scholarly journals The impact of a preventive intervention on persistent, cross-situational early onset externalizing problems

2019 ◽  
Author(s):  
Michael F Lorber ◽  
David Olds ◽  
Nancy Donelan-McCall
Keyword(s):  
Low Income ◽  
Externalizing Behavior ◽  
Early Onset ◽  
Externalizing Problems ◽  
Home Visiting ◽  
Preventive Intervention ◽  
Parent Report ◽  
Control Group ◽  
Developmental Problems ◽  
The Impact

The Nurse-Family Partnership (NFP) home visiting intervention for low income first time mothers was evaluated for its preventive impact on persistent, cross-situational early onset externalizing problems (EXT). Seven hundred and thirty-five women in the Denver, Colorado area were randomly assigned into one of two active conditions (nurse or paraprofessional home visiting from pregnancy through child age 2) or a control group in which children were screened and referred for behavioral and developmental problems. Externalizing behavior was assessed by parent report when the children were 2, 4, 6, and 9 years old; teachers provided reports at ages 6 and 9. Latent profile analyses suggested the presence of persistent, cross-situational early onset EXT in approximately 6% to 7% of girls and boys. The intervention deflected girls away from these EXT and toward a pattern marked by a persistent moderate elevation of externalizing behavior that was evident at home and not at school. This finding should be interpreted cautiously given the small number of girls with the elevated EXT. Surprisingly, the intervention also moved girls away from stable low level externalizing behavior toward the moderately elevated pattern. Both of the significant effects on girls’ externalizing behavior were modest. No statistically significant effects were found for boys’ externalizing behaviors, which exhibited a somewhat different patterning across time and reporter. Effect sizes were generally similar for the nurse and paraprofessional-visited groups. The results are discussed in the context of prior efforts to prevent early EXT and emerging evidence on the normative development of externalizing behavior.

scholarly journals The Impact of a Preventive Intervention on Persistent, Cross-Situational Early Onset Externalizing Problems

2019 ◽  
Vol 20 (5) ◽  
pp. 684-694
Author(s):  
Michael F. Lorber ◽  
David L. Olds ◽  
Nancy Donelan-McCall
Keyword(s):  
Early Onset ◽  
Externalizing Problems ◽  
Preventive Intervention ◽  
The Impact

Impact of Medicaid expansion on pancreatic cancer care: A difference-in-difference analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18567-e18567
Author(s):  
Ahmad Hamad ◽  
Mariam Eskander ◽  
Yaming Li ◽  
Oindrila Bhattacharyya ◽  
James L Fisher ◽  
...  
Keyword(s):  
Low Income ◽  
Early Stage ◽  
Ductal Adenocarcinoma ◽  
Control Group ◽  
Medicaid Expansion ◽  
Difference In Difference ◽  
Post Surgery ◽  
Number Of Patients ◽  
The Impact ◽  
Expansion Period

