Showing papers in "Public Health Reports in 2006"
TL;DR: It is essential that the nation find ways to support emo tional health of the authors' youngest children and their families through a continuum of comprehensive, individualized, culturally competent services that focus on promotion, prevention, and intervention.
Abstract: Cheryl Boydell Brauner, MPHa Cheryll Bowers Stephens, MD, MBAb An expanding literature base indicates the incidence and prevalence of emo tional/behavioral problems in young children is increasing. The U.S. Depart ment of Health and Human Services' (DHHS') 1999 report, Mental Health: A Report of the Surgeon General, estimates that at least one in five (20%) children and adolescents has a mental health disorder at some point in their life from childhood to adolescence.1 At least one in 10 (10%), or about 6 million people, has a serious emotional disturbance at some point in their life.1 On October 23-24, 2000, DHHS convened a multidisciplinary group of experts from fields including mental health, public health, and epidemiology. The group advised, "It is essential that the nation find ways to support emo tional health of our youngest children and their families through a continuum of comprehensive, individualized, culturally competent services that focus on promotion, prevention, and intervention." They also recommended steps to ensure the emotional health of infants not only to address school readiness, but to help families be stronger, supportive teachers for their children. Research highlights the importance of the first three years of life for school readiness, but also the important role that emotional health plays in preparing children to engage in cognitive tasks.2"5 Before there is thought and language, there is emotion, and it is this early affect within the context of the earliest relationships that forms the basis for all future development.6-8 Research has also shown that the emergence of early onset emotional/behavioral problems in young children is related to a variety of health and behavior problems in adolescence, not to mention juvenile delinquency, school drop out, etc.9-11 Families and communities, working together, can help children with mental disorders. A broad range of services is often necessary to meet the needs of these children and their families. However, in many communities, services for young people with serious emotional disturbances are unavailable, unaffordable, or inappropriate. An estimated two-thirds of the young people who need men tal health services in the United States are not receiving them.1 As a result, many children with mental health issues become involved with the juvenile
313 citations
TL;DR: While women have greater exposure to IPV, and subsequently a greater range of health problems, the effects on men should not be ignored, and more attention to the ways in which interpersonal violence is conceptualized, measured, and screened for is crucial.
Abstract: Objectives.The purpose of this work is to formally model patterns of intimate partner violence (IPV) separately for males and females and to assess the unique contributions of different types of vi...
288 citations
TL;DR: In a low-income population with diabetes, literacy mediated the relationship between education and glycemic control, with important implications for both education and health policy.
Abstract: dSYNOPSIS Objectives. We sought to determine whether literacy mediates the relationship between education and glycemic control among diabetes patients. Methods. We measured educational attainment, literacy using the Short Test of Functional Health Literacy in Adults (s-TOFHLA), and glycemic control (HbA1c) in 395 diabetes patients at a U.S. public hospital. We performed path analysis to compare two competing models to explain glycemic control. The direct effects model estimated how education was related to HbA1c; the mediational model estimated the strength of the direct relationship when the additional pathway from education to literacy to HbA1c was added. Results. Both the model with a direct effect of education on HbA1c and the model with literacy as a mediator were supported by good fit to observed data. The mediational model, however, was a significant improvement, with the additional path from literacy to HbA1c reducing the discrepancy from observed data (p0.01). After including this path, the direct relationship between education and HbA1c fell to a non-significant threshold. Conclusions. In a low-income population with diabetes, literacy mediated the relationship between education and glycemic control. This finding has important implications for both education and health policy.
278 citations
TL;DR: The significant association of maternal and paternal education with breastfeeding, even after adjustment for income, occupation, and many other factors, suggests that social policies affecting educational attainment may be important factors in breastfeeding.
