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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

    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

  2. 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

  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.

  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

    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.

  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 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

  6. 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

  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.

  8. Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting.

    PubMed

    Hodgkinson, Stacy; Godoy, Leandra; Beers, Lee Savio; Lewin, Amy

    2017-01-01

    Poverty is a common experience for many children and families in the United States. Children <18 years old are disproportionately affected by poverty, making up 33% of all people in poverty. Living in a poor or low-income household has been linked to poor health and increased risk for mental health problems in both children and adults that can persist across the life span. Despite their high need for mental health services, children and families living in poverty are least likely to be connected with high-quality mental health care. Pediatric primary care providers are in a unique position to take a leading role in addressing disparities in access to mental health care, because many low-income families come to them first to address mental health concerns. In this report, we discuss the impact of poverty on mental health, barriers to care, and integrated behavioral health care models that show promise in improving access and outcomes for children and families residing in the contexts of poverty. We also offer practice recommendations, relevant to providers in the primary care setting, that can help improve access to mental health care in this population.

  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 having…

  10. 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 having…

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

    PubMed

    Cheah, Phaik Yeong; Parker, Michael

    2014-03-05

    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. 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. 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 paper argues that a context specific

  12. 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

  13. 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…

  14. 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…

  15. 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…

  16. Reviewing the application of the balanced scorecard with implications for low-income health settings.

    PubMed

    Rabbani, Fauziah; Jafri, S M Wasin; Abbas, Farhat; Pappas, Gregory; Brommels, Mats; Tomson, Goran

    2007-01-01

    High-income countries (HICs) are increasingly making use of the balanced scorecard (BSC) in healthcare. Evidence about BSC usage in low-income countries (LICs) is deficient. This study assessed feasibility of BSC use in LICs. Systematic review of electronic databases shows that the BSC improved patient, staff, clinical, and financial outcomes in HICs. To translate the experience of BSC use in HICs to their use in LICs, the applicability parameters of the National Committee for Quality Assurance were applied. Despite contextual challenges, pilot testing of BSC use can be undertaken in selected LICs. Committed leadership, cultural readiness, quality information systems, viable strategic plans, and optimum resources are required.

  17. 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

  18. 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

  19. Rotavirus vaccine effectiveness in low-income settings: An evaluation of the test-negative design.

    PubMed

    Schwartz, Lauren M; Halloran, M Elizabeth; Rowhani-Rahbar, Ali; Neuzil, Kathleen M; Victor, John C

    2017-01-03

    The test-negative design (TND), an epidemiologic method currently used to measure rotavirus vaccine (RV) effectiveness, compares the vaccination status of rotavirus-positive cases and rotavirus-negative controls meeting a pre-defined case definition for acute gastroenteritis. Despite the use of this study design in low-income settings, the TND has not been evaluated to measure rotavirus vaccine effectiveness. This study builds upon prior methods to evaluate the use of the TND for influenza vaccine using a randomized controlled clinical trial database. Test-negative vaccine effectiveness (VE-TND) estimates were derived from three large randomized placebo-controlled trials (RCTs) of monovalent (RV1) and pentavalent (RV5) rotavirus vaccines in sub-Saharan Africa and Asia. Derived VE-TND estimates were compared to the original RCT vaccine efficacy estimates (VE-RCTs). The core assumption of the TND (i.e., rotavirus vaccine has no effect on rotavirus-negative diarrhea) was also assessed. TND vaccine effectiveness estimates were nearly equivalent to original RCT vaccine efficacy estimates. Neither RV had a substantial effect on rotavirus-negative diarrhea. This study supports the TND as an appropriate epidemiologic study design to measure rotavirus vaccine effectiveness in low-income settings. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  20. 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

  1. 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

  2. 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

  3. Guided goal setting: effectiveness in a dietary and physical activity intervention with low-income adolescents.

    PubMed

    Shilts, Mical Kay; Horowitz, Marcel; Townsend, Marilyn S

    2009-01-01

    Determining the effectiveness of the guided goal setting strategy on changing adolescents' dietary and physical activity self-efficacy and behaviors. Adolescents were individually assigned to treatment (intervention with guided goal setting) or control conditions (intervention without guided goal setting) with data collected before and after the education intervention. Urban middle school in a low-income community in Central California. Ethnically diverse middle school students (n = 94, 55% male) who were participants of a USDA nutrition education program. Driven by the Social Cognitive Theory, the intervention targeted dietary and physical activity behaviors of adolescents. Dietary self-efficacy and behavior; physical activity self-efficacy and behavior; goal effort and spontaneous goal setting. ANCOVA and path analysis were performed using the full sample and a sub-sample informed by Locke's recommendations (accounting for goal effort and spontaneous goal setting). No significant differences were found between groups using the full sample. Using the sub-sample, greater gains in dietary behavior (p < .05), physical activity behavior (p < .05), and physical activity self-efficacy (p < .05) were made by treatment participants compared to control participants. Change in physical activity behaviors was mediated by self-efficacy. Accounting for goal effort and spontaneous goal setting, this study provides some evidence that the use of guided goal setting with adolescents may be a viable strategy to promote dietary and physical activity behavior change.

  4. 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…

  5. 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…

  6. Predictors of anticipated breastfeeding in an urban, low-income setting.

    PubMed

    Mahoney, M C; James, D M

    2000-06-01

    Although the proportion of women who breastfeed is known to vary by demographic group, breastfeeding practices have not been sufficiently studied among urban, lower income African American populations seen in family medicine centers. A cross-sectional design was used to examine demographic, clinical, and attitudinal factors that affect anticipated infant feeding practices reported by postpartum women from a low-income, urban family practice setting. Data was analyzed using chi-square, odds ratios (OR), and multiple logistic regression techniques. Among 66 respondents, only 3 subjects (4.5%) indicated that they planned to breastfeed exclusively, while an additional 11 subjects (16.7%) reported plans to use a combination of bottle-feeding and breastfeeding. Based on univariate analyses, women with less than 12 years of education were less likely to report anticipated breastfeeding. Otherwise, breastfeeding plans were not associated with subject demographic features or with reproductive characteristics. Respondents planning to bottle-feed noted that breastfeeding was too complicated. Logistic regression demonstrated an inverse relationship between level of maternal education and anticipated breastfeeding (OR=0.13, 95% confidence interval [CI], 0.05-0.35), and a direct association for encouragement from the baby's father or the woman's mother to breastfeed and anticipated breastfeeding (OR=12.4; 95% CI, 4.92-31.4). This study reports unique data regarding anticipated infant feeding practices among patients from an urban, low-income community served by a family medicine center. Findings from this study will be used to develop a family-centered educational intervention involving the mothers, grandmothers, and partners of pregnant patients to promote the benefits of breastfeeding in this community.

  7. Height and cognition at work: Labor market productivity in a low income setting.

    PubMed

    LaFave, Daniel; Thomas, Duncan

    2016-11-05

    Taller workers earn more, particularly in lower income settings. It has been argued that adult height is a marker of strength which is rewarded in the labor market; a proxy for cognitive performance or other dimensions of human capital such as school quality; a proxy for health status; and a proxy for family background and genetic characteristics. As a result, the argument goes, height is rewarded in the labor market because it is an informative signal of worker quality to an employer. It has also been argued that the height premium is driven by occupational and sectoral choice. This paper evaluates the relative importance of these potential mechanisms underlying the link between adult stature and labor market productivity in a specific low income setting, rural Central Java, Indonesia. Drawing on twelve waves of longitudinal survey data, we establish that height predicts hourly earnings after controlling education, multiple indicators of cognitive performance and physical health status, measures of family background, sectoral and occupational choice, as well as local area market characteristics. The height premium is large and significant in both the wage and self-employed sectors indicating height is not only a signal of worker quality to employers. Since adult stature is largely determined in the first few years of life, we conclude that exposures during this critical period have an enduring impact on labor market productivity.

  8. Estimating the Cost of Neurosurgical Procedures in a Low-Income Setting: An Observational Economic Analysis.

    PubMed

    Abdelgadir, Jihad; Tran, Tu; Muhindo, Alex; Obiga, Doomwin; Mukasa, John; Ssenyonjo, Hussein; Muhumza, Michael; Kiryabwire, Joel; Haglund, Michael M; Sloan, Frank A

    2017-05-01

    There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. In this observational economic analysis, microcosting was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). During the study period, October 2014 to September 2015, 1440 charts were reviewed. Of these patients, 434 had surgery, whereas the other 1006 were treated nonsurgically. Thirteen types of procedures were performed at the hospital. The estimated mean cost of a neurosurgical procedure was $542.14 (standard deviation [SD], $253.62). The mean cost of different procedures ranged from $291 (SD, $101) for burr hole evacuations to $1,221 (SD, $473) for excision of brain tumors. For most surgeries, overhead costs represented the largest proportion of the total cost (29%-41%). This is the first study using primary data to determine the cost of neurosurgery in a low-resource setting. Operating theater capacity is likely the binding constraint on operative volume, and thus, investing in operating theaters should achieve a higher level of efficiency. Findings from this study could be used by stakeholders and policy makers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. SIOP PODC: clinical guidelines for the management of children with Wilms tumour in a low income setting.

    PubMed

    Israels, Trijn; Moreira, Claude; Scanlan, Trish; Molyneux, Liz; Kampondeni, Sam; Hesseling, Peter; Heij, Hugo; Borgstein, Eric; Vujanic, Gordan; Pritchard-Jones, Kathy; Hadley, Larry

    2013-01-01

    Wilms tumour is a relatively common and curable paediatric tumour. Known challenges to cure in low income countries are late presentation with advanced disease, malnutrition, failure to complete treatment and limited facilities. In this article, management recommendations are given for a low income setting where only the minimal requirements for treatment with curative intent are available (setting 1). These include general management, supportive care, social support and registration of patients. Recommendations specific for Wilms tumour care include diagnostic procedures with emphasis on the role of ultrasonography, preoperative chemotherapy with a reduced dosage for malnourished children and postoperative chemotherapy based on surgical staging.

  10. Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India.

    PubMed

    Desai, Sapna; Campbell, Oona Mr; Sinha, Tara; Mahal, Ajay; Cousens, Simon

    2017-02-01

    Hysterectomy is a leading reason for use of health insurance amongst low-income women in India, but there are limited population-level data available to inform policy. This paper reports on the findings of a mixed-methods study to estimate incidence and identify predictors of hysterectomy in a low-income setting in Gujarat, India. The estimated incidence of hysterectomy, 20.7/1000 woman- years (95% CI: 14.0, 30.8), was considerably higher than reported from other countries, at a relatively low mean age of 36 years. There was strong evidence that among women of reproductive age, those with lower income and at least two children underwent hysterectomy at higher rates. Nearly two-thirds of women undergoing hysterectomy utilized private hospitals, while the remainder used government or other non-profit facilities. Qualitative research suggested that weak sexual and reproductive health services, a widespread perception that the post-reproductive uterus is dispensable and lack of knowledge of side effects have resulted in the normalization of hysterectomy. Hysterectomy appears to be promoted as a first or second-line treatment for menstrual and gynaecological disorders that are actually amenable to less invasive procedures. Most women sought at least two medical opinions prior to hysterectomy, but both public and private providers lacked equipment, skills and motivation to offer alternatives. Profit and training benefits also appeared to play a role in some providers' behaviour. Although women with insecure employment underwent the procedure knowing the financial and physical implications of undergoing a major surgery, the future health and work security afforded by hysterectomy appeared to them to outweigh risks. Findings suggest that sterilization may be associated with an increased risk of hysterectomy, potentially through biological or attitudinal links. Health policy interventions require improved access to sexual and reproductive health services and health

  11. Diabetes and obesity prevention: changing the food environment in low-income settings.

    PubMed

    Gittelsohn, Joel; Trude, Angela

    2017-01-01

    Innovative approaches are needed to impact obesity and other diet-related chronic diseases, including interventions at the environmental and policy levels. Such interventions are promising due to their wide reach. This article reports on 10 multilevel community trials that the present authors either led (n = 8) or played a substantial role in developing (n = 2) in low-income minority settings in the United States and other countries that test interventions to improve the food environment, support policy, and reduce the risk for developing obesity and other diet-related chronic diseases. All studies examined change from pre- to postintervention and included a comparison group. The results show the trials had consistent positive effects on consumer psychosocial factors, food purchasing, food preparation, and diet, and, in some instances, obesity. Recently, a multilevel, multicomponent intervention was implemented in the city of Baltimore that promises to impact obesity in children, and, potentially, diabetes and related chronic diseases among adults. Based on the results of these trials, this article offers a series of recommendations to contribute to the prevention of chronic disease in Mexico. Further work is needed to disseminate, expand, and sustain these initiatives at the city, state, and federal levels. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Factors affecting decision making of low-income young women with unplanned pregnancies in Bangkok, Thailand.

    PubMed

    Naravage, Wanapa; Vichit-Vadakan, Nuntavarn; Sakulbumrungsil, Rungpetch C; Van der Putten, Marc

    2005-05-01

    Unplanned pregnancy is one of the most difficult life experiences for young women. Women are often confused and seek help and support. When the problem occurs, a woman has three choices: parenting the baby, planning for adoption, or terminating the pregnancy. Choosing one of these three options is often difficult. This study aimed to identify the factors (variables) influencing women's decision making when choosing the options available to them. The study was conducted in five shelters and low-income communities in the Bangkok area. Data were collected for five months, November 2003 to March 2004. Young women, age 13-24, who experienced an unplanned pregnancy at least once, or currently experiencing an unplanned pregnancy, were recruited into the study. One hundred and twenty volunteer cases were recruited. Discriminant analysis was used to determine the factors that affecting the choices of young women with unplanned pregnancies. There were 6 potential influencing variables, in three broad categories of factors that influenced their choices. In this study, the influencing factors from the personal history variables were, age of the most recent unplanned pregnancy. The individual psychosocial variables were: attitude towards unplanned pregnancy, attitude towards contraception, and making a decision without consultation. The relationship variables were: relationship with partner, and consulting partner when having a problem. The results from discriminant analysis yielded 68.3% predictive accuracy. This result was satisfactory compared with a 33% chance of accuracy (classified as chance alone would yield a 33% accuracy). Knowing the influencing factors for the choices of young women with unplanned pregnancies allows us to understand the women's decisions and their utilization of services with some degree of confidence. The program managers or implementers should do as much as possible to support the decision making process in these young women in order to provide

  13. Implications of parental compliance on decision making in care provided using general anesthesia in a low-income population.

    PubMed

    Worthen, T B; Mueller, W

    2000-01-01

    The purpose of this study was to determine the compliance of parents for bringing the child back to the dentist for follow up dental care to aid in the decision making for care provided to the children of low income families requiring general anesthesia. The dental records of 244 children of low-income families were examined. Forty-three percent of the patients did not return for follow-up dental care. Consideration should be given to modifying treatment plans to include full coverage restorations and possibly delaying treatment before the eruption of the primary second molars.

  14. Love, Care and Politics in Low Income Early Childhood Settings: The Process of Constructing a Professional Identity.

    ERIC Educational Resources Information Center

    Hill, Susan; Veale, Ann

    This paper reports on a planned 4-year longitudinal study in Adelaide, South Australia, that seeks to trace the development of student teachers' constructs about becoming a teacher in three settings, namely, day care, preschool, and early primary school, in low-income and middle-to-high-income areas. Thus far, the study has focused on 20 student…

  15. Ethics, human rights and HIV vaccine trials in low-income settings.

    PubMed

    London, Leslie; Kagee, Ashraf; Moodley, Keymanthri; Swartz, Leslie

    2012-05-01

    The massive growth in global health research in past decades has posed many challenges for its effective ethical oversight, not least of which is how best to provide effective protection of research participants. The extent of the HIV epidemic in sub-Saharan Africa in particular makes research into prevention technologies for HIV, including HIV vaccine research, a global priority. However, the need for vaccine research must be considered in conjunction with the individual's right to informed consent, which is based on the principle of respect for autonomy. One of the primary human rights violations likely to occur in the context of HIV vaccine research is that potential research participants may not fully understand what participation in research studies entails. People who elect to enrol in HIV vaccine trials are required to understand both the potential negative effects of participation (eg, discrimination) as well as complex scientific concepts such as randomisation and prophylaxis in order to be ethically enrolled. In this study, two vignettes are presented to illustrate two core issues in conducting phase III HIV vaccine trials in low-income countries-namely, (1) from the perspective of participants, the extent to which understanding is a prerequisite for consenting to participate in a trial, and (2) from the perspective of trial investigators, whether it is appropriate to persuade eligible people to enrol in a trial, even though their initial reaction is to decline to participate. These vignettes are used to analyse these issues through the prisms of research ethics and human rights in order to identify helpful synergies. It is argued that the human rights perspective provides a helpful lens on ethical issues.

  16. 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

  17. Development of a brief instrument for assessing healthcare employee satisfaction in a low-income setting.

    PubMed

    Alpern, Rachelle; Canavan, Maureen E; Thompson, Jennifer T; McNatt, Zahirah; Tatek, Dawit; Lindfield, Tessa; Bradley, Elizabeth H

    2013-01-01

    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. 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. 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. 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 essential for addressing problems that

  18. Meat consumption is associated with less stunting among toddlers in four diverse low-income settings.

    PubMed

    Krebs, Nancy F; Mazariegos, Manolo; Tshefu, Antoinette; Bose, Carl; Sami, Neelofar; Chomba, Elwyn; Carlo, Waldemar; Goco, Norman; Kindem, Mark; Wright, Linda L; Hambidge, K Michael

    2011-09-01

    Early growth faltering is common but is difficult to reverse after the first 2 years of life. To describe feeding practices and growth in infants and young children in diverse low-income settings prior to undertaking a complementary feeding trial. This cross-sectional study was conducted through the Global Network for Women's and Children's Health Research in Guatemala, Democratic Republic of Congo, Zambia, and Pakistan. Feeding questionnaires were administered to convenience samples of mothers of 5- to 9-month old infants and 12- to 24-month-old toddlers. After standardized training, anthropometric measurements were obtained from the toddlers. Following the 2006 World Health Organization Growth Standards, stunting was defined as length-for-age < -2SD, and wasting as weight-for-length < -2SD. Logistic regression was applied to evaluate relationships between stunting and wasting and consumption of meat (including chicken and liver and not including fish). Data were obtained from 1,500 infants with a mean (+/- SD) age of 6.9 +/- 1.4 months and 1,658 toddlers with a mean age of 17.2 +/- 3.5 months. The majority of the subjects in both age groups were breastfed. Less than 25% of the infants received meat regularly, whereas 62% of toddlers consumed these foods regularly, although the rates varied widely among sites. Stunting rate ranged from 44% to 66% among sites; wasting prevalence was less than 10% at all sites. After controlling for covariates, consumption of meat was associated with a reduced likelihood of stunting (OR = 0.64; 95% CI, 0.46 to 0.90). The strikingly high stunting rates in these toddlers and the protective effect of meat consumption against stunting emphasize the need for interventions to improve complementary feeding practices, beginning in infancy.

  19. 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…

  20. Childhood nutrition: perceptions of caretakers in a low-income urban setting.

    PubMed

    Kelly, Lynn E; Patterson, Barbara J

    2006-12-01

    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 low-income urban caretakers' understanding and attitudes regarding children's nutrition. A focused ethnography was used as a means of understanding behavior within the context of a person's cultural environment. The sample was 17 caretakers of children in the 1st-3rd grades. Four focus groups were conducted. Two themes emerged from caretakers' perceptions: knowing the right things children should eat and balancing healthy nutrition with unhealthy choices. Four categories emerged regarding influences on food choices: tradition, finances, time constraints, and role models. Lastly, five barriers and three facilitating factors emerged. Implications of the study findings for school nurses include the need, when implementing healthy eating programs for school children, to gain information from caretakers about their perceptions of childhood nutrition.

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. Health financing to promote access in low income settings-how much do we know?

    PubMed

    Palmer, Natasha; Mueller, Dirk H; Gilson, Lucy; Mills, Anne; Haines, Andy

    In this article we outline research since 1995 on the impact of various financing strategies on access to health services or health outcomes in low income countries. The limited evidence available suggests, in general, that user fees deterred utilisation. Prepayment or insurance schemes offered potential for improving access, but are very limited in scope. Conditional cash payments showed promise for improving uptake of interventions, but could also create a perverse incentive. The largely African origin of the reports of user fees, and the evidence from Latin America on conditional cash transfers, demonstrate the importance of the context in which studies are done. There is a need for improved quality of research in this area. Larger scale, upfront funding for evaluation of health financing initiatives is necessary to ensure an evidence base that corresponds to the importance of this issue for achieving development goals.

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

    PubMed

    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. Despite this global burden, fewer than 25% of affected individuals ever access mental health treatment; in low-income settings, access is much lower, although nonallopathic interventions through traditional healers are common in many venues. Three main barriers to reducing the gap between individuals who need mental health treatment and those who have access to it 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. 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. We describe a new North-South and South-South research partnership between Universidade Eduardo Mondlane (Mozambique), Columbia University (United States), Vanderbilt University (United States), and Universidade Federal de São Paulo (Brazil), to build research capacity in Mozambique and other Portuguese-speaking African countries. 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

  8. Breastfeeding among low income, African-American women: power, beliefs and decision making.

    PubMed

    Bentley, Margaret E; Dee, Deborah L; Jensen, Joan L

    2003-01-01

    Breastfeeding rates among African-American women lag behind all other ethnic groups. National data show that only 45% of African-American women reported ever breastfeeding compared to 66 and 68% of Hispanic and white women, respectively. Of African-American women who do choose to breastfeed, duration is short, with many discontinuing in the first days after birth. This report applies a social ecological framework to breastfeeding to investigate macrolevel-microlevel linkages. We posit that macrolevel factors, such as the media, aggressive marketing of breastmilk substitutes, welfare reform, hospital policy and breastfeeding legislation, interact with microlevel factors to influence a woman's decision to breastfeed. These microlevel factors include features of the community, neighborhoods, workplaces that support or discourage breastfeeding, social and personal networks and cultural norms and individual beliefs about breastfeeding. The report discusses how power operates at each level to influence women's choices and also emphasizes the value of ethnographic data in breastfeeding studies. Through a case study of a sample of low income, African-American women living in Baltimore, MD, where breastfeeding role models are few, beliefs that discourage breastfeeding are many, and where everyday life is full of danger and fear, it is understandable that breastfeeding is not considered practical. The narrative data provide important information that can be used to enhance intervention efforts. To reach the Surgeon General's Healthy People 2010 breastfeeding goals requires a shift in cultural norms and structures at all levels that will support breastfeeding for all women.

  9. HealthKick: a nutrition and physical activity intervention for primary schools in low-income settings

    PubMed Central

    2010-01-01

    Background The burden of non-communicable diseases, including type 2 diabetes, is growing in South Africa. This country has a complex mix of over- and under-nutrition, especially in low-income communities, and concerning levels of physical inactivity in children and youth. This paper describes HealthKick, a school-based nutrition and physical activity intervention in primary schools in these settings aimed at reducing diabetes risk factors. Methods/Design This study includes schools within historically disadvantaged, low-income communities from an urban area close to the city of Cape Town and from two rural areas outside of Cape Town, South Africa. The three Educational Districts involved are Metropole North, Cape Winelands and the Overberg. The study has three phases: intervention mapping and formative assessment, intervention development, and outcome and process evaluation. Sixteen schools were purposively selected to participate in the study and randomly allocated as intervention (eight schools) and control (eight schools). The primary aims of HealthKick are to promote healthful eating habits and increase regular participation in health-enhancing physical activity in children, parents and teachers, to prevent overweight, and reduce risk of chronic diseases (particularly type 2 diabetes); as well as to promote the development of an environment within the school and community that facilitates the adoption of healthy lifestyles. The components of HealthKick are: action planning, toolkit (resource guide, a resource box and physical activity resource bin), and an Educators' Manual, which includes a curriculum component. Discussion This study continues to highlight the key role that educators play in implementing a school-based intervention, but that developing capacity within school staff and stakeholders is not a simple or easy task. In spite of the challenges experienced thus far, valuable findings are being produced from this study, especially from Phase 1

  10. 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.

  11. 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

  12. Towards a workflow driven design for mHealth devices within temporary eye clinics in low-income settings.

    PubMed

    Bolster, Nigel M; Bastawrous, Andrew; Giardini, Mario E

    2015-01-01

    Only a small minority of mobile healthcare technologies that have been successful in pilot studies have subsequently been integrated into healthcare systems. Understanding the reasons behind this discrepancy is crucial if such technologies are to be adopted. We believe that the mismatch is due to a breakdown in the relation between technical soundness of the original mobile health (mHealth) device design, and integration into healthcare provision workflows. Quantitative workflow modelling provides an opportunity to test this hypothesis. In this paper we present our current progress in developing a clinical workflow model for mobile eye assessment in low-income settings. We test the model for determining the appropriateness of design parameters of a mHealth device within this workflow, by assessing their impact on the entire clinical workflow performance.

  13. Cardiovascular screening in low-income settings using a novel 4-lead smartphone-based electrocardiograph (D-Heart®).

    PubMed

    Maurizi, Niccolo'; Faragli, Alessandro; Imberti, Jacopo; Briante, Nicolò; Targetti, Mattia; Baldini, Katia; Sall, Amadou; Cisse, Abibou; Berzolari, Francesca Gigli; Borrelli, Paola; Avvantaggiato, Fulvio; Perlini, Stefano; Marchionni, Niccolo'; Cecchi, Franco; Parigi, Gianbattista; Olivotto, Iacopo

    2017-06-01

    MHealth technologies are revolutionizing cardiovascular medicine. However, a low-cost, user-friendly smartphone-based electrocardiograph is still lacking. D-Heart® is a portable device that enables the acquisition of the ECG on multiple leads which streams via Bluetooth to any smartphone. Because of the potential impact of this technology in low-income settings, we determined the accuracy of D-Heart® tracings in the stratification of ECG morphological abnormalities, compared with 12-lead ECGs. Consecutive African patients referred to the Ziguinchor Regional Hospital (Senegal) were enrolled (n=117; 69 males, age 39±11years). D-Heart® recordings (3 peripheral leads plus V5) were obtained immediately followed by 12 lead ECGs and were assessed blindly by 2 independent observers. Global burden of ECG abnormalities was defined by a semi-quantitative score based on the sum of 9 criteria, identifying four classes of increasing severity. D-Heart® and 12-lead ECG tracings were respectively classified as: normal: 72 (61%) vs 69 (59%); mildly abnormal: 42 (36%) vs 45 (38%); moderately abnormal: 3 (3%) vs 3 (3%). None had markedly abnormal tracings. Cohen's weighted kappa (kw) test demonstrated a concordance of 0,952 (p<0,001, agreement 98,72%). Concordance was high as well for the Romhilt-Estes score (kw=0,893; p<0,001 agreement 97,35%). PR and QRS intervals comparison with Bland-Altman method showed good accuracy for D-Heart® measurements (95% limit of agreement ±20ms for PR and ±10ms for QRS). D-Heart® proved effective and accurate stratification of ECG abnormalities comparable to the 12-lead electrocardiographs, thereby opening new perspectives for low-cost community cardiovascular screening programs in low-income settings. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  14. Cost-effectiveness of HIV drug resistance testing to inform switching to second line antiretroviral therapy in low income settings.

