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Sample records for low-income setting making

  1. District decision-making for health in low-income settings: a systematic literature review

    PubMed Central

    Avan, Bilal Iqbal

    2016-01-01

    Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages—identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would

  2. District decision-making for health in low-income settings: a systematic literature review.

    PubMed

    Wickremasinghe, Deepthi; Hashmi, Iram Ejaz; Schellenberg, Joanna; Avan, Bilal Iqbal

    2016-09-01

    Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase

  3. Making a difference: using the safe surgery checklist to initiate continuing education for perioperative nurses in low-income settings.

    PubMed

    Leifso, Genelle

    2014-03-01

    The WHO Safe Surgery Checklist (2008) patient safety focus and communication prompts are widely accepted. In many low-income regions (as defined by the World Bank and accepted by the World Health Organization) perioperative nurses have little or no formal training; continuing and in-service education are virtually unknown; nor does an articulated "culture of safety" exist. In 2009 the Canadian Network for International Surgery (CNIS) piloted a two-day perioperative nursing course, in Addis Ababa, Ethiopia, using lectures, case studies, skills sessions, and role-play exercises based on the SSSL Checklist outline and protocols. Canadian instructors (who are certified after taking the Canadian Network for International Surgery-sponsored Instructor's Course) have since returned and taught at additional sites in Ethiopia and Uganda. Course participants now include perioperative nurses, anaesthetists, and junior surgical residents--mirroring the interdisciplinary teamwork that is crucial to safe perioperative patient care. The course's facilitated discussions focus on workplace and practice issues in order to allow for appropriate evaluation and planning of future educational initiatives. Participants complete pre- and post-course questionnaires, which evaluate baseline and post-course knowledge, and further follow-up is completed four months after course completion. This article explains the need for aiding in the expansion of perioperative nursing knowledge and skill in low-income settings and provides the author's personal perspective and experience in responding to this need. Her experience as facilitator in a pilot project and subsequent course development described. The objective is to discuss ways that other perioperative nurses can work to make a positive difference on professional practice and patient care in low-income regions. PMID:24791444

  4. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia

    PubMed Central

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-01-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

  5. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

    PubMed

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

    2016-09-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

  6. Financial incentives to influence maternal mortality in a low-income setting: making available ‘money to transport’ – experiences from Amarpatan, India

    PubMed Central

    De Costa, Ayesha; Patil, Rajkumar; Kushwah, Surgiv Singh; Diwan, Vinod Kumar

    2009-01-01

    Objectives Only 40.7% women in India deliver in an institution; leaving many vulnerable to maternal morbidity and mortality (India has 22% of global maternal deaths). While limited accessibility to functioning institutions may account in part, a common reason why women deliver at home is poverty. A lack of readily available financial resources for families to draw upon at the time of labor to transport the mother to an institution, is often observed. This paper reports a yearlong collaborative intervention (between the University and Department of Health) to study if providing readily available and easily accessible funds for emergency transportation would reduce maternal deaths in a rural, low income, and high maternal mortality setting in central India. It aimed to obviate a deterrent to emergency obstetric care; the non-availability of resources with mothers when most needed. Issues in implementation are also discussed. Methods Maternal deaths were actively identified in block Amarpatan (0.2 million population) over a 2-year period. The project, with participation from local government and other groups, trained 482 local health care providers (public and private) to provide antenatal care. Emergency transport money (in cash) was placed with one provider in each village. Maternal mortality in the adjacent block (Maihar) was followed (as a ‘control’ block). Results Maternal deaths in Amarpatan decreased during the project year relative to the previous year, or in the control block the same year. Discussion and conclusions Issues in implementation of the cash incentive scheme are discussed. Although the intervention reduced maternal deaths in this low-income setting, chronic poverty and malnutrition are underlying structural problems that need to be addressed. PMID:20027276

  7. District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia.

    PubMed

    Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-09-01

    Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India's extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. PMID:27591204

  8. District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia

    PubMed Central

    Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-01-01

    Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India’s extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. PMID:27591204

  9. Child Care Decision Making: Understanding Priorities and Processes Used by Low-Income Families in Minnesota

    ERIC Educational Resources Information Center

    Forry, Nicole; Isner, Tabitha K.; Daneri, Maria P.; Tout, Kathryn

    2014-01-01

    Research Findings: Few studies have described parents' child care decision-making process, yet understanding how parents make child care choices is fundamental to developing effective services to promote the selection of high-quality care. This study used latent profile analysis to distinguish subgroups of low-income parents identified as…

  10. Self-Rated Health and Mortality: Does the Relationship Extend to a Low Income Setting?

    ERIC Educational Resources Information Center

    Frankenberg, Elizabeth; Jones, Nathan R.

    2004-01-01

    Although a relationship between poor self-reported health status and excess mortality risk has been well-established for industrialized countries, almost no research considers developing countries. We use data from Indonesia to show that in a low-income setting, as in more advantaged parts of the world, individuals who perceive their health to be…

  11. Consent and assent in paediatric research in low-income settings

    PubMed Central

    2014-01-01

    Background In order to involve children in the decision-making process about participation in medical research it is widely recommended that the child’s assent be sought in addition to parental consent. However, the concept of assent is fraught with difficulties, resulting in confusion among researchers and ethics committees alike. Discussion In this paper, we outline the current international debate surrounding pediatric consent and assent, and its unique challenges arising in low-income settings. We go on to propose some key requirements for a fit-for-purpose assent model in these difficult settings. The paper recommends that children who are competent, that is, children who are judged to be able to understand and retain relevant information, weigh this information in making a mature judgment, come to a decision and communicate the decision, should be able to consent for themselves. Our proposal is that where the decision about whether to participate in a study is of comparable complexity to the decisions the child is used to making in other aspects of his or her life, it should be made by the child him or herself. The relevant level of complexity should be judged by local standards rather than standards of the developed world. In the paper we explore some of the practical challenges and counter arguments of implementing this proposal. As in high-income settings, we argue that in the case of children who are judged to lack this level of competence both parental consent and assent from the child should be sought and go on to define assent as involving the child to the extent compatible to his or her maturity and with cultural norms and not as obtaining the child’s permission to proceed. Summary The concept of assent in the current guidelines is confusing. There is an urgent need for clearer guidelines that can be adapted for all types of paediatric research wherever it is to be carried out and an evidence-base concerning good assent/consent practice. This

  12. Activity Settings and Daily Routines in Preschool Classrooms: Diverse Experiences in Early Learning Settings for Low-Income Children

    ERIC Educational Resources Information Center

    Fuligni, Allison Sidle; Howes, Carollee; Huang, Yiching; Hong, Sandra Soliday; Lara-Cinisomo, Sandraluz

    2012-01-01

    This paper examines activity settings and daily classroom routines experienced by 3- and 4-year-old low-income children in public center-based preschool programs, private center-based programs, and family child care homes. Two daily routine profiles were identified using a time-sampling coding procedure: a High Free-Choice pattern in which…

  13. The Impact of a Program for Control of Asthma in a Low-Income Setting

    PubMed Central

    Souza-Machado, Adelmir; Franco, Rosana; Souza-Machado, Carolina; Ponte, Eduardo V.; Moura Santos, Pablo; Barreto, Maurício L.

    2010-01-01

    Abstract: The prevalence of asthma is increasing in developing countries and the burden of uncontrolled asthma affects patients, families, and the health system. This is to summarize, evaluate, and discuss previous reports on the impact of a targeted and comprehensive approach to the most severe cases of asthma in a low-income setting. A Program for Control of Asthma (ProAR) was developed in Salvador, Bahia, Brazil, prioritizing the control of severe asthma. By facilitating referrals from the public health system and providing proper multidisciplinary but simple management including education and medication, for free, the Program enrolled 2385 patients in 4 reference clinics. They are offered regular follow up and discharged back to primary health care only when asthma control can be maintained without requirement of a combination of an inhaled corticosteroid and a long-acting β2 agonist. ProAR has markedly reduced health resource utilization and decreased the rate of hospital admissions because of asthma in the entire City (2.8 million inhabitants) by 74%. Moderate to severe rhinitis was associated with lack of control of asthma. The average income of the families in the ProAR was US$2955 a year, and they spent 29% of all their income attempting to control the severe asthma of one member, a unbearable expenditure for a low-income family. The ProAR was shown to be cost-effective, reducing costs to the public health system (US$387 patient/year) and the families (US$789 patient/year). In a low-income setting of Brazil, an intervention prioritizing the control of severe asthma was feasible, effective, and reduced costs. PMID:23268428

  14. Use of a national collaborative to improve hospital quality in a low-income setting

    PubMed Central

    Linnander, Erika; McNatt, Zahirah; Sipsma, Heather; Tatek, Dawit; Abebe, Yigeremu; Endeshaw, Abraham; Bradley, Elizabeth H.

    2016-01-01

    Background Quality improvement collaboratives are a widely used mechanism to improve hospital performance in high-income settings, but we lack evidence about their effectiveness in low-income settings. Methods We conducted cross-sectional and longitudinal analysis of data from the Ethiopian Hospital Alliance for Quality, a national collaborative sponsored by Ethiopia's Federal Ministry of Health. We identified hospital strategies associated with more positive patient satisfaction using linear regression and assessed changes in patient experience over a 3-year period (2012–2014) using matched t-tests. Results A total of 68 hospitals (response rate 68/120, 56.7%) were included in cross-sectional analysis. Four practices were significantly associated with more positive patient satisfaction (p<0.05): posting a record of cleaning activity in toilets and in patient wards, distributing leaflets in the local language with each prescription, and sharing ideas about patient experience across the hospital. Among hospitals that had complete data for longitudinal analysis (44/68, 65%), we found a 10% improvement in a 10-point measure of patient satisfaction (7.7 vs 8.4, p<0.01) from the start to the end of the study period. Conclusions Quality improvement collaboratives can be useful at scale in low-income settings in sub-Saharan Africa, particularly for hospitals that adopt strategies associated with patient satisfaction. PMID:26796023

  15. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.

    PubMed

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-09-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private

  16. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data

    PubMed Central

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-01-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3–200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector’s non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with

  17. Global burden of Influenza: Contributions from Resource Limited and Low-Income Settings

    PubMed Central

    Fischer, William A.; Gong, Michelle; Bhagwanjee, Satish; Sevransky, Jonathan

    2014-01-01

    Severe acute respiratory infections (SARI), including influenza, are a leading cause of cardiopulmonary morbidity and mortality worldwide. Until recently the epidemiology of influenza was limited to resource-rich countries. Emerging epidemiological reports characterizing the 2009 H1N1 pandemic however suggest that influenza exerts an even greater toll in low-income resource constrained environments where it is the cause of 5–27% of all SARI. The increased burden of disease in this setting is multifactorial and likely is the results of higher rates of comorbidities such as HIV, decreased access to healthcare including vaccinations and antiviral medications, and limited healthcare infrastructure including oxygen therapy or critical care support. Improved global epidemiology of influenza is desperately needed in order to guide allocation of life saving resources including vaccines, antiviral medications, and direct the improvement of basic health care in order to mitigate the impact of influenza infection on the most vulnerable populations. PMID:25667184

  18. Childhood Nutrition: Perceptions of Caretakers in a Low-Income Urban Setting

    ERIC Educational Resources Information Center

    Kelly, Lynn E.; Patterson, Barbara J.

    2006-01-01

    The incidence of overweight and obese children, especially those from low-income and minority backgrounds, continues to rise. Multiple factors contribute to the rising rates. In order to gain an understanding of factors contributing to obesity in low-income families, a qualitative study was conducted with the purpose of gaining knowledge of…

  19. Development of a Brief Instrument for Assessing Healthcare Employee Satisfaction in a Low-Income Setting

    PubMed Central

    Thompson, Jennifer T.; McNatt, Zahirah; Tatek, Dawit; Lindfield, Tessa; Bradley, Elizabeth H.

    2013-01-01

    Background Ethiopia is one of 57 countries identified by the World Health Report 2006 as having a severely limited number of health care professionals. In recognition of this shortage, the Ethiopian Federal Ministry of Health, through the Ethiopian Hospital Management Initiative, prioritized the need to improve retention of health care workers. Accordingly, we sought to develop the Satisfaction of Employees in Health Care (SEHC) survey for use in hospitals and health centers throughout Ethiopia. Methods Literature reviews and cognitive interviews were used to generate a staff satisfaction survey for use in the Ethiopian healthcare setting. We pretested the survey in each of the six hospitals and four health centers across Ethiopia (98% response rate). We assessed content validity and convergent validity using factor analysis and examined reliability using the Cronbach alpha coefficients to assess internal consistency. The final survey was comprised of 18 questions about specific aspects of an individual's work and two overall staff satisfaction questions. Results We found support for content validity, as data from the 18 responses factored into three factors, which we characterized as 1) relationship with management and supervisors, 2) job content, and 3) relationships with coworkers. Summary scores for two factors (relationship with management and supervisors and job content) were significantly associated (P-value, <0.001) with the two overall satisfaction items. Cronbach's alpha coefficients showed good to excellent internal consistency (Cronbach alpha coefficients >0.70) for the items in the three summary scores. Conclusions The introduction of consistent and reliable measures of staff satisfaction is crucial to understand and improve employee retention rates, which threaten the successful achievement of the Millennium Development Goals in low-income countries. The use of the SEHC survey in Ethiopian healthcare facilities has ample leadership support, which is

  20. Making It Work: Low-Income Working Mothers' Involvement in Their Children's Education

    ERIC Educational Resources Information Center

    Weiss, Heather B.; Mayer, Ellen; Kreider, Holly; Vaughan, Margaret; Dearing, Eric; Hencke, Rebecca; Pinto, Kristina

    2003-01-01

    This article explores the complex relation between employment and family involvement in children's elementary education for low-income women. Mixed-method analyses showed work as both an obstacle to and opportunity for involvement. Mothers who worked or attended school full time were less involved in their children's schooling than other mothers,…

  1. Increasing Access for Low-Income Students and Making Financial Education a Priority for Higher Education

    ERIC Educational Resources Information Center

    Kezar, Adrianna

    2009-01-01

    While widespread financial illiteracy and reduced opportunities for low-income students to participate in higher education may seem unrelated, both challenges can be addressed through Individual Development Accounts (IDAs), an existing but widely underutilized tool. IDAs have the potential both to increase access and retention of low-income…

  2. Combining evidence and values in priority setting: testing the balance sheet method in a low-income country

    PubMed Central

    Makundi, Emmanuel; Kapiriri, Lydia; Norheim, Ole Frithjof

    2007-01-01

    Background Procedures for priority setting need to incorporate both scientific evidence and public values. The aim of this study was to test out a model for priority setting which incorporates both scientific evidence and public values, and to explore use of evidence by a selection of stakeholders and to study reasons for the relative ranking of health care interventions in a setting of extreme resource scarcity. Methods Systematic search for and assessment of relevant evidence for priority setting in a low-income country. Development of a balance sheet according to Eddy's explicit method. Eight group interviews (n-85), using a modified nominal group technique for eliciting individual and group rankings of a given set of health interventions. Results The study procedure made it possible to compare the groups' ranking before and after all the evidence was provided to participants. A rank deviation is significant if the rank order of the same intervention differed by two or more points on the ordinal scale. A comparison between the initial rank and the final rank (before deliberation) showed a rank deviation of 67%. The difference between the initial rank and the final rank after discussion and voting gave a rank deviation of 78%. Conclusion Evidence-based and deliberative decision-making does change priorities significantly in an experimental setting. Our use of the balance sheet method was meant as a demonstration project, but could if properly developed be feasible for health planners, experts and health workers, although more work is needed before it can be used for laypersons. PMID:17892561

  3. Activity Settings and Daily Routines in Preschool Classrooms: Diverse Experiences in Early Learning Settings for Low-Income Children

    PubMed Central

    Fuligni, Allison Sidle; Howes, Carollee; Huang, Yiching; Hong, Sandra Soliday; Lara-Cinisomo, Sandraluz

    2011-01-01

    This paper examines activity settings and daily classroom routines experienced by 3- and 4-year-old low-income children in public center-based preschool programs, private center-based programs, and family child care homes. Two daily routine profiles were identified using a time-sampling coding procedure: a High Free-Choice pattern in which children spent a majority of their day engaged in child-directed free-choice activity settings combined with relatively low amounts of teacher-directed activity, and a Structured-Balanced pattern in which children spent relatively equal proportions of their day engaged in child-directed free-choice activity settings and teacher-directed small- and whole-group activities. Daily routine profiles were associated with program type and curriculum use but not with measures of process quality. Children in Structured-Balanced classrooms had more opportunities to engage in language and literacy and math activities, whereas children in High Free-Choice classrooms had more opportunities for gross motor and fantasy play. Being in a Structured-Balanced classroom was associated with children’s language scores but profiles were not associated with measures of children’s math reasoning or socio-emotional behavior. Consideration of teachers’ structuring of daily routines represents a valuable way to understand nuances in the provision of learning experiences for young children in the context of current views about developmentally appropriate practice and school readiness. PMID:22665945

  4. Activity Settings and Daily Routines in Preschool Classrooms: Diverse Experiences in Early Learning Settings for Low-Income Children.

    PubMed

    Fuligni, Allison Sidle; Howes, Carollee; Huang, Yiching; Hong, Sandra Soliday; Lara-Cinisomo, Sandraluz

    2012-06-01

    This paper examines activity settings and daily classroom routines experienced by 3- and 4-year-old low-income children in public center-based preschool programs, private center-based programs, and family child care homes. Two daily routine profiles were identified using a time-sampling coding procedure: a High Free-Choice pattern in which children spent a majority of their day engaged in child-directed free-choice activity settings combined with relatively low amounts of teacher-directed activity, and a Structured-Balanced pattern in which children spent relatively equal proportions of their day engaged in child-directed free-choice activity settings and teacher-directed small- and whole-group activities. Daily routine profiles were associated with program type and curriculum use but not with measures of process quality. Children in Structured-Balanced classrooms had more opportunities to engage in language and literacy and math activities, whereas children in High Free-Choice classrooms had more opportunities for gross motor and fantasy play. Being in a Structured-Balanced classroom was associated with children's language scores but profiles were not associated with measures of children's math reasoning or socio-emotional behavior. Consideration of teachers' structuring of daily routines represents a valuable way to understand nuances in the provision of learning experiences for young children in the context of current views about developmentally appropriate practice and school readiness. PMID:22665945

  5. Laboratory assessment of a gravity-fed ultrafiltration water treatment device designed for household use in low-income settings.

    PubMed

    Clasen, Thomas; Naranjo, Jaime; Frauchiger, Daniel; Gerba, Charles

    2009-05-01

    Interventions to improve water quality, particularly when deployed at the household level, are an effective means of preventing endemic diarrheal disease, a leading cause of mortality and morbidity in the developing world. We assessed the microbiologic performance of a novel water treatment device designed for household use in low-income settings. The device employs a backwashable hollow fiber ultrafiltration cartridge and is designed to mechanically remove enteric pathogenic bacteria, viruses, and protozoan cysts from drinking water without water pressure or electric power. In laboratory testing through 20,000 L (approximately 110% of design life) at moderate turbidity (15 nephelometric turbidity unit [NTU]), the device achieved log(10) reduction values of 6.9 for Escherichia coli, 4.7 for MS2 coliphage (proxy for enteric pathogenic viruses), and 3.6 for Cryptosporidium oocysts, thus exceeding levels established for microbiological water purifiers. With periodic cleaning and backwashing, the device produced treated water at an average rate of 143 mL/min (8.6 L/hour) (range 293 to 80 mL/min) over the course of the evaluation. If these results are validated in field trials, the deployment of the unit on a wide scale among vulnerable populations may make an important contribution to public health efforts to control intractable waterborne diseases. PMID:19407130

  6. Judgment under uncertainty; a probabilistic evaluation framework for decision-making about sanitation systems in low-income countries.

    PubMed

    Malekpour, Shirin; Langeveld, Jeroen; Letema, Sammy; Clemens, François; van Lier, Jules B

    2013-03-30

    This paper introduces the probabilistic evaluation framework, to enable transparent and objective decision-making in technology selection for sanitation solutions in low-income countries. The probabilistic framework recognizes the often poor quality of the available data for evaluations. Within this framework, the evaluations will be done based on the probabilities that the expected outcomes occur in practice, considering the uncertainties in evaluation parameters. Consequently, the outcome of evaluations will not be single point estimates; but there exists a range of possible outcomes. A first trial application of this framework for evaluation of sanitation options in the Nyalenda settlement in Kisumu, Kenya, showed how the range of values that an evaluation parameter may obtain in practice would influence the evaluation outcomes. In addition, as the probabilistic evaluation requires various site-specific data, sensitivity analysis was performed to determine the influence of each data set quality on the evaluation outcomes. Based on that, data collection activities could be (re)directed, in a trade-off between the required investments in those activities and the resolution of the decisions that are to be made. PMID:23416987

  7. Promoting health and advancing development through improved housing in low-income settings.

    PubMed

    Haines, Andy; Bruce, Nigel; Cairncross, Sandy; Davies, Michael; Greenland, Katie; Hiscox, Alexandra; Lindsay, Steve; Lindsay, Tom; Satterthwaite, David; Wilkinson, Paul

    2013-10-01

    There is major untapped potential to improve health in low-income communities through improved housing design, fittings, materials and construction. Adverse effects on health from inadequate housing can occur through a range of mechanisms, both direct and indirect, including as a result of extreme weather, household air pollution, injuries or burns, the ingress of disease vectors and lack of clean water and sanitation. Collaborative action between public health professionals and those involved in developing formal and informal housing could advance both health and development by addressing risk factors for a range of adverse health outcomes. Potential trade-offs between design features which may reduce the risk of some adverse outcomes whilst increasing the risk of others must be explicitly considered. PMID:23271143

  8. Psychological Symptoms and Social Functioning Following Repair of Obstetric Fistula in a Low-Income Setting.

    PubMed

    Wilson, Sarah M; Sikkema, Kathleen J; Watt, Melissa H; Masenga, Gileard G; Mosha, Mary V

    2016-05-01

    Objectives Obstetric fistula is a maternal injury that causes uncontrollable leaking of urine or stool, and most women who develop it live in poverty in low-income countries. Obstetric fistula is associated with high rates of stigma and psychological morbidity, but there is uncertainty about the impact of surgical treatment on psychological outcomes. The objective of this exploratory study was to examine changes in psychological symptoms following surgical fistula repair, discharge and reintegration home. Methods Women admitted for surgical repair of obstetric fistula were recruited from a Tanzanian hospital serving a rural catchment area. Psychological symptoms and social functioning were assessed prior to surgery. Approximately 3 months after discharge, a data collector visited the patients' homes to repeat psychosocial measures and assess self-reported incontinence. Baseline to follow-up differences were measured with paired t tests controlling for multiple comparisons. Associations between psychological outcomes and leaking were assessed with t tests and Pearson correlations. Results Participants (N = 28) had been living with fistula for an average of 11 years. Baseline psychological distress was high, and decreased significantly at follow-up. Participants who self-reported continued incontinence at follow-up endorsed significantly higher PTSD and depression symptoms than those who reported being cured, and severity of leaking was associated with psychological distress. Conclusions Fistula patients experience improvements in mental health at 3 months after discharge, but these improvements are curtailed when women experience residual leaking. Given the rate of stress incontinence following surgery, it is important to prepare fistula patients for the possibility of incomplete cure and help them develop appropriate coping strategies. PMID:27010550

  9. Closing the mental health gap in low-income settings by building research capacity: Perspectives from Mozambique

    PubMed Central

    Sweetland, Annika C.; Oquendo, Maria A.; Sidat, Mohsin; Santos, Palmira F.; Vermund, Sten H.; Duarte, Cristiane S.; Arbuckle, Melissa; Wainberg, Milton L.

