bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the Quality of Discharge Care for the Homeless: A Patient-centered Approach
Authors: Greysen S. Ryan , Allen Rebecca , Rosenthal Marjorie S. , Lucas Georgina I. , Wang Emily A.
Published: June 2013

Homeless patients are at risk for low-quality discharge care, yet there are limited patient-centered data to guide improvement. We explored relationships between assessment of housing status by hospital staff and quality of discharge care using quantitative and qualitative data from interviews and chart reviews with 98 homeless patients: 80% male, mean homelessness 2.8 years, mean age 44. Patient-reported performance of discharge care varied substantially across seven domains from 16-75% and chart review documented lower performance than patient report. Over half (56%) were not asked about their housing status and multivariable logistic regression showed assessment of housing status was independently associated with higher performance in five domains: discussions about cost of medications, physical activity levels, diet, transportation, and mental health follow-up. Qualitative data revealed patient concerns about stigmatization from disclosure of housing status. Our findings suggest that addressing housing status in acute care settings while avoiding stigmatization may improve discharge care for homeless patients.
Implementing Institute of Medicine Recommendations on Collection of Patient Race, Ethnicity, and Language Data in a Community Health Center
Authors: Wilson Geniene , Hasnain-Wynia Romana , Hauser Diane , Calman Neil
Published: June 2013

The Institute for Family Health is one of the first health care organizations to implement the 2009 Institute of Medicine recommendations on collection of patient race, ethnicity, and language data as a means of identifying and addressing health disparities. This paper describes the implementation process and lessons learned from the project.
Health Care Access and Utilization among Hispanic Manufacturing Workers along the Texas-Mexico Border
Authors: Talavera-Garza Liza , Ghaddar Suad , Valerio Melissa , Garcia Carolyn
Published: June 2013

Disparities in health care access, including utilization of preventive health services, are well-documented among ethnic minority populations. This study examines factors associated with health care access and utilization among Hispanic manufacturing employees along the Texas-Mexico border. A cross-sectional survey was administered in 2010 to 228 mostly male (71%) workers. About half of participants (53%) lacked health insurance, which emerged as the most important variable related to health care access and utilization. In multivariate logistic regression analyses, relative to insured workers, uninsured workers were significantly more likely to delay getting medical care (p<.001) and to need medical services that they could not afford (p<.05). They were also less likely to receive a flu vaccine (p<.001). Additionally, uninsured women were less likely to receive screening for cervical cancer compared to insured women (p<.05). Findings support the promotion of employment-based health insurance and education programs stressing the importance of preventive health services.
Home Asthma Triggers: Barriers to Asthma Control in Chicago Puerto Rican Children
Authors: Martin Molly A. , Thomas Ann Marie , Mosnaim Giselle , Greve Matthew , Swider Susan M. , Rothschild Steven K.
Published: June 2013

We sought objectively to measure, summarize, and contextualize the asthma triggers found in the homes of urban high-risk Puerto Rican children and adolescents with asthma in Chicago. Data were from the baseline home assessments of Project CURA. Research assistants interviewed caregivers, conducted a home visual inspection, and collected saliva samples for cotinine analysis. A trigger behavior summary score was created. The housing inspected was old with multiple units and obvious structural deficiencies. Many allergic and irritant triggers were observed. Having a controller medicine or private insurance was associated with lower trigger behavior summary scores; caregiver depression, caregiver perceived stress, and child negative life events were associated with high trigger scores. The final multivariate model retained had a controller medicine, private insurance, and caregiver perceived stress. The data from this high-risk cohort identified modifiable areas where environmental interventions could reduce morbidity in Puerto Rican children and adolescents.
Poverty is the Main Environmental Factor for Obesity in a Mexican-Border City
Authors: Jiménez-Cruz Arturo , Castañeda-Gonzalez Lidia M. , Bacardí-Gascón Montserrat
Published: June 2013

Introduction . Obesity is a pandemic in Mexico. The purpose of this study was to assess the environmental factors that have the strongest association with obesity and abdominal obesity among adults in Tijuana. Methods . Four neighborhoods differing in socioeconomic status were chosen. A questionnaire for weekly walking, social cohesion, satisfaction with their community, weekly income, and convenience store, education, family income, crime safety, pedestrian safety, street connectivity, walking/cycling facilities, and sociodemographic characteristics was administered. Weight, height, and waist circumference were measured. Univariate and multivariate binomial logistic regressions were conducted. Results . Three hundred and twenty-two (322) individuals, 70% females with a mean age of 39 years, were assessed. The prevalence of obesity and abdominal obesity was 27% and 43.5% respectively. The odds ratio for obesity and abdominal obesity among those living in the lowest-income neighborhood was 2.4 and 7.8 respectively, compared with those living in a middle-class neighborhood. Conclusions . Residence in a low-income neighborhood was a predictor for obesity.
Organizing Uninsured Safety-Net Access to Specialist Physician Services
Authors: Hall Mark A.
Published: June 2013

Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.
Factors Associated with Geriatric Syndromes in Older Homeless Adults
Authors: Brown Rebecca T. , Kiely Dan K. , Bharel Monica , Mitchell Susan L.
Published: June 2013

Although older homeless adults have high rates of geriatric syndromes, risk factors for these syndromes are not known. We used multivariable regression models to estimate the association of subject characteristics with the total number of geriatric syndromes in 250 homeless adults aged 50 years and older. Geriatric syndromes included falls, cognitive impairment, frailty, major depression, sensory impairment, and urinary incontinence. A higher total number of geriatric syndromes was associated with having less than a high school education, medical comorbidities (diabetes and arthritis), alcohol and drug use problems, and difficulty performing one or more activities of daily living. Clinicians who care for older homeless patients with these characteristics should consider screening them for geriatric syndromes. Moreover, this study identifies potentially modifiable risk factors associated with the total number of geriatric syndromes in older homeless adults. This knowledge may provide targets for clinical interventions to improve the health of older homeless patients.
Equal and Universal Access?: Water at Mealtimes, Inequalities, and the Challenge for Schools in Poor and Rural Communities
Authors: Ramirez Sarah M. , Stafford Randall
Published: June 2013

As a result of the rising national obesity rates, public health researchers and advocates have initiated a number of obesity prevention interventions to reduce the rates of overweight and obesity along with their related medical conditions and costs. Policymakers have also initiated a wide range of environmental and policies to support healthy eating and physical activity. Policies such as California's SB1413, which requires that free drinking water be served in school cafeterias during mealtimes, and subsequently the Healthy Hunger-Free Kids Act of 2010, assume an equal access to safe and healthy drinking water. As a result, these policies and their application may unintentionally, exacerbate the inequities already present. Unless we take reasonable steps to address the needs of high-need communities, these one-size-fits-all policy efforts may result in an unequal patchwork of disparities and may have a greater negative impact in high-need poor and rural areas.
Hepatitis B Knowledge, Screening, and Vaccination among Hmong Americans
Authors: Kue Jennifer , Thorburn Sheryl
Published: June 2013

We examined Hmong women and men's knowledge of hepatitis B and their screening and vaccination behavior. In-depth interviews were conducted with Hmong in Oregon aged 18 and older (n=83). Independent samples t-test was used to assess mean differences in knowledge by demographic characteristics. Qualitative data were analyzed using content analysis. Most participants had heard of hepatitis B (96.4%). Fifty-three percent of participants had been screened, and half had been vaccinated (50.6%). Transmission knowledge was significantly higher among younger participants, those born in the U.S., and those who reported seeking preventive care. Sequelae knowledge was significantly higher among those who sought preventive care. Transmission and sequelae knowledge were not associated with screening and vaccination. Qualitative data showed that, of those hepatitis B positive participants, most did not have a comprehensive understanding of their illness. Intervention strategies should address knowledge deficits and improve health literacy, especially among Hmong who have hepatitis B.
African American Women's Perspectives on Breast Cancer: Implications for Communicating Risk of Basal-like Breast Cancer
Authors: Allicock Marlyn , Graves Neasha , Gray Kathleen , Troester Melissa A.
Published: June 2013

African American women suffer a disproportionately high burden of basal-like breast cancer, an aggressive subtype that has no targeted therapy. While epidemiologic research has identified key prevention strategies, little is known about how best to communicate risk to this population. This study explored women's knowledge, beliefs, and attitudes about breast cancer to learn about risk perceptions. Six focus groups were conducted in North Carolina with 57 women (ages 18-49). Age, race (especially perceptions of cancer as a "White disease"), and lack of family history of breast cancer were all shown to contribute to women's perceptions of low breast cancer susceptibility. Perceptions of low risk were also attributed to conflicting risk information from family, media, and health providers. Women had little to no knowledge of breast cancer subtypes, and emphasized that health communications should be personally relevant, culturally appropriate, and convenient. These findings will assist in developing health communication tools that encourage prevention.
Do Official Hospitalizations Predict Medical Vulnerability among the Homeless?: A Postdictive Validity Study of the Vulnerability Index
Authors: Cronley Courtney , Petrovich James , Spence-Almaguer Emily , Preble Kathleen
Published: June 2013

