scholarly journals Delivering the Same Intervention to Hispanic/Latinos With Pre-diabetes and Diabetes. Early Evidence of Success in a Longitudinal Mixed Method Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110555
Author(s):  
Maud Joachim-Célestin ◽  
Thelma Gamboa-Maldonado ◽  
Hildemar Dos Santos ◽  
Susanne B Montgomery
Keyword(s):  
Low Income ◽  
Mixed Method ◽  
Health Workers ◽  
Glycosylated Hemoglobin ◽  
Diabetes Prevention Program ◽  
Cost Effective ◽  
Post Intervention ◽  
Management Intervention ◽  
Quasi Experimental ◽  
Hispanic Latinos

Background Despite nationwide efforts to address the diabetes epidemic and reduce prevalence disparities, higher rates persist among the poor, especially those with limited literacy. Currently, individuals with abnormal glycemia who have pre-diabetes and diabetes qualify for different programs. However, evidence suggests that, for low-income Hispanic/Latinos, offering a single intervention to all those with abnormal glycemia may provide a more culturally acceptable and effective approach. Our objective was to explore the feasibility of such an intervention led by community health workers (CHWs) among low-income Hispanic/Latinos with diabetes and at risk for diabetes. Methods Using a quasi-experimental mixed method design, we assessed weight, glycosylated hemoglobin, diabetes knowledge, and behavior changes of Hispanic/Latinos participants with pre-diabetes and diabetes living in Southern California. Biometric measurements, blood tests, and surveys were collected at baseline and 3 months post-intervention. Interviews and focus group discussions provided qualitative data. Results Although the program was less costly, results exceeded those reported for low-income H/L attending the National Diabetes Prevention Program and did not differ between pre-diabetes and diabetes groups. Instead, including individuals at different stages of the dysglycemic spectrum seemed to have enhanced the intervention. Physician referral and attendance of family/friends were associated with better outcomes. Conclusion Our findings indicate that a joint prevention/self-management intervention led by CHWs for low-income Hispanic/Latinos with diabetes and with pre-diabetes is feasible and cost-effective, providing results that could help reduce the success gap. Incorporating suggestions and replicating this study on a larger scale could help determine whether or not results are reproducible.

scholarly journals Perceptions of caregivers on immunization in Ntungamo district, Uganda

2021 ◽  
Vol 8 (12) ◽  
pp. 5729
Author(s):  
Byamukama Topher ◽  
Keraka M. Margaret ◽  
Gitonga Eliphas
Keyword(s):  
Risk Factor ◽  
Intervention Group ◽  
Cost Effective ◽  
Systematic Sampling ◽  
Control Group ◽  
Post Intervention ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Quasi Experimental ◽  
And Control

Background: Immunization is one of the most cost-effective public health interventions to reduce child mortality and morbidity associated with infectious diseases. The objective of this study was to determine the perceptions of caregivers on immunization in Ntungamo district.Methods: Quasi-experimental study was used with health centres assigned to intervention and control groups. Purposive sampling was used to select the two counties where the study was done. Proportional sampling was done to get study samples from each health facility, while systematic sampling was done to get study participants. A total of 787 children from twelve health facilities provided the study sample. A post intervention evaluation was conducted to determine the effect of these interventions. Association of variables was tested using Mann Whitney U-test and Chi-square.Results: On benefits, most caregivers in the intervention group (85.3%) and in the control group (54.3%) regarded immunization as very highly and moderately beneficial to their children respectively. On risks, most caregivers in the intervention group (85.5%) and control group (43.1%) regarded the risk factor associated with immunization as very low and moderate respectively. From hypothesis testing, there was a significant difference on the perceived benefits and risks of immunization between the intervention and control group.Conclusions: Most caregivers in the intervention and control group regarded immunization as very highly beneficial and moderately to their children respectively. Most of the caregivers in the intervention and control group regarded the risk factor associated with immunization as very low and moderate respectively. 