    2014-01-01

    Neuropsychiatric disorders are the leading cause of disability worldwide, accounting for 22.7% of all years lived with disability (YLDs). Despite this global burden, fewer than 25% of affected individuals ever access mental health treatment; in low-income settings, access is much lower, though non-allopathic interventions through traditional healers are common in many venues. Three main barriers to reducing the gap between individuals who need and those who have access to mental health treatment include stigma and lack of awareness, limited material and human resources, and insufficient research capacity. We argue that investment in dissemination and implementation research is critical to face these barriers. Dissemination and implementation research can improve mental health care in low-income settings by facilitating the adaptation of effective treatment interventions to new settings, particularly when adapting specialist-led interventions developed in high-resource countries to settings with few, if any, mental health professionals. In Mozambique, the World Health Organization estimates only 0.04 psychiatrists per 100,000 population, representing 30 times less than the global median, and more than 150 times lower than the median in high income countries. Emerging evidence from other low-income settings suggests that lay providers can be trained to detect mental disorders and deliver basic psychotherapeutic and psychopharmacological interventions when supervised by an expert. Mozambique has both the political commitment and available resources for mental health, but inadequate research capacity and workforce limits the country’s ability to assess local needs, adapt and test interventions, and identify implementation strategies that can be used to effectively bring evidence-based mental health interventions to scale within the public sector. Global training and research partnerships are critical to building capacity, promoting bilateral learning between and

  10. Cost-Effectiveness of HIV Drug Resistance Testing to Inform Switching to Second Line Antiretroviral Therapy in Low Income Settings

    PubMed Central

    Phillips, Andrew; Cambiano, Valentina; Nakagawa, Fumiyo; Magubu, Travor; Miners, Alec; Ford, Debbie; Pillay, Deenan; De Luca, Andrea; Lundgren, Jens; Revill, Paul

    2014-01-01

    Background To guide future need for cheap resistance tests for use in low income settings, we assessed cost-effectiveness of drug resistance testing as part of monitoring of people on first line ART - with switching from first to second line ART being conditional on NNRTI drug resistance mutations being identified. Methods An individual level simulation model of HIV transmission, progression and the effect of ART which accounts for adherence and resistance development was used to compare outcomes of various potential monitoring strategies in a typical low income setting in sub-Saharan Africa. Underlying monitoring strategies considered were based on clinical disease, CD4 count or viral load. Within each we considered a strategy in which no further measures are performed, one with a viral load measure to confirm failure, and one with both a viral load measure and a resistance test. Predicted outcomes were assessed over 2015–2025 in terms of viral suppression, first line failure, switching to second line regimen, death, HIV incidence, disability-adjusted-life-years averted and costs. Potential future low costs of resistance tests ($30) were used. Results The most effective strategy, in terms of DALYs averted, was one using viral load monitoring without confirmation. The incremental cost-effectiveness ratio for this strategy was $2113 (the same as that for viral load monitoring with confirmation). ART monitoring strategies which involved resistance testing did not emerge as being more effective or cost effective than strategies not using it. The slightly reduced ART costs resulting from use of resistance testing, due to less use of second line regimens, was of similar magnitude to the costs of resistance tests. Conclusion Use of resistance testing at the time of first line failure as part of the decision whether to switch to second line therapy was not cost-effective, even though the test was assumed to be very inexpensive. PMID:25290340

  11. Hyponatremia in patients hospitalized with heart failure: a condition often overlooked in low-income settings

    PubMed Central

    Ali, Khalid; Workicho, Abdulhalik; Gudina, Esayas Kebede

    2016-01-01

    Background Hyponatremia is a common electrolyte abnormality in patients with heart failure (HF). It is independently associated with increased short-term and long-term morbidity and mortality. The main objective of this study was to assess patterns of hyponatremia and its association with discharge outcomes in patients with HF admitted to a teaching hospital in Ethiopia. Patients and methods This is a descriptive, prospective, hospital-based cohort study of patients with HF admitted to Jimma University Hospital, Ethiopia, between November 1, 2013 and July 31, 2014. A structured questionnaire was used to collect information on sociodemographic characteristics, clinical profile at admission, and outcomes at discharge. Plasma sodium concentration was analyzed at admission for all patients. The relationship between hyponatremia at admission and in-hospital mortality, as well as length of hospital stay, was assessed using both bivariate analysis and multivariable logistic regressions. The level of statistical significance was set at P<0.05. Results Of 152 participants admitted with HF, 44 (28.9%) had hyponatremia, which is defined as serum sodium level <135 mmol/L. Patients on salt restriction, on chronic diuretic treatment (furosemide and spironolactone), and with impaired renal function at admission were found to be highly affected. Hyponatremia was found to be associated with increased in-hospital mortality (P=0.008) and longer hospital stay (16.6 vs 12 days, P<0.001). Patients with hyponatremia also had lower blood pressure and poor functional status at discharge. Conclusion This study demonstrates that hyponatremia is highly prevalent in patients hospitalized with HF and is associated with increased in-hospital mortality and longer hospital stay. Thus, great emphasis should be given to identify high-risk patients, and prevention and early detection of hyponatremia to prevent its deleterious effects. Large-scale national studies are also needed to complement our

  12. Lessons Learned from the Development and Implementation of a Parent Nutrition Education Program with Low-Income Latina Mothers in an Urban School District Setting

    ERIC Educational Resources Information Center

    Thai, Chan Le; Prelip, Michael; Erausquin, Jennifer Toller; Slusser, Wendelin

    2012-01-01

    This article describes the steps involved in the development and implementation of a parent nutrition education workshop series for a low-income, primarily Spanish-speaking population in an urban school district setting. Overall, those parents who participated in the nutrition education workshops showed positive changes in their knowledge,…

  13. Outcome of a Food Observational Study among Low-Income Preschool Children Participating in a Family-Style Meal Setting

    ERIC Educational Resources Information Center

    Treviño, Roberto P.; Vasquez, Liset; Shaw-Ridley, Mary; Mosley, Desiree; Jechow, Katherine; Piña, Christina

    2015-01-01

    Introduction: In the United States, one out of every seven low-income children between the ages of 2 and 5 years is at risk for overweight and obesity. Formative research was conducted to determine if preschool children participating in family-style meals consumed the minimum food servings according to U.S. Department of Agriculture dietary…

  14. Helping Low-Income Urban Youth Make the Transition to Early Adulthood: A Retrospective Study of the YMCA Youth Institute

    ERIC Educational Resources Information Center

    O'Donnell, Julie; Kirkner, Sandra L.

    2016-01-01

    Low-income urban youth of color often face challenges in their transition to early adulthood. High school out-of-school time (OST) programs that promote positive youth development may help youth to better negotiate this period. However, little research exists on the long-term impact of such programs on young adults. The authors conducted a pilot…

  15. Relationship education in community settings: effectiveness with distressed and non-distressed low-income racial minority couples.

    PubMed

    Quirk, Kelley; Strokoff, Johanna; Owen, Jesse J; France, Tiffany; Bergen, Carrie

    2014-10-01

    Couple relationship education (CRE) programs are intended to prevent negative couple outcomes, however, some evidence suggests couples in greater distress may still benefit. The current study examined pre- and postchanges in relationship functioning of 362 low-income African American and Hispanic couples. Outcomes (dedication and communication) were assessed by examining differences between two distinct groupings of couples; distressed (both partners reporting clinically significant distress) and nondistressed (neither partner reporting clinically significant distress) couples. Distressed couples at predemonstrated large-sized gains in all outcome variables, as compared to nondistressed couples. Those who participated in the single-couple format demonstrated lower gains in positive communication as compared to those in the group format. Implications for distressed couples in CRE programs are offered. PMID:24974896

  16. Integrated Strategies to Address Maternal and Child Health and Survival in Low-Income Settings: Implications for Haiti.

    PubMed

    Bhutta, Zulfiqar A

    2016-01-01

    The Millennium Development Goals for improving maternal and child health globally were agreed on in 2000, and several monitoring and evaluation strategies were put in place, including "Countdown to 2015" for monitoring progress and intervention coverage to reach the goals. However, progress in achieving the goals has been slow, with only 13 of the 75 participating Countdown countries on track to reach the targets for reducing child mortality.An overview of child mortality rates in low-income countries is presented, followed by a discussion of evidenced-based interventions that can bridge the equity gaps in global health. Finally, comments are included on the companion article in this issue, "Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care" (page 59), and what is needed for that new project to succeed. PMID:27065474

  17. Integrated Strategies to Address Maternal and Child Health and Survival in Low-Income Settings: Implications for Haiti

    PubMed Central

    Bhutta, Zulfiqar A

    2016-01-01

    The Millennium Development Goals for improving maternal and child health globally were agreed on in 2000, and several monitoring and evaluation strategies were put in place, including “Countdown to 2015” for monitoring progress and intervention coverage to reach the goals. However, progress in achieving the goals has been slow, with only 13 of the 75 participating Countdown countries on track to reach the targets for reducing child mortality. An overview of child mortality rates in low-income countries is presented, followed by a discussion of evidenced-based interventions that can bridge the equity gaps in global health. Finally, comments are included on the companion article in this issue, “Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care” (page 59), and what is needed for that new project to succeed. PMID:27065474

  18. Indications and morbidity of tube thoracostomy performed for traumatic and non-traumatic free pleural effusions in a low-income setting

    PubMed Central

    Mefire, Alain Chichom; Fokou, Marcus; Dika, Louis Din

    2014-01-01

    Introduction Tube thoracostomy (TT) is widely used to resolve a number of pleural conditions. Few data are available on the complications of TT performed for non-traumatic conditions, especially in low income setting. The aim of this study is to analyse the indications and complications of TT performed for both traumatic and non-traumatic conditions of the chest in a low-income environment. Methods This retrospective study conducted over a four years period in a the Regional Hospital, Limbe in South-West Cameroon analyses the rate and nature of complications after TT performed for both traumatic and non-traumatic conditions. Different factors related to complications are analysed. Results We analysed 134 patients who had 186 chest tubes inserted. After placement, tubes were either connected to a water seal system (40%) or submitted to suction (60%). Most (91%) procedures were performed for a non-traumatic condition. Non-infectious pleural effusion in patients with HIV infection or pulmonary tuberculosis was the most common indication. Sixty six per-cents of procedures were carried out by a general surgeon. The complication rate was 19.35%. The most common complications included tube dislocation and pneumothorax. Most complications were solved by replacement of the tube. The nature of operator (general surgeon vs general practitioner) was a significant predictor of outcome (p < 0.01). No procedure related death was recorded. Conclusion TT is a safe and efficient procedure to drain pleural collections of both traumatic and non-traumatic origins, even in low-income settings. The incidence of complications could be reduced by a better training of general practitioners on this procedure. PMID:25489361

  19. First look: a cluster-randomized trial of ultrasound to improve pregnancy outcomes in low income country settings

    PubMed Central

    2014-01-01

    Background In high-resource settings, obstetric ultrasound is a standard component of prenatal care used to identify pregnancy complications and to establish an accurate gestational age in order to improve obstetric care. Whether or not ultrasound use will improve care and ultimately pregnancy outcomes in low-resource settings is unknown. Methods/Design This multi-country cluster randomized trial will assess the impact of antenatal ultrasound screening performed by health care staff on a composite outcome consisting of maternal mortality and maternal near-miss, stillbirth and neonatal mortality in low-resource community settings. The trial will utilize an existing research infrastructure, the Global Network for Women’s and Children’s Health Research with sites in Pakistan, Kenya, Zambia, Democratic Republic of Congo and Guatemala. A maternal and newborn health registry in defined geographic areas which documents all pregnancies and their outcomes to 6 weeks post-delivery will provide population-based rates of maternal mortality and morbidity, stillbirth, neonatal mortality and morbidity, and health care utilization for study clusters. A total of 58 study clusters each with a health center and about 500 births per year will be randomized (29 intervention and 29 control). The intervention includes training of health workers (e.g., nurses, midwives, clinical officers) to perform ultrasound examinations during antenatal care, generally at 18–22 and at 32–36 weeks for each subject. Women who are identified as having a complication of pregnancy will be referred to a hospital for appropriate care. Finally, the intervention includes community sensitization activities to inform women and their families of the availability of ultrasound at the antenatal care clinic and training in emergency obstetric and neonatal care at referral facilities. Discussion In summary, our trial will evaluate whether introduction of ultrasound during antenatal care improves pregnancy

  20. Assessing the Health Impact of Water Quality Interventions in Low-Income Settings: Concerns Associated with Blinded Trials and the Need for Objective Outcomes

    PubMed Central

    Clasen, Thomas; Boisson, Sophie

    2015-01-01

    Background: A dramatic disparity between the results of blinded versus open trial designs has raised questions about the effectiveness of water quality interventions and other environmental interventions to prevent diarrhea, a leading killer of young children in low-income countries. Objectives: We summarize the results of blinded versus open trials of water quality interventions, describe evidence from a recent placebo-controlled trial in India suggesting that control households were put at risk from their participation, and suggest alternatives to blinded trials that could resolve continued uncertainty about the magnitude of the protective effect of water, sanitation, and hygiene (WASH) interventions without presenting ethical questions. Discussion: Concerns about reporting bias in open trial designs continue to cause uncertainty about the effectiveness of WASH interventions. However, evidence suggests that despite instructions to the contrary, placebos may encourage control group participants in blinded trials to cease practicing traditional water treatment practices in the mistaken belief that they are protected by an active intervention. Although objective outcomes such as pathogen incrimination, seroconversion, biomarkers, and anthropometry can be helpful, these are often costly, nonspecific, and unsuitable for evaluating programmatic interventions. Conclusions: Unless researchers can be assured that a placebo will not cause those in a control group to change their behavior in a manner that increases their risk, it is incumbent on researchers to use alternatives. Validated objective measures are needed for assessing the health impact of WASH interventions that are reliable, affordable, and suitable both for research and program evaluation. Citation: Clasen T, Boisson S. 2016. Assessing the health impact of water quality interventions in low-income settings: concerns associated with blinded trials and the need for objective outcomes. Environ Health Perspect

  1. Understanding of informed consent in a low-income setting: three case studies from the Kenyan Coast.

    PubMed

    Molyneux, C S; Peshu, N; Marsh, K

    2004-12-01

    In our research unit on the Kenyan Coast, parents sign consent for over 4000 children to be involved in research activities every year. Children are recruited into studies ranging from purely observational research to the testing of new procedures and drugs. Thousands more community members consent verbally or in writing to the interviews and sometimes invasive procedures required in community-based research. Although every study and consent form is reviewed in advance by independent national and international committees, the views and understanding of the 'subjects' of these activities had not been documented before this study. In this paper, we focus on participant understanding of one field-based and two hospital-based studies, all of which involve blood sampling. The findings highlight a range of inter-related issues for consideration in the study setting and beyond, including conceptual and linguistic barriers to communicating effectively about research, the critical and complex role of communicators (fieldworkers and nurses) in consent procedures, features of research unit-community relations which impact on these processes, and the special sensitivity of certain issues such as blood sampling. These themes and emerging recommendations are expected to be relevant to, and would benefit from, experiences and insights of researchers working elsewhere. PMID:15474208

  2. Vaccine Induced Herd Immunity for Control of Respiratory Syncytial Virus Disease in a Low-Income Country Setting

    PubMed Central

    Kinyanjui, Timothy M.; House, Thomas A.; Kiti, Moses C.; Cane, Patricia A.; Nokes, David J.; Medley, Graham F.

    2015-01-01

    Background Respiratory syncytial virus (RSV) is globally ubiquitous, and infection during the first six months of life is a major risk for severe disease and hospital admission; consequently RSV is the most important viral cause of respiratory morbidity and mortality in young children. Development of vaccines for young infants is complicated by the presence of maternal antibodies and immunological immaturity, but vaccines targeted at older children avoid these problems. Vaccine development for young infants has been unsuccessful, but this is not the case for older children (> 6m). Would vaccinating older children have a significant public health impact? We developed a mathematical model to explore the benefits of a vaccine against RSV. Methods and Findings We have used a deterministic age structured model capturing the key epidemiological characteristics of RSV and performed a statistical maximum-likelihood fit to age-specific hospitalization data from a developing country setting. To explore the effects of vaccination under different mixing assumptions, we included two versions of contact matrices: one from a social contact diary study, and the second a synthesised construction based on demographic data. Vaccination is assumed to elicit an immune response equivalent to primary infection. Our results show that immunisation of young children (5–10m) is likely to be a highly effective method of protection of infants (<6m) against hospitalisation. The majority benefit is derived from indirect protection (herd immunity). A full sensitivity and uncertainty analysis using Latin Hypercube Sampling of the parameter space shows that our results are robust to model structure and model parameters. Conclusions This result suggests that vaccinating older infants and children against RSV can have a major public health benefit. PMID:26390032

  3. Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting

    PubMed Central

    Whittle, Henry J; Palar, Kartika; Napoles, Tessa; Hufstedler, Lee Lemus; Ching, Irene; Hecht, Frederick M; Frongillo, Edward A; Weiser, Sheri D

    2015-01-01

    Background Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM). Methods Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were coded and analyzed according to content analysis methods using an inductive-deductive approach. Results Food insecurity was reported to be a strong contributor to risky sexual practices among MSM and female participants. Individuals described engaging in transactional sex for food or money to buy food, often during times of destitution. Participants also explained how food insecurity could lead to condomless sex despite knowledge of and desire to use safe sexual practices, largely because the need to obtain food in the short term was prioritized over the desire to use barrier protection. Conclusions Our data extend previous research by demonstrating that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among MSM. These findings underscore the importance of public health and social intervention efforts focused on structural inequalities. PMID:26546789

  4. Local Wellness Policy 5 Years Later: Is It Making a Difference for Students in Low-Income, Rural Colorado Elementary Schools?

    PubMed Central

    Cutforth, Nick; Gilbert, Lynn; Litt, Jill; Reed, Hannah; Scarbro, Sharon; Marshall, Julie A.

    2013-01-01

    Introduction The federally mandated Local Wellness Policy (LWP) was intended to promote student health in schools. This study assesses the 5-year effects of the LWP on the health practices of rural elementary schools in Colorado. Methods One year before and 5 years after the LWP mandate, a survey was administered to a random sample of principals, physical education (PE) teachers, and food-service managers in 45 rural, low-income elementary schools in Colorado. Response rates were 71% in 2005 and 89% in 2011. Results Minutes for PE and recess did not increase, nor did offerings of fresh fruits and vegetables. More schools adopted policies prohibiting teachers from taking recess away as punishment (9.7% in 2005 vs 38.5% in 2011, P = .02) or for making up missed instructional time, class work, or tests in other subjects (3.2% in 2005 vs 28.2% in 2011, P = .03). More schools scheduled recess before lunch (22.6% in 2005 vs 46.2% in 2011, P = .04) and developed policies for vending machines (42.9% in 2005 vs 85.7% in 2011, P = .01) and parties (21.4% in 2005 vs 57.9% in 2011, P = .004). Conclusion Changes in school practices are modest, and arguably the important school practices such as increased PE and recess time and increased offerings of fruits and vegetables in the lunch line have not changed in the 5 years since the mandate went into effect. Further investigation is needed to identify the knowledge, skills, and attitudes as well as financial and physical resources required for school administrators to make changes in school practices. PMID:24199737

  5. 'Faking til you make it': social capital accumulation of individuals on low incomes living in contrasting socio-economic neighbourhoods and its implications for health and wellbeing.

    PubMed

    Browne-Yung, Kathryn; Ziersch, Anna; Baum, Fran

    2013-05-01

    People on low-income living in low socio-economic neighbourhoods have poorer health in comparison with those living in advantaged neighbourhoods. To explore neighbourhood effects on health and social capital creation, the experiences of low-income people living in contrasting socio-economic neighbourhoods were compared, in order to examine how low-income status and differing levels of neighbourhood resources contributed to perceived health and wellbeing. Quantitative and qualitative data were analysed: survey data from 601 individuals living in contrasting socio-economic areas and in-depth interviews with a new sample of 24 individuals on low-incomes. The study was guided by Bourdieu's theory of practice, which examines how social inequalities are created and reproduced through the relationship between individuals' varying resources of economic, social and cultural capital. This included an examination of individual life histories, cultural distinction and how social positions are reproduced. Participants' accounts of their early life experience showed how parental socio-economic position and socially patterned events taking place across the life course, created different opportunities for social network creation, choice of neighbourhood and levels of resources available throughout life, all of which can influence health and wellbeing. A definition of poverty by whether an individual or household has sufficient income at a particular point in time was an inadequate measure of disadvantage. This static measure of 'low income' as a category disguised a number of different ways in which disadvantage was experienced or, conversely, how life course events could mitigate the impact of low-income. This study found that the resources necessary to create social capital such as cultural capital and the ability to socially network, differed according to the socio-economic status of the neighbourhood, and that living in an advantaged area does not automatically guarantee

  6. Non-Violent Males in Violent Settings: An Exploratory Qualitative Study of Prosocial Low-Income Adolescent Males in Two Chicago (USA) Neighborhoods.

    ERIC Educational Resources Information Center

    Barker, Gary

    1998-01-01

    Analyzed factors associated with being non-violent and constructing a non-violent, prosocial masculine identity. Subjects were African-American and Hispanic adolescent males in two low-income Chicago neighborhoods. Found several factors associated with being non-violent, including the ability to draw lessons from past experiences and have a…

  7. Making Pre-Kindergarten Work for Low-Income Working Families. CLASP Child Care and Early Education Series. Policy Paper No. 1

    ERIC Educational Resources Information Center

    Schumacher, Rachel; Hamm, Katie; Ewen, Danielle

    2007-01-01

    A growing number of state leaders believe that it is essential to expand high-quality early learning and development opportunities for all young children before they reach kindergarten. A key component of this strategy is providing access to voluntary, high-quality pre-kindergarten programs, especially for low-income children. Over the last few…

  8. Getting into the Black Box: How Do Low-Income Parents Make Choices about Early Care and Education in Maryland? Publication #2012-42

    ERIC Educational Resources Information Center

    Forry, Nicole; Wessel, Julia; Simkin, Shana; Rodrigues, Katherine

    2012-01-01

    Existing literature highlights the positive influence of high-quality early care and education on the development of young children, and particularly young children in impoverished or low-income families. Reflecting the promising influence of high-quality early care and education on children's developmental outcomes, policy makers and state…

  9. Launching Low-Income Entrepreneurs

    ERIC Educational Resources Information Center

    Laney, Kahliah

    2013-01-01

    With middle-income jobs in decline, entrepreneurship offers an increasingly promising pathway out of poverty; but few low-income New Yorkers are currently taking this route to economic self-sufficiency. This report provides the most comprehensive examination of low-income entrepreneurship in New York. The report documents current self-employment…

  10. Making daddies into fathers: community-based fatherhood programs and the construction of masculinities for low-income African American men.