The current study tested the postdictive validity of the Vulnerability Index (VI), an instrument used to assess medical vulnerability among people who are homeless. It also examined the relationship between hospitalization records and self-reported health status. The VI is based on self-reports of hospital utilization and chronic health conditions. Data were collected over a one-year period from individuals receiving homeless services in a southwestern city (N = 97, 53.3% male, 57.7% African American). Vulnerability Index scores and three subcomponents of the measure (chronic health conditions, substance use, and mental health problems) were regressed on official reports of past-year hospitalizations, controlling for gender and race, using four separate regression models. Official hospitalization records significantly predicted overall VI scores, but they did not predict the subcomponents of the measure. Results show that, within the current sample, official hospital records are predictive of overall VI scores and are correlated with self-reported hospitalization. The lack of relationship between hospital records and subcomponents of the VI may indicate an underutilization of health care for those with serious health conditions.
Can Midlevel Dental Providers Be a Benefit to the American Public?
Authors: Rodriguez Tobias E. , Galka Audrey L. , Lacy Ernestine S. , Pellegrini August D. , Sweier Domenica G. , Romito Laura M.
Published: June 2013

The use of midlevel dental providers (MLDPs) is being debated as a means of reducing oral health disparities and increasing access to care among underserved populations. Midlevel dental providers include the advanced dental hygiene practitioner, community dental health coordinator, dental health aide therapist, and dental therapist. While midlevel providers are new to the U.S. dental profession, medicine has utilized these positions for years. Medical literature has shown mixed results as to whether midlevel providers improve access to care and increased practice efficiency, however, it has demonstrated clearly that the quality of care outcomes of these providers have been comparable to those of physicians. Studies of MLDPs suggest potential practice and public health benefits. With appropriate training, licensure, supervision, and deployment to geographical areas of significant need, we believe MLDPs could increase access to care to underserved populations and help in the prevention of deaths attributable to untreated dental disease.
Identifying Patient, Community and Program Specific Barriers to Free Specialty Care Utilization by Uninsured Patients in East Baltimore
Authors: Handy Catherine , Ma Sai , Block Lauren , de la Torre Desiree , Langley Anne , Cook Barbara
Published: June 2013

Uninsured individuals face multiple barriers to accessing specialty care. The Access Partnership (TAP) offers free specialty care and care coordination to qualified uninsured patients at an urban academic medical center for a small program entry fee (waived for financial hardship). In the program's first year, 104 eligible patients (31%) did not enroll. To understand why, we investigated demographic, referral, personal, and program-specific factors. After adjusting for age, gender, and ZIP code, diagnostic and therapeutic referrals were more likely to be completed than ancillary referrals (OR=8.56, p=.001; OR 3.53, p=.03). There was no difference between pain related and ancillary referrals (OR=2.80, p=.139). Eighteen patients were surveyed and reported program and patient-specific barriers. While removing costs is necessary to improve access to specialty care for underserved patients, it is insufficient. Improving communication from program coordinators and enrollment strategies may help to improve utilization of free care programs by the uninsured.
Increasing the Relevance of Research to Underserved Communities: Lessons Learned from a Retreat to Engage Community Health Workers with Researchers
Authors: Angier Heather , Wiggins Noelle , Gregg Jessica , Gold Rachel , DeVoe Jennifer
Published: June 2013

This article presents information on a community retreat developed to seek input from community health workers (CHWs) to increase the relevance of our research to underserved communities in Oregon. Retreats facilitating dialogue between researchers and CHWs could yield important insight to enhance the significance of research for communities.
Colorectal Cancer Screening among Korean American Immigrants: Unraveling the Influence of Culture
Authors: Lee Hee Yun , Im Hyojin
Published: June 2013

Screening for colorectal cancer (CRC) is underutilized among ethnic minority groups, particularly among Korean American immigrants. To explore the role of cultural and health beliefs in CRC screening, a structured questionnaire was administered to 281 Korean American immigrants aged between 50 and 88 in the New York metropolitan area. Results showed that 20% of the sample had undergone a fecal occult blood test within the past year, and 35% of the respondents had received a sigmoidoscopy and/or colonoscopy within the previous five years. Binary logistic regression analyses revealed significant predictors including health belief constructs, such as perceived seriousness of cancer and confidence in screening uptake, and gender-specific cultural beliefs and attitudes about CRC screening. Perceived helplessness lowered CRC screening among the women, while fatalism lowered it among the men. The findings reinforce a need for cultural-and gender-specific intervention strategies to increase CRC screening in this particularly vulnerable population.
Attitudes Surrounding Implementation of the HPV Vaccine for Males among Primary Care Providers Serving Large Minority Populations
Authors: Aragones Abraham , Bruno Denise , Gany Francesca
Published: June 2013