Abstract: Results. Consistent with previous research, there was a marked socioeconomic gradient in breastfeeding. Women with higher family incomes, those who had or whose partners had higher education levels, and women who had or whose partners had professional or executive occupations were more likely than their counterparts to breastfeed. After adjustment for many potential confounders, maternal and paternal education remained positively associated with breastfeeding, while income and occupation were no longer significant. Compared with other racial or ethnic groups, foreign-born Latina women were the most likely to breastfeed. Conclusions. The significant association of maternal and paternal education with breastfeeding, even after adjustment for income, occupation, and many other factors, suggests that social policies affecting educational attainment may be important factors in breastfeeding. Breastfeeding rates may be influenced by health education specifically or by more general levels of schooling among mothers and their partners. The continuing importance of racial/ethnic differences after adjustment for socioeconomic factors could reflect unmeasured socioeconomic effects, cultural differences, and/or policies in Latin American countries.
248 citations
TL;DR: The PRAMS mail/telephone methodology is an effective means of reaching most recent mothers in the 23 states examined, but some population subgroups are more difficult to reach than others.
Abstract: Objectives.Our objectives were to describe the methodology of the Pregnancy Risk Assessment Monitoring System (PRAMS), examine recent response rates, determine characteristics associated with respo...
175 citations
TL;DR: Expanded availability of HCV screening with high quality counseling is clearly needed for this population to promote the health of chronically HCV-infected IDUs and to decrease risk among injectors susceptible to acquiring or transmitting HCV.
Abstract: Objective.This study was conducted to assess the accuracy of self-reported hepatitis C virus (HCV) antibody (anti-HCV) serostatus in injection drug users (IDUs), and examine whether self-reported a...
156 citations
TL;DR: It is argued that research efforts concerning BIP effectiveness should borrow the design strategies and programmatic research efforts that have proven successful in psychotherapy research, in which significant advances have been made with regard to the evaluation and validation of empirically supported treatments for a wide variety of mental health problems.
Abstract: In this article, the authors consider the empirical status of batterer intervention programs (BIPs) for male perpetrators of intimate partner violence (IPV). Recent reviews have reported only small average effect sizes for BIPs, with the small number of randomized trials showing little benefit of BIP attendance in preventing future abuse. The most widely adopted BIP intervention model has little empirical justification to support this dominance, yet states with standards governing the content of BIPs often mandate this approach as a contingency for state funding. Little data exist concerning the moderators and mediators of BIP effects on IPV recidivism, and a variety of factors threaten to impede future design advancements, including "turf" battles regarding the causes of IPV and limited funding outlets. Given this discouraging summary, the authors argue that research efforts concerning BIP effectiveness should borrow the design strategies and programmatic research efforts that have proven successful in psychotherapy research, in which significant advances have been made with regard to the evaluation and validation of empirically supported treatments for a wide variety of mental health problems. They conclude by calling for a new generation of IPV researchers to work across professional boundaries in a multidisciplinary manner to design the sophisticated evaluation studies that funding agencies would readily support, and that would provide the substantive answers to the many IPV-related public health questions that remain.
131 citations
TL;DR: Acculturation as measured through language is associated with diabetes and complications among Hispanics even after controlling for a variety of demographic characteristics including health insurance and education, and there are differences in disease prevalence and complications and access to health care.
Abstract: Objective.Hispanic individuals in the United States have a greater prevalence of diabetes mellitus than non-Hispanic white individuals; however, it is unclear whether Hispanics' risk of diabetes di...
122 citations
TL;DR: Health policy and practice call for health and mental health parity and for a greater focus on universal interventions to promote, prevent, and intervene as early after problem onset as is feasible.
Abstract: Health policy and practice call for health and mental health parity and for a greater focus on universal interventions to promote, prevent, and intervene as early after problem onset as is feasible. Those in the public health field are uniquely positioned to help promote the mental health of young people and to reshape how the nation thinks about and addresses mental health. And schools are essential partners for doing the work.
120 citations
TL;DR: It is argued that expanding the repertoire of measures of the public's health is a critical step in targeting attention and resources to improve health, stemming mounting health care costs, and slowing declining quality of life that threatens the nation's future.