    PubMed

    Roy, Kevin M; Dyson, Omari

    2010-03-01

    In this analysis, we explore how low-income African American fathers build understandings of successful manhood in the context of community-based responsible fatherhood programs. Drawing on life history interviews with 75 men in Illinois and Indiana, we explore men's attempts to fulfill normative expectations of fatherhood while living in communities with limited resources. We examine the efforts of community-based fatherhood programs to shape alternative African American masculinities through facilitation of personal turning points and "breaks with the past," use of social support and institutional interventions, and the reframing of provision as a priority of successful fatherhood. We refer to Connell's hegemonic masculinity framework (Connell in Masculinities, Polity Press, Cambridge, 1995) and discuss how both men and programs borrow from hegemonic and street masculinities to develop alternative approaches to paternal involvement for marginalized men. PMID:20077133

  11. Food Group Categories of Low-Income African American Women

    ERIC Educational Resources Information Center

    Lynch, Elizabeth B.; Holmes, Shane

    2011-01-01

    Objective: Describe lay food group categories of low-income African American women and assess the overlap of lay food groups and MyPyramid food groups. Design: A convenience sample of African American mothers from a low-income Chicago neighborhood performed a card-sorting task in which they grouped familiar food items into food groups. Setting:…

  12. Effectiveness of an Alternative Dental Workforce Model on the Oral Health of Low-Income Children in a School-Based Setting

    PubMed Central

    Walker, Mary; Gadbury-Amyot, Cynthia; Liu, Ying; Kelly, Patricia; Branson, Bonnie

    2015-01-01

    Objectives. We evaluated the effect of an alternative dental workforce program—Kansas’s Extended Care Permit (ECP) program—as a function of changes in oral health. Methods. We examined data from the 2008 to 2012 electronic medical records of children (n = 295) in a Midwestern US suburb who participated in a school-based oral health program in which preventive oral health care was delivered by ECP dental hygienists. We examined changes in oral health status as a function of sealants, caries, restorations, and treatment urgency with descriptive statistics, multivariate analysis of variance, Kruskal–Wallis test, and Pearson correlations. Results. The number of encounters with the ECP dental hygienist had a statistically significant effect on changes in decay (P = .014), restorations (P = .002), and treatment urgency (P = .038). Based on Pearson correlations, as encounters increased, there was a significant decrease in decay (–0.12), increase in restorations (0.21), and decrease in treatment urgency (–0.15). Conclusions. Increasing numbers of encounters with alternative providers (ECP dental hygienists), such as with school-based oral health programs, can improve the oral health status of low-income children who would not otherwise have received oral health services. PMID:26180957

  13. Perceptions and impact of plain packaging of tobacco products in low and middle income countries, middle to upper income countries and low-income settings in high-income countries: a systematic review of the literature

    PubMed Central

    Hughes, Nicole; Arora, Monika; Grills, Nathan

    2016-01-01

    Objective To review the current literature around the potential impact, effectiveness and perceptions of plain packaging in low income settings. Method A systematic review of the literature. Data sources 9 databases (PubMed, Global Health, Social Policy and Practice, Applied Social Sciences Index and Abstracts (ASSIA), CINAHL, PsycINFO, British Library for Development Studies (BLDS), Global Health Library and Scopus) were searched. The terms used for searching combined terms for smoking and tobacco use with terms for plain packaging. Study selection Studies investigating the impact of plain packaging on the determinants of tobacco use, such as smoking behaviour, appeal, prominence, effectiveness of health warnings, response to plain packs, attitudes towards quitting or likelihood of smoking in low-income settings, were identified. Studies must have been published in English and be original research of any level of rigour. Data extraction Two independent reviewers assessed studies for inclusion and extracted data. Data synthesis The results were synthesised qualitatively, with themes grouped under four key headings: appeal and attractiveness; salience of health warnings and perceptions of harm; enjoyment and perceived taste ratings; and perceptions of the impact on tobacco usage behaviour. Results This review has identified four articles that met the inclusion criteria. Studies identified that tobacco products in plain packaging had less appeal than in branded packaging in low-income settings. Conclusions This review indicates that plain packaging appears to be successful in reducing appeal of smoking and packets, and supports the call for plain packaging to be widely implemented in conjunction with other tobacco control policies. However, there are considerable gaps in the amount of research conducted outside high-income countries. PMID:27000787

  14. A model for scale up of family health innovations in low-income and middle-income settings: a mixed methods study

    PubMed Central

    Bradley, Elizabeth H; Curry, Leslie A; Taylor, Lauren A; Pallas, Sarah Wood; Talbert-Slagle, Kristina; Yuan, Christina; Fox, Ashley; Minhas, Dilpreet; Ciccone, Dana Karen; Berg, David; Pérez-Escamilla, Rafael

    2012-01-01

    Background Many family health innovations that have been shown to be both efficacious and cost-effective fail to scale up for widespread use particularly in low-income and middle-income countries (LMIC). Although individual cases of successful scale-up, in which widespread take up occurs, have been described, we lack an integrated and practical model of scale-up that may be applicable to a wide range of public health innovations in LMIC. Objective To develop an integrated and practical model of scale-up that synthesises experiences of family health programmes in LMICs. Data sources We conducted a mixed methods study that included in-depth interviews with 33 key informants and a systematic review of peer-reviewed and grey literature from 11 electronic databases and 20 global health agency web sites. Study eligibility criteria, participants and interventions We included key informants and studies that reported on the scale up of several family health innovations including Depo-Provera as an example of a product innovation, exclusive breastfeeding as an example of a health behaviour innovation, community health workers (CHWs) as an example of an organisational innovation and social marketing as an example of a business model innovation. Key informants were drawn from non-governmental, government and international organisations using snowball sampling. An article was excluded if the article: did not meet the study's definition of the innovation; did not address dissemination, diffusion, scale up or sustainability of the innovation; did not address low-income or middle-income countries; was superficial in its discussion and/or did not provide empirical evidence about scale-up of the innovation; was not available online in full text; or was not available in English, French, Spanish or Portuguese, resulting in a final sample of 41 peer-reviewed articles and 30 grey literature sources. Study appraisal and synthesis methods We used the constant comparative method of

  15. "When One Person Makes It, We All Make It": A Study of "Beyond Welfare", a Women-Centered Community-Based Organization that Helps Low-Income Mothers Achieve Personal and Academic Success

    ERIC Educational Resources Information Center

    Bloom, Leslie Rebecca

    2009-01-01

    Access to post-secondary education for welfare recipients has been profoundly curtailed by social and welfare policies. However, many low-income mothers know that post-secondary education is the best means to escape poverty. This article focuses on five "student mothers" who have persisted in fulfilling their dreams of a college education with the…

  16. 42 CFR 423.904 - Eligibility determinations for low-income subsidies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Eligibility determinations for low-income subsidies... Eligibility determinations for low-income subsidies. (a) General rule. The State agency must make eligibility determinations and redeterminations for low-income premium and cost-sharing subsidies in accordance with...

  17. Shopping Behaviors of Low-income Families during a 1-Month Period of Time

    ERIC Educational Resources Information Center

    Darko, Janice; Eggett, Dennis L.; Richards, Rickelle

    2013-01-01

    Objective: To explore food shopping behaviors among low-income families over the course of the month. Design: Two researchers conducted 13 90-minute focus groups. Setting: Two community organizations serving low-income populations and a university campus. Participants: Low-income adults (n = 72) who were the primary household food shoppers and who…

  18. California's “Bridge to Reform”: Identifying Challenges and Defining Strategies for Providers and Policymakers Implementing the Affordable Care Act in Low-Income HIV/AIDS Care and Treatment Settings

    PubMed Central

    Hazelton, Patrick T.; Steward, Wayne T.; Collins, Shane P.; Gaffney, Stuart; Morin, Stephen F.; Arnold, Emily A.

    2014-01-01

    Background In preparation for full Affordable Care Act implementation, California has instituted two healthcare initiatives that provide comprehensive coverage for previously uninsured or underinsured individuals. For many people living with HIV, this has required transition either from the HIV-specific coverage of the Ryan White program to the more comprehensive coverage provided by the county-run Low-Income Health Programs or from Medicaid fee-for-service to Medicaid managed care. Patient advocates have expressed concern that these transitions may present implementation challenges that will need to be addressed if ambitious HIV prevention and treatment goals are to be achieved. Methods 30 semi-structured, in-depth interviews were conducted between October, 2012, and February, 2013, with policymakers and providers in 10 urban, suburban, and rural California counties. Interview topics included: continuity of patient care, capacity to handle payer source transitions, and preparations for healthcare reform implementation. Study team members reviewed interview transcripts to produce emergent themes, develop a codebook, build inter-rater reliability, and conduct analyses. Results Respondents supported the goals of the ACA, but reported clinic and policy-level challenges to maintaining patient continuity of care during the payer source transitions. They also identified strategies for addressing these challenges. Areas of focus included: gaps in communication to reach patients and develop partnerships between providers and policymakers, perceived inadequacy in new provider networks for delivering quality HIV care, the potential for clinics to become financially insolvent due to lower reimbursement rates, and increased administrative burdens for clinic staff and patients. Conclusions California's new healthcare initiatives represent ambitious attempts to expand and improve health coverage for low-income individuals. The state's challenges in maintaining quality care and

  19. High Mortality Risk in Hypoglycemic and Dysglycemic Children Admitted at a Referral Hospital in a Non Malaria Tropical Setting of a Low Income Country

    PubMed Central

    Barennes, Hubert; Sayavong, Eng; Pussard, Eric

    2016-01-01

    Introduction Hypoglycemia is a recognized feature of severe malaria but its diagnosis and management remain problematic in resource-limited settings. There is limited data on the burden and prognosis associated with glycemia dysregulation in non-neonate children in non-malaria areas. We prospectively assessed the abnormal blood glucose prevalence and the outcome and risk factors of deaths in critically ill children admitted to a national referral hospital in Laos. Methods Consecutive children (1 month-15 years) admitted to the pediatric ward of Mahosot hospital, were categorized using the integrated management of childhood illness (IMCI). Blood glucose was assessed once on admission through a finger prick using a bedside glucometer. Glycemia levels: hypoglycemia: < 2.2 mmol/L (< 40 mg⁄ dl), low glycemia: 2.2–4.4 mmol/L (40–79 mg⁄ dl), euglycemia: 4.4–8.3 mmol/L (80–149 mg⁄ dl), and hyperglycemia: > 8.3 mmol/L (≥150 mg⁄ dl), were related to the IMCI algorithm and case fatality using univariate and multivariate analysis. Results Of 350 children, 62.2% (n = 218) were severely ill and 49.1% (n = 172) had at least one IMCI danger sign. A total of 15 (4.2%, 95%CI: 2.4–6.9) had hypoglycemia, 99 (28.2%, 95%CI: 23.6–33.3) low glycemia, 201 (57.4%, 95% CI: 52.0–62.6) euglycemia and 35 (10.0%, 95% CI: 7.0–13.6) hyperglycemia. Hypoglycemia was associated with longer fasting (p = 0.001) and limited treatment before admission (p = 0.09). Hypoglycemia and hyperglycemia were associated with hypoxemia (SaO2) (p = 0.001). A total of 21 (6.0%) of the children died: 66.6% with hypoglycemic, 6.0% with low glycemic, 5.7% with hyperglycemic and 1.4% with euglycemic groups. A total of 9 (2.5%) deaths occurred during the first 24 hours of admission and 5 (1.7%) within 3 days of hospital discharge. Compared to euglycemic children, hypoglycemic and low glycemic children had a higher rate of early death (20%, p<0.001 and 5%, p = 0.008; respectively). They also had a

  20. A mixed-methods study on perceptions towards use of Rapid Ethical Assessment to improve informed consent processes for health research in a low-income setting

    PubMed Central

    2014-01-01

    Background Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia. Methods Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health researchers and regulators including ethics committee members in Ethiopian health research institutions and universities. Results In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity (48.1%), inadequate information (34%), language barriers (28.2%), cultural differences (27.4%), undue expectations (26.6%) and power imbalances (20.7%). About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test (pilot) phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed. Conclusion The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered

  1. Exploring the Feasibility of Service Integration in a Low-Income Setting: A Mixed Methods Investigation into Different Models of Reproductive Health and HIV Care in Swaziland

    PubMed Central

    Church, Kathryn; Wringe, Alison; Lewin, Simon; Ploubidis, George B.; Fakudze, Phelele; Mayhew, Susannah H.

    2015-01-01

    Integrating reproductive health (RH) with HIV care is a policy priority in high HIV prevalence settings, despite doubts surrounding its feasibility and varying evidence of effects on health outcomes. The process and outcomes of integrated RH-HIV care were investigated in Swaziland, through a comparative case study of four service models, ranging from fully integrated to fully stand-alone HIV services, selected purposively within one town. A client exit survey (n=602) measured integrated care received and unmet family planning (FP) needs. Descriptive statistics were used to assess the degree of integration per clinic and client demand for services. Logistic regression modelling was used to test the hypothesis that clients at more integrated sites had lower unmet FP needs than clients in a stand-alone site. Qualitative methods included in-depth interviews with clients and providers to explore contextual factors influencing the feasibility of integrated RH-HIV care delivery; data were analysed thematically, combining deductive and inductive approaches. Results demonstrated that clinic models were not as integrated in practice as had been claimed. Fragmentation of HIV care was common. Services accessed per provider were no higher at the more integrated clinics compared to stand-alone models (p>0.05), despite reported demand. While women at more integrated sites received more FP and pregnancy counselling than stand-alone models, they received condoms (a method of choice) less often, and there was no statistical evidence of difference in unmet FP needs by model of care. Multiple contextual factors influenced integration practices, including provider de-skilling within sub-specialist roles; norms of task-oriented routinised HIV care; perceptions of heavy client loads; imbalanced client-provider interactions hindering articulation of RH needs; and provider motivation challenges. Thus, despite institutional support, factors related to the social context of care inhibited

  2. A Model for the Roll-Out of Comprehensive Adult Male Circumcision Services in African Low-Income Settings of High HIV Incidence: The ANRS 12126 Bophelo Pele Project

    PubMed Central

    Lissouba, Pascale; Taljaard, Dirk; Rech, Dino; Doyle, Sean; Shabangu, Daniel; Nhlapo, Cynthia; Otchere-Darko, Josephine; Mashigo, Thabo; Matson, Caitlin; Lewis, David; Billy, Scott; Auvert, Bertran

    2010-01-01

    Background World Health Organization (WHO)/Joint United Nations Programme on AIDS (UNAIDS) has recommended adult male circumcision (AMC) for the prevention of heterosexually acquired HIV infection in men from communities where HIV is hyperendemic and AMC prevalence is low. The objective of this study was to investigate the feasibility of the roll-out of medicalized AMC according to UNAIDS/WHO operational guidelines in a targeted African setting. Methods and Findings The ANRS 12126 “Bophelo Pele” project was implemented in 2008 in the township of Orange Farm (South Africa). It became functional in 5 mo once local and ethical authorizations were obtained. Project activities involved community mobilization and outreach, as well as communication approaches aimed at both men and women incorporating broader HIV prevention strategies and promoting sexual health. Free medicalized AMC was offered to male residents aged 15 y and over at the project's main center, which had been designed for low-income settings. Through the establishment of an innovative surgical organization, up to 150 AMCs under local anesthesia, with sterilized circumcision disposable kits and electrocautery, could be performed per day by three task-sharing teams of one medical circumciser and five nurses. Community support for the project was high. As of November 2009, 14,011 men had been circumcised, averaging 740 per month in the past 12 mo, and 27.5% of project participants agreed to be tested for HIV. The rate of adverse events, none of which resulted in permanent damage or death, was 1.8%. Most of the men surveyed (92%) rated the services provided positively. An estimated 39.1% of adult uncircumcised male residents have undergone surgery and uptake is steadily increasing. Conclusion This study demonstrates that a quality AMC roll-out adapted to African low-income settings is feasible and can be implemented quickly and safely according to international guidelines. The project can be a model for

  3. Measuring indirect effects of rotavirus vaccine in low income countries.

    PubMed

    Bennett, Aisleen; Bar-Zeev, Naor; Cunliffe, Nigel A

    2016-08-17

    Widespread introduction of rotavirus vaccines has led to major reductions in the burden of rotavirus gastroenteritis worldwide. Vaccine effectiveness is diminished, however, in low income countries, that harbour the greatest burden of rotavirus attributed morbidity and mortality. Indirect effects of rotavirus vaccine (herd immunity and herd protection) could increase population level impact and improve vaccine cost effectiveness in such settings. While rotavirus vaccine indirect effects have been demonstrated in high and middle income countries, there are very little data from low income countries where force of infection, population structures and vaccine schedules differ. Targeted efforts to evaluate indirect effects of rotavirus vaccine in low income countries are required to understand the total impact of rotavirus vaccine on the global burden of rotavirus disease. PMID:27443593

  4. Development of Cities Mentor Project: An Intervention to Improve Academic Outcomes for Low-Income Urban Youth through Instruction in Effective Coping Supported by Mentoring Relationships and Protective Settings

    ERIC Educational Resources Information Center

    Grant, Kathryn E.; Farahmand, Farahnaz; Meyerson, David A.; Dubois, David L.; Tolan, Patrick H.; Gaylord-Harden, Noni K.; Barnett, Alexandra; Horwath, Jordan; Doxie, Jackie; Tyler, Donald; Harrison, Aubrey; Johnson, Sarah; Duffy, Sophia

    2014-01-01

    This manuscript summarizes an iterative process used to develop a new intervention for low-income urban youth at risk for negative academic outcomes (e.g., disengagement, failure, drop-out). A series of seven steps, building incrementally one upon the other, are described: 1) identify targets of the intervention; 2) develop logic model; 3)…

  5. Utility investments in low-income-energy-efficiency programs

    SciTech Connect

    Brown, M.A.; Beyer, M.A.; Eisenberg, J.; Power, M.; Lapsa, E.J.

    1994-09-01

    The objective of this study is to describe the energy-efficiency programs being operated by utilities for low-income customers. The study focuses, in particular, on programs that install major residential weatherization measures free-of-charge to low-income households. A survey was mailed to a targeted list of 600 utility program managers. Follow-up telephone calls were made to key non- respondents, and a random sample of other non-respondents also was contacted. Completed surveys were received from 180 utilities, 95 of which provided information on one or more of their 1992 low-income energy-efficiency programs for a total of 132 individual programs. These 132 utility programs spent a total of $140.6 million in 1992. This represents 27% of the total program resources available to weatherize the dwellings of low-income households in that year. Both the total funding and the number of programs has grown by 29% since 1989. A majority of the 132 programs are concentrated in a few regions of the country (California, the Pacific Northwest, the Upper Midwest, and the Northeast). Although a majority of the programs are funded by electric utilities, gas utilities have a significantly greater average expenditure per participant ($864 vs. $307 per participant). The most common primary goal of low-income energy-efficiency programs operating in 1992 was {open_quotes}to make energy services more affordable to low-income customers{close_quotes}. Only 44% of the programs were operated primarily to provide a cost-effective energy resource. Based on a review of household and measure selection criteria, equity and not the efficiency of resource acquisition appears to dominate the design of these programs.

  6. Development of cities mentor project: an intervention to improve academic outcomes for low-income urban youth through instruction in effective coping supported by mentoring relationships and protective settings.

    PubMed

    Grant, Kathryn E; Farahmand, Farahnaz; Meyerson, David A; Dubois, David L; Tolan, Patrick H; Gaylord-Harden, Noni K; Barnett, Alexandra; Horwath, Jordan; Doxie, Jackie; Tyler, Donald; Harrison, Aubrey; Johnson, Sarah; Duffy, Sophia

    2014-01-01

    This manuscript summarizes an iterative process used to develop a new intervention for low-income urban youth at risk for negative academic outcomes (e.g., disengagement, failure, drop-out). A series of seven steps, building incrementally one upon the other, are described: 1) identify targets of the intervention; 2) develop logic model; 3) identify effective elements of targets; 4) vet intervention with stakeholders; 5) develop models for sustaining the intervention; 6) develop measures of relevant constructs currently missing from the literature; 7) assess feasibility and usability of the intervention. Methods used to accomplish these steps include basic research studies, literature reviews, meta-analyses, focus groups, community advisory meetings, consultations with scholarly consultants, and piloting. The resulting intervention provides early adolescents in low-income urban communities with a) training in contextually relevant coping, b) connection to mentors who support youth's developing coping strategies, and c) connection to youth-serving community organizations, where youth receive additional support. PMID:25050606

  7. Concepts of Healthful Food among Low-Income African American Women

    ERIC Educational Resources Information Center

    Lynch, Elizabeth B.; Holmes, Shane; Keim, Kathryn; Koneman, Sylvia A.

    2012-01-01

    Objective: Describe beliefs about what makes foods healthful among low-income African American women. Methods: In one-on-one interviews, 28 low-income African American mothers viewed 30 pairs of familiar foods and explained which food in the pair was more healthful and why. Responses were grouped into codes describing concepts of food…

  8. Sooner or Later...The Disappearance of Federally Subsidized Low Income Rental Housing in Minnesota.

    ERIC Educational Resources Information Center

    Larsen, Janet

    Federal housing programs since the 1960's have provided subsidies for nearly two million privately-owned rental housing units to make them affordable for low-income people. Since taking office, the Reagan administration has focused the little attention it has given to low-income housing on person-based subsidies, and has reduced funding levels to…

  9. Toddler Feeding: Expectations and Experiences of Low-Income African American Mothers

    ERIC Educational Resources Information Center

    Horodynski, Mildred A.; Brophy-Herb, Holly; Henry, Michelle; Smith, Katharine A.; Weatherspoon, Lorraine

    2009-01-01

    Objective: To ascertain maternal expectations and experiences with mealtimes and feeding of toddlers among low-income African American mothers in two mid- to large-size cities in the United States. Design: Qualitative focus group study. Setting: Two Early Head Start programme sites in a Midwestern state which serve low income families. Method:…

  10. Longitudinal Roles of Precollege Contexts in Low-Income Youths' Postsecondary Persistence

    ERIC Educational Resources Information Center

    Diemer, Matthew A.; Li, Cheng-Hsien

    2012-01-01

    Low-income youths enroll at postsecondary institutions less frequently, drop out more often, are less likely to return after dropping out, and are less likely to attain a postsecondary degree than their more affluent peers. It is therefore important to understand how low-income youths develop the capacity to persist in the postsecondary setting.…

  11. Low Income African Americans' Parental Involvement in Intermediate Schools: Perceptions, Practices, and Influences

    ERIC Educational Resources Information Center

    Petty, Benjamin

    2012-01-01

    Purpose: The purpose of this study was to examine how the parental involvement perceptions, practices, and influences of low-income African Americans in an intermediate school setting are affected by low-incomes. Although involving African American parents in the educational process is a difficult task for educators (Alldred & Edwards, 2000;…

  12. A Portrait of Low-Income Young Adults in Education. Portraits

    ERIC Educational Resources Information Center

    Institute for Higher Education Policy, 2010

    2010-01-01

    This brief takes a broad look at low-income young adults in an effort to contribute to the national discussion on improving degree completion by increasing participation among all disadvantaged populations--especially those who attempt to succeed in postsecondary settings under financial stress. Understanding the linkages between low-income young…

  13. Recruitment and Retention Strategies in Longitudinal Clinical Studies with Low-Income Populations

    PubMed Central

    Nicholson, Lisa; Schwirian, Patricia M.; Klein, Elizabeth G.; Skybo, Theresa; Murray-Johnson, Lisa; Eneli, Ihuoma; Boettner, Bethany; French, Gina; Groner, Judith A.

    2011-01-01

    Background Conducting longitudinal research studies with low-income and/or minority participants present a unique set of challenges and opportunities. Purpose To outline the specific strategies employed to successfully recruit and retain participants in a longitudinal study of nutritional anticipatory guidance during early childhood, conducted with a low-income, ethnically diverse, urban population of mothers. Methods We describe recruitment and retention efforts made by the research team for the ‘MOMS’ Study (Making Our Mealtimes Special). The ‘multilayered’ approach for recruitment and retention included commitment of research leadership, piloting procedures, frequent team reporting, emphasis on participant convenience, incentives, frequent contact with participants, expanded budget, clinical staff buy-in, a dedicated phone line, and the use of research project branding and logos. Results Barriers to enrollment were not encountered in this project, despite recruiting from a low-income population with a large proportion of African-American families. Process evaluation with clinic staff demonstrated the perception of the MOMS staff was very positive Participant retention rate was 75% and 64% at 6 months and 12 months post-recruitment, respectively. We attribute retention success largely to a coordinated effort between the research team and the infrastructure support at the clinical sites, as well as project branding and a dedicated phone line. Conclusions Successful participant recruitment and retention approaches need to be specific and consistent with clinical staff buy in throughout the project. PMID:21276876

  14. Initial validation of the Argentinean Spanish version of the PedsQL™ 4.0 Generic Core Scales in children and adolescents with chronic diseases: acceptability and comprehensibility in low-income settings

    PubMed Central

    Roizen, Mariana; Rodríguez, Susana; Bauer, Gabriela; Medin, Gabriela; Bevilacqua, Silvina; Varni, James W; Dussel, Veronica

    2008-01-01

    .72 and 66.87, for healthy and ill children, respectively, p = 0.01), between different chronic health conditions, and children from lower socioeconomic status. Conclusion Results suggest that the Argentinean Spanish PedsQL™ 4.0 is suitable for research purposes in the public health setting for children over 8 years old and parents of children over 5 years old. People with low income and low literacy need help to complete the instrument. Steps to expand the use of the Argentinean Spanish PedsQL™ 4.0 include an alternative approach to scoring for the 2–4 year-olds, further understanding of how to increase reliability for the 5–7 year-olds self-report, and confirmation of other aspects of validity. PMID:18687134

  15. Upward Mobility of Low-Income Workers.

    ERIC Educational Resources Information Center

    Steinberg, Edward

    The purpose of the study is to help fill the present gap in our knowledge of the internal labor market, and particularly of the internal mobility patterns of low income workers. Through the analysis of data from two samples, one drawn from New York City and the other from the entire nation, the document explores the determinants of worker…

  16. Assessing Infant Breastfeeding Beliefs Among Low-Income Mexican Americans

    PubMed Central

    Gill, Sara L.; Reifsnider, Elizabeth; Mann, Angela R.; Villarreal, Patty; Tinkle, Mindy B.

    2004-01-01

    Focus groups were conducted with low-income, pregnant women and new mothers receiving services from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) along with their male partners and their mothers. All participants were Hispanics of Mexican American origin. The topics for the focus-group discussions were breastfeeding beliefs and perceptions. All participants were aware of the benefits of breastfeeding. Participants identified time, embarrassment, and pain as barriers to breastfeeding; discussed decision-making efforts regarding breastfeeding; identified cultural beliefs related to breastfeeding; and discussed the lack of care-provider support for breastfeeding. PMID:17273399

  17. 47 CFR 54.420 - Low income program audits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Low income program audits. 54.420 Section 54.420 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Low-Income Consumers § 54.420 Low income program audits. (a) Independent audit requirements...