scholarly journals Task Sharing in Hearing Care: Putting Principles Into Practice to Advance Access to Hearing Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 807-807
Author(s):  
Nicole Marrone ◽  
Aileen Wong ◽  
Maia Ingram ◽  
Rosie Piper ◽  
Scott Carvajal ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Health Workers ◽  
Cost Effective ◽  
Rehabilitation Program ◽  
Lessons Learned ◽  
Task Sharing ◽  
Post Intervention ◽  
Aural Rehabilitation ◽  
Age Related ◽  
Mexico Border

Abstract Task sharing, through models such as community health workers (CHWs), is considered an efficacious and cost-effective approach to extending access, addressing disparities, and building capacity. Increasingly, task sharing is recognized as a promising approach within sensory health. This session will share results from an NIH-funded trial of a first-in-kind CHW-delivered intervention along the U.S.-Mexico border. Trained CHWs provided a 5-week group aural rehabilitation program that included education and counseling on age-related hearing loss. A total of 136 Spanish-speaking older adults with hearing loss were randomized. Those in the immediate treatment group reported significantly greater use of communication strategies post-intervention, which was maintained over 1 year. Participants were more likely to report taking action on their hearing at 6 months (OR:1.56, p=0.001) and 1 year (OR:1.82, p=0.001). Building upon lessons learned, including post-intervention focus groups, the presentation will share guiding principles on the application of task sharing to support sensory health.

Education and Support: Tilting the Scale Toward Exclusive Breastfeeding

2021 ◽  
Vol 12 (2) ◽  
pp. 83-90
Author(s):  
Naomi Pitcock ◽  
Kimberly Pineda ◽  
Natasha Ossinova ◽  
Laura Yoder
Keyword(s):  
Peer Support ◽  
Low Income ◽  
Exclusive Breastfeeding ◽  
Healthcare Providers ◽  
Cost Effective ◽  
The United States ◽  
Peer Counseling ◽  
Culturally Competent ◽  
Breastfeeding Intention ◽  
Quasi Experimental

The Hispanic population in the United States is growing, and healthcare providers are challenged to design targeted, culturally appropriate programs to improve health outcomes related to breastfeeding.ObjectivesThis study was designed to detect the exclusive breastfeeding (EBF) rate among Hispanic women who chose education plus peer support versus peer support only. In addition, this study further evaluates ¡Tengo Leche!, an educational program previously evaluated in the literature.MethodsThe sample (n = 103) consisted of Hispanic pregnant, low-income, and uninsured women. A two-group quasi-experimental design was used to test the educational intervention combined with peer support (n = 35) versus stand-alone peer support (n = 68). The education-plus group (n = 35) voluntarily participated in the education portion. All participants received the inpatient peer counseling. The participants' breastfeeding intention was gathered through chart review.ResultsEBF at discharge was significantly higher (c2 = 4.51, p = .02) among mothers in the education plus peer support group, who were more likely to be exclusively breastfeeding at discharge (46.7%) versus the peer-support-only group (24.6%).ConclusionsThe outcomes of this study may provide guidance for designing culturally competent interventions with a focus on cost-effective and outcome-driven interventions to increase EBF.

scholarly journals Effectiveness of a health education intervention on the use of long-lasting insecticidal nets for the prevention of malaria in pregnant women of Pakistan: a quasi-experimental study

2020 ◽  
Author(s):  
Ramesh Kumar ◽  
Midhat Farzeen ◽  
Assad Hafeez ◽  
Baseer Khan Achakzai ◽  
Muskan Vankwani ◽  
...  
Keyword(s):  
Experimental Study ◽  
Health Education ◽  
Pregnant Women ◽  
Health Workers ◽  
Intervention Group ◽  
Educational Interventions ◽  
Bed Nets ◽  
Control Group ◽  
Post Intervention ◽  
Quasi Experimental