    PubMed

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

    2014-01-01

    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. 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. 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. 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.

  15. Measuring material wealth in low-income settings: A conceptual and how-to guide.

    PubMed

    Kaiser, Bonnie N; Hruschka, Daniel; Hadley, Craig

    2017-07-08

    Although wealth is consistently found to be an important predictor of health and well-being, there remains debate as to the best way to conceptualize and operationalize wealth. In this article, we focus on the measurement of economic resources, which is one among many forms of wealth. We provide an overview of the process of measuring material wealth, including theoretical and conceptual considerations, a how-to guide based on the most common approach to measurement, and a review of important theoretical and empirical questions that remain to be resolved. Throughout, we emphasize considerations particular to the settings in which anthropologists work, and we include variations on common approaches to measuring material wealth that might be better suited to anthropologists' theoretical questions, methodological approaches, and fieldwork settings. © 2017 Wiley Periodicals, Inc.

  16. Cancer Counseling of Low-Income Limited English Proficient Latina Women Using Medical Interpreters: Implications for Shared Decision-Making.

    PubMed

    Kamara, Daniella; Weil, Jon; Youngblom, Janey; Guerra, Claudia; Joseph, Galen

    2017-08-09

    In cancer genetic counseling (CGC), communication across language and culture challenges the model of practice based on shared decision-making. To date, little research has examined the decision-making process of low-income, limited English proficiency (LEP) patients in CGC. This study identified communication patterns in CGC sessions with this population and assessed how these patterns facilitate or inhibit the decision-making process during the sessions. We analyzed 24 audio recordings of CGC sessions conducted in Spanish via telephone interpreters at two public hospitals. Patients were referred for risk of hereditary breast and ovarian cancer; all were offered genetic testing. Audio files were coded by two bilingual English-Spanish researchers and analyzed using conventional content analysis through an iterative process. The 24 sessions included 13 patients, 6 counselors, and 18 interpreters. Qualitative data analyses identified three key domains - Challenges Posed by Hypothetical Explanations, Misinterpretation by the Medical Interpreter, and Communication Facilitators - that reflect communication patterns and their impact on the counselor's ability to facilitate shared decision-making. Overall, we found an absence of patient participation in the decision-making process. Our data suggest that when counseling LEP Latina patients via medical interpreter, prioritizing information with direct utility for the patient and organizing information into short- and long-term goals may reduce information overload and improve comprehension for patient and interpreter. Further research is needed to test the proposed counseling strategies with this population and to assess how applicable our findings are to other populations.

  17. Outcome of a food observational study among low-income preschool children participating in a family-style meal setting.

    PubMed

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

    2015-04-01

    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 guidelines. Participants were 135 low-income children aged 3 to 4 years who attended an urban child care center. Participant's parents completed a Family Demographic Questionnaire to provide information on race/ethnicity, parent's level of education, and household income. Direct observation of children's food and beverage consumption during school breakfast and lunch was collected over 3 consecutive days. Dietary data were assessed using the Nutrition Data System for Research software. Height and weight measurements were obtained to determine risk for obesity. Descriptive statistics were reported by using the Statistical Package for the Social Sciences Version 16. Among 135 participants, 98% identified as Mexican American, 75% lived at or below poverty level, and 24% reported a family history of diabetes. Children consumed less than half of the calories provided between breakfast and lunch and did not consume the minimum recommended dietary food servings. Despite the poor dietary intake, physical measurement findings showed 25% obesity prevalence among study participants. Findings support the need for evidenced-based early childhood obesity prevention programs that provide behavior change opportunities for children, their families, teachers, and menu planners. Family-style meal settings are ideal opportunities for implementing nutrition education strategies to prevent early childhood obesity. © 2014 Society for Public Health Education.

  18. Evaluating vaccination strategies for reducing infant respiratory syncytial virus infection in low-income settings.

    PubMed

    Poletti, Piero; Merler, Stefano; Ajelli, Marco; Manfredi, Piero; Munywoki, Patrick K; Nokes, D; Melegaro, Alessia

    2015-03-10

    Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease and related hospitalization of young children in least developed countries. Individuals are repeatedly infected, but it is the first exposure, often in early infancy, that results in the vast majority of severe RSV disease. Unfortunately, due to immunological immaturity, infants are a problematic RSV vaccine target. Several trials are ongoing to identify a suitable candidate vaccine and target group, but no immunization program is yet in place. In this work, an individual-based model that explicitly accounts for the socio-demographic population structure is developed to investigate RSV transmission patterns in a rural setting of Kenya and to evaluate the potential effectiveness of alternative population targets in reducing RSV infant infection. We find that household transmission is responsible for 39% of infant infections and that school-age children are the main source of infection within the household, causing around 55% of cases. Moreover, assuming a vaccine-induced protection equivalent to that of natural infection, our results show that annual vaccination of students is the only alternative strategy to routine immunization of infants able to trigger a relevant and persistent reduction of infant infection (on average, of 35.6% versus 41.5% in 10 years of vaccination). Interestingly, if vaccination of pregnant women boosts maternal antibody protection in infants by an additional 4 months, RSV infant infection will be reduced by 31.5%. These preliminary evaluations support the efforts to develop vaccines and related strategies that go beyond targeting vaccines to those at highest risk of severe disease.

  19. 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

  20. Simulated Models Suggest That Price per Calorie Is the Dominant Price Metric That Low-Income Individuals Use for Food Decision Making.

    PubMed

    Beheshti, Rahmatollah; Igusa, Takeru; Jones-Smith, Jessica

    2016-11-01

    The price of food has long been considered one of the major factors that affects food choices. However, the price metric (e.g., the price of food per calorie or the price of food per gram) that individuals predominantly use when making food choices is unclear. Understanding which price metric is used is especially important for studying individuals with severe budget constraints because food price then becomes even more important in food choice. We assessed which price metric is used by low-income individuals in deciding what to eat. With the use of data from NHANES and the USDA Food and Nutrient Database for Dietary Studies, we created an agent-based model that simulated an environment representing the US population, wherein individuals were modeled as agents with a specific weight, age, and income. In our model, agents made dietary food choices while meeting their budget limits with the use of 1 of 3 different metrics for decision making: energy cost (price per calorie), unit price (price per gram), and serving price (price per serving). The food consumption patterns generated by our model were compared to 3 independent data sets. The food choice behaviors observed in 2 of the data sets were found to be closest to the simulated dietary patterns generated by the price per calorie metric. The behaviors observed in the third data set were equidistant from the patterns generated by price per calorie and price per serving metrics, whereas results generated by the price per gram metric were further away. Our simulations suggest that dietary food choice based on price per calorie best matches actual consumption patterns and may therefore be the most salient price metric for low-income populations. © 2016 American Society for Nutrition.

  1. Goal setting for health behavior change: evidence from an obesity intervention for rural low-income women.

    PubMed

    Ries, A V; Blackman, L T; Page, R A; Gizlice, Z; Benedict, S; Barnes, K; Kelsey, K; Carter-Edwards, L

    2014-01-01

    Rural, minority populations are disproportionately affected by overweight and obesity and may benefit from lifestyle modification programs that are tailored to meet their unique needs. Obesity interventions commonly use goal setting as a behavior change strategy; however, few have investigated the specific contribution of goal setting to behavior change and/or identified the mechanisms by which goal setting may have an impact on behavior change. Furthermore, studies have not examined goal setting processes among racial/ethnic minorities. Using data from an obesity intervention for predominately minority women in rural North Carolina, this study sought to examine whether intervention participation resulted in working on goals and using goal setting strategies which in turn affected health behavior outcomes. It also examined racial/ethnic group differences in working on goals and use of goal setting strategies. Data came from a community-based participatory research project to address obesity among low-income, predominately minority women in rural North Carolina. A quasi-experimental intervention design was used. Participants included 485 women aged 18 years and over. Intervention participants (n=208) received health information and goal setting support through group meetings and tailored newsletters. Comparison participants (n = 277) received newsletters on topics unrelated to obesity. Surveys assessed physical activity, fruit and vegetable intake, goal-related stage of change, and use of goal setting strategies. Chi squared statistics were used to assess intervention group differences in changes in goal-related stage of change and use of goal setting strategies as well as racial/ethnic group differences in stage of change and use of goal setting strategies at baseline. The causal steps approach of Baron and Kenny was used to assess mediation. Intervention compared to comparison participants were more likely to move from contemplation to action/maintenance for the

  2. Planning for health promotion in low-income preschool child care settings: focus groups of parents and child care providers.

    PubMed

    Taveras, Elsie M; LaPelle, Nancy; Gupta, Ruchi S; Finkelstein, Jonathan A

    2006-01-01

    To identify potentially successful strategies, barriers, and facilitators for health promotion in preschool child care settings. We conducted 6 focus groups including each of the following: parents of children attending child care centers and home-based family child care (2 in English, 1 in Spanish) and directors of child care centers and family child care providers (2 in English, 1 in Spanish). Systematic thematic analysis was conducted to generate themes to address study questions. A total of 24 parents and 45 child care providers, serving predominantly urban, low-income children in Boston, participated. Parents and child care providers agreed that in-person group discussions would be the most effective strategy for providing health education information to parents. Several barriers that could affect implementation emerged. First, some providers expressed frustration toward parents' attitudes about child safety and health. Second, there was diversity of opinion among providers on whether conducting health promotion activities was consistent with their training and role. In addition, literacy, language, and cultural barriers were identified as potential barriers to health promotion in child care. In order to be successful, health promotion strategies in child care settings will need to overcome tensions between providers and parents, allow professional growth of child care providers to serve in a health promotion role, and better integrate external health resources and personnel. Group sessions and peer learning opportunities that are culturally and linguistically sensitive are potentially successful strategies for implementation of health promotion interventions for many parents.

  3. 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,…

  4. 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,…

  5. 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…

  6. 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…

  7. 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…

  8. Gram stain method shows better sensitivity than clinical criteria for detection of bacterial vaginosis in surveillance of pregnant, low-income women in a clinical setting.

    PubMed Central

    Tam, M T; Yungbluth, M; Myles, T

    1998-01-01

    OBJECTIVE: The purpose of the study is to determine whether the Gram stain method is superior to the clinical criteria for the diagnosis of bacterial vaginosis in low-income pregnant women seen in a resident clinic setting. The clinical criteria is the current diagnostic method employed to diagnose bacterial vaginosis. STUDY DESIGN: In this study, 51 pregnant women with vaginal discharge were prospectively evaluated. All were screened using the clinical criteria, Gram stain method, and culture of the discharge. The modified scoring system instituted by Nugent et al. (J Clin Microbiol 29:297-301, 1991) was employed in reading the Gram stain smears. The clinical criteria were then compared with the Gram stain method. Isolation of moderate to many Gardnerella vaginalis growth by culture was used as the confirmatory finding. RESULTS: Sensitivity of the Gram stain method (91%) was significantly higher than that of the clinical criteria (46%), (sign test P = 0.0023, < 0.01). The Gram stain method also has both a low false-negative (4%) and high negative predictive value (96%), making it an ideal diagnostic test. CONCLUSION: The Gram stain method is a rapid and cost-effective test that is also highly reproducible and readily available in many laboratories. These features make the Gram stain method a more desirable screening procedure for bacterial vaginosis in a clinic population. PMID:9894174

  9. Distinct Salmonella Enteritidis lineages associated with enterocolitis in high-income settings and invasive disease in low-income settings

    PubMed Central

    Feasey, Nicholas A.; Hadfield, James; Keddy, Karen H.; Dallman, Timothy J; Jacobs, Jan; Deng, Xiangyu; Wigley, Paul; Barquist, Lars; Langridge, Gemma C.; Feltwell, Theresa; Harris, Simon R.; Mather, Alison E.; Fookes, Maria; Aslett, Martin; Msefula, Chisomo; Kariuki, Samuel; Maclennan, Calman A.; Onsare, Robert S.; Weill, François-Xavier; Le Hello, Simon; Smith, Anthony M.; McClelland, Michael; Desai, Prerak; Parry, Christopher M.; Cheesbrough, John; French, Neil; Campos, Josefina; Chabalgoity, Jose A.; Betancor, Laura; Hopkins, Katie L.; Nair, Satheesh; Humphrey, Tom J.; Lunguya, Octavie; Cogan, Tristan A.; Tapia, Milagritos D.; Sow, Samba O.; Tennant, Sharon M.; Bornstein, Kristin; Levine, Myron M.; Lacharme-Lora, Lizeth; Everett, Dean B.; Kingsley, Robert A.; Parkhill, Julian; Heyderman, Robert S.; Dougan, Gordon

    2016-01-01

    An epidemiological paradox surrounds Salmonella enterica serovar Enteritidis. In high-income settings, it has been responsible for an epidemic of poultry-associated, self-limiting enterocolitis, whilst in sub-Saharan Africa it is a major cause of invasive nontyphoidal Salmonella disease, associated with high case-fatality. Whole-genome sequence analysis of 675 isolates of S. Enteritidis from 45 countries reveals the existence of a global epidemic clade and two novel clades of S. Enteritidis that are each geographically restricted to distinct regions of Africa. The African isolates display genomic degradation, a novel prophage repertoire and have an expanded, multidrug resistance plasmid. S. Enteritidis is a further example of a Salmonella serotype that displays niche plasticity, with distinct clades that enable it to become a prominent cause of gastroenteritis in association with the industrial production of eggs, and of multidrug resistant, bloodstream invasive infection in Africa. PMID:27548315

  10. Distinct Salmonella Enteritidis lineages associated with enterocolitis in high-income settings and invasive disease in low-income settings.

    PubMed

    Feasey, Nicholas A; Hadfield, James; Keddy, Karen H; Dallman, Timothy J; Jacobs, Jan; Deng, Xiangyu; Wigley, Paul; Barquist, Lars; Langridge, Gemma C; Feltwell, Theresa; Harris, Simon R; Mather, Alison E; Fookes, Maria; Aslett, Martin; Msefula, Chisomo; Kariuki, Samuel; Maclennan, Calman A; Onsare, Robert S; Weill, François-Xavier; Le Hello, Simon; Smith, Anthony M; McClelland, Michael; Desai, Prerak; Parry, Christopher M; Cheesbrough, John; French, Neil; Campos, Josefina; Chabalgoity, Jose A; Betancor, Laura; Hopkins, Katie L; Nair, Satheesh; Humphrey, Tom J; Lunguya, Octavie; Cogan, Tristan A; Tapia, Milagritos D; Sow, Samba O; Tennant, Sharon M; Bornstein, Kristin; Levine, Myron M; Lacharme-Lora, Lizeth; Everett, Dean B; Kingsley, Robert A; Parkhill, Julian; Heyderman, Robert S; Dougan, Gordon; Gordon, Melita A; Thomson, Nicholas R

    2016-10-01

    An epidemiological paradox surrounds Salmonella enterica serovar Enteritidis. In high-income settings, it has been responsible for an epidemic of poultry-associated, self-limiting enterocolitis, whereas in sub-Saharan Africa it is a major cause of invasive nontyphoidal Salmonella disease, associated with high case fatality. By whole-genome sequence analysis of 675 isolates of S. Enteritidis from 45 countries, we show the existence of a global epidemic clade and two new clades of S. Enteritidis that are geographically restricted to distinct regions of Africa. The African isolates display genomic degradation, a novel prophage repertoire, and an expanded multidrug resistance plasmid. S. Enteritidis is a further example of a Salmonella serotype that displays niche plasticity, with distinct clades that enable it to become a prominent cause of gastroenteritis in association with the industrial production of eggs and of multidrug-resistant, bloodstream-invasive infection in Africa.

  11. Are school feeding programs in low-income settings sustainable? Insights on the costs of school feeding compared with investments in primary education.

    PubMed

    Gelli, Aulo; Daryanani, Roshan

    2013-09-01

    School feeding programs are ubiquitous. Benchmarking expenditures for school feeding is an important component of program accountability and sustainability. To analyze the costs of school feeding and the cost relative to education expenditure and other measures of economic growth. Data on the costs of school feeding were collected from multiple sources, including United Nations databases, gray literature, and published reviews. Relationships between costs of school feeding, costs of education, and GDP per capita were analyzed through standard linear regression. Data on costs of school feeding were obtained for 74 countries, including 12 high-income, 40 middle-income, and 22 in low-income countries. School feeding programs were found to cost US$173 per child per year, ranging from US$54 in low-income countries to US$693 in high-income countries. In high-income countries, school feeding costs per capita were on average equivalent to 11% of the per capita investments in primary education, compared with 19% in middle-income countries and 68% in low-income countries. In middle- and low-income countries, school feeding programs covered on average 18% and 13% of the children enrolled in primary school, respectively. The total budget for school feeding in low-income countries was found to be on average 11% of the estimated total primary school education budget, compared to 4% in middle-income countries. School feeding investments are targeted in low- and middle-income settings, reaching only a portion of primary schoolchildren, with total costs only a fraction of the overall investment in education. As countries get richer, school feeding costs become a much smaller proportion of education costs. The findings of this study provide an updated framework for benchmarking school feeding programs.

  12. Did HealthKick, a randomised controlled trial primary school nutrition intervention improve dietary quality of children in low-income settings in South Africa?

    PubMed

    Steyn, Nelia P; de Villiers, Anniza; Gwebushe, Nomonde; Draper, Catherine E; Hill, Jillian; de Waal, Marina; Dalais, Lucinda; Abrahams, Zulfa; Lombard, Carl; Lambert, Estelle V

    2015-09-23

    Numerous studies in schools in the Western Cape Province, South Africa have shown that children have an unhealthy diet with poor diversity and which is high in sugar and fat. HealthKick (HK) was a three-year randomised controlled trial aimed at promoting healthy eating habits. Sixteen schools were selected from two low-income school districts and randomly allocated to intervention (n = 8) or control school (n = 8) status. The HK intervention comprised numerous activities to improve the school nutrition environment such as making healthier food choices available and providing nutrition education support. Dietary intake was measured by using a 24-h recall in 2009 in 500 grade 4 learners at intervention schools and 498 at control schools, and repeated in 2010 and 2011. A dietary diversity score (DDS) was calculated from nine food groups and frequency of snack food consumption was determined. A school level analysis was performed. The mean baseline (2009) DDS was low in both arms 4.55 (SD = 1.29) and 4.54 (1.22) in the intervention and control arms respectively, and 49 % of learners in HK intervention schools had a DDS ≤4 (=low diversity). A small increase in DDS was observed in both arms by 2011: mean score 4.91 (1.17) and 4.83 (1.29) in the intervention and control arms respectively. The estimated DSS intervention effect over the two years was not significant [0 .04 (95 % CI: -0.37 to 0.46)]. Food groups least consumed were eggs, fruit and vegetables. The most commonly eaten snacking items in 2009 were table sugar in beverages and/or cereals (80.5 %); followed by potato crisps (53.1 %); non-carbonated beverages (42.9 %); sweets (26.7 %) and sugar-sweetened carbonated beverages (16 %). Unhealthy snack consumption in terms of frequency of snack items consumed did not improve significantly in intervention or control schools. The results of the HK intervention were disappointing in terms of improvement in DDS and a decrease in unhealthy snacking. We

  13. 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.

  14. Increasing access to fresh produce by pairing urban farms with corner stores: a case study in a low-income urban setting

    PubMed Central

    Gudzune, Kimberly A.; Welsh, Claire; Lane, Elisa; Chissell, Zach; Steeves, Elizabeth Anderson; Gittelsohn, Joel

    2015-01-01

    Objective Our objective was to pilot collaborations between two urban farms with two corner stores to increase access to fresh produce in low-income neighborhoods. Design We conducted a pre-post evaluation of two farm-store collaborations using quantitative distribution and sales data. Using semi-structured interviews, we qualitatively assessed feasibility of implementation and collaboration acceptability to farmers and storeowners. Setting Low-income urban neighborhoods in Baltimore, MD in 2012 Subjects Pair #1 included a ½-acre urban farm with a store serving local residents and was promoted by the neighborhood association. Pair #2 included a 6-acre urban farm with a store serving bus commuters. Results Produce was delivered all 9 weeks in both pairs. Pair #1 produced a significant increase in the mean number of produce varieties carried in the store by 11.3 (p<0.01) and sold 86% of all items delivered. Pair #2 resulted in a non-significant increase in number of produce varieties carried by 2.2 (p=0.44) and sold 63% of all items delivered. Conclusions Our case study suggests that pairing urban farms with corner stores for produce distribution may be feasible, and could be a new model to increase access to fruits and vegetables among low-income urban neighborhoods. For future programs to be successful, strong community backing may be vital to support produce sales. PMID:25649045

  15. Predictors of nicotine withdrawal symptoms: findings from the first randomized smoking cessation trial in a low-income country setting.

    PubMed

    Ben Taleb, Ziyad; Ward, Kenneth D; Asfar, Taghrid; Jaber, Rana; Auf, Rehab; Maziak, Wasim

    2016-07-01

    To identify predictors of nicotine withdrawal symptoms among smokers who participated in a randomized cessation trial in a low-income country. We analyzed data from 269 smokers who participated in a randomized, placebo-controlled smoking cessation trial conducted in primary healthcare in Aleppo, Syria. All participants received behavioral counseling and were randomized to receive either 6 weeks of nicotine or placebo patch and were followed for one year. Throughout the study, lower total withdrawal score was associated with greater education (p = 0.044), older age of smoking initiation (p = 0.017), lower nicotine dependence (p = 0.024), higher confidence in ability to quit (p = 0.020), lower reported depression (p < 0.001), higher adherence to patch (p = 0.026), belief of receiving nicotine patches rather than placebo (p = 0.011), and waterpipe use (p = 0.047). Lower nicotine dependence, greater educational attainment, higher confidence in ability to quit and waterpipe use predict lower withdrawal severity. Waterpipe smoking may serve as a barrier to smoking cessation efforts in countries where its use is highly prevalent. Further, expectancies about the effects of pharmacotherapy appear to mediate the experience of nicotine withdrawal.

  16. The art of grocery shopping on a food stamp budget: factors influencing the food choices of low-income women as they try to make ends meet.

    PubMed

    Wiig, Kristen; Smith, Chery

    2009-10-01

    Amidst a hunger-obesity paradox, the purpose of the present study was to examine the grocery shopping behaviour and food stamp usage of low-income women with children to identify factors influencing their food choices on a limited budget. Focus groups, which included questions based on Social Cognitive Theory constructs, examined food choice in the context of personal, behavioural and environmental factors. A quantitative grocery shopping activity required participants to prioritize food purchases from a 177-item list on a budget of $US 50 for a one-week period, an amount chosen based on the average household food stamp allotment in 2005. Ninety-two low-income women, with at least one child aged 9-13 years in their household, residing in the Twin Cities, Minnesota, USA. Participants' mean age was 37 years, and 76% were overweight or obese (BMI> or =25.0 kg/m2). Key findings suggest that their food choices and grocery shopping behaviour were shaped by not only individual and family preferences, but also their economic and environmental situation. Transportation and store accessibility were major determinants of shopping frequency, and they used various strategies to make their food dollars stretch (e.g. shopping based on prices, in-store specials). Generally, meat was the most important food group for purchase and consumption, according to both the qualitative and quantitative data. Efforts to improve food budgeting skills, increase nutrition knowledge, and develop meal preparation strategies involving less meat and more fruits and vegetables, could be valuable in helping low-income families nutritionally make the best use of their food dollars.

  17. 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

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

    PubMed

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

    2014-01-01

    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. 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. 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. 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.

  19. Environmental Intervention in Carryout Restaurants Increases Sales of Healthy Menu Items in a Low-Income Urban Setting.

    PubMed

    Lee-Kwan, Seung Hee; Bleich, Sara N; Kim, Hyunju; Colantuoni, Elizabeth; Gittelsohn, Joel

    2015-01-01

    To investigate how a pilot environmental intervention changed food sales patterns in carryout restaurants. Quasi-experimental. Low-income neighborhoods of Baltimore, Maryland. Seven carryouts (three intervention, four comparison). Phase 1, menu board revision and healthy menu labeling; phase 2, increase of healthy sides and beverages; and phase 3, promotion of cheaper and healthier combination meals. Weekly handwritten menu orders collected to assess changes in the proportion of units sold and revenue of healthy items (entrée, sides and beverages, and combined). Logistic and Poisson regression models with generalized estimating equations. In the intervention group, odds for healthy entrée units and odds for healthy side and beverage units sold significantly increased in phases 2 and 3; odds for healthy entrée revenue significantly increased in phase 1 (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.08-1.26), phase 2 (OR 1.32, 95% CI 1.25-1.41), and phase 3 (OR 1.39, 95% CI 1.14-1.70); and odds for healthy side and beverage revenues increased significantly in phase 2 (OR 1.62, 95% CI 1.33-1.97) and phase 3 (OR 2.73, 95% CI 2.15-3.47) compared to baseline. Total revenue in the intervention group was significantly higher in all phases than in the comparison group (p < .05). Environmental intervention changes such as menu revision, menu labeling, improved healthy food selection, and competitive pricing can increase availability and sales of healthy items in carryouts.

  20. Addressing Antiretroviral Therapy-Associated Drug-Drug Interactions in Patients Requiring Treatment for Opportunistic Infections in Low-Income and Resource-Limited Settings.