  18. The Effects of Low Income Housing Tax Credit Developments on Neighborhoods.

    PubMed

    Baum-Snow, Nathaniel; Marion, Justin

    2009-06-01

    This paper evaluates the impacts of new housing developments funded with the Low Income Housing Tax Credit (LIHTC), the largest federal project based housing program in the U.S., on the neighborhoods in which they are built. A discontinuity in the formula determining the magnitude of tax credits as a function of neighborhood characteristics generates pseudo-random assignment in the number of low income housing units built in similar sets of census tracts. Tracts where projects are awarded 30 percent higher tax credits receive approximately six more low income housing units on a base of seven units per tract. These additional new low income developments cause homeowner turnover to rise, raise property values in declining areas and reduce incomes in gentrifying areas in neighborhoods near the 30th percentile of the income distribution. LIHTC units significantly crowd out nearby new rental construction in gentrifying areas but do not displace new construction in stable or declining areas. PMID:24235779

  19. The Effects of Low Income Housing Tax Credit Developments on Neighborhoods

    PubMed Central

    Baum-Snow, Nathaniel; Marion, Justin

    2013-01-01

    This paper evaluates the impacts of new housing developments funded with the Low Income Housing Tax Credit (LIHTC), the largest federal project based housing program in the U.S., on the neighborhoods in which they are built. A discontinuity in the formula determining the magnitude of tax credits as a function of neighborhood characteristics generates pseudo-random assignment in the number of low income housing units built in similar sets of census tracts. Tracts where projects are awarded 30 percent higher tax credits receive approximately six more low income housing units on a base of seven units per tract. These additional new low income developments cause homeowner turnover to rise, raise property values in declining areas and reduce incomes in gentrifying areas in neighborhoods near the 30th percentile of the income distribution. LIHTC units significantly crowd out nearby new rental construction in gentrifying areas but do not displace new construction in stable or declining areas. PMID:24235779

  20. 12 CFR 701.34 - Designation of low income status; Acceptance of secondary capital accounts by low-income...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Designation of low income status; Acceptance of secondary capital accounts by low-income designated credit unions. 701.34 Section 701.34 Banks and Banking... FEDERAL CREDIT UNIONS § 701.34 Designation of low income status; Acceptance of secondary capital...

  1. Feeding Practices and Styles Used by a Diverse Sample of Low-Income Parents of Preschool-age Children

    ERIC Educational Resources Information Center

    Ventura, Alison K.; Gromis, Judy C.; Lohse, Barbara

    2010-01-01

    Objective: To describe the feeding practices and styles used by a diverse sample of low-income parents of preschool-age children. Design: Thirty- to 60-minute meetings involving a semistructured interview and 2 questionnaires administered by the interviewer. Setting: Low-income communities in Philadelphia, PA. Participants: Thirty-two parents of…

  2. The Effect of Lactation Educators Implementing a Telephone-Based Intervention among Low-Income Hispanics: A Randomised Trial

    ERIC Educational Resources Information Center

    Efrat, Merav W.; Esparza, Salvador; Mendelson, Sherri G.; Lane, Christianne J.

    2015-01-01

    Objectives: To assess whether a telephone-based breastfeeding intervention delivered by lactation educators influenced exclusive breastfeeding rates among low-income Hispanic women in the USA. Design: Randomised two-group design. Setting: Pregnant low-income Hispanic women (298) were recruited from community health clinics in Los Angeles County…

  3. Reducing stillbirths in low-income countries.

    PubMed

    Goldenberg, Robert L; Saleem, Sarah; Pasha, Omrana; Harrison, Margo S; Mcclure, Elizabeth M

    2016-02-01

    Worldwide, 98% of stillbirths occur in low-income countries (LIC), where stillbirth rates are ten-fold higher than in high-income countries (HIC). Although most HIC stillbirths occur prenatally, in LIC most stillbirths occur at term and during labor/delivery. Conditions causing stillbirths include those of maternal origin (obstructed labor, trauma, antepartum hemorrhage, preeclampsia/eclampsia, infection, diabetes, other maternal diseases), and fetal origin (fetal growth restriction, fetal distress, cord prolapse, multiples, malpresentations, congenital anomalies). In LIC, aside from infectious origins, most stillbirths are caused by fetal asphyxia. Stillbirth prevention requires recognition of maternal conditions, and care in a facility where fetal monitoring and expeditious delivery are possible, usually by cesarean section (CS). Of major causes, only syphilis and malaria can be managed prenatally. Targeting single conditions or interventions is unlikely to substantially reduce stillbirth. To reduce stillbirth rates, LIC must implement effective modern antepartum and intrapartum care, including fetal monitoring and CS. PMID:26577070

  4. Interconnected microbiomes and resistomes in low-income human habitats.

    PubMed

    Pehrsson, Erica C; Tsukayama, Pablo; Patel, Sanket; Mejía-Bautista, Melissa; Sosa-Soto, Giordano; Navarrete, Karla M; Calderon, Maritza; Cabrera, Lilia; Hoyos-Arango, William; Bertoli, M Teresita; Berg, Douglas E; Gilman, Robert H; Dantas, Gautam

    2016-05-12

    Antibiotic-resistant infections annually claim hundreds of thousands of lives worldwide. This problem is exacerbated by exchange of resistance genes between pathogens and benign microbes from diverse habitats. Mapping resistance gene dissemination between humans and their environment is a public health priority. Here we characterized the bacterial community structure and resistance exchange networks of hundreds of interconnected human faecal and environmental samples from two low-income Latin American communities. We found that resistomes across habitats are generally structured by bacterial phylogeny along ecological gradients, but identified key resistance genes that cross habitat boundaries and determined their association with mobile genetic elements. We also assessed the effectiveness of widely used excreta management strategies in reducing faecal bacteria and resistance genes in these settings representative of low- and middle-income countries. Our results lay the foundation for quantitative risk assessment and surveillance of resistance gene dissemination across interconnected habitats in settings representing over two-thirds of the world's population. PMID:27172044

  5. Maximising access to achieve appropriate human antimicrobial use in low-income and middle-income countries.

    PubMed

    Mendelson, Marc; Røttingen, John-Arne; Gopinathan, Unni; Hamer, Davidson H; Wertheim, Heiman; Basnyat, Buddha; Butler, Christopher; Tomson, Göran; Balasegaram, Manica

    2016-01-01

    Access to quality-assured antimicrobials is regarded as part of the human right to health, yet universal access is often undermined in low-income and middle-income countries. Lack of access to the instruments necessary to make the correct diagnosis and prescribe antimicrobials appropriately, in addition to weak health systems, heightens the challenge faced by prescribers. Evidence-based interventions in community and health-care settings can increase access to appropriately prescribed antimicrobials. The key global enablers of sustainable financing, governance, and leadership will be necessary to achieve access while preventing excess antimicrobial use. PMID:26603919

  6. Low-Income First-Time Mothers

    PubMed Central

    Hannan, Jean; Brooten, Dorothy; Page, Timothy; Galindo, Ali; Torres, Maritza

    2016-01-01

    Background. Low-income mothers have greater challenges in accessing health care services due changes in the health care system and budget cuts. The purpose of this randomized clinical trial was to test a nurse practitioner (NP) intervention using cell phone and texting on maternal/infant outcomes. Methods. The sample included 129 mother-infant pairs. Intervention group mothers received NP 2-way cell phone follow-up intervention post–hospital discharge for 6 months. Results. Intervention mothers’ perceived social support was significantly higher. Intervention infants received their first newborn follow-up visit significantly earlier (6 vs 9 days); significantly more infants were immunized at recommended times (2, 4, and 6 months of age); and there were fewer infant morbidities compared to controls. The intervention saved between $51 030 and $104 277 in health care costs averted. Conclusion. This easy-to-use, safe intervention is an effective way to reach a wide range of populations and demonstrated improved maternal/infant outcomes and decreased cost. PMID:27508211

  7. Children's Birthday Celebrations from the Lived Experiences of Low-Income Rural Mothers

    ERIC Educational Resources Information Center

    Lee, Jaerim; Katras, Mary Jo; Bauer, Jean W.

    2009-01-01

    This exploratory study investigates how low-income rural families celebrate children's birthdays, using interview data from 128 mothers residing in five states. Findings from a qualitative content analysis show that the mothers make special efforts to have birthday celebrations as other families do despite their financial constraints. Making the…

  8. Decision Making in Educational Settings. Fastback 211.

    ERIC Educational Resources Information Center

    Sharman, Charles S.

    This booklet reviews decision-making, an important part of administrative processes, from the perspective of school teachers and other educators. The two most commonly used processes are the rational decision-making process (identify the problem, evaluate the problem, collect information, identify alternative solutions, select and implement…

  9. A New Safety Net for Low-Income Families

    ERIC Educational Resources Information Center

    Zedlewski, Sheila; Chaudry, Ajay; Simms, Margaret

    2008-01-01

    During the 1990s, the federal government promised low-income families that work would pay. Parents moved into jobs in response to new welfare rules requiring work, tax credits and other work supports that boosted take-home pay. Unfortunately, the record shows that low-income families have not progressed much. Many do not bring home enough to cover…

  10. Improving Strategies for Low-Income Family Children's Information Literacy

    ERIC Educational Resources Information Center

    Zhang, Haiyan; Washington, Rodney; Yin, Jianjun

    2014-01-01

    This article discussed the significance of improving low-income family children's information literacy, which could improve educational quality, enhance children's self-esteem, adapt children to the future competitive world market, as well as the problems in improving low-income family children's information literacy, such as no home computer and…

  11. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  12. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  13. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  14. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  15. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  16. Policies Affecting New York City's Low-Income Families.

    ERIC Educational Resources Information Center

    O'Neill, Hugh; Garcia, Kathryn; Amerlynck, Virginie; Blum, Barbara

    This report describes policy and program changes affecting New York's low-income families, issues related to these changes, and ways that city, state, and federal governments might further enhance the well-being of low-income families. Part 1 reviews major new policies enacted by the federal and state governments since the mid-1990s, noting how…

  17. Supporting Low Income Neighborhood Organizations. A Guide for Community Foundations.

    ERIC Educational Resources Information Center

    Mayer, Steven E.; Scheie, David M.

    Community foundations can be effective vehicles for channeling support to low income neighborhood organizations. This document comprises a guide for community foundations to help them develop their grantmaking and programming skills and to connect with other elements of community leadership. Chapter 1, "Why Support Low Income Neighborhood…

  18. Identification of Workplace Dress by Low-Income Job Seekers

    ERIC Educational Resources Information Center

    Saiki, Diana

    2013-01-01

    The author examined how low-income job seekers participating in a workplace dress program identified traditional business and business casual dress. Seventy low-income job seekers identified clothing items as traditional business (e.g., suits, ties), similar to identifications made by professionals and image consultants in previous literature.…

  19. Low Income Women and Physician Breastfeeding Advice: A Regional Assessment

    ERIC Educational Resources Information Center

    Stolzer, J; Zeece, Pauline

    2006-01-01

    Objectives: The aims of the pilot study presented here were to determine whether low income women were receiving compendious breastfeeding advice from their attending physicians. Design: This study assessed low income women's reports of physician breastfeeding advice using a newly designed Likert scaled survey based on the American Surgeon…

  20. Initial College Attendance of Low-Income Young Adults. Portraits

    ERIC Educational Resources Information Center

    Institute for Higher Education Policy, 2011

    2011-01-01

    More than 2.3 million low-income young adults began postsecondary education in 2008. Where these students initially enroll is of greater consequence than it is to their economically better-off peers because the likelihood of completing college for students from low-income backgrounds depends strongly on where they start their studies. This brief…

  1. Conceptualizing Parent Involvement: Low-Income Mexican Immigrant Perspectives

    ERIC Educational Resources Information Center

    Crane, Thomas B.

    2012-01-01

    The purposes of this study were to (a) investigate the conceptualization of low-income Mexican immigrant parents about their parental involvement and the family-school connection, (b) identify the influences on low-income Mexican immigrant parents' approach to parent involvement, and (c) identify the ways that Mexican immigrant parents…

  2. 13 CFR 108.130 - Identified Low Income Geographic Areas.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Identified Low Income Geographic Areas. 108.130 Section 108.130 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Organizing A Nmvc Company § 108.130 Identified Low Income Geographic Areas....

  3. Siblings, Language, and False Belief in Low-Income Children

    ERIC Educational Resources Information Center

    Tompkins, Virginia; Farrar, M. Jeffrey; Guo, Ying

    2013-01-01

    The authors examined the relationship between number of siblings and false belief understanding (FBU) in 94 low-income 4-5-year-olds. Previous research with middle-income children has shown a positive association between number of siblings and FBU. However, it is unclear whether having multiple siblings in low-income families is related to better…

  4. Federal Income Tax Cuts and Low-Income Families.

    ERIC Educational Resources Information Center

    Sammartino, Frank J.

    This report identifies overall tax burdens faced by low income families, explaining how those burdens would change if certain types of federal income tax cuts were enacted. Using detailed household-level data on incomes and taxes, the report shows how federal income and payroll taxes differ for low income families and how these families benefit…

  5. Low-Income Students' Access to Selective Higher Education

    ERIC Educational Resources Information Center

    Park, Eunkyoung

    2013-01-01

    The undermatch between low-income students' academic achievement and college destinations has become increasingly important in discussions of higher education access and equity. This study investigates whether low-income students are undermatched in their college choice, and if so, what factors are related to the undermatching. Specifically, this…

  6. Juggling the five dimensions of food access: Perceptions of rural low income residents.

    PubMed

    Andress, Lauri; Fitch, Cindy

    2016-10-01

    Using focus groups (n = 6) from six West Virginia counties we assessed how low income, rural women (n = 30) enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program perceived the food environment and the ability to access healthy food. For WIC clients who are at risk for nutrition problems and live at or below 185% of poverty, challenges with food access threaten the positive aspects and impacts of the WIC program. We undertook a qualitative analysis by coding the focus group data on rural food access, into three themes. Our analysis demonstrated how the three major themes interact with five dimensions of food access and underscores the issues with food access that decrease the effectiveness of the food packages and nutrition education that low income WIC participants receive. To increase food access we recommend creating a formal structure where vendors and low income clients may discuss concerns; encouraging greater investment in rural communities through state issued incentives to build full service grocery stores or informal transportation networks; and additional research on the status of low income clients as social change agents capable of addressing issues that act as barriers to their shopping experiences. However, even with the data and prior literature, the pathways by which these environmental factors shape nutrition remain unclear-entangled - much like the issues that low income, rural residents must juggle when they make grocery shopping and nutrition decisions. PMID:27208595

  7. The impact of Medicaid on physician use by low-income children.

    PubMed Central

    Rosenbach, M L

    1989-01-01

    This study evaluated the determinants of physician use by low-income children, with an emphasis on the effect of Medicaid. Data are from the 1980 National Medical Care Utilization and Expenditure Survey. Regression analysis revealed that Medicaid children were more likely than both privately insured and uninsured children to visit an office-based physician. Also, Medicaid children with at least one visit to any setting had a higher number of visits than uninsured children. Such factors as age, health status, number of children in the family, educational status, and income also accounted for differences within the low-income population. The results suggest that access to physicians' services (including office-based physicians) can be increased by expanding Medicaid eligibility to uninsured low-income children and by improving private health insurance benefits among the underinsured. PMID:2669539

  8. 77 FR 65139 - Designation of Low-Income Status; Acceptance of Secondary Capital Accounts by Low-Income...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-25

    ... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Parts 701 and 741 RIN 3133-AE09 Designation of Low-Income Status; Acceptance of Secondary...; Acceptance of secondary capital accounts by low-income designated credit unions. (a) Designation of...

  9. Developing a Culture of Resilience for Low-Income Immigrant Youth

    ERIC Educational Resources Information Center

    Borrero, Noah; Lee, Diane Sookyoung; Padilla, Amado M.

    2013-01-01

    This study explores a story of success at a school where low-income, English language learners (ELLs) comprise a majority of its students. In this paper, we examine Bay Academy's teaching and organizational practices that make it a place where youth feel they belong and can succeed. Central to this description is its culture of college, community-…

  10. Teachers Matter: Measures of Teacher Effectiveness in Low-Income Minority Schools

    ERIC Educational Resources Information Center

    Mangiante, Elaine M. Silva

    2011-01-01

    Teachers make a difference in student academic growth. Students from low-income, minority communities attend schools with less resources and less qualified teachers than students in wealthier communities. The Race to the Top (RTTT) policy by the U.S. Department of Education has attempted to address the achievement gap based on SES and the…

  11. The Knowledgeable Tenant. Teaching Low-Income Consumers a Logical Approach to Renting.

    ERIC Educational Resources Information Center

    Shurtz, Mary Ann; LeFlore, Ann Becker

    This module, one of six on teaching consumer matters to low-income groups, focuses on helping clients make wise choices about housing. It reviews factors to consider in selecting an apartment and discusses the laws in Virginia which relate to housing. Methods for helping clients learn more about housing and housing regulations are also discussed.…

  12. Not Poor in Spirit: Hope for Kentucky's Low-Income Families and Children.

    ERIC Educational Resources Information Center

    Gall-Clayton, Nancy; Chandler, Betsy, Ed.

    This report tells the stories of dozens of low-income families from all parts of Kentucky. It is a personal report, compiled after 4 months of travel and interviews. The report also makes recommendations for improvements in programs designed to serve impoverished families. The introduction discusses the seeming paradoxes of poverty and generosity,…

  13. Pilot evaluation of a walking school bus program in a low-income, urban community

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to evaluate the impact of a walking school bus (WSB) program on student transport in a low-income, urban neighborhood. The design was a controlled, quasi-experimental trial with consecutive cross-sectional assessments. The setting was three urban, socioeconomically disadvantaged, p...

  14. Running in Place: Low-Income Students and the Dynamics of Higher Education Stratification

    ERIC Educational Resources Information Center

    Bastedo, Michael N.; Jaquette, Ozan

    2011-01-01

    The increasing concentration of wealthy students at highly selective colleges is widely perceived, but few analyses examine the underlying dynamics of higher education stratification over time. To examine these dynamics, the authors build an analysis data set of four cohorts from 1972 to 2004. They find that low-income students have made…

  15. Interactions into Opportunities: Career Management for Low-Income, First-Generation African American College Students

    ERIC Educational Resources Information Center

    Parks-Yancy, Rochelle

    2012-01-01

    This study explores how low-income, African American college students obtain social capital resources from university contacts to set and achieve career goals. Students knew little about career options available to future college graduates beyond jobs that were related to their current jobs. Few students utilized the information, influence, and…

  16. Best Practice Program for Low-Income African American Students Transitioning from Middle to High School

    ERIC Educational Resources Information Center

    Gentle-Genitty, Carolyn

    2009-01-01

    On the basis of systematic evaluation of three program databases, totaling 246 programs, this article provides a discussion on a best practice program for low-income African American students transitioning from middle school to high school in urban school settings. The main research question was "Of the programs touted as best practice, is there…

  17. A Phenomenological Inquiry into the Financial Education Experiences of Young, Low-Income Credit Union Members

    ERIC Educational Resources Information Center

    Santangelo, Dan

    2012-01-01

    This qualitative phenomenological study engaged 20 young, low-income credit union members who participated in financial education classes at Denver Community Credit Union. The study explored learning experiences that generated changes in money management behaviors and sought evidence of transformational learning in a nonformal education setting.…

  18. Low-Income, African American Adolescent Mothers and Their Toddlers Exhibit Similar Dietary Variety Patterns

    ERIC Educational Resources Information Center

    Papas, Mia A.; Hurley, Kristen M.; Quigg, Anna M.; Oberlander, Sarah E.; Black, Maureen M.

    2009-01-01

    Objective: To examine the relationship between maternal and toddler dietary variety. Design: Longitudinal; maternal and toddler dietary data were collected at 13 months; anthropometry was collected at 13 and 24 months. Setting: Data were collected in homes. Participants: 109 primiparous, low-income, African American adolescent mothers and…

  19. Predictors of Low-income, Obese Mothers' Use of Healthful Weight Management Behaviors

    ERIC Educational Resources Information Center

    Chang, Mei-Wei; Nitzke, Susan; Brown, Roger; Baumann, Linda

    2011-01-01

    Objective: To examine the influence of personal and environmental factors on healthful weight management behaviors mediated through self-efficacy among low-income obese mothers. Design: Cross-sectional design. Setting: Special Supplemental Nutrition Program for Women, Infants, and Children in Wisconsin. Participants: Two hundred eighty-four obese…

  20. Household Food Security and Fruit and Vegetable Intake among Low-Income Fourth-Graders

    ERIC Educational Resources Information Center

    Grutzmacher, Stephanie; Gross, Susan

    2011-01-01

    Objective: To examine the relationship between household food security and children's and parents' fruit, vegetable, and breakfast consumption and fruit and vegetable availability. Design: Cross-sectional study using matched parent-child surveys. Setting: Title I elementary schools in Maryland. Participants: Ninety-two low-income parent-child…

  1. Social Justice, Capabilities and the Quality of Education in Low Income Countries

    ERIC Educational Resources Information Center

    Tikly, Leon; Barrett, Angeline M.

    2011-01-01

    The paper sets out a theoretical approach for understanding the quality of education in low income countries from a social justice perspective. The paper outlines and critiques the two dominant approaches that currently frame the debate about education quality, namely, the human capital and human rights approaches. Drawing principally on the ideas…

  2. Reading and Comprehension Levels in a Sample of Urban, Low-Income Persons

    ERIC Educational Resources Information Center

    Delgado, Cheryl; Weitzel, Marilyn

    2013-01-01

    Objective: Because health literacy is related to healthcare outcomes, this study looked at reading and comprehension levels in a sample of urban, low-income persons. Design: This was a descriptive exploration of reading comprehension levels, controlled for medical problems that could impact on vision and therefore ability to read. Setting: Ninety…

  3. Networks of Attachment Relationships in Low-Income Children of Mexican Heritage: Infancy through Preschool

    ERIC Educational Resources Information Center

    Howes, Carollee; Wishard Guerra, Alison G.

    2009-01-01

    Eighty-three low-income Mexican-heritage children (44 girls) and their mothers participated in this research. Children were observed with alternative caregivers at 14, 24, and 36 months of age using the Attachment Q-Set. Most children received regular care from infancy through preschool from relatives and childcare providers. Children had high…

  4. Welfare and the family size decision of low-income, two-parent families.

    PubMed

    Gensler, H

    1997-10-01

    This study determines the increase in family size given an increase in the per child welfare benefit for a family with children in the US. The family size decision was modeled as a discrete choice decision. Data were obtained from the 1980-91 March Current Population Surveys of the US Census Bureau on 13,516 low-income, nonmilitary, non-farm, two-parent families with at least one dependent child. Low income was any amount under twice the official poverty level. Parents were limited to ages 18-40 years. Alaska and Hawaii were excluded. The data sets for 1979-90 were pooled. The sample included 10% Blacks and 27% receiving some amount of welfare. Average ages were 28.9 years for mothers and 30.8 years for fathers. The average number of children was 2.43. Findings from the ordered probit model indicate that education had a negative impact on family size, and age and race had positive impacts. Wages did not have a significant effect. The state unemployment rate and the average state income had negative effects. Unearned income had a small but significant effect on family size. The marginal welfare benefit had a positive impact. Findings reinforce the wealth hypothesis, that wealthier societies have smaller family sizes. Family size declines with increases in wages and education, which reflect increases in opportunity costs for time. Family size increases with age, as rearing children is labor-intensive. Family size increases with unearned income and welfare benefits that make childbearing affordable. It is argued that poor people in developed societies behave more consistently like poor people in developing countries. A 100% increase in the per child welfare benefit resulted in a 2% increase in the number of children. The policy implication is that a considerable increase in welfare benefits will have only trivial behavioral impacts for the poor on family size decisions. PMID:12321292

  5. Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market

    PubMed Central

    2013-01-01

    Background The price of antiretroviral drugs (ARVs) in low income countries declined steadily in recent years. This raises concerns about the commercial viability of the market of ARVs in low income countries. Methods Using 2 costing scenarios, we modeled the production cost of the most commonly used ARVs in low income countries in 2010 and 2012, and assessed whether, at the median price paid by low income countries, their manufacturers would still make profits. By interviews we consulted 11 generic manufacturers on the current state of the ARV market, and on what would be required to ensure their continued commitment to supply ARVs to low income countries. Results Using the lowest prices for active pharmaceutical ingredients (API) quoted to WHO, and applying published assumptions about the production cost of ARVs, our baseline estimate was that Indian generic manufacturers would have made profits on only 1 out of 13 formulations of ARVs in both 2010 and 2012, and publicly owned manufacturers would have made profits on 5 and 3 out of 13 formulations in 2010 and 2012, respectively. We needed to assume a 20% and a 40% lower API cost for our model to predict that publicly owned and Indian manufacturers, respectively, would make profits on the sale of the majority of their ARVs. Between 2010 and 2012, we estimate that - across the ARV portfolio - the gross profit on sales of ARVs to low income countries decreased with between 6% and 7% of their sales price. Generic manufacturers consider that current prices are unsustainable. They suggested amendments to the tender procedures, simplified regulatory procedures, improved forecasting, and simplification of the ARV guidelines as critical improvements to maintain a viable ARV market. Conclusions While recent price decreases indicate that there is still space for price reduction, our estimate that gross profit margin on sales decreased by 6 to 7% between 2010 and 2012 lends credibility to assertions by generic manufacturers

  6. Environment and air pollution like gun and bullet for low-income countries: war for better health and wealth.

    PubMed

    Zou, Xiang; Azam, Muhammad; Islam, Talat; Zaman, Khalid

    2016-02-01

    The objective of the study is to examine the impact of environmental indicators and air pollution on "health" and "wealth" for the low-income countries. The study used a number of promising variables including arable land, fossil fuel energy consumption, population density, and carbon dioxide emissions that simultaneously affect the health (i.e., health expenditures per capita) and wealth (i.e., GDP per capita) of the low-income countries. The general representation for low-income countries has shown by aggregate data that consist of 39 observations from the period of 1975-2013. The study decomposes the data set from different econometric tests for managing robust inferences. The study uses temporal forecasting for the health and wealth model by a vector error correction model (VECM) and an innovation accounting technique. The results show that environment and air pollution is the menace for low-income countries' health and wealth. Among environmental indicators, arable land has the largest variance to affect health and wealth for the next 10-year period, while air pollution exerts the least contribution to change health and wealth of low-income countries. These results indicate the prevalence of war situation, where environment and air pollution become visible like "gun" and "bullet" for low-income countries. There are required sound and effective macroeconomic policies to combat with the environmental evils that affect the health and wealth of the low-income countries. PMID:26493298

  7. Promoting Integrated Approaches to Reducing Health Inequities among Low-Income Workers: Applying a Social Ecological Framework

    PubMed Central

    Baron, Sherry L; Beard, Sharon; Davis, Letitia K.; Delp, Linda; Forst, Linda; Kidd-Taylor, Andrea; Liebman, Amy K.; Linnan, Laura; Punnett, Laura; Welch, Laura S.

