Bibliography
Bibliography — Family and Community
This section contains articles that address factors associated with family and community influence on health behavior and health status and strategies to improve health among children and adolescents.
Research
Relationships Among Youth Assets and Neighborhood and Community Resources
Michelle Crozier Kegler, Roy F. Oman, Sara K. Vesely, Kenneth R. McLeroy, Cheryl B. Aspy, Sharon Rodine, and LaDonna Marshall
Health Education & Behavior, Jun 2005; vol. 32(3): 380-397.
Recent research suggests that a youth development framework emphasizing youth assets may be a promising intervention strategy for preventing adolescent risk behaviors. Understanding how neighborhood and community resources relate to youth assets may aid in identifying environmental strategies to complement individually oriented asset-building interventions. In this study, 1,350 randomly selected inner-city youth and their parents (paired interviews) were interviewed in person. After controlling for demographic characteristics of youth and parents using multivariate logistic regression, parental perception of neighborhood safety was associated with the non-parental adult role model asset, peer role model asset, and for African American youth, the community involvement asset. City services and neighborhood services were associated with use of time (groups/sports) and use of time (religion), respectively. Psychological sense of community was associated with community involvement for Native American youth. Findings suggest that neighborhood and community-level influences should be considered when designing youth development interventions to reduce risk behaviors.
Engaging Parents in Preventive Parenting Groups: Do Ethnic, Socioeconomic, and Belief Match Between Parents and Group Leaders Matter?
Jean E. Dumas, Angela D. Moreland, Alexandra H. Gitter, Amanda M. Pearl, and Alicia H. Nordstrom
Health Education & Behavior, Oct 2008; vol. 35: 619 - 633.
The authors evaluate the relation of ethnic, socioeconomic status (SES), and belief match between parents and group leaders and engagement in a preventive intervention for parents of preschoolers. Engagement was assessed through attendance, retention, and quality of participation in sessions with 171 parents and 11 group leaders. SES match predicted attendance, retention, and quality of participation. Parents attended more sessions, remained longer in the program, and participated more actively when their group leader came from comparable SES backgrounds. Ethnic match predicted retention only, with parents attending longer when their ethnicity matched their group leader's. Engagement was unrelated to the extent of match across different characteristics, nor was the link between ethnic match and retention mediated by SES or belief match. Results suggest that social, cultural, and belief similarities between parents and group leaders may be less salient in preventive parenting interventions than is assumed. Implications for research and practice are discussed.
Sustaining a School-Based Prevention Program: Results From the Aban Aya Sustainability Project
Michael C. Fagen and Brian R. Flay
Health Education & Behavior, Feb 2009; vol. 36: 9 - 23.
Sustaining effective school-based prevention programs is critical to improving youth and population-based health. This article reports on results from the Aban Aya Sustainability Project, an effort to sustain a school-based prevention program that was tested via a randomized trial and targeted violence, drug use, and risky sex-related behaviors among a cohort of 5th-grade African American children followed through 10th grade. Sustainability project health educators trained parent educators to deliver the Aban Aya prevention curriculum in five schools, and project researchers studied the resultant curricular implementation and relations between the research and school-based teams. Study results showed uneven implementation across the five schools that we largely attributed to parent educator preparation and parent educator-health educator relations. These and related results are discussed to answer the study's primary research question: How viable was the sustainability project's parent-centered approach to sustaining a school-based prevention program?
Coaching Process Outcomes of a Family Visit Nutrition and Physical Activity Intervention
Jerianne Heimendinger, Terry Uyeki, Aurielle Andhara, Julie A. Marshall, Sharon Scarbro, Elaine Belansky, and Lori Crane
Health Education & Behavior, Feb 2007; vol. 34: 71 – 89.
