Kim Nichols Dauner

Psychosocial and Environmental Determinants of Eating Behaviors, Physical Activity, and Weight Change Among College Students: A Qualitative Analysis

Abstract Objective: The goal of this study was to identify factors that college students perceived as contributing to healthy and unhealthy eating patterns, physical activity (PA) levels, and weight change. Participants: Forty-nine 18- to 22-year-old students at a midwestern university participated. Methods: Six focus groups (3 with each gender) were conducted, and data were analyzed using qualitative software to code and categorize themes and then reduce these to clusters according to commonly practiced methods of qualitative analysis. Results: Eating and PA behaviors appear to be determined by a complex interplay between motivations and self-regulatory skills as well as the unique social and physical environment comprising college life. Moreover, there appear to be gender differences in how these determinants impact behavior. Conclusions: Future research should examine these interactions in the college context in order to further our understanding of potential interventions or environmental modifications that support healthy eating and PA.

Investigating the temporal relationship between individual-level social capital and health in fragile families.

BackgroundThe potential for social capital to influence health outcomes has received significant attention, yet few studies have assessed the temporal ordering between the two. Even less attention has been paid to more vulnerable populations, such as low-income women with children. Our objective was to explore how different dimensions of social capital impact future health status among this population.MethodsThis study uses data from the Fragile Families and Child Well-Being (FFCWB) Study, which has followed a cohort of children and their families born in large U.S. cities between 1998 and 2000 to mostly minority, unmarried parents who tend to be at greater risk for falling into poverty. Four separate measures of social capital were constructed, which include measures of social support and trust, social participation, perceptions of neighborhood social cohesion, and perceptions of neighborhood social control. The temporal effect of social capital on self-reported health (SRH) is investigated using logistic regression and we hypothesize that higher levels of social capital are associated with higher levels of self-rated health.ResultsAfter controlling for socioeconomic and demographic factors related to social capital and self-rated health, social support and trust, perceptions of neighborhood social cohesion and control at an earlier point in time were positively associated with higher levels of health four-years later. Social participation was not related to increased health. The empirical results appear robust.ConclusionHigher levels of social capital are predictive of improved health over a four-year time frame. These results suggest that policy initiatives supporting increasing the social capital available and accessible by low-income, urban, minority women are viable for improving health. Such policies may have the potential to reduce socioeconomic health disparities.

An Evaluation of the Peer Helper Component of Go !: A Multimessage, Multi-“step” Obesity Prevention Intervention

Background Obesity prevention efforts typically involve changing eating and exercise behaviors as well as the physical and social environment in which those behaviors occur. Due to existing social networks, worksites are a logical choice for implementing such interventions. Purpose This article describes the development and implementation of a peer helper intervention, which was part of a multicomponent obesity prevention program conducted at a hospital worksite. It also presents qualitative evaluation findings of peer helper perceptions, roles, and institutional outcomes. Methods Fifty-one male and female employees were recruited to promote healthy eating and physical activity amongst their peers. They received health and communication skill-building training. Semistructured interviews were conducted with 20 peer helpers to evaluate this component of the intervention. Results Findings showed that peer helpers took on many helping roles, became effective role models, and contributed to creating health-promoting social and environmental changes at work. Discussion We found evidence for synergies between the peer helper component and other components of the campaign and present recommendations and questions related to best practices for peer helper interventions at worksites. Translation to Health Education Practice Training on the use of peer helpers and the incorporation of peer helper components into interventions is needed.

