Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative ...presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer's disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer's disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.
This article focuses on the rationale, design and methods of an effectiveness-implementation hybrid type I randomized trial of eHealth Familias Unidas Mental Health, a family-based, online delivered ...intervention for Hispanic families to prevent/reduce depressive and anxious symptoms, suicide ideation/behaviors, and drug use in Hispanic youth. Utilizing a rollout design with 18 pediatric primary care clinics and 468 families, this study addresses intervention effectiveness, implementation research questions, and intervention sustainment, to begin bridging the gap between research and practice in eliminating mental health and drug use disparities among Hispanic youth. Further, we will examine whether intervention effects are partially mediated by improved family communication and reduced externalizing behaviors, including drug use, and moderated by parental depression. Finally, we will explore whether the intervention's impact on mental health and drug use, as well as sustainment of the intervention in clinics, varies by quality of implementation at clinic and clinician levels. Trail registration: ClinicalTrials.gov Identifier: NCT05426057, First posted June 21, 2022.
Few studies have evaluated the effects of alcohol consumption on the incidence of the metabolic syndrome (MetS). Therefore, the objective of the present study was to examine the association between ...alcohol consumption and incident MetS in a population of US men. This is a prospective study of 7483 Caucasian men, who were free of the MetS and CVD at baseline. Information was collected on alcohol consumption, health status and fitness level at an initial clinical examination. Additional health information and determination of incident cases of the MetS were obtained at follow-up clinical examinations between 1979 and 2005. Compared with non-drinkers, the multivariate hazard ratios of the MetS for light (1-3 drinks/week), moderate (4-7 drinks/week), moderate-heavy (8-13 drinks/week) and heavy ( ≥ 14 drinks/week) drinkers were 0.81 (95 % CI 0.68, 0.95), 0.68 (95 % CI 0.57, 0.80), 0.70 (95 % CI 0.59, 0.83) and 0.78 (95 % CI 0.66, 0.91), respectively. This association was seen across age groups, in men with one or more pre-existing MetS risk factors, and those with BMI ≥ 25 kg/m2, and in all alcohol beverage types at most levels of alcohol consumption. An inverse dose-response association between alcohol consumption and low HDL concentrations was observed, while significant associations were observed between high fasting glucose concentrations and moderate, moderate-heavy and heavy levels of alcohol consumption. Alcohol consumption was not significantly associated with central obesity, hypertriacylglycerolaemia or hypertension. All levels of alcohol consumption provided significant inverse associations with incidence of the MetS. In particular, this effect was observed in overweight and/or obese individuals, in those who had pre-existing risk factors for the MetS, and extended across all types of alcoholic beverages consumed.
Complex and continuous developments in health and healthcare require innovative changes in programs that educate public health scientists and professionals. Public health change agents need critical ...competencies to confront today and tomorrow's leading problems including leadership, communication, interprofessional practice, and systems thinking.
Public Health training programs teach competencies through their applied field experience and culminating project, typically late in the program, and often implemented in isolation from peers and faculty. Objectives and skills do not always align closely with community-based program needs. Students pursuing a degree in science in public health need to deeply comprehend multi-dimensional and interconnected systemic problems and communicate with diverse stakeholders across disciplines to produce relevant community-engaged research. The University of Miami Public Health Learning Collaboratory (LC) was established to transform the learning experience of public health master's students by providing opportunities to develop necessary core skills for effective public health practice early in their training, while applying these skills to address real-world public health needs in the community.
Spanning an average of 3 semesters, the LC promotes student involvement in collaborative and impactful capstone and thesis projects. Practice-based teaching and service learning are central approaches to teaching cross-cutting competencies of leadership, communication, problem solving, collaboration, and systems thinking in public health. Significant to the approach is the engagement of previous cohorts of senior students to teach back to junior students, further integrating concepts learned. Long term alumni feedback recognized strengths of the program, including its structure, teamwork & collaboration, critical thinking & problem solving, guidance, nurture & support, teaching back, and content & curriculum. Community partners agreed the LC prepared students to practice in the field of public health.