The purpose of this article is to report the process outcomes of a coaching methodology used in a study designed to increase fruit and vegetable consumption and physical activity in families. Eighty-eight families with second graders were recruited from a rural, biethnic community in Colorado and randomized to intervention and delayed intervention conditions. This article reports on the 27 families in the delayed intervention group. Families received up to 10 home visits over 10 months from a family advisor and completed activities to improve their dietary and physical activity behaviors. Coaching conversations took place during each home visit. Coaching process outcomes were evaluated by analysis of visit documentation, participant survey, and qualitative interviews. Results indicated that coaching, in conjunction with family activities, engaged families in the process of change and facilitated movement toward the achievement of their weekly nutrition or physical activity goals. Coaching methodology may be particularly useful for participatory research.
Empowerment and Sense of Community: Clarifying Their Relationship in Community Organizations
Joseph Hughey, N. Andrew Peterson, John B. Lowe, and Florin Oprescu
Health Education & Behavior, Oct 2008; vol. 35: 651 - 663.
The research reported here tested the factor structure of a measure for sense of community in community organizations, and it evaluated sense of community's potential as an empowering organizational characteristic within an organizational empowerment framework. Randomly selected community organization participants (N = 561) were surveyed as part of a study of a substance abuse prevention initiative located in the northeastern United States. Confirmatory factor analysis verified the putative structure of the sense of community measure tailored to community organizations. Hierarchical regression analyses indicated that community organization sense of community significantly predicted intrapersonal empowerment after controlling for demographics, participation, alienation, and other empowering organizational characteristic. Findings imply that organizational sense of community should be considered as an empowering organizational characteristic in community-based health education.
School-Based Drug Prevention Among At-Risk Adolescents: Effects of ALERT Plus
Douglas Longshore, Phyllis L. Ellickson, Daniel F. McCaffrey, and Patricia A. St. Clair
Health Education & Behavior,Aug 2007; vol. 34: 651 - 668.
In a recent randomized field trial, Ellickson et al. found the Project ALERT drug prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth grade with five booster lessons) and at-risk girls in control schools showed the program curbed weekly alcohol and marijuana use, at-risk drinking, alcohol use resulting in negative consequences, and attitudinal and perceptual factors conducive to drug use. Program-induced changes in perceived social influences, one’s ability to resist those influences, and beliefs about the consequences of drug use mediated the ALERT Plus effects on drug use. No significant effects emerged for at-risk boys or at-risk adolescents in schools where the basic ALERT curriculum (covering seventh and eighth grades only) was delivered. Possible reasons for gender differences and implications for prevention programming are discussed.
Validation of a Parent-Adolescent Communication Scale for Use in STD/HIV Prevention Interventions
Jessica McDermott Sales, Robin R. Milhausen, Gina M. Wingood, Ralph J. DiClemente, Laura F. Salazar, and Richard A. Crosby
Health Education & Behavior, Jun 2008; vol. 35: 332 - 345.
This study reports on the validation of a scale to assess adolescent girls’ frequency of sexual communication with their parents. The Parent-Adolescent Communication Scale (PACS) was administered to 522N African American female adolescents ranging in age from 14 to 18. The PACS demonstrated satisfactory internal consistency (across multiple administrations) and acceptable test-retest reliability over a 12-month follow-up period. Concurrently, scores on the PACS were correlated with frequency of sexual communication with partner, sexual communication self-efficacy (boyfriend), perceived parental knowledge, family support, depression, and condom use with steady male sex partners. Prospectively, baseline PACS scores were correlated with frequency of sexual communication with partner and condom use. The present investigation indicates that the PACS is a reliable and valid measure of frequency of sexual communication between female adolescents and their parents. Utility of the PACS for researchers and practitioners is discussed.
Evaluation of Community Action Against Asthma: A Community Health Worker Intervention to Improve Children’s Asthma-Related Health by Reducing Household Environmental Triggers for Asthma
Edith A. Parker, Barbara A. Israel, Thomas G. Robins, Graciela Mentz, Xihong Lin, Wilma Brakefield-Caldwell, Erminia Ramirez, Katherine K. Edgren, Maria Salinas, and Toby C. Lewis
Health Education & Behavior, Jun 2008; vol. 35: 376 - 395.