Abstract Background About one quarter of pregnant women in the population of Pakistan are using long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria. Past research reported that adequate information and education would act as mediator to change behaviour among patients for prevention of malaria infection. The effective use of LLINs would contribute to reduction of disease burden caused by malaria. The aim of this study was to determine the effectiveness of health education on the adoption of LLINs among pregnant women living in Tharparkar, a remote district in Sindh Province, Pakistan.Methods A quasi-experimental study design with control and intervention groups was conducted with 200 pregnant women (100 in each group). Women in the intervention group were provided with health education sessions on malaria for 12 weeks, while those in the control group obtained routine information from lady health workers (LHWs). Pre- and post-intervention assessment was done of knowledge about malaria and use of LLIN, which was statistically analysed using descriptive statistics and difference in difference (DID) multivariable regression analysis to test effectiveness of the intervention.Results Baseline was conducted with 200 pregnant women. Demographic characteristics were similar in both groups with slight differences in age, education, income, type of latrine, and source of drinking water. There were no significant differences between mean knowledge and use of LLINs scores between groups at baseline. However, the estimated DID value after the intervention was 4.170 (p <0.01) and represents an increase in scores of knowledge in the intervention group compared to control. Similarly DID value of 3.360 (p <0.05) showed an increase in use of LLINs score after the intervention which was significant, showing that the intervention had a positive effect.Conclusions Results proved that health education could be an effective intervention for improving knowledge and usage of LLINs among pregnant women for the prevention of malaria. Such educational interventions have a positive potential to be implemented at larger scale by incorporating them into routine health sessions provided by health workers.

Abstract TP190: The Effectiveness of a Person-centered Empowerment-based Self-management Intervention in Reducing Risk of Stroke Among Male Patients With Poorly Controlled Type 2 Diabetes: A Mixed-method Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Li Cheng ◽  
Janet W Sit ◽  
Sek-ying Chair
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Mixed Method ◽  
Intervention Group ◽  
Self Management ◽  
Post Intervention ◽  
Management Intervention ◽  
Male Patients ◽  
Male Subjects

Introduction: The overall incidence of stroke was higher in men than women. Type 2 diabetes is found to be a risk factor for stroke. Previous prospective studies showed each 1% increase in HbA1c would be associated with 12% increase in the risk of developing a stroke. Identifying effective strategies to optimize the glycemic control of male patients with poorly controlled type 2 diabetes would be valuable for reducing the risk of stroke. This mixed-method study aims to examine how male patients with poorly controlled type 2 diabetes responded to a person-centered empowerment-based self-management intervention. Methods: Phase I study was based on a sub-group analysis of 179 male subjects with poorly controlled type 2 diabetes [with Glycated hemoglobin (HbA1c) ≥7.5%] who received a six-week empowerment-based self-management intervention (n= 93) or attentional control (n= 86), respectively. The primary outcome was HbA1c level from baseline to three-month post-intervention. Phase II study was an in-depth individual interview with the purpose to reveal how facilitating factors or barriers become apparent in the implementation of self-management practice. Integration of quantitative and qualitative data was performed to disclose a comprehensive picture of intervention effect and mechanism. Results: The pre-post HbA1c change for male subjects in the intervention group was 1.01%, which indicated a clinical significant reduction in the risk of developing stroke. At three-month post-intervention, male participants in the intervention group showed significant improvement in glycemic control (8.99% vs. 9.68%, between-group difference: 0.69±2.64, p= 0.045). Content analysis revealed that setting personally meaningful goals, making a personalized action plan, and reflecting and solution-finding were facilitating factors perceived by male subjects with poorly controlled type 2 diabetes. Two categories for barriers to optimal glycemic control were identified, including collective culture and diabetes fatalism. Conclusions: Person-centered empowerment-based intervention could facilitate male subjects with poorly controlled type 2 diabetes to actively engage in self-management activities for stroke prevention.