    PubMed

    Chastain, Daniel B; Franco-Paredes, Carlos; Stover, Kayla R

    2017-09-08

    An increasing number of human immunodeficiency virus (HIV)-infected patients are achieving virologic suppression on antiretroviral therapy (ART) limiting the use of primary and secondary antimicrobial prophylaxis. However, in low-income and resource-limited settings, half of those infected with HIV are unaware of their diagnosis, and fewer than 50% of patients on ART achieve virologic suppression. Management of comorbidities and opportunistic infections among patients on ART may lead to inevitable drug-drug interactions (DDIs) and even toxicities. Elderly patients, individuals with multiple comorbidities, those receiving complex ART, and patients living in low-income settings experience higher rates of DDIs. Management of these cytochrome P450-mediated, nonmediated, and drug transport system DDIs is critical in HIV-infected patients, particularly those in resource-limited settings with few options for ART. This article critically analyzes and provides recommendations to manage significant DDIs and drug toxicities in HIV-infected patients receiving ART. © 2017, The American College of Clinical Pharmacology.

  1. Overcoming Access Barriers for Facility-based Delivery in Low-income Settings: Insights from Bangladesh and Uganda

    PubMed Central

    Rahman, Syed Azizur; Ssengooba, Freddie

    2006-01-01

    Women in both Bangladesh and Uganda face a number of barriers to delivery in professional health facilities, including costs, transportation problems, and sociocultural norms to deliver at home. Some women in both the countries manage to overcome these barriers. This paper reports on a comparative qualitative study investigating how some women and their families were able to use professional delivery services. The study provides insights into the decision-making processes and overcoming access barriers. Husbands were found to be particularly important in Uganda, while, in Bangladesh, a number of individuals could influence care-seeking, including unqualified local healers or traditional birth attendants. In both the settings, cost and transport barriers were often overcome through social networks. Social prohibitions on birth in the health facility did not feature strongly in women's accounts, with several Ugandan women explaining that friends or peers also used facilities, while, in Bangladesh, perceived complications apparently justified the use of professional medical care. Investigating the ways in which some women can overcome common barriers can help inform policy and planning to increase the use of health facilities for child delivery. PMID:17591340

  2. Measuring domestic water use: a systematic review of methodologies that measure unmetered water use in low-income settings.

    PubMed

    Tamason, Charlotte C; Bessias, Sophia; Villada, Adriana; Tulsiani, Suhella M; Ensink, Jeroen H J; Gurley, Emily S; Mackie Jensen, Peter Kjaer

    2016-11-01

    To present a systematic review of methods for measuring domestic water use in settings where water meters cannot be used. We systematically searched EMBASE, PubMed, Water Intelligence Online, Water Engineering and Development Center, IEEExplore, Scielo, and Science Direct databases for articles that reported methodologies for measuring water use at the household level where water metering infrastructure was absent or incomplete. A narrative review explored similarities and differences between the included studies and provide recommendations for future research in water use. A total of 21 studies were included in the review. Methods ranged from single-day to 14-consecutive-day visits, and water use recall ranged from 12 h to 7 days. Data were collected using questionnaires, observations or both. Many studies only collected information on water that was carried into the household, and some failed to mention whether water was used outside the home. Water use in the selected studies was found to range from two to 113 l per capita per day. No standardised methods for measuring unmetered water use were found, which brings into question the validity and comparability of studies that have measured unmetered water use. In future studies, it will be essential to define all components that make up water use and determine how they will be measured. A pre-study that involves observations and direct measurements during water collection periods (these will have to be determined through questioning) should be used to determine optimal methods for obtaining water use information in a survey. Day-to-day and seasonal variation should be included. A study that investigates water use recall is warranted to further develop standardised methods to measure water use; in the meantime, water use recall should be limited to 24 h or fewer. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  3. No data, no problem, no action: parenting programs in low-income countries. Making the social-emotional outcomes more visible.

    PubMed

    Tinajero, A R; Cohen, N J; Ametorwo, S

    2016-01-01

    Parenting programs are delivered in many low income countries in an effort to address the effects of insufficient cognitive stimulation, major social-emotional risk factors related to inadequate caregiver sensitivity and responsiveness, maternal depression, violence and biological risk factors. However, the outcomes of these programs are often untested because of methodological limitations in the existing evaluation tools available for cross-cultural research, and especially those related to social-emotional development and functioning. This study takes an approach that involves organizing data from focus groups collected following caregiver participation in a parenting program, Learning Through Play (LTP) delivered in 11 low income countries. The LTP program has as its aim to increase parent knowledge and influence parental practice regarding the essential components of early development of children aged birth to 6 years. The purpose of systematically organizing focus group data was to illustrate a means by which program developers worldwide can discuss outcomes of program participation, particularly in social-emotional domains that have been overlooked in past studies on parenting programs. The findings from this study suggest that qualitative outcome data can be organized to make the social-emotional outcomes of participation in parenting programs more visible. © 2015 John Wiley & Sons Ltd.

  4. Computer aided learning to link evidence to paediatric learning and practice: a pilot in a medical school in a low income setting

    PubMed Central

    Senga, John; Ndiritu, Moses; Osundwa, Juliana; Irimu, Grace; English, Mike

    2010-01-01

    Bridging the gap between research evidence and practice is problematic in low income settings. Wereport medical students' experience with a pilot computer aided learning (CAL) program developed to enable students to explore research evidence supporting national guidelines. We asked 50 students to enter data from pre-set clinical scenarios, diagnose the severity of pneumonia/asthma and suggest treatment and then compare their diagnosis and treatment with that suggested by a computer algorithm based on the guidelines. Links to evidence supporting the guideline-suggested diagnosis and treatment were provided. Brief evidence summaries and video clips were accessed by 92% of students and full text articles by 86%. The majority of the students showed an interest in the CAL approach and suggested the scope of the approach be expanded to other illnesses. Such a system might provide one means to help students understand the link between research and policy and ultimately influence practice. PMID:21151759

  5. Influence of Goal Setting on Physical Activity and Cardiorespiratory Endurance in Low-Income Children Enrolled in CSPAP Schools

    ERIC Educational Resources Information Center

    Burns, Ryan D.; Brusseau, Timothy A.; Fu, You

    2017-01-01

    Background: Comprehensive school physical activity programming (CSPAP) has been shown to increase school day physical activity and health-related fitness. The use of goal setting may further enhance the outcomes of CSPAP. Purpose: The purpose of this study was to examine the effect of physical activity leader (PAL) goal setting on school day…

  6. Influence of Goal Setting on Physical Activity and Cardiorespiratory Endurance in Low-Income Children Enrolled in CSPAP Schools

    ERIC Educational Resources Information Center

    Burns, Ryan D.; Brusseau, Timothy A.; Fu, You

    2017-01-01

    Background: Comprehensive school physical activity programming (CSPAP) has been shown to increase school day physical activity and health-related fitness. The use of goal setting may further enhance the outcomes of CSPAP. Purpose: The purpose of this study was to examine the effect of physical activity leader (PAL) goal setting on school day…

  7. SU-F-P-08: Medical Physics Perspective On Radiation Therapy Quality and Safety Considerations in Low Income Settings

    SciTech Connect

    Van Dyk, J; Meghzifene, A

    2016-06-15

    Purpose: The last few years have seen a significant growth of interest in the global radiation therapy crisis. Various organizations are quantifying the need and providing aid in support of addressing the shortfall existing in many low-to-middle income countries (LMICs). The Lancet Oncology Commission report (Lancet Oncol. Sep;16(10):1153-86, 2015) projects a need of 22,000 new medical physicists in LMICs by 2035 if there is to be equal access globally. With the tremendous demand for new facilities, equipment and personnel, it is very important to recognize quality and safety considerations and to address them directly. Methods: A detailed examination of quality and safety publications was undertaken. A paper by Dunscombe (Front. Oncol. 2: 129, 2012) reviewed the recommendations of 7 authoritative reports on safety in radiation therapy and found the 12 most cited recommendations, summarized in order of most to least cited: training, staffing, documentation/standard operating procedures, incident learning, communication/questioning, check lists, QC/PM, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment, and safety culture. However, these authoritative reports were generally based on input from high income contexts. In this work, the recommendations were analyzed with a special emphasis on issues that are significant in LMICs. Results: The review indicated that there are significant challenges in LMICs with training and staffing ranking at the top in terms quality and safety. Conclusion: With the recognized need for expanding global access to radiation therapy, especially in LMICs, and the backing by multiple support organizations, quality and safety considerations must be overtly addressed. While multidimensional, training and staffing are top priorities. The use of outdated systems with poor interconnectivity, coupled with a lack of systematic QA in high patient load settings are additional concerns. Any support provided to lower

  8. Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia

    PubMed Central

    Gebremariam, Solmon

    2016-01-01

    Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases. Objective. To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children. Methods. In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package. t-test and statistical significance at P value < 0.05 with 95% CI were used. Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death with P value of 0.00, 0.01, and 0.02, respectively. Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality. PMID:27974990

  9. Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia.

    PubMed

    Gebremariam, Solmon; Moges, Tamirat

    2016-01-01

    Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases. Objective. To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children. Methods. In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package. t-test and statistical significance at P value < 0.05 with 95% CI were used. Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death with P value of 0.00, 0.01, and 0.02, respectively. Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality.

  10. 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

  11. Access to primary health care for acute vascular events in rural low income settings: a mixed methods study.

    PubMed

    Ahmed, Shyfuddin; Chowdhury, Muhammad Ashique Haider; Khan, Md Alfazal; Huq, Nafisa Lira; Naheed, Aliya

    2017-01-18

    . This study will help to generate hypothesis, develop programs and policies for better access to care for AVE in similar rural settings considering barriers of access and improving utilization.

  12. Immediate fluid management of children with severe febrile illness and signs of impaired circulation in low-income settings: a contextualised systematic review

    PubMed Central

    Opiyo, Newton; Molyneux, Elizabeth; Sinclair, David; Garner, Paul; English, Mike

    2014-01-01

    Objective To evaluate the effects of intravenous fluid bolus compared to maintenance intravenous fluids alone as part of immediate emergency care in children with severe febrile illness and signs of impaired circulation in low-income settings. Design Systematic review of randomised controlled trials (RCTs), and observational studies, including retrospective analyses, that compare fluid bolus regimens with maintenance fluids alone. The primary outcome measure was predischarge mortality. Data sources and synthesis We searched PubMed, The Cochrane Library (to January 2014), with complementary earlier searches on, Google Scholar and Clinical Trial Registries (to March 2013). As studies used different clinical signs to define impaired circulation we classified patients into those with signs of severely impaired circulation, or those with any signs of impaired circulation. The quality of evidence for each outcome was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Findings are presented as risk ratios (RRs) with 95% CIs. Results Six studies were included. Two were RCTs, one large trial (n=3141 children) from a low-income country and a smaller trial from a middle-income country. The remaining studies were from middle-income or high-income settings, observational, and with few participants (34–187 children). Severely impaired circulation The large RCT included a small subgroup with severely impaired circulation. There were more deaths in those receiving bolus fluids (20–40 mL/kg/h, saline or albumin) compared to maintenance fluids (2.5–4 mL/kg/h; RR 2.40, 95% CI 0.84 to 6.88, p=0.054, 65 participants, low quality evidence). Three additional observational studies, all at high risk of confounding, found mixed effects on mortality (very low quality evidence). Any signs of impaired circulation The large RCT included children with signs of both severely and non-severely impaired circulation. Overall, bolus fluids

  13. Using Economic Evidence to Set Healthcare Priorities in Low-Income and Lower-Middle-Income Countries: A Systematic Review of Methodological Frameworks.

    PubMed

    Wiseman, Virginia; Mitton, Craig; Doyle-Waters, Mary M; Drake, Tom; Conteh, Lesong; Newall, Anthony T; Onwujekwe, Obinna; Jan, Stephen

    2016-02-01

    Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop 'evidence-based' frameworks for identifying priority health interventions. This paper synthesises and appraises the literature on methodological frameworks--which incorporate economic evaluation evidence--for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion. These covered a wide range of health interventions with only two studies including health systems strengthening interventions related to financing, governance and human resources. A little under half of the studies (39%) included multiple criteria for priority setting, most commonly equity, feasibility and disease severity. Most studies (91%) specified a measure of 'efficiency' defined as cost per disability-adjusted life year averted. Ranking of health interventions using multi-criteria decision analysis and generalised cost-effectiveness were the most common frameworks for identifying priority health interventions. Approximately a third of studies discussed the affordability of priority interventions. Only one study identified priority areas for the release or redeployment of resources. The paper concludes by highlighting the need for local capacity to conduct evaluations (including economic analysis) and empowerment of local decision-makers to act on this evidence.

  14. Quality of care in a low-income consumer-driven health plan: assessment of healthcare effectiveness data information set (HEDIS) scores for secondary prevention.

    PubMed

    Westover, Chad; Arredondo, Patricia H; Chapa, Griselda; Cole, Evan; Campbell, Claudia R

    2014-01-01

    The passage of the Patient Protection and Affordable Care Act of 2010 (PPACA) may create an estimated 16 million new Medicaid enrollees. This underscores the need to develop innovative strategies to provide efficient care to this population without compromising quality. To address concerns that consumer-driven health plans (CDHPs) and cost sharing discourage individuals from seeking needed care, we examined the Healthcare Effectiveness Data Information Set (HEDIS) measures of secondary prevention for a CDHP offered to uninsured, non-Medicaid eligible adults with incomes under 200% of the federal poverty level and compared them to the National Committee for Quality Assurance (NCQA) benchmarks achieved by national Medicaid and commercially insured health plans. Results suggest that the cost-sharing component in the CDHP plan did not deter these low-income enrollees from pursuing or receiving appropriate care when compared to either Medicaid or commercially insured populations. As these results are only descriptive and not statistical measures, further research is needed with comparable populations and more detailed data for hypothesis testing.

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

    PubMed

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

    2015-01-01

    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). 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. 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. 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.

  16. 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

  17. '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

  18. Effectiveness of a two-stage strategy with HPV testing followed by visual inspection with acetic acid for cervical cancer screening in a low-income setting.

    PubMed

    Tebeu, Pierre-Marie; Fokom-Domgue, Joël; Crofts, Victoria; Flahaut, Emmanuel; Catarino, Rosa; Untiet, Sarah; Vassilakos, Pierre; Petignat, Patrick

    2015-03-15

    The World Health Organization recently advocated a two-stage strategy with human papillomavirus (HPV) testing followed by visual inspection of the cervix with acetic acid (VIA) as a suitable option for cervical cancer screening. However, its accuracy has never been directly assessed in the context of primary screening. To evaluate effectiveness of HPV testing on self-obtained specimens (self-HPV) followed by VIA (sequential testing) in a low-income setting, we recruited 540 women aged between 30 and 65 years in two Cameroonian periurban areas. Eligible women were counseled about cervical cancer and how to perform self-sampling. HPV positive and a random sample of HPV-negative women were called back for VIA and biopsy. Disease was defined by interpretation of cervical intraepithelial neoplasia Grade 2 or worse (CIN2+). Performances of VIA, self-HPV and sequential testing were determined after adjustment for verification bias. HPV prevalence was 27.0%. VIA positivity was 12.9% and disease prevalence was 5%. Sensitivity and specificity of VIA for CIN2+ were 36.4% [95% confidence interval (CI): 15.2-64.6%] and 90.4% (95% CI: 85.4-93.7%), respectively. Sensitivity of self-HPV [100.0% (95% CI: 79.6-100.0%)] was 66% higher than that of sequential testing [33.3% (95% CI: 15.2-58.3%)]. Meanwhile, specificity of self-HPV [74.5% (95% CI: 70.6-78.1%)] was 22% lower than that of sequential testing [96.7% (95% CI: 94.8-97.9%)]. A two-stage screening strategy with self-HPV followed by VIA improves specificity of cervical cancer screening, but at the cost of an important loss of sensitivity. Ways to improve VIA performance or other tools are needed to increase positive predictive value of HPV testing. © 2014 UICC.

  19. 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…

  20. 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…

  1. Detection of alcohol use in the second trimester among low-income pregnant women in the prenatal care settings in Jefferson County, Alabama

    PubMed Central

    Li, Qing; Hankin, Janet; Wilsnack, Sharon C.; Abel, Ernest; Kirby, Russell S.; Keith, Louis G.; Obican, Sarah

    2012-01-01

    Background Prenatal alcohol use, a leading preventable cause of birth defects and developmental disabilities, remains a prevalent public health concern in the United States. This study aims to detect the proportion and correlates of prenatal alcohol use in the prenatal care settings in Alabama. Prenatal care settings were chosen because of their potential as stable locations to screen for and to reduce prenatal alcohol use within a community. Methods We conducted a cross-sectional study of 3,046 women in the 22 and 23 weeks of gestation who sought prenatal care in eight community-based public clinics and participated in the Perinatal Emphasis Research Center project in Jefferson County, Alabama, in 1997–2001. Frequency and quantity of alcohol use in the past 3 months were assessed by research nurses during face-to-face interviews. We conducted logistic regression analyses to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) of correlates of prenatal alcohol use. Results Participants were predominantly young, African American, and unmarried, 86.5% on Medicaid. The proportion of alcohol use in the second trimester of pregnancy was 5.1%; 0.3% of women reported 4 or more drinks on a drinking day to research nurses. Older maternal age (OR=1.11; 95% CI=1.08–1.15), use of welfare (OR=1.43; 95% CI=1.02–2.02), and male partner–perpetrated violence (OR=2.96; 95% CI=1.92–4.56) were positively associated with elevated risk of prenatal alcohol use. Protective factors included higher levels of self-esteem (OR=0.94; 95% CI=0.89–0.98) and more years of education (OR=0.88; 95% CI=0.78–0.98). Conclusions Prenatal alcohol use remains a public health issue among low-income pregnant women in Jefferson County, Alabama. Research nurses detected it in the second trimester. Future studies need to encourage screening for prenatal alcohol use in the prenatal care settings by obstetrician-gynecologists, family physicians, nurses, and midwifes. Combined

  2. 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…

  3. Medicine prices in urban Mozambique: a public health and economic study of pharmaceutical markets and price determinants in low-income settings.

    PubMed

    Russo, Giuliano; McPake, Barbara

    2010-01-01

    It has been suggested that medicines are unaffordable in low-income countries and that world manufacturing and trade policies are responsible for high prices. This research investigates medicine prices in urban Mozambique with the objective of understanding how prices are formed and with what public health implications. The study adopts an economic framework and uses a combination of quantitative and qualitative methods to analyse local pharmaceutical prices and markets. The research findings suggest that: (a) local mark-ups are responsible for up to two-thirds of drugs' final prices in private pharmacies; (b) statutory profit and cost ceilings are applied unevenly, due to lack of government control and collusion among suppliers; and (c) the local market appears to respond effectively to the urban population's diverse needs through its low-cost and high-cost segments, although uncertainty around the quality of generics may be inducing consumers to purchase less affordable drugs. We conclude that local markets play a larger than expected role in the determination of prices in Mozambique, and that more research is needed to address the complex issue of affordability of medicines in low-income countries. We also argue that price controls may not be the most effective way to influence access to medicines in low-income countries, and managing demand and supply towards cheaper effective drugs appears a more suitable policy option.

  4. Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-Health tools versus print materials: A randomized controlled trial

    PubMed Central

    Heisler, Michele; Choi, Hwajung; Palmisano, Gloria; Mase, Rebecca; Richardson, Caroline; Fagerlin, Angela; Montori, Victor M.; Spencer, Michael; An, Laurence C.

    2015-01-01

    Background Health care centers serving low-income communities have scarce resources to support medication decision-making among patients with poorly controlled diabetes. Objective We compared outcomes between community health worker (CHW) use of a tailored, interactive web-based tablet-delivered tool (iDecide) versus use of print educational materials. Design A randomized two-arm trial from 2011-2013. Trial Registration NCT01427660. Setting Community health center in Detroit serving a Latino and African American low-income population. Participants 188 adults with a hemoglobinA1c >7.5% (55%) or who reported questions, concerns, or difficulty taking diabetes medications Primary Funding Sources Agency for Health Care Quality and Research (1R18HS019256-01) and P30DK092926 (MCDTR) Measurements Primary outcomes were changes in knowledge about anti-hyperglycemic medications, patient-reported medication decisional conflict, and satisfaction with anti-hyperglycemic medication information. We also examined changes in diabetes distress, self-efficacy, medication adherence, and A1c. Intervention Participants were randomized to receive a 1-2 hour session with a CHW using either iDecide or printed educational materials and two follow-up calls. Results 94% of participants completed three-month follow-up. Both groups improved across most measures. iDecide participants reported greater improvements in satisfaction with medication information (helpfulness, p=.007; clarity, p=.03) and in diabetes distress compared to the print materials group (p<0.001). There were no differences between groups in other outcomes. Limitations The study was conducted at one health center over a short period, and the CHWs were experienced in behavioral counseling, thus possibly mitigating the need for additional support tools. Conclusions Most outcomes were similarly improved among participants receiving both types of diabetes medication decision-making support. Longer-term evaluations are necessary to

  5. 75 FR 47171 - The Low-Income Definition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... 701 RIN 3133-AD75 The Low-Income Definition AGENCY: National Credit Union Administration (NCUA). ACTION: Interim final rule and request for comments. SUMMARY: NCUA is amending the definition of ``low... text so it is consistent with the geo-coding software the agency uses to make the low-income credit...

  6. 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:…

  7. 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:…

  8. Encouraging Asset Development for Low-Income Workers.

    ERIC Educational Resources Information Center

    Resources for Welfare Decisions, 2002

    2002-01-01

    Asset development is an emerging approach to promoting self-sufficiency for low-income workers. By promoting and rewarding savings, asset development strategies encourage individuals to set long-term economic goals. Asset development strategies can accomplish the following objectives: (1) give low-income workers the knowledge required to navigate…

  9. 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

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

    PubMed

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

    2015-09-01

    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. 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. 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). 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.

  11. 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

    Hughes, Nicole; Arora, Monika; Grills, Nathan

    2016-03-21

    To review the current literature around the potential impact, effectiveness and perceptions of plain packaging in low income settings. A systematic review of the literature. 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. 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. Two independent reviewers assessed studies for inclusion and extracted data. 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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. 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

  13. 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

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

    PubMed

    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

    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. To develop an integrated and practical model of scale-up that synthesises experiences of family health programmes in LMICs. 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. 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. We used the constant comparative method of qualitative data analysis to extract recurrent themes from the interviews, and we integrated these themes with findings from the

  15. Low-Income Kids More Likely to Have ADHD, Asthma

    MedlinePlus

    ... Low-Income Kids More Likely to Have ADHD, Asthma Autism more often diagnosed among children in higher- ... families struggling to make ends meet are developing asthma and attention-deficit/hyperactivity disorder (ADHD) at faster ...

  16. The complex remuneration of human resources for health in low-income settings: policy implications and a research agenda for designing effective financial incentives.

    PubMed

    Bertone, Maria Paola; Witter, Sophie

    2015-07-28

    Human resources for health represent an essential component of health systems and play a key role to accelerate progress towards universal health coverage. Many countries in sub-Saharan Africa face challenges regarding the availability, distribution and performance of health workers, which could be in part addressed by providing effective financial incentives. Based on an overview of the existing literature, the paper highlights the gaps in the existing research in low-income countries exploring the different components of health workers' incomes. It then proposes a novel approach to the analysis of financial incentives and delineates a research agenda, which could contribute to shed light on this topic. The article finds that, while there is ample research that investigates separately each of the incomes health workers may earn (for example, salary, fee-for-service payments, informal incomes, "top-ups" and per diems, dual practice and non-health activities), there is a dearth of studies which look at the health workers' "complex remuneration", that is, the whole of the financial incentives available. Little research exists which analyses simultaneously all revenues of health workers, quantifies the overall remuneration and explores its complexity, its multiple components and their features, as well as the possible interaction between income components. However, such a comprehensive approach is essential to fully comprehend health workers' incentives, by investigating the causes (at individual and system level) of the fragmentation in the income structure and the variability in income levels, as well as the consequences of the "complex remuneration" on motivation and performance. This proposition has important policy implications in terms of devising effective incentive packages as it calls for an active consideration of the role that "complex remuneration" plays in determining recruitment, retention and motivation patterns, as well as, more broadly, the

  17. The epidemiology of developmental disabilities in low-income countries.

    PubMed

    Durkin, Maureen

    2002-01-01

    Although most of the world's children live in developing countries and may be at high risk for disability, very little is known about the prevalence and causes of developmental disabilities in these countries. This paper discusses methodological difficulties contributing to this lack of knowledge, and provides an overview of what is known about the epidemiology of developmental disabilities in low-income countries. At least some forms of developmental disability appear to be more common in low-income countries than in wealthier countries, despite the probability of higher mortality among children with disabilities in low-income countries. For example, most studies of severe mental retardation in low-income countries report prevalences greater than 5 per 1,000 children, while prevalence estimates from industrialized countries are consistently below this. Major risk factors for developmental disabilities in some low-income countries include specific genetic diseases, a higher frequency of births to older mothers, consanguinity, and specific micronutrient deficiencies and infections. Trauma and toxic exposures are also important risk factors, but their contributions to the etiology of developmental disabilities in low-income countries are not well documented. Though many of the causes of developmental disabilities are understood and preventable, proven methods of prevention are not being fully implemented in developing countries. Epidemiologic studies are needed to raise awareness of the public health impacts of developmental disabilities in low-income countries and to provide a basis for setting priorities and designing efficient interventions.

  18. 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...

  19. 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…

  20. 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…

  1. Psychometric assessment of measures of psychological symptoms, functional status, life events, and context for low income Hispanic patients in a primary care setting.

    PubMed

    Katerndahl, David A; Amodei, Nancy; Larme, Anne C; Palmer, Raymond

    2002-12-01

    This study assessed the psychometric properties of a set of nine commonly used lists in an English-speaking Hispanic sample taken from a primary care setting. Those were the General Health Questionnaire-12, the Anxiety, Depression, and Somatization scales from the SCL-90, the Medical Outcomes Study Short Form-36, the Holmes and Rahe Family Life Changes, abbreviated versions of the Daily Hassles and Uplifts, the Herth Hope Index, Duke Social Support and Stress scales, Alcohol Use Disorders Identification Test, and Marlowe-Crowne Brief Social Desirability Scale. 68 adult patients completed the measures via structured interview. Internal consistency was measured using Cronbach alpha and the Kuder-Richardson-20. Construct validity was assessed using Pearson correlations among sets of scores. Internal consistencies were good-to-excellent for all measures except for the Duke Social Support and Stress scales (Stress scale), and the Brief Social Desirability Scale. Construct validity was suggested for all except the Mental Health and Energy/Fatigue scales of the Short Form-36. Further study is needed to verify these results in other Hispanic populations and to address other forms of reliability and validity.