e18567 Background: The Affordable Care Act (ACA) increased insurance coverage for low-income individuals, which should potentially lead to better access to care and improved oncological outcomes. This study seeks to evaluate the impact of Medicaid expansion (ME) on care for pancreatic ductal adenocarcinoma (PDAC). Methods: Patients who were uninsured or on Medicaid and diagnosed with PDAC between 2004 and 2017 were queried from the National Cancer Database (NCDB). Two different expansion cohorts were included: early expansion states and 2014 expansion states. For early expansion states, the time period of pre-expansion was 2004-2009 and post-expansion was 2010-2017. As for the 2014 expansion states, the pre-expansion period was from 2004-2013 and post-expansion period was from 2014-2017. Patients in non-expansion states formed the control group. A difference-in-difference (DID) analysis was used to assess the association of ME with stage of diagnosis, treatment and survival for each expansion cohort. Results: In both early and January 2014 expansion states, there was an increase in overall Medicaid coverage (Early: DID = 0.29, 2014: DID = 0.37; P < 0.001), in particular for non-Hispanic Black and Hispanic Black patients (Non-Hispanic Black: Early: DID = 0.11, 2014: DID = 0.11; P < 0.001, Hispanic-Black: 2014: DID = 0.20; P = 0.003). There were no differences in early stage diagnosis (Early: DID = 0.02, 2014: DID = -0.02; P > 0.05). There was an increase in the number of patients receiving surgery (Early: DID = 0.05; P = 0.001, 2014: DID = 0.03; P = 0.029) but no difference in time to surgery among patients receiving surgery upfront (Early: DID = 1.75, 2014: DID = 0.38; P > 0.05). There was no difference in 30-day readmission post-surgery (Early: DID = 0.003; 2014: DID = -0.00007; P > 0.05) or 90-day mortality (Early: DID = -0.007, 2014: DID = -0.035; P > 0.05). Moreover, there was no difference in receipt of chemotherapy (Early: DID = 0.01, 2014: DID = 0.005; P > 0.05) or time to chemotherapy for patients receiving neoadjuvant chemotherapy (Early: Early: DID = 9.62, 2014: DID = 0.01; P > 0.05). Finally, there was no difference in receipt of palliative care among stage IV patients in both cohorts (Early: DID = -0.004, 2014: DID = 0.004; P > 0.05). Conclusions: This study suggests that after ME, PDAC patients were more likely to be insured and had increased access to surgical care. Future, studies should evaluate the implications of improved surgical access on clinical outcomes such as mortality.

scholarly journals Health Outcomes of an Integrated Behaviour-Centred Water, Sanitation, Hygiene and Food Safety Intervention–A Randomised before and after Trial

2020 ◽  
Vol 17 (8) ◽  
pp. 2648 ◽  
Author(s):  
Tracy Morse ◽  
Elizabeth Tilley ◽  
Kondwani Chidziwisano ◽  
Rossanie Malolo ◽  
Janelisa Musaya
Keyword(s):  
Low Income ◽  
Diarrhoeal Disease ◽  
Control Group ◽  
Food Hygiene ◽  
Children Under Five ◽  
Under Five ◽  
Cluster Group ◽  
Point Reduction ◽  
Before And After ◽  
The Impact

Diarrhoeal disease in children under five in low income settings has been associated with multiple environmental exposure pathways, including complementary foods. Conducted from February to December 2018 in rural Malawi, this before and after trial with a control used diarrhoeal disease as a primary outcome, to measure the impact of a food hygiene intervention (food hygiene + handwashing) relative to a food hygiene and water, sanitation and hygiene (WASH) intervention (food hygiene + handwashing + faeces management + water management). The 31-week intervention was delivered by community-based coordinators through community events (n = 2), cluster group meetings (n = 17) and household visits (n = 14). Diarrhoeal disease was self-reported and measured through an end line survey, and daily diaries completed by caregivers. Difference-in-differences results show a 13-percentage point reduction in self-reported diarrhoea compared to the control group. There were also significant increases in the presence of proxy measures in each of the treatment groups (e.g., the presence of soap). We conclude that food hygiene interventions (including hand washing with soap) can significantly reduce diarrhoeal disease prevalence in children under five years in a low-income setting. Therefore, the promotion of food hygiene practices using a behaviour-centred approach should be embedded in nutrition and WASH policies and programming.

scholarly journals The Impact of the Revised WIC Food Package on Maternal Nutrition During Pregnancy and Postpartum

2019 ◽  
Vol 188 (8) ◽  
pp. 1493-1502 ◽  
Author(s):  
Rita Hamad ◽  
Akansha Batra ◽  
Deborah Karasek ◽  
Kaja Z LeWinn ◽  
Nicole R Bush ◽  
...  
Keyword(s):  
Low Income ◽  
Maternal Nutrition ◽  
Temporal Trends ◽  
Dietary Quality ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Food Package ◽  
Pregnancy And Postpartum ◽  
Before And After ◽  
The Impact