Abstract: Allocation of public health resources should be based, where feasible, on objective assessments of health status, burden of disease, injury, and disability, their preventability, and related costs. In this article, we first analyze traditional measures of the public's health that address the burden of disease and disability and associated costs. Second, we discuss activities that are essential to protecting the public's health but whose impact is difficult to measure. Third, we propose general characteristics of useful measures of the public's health. We contend that expanding the repertoire of measures of the public's health is a critical step in targeting attention and resources to improve health, stemming mounting health care costs, and slowing declining quality of life that threatens the nation's future.
113 citations
TL;DR: The consistency of effect for economic vulnerability and its invariance across neighborhood settings suggests that reducing economic vulnerability is likely to have beneficial effects in both disadvantaged and non-disadvantaged neighborhoods.
Abstract: SynopSiS objectives. Two sources of contextual risk on the prevalence and severity of intimate partner violence (IPV) are investigated: household economic condition and neighborhood disadvantage. There is debate about whether each context is an independent source of IPV risk and whether risks cumulate over contexts. Methods. Data from the second wave of the National Survey of Families and Households are combined with tract level data from the 1990 U.S. Census. A sub-sample of co-resident couples with a child aged 5–17 in the household was selected for analysis (n52,273). IPV is measured in three ways: as any physical violence reported by either partner in the year prior to the survey, as gendered violence in which both partners are identified as aggressors, and as severe violence in terms of injury and frequency.
TL;DR: The extent to which criminal domestic violence offenders specialize in violence is determined, and whether the severity of an offender's attacks against the same victim increase, decrease, or stay about the same over time is determined.
Abstract: ObjectiveOver the past quarter century, intimate partner violence research has occupied an increasingly important position in the research agenda of criminology, public policy, and public health Yet, a number of questions about the criminal careers of domestic violence offenders remain unresolved This study attempts to determine (1) the extent to which criminal domestic violence offenders specialize in violence, and (2) whether the severity of an offender's attacks against the same victim increase, decrease, or stay about the same over timeMethodsData from the Spouse Assault Replication Program (SARP) are used to address two questions corresponding to different features of the criminal careers of domestic violence offendersResultsThe specialization analysis reveals that the majority of domestic violence offenders with prior official criminal records have been involved in nonviolent forms of criminal behavior in addition to domestic violence The escalation analysis identifies groups of escalators a
TL;DR: This study investigated whether disclosure of violence to health care providers and the receipt of interventions relate to women's exit from an abusive relationship and to their improved health, and found that health care care providers may make positive contributions toWomen's access to intimate partner violence services.
Abstract: OBJECTIVE: This study investigated whether disclosure of violence to health care providers and the receipt of interventions relate to women's exit from an abusive relationship and to their improved health. METHODS: A volunteer sample of 132 women outpatients who described intimate partner violence during the preceding year were recruited from multiple hospital departments and community agencies in suburban and urban metropolitan Boston. Through in-person interviews, women provided information on demographics, past year exposure to violence, past year receipt of interventions, and whether they disclosed partner violence to their health care provider. They also described their past month health status with the 12-Item Short-Form Health Survey and further questions. RESULTS: Of the 132 women, 44% had exited the abusive relationship. Among those who were no longer with their partner, 55% received a domestic violence intervention (e.g. advocacy, shelter, restraining order), compared with 37% of those who remained with their partner. Talking to their health care provider about the abuse increased women's likelihood of using an intervention (odds ratio [OR]=3.9). Those who received interventions were more likely to subsequently exit (OR=2.6) and women no longer with the abuser reported better physical health based on SF-12 summary scores (p=0.05) than women who stayed. CONCLUSIONS: Health care providers may make positive contributions to women's access to intimate partner violence services. Intimate partner violence interventions relate to women's reduced exposure to violence and better health. Language: en
TL;DR: The purpose of the consultation was to review a representation of the current state of the science and practice on the topic in order to reduce the situational link of methamphetamine use and sexual risk.
Abstract: In January 2005, the U.S. Centers for Disease Control and Prevention hosted a national consultation of scientists, public health officials, and community service providers to address growing concerns about the association of methamphetamine use and sexual risk behavior for HIV/STD infection, which is well documented among men who have sex with men. The purpose of the consultation was to review a representation of the current state of the science and practice on the topic in order to reduce the situational link of methamphetamine use and sexual risk. A set of suggestions for future research and programs were developed by the participants. This article provides a summary of content and recommendations from the consultation, and not an exhaustive review of the literature.