  2. Engaging communities to strengthen research ethics in low-income settings: selection and perceptions of members of a network of representatives in coastal Kenya.

    PubMed

    Kamuya, Dorcas M; Marsh, Vicki; Kombe, Francis K; Geissler, P Wenzel; Molyneux, Sassy C

    2013-04-01

    There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. © 2013 Blackwell Publishing Ltd.

  3. ENGAGING COMMUNITIES TO STRENGTHEN RESEARCH ETHICS IN LOW-INCOME SETTINGS: SELECTION AND PERCEPTIONS OF MEMBERS OF A NETWORK OF REPRESENTATIVES IN COASTAL KENYA

    PubMed Central

    Kamuya, Dorcas M; Marsh, Vicki; Kombe, Francis K; Geissler, P Wenzel; Molyneux, Sassy C

    2013-01-01

    There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. PMID:23433404

  4. 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

  5. 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

  6. Cost-effectiveness of an HPV self-collection campaign in Uganda: comparing models for delivery of cervical cancer screening in a low-income setting.

    PubMed

    Campos, Nicole G; Tsu, Vivien; Jeronimo, Jose; Njama-Meya, Denise; Mvundura, Mercy; Kim, Jane J

    2017-09-01

    With the availability of a low-cost HPV DNA test that can be administered by either a healthcare provider or a woman herself, programme planners require information on the costs and cost-effectiveness of implementing cervical cancer screening programmes in low-resource settings under different models of healthcare delivery. Using data from the START-UP demonstration project and a micro-costing approach, we estimated the health and economic impact of once-in-a-lifetime HPV self-collection campaign relative to clinic-based provider-collection of HPV specimens in Uganda. We used an individual-based Monte Carlo simulation model of the natural history of HPV and cervical cancer to estimate lifetime health and economic outcomes associated with screening with HPV DNA testing once in a lifetime (clinic-based provider-collection vs a self-collection campaign). Test performance and cost data were obtained from the START-UP demonstration project using a micro-costing approach. Model outcomes included lifetime risk of cervical cancer, total lifetime costs (in 2011 international dollars [I$]), and life expectancy. Cost-effectiveness ratios were expressed using incremental cost-effectiveness ratios (ICERs). When both strategies achieved 75% population coverage, ICERs were below Uganda's per capita GDP (self-collection: I$80 per year of life saved [YLS]; provider-collection: I$120 per YLS). When the self-collection campaign achieved coverage gains of 15-20%, it was more effective than provider-collection, and had a lower ICER unless coverage with both strategies was 50% or less. Findings were sensitive to cryotherapy compliance among screen-positive women and relative HPV test performance. The primary limitation of this analysis is that self-collection costs are based on a hypothetical campaign but are based on unit costs from Uganda. Once-in-a-lifetime screening with HPV self-collection may be very cost-effective and reduce cervical cancer risk by > 20% if coverage is high

  7. 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

    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

  8. 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

  9. Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.

    PubMed

    Heisler, Michele; Choi, Hwajung; Palmisano, Gloria; Mase, Rebecca; Richardson, Caroline; Fagerlin, Angela; Montori, Victor M; Spencer, Michael; An, Laurence C

    2014-11-18

    Health care centers serving low-income communities have scarce resources to support medication decision making among patients with poorly controlled diabetes. To compare outcomes between community health worker use of a tailored, interactive, Web-based, tablet computer-delivered tool (iDecide) and use of print educational materials. Randomized, 2-group trial conducted from 2011 to 2013 (ClinicalTrials.gov: NCT01427660). Community health center in Detroit, Michigan, serving a Latino and African American low-income population. 188 adults with a hemoglobin A1c value greater than 7.5% (55%) or those who reported questions, concerns, or difficulty taking diabetes medications. Participants were randomly assigned to receive a 1- to 2-hour session with a community health worker who used iDecide or printed educational materials and 2 follow-up calls. Primary outcomes were changes in knowledge about antihyperglycemic medications, patient-reported medication decisional conflict, and satisfaction with antihyperglycemic medication information. Also examined were changes in diabetes distress, self-efficacy, medication adherence, and hemoglobin A1c values. Ninety-four percent of participants completed 3-month follow-up. Both groups improved across most measures. iDecide participants reported greater improvements in satisfaction with medication information (helpfulness, P = 0.007; clarity, P = 0.03) and in diabetes distress compared with the print materials group (P < 0.001). The other outcomes did not differ between the groups. The study was conducted at 1 health center during a short period. The community health workers were experienced in behavioral counseling, thereby possibly mitigating the need for additional support tools. Most outcomes were similarly improved among participants receiving both types of decision-making support for diabetes medication. Longer-term evaluations are necessary to determine whether the greater improvements in satisfaction with medication

  10. Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia.

    PubMed

    Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

    2017-01-01

    environment, especially in handling human resource management matters. The smallest improvement was noted in ethics and accountability. Qualitative interviews showed improvements in the meeting culture and a greater appreciation for the importance of meetings. Shared vision, teamwork and coordination seemed to have improved more in work places where the overall manager had received ZMLA training. Leadership and management training will be a key ingredient in health system strengthening in low-income settings. The ZMLA model was found to be acceptable and effective in improving knowledge and skills for health system managers with minimal disruption to health services.

  11. Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia

    PubMed Central

    Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

    2017-01-01

    improvements in the workplace environment, especially in handling human resource management matters. The smallest improvement was noted in ethics and accountability. Qualitative interviews showed improvements in the meeting culture and a greater appreciation for the importance of meetings. Shared vision, teamwork and coordination seemed to have improved more in work places where the overall manager had received ZMLA training. Conclusion Leadership and management training will be a key ingredient in health system strengthening in low-income settings. The ZMLA model was found to be acceptable and effective in improving knowledge and skills for health system managers with minimal disruption to health services. PMID:28742853

  12. Family ties: constructing family time in low-income families.

    PubMed

    Tubbs, Carolyn Y; Roy, Kevin M; Burton, Linda M

    2005-03-01

    "Family time" is reflected in the process of building and fortifying family relationships. Whereas such time, free of obligatory work, school, and family maintenance activities, is purchased by many families using discretionary income, we explore how low-income mothers make time for and give meaning to focused engagement and relationship development with their children within time constraints idiosyncratic to being poor and relying on welfare. Longitudinal ethnographic data from 61 low-income African American, European American, and Latina American mothers were analyzed to understand how mothers construct family time during daily activities such as talking, play, and meals. We also identify unique cultural factors that shape family time for low-income families, such as changing temporal orientations, centrality of television time, and emotional burdens due to poverty. Implications for family therapy are also discussed.

  13. Best Practices in Nutrition Education for Low-Income Audiences

    ERIC Educational Resources Information Center

    Baker, Susan; Auld, Garry; MacKinnon, Chloe; Ammerman, Alice; Hanula, Gail; Lohse, Barbara; Scott, Marci; Serrano, Elena; Tucker, Easter; Wardlaw, Mary Kay

    2014-01-01

    The Food and Nutrition Service (FNS) identified a need for a comprehensive set of best practices in nutrition education for low-income audiences for the Supplemental Nutrition Assistance Program (SNAP) educational projects, including SNAP-Ed. A comprehensive list of best practices would promote consistency and efficacy in program planning,…

  14. 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.

  15. 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)…

  16. Solar upgrading of low income housing

    SciTech Connect

    Lumsdaine, E.; Farrer, R.; Callahan, D.

    1980-01-01

    The design, installation, training and operation experience of retrofitting solar devices (active and passive water heaters, Trombe walls, convective loop window units, etc.) on hundreds of low-income houses along the Southwest Border Region are summarized. The project demonstrates a wide variety of appropriate low-cost solar applications and provides prototypical models for the region's low-income inhabitants. Space heating and cooling systems and water heating systems have been combined with weatherization and conservation techniques. CETA employees, members of various community groups and youth groups, and employees of local non-profit organizations have been trained as installers, and low-income people have been educated in the operation and use of these solar devices. It is anticipated that this transfer of appropriate technology into the region will result in continued retrofitting of solar installations and in the stimulation of local industries, which will create employment opportunities for members of the low-income population.

  17. Exploring sources of variability in adherence to guidelines across hospitals in low-income settings: a multi-level analysis of a cross-sectional survey of 22 hospitals.

    PubMed

    Gathara, David; English, Mike; van Hensbroek, Michael Boele; Todd, Jim; Allen, Elizabeth

    2015-04-28

    Variability in processes of care and outcomes has been reported widely in high-income settings (at geographic, hospital, physician group and individual physician levels); however, such variability and the factors driving it are rarely examined in low-income settings. Using data from a cross-sectional survey undertaken in 22 hospitals (60 case records from each hospital) across Kenya that aimed at evaluating the quality of routine hospital services, we sought to explore variability in four binary inpatient paediatric process indicators. These included three prescribing tasks and use of one diagnostic. To examine for sources of variability, we examined intra-class correlation coefficients (ICC) and their changes using multi-level mixed models with random intercepts for hospital and clinician levels and adjusting for patient and clinician level covariates. Levels of performance varied substantially across indicators and hospitals. The absolute values for ICCs also varied markedly ranging from a maximum of 0.48 to a minimum of 0.09 across the models for HIV testing and prescription of zinc, respectively. More variation was attributable at the hospital level than clinician level after allowing for nesting of clinicians within hospitals for prescription of quinine loading dose for malaria (ICC = 0.30), prescription of zinc for diarrhoea patients (ICC = 0.11) and HIV testing for all children (ICC = 0.43). However, for prescription of correct dose of crystalline penicillin, more of the variability was explained by the clinician level (ICC = 0.21). Adjusting for clinician and patient level covariates only altered, marginally, the ICCs observed in models for the zinc prescription indicator. Performance varied greatly across place and indicator. The variability that could be explained suggests interventions to improve performance might be best targeted at hospital level factors for three indicators and clinician factors for one. Our data suggest that better

  18. 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.

  19. 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…

  20. 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…

  1. 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…

  2. Accuracy of the WHO Haemoglobin Colour Scale for the diagnosis of anaemia in primary health care settings in low-income countries: a systematic review and meta-analysis.

    PubMed

    Marn, Heiko; Critchley, Julia Alison

    2016-04-01

    Anaemia is a major cause of morbidity and mortality in low-income countries. Primary health-care workers in resource-poor settings usually diagnose anaemia clinically, but this is inaccurate. The WHO Haemoglobin Colour Scale (HCS) is a simple, cheap quantitative method to assess haemoglobin concentration outside of the laboratory. We systematically reviewed the literature to assess the accuracy of the HCS in primary care to diagnose anaemia, and compared this with clinical assessment. We searched the electronic databases including MEDLINE, EMBASE, SCOPUS, Web of Science, Cochrane library, CINAHL plus, Popline, Reproductive Health Library, and Google Scholar and regional databases up to Nov 14, 2014, "haemoglobin colour scale" in alternative spellings published in any language. Two reviewers independently screened studies, extracted data, and assessed quality using the QUADAS-2 instrument. Statistical analyses were carried out in STATA using the bivariate model. Of 141 records and abstracts screened, 14 studies were included. The pooled sensitivity of the HCS to diagnose anaemia was 80% (95% CI 68-88) compared with 52% for clinical assessment ([95% CI 36-67]; p=0·008). Specificity was similar between the HCS (80% [95% CI 59-91]) and clinical assessment (75% [56-88]; p=0·8250). For severe anaemia, diagnostic accuracy was again higher overall for the HCS (p<0·0001); sensitivity was 57% (36-76) for the HCS and 45% (95% CI 12-83) for clinical assessment, but specificity was 99·6% (95% CI 95-99·9) versus 92% (62-99). Combining clinical assessment and the HCS could result in higher sensitivity (anaemia: 91% [95% CI 81-96]); severe anaemia 83% (33-98), but at the expense of specificity (anaemia: 59% [35-79]; severe anaemia 90% [40-99]). Individual studies were highly heterogeneous but pooled results did not differ substantially in a series of sensitivity analyses for indicators of study robustness. In so-called real-life primary health-care conditions, HCS can

  3. 'Life does not make it easy to breast-feed': using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico.

    PubMed

    Bueno-Gutierrez, Diana; Chantry, Caroline

    2015-12-01

    Breast-feeding rates reflect sociodemographic discrepancies. In Mexico, exclusive breast-feeding under 6 months of age has deteriorated among the poor, rural and indigenous populations from 1999 to 2012. Our objective of the present study was to identify the main social obstacles to breast-feeding in a low-income population in Tijuana, Mexico. Qualitative study using a socio-ecological framework for data collection. Low-income communities in Tijuana, Mexico. Mothers (n 66), fathers (n 11), grandparents (n 27) and key informants (n 25). One hundred and twenty-nine individuals participated in the study: six focus groups (n 53) and fifty-one interviews among mothers, fathers and grandparents; and twenty-five interviews among key informants. Seven social themes were identified: (i) embarrassment to breast-feed in public; (ii) migrant experience; (iii) women's role in society; (iv) association of formula with higher social status; (v) marketing by the infant food industry; (vi) perception of a non-breast-feeding culture; and (vii) lack of breast-feeding social programmes. Socio-structural factors influence infant feeding practices in low-income communities in Tijuana. We hypothesize that messages emphasizing Mexican traditions along with modern healthy practices could help to re-establish and normalize a breast-feeding culture in this population. The target audience for these messages should not be limited to mothers but also include family, health-care providers, the work environment and society as a whole.

  4. 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:…

  5. Tax Reform; A Minimalist Approach for Assisting the Low-Income.

    ERIC Educational Resources Information Center

    Burbridge, Lynn

    1987-01-01

    The 1986 Tax Reform Act is a positive step toward improving the plight of low-income families; however, it will not produce dramatic effects. The tax burden will be more equitable and low-income housing may increase, but a better way to help the poor is to develop a comprehensive set of assistance policies. (VM)

  6. Tax Reform; A Minimalist Approach for Assisting the Low-Income.

    ERIC Educational Resources Information Center

    Burbridge, Lynn

    1987-01-01

    The 1986 Tax Reform Act is a positive step toward improving the plight of low-income families; however, it will not produce dramatic effects. The tax burden will be more equitable and low-income housing may increase, but a better way to help the poor is to develop a comprehensive set of assistance policies. (VM)

  7. 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:…

  8. 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;…

  9. 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;…

  10. 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…

  11. 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.…

  12. Recruitment and retention strategies in longitudinal clinical studies with low-income populations.

    PubMed

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

    2011-05-01

    Conducting longitudinal research studies with low-income and/or minority participants present a unique set of challenges and opportunities. 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. 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. 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. Successful participant recruitment and retention approaches need to be specific and consistent with clinical staff buy in throughout the project. Published by Elsevier Inc.

  13. 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

  14. 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…

  15. Low-Income and Elderly Populations.

    ERIC Educational Resources Information Center

    Brun, Judy K.; Clancy, Katherine L.

    1980-01-01

    Recommendations are given in this task force report which focus on nutrition education programs for the low income and elderly. Issues include: accessibility to food, national policy, nutritionally vulnerable individuals, program development, health care, preparation of nutrition educators, and evaluation of existing nutrition programs. (SA)

  16. Child Care for Low-Income Families.

    ERIC Educational Resources Information Center

    Shonkoff, Jack P.

    1995-01-01

    Discusses issues raised in three workshops organized by the Board on Children and Families devoted to childcare for low-income families. The workshops sought to distill the available information from current research, examine the current status of the childcare delivery system, and consider promising directions for future research. The conclusions…

  17. Low-Income and Elderly Populations.

    ERIC Educational Resources Information Center

    Brun, Judy K.; Clancy, Katherine L.

    1980-01-01

    Recommendations are given in this task force report which focus on nutrition education programs for the low income and elderly. Issues include: accessibility to food, national policy, nutritionally vulnerable individuals, program development, health care, preparation of nutrition educators, and evaluation of existing nutrition programs. (SA)

  18. Adverse childhood experiences of low-income urban youth.

    PubMed

    Wade, Roy; Shea, Judy A; Rubin, David; Wood, Joanne

    2014-07-01

    Current assessments of adverse childhood experiences (ACEs) may not adequately encompass the breadth of adversity to which low-income urban children are exposed. The purpose of this study was to identify and characterize the range of adverse childhood experiences faced by young adults who grew up in a low-income urban area. Focus groups were conducted with young adults who grew up in low-income Philadelphia neighborhoods. Using the nominal group technique, participants generated a list of adverse childhood experiences and then identified the 5 most stressful experiences on the group list. The most stressful experiences identified by participants were grouped into a ranked list of domains and subdomains. Participants identified a range of experiences, grouped into 10 domains: family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, child welfare/juvenile justice, and media/technology. Included in these domains were many but not all of the experiences from the initial ACEs studies; parental divorce/separation and mental illness were absent. Additional experiences not included in the initial ACEs but endorsed by our participants included single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination. Gathering youth perspectives on childhood adversity broadens our understanding of the experience of stress and trauma in childhood. Future work is needed to determine the significance of this broader set of adverse experiences in predisposing children to poor health outcomes as adults. Copyright © 2014 by the American Academy of Pediatrics.

  19. Exploring health systems research and its influence on policy processes in low income countries

    PubMed Central

    Hyder, Adnan A; Bloom, Gerald; Leach, Melissa; Syed, Shamsuzzoha B; Peters, David H

    2007-01-01

    Background The interface between research and policymaking in low-income countries is highly complex. The ability of health systems research to influence policy processes in such settings face numerous challenges. Successful analysis of the research-policy interface in these settings requires understanding of contextual factors as well as key influences on the interface. Future Health Systems (FHS): Innovations for Equity is a consortium conducting research in six countries in Asia and Africa. One of the three cross-country research themes of the consortium is analysis of the relationship between research (evidence) and policy making, especially their impact on the poor; insights gained in the initial conceptual phase of FHS activities can inform the global knowledge pool on this subject. Discussion This paper provides a review of the research-policy interface in low-income countries and proposes a conceptual framework, followed by directions for empirical approaches. First, four developmental perspectives are considered: social institutional factors; virtual versus grassroots realities; science-society relationships; and construction of social arrangements. Building on these developmental perspectives three research-policy interface entry points are identified: 1. Recognizing policy as complex processes; 2. Engaging key stakeholders: decision-makers, providers, scientists, and communities; and 3. Enhancing accountability. A conceptual framework with three entry points to the research-policy interface – policy processes; stakeholder interests, values, and power; and accountability – within a context provided by four developmental perspectives is proposed. Potential empirical approaches to the research-policy interface are then reviewed. Finally, the value of such innovative empirical analysis is considered. Conclusion The purpose of this paper is to provide the background, conceptual framework, and key research directions for empirical activities focused on the

  20. Residential Instability Among Low-Income Families: A Concept Analysis.

    PubMed

    Cotton, Brandi Parker; Schwartz-Barcott, Donna

    2016-04-01

    Residential instability is relatively common among low-income families and is associated with a host of negative outcomes, especially for children and adolescents. Psychiatric nurses, especially those in the advanced practice role, observe the consequences of residential instability within the clinical setting. Yet, to-date, the concept is somewhat vague and its essential meaning and definition remain unclear. The aim of this paper is to develop a definition of residential instability using Wilson's method of concept analysis. An overview of historical perspectives is included. The paper concludes with recommendations for future research and application within clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Parenting perceptions of low-income mothers.

    PubMed

    Webb, Jenny; Morris, Melanie Hall; Thomas, Sandra P; Combs-Orme, Terri

    2015-01-01

    The purpose of this descriptive qualitative study was to gain understanding of perceptions of low-income pregnant women and mothers about parenting. Participants were 65 low-income, primarily African American, women in their 20s and 30s who were recruited from a faith-based social service center in Memphis, Tennessee. Interviews were conducted by nursing, social work, and psychology students. The existential phenomenological method was used to analyze verbatim responses of participants to vignettes depicting parenting behaviors of hypothetical mothers. Five global themes were identified: (a) Focus on baby's development: "Because I'm the Mother, I'm the First Teacher"; (b) Focus on baby's safety/security: "The Baby Could Be Hurt"; (c) Focus on conveying love: "She Just Wants the Baby to Feel Her Love"; (d) Focus on learning the rules of good childcare: "It's Important to Know the Do's and Don'ts"; and (e) Focus on doing it differently (better) than parents did: "When You Know Better, You Do Better." Findings suggest that these mothers care deeply about providing a better life for their children than the life they have had. They desire to learn about being the best parents they can be. As nurses, we can help to provide educational opportunities for mothers through a variety of evidence-based interventions delivered across the childbearing years.

  2. 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

  3. 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

    ... ADMINISTRATION 12 CFR Parts 701 and 741 RIN 3133-AE09 Designation of Low-Income Status; Acceptance of Secondary Capital Accounts by Low-Income Designated Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Proposed rule. SUMMARY: The NCUA Board proposes to amend its low-income credit unions...

  4. 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...

  5. 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…

  6. A Qualitative Analysis of Mexican-Immigrant Mothers' Involvement in a High-Performing Low-Income Elementary School

    ERIC Educational Resources Information Center

    Russell, Isela

    2013-01-01

    This qualitative study explores how low-income first- and second-generation Mexican-immigrant mothers, the largest sub-group of the Latino population, support the academic success of their children who are in a low-income successful elementary school. The specific setting was Roosevelt Elementary located in North Texas. Participants were selected…

  7. 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…

  8. 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…

  9. A Qualitative Analysis of Mexican-Immigrant Mothers' Involvement in a High-Performing Low-Income Elementary School

    ERIC Educational Resources Information Center

    Russell, Isela

    2013-01-01

    This qualitative study explores how low-income first- and second-generation Mexican-immigrant mothers, the largest sub-group of the Latino population, support the academic success of their children who are in a low-income successful elementary school. The specific setting was Roosevelt Elementary located in North Texas. Participants were selected…

  10. 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…

  11. Factors associated with psychological distress in the Canadian population: a comparison of low-income and non low-income sub-groups.

    PubMed

    Caron, Jean; Liu, Aihua

    2011-06-01

    This study presents a comparison of the level of psychological distress between low-income and non low-income populations in Canada. It describes the factors associate with distress identified for each population and presents the differences found with the models used in predicting distress. Data were collected through the Canadian Community Health Survey, Cycle 1.2 including 36,984 individuals aged 15 or over. Of this sample, 17.9% (N = 7,940) was identified as being within the low-income population. In the low-income population, the percentage of high psychological distress was as high as 28%, compared to 19% in the non low-income population. Variables related to social support, stress and coping abilities were the stronger sets of variables related to distress in both populations. The results provided evidence that although economically disadvantaged and more affluent populations share many variables associated with psychological distress, they have a different profile on the correlates of psychological distress.

  12. How have systematic priority setting approaches influenced policy making? A synthesis of the current literature.

    PubMed

    Kapiriri, Lydia; Razavi, Donya

    2017-09-01

    There is a growing body of literature on systematic approaches to healthcare priority setting from various countries and different levels of decision making. This paper synthesizes the current literature in order to assess the extent to which program budgeting and marginal analysis (PBMA), burden of disease & cost-effectiveness analysis (BOD/CEA), multi-criteria decision analysis (MCDA), and accountability for reasonableness (A4R), are reported to have been institutionalized and influenced policy making and practice. We searched for English language publications on health care priority setting approaches (2000-2017). Our sources of literature included PubMed and Ovid databases (including Embase, Global Health, Medline, PsycINFO, EconLit). Of the four approaches PBMA and A4R were commonly applied in high income countries while BOD/CEA was exclusively applied in low income countries. PBMA and BOD/CEA were most commonly reported to have influenced policy making. The explanations for limited adoption of an approach were related to its complexity, poor policy maker understanding and resource requirements. While systematic approaches have the potential to improve healthcare priority setting; most have not been adopted in routine policy making. The identified barriers call for sustained knowledge exchange between researchers and policy-makers and development of practical guidelines to ensure that these frameworks are more accessible, applicable and sustainable in informing policy making. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. 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.

  14. Food Choices of Minority and Low-Income Employees

    PubMed Central

    Levy, Douglas E.; Riis, Jason; Sonnenberg, Lillian M.; Barraclough, Susan J.; Thorndike, Anne N.

    2012-01-01

    Background Effective strategies are needed to address obesity, particularly among minority and low-income individuals. Purpose To test whether a two-phase point-of-purchase intervention improved food choices across racial, socioeconomic (job type) groups. Design A 9-month longitudinal study from 2009 to 2010 assessing person-level changes in purchases of healthy and unhealthy foods following sequentially introduced interventions. Data were analyzed in 2011. Setting/participants Participants were 4642 employees of a large hospital in Boston MA who were regular cafeteria patrons. Interventions The first intervention was a traffic light–style color-coded labeling system encouraging patrons to purchase healthy items (labeled green) and avoid unhealthy items (labeled red). The second intervention manipulated “choice architecture” by physically rearranging certain cafeteria items, making green-labeled items more accessible, red-labeled items less accessible. Main outcome measures Proportion of green- (or red-) labeled items purchased by an employee. Subanalyses tracked beverage purchases, including calories and price per beverage. Results Employees self-identified as white (73%), black (10%), Latino (7%), and Asian (10%). Compared to white employees, Latino and black employees purchased a higher proportion of red items at baseline (18%, 28%, and 33%, respectively, p<0.001) and a lower proportion of green (48%, 38%, and 33%, p<0.001). Labeling decreased all employees’ red item purchases (−11.2% [95% CI= −13.6%, −8.9%]) and increased green purchases (6.6% [95% CI=5.2%, 7.9%]). Red beverage purchases decreased most (−23.8% [95% CI= −28.1%, −19.6%]). The choice architecture intervention further decreased red purchases after the labeling. Intervention effects were similar across all race/ethnicity and job types (p>0.05 for interaction between race or job type and intervention). Mean calories per beverage decreased similarly over the study period for all

  15. 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

  16. 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

    2016-01-09

    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.

