IntroductionHispanics are at increased risk of developing type 2 diabetes. Lifestyle interventions are effective in preventing diabetes and restoring glucose regulation.MethodsWe recruited Hispanic men and women (N = 320) who were residents of the Lower Yakima Valley, Washington, aged 18 years or older with hemoglobin A1c (HbA1c) levels higher than 6% to a parallel 2-arm randomized-controlled trial conducted from 2008 through 2012. The trial compared participants in the intervention arm, who received an immediate educational curriculum (n = 166), to participants in the control arm, who received a delayed educational curriculum (n = 154). The home-based curriculum consisted of 5 sessions led by community health workers and was designed to inform participants about diabetes, diabetes treatment, and healthy dietary and physical activity behaviors. Participants were randomly assigned to the intervention and control arms, and analysts were blinded as to participant arm. We evaluated intervention effects on HbA1c levels; frequency (times per week) of fruit and vegetable consumption; and frequency (times per week) of mild, moderate, and strenuous leisure-time physical activity. At baseline, 3 months, and 6 months after randomization, participants completed a questionnaire and provided a blood sample. Analysts were blinded to intervention arm.ResultsThe immediate intervention group (−0.64% [standard error (SE) 0.10]) showed a significant improvement in HbA1c scores (–37.5%, P = .04) compared with the delayed intervention group (–0.44%, P = .14). No significant changes were seen for dietary end points or changes in physical activity. We did observe a trend of greater increases in frequency of moderate and vigorous physical activity and a smaller increase in mild physical activity in the immediate intervention group than in the delayed intervention group.ConclusionThis home-based intervention delivered by CHWs was associated with a clinically and statistically significant reduction in HbA1c levels in Hispanic adults with HbA1c levels higher than 6%.
BackgroundHispanics bear some of the highest burden of the obesity epidemic and the disparities gap is bigger among Hispanics in rural communities. This mixed methods study examined the objective and subjective assessment of food availability and food access in four rural, agricultural, and predominantly Hispanic communities.MethodsIn this convergent parallel mixed methods study, we used the Nutrition Environment Measures Survey (NEMS) of Food Stores and Restaurants to objectively assess 57 food stores and 69 restaurants in four rural agricultural communities in Washington State. To complement the objective assessment findings, we conducted semi-structured interviews with 32 community residents. The data were collected from 2013 to 2014. Frequencies and means were calculated for quantitative data and content analysis conducted for interview data.ResultsParticipants (n = 32) had a mean age of 35.6 (SD 6.2) years, were mostly women, uninsured, low income, and had less than a high school education. Grocery and convenience stores had low NEMS composite scores indicating low overall availability of food items, low quality, and high food prices. Composite scores for sit-down restaurants, fast casual restaurants, and fast-food restaurants were similarly low in all four towns indicating limited availability of healthier options. Semi-structured interviews revealed participants perceived high availability and accessibility of quality fresh produce. Most participants reported eating out regularly several times a week, frequenting restaurant chains that serve buffets or fast foods, and allowing children to make decisions regarding their own food choices.ConclusionsCommunity members’ perception of food availability and food access may be different from the objective assessment of food environment. This information can be used to inform community-wide interventions to address food environment in these rural communities.
Racial/ethnic discrimination is associated disparate health outcomes among racial/ethnic minorities. Theory and empirical evidence suggest that stress associated with experiencing discrimination can lead to the adoption of unhealthy behaviors such as poor diet, tobacco and alcohol use. Our study sought to explore the relationship between discrimination, stress and health behaviors among Latinos in both rural and urban settings in Washington state. Latinos were recruited for the study through community based organizations serving Latinos in both Seattle (urban) and the lower Yakima valley (rural). The sample of 40 participants included both men and women, United States and foreign-born, and a broad age range (20 – 70). Qualitative in-depth interviews were conducted in participants’ preferred language (Spanish or English). Interviews were transcribed, entered into Atlas. ti and coded for analysis. Analysis allowed for deductive codes based on theory and previous literature, as well as deductive codes that emerged from the data. Transcripts were also analyzed to identify differences by urban/rural setting, language use and immigrant status. The analysis revealed several key themes related to types of discrimination, health effects of discrimination and stress, and coping strategies. The majority of the participants had experienced discrimination in their lifetime, most often related to their race/ethnicity or language use. Settings in which discrimination occurred included work, school, and when seeking services. Common reactions to discrimination were to avoid it, ignore it, talk with someone about it, or pray about it. Respondents also reported that discrimination and other stressors influenced their sleeping habits, diet, physical activity, smoking and alcohol use. The findings reveal important relationships between discrimination, stress and behavioral risk factors for cancer. The results can inform future research on the health impact of discrimination among Latinos, including the measurement of discrimination and stress. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B34.