Background . Minority populations are disproportionally affected by human papilloma virus (HPV) infection. We examined the attitudes of primary care providers serving large minority populations towards the implementation of the HPV vaccine for males in their practices. Design . Cross-sectional survey of randomly selected primary care providers in Brooklyn, N.Y. Results . Ninety-three eligible providers were surveyed, of whom 62% were pediatricians. Sixty-two percent of all participants reported that they were very likely or will definitely be offering the vaccine to their male patients. The rate was higher among providers who reported higher numbers of minority patient population and who acknowledged high risk among their patient population. Conclusions . Primary care providers included in the study were likely to report incorporation of the HPV vaccine for males as part of their regular clinical practice. Their adoption and dissemination of the vaccine will be a significant factor in determining whether its full benefits are achieved.
Perceptions of Homelessness in Older Homeless Veterans, VA Homeless Program Staff Liaisons, and Housing Intervention Providers
Authors: Molinari Victor A. , Brown Lisa M. , Frahm Kathryn A. , Schinka John A. , Casey Roger
Published: June 2013

Purpose . To understand the needs and challenges encountered by older homeless veterans. Methods . We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Results . Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Discussion . Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.
Cumulative Social Risk and Racial/Ethnic Disparities in Obesity during the Transition to Adulthood
Authors: Lee Hedwig , Hicken Margaret T.
Published: June 2013

Racial/ethnic disparities in adolescent obesity in the U.S. are stark, and the causes of these disparities are largely unknown. We used a cumulative risk index (CRI) to examine the role of social risk in racial/ethnic disparities in obesity. Using the National Longitudinal Study of Adolescent Health and multinomial logistic regression, we examined the role of this CRI in disparities in obesity in the transition from adolescence to adulthood. Controlling for sociodemographic characteristics, compared with White females, Black and Hispanic females had roughly a 50% increase in the odds of newly-developed obesity in adulthood and a 90% increase in the odds of persistent obesity in adolescence and adulthood. After adding our CRI, the Black-White disparities were attenuated to statistical non-significance. Hispanic-White disparities did not change. There were no disparities in obesity for males. Our results suggest that social risk factors accumulate to explain Black-White disparities in obesity for females.
Home-Based Caregiving for People Living with HIV/AIDS in South Africa
Authors: Mieh Theresa M. , Iwelunmor Juliet , Airhihenbuwa Collins O.
Published: June 2013

Caregiving for people living with HIV/AIDS (PLWHAs) reportedly affects the physical, mental, and socioeconomic well-being of family and volunteer caregivers. This study uses the PEN-3 cultural model to examine the positive, existential (unique), or negative roles and expectations that influence HIV and AIDS caregiving among home-based caregivers (HBCs) in Limpopo, South Africa. Data from 41 women who participated in four focus group discussions held in Limpopo provides a deeper understanding of culture in providing care and support to PLWHAs. Using the cultural empowerment domain of PEN-3, our analyses revealed the following themes: perceptions associated with HIV/AIDS caregiving, HBCs assuming the roles of family, and voicelessness of HBCs due to the lack of support. The findings highlight the resilience of HBCs in South Africa in responding to the stigmatized disease of HIV/AIDS in the context of cultural expectation of caring for the sick.
Health Behavior Changes following Breast Cancer Treatment: A Qualitative Comparison among Chinese American, Korean American, and Mexican American Survivors
Authors: Lim Jung-won , Gonzalez Patricia , Wang-Letzkus Ming F. , Baik Okmi , Ashing-Giwa Kimlin T.
Published: June 2013

This study explored how Chinese American, Korean American, and Mexican American women modify their health behaviors following breast cancer treatment and identified motivators and barriers that influence their changes. An exploratory, descriptive, qualitative study was undertaken using six focus groups. Discussions were transcribed and translated for content analysis. Significant differences among the ethnic groups were noted in the following health behavior practices which were most commonly stated as changed behaviors after a breast cancer diagnosis: 1) eating habits, 2) physical activity, 3) alternative medicine, 4) sleeping, 5) social activity, 6) weight control, and 7) alcohol consumption. Family, financial concerns, environment, and religious faith were commonly mentioned as motivators of and/or barriers to changes in health behaviors. Findings provide insight into different perspectives related to changes in health behaviors by ethnicity, which is critical for developing culturally tailored behavioral interventions to improve underserved breast cancer survivors' quality of life and to reduce health disparities.
The Healthy Weight Collaborative: Using Learning Collaboratives to Enhance Community-based Prevention Initiatives Addressing Childhood Obesity
Authors: Hargreaves Margaret B. , Honeycutt Todd , Orfield Cara , Vine Michaela , Cabili Charlotte , Morzuch Michaella , Fisher Sylvia K. , Briefel Ronette
Published: June 2013