TL;DR: Analysis of the social and demographic correlates of nonfatal structural fire injury rates for the civilian population for Philadelphia census tracts during 1993–2001 indicates that older housing, low income, the prevalence of vacant houses, and the ability to speak English have significant independent effects onFire injury rates in Philadelphia.
Abstract: OBJECTIVES: This study investigates the social and demographic correlates of nonfatal structural fire injury rates for the civilian population for Philadelphia census tracts during 1993-2001. METHODS: The author analyzed 1,563 fire injuries by census tract using the 1990 census (STF 3) and unpublished data from the Office of the Fire Marshal of the Philadelphia Fire Department. Injury rates were calculated per 1,000 residents of a given census tract. Multiple regression was used to determine significant variables in predicting fire injuries in a given census tract over a nine-year period and interaction effects between two of these variables-age of housing and income. RESULTS: Multiple regression analysis indicates that older housing (prior to 1940), low income, the prevalence of vacant houses, and the ability to speak English have significant independent effects on fire injury rates in Philadelphia. In addition, the results show a significant interaction between older housing and low income. CONCLUSIONS: Given the finding of very high rates of fire injuries in census tracts that are both low income and have older housing, fire prevention units can take preventative measures. Fire protection devices, especially smoke alarms, should be distributed in the neighborhoods most at risk. Multiple occupancy dwellings should have sprinkler systems and fire extinguishers. Laws concerning the maintenance of older rental housing need to be strictly enforced. Vacant houses should be effectively boarded up or renovated for residential use. Fire prevention material should be distributed in a number of languages to meet local needs.
TL;DR: The findings suggest that media coverage of the risks of influenza was associated with a significant increase in vaccination rates, and physician recommendations and parental education about influenza vaccine availability, effectiveness, and adverse effects are potentially important influences on influenza vaccination.
Abstract: Objectives.The objectives of this study were to: (1) identify modifiable factors influencing receipt of influenza vaccination among children with asthma, and (2) to evaluate the effect of heightene...
TL;DR: Findings indicate that some Asian American groups are at greater risk for initiating smoking and/or continuing smoking, and highlight the need for tailored interventions that address differential smoking patterns by gender, nativity, and other social characteristics.
Abstract: ObjectiveNational studies suggest that the prevalence of current smoking among Asian Americans is lower than that for other racial/ethnic groups However, these studies may have yielded inaccurate
TL;DR: The asking of many kinds of questions is affected by mode choice, and surveyors inadvertently or sometimes inten tionally change how survey questions get asked and answered to better fit the particular survey mode.
Abstract: Don A. Dillman, MS, PhD* Recently, a surveyor who directs a large monthly survey of a general population called to tell me that a simple question he asked on marital status was produc ing different responses over the Internet than when asked by telephone. In particular, he reported that the percent of respondents who answered "single" had consistently declined by about 10% on the Internet version. The reason for his call was to ask me why the web survey was being answered by more unmar ried people than the telephone survey. I responded by asking to see the exact wording of the question for both modes. Over the telephone the respondent had been read this open-ended ques tion: "What is your marital status?" The interviewer then coded the respondent's answer into one of the listed categories: single, married, separated, divorced, or widowed. Although identical wording was used for the query on the web, the respondents needed to answer by reading and marking one of the five answer categories. Further examination of the data showed that the percent of married respondents had also decreased slightly, while the percent separated had in creased significantly and the divorced and widowed categories had each in creased a little. The likely reason for these differences seemed apparent. When asked one's marital status in an open-ended fashion, single or married are the usual responses one would provide to a casual inquiry from a stranger. The remaining three categories?separated, divorced, or widowed?are more spe cific responses, which if available, some respondents would choose, but would otherwise not feel a need to volunteer. There are many reasons in this age of increased survey alternatives that differences are frequently observed in responses across different modes. Yet one of the most frequent is that surveyors inadvertently or sometimes inten tionally change how survey questions get asked and answered to better fit the particular survey mode. When I pointed out the difference between offering both the query and response choices on the web, but only the former by telephone, he responded by saying that was the standard way of asking this question over the telephone: "Our interviewers prefer it that way." The asking of many kinds of questions is affected by mode choice. In earlier years when face-to-face to interviews were our predominant data collection
TL;DR: The empirical findings support the concurrent and predictive validity of the DVSI-R and show that it is robust in its applicability, and the findings show that incidents involving multiple victims are highly associated with DV SI-R risk scores and recidivistic violence.