  17. 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…

  18. Problem Behavior and Urban, Low-Income Youth

    PubMed Central

    Lewis, Kendra M.; Schure, Marc B.; Bavarian, Niloofar; DuBois, David L.; Day, Joseph; Ji, Peter; Silverthorn, Naida; Acock, Alan; Vuchinich, Samuel; Flay, Brian R.

    2013-01-01

    Background Youth problem behaviors remain a public health issue. Youth in low-income, urban areas are particularly at risk for engaging in aggressive, violent, and disruptive behaviors. Purpose To evaluate the effects of a school-based social–emotional learning and health promotion program on problem behaviors and related attitudes among low-income, urban youth. Design A matched-pair, cluster RCT. Setting/participants Participants were drawn from 14 Chicago Public Schools over a 6-year period of program delivery with outcomes assessed for a cohort of youth followed from Grades 3 to 8. Data were collected from Fall 2004 to Spring 2010, and analyzed in Spring 2012. Intervention The Positive Action program includes a scoped and sequenced K–12 classroom curriculum with six components: self-concept, social and emotional positive actions for managing oneself responsibly, and positive actions directed toward physical and mental health, honesty, getting along with others, and continually improving oneself. The program also includes teacher, counselor, family, and community training as well as activities directed toward schoolwide climate development. Main outcome measures Youth reported on their normative beliefs in support of aggression and on their bullying, disruptive and violent behaviors; parents rated youths’ bullying behaviors and conduct problems; schoolwide data on disciplinary referrals and suspensions were obtained from school records. Results Multilevel growth-curve modeling analyses conducted on completion of the trial indicated that Positive Action mitigated increases over time in (1) youth reports of normative beliefs supporting aggressive behaviors and of engaging in disruptive behavior and bullying (girls only); and (2) parent reports of youth bullying behaviors (boys only). At study end-point, students in Positive Action schools also reported a lower rate of violence-related behavior than students in control schools. Schoolwide findings indicated

  19. Anaemia in low-income and middle-income countries.

    PubMed

    Balarajan, Yarlini; Ramakrishnan, Usha; Ozaltin, Emre; Shankar, Anuraj H; Subramanian, S V

    2011-12-17

    Anaemia affects a quarter of the global population, including 293 million (47%) children younger than 5 years and 468 million (30%) non-pregnant women. In addition to anaemia's adverse health consequences, the economic effect of anaemia on human capital results in the loss of billions of dollars annually. In this paper, we review the epidemiology, clinical assessment, pathophysiology, and consequences of anaemia in low-income and middle-income countries. Our analysis shows that anaemia is disproportionately concentrated in low socioeconomic groups, and that maternal anaemia is strongly associated with child anaemia. Anaemia has multifactorial causes involving complex interaction between nutrition, infectious diseases, and other factors, and this complexity presents a challenge to effectively address the population determinants of anaemia. Reduction of knowledge gaps in research and policy and improvement of the implementation of effective population-level strategies will help to alleviate the anaemia burden in low-resource settings.

  20. ACTION APPROACHES TO LOW-INCOME CULTURE. PART I.

    ERIC Educational Resources Information Center

    RIESSMAN, FRANK

    THE MAJOR THEMES THAT DESRIBED LOW-INCOME CULTURE WERE--SECURITY OVER STATUS, PRAGMATISM AND ANTI-INTELLECTUALISM, ALIENATION ATTITUDE, COOPERATION, PERSON-CENTERED ATTITUDE, PHYSICALISM, TRADITIONALISM, EXCITEMENT, NONJOINING ATTITUDE, AND STABLE, FEMALE BASED EXTENDED FAMILY. THE LEARNING STYLES OF THE LOW-INCOME GROUP WERE PHYSICAL AND VISUAL,…

  1. 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... Identified Low Income Geographic Areas. A NMVC Company must identify the specific LI Areas in which...

  2. 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…

  3. 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…

  4. 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.…

  5. 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…

  6. Low-Income Parents' Adult Interactions at Childcare Centres

    ERIC Educational Resources Information Center

    Reid, Jeanne L.; Martin, Anne; Brooks-Gunn, Jeanne

    2017-01-01

    Little is known about the extent and nature of low-income parents' interactions with other parents and staff at childcare centres, despite the potential for these interactions to provide emotional, informational, and instrumental support. This study interviewed 51 parents at three childcare centres in low-income neighbourhoods in New York City.…

  7. 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.…

  8. 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…

  9. 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…

  10. 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…

  11. ACTION APPROACHES TO LOW-INCOME CULTURE. PART I.

    ERIC Educational Resources Information Center

    RIESSMAN, FRANK

    THE MAJOR THEMES THAT DESRIBED LOW-INCOME CULTURE WERE--SECURITY OVER STATUS, PRAGMATISM AND ANTI-INTELLECTUALISM, ALIENATION ATTITUDE, COOPERATION, PERSON-CENTERED ATTITUDE, PHYSICALISM, TRADITIONALISM, EXCITEMENT, NONJOINING ATTITUDE, AND STABLE, FEMALE BASED EXTENDED FAMILY. THE LEARNING STYLES OF THE LOW-INCOME GROUP WERE PHYSICAL AND VISUAL,…

  12. 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…

  13. 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…

  14. Family Life and Sex Education Among Low-Income Families.

    ERIC Educational Resources Information Center

    Conley, Martha McClenny

    A sample of 218 black low-income mothers is used to investigate the mothers' perception of their need for family life and sex education for their entire family, attitude toward public school, family life and sex education, and the concept of the population crisis. This study focuses on low income families because this population has been most…

  15. Transformative learning through study abroad in low-income countries.

    PubMed

    Foronda, Cynthia; Belknap, Ruth Ann

    2012-01-01

    Study abroad in low-income countries is an emerging trend in nursing education, yet student outcomes vary from positive to negative. Study abroad in low-income countries can be transformative because it has the potential to increase student awareness of socioeconomic relations, structural oppression, and human connectedness. The authors discuss 10 strategies to facilitate transformative learning in students who study abroad.

  16. 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....

  17. 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....

  18. 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....

  19. 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....

  20. 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…

  1. 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…

  2. 75 FR 80677 - The Low-Income Definition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-23

    ... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 701 RIN 3133-AD75 The Low-Income Definition AGENCY: National Credit Union... clarify that, in determining if a credit union qualifies for a low- income designation, the comparison of...

  3. 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…

  4. 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…

  5. Dietary patterns of young, low-income US children.

    PubMed

    Knol, Linda L; Haughton, Betsy; Fitzhugh, Eugene C

    2005-11-01

    The purpose of this study was to identify dietary patterns of young, low-income US children, describe differences in diet quality between identified patterns, and make targeted food recommendations to improve diet quality. Dietary patterns were assessed using dietary variables from the Pyramid Servings Database within the Continuing Survey of Food Intakes by Individuals 1994-1996, 1998. Healthy Eating Index (HEI) scores were used to validate identified dietary patterns. Two subsamples of low-income children, aged 2 to 3 years (n = 1,242) and 4 to 8 years (n = 1,506), were selected from the Continuing Survey of Food Intakes by Individuals data. Cluster analysis was performed to determine unique dietary patterns within the two subsamples. Linear regression analyses were used to compare energy intake, discretionary fat, added sugars, and HEI scores across cluster groups. Descriptive statistics were computed for each cluster. Cluster analysis identified six and seven distinct dietary patterns for the younger and older children, respectively. Four patterns were similar for both age groups. For the 2- to 3-year-old children, energy intake, overall HEI scores, and nine of the 10 HEI component scores differed among the four most prevalent dietary patterns. Among the older children, energy intake and six of the HEI component scores differed between the four most prevalent clusters but not overall HEI. Neither age group had a cluster of children who followed a balanced/moderate diet pattern consistent with Food Guide Pyramid recommendations. Children consuming almost every pattern identified could benefit by reducing added sugars and discretionary fat and increasing low-fat, low-sugar options from the vegetables, fruits, meat, and milk groups.

  6. 77 FR 11737 - Weatherization Assistance for Low-Income Persons: Maintaining the Privacy of Applicants for and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-28

    ...-AC16 Weatherization Assistance for Low-Income Persons: Maintaining the Privacy of Applicants for and... preamble, DOE is amending 10 CFR part 440 as set forth below: PART 440--WEATHERIZATION ASSISTANCE FOR...

  7. Tailoring science education graduate programs to the needs of science educators in low-income countries

    NASA Astrophysics Data System (ADS)

    Lunetta, Vincent N.; van den Berg, Euwe

    Science education graduate programs in high-income countries frequently enroll students from low-income countries. Upon admission these students have profiles of knowledge, skills, and experiences which can be quite different from those of students from the host high-income countries. Upon graduation, they will normally return to work in education systems with conditions which differ greatly from those in high-income countries. This article attempts to clarify some of the differences and similarities between such students. It offers suggestions for making graduate programs more responsive to the special needs of students from low-income countries and to the opportunities they offer for enhancing cross-cultural sensitivity. Many of the suggestions can be incorporated within existing programs through choices of elective courses and topics for papers, projects, and research. Many references are provided to relevant literature on cultural issues and on science education in low-income countries.

  8. 78 FR 4030 - Designation of Low-Income Status; Acceptance of Secondary Capital Accounts by Low-Income...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-18

    ... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION... Capital Accounts by Low-Income Designated Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Final rule. SUMMARY: The NCUA Board (Board) is amending its low-income credit unions regulation...

  9. 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

  10. 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.…

  11. 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,…

  12. 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…

  13. 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-…

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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.…

  20. 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…

  1. 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…

  2. 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…

  3. A Person-Oriented Approach to Understanding Dimensions of Parenting in Low-Income Mothers

    ERIC Educational Resources Information Center

    Cook, Gina A.; Roggman, Lori A.; D'zatko, Kim

    2012-01-01

    The purpose of this study was to examine parenting types in a low-income sample from a person-oriented approach. Data were used from a public use data set from the Early Head Start Research and Evaluation Project (EHSREP) along with new extant ratings of parenting behavior from the EHSREP archive of videotaped parent-child observations. Parenting…

  4. Household Risk and Child Sexual Abuse in a Low Income, Urban Sample of Women.

    ERIC Educational Resources Information Center

    Rowland, David L.; Zabin, Laurie S.; Emerson, Mark

    2000-01-01

    Explored the impact of household environment and childhood sexual abuse (CSA) on psychosocial development. Data on low-income, urban CSA victims, and non-CSA women indicated that household conditions indicative of parental dysfunction, antisocial behavior, and instability set the stage for CSA by interfering with parental protection. Victims'…

  5. Household Risk and Child Sexual Abuse in a Low Income, Urban Sample of Women.

    ERIC Educational Resources Information Center

    Rowland, David L.; Zabin, Laurie S.; Emerson, Mark

    2000-01-01

    Explored the impact of household environment and childhood sexual abuse (CSA) on psychosocial development. Data on low-income, urban CSA victims, and non-CSA women indicated that household conditions indicative of parental dysfunction, antisocial behavior, and instability set the stage for CSA by interfering with parental protection. Victims'…

  6. 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.…

  7. A Person-Oriented Approach to Understanding Dimensions of Parenting in Low-Income Mothers

    ERIC Educational Resources Information Center

    Cook, Gina A.; Roggman, Lori A.; D'zatko, Kim

    2012-01-01

    The purpose of this study was to examine parenting types in a low-income sample from a person-oriented approach. Data were used from a public use data set from the Early Head Start Research and Evaluation Project (EHSREP) along with new extant ratings of parenting behavior from the EHSREP archive of videotaped parent-child observations. Parenting…

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. 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…

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

    USDA-ARS?s Scientific Manuscript database

    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. 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…

  15. 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…

  16. 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.

  17. Low-income households and energy use in California

    SciTech Connect

    Vine, E.L.; Gold, S.J.

    1985-03-01

    This report examines the relationship between energy consumption and income with a particular emphasis on low-income households in California. The low-income population constitutes 10 to 20% of California's population, and almost 20% of these people live in the rural areas of California. While home energy use (primary electricity and natural gas) and payments of low-income households are less than those of other income groups, the former's ''payment burden'' (fraction of income spent on home energy) is as much as 350% greater than the burden for high-income households.

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

    PubMed

    Nakakeeto, Olive N; Elliott, Brian V

    2013-02-15

    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. 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. 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. 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 that the ARV market in low income

  19. 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

  20. 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.

  1. Efficient group decision making in workshop settings

    Treesearch

    Daniel L. Schmoldt; David L. Peterson

    2001-01-01

    Public land managers must treat multiple values coincidentally in time and space, which requires the participation of multiple resource specialists and consideration of diverse clientele interests in the decision process. This implies decision making that includes multiple participants, both internally and externally. Decades of social science research on decision...

  2. 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

  3. 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.

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

    PubMed Central

    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

    2016-01-01

    Summary Antibiotic-resistant infections annually claim hundreds of thousands of lives worldwide. This problem is exacerbated by resistance gene exchange between pathogens and benign microbes from diverse habitats. Mapping resistance gene dissemination between humans and their environment is a public health priority. We characterized the bacterial community structure and resistance exchange networks of hundreds of interconnected human fecal 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 fecal 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 dissemination across interconnected habitats in settings representing over two-thirds of the world’s population. PMID:27172044

  5. 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.

  6. Mothers’ Employment and Health of Low-Income Children

    PubMed Central

    Gennetian, Lisa; Hill, Heather; Lopoo, Leonard; London, Andrew

    2010-01-01

    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. Mother’s report of child health status is predicted as a function of exogenous variation in maternal employment associated with random assignment to the program 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

  7. The management of adult psychiatric emergencies in low-income and middle-income countries: a systematic review.

    PubMed

    Nadkarni, Abhijit; Hanlon, Charlotte; Bhatia, Urvita; Fuhr, Daniela; Ragoni, Celina; de Azevedo Perocco, Sérgio Luiz; Fortes, Sandra; Shidhaye, Rahul; Kinyanda, Eugene; Rangaswamy, Thara; Patel, Vikram

    2015-06-01

    The aim of this Review is to identify effective interventions and treatment guidelines to manage common types of psychiatric emergencies in non-specialist settings in low-income and middle-income countries. Mental health specialist services in low-income and middle-income countries are scarce. We did a systematic review of interventions for psychiatric emergencies and a literature search for low-income and middle-income-specific treatment guidelines for psychiatric emergencies. A dearth of high-quality guidelines and contextualised primary evidence for management of psychiatric emergencies in low-income and middle-income countries exists. Filling these gaps in present guidelines needs to be an urgent research priority in view of the adverse health and social consequences of such presentations and the present drive to scale up mental health care.

  8. Disability in low-income countries: issues and implications.

    PubMed

    Parnes, Penny; Cameron, Debra; Christie, Nancy; Cockburn, Lynn; Hashemi, Goli; Yoshida, Karen

    2009-01-01

    This article reports on a study conducted for the Canadian International Development Agency by The International Centre for Disability and Rehabilitation at the University of Toronto. We critically examined the broad literature in the area of disability and development and in this article we identify the key issues which emerged. Most of the data were collected from existing literature in the academic and practice settings and from the publications of key NGOs and governments. We first, examine disability in the context of low-income countries, and then discuss key critical issues: disability and poverty, disability and health, disability and education, disability and gender, disability and children/youth, disability and conflict/natural disasters and disability and human rights. In all these areas we find reports of discrimination, stigmatisation and marginalisation. We conclude that, as we address issues of multi-cultural disability services in developed countries, it is important to bear in mind the various issues that many people with disabilities and their families bring with them as the result of immigrating from a developing country. Although we address these issues within our own countries, we must bear in mind the changes that are occurring due to globalisation.

  9. Maternal Feeding Goals Described by Low-Income Mothers

    PubMed Central

    Goulding, Alison N.; Lumeng, Julie C.; Rosenblum, Katherine L.; Chen, Yu-Pu; Kaciroti, Niko; Miller, Alison L.

    2015-01-01

    Objective To identify maternal feeding goals and examine associations of number and type of goals with mother and child characteristics. Design Qualitative interviews about child feeding and quantitative assessment of goal prevalence and associations with mother and child characteristics. Setting Southeastern Michigan. Participants 287 low-income mothers (31% Hispanic or non-white) and their 4- to 8-year-old children. Main Outcome Measure Maternal feeding goals. Analysis Themes were generated using constant comparative method, individual interviews were coded, and prevalence of feeding goals determined. Regression analyses examined associations of mother and child characteristics with number and type of feeding goals. Results Thirteen maternal feeding goals were identified. The most prevalent were to restrict junk food (60%), promote autonomy around eating (54%), prevent obesity (53%), and promote fruits or vegetables (52%). The child being female and heavier with an older, non-Hispanic white, more educated mother with less chaos in the home predicted more maternal feeding goals (all p’s <.05). Specific maternal and child characteristics were associated with individual feeding goals. Conclusions and Implications Depending on their current goals for child feeding, some mothers may benefit from interventions focused on goal development, whereas other mothers may benefit from interventions designed to facilitate goal implementation. PMID:26003749

  10. Relationship violence and psychological distress among low-income urban women.

    PubMed

    Hill, Terrence D; Mossakowski, Krysia N; Angel, Ronald J

    2007-07-01

    In this paper, we examined the association between relationship violence and psychological distress among low-income urban women. Extending prior research, we considered the effects of relationship violence within the context of other chronic stressors that are common in the lives of these women. Using data from the Welfare, Children, and Families project (1999), a probability sample of 2,402 low-income women with children living in low-income neighborhoods in Boston, Chicago, and San Antonio, we predicted psychological distress with multiple measures of relationship violence, a wide range of sociodemographic variables, and several chronic stressors. Our results show that relationship violence is associated with higher levels of economic hardship, neighborhood disorder, and household disrepair. We also find that relationship violence is associated with higher levels of psychological distress, net of these other chronic stressors. Finally, we observe that the effects of relationship violence do not vary according to the chronic stressors under study. Because the adverse effects of relationship violence are similar for women despite other adverse circumstances, interventions and treatment efforts focused exclusively on relationship violence may make a unique contribution to the psychological well-being of low-income urban women.

  11. 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

  12. 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

  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. 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…

  15. Bell v. Low Income Women of Texas.

    PubMed

    2002-01-01

    Court Decision: 95 South Western Reporter, 3d Series 253; 2002 Dec 31 (date of decision). The Supreme Court of Texas reversed a lower court and held that the Texas Medical Assistance Program's restrictions on abortion funding for indigent women were constitutional because they did not violate the U.S. Equal Rights Amendment, the constitutional right to privacy, or the Texas Equal Protection Clause. The plaintiffs challenged the constitutionality of Texas's Medicaid program's funding restrictions which only provided funding for medically necessary abortions if the pregnancy resulted from rape or incest, or if the woman was in danger of death. The court held that the restrictions did not violate the Equal Rights Amendment because there was no evidence of discriminatory intent and the restrictions were rationally related to legitimate governmental purposes of only funding services for which federal reimbursement is available and of encouraging childbirth and protecting potential life. The court noted that the state may make a value judgment favoring childbirth and may implement that judgment through the allocation of public funds. The court also held that the restrictions did not violate the right to privacy because there is a fundamental difference between prohibiting abortion and encouraging childbirth as a matter of policy in the public interest. Moreover, the indigent woman retained the same range of choice she would have had if the state did not subsidize any health care costs. Finally, the court held that the restrictions did not violate the Equal Protection Clause because the underlying purpose of Texas's Medicaid Program was to provide indigent health care only to the extent that matching federal funds were available and the restrictions were rationally related to this underlying purpose.

  16. Enhancing low-income parents' capacities to promote their children's health: education is not enough.

    PubMed

    Williamson, D L; Drummond, J

    2000-01-01

    In 1996 the Capital Heath Region in Edmonton, Alberta integrated a primary health care component into Head Start programs. One aspect of the primary health care component (PHC-HS) was a series of education sessions aimed at strengthening parents' capacities to enhance their children's health. To make the education sessions relevant, 10 focus groups with 65 parents of children who attended Head Start were conducted prior to the sessions. Findings indicated that participants' ability to enhance their children's health and manage their children's illnesses was limited as much by low incomes, inadequate health care coverage, and lack of transportation as it was by a lack of knowledge. Results provide evidence that health education sessions alone are not adequate to significantly enhance low-income parents' capacities to promote their children's health. Efforts to strengthen the abilities of low-income individuals and families to promote their health will be most effective if health education is accompanied by policy advocacy and social action strategies that challenge the socioeconomic and political conditions that negatively affect health. Public health nursing's commitment to social justice, as well as findings about the limitations that low incomes, inadequate health care benefits, and lack of transportation placed on participants' ability to enhance their children's health, underscore the need for public health nurses (PHNs) to address structural conditions contributing to health inequities. As such, an overview of literature that details strategies and theoretical models for challenging socioeconomic and political conditions which restrict the ability of low-income individuals and families to enhance their health is provided.

  17. Availability, affordability, and accessibility of a healthful diet in a low-income community, Central Falls, Rhode Island, 2007-2008.

    PubMed

    Sheldon, Marissa; Gans, Kim M; Tai, Ryan; George, Tiffiney; Lawson, Eliza; Pearlman, Deborah N

    2010-03-01

    Many Americans have diets that do not meet the dietary guidelines set by the US Department of Agriculture (USDA). Additionally, low-income people have the highest rates of obesity and have difficulty accessing the necessary foods for maintaining a healthful diet. In December 2007 and January 2008, 21 retail food stores in Central Falls, Rhode Island, where residents were predominantly low-income Hispanics, were evaluated for the availability and costs of foods that fulfill the USDA's Thrifty Food Plan (TFP) guidelines. Each surveyed store was evaluated for variety and weekly cost of 3 different types of market baskets (2 families and an elder). Each store's proximity to public transportation was estimated by using geographic information systems mapping. Only 2 stores in Central Falls and the discount supermarket in an adjacent city, Pawtucket, carried enough variety of foods to fill the TFP basket. At the 2 stores, costs were up to 40% higher, and at the discount store, costs were up to 18% cheaper, than the national average. Each of the stores was accessible by public transportation. Meeting the USDA TFP guidelines is difficult in this low-income, predominantly Hispanic city. Although the components of the TFP are available, high prices may make a nutritious diet unaffordable.

  18. Siblings, language, and false belief in low-income children.

    PubMed

    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 FBU. Language, specifically vocabulary, was examined as a possible mediator between number of siblings and FBU as several researchers have found that language is causally related to FBU. Contrary to research with middle-income preschoolers, the authors found that number of siblings was negatively related to low-income children's FBU. This relationship was mediated by children's vocabulary skill. Suggestions for why the sibling-FB relationship may differ in low- and middle-income samples are offered.

  19. Healthy eating for rural low-income toddlers: caregivers' perceptions.

    PubMed

    Omar, M A; Coleman, G; Hoerr, S

    2001-01-01

    Caregivers exert a powerful influence on young children's eating habits. This qualitative study used focus groups to assess nutritional needs and barriers in establishing healthy eating habits in toddlers. Three focus groups were conducted with rural, low-income caregivers, 2 with men and 1 with women, in 3 rural Michigan counties. Four major themes emerged: (a) barriers to providing healthy meals, (b) division of responsibility, (c) mealtime behavior, and (d) desired nutrition education. The major barriers identified were work schedules; cost of food; inadequate time to shop, plan, and prepare nutritious meals; or a combination thereof. Caregivers expressed concern for the nutritional well-being of their toddlers. The perceived needs and perceptions of low-income caregivers need to be considered when providing nutrition education. Findings from this study provided the basis for developing a nutrition education intervention for low-income parents of young children.

  20. Expanding Coverage to Low-Income Childless Adults in Massachusetts: Implications for National Health Reform

    PubMed Central

    Long, Sharon K; Dahlen, Heather

    2014-01-01

    Objective To draw on the experiences under Massachusetts's 2006 reform, the template for the Affordable Care Act (ACA), to provide insights into the potential impacts of the ACA Medicaid expansion for low-income childless adults in other states. Data Sources/Study Setting The study takes advantage of the natural experiment in Massachusetts and combined data from two surveys—the Massachusetts Health Reform Survey (MHRS) and the National Health Interview Survey (NHIS)—to estimate the impacts of reform on low-income adults. Study Design Difference-in-differences models of the impacts of health reform, using propensity-score reweighting to improve the match between Massachusetts and the comparison states. Data Collection/Extraction Methods Data for low-income adults are obtained by combining data from the MHRS and the NHIS, where the MHRS provides a relatively large Massachusetts sample and the NHIS provides data for samples in other states to support the difference-in-differences model. Supplemental data on county economic and health care market characteristics are obtained from the Area Health Resource File. Principal Findings There are strong increases in coverage and access to health care for low-income adults under health reform in Massachusetts, with the greatest gains observed for childless adults, who were not eligible for public coverage prior to reform. Conclusions In the states that implement the Medicaid provisions of the ACA, we would expect to see large increases in coverage rates and commensurate gains in access to care for low-income childless adults. Linking state and federal surveys offers a strategy for leveraging the value of state-specific survey data for stronger policy evaluations. PMID:24834813

  1. Evaluating the Iowa Gambling Task as a Direct Assessment of Impulsivity with Low-Income Children.

    PubMed

    Burdick, Jessica D; Roy, Amanda L; Raver, C Cybele

    2013-10-01

    This study examined performance on the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994) as a measure of low-income school-aged children's affective decision-making and considered its utility as a direct indicator of impulsivity. One hundred and ninety-three 8-11 year olds performed a computerized version of the Iowa Gambling Task, a validated measure of decision-making. Multi-level modeling was used to examine children's performance over the course of the task, with age, gender, and teachers' ratings of child impulsivity (BIS-11; Patton, Stanford, & Barratt, 1995) used to predict children's Iowa Gambling performance. Higher impulsivity scores predicted a decrease in slope of Iowa Gambling performance, indicating students rated higher on impulsivity chose more disadvantageously across the task blocks. Results support evidence of the validity of the Iowa Gambling Task as a measure of impulsivity in low-income minority children.

