudes and behaviors regarding oral health among migrant workers.
We used a pre-post uncontrolled design to assess the impact of the education program on participant knowledge about oral health practices. Changes in knowledge were assessed using a paper and pencil survey given to participants before the session began (pre) and at the end of the session (post). The pre-post survey was supplemented by qualitative information in the form of participant self-reported barriers and facilitators, and figure drawings illustrating their feelings about the state of their own oral health.
There were 311 participants in 12 workshops held in 2017 throughout Washington State. There were statistically significant increases in knowledge for all of the pre/post survey questions. Questions with particularly large improvements included: the results of having a mouth infection, factors causing oral health problems, and whether children in low-income families experience more tooth decay.
An interactive, lay-led oral health education program can be an effective way to increase oral health knowledge in migrant populations. Recommendations for similar programs include using interactive approaches to engage participants, being open to learning and changing your own thinking, and using lay leaders for the education sessions.
Objectives:
To evaluate the impact of a Community Health Worker (CHW)-led influenza campaign on knowledge and attitudes about vaccination in Latinx migrant and refugee populations.
Methods:
Twelve ...online workshops were conducted with 183 participants and 24 CHWs between January 12 and May 12, 2021. Participants were Latinx families living in underserved communities throughout Washington state. The initiative also included radio, animated videos, advertisements, social media, and educational materials.
Results:
Analysis of pre and post workshop surveys from 155 participants showed statistically significant improvements in all questions about the definition of influenza, symptoms, and risks: and in 7 of 9 questions about treatments and vaccines. Analysis of 2 open-ended questions showed increases in words key to understanding influenza, such as “virus,” “illness,” “death,” and “contagious.” There were significant increases in rates of participants identifying vaccination and antibiotics as cures for influenza.
Conclusions:
CHW-led workshops can be an effective way to increase knowledge about influenza and influenza vaccine. Future curriculum should emphasize the difference between viruses and bacteria, and the use of vaccination for prevention as opposed to treatment for illness.
Introduction
An important question for oral health education is whether knowledge gained during lay-led workshops is retained and applied in daily practice. This study assessed the knowledge ...retention and changes in oral health practices several months after oral health education workshops were held for migrant farmworkers by Community Health Workers (CHWs).
Methods and Results
Follow-up surveys were conducted with 32 participants 1 to 43 months post participation (60% between 6 and 21 months). The results showed a high degree of retention, in such areas as general oral health knowledge, and brushing/flossing frequency and technique among this sample. There was no relationship between length of time since the educational workshop and knowledge retained or behaviors changed.
Conclusions and Recommendations
An interactive, lay-led oral health education program run by CHWs can be an effective way to deliver sustained improvements in oral health knowledge and changes in oral health practice in migrant populations.
Abstract Objective Social support may be associated with improved diet and physical activity—determinants of overweight and obesity. Wellness programs increasingly target worksites. The aim was to ...evaluate the relationship between worksite social support and dietary behaviors, physical activity, and body mass index (BMI). Method Baseline data were obtained on 2878 employees from 2005 to 2007 from 34 worksites through Promoting Activity and Changes in Eating, a group-randomized weight reduction intervention in Greater Seattle. Worksite social support, diet, physical activity, and BMI were assessed via self-reported questionnaire. Principal component analysis was applied to workgroup questions. To adjust for design effects, random effects models were employed. Results No associations were found with worksite social support and BMI, or with many obesogenic behaviors. However, individuals with higher worksite social support had 14.3% higher (95% CI: 5.6%–23.7%) mean physical activity score and 4% higher (95% CI: 1%–7%) mean fruit and vegetable intake compared to individuals with one-unit lower support. Conclusion Our findings do not support a conclusive relationship between higher worksite social support and obesogenic behaviors, with the exception of physical activity and fruit and vegetable intake. Future studies are needed to confirm these relationships and evaluate how worksite social support impacts trial outcomes.
Intraoperative cholangiography (IOC) may decrease the risk of common bile duct (CBD) injury during cholecystectomy by helping to avoid misidentification of the CBD.
