scholarly journals Reducing Socioeconomic Disparities in Comprehensive Smoke-Free Rules among Households with Children: A Pilot Intervention Implemented through a National Cancer Program

2020 ◽  
Vol 17 (18) ◽  
pp. 6787
Author(s):  
Michael J. Parks ◽  
Michelle C. Kegler ◽  
John H. Kingsbury ◽  
Iris W. Borowsky
Keyword(s):  
Low Income ◽  
Response Rate ◽  
Retention Rate ◽  
Socioeconomically Disadvantaged ◽  
Percentage Points ◽  
Cancer Program ◽  
National Breast ◽  
Shs Exposure ◽  
Households With Children ◽  
National Cancer Program

Most households with a smoker do not implement comprehensive smoke-free rules (smoke-free homes and cars), and secondhand smoke (SHS) exposure remains prevalent among children and low-socioeconomic status (SES) populations. This pilot project aimed to assess implementation feasibility and impact of an intervention designed to increase smoke-free rules among socioeconomically disadvantaged households with children. The pilot was implemented through Minnesota’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP). NBCCEDPs provide cancer prevention services to low-income individuals experiencing health disparities. We successfully utilized and adapted the Smoke-Free Homes Program (SFHP) to address comprehensive smoke-free rules among households with children. We used two recruitment methods: (a) direct mail (DM) and (b) opportunistic referral (OR) by patient navigators in the NBCCEDP call center. We used descriptive statistics to assess implementation outcomes and hierarchical logistic regression models (HLM) to assess change in smoke-free rules and SHS exposure over the study period. There was no comparison group, and HLM was used to examine within-person change. A total of 64 participants were recruited. Results showed 83% of participants were recruited through DM. OR had a high recruitment rate, and DM recruited more participants with a low response rate but higher retention rate. Among recruited participants with data (n = 47), smoke-free home rules increased by 50.4 percentage points during the study period (p < 0.001). Among recruited participants who had a vehicle (n = 38), smoke-free car rules increased by 37.6 percentage points (p < 0.01) and comprehensive smoke-free rules rose 40.9 percentage points (p < 0.01). Home SHS exposure declined, and within-person increase in smoke-free home rules was significantly related to less home SHS exposure (p < 0.05). It is feasible to adapt and implement the evidence-based SFHP intervention through a national cancer program, but the current pilot demonstrated recruitment is a challenge. DM produced a low response rate and therefore OR is the recommended recruitment route. Despite low recruitment rates, we conclude that the SFHP can successfully increase comprehensive smoke-free rules and reduce SHS exposure among socioeconomically disadvantaged households with children recruited through a NBCCEDP.

scholarly journals The 2015 National Cancer Program in Sweden: Introducing standardized care pathways in a decentralized system

Health Policy ◽  
2016 ◽  
Vol 120 (12) ◽  
pp. 1378-1382 ◽  
Author(s):  
Jens Wilkens ◽  
Hans Thulesius ◽  
Ingrid Schmidt ◽  
Christina Carlsson
Keyword(s):  
Care Pathways ◽  
Decentralized System ◽  
Cancer Program ◽  
National Cancer Program ◽  
Standardized Care

scholarly journals Supporting Community College Students from Start to Degree Completion: Long-Term Evidence from a Randomized Trial of CUNY’s ASAP

2019 ◽  
Vol 11 (3) ◽  
pp. 253-297 ◽  
Author(s):  
Michael J. Weiss ◽  
Alyssa Ratledge ◽  
Colleen Sommo ◽  
Himani Gupta
Keyword(s):  
Community College ◽  
Community Colleges ◽  
Graduation Rates ◽  
Degree Completion ◽  
Low Income ◽  
Randomized Experiments ◽  
Low Income Students ◽  
Percentage Points ◽  
The City

Nationwide, graduation rates at community colleges are discouragingly low. This randomized experiment provides evidence that graduation rates can be increased dramatically. The City University of New York’s (CUNY) Accelerated Study in Associate Programs (ASAP) is a comprehensive, integrated, 3-year program that has an estimated 18 percentage point effect on 3-year graduation rates, increases 6-year graduation rates by an estimated 10 percentage points, and helps students graduate more quickly. Graduation effect estimates of this magnitude are exceptional in randomized experiments conducted in higher education, offering hope of what is possible when serving low-income students. (JEL H75, I23, I24, I28)

scholarly journals Depressive Risk among Italian Socioeconomically Disadvantaged Children and Adolescents during Covid-19 Pandemic: A Cross-Sectional Online Survey