The LC is a promising model for master's level public health education and community application, given the opportunities it provides to strengthen and integrate students' public health skills in a supportive environment, and enhance the transferability and sustainability of student and faculty's community public health work.
Background Planners have relied on the urban development boundary (UDB)/urban growth boundary (UGB) and central business district (CBD) to encourage contiguous urban development and conserve ...infrastructure. However, no studies have specifically examined the relationship between proximity to the UDB/UGB and CBD and walking behavior. Purpose To examine the relationship between UDB and CBD distance and walking in a sample of recent Cuban immigrants, who report little choice in where they live after arrival to the U.S. Methods Data were collected in 2008–2010 from 391 healthy, recent Cuban immigrants recruited and assessed within 90 days of arrival to the U.S. who resided throughout Miami–Dade County FL. Analyses in 2012–2013 examined the relationship between UDB and CBD distances for each participant’s residential address and purposive walking, controlling for key sociodemographics. Follow-up analyses examined whether Walk Score® , a built-environment walkability metric based on distance to amenities such as stores and parks, mediated the relationship between purposive walking and each of UDB and CBD distance. Results Each one-mile increase in distance from the UDB corresponded to an 11% increase in the number of minutes of purposive walking, whereas each one-mile increase from the CBD corresponded to a 5% decrease in the amount of purposive walking. Moreover, Walk Score mediated the relationship between walking and each of UDB and CBD distance. Conclusions Given the lack of walking and walkable destinations observed in proximity to the UDB/UGB boundary, a sprawl repair approach could be implemented, which strategically introduces mixed-use zoning to encourage walking throughout the boundary’s zone.
The study examined the association of childhood and current economic hardship with anthropometric indices in Hispanic/Latino adults, using data from the HCHS/SOL Socio-cultural ancillary study (N = ...5,084), a community-based study of Hispanic/Latinos living in four urban areas (Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA). Childhood economic hardship was defined as having experienced a period of time when one's family had trouble paying for basic needs (e.g., food, housing), and when this economic hardship occurred: between 0-12, 13-18 years old, or throughout both of those times. Current economic hardship was defined as experiencing trouble paying for basic needs during the past 12 months. Anthropometry included height, body mass index (BMI), waist circumference (WC), and percentage body fat (%BF). Complex survey linear regression models were used to test the associations of childhood economic hardship with adult anthropometric indices, adjusting for potential confounders (e.g., age, sex, Hispanic background). Childhood economic hardship varied by Hispanic background, place of birth, and adult socio-economic status. Childhood economic hardship during both periods, childhood and adolescence, was associated with shorter height. Childhood economic hardship was associated with greater adiposity among US born individuals only. Current economic hardship was significantly associated with all three measures of adiposity (BMI, WC, %BF). These findings suggest that previous periods of childhood economic hardship appear to influence adult height more than adiposity, whereas current economic hardship may be a better determinant of adult adiposity in Hispanics.
Abstract Introduction The purpose of this qualitative study was to understand the feasibility and acceptability of implementing eHealth Familias Unidas, an Internet-based, family-based, preventive ...intervention for Hispanic adolescents, in primary care. Methods Semistructured individual interviews with clinic personnel and facilitators (i.e., physicians, nurse practitioners, administrators, and mental health workers; n = 9) and one focus group with parents ( n = 6) were audiorecorded, transcribed verbatim, and analyzed using a general inductive approach. Results Nine major themes emerged, including recommendations to minimize disruption to clinic flow, improve collaboration and training of clinic personnel and the research team, promote the clinic as a trusted setting for improving children's behavioral health, and highlight the flexibility and convenience of the eHealth format. Discussion This study provides feasibility and acceptability findings, along with important considerations for researchers and primary care personnel interested in collaborating to implement an eHealth preventive intervention in pediatric primary care.