To characterize the relationship ...of IOC use and CBD injury while controlling for patient and surgeon characteristics.
Retrospective nationwide cohort analysis of Medicare patients undergoing cholecystectomy from January 1, 1992, to December 31, 1999. Patients were identified using Current Procedural Terminology codes from the Medicare Part B depository. Common bile duct injury was defined by a second surgical procedure to repair the CBD injury within 1 year of cholecystectomy. Surgeon demographic features were obtained from matching the Medicare Part B data to the American Medical Association Physician Masterfile database.
Frequency of CBD injury in patients who did and did not have IOC performed during cholecystectomy, controlling for patient-level (age, sex, race, and case complexity) and surgeon-level (surgeon's age, sex, race, year of surgical procedure, case order, percentage of IOC use in prior surgical procedures, years in medical practice, board certification, and specialization) factors.
The database search identified 1 570 361 cholecystectomies and 7911 CBD injuries (0.5%). Common bile duct injury was found in 2380 (0.39%) of 613 706 patients undergoing cholecystectomy with IOC and in 5531 (0.58%) of 956 655 patients undergoing cholecystectomy without IOC (unadjusted relative risk, 1.49; 95% confidence interval, 1.42-1.57). After controlling for patient-level factors and surgeon-level factors, the risk of injury was increased when IOC was not used (adjusted relative risk, 1.71; 95% confidence interval, 1.38-2.28). While surgeons performing IOCs routinely had a lower rate of CBD injuries than those who did not, this difference disappeared when IOC was not used.
In this study of Medicare patients undergoing cholecystectomy in the 1990s, the risk of CBD injury was significantly higher when IOC was not used. Although IOCs may not prevent all CBD injuries, this study suggests that the routine use of IOC may decrease the rate of CBD injury.
This study examined health care utilization and costs of care among Veterans Affairs (VA) patients with depression and with or without symptoms of comorbid posttraumatic stress disorder (PTSD).
...Cross-sectional comparisons of health care utilization and costs were conducted with VA administrative data for a sample of veterans from a randomized trial of collaborative care depression treatment in ten VA primary care clinics across five states. Patients with depression or dysthymia were included in the study, and those who were acutely suicidal or had probable bipolar disorder were excluded. The sample of 606 patients was mainly male, white, and aged 55 or older. Health care utilization, costs, and medication data from VA administrative databases were analyzed over 12 months.
Patients with depression and PTSD (screen score > or =3) were more emotionally distressed, had more frequent mental health specialty visits (6.91 versus 1.68, p<.001), more total outpatient visits (26.16 versus 19.94, p<.001), and correspondingly higher outpatient mental health care costs over the previous 12 months compared with depressed patients without PTSD. Antidepressants were prescribed to a higher proportion of depressed patients with PTSD (61% versus 40%).
Patients with PTSD and depression had greater utilization of specialty mental health treatments and antidepressant medications and higher mental health care costs in the previous 12 months than depressed patients without PTSD. As military personnel return from Iraq, both VA and non-VA health care providers need to plan for an increase in outpatient mental health services and costs, particularly among depressed veterans who also have PTSD.
Objective
Recognition is growing that to create truly patient‐centred care, health‐care organizations need to partner with patients around care design. More research into the benefits of engaging ...patients and the most effective ways of partnering with them is needed.
Methods
This study assessed the process and impact of a collaborative effort to design a new clinic service that balanced the number of patient and clinical provider/staff codesigners involved and recruited patients to represent diverse perspectives. Data sources included interviews with participants, event observation and participant surveys.
Results
Our evaluation found that including patients as equal partners improved the design process by infusing a real‐world, patient perspective. The pre‐event orientation and interactive methods used in the event fostered positive collaboration, as well as personal growth for the patient codesigners.
Conclusion
This study demonstrated the feasibility and benefits of including a roughly equal number of patients and clinical providers/staff in design events and ensuring that the patients represent diverse perspectives.
