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Preventing Chronic Disease Dialogue

The Preventing Chronic Disease journal welcomes comments from readers on selected published articles to encourage dialogue between chronic disease prevention, researchers, practitioners and advocates.

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A Tool for Rating Chronic Disease Prevention and Public Health Interventions

TOOLS AND TECHNIQUES

Cheryl Kelly, PhD, MPH; Darcell Scharff, PhD; Jessi LaRose, MPH; Nikole Lobb Dougherty, MA; Amy Stringer Hessel, MSW; Ross C. Brownson, PhD

Suggested citation for this article: Kelly C, Scharff D, LaRose J, Dougherty NL, Hessel AS, Brownson RC. A Tool for Rating Chronic Disease Prevention and Public Health Interventions. Prev Chronic Dis 2013;10:130173. DOI: http://dx.doi.org/10.5888/pcd10.130173.

PEER REVIEWED

Abstract

Bridging the gap between research and practice requires more than evaluating the effectiveness of interventions in controlled studies. To bridge this gap, evidence needs to be defined in different ways, and opportunities need to be provided for practice-based evidence to be replicated and disseminated. Community-based interventions are often not conducted or evaluated in controlled settings, yet they provide more real-world context and have the potential to have a greater effect on population health than findings from controlled studies that are limited in generalizability. The purpose of this article is to describe an approach to identify community-based programs and interventions that have the potential for replication and dissemination. In our study, such interventions met criteria in 3 primary domains: innovativeness, effectiveness, and sustainability. The criteria and tool developed were applied to 2 obesity-prevention programs to demonstrate the usefulness of the tool for identifying potential programs for replication and dissemination, contributing to practice-based evidence. Funders, practitioners, and researchers can apply these criteria to identify programs, environmental changes, or policies that may be replicated and disseminated.

Community-Based Participatory Research: Its Role in Future Cancer Research and Public Health Practice

SPECIAL TOPIC

Vanessa W. Simonds, ScD; Nina Wallerstein, DrPH; Bonnie Duran, DrPH; Malia Villegas, EdD

Suggested citation for this article: Simonds VW, Wallerstein N, Duran B, Villegas M. Community-Based Participatory Research: Its Role in Future Cancer Research and Public Health Practice. Prev Chronic Dis 2013;10:120205. DOI: http://dx.doi.org/10.5888/pcd10.120205.

PEER REVIEWED

Abstract

The call for community-based participatory research approaches to address cancer health disparities is increasing as concern grows for the limited effectiveness of existing public health practice and research in communities that experience a disparate burden of disease. A national study of participatory research projects, Research for Improved Health, funded by the National Institutes of Health (2009–2013), identified 64 of 333 projects focused on cancer and demonstrated the potential impact participatory approaches can have in reducing cancer disparities. Several projects highlight the success of participatory approaches to cancer prevention and intervention in addressing many of the challenges of traditional practice and research. Best practices include adapting interventions within local contexts, alleviating mistrust, supporting integration of local cultural knowledge, and training investigators from communities that experience cancer disparities. The national study has implications for expanding our understanding of the impact of participatory approaches on alleviating health disparities and aims to enhance our understanding of the barriers and facilitators to effective community-based participatory research.

Methods for Translating Evidence-Based Behavioral Interventions for Health-Disparity Communities

TOOL AND TECHNIQUES

Anna Maria Nápoles, PhD, MPH; Jasmine Santoyo-Olsson, MS; Anita L. Stewart, PhD

Suggested citation for this article: Nápoles AM, Santoyo-Olsson J, Stewart AL. Methods for Translating Evidence-Based Behavioral Interventions for Health-Disparity Communities. Prev Chronic Dis 2013;10:130133. DOI: http://dx.doi.org/10.5888/pcd10.130133.

PEER REVIEWED

Abstract

Populations composed of racial/ethnic minorities, disabled persons, and people with low socioeconomic status have worse health than their counterparts. Implementing evidence-based behavioral interventions (EBIs) to prevent and manage chronic disease and disability in community settings could help ameliorate disparities. Although numerous models of implementation processes are available, they are broad in scope, few offer specific methodological guidance, and few address the special issues in reaching vulnerable populations. Drawing from 2 existing models, we describe 7 methodological phases in the process of translating and implementing EBIs in communities to reach these vulnerable groups: establish infrastructure for translation partnership, identify multiple inputs (information gathering), review and distill information (synthesis), adapt and integrate program components (translation), build general and specific capacity (support system), implement intervention (delivery system), and develop appropriate designs and measures (evaluation). For each phase, we describe specific methodological steps and resources and provide examples from research on racial/ethnic minorities, disabled persons, and those with low socioeconomic status. Our methods focus on how to incorporate adaptations so that programs fit new community contexts, meet the needs of individuals in health-disparity populations, capitalize on scientific evidence, and use and build community assets and resources. A key tenet of our approach is to integrate EBIs with community best practices to the extent possible while building local capacity. We discuss tradeoffs between maintaining fidelity to the EBIs while maximizing fit to the new context. These methods could advance our ability to implement potentially effective interventions to reduce health disparities.