    2013-01-01

    Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity. We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations. An example of successful approaches to developing integrated programs in each of these settings is described. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed. PMID:23532780

  8. DataCite - Making data sets citable

    NASA Astrophysics Data System (ADS)

    Brase, J.

    2013-12-01

    The scientific and information communities have largely mastered the presentation of, and linkages between, text-based electronic information by assigning persistent identifiers to give scientific literature unique identities and accessibility. Knowledge, as published through scientific literature, is however often the last step in a process originating from scientific research data. Today scientists are using simulation, observational, and experimentation techniques that yield massive quantities of research data. These data are analysed, synthesised, interpreted, and the outcome of this process is generally published as a scientific article. Access to the original data as the foundation of knowledge has become an important issue throughout the world and different projects have started to find solutions. Global collaboration and scientific advances could be accelerated through broader access to scientific research data. In other words, data access could be revolutionized through the same technologies used to make textual literature accessible. The most obvious opportunity to broaden visibility of and access to research data is to integrate its access into the medium where it is most often cited: electronic textual information. Besides this opportunity, it is important, irrespective of where they are cited, for research data to have an internet identity. Since 2005, the German National Library of Science and Technology (TIB) has offered a successful Digital Object Identifier (DOI) registration service for persistent identification of research data. Since 2010 these services are offered by the global consortium DataCite, carried by 17 member organisations from 12 different countries: The German National Library of Science and Technology (TIB), the German National Library of Medicine (ZB MED), the German National Library of Economics (ZBW) and the German GESIS - Leibniz Institute for the Social Sciences. Additional European members are: The Library of the ETH Z

  9. Resource handbook for low-income residential retrofits

    SciTech Connect

    Callaway, J.W.; Brenchley, D.L.; Davis, L.J.; Ivey, D.L.; Smith, S.A.; Westergard, E.J.

    1987-04-01

    The purpose of the handbook is to provide technical assistance to state grantees participating in the Partnerships in Low-Income Residential Retrofit (PILIRR) Program. PILIRR is a demonstration program aimed at identifying innovative, successful approaches to developing public and private support for weatherization of low-income households. The program reflects the basic concept that responsibility for financial support for conservation activities such as low-income residential retrofitting is likely to gradually shift from the DOE to the states and the private sector. In preparing the handbook, PNL staff surveyed over 50 programs that provide assistance to low-income residents. The survey provided information on factors that contribute to successful programs. PNL also studied the winning PILIRR proposals (from the states of Florida, Iowa, Kentucky, Oklahoma and Washington) and identified the approaches proposed and the type of information that would be most helpful in implementing these approaches.

  10. Utility investments in low-income energy-efficiency programs

    SciTech Connect

    Brown, M.A.

    1995-06-01

    In the increasingly competitive utility industry, it is imperative that equity programs be as cost-effective as possible. In some cases, this is accomplished by working in partnership with government programs such as the US Department of Energy`s low-income Weatherization Assistance Program. This paper provides an overview of the DSM and conservation programs being operated by utilities for low-income customers and describes the types of utility-government partnerships that exist.

  11. Cold times for conservation. [Cuts in low income weatherization program

    SciTech Connect

    Lyman, F.

    1982-02-01

    There are about a million families living at or below poverty level, who have cut down their energy use in the last few years through the help of the federal low income weatherization program. One of several energy conservation programs launched in the early days of the energy crisis, it was set up to reach the poor and elderly, since they're the ones most keenly affected by high energy prices. Weatherization was considered a better way of helping than doling out fuel assistance checks, which simply carry the poor from one winter's crisis to another and end up in the pockets of utility companies. The program has made great strides since it was started as a pilot project in 1975. But, like other energy conservation programs, its days may be numbered. Weatherization efforts have slowed down as a result of budget cuts and increased costs, and the program could be phased out completely by fiscal year 1983. With President Reagan's plan to dismantle the Department of Energy (DOE), a whole slew of energy conservation and research programs are likely to be wiped out next year unless Congress mounts significant opposition. (JMT)

  12. Low-income individuals’ perceptions about fruit and vegetable access programs: A qualitative study

    PubMed Central

    Haynes-Maslow, Lindsey; Auvergne, Lauriane; Mark, Barbara; Ammerman, Alice; Weiner, Bryan J.

    2015-01-01

    Objective To examine how fruit and vegetable (F&V) programs address barriers to F&V access and consumption as perceived by low-income individuals. Design From 2011–2012 thirteen focus groups were used to better understand low-income individuals’ perceptions about F&V programs. Setting Five North Carolina counties at community-serving organizations. Participants Low-income participants ages 18 or older were included in the study. A majority were African American females with a high school education or less and received government assistance. Phenomenon of Interest Low-income individuals’ perceptions about how F&V access programs can reduce barriers and increase consumption. Analysis A socioecological framework guided data analysis, and 2 trained researchers coded transcripts, identified major themes, and summarized findings. Results A total of 105 participants discussed that mobile markets could overcome barriers such as availability, convenience, transportation, and quality/variety. Some were worried about safety in higher crime communities. Participants’ opinions about how successful food assistance programs were at overcoming cost barriers were mixed. Participants agreed that community gardens could increase access to affordable, conveniently located produce, but worried about feasibility/implementation issues. Implications for Research and Practice Addressing access barriers through F&V programs could improve consumption. Programs have the potential to be successful if they address multiple access barriers. (200 words). PMID:25910929

  13. Food-Related Attitudes and Behaviors at Home, School, and Restaurants: Perspectives from Racially Diverse, Urban, Low-Income 9- to 13-Year-Old Children in Minnesota

    ERIC Educational Resources Information Center

    Dammann, Kristen; Smith, Chery

    2010-01-01

    Objective: This qualitative study explored low-income children's food-related attitudes and behaviors, and current weight status. Design: Two researchers conducted 14 audiotaped, 60-minute focus groups. Height and weight were measured. Setting: Libraries, homeless shelters, and a community center. Participants: Ninety-two low-income children aged…

  14. Implementing microbicides in low-income countries.

    PubMed

    Gengiah, Tanuja N; Abdool Karim, Quarraisha

    2012-08-01

    The magnitude of the global human immunodeficiency virus (HIV) epidemic is determined by women from lower income countries, specifically sub-Saharan Africa. Microbicides offer women who are unable to negotiate safe sex practices a self-initiated HIV prevention method. Of note, is its potential to yield significant public health benefits even with relatively conservative efficacy, coverage and user adherence estimates, making microbicides an effective intervention to invest scarce healthcare resources. Existing healthcare delivery systems provide an excellent opportunity to identify women at highest risk for infection and to also provide an access point to initiate microbicide use. Innovative quality improvement approaches, which strengthen existing sexual reproductive health services and include HIV testing, and linkages to care and treatment services, provide an opportunity to lay the foundations for wide-scale provision of microbicides. The potential to enhance health outcomes in women and infants and potentially affect rates of new HIV infection may soon be realised. PMID:22498040

  15. Do French low-income GPs choose to work less?

    PubMed

    Samson, Anne-Laure

    2011-09-01

    In France, a significant number of General Practitioners (GPs) earn less than 1.5 times the French minimum salary. Using a representative panel of self-employed GPs over the years 1993-2004, this paper tests whether these low-income GPs choose to work less than all other GPs or whether they are constrained to do so. The test is based on measuring reactions to positive and negative demand shocks. As low-income GPs do not increase activity in response to a positive demand shock but decrease activity in response to a negative demand shock, it appears that their low-income status is attributable to a strong preference for leisure. PMID:21728212

  16. Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention

    PubMed Central

    Lehmann, Uta; Dieleman, Marjolein; Martineau, Tim

    2008-01-01

    Background Many countries in middle- and low-income countries today suffer from severe staff shortages and/or maldistribution of health personnel which has been aggravated more recently by the disintegration of health systems in low-income countries and by the global policy environment. One of the most damaging effects of severely weakened and under-resourced health systems is the difficulty they face in producing, recruiting, and retaining health professionals, particularly in remote areas. Low wages, poor working conditions, lack of supervision, lack of equipment and infrastructure as well as HIV and AIDS, all contribute to the flight of health care personnel from remote areas. In this global context of accelerating inequities health service policy makers and managers are searching for ways to improve the attraction and retention of staff in remote areas. But the development of appropriate strategies first requires an understanding of the factors which influence decisions to accept and/or stay in a remote post, particularly in the context of mid and low income countries (MLICS), and which strategies to improve attraction and retention are therefore likely to be successful. It is the aim of this review article to explore the links between attraction and retention factors and strategies, with a particular focus on the organisational diversity and location of decision-making. Methods This is a narrative literature review which took an iterative approach to finding relevant literature. It focused on English-language material published between 1997 and 2007. The authors conducted Pubmed searches using a range of different search terms relating to attraction and retention of staff in remote areas. Furthermore, a number of relevant journals as well as unpublished literature were systematically searched. While the initial search included articles from high- middle- and low-income countries, the review focuses on middle- and low-income countries. About 600 papers were

  17. Global Health Equity: Cancer Care Outcome Disparities in High-, Middle-, and Low-Income Countries.

    PubMed

    de Souza, Jonas A; Hunt, Bijou; Asirwa, Fredrick Chite; Adebamowo, Clement; Lopes, Gilberto

    2016-01-01

    Breakthroughs in our global fight against cancer have been achieved. However, this progress has been unequal. In low- and middle-income countries and for specific populations in high-income settings, many of these advancements are but an aspiration and hope for the future. This review will focus on health disparities in cancer within and across countries, drawing from examples in Kenya, Brazil, and the United States. Placed in context with these examples, the authors also draw basic recommendations from several initiatives and groups that are working on the issue of global cancer disparities, including the US Institute of Medicine, the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, and the Union for International Cancer Control. From increasing initiatives in basic resources in low-income countries to rapid learning systems in high-income countries, the authors argue that beyond ethics and equity issues, it makes economic sense to invest in global cancer control, especially in low- and middle-income countries. PMID:26578608

  18. A Success Model for Low-Income Students

    ERIC Educational Resources Information Center

    Wilt, Richard W.

    2006-01-01

    Today's community college serves as the entry point to well-paying technical jobs as well as the entry point to the baccalaureate degree and beyond. What, then, can be done to ensure that low-income students have access to and success in community colleges? Research, both theoretical and empirical, shows that there is no one student characteristic…

  19. The Rural Low-Income Student and the Community College.

    ERIC Educational Resources Information Center

    Morgan, Don A., Ed.

    Topics discussed at this conference concerned with education for the rural poor were: (1) "The Community College and the Rural Poor," (2) "The Rural Low Income Student--What a Small College Can Do to Get Them Into School and Keep Them There," (3) "The New Iron Ore Industry Worker Needs New Schools and New Programs to Keep Marketable," (4) "The…

  20. ENGINEERED STORMWATER MANAGEMENT FOR LOW-INCOME URBAN COMMUNITIES

    EPA Science Inventory

    This project addresses issues related to water quality and quantity in New Jersey’s urbanized watersheds and targets the need for improved environmental quality as a form of prosperity for the people in low-income urban communities.

  1. Assessing the Eating Behaviors of Low-Income, Urban Adolescents

    ERIC Educational Resources Information Center

    Fahlman, Mariane; McCaughtry, Nate; Martin, Jeffrey; Garn, Alex C.; Shen, Bo

    2012-01-01

    Background: There is a need for instruments that can accurately determine the effectiveness of nutrition interventions targeting low-income, inner-city adolescents. Purpose: To examine the development of a valid and reliable eating behavior scale (EBS) for use in school-based nutrition interventions in urban, inner-city communities dominated by…

  2. 75 FR 8392 - Low Income Housing Tax Credit Tenant Database

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Low Income Housing Tax Credit Tenant Database AGENCY: Office of the Chief Information... Income Housing Tax Credit Tenant Database. Omb Approval Number: 2528-0165. Form Numbers:...

  3. Psychological Symptoms Affecting Low-Income Urban Youth

    ERIC Educational Resources Information Center

    Grant, Kathryn E.; Katz, Brian N.; Thomas, Kina J.; O'Koon, Jeffrey H.; Meza, C. Manuel; DiPasquale, Anna-Marie; Rodriguez, Vanessa O.; Bergen, Carrie

    2004-01-01

    Rates and cooccurrence of internalizing and externalizing syndromes were examined in a sample of 1,520 low-income urban early adolescents. Results indicate higher rates of clinically elevated internalizing and externalizing symptoms in this sample relative to normative data. In particular, both boys and girls were more likely to score in the…

  4. Smoking among Low-Income Pregnant Women: An Ethnographic Analysis

    ERIC Educational Resources Information Center

    Nichter, Mimi; Nichter, Mark; Muramoto, Myra; Adrian, Shelly; Goldade, Kate; Tesler, Laura; Thompson, Jennifer

    2007-01-01

    This article presents findings from a qualitative study of 53 low-income women who were smokers at the onset of pregnancy. Study participants were interviewed during pregnancy to document smoking trajectories and factors contributing to, or undermining, harm reduction and quit attempts. Thirty percent of women quit smoking completely, 43% engaged…

  5. Stress and Somatic Complaints in Low-Income Urban Adolescents.

    ERIC Educational Resources Information Center

    Reynolds, Linda K.; O'Koon, Jeffrey H.; Papademetriou, Eros; Szczygiel, Sylvia; Grant, Kathryn E.

    2001-01-01

    Studied rates of somatic complaints and the association between stress and somatic complaints for 1,030 low-income urban adolescents in grades 6 through 8. For both boys and girls, somatization was the most commonly reported internalizing symptom, and heightened rates of urban stress predicted heightened rates of somatic complaints. (SLD)

  6. Child Care Choices, Consumer Education, and Low-Income Families.

    ERIC Educational Resources Information Center

    Mitchell, Anne; And Others

    In 1991, the National Center for Children in Poverty undertook a study of low-income parents as child care consumers. The study involved a review of current research findings, interviews with staff of child resource and referral agencies, and an examination of child care consumer education provided in the Job Opportunities and Basic Skills (JOBS)…

  7. What's (Not) Wrong with Low-Income Marriages

    ERIC Educational Resources Information Center

    Trail, Thomas E.; Karney, Benjamin R.

    2012-01-01

    In the United States, low marriage rates and high divorce rates among the poor have led policymakers to target this group for skills- and values-based interventions. The current research evaluated the assumptions underlying these interventions; specifically, the authors examined whether low-income respondents held less traditional values toward…

  8. Targeting Interventions for Ethnic Minority and Low-Income Populations

    ERIC Educational Resources Information Center

    Kumanyika, Shiriki; Grier, Sonya

    2006-01-01

    Although rates of childhood obesity among the general population are alarmingly high, they are higher still in ethnic minority and low-income communities. The disparities pose a major challenge for policymakers and practitioners planning strategies for obesity prevention. In this article Shiriki Kumanyika and Sonya Grier summarize differences in…

  9. Low Income Family Day Care Home Demonstration. Final Report.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    A 1-year demonstration project was conducted by the United States Department of Agriculture's Food and Nutrition Service (FNS) to help remove or reduce barriers to the participation of low-income family day care homes in the Child and Adult Care Food Program (CACFP). FNS funded six grantees to conduct a demonstration of three different strategies.…

  10. Camouflage: The Experiences of Low-Income Business College Students

    ERIC Educational Resources Information Center

    Ponton de Dutton, Scarlett

    2011-01-01

    This qualitative study shares the complex stories of two low-income business students who attend a flagship, public university as out-of-state students with the purpose of understanding, describing, giving voice to, and discovering insight from their experiences. Throughout U.S. Higher Education history, there is a pattern of limited participation…

  11. Alienation: A Concept for Understanding Low-Income, Urban Clients

    ERIC Educational Resources Information Center

    Holcomb-McCoy, Cheryl

    2004-01-01

    The author examines the concept of alienation and how it can be used to understand low-income, urban clients. A description is presented of 4 dimensions of alienation: powerlessness, meaninglessness, normlessness, and social isolation. Case illustrations are provided, and recommendations are made for counseling alienated clients. This article…

  12. Predictors of Depression Among Low-Income, Nonresidential Fathers

    ERIC Educational Resources Information Center

    Anderson, Elaine A.; Kohler, Julie K.; Letiecq, Bethany L.

    2005-01-01

    This article investigates the life conditions that contribute to low-income fathers' depression and that may jeopardize their relationships with their children. This work is based on a cultural-ecological framework that emphasizes the need to understand these fathers within their larger familial and social contexts. The sample consisted of 127…

  13. Is Maternal Marriage Beneficial for Low-Income Adolescents?

    ERIC Educational Resources Information Center

    Bachman, Heather J.; Coley, Rebekah Levine; Chase-Lansdale, P. Lindsay

    2009-01-01

    The present study investigated the association of mothers' marriage and changes in young adolescents' cognitive and socioemotional development and changes in family processes. Analyses employed longitudinal data from the "Three-City Study" to track maternal partnerships for 860 low-income adolescents (10-14 years-old in Wave 1) across a 16 month…

  14. Financial Arrangements and Relationship Quality in Low-Income Couples

    ERIC Educational Resources Information Center

    Addo, Fenaba R.; Sassler, Sharon

    2010-01-01

    This study explored the association between household financial arrangements and relationship quality using a representative sample of low-income couples with children. We detailed the banking arrangements couples utilize, assessed which factors relate to holding a joint account versus joint and separate, only separate, or no account, and analyzed…

  15. Underprotected, Undersupported: Low-Income Children at Risk

    ERIC Educational Resources Information Center

    Apollon, Dominique; Corral, Victor; Kurland, Shannah

    2009-01-01

    The major purpose of this report is to study the effects of unlicensed care on the quality and safety of childcare available to low-income families. Although this is a national study, the investigations and analyses focused on three states in particular: Alabama, California, and Maryland. Dozens of advocates, providers and administrators were…

  16. How Low-Income Children Use the Internet at Home

    ERIC Educational Resources Information Center

    Jackson, Linda A.; von Eye, Alexander; Biocca, Frank; Barbatsis, Gretchen; Zhao, Yong; Fitzgerald, Hiram E.

    2005-01-01

    HomeNetToo is a longitudinal field study designed to examine home Internet use by low-income families in the United States. Participants were 140 children, mostly African American, whose Internet use was continuously and automatically recorded for one year. This article focuses on relationships between children's main computer activities, academic…

  17. ROLE-PLAYING WITH LOW-INCOME PEOPLE.

    ERIC Educational Resources Information Center

    GOLDFARB, JEAN; RIESSMAN, FRANK

    ROLE-PLAYING, THE FLEXIBLE ACTING OUT OF VARIOUS TYPES OF PROBLEMS IN A PERMISSIVE GROUP ATMOSPHERE, WAS AIMED AT DEVELOPING A FULL, INNER FEELING ABOUT A SITUATION FROM ACTING OUT HOW OTHER PEOPLE ACTUALLY FELT IN THE SITUATION. ROLE-PLAYING WAS ESPECIALLY USEFUL FOR LOW-INCOME GROUPS BECAUSE THEY EXPRESS THEMSELVES MORE READILY WHEN REACTING TO…

  18. Diamonds in the Rough: Identifying and Serving Low Income Students

    ERIC Educational Resources Information Center

    Ford, Donna Y.; Grantham, Tarek C.; Frazier-Trotman, Michelle

    2007-01-01

    Children who live in poverty are frequently at risk for underachievement. This is not to say that poverty automatically causes lack of achievement, but being poor can certainly take its toll. Gifted low income students can be compared to diamonds, which can only be formed under conditions of extreme heat and pressure. Both diamonds and…

  19. 24 CFR 248.231 - Incentives to extend low income use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Incentives to extend low income use... AUTHORITIES PREPAYMENT OF LOW INCOME HOUSING MORTGAGES Prepayment and Plans of Action Under the Emergency Low Income Preservation Act of 1987 § 248.231 Incentives to extend low income use. The Commissioner may...

  20. Gender Differences in Caregiver Emotion Socialization of Low-Income Toddlers

    ERIC Educational Resources Information Center

    Chaplin, Tara M.; Casey, James; Sinha, Rajita; Mayes, Linda C.

    2010-01-01

    Low-income children are at elevated risk for emotion-related problems; however, little research has examined gender and emotion socialization in low-income families. The authors describe the ways in which emotion socialization may differ for low-income versus middle-income families. They also present empirical data on low-income caregivers'…

  1. Perceptions of older, low-income women about increasing intake of fruits and vegetables.

    PubMed

    Dye, Cheryl J; Cason, Katherine L

    2005-01-01

    Focus groups were conducted with 28 older, low-income women in order to identify factors that affected their fruit and vegetable (F&V) consumption. Themes emerging from data analysis include barriers to making dietary changes, specifically to increasing F&V consumption; beliefs about benefits of consuming F&V as compared with other dietary changes; and use of supplements as a substitution for eating F&V. A prominent subtheme concerned the conflict women felt between their desire to consume more F&V and their desire not to waste food. Focus group participants gave concrete suggestions on how to help older, low-income women increase F&V consumption, which included environmental supports. PMID:16891261

  2. Characteristics of Low-income Racial/Ethnic Minority Pregnant Women Screening Positive for Alcohol Risk.

    PubMed

    Washio, Yukiko; Mericle, Amy A; Cassey, Heather; Daubert, Angela M; Kirby, Kimberly C

    2016-08-01

    The current study examined the prevalence and characteristics associated with alcohol risk among low-income, predominantly racial/ethnic minority pregnant women in an urban area. We surveyed 225 pregnant women receiving nutritional care. Twenty-six percent screened positive for alcohol risk. Current smoking status (AOR 2.9, p = 0.018, 95 % CI [1.2, 7.0]) and a history of marijuana use (AOR 3.1, p = 0.001, 95 % CI [1.6, 6.2]) were the strongest predictors of alcohol risk status. This study underscores the need for screening for alcohol risk, smoking, and illicit drug use among low-income, racial/ethnic minority pregnant women and highlights the usefulness of the TWEAK in identifying alcohol risk in WIC settings. PMID:26187172

  3. 26 CFR 1.42-1 - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Limitation on low-income housing credit allowed with respect to qualified low-income buildings receiving housing credit allocations from a State or... OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-1 Limitation on low-income...

  4. 24 CFR 1000.142 - What is the “useful life” during which low-income rental housing and low-income homebuyer housing...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is the âuseful lifeâ during which low-income rental housing and low-income homebuyer housing must remain affordable as required in... Activities § 1000.142 What is the “useful life” during which low-income rental housing and...