Attributes of Environments Supporting Walking Moudon, Anne Vernez; Lee, Chanam; Cheadle, Allen D. ...
American journal of health promotion,
05/2007, Letnik:
21, Številka:
5
Journal Article
Recenzirano
Purpose.
This study established a framework to audit environments supporting walking in neighborhoods.
Design.
Cross-sectional analysis using a telephone survey and 200 objective environmental ...variables.
Setting.
Urbanized King County, WA.
Subjects.
608 randomly sampled adults.
Measures.
Walking measures constructed from survey questions; objective environmental measures taken from parcel-level databases in Geographic Information Systems.
Analysis.
Multinomial models estimated the odds of people engaging in moderate walking (< 149 min/wk) and in walking sufficiently to meet recommendations for health (150+min/wk), relative to not walking; and in walking sufficiently, relative to walking moderately. A base model consisted of survey variables, and final models incorporated both survey and environmental variables.
Results.
Survey variables strongly associated with walking sufficiently to enhance health included household income, not having difficulty walking, using transit, perceiving social support for walking, walking outside of the neighborhood, and having a dog (p < .01). The models isolated 14 environmental variables associated with walking sufficiently (pseudo R2 up to 0.46). Measures of distance to neighborhood destinations dominated the results: shorter distances to grocery stores/markets, restaurants, and retail stores, but longer distances to offices or mixed-use buildings (p < .01 or .05). The density of the respondent's parcel was also strongly associated with walking sufficiently (p < .01).
Conclusions.
The study offered valid environmental measures of neighborhood walkability.
Cycling and the built environment, a US perspective Moudon, Anne Vernez; Lee, Chanam; Cheadle, Allen D. ...
Transportation research. Part D, Transport and environment,
05/2005, Letnik:
10, Številka:
3
Journal Article
Recenzirano
This disaggregate cross-sectional study uses primary data on the cycling behavior of 608 randomly sampled respondents in urbanized King County, Washington, and objective parcel-level GIS measures of ...land use and infrastructure conditions. Binary logit model findings provide new insights on who bicycles, and on perceived and actual built environmental conditions associated with the likelihood of cycling in neighborhoods, controlling for socio-demographic variables. A high 21% of the respondents report cycling at least once a week in their neighborhood, more often for recreation or exercise than for transportation. Cycling is more popular among male, younger adults, transit users, and those who are physically active and in good health. Both perceived and objective environmental conditions contribute to the likelihood of cycling. Proximity to trails and the presence of agglomerations of offices, clinics/hospitals, and fast food restaurants, measured objectively, are significant environmental variables. Previously researched correlates of cycling, such as the presence of bicycle lanes, traffic speed and volume, slope, block size, and the presence of parks, are found insignificant when objectively measured. A non-linear relationship is found between the odds of cycling and the perception of traffic problems and automobile-oriented facilities. Overall, cycling is only moderately associated with the neighborhood environment. It appears to be an individual choice that is independent from environmental support. This finding likely reflects the limited bicycle infrastructure in the sample frame—an unfortunate condition found in most US metropolitan regions. Policy and intervention programs could increase cycling by improving both actual and perceived environmental conditions.
Purpose.
To examine the association between worksite social support and changes in diet, physical activity, and body mass index (BMI).
Design.
Cohort analysis of an underlying randomized, controlled ...weight gain prevention worksite trial: Promoting Activity and Changes in Eating.
Setting.
The trial occurred in the greater Seattle area.
Subjects.
Baseline and follow-up data were obtained on a nested cohort of employees (n = 958–1078) from 33 small- to medium-sized worksites.
Measures.
Worksite social support, diet, physical activity, and BMI measures were assessed using a self-reported questionnaire.
Analysis.
To adjust for multilevel data and multiple time points, we used generalized estimating equations and logistic mixed models.
Results.
Higher baseline worksite social support was associated with greater changes in fruit and vegetable intake (p= .001; summary food-frequency questions).
Conclusion.
This study does not support a conclusive relationship between worksite social support and health behavior change.
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