Background: Research on neighborhood effects increasingly includes the influences of the built environment on health and social well-being. Objectives: In this population-based study in a ...low-socioeconomic-status (SES), Hispanic neighborhood, we examined whether architectural features of the built environment theorized to promote direct observations and interactions (e.g., porches, stoops) predicted Hispanic elders' social support and psychological and physical functioning. Methods: We coded built-environment features for all 3,857 lots in the 403-block area of an urban Miami, Florida, community. We then conducted three annual assessments of social support, psychological distress, and physical functioning in a population-based sample of 273 low-SES Hispanic elders (70-100 years of age). We used structural equation modeling analytic techniques to examine hypothesized relationships between the built environment and elders' social support, psychological distress, and physical functioning over a 3-year period. Results: After controlling for age, sex, and income, architectural features of the built environment theorized to facilitate visual and social contact had a significant direct relationship with elders' physical functioning as measured 3 years later, and an indirect relationship through social support and psychological distress. Further binomial regression analyses suggested that elders living on blocks marked by low levels of positive front entrance features were 2.7 times as likely to have subsequent poor levels of physical functioning, compared with elders living on blocks with a greater number of positive front entrance features b = 0.99; $\chi ^{2}$ (1 df) = 3.71; p = 0.05; 95% confidence interval, 1.0-7.3. Conclusions: Architectural features that facilitate visual and social contacts may be a protective factor for elders' physical functioning.
Early-life alcohol use raises the risk of poor long-term alcohol and other health outcomes. U.S. Hispanics are less likely to access treatment if they develop alcohol abuse or dependence, making ...preventive interventions critical. Familias Unidas is a family-based intervention effective in preventing drug and sexual risk behavior among Hispanic youth. The effects of this intervention specifically on youth alcohol use have been less consistent and may be affected by parental factors. The intervention is primarily delivered to parents to ultimately reduce youth risk behaviors, applying research on protective parenting and family influences, such as parental monitoring and positive communication. This study conducted secondary data analysis of an effectiveness randomized controlled trial of the Familias Unidas intervention, examining parent moderators of intervention effects on adolescent alcohol use. A total of 746 Hispanic families with 12-16-year-old adolescents were randomized to intervention or control. Logistic regression analyses confirmed no evidence of intervention effectiveness in reducing 90-day adolescent alcohol use at 30-month follow-up. However, there was evidence that parent misuse moderated intervention effects on adolescent alcohol use. Among youth whose parents reported any episode of alcohol misuse in their lifetime, the intervention was associated with lower odds of youth alcohol use at 30 months compared to youth in the control condition. Potential reasons and intervention implications are reviewed, including how parent alcohol use experiences might raise awareness of youth risks and motivate involvement or protective behaviors. Understanding intervention moderators can help shape, target, and adapt interventions to enhance their effectiveness and reach.
Walk Score Brown, Scott C., PhD; Pantin, Hilda, PhD; Lombard, Joanna, MArch ...
American journal of preventive medicine,
August 2013, Letnik:
45, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Background Walk Score® is a nationally and publicly available metric of neighborhood walkability based on proximity to amenities (e.g., retail, food, schools). However, few studies have examined the ...relationship of Walk Score to walking behavior. Purpose To examine the relationship of Walk Score to walking behavior in a sample of recent Cuban immigrants, who overwhelmingly report little choice in their selection of neighborhood built environments when they arrive in the U.S. Methods Participants were 391 recent healthy Cuban immigrants (mean age=37.1 years) recruited within 90 days of arrival in the U.S., and assessed within 4 months of arrival (mean=41.0 days in the U.S.), who resided throughout Miami-Dade County FL. Data on participants’ addresses, walking, and sociodemographics were collected prospectively from 2008 to 2010. Analyses conducted in 2011 examined the relationship of Walk Score for each participant’s residential address in the U.S. to purposive walking, controlling for age, gender, education, BMI, days in the U.S., and habitual physical activity level in Cuba. Results For each 10-point increase in Walk Score, adjusting for covariates, there was a significant 19% increase in the likelihood of purposive walking, a 26% increase in the likelihood of meeting physical activity recommendations by walking, and 27% more minutes walked in the previous week. Conclusions Results suggest that Walk Score is associated with walking in a sample of recent immigrants who initially had little choice in where they lived in the U.S. These results support existing guidelines indicating that mixed land use (such as parks and restaurants near homes) should be included when designing walkable communities.
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