  2. Evaluating the Iowa Gambling Task as a Direct Assessment of Impulsivity with Low-Income Children

    PubMed Central

    Burdick, Jessica D.; Roy, Amanda L.; Raver, C. Cybele

    2013-01-01

    This study examined performance on the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994) as a measure of low-income school-aged children's affective decision-making and considered its utility as a direct indicator of impulsivity. One hundred and ninety-three 8-11 year olds performed a computerized version of the Iowa Gambling Task, a validated measure of decision-making. Multi-level modeling was used to examine children's performance over the course of the task, with age, gender, and teachers' ratings of child impulsivity (BIS-11; Patton, Stanford, & Barratt, 1995) used to predict children's Iowa Gambling performance. Higher impulsivity scores predicted a decrease in slope of Iowa Gambling performance, indicating students rated higher on impulsivity chose more disadvantageously across the task blocks. Results support evidence of the validity of the Iowa Gambling Task as a measure of impulsivity in low-income minority children. PMID:24072950

  3. Targeting interventions for ethnic minority and low-income populations.

    PubMed

    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 childhood obesity prevalence by race and ethnicity and by socioeconomic status. They show how various environmental factors can have larger effects on disadvantaged and minority children than on their advantaged white peers-and thus contribute to disparities in obesity rates. The authors show, for example, that low-income and minority children watch more television than white, non-poor children and are potentially exposed to more commercials advertising high-calorie, low-nutrient food during an average hour of TV programming. They note that neighborhoods where low-income and minority children live typically have more fast-food restaurants and fewer vendors of healthful foods than do wealthier or predominantly white neighborhoods. They cite such obstacles to physical activity as unsafe streets, dilapidated parks, and lack of facilities. In the schools that low-income and minority children attend, however, they see opportunities to lead the way to effective obesity prevention. Finally, the authors examine several aspects of the home environment-breast-feeding, television viewing, and parental behaviors-that may contribute to childhood obesity but be amenable to change through targeted intervention. Kumanyika and Grier point out that policymakers aiming to prevent obesity can use many existing policy levers to reach ethnic minority and low-income children and families: Medicaid, the State Child Health Insurance Program, and federal nutrition "safety net" programs. Ultimately, winning the fight against childhood obesity in minority and low-income communities will depend on the nation's will to change the social and physical

  4. Low-income countries' orthopaedic information needs: challenges and opportunities.

    PubMed

    Doughty, Kathryn; Rothman, Linda; Johnston, Luke; Le, Kim; Wu, Joanna; Howard, Andrew

    2010-10-01

    The Internet should, in theory, facilitate access to peer-reviewed scientific articles for orthopaedic surgeons in low-income countries (LIC). However, there are major barriers to access, and most full-text journal articles are available only on a subscription basis, which many in LIC cannot afford. Various models exist to remove such barriers. We set out to examine the potential, and reality, of journal article access for surgeons in LIC by studying readership patterns and journal access through a number of Internet-based initiatives, including an open access journal ("PLoS Medicine"), and programs from the University of Toronto (The Ptolemy Project) and World Health Organization (WHO) (Health InterNetwork Access to Research Initiative [HINARI]). Do Internet-based initiatives that focus on peer-reviewed journal articles deliver clinically relevant information to those who need it? More specifically: (1) Can the WHO's program meet the information needs of practicing surgeons in Africa? (2) Are healthcare workers across the globe aware of, and using, open access journals in a manner that reflects global burden of disease (GBD)? We compared actual Ptolemy use to HINARI holdings. We also compared "PLoS Medicine" readership patterns among low-, middle-, and high-income regions. Many of the electronic resources used through Ptolemy are not available through HINARI. In contrast to higher-income regions, "PLoS Medicine" readership in Africa is proportional to both the density of healthcare workers and the GBD there. Free or low-cost Internet-based initiatives can improve access to the medical literature in LIC. Open access journals are a key component to providing clinically relevant literature to the regions and healthcare workers who need it most.

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

    PubMed

    Lehmann, Uta; Dieleman, Marjolein; Martineau, Tim

    2008-01-23

    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. 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 initially assessed and

  6. 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

  7. Three models of community mental health services In low-income countries

    PubMed Central

    2011-01-01

    Objective To compare and contrast three models of community mental health services in low-income settings. Data Sources/Study Setting Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. Study Design Qualitative case study methodology. Data Collection Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. Principal Findings A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. Conclusions Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models. PMID:21266051

  8. 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…

  9. 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…

  10. Job Training for Low Income Women: The Need for Change.

    ERIC Educational Resources Information Center

    Steiger, JoAnn M.; Szanton, Eleanor S.

    This document presents the conclusions and recommendations of a study conducted to explain the inequalities faced by low-income women in job training, employment, and earnings. The study explored the dimensions of the problems such women face, possible solutions, and the extent to which a group of Health Education and Welfare (HEW) and HEW-related…

  11. Cumulative Risk and Low-Income Children's Language Development

    ERIC Educational Resources Information Center

    Stanton-Chapman, Tina L.; Chapman, Derek A.; Kaiser, Ann P.; Hancock, Terry B.

    2004-01-01

    This study utilized an electronic data linkage method to examine the effects of risk factors present at birth on language development in preschool. The Preschool Language Scale-3 (PLS-3) was administered to 853 low-income children, and cumulative risk data were abstracted from linked birth records. At least one risk factor was present in 94% of…

  12. Low Income Housing Mixing: An Annotated Bibliography. Exchange Bibliography 735.

    ERIC Educational Resources Information Center

    Newbacher, Gary D., Comp.

    This bibliography, compiled for the author's work entitled "A Low-income Mixing Strategy for Hamilton County, Ohio 1974," is comprised of four broad reference-type categories including one for those which are directly applicable to the subject for the Cincinnati area. This serves as an indicator to the reader of what kind of sources may…

  13. Paraprofessionals in Home Economics Programs for Low-Income Families.

    ERIC Educational Resources Information Center

    Leidenfrost, Nancy B.; And Others

    This booklet was developed as a guide for home economists who are responsible for teaching paraprofessionals (individuals who usually have no college degree and are trained and supervised by county home economists) how to teach low-income families. The content is in seven short sections: (1) Planning the Program discusses available resources,…

  14. A Nutrition Education Service for Low Income Families

    ERIC Educational Resources Information Center

    Leidenfrost, Nancy B.

    1972-01-01

    The Expanded Food and Nutrition Education Program of the Cooperative Extension Service, Department of Agriculture, seeks to improve the diets of low income families using paid nonprofessional workers called program aides, supervised by professional home economists, to deliver services. (Author/JM)

  15. 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…

  16. "PROGRAM AIDES" FOR WORK WITH LOW-INCOME FAMILIES.

    ERIC Educational Resources Information Center

    SPINDLER, EVELYN B.; AND OTHERS

    THIS FOUR-PART ARTICLE DESCRIBES THE USE OF PROFESSIONAL AND NONPROFESSIONAL PROGRAM AIDES TO TEACH LOW-INCOME HARD-TO-REACH HOMEMAKERS HOW TO PREPARE NUTRITIONALLY BALANCED MEALS USING LOW-COST FOODS. THE PROGRAM IS SPONSORED BY THE FEDERAL EXTENSION SERVICE OF THE U.S. DEPARTMENT OF AGRICULTURE. SPECIFICALLY DISCUSSED ARE THE REQUIREMENTS FOR…

  17. 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…

  18. An Insurance Planner. Teaching Low-Income Consumers about Insurance.

    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 buying insurance. Topics include life insurance (language, types, settlement options), auto insurance, health insurance (standard, health maintenance organizations, medicaid, medicare), tenant's insurance (property damage, liability), what to do in case of loss,…

  19. Group Therapy with Low-Income Mexican Americans

    ERIC Educational Resources Information Center

    Boulette, Teresa Ramirez

    1975-01-01

    Author describes difficulties facing counselors in dealing with low income Mexican Americans. Counselors should be bilingual and have comprehensive knowledge of Mexican-American culture to provide effective help to counselees. Counselors should encourage counselee to participate in group therapy sessions in which behavioral and problem solving…

  20. 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…

  1. 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…

  2. 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…

  3. Energy Efficiency and Renewable Energy in Low-Income Communities

    EPA Pesticide Factsheets

    This guide is designed to help state and local governments connect with EPA programs that can help them expand or develop their own energy efficiency/renewable energy (EE/RE) and climate initiatives in ways that benefit low-income communities.

  4. Economic Roles of Children in Low-Income Countries.

    ERIC Educational Resources Information Center

    Rodgers, Gerry; Standing, Guy

    1981-01-01

    Proposes a classification into nine categories of children's work activities in low-income countries. Considers the structural determinants of child work and its principal economic consequences. Critically assesses the potential role of labor and welfare policies in reducing, if not eliminating child labor. (Author/CT)

  5. 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…

  6. Opening Doors: Expanding Educational Opportunities for Low-Income Workers.

    ERIC Educational Resources Information Center

    Golonka, Susan; Matus-Grossman, Lisa

    This report is a summary of discussions at a roundtable meeting conducted in April 2000 by the National Governors' Association Center for Best Practices and Manpower Demonstration Research Corporation to discuss expanding postsecondary opportunities for low-income, working parents and welfare recipients. Section I offers background. Sections II-IX…

  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. 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…

  9. Energy Efficiency and Renewable Energy in Low-Income Communities

    EPA Pesticide Factsheets

    This guide is designed to help state and local governments connect with EPA programs that can help them expand or develop their own energy efficiency/renewable energy (EE/RE) and climate initiatives in ways that benefit low-income communities.

  10. High-Rise Housing for Low-Income Families.

    ERIC Educational Resources Information Center

    Fuerst, J. S.; Petty, Roy

    1991-01-01

    Discusses successes and failures of subsidized housing in urban areas and the relationship between architectural environment and quality of life, particularly as regards high-rise buildings. Given that some high-rise projects are successful, most should be maintained because of the scarcity of low-income housing. (DM)

  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. 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…

  13. 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)…

  14. 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…

  15. 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…

  16. 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…

  17. School Achievement and Causal Attribution Patterns among Low Income Students.

    ERIC Educational Resources Information Center

    Gama, Elizabeth Maria Pinheiro; de Jesus, Denise Meyrelles

    This research assessed the impact of the experience of academic success and failure on the causal attribution patterns of low income Brazilian elementary school students. The sample consisted of 147 first, third, and fifth graders, previously classified as success or failure students. Causal attribution was measured through individual interviews…

  18. Teaching Low-Income Mothers to Teach Their Children.

    ERIC Educational Resources Information Center

    Johnson, Dale L.; And Others

    1996-01-01

    Examined the effectiveness of the Avance Parent-Child Education Program in teaching low-income, Mexican American mothers of infants to teach their own children. Found significant program effects on Home Observation for Measurement of the Environment scores, on view of self as teacher, and on videotaped mother-child interactions. Found results…

  19. Teaching Low-Income Mothers To Teach Their Children.

    ERIC Educational Resources Information Center

    Johnson, Dale L.; And Others

    This study examined the effectiveness of the Avance Parent-Child Education Program, a 9-month center-based program, with an in-home component, designed to provide low-income, Mexican-American mothers of infants with parenting education and family support services. A total of 524 mother-infant diads took part in the Avance program or served in a…

  20. 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…

  1. 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…

  2. Top Colleges Admit Fewer Low-Income Students

    ERIC Educational Resources Information Center

    Fischer, Karin

    2008-01-01

    Elite colleges have made headlines in recent years with financial-aid plans aimed at enrolling more low-income students. Despite those efforts, the proportion of financially needy undergraduates at the nation's wealthiest colleges and universities actually dropped between the 2004-2005 and 2006-2007 academic years, according to a "Chronicle"…

  3. Parent Education: A Model for Low-Income Parents.

    ERIC Educational Resources Information Center

    Goodyear, Rodney K.; Rubovits, James J.

    1982-01-01

    Provides a metamodel with which counselors can design programs for all populations of parents, particularly low-income. Suggests that education programs can provide training in interpersonal skills and family management skills. Describes development and application of the model and how components might be sequenced for training a particular parent…

  4. Using Banks: Teaching Banking Skills to Low-Income Consumers.

    ERIC Educational Resources Information Center

    Shurtz, Mary Ann; LeFlore, Ann Becker

    This module, one of six on teaching consumer matters to low-income adults, discusses banking skills. Topics include banking services (savings accounts, safety deposit boxes, Christmas clubs, loans, etc.), checking accounts (deposits, checkwriting, check registers, opening an account), how to use the check register (cancelled checks, deposits),…

  5. 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…

  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. 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:...

  8. 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…

  9. The Low-Income Farmer in a Changing Society.

    ERIC Educational Resources Information Center

    Fliegel, Frederick C.

    To identify some major differences among low-income farmers, and delineate that group representing the real core of the persistently poor, data were obtained from 189 farm operators representing a stratified random sample in Fayette County, Pennsylvania in 1957. The five main categories of individuals identified were: (1) the aged, (2) the…

  10. 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…

  11. 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.

  12. 24 CFR 248.153 - 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 Prepayments and Plans of Action Under the Low Income Housing Preservation and Resident Homeownership Act of 1990 § 248.153 Incentives to extend low income...

  13. 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...

  14. 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'…

  15. A number sense intervention for low-income kindergartners at risk for mathematics difficulties.

    PubMed

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

    2013-01-01

    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 to either a number sense intervention or a business as usual contrast group. The intervention was carried out in small-group, 30-min 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.

  16. Nutrition education among low-income older adults: a randomized intervention trial in Congregate Nutrition sites.

    PubMed

    Mitchell, Roger E; Ash, Sarah L; McClelland, Jacquelyn W

    2006-06-01

    Nutritional well-being among older adults is critical for maintaining health, increasing longevity, and decreasing the impact of chronic illness. However, few well-controlled studies have examined nutritional behavior change among low-income older adults. A prospective, controlled, randomized design examined a five session nutrition education module delivered to limited-resource older adults (N = 703) in Congregate Nutrition sites by Cooperative Extension agents. Experimental group participants were significantly more likely than control group participants to increase multivitamin use, to increase calcium supplement use, to read labels of dietary supplements, to carry a supplement and/or medication list, and to discuss such use with their health care professional. The study addresses weaknesses in the literature by using a theoretically derived education component, implementing the intervention within a setting regularly used by low-income older adults, employing randomized assignment to intervention and control conditions, and using hierarchical linear modeling to deal with "nested" data.

  17. 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...

  18. 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...

  19. Overweight and obesity among low-income Muslim Uyghur women in far western China: correlations of body mass index with blood lipids and implications in preventive public health.

    PubMed

    Cong, Li; Zhan, Jin Qiong; Yang, Lan; Zhang, Wei; Li, Shu Gang; Chen, Cheng; Zhang, Hong Yan; Ma, Zhi Ping; Hao, Xiao Ling; Simayi, Dilixia; Tao, Lin; Zhao, Jin; Amanguli, A; Mohemaiti, Meiliguli; Jing, Ming Xia; Wang, Wei; Saimaiti, Abudukeyoumu; Zou, Xiao Guang; Gu, Yan; Li, Li; Wang, Ying Hong; Li, Feng; Zhang, Wen Jie

    2014-01-01

    The pandemic of obesity is a global public health concern. Most studies on obesity are skewed toward high-income and urban settings and few covers low-income populations. This study focused on the prevalence of overweight and obesity and their correlations with blood lipids/metabolites/enzymes (bio-indicators) in a rural community typical of low-income in remote western China. This study was performed in a Muslim ethnic Uyghur rural community in Kashi Prefecture of Xinjiang, about 4,407 km (2,739 miles) away from Beijing. Body mass index (BMI) and major blood bio-indicators (25 total items) were measured and demographic information was collected from 1,733 eligible healthy women aged 21 to 71 yrs, of whom 1,452 had complete data for analysis. More than 92% of the women lived on US$1.00/day or less. According to the Chinese criteria, overweight and obesity were defined as BMI at 24 to <28 kg/m(2) and at ≥ 28 kg/m(2), respectively. The average BMI among these low-income women was 24.0 ± 4.0 (95% CI, 17.5-33.7) kg/m(2). The prevalence of obesity and overweight was high at 15.1% and 28.9%, respectively. Among 25 bio-indicators, BMI correlated positively with the levels of 11 bio-indicators including triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TCHOL), glucose (GLU), and uric acid (UA); but negatively with the levels of 5 bio-indicators including high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A/B (APO A/B). This is the first investigation reporting overweight and obesity being common in low-income Muslim Uyghur women, whose BMI correlates with several important blood bio-indicators which are risk factors for diabetes and cardiovascular diseases. These findings may help make preventive public health policies in Uyghur communities. To prevent diabetes and cardiovascular diseases in low-income settings, we therefore propose a cost-effective, two-step strategy first to screen for obesity and then to screen persons

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...-income members” also includes those members enrolled as students in a college, university, high school... determination that the credit union no longer meets the criteria for a low-income designation to the Board...) and 702.305(b) of this chapter, the NCUA Board may prohibit a LICU classified...

  1. 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

  2. Investigating the Decision-Making Process of Standard Setting Participants

    ERIC Educational Resources Information Center

    Papageorgiou, Spiros

    2010-01-01

    Despite the growing interest of the language testing community in standard setting, primarily due to the use of the Common European Framework of Reference (CEFR-Council of Europe, 2001), the participants' decision-making process in the CEFR standard setting context remains unexplored. This study attempts to fill in this gap by analyzing these…

  3. 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

  4. A Qualitative Exploration of Low-Income Women's Experiences Accessing Abortion in Massachusetts.

    PubMed

    Dennis, Amanda; Manski, Ruth; Blanchard, Kelly

    2015-01-01

    At a time when most states are working to restrict abortion, Massachusetts stands out as one of the few states with multiple state-level policies in place that support abortion access for low-income women. In 2006, Massachusetts passed health care reform, which resulted in almost all residents having insurance. Also, almost all state-level public and subsidized insurance programs cover abortion and there are fewer restrictions on abortion in Massachusetts compared with other states. We explored low-income women's experiences accessing abortion in Massachusetts through 27 in-depth telephone interviews with a racially diverse sample of low-income women who obtained abortions. Interviews were digitally recorded, transcribed, coded, and analyzed thematically. Most women described having access to timely, conveniently located, affordable, and highly acceptable abortion care. However, a sizable minority of women had difficulty enrolling in or staying on insurance, making abortion expensive. A small minority of women said their abortion care could be improved by increasing emotional support and privacy, and decreasing appointment times. Some limited data also suggest that young women and immigrant women face specific barriers to care. This study provides important, novel information about the need for state-level policies that support access to health insurance and comprehensive abortion coverage. Such policies, along with a well-functioning health care environment, help to ensure that low-income women have access to abortion. However, not all abortion access challenges have been resolved in Massachusetts. More work is needed to ensure that all women can access affordable, confidential care that is responsive to their specific needs and preferences. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  5. HIV prevention and low-income Chilean women

    PubMed Central

    CIANELLI, ROSINA; FERRER, LILIAN; MCELMURRY, BEVERLY J.

    2008-01-01

    Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV. PMID:18432428

  6. Low-income Californians bear unequal burden of asthma.

    PubMed

    Babey, Susan H; Hastert, Theresa A; Meng, Ying-Ying; Brown, E Richard

    2007-02-01

    In California, 2.8 million children and adults (900,000 children and 1.9 million adults) suffer from active asthma. One out of six of these Californians (16%) lives below the poverty level. Low-income adults and children with active asthma disproportionately bear the burden of asthma. They experience more frequent symptoms, go to the emergency department (ED) more often for asthma care, miss more school and have poorer health status. They also are more likely to lack access to health care and to live in conditions associated with asthma exacerbations. Using data from the 2003 California Health Interview Survey (CHIS 2003), this policy brief examines the burden of asthma among low-income asthma sufferers as well as some opportunities to reduce the burden for these asthma sufferers. Active asthma refers to people who have been diagnosed with asthma and who reported they still have asthma and/or experienced an asthma attack in the past year.

  7. 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

  8. The impact of patient cost-sharing on low-income populations: evidence from Massachusetts.

    PubMed

    Chandra, Amitabh; Gruber, Jonathan; McKnight, Robin

    2014-01-01

    Greater patient cost-sharing could help reduce the fiscal pressures associated with insurance expansion by reducing the scope for moral hazard. But it is possible that low-income recipients are unable to cut back on utilization wisely and that, as a result, higher cost-sharing will lead to worse health and higher downstream costs through increased use of inpatient and outpatient care. We use exogenous variation in the copayments faced by low-income enrollees in the Massachusetts Commonwealth Care program to study these effects. We estimate separate price elasticities of demand by type of service. Overall, we find price elasticities of about -0.16 for this low-income population - similar to elasticities calculated for higher-income populations in other settings. These elasticities are somewhat smaller for the chronically sick, especially for those with asthma, diabetes, and high cholesterol. These lower elasticities are attributable to lower responsiveness to prices across all categories of service, and to some statistically insignificant increases in inpatient care. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations.

    PubMed

    Mendenhall, Emily; Kohrt, Brandon A; Norris, Shane A; Ndetei, David; Prabhakaran, Dorairaj

    2017-03-04

    The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.

  10. 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.

  11. Successful schools and risky behaviors among low-income adolescents.

    PubMed

    Wong, Mitchell D; 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

    2014-08-01

    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. 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 (e.g., 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. 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. 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. Copyright © 2014 by the American Academy of Pediatrics.

  12. Breast Cancer Screening in a Low Income Managed Care Population

    DTIC Science & Technology

    1997-10-01

    to invasive beast cancer ratio, a pattern previously demonstrated for cervical cancer (9). This decline in the ratio of invasive to non- invasive...cervical carcinoma. Int. J Cancer 1978; 21:418-25. 10. Guzik DS. Efficacy of screening for cervical cancer : A review. Am J Public Health 1978; 68:125-34...and Cervical Cancer Screening in Low Income Managed Care Sample: The Efficacy of Physician Letters and Phone Calls. Am J of Public health. 85(6): 834

  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. Published by Elsevier Ltd.

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

    PubMed

    Winham, Donna M; Armstrong Florian, Traci L; Thompson, Sharon V

    2016-01-01

    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. 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. 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. 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.

  15. 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

  16. Tobacco Cessation Among Low-Income Smokers: Motivational Enhancement and Nicotine Patch Treatment

    PubMed Central

    2014-01-01

    Introduction: Despite decades of tobacco use decline among the general population in the United States, tobacco use among low-income populations continues to be a major public health concern. Smoking rates are higher among individuals with less than a high school education, those with no health insurance, and among individuals living below the federal poverty level. Despite these disparities, smoking cessation treatments for low-income populations have not been extensively tested. In the current study, the efficacy of 2 adjunctive smoking cessation interventions was evaluated among low-income smokers who were seen in a primary care setting. Methods: A total of 846 participants were randomly assigned either to motivational enhancement treatment plus brief physician advice and 8 weeks of nicotine replacement therapy (NRT) or to standard care, which consisted of brief physician advice and 8 weeks of NRT. Tobacco smoking abstinence was at 1, 2, 6, and 12 months following baseline. Results: The use of the nicotine patch, telephone counseling, and positive decisional balance were predictive of increased abstinence rates, and elevated stress levels and temptation to smoke in both social/habit and negative affect situations decreased abstinence rates across time. Analyses showed intervention effects on smoking temptations, length of patch use, and number of telephone contacts. Direct intervention effects on abstinence rates were not significant, after adjusting for model predictors and selection bias due to perirandomization attrition. Conclusions: Integrating therapeutic approaches that promote use of and adherence to medications for quitting smoking and that target stress management and reducing negative affect may enhance smoking cessation among low-income smokers. PMID:24174612

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  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. 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…

  4. 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…

  5. 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…

  6. 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:…

  7. 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…

  8. 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…

  9. 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,…

  10. 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…

  11. Implementing Digital Reference Services: Setting Standards and Making It Real.

    ERIC Educational Resources Information Center

    Lankes, R. David, Ed.; McClure, Charles R., Ed.; Gross, Melissa, Ed.; Pomerantz, Jeffrey, Ed.

    The chapters in this volume, originally presented at the Third Annual Virtual Reference Desk (VRD) conference, "Setting Standards and Making It Real," (Orlando, Florida, November 2001), were organized, revised, and updated to reflect current technology and practice. The VRD conference and the ideas in this book represent the cutting edge…

  12. Implementing Digital Reference Services: Setting Standards and Making It Real.

    ERIC Educational Resources Information Center

    Lankes, R. David, Ed.; McClure, Charles R., Ed.; Gross, Melissa, Ed.; Pomerantz, Jeffrey, Ed.

    The chapters in this volume, originally presented at the Third Annual Virtual Reference Desk (VRD) conference, "Setting Standards and Making It Real," (Orlando, Florida, November 2001), were organized, revised, and updated to reflect current technology and practice. The VRD conference and the ideas in this book represent the cutting edge…

  13. Measuring antibiotic consumption in low-income countries: a systematic review and integrative approach.

    PubMed

    Padget, Michael; Guillemot, Didier; Delarocque-Astagneau, Elisabeth

    2016-07-01

    Antibiotic resistance is a global issue. Risk factors specific to low-income countries (LICs), including non-prescribed antibiotic use, place them at risk for the emergence of resistance and make them important targets for reducing the burden of resistance worldwide. Responding to this threat in LICs means first having access to appropriate antibiotic consumption data. A PubMed search was conducted for studies examining antibiotic consumption in the community in LICs. For the articles included in the analysis, the methodologies used, type of data gathered and methodological appropriateness in responding to specific LIC data needs were noted. Of the 487 articles identified by the search strategy, 27 were retained for final analysis. Four main investigative methods were identified, including pharmacy/hospital document reviews, the simulated client method, observed prescribing encounters/patient exit interviews and community surveys. Observed encounters and exit interviews are well adapted to answering a number of important questions surrounding antibiotic consumption but may include bias and miss some sources of non-prescribed antibiotics. Community surveys are the only approach able to fully account for non-prescribed antibiotics and should be used as the first step in an integrative approach towards antibiotic consumption measurement and monitoring in LICs. Antibiotic consumption data needed for programmes to control use must take into account the LIC context. An integrated and adaptive approach beginning with community surveys responds to the various data needs and difficulties of LIC contexts and may help facilitate the investigation and optimisation of antibiotic consumption in these settings.

