Ashley D. Walker

The relation between adolescent self assessment of health and risk behaviours Could a global measure of health provide indications of health risk exposures

Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations’ physical and psychosocial health functioning. However, it is unclear how adolescents’ subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing health conditions. It is unknown whether adolescents place more emphasis on mental or physical health functioning in determining overall health. Methods: We evaluated the association between SRH and a set of behavioural and other psychosocial health risks including pre-existing medical conditions using Colorado Youth Risk Behavioural Survey (2005). We analyzed the data using descriptive statistics and logistic regression models. Results: Adolescents with behavioural problems were at increased risk of poor health, and in particular females were at a higher risk of poor health compared with boys. However, in sub-group analyses boys with risks of sexual abuses were more likely to report worse health. Current smoking status, perception of body image as overweight and suicidal attempts were the most consistent predictors of poor health among this sampled population. Conclusions: SRH could be an indicator of health risk in situations where other biomedical information about an adolescent is unavailable. It appears that mental health functioning might be one of the most important factors used to determine the overall health in this population of adolescents. The role of parents and other adult mentors might be crucial in assisting adolescents to make appropriate choices regarding underlying health risks related to overall health functioning.

A Needs Assessment to Develop Community Partnerships: Initial Steps Working with a Major Agricultural Community

Abstract Background: Healthy People 2010 identified community partnership as one of the most effective strategies in eliminating health disparities and considered it a critical element in improving an individuals quality of life. To be effective at engaging communities in partnerships, an initial community based needs assessment is recommended. Purpose: The purpose of this project was to use a community assessment to establish if there is a need for community partnerships in a rural Northern Colorado county. Methods: A mixed-methods design using an online survey and focus groups was used to collect data. Results: The analysis of the online survey indicated strong support for community partnerships and analysis of focus group transcriptions found both barriers and solutions to human service delivery. Discussion: Survey responses indicated a perception of support, involvement, and interest in community partnerships; however, focus groups revealed that although some partnerships do exist, significant improvement is needed to better serve disparate populations. Translation to Health Education Practice: Future health educators must be equipped with the strategies to effectively address disparate populations and incorporate community partnerships within their agencies once they graduate and enter into employment.

Parent Perspectives on Health and Functioning of School-Aged Adolescents With Disabilities

BACKGROUND Youth living with disabilities are at risk of experiencing poor health outcomes. Coordinated school health programs have an opportunity to help youth with disabilities and their families through health education, health services, and community engagement. The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) as a framework to analyze factors related to health conditions. We used the ICF to examine parental perceptions of health and function among students with disabilities living in rural and urban areas. METHODS We surveyed parents (N = 71) using the parent-report versions of the Pediatric Outcomes Data Collection Instrument and Child Health and Illness Profile. From this group, parents were asked to volunteer to participate in in-depth, individual interviews (N = 18). The interviews were audio-recorded and transcribed verbatim. Researchers used the ICF linking rules to analyze and code the transcriptions. Emergent themes were assigned numerical ICF codes. RESULTS There were more similarities than differences among rural and urban families. Children living with disabilities face significant environmental barriers regardless of context. CONCLUSIONS Schools can facilitate education to improve the quality of life of parents and families of children with disabilities. School authorities should consider the many environmental barriers both urban and rural these families face in the community. The ICF can be used as a framework for program planning for community-based, health education for this population.

Predictors of Coordinated and Comprehensive Care Within a Medical Home for Children With Special Healthcare (CHSCN) Needs

The purpose of this study was to examine predictors of coordinated and comprehensive care within a medical home among children with special health care needs (CSHCN). The latest version of the National Survey of Children with Special Health Care Needs (NS-CSHCN) employed a national random-digit-dial sample whereby US households were screened, resulting in 40,242 eligible respondents. Logistic regression analyses were performed modeling the probability of coordinated, comprehensive care in a medical home based on shared decision-making and other factors. A total of 29,845 cases were selected for inclusion in the model. Of these, 17,390 cases (58.3%) met the criteria for coordinated, comprehensive care in a medical home. Access to a community-based service systems had the greatest positive impact on coordinated, comprehensive care in a medical home. Adequate insurance coverage and being White/Caucasian were also positively associated with the dependent variable. Shared decision-making was reported by 72% of respondents and had a negative, but relatively negligible impact on coordinated, comprehensive care in a medical home. Increasing age, non-traditional family structures, urban residence, and public insurance were more influential, and negatively impacted the dependent variable. Providers and their respective organizations should seek to expand and improve health and support services at the community level.