Abstract: Objective.This study extends recent research on assessing the risk of intimate partner violence by determining the concurrent and predictive validity of a revised version of the Domestic Violence S...
TL;DR: Parts of the response to the Northeast blackout identified for improvement included communications during the event, DOHMH dependence on an external source of electricity, facility management during the response, and lack of readily available and appropriate emergency supplies.
Abstract: We examined the public health effects of the Northeast blackout of August 2003 and the emergency response to the blackout by the New York City Department of Health and Mental Hygiene (DOHMH). We reviewed departmental documents from the DOHMH Emergency Operations Center and surveyed DOHMH employees to identify deficiencies in the response and elicit suggestions for improvement. DOHMH deployed its all-hazards, scalable public health Incident Management System to respond to several impacts: (1) failure of multiple hospital emergency generators; (2) patients dependent on electrically powered equipment; (3) loss of electronic data input to the DOHMH syndromic surveillance system from hospital emergency departments; (4) potential for vaccine spoilage due to loss of refrigeration; (5) beach contamination with untreated sewage; (6) heat-related health effects and increase of foodborne disease; and (7) potential for an increased rodent population as a result of increased amounts of discarded perishables. Areas identified for improvement included communications during the event, DOHMH dependence on an external source of electricity, facility management during the response, and lack of readily available and appropriate emergency supplies.
TL;DR: The effect of low birthweight on chronic renal failure among young Medicaid patients with diabetes and/or hypertension was highest in patients with both diabetes and hypertension, suggesting that the mechanism(s) involved in the disease progression to Chronic renal failure may have a fetal early life origin.
Abstract: OBJECTIVE The purpose of this study was to assess the effect of low birthweight on chronic renal failure among young Medicaid patients with diabetes and/or hypertension. METHODS The study included Caucasian and African American young adults, aged 18-50, who enrolled in the Medicaid program from 1993 to 1996 in South Carolina and were diagnosed with diabetes and/or hypertension. The odds of chronic renal failure by low birthweight (< 2,500 grams) was estimated using logistic regression. RESULTS Of the 7,505 Medicaid patients with diabetes and/or hypertension, 179 (2.4%) were diagnosed with chronic renal failure. These patients were younger (mean age of 33.9 vs. 37.6, p = 0.0024) and had a higher proportion of low birthweight (15.1% vs. 11.4%, p = 0.07) compared with the 7,326 patients without renal failure. The odds ratio of chronic renal failure for low birthweight was significantly higher compared with normal birthweight (2,500-3,999 grams) (adjusted odds ratio [OR] 1.56, 95% confidence interval [95% CI] 1.0, 2.4). The association between low birthweight and chronic renal failure was stronger among the 888 patients with both diabetes and hypertension (OR 2.6, 95% Cl 1.3, 5.7) than the 1,812 diabetes or the 4,805 hypertension patients. CONCLUSIONS The odds of chronic renal failure by low birthweight was highest in patients with both diabetes and hypertension, suggesting that the mechanism(s) involved in the disease progression to chronic renal failure may have a fetal early life origin.
TL;DR: Ischemic heart disease, lung cancer, and traumatic deaths account for as much as three-quarters of the excess YPLL among men, suggesting that a few modifiable behaviors such as the use of tobacco, alcohol, and drugs and violence may account for much of the shorter life expectancy among men.