  5. Energy-microfinance intervention for low income households in India

    NASA Astrophysics Data System (ADS)

    Rao, P. Sharath Chandra

    In India, limited energy access and energy inequity hamper the lives of low income households. Traditional fuels such as firewood and dung cake account for 84 percent and 32 percent of the rural and urban household cooking energy (NSSO, 2007). With 412 million people without access to electricity in 2005, India hosts the world's largest such population (IEA, 2007). But, low income households still spend 9 - 11.7 percent1 of their incomes on inefficient forms of energy while wealthy households spend less than 5 percent on better energy products (Saghir, 2005). Renewable energy technologies coupled with innovative financial products can address the energy access problem facing the low income households in India (MacLean & Siegel, 2007; REEEP, 2009). Nevertheless, the low income households continue to face low access to mainstream finance for purchasing renewable energy technology at terms that meet their monthly energy related expenditure (ESMAP, 2004a; SEEP, 2008a) and low or no access to energy services (Ailawadi & Bhattacharyya, 2006; Modi et. al., 2006). The lack of energy-finance options has left the marginalized population with little means to break the dependence on traditional fuels. This dissertation proposes an energy microfinance intervention to address the present situation. It designed a loan product dedicated to the purchase of renewable energy technologies while taking into account the low and irregular cash flows of the low income households. The arguments presented in this dissertation are based on a six-month pilot project using this product designed and developed by the author in conjunction with a microfinance institution and its low income clients and Energy Service Companies in the state of Karnataka. Finding the right stakeholders and establishing a joint agreement, obtaining grant money for conducting the technology dissemination workshops and forming a clear procedure for commissioning the project, are the key lessons learnt from this study

  6. Pediatric clinical drug trials in low-income countries: key ethical issues.

    PubMed

    MacLeod, S M; Knoppert, D C; Stanton-Jean, M; Avard, D

    2015-02-01

    Potential child participants in clinical research trials in low-income countries are often vulnerable because of poverty, high morbidity and mortality, inadequate education, and varied local cultural norms. However, vulnerability by itself must not be accepted as an obstacle blocking children from the health benefits that may accrue as an outcome of sound clinical research. As greater emphasis is placed on evidence-based treatment of children, it should be anticipated that there will be a growing call for agreement on principles to guide clinical investigations in low-income countries. There is now general acceptance of the view that children must be protected from non-evidence-based interventions and from substandard treatments. The questions remaining relate to how best to stimulate clinical research activity that will serve the needs of infants, children, and youth in developing countries and how best to assign priority to ethically sound research that will meet their clinical requirements. In low-income countries, 39 % of citizens are 13 years of age or younger, and consequently it is certain that clinical investigations of some new therapeutic products will be conducted there more frequently. This review offers some suggestions for approaches that will help to achieve more effective ethical consideration, including (1) improving the quality of research ethics boards; (2) fostering collaborative partnerships among important stakeholders; (3) making concerted efforts to build capacity; (4) improving the quality of the consent and waiver process; and (5) developing improved governance for harmonized ethics platforms. Continuing support by international organizations is required to sustain the establishment and maintenance of stronger research ethics boards to protect children enrolled in clinical trials. This review underscores the importance of developing a culture of solidarity and true partnership between developed and low-income country organizations, which

  7. Low-Income US Women Under-informed of the Specific Health Benefits of Consuming Beans

    PubMed Central

    Winham, Donna M.

    2016-01-01

    Background Bean consumption can reduce chronic disease risk and improve nutrition status. Consumer knowledge of bean health benefits could lead to increased intakes. Low-income women have poorer health and nutrition, but their level of knowledge about bean health benefits is unknown. Beans are a familiar food of reasonable cost in most settings and are cultural staples for Hispanics and other ethnicities. Study objectives were to assess awareness of bean health benefits among low-income women, and to evaluate any differences by acculturation status for Hispanic women in the Southwestern United States. Methods A convenience sample of 406 primarily Mexican-origin (70%) low-income women completed a survey on knowledge of bean health benefits and general food behaviors. Principal components analysis of responses identified two summary scale constructs representing “bean health benefits” and “food behaviors.” Acculturation level was the main independent variable in chi-square or ANOVA. Results The survey completion rate was 86% (406/471). Most women agreed or strongly agreed that beans improved nutrition (65%) and were satiating (62%). Over 50% answered ‘neutral’ to statements that beans could lower LDL cholesterol (52%), control blood glucose (56%) or reduce cancer risk (56%), indicating indifference or possible lack of knowledge about bean health benefits. There were significant differences by acculturation for beliefs that beans aid weight loss and intestinal health. Scores on the bean health benefits scale, but not the food behavior scale, also differed by acculturation. Conclusions Limited resource women have a favorable view of the nutrition value of beans, but the majority did not agree or disagreed with statements about bean health benefits. Greater efforts to educate low-income women about bean health benefits may increase consumption and improve nutrition. PMID:26820889

  8. Cohabitation and Repartnering among Low-Income Black Mothers

    PubMed Central

    GOLUB, ANDREW; REID, MEGAN

    2015-01-01

    Serial cohabitation has increased dramatically in the U.S., especially in the low-income Black population. The purpose of the study is to understand cohabiting and co-parenting relationships among unmarried cohabiting low-income urban Black families on their own terms, identifying the strengths, challenges, and unique needs of these families. Though cohabitation patterns varied widely, most participants had extensive periods living without a partner. This finding provides more support for the unbalanced marriage markets explanation than the serial cohabitation explanation. Indeed, most participants’ children (83%) had none or only one resident father prior to the current cohabitation. Implications for having a new resident father and child development are discussed. PMID:26161432

  9. Empowering low-income black families of handicapped children.

    PubMed

    Kalyanpur, M; Rao, S S

    1991-10-01

    A qualitative study of four black, low-income, single mothers used in-depth interviews and participant observation to evaluate their interactions with outreach agency professionals. Three perceived aspects (disrespect, focus on deficits, and discounting parenting style differences) were associated with exclusionary (unempowering) relationships. A reciprocal and supportive approach was associated with collaborative (empowering) relationships. Implications of these findings for professionals serving minority families are discussed. PMID:1836108

  10. Successful Schools and Risky Behaviors Among Low-Income Adolescents

    PubMed Central

    Coller, Karen M.; Dudovitz, Rebecca N.; Kennedy, David P.; Buddin, Richard; Shapiro, Martin F.; Kataoka, Sheryl H.; Brown, Arleen F.; Tseng, Chi-Hong; Bergman, Peter; Chung, Paul J.

    2014-01-01

    OBJECTIVES: We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. METHODS: By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug use, unprotected sex) and very risky health behaviors (eg, binge drinking, substance use at school, risky sex, gang participation). We surveyed 521 ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered admission (control group) about their health behaviors and obtained their state-standardized test scores. RESULTS: The intervention and control groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention effect) led to improved math (P < .001) and English (P = .04) standard test scores, greater school retention (91% vs 76%; P < .001), and lower rates of engaging in ≥1 very risky behaviors (odds ratio = 0.73, P < .05) but no difference in risky behaviors, such as any recent use of alcohol, tobacco, or drugs. School retention and test scores explained 58.0% and 16.2% of the intervention effect on engagement in very risky behaviors, respectively. CONCLUSIONS: Increasing performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors among low-income adolescents and to decrease health disparities across the life span. PMID:25049339

  11. The farmers' market coupon program for low-income elders.

    PubMed

    Balsam, A; Webber, D; Oehlke, B

    1994-01-01

    The Massachusetts Farmers' Market Coupon Program provides coupons to low-income elders redeemable for fresh produce at farmers' markets. The program was conceived to create new direct marketing opportunities for small farmers, while at the same time introducing people at nutritional risk to farmers' markets. This article reports on the results of an evaluation of the program by participating elders and draws conclusions regarding program successes based on the data. PMID:7830223

  12. Low Income Consumer Utility Issues: A National Perspective

    SciTech Connect

    Eisenberg, J

    2001-03-26

    This report has been prepared to provide low-income advocates and other stakeholders information on the energy burden faced by low-income customers and programs designed to alleviate that burden in various states. The report describes programs designed to lower payments, manage arrearages, weatherize and provide other energy efficiency measures, educate consumers, increase outreach to the target It discusses the costs and benefits of the population, and evaluate the programs. various options--to the degree this information is available--and describes attempts to quantify benefits that have heretofore not been quantified. The purpose of this report is to enable the low-income advocates and others to assess the options and design program most suitable for the citizens of their states or jurisdictions. It is not the authors' intent to recommend a particular course of action but, based on our broad experience in the field, to provide the information necessary for others to do so. We would be happy to answer any questions or provide further documentation on any of the material presented herein. The original edition of this report was prepared for the Utah Committee on Consumer Services, pursuant to a contract with the National Consumer Law Center (NCLC), to provide information to the Utah Low-Income Task Force established by the Utah Public Service, Commission. Attachment 1 is drawn from NCLC's 1998 Supplement to its Access to Utility Services; NCLC plans to update this list in 2001, and it will be available then from NCLC. This report has been updated by the authors for this edition.

  13. Connecting low-income smokers to tobacco treatment services.

    PubMed

    Slater, Jonathan S; Nelson, Christina L; Parks, Michael J; Ebbert, Jon O

    2016-01-01

    The Affordable Care Act calls for using population-level incentive-based interventions, and cigarette smoking is one of the most significant health behaviors driving costs and adverse health in low-income populations. Telehealth offers an opportunity to facilitate delivery of evidence-based smoking cessation services as well as incentive-based interventions to low-income populations. However, research is needed on effective strategies for linking smokers to services, how to couple financial incentives with telehealth, and on how to scale this to population-level practice. The current paper evaluates primary implementation and follow-up results of two strategies for connecting low-income, predominantly female smokers to a telephone tobacco quitline (QL). The population-based program consisted of participant-initiated phone contact and two recruitment strategies: (1) direct mail (DM) and (2) opportunistic telephone referrals with connection (ORC). Both strategies offered financial incentives for being connected to the QL, and all QL connections were made by trained patient navigators through a central call center. QL connections occurred for 97% of DM callers (N=870) and 33% of ORC callers (N=4550). Self-reported continuous smoking abstinence (i.e., 30 smoke-free days at seven-month follow-up) was 20% for the DM group and 16% for ORC. These differences between intervention groups remained in ordered logistic regressions adjusting for smoking history and demographic characteristics. Each recruitment strategy had distinct advantages; both successfully connected low-income smokers to cessation services and encouraged quit attempts and continuous smoking abstinence. Future research and population-based programs can utilize financial incentives and both recruitment strategies, building on their relative strengths. PMID:26489597

  14. Determinants of healthy eating among low-income Canadians.

    PubMed

    Power, Elaine M

    2005-01-01

    This paper draws on four bodies of literature to consider the determinants of healthy eating for low-income Canadians: a) the social determinants of health; b) socio-economic gradients in diet; c) food security; and d) the sociology of food. Though there is a paucity of data for Canada, it is very likely that, as in other industrialized countries, there are socio-economic gradients in diet such that those who are better off consume healthier diets than those less well-to-do. The available evidence suggests that income affects food intake both directly and indirectly through the dispositions associated with particular social class locations. Thus, there may be both economic and cultural thresholds for some food groups or particular foods in food groups. Understanding these thresholds is especially important in addressing the issues facing those who are the most vulnerable among Canadians with low incomes: the food insecure. The literature reviewed suggests that improved nutrition for low-income Canadians may be difficult to achieve a) in isolation from other changes to improve their lives; b) without improvement in the nutrition of the general population of Canadians; and c) without some combination of these two changes. Four major areas of research need were identified: a) national data on socio-economic gradients in diet; b) sociological research on the interaction of income and class with other factors affecting food practices; c) sociological research on Canadian food norms and cultures; and d) research on the costs of healthy eating. PMID:16042163

  15. Child Care Use by Low-Income Families: Variations across States. Research Brief. Publication #2008-23

    ERIC Educational Resources Information Center

    Lippman, Laura; Vandivere, Sharon; Keith, Julie; Atienza, Astrid

    2008-01-01

    For many low-income and single parents, employment depends on securing reliable, affordable child care. Yet these parents may face greater challenges than do higher-income and two-parent families in making affordable, appropriate child care arrangements that complement their work schedules. Indeed, the cost, availability, stability, and quality of…

  16. Impact of fatty acid status on immune function of children in low-income countries.

    PubMed

    Prentice, Andrew M; van der Merwe, Liandré

    2011-04-01

    In vitro and animal studies point to numerous mechanisms by which fatty acids, especially long-chain polyunsaturated fatty acids (LCPUFA), can modulate the innate and adaptive arms of the immune system. These data strongly suggest that improving the fatty acid supply of young children in low-income countries might have immune benefits. Unfortunately, there have been virtually no studies of fatty acid/immune interactions in such settings. Clinical trial registers list over 150 randomized controlled trials (RCTs) involving PUFAs, only one in a low-income setting (the Gambia). We summarize those results here. There was evidence for improved growth and nutritional status, but the primary end point of chronic environmental enteropathy showed no benefit, possibly because the infants were still substantially breastfed. In high-income settings, there have been RCTs with fatty acids (usually LCPUFAs) in relation to 18 disease end points, for some of which there have been numerous trials (asthma, inflammatory bowel disease and rheumatoid arthritis). For these diseases, the evidence is judged reasonable for risk reduction for childhood asthma (but not in adults), as yielding possible benefit in Crohn's disease (insufficient evidence in ulcerative colitis) and for convincing evidence for rheumatoid arthritis at sufficient dose levels, though formal meta-analyses are not yet available. This analysis suggests that fatty acid interventions could yield immune benefits in children in poor settings, especially in non-breastfed children and in relation to inflammatory conditions such as persistent enteropathy. Benefits might include improved responses to enteric vaccines, which frequently perform poorly in low-income settings, and these questions merit randomized trials. PMID:21366869

  17. Impact of a Community-Based Intervention on Serving and Intake of Vegetables among Low-Income, Rural Appalachian Families

    ERIC Educational Resources Information Center

    Wenrich, Tionni R.; Brown, J. Lynne; Wilson, Robin Taylor; Lengerich, Eugene J.

    2012-01-01

    Objective: To evaluate the effectiveness of a community-based intervention promoting the serving and eating of deep-orange, cruciferous, and dark-green leafy vegetables. Design: Randomized, parallel-group, community-based intervention with a baseline/postintervention/3-month follow-up design. Setting and Participants: Low-income food preparers (n…

  18. The Impact of WIC Food Package Changes on Access to Healthful Food in 2 Low-Income Urban Neighborhoods

    ERIC Educational Resources Information Center

    Hillier, Amy; McLaughlin, Jacqueline; Cannuscio, Carolyn C.; Chilton, Mariana; Krasny, Sarah; Karpyn, Allison

    2012-01-01

    Objective: To evaluate the impact of the 2009 food package changes for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the availability of healthful food. Design: Survey of all food stores in the study area before and after the changes were implemented. Setting: Two low-income neighborhoods in Philadelphia, 1…

  19. The Feasibility of Personal Digital Assistants (PDAs) to Collect Dietary Intake Data in Low-Income Pregnant Women

    ERIC Educational Resources Information Center

    Fowles, Eileen R.; Gentry, Breine

    2008-01-01

    Objectives: To determine the feasibility of using personal digital assistant (PDA)-based technology for tracking and analysis of food intake in low-income pregnant women. Design: Descriptive. Participants provided an initial 24-hour dietary recall and recorded their food intake using a PDA-based software program for 2 days. Setting: Recruitment…

  20. Achieving College Access Goals: The Relevance of New Media in Reaching First-Generation and Low-Income Teens

    ERIC Educational Resources Information Center

    Krywosa, Jessica

    2008-01-01

    With so much interest around the use of new media, many people concerned with improving college access are striving to master this emerging set of resources in order to better reach students, who without encouragement, are unlikely to pursue higher education. But, how much do individuals understand about the way low-income, first-generation, and…

  1. Use of Qualitative Research to Inform Development of Nutrition Messages for Low-Income Mothers of Preschool Children

    ERIC Educational Resources Information Center

    White, Alicie H.; Wilson, Judy F.; Burns, Adam; Blum-Kemelor, Donna; Singh, Anita; Race, Patricia O.; Soto, Valery; Lockett, Alice F.

    2011-01-01

    Objective: To develop and test nutrition messages and supporting content with low-income mothers for use with theory-based interventions addressing fruit and vegetable consumption and child-feeding practices. Design: Six formative and 6 evaluative focus groups explored message concepts and tested messages, respectively. Setting: Research…

  2. An Exploratory Mixed Method Assessment of Low Income, Pregnant Hispanic Women's Understanding of Gestational Diabetes and Dietary Change

    ERIC Educational Resources Information Center

    Rhoads-Baeza, Maria Elena; Reis, Janet

    2012-01-01

    Objective: To describe and assess low income, healthy, pregnant Hispanic women's understanding of gestational diabetes (GDM) and willingness to change aspects of their diet. Design: One-on-one, in-person interviews conducted in Spanish with 94 women (primarily Mexican). Setting: Federal Qualified Community Health Center's prenatal clinic. Method:…

  3. Family Ties: Improving Paternity Establishment Practices and Procedures for Low-Income Mothers, Fathers and Children. Reaching Common Ground.

    ERIC Educational Resources Information Center

    Campbell, Nancy Duff; Entmacher, Joan; Boggess, Jacquelyn; Pate, David

    Low-income mothers and fathers often share a desire to support their children, but current government policies may pit parents against each other, often to the detriment of their children. This report sets out a shared public policy agenda for newly elected leaders at all levels of U.S. government as part of the Common Ground Project, designed to…

  4. Relationship between Academic Resilience and College Success: Cross-National Experiences of Low-Income/First-Generation Students

    ERIC Educational Resources Information Center

    Mbindyo, Margaret N.

    2011-01-01

    The present study examines the relationship between academic resilience (defined as the ability to effectively deal with setbacks, stress, or pressure in an academic setting) and the experiences of US students served by TRIO intervention programs (federally funded programs) that serve low-income/first-generation students. Based on a sample of 106,…

  5. Service use among low-income minority elderly: strategies for overcoming barriers.

    PubMed

    Yeatts, D E; Crow, T; Folts, E

    1992-02-01

    The 1987 amendments to the Older Americans Act mandate a special effort to serve low-income minority elderly persons. A literature review showed that "practice-oriented" research on service use has focused primarily on identifying barriers with much less attention to identification of strategies for overcoming the barriers. This paper identifies and describes strategies used throughout Texas. Strategies addressing the "lack of knowledge" barrier included use of influential groups, working with significant individuals, and the media. Strategies addressing the "lack of access" barrier included transportation, affordability, and availability. Strategies addressing the "lack of intent" barrier focused on cultural differences, making services attractive, and overcoming negative attitudes toward service use. PMID:1740252

  6. Sterilization. Low-income women have special counseling needs.

    PubMed

    1993-05-01

    An increasing percentage of low income women are using sterilization as a method of contraception. 26% of low income women in 1982 used sterilization; 37% used it in 1988. This group of women has less access to services and information than women in other income brackets, who use sterilization less. A 16 page booklet, which is based on a study, conducted from 1985-1989 at three hospital clinics, of 1800 low income women, has been prepared by the Association for Voluntary Surgical Contraception (AVSC) for use by counselors. According to Joseph Feldman of Planned Parenthood of Central and Northern Arizona (PPCNA), low motivation to postpone pregnancy (due to concentration on the roles of wife and mother) and a sense of powerlessness over their lives are problems among poor women. Libby Antarsh of AVSC states the booklet has been designed to give women all the information necessary for an informed decision. Susan Philliber of the State University of New York at New Paltz, one of the investigators in the study, says the booklet removes one of the barriers to sterilization by alleviating the fears of physicians concerned about litigation. Barriers faced by low income women in undergoing sterilization, as revealed by the study, include 1) inadequate health care services and overburdened clinic staff; 2) less access to information about contraception, and less knowledge about using the health care system; and 3) little economic or psychological support for these, often, single parents. Culture effects support for the women and their ability to use the information provided. The number of women who actually follow through on being sterilized is double among those with the approval of their male partners. Counselors should include partners and discuss the influences of others who are pressuring the woman (friends, family, physicians). The woman should separate her feelings, but be aware of the consequences of the disapproval of others. Accurate information concerning

  7. Infant feeding practices of urban low income group in Ibadan.

    PubMed

    Omotola, B D; Akinyele, I O

    1985-04-01

    The feeding pattern of 915 children from the low income areas of Ibadan were determined with the aid of a questionnaire administered on their mothers. All the 915 infants were breast-fed for varying periods starting from birth. About 80% of the infants were breast-fed within 48 hours of delivery but most of the mothers in all areas claimed to have discarded the colostrum produced in the first 24 hours postpartum. Infants not breast-fed until a few days postpartum were fed on glucose water or herbal preparations. Culture played no significant role in infant feeding practices. PMID:12340967

  8. Are the current recommendations for the use of aspirin in primary prevention of cardiovascular disease applicable in low-income countries?

    PubMed

    Noubiap, Jean Jacques N; Nansseu, Jobert Richie N

    2015-01-01

    Although evidence has accumulated that long-term aspirin therapy is beneficial in secondary prevention of cardiovascular disease (CVD), a lot of controversies persist regarding the benefit of aspirin use in primary prevention of CVD. In low-income countries (LIC) specifically, the decision to prescribe aspirin for primary CVD prevention is more problematic, as there is a dearth of evidence in this regard. Aspirin has been shown to have relative beneficial effects in preventing a first myocardial infarction, but not stroke. However, as stroke is the prevailing CVD in many LIC, especially in Africa, the benefit of aspirin in these settings is therefore questionable. Indeed, there is no published trial that has evaluated the benefits and risks of continuous aspirin therapy in populations of LIC. Furthermore, though cardiovascular risk assessment is crucial in decision-making for the use of aspirin in primary prevention of CVD, there are no risk assessment tools that have been validated in African populations. Studies are urgently warranted, to determine the usefulness of aspirin in primary prevention of CVD in low-income settings where the drug is highly available and affordable, as CVD is becoming the leading cause of deaths in LIC. PMID:26345154

  9. 42 CFR 435.229 - Optional targeted low-income children.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Optional targeted low-income children. 435.229... Coverage of Families and Children § 435.229 Optional targeted low-income children. The agency may provide Medicaid to— (a) All individuals under age 19 who are optional targeted low-income children as defined...

  10. 42 CFR 435.229 - Optional targeted low-income children.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Optional targeted low-income children. 435.229... Coverage of Families and Children § 435.229 Optional targeted low-income children. The agency may provide Medicaid to— (a) All individuals under age 19 who are optional targeted low-income children as defined...

  11. 42 CFR 435.229 - Optional targeted low-income children.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Optional targeted low-income children. 435.229... Coverage of Families and Children § 435.229 Optional targeted low-income children. The agency may provide Medicaid to— (a) All individuals under age 19 who are optional targeted low-income children as defined...

  12. 42 CFR 435.229 - Optional targeted low-income children.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Optional targeted low-income children. 435.229... Children § 435.229 Optional targeted low-income children. The agency may provide Medicaid to— (a) All individuals under age 19 who are optional targeted low-income children as defined in § 435.4; or...

  13. 42 CFR 435.229 - Optional targeted low-income children.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Optional targeted low-income children. 435.229... Children § 435.229 Optional targeted low-income children. The agency may provide Medicaid to— (a) All individuals under age 19 who are optional targeted low-income children as defined in § 435.4; or...

  14. 45 CFR 96.48 - Low-income home energy assistance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Low-income home energy assistance. 96.48 Section... Direct Funding of Indian Tribes and Tribal Organizations § 96.48 Low-income home energy assistance. (a) This section applies to direct funding of Indian tribes under the low-income home energy...

  15. 45 CFR 96.48 - Low-income home energy assistance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Low-income home energy assistance. 96.48 Section... Direct Funding of Indian Tribes and Tribal Organizations § 96.48 Low-income home energy assistance. (a) This section applies to direct funding of Indian tribes under the low-income home energy...

  16. 45 CFR 96.48 - Low-income home energy assistance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Low-income home energy assistance. 96.48 Section... Direct Funding of Indian Tribes and Tribal Organizations § 96.48 Low-income home energy assistance. (a) This section applies to direct funding of Indian tribes under the low-income home energy...

  17. 45 CFR 96.48 - Low-income home energy assistance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Low-income home energy assistance. 96.48 Section... Direct Funding of Indian Tribes and Tribal Organizations § 96.48 Low-income home energy assistance. (a) This section applies to direct funding of Indian tribes under the low-income home energy...

  18. 24 CFR 248.111 - Appraisal and preservation value of eligible low income housing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... eligible low income housing. 248.111 Section 248.111 Housing and Urban Development Regulations Relating to... HOUSING ACT AND OTHER AUTHORITIES PREPAYMENT OF LOW INCOME HOUSING MORTGAGES Prepayments and Plans of Action Under the Low Income Housing Preservation and Resident Homeownership Act of 1990 §...

  19. 24 CFR 791.402 - Determination of low-income housing needs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Determination of low-income housing... Allocation of Budget Authority for Housing Assistance § 791.402 Determination of low-income housing needs. (a... determine the relative need for low-income housing assistance in each HUD field office jurisdiction....

  20. 24 CFR 1006.305 - Low-income requirement and income targeting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Low-income requirement and income... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Program Requirements § 1006.305 Low-income... made available for occupancy only by a family that is a low-income family at the time of the...