This report from the field describes the design, implementation, and early evaluation results of the Healthy Weight Collaborative, a federally-supported learning collaborative to develop, test, and disseminate an integrated change package of six promising, evidence-based clinical and community-based strategies to prevent and treat obesity for children and families.
Screening and Management of Obesity and Perception of Weight Status in Medicaid Recipients
Authors: Rose Stephanie A. , Gokun Yevgeniya , Talbert Jeffery , Conigliaro Joseph
Published: June 2013

Objective . We sought to identify any correlations among primary care provider weight screening and counseling, patient weight perception, and weight loss attempt. Methods . We performed a cross-sectional analysis of obesity-related questions from 2009 and 2010 Kentucky Medicaid Adult Patient and Provider survey data. Results . 1,510 patients [46% obese (body mass index (BMI) ≥30 kg/m 2 ), 26% overweight (BMI 25 to <30), 26% normal weight (BMI 18 to <25), and 2% underweight (BMI<18)] and 787 providers (41% primary care) met criteria. Patients and providers differed on report of physician weight loss counseling (46% versus 92%). Patient report of physician weight loss counseling and weight loss attempt were positively correlated (77% with versus 38% without counseling, p<.01). One-fifth of patients underperceived their weight. Patients reporting physician weight counseling were less likely to underperceive their weight (13% versus 23%, p<.0001). Conclusions . Weight loss attempt and accurate weight perception were positively correlated with physician weight discussion.
Accelerating Progress in Reducing Childhood Obesity Disparities: Exploring Best Practices of Positive Outliers
Authors: Sharifi Mona , Marshall Gareth , Marshall Richard , Bottino Clement , Goldman Roberta , Sequist Thomas , Taveras Elsie M.
Published: June 2013

Childhood obesity rates may have plateaued in some U.S. population subgroups, yet overall rates remain high and racial/ethnic and socioeconomic disparities appear to be widening. Successful strategies and best practices to inform obesity interventions and accelerate progress in reducing disparities in childhood obesity can be found among people who can be categorized as positive outliers , i.e., individuals who have succeeded, where many others have not, in changing their health behaviors, reducing their body mass index, and developing resilience in the context of adverse built and social environments. In this commentary, we discuss the central premise of a positive outlier approach and how successful strategies learned from positive outliers can be generalized and promoted to accelerate progress in childhood obesity.
Combating Obesity at Community Health Centers (COACH): A Quality Improvement Collaborative for Weight Management Programs
Authors: Wilkes Abigail E. , John Priya M. , Vable Anusha M. , Campbell Amanda , Heuer Loretta , Schaefer Cynthia , Vinci Lisa , Drum Melinda L. , Chin Marshall H. , Quinn Michael T. , Burnet Deborah L.
Published: June 2013

Community health centers (CHCs) seek effective strategies to address obesity. MidWest Clinicians' Network partnered with [an academic medical center] to test feasibility of a weight management quality improvement (QI) collaborative. MidWest Clinicians' Network members expressed interest in an obesity QI program. This pilot study aimed to determine whether the QI model can be feasibly implemented with limited resources at CHCs to improve weight management programs. Five health centers with weight management programs enrolled with CHC staff as primary study participants; this study did not attempt to measure patient outcomes. Participants attended learning sessions and monthly conference calls to build QI skills and share best practices. Tailored coaching addressed local needs. Topics rated most valuable were patient recruitment/retention strategies, QI techniques, evidence-based weight management, motivational interviewing. Challenges included garnering provider support, high staff turnover, and difficulty tracking patient-level data. This paper reports practical lessons about implementing a weight management QI collaborative in CHCs.
Unidas por La Vida (United for Life): Implementing A Culturally-Tailored, Community-Based, Family-Oriented Lifestyle Intervention
Authors: Sorkin Dara H. , Biegler Kelly A. , Peyreda Margarita , Kilgore David , Dow Emily , Ngo-Metzger Quyen
Published: June 2013

Unidas por la Vida , a behavioral weight-loss program, was developed for use among low-income, Mexican-American women with diabetes and their overweight/obese adult daughters. The program leverages community resources in a partnership between primary care and community-based organizations. This paper describes the program's implementation, lessons learned, and implications for sustainability.
Action-Learning Collaboratives as a Platform for Community-Based Participatory Research to Advance Obesity Prevention
Authors: Bazos Dorothy A. , Schifferdecker Karen E. , Fedrizzi Rudolph , Hoebeke Jaime , Ruggles Laural , Goldsberry Yvonne
Published: June 2013

