Development of the Live Well Curriculum for Recent Immigrants: A Community-Based Participatory Approach (original) (raw)

Behavioral theory and health disparities research: Where do we go from here?

Health behavior theory, anchored in the realm of cognition, has been developed and tested predominantly among middle class white Euro-Americans. Yet there has been an implied universality in the way theories and their constructs are used, an assumption we challenged using mixed method basic behavioral research. We conducted an intensive mixed methods study, Behavioral Constructs and Culture in Cancer Screening, to explore the cultural appropriateness of the five behavioral theory constructs commonly used to explain and predict cancer screening behavior and to inform interventions. Among our quantitative findings, the major construct Intention, when tested longitudinally in a multi-ethnic, multi-lingual cohort predicted receipt of recent mammogram overall and for white women but not for other ethnic groups. Our inductive qualitative inquiry suggested that women's health-related beliefs and practices are inextricably intertwined with the multi-layered context in which their lives ...

Addressing the Social Determinants of Health through Academic-Community Partnerships

Ethnicity & Disease, 2017

While health disparities have been documented for years, we have learned that, to understand the causes of health disparities, we need to focus above and beyond individual risk factors and turn our attention to the social determinants of health (SDOH) or the causes of the causes. 1 However, it was not until the end of the 20th century with the publication of The Solid Facts 2 by the World Health Organization,that these determinants were translated into action to address health inequities within and between countries. In fact, The Solid Facts summarizes the evidence on SDOH into 10 messages to provide a guide to policy makers and the public. Despite health disparities being pervasive in the United States, the SDOH model has only recently emerged as an important foundational element supporting work to eliminate health disparities. Interestingly, Healthy People 2020 recognizes the importance of SDOH by including it in one of its four overarching goals: "Create social and physical environments that promote good health for all." This goal is limited relative to the determinants proposed by WHO (social gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food and transportation, 2003) 2 and the ones used in Canada (income and income distribution, education, unemployment and job security, employment and working conditions, early childhood development, food insecurity, housing, social exclusion, social safety network, health services, Aboriginal status, gender, race and disability). 3 The Healthy People 2020 goal focuses on five key areas: economic stability, education, social and community context, health and health care, and neighborhood and built environment (http://tinyurl.com/z32yfnv). I commend and congratulate the guest editors of the supplement for being ahead of the game in finding creative ways to eliminate health disparities in the United States. This supplement comprises a collection of nine articles emanating from research supported by the Academic-Com

Health is power: An ecological, theory-based health intervention for women of color

Contemporary Clinical Trials, 2011

Objective-Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. This manuscript describes the rationale, design and methodology of Health Is Power (HIP), a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity and improve dietary habits in African American and Hispanic or Latina women in Houston and Austin, Texas.

A Midpoint Process Evaluation of the Los Angeles Basin Racial and Ethnic Approaches to Community Health Across the US (REACH US) Disparities Center, 2007-2009

Preventing Chronic Disease, 2011

Background Racial/ethnic minority groups have higher risks for disease resulting from obesity. Community Context The University of California, Los Angeles, and the Los Angeles County Department of Public Health partnered with community organizations to disseminate culturally targeted physical activity and nutrition-based interventions in worksites. Methods We conducted community dialogues with people from 59 government and nonprofit health and social service agencies to develop wellness strategies for implementation in worksites. Strategies included structured group exercise breaks and serving healthy refreshments at organizational functions. During the first 2 years, we subcontracted with 6 community-based organizations (primary partners) who disseminated these wellness strategies to 29 organizations within their own professional networks (secondary worksites) through peer modeling and social support. We analyzed data from the first 2 years of the project to evaluate our disseminat...

A qualitative exploration of the health needs and goals of urban women to inform the tailoring and adaptation of Strong Hearts Healthy Communities: a community-based cardiovascular disease prevention intervention

BMC public health, 2024

Background In the United States, cardiovascular diseases (CVD) are the leading cause of death and disability in women. CVD-modifiable risk factors, including poor diet quality and inadequate physical activity, can be addressed through evidence-based interventions (EBIs). Strong Hearts Healthy Communities (SHHC) is an EBI that has demonstrated effectiveness in reducing CVD risk and improving health outcomes among rural white women. The aims of this study were to understand the general health, diet, and physical activity-related needs and goals of women living in an urban community, to inform the tailoring and adaptation of the SHHC EBI to an urban setting and more diverse population. Methods Focus groups (FGs) were conducted with African American/Black and Hispanic/Latinx women in the Dallas metropolitan area who had a BMI ≥ 25 kg/m 2 and engaged in ≤ 150 min per week of moderate physical activity. The data were coded using a team-based, deductive, and thematic analysis approach, that included multiple coders and in-depth discussions. Results Four FGs with a total of 18 participants (79% Black and 21% Latinx) were conducted, and three themes were developed: (1) participants had adequate knowledge and positive attitudes towards healthy living but faced many barriers to practicing healthy behaviors; (2) culturally-based beliefs and community practices exerted a strong influence on behaviors related to food and stress, revealing barriers to healthy eating and generational differences in stress and stress management; (3) participants desired a more individualized approach to nutrition and physical

An Investigation Into the Social Context of Low-Income, Urban Black and Latina Women: Implications for Adherence to Recommended Health Behaviors

Health Education & Behavior, 2011

Understanding factors that promote or prevent adherence to recommended health behaviors is essential for developing effective health programs, particularly among lower-income populations who carry a disproportionate burden of disease. We conducted in-depth qualitative interviews (n=64) with low-income Black and Latina women who shared the experience of requiring diagnostic follow-up after having an abnormal screening mammogram. In addition to holding negative and fatalistic cancer-related beliefs, we found that the social context of these women was largely defined by multiple challenges and major life stressors that interfered with their ability to attain health. Factors commonly mentioned included competing health issues, economic hardship, demanding caretaking responsibilities and relationships, insurance-related challenges, distrust of healthcare providers, and inflexible work policies. Black women also reported discrimination and medical mistrust, while Latinas experienced difficulties associated with immigration and social isolation. These results suggest that effective health interventions not only address change among individuals, but must also change healthcare systems and social policies in order to reduce health disparities.

Health disparities: Understanding and promoting healthy communities

Journal of Prevention & Intervention in the Community

This themed issue focuses on understanding and addressing several public health issues affecting communities today nationally and internationally. Health disparities, and global health in general, cover a large breadth of health concerns impossible to address in one issue. Here we provide a scope of some health disparities while focusing on health promotion and well-being of diverse populations, specifically within urban undeserved populations, rural communities in Peru, Roma minorities in Spain, and refugee communities. We focus on understanding contextual issue that affect health disparities as well as on examining the effectiveness of community-based interventions and community coalitions designed to address disparities.

SEEKING COMMUNITY INPUT TO IMPROVE IMPLEMENTATION OF A LIFESTYLE MODIFICATION PROGRAM

2006

Objectives: Obesity increases a person's risk for diabetes, which is becoming the most common chronic disease in the United States. Latina and African-American women in disadvantaged communities are at higher risk for becoming overweight and subsequently developing diabetes. The purpose of this focusgroup study was to guide our adaptation of an evidence-based lifestyle intervention and implementation of the Community-Based Lifestyle Balance program (CLSB).