Physical Activity During Recess Outdoors and Indoors Among Urban Public School Students, St. Louis, Missouri, 2010–2011

BRIEF

Irene Tran, DPT, MSCI; B. Ruth Clark, PT, PhD; Susan B. Racette, PhD

Suggested citation for this article: Tran I, Clark BR, Racette SB. Physical Activity During Recess Outdoors and Indoors Among Urban Public School Students, St. Louis, Missouri, 2010–2011. Prev Chronic Dis 2013;10:130135. DOI: http://dx.doi.org/10.5888/pcd10.130135.

PEER REVIEWED

Abstract

We measured the quantity and intensity of physical activity in 106 urban public school students during recess outdoors, recess indoors in the gym, and recess indoors in the classroom. Students in grades 2 through 5 wore accelerometer pedometers for an average of 6.2 (standard deviation [SD], 1.4) recess periods over 8 weeks; a subsample of 26 also wore heart rate monitors. We determined, on the basis of 655 recess observations, that outdoor recess enabled more total steps per recess period (P < .0001), more steps in moderate-to-vigorous physical activity (P < .0001), and higher heart rates than recess in the gym or classroom. To maximize physical activity quantity and intensity, school policies should promote outdoor recess.

The Physical and Mental Health of Head Start Staff: The Pennsylvania Head Start Staff Wellness Survey, 2012

ORIGINAL RESEARCH

Robert C. Whitaker, MD, MPH; Brandon D. Becker, MPH; Allison N. Herman, MEd, MPH; Rachel A. Gooze, PhD, MPH

Suggested citation for this article: Whitaker RC, Becker BD, Herman AN, Gooze RA. The Physical and Mental Health of Head Start Staff: The Pennsylvania Head Start Staff Wellness Survey, 2012. Prev Chronic Dis 2013;10:130171. DOI: http://dx.doi.org/10.5888/pcd10.130171.

PEER REVIEWED

Abstract

Introduction
Despite attention to the health of low-income children in Head Start, little is known about the health of adults working for the program. The objective of our study was to compare the physical and mental health of women working in Pennsylvania Head Start programs with the health of US women who have similar sociodemographic characteristics.

Barriers to Colorectal Cancer Screening Among American Indian Men Aged 50 or Older, Kansas and Missouri, 2006–2008

BRIEF

Aimee S. James, PhD, MPH; Melissa K. Filippi, PhD; Christina M. Pacheco; Lance Cully; David Perdue, MD, MSPH; Won S. Choi, PhD, MPH; K. Allen Greiner, MD, MPH; Christine M. Daley, PhD, SM, MA

Suggested citation for this article: James AS, Filippi MK, Pacheco CM, Cully L, Perdue D, Choi WS, et al. Barriers to Colorectal Cancer Screening Among American Indian Men Aged 50 or Older, Kansas and Missouri, 2006–2008. Prev Chronic Dis 2013;10:130067. DOI: http://dx.doi.org/10.5888/pcd10.130067.

PEER REVIEWED

Abstract

American Indian (AI) men have some of the highest rates of colorectal cancer (CRC) in the United States but among the lowest screening rates. Our goal was to better understand awareness and discourse about colorectal cancer in a heterogeneous group of AI men in the Midwestern United States. Focus groups were conducted with AI men (N = 29); data were analyzed using a community-participatory approach to qualitative text analysis. Several themes were identified regarding knowledge, knowledge sources, and barriers to and facilitators of screening. Men in the study felt that awareness about colorectal cancer was low, and people were interested in learning more. Education strategies need to be culturally relevant and specific.

Raising Awareness of Sleep as a Healthy Behavior

ESSAY

Geraldine S. Perry, DrPH, RDN; Susheel P. Patil, MD, PhD; Letitia R. Presley-Cantrell, PhD

Suggested citation for this article: Perry GS, Patil SP, Presley-Cantrell LR. Raising Awareness of Sleep as a Healthy Behavior. Prev Chronic Dis 2013;10:130081. DOI: http://dx.doi.org/10.5888/pcd10.130081.

