Fern J. Webb

Facilitators of and barriers to healthy eating and physical activity for Black women: a focus group study in Florida, USA

Black women’s experiences of, perceptions of, and attitudes to healthy eating and physical activity have been suggested as contributors to their high rates of obesity. This paper uses data from four focus groups with Black women aged 18–45 years in Broward County, Florida, to explore their views. Findings suggest that participants were aware of the importance of healthy eating and physical activity, and motivated by wanting to model healthy behaviors for their families, but that ‘healthy’ behavior was perceived as requiring considerable ‘pre-planning’ and commitment. Programs addressing Black women that incorporate their perceptions and work with them to overcome challenges are needed.

Community-Engaged Strategies to Increase Diversity of Participants in Health Education Research

Minorities have historically been underrepresented in health-related research. Several strategies have been recommended to increase the participation of minorities in health-related research. However, most of the recommendations and guidelines apply to research in clinical or laboratory contexts. One of the more prominent methods to enhance minority participation in health-related research that has recently come to the fore is the use of community-engaged strategies. The purpose of this article is to summarize community-engaged outreach efforts that can be translated into useable strategies for health education research teams seeking to diversify the pool of research participants. Also, we provide a succinct overview of the various components of a research endeavor that may influence minority participation in health-related research. Finally, we analyze how health education specialists and SOPHE (Society of Public Health Education) can play a leading role in helping enhance minority participation in health-related research.

Whatʼs Inside a Medical Home? Providers and Staff Give Insight

This study describes how 4 primary care practices deliver components of the patient-centered medical home (PCMH) model. Interviews with administrators and clinicians were conducted and analyzed. All practices had achieved National Committee for Quality Assurance Level 3 Medical Home Accreditation. Yet, the manner in which some of the core PCMH components were delivered varied across sites. For example, information technology is used in different ways and to different degrees although the same electronic medical record is employed in all settings. Evaluations of the PCMH model must account for differences in approach to truly assess its effectiveness.

Marijuana Use and Its Association with Participation, Navigation, and Enrollment in Health Research among African Americans.

This analysis examined the association between marijuana (Mj) use, willingness to participate, navigation and enrollment in health research among African Americans. Data from HealthStreet, a community-engagement model implemented in North Central Florida that reduces health disparities by engaging and linking community members to medical and social services and health research opportunities, were analyzed to determine willingness of African American Mj users to participate, be navigated to and enroll in health research studies. Among 1,496 African American community members, 8.0% were current Mj users, 30.3% were past Mj users and 61.7% reported never using Mj. Current and past Mj users were more willing to volunteer for a research study that only involved the use of medical records, required an overnight stay in a hospital or clinic, or might require use of medical equipment compared to those who never used Mj. Current Mj users were significantly less likely to be navigated (95% CI: 0.21–0.58) to health research studies while past Mj users (95% CI: 1.05–2.64) were significantly more likely to be enrolled in health research studies. Navigating and enrolling Mj users into health research studies could help decrease health disparities and increase health equity for the entire community since study findings would undoubtedly be more representative of the entire community rather than a select few.

Differences in Patient Ratings of Medical Home Domains Among Adults With Diabetes Comparisons Across Primary Care Sites

Background: There is growing and sustained recognition that Patient-Centered Medical Homes (PCMHs) represent a viable approach to dealing with the fragmentation of care faced by many individuals, including those living with diabetes. The National Committee for Quality Assurance (NCQA) has spearheaded a program that recognizes medical practices that adopt key elements of the PCMH. Even though practices can achieve the same level of recognition, it is unclear whether all PCMHs deliver care in the same manner and how these differences can be associated with patient ratings of their experience with care. Methods: This study uses a mixed-methods approach to explore differences in care delivery across 4 NCQA level 3 recognized PCMHs located in a southern state. Furthermore, the study examines the association between each clinic and patient ratings of key PCMH domains. The qualitative component of the study included in-depth interviews with medical directors at each site in order to determine how the PCMH at each clinic was operationalized. In addition, 1300 adult patients with diabetes were surveyed about their experiences with their PCMH. Bivariate and ordinal logistical analyses were conducted to determine how PCMH experiences varied across the 4 clinics. Results: The in-depth interviews revealed that one clinic (clinic 1) had a stronger primary care orientation relative to the other locations. Furthermore, patients at these clinics were more likely to provide higher ratings of care across all PCMH domains. Conclusions: This study demonstrates that not all PCMH clinics are alike and that these differences can possibly affect patient perceptions of their care.

