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The influence of health and socioeconomic status on perceptions of aging and adaptation strategies of older African/Caribbean-American women was examined. Responses of 38 women (average age = 77.3 years) to: “What do you like and dislike about growing old?” and To what would you attribute your long life? were analyzed. Respondents were classified as: financially independent/healthy, financially dependent/healthy, financially independent/not healthy and financially dependent/not healthy. Narratives revealed declining health and restricted financial resources limited perceptions of opportunities for well-being. Despite differences in health and financial status, groups had some common strategies: avoiding risk behaviors, holding moral beliefs, optimism, altruism and spirituality. It was concluded that health and socioeconomic status had some influence on perceptions of aging and adaptation strategies.

Research has shown that service-learning can increase student-learning outcomes across various disciplines. Service-learning opportunities have been steadily increasing in college settings, especially in health-related fields. This evaluation of an undergraduate public health course at a mid-size, public university in New England sought to understand the impact of service-learning on material retention, internships, and post-graduation public health careers. A 25-item questionnaire was emailed to students who took the course between the Fall 2010 and Spring 2016 semesters with 75 completed (33.3% completion rate). More than half of the respondents noted that their participation in a service-learning project positively affected their internship experience, their first post-graduation job, and their overall career, while also helping them retain the course material after graduation. Open-ended responses provided insight to the qualitative responses. Respondents noted that in addition to having the understanding and ability to put on programs in their community, they also had more confidence in their abilities. The opportunity to practice public speaking skills as well as work collaboratively in group settings, were both noted as essential skills needed to succeed in the public health workforce. It was concluded the project had a positive impact on student's learning and retention in planning, implementing, and evaluating an actual health promotion program as well as how they were able to use those skills in their careers., (C)2021Sage Publications

The objectives of this study were the following: (1) describe one organization's experience with recruiting minority-serving private practice primary care physicians to an ambulatory quality improvement (QI) project; (2) compare and contrast physicians who agreed to participate with those who declined; and (3) list incentives and barriers to participation. The authors identified eligible physicians by analyzing Medicare Part B claims data, a publicly available physician database, and office staff responses to telephone inquiries. The recruitment team had difficulty identifying, contacting, and recruiting eligible physicians. Solo practitioners and physicians who had lower scores on certain quality measures were more likely to participate. Barriers to participation were similar in all practices and included concerns about extra work, difficulty of change, and impact on office work flow. Commonly used incentives were offered but were not universally embraced. Additional work is required to refine the process of physician recruitment and to find more compelling incentives for QI.

The authors conducted a diabetes quality improvement project in 5 privately owned primary care practices serving at least 25% minority patients. Interventions included group-specific and practice-specific training on an electronic patient registry, cultural competency practices and tools, and selected quality improvement strategies. The authors conducted a comprehensive evaluation involving quantitative and qualitative data to assess project impact. Although overall clinical performance did not improve over the 14- to 20-month project time frame, other practice structural characteristics and processes did show improvement: successful implementation of the registry and clinician reminders in all practices, institution of team care and patient reminders in 4 practices, and collection of patient race/ethnicity data in 4 practices. These results highlight the difficulty of bringing about clinical improvement in this subset of practices and also the importance of conducting comprehensive evaluations to fully understand and interpret multicomponent quality improvement projects. © 2012 by the American College of Medical Quality.

Age and portion size have been found to influence food intake in American children but have not been examined in an international context. This study evaluated the association between age and the effects of portion size on the food intake of kindergarteners in Kunming, China. Using a within-subjects crossover design in a classroom setting, 173 children in two age groups, mean age 4.2 years and 6.1 years, were served a predefined reference, small (-30%) and large (+30%) portion of rice, vegetables, and a protein source during lunchtime over three consecutive days. Each portion was weighed before and after the meal to determine amount of food consumed. Linear mixed modeling, controlling for repeated measures and clustering by classroom, was used to compare food intake under small and large portion size conditions to the reference portion. Children ate significantly less food when served small portions. When served a large portion, 6-year-old children increased food intake while 4-year-old children decreased food intake in comparison to the reference portion. Findings indicate that portion size affects food intake in Chinese children 4-6-years old. Older children show larger increases in food intake with increased portion size than do younger children. (c) 2013 Elsevier Ltd. All rights reserved.

Aims: There is a need for greater understanding of the recursive processes involved in drug policy development and its impact on stakeholders. The aim of this study was to examine the challenges of implementing marijuana policy in Massachusetts, where recent policy shifts have occurred. Methods: Qualitative data were generated from ethnographic field notes, media reports, public records and in-depth interviews with 25 stakeholders, including six medical marijuana dispensary entrepreneurs, eight health care professionals and 11 medical marijuana patients. Data were triangulated using a grounded theory approach. Findings: Stakeholders expressed confusion and misunderstanding, and demonstrated that they held conflicting interpretations of the policy and regulations. Analyses revealed gaps in policy development and implementation that are organised by three specific core implementation processes and the themes of transparency, communication and education. Conclusions: Findings show a need for more transparency in implementation processes, a more effective mode of communicating regulations, and a comprehensive plan for medical marijuana education. Based on our findings, we provide recommendations to help policymakers in the US and other countries considering legalisation of marijuana or other drugs.