2021 ◽  
Author(s):  
Maria Serra ◽  
Anna Presicci ◽  
Luigi Quaranta ◽  
Maria Rosaria Erminia Urbano ◽  
Lucia Marzulli ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Children And Adolescents ◽  
Low Income ◽  
Online Survey ◽  
Self Report ◽  
Socioeconomically Disadvantaged ◽  
Cross Sectional ◽  
Disadvantaged Children ◽  
Parent Version

Abstract Background Children and adolescents and low-income individuals are considered particularly vulnerable for mental health implications during the current COVID-19 pandemic. Depression is one of the most frequent negative emotional responses during an epidemic outbreak, mainly due to the imposed restriction of social contacts. We aimed to assess depressive symptomatology in a sample of Italian low-income minors and to determine if pandemic-related stressors and pre-existing neuropsychiatric diagnoses would behave as risk factors for depressive symptoms. Methods We performed a cross-sectional study during July 2020, at the end of the Italian first wave of COVID-19 pandemic. We recruited 109 Italian socioeconomically disadvantaged children and adolescents, from 7 to 17 years. We used an online survey to collect socio-demographic and clinical data and information about pandemic-related stressors, and to assess depressive symptoms with the Children’s Depression Inventory 2 (CDI 2), Parent Version (Emotional Problems subscale) and Self-Report Short Form. We performed logistic regression analysis to assess the association between depressive symptoms and potential risk factors for mental health. Results 22% and 14% of participants showed depressive symptoms at the CDI 2 Parent Version and Self-Report, respectively. Participants coming from families experiencing a lack of basic supplies during the pandemic (34.9%) were more expected to show depressive symptoms at CDI 2 Parent Version. Participants with a pre-existing neuropsychiatric diagnosis (26.6%) were more likely to exhibit depressive symptoms measured by CDI 2 Parent Version. Conclusions The results of our study may be representative of a particular group of frail subjects, the socioeconomically disadvantaged children and adolescents, who were more vulnerable to depressive symptoms if they suffered from a paucity of essential supplies during the pandemic or had pre-existing neurodevelopmental disorders. The promotion of educational and child-care programs and activities could be crucial in sustaining the prevention of mental distress in those frail subjects who particularly need support outside the family.

The Effect of Parents' Insurance Coverage on Access to Care for Low-Income Children

2003 ◽  
Vol 40 (3) ◽  
pp. 254-268 ◽  
Author(s):  
Amy Davidoff ◽  
Lisa Dubay ◽  
Genevieve Kenney ◽  
Alshadye Yemane
Keyword(s):  
Access To Care ◽  
Low Income ◽  
Insurance Coverage ◽  
Spillover Effects ◽  
Medical Provider ◽  
Low Income Children ◽  
Point Reduction ◽  
Percentage Points ◽  
Well Child Visit ◽  
Child Visit

This study examines the effects of having an uninsured parent on access to health care for low-income children. Using data from the 1999 National Survey of America's Families, we find that having an uninsured parent decreases the likelihood that a child will have any medical provider visit by 6.5 percentage points, and decreases the likelihood of a well-child visit by 6.7 percentage points. Estimates for low-income children who have insurance but have an uninsured parent indicate a 4.1 percentage-point reduction in the probability of having any medical provider visit, and a similar 4.2 percentage-point reduction in the probability of having a well-child visit relative to those with insured parents. The effects of having an uninsured parent are smaller in magnitude than the effects of a child being uninsured. Efforts to increase insurance coverage of parents, either by extending eligibility for public insurance or through other policy interventions, will have positive spillover effects on access to care for children. Although the magnitude of these effects is small relative to the direct effect of providing insurance to either the child or parent, they should be considered in analyses of costs and benefits of proposed policies.