Abstract The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritional support for pregnant and postpartum women and young children. The typical food package provided to recipient families was revised in October 2009 to include more whole grains, fruits, vegetables, and low-fat milk. Little is known about whether these revisions improved nutrition among women during this critical period of the life course. We conducted a quasiexperimental difference-in-differences analysis, comparing WIC recipients (“treatment” group) before and after the WIC policy change, while accounting for temporal trends among nonrecipients (“control” group). We examined nutritional outcomes among a cohort of 1,454 women recruited during pregnancy in 2006–2011 in Memphis and surrounding Shelby County, Tennessee. We found improvements in several measures of dietary quality and nutrient intake during pregnancy, although these did not persist into the postpartum period. Results were robust to numerous sensitivity analyses. At a time when federal WIC funding is threatened, this study provides some of the first evidence of the benefits of recent WIC revisions among low-income women.

Home Visiting Effects on Breastfeeding and Bedsharing in a Low-Income Sample

2020 ◽  
pp. 109019812096419
Author(s):  
Joshua P. Mersky ◽  
Colleen E. Janczewski ◽  
ChienTi Plummer Lee ◽  
Ross M. Gilbert ◽  
Cali McAtee ◽  
...  
Keyword(s):  
Low Income ◽  
Home Visiting ◽  
Health Department ◽  
The United States ◽  
Breastfeeding Duration ◽  
Breastfeeding Initiation ◽  
Public Health Department ◽  
Safe Sleep ◽  
Quasi Experimental ◽  
The Impact

Background Research suggests that home visiting interventions can promote breastfeeding initiation, though their effects on breastfeeding continuation are unclear. No known studies have assessed the impact of home visiting on bedsharing. Aims To test the effects of home visiting on breastfeeding and bedsharing in a low-income, urban sample in the United States. Methods During a field trial conducted in Milwaukee, Wisconsin, from April 2014 to March 2017, referrals to a public health department were randomized to a Healthy Families America (HFA) program or a prenatal care and coordination (PNCC) program. Of the 204 women who accepted services, 139 consented to the study and were allocated to the two treatment groups, which were compared with each other and a third quasi-experimental group of 100 women who did not accept services. Data were collected at four time points up to 12 months postpartum. Results Breastfeeding initiation was higher among 72 HFA participants (88.4%; odds ratio [OR] = 2.7) and 67 PNCC participants (88.5%; OR = 2.2) than 100 comparison participants (76.5%). Similar results emerged for breastfeeding duration, though group differences were not statistically significant. Unexpectedly, bedsharing prevalence was higher among HFA participants (56.5%) than PNCC participants (31.1%; OR = 2.9) and comparison group participants (38.8%; OR = 2.0). Discussion Home visiting was linked to increased breastfeeding, while effects on bedsharing varied by program. Progress toward precision home visiting will be advanced by identifying program components that promote breastfeeding and safe sleep. Conclusion Further research is needed to examine whether home visiting reduces disparities in breastfeeding and safe sleep practices.

Evaluating the Impact of Teacher-designed, Wellbeing and Sustainability Play-based Learning Experiences on Young Children's Knowledge Connections: A Randomised Trial

2018 ◽  
Vol 43 (4) ◽  
pp. 33-42
Author(s):  
Heather Morris ◽  
Susan Edwards ◽  
Amy Cutter-Mackenzie ◽  
Leonie Rutherford ◽  
Janet Williams-Smith ◽  
...  
Keyword(s):  
Digital Media ◽  
Randomised Trial ◽  
Learning Experiences ◽  
Intervention Group ◽  
Parent Report ◽  
Control Group ◽  
Post Intervention ◽  
Waitlist Control Group ◽  
Children's Interests ◽  
The Impact