ResumenEl objetivo general del estudio fue determinar la influencia de la gestión directiva en la investigación docente universitaria, en Lima Norte, en el año 2019. La investigación empleó el enfoque cuantitativo, el tipo de investigación fue básica, de nivel explicativo, con la aplicación del diseño no experimental, de corte transversal, para la prueba de hipótesis se utilizó la regresión logística interpretando los resultados del índice del pseudo R cuadrado de Nagelkerke y del nivel de significancia. La población estuvo conformada por 182 docentes universitarios del Programa de Estudios Generales, de una universidad privada societaria, de Lima, Perú, correspondiente al semestre académico 2019-2; y la muestra representativa fue de 124 docentes. Se aplicó la técnica de la encuesta y como instrumentos se utilizaron: la escala de evaluación de la gestión directiva y el cuestionario de investigación docente. Los instrumentos fueron sometidos a la validez de contenido a través del juicio de tres expertos con un resultado de aplicable y el valor de la confiabilidad fue con la prueba Alfa de Cronbach con coeficientes de 0,975 y 0,864 respectivamente, indicándonos una fuerte confiabilidad para ambos instrumentos. Los resultados de la investigación permitieron concluir que: existe influencia de la gestión directiva en la investigación docente universitaria, dado que el nivel de significancia resultó 0,000 y el Pseudo R cuadrado de Nagelkerke fue 0,708 equivalente a un 70,8% de influencia. Palabras claves: Gestión directiva, investigación docente, formación académica, motivación, publicación.
Introduction: Hispanics are at increased risk for obesity, which places them at increased risk for a variety of health conditions, including cancer. Risk factors for both obesity and cancer include limited access to healthy affordable foods. This problem is especially prevalent in low-income communities such as rural towns. This study assessed the availability of healthful foods and food environment scores in two rural towns with large percentages of Hispanic residents in Eastern Washington State. Experimental Procedures: Store inventories were collected in 14 food stores (3 grocery and 11 convenience stores) from July-August 2013 using the Nutrition Environment Measures Survey. We recorded data on availability of a variety of fresh fruits, vegetables, whole grain bread, lean ground beef, low-fat hot dogs, baked or low-fat chips, and low sugar cereal. Food environment scores were generated for stores, which consisted of a composite score of availability of healthy food, quality, and price. Results: Convenience stores comprised 79% of food stores. Availability of specific healthful items differed between grocery and convenience stores with all the grocery stores (100%) selling at least 1 fresh fruit compared to 27% of the convenience stores. More grocery stores also had fresh vegetables (100% vs. 18%), whole grain bread (100% vs. 36%), lean ground beef (100% vs. 9%), low-fat hot dogs (100% vs. 9%), baked or low-fat chips (67% vs. 0%), and low sugar cereal (67% vs. 18%). Grocery stores, however, were slightly less likely to be stocked with 100% fruit juice (67% vs. 73%), while more stocked with diet soda (100% vs. 91%) than convenience stores. Out of a possible maximum food environment score of 62, grocery stores scored 29 while convenience stores scored 3.64. Conclusions: Convenience stores make up a large proportion of available food sources in rural towns and have limited stocks of healthful foods. The low food environment scores of both grocery and convenience stores are indication that stores have room for improvements. Increasing the variety of healthy food offerings in food stores could be the first step in improving the food environment in rural towns. Citation Format: Linda K. Ko, Cynthia Perry, Norma Mariscal, Edgar Rodriguez, Catherine Duggan, Mario Kratz, Beti Thompson. Evaluation of the food environment in rural towns in eastern Washington. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A25. doi:10.1158/1538-7755.DISP13-A25
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