Teresa Scherzer

Women's Perceptions of Neighborhood Resources and Hazards Related to Diet, Physical Activity, and Smoking: Focus Group Results from Economically Distinct Neighborhoods in a Mid-sized U.S. City

Purpose. To investigate womens perceptions of neighborhood resources and hazards associated with poor diet, physical inactivity, and cigarette smoking. Design. After interviewing city officials and analyzing visual assessments, three economically distinct neighborhoods in a mid-sized city were selected. Setting. Salinas, California, a predominantly Latino city. Methods. Eight focus groups, conducted in Spanish or English in the three neighborhoods. Thematic coding of focus group transcripts identified key concepts. Women also mapped their perceived neighborhood boundaries. Participants. Women who had at least one child under age 18 living with them. Results. Women identified food stores, parks, recreation areas, and schools as key resources in their neighborhoods. They identified fast food restaurants, convenience stores, violent crime, gangs, and drug-associated issues as “hazards.” Distinctions between resources and hazards were not always clear cut. For example, parks were sometimes considered dangerous, and fast food restaurants were sometimes considered a convenient and inexpensive way to feed ones family. Womens perceptions of their neighborhood boundaries differed greatly by type of neighborhood—the perceived neighborhood area (in acres) drawn by women in the lower-income neighborhood was one-fourth the size of the area drawn by women in the higher-income neighborhood. Conclusion. This qualitative, exploratory study illustrates how resources and hazards in ones neighborhood cannot be viewed as having solely one dimension—each may influence health behaviors both positively and negatively.

Negotiating health care: the experiences of young lesbian and bisexual women

An emerging body of research shows that lesbians and bisexual women face multiple barriers to health care and are in a vulnerable position when accessing care and interacting with health care providers. Young womens experiences have been only marginally researched, however. This article describes findings from a qualitative study that explored the health-related experiences of eight young lesbian and bisexual women ages 18-21 in San Francisco, California, USA, and focuses on how participants negotiated the health care interaction. The negotiations highlight (1) the agency exercised by these young women; (2) the impact of health care providers on young lesbian and bisexual womens access to and utilization of medical care; and (3) the ways the health care interaction reflects larger power dynamics in society.

Associations between psychological demands, decision latitude, and job strain with smoking in female hotel room cleaners in Las Vegas

Background: Little is known of the impact of the work environment on smoking among women holding low-paid jobs in the service sector. Purpose: To study the associations between the components of the demand-control model with smoking in hotel room cleaners. Methods: We conducted a survey on work and health among 776 female hotel room cleaners in Las Vegas. Associations between psychosocial work characteristics and smoking were analyzed with multivariate regression analyses. Results: Psychosocial work characteristics were associated with smoking after adjustment for covariates. Effect estimates were substantially reduced by additional adjustment for ethnicity, but remained significant for high psychological demands and smoking prevalence (OR = 1.97, p = 0.02), high job strain and smoking prevalence (OR = 1.87 ,p = 0.04), and high job strain and smoking intensity (coefficient = 3.52, p = 0.03). When analyses were restricted to Hispanic workers and further adjusted for place of birth, low decision latitude (coefficient = 3.94, p = 0.04) and high job strain (coefficient = 4.57, p = 003) were associated with smoking intensity but not with smoking status. Conclusion: Workplace smoking cessation programs may benefit from a primary prevention component reducing job strain among service workers. More research is needed on perceived and objective differences in psychosocial work characteristics across ethnic, immigrant, and other social groups within the same occupation.

Meeting the Nursing Faculty Shortage Challenge: An Accelerated Doctoral Program in Nursing

In 2003, the Gordon and Betty Moore Foundation partnered with a major west coast school of nursing to create an accelerated doctoral program in nursing. The programs chief aim was to address the nursing shortage by increasing the number of nurse faculty by funding 42 doctoral students in five cohorts. Students accepted into the accelerated program receive a generous stipend and commit to earn their doctorate in 3 years and teach for 3 years after graduation at 1 of 17 area nursing programs. Two cohorts have graduated from the accelerated program and are currently in faculty positions. This article describes the accelerated doctoral program and the academic progression and postgraduation employment of the first two cohorts.

Financial management services in consumer-directed programs.

ABSTRACT Shifting from an agency-based model of personal assistance services to consumer direction has important consequences for both recipients and workers. In consumer direction, recipients assume the responsibilities of employing their attendants–for both self-directing their supportive services and being responsible for numerous fiscal responsibilities. Many states have eased these fiscal responsibilities among recipients in publicly financed personal care programs by using Financial Management Services (also known as fiscal intermediaries). This article introduces the major types of Financial Management Services organizations used by Medicaid consumer-directed personal care programs, and examines the extent to which the varied approaches can and do serve the needs of both recipients and workers. Despite the expansion of consumer-directed programs and the accompanying emergence of Financial Management Services, these organizations have not been extensively studied or evaluated. The paper concludes with a discussion of the challenges, opportunities, and policy implications of the current practice; and suggests directions for future research.

Older adults' perspectives on key domains of childhood social and economic experiences and opportunities: a first step to creating a multidimensional measure

Objectives Although research has found that childhood socioeconomic status (SES) is associated with physical and mental health in mid- and later life, most of these studies used conventional, single dimension SES measures for the childhood period such as household income or educational attainment of parents. Life course and health disparities research would benefit from identification and measurement of a variety of childhood social and economic experiences and opportunities that might affect health in later life. Design This study utilized qualitative research methods to identify key dimensions of childhood experiences related to SES. We conducted in-depth interviews with 25 adults age 55 to 80 years from diverse economic and ethnic backgrounds. Topics included home, neighborhood, school, and work experiences during early childhood and adolescence. Interviews were audio-taped and transcripts were coded to identify thematic domains. Results We identified eight thematic domains, many of which had clear subdomains: home and family circumstances, neighborhood, work and money, potential for advancement through schooling, school quality and content, discrimination, influence and support of adults, and leisure activities. These domains highlight individual characteristics and experiences and also economic and educational opportunities. Conclusion These domains of childhood social and economic circumstances add breadth and depth to conventional conceptualization of childhood SES. When the domains are translated into a measurement tool, it will allow for the possibility of classifying people along multiple dimensions, such as from a low economic circumstance with high levels of adult support.