Abstract: OBJECTIVE: Men have higher mortality rates than women for most causes of death. This study was conducted to determine the contribution of specific causes of death to the sex difference in years of potential life lost (YPLL). METHODS: The authors examined data from the National Health Interview Survey with linked mortality data through 1997. Using survival analysis estimates, a stochastic simulation model to simulate death events for cohorts of white, African American, and Latino adults was created. RESULTS: YPLL from all causes were greater among men than women. Homicide, motor vehicle accidents, and suicide accounted for 33% of YPLL sex difference among whites, 36% among African Americans, and 52% among Latinos. For all three racial/ethnic groups, cardiovascular disease (principally ischemic heart disease) was the second largest contributor to the sex difference in YPLL (29% among whites, 23% among African Americans, and 25% among Latinos). Lung cancer was also important among whites and African Americans, accounting for 15% and 17% of the sex difference in YPLL from all causes, respectively. CONCLUSIONS: Ischemic heart disease, lung cancer, and traumatic deaths account for as much as three-quarters of the excess YPLL among men, suggesting that a few modifiable behaviors such as the use of tobacco, alcohol. Language: en
TL;DR: The Public Health Detailing Program is an effective method of reaching providers to deliver key prevention messages, feasible for public health agencies and acceptable to practices.
Abstract: To promote use of essential clinical preventive services, the New York City Department of Health and Mental Hygiene developed the Public Health Detailing Program, a primary care provider outreach initiative modeled on pharmaceutical detailing Department representatives conducted topical campaigns, making unscheduled visits to health care practices and meeting with providers and office staff members Representatives distributed "action kits" containing practice tools, provider information, and patient education materials; nicotine replacement therapy was distributed during the smoking cessation campaign More than 2,500 interactions with practice staff members were completed by six health department representatives at approximately 200 sites Physician visits lasted 10 minutes or longer, and by provider self-report, use of office systems for prevention and adherence to recommended practices increased Public health detailing is an effective method of reaching providers to deliver key prevention messages, feasible for public health agencies and acceptable to practices The effectiveness of this intervention in improving clinical prevention services requires further evaluation
TL;DR: The prospective space-time scan statistic offers local health departments an objective way of describing clusters of shigellosis cases, and could help prioritize the assignment and investigation of cases, particularly when overall shIGellosis incidence exceeds expected numbers or when an agency's resources are stressed by other events, such as outbreaks.
Abstract: SYNOPSIS Objective. A prospective space-time scan statistic was applied to Chicago's 2002 shigellosis surveillance data to evaluate its utility in objectively describing clusters and assisting in the prioritization of investigations. Methods. The prospective space-time module of SaTScan, a free software available online, was used to identify "live" clusters of disease, meaning cases that were current as of the date of the analysis and strongly associated in place and time. Fifty-two separate space-time analyses were run, one simulation for each week of 2002. Identified clusters were described in terms of space, time, risk factors reported by involved case-patients, and cases' links to venue-associated outbreaks. Results. Twelve live clusters were detected at the p<0.05 significance level: two single-household clusters and 10 community clusters. The community clusters ranged in size from 194 to 367 census tracts (median=294), and in disease burden from 21 to 41 cases (median=29). Geographically, all of the community clusters were located in the west-central part of the city and had a temporal span of 28 days. Within the 10 community clusters, 15 different day care centers were identified as potential exposure settings for case-patients or their close contacts. Conclusions. The prospective space-time scan statistic offers local health departments an objective way of describing clusters of shigellosis cases. The method used in this study could help prioritize the assignment and investigation of cases, particularly when overall shigellosis incidence exceeds expected numbers or when an agency's resources are stressed by other events, such as outbreaks.
TL;DR: After adding missed cases to cases captured by death certificate surveillance, traffic crashes surpassed firearm fatalities as the leading external cause of TBI-relatedDeath in Oklahoma and might lead to national underreporting.