This article describes the evaluation of a community-based participatory research (CBPR) community health worker (CHW) intervention to improve children’s asthma-related health by reducing household environmental triggers for asthma. After randomization to an intervention or control group, 298 households in Detroit, Michigan, with a child, aged 7 to 11, with persistent asthma symptoms participated. The intervention was effective in increasing some of the measures of lung function (daily nadir Forced Expiratory Volume at one second [p = .03] and daily nadir Peak Flow [p = .02]), reducing the frequency of two symptoms (“cough that won’t go away,” “coughing with exercise”), reducing the proportion of children requiring unscheduled medical visits and reporting inadequate use of asthma controller medication, reducing caregiver report of depressive symptoms, reducing concentrations of dog allergen in the dust, and increasing some behaviors related to reducing indoor environmental triggers. The results suggest a CHW environmental intervention can improve children’s asthma-related health, although the pathway for improvement is complex.
Impact Analysis and Mediation of Outcomes: The Going Places Program
Bruce Simons-Morton, Denise Haynie, Keith Saylor, Aria Davis Crump, and Rusan Chen
Health Education & Behavior, Apr 2005; Vol. 32(2): 227-241.
The purpose of the study was to evaluate the impact of the Going Places Program and mediation of treatment effects. Seven middle schools were randomized to intervention or comparison conditions and students (n = 1,320) in two successive cohorts provided five waves of data from sixth through eighth grade. The Going Places Program included classroom curriculum, parent education, and school environment components. Latent growth curve analyses demonstrated significant treatment group effects on outcome expectancies, friends who smoke, and smoking. Friends who smoke mediated the program effect on adolescents’ smoking progression. The protective effect of the Going Places Program on smoking progression was due in part to the prevention of increases in friends who smoke.
The Dose-Response Relationship of Adolescent Religious Activity and Substance Use: Variation Across Demographic Groups
Kenneth J. Steinman, Amy K. Ferketich, and Timothy Sahr
Health Education & Behavior, Feb 2008; vol. 35: 22 - 43.
This article addresses two inconsistent findings in the literature on adolescent religious activity (RA) and substance use: whether a dose-response relationship characterizes the association of these variables, and whether the association varies by grade, gender, ethnicity, family structure, school type, and type of substance. Multinomial logistic regression analyses of a large, diverse data set of high school students in metropolitan Colum bus, Ohio (n = 33,007), found marked differences in alcohol, marijuana, and cigarette use among youths who never, occasionally, or regularly participated in RA. Weekly RA was consistently associated with less sub -stance use, yet occasional RA some times was associated with greater use. Four groups accounted for variations in the RA-sub stance use relationship: African American youths, younger White youths, 12th-grade White.
Neighborhood-Level Factors and Youth Violence: Giving Voice to the Perceptions of Prominent Neighborhood Individuals
Michael A. Yonas, Patricia O'Campo, Jessica G. Burke, and Andrea C. Gielen
Health Education & Behavior, Aug 2007; vol. 34: 669 - 685.
Youth violence is a significant public health problem. Although the relationship between neighborhood level factors and urban youth violence is recognized, the specific mechanisms of this relationship are often unclear. Prominent neighborhood individuals were identified within four select low-income urban neighborhoods in Baltimore City. In-depth interviews were conducted to explore these individuals’ perceptions of the relationship between social and structural neighborhood-level factors and urban youth violence. Employment opportunities, local businesses, trash management, vacant housing, and street lighting were perceived as important neighborhood factors influencing young people’s experiences. The relationship between these neighborhood characteristics and the local illicit drug market and youth violence is highlighted. Results provide an enhanced understanding of the importance of using a participatory-based research approach and the mechanisms of the relationship between neighborhood-level factors and youth violence. Both are critical components in designing and implementing multilevel youth violence prevention efforts.