The Association Between Religiosity and Substance Use Patterns Among Women Involved in the Criminal Justice System

A growing body of research is exploring the association between religiosity and drug use. Thus, this analysis examines the association between religiosity and substance use patterns among females in the criminal justice system. Data derived from 318 women recruited from a Municipal Drug Court System in St. Louis, Missouri, were used to determine the association between religiosity and substance use patterns. Results indicate that religiosity decreased the odds of cocaine use, observed for both crack/cocaine (CC) use alone (adjusted odds ratio [AOR] = 0.41) and crack/cocaine + marijuana (CC + MJ) (AOR = 0.32). Interestingly, this association was not found for MJ use alone. Other variables that were significantly associated with CC + MJ use included being non-Black (CC + MJ: AOR = 0.46; MJ: AOR = 0.28), 4+ arrests (CC + MJ: AOR = 4.66; CC: AOR = 2.64), and <30 years of age (CC + MJ: AOR = 0.37; CC: AOR = 0.16; MJ: AOR = 2.84). Future drug prevention and interventions should consider the potential protective effects of religiosity on substance use.

Poverty and Health Disparities: What Can Public Health Professionals Do?

More than a tenth of the U.S. population (13% = 41 million people) is currently living in poverty. In this population, the socioeconomic, cultural, and environmental conditions have detrimental health effects such as higher rates of chronic diseases, communicable illnesses, health risk behaviors, and premature mortality. People living in poverty are also deprived of social, psychological, and political power, leading to continuation of worsening health and chronic deprivation over generations. The health of individuals living in poverty poses greater challenges from policy, practice, and research standpoints. Public health professionals are poised uniquely to be advocates for the marginalized, be the resource persons for health education, implement health promotion programs, and conduct research to understand health effects of poverty and design tailored and targeted public health interventions. In this article, we summarize the opportunities for public health practice with individuals living in poverty.

Community-engaged strategies to promote hepatitis B testing and linkage to care in immigrants of Florida.

To improve early identification and linkage to treatment and preventive services for hepatitis B virus (HBV) in persons born in countries with intermediate or high (>2%) HBV prevalence, the University of Florida Center for HIV/AIDS Research, Education, and Services (UF CARES) employed community-engaged strategies to implement the Hepatitis B Awareness and Service Linkage (HBASL) program. In this brief report, we present a summary of program components, challenges, and successes. Faith and community-based networks were established to improve HBV testing and screening and to increase foreign born nationals (FBNs) access to HBV care. A total of 1516 FBNs were tested and screened for hepatitis B. The majority were females (50.4%), Asians (62.8%), non-Hispanic (87.2%), and they also received post-test counseling (54.8%). Noted program advantages included the development of community networks and outreach to a large population of FBNs. The major challenges were institutional delays, pressures related to meeting program deliverables, and diversity within FBNs populations. Community health workers in the United States can replicate this program in their respective communities and ensure success by maintaining a strong community presence, establishing partnerships and linkage processes, developing a sustainability plan, and ensuring the presence of dedicated program staff.

Capillary haemangioma in a 13-year-old boy

This case presents a 13-year-old boy who developed an unusual skin lesion on his chest that occurred after 2–3 weeks following a traumatic injury. The lesion was raised and bled easily. It was surgically removed via shave excision and treated with electrocautery. The patient healed with no recurrence and minimal scarring. Pathology determined the skin lesion to be a capillary haemangioma.