THIS PAPER REPORTS FINDINGS from a randomised investigation into the effect of teacher-designed, play-based learning experiences on preschool-aged children's knowledge connections between healthy eating and active play as wellbeing concepts, and sustainability. The investigation used a ‘ funds of knowledge’ theoretical framework to situate young children's interests in digital media and popular culture, as a site for learning these knowledge connections. The findings suggest that the intervention group children created more wellbeing and sustainability knowledge connections than the waitlist control group children. Additionally, the intervention group children demonstrated an increase in vegetable serves and a decrease in unhealthy food servings post intervention (measured by parent report). The paper suggests that more attention should be paid to early childhood teachers’ capacity for actively building children's knowledge about wellbeing and sustainability concepts through play-based learning, as opposed to top-down approaches towards obesity education and prevention alone.

scholarly journals The Impact of Group Drumming on Social-Emotional Behavior in Low-Income Children

2011 ◽  
Vol 2011 ◽  
pp. 1-14 ◽  
Author(s):  
Ping Ho ◽  
Jennie C. I. Tsao ◽  
Lian Bloch ◽  
Lonnie K. Zeltzer
Keyword(s):  
Youth Development ◽  
Low Income ◽  
School Counselor ◽  
Broad Band ◽  
Attention Problems ◽  
Emotional Behavior ◽  
Control Group ◽  
Social Emotional ◽  
Oppositional Defiant ◽  
The Impact

Low-income youth experience social-emotional problems linked to chronic stress that are exacerbated by lack of access to care. Drumming is a non-verbal, universal activity that builds upon a collectivistic aspect of diverse cultures and does not bear the stigma of therapy. A pretest-post-test non-equivalent control group design was used to assess the effects of 12 weeks of school counselor-led drumming on social-emotional behavior in two fifth-grade intervention classrooms versus two standard education control classrooms. The weekly intervention integrated rhythmic and group counseling activities to build skills, such as emotion management, focus and listening. The Teacher’s Report Form was used to assess each of 101 participants (n= 54 experimental,n= 47 control, 90% Latino, 53.5% female, mean age 10.5 years, range 10–12 years). There was 100% retention. ANOVA testing showed that intervention classrooms improved significantly compared to the control group in broad-band scales (total problems (P< .01), internalizing problems (P< .02)), narrow-band syndrome scales (withdrawn/depression (P< .02), attention problems (P< .01), inattention subscale (P< .001)), Diagnostic and Statistical Manual of Mental Disorders-oriented scales (anxiety problems (P< .01), attention deficit/hyperactivity problems (P< .01), inattention subscale (P< .001), oppositional defiant problems (P< .03)), and other scales (post-traumatic stress problems (P< .01), sluggish cognitive tempo (P< .001)). Participation in group drumming led to significant improvements in multiple domains of social-emotional behavior. This sustainable intervention can foster positive youth development and increase student-counselor interaction. These findings underscore the potential value of the arts as a therapeutic tool.

Obesity Prevention Program in Childcare Centers: Two-Year Follow-Up

2016 ◽  
Vol 31 (6) ◽  
pp. 502-510 ◽  
Author(s):  
Ruby A. Natale ◽  
Sarah E. Messiah ◽  
Lila S. Asfour ◽  
Susan B. Uhlhorn ◽  
Nicole E. Englebert ◽  
...  
Keyword(s):  
Obesity Prevention ◽  
Low Income ◽  
Negative Slope ◽  
Control Group ◽  
Healthy Children ◽  
Unhealthy Food ◽  
Healthy Weight ◽  
Obese Children ◽  
Childcare Centers ◽  
The Impact