Although process elements that define community-based participatory research (CBPR) are well articulated and provide guidance for bringing together researchers and communities, additional models to implement CBPR are needed. One potential model for implementing and monitoring CBPR is Action Learning Collaboratives (ALCs); short term, team-based learning processes that are grounded in quality improvement. Since 2010, the Prevention Research Center at Dartmouth (PRCD) has used ALCs with three communities as a platform to design, implement and evaluate CBPR. The first ALC provided an opportunity for academia and community leadership to strengthen their relationships and knowledge of respective assets through design and evaluation of community-based QI projects. Building on this work, we jointly designed and are implementing a second ALC, a cross-community research project focused on obesity prevention in vulnerable populations. An enhanced community capacity now exists to support CBPR activities with a high degree of sophistication and decreased reliance on external facilitation.
Family-Based Risk Reduction of Obesity and Metabolic Syndrome: An Overview and Outcomes of the Idaho Partnership for Hispanic Health
Authors: Schwartz Rachel , Powell Linda , Keifer Matthew
Published: June 2013

Mexican American women have the highest incidence of metabolic syndrome among all U.S. demographic groups. This paper details an innovative approach to reducing the risks for metabolic syndrome among Hispanic families in rural Idaho. Compañeros en Salud (CeS) is a promotora-led wellness program and community-based participatory research project from the Idaho Partnership for Hispanic Health. As behavior change is the first line of prevention and treatment of obesity and metabolic syndrome, the program aimed to improve nutrition and physical activity behaviors as well as increase community support and infrastructure for healthy living. CeS has demonstrated substantial improvement in health outcomes, with statistically significant reductions in weight, BMI, metabolic syndrome risk, A1c, glucose, blood pressure, and cholesterol, from pre-intervention to post-intervention and/or pre-intervention to one-year follow-up. These outcomes suggest the CeS model as a promising best practice for effecting individual and family-level physiologic and behavioral outcomes for obesity prevention.
San Diego Healthy Weight Collaborative: A Systems Approach to Address Childhood Obesity
Authors: Serpas Shaila , Brandstein Kendra , McKennett Marianne , Hillidge Sharon , Zive Michelle , Nader Philip R
Published: June 2013

A collaborative approach to identify opportunities for interactions between multiple systems is an important model for childhood obesity prevention. This paper describes a process aligning multiple partners in primary care, public health, university research, schools, and community organizations. Jointly implemented strategies in a Latino underserved community included: (1) building an effective and sustainable collaborative team; (2) disseminating a healthy weight message across sectors; (3) assessing weight status and healthy weight plans in primary care, school, and early childhood settings; and (4) implementing policy changes to support healthy eating and physical activity. The process and lessons learned were analyzed so other communities can utilize a systems approach to develop culturally appropriate interventions tailored to a specific community.
Implementing the Obesity Care Model at a Community Health Center in Hawaii to Address Childhood Obesity
Authors: Okihiro May , Pillen Michelle , Ancog Cristeta , Inda Christy , Sehgal Vija
Published: June 2013

Obesity, the most common chronic disease of childhood, is prevalent among economically disadvantaged children. The Chronic Care and Obesity Care Models are comprehensive health care strategies to improve outcomes by linking primary care best practices and community-based programs. Pediatric providers and community health centers are well positioned to design and implement coordinated and synergistic programs to address childhood health disparities. This article describes a comprehensive project based on the Obesity Care Model initiated at a rural community health center in Hawaii to address childhood obesity including: (1) the health care delivery changes constituting the quality improvement project; (2) capacity and team-building activities; (3) use of the project community level data to strengthen community engagement and investment; and (4) the academic-community partnership providing the project framework. We anticipate that these efforts will contribute to the long-term goal of reducing the prevalence of obesity and obesity associated morbidity in the community.
A Community-Academic Partnership to Promote Student Health and Education Outcomes
Authors: Snelling Anastasia
Published: June 2013

Rising childhood obesity rates have spurred the government and school districts to legislate school wellness policies. Policy formulation must be paired with policy implementation. This article describes how a school-wide health education program addressed the needs of students, faculty, and parents while advancing academic achievement.
Linking Pediatric Primary Care Obesity Management to Community Programs
Authors: Ariza Adolfo J. , Hartman Jennifer , Grodecki Jennifer , Clavier Alejandro , Ghaey Kamala , Elsner Mary , Moore Chantal , Reina Olga Ochoa , Binns Helen J.
Published: June 2013