Photovoice, a community-based participatory research method that allows participants to inform research questions in an intimate way, has proven successful with youth. A diverse group of teenage girls living in New York City were asked to take photographs and reflect on what messages they received and from whom, how these messages translate across cultures and ethnicities, and how these messages are internalized and acted on. The group selected specific photographs to discuss together and themes emerged to answer the research questions; themes were reinforced by journal responses and agreed on by the group at the concluding session. The participants identified the media, peers, and family as cultural influencers on body image but noted that these messages change depending on the delivering medium. Participants not only offered recommendations with policy implications for advertising and media giants but also urged public health practitioners, teachers, and other key stakeholders working with young women of color to simply provide them with more space for talking. While Photovoice served as an effective methodology for gaining a more expansive understanding of how body image messages are received with young women of color, the tool should be considered for youth development interventions that take a community-based participatory approach. © 2015, © 2015 Society for Public Health Education.

Children's exposure to potentially traumatic events is related to negative mental health outcomes. To promote more positive outcomes, protective factors that can buffer the impact of these experiences need to be identified. The present study examined whether lower parental stress might function as a protective factor for children enrolled in a behavioral health system of care. Specifically, the relationship between a history of interpersonal trauma (physical abuse, sexual abuse, and witnessing domestic violence) and internalizing and externalizing problem behaviors were examined, as was the role of parenting stress in helping to explain this relationship. The sample included African American and Latino children (ages 5-19) from low-income families, who have a serious emotional disturbance, and received services in a school-based system of care. Results of path analyses revealed that parenting stress mediated the relationship between trauma exposure and internalizing problem behaviors. For the relationship between trauma exposure and externalizing problem behaviors, mediation approached significance. The findings suggest that family factors, such as parenting stress, could be potential modifiable protective factors for these children. Systems of care can use this information to encourage the implementation of more family-focused treatments and interventions.

Introduction: Research has shown that adults perceive that electronic cigarettes (e-cigarettes) are effective for smoking cessation, yet little is known about adolescents and young adults' perceptions of e-cigarettes for quitting cigarette smoking. This study describes middle, high school, and college students' beliefs about, and experiences with, e-cigarettes for cigarette smoking cessation., Methods: We conducted 18 focus groups (n = 127) with male and female cigarette smokers and nonsmokers in 2 public colleges, 2 high schools, and 1 middle school in Connecticut between November 2012 and April 2013. Participants discussed cigarette smoking cessation in relation to e-cigarettes. Verbatim transcripts were analyzed using thematic analysis., Results: All participants, regardless of age and smoking status, were aware that e-cigarettes could be used for smoking cessation. College and high school participants described different methods of how e-cigarettes could be used for smoking cessation: (a) nicotine reduction followed by cessation; (b) cigarette reduction/dual use; and (c) long-term exclusive e-cigarette use. However, overall, participants did not perceive that e-cigarette use led to successful quitting experiences. Participants described positive attributes (maintenance of smoking actions, "healthier" alternative to cigarettes, and parental approval) and negative attributes (persistence of craving, maintenance of addiction) of e-cigarettes for cessation. Some college students expressed distrust of marketing of e-cigarettes for smoking cessation., Conclusions: Adolescent and young adult smokers and nonsmokers perceive that there are several methods of using e-cigarettes for quitting and are aware of both positive and negative aspects of the product. Future research is needed to determine the role of e-cigarettes for smoking cessation in this population., (C) Copyright Oxford University Press 2015.

We propose that female methamphetamine users who live in suburbia experience risks for disease transmission stemming from their social environment that remain under the radar of public health surveillance networks. The data analyzed in this article were collected from 2007 to 2011 and were drawn from two sequential studies on methamphetamine use. The studies were conducted in the suburbs of a southeastern U.S. metropolis. We analyzed a total of 65 qualitative interviews with former and active methamphetamine-using women. Data from focus groups also were included in the analysis. The participants’ ages ranged from 18 to 51 years. We identified three major themes with regard to risk behaviors and transmission of infectious diseases: (1) setting risk behaviors such as sharing syringes and homelessness, lack of transportation, and unemployment; (2) sexual risk behaviors such as condom use and having multiple partners; and (3) service-related risks such as risk awareness and prevention behaviors as well as utilization of social services and health care. Our findings point to the pervasive nature of social influences on the risk for infectious disease transmission. We suggest that harm-reduction programs (HRPs) be implemented in suburban communities to increase access to these services. Second, our data support the concept of social recovery for drug users to better their health and social lives holistically. © 2014, © The Author(s) 2014.