Practice
This section contains articles addressing the effectiveness and practical application of family, community and school health programs and policies for improved health outcomes in children and adolescents.
Youth Participation in a Community Campaign to Pass a Clean Indoor Air Ordinance
Christine Taggart Bozlak and Michele A. Kelley
Health Promotion Practice, Feb 2009; vol. 0: 1524839908330815v1.
Because of the harmful effects of secondhand smoke, communities are organizing to pass clean indoor air policies. With youth being considered one of the most vulnerable populations to this health hazard, it can be strategic to campaigns and beneficial to the youth’s development to involve them in efforts to control this toxin. However, youth participation in health campaigns is limited because of barriers inherent in these initiatives. This article presents lessons learned from a qualitative case study on the youth involvement in a successful local clean indoor air campaign. Through the analysis of semistructured interviews with the adult members of the campaign, group interviews and questionnaire completion by the youth members of the campaign, and additional insight made possible by participant observation, recommendations are provided to engage and sustain youth involvement in local public health initiatives.
Community-Based Prevention Marketing: Organizing a Community for Health Behavior Intervention
Carol A. Bryant, Kelli R. McCormack Brown, Robert J. McDermott, Melinda S. Forthofer, Elizabeth C. Bumpus, Susan A. Calkins, and Lauren B. Zapata
Health Promotion Practice, Apr 2007; vol. 8: 154 - 163.
This article describes the application and refinement of community-based prevention marketing (CBPM), an example of community-based participatory research that blends social marketing theories and techniques and community organization principles to guide voluntary health behavior change. The Florida Prevention Research Center has worked with a community coalition in Sarasota County, Florida to define locally important health problems and issues and to develop responsive health-promotion interventions. The CBPM framework has evolved as academic and community-based researchers have gained experience applying it. Community boards can use marketing principles to design evidence-based strategies for addressing local public health concerns. Based on 6 years of experience with the “Believe in All Your Possibilities” program, lessons learned that have led to revision and improvement of the CBPM framework are described.
Using Community Ties to Facilitate School-Based Prevention Research
Pamela K. Cupp, Rick S. Zimmerman, Christi Sporl Massey, Jennifer R. Howell, and Rachel Swan
Health Promotion Practice, Oct 2006; vol. 7: 459 - 466.
One of the greatest obstacles to conducting school based HIV/STD/pregnancy prevention research with adolescents is the reluctance of administrators or site based decision-making councils to commit their teachers and students to participation in a project designed and managed by an outside group of researchers. A major concern is that researchers may not understand or agree with community sensitivities about such personal topics. By first establishing a collaborative relationship with health district educators currently working in Appalachian schools and residing in those communities, one finds a distinct advantage in terms of gaining admittance to area schools. The presence of local health educators at formative meetings also allays many concerns of community members, as they view these local participants as monitors of outsider research efforts, thereby protecting the community culture from undue outside influence. During the course of the current study, health educators found they also learned more about their communities and about HIV prevention.
Community Involvement in the Conduct of a Health Education Intervention and Research Project: Community Action Against Asthma
Katherine K. Edgren, Edith A. Parker, Barbara A. Israel, Toby C. Lewis, Maria A. Salinas, Thomas G. Robins, and Yolanda R. Hill
Health Promotion Practice, July 2005; vol. 6 (3): 263-269.
There is a need for more guidance on how to implement community-based participatory research, particularly on the roles of community members, throughout the process. This article focuses on how a Steering Committee, composed of representatives from community based organizations, a local health department, an integrated health care system, and academia from the University of Michigan, participated in the design and implementation of a children’s asthma study in Detroit, Michigan: Community Action Against Asthma. In addition, this article focuses on the role of community members as data collectors, examining a variety of sophisticated data collection roles. A description and analysis of how community members shaped and participated in the project, the lessons learned, and recommendations for practitioners are also presented.