  14. Beverage intake in low-income parent-child dyads.

    PubMed

    Pinard, Courtney A; Davy, Brenda M; Estabrooks, Paul A

    2011-12-01

    Beverage consumption adds to daily energy intake and often exceeds the recommended amount for discretionary energy. Previous research has shown that children are consuming sugar-sweetened beverages (SSB) in greater frequency and the relationship between parent-child dyads in beverage consumption is meaningful due to the parental influence on the development of beverage consumption behaviors. In particular, low-income families are at greater risk for obesity and higher levels of SSB consumption. The current investigation assessed habitual beverage intake among low-income parent-child dyads (N=95) with children between the ages of 9-17 years. The sample (46% African American; 45% Caucasian) had a mean body mass index (BMI) for the parents of 31.8±8.9 kg/m(2), while the mean BMI percentile for age and gender for the children was 70.3±31.3. Both parents and children consumed fewer nutrient-dense beverages and more energy-dense beverages than the recommended amount. The mean daily energy intake from beverages was 451±236 kcal for the parents and 457±237 kcal for the children. Correlations between parent-child dyad intake was also evident, identifying parents as potential role models and gatekeepers of the home food environment. Future interventions to prevent childhood obesity in low-income populations should address beverage intake, particularly SSB consumption, and determine the degree to which this behavior is learned behavior in the home. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Childhood asthma in low income countries: an invisible killer?

    PubMed

    Østergaard, Marianne Stubbe; Nantanda, Rebecca; Tumwine, James K; Aabenhus, Rune

    2012-06-01

    Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts of pneumonia and asthma/wheezing/bronchiolitis and examines whether asthma in under-5s may be confused with pneumonia. Over-diagnosing of bacterial pneumonia can be suspected from the limited association between clinical pneumonia and confirmatory test results such as chest x-ray and microbiological findings and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing remain undiagnosed. New studies demonstrate that approximately 50% of acutely admitted under-5s diagnosed with pneumonia according to Integrated Management of Childhood Illnesses could be re-diagnosed with asthma or wheezing when using re-defined diagnostic criteria and treatment. It is hypothesised that untreated asthma may contribute to respiratory mortality since respiratory syncytial virus (RSV) is an important cause of respiratory death in childhood, and asthma in under-5s is often exacerbated by viral infections, including RSV. Furthermore, acute respiratory treatment failures were predominantly seen in under-5s without fever, which suggests the diagnosis of asthma/wheezing rather than bacterial pneumonia. Ultimately, underlying asthma may have contributed to malnutrition and fatal bacterial pneumonia. In conclusion, preschool asthma in low-income countries may be significantly under-diagnosed and misdiagnosed as pneumonia, and may be the cause of much morbidity and mortality.

  16. Psychiatric disorders and substance dependence among unmarried low-income mothers.

    PubMed

    Rosen, Daniel; Spencer, Michael S; Tolman, Richard M; Williams, David R; Jackson, James S

    2003-05-01

    The study reported in this article examined the prevalence of mental health disorders and the sociodemographic factors associated with having a mental health disorder in a probability sample of 185 African American and white single mothers. Logistic regression analyses revealed that race (being white) and being on welfare were associated with increased risk of having a mental health disorder, when controlling for other sociodemographic variables. The association of welfare status and psychiatric disorders highlights the need for access to mental health services for this population. Implications for low-income women making the transition from welfare to employment are discussed.

  17. Improving communication between patients and providers using health information technology and other quality improvement strategies: focus on low-income children.

    PubMed

    Ngo-Metzger, Quyen; Hayes, Gillian R; Yunan Chen; Cygan, Ralph; Garfield, Craig F

    2010-10-01

    Effective communication between providers and patients has been linked to improved outcomes. Previous reviews of quality improvement strategies, including health information technology (health IT), have not focused on the needs of low-income children. The authors conducted a systematic review of the literature on studies of communication surrounding the care of low-income children, with an emphasis on interventions and health IT.The search yielded six studies that focused on low-income children; three of the studies used health IT. Key informant interviews provided insight to the current use of health IT for provider-patient communication in geographically diverse, underresourced settings.The authors identify gaps between existing literature and clinical practice. Future research should focus on the specific impact of health IT in pediatric medicine, particularly in underresourced and safety net settings. These efforts should focus on the use of technological innovations to improve care for low-income children and their families.

  18. An ecological perspective on rural, low-income mothers' health.

    PubMed

    Bice-Wigington, Tiffany; Simmons, Leigh Ann; Huddleston-Casas, Catherine

    2015-01-01

    Using structural equation modeling, this study examined interactions among factors traditionally associated with health outcomes within a sample of rural low-income mothers. Prior research has established that education, employment, income, marital status, and health insurance coverage independently predict health outcomes. However, no studies have examined the simultaneous influence of these factors as conceptualized from an ecological systems perspective. Results indicate that when the multiple factors are considered simultaneously, different effects emerge. Implications are that the context in which these women live and the interactions between and among key influencing factors must be considered when addressing health challenges in rural areas.

  19. An Approach to Assessing Patient Safety in Hospitals in Low-Income Countries

    PubMed Central

    2015-01-01

    Objective The aim of the study was to assess non-technical aspects of patient safety practices using non-participant observation in different clinical areas. Design Qualitative study using non-participant observation and thematic analysis. Setting Two eye care units in Uganda. Participants Staff members in each hospital. Main outcome measures A set of observations of patient safety practices by staff members in clinical areas that were then coded using thematic analysis. Results Twenty codes were developed that explained patient safety practices in the hospitals based on the observations. These were grouped into four themes: the team, the environment, patient-centred care and the process. The complexity of patient safety in each hospital was described using narrative reports to support the thematic analysis. Overall both hospitals demonstrated good patient safety practices however areas for improvement were staff-patient communication, the presence and use of protocols and a focus on consistent practice. Conclusions This is the first holistic assessment of patient safety practices in a low-income setting. The methods allowed the complexity of patient safety to be understood and explained with areas of concern highlighted. The next step will be to develop a useful and easy to use tool to measure patient safety practices in low-income settings. PMID:25894554

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

    PubMed Central

    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

  1. Sleep Quality and Quantity in Low-Income Postpartum Women.

    PubMed

    Doering, Jennifer J; Szabo, Aniko; Goyal, Deepika; Babler, Elizabeth

    To describe and explore patterns of postpartum sleep, fatigue, and depressive symptoms in low-income urban women. In this descriptive, exploratory, nonexperimental study, participants were recruited from an inpatient postpartum unit. Subjective measures were completed by 132 participants across five time points. Objective sleep/wake patterns were measured by 72-hour wrist actigraphy at 4 and 8 weeks. Mean sample age was 25 years, high school educated with 3.1 children. Over half the sample reported an annual income less than 50% of the federal poverty level. Objectively, total nighttime sleep was 5.5 hours (week 4) and 5.4 hours (week 8). Subjectively, 85% met criteria for "poor sleep quality" at week 4, and nearly half were persistently and severely fatigued through 8 weeks postpartum. The majority (65%) of women in this study met the definition of "short sleep duration," defined as sleeping ≤ 6 hours per night. Adverse effects of this short sleep on physical and mental health as well as safety and functioning, especially within the context of poverty, may be profound. There is an urgent need for further research on sleep in low-income underrepresented women to identify interventions that can improve sleep and fatigue as well as discern the implications of sleep deprivation on the safety and physical and mental health of this population.

  2. 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

  3. Low-income mothers' social support and children's injuries.

    PubMed

    Leininger, Lindsey Jeanne; Ryan, Rebecca M; Kalil, Ariel

    2009-06-01

    This study examined the association between low-income mothers' perceived social support and the prevalence of their children's medically treated accidents and injuries. Data were drawn from the National Evaluation of Welfare-to-Work Strategies (NEWWS), an experimental evaluation of 11 welfare-to-work programs in seven U.S. cities. In regression models, maternal social support was significantly associated with the likelihood that children experienced an accident or injury between the ages of 8 and 10 such that children of mothers with very limited support were at the highest risk. This association was robust to the inclusion of a wide range of controls, including a prior measure of accident and injury occurrence. A primary finding was that only children whose mothers had the lowest levels of social support, characterized here as socially isolated, suffered significantly higher rates of injury. This suggests that social isolation presents a meaningful threat to child safety and may play an important role in the etiology of child injury among low-income families.

  4. A sports wheelchair for low-income countries.

    PubMed

    Authier, Erica L; Pearlman, Jon; Allegretti, Ana L; Rice, Ian; Cooper, Rory A

    Appropriate wheelchairs for basic mobility needs are still not commonly available in low-income countries, although several organizations are working toward this goal. After basic mobility is secured it is important to provide more diverse assistive technology to allow people with disabilities to more completely participate in society and live healthy lives. Our goal was to design an affordable sports wheelchair that would allow individuals in low-income countries to participate in basketball. Design requirements established for the sports wheelchair included: removable anti-tippers, adjustable tension backrest, 24'' wheels, adjustable seat dump, variable camber, 4'' casters, fore-aft axle position, removable bumpers, height adjustable footrest, four wheels, single anti-tipper (pivot), cost less than $125 without wheels, 16'' seat width and backrest height, and nylon upholstery. The wheelchair was designed using 3D modeling, standard materials, and standard tools. An affordable wheelchair, versatile enough to be used for a variety of sports and even everyday use, was designed and prototyped successfully. Documentation for the design including step-by-step directions, engineering drawings, and photographs are available at the Human Engineering Research Laboratories website (http://www.herlpitt.org/intw.htm). Future work on the prototype should include design refinement including adaptations for other sports, and standards testing.

  5. 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

  6. Research, empiricism and clinical practice in low-income countries.

    PubMed

    Isaac, Mohan; Chand, Prabhat; Murthy, Pratima

    2007-10-01

    Mental health problems are relevant for every country. They are particularly important for low-income countries which face a high burden of illness due to infectious disease, greater socio-economic disparities, and have limited resources for mental health care. There is a great mismatch in the areas of mental health research, practice, policy and services in comparison to developed countries. There have been a few studies that have investigated major mental health problems prevailing in these countries but missed out significant health problems. Studies have tended to be more donor driven and conducted in tertiary centres. The low priority accorded to mental health by the policy makers, scarcity of human resources, lack of culture-specific study instruments, lack of support from scientific journals have been some of the impediments to mental health research in these countries. In addition, lack of community participation and absence of sound mental health policies have deprived the vast majority of the benefit of modern psychiatric treatments. Recently, with increase in collaboration in research, availability of treatment including low-priced psychotropics, and a growing emphasis on the need for mental health policy in some low-income countries, the bleak scenario is expected to change.

  7. 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.

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  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. Involving Low-Income Parents in the Schools: Communitycentric Strategies for School Counselors

    ERIC Educational Resources Information Center

    Van Velsor, Patricia; Orozco, Graciela L.

    2007-01-01

    Low-income parents participate less in schools than higher-income parents despite the benefits of parent involvement. Barriers that low-income parents face suggest that schools must develop a new approach to engaging these parents. School counselors can play a leadership role in strengthening the relationship between schools and low-income parents…

  17. Low-Income Students: Who They Are and How They Pay for Their Education.

    ERIC Educational Resources Information Center

    Choy, Susan P.

    2000-01-01

    Profiles low-income students, focusing on financial need and the contribution of financial aid. Findings from the National Postsecondary Student Aid Study show that low-income students who began their postsecondary education in 1995-1996 were less likely than their not-low-income counterparts to have earned a degree or certificate or still be…

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. Housing ownership and affordability among low-income society in the poorest sub-district of Semarang, Central Java, Indonesia

    NASA Astrophysics Data System (ADS)

    Indrianingrum, Lulut

    2017-03-01

    The Government has intervened to deal with various affordable public housing programs, as well as financing programs for Low Income society in Indonesia. The characteristics of this society in each region are so diverse, that made the housing programs for this social segment uneasy in reaching the right target. Regulation of Housing and Settlement No. 2/2001 has mandated that the State are obliged to implement a habitable public housing for people, especially for the low income society. The purpose of this study is exploring the low-income residents' preferences and affordability of home ownership for their families in the poorest sub-district of Semarang. Aspects of studies include family conditions, financing, location, housing type and price. The research used a descriptive method to analyze a set of questionnaire data, distributed to low income residents in Sub district Tanjungmas, which isthe poorest sub district in Semarang. The results showed that the respondents developed a vision of home ownership by saving their money for the allocated housing budget and taking a bank installment. They tended to plan to get a house in their current neighborhood or nearby or anywhere else with the same price range. They really understood that, in order to get a better home and neighborhood they have to pay for higher prices. Therefore, their housing criteria or standards were set based on the quality of life in their current residential area, and should be located in a township (kampung).

  4. 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

  5. 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

  6. Medicaid expansion and chronic obstructive pulmonary disease among low-income adults in the United States.

    PubMed

    Tumin, Dmitry; Jackson, Edwin J; Hayes, Don

    2017-07-29

    Chronic obstructive pulmonary disease (COPD) is common but often underdiagnosed in the United States (US). Public health insurance coverage expansion may increase the prevalence of diagnosed COPD due to improved access to care and diagnosis. We sought to determine the effects of Medicaid expansion on the prevalence of diagnosed COPD among low-income US adults. The 2011-2015 Behavioral Risk Factor Surveillance System survey data were used to identify adults with annual household income <$50 000. The outcome was self-report of being diagnosed with COPD by a health-care provider. Difference-in-difference logistic regression contrasted the influence of period (pre-expansion, 2011-2013, vs post-expansion, 2014-2015) between states participating and opting out of Medicaid expansion. Data on 521 622 respondents were analysed. The prevalence of diagnosed COPD was 7% in Medicaid expansion states and 8% in non-participating states. In participating states, lack of health insurance among low-income adults decreased from 32% to 21% after Medicaid expansion (P < .001), but the prevalence of diagnosed COPD was unchanged. Multivariable logistic regression confirmed that residents of participating states surveyed after Medicaid expansion were no more likely to report diagnosed COPD than residents of these states surveyed before Medicaid expansion (OR = 1.03; 95% CI: 0.97, 1.10; P = .276). Notwithstanding increased health insurance coverage among low-income adults after Medicaid expansion, this policy did not increase the prevalence of diagnosed COPD. Access to primary care among new Medicaid enrollees and practices of diagnosing COPD in this setting should be evaluated to reduce the extent of undiagnosed COPD in socioeconomically disadvantaged groups. © 2017 John Wiley & Sons Ltd.

  7. 26 CFR 1.42-1 - 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... local housing credit agency. 1.42-1 Section 1.42-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-1 Limitation on low-income housing...

  8. 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

    ... of such excess) for buildings in the reverse order in which such allocations were made during such... not perform an independent investigation of the qualified low-income building in order to certify on... with respect to qualified low-income buildings receiving housing credit allocations from a State or...

  9. Preschool Enrollment, Classroom Instruction, Elementary School Context, and the Reading Achievement of Children from Low-Income Families

    PubMed Central

    Crosnoe, Robert; Benner, Aprile D.; Davis-Kean, Pamela

    2017-01-01

    Purpose The goal of this study was test expectations derived from sociological and developmental perspectives that the association between phonics instruction in kindergarten classrooms and reading achievement during the first year of school in the low-income population would depend on whether children had previously attended preschool as well as the socioeconomic composition of their elementary schools. Methodological approach Autoregressive modeling was applied to nationally representative data from 7,710 children from low-income families in the Early Childhood Longitudinal Study-Kindergarten Cohort, with a series of sensitivity tests to improve causal inference and explore the robustness of results. Findings The association between phonics instruction and achievement was strongest among children from low-income families who had not attended preschool and then enrolled in socioeconomically disadvantaged elementary schools and among children from low-income families who had attended preschool and then enrolled in socioeconomically advantaged elementary schools. Research and practical implications Insight into educational inequality can be gained by situating developing children within their proximate ecologies and institutional settings, especially looking to the match between children and their contexts. These findings are relevant to policy discussions of early education, instructional practices, and desegregation. PMID:28824338

  10. 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.

  11. 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.

  12. Lead screening among low-income children in Galveston, Texas.

    PubMed

    Javier, F C; McCormick, D P; Alcock, N W

    1999-11-01

    The objective of this study was to report results of a lead-screening program for low-income children living in Galveston, Texas. We obtained blood lead by graphite furnace spectrophotometry on 1,571 children aged 6 months to 8 years. Nineteen percent of children had blood lead levels > or = 10 mcg/dL. Risk factors included African-American ethnicity, young age, and residence in old housing. Follow-up was accomplished in only 50% of children with low-level toxicity. Lead screening is an important public health measure in communities with old houses. For screening to be successful, caregivers need to devote additional effort to follow-up.

  13. Low-income preschoolers' false-belief performance.

    PubMed

    Curenton, Stephanie M

    2003-12-01

    A group of 72 preschoolers (36 African Americans, 36 European Americans) enrolled in Head Start programs and other preschools serving low-income children were asked 3 variations of false-belief questions across 3 scenarios and given a language and cognition subtest. Children's performance varied across the questions and tasks, but after covarying for children's language and cognitive scores, those effects were no longer found to be significant. Age effects were still significant even after differences in children's language and cognitive abilities had been accounted for. Although no language and cognitive differences were found among European Americans and African Americans, the European Americans still outperformed African Americans on 1 of the task scenarios. Those results demonstrate (a) the importance of considering testing procedures and language and cognitive abilities when assessing children's social cognitive skills and (b) that age-related changes in false-belief understanding are associated with social cognitive conceptual changes that are independent of language and cognitive skills.

  14. Low-income energy assistance: State responses to funding reductions

    SciTech Connect

    Not Available

    1988-01-01

    Appropriations for the Low Income Home Energy Assistance Program have declined each year since FY 1986, from a level of about $2.0 billion to about $1.5 billion in FY 1988. The President's budget for FY 1989 has proposed a further reduction to about $1.2 billion. The reduction was proposed in recognition of the hundreds of millions of dollars in oil overcharge settlements available to states for this and certain other activities. GAO reviewed 13 states for information on the availability and use of oil overcharge funds; federal allotments to LIHEAP, total LIHEAP funding, and a projection of possible FY 1989 funding; the number of LIHEAP households provided heating assistance; heating benefit levels per household; LIHEAP transfers to and from other block grants; and perceptions of interest groups of past and proposed LIHEAP budget cuts.

  15. Health literacy and nutrition behaviors among low-income adults.

    PubMed

    Speirs, Katherine E; Messina, Lauren A; Munger, Ashley L; Grutzmacher, Stephanie K

    2012-08-01

    The purpose of this study was to explore the relationship between health literacy and nutrition behaviors using a low-income sample. Face-to-face surveys at 11 social services offices generated a convenience sample of 154 Supplemental Nutrition Assistance Program (SNAP)-eligible adults. We assessed health literacy, fruit and vegetable intake, food label use, consumption of healthy foods, and demographic characteristics. Thirty seven percent of the sample had adequate health literacy as measured by the Newest Vital Sign (NVS). Race and parenthood were significantly related to health literacy scores. Adequate health literacy, as measured by the NVS, was associated with frying chicken less often and eating the peels of fresh fruit more often. The findings suggest that health practitioners should ensure nutrition-related messages are accessible to all of their clients, especially those with the lowest health literacy levels.

  16. 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

  17. Management of obesity in low-income African Americans.

    PubMed Central

    Kaul, L.; Nidiry, J. J.

    1999-01-01

    The Bariatrics Clinic at Howard University Hospital was initiated to help low-income African-American adults with low literacy skills in obesity control. Fourteen African-American women and two men participated in the study. Essential components of the treatment included nutrition education, exercise, and behavior modification related to food intake. The nutrition education component involved teaching nutritional needs, taking into account low literacy skills, low economic status, and individual food preferences. A realistic diet plan was based on individual needs, economic status, availability of food, likes and dislikes, lifestyle, and family dynamics. On average, patients lost 2 lb a week on this program. On average, a 14-lb weight loss occurred in seven weeks. There has been a 10% dropout from this program as opposed to drop out rates of 40% to 50% with other treatments. The main reasons for the success of this program is that it is individualized and is sensitive to food preferences. PMID:10203915

  18. HIV testing among low-income African-American mothers.

    PubMed

    Battle, R S; Cummings, G L; Yamada, K A; Krasnovsky, F M

    1996-04-01

    HIV testing patterns were examined among low-income African Americans who were mothers of young school-age children. In-person interviews were conducted to determine whether African-American women had been tested for HIV; their sexual behaviors, including the number of sexual partners and condom use; and health care access and utilization. Forty-one percent of the women had been tested for HIV; 18 percent tested more than once. Levels of education, source of primary health care, and type of insurance were not associated with HIV testing. The total number of sexual partners for their current lifetime and within the past five years was significantly associated with their HIV testing status (chi 2 = 39.97; DF = 3; p < .01 and chi 2 = 66.68; DF = 3; p < .01 respectively). Women who have used condoms during their last intercourse (20%) were less likely to have been tested than women who did not use a condom (50%) (p < .01). Results suggest that low-income African-American women get tested for HIV. This suggests that these women understand the concept of risk and how certain behaviors may place them at risk. However, these women still confront conditions that place them at risk, such as having sex with multiple partners and/or partners with a history of incarceration, in addition to drug use. HIV testing may not serve as the most effective intervention for this sub-population of women. Educational and preventive measures should extend to women outside traditional high-risk populations by incorporating methods to promote protective behavioral changes which will empower women with self-esteem and confidence.

  19. Low-income women's perceptions of family planning service alternatives.

    PubMed

    Severy, L J; McKillop, K

    1990-01-01

    A sample of 665 low-income women from a predominantly rural area of north central Florida rated the value of 25 features of family planning providers and reported their perceptions of how characteristic each feature was of different types of providers. A well-trained, trustworthy and friendly staff, the presence of a doctor if you need one and a staff that is gentle with the examination were the most desirable features of family planning services. The respondents' perceptions of public health clinics suggest that the strongest qualities of such facilities are that they treat people from different backgrounds, accept Medicaid, are easy to find and teach you how to avoid pregnancy and how to take care of yourself and stay healthy. Features thought most characteristic of private physician services were a well-trained staff, privacy and the presence of a doctor if you need one. Voluntary organizations were seen as providing services for people of different backgrounds, having a friendly staff, serving as a referral agency and teaching about staying healthy and avoiding pregnancy. However, voluntary organizations were rated lower than public health clinics or private physicians on nearly all features. The total scores for public health clinics and private physicians were not significantly different from each other, but both were noticeably higher than the score for voluntary organizations. Ethnicity affected ratings dramatically, with black respondents clearly more favorable toward public health clinics and private physicians than white respondents; conversely, whites were more positive toward voluntary organizations than were blacks. For many of these low-income respondents, the high ratings of private physicians may have represented their expectations rather than their actual experience.

  20. Making Debris Avoidance Decisions for ESMO's EOS Mission Set

    NASA Technical Reports Server (NTRS)

    Mantziaras, Dimitrios

    2016-01-01

    The presentation will cover the aspects of making debris risk decisions from the NASA Mission Director's perspective, specifically for NASA Earth Science Mission Operations (ESMO) Earth Observing System (EOS) mission set. ESMO has been involved in analyzing potential debris risk conjunctions with secondary objects since the inception of this discipline. Through the cumulated years of experience and continued exposure to various debris scenarios, ESMO's understanding of the problem and process to deal with this issue has evolved. The presentation will describe the evolution of the ESMO process, specifically as it relates to the maneuver execution and spacecraft risk management decision process. It will briefly cover the original Drag Make-Up Maneuver, several day, methodical manually intensive, ramp up waive off approach, to the present day more automated, pre-canned onboard command, tools based approach. The presentation will also cover the key information needed to make debris decisions and challenges in doing so while still trying to meet science goals, constellation constraints and manage resources. A slide or two at the end of the presentation, will be devoted to discussing what further improvements could be helpful to improve decision making and future process improvement plans challenges.

  1. Different Forms of Child Maltreatment have Comparable Consequences Among Children from Low-Income Families

    PubMed Central

    Vachon, David D.; Krueger, Robert F.; Rogosch, Fred A.; Cicchetti, Dante

    2015-01-01

    Context Several widely held beliefs about child abuse and neglect may be incorrect. It is most commonly assumed that some forms of abuse (e.g., physical and sexual abuse) are more harmful than others (e.g., emotional abuse and neglect); other assumptions are that each form of abuse has specific consequences, and that the effects of abuse differ across sex and race. Objective To determine whether these assumptions are valid by testing the hypothesis that different types of child maltreatment actually have equivalent, broad, and universal effects. Design Large, diverse sample collected over 27 years. Setting Research summer camp program for low-income, school-aged children. Participants Participants were 2,292 racially and ethnically diverse boys (55%) and girls (45%), aged 5–13 years. Of these, 1,193 (52%) had a well-documented history of child maltreatment. Main Outcome Measures Various forms of internalizing and externalizing personality and psychopathology were assessed using multiple informant ratings on the California Child Q-set and Teacher Report Form, as well as child self-reported depression and peer ratings of aggression and disruptive behavior. Results Using a structural analysis, we found that different forms of child maltreatment have equivalent psychiatric effects. We also found that maltreatment alters two broad vulnerability factors, Internalizing (β = .185, p < .001) and Externalizing (β = .283, p < .001), that underlie multiple forms of psychiatric disturbance, and that maltreatment has equal consequences for boys and girls of different races. Finally, our results allowed us to describe a base rate and co-occurrence issue that makes it difficult to identify the unique effects of child sexual abuse. Conclusions Our findings challenge widely held beliefs about how child abuse should be recognized and treated—a responsibility that often lies with the clinician. Because different types of child abuse have equivalent, broad, and universal effects

  2. Disclosure of Complementary Health Approaches among Low Income and Racially Diverse Safety Net Patients with Diabetes

    PubMed Central

    Chao, MT; Handley, MA; Quan, J; Sarkar, U; Ratanawongsa, N; Schillinger, D

    2015-01-01

    Objective Patient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. Methods We used data from San Francisco Health Plan's SMARTSteps Program, a trial of diabetes self-management support for low-income patients (n=278) through multilingual automated telephone support. Interviews collected use and disclosure of complementary health approaches in the prior month, patient-physician language concordance, and quality of communication. Results Among racially, linguistically diverse participants, half (47.8%) reported using complementary health practices (n=133), of whom 55.3% disclosed use to providers. Age, sex, race/ethnicity, nativity, education, income, and health literacy were not associated with disclosure. In adjusted analyses, disclosure was associated with language concordance (AOR=2.21, 95% CI: 1.05, 4.67), physicians' interpersonal communication scores (AOR=1.50, 95% CI: 1.03, 2.19), shared decision making (AOR=1.74, 95% CI: 1.33, 2.29), and explanatory-type communication (AOR = 1.46, 95% CI: 1.03, 2.09). Conclusion Safety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication. Practice Implications Patient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches. PMID:26146238

  3. 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

  4. 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

  5. Concepts of healthful food among low-income African American women.

    PubMed

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

    2012-01-01

    Describe beliefs about what makes foods healthful among low-income African American women. 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 healthfulness. Nutrient content, physical effects of food, and food categories were used to judge the healthfulness of foods. Fruits, vegetables, and dairy foods were considered the most healthful and starchy foods the least healthful because they were believed to cause weight gain. Beliefs about which foods contain which nutrients and which foods have particular physical effects varied widely across participants. Participants demonstrated awareness of which foods are healthful but lacked understanding of why those foods are more healthful than others. Knowledge about the health effects of foods may be necessary to motivate individuals to choose healthful foods. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    Linne, Joaquín

    2014-10-02

    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.