Fulfilling Community Health Assessment Requirements: Lessons Learned From Facilitating State-wide Community Health Forums

Background: A prerequisite for National Public Health Accreditation is completion of a Community Health Assessment (CHA) that presents an exhaustive profile of the population served by a particular public health agency. Methods: The Georgia Department of Public Health (GA DPH) contracted with the Center for Public Health Practice and Research at Georgia Southern University to facilitate five state-wide community health forums. Results: Evaluation of the forums yielded qualitative data illustrating current challenges faced by Georgians, as well as assets that could be leveraged to improve health status. Conclusion: Lessons learned from these state-wide community health forums can be applied to improve the overall process of gathering data for a comprehensive CHA throughout Georgia or other areas interested in pursuing public health agency accreditation.

Relationships among meeting physical activity guidelines and health risk behaviors

BACKGROUND Young adults have the highest participation in physical activity but also have the highest incidence rates of binge drinking, cigarette smoking, and smokeless tobacco use. We examined these factors to determine whether there are relationships among physical activity and health risk behaviors. METHODS We conducted correlation and χ² analyses using the American College Health Association-National College Health Assessment fall 2009 data set (N = 34,208) to examine the relationship among meeting physical-activity guidelines, binge drinking, and tobacco use among survey participants. RESULTS The data suggest a positive relationship between meeting physical-activity guidelines and binge drinking, with the strongest relationship between those reporting binge drinking 4 times in a 2-week period. Meeting physical-activity guidelines was negatively associated with cigarette use but positively associated with all other types of tobacco use. CONCLUSIONS Associations between physical activity and binge-drinking episodes indicate a need to address the relationship between heavy drinking and alcohol dependence and physical-activity behavior patterns. Further studies should examine relationships between physical activity and binge drinking in other age groups. Results also suggest the need to examine differing associations between physical activity and types of tobacco use.

Becoming the Physical Activity Champion: Empowerment through Social Marketing

Physical education teachers can champion their profession through marketing the importance of physical activity to children and families in the communities they serve. Social marketing, a consumer-based approach to behavior change, is an excellent choice for physical education teachers who want to ‘sell’ physical activity to their ‘audiences’. This article describes how teachers can apply the concept of social marketing to advocate for what they do.

Tailoring a Physical Activity Promotion Program for a Rural Area

ed/indexed in: Research Quarterly for Exercise and Sport is an SCI (Science Citation Information) and SSCI (Social Science Citation Information) journal. It is also abstracted/indexed in Biological Abstracts, CurrentREFERENCES The VERBTM Summer Scorecard (VSS) program was designed with the purpose of promoting physical activity among ‘tweens’ (8-13 year olds). A unique aspect of the VSS program is the scorecard which serves multiple purposes. The scorecard primarily serves as a behavioral reinforcer for physical activity. The scorecard also tracks physical activity for each participant. A community-based prevention marketing (CBPM) approach was taken to adapt the VSS to meet the needs of a rural, diverse population in the southeastern United States. Formative research was conducted with the target audience. Focus group interviews were conducted with parents and their children. Content analysis showed significant changes were needed for program. Previous versions of the Scorecard did not test well with the target audience, who suggested the use of smaller Scorecards and fobs as a secondary reinforcer. These changes offer many potential benefits to participation reinforcement and physical activity participation tracking. Figure 2. Scorecard from Southeast Georgia