Improving Hand Hygiene Practices in a Rural Hospital in Sub-Saharan Africa

2016 ◽  
Vol 37 (7) ◽  
pp. 834-839 ◽  
Author(s):  
Ian C. Holmen ◽  
Celestin Seneza ◽  
Berthine Nyiranzayisaba ◽  
Vincent Nyiringabo ◽  
Mugisha Bienfait ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Low Income ◽  
Rural Hospital ◽  
Sub Saharan Africa ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
Quasi Experimental ◽  
Sub Saharan

OBJECTIVETo improve hand hygiene (HH) compliance among physicians and nurses in a rural hospital in sub-Saharan Africa (SSA) using the World Health Organization’s (WHO’s) Guidelines on Hand Hygiene in Health Care.DESIGNThis study was a quasi-experimental design divided into 4 phases: (1) preparation of materials and acquisition of the hospital administration’s support, (2) baseline evaluation, (3) intervention, and (4) follow-up evaluation.SETTINGA 160-bed, non-referral hospital in Gitwe, RwandaPARTICIPANTSA total of 12 physicians and 54 nurses participated in this study.METHODSThe intervention consisted of introducing locally produced alcohol-based hand rub (ABHR); educating healthcare workers (HCWs) on proper HH practice; providing pocket-sized ABHR bottles for HCWs; placing HH reminders in the workplace; and surveying HCWs at surrounding health centers regarding HH compliance barriers. Hand hygiene infrastructure, compliance, and knowledge were assessed among physicians and nurses using baseline observations and a follow-up evaluation survey.RESULTSOverall, HH compliance improved from 34.1% at baseline to 68.9% post intervention (P<.001), and HH knowledge was significantly enhanced (P<.001). The 3 departments included in this study had only 1 sink for 29 patient rooms, and 100% of HH opportunities used ABHR. Hand hygiene compliance was significantly higher among physicians than nurses both before and after the intervention. All measures of HH compliance improved except for “after body fluid exposure,” which was 51.7% before intervention and 52.8% after intervention (P>.05).CONCLUSIONHand hygiene campaigns using WHO methods in SSA have been implemented exclusively in large, referral hospitals. This study shows that an HH program using the WHO tools successfully improved HH in a low-income, rural hospital in SSA.Infect Control Hosp Epidemiol2016;37:834–839

scholarly journals Incorporating an Increase in Plant-Based Food Choices into a model of Culturally Responsive Care for Obesity in Hispanic/Latino Adults and Children

2019 ◽  
Author(s):  
Pramil Singh ◽  
Jessica Steinbach ◽  
Anna Nelson ◽  
Wendy Shih ◽  
Mary D'Avila ◽  
...  
Keyword(s):  
Pediatric Obesity ◽  
Culturally Responsive ◽  
Stakeholder Analysis ◽  
Great Promise ◽  
Post Intervention ◽  
Minimal Processing ◽  
Lifestyle Program ◽  
Important Health ◽  
Quasi Experimental ◽  
Hispanic Latinos

The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparity populations. The objective of our study was to evaluate the efficacy and scalability of the Healthy Eating Lifestyle Program (HELP) &ndash; a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino pediatric obesity patients and their families. Our evaluation methods included: 1) a quasi-experimental, one group, longitudinal study to measures changes in BMI at 0, 6, and 18 weeks of follow-up, and 2) A stakeholder analysis consisting of six key informant interviews of HELP program staff. We found a significant decrease in body mass index across all adults (-0.2 kg/m2 p=0.0047), that was much stronger in men. For children ages 5-12 years, there was also a significant decrease in BMI Z score from pre- to post- intervention (p=0.04). Program strengths were the cultural tailoring of the plant-based diet choices, and allowing a tiered approached that did not require adherence to strict vegetarianism. Our pilot study findings from HELP raise the possibility that incorporating plant-based diet choices into the treatment of pediatric obesity patients and their families can be an effective addition to a culturally responsive care model.

scholarly journals Evaluating the Impact of Telehealth-Based, Diabetes Medication Training for Community Health Workers on Glycemic Control