  1. 24 CFR 882.513 - Public notice to low-income families; waiting list.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Public notice to low-income... Procedures for Moderate Rehabilitation-Program Development and Operation § 882.513 Public notice to low-income families; waiting list. (a) Public notice to low-income Families. (1) If the PHA does not have...

  2. 12 CFR 741.204 - Maximum public unit and nonmember accounts, and low-income designation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... low-income designation. 741.204 Section 741.204 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION... Unions § 741.204 Maximum public unit and nonmember accounts, and low-income designation. Any credit union...) Obtain a low-income designation in order to accept nonmember accounts, other than from public units...

  3. 45 CFR 96.48 - Low-income home energy assistance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Low-income home energy assistance. 96.48 Section... Direct Funding of Indian Tribes and Tribal Organizations § 96.48 Low-income home energy assistance. (a) This section applies to direct funding of Indian tribes under the low-income home energy...

  4. Early childhood obesity prevention in low-income, urban communities.

    PubMed

    Dawson-McClure, Spring; Brotman, Laurie Miller; Theise, Rachelle; Palamar, Joseph J; Kamboukos, Dimitra; Barajas, R Gabriela; Calzada, Esther J

    2014-01-01

    Given the disproportionately high rates of obesity-related morbidity among low-income, ethnic minority youth, obesity prevention in this population is critical. Prior efforts to curb childhood obesity have had limited public health impact. The present study evaluates an innovative approach to obesity prevention by promoting foundational parenting and child behavioral regulation. This pre-post intervention study evaluated an enhanced version of ParentCorps with 91 families of pre-Kindergarten students in low-income, urban communities. Assessments included tests of knowledge and parent report. Consistent with findings from two randomized controlled trials of ParentCorps, parent knowledge and use of foundational parenting practices increased and child behavior problems decreased. Child nutrition knowledge and physical activity increased and television watching decreased; for boys, sleep problems decreased. Comparable benefits occurred for children at high risk for obesity based on child dysregulation, child overweight, and parent overweight. Results support a "whole child," family-centered approach to health promotion in early childhood. PMID:24702665

  5. Chronic pain management strategies used by low income overweight Latinos

    PubMed Central

    Rutledge, Dana N; Cantero, Patricia J; Ruiz, Jeanette E

    2013-01-01

    Objectives In group interviews, we examined strategies used to manage chronic pain from the perspective of the individual. Methods Sixteen low income overweight Latino adults participated in two group interviews facilitated by a trained moderator who inquired about the type of chronic pain suffered by participants, followed by more specific questions about pain management. Interviews were audio-recorded, transcribed verbatim (Spanish), back-translated into English, and analyzed using thematic analysis. Results Participants’ pain varied in type, location, and intensity. Participants discussed pain-related changes in activities and social life, and difficulties with health care providers, and as a result, we discovered five major themes: Pain-related Life Alterations, Enduring the Pain, Trying Different Strategies, Emotional Suffering, and Encounters with Health Care System/Providers. Discussion Findings indicated that there are opportunities for providers to improve care for low income overweight Latinos with chronic pain by listening respectfully to how pain alters their daily lives and assisting them in feasible self management strategies. PMID:23129787

  6. Designing prenatal care messages for low-income Mexican women.

    PubMed Central

    Alcalay, R; Ghee, A; Scrimshaw, S

    1993-01-01

    Communication theories and research data were used to design cross-cultural health education messages. A University of California Los Angeles-Universidad Autonoma in Tijuana, Mexico, research team used the methods of ethnographic and survey research to study behaviors, attitudes, and knowledge concerning prenatal care of a sample of pregnant low-income women living in Tijuana. This audience provided information that served as a framework for a series of messages to increase awareness and change prenatal care behaviors. The message design process was guided by persuasion theories that included Petty and Caccioppo's elaboration likelihood model, McGuire's persuasion matrix, and Bandura's social learning theory. The results from the research showed that poor women in Tijuana tend to delay or not seek prenatal care. They were not aware of symptoms that could warn of pregnancy complications. Their responses also revealed pregnant women's culturally specific beliefs and behaviors regarding pregnancy. After examination of these and other results from the study, prenatal care messages about four topics were identified as the most relevant to communicate to this audience: health services use, the mother's weight gain, nutrition and anemia, and symptoms of high-risk complications during pregnancy. A poster, a calendar, a brochure, and two radio songs were produced and pretested in focus groups with low-income women in Tijuana. Each medium included one or more messages addressing informational, attitudinal, or behavioral needs, or all three, of the target population. PMID:8497574

  7. Set-based corral control in stochastic dynamical systems: Making almost invariant sets more invariant

    PubMed Central

    Forgoston, Eric; Billings, Lora; Yecko, Philip; Schwartz, Ira B.

    2011-01-01

    We consider the problem of stochastic prediction and control in a time-dependent stochastic environment, such as the ocean, where escape from an almost invariant region occurs due to random fluctuations. We determine high-probability control-actuation sets by computing regions of uncertainty, almost invariant sets, and Lagrangian coherent structures. The combination of geometric and probabilistic methods allows us to design regions of control, which provide an increase in loitering time while minimizing the amount of control actuation. We show how the loitering time in almost invariant sets scales exponentially with respect to the control actuation, causing an exponential increase in loitering times with only small changes in actuation force. The result is that the control actuation makes almost invariant sets more invariant. PMID:21456830

  8. Assessing perceived health promotion needs and interests of low-income older women.

    PubMed

    Bertera, E M

    1999-12-01

    This study focuses on an assessment of perceived health promotion needs and interests among predominantly older low-income women (76%) in the state of Pennsylvania. A questionnaire was completed by a convenience sample of 140 individuals attending four senior centers and two nutrition sites. In addition, 14 focus groups with an average of 8 members per group were conducted for a total of 105 people from two of the four senior centers. The health topics of greatest interest to women were exercise (57.6%), making friends (50.9%), nutrition (37.5%), losing weight (33.6%), and home safety (34.6%). Compared with women, men were significantly more interested in exercise and its effect on mood (41.3% versus 24.0%) and love and sex after 60 (44.8% versus 18.2%) and significantly less interested in nutrition (17.2% versus 37.5%). The fitness activities of greatest interest to women were walking (63.1%), back exercises (37.5%), toning to music (22.1%), and self-defense (18.2%), none of which was significantly different from the men in the sample. Results suggest that many of the key health needs perceived by low-income older women could be addressed by a combination of fitness activities and health education, especially if they are also designed to facilitate social interactions. The barriers to participation in such programs most often cited were transportation, scheduling, and cost factors. Fortunately, many communities already have the resources to offer low-cost interventions in the areas of need, such as walking groups, self-defense, and home safety. Communities interested in serving low-income older women should more closely examine the barriers and the unmet needs of this group when designing intervention programs. PMID:10643841

  9. Perceptions of low-income African-American mothers about excessive gestational weight gain.

    PubMed

    Herring, Sharon J; Henry, Tasmia Q; Klotz, Alicia A; Foster, Gary D; Whitaker, Robert C

    2012-12-01

    A rising number of low-income African-American mothers gain more weight in pregnancy than is recommended, placing them at risk for poor maternal and fetal health outcomes. Little is known about the perceptions of mothers in this population that may influence excessive gestational weight gain. In 2010-2011, we conducted 4 focus groups with 31 low-income, pregnant African-Americans in Philadelphia. Two readers independently coded the focus group transcripts to identify recurrent themes. We identified 9 themes around perceptions that encouraged or discouraged high gestational weight gain. Mothers attributed high weight gain to eating more in pregnancy, which was the result of being hungrier and the belief that consuming more calories while pregnant was essential for babies' health. Family members, especially participants own mothers, strongly reinforced the need to "eat for two" to make a healthy baby. Mothers and their families recognized the link between poor fetal outcomes and low weight gains but not higher gains, and thus, most had a greater pre-occupation with too little food intake and weight gain rather than too much. Having physical symptoms from overeating and weight retention after previous pregnancies were factors that discouraged higher gains. Overall, low-income African-American mothers had more perceptions encouraging high gestational weight gain than discouraging it. Interventions to prevent excessive weight gain need to be sensitive to these perceptions. Messages that link guideline recommended weight gain to optimal infant outcomes and mothers' physical symptoms may be most effective for weight control. PMID:22160656

  10. Increasing access to healthful foods: a qualitative study with residents of low-income communities

    PubMed Central

    2015-01-01

    Background Inadequate access to healthful foods has been identified as a significant barrier to healthful dietary behaviors among individuals who live in low-income communities. The purpose of this study was to gather low-income community members’ opinions about their food purchasing choices and their perceptions of the most effective ways to increase access to healthful foods in their communities. Methods Spanish and English focus groups were conducted in low-income, ethnically-diverse communities. Participants were asked about their knowledge, factors influencing their food purchasing decisions, and their perceptions regarding solutions to increase access to healthful foods. Results A total of 148 people participated in 13 focus groups. The majority of participants were female and ethnically diverse (63% Hispanic, 17% African American, 16% Caucasian, and 4% “other”). More than 75% of the participants reported making less than $1999 USD per month. Participants reported high levels of knowledge and preference for healthful foods. The most important barriers influencing healthful shopping behaviors included high price of healthful food, inadequate geographical access to healthful food, poor quality of available healthful food, and lack of overall quality of the proximate retail stores. Suggested solutions to inadequate access included placement of new chain supermarkets in their communities. Strategies implemented in convenience stores were not seen as effective. Farmers’ markets, with specific stipulations, and community gardens were regarded as beneficial supplementary solutions. Conclusion The results from the focus groups provide important input from a needs assessment perspective from the community, identify gaps in access, and offer potential effective solutions to provide direction for the future. PMID:26222910

  11. Inadequate: A Metaphor for the Lives of Low-Income Women?

    PubMed Central

    Solomonik, Anna

    2009-01-01

    Abstract Exclusive breastfeeding of infants for the first 6 months of life with continued breastfeeding for at least 6 more months occurs only 11.9% of the time in the United States. Efforts of the past 30 years to promote optimal breastfeeding practices have had little impact. In order to create significant change in the way we feed infants in this country, we need to change the way we look at this public health issue and examine the cultural logic that makes bottle feeding the preferred choice of most U.S. women. This article analyzes the term “inadequate” not just as self-description of a woman's milk supply, but also as a metaphor for the lives of low-income women in the United States, the group least likely to breastfeed. Low-income women in the United States not only have inadequate incomes as compared to the general population, but inadequate child care, education, preventive health services, inadequate lifespans, and lives saturated with violence, leaving them inadequately safe even in their own homes. Here we outline a research agenda to explore the relationship between socially determined inadequacies and the cultural logic that makes bottle feeding a preferred form of infant feeding. PMID:19827922

  12. Health systems performance assessment in low-income countries: learning from international experiences

    PubMed Central

    2014-01-01

    Background The study aimed at developing a set of attributes for a ‘good’ health system performance assessment (HSPA) framework from literature and experiences in different contexts and using the attributes for a structured approach to lesson learning for low-income countries (LICs). Methods Literature review to identify relevant attributes for a HSPA framework; attribute validation for LICs in general, and for Uganda in particular, via a high-level Ugandan expert group; and, finally, review of a selection of existing HSPA frameworks using these attributes. Results Literature review yielded six key attributes for a HSPA framework: an inclusive development process; its embedding in the health system’s conceptual model; its relation to the prevailing policy and organizational set-up and societal context; the presence of a concrete purpose, constitutive dimensions and indicators; an adequate institutional set-up; and, its capacity to provide mechanisms for eliciting change in the health system. The expert group contextualized these attributes and added one on the adaptability of the framework. Lessons learnt from the review of a selection of HSPA frameworks using the attributes include: it is possible and beneficial to involve a range of stakeholders during the process of development of a framework; it is important to make HSPA frameworks explicit; policy context can be effectively reflected in the framework; there are marked differences between the structure and content of frameworks in high-income countries, and low- and middle-income countries; champions can contribute to put HSPA high on the agenda; and mechanisms for eliciting change in the health system should be developed alongside the framework. Conclusion It is possible for LICs to learn from literature and the experience of HSPA in other contexts, including HICs. In this study a structured approach to lesson learning included the development of a list of attributes for a ‘good’ HSPA framework. The

  13. Peri-operative pulse oximetry in low-income countries: a cost–effectiveness analysis

    PubMed Central

    Chilton, Peter J; Gawande, Atul A; Lilford, Richard J

    2014-01-01

    Abstract Objective To evaluate the cost–effectiveness of pulse oximetry – compared with no peri-operative monitoring – during surgery in low-income countries. Methods We considered the use of tabletop and portable, hand-held pulse oximeters among patients of any age undergoing major surgery in low-income countries. From earlier studies we obtained baseline mortality and the effectiveness of pulse oximeters to reduce mortality. We considered the direct costs of purchasing and maintaining pulse oximeters as well as the cost of supplementary oxygen used to treat hypoxic episodes identified by oximetry. Health benefits were measured in disability-adjusted life-years (DALYs) averted and benefits and costs were both discounted at 3% per year. We used recommended cost–effectiveness thresholds – both absolute and relative to gross domestic product (GDP) per capita – to assess if pulse oximetry is a cost–effective health intervention. To test the robustness of our results we performed sensitivity analyses. Findings In 2013 prices, tabletop and hand-held oximeters were found to have annual costs of 310 and 95 United States dollars (US$), respectively. Assuming the two types of oximeter have identical effectiveness, a single oximeter used for 22 procedures per week averted 0.83 DALYs per annum. The tabletop and hand-held oximeters cost US$ 374 and US$ 115 per DALY averted, respectively. For any country with a GDP per capita above US$ 677 the hand-held oximeter was found to be cost–effective if it prevented just 1.7% of anaesthetic-related deaths or 0.3% of peri-operative mortality. Conclusion Pulse oximetry is a cost–effective intervention for low-income settings. PMID:25552770

  14. 26 CFR 1.42-1T - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Limitation on low-income housing credit allowed with respect to qualified low-income buildings receiving housing credit allocations from a State or local housing credit agency (temporary). 1.42-1T Section 1.42-1T Internal Revenue INTERNAL...

  15. 26 CFR 1.42-1T - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Limitation on low-income housing credit allowed with respect to qualified low-income buildings receiving housing credit allocations from a State or local housing credit agency (temporary). 1.42-1T Section 1.42-1T Internal Revenue INTERNAL...

  16. 26 CFR 1.42-1T - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Limitation on low-income housing credit allowed with respect to qualified low-income buildings receiving housing credit allocations from a State or local housing credit agency (temporary). 1.42-1T Section 1.42-1T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME...

  17. 26 CFR 1.42-1T - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Limitation on low-income housing credit allowed with respect to qualified low-income buildings receiving housing credit allocations from a State or local housing credit agency (temporary). 1.42-1T Section 1.42-1T Internal Revenue INTERNAL...

  18. 26 CFR 1.42-1T - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Limitation on low-income housing credit allowed with respect to qualified low-income buildings receiving housing credit allocations from a State or local housing credit agency (temporary). 1.42-1T Section 1.42-1T Internal Revenue INTERNAL...

  19. A "contract for change" increases produce consumption in low-income women: a pilot study.

    PubMed

    Heneman, Karrie; Block-Joy, Amy; Zidenberg-Cherr, Sheri; Donohue, Susan; Garcia, Linda; Martin, Anna; Metz, Diane; Smith, Dorothy; West, Estella; Steinberg, Francene M

    2005-11-01

    This study determined whether a "Contract for Change" goal-setting exercise enhanced the effectiveness of the Expanded Food and Nutrition Education/Food Stamp Nutrition Education programs to increase produce consumption in low-income (<130% of poverty) women after 4 weeks. Thirty-eight participants were randomized in this three-group parallel arm study: (a) control group participants received life-skills lessons, (b) the education group received the Expanded Food and Nutrition Education/Food Stamp Nutrition Education "Food Guide Pyramid" lessons, and (c) the contract group also received the "Food Guide Pyramid" series and completed a "Contract for Change." It was hypothesized that the contract group would have the greatest increases in advancement toward dietary change and produce consumption. Compared with controls, the contract group significantly moved toward acceptance of vegetable consumption (P < or = .05). Compared with the education group, the contract group significantly increased fruit consumption. Results suggest that nutrition professionals can effectively use goal-setting to assist low-income populations with dietary change. PMID:16256766

  20. Digital expression among urban, low-income African American adolescents.

    PubMed

    Baker, Christina M; Staiano, Amanda E; Calvert, Sandra L

    2011-01-01

    Digital production is a means through which African American adolescents communicate and express their experiences with peers. This study examined the content and the form of the digital productions of 24 urban, low-income African American adolescents who attended a summer academic program. The content of student digital productions focused on academic experiences and friendships. Their production styles revealed that youth used perceptually salient production features, such as rapid scene changes and loud rap music. The results suggest that when placed in a supportive, academic environment and provided with digital production resources, students who traditionally face barriers due to cultural and economic inequalities digitally express to their peers an interest in academics and positive peer relationships, and that these youth communicate their experiences through a shared production style that reflects their broader cultural experiences. PMID:21910270

  1. The health of children of low-income families.

    PubMed Central

    Shah, C P; Kahan, M; Krauser, J

    1987-01-01

    Childhood poverty is common in Canada: 1,114,000 children under 16 years of age live below the poverty line. The incidence is highest among children of single mothers, unemployed parents, Canadian native peoples and recent immigrants, particularly refugees. Compared with the national average, the infant mortality rate is twice as high, deaths from infectious diseases are 2.5 times more common and accidental deaths are twice as common among children of low-income families. Other problems associated with poverty are iron deficiency anemia, dental caries, chronic ear infections, mental retardation, learning disabilities, poor school performance and increased suicide rates. Health care professionals can help address the poor physical and mental health associated with poverty in children by promoting a broad range of public policies. PMID:3308037

  2. Financial Arrangements and Relationship Quality in Low-Income Couples

    PubMed Central

    Addo, Fenaba R.; Sassler, Sharon

    2012-01-01

    This study explored the association between household financial arrangements and relationship quality using a representative sample of low-income couples with children. We detailed the banking arrangements couples utilize, assessed which factors relate to holding a joint account versus joint and separate, only separate, or no account, and analyzed the association between fiscal practices and men’s and women’s relationship quality. The majority of couples held joint accounts, though over one-quarter also have separate accounts; nearly one-tenth have no account. Joint bank accounts were associated with higher levels of relationship quality on numerous dimensions, though more consistently for women than men. Individualistic arrangements appeared to undermine women’s relationship satisfaction and reduce feelings of intimacy, sexual compatibility, and satisfaction with conflict resolution. PMID:22844174

  3. Interviews with low-income Pennsylvanians verify a need to enhance eating competence.

    PubMed

    Stotts Krall, Jodi; Lohse, Barbara

    2009-03-01

    Continuation of unhealthful dietary patterns and poor diet-related health outcomes among socioeconomically disadvantaged populations underscores the need to improve diet quality for this group. Enhancing eating competence, based on the Satter model of eating competence (ecSatter), may be one effective method to reach this goal, but requires substantiation in a low-income audience. This study utilized a qualitative approach to examine the congruence of the ecSatter model with the cognitive eating behaviors of a low-income audience. Structured interviews were conducted during summer of 2006 with 70 low-income adults in Pennsylvania. Themes about decisional factors that guide food selection, nutrition/health interests, and cognitive and affective responses to eating experiences were generated through content analysis. Thematic differences among eating competence levels and food security categories were examined. Nutrition information access preferences were also obtained. Eating competence, measured with the ecSatter Inventory, was low for this sample (mean 28.8+/-8.3). Convenience, mood, family, and availability of food at home, but not nutrition, were salient factors guiding meal and snack planning for both eating competent and noneating competent participants. Nearly equal proportions of persons with eating competence and without eating competence reported that they would make changes to their food purchases if they had more money to spend on food. Interestingly, for participants without eating competence, but not for those with eating competence, weight management played an important role in meal/snack planning, food purchases, and nutrition/health interests. ecSatter provided a tenable framework for rationalizing participants' cognitive and affective responses to eating experiences. Participants without eating competence were more likely to express negative thoughts and feelings associated with eating, regardless of food security status. The Internet, which was

  4. Medicines coverage and community-based health insurance in low-income countries

    PubMed Central

    Vialle-Valentin, Catherine E; Ross-Degnan, Dennis; Ntaganira, Joseph; Wagner, Anita K

    2008-01-01

    Objectives The 2004 International Conference on Improving Use of Medicines recommended that emerging and expanding health insurances in low-income countries focus on improving access to and use of medicines. In recent years, Community-based Health Insurance (CHI) schemes have multiplied, with mounting evidence of their positive effects on financial protection and resource mobilization for healthcare in poor settings. Using literature review and qualitative interviews, this paper investigates whether and how CHI expands access to medicines in low-income countries. Methods We used three complementary data collection approaches: (1) analysis of WHO National Health Accounts (NHA) and available results from the World Health Survey (WHS); (2) review of peer-reviewed articles published since 2002 and documents posted online by national insurance programs and international organizations; (3) structured interviews of CHI managers about key issues related to medicines benefit packages in Lao PDR and Rwanda. Results In low-income countries, only two percent of WHS respondents with voluntary insurance belong to the lowest income quintile, suggesting very low CHI penetration among the poor. Yet according to the WHS, medicines are the largest reported component of out-of-pocket payments for healthcare in these countries (median 41.7%) and this proportion is inversely associated with income quintile. Publications have mentioned over a thousand CHI schemes in 19 low-income countries, usually without in-depth description of the type, extent, or adequacy of medicines coverage. Evidence from the literature is scarce about how coverage affects medicines utilization or how schemes use cost-containment tools like co-payments and formularies. On the other hand, interviews found that medicines may represent up to 80% of CHI expenditures. Conclusion This paper highlights the paucity of evidence about medicines coverage in CHI. Given the policy commitment to expand CHI in several countries

  5. Adolescents from low-income sectors: the challenge of studying in a time of digital environments.

    PubMed

    Linne, Joaquín

    2014-10-01

    This paper is about practices and perceptions regarding the study of adolescents from low-income sectors in the City of Buenos Aires. The methodology consisted of 26 in-depth interviews with low-income adolescents and participant observations in twenty cybercafés of the South Area of the City of Buenos Aires. Among the findings, these students highlight that ICTs allow them to handle information in a more agile and entertaining way, more consistent with their daily uses. However, doing research on school content is what students do the least, since adolescents use technology mainly for communicative, social and recreational ends. These adolescents recognise some disadvantages in using ICTs to study: the unreliable information, the difficulty to distinguish which topics related to school content are more appropriate and the disruptive and continuous use of social networks. In this sense, these adolescents tend to have more problems in benefitting from ICTs for academic purposes than other adolescents. While communication and recreational skills tend to be similar, the evaluation of different sources of information and the skill to make complex searches online are usually more strongly developed in adolescents of middle and high-income households. In conclusion, we think it is necessary to take these problems into consideration in the social sciences research of the area and besides when implementing digital literacy programs. PMID:25364088

  6. Adolescents from low-income sectors: the challenge of studying in a time of digital environments

    PubMed Central

    Linne, Joaquín

    2014-01-01

    This paper is about practices and perceptions regarding the study of adolescents from low-income sectors in the City of Buenos Aires. The methodology consisted of 26 in-depth interviews with low-income adolescents and participant observations in twenty cybercafés of the South Area of the City of Buenos Aires. Among the findings, these students highlight that ICTs allow them to handle information in a more agile and entertaining way, more consistent with their daily uses. However, doing research on school content is what students do the least, since adolescents use technology mainly for communicative, social and recreational ends. These adolescents recognise some disadvantages in using ICTs to study: the unreliable information, the difficulty to distinguish which topics related to school content are more appropriate and the disruptive and continuous use of social networks. In this sense, these adolescents tend to have more problems in benefitting from ICTs for academic purposes than other adolescents. While communication and recreational skills tend to be similar, the evaluation of different sources of information and the skill to make complex searches online are usually more strongly developed in adolescents of middle and high-income households. In conclusion, we think it is necessary to take these problems into consideration in the social sciences research of the area and besides when implementing digital literacy programs. PMID:25364088

  7. Colorectal cancer screening awareness and intentions among low income, sociodemographically diverse adults under age 50.