Guidelines for obesity management in primary care call for linking to community services. The Promoting Health Project (PHP) was a multi-component, practice-based intervention aimed at improving care of obese children, including referrals to community services. Promoting Health Project staff identified and interviewed representatives of 40 nutrition or physical activity services/programs. Quality improvement (QI) teams at three practices worked to improve overweight/obesity identification and care and implement practice-to-community connections that used the information gathered from the programs/ services. A practice community coordinator (PCC) facilitated interactions between practices, community programs and families. Researchers tracked patients referred, PCC to family interactions, and time spent. They surveyed parents of referred patients and interviewed key clinicians. Forty-six patients participated in programs. Substantial efforts were necessary to create smooth referral systems. Family motivation was perceived as a limiting factor in program attendance. Clinicians were satisfied with systems established. Effectively linking practitioners to community programs requires the use of additional resources.
Getting Research into Policy and Practice: A Review of the Work of Bob Usherwood
Authors: Corrall Sheila
Published: June 2013

Professor Bob Usherwood is a leading scholar in the field of public librarianship who spent three decades of his working life at the University of Sheffield, where he founded the Centre for the Public Library and Information in Society to pursue the mission of “Getting Research Into Policy and Practice.” His career took him from librarian and chief officer to faculty member and a personal chair and included important roles in professional organizations, such as president of The Library Association. Usherwood’s published output of books, research reports, journal articles, and other material is selectively reviewed, concentrating on publications related to his personal research and funded projects. His research interests are in three interrelated areas: library and information service management, public policy decisions and their effects on libraries, and the impact of libraries on individuals and communities. A distinctive feature is his use of different publication venues to reach diverse audiences and the promotion of qualitative methodologies to demonstrate the value and impact of libraries. Major concerns identified in his work include library values, public service, professional engagement, intellectual standards, and literary excellence, which are issues of continuing relevance for researchers, practitioners, and managers of library services today.
Mind the Gap: Do Librarians Understand Service User Perspectives on Bibliotherapy?
Authors: Brewster Liz , Sen Barbara , Cox Andrew
Published: June 2013

Bibliotherapy schemes aim to improve mental health and well-being. Schemes focus on engagement with either imaginative literature or self-help texts and are now commonplace in U.K. public libraries. Impetus for bibliotherapy schemes was influenced by health policy and a drive toward partnership working. There is a recognized need for in-depth evaluation of bibliotherapy services; the lack of evaluation is problematic, as the schemes are designed without reference to service user perspectives. There is a need to identify and analyze usage to assess effectiveness of the schemes. Drawing on data from interviews and focus groups with library and health professionals and service users, this article explores the service provider and service user perspective on bibliotherapy schemes. It concludes that—for service providers—there is a lack of clarity and understanding about how bibliotherapy works, and this impacts on the experience of service users. While service providers and service users share a common goal of improving mental health and well-being, their understandings of bibliotherapy differ, meaning there is a potential gap between service provision and service user needs. The article concludes that in-depth research influenced by user-centered design principles, may help to improve services in practice.
Collection Growth in Postwar America: A Critique of Policy and Practice
Authors: Jones David E.
Published: June 2013

The accumulation of large collections by members of the American Association of Research Libraries is seen by them as fundamental to their research support role. This article outlines collection development and management practice and policy of the association members between 1945 and 1979. The study is a critical history where narrative is accompanied by analysis and context. Collecting policy and practice is reviewed with a focus on the strategies adopted to cope with the consequences of growth which led to pressure on capacity. A critique of collections policy reviews three significant causal factors: institutional competition, the conception of the role of librarian as a “bookman” as opposed to manager, and the belief that collections would be of longer-term value to the university in that they transcended immediate needs. The advent of usage studies is examined, and the implications of the study for current policy concerning printed collections are discussed.
Provision of Distance Learner Support Services at U.K. Universities: Identification of Best Practice and Institutional Case Study
Authors: Brooke Charlotte , McKinney Pamela , Donoghue Angie
Published: June 2013

An investigation of library support for distance learners (DLs) was commissioned and conducted in partnership with the Distance Learning Support Service (DLSS) at Sheffield Hallam University (SHU). It aimed to collect evidence of best practice at U.K. university libraries and develop a better understanding of the needs and expectations of distance learners at SHU. The study used a mixed-methods research strategy. A review of the literature established key themes and informed the design of the data collection tools. Librarians from two different institutions were interviewed, and two separate self-completion questionnaires were distributed to librarians at U.K. universities and DLs at SHU. Sixty-six librarians (forty-one completed in full) and 112 DLs (109 completed in full) responded to the questionnaires distributed. Results showed limited use of synchronous virtual reference and user-education tools. The biggest challenge faced by librarians is collaborating with course tutors. A marked difference exists between what librarians believe are the most significant challenges faced by DLs and what DLs identify as challenges. Librarians need to experiment with technological innovations, such as synchronous virtual referencing tools, to increase the effectiveness and efficiency of future service provision.
Bibliometrics and Research Data Management Services: Emerging Trends in Library Support for Research
Authors: Corrall Sheila , Kennan Mary Anne , Afzal Waseem
Published: June 2013