Abstract: OBJECTIVES: Death certificate data are used to estimate state and national incidence of traumatic brain injury (TBI)-related deaths. This study evaluated the accuracy of this estimate in Oklahoma and examined the case characteristics of those persons who experienced a TBI-related death but whose death certificate did not reflect a TBI. METHODS: Data from Oklahoma's vital statistics multiple-cause-of-death database and from the Oklahoma Injury Surveillance System database were analyzed for TBI deaths that occurred during 2002. Cases were defined using the Centers for Disease Control and Prevention (CDC) ICD-10 code case definition. In multivariate analysis using a logistic regression model, we examined the association of case characteristics and the absence of a death certificate for persons who experienced a TBI-related death. RESULTS: Overall, sensitivity of death certificate-based surveillance was 78%. The majority (62%) of missed cases were due to listing "multiple trauma" as the cause of death. Death certificate surveillance was more likely to miss TBI-related deaths among traffic crashes, falls, and persons aged > or = 65 years. After adding missed cases to cases captured by death certificate surveillance, traffic crashes surpassed firearm fatalities as the leading external cause of TBI-related death. CONCLUSIONS: Death certificate surveillance underestimated TBI-related death in Oklahoma and might lead to national underreporting. More accurate and detailed completion of death certificates would result in better estimates of the burden of TBI-related death. Educational efforts to improve death certificate completion could substantially increase the accuracy of mortality statistics. Language: en
TL;DR: The findings are useful to describe the health characteristics of U.S. adults and may be used to anticipate future demand for health services and to support intervention programs that help individuals achieve desirable weight status.
Abstract: Objectives.We examined self-reported health characteristics, health care utilization, activity patterns, and demographic characteristics of U.S. adults 20 years and over by body mass index (BMI) ca...
TL;DR: The hypothesis that multiracial Hispanic adolescents have more behavioral health problems than monoracialHispanic adolescents was supported and the second hypothesis—that multirac Hispanic adolescents are more similar to multirracial non-Hispanic adolescents—was supported.
Abstract: OBJECTIVES: The purpose of the present study was twofold: (1) to determine whether adolescents who self-identify as multiracial have more adverse health behaviors than their monoracial counterparts, and (2) to examine whether the health behaviors of adolescents who are multiracial and Hispanic are more similar to those who identify as monoracial Hispanic or those who are multiracial and non-Hispanic. METHODS: Secondary analyses of data in a subsample from the Youth Risk Behavior Survey of 3,704 (27.2%) adolescents who identified as Hispanic/Latino only, multiracial Hispanic, or multiracial non-Hispanic were conducted. Regression analyses were conducted using SUDAAN for the complex sampling to test for differences in health behaviors (i.e., smoking, exercise, substance abuse, and suicide risk) among the three ethnicity/race groups. RESULTS: Each health behavior scale yielded significant between-group differences according to ethnic/racial identity: Hispanic/Latino adolescents scored significantly lower than both multiracial groups on the measure of cigarette smoking, lower than multiracial Hispanic adolescents on the substance abuse scale, and lower than multiracial non-Hispanic adolescents on the measure of exercise. The multiracial Hispanic group was also at marginally increased risk for suicide compared to the Hispanic/Latino group. CONCLUSIONS: The results support the hypothesis that multiracial Hispanic adolescents have more behavioral health problems than monoracial Hispanic adolescents. The second hypothesis--that multiracial Hispanic adolescents are more similar to multiracial non-Hispanic adolescents--was also supported. The implications of these findings for the classification of Hispanic adolescents in terms of ethnicity and race in relation to health behaviors are discussed.
Journal Article•
TL;DR: In this article, the authors explore the opportunity for scholarship to enhance the evidence base for academic public health practice and practice-based research and recommend actions for its stakeholders in both academic and practice communities.
Abstract: This document explores the opportunity for scholarship to enhance the evidence base for academic public health practice and practice-based research. Demonstrating Excellence in Practice-Based Research for Public Health defines practice-based research; describes its various approaches, models, and methods; explores ways to overcome its challenges; and recommends actions for its stakeholders in both academic and practice communities. It is hoped that this document will lead to new partnership opportunities between public health researchers and public health practitioners to strengthen the infrastructure of public health and add new dimensions to the science of public health practice. Demonstrating Excellence in Practice-Based Research for Public Health is intended for those who produce, participate in, and use practice-based research. This includes academic researchers and educators, public health administrators and field staff, clinical health professionals, community-based organizations and professionals, and interested members of the public.