2020 ◽  
Vol 10 (3) ◽  
pp. 121
Author(s):  
Casey N. Keegan ◽  
Craig A. Johnston ◽  
Victor J. Cardenas ◽  
Elizabeth M. Vaughan
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Community Health Workers ◽  
Patient Outcomes ◽  
Low Income ◽  
Health Workers ◽  
Cost Effective ◽  
Diabetes Medication ◽  
Personalized Care ◽  
The Impact

Background: Diabetes is a major contributor to morbidity and mortality. Community Health Workers (CHWs) have been instrumental in improving patient outcomes. However, CHW training largely focuses on general diabetes concepts rather than medications. Providing accessible, diabetes medication training for CHWs has the potential to increase patient understanding, personalized care, and adherence, thereby improving outcomes. Objective: To evaluate the impact of a telehealth-based diabetes medication training for CHWs on patient outcomes as measured by HbA1c changes. Methods: We provided a 12-month weekly, telehealth (videoconference) medication training for CHWs who led 6-month diabetes programs for low-income Latino(a)s in community clinics. We measured participant HbA1c (primary outcome), blood pressure, and body mass index (BMI) changes. We evaluated CHW knowledge via two pre/post-tests: medication adverse events/side effects (TEST-1, months 1–6) and dosing, titration, and emergencies (TEST-2, months 7–12). We assessed CHW training application by their ability to identify patient, provider, and healthcare system medication barriers. Results: Participants’ (n = 55) HbA1c improved (9.0% (75 mmol/mol) to 7.8% (62 mmol/mol) (p = 0.001)). Blood pressure and BMI changes were not significant. CHWs improved their knowledge: TEST-1: 10.5-18.2/20.0 (p = 0.002), TEST-2: 10.3–17.3/19.0 (p = 0.0019). CHWs identified 984 patients (n = 610), providers (n = 151), and healthcare systems (n = 223) medication barriers during the 12-month training. Conclusions: Providing a telehealth-based, diabetes medication training program for CHWs allowed a personalized approach to identify barriers to care at several levels, which was associated with significant participant HbA1c reductions and improved CHW knowledge. This is a promising cost-effective, culturally sensitive strategy to improve diabetes care. Larger longitudinal evaluations are needed to fully understand the impact of CHW medication training.

scholarly journals A corner store intervention in a low-income urban community is associated with increased availability and sales of some healthy foods

2009 ◽  
Vol 12 (11) ◽  
pp. 2060-2067 ◽  
Author(s):  
Hee-Jung Song ◽  
Joel Gittelsohn ◽  
Miyong Kim ◽  
Sonali Suratkar ◽  
Sangita Sharma ◽  
...  
Keyword(s):  
Low Income ◽  
Urban Community ◽  
Evaluation Studies ◽  
Healthy Foods ◽  
Post Intervention ◽  
Baltimore City ◽  
Corner Store ◽  
Corner Stores ◽  
Quasi Experimental ◽  
Potential Strategy

AbstractObjectiveWhile corner store-based nutrition interventions have emerged as a potential strategy to increase healthy food availability in low-income communities, few evaluation studies exist. We present the results of a trial in Baltimore City to increase the availability and sales of healthier food options in local stores.DesignQuasi-experimental study.SettingCorner stores owned by Korean-Americans and supermarkets located in East and West Baltimore.SubjectsSeven corner stores and two supermarkets in East Baltimore received a 10-month intervention and six corner stores and two supermarkets in West Baltimore served as comparison.ResultsDuring and post-intervention, stocking of healthy foods and weekly reported sales of some promoted foods increased significantly in intervention stores compared with comparison stores. Also, intervention storeowners showed significantly higher self-efficacy for stocking some healthy foods in comparison to West Baltimore storeowners.ConclusionsFindings of the study demonstrated that increases in the stocking and promotion of healthy foods can result in increased sales. Working in small corner stores may be a feasible means of improving the availability of healthy foods and their sales in a low-income urban community.

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