Community-Based Strategies to Reduce Childhood Immunization Disparities
Sally E. Findley, Matilde Irigoyen, Martha Sanchez, Letty Guzman, Miriam Mejia, Michelle Sajous, Deborah A. Levine, Shaofu Chen, and Frank Chimkin
Health Promotion Practice, Jul 2006; vol. 7: 191S - 200S.
This study demonstrates how community-based immunization promotion reduced immunization disparities. In 2002 to 2004, the coalition enrolled 3,748 children younger than 5, with 1,502 aged 19 to 35 months in April 2004. Disparity reduction was assessed by comparing coalition immunization coverage rates (4:3:1:3:3) to the National Immunization Survey 2003 rates. Logistic regression was used to assess factors contributing to up-todate immunizations. Coverage increased from 46.0% at enrollment to 80.5%, matching nationwide rates for all (t = 0.87) or White (t = 1.99) children. The 78% for African Americans was higher than 73% for U.S. African American children (t = 2.90); 84% for Latinos was higher than 77% for U.S. Latinos (t = 2.32). Being current with age-appropriate immunizations at enrollment (OR = 9.8), being Latino (OR = 1.6), and participating through child health insurance enrollment (OR = 4.9), Women, Infants, and Children (OR = 3.1), or child care or parenting (OR = 1.9) programs increased immunization coverage. Embedding immunization promotion into existing community programs was successful in eliminating immunization disparities. Most effective programs were those with direct linkages to health care systems or that targeted young children.
REACH 2010: New York City: Effective Strategies for Integrating Immunization Promotion Into Community Programs
Sally E. Findley, Martha Sanchez, Miriam Mejia, Richard Ferreira, Oscar Pena, Sergio Matos, Melissa S. Stockwell, and Matilde Irigoyen
Health Promotion Practice, Apr 2009; vol. 10: 128S - 137S.
Most immunization coalitions have originated with health care providers, potentially excluding families without medical homes. This study focused on a community-based approach to providing timely vaccinations. A coalition of 23 organizations developed an immunization program in a low-income community in New York City. Nearly 1,000 community health workers incorporated immunization promotion into social service and educational programs. Outcomes were coverage rates for the 4:3:1:3:3 series at 19 to 35 months, which were compared with national data by ethnicity, as reported in the National Immunization Survey 2002-2006. Parents (n = 10,251) of children <5 years received immunization education and reminders. The 2003-2007 rates of 80% equaled or exceeded the national rates for 19- to 35-month-olds, and the 2007 rate of 96.8% far surpassed the national average. Coalitions can effectively integrate immunization promotion activities into community programs. Immunization rate improvements maintained for a 5-year period, suggesting this approach to be sustainable.
Factors Influencing Booster Seat Use in a Multiethnic Community: Lessons for Program Implementation
Brian D. Johnston, Elizabeth Bennett, Linda Quan, Denise Gonzalez-Walker, Beth Crispin, and Beth Ebel
Health Promotion Practice, Jun 2008; vol. 0: 1524839908317743v1.
Based on the local incidence and severity of motor vehicle occupant injuries, the authors’ community and hospital injury prevention partnership identified child passenger safety for 4-to-8-year-old children as a priority. They designed a booster seat promotion campaign using an integrated social cognition model of health behavior. A series of focus groups were held with low-income African American, Somali, and Vietnamese parents to understand determinants of booster seat use in these communities. Deficits in understanding about the purpose of booster seats were seen in all groups, and concerns about cost and self-efficacy varied in important ways. Although legislation is an important tool in motivating child passenger restraint, most families saw safety as the prime reason to use booster seats with their children. These results illustrate the use of qualitative data to adapt a theory-based intervention to the needs of specific communities.
Acknowledging Adult Bias: A Focus-Group Approach to Utilizing Beauty Salons as Health-Education Portals for Inner-City Adolescent Girls
Alexis Lieberman and Diana Harris
Health Promotion Practice, Apr 2007; vol. 8: 205 - 213.