    PubMed

    Emmons, Karen; Puleo, Elaine; McNeill, Lorna H; Bennett, Gary; Chan, Sophia; Syngal, Sapna

    2008-12-01

    Colorectal cancer (CRC) screening rates in the US are suboptimal, particularly among lower income and racial/ethnically diverse groups. If specific populations have limited awareness of screening when they reach age 50, there may be delays in screening adoption. This study investigated sociodemographic and social contextual factors associated with awareness of CRC and intentions to be screened at age 50 among 692 low income, racial, and ethnic minority adults living in low income housing. The majority of respondents (62%) were between ages 30 and 49, and 94% had some form of health insurance (e.g., Medicaid). About 70% reported having heard about CRC screening; 66% reported intentions to be screened at age 50. In multivariable analyses, screening awareness was associated with age and education. Immigrants who had English as a second language had lower awareness. Females tended to have higher awareness if they had private insurance; there were no differences among males. Multivariable analyses found that screening intentions were higher among men, those with more role responsibilities, more role conflicts, and higher levels of social cohesion. It is important to identify opportunities for maximizing screening uptake among those who become age-eligible for screening if we are to make a significant impact on CRC disparities. PMID:18478340

  8. Chronic Kidney Disease (CKD) Treatment Burden Among Low-Income Primary Care Patients

    PubMed Central

    Kahn, Linda S.; Vest, Bonnie M.; Madurai, Nethra; Singh, Ranjit; York, Trevor R.M.; Cipparone, Charlotte W.; Reilly, Sarah; Malik, Khalid S.; Fox, Chester H.

    2015-01-01

    Objective This study explored the self-management strategies and treatment burden experienced by low income US primary care patients with chronic kidney disease. Methods Semi-structured interviews were conducted with 34 patients from two primary care practices on Buffalo’s East Side, a low-income community. Qualitative analysis was undertaken using an inductive thematic content analysis approach. We applied Normalization Process Theory (NPT) to the concept of treatment burden to interpret and categorize our findings. Results The sample was predominantly African-American (79%) and female (59%). Most patients (79%) had a diagnosis of Stage 3 CKD. Four major themes were identified corresponding to NPT and treatment burden: (1) Coherence – making sense of CKD; (2) Cognitive participation – enlisting support and organizing personal resources; (3) Collective action – self-management work; and (4) Reflexive monitoring – further refining chronic illness self-care in the context of CKD. For each component we identified barriers hindering patients’ ability to accomplish the necessary tasks. Conclusions Our findings highlight the substantial treatment burden faced by inner-city primary care patients self-managing CKD in combination with other chronic illnesses. Health care providers’ awareness of treatment burden can inform the development of person-centered care plans that can help patients to better manage their chronic illnesses. PMID:25416418

  9. Barriers to depression treatment among low-income, Latino emergency department patients.

    PubMed

    Wells, Anjanette; Lagomasino, Isabel T; Palinkas, Lawrence A; Green, Jennifer M; Gonzalez, Diana

    2013-08-01

    Low-income and Latinos use the emergency department (ED) as a primary source of care. Also, the depression prevalence in ED patients is high, making the ED a compelling venue for depression screening and intervention. This study examined barriers and facilitators to depression treatment among low-income, predominantly Latino ED patients. We conducted telephone interviews with 24 ED patients (18-62 years of age, 79 % female) who dropped out of a depression treatment intervention. Using grounded theory, we analyzed perceptions of depression and treatment, and barriers and facilitators to mental health treatment. Although most patients acknowledged signs of depression, there was a lack of readiness to seek help. Patients reported negative perceptions about anti-depressant medication, even if they had no previous use. Barriers to treatment included transportation concerns, employment/unemployment, patient-provider issues, and immigrant documentation. Identified facilitators included consistent provider advice and "talking." This study introduced new misunderstanding and miscommunication barriers. PMID:23054150

  10. High Resolution Population Maps for Low Income Nations: Combining Land Cover and Census in East Africa

    PubMed Central

    Tatem, Andrew J.; Noor, Abdisalan M.; von Hagen, Craig; Di Gregorio, Antonio; Hay, Simon I.

    2007-01-01

    Background Between 2005 and 2050, the human population is forecast to grow by 2.7 billion, with the vast majority of this growth occurring in low income countries. This growth is likely to have significant social, economic and environmental impacts, and make the achievement of international development goals more difficult. The measurement, monitoring and potential mitigation of these impacts require high resolution, contemporary data on human population distributions. In low income countries, however, where the changes will be concentrated, the least information on the distribution of population exists. In this paper we investigate whether satellite imagery in combination with land cover information and census data can be used to create inexpensive, high resolution and easily-updatable settlement and population distribution maps over large areas. Methodology/Principal Findings We examine various approaches for the production of maps of the East African region (Kenya, Uganda, Burundi, Rwanda and Tanzania) and where fine resolution census data exists, test the accuracies of map production approaches and existing population distribution products. The results show that combining high resolution census, settlement and land cover information is important in producing accurate population distribution maps. Conclusions We find that this semi-automated population distribution mapping at unprecedented spatial resolution produces more accurate results than existing products and can be undertaken for as little as $0.01 per km2. The resulting population maps are a product of the Malaria Atlas Project (MAP: http://www.map.ox.ac.uk) and are freely available. PMID:18074022

  11. A Number Sense Intervention for Low-Income Kindergartners at Risk for Mathematics Difficulties

    PubMed Central

    Dyson, Nancy I.; Jordan, Nancy C.; Glutting, Joseph

    2012-01-01

    Early number sense is a strong predictor of later success in school mathematics. A disproportionate number of children from low-income families come to first grade with weak number competencies, leaving them at-risk for a cycle of failure. The present study examined the effects of an 8-week number sense intervention to develop number competencies of low-income kindergartners (n = 121). The intervention purposefully targeted whole number concepts related to counting, comparing, and manipulating sets. Children were randomly assigned either to a number sense intervention or a business as usual contrast group. The intervention was carried out in small group, 30-minute sessions, 3 days per week for a total of 24 sessions. Controlling for number sense at pretest, the intervention group made meaningful gains relative to the control group at immediate as well delayed posttest on a measure of early numeracy. Intervention children also performed better than controls on a standardized test of mathematics calculation at immediate posttest. PMID:21685346

  12. Effects of Social Injustice on Breast Health–Seeking Behaviors of Low-Income Women

    PubMed Central

    Bowen, Shelly-Ann; Williams, Edith M.; Stoneberg-Cooper, Chayah M.; Glover, Saundra H.; Williams, Michelle S.; Byrd, Michael D.

    2014-01-01

    Purpose The study uses qualitative research to gain a better understanding of what occurs after low-income women receive an abnormal breast screening and the factors that influence their decisions and behavior. A heuristic model is presented for understanding this complexity. Design Qualitative research methods used to elicited social and cultural themes related to breast cancer screening follow-up. Setting Individual telephone interviews were conducted with 16 women with confirmed breast anomaly. Participants Low-income women screened through a national breast cancer early detection program. Method Grounded theory using selective coding was employed to elicit factors that influenced the understanding and follow-up of an abnormal breast screening result. Interviews were digitally recorded, transcribed, and uploaded into NVivo 8, a qualitative management and analysis software package. Results For women (16, or 72% of case management referrals) below 250% of the poverty level, the impact of social and economic inequities creates a psychosocial context underlined by structural and cultural barriers to treatment that forecasts the mechanism that generates differences in health outcomes. The absence of insurance due to underemployment and unemployment and inadequate public infrastructure intensified emotional stress impacting participants’ health decisions. Conclusion The findings that emerged offer explanations of how consistent patterns of social injustice impact treatment decisions in a high-risk vulnerable population that have implications for health promotion research and systems-level program improvement and development. PMID:23448411

  13. Patterns of Violence Exposure and Sexual Risk in Low-Income, Urban African American Girls

    PubMed Central

    Wilson, Helen W.; Woods, Briana A.; Emerson, Erin; Donenberg, Geri R.

    2013-01-01

    Objective This study examined the relationship between violence exposure and sexual risk-taking among low-income, urban African American (AA) adolescent girls, considering overlap among different types and characteristics of violence. Methods AA adolescent girls were originally recruited from outpatient mental health clinics serving urban, mostly low-SES communities in Chicago, IL as part of a two-year longitudinal investigation of HIV-risk behavior. A subsequent follow-up was completed to assess lifetime history of trauma and violence exposure. The current study (N=177) included violence exposure and sexual risk behavior reported at the most recent interview (ages 14-22). Multiple regression was used to examine combined and unique contributions of different types, ages, settings, and perpetrators or victims of violence to variance in sexual risk. Results More extensive violence exposure and cumulative exposure to different kinds of violence were associated with overall unsafe sex, more partners, and inconsistent condom use. The most significant unique predictors, accounting for overlap among different forms of violence, were physical victimization, adolescent exposure, neighborhood violence, and violence involving dating partners. Conclusions These findings put sexual risk in the context of broad traumatic experiences but also suggest that the type and characteristics of violence exposure matter in terms of sexual health outcomes. Violence exposure should be addressed in efforts to reduce STIs among low-income, urban African American girls. PMID:24563808

  14. [MATCHE: Management Approach to Teaching Consumer and Homemaking Education.] Economically Depressed Areas Strand: Housing. Module III-B-1: Low-Income Housing.

    ERIC Educational Resources Information Center

    Hennings, Patricia

    This competency-based preservice home economics teacher education module on low income housing is the first in a set of three modules on housing in economically depressed areas. (This set is part of a larger set of sixty-seven modules on the Management Approach to Teaching Consumer and Homemaking Education [MATCHE]--see CE 019 901-967.) Following…

  15. [MATCHE: Management Approach to Teaching Consumer and Homemaking Education.] Economically Depressed Areas Strand: Management. Module III-F-3: Marketing Practices in Relation to Low Income Clientele.

    ERIC Educational Resources Information Center

    California State Univ., Fresno. Dept. of Home Economics.

    This competency-based preservice home economics teacher education module on marketing practices in relation to low income clientele is the third in a set of three modules on management in economically depressed areas (EDAs). (This set is part of a larger set of sixty-seven modules on the Management Approach to Teaching Consumer and Homemaking…

  16. Expecting to work, fearing homelessness: The possible selves of low-income mothers

    PubMed Central

    Lee, Shawna J.; Oyserman, Daphna

    2010-01-01

    We explored the content of possible selves of low-income mothers and the strategies they have to work on their possible selves. Positive, expected possible selves focused on getting a job, making ends meet and caregiving. Negative, to-be-avoided possible selves focused on failing to make ends meet, losing (or not getting) jobs, and problems with mental health. Immediate social context, rather than demographic characteristics or global work-family variables, were associated with content of possible selves. Controlling for demographic and work-family variables, job-focused possible selves (and strategies to attain them) were more salient and caregiving and mental health-related possible selves (and relevant strategies) less salient to mothers in job-training programs vs. welfare offices. PMID:20563288

  17. Knowledge translation: a case study on pneumonia research and clinical guidelines in a low- income country

    PubMed Central

    2014-01-01

    Background The process and effectiveness of knowledge translation (KT) interventions targeting policymakers are rarely reported. In Cambodia, a low-income country (LIC), an intervention aiming to provide evidence-based knowledge on pneumonia to health authorities was developed to help update pediatric and adult national clinical guidelines. Through a case study, we assessed the effectiveness of this KT intervention, with the goal of identifying the barriers to KT and suggest strategies to facilitate KT in similar settings. Methods An extensive search for all relevant sources of data documenting the processes of updating adult and pediatric pneumonia guidelines was done. Documents included among others, reports, meeting minutes, and email correspondences. The study was conducted in successive phases: an appraisal of the content of both adult and pediatric pneumonia guidelines; an appraisal of the quality of guidelines by independent experts, using the AGREE-II instrument; a description and modeling of the KT process within the guidelines updating system, using the Unified Modeling Language (UML) tools 2.2; and the listing of the barriers and facilitators to KT we identified during the study. Results The first appraisal showed that the integration of the KT key messages in pediatric and adult guidelines varied with a better efficiency in the pediatric guidelines. The overall AGREE-II quality assessments scored 37% and 44% for adult and pediatric guidelines, respectively. Scores were lowest for the domains of ‘rigor of development’ and ‘editorial independence.’ The UML analysis highlighted that time frames and constraints of the involved stakeholders greatly differed and that there were several missed opportunities to translate on evidence into the adult pneumonia guideline. Seventeen facilitating factors and 18 potential barriers to KT were identified. Main barriers were related to the absence of a clear mandate from the Ministry of Health for the researchers

  18. Treatment of Prolactinomas in Low-Income Countries

    PubMed Central

    Kruljac, Ivan; Kirigin, Lora Stanka; Strinović, Mateja; Marinković, Jelena; Pećina, Hrvoje Ivan; Čerina, Vatroslav; Stipić, Darko; Vrkljan, Milan

    2015-01-01

    Purpose. In low-income countries, prolactinomas are difficult to manage with dopamine agonists (DA). We compared the effectiveness of DA in microprolactinomas as a first line treatment and as adjuvant therapy for residual macroprolactinomas treated surgically. Methods. Our retrospective study analyzed 78 patients, 38 with microprolactinomas and 40 with macroprolactinomas. Microprolactinomas were treated with DA. Macroprolactinomas were treated with microsurgical or endoscopic adenomectomies and adjuvant DA. Surgical remission was defined as normoprolactinemia three months postoperatively, and long-term remission as normoprolactinemia at the last control. Results. Surgical remission was achieved in 9 patients (23%). Postsurgical tumor mass was reduced by 50% (34–68). Residual macroprolactinoma size was greater than microprolactinoma size prior to treatment (10 mm versus 4 mm, P < 0.001). Both groups received similar doses of DA. Long-term remission occurred in 68% of microprolactinomas and 43% of macroprolactinomas (P = 0.102). Prolactin (PRL) levels at the last control were similar in both groups (23.1 versus 32.9 mcg/L, P = 0.347). Conclusion. Comparable remission rates and PRL levels were reached in microprolactinomas and macroprolactinomas using similar doses of DA. Although complete tumor resection is the goal of surgery, our study suggests that even partial surgical removal has a role in treatment of prolactinomas since it may enhance the response to DA. PMID:25737721

  19. Concepts of anemia among low income Nicaraguan women.

    PubMed

    Ailinger, Rita L; Moore, Jean B; Pawloski, Lisa; Cortés, Lidya Ruth Zamora

    2009-01-01

    Anemia is a common health problem among women throughout the world, however, there has been minimal research on women's concepts of anemia. The purpose of this study was to examine concepts of anemia in low income Nicaraguan women. A qualitative design was used. Audio-taped open-ended interviews in Spanish with 14 women were used to obtain data. Tapes were transcribed and content analyzed. The findings indicate that few of the women had biomedically accurate concepts of anemia, such as that it was due to lack of iron from poor eating. Others held folk medical beliefs including home remedies, for example drinking the milk of a mare or beet juice and eating certain foods such as bean soup. Most of the women did not know any symptoms of anemia and a few reported that it can develop into leukemia. These concepts of anemia are instructive for nurses working with patients from Nicaragua and will be useful in developing nursing interventions to alleviate this public health problem. PMID:19551265

  20. Goal Setting and Decision Making by At-Risk Youth

    ERIC Educational Resources Information Center

    Galotti, Kathleen M.; Kozberg, Steven F.; Gustafon, Mary

    2009-01-01

    Typically, adolescence is a time when individuals begin to make consequential, life-framing decisions. However, much of the decision-making literature focuses on high-risk decisions, such as the use of drugs and alcohol, while much less is known about how adolescents make positive decisions, for example, regarding their educational or career…

  1. Homes of low-income minority families with asthmatic children have increased condition issues

    PubMed Central

    Ciaccio, Christina E.; Nazir, Niaman; Daley, Christine M.; DiDonna, Anita; Choi, Won S.; Barnes, Charles S.; Rosenwasser, Lanny J.

    2014-01-01

    The home is increasingly associated with asthma. It acts both as a reservoir of asthma triggers and as a refuge from seasonal outdoor allergen exposure. Racial/ethnic minority families with low incomes tend to reside in neighborhoods with low housing quality. These families also have higher rates of asthma. This study explores the hypothesis that black and Latino urban households with asthmatic children experienced more home mechanical, structural condition–related areas of concern than white households with asthmatic children. Participant families (n = 140) took part in the Kansas City Safe and Healthy Homes Program, had at least one asthmatic child, and met income qualifications of no more than 80% of local median income; many were below 50%. Families self-identified their race. Homes were assessed by environmental health professionals using a standard set of criteria and a specific set of on-site and laboratory sampling and analyses. Homes were given a score for areas of concern between 0 (best) and 53 (worst). The study population self-identified as black (46%), non-Latino white (26%), Latino (14.3%), and other (12.9%). Mean number of areas of concern were 18.7 in Latino homes, 17.8 in black homes, 13.3 in other homes, and 13.2 in white homes. Latino and black homes had significantly more areas of concern. White families were also more likely to be in the upper portion of the income. In this set of 140 low-income homes with an asthmatic child, households of minority individuals had more areas of condition concerns and generally lower income than other families. PMID:25584914

  2. 24 CFR 884.116 - Establishment of income limit schedules; 30 percent occupancy by very-low income families.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... schedules; 30 percent occupancy by very-low income families. 884.116 Section 884.116 Housing and Urban... percent occupancy by very-low income families. (a) HUD will establish schedules of Income limits for determining whether families qualify as Low-Income Families and Very Low-Income Families. (b) In the...

  3. High Tech Programmers in Low-Income Communities: Creating a Computer Culture in a Community Technology Center

    NASA Astrophysics Data System (ADS)

    Kafai, Yasmin B.; Peppler, Kylie A.; Chiu, Grace M.

    For the last twenty years, issues of the digital divide have driven efforts around the world to address the lack of access to computers and the Internet, pertinent and language appropriate content, and technical skills in low-income communities (Schuler & Day, 2004a and b). The title of our paper makes reference to a milestone publication (Schon, Sanyal, & Mitchell, 1998) that showcased some of the early work and thinking in this area. Schon, Sanyal and Mitchell's book edition included an article outlining the Computer Clubhouse, a type of community technology center model, which was developed to create opportunities for youth in low-income communities to become creators and designers of technologies by (1998). The model has been very successful scaling up, with over 110 Computer Clubhouses now in existence worldwide.

  4. Measuring self-reported health in low-income countries: piloting three instruments in semi-rural Burkina Faso

    PubMed Central

    Blomstedt, Yulia; Souares, Aurélia; Niamba, Louis; Sie, Ali; Weinehall, Lars; Sauerborn, Rainer

    2012-01-01

    Background National surveys in low-income countries increasingly rely on self-reported measures of health. The ease, speed, and economy of collecting self-reports of health make such collection attractive for rapid appraisals. However, the interpretation of these measures is complicated since different cultures understand and respond to the same question in different ways. Objective The aim of this pilot study was to develop a culturally sensitive tool to study the self-reported health (SRH) of the local adult population in Burkina Faso. Design The study was carried out in the 2009 rainy season. The sample included 27 men and 25 women aged 18 or older who live in semi-urban Nouna, Burkina Faso. Three culturally adapted instruments were tested: a SRH question, a wooden visual analogue scale (VAS), and a drawn VAS. Respondents were asked to explain their answers to each instrument. The narratives were analyzed with the content analysis technique, and the prevalence of poor SRH was estimated from the quantitative data by stratification for respondent background variables (sex, age, literacy, education, marital status, ethnicity, chronic diseases). The correlation between the instruments was tested with Spearman’s correlation test. Results The SRH question showed a 38.5% prevalence of poor SRH and 44.2% prevalence with both VAS. The correlation between the VAS was 0.89, whereas the correlation between the VAS and the SRH question was 0.60–0.64. Nevertheless, the question used as the basis of each instrument was culturally sensitive and clear to all respondents. Analysis of the narratives shows that respondents clearly differentiated between the various health statuses. Conclusion In this pilot, we developed and tested a new version of the SRH question that may be more culturally sensitive than its non-adapted equivalents. Additional insight into this population’s understanding and reporting of health was also obtained. A larger sample is needed to further study

  5. Maternal employment and the health of low-income young children.

    PubMed

    Gennetian, Lisa A; Hill, Heather D; London, Andrew S; Lopoo, Leonard M

    2010-05-01

    This study examines whether maternal employment affects the health status of low-income, elementary-school-aged children using instrumental variables estimation and experimental data from a welfare-to-work program implemented in the early 1990s. Maternal report of child health status is predicted as a function of exogenous variation in maternal employment associated with random assignment to the experimental group. IV estimates show a modest adverse effect of maternal employment on children's health. Making use of data from another welfare-to-work program we propose that any adverse effect on child health may be tempered by increased family income and access to public health insurance coverage, findings with direct relevance to a number of current policy discussions. In a secondary analysis using fixed effects techniques on longitudinal survey data collected in 1998 and 2001, we find a comparable adverse effect of maternal employment on child health that supports the external validity of our primary result. PMID:20356641

  6. Cohabitating Partners and Domestic Labor in Low-Income Black Families

    PubMed Central

    Reid, Megan; Golub, Andrew; Vazan, Peter

    2014-01-01

    This article examines the division of domestic labor in low-income cohabiting Black stepfamilies. We analyze survey data collected from 136 such families in order to understand how stepparent gender and relationship length impact the distribution of domestic labor. We hypothesize that women do more domestic work than men across all three family types, and that stepfathers are more involved in domestic labor in established relationships compared to new relationships. Findings indicate that cohabiting stepfathers in both new and established cohabiting Black stepfamilies make substantial contributions to domestic labor. These families demonstrate a division of labor consistent with traditional gender roles, though both partners agree on how much work each does. Parents, regardless of gender, are more involved in domestic labor than stepparents. PMID:25400532

  7. Design Considerations for Patient Portal Adoption by Low-Income, Older Adults

    PubMed Central

    Latulipe, Celine; Gatto, Amy; Nguyen, Ha T.; Miller, David P.; Quandt, Sara A.; Bertoni, Alain G.; Smith, Alden; Arcury, Thomas A.

    2016-01-01

    This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. We describe attitudes of this population of older adults and their current level of technology use and patient portal use. From qualitative analysis of 36 patient interviews and 16 caregiver interviews within these communities, we derive themes related to benefits of portals, barriers to use, concerns and desired features. Based on our initial findings, we present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated ‘meaningful use’ requirements. PMID:27077140

  8. Low-income cancer patients in depression treatment: dropouts and completers.

    PubMed

    Wells, Anjanette A; Palinkas, Lawrence A; Shon, En-Jung; Ell, Kathleen

    2013-10-01

    This study aims to explore reasons for depression treatment dropout among low-income, minority women with depression and cancer. Semi-structured telephone interviews are conducted with 20, predominately Latina, patients who dropped out of depression treatment and 10 who completed. Transcripts analyzed using techniques rooted in grounded theory. Treatment completion barriers cluster according to Meichenbaum and Turk's (Facilitating treatment adherence: A practitioner's guidebook, Plenum Press, New York, 1987) five adherence dimensions: (a) Barriers to Treatment (informational, instrumental, cultural [language, discrimination]); (b) Disease Features (emotional burden of cancer/depression); (c) Cancer/Depression Treatment Regimens; (d) Provider-Patient Relationship (depression treatment dissatisfaction); and (e) Clinical Setting (hospital organizational issues). Although both groups describe multiple overlapping dimensions of barriers, completers seem more motivated and satisfied with treatment, possibly due to completers experiencing the positive treatment effects after the first several sessions. More research should be conducted to determine the most effective clinical treatment methods for this population. PMID:23868016

  9. Retaining Low-Income Minority Cancer Patients in a Depression Treatment Intervention Trial: Lessons Learned.

    PubMed

    Wells, Anjanette A; Palinkas, Lawrence A; Williams, Sha-Lai L; Ell, Kathleen

    2015-08-01

    Previously published work finds significant benefit from medical and behavioral health team care among safety-net patients with major depression. This qualitative study assessed clinical social worker, psychiatrist and patient navigator strategies to increase depression treatment among low-income minority cancer patients participating in the ADAPt-C clinical depression trial. Patient care retention strategies were elicited through in-depth, semi-structured interviews with nine behavioral health providers. Using grounded theory, concepts from the literature and dropout barriers identified by patients, guided interview prompts. Retention strategies clustered around five dropout barriers: (1) informational, (2) instrumental, (3) provider-patient therapeutic alliance, (4) clinic setting, and (5) depression treatment. All strategies emphasized the importance of communication between providers and patients. Findings suggest that strong therapeutic alliance and telephone facilitates collaborative team provider communication and depression treatment retention among patients in safety-net oncology care systems. PMID:25544505

  10. Physical activity during recess in low-income 3rd grade students in Texas

    PubMed Central

    Springer, Andrew E.; Tanguturi, Yasas; Ranjit, Nalini; Skala, Katherine A.; Kelder, Steven H.

    2012-01-01

    Objectives We estimated the prevalence of recess-based moderate and vigorous physical activity (MVPA) and vigorous physical activity (VPA) among third grade students attending low-income, urban schools in Texas. Methods Structured observations (n=77 class and 616 student observations) using SOFIT were conducted over three-months in 8 elementary schools with majority Hispanic students. Results Students engaged in 66.4% and 19.2% of their ~20 minute recess time in MVPA and VPA, respectively. Boys engaged in more MVPA and VPA (P<.007). Contextual differences in activity (setting and activity type) were identified. Conclusions Findings underscore the importance of scheduled recess time for children’s physical activity. PMID:23985178