Developments in network technologies, scholarly communication, and national policy are challenging academic libraries to find new ways to engage with research communities in the economic downturn. Librarians are responding with service innovations in areas such as bibliometrics and research data management. Previous surveys have investigated research data support within North America and other research services globally with small samples. An online multiple-choice questionnaire was used to survey bibliometric and data support activities of 140 libraries in Australia, New Zealand, Ireland, and the United Kingdom, including current and planned services, target audiences, service constraints, and staff training needs. A majority of respondents offered or planned bibliometrics training, citation reports, and impact calculations but with significant differences between countries. Current levels of engagement in data management were lower than for bibliometrics, but a majority anticipated future involvement, especially in technology assistance, data deposit, and policy development. Initiatives were aimed at multiple constituencies, with university administrators being important clients and partners for bibliometric services. Gaps in knowledge, skills, and confidence were significant constraints, with near-universal support for including bibliometrics and particularly data management in professional education and continuing development programs. The study also found that librarians need a multilayered understanding of the research environment.
On Your Own but Not Alone: One-Person Librarians in Ireland and Their Perceptions of Continuing Professional Development
Authors: Hornung Eva
Published: June 2013

One-person librarians (OPLs) are the sole information provider in their respective organizations. Continuing professional development (CPD) is vital to satisfy their own information needs and, by proxy, those of the people they serve. No research has so far been carried out to establish what CPD means to these highly specialized library workers. This article reports on some of the findings of a phenomenographic study conducted among thirty OPLs in the Republic of Ireland. The researcher found five different ways of experiencing CPD, ranging from an organizational focus only to a lifelong, life-wide learning orientation. She also discovered four dimensions of variation, namely, “time,” “style,” “networking,” and “role,” each of which influenced succinctly how solo librarians perceived the effectiveness of different means of CPD. The study suggests that a new model of understanding CPD is needed if library associations want to provide successful support to OPLs. A “one-size-fits-all” approach is not appropriate for OPLs.
Community Resilience and the Role of the Public Library
Authors: Grace Dan , Sen Barbara
Published: June 2013

Communities face increasing threats from disasters precipitated by climate change, biodiversity loss, and energy and food insecurity. In the face of such threats, communities must adopt strategies that build resilience. The library has a role to play in such strategies. This study explores how, through an examination of day-to-day working practices, public libraries promote and inhibit community resilience. The methodology used combined autoethnography and situational analysis. A reflective journal was kept documenting experience across a period of four months. Situational analysis was used to elucidate the data content. Several areas of interest emerged: the existence of a split between the social worlds of the library worker and user, the role of technology in this split, the role of professionalism as discourse in rationalizing the use of certain technologies, the role of management in perpetuating this discourse, the place of outreach in bridging the gap between these social worlds, and the environment as an abiding concern. Each of these areas provides a potential site for new policies and practices and for further research regarding the role of the public library in building community resilience.
Knowledge Management through the Lens of Library and Information Science: A Study of Job Advertisements
Authors: Harper Ray
Published: June 2013

Knowledge management (KM) is influential as a concept and practice, referring to the capture, codification, and interpretation of knowledge. KM can be viewed as a form of library and information science (LIS) or a distinct professional area. Wider debates around the skills of newly qualified LIS workers, the LIS curriculum, and the current employment market have meant that KM roles present opportunities to LIS professionals. The reported study investigated similarities between KM and LIS jobs by examining 165 U.K.-based KM jobs in 2011. Job advertisements were coded using keywords derived from the Quality Assurance Agency’s Subject Benchmark Statement for LIS. Findings showed KM jobs required and prized the development of information architecture, Web 2.0 tools, databases, and other applications and emphasized the capture and dissemination of knowledge through brokerage. Advertisements showed the importance of “contextual” skills, including relationship management, strategic management, and compliance. Numerous areas in the LIS benchmark statement are shared with KM job roles, particularly facilitating access to information, structuring information, and providing an “expert advisor” service. LIS and KM have similar traits but not necessarily of the same type. LIS can be conceptualized as a profession with clearly defined boundaries, professional routes, and frameworks, while KM is more of a cross-cutting “practice” that embodies a range of professional skills, including, but not limited to, LIS.