Sleep is an essential component of health, and its timing, duration, and quality are critical determinants of health (1). Sleep may play an important role in metabolic regulation, emotion regulation, performance, memory consolidation, brain recuperation processes, and learning (2). Because of the importance of these functions, sleep should be viewed as being as critical to health as diet and physical activity. However, public health practitioners and other health care providers have not focused major attention on the importance of sleep to health. In this essay, we briefly summarize the scientific literature about hours of sleep needed and why sleep is an important public health issue. We also suggest areas for expanding sleep research and strategies for increasing awareness of the importance of sleep and improving sleep health. Finally, we call for action to bring sleep to the forefront of public health.

Healthy Eating Design Guidelines for School Architecture

TOOLS AND TECHNIQUES

Terry T-K Huang, PhD, MPH, CPH; Dina Sorensen, MArch; Steven Davis, AIA; Leah Frerichs, MS; Jeri Brittin, MM; Joseph Celentano, AIA; Kelly Callahan, AIA; Matthew J. Trowbridge, MD, MPH

Suggested citation for this article: Huang TT, Sorensen D, Davis S, Frerichs L, Brittin J, Celentano J, et al. Healthy Eating Design Guidelines for School Architecture. Prev Chronic Dis 2013;10:120084. DOI: http://dx.doi.org/10.5888/pcd10.120084.
PEER REVIEWED

Abstract

We developed a new tool, Healthy Eating Design Guidelines for School Architecture, to provide practitioners in architecture and public health with a practical set of spatially organized and theory-based strategies for making school environments more conducive to learning about and practicing healthy eating by optimizing physical resources and learning spaces. The design guidelines, developed through multidisciplinary collaboration, cover 10 domains of the school food environment (eg, cafeteria, kitchen, garden) and 5 core healthy eating design principles. A school redesign project in Dillwyn, Virginia, used the tool to improve the schools’ ability to adopt a healthy nutrition curriculum and promote healthy eating. The new tool, now in a pilot version, is expected to evolve as its components are tested and evaluated through public health and design research.

Declines in Sugar-Sweetened Beverage Consumption Among Children in Los Angeles County, 2007 and 2011

Paul A. Simon, MD, MPH; Amy S. Lightstone, MPH, MA; Steve Baldwin, RD, MS; Tony Kuo, MD, MSHS; Margaret Shih, MD, PhD; Jonathan E. Fielding, MD, MPH

Suggested citation for this article: Simon PA, Lightstone AS, Baldwin S, Kuo T, Shih M, Fielding JE. Declines in Sugar-Sweetened Beverage Consumption Among Children in Los Angeles County, 2007 and 2011. Prev Chronic Dis 2013;10:130049.
DOI: http://dx.doi.org/10.5888/pcd10.130049

PEER REVIEWED

Abstract

This study assessed changes in consumption of sugar-sweetened beverages (SSBs) among children (aged ≤17 years) in Los Angeles County. We analyzed children’s data from the 2007 (n = 5,595) and 2011 (n = 5,934) Los Angeles County Health Survey. The percentage of children who consumed 1 or more SSB per day decreased from 43.3% in 2007 to 38.3% in 2011 (P < .001); this decrease was seen across most sociodemographic subgroups. Despite measurable progress in reducing SSB consumption among children in Los Angeles County, consumption remains high, highlighting the need for additional policy and programmatic interventions.

Improving Public Health Agency and System Performance: Fortification for Promoting Population Health and Wellness

ESSAY

Judith A. Monroe, MD; Craig Thomas, PhD

Suggested citation for this article: Monroe JA, Thomas C. Improving Public Health Agency and System Performance: Fortification for Promoting Population Health and Wellness. Prev Chronic Dis 2013;10:130202.
DOI: http://dx.doi.org/10.5888/pcd10.130202.

America faces a new frontier in preventing chronic disease. Nearly 80% of the 10,000 people who turn 65 each day have at least 1 chronic health condition, and most have multiple chronic conditions (1). The costs of braving this new world are staggering, especially given the nation’s strained economy and budget cuts that have forced health departments to reduce their workforce and impose furloughs and reduce or eliminate chronic disease programs. Despite these daunting challenges, government public health agencies have opportunities to be the driving force behind improving the nation’s health.

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