Linking a sugar-sweetened beverage tax with fruit and vegetable subsidies: A simulation analysis of the impact on the poor

2021 ◽  
Author(s):  
Pourya Valizadeh ◽  
Barry M Popkin ◽  
Shu Wen Ng
Keyword(s):  
Low Income ◽  
Simulation Analysis ◽  
Fruit And Vegetable ◽  
Sugar Sweetened Beverage ◽  
Subsidy Rate ◽  
Sweetened Beverage ◽  
Financial Gain ◽  
Households With Children ◽  
The Impact ◽  
Low Income Households

Abstract Background US individuals, particularly from low-income subpopulations, have very poor diet quality. Policies encouraging shifts from consuming unhealthy food towards healthy food consumption are needed. Objectives We simulate the differential impacts of a national sugar-sweetened beverage (SSB) tax and its combination with fruit and vegetable (FV) subsidies targeted to low-income households, on SSB and FV purchases of lower and higher SSB purchasers. Design We considered a one-cent-per-ounce SSB tax and two FV subsidy rates of 30% and 50% and used longitudinal grocery purchase data for 79,044 urban/semiurban US households from 2010-2014 Nielsen Homescan. We used demand elasticities for lower and higher SSB purchasers, estimated via longitudinal quantile regression, to simulate policies’ differential effects. Results Higher-SSB purchasing households made larger reductions (per adult equivalent) in SSB purchases than lower SSB purchasers due to the tax (e.g., 4.4 oz/day at SSB purchase percentile 90 vs. 0.5 oz/day at percentile 25; p &lt; 0.05). Our analyses by household income indicated low-income households would make larger reductions than higher-income households at all SSB purchase levels. Targeted FV subsidies induced similar, but nutritionally insignificant, increases in FV purchases of low-income households regardless of their SSB purchase levels. Subsidies, however, were effective in mitigating the tax burdens. All low-income households experienced a net financial gain when the tax was combined with a 50% FV subsidy, but net gains were smaller among higher SSB purchasers. Further, low-income households with children gained smaller net financial benefits than households without children and incurred net financial losses under a 30% subsidy rate. Conclusions SSB taxes can effectively reduce SSB consumption. FV subsidies would increase FV purchases, but nutritionally meaningful increases are limited due to low purchase levels pre-policy. Expanding taxes beyond SSBs, larger FV subsidies, or subsidies beyond FVs, particularly for low-income households with children, may be more effective.

scholarly journals National Breast Cancer Chemotherapy Program in Haiti

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 20s-20s
Author(s):  
Estefania Santamaria ◽  
Jean Ronald Cornely ◽  
Georges Dubuche ◽  
Vincent DeGennaro
Keyword(s):  
Breast Cancer ◽  
Low Income ◽  
Cancer Care ◽  
Conflicts Of Interest ◽  
Public Hospitals ◽  
Practical Training ◽  
Breast Cancer Chemotherapy ◽  
Low Income Country ◽  
National Breast ◽  
Treatment Plans

Abstract 19 Background: Project Medishare launched a breast cancer program in Port-au-Prince in 2013 at the request of local partners. In 2015, the program was expanded as part of a national breast cancer treatment program with Equal Health International. With the mission of strengthening Haiti’s Ministry of Health (MSPP) cancer care infrastructure, the program seeks to decentralize cancer care for women living up to eight hours driving distance from Port-au-Prince by building hospital capacity for cancer screening, diagnosis, chemotherapy and hormone therapy provision at outlying hospitals. Methods: In 2013, two physicians and three nurses were trained to handle, mix and administer chemotherapy by American nurses and doctors. To expand the national program in January 2015, 20 additional physicians and 32 nurses from all ten geographic regions underwent a three-day training in Port-au-Prince on treatment algorithms and practical training for breast cancer. As patients came in for treatment at the local institutions, Project Medishare nurses were on site to supervise mixing and administration of chemotherapy. Physicians continued their practical training via telemedicine to confirm treatment plans and dosage calculations. Results: By September 2015, onsite practical training and chemotherapy had occurred at the primary public hospitals in Gonaives, Jacmel, and Les Cayes. One physician and three nurses were fully trained at each site and seven patients with breast cancer have been treated thus far at the new sites. Future efforts will focus on quality improvement and continuing onsite training at the other hospitals as well as encouraging more doctors and patients to utilize regional programs instead of coming to the capital for treatment. Conclusion: To our knowledge, this is the first regularly-operating multi-site chemotherapy program in a low-income country. Our experiences may inform others to expand already established protocol-based cancer programs in low-resource settings. Next steps include working with MSPP to expand chemotherapy access to Cap-Haitien and to launch breast reconstruction programs through similar trainings in Port-au-Prince. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