To assess the feasibility of using beauticians as health literacy agents and beauty salons as health-education portals for adolescent, inner-city, African American girls, the authors conducted focus groups with 25 women: salon clients, salon owners, and medical students. Facilitators to program development included (a) beautician-client relationships, (b) teens’ access to health information, and (c) beauticians as information resources. Barriers included (a) adult opinions of teen behaviors, (b) teen mistrust of adults, and (c) low health literacy of beauticians. In developing a health-education program for this population, beauticians and salons may be excellent health information agents and portals if barriers including beautician poor health literacy, adolescent mistrust in adults, and adults’ anti-adolescent bias are improved. Program implementation must not solely focus on teens but should also include adult salon users, with the goal of reaching the teens first through these adults and, with time and trust, reaching the teens directly.
Do Urban Parents’ Interests in Safety Topics Match Their Children’s Injury Risks?
Eileen M. McDonald, Barry S. Solomon, Wendy C. Shields, Janet R. Serwint, Mei-Cheng Wang, and Andrea C. Gielen
Health Promotion Practice, Oct 2006; vol. 7: 388 - 395.
Objective: To assess childhood injury risk and parents’ injury interests, and the association between the two. Method: A cross-sectional computer and telephone survey was conducted as part of a randomized controlled trial. The authors enrolled parents of children being seen at an urban pediatric primary care practice and measured selected injury knowledge, beliefs and safety practices. Parents were asked to select two of four topics of interest and recommendations regarding them were included in a computer-tailored report. Results: Participants (N = 105) were assessed as being at risk for all four areas: poisoning (88%), fires (85%), falls (55%), and car crashes (18%). Parents were interested in poisoning (81%) and car crashes (49%); their interests were unrelated to child’s assessed risk. Conclusion: Soliciting parents’ interests prior to counseling may help to identify priority areas for counseling as well as dispel myths and unfounded fears regarding childhood injury risks.
Informing Best Practice With Community Practice: The Community Change Chronicle Method for Program Documentation and Evaluation
Sheryl A. Scott and Scott Proescholdbell
Health Promotion Practice, Jan 2009; vol. 10: 102 - 110.
Health promotion professionals are increasingly encouraged to implement evidence-based programs in health departments, communities, and schools. Yet translating evidence-based research into practice is challenging, especially for complex initiatives that emphasize environmental strategies to create community change. The purpose of this article is to provide health promotion practitioners with a method to evaluate the community change process and document successful applications of environmental strategies. The community change chronicle method uses a five-step process: first, develop a logic model; second, select outcomes of interest; third, review programmatic data for these outcomes; fourth, collect and analyze relevant materials; and, fifth, disseminate stories. From 2001 to 2003, the authors validated the use of a youth empowerment model and developed eight community change chronicles that documented the creation of tobacco-free schools policies (n = 2), voluntary policies to reduce secondhand smoke in youth hangouts (n = 3), and policy and program changes in diverse communities (n = 3).
Exploring Local Perceptions of and Responses to Urban Youth Violence
Michael A. Yonas, Patricia O'Campo, Jessica G. Burke, and Andrea C. Gielen
Health Promotion Practice, Mar 2008; vol. 0: 1524839907311050v1.
Objective: Despite widespread prevention efforts, youth violence persists in many urban communities. This investigation explores the unique perspectives and local capacities to address urban youth violence. Method: Qualitative in-depth interviews were conducted with prominent neighborhood individuals (PNIs) from low-wealth neighborhoods that varied by risk for youth violence. Findings: Findings reveal examples of increased levels of social action in the designated low risk for youth violence neighborhoods. Similar activities were also present, but to a lesser extent, within the high-risk neighborhoods. Results illustrate how PNIs formally and informally share information and take action to address youth violence. Conclusion: PNIs are an often-overlooked resource in gaining local insight for addressing health issues, such as youth violence. The efforts identified exhibit expertise and culturally sensitive opportunities for working together to address youth violence. Understanding such dynamics is essential for informing the development of locally endorsed violence-prevention interventions.
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