Purpose: To assess the impact of an early childhood obesity prevention intervention “Healthy Caregivers–Healthy Children” (HC2) on dietary patterns and body mass index percentile (PBMI) over 2 school years. Design: Randomized controlled trial. Setting: Childcare centers. Participants: Low-income families. Intervention: Intervention centers (N = 12) received HC2 which consisted of (1) menu modifications, (2) a healthy eating and physical activity curriculum for children, and (3) a parent curriculum for healthy meal preparation, reinforced through a role-modeling curriculum. Control centers (N = 16) received an injury prevention/safety intervention. Measures: Child PBMI and parent report of child’s consumption of fruits/vegetables and unhealthy food. Analysis: Confirmatory factor analysis verified the psychometric properties of factor scores for children’s consumption of fruits/vegetables and unhealthy food. Growth curve analysis assessed the impact of HC2 on change in consumption of fruits/vegetables and unhealthy food and PBMI over 2 school years. Results: Children in the intervention group (n = 754) had a negative slope (β = −1.95, standard error [SE] = 0.97, P = .04), indicating less increase in PBMI versus control children (n = 457). Stratified analyses showed that obese children in the intervention arm had a significantly higher increase in fruit/vegetable consumption versus control group obese children (β = 0.24, SE = 0.08, P = .003). Conclusion: The HC2 intervention resulted in the maintenance of healthy PBMI over 2 preschool years among low-income multiethnic children. These findings support efforts to implement healthy weight programs in the childcare setting.

scholarly journals Gestational Weight Gain: Results from the Delta Healthy Sprouts Comparative Impact Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Jessica L. Thomson ◽  
Lisa M. Tussing-Humphreys ◽  
Melissa H. Goodman ◽  
Sarah E. Olender
Keyword(s):  
African American ◽  
Weight Gain ◽  
African American Women ◽  
Gestational Weight Gain ◽  
Low Income ◽  
Home Visiting ◽  
High Risk Population ◽  
American Women ◽  
Gestational Weight ◽  
The Impact

Introduction. Delta Healthy Sprouts trial was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of Southern African American women and their infants. Results pertaining to the primary outcome, gestational weight gain, are reported.Methods. Participants (n=82), enrolled early in their second trimester of pregnancy, were randomly assigned to one of two treatment arms. Gestational weight gain, measured at six monthly home visits, was calculated by subtracting measured weight at each visit from self-reported prepregnancy weight. Weight gain was classified as under, within, or exceeding the Institute of Medicine recommendations based on prepregnancy body mass index. Chi-square tests and generalized linear mixed models were used to test for significant differences in percentages of participants within recommended weight gain ranges.Results. Differences in percentages of participants within the gestational weight gain guidelines were not significant between treatment arms across all visits.Conclusions. Enhancing the gestational nutrition and physical activity components of an existing home visiting program is feasible in a high risk population of primarily low income African American women. The impact of these enhancements on appropriate gestational weight gain is questionable given the more basic living needs of such women. This trial is registered with ClinicalTrials.govNCT01746394, registered 4 December 2012.

scholarly journals Maternal Feeding Styles and Food Parenting Practices as Predictors of Longitudinal Changes in Weight Status in Hispanic Preschoolers from Low-Income Families

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Sheryl O. Hughes ◽  
Thomas G. Power ◽  
Teresia M. O’Connor ◽  
Jennifer Orlet Fisher ◽  
Tzu-An Chen
Keyword(s):  
Low Income ◽  
Parenting Practices ◽  
Weight Status ◽  
Parent Report ◽  
Feeding Styles ◽  
Child Weight ◽  
Low Income Families ◽  
Child Bmi ◽  
The Impact ◽  
Over Time

Objective. The aim was to investigate the influence of feeding styles and food parenting practices on low-income children’s weight status over time.Method. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) and again eighteen months later. At each time point, parents completed questionnaires and height and weight measures were taken on the child.Results. The indulgent feeding style (parent-report at baseline) was associated with increased child BMIz-score eighteen months later compared to other feeding styles. Authoritative, authoritarian, and uninvolved feeding styles were not significantly associated with increased child BMIz-score. Child BMIz-score at Time 1 (strongest) and maternal acculturation were positive predictors of child BMIz-score at Time 2. Maternal use of restriction positively predicted and maternal monitoring negatively predicted Time 2 BMIz-score, but only when accounting for feeding styles.Conclusion. This is the first study to investigate the impact of feeding styles on child weight status over time. Results suggest that indulgent feeding predicts later increases in children’s weight status. The interplay between feeding styles and food parenting practices in influencing child weight status needs to be further explored.

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