Access and Adoption of Hybrid Seeds: Evidence from Uganda

2019 ◽  
Vol 29 (3) ◽  
pp. 215-235
Author(s):  
Nikolaus Axmann ◽  
Torben Fischer ◽  
Kevin Keller ◽  
Kevin Leiby ◽  
Daniel Stein ◽  
...  
Keyword(s):  
Low Income ◽  
Smallholder Farmers ◽  
Low Income Countries ◽  
Control Group ◽  
Maize Seeds ◽  
Percentage Points ◽  
Female Farmers ◽  
Hybrid Seeds ◽  
Plant Hybrid ◽  
Hybrid Maize

Abstract Adoption of hybrid seeds remains low in many low-income countries. We conduct a field-experiment designed to measure the effect of offering hybrid maize seeds for purchase during a time when potential customers have high liquidity. Working with a large buyer of agricultural commodities in Northern Uganda, we randomly offer smallholder farmers the opportunity to purchase certified hybrid maize seeds at the same time as they visit the buyers’ stores to sell crops from a previous harvest. 16% of those offered purchase hybrid seeds, and average adoption of hybrid maize among those offered increases by 8 percentage points compared to a control group who does not receive the offer. Among those who accept the offer, we see an increase in the propensity to plant hybrid maize of 50 percentage points. This effect is more pronounced for female farmers than for their male counterparts. Our findings suggest that providing access to certified agricultural inputs at the place and time of post-harvest sales is a promising strategy to increase input usage.

scholarly journals EXTERNAL HOME DISREPAIR ASSOCIATED WITH OBJECTIVE SLEEP DISTURBANCES IN LOW-INCOME OLDER ADULTS WITH DISABILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S922-S922
Author(s):  
Safiyyah M Okoye ◽  
Nancy Perrin ◽  
Sarah Szanton ◽  
Adam P Spira
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Sleep Disturbances ◽  
Socioeconomically Disadvantaged ◽  
Neighborhood Conditions ◽  
Adults With Disabilities ◽  
Time In Bed ◽  
Wrist Actigraphy ◽  
Objectively Measured ◽  
Home Conditions

Abstract Sleep disturbances are linked to poor health, loss of independence and mortality in older adults. Rates of poor sleep are higher among socioeconomically disadvantaged older adults. Understanding how environmental factors may affect sleep in this population could lead to interventions to improve sleep-related health outcomes. We determined cross-sectional associations of home and neighborhood conditions with sleep parameters, measured by wrist actigraphy, in 136 low-income, predominantly African-American older adults with disabilities. Primary predictors were third-party-rated objective indicators of disrepair or disorder based on: 1) inside-home conditions (e.g., evidence of pests, tripping hazards, clutter); 2) outside-home conditions (e.g., broken windows, crumbling foundation); and 3) neighborhood conditions (e.g., litter, graffiti, vacant buildings). Outcomes were actigraphic total sleep time (TST; total number of minutes in bed spent asleep), wake time after sleep onset (WASO; total number of minutes spent awake after initially falling asleep), and sleep efficiency (SE; % of time in bed spent asleep). Presence of one or more outside-home conditions indicating disrepair or disorder was associated with 36.3-minutes shorter TST, 18.1-minutes more WASO, and 4.7% lower SE (all p &lt;0.05). Conditions inside the home and of the neighborhood were not associated with sleep. These preliminary findings suggest that among low-income older adults with disabilities, external-home disrepair is associated with objectively measured WASO, TST, and SE. External-home disrepair may affect sleep through physical, psychosocial and behavioral pathways. Further research should examine longitudinal associations between external-home conditions and objectively measured sleep in socioeconomically disadvantaged older adults.

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