Examination of the influence of social capital on depression in fragile families

Background While it appears that social capital has a positive effect on mental health, most studies have been cross-sectional in nature and/or employ weak measures of social capital or mental health. Even less attention has been paid to vulnerable populations, such as low-income women with children. Thus, our objective was to explore how different dimensions of social capital impact depression in this population. Methods We used data from the Fragile Families and Child Wellbeing Study, which has followed a cohort of children born in large US cities to mostly minority, unmarried parents for over 9 years. These families tend to be at greater risk for falling into poverty. Four separate measures of social capital were constructed, using measures that are reliable and that offer evidence of validity including social support and trust, social participation, perceptions of neighbourhood social cohesion and perceptions of neighbourhood social control. The temporal effect of social capital on mental health, as measured by a standardised screening for depression was investigated using logistic regression. Results After controlling for relevant socioeconomic and demographic factors, prior depression, and prior self-rated health, the social capital dimensions of social support and trust and perceived neighbourhood social cohesion are significant predictors of depression. Conclusions These results suggest that social and neighbourhood environments play an important role in mental health status. Intervention and policy initiatives that increase social capital may be viable for improving mental health among low-income urban, minority women.

Implementing Healthy and Sustainable Food Practices in a Hospital Cafeteria: A Qualitative Look at Processes, Barriers, and Facilitators of Implementation

The health care industry is in the unique position to model healthfulness in food systems. However, there is little available information on the processes that hospitals have used to change food environments. To assess such processes, interviews were conducted with hospital and community members involved in food management and service at a mid-sized Midwestern hospital. Results indicate that incorporating more nutritious and sustainable foods in a hospital is a dynamic process that must capitalize on institutional strengths and minimize barriers. Disseminating information to the community and gaining resources from top-level administrators are challenges that point to future directions for research and practice.

A longitudinal examination of social capital as a predictor of depression

ABSTRACT Depression is the world’s most common mental health disorder and its prevalence is higher among women and the poor. This article seeks to examine the effect that social capital has on mental health, in a longitudinal study. We used data from the Fragile Families and Child Wellbeing Study, which has followed a cohort of families born in large US cities to mostly minority, unmarried parents for over 15 years. Two measures of social capital are constructed, an index of social support and trust, and a measure of social participation. Data from four waves (totalling 8 years) of the study are analyzed in a panel logit model. After controlling for socioeconomic and demographic factors, the measure of social support and trust is found to be a significant predictor of depression, and remains so even after controlling for the effect of social participation. Our measure of social participation, based on attendance at religious services, does not appear to be a significant predictor of depression. Intervention and policy initiatives that increase social capital, particularly social support and trust, may be viable for improving depression among low-income urban, minority women.

0421 Injury severity, return to work, and outcomes in collectively-bargained alternative workers’ compensation arrangements

Introduction The construction industry experiences severe injuries. When an employee is injured, the goal is to minimise long-term disability and efficiently return the employee to work. The Union Construction Workers Compensation Program (UCWCP) of Minnesota provides an alternative, collectively-bargained system administered by workers’ compensation insurance providers. The program includes exclusive provider network for medical care and access to alternative dispute resolution process. The goal of this study is to determine injury outcome differences for UCWCP members. Methods Workers’ compensation claims were examined over a ten year period. UCWCP membership and date of enrollment were determined. Claims were stratified by medical or lost-time status. Multiple measures of severity and outcome were examined, including claim rate and duration, time to return-to-work, and permanent partial disability status. We calculated rates and comparative risk based on UCWCP. A logistic model will estimate rate ratios (RR) and 95% confidence intervals (CI) as a function of claim rate. Time-to-event models will assess differences in duration of disability based on UCWCP. Proportional hazards regression estimated hazard ratios (HR) and 95% CI. Results UCWCP employers had a lower rate of lost-time claims. Compared to non-UCWCP employers, UCWCP-membership was associated with a 9% increased likelihood of claim closure for both medical and lost-time claims (HR=1.09, CI=1.05–1.13; HR=1.09, CI=1.02–1.17). Most differences occurred in the first 90 days. Return-to-work likelihood and reduced permanent disability appeared to be related to UCWCP. Conclusions Alternative workers’ compensation arrangements may include elements that collectively protect workers’ interests, reduce injury severity, and are cost-effective for insurers.