  7. Nutrition information-seeking behaviour of low-income pregnant Maghrebian women.

    PubMed

    Legault, Anik; Marquis, Marie

    2014-01-01

    Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women's nutrition decision-making. Environmental factors likely to influence information-seeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women's specific information needs.

  8. Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.

    PubMed

    Chao, M T; Handley, M A; Quan, J; Sarkar, U; Ratanawongsa, N; Schillinger, D

    2015-11-01

    Patient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. We used data from San Francisco Health Plan's SMARTSteps Program, a trial of diabetes self-management support for low-income patients (n=278) through multilingual automated telephone support. Interviews collected use and disclosure of complementary health approaches in the prior month, patient-physician language concordance, and quality of communication. Among racially, linguistically diverse participants, half (47.8%) reported using complementary health practices (n=133), of whom 55.3% disclosed use to providers. Age, sex, race/ethnicity, nativity, education, income, and health literacy were not associated with disclosure. In adjusted analyses, disclosure was associated with language concordance (AOR=2.21, 95% CI: 1.05, 4.67), physicians' interpersonal communication scores (AOR=1.50, 95% CI: 1.03, 2.19), shared decision making (AOR=1.74, 95% CI: 1.33, 2.29), and explanatory-type communication (AOR=1.46, 95% CI: 1.03, 2.09). Safety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication. Patient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. A framework for understanding grocery purchasing in a low-income urban environment.

    PubMed

    Zachary, Drew A; Palmer, Anne M; Beckham, Sarah W; Surkan, Pamela J

    2013-05-01

    Research demonstrates that food desert environments limit low-income shoppers' ability to purchase healthy foods, thereby increasing their likelihood of diet-related illnesses. We sought to understand how individuals in an urban American food desert make grocery-purchasing decisions, and specifically why unhealthy purchases arise. Analysis is based on ethnographic data from participant observation, 37 in-depth interviews, and three focus groups with low-income, primarily African American shoppers with children. We found participants had detailed knowledge of and preference for healthy foods, but the obligation to consistently provide food for their families required them to apply specific decision criteria which, combined with structural qualities of the supermarket environment, increased unhealthy purchases and decreased healthy purchases. Applying situated cognition theory, we constructed an emic model explaining this widely shared grocery-purchasing decision process and its implications. This context-specific understanding of behavior suggests that multifaceted, system-level approaches to intervention are needed to increase healthy purchasing in food deserts.

  10. Shared decision making within goal setting in rehabilitation settings: A systematic review.

    PubMed

    Rose, Alice; Rosewilliam, Sheeba; Soundy, Andrew

    2017-01-01

    To map out and synthesise literature that considers the extent of shared decision-making (SDM) within goal-setting in rehabilitation settings and explore participants' views of this approach within goal-setting. Four databases were systematically searched between January 2005-September 2015. All articles addressing SDM within goal-setting involving adult rehabilitation patients were included. The literature was critically appraised followed by a thematic synthesis. The search output identified 3129 studies and 15 articles met the inclusion criteria. Themes that emerged related to methods of SDM within goal-setting, participants' views on SDM, perceived benefits of SDM, barriers and facilitators to using SDM and suggestions to improve involvement of patients resulting in a better process of goal-setting. The literature showed various levels of patient involvement existing within goal-setting however few teams adopted an entirely patient-centred approach. However, since the review has identified clear value to consider SDM within goal-setting for rehabilitation, further research is required and practice should consider educating both clinicians and patients about this approach. To enhance the use of SDM within goal-setting in rehabilitation it is likely clinicians and patients will require further education on this approach. For clinicians this could commence during their training at undergraduate level. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Comparison of a web-based vs in-person nutrition education program for low-income adults.

    PubMed

    Neuenschwander, Lauren M; Abbott, Angela; Mobley, Amy R

    2013-01-01

    As access to computers and the Internet by the low-income population is increasing and the "digital divide" is slowly diminishing, other methods of delivering nutrition information to this audience are evolving. This randomized, block equivalence trial sought to determine whether web-based nutrition education could result in equivalent nutrition-related behavior outcomes when compared with traditional in-person nutrition education in low-income adults. A convenience sample of low-income adults (n=123) was randomized to receive in-person education (n=66) or web-based education (n=57) in a community setting within 14 counties of Indiana from April through December 2010. The web-based group received three nutrition education lessons (eg, fruits and vegetables, Nutrition Facts label reading, and whole grains) designed to replicate lessons received by the in-person group. Lessons were developed using Kolb's Learning Styles and Experiential Learning Model. Self-reported nutrition-related behaviors were assessed using a previously validated survey for low-income adults. Most nutrition-related behavior outcomes (eg, fruit, vegetable, whole-grain intake, Nutrition Facts label use, breakfast, and meal-planning frequency) improved significantly (P<0.05) from pre to post within both groups, meaning that each intervention was effective. When these nutrition-related behavior improvements were compared between groups, the changes were statistically equivalent (P>0.05), except for one question about use of the Nutrition Facts label. Therefore, web-based nutrition education can lead to favorable and equivalent nutrition-related changes when compared with in-person delivery. Most (83%) web-based participants also reported willingness to use the website again. Future application of web-based interventions for low-income populations could broaden delivery reach, increase frequency and length of contacts, and possibly decrease costs.

  12. Expectations of parents on low incomes and therapists who work with parents on low incomes of the first therapy session.

    PubMed

    Andrews, Fiona; Griffiths, Natasha; Harrison, Lorinda; Stagnitti, Karen

    2013-12-01

    Family-centred practice involves allowing families' needs to direct therapy. Parents and therapists often come from different socio-economic positions, yet little is known about how this impacts family-centred practice. This study aimed to explore expectations of care among parents on low incomes and among occupational therapists who work with these families. Ten parents who were holders of a low-income Health Care Card and had a child on a waiting list for publicly funded occupational therapy services, and nine paediatric occupational therapists were asked about perceptions of therapy using semi-structured, in-depth interviews. Interview transcripts were analysed using a qualitative descriptive approach. While therapists recognised families' expectations that therapy would 'fix' their child, some of the concerns of parents such as how their child's behaviour reflected on their parenting skills went largely unrecognised. In addition, no therapists recognised parents' primary concerns about their child's physical health, their desires for a structured approach to therapy or the somewhat fatalistic approach some parents were taking to therapy. Some therapists recognised the complexities they encountered in engaging with parents from low socio-economic positions and tried to adapt their practice with some taking less of a family-centred approach and focussing on the needs of either the parent or the child while others continued to practice with a focus on the family as a whole. These findings have implications for therapists seeking to work within a framework of family-centred practice with clients from low socio-economic positions. © 2013 Occupational Therapy Australia.

  13. The Effects of Expanding Public Insurance to Rural Low-Income Childless Adults

    PubMed Central

    Burns, Marguerite E; Dague, Laura; DeLeire, Thomas; Dorsch, Mary; Friedsam, Donna; Leininger, Lindsey Jeanne; Palmucci, Gaston; Schmelzer, John; Voskuil, Kristen

    2014-01-01

    Objective This study measures the change in health care use after enrollment into a new public insurance program for low-income childless adults. Data Sources/Study Setting The data sources include claims from a large integrated health system in rural Wisconsin and Medicaid enrollment files, January 2007–September 2012. Study Design We employ a regression discontinuity design to measure the causal effect of public insurance enrollment on counts of outpatient, emergency department, and inpatient events for 2 years following enrollment for a sample of previously uninsured low-income adults in rural Wisconsin. Principal Findings Public insurance enrollment led to substantial increases in outpatient visits including preventive visits, but not mental health visits. Public insurance enrollment also led to increases in inpatient stays, but the study is inconclusive on whether it led to an increase in ED visits. Conclusions Public insurance expansions to childless adults have the potential to impact the use of health care. The large increase in Medicaid coverage and reduction in rates of uninsurance anticipated to result from the Affordable Care Act should increase the use of inpatient and outpatient services, but they will have an uncertain impact on the use of ED among rural populations. PMID:25262774

  14. 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

  15. CHILDREN OF LOW-INCOME DEPRESSED MOTHERS: PSYCHIATRIC DISORDERS AND SOCIAL ADJUSTMENT†

    PubMed Central

    Feder, Adriana; Alonso, Angelique; Tang, Min; Liriano, Wanda; Warner, Virginia; Pilowsky, Daniel; Barranco, Eva; Wang, Yanping; Verdeli, Helena; Wickramaratne, Priya; Weissman, Myrna M.

    2010-01-01

    Background Although several studies have documented a higher prevalence of psychiatric disorders in children of depressed than nondepressed parents, previous research was conducted in predominantly White, middle, or upper-middle class populations. Only limited information is available on psychiatric disorders and psychosocial functioning in children of low-income depressed mothers. Methods We report the findings in children of mothers with and without a lifetime history of major depressive disorder, who were recruited from a large urban primary-care practice. Bilingual clinical interviewers assessed 58 children with structured diagnostic interviews administered to most children (90%) and to their mothers as informants. Diagnostic assessments and best estimate diagnoses of the children were blind to the mothers’ diagnostic status. Results The families were poor and predominantly Hispanic, more than half of them headed by single mothers. After adjusting for child age and gender, and for any possible sibling correlation, children of depressed mothers had significantly higher rates of lifetime depressive, separation anxiety, oppositional defiant, and any psychiatric disorders than children of control mothers, with a lifetime prevalence of any psychiatric disorder of 84.6 versus 50.0%, respectively. Children of depressed mothers also reported significantly lower psychosocial functioning and had higher rates of psychiatric treatment. Conclusions We conclude that the risk for psychiatric disorders may be particularly high in children of low-income depressed mothers. The primary-care setting offers a unique opportunity for early intervention with this underserved group. PMID:19016460

  16. Generating political priority for newborn survival in three low-income countries.

    PubMed

    Smith, Stephanie L; Shiffman, Jeremy; Kazembe, Abigail

    2014-01-01

    Deaths to babies in their first 28 days of life now account for more than 40% of global under-5 child mortality. High neonatal mortality poses a significant barrier to achieving the child survival Millennium Development Goal. Surmounting the problem requires national-level political commitment, yet only a few nation-states have prioritised this issue. We compare Bolivia, Malawi and Nepal, three low-income countries with high neonatal mortality, with a view to understanding why countries prioritise or neglect the issue. The three have had markedly different trajectories since 2000: attention grew steadily in Nepal, stagnated then grew in Malawi and grew then stagnated in Bolivia. The comparison suggests three implications for proponents seeking to advance attention to neglected health issues in low-income countries: the value of (1) advancing solutions with demonstrated efficacy in low-resource settings, (2) building on existing and emerging national priorities and (3) developing a strong network of domestic and international allies. Such actions help policy communities to weather political storms and take advantage of policy windows.

  17. 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

  18. Introduction of farm stands in low-income communities increases fruit and vegetable among community residents.

    PubMed

    Evans, Alexandra E; Jennings, Rose; Smiley, Andrew W; Medina, Jose L; Sharma, Shreela V; Rutledge, Ronda; Stigler, Melissa H; Hoelscher, Deanna M

    2012-09-01

    The purpose of this longitudinal pilot study was to measure the impact of introducing farm stands in low-income communities with limited access to fresh and quality fruits and vegetables (F&V) on residents' F&V consumption. Two farm stands were placed outside two local community sites one day a week for 12 weeks. A variety of locally grown, culturally appropriate produce was sold at the stands. Data on F&V intake, awareness and usage of farmers' markets, family behaviors, and importance of eating F&V were collected from individuals (n=61) before and after farm stands were placed in the two communities. Paired sample t-tests, chi-square and McNemar tests were used to evaluate the impact of the intervention on the outcome variables. Significance level was set at p<.05. Significant increases were found for participants' consumption of fruit, fruit juice, tomatoes, green salad, and other vegetables (P<.05). Additionally, participants also reported increases in mediating variables of F&V consumption. This study underscores the potential of farmers' markets to increase F&V consumption through increasing F&V access in low-income communities.

  19. Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements

    PubMed Central

    Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

    2017-01-01

    Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix. PMID:28157149

  20. Mobile Technology, Cancer Prevention, and Health Status among Diverse, Low-Income Adults

    PubMed Central

    Purnell, Jason Q.; Griffith, Julia; Eddens, Katherine S.; Kreuter, Matthew W.

    2014-01-01

    Purpose Characterize mobile technology ownership, use, and relationship to self-reported cancer prevention behaviors and health status in a diverse, low-income sample of callers to 2-1-1. Design Secondary analyses of cross-sectional survey data from a larger trial collected from June 2010 to December 2012. Setting United Way Missouri 2-1-1 serves 99 of 114 counties and received 166,000 calls in 2011. Subjects The respondents (baseline n = 1,898; 4-month n = 1,242) were predominantly female, non-Hispanic Black, under 50, with ≤ high school education and annual income < $20,000. Measures Cell phone ownership and use and its relationship to cancer prevention services and health status were assessed via telephone-based survey using items adapted from previous research and the BRFSS. Smartphone ownership and use were also assessed. Analysis Descriptive statistics and bivariate and multivariate associations between cell phone ownership and prevention and health status are reported. Results Three-fourths (74%) of study participants owned a cell phone and 19% owned a smartphone. Text messaging was the most popular use. Ownership was significantly associated with good to excellent health status and presence of smoke-free home policies in multivariate models. Conclusion Cell phone ownership is growing and has potential to deliver health information to low-income populations. With 16 million calls annually, the national 2-1-1 system may be a promising model and platform. PMID:24200336

  1. Focus group study of ethnically diverse low-income users of paid personal assistance services.

    PubMed

    Mullan, Joseph T; Grossman, Brian R; Hernandez, Mauro; Wong, Alice; Eversley, Rani; Harrington, Charlene

    2009-01-01

    This study examined the experiences of ethnically diverse, low-income consumers of paid personal assistance services (PAS) to understand the successes and problems they faced setting up and maintaining their assistance. A thematic analysis was conducted with transcripts from eight focus groups of ethnically homogeneous consumers (n = 67): African American, Latino, Chinese, Native American, and non-Hispanic white. These experienced consumers were generally satisfied with their current PAS but noted significant difficulties: Getting access to appropriate care, obtaining enough paid care to avoid unmet need, and dealing with confusing bureaucracies and cultural differences between them and agency staff/attendants. They desired more control over their care, including the use of paid family attendants when possible. Respondents recommended improved screening and training of attendants, more attendant time, higher wages for attendants, improved cultural sensitivity of attendants and agency staff, and greater consumer control over PAS. Although these low-income PAS consumers are ethnically and geographically diverse, the similarity of findings points to their ongoing struggle to access adequate high quality assistance. The burden they have in obtaining and maintaining services is substantial.

  2. Perceptions of mental health services among low-income, perinatal African-American women.

    PubMed

    Leis, Julie A; Mendelson, Tamar; Perry, Deborah F; Tandon, S Darius

    2011-01-01

    The objective of this qualitative study was to explore perceptions of mental health services as a barrier to service use among low-income, urban, perinatal African-American clients of home visiting programs. Inductive thematic analysis procedures were used to analyze data collected from focus groups conducted with clients (n = 38) and staff (n = 26) of two paraprofessional home visiting programs. Four complementary themes were identified: Perceptions of mental health care providers, concerns about confidentiality, beliefs about the effectiveness of psychotherapy, and perceptions of psychotropic medication. Overall, perceptions of mental health services were largely negative. Many women equated seeing a mental health care provider with being prescribed psychotropic medication, and providers were commonly described as uncaring and emotionally detached. In general, psychotherapy was perceived as ineffective, and many women expressed strong negative views about psychotropic medication. Perceptions of mental health services were clearly an impediment to service use in this population of low-income, perinatal African-American women. Findings from this study can inform efforts to overcome barriers to mental health service use and develop effective perinatal mental health interventions. Implications of this work include use of the home visitation setting as a context for delivering knowledge and shaping positive attitudes and behaviors with respect to mental health practices. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  3. 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

  4. Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements.

    PubMed

    Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

    2017-02-01

    Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

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

    PubMed

    Lee, Shawna J; Oyserman, Daphna

    2009-06-04

    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.

  6. [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…

  7. [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…

  8. [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…

  9. 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

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

    PubMed

    Goyet, Sophie; Barennes, Hubert; Libourel, Therese; van Griensven, Johan; Frutos, Roger; Tarantola, Arnaud

    2014-06-26

    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. 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. 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 and to a lack of synchronization

  11. 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

  12. [Induced abortion among low income women: dimensions of the problem].

    PubMed

    Martins, I R; Costa, S H; Freitas, S R; Pinto, C S

    1991-01-01

    This paper examines the practice of abortion, especially induced abortion among low income women. The discussion is based on survey data collected between 1984 and 1985 in seven slum communities (favelas) situated in the metropolitan area of Rio de Janeiro, Brazil. Despite restrictive law, induced abortion is extremely frequent. Among married women 21.4 per cent reported experience of induced abortion. Most abortions were performed by physicians, however the quality of care of these procedures can be questioned since almost all induced abortions are illegal there is no possible supervision by health authorities. The incidence of post-abortion complication is very high, especially for those performed by traditional midwifes or by the woman herself. More than 60 per cent of the women were not using contraception at the time of pregnancy. About, 21 per cent reported that they were using the pill. Such a high pill failure rate is inacceptable, and probably was related to incorrect use. This points to the need for a better access to family planning care within the health services. The consequences of the restrictive abortion laws in Brazil are also discussed. Restrictions that in practice prove to have little impact on the practice of induced abortion, appear to be very effective in brooding even more the social-economic inequalities.

  13. Home safety and low-income urban housing quality.

    PubMed

    Gielen, Andrea C; Shields, Wendy; McDonald, Eileen; Frattaroli, Shannon; Bishai, David; Ma, Xia

    2012-12-01

    Living in substandard housing may be one factor that increases the risk of fire and burn injuries in low-income urban environments. The purposes of this study are to (1) describe the frequency and characteristics of substandard housing in urban homes with young children and (2) explore the hypothesis that better housing quality is associated with a greater likelihood of having working smoke alarms and safe hot water temperatures. A total 246 caregivers of children ages 0 to 7 years were recruited from a pediatric emergency department and a well-child clinic. In-home observations were completed by using 46 items from the Housing and Urban Development's Housing Quality Standards. Virtually all homes (99%) failed the housing quality measure. Items with the highest failure rates were those related to heating and cooling; walls, ceilings, and floors; and sanitation and safety domains. One working smoke alarm was observed in 82% of the homes, 42% had 1 on every level, and 62% had safe hot water temperatures. For every increase of 1 item in the number of housing quality items passed, the odds of having any working smoke alarm increased by 10%, the odds of having 1 on every level by 18%, and the odds of having safe hot water temperatures by 8%. Many children may be at heightened risk for fire and scald burns by virtue of their home environment. Stronger collaboration between housing, health care, and injury prevention professionals is urgently needed to maximize opportunities to improve home safety.

  14. Online support for single, low-income, African American mothers.

    PubMed

    Hudson, Diane Brage; Campbell-Grossman, Christie; Keating-Lefler, Rebecca; Carraher, Sydnie; Gehle, Jennifer; Heusinkvelt, Sally

    2009-01-01

    To enhance understanding of the phenomenon of being a single, low-income, African American mother through their discussions and use of an Internet-based social support intervention. The New Mothers Network discussion forum was made available to 20 mothers in their homes for 6 months after the infant's birth. Nineteen mothers posted 174 messages to research nurses and to one another. Thematic analysis of the written messages was completed. The following themes emerged from discussion forum comments: (a) dealing with the father of the baby, (b) mourning losses, (c) positive and negative support, (d) financial needs and concerns, (e) career and educational goals, (f) balancing act, (g) trust issues, and (h) tuned in to baby. The New Mothers Network allowed these African American mothers to share their experiences and assimilate information from nurses about caring for themselves and their infants. Other nurses can create similar Internet discussion forums for the purposes of providing social support to mothers who have access to computers. Computer software for creating discussion forum sites can be purchased at a reasonable cost, and some are available free of charge.

  15. Maternal concerns about children overeating among low-income children.

    PubMed

    Pesch, Megan H; Rizk, Monika; Appugliese, Danielle P; Rosenblum, Katherine L; Miller, Alison; Lumeng, Julie C

    2016-04-01

    Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N=289) of children (mean age 70.8months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child's eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents' practical, healthy ways to prevent child overeating may be helpful.

  16. Maternal concerns about children overeating among low-income children

    PubMed Central

    Pesch, Megan H.; Rizk, Monika; Appugliese, Danielle P.; Rosenblum, Katherine L.; Miller, Alison; Lumeng, Julie C.

    2016-01-01

    Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N = 289) of children (mean age 70.8 months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child’s eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents practical, healthy ways to prevent child overeating may be helpful. PMID:27010491

  17. Maternal Feeding Goals Described by Low-Income Mothers.

    PubMed

    Goulding, Alison N; Lumeng, Julie C; Rosenblum, Katherine L; Chen, Yu-Pu; Kaciroti, Niko; Miller, Alison L

    2015-01-01

    To identify maternal feeding goals and examine associations of number and type of goals with mother and child characteristics. Qualitative interviews about child feeding and quantitative assessment of goal prevalence and associations with mother and child characteristics. Southeastern Michigan. A total of 287 low-income mothers (31% Hispanic or non-white) and their children ages 4 to 8 years. Maternal feeding goals. Themes were generated using the constant comparative method, individual interviews were coded, and the prevalence of feeding goals was determined. Regression analyses examined associations of mother and child characteristics with the number and type of feeding goals. Thirteen maternal feeding goals were identified. The most prevalent were to restrict less nutrient-dense food (60%), promote autonomy around eating (54%), prevent obesity (53%), and promote fruits or vegetables (52%). A child who was female and heavier with an older, non-Hispanic white, more educated mother with less chaos in the home predicted more maternal feeding goals (all P < .05). Specific maternal and child characteristics were associated with individual feeding goals. Depending on their current goals for child feeding, some mothers may benefit from interventions focused on goal development, whereas other mothers may benefit from interventions designed to facilitate goal implementation. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  18. Physical abuse in low-income women in Aleppo, Syria.

    PubMed

    Maziak, Wasim; Asfar, Taghrid

    2003-04-01

    Violence against women is a vicious practice present in all societies. Yet data about its occurrence and associated factors are scarce in the Arab world. In this study, we attempt to determine the spread of physical abuse and its sociodemographic correlates among low-income women in Aleppo, Syria. A sample of 411 women was recruited from 8 randomly selected primary care centers in Aleppo. Response rate was 97%, mean age of participants 28 +/- 8 years, and most women (88%) were married. A special questionnaire was used including questions about physical abuse, the self-reporting questionnaire (SRQ-20), and questions about relevant sociodemographic information. Current physical abuse (battering at least 3 times during the previous year) was found in 23% of the investigated and among 26% of married women, while regular abuse (battering at least once weekly) was found in 3.3% of married women. Correlates of physical abuse were women's education, religion, age, marital status, economic status, mental distress, smoking, and residence. Our data show that physical abuse is prevalent in this population and that women's education is the most important modifiable factor.

  19. Priced out: How the Wrong Financial-Aid Policies Hurt Low-Income Students

    ERIC Educational Resources Information Center

    Lynch, Mamie; Engle, Jennifer; Cruz, Jose L.

    2011-01-01

    This report demonstrates how much low-income students must stretch to pay for college, even after grant aid is taken into account. This report finds that just five of the nation's nearly 1,200 four-year colleges and universities have student bodies that are at least 30 percent low-income and offer low-income students a reasonable chance at a…

  20. Low-Income Latino Students and California's Early Assessment Program: The Role of Sensemaking in the Use of College Readiness Information

    ERIC Educational Resources Information Center

    Almeida, Daniel J.

    2016-01-01

    California's Early Assessment Program is designed to notify students about their college readiness, encouraging them to take action to improve their skills during their senior year. The author uses qualitative methods and applies sense-making theory to examine how students attending majority Latino, low-income high schools make sense of the…

  1. Low-Income Latino Students and California's Early Assessment Program: The Role of Sensemaking in the Use of College Readiness Information

    ERIC Educational Resources Information Center

    Almeida, Daniel J.

    2016-01-01

    California's Early Assessment Program is designed to notify students about their college readiness, encouraging them to take action to improve their skills during their senior year. The author uses qualitative methods and applies sense-making theory to examine how students attending majority Latino, low-income high schools make sense of the…

  2. 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

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

    PubMed

    Pacheco, Christina M; 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.

  4. Feeding practices and styles used by a diverse sample of low-income parents of preschool-age children.

    PubMed

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

    2010-01-01

    To describe the feeding practices and styles used by a diverse sample of low-income parents of preschool-age children. Thirty- to 60-minute meetings involving a semistructured interview and 2 questionnaires administered by the interviewer. Low-income communities in Philadelphia, PA. Thirty-two parents of 2- to 6-year-old children. The feeding practices and styles of low-income parents of preschoolers. Qualitative interviews analyzed iteratively following a thematic approach; quantitative data analyzed using nonparametric and chi-square tests. Qualitative analyses revealed parents used a myriad of feeding practices to accomplish child-feeding goals. Racial/ethnic differences were seen; East Asian parents used more child-focused decision-making processes, whereas black parents used more parent-focused decision-making processes. Quantitative analyses substantiated racial/ethnic differences; black parents placed significantly higher demands on children for the amounts (H = 5.89, 2 df, P = .05; Kruskal-Wallis) and types (H = 8.39, 2 df, P = .01; Kruskal-Wallis) of food eaten compared to parents of other races/ethnicities. In contrast, significantly higher proportions of East Asian parents were classified as having an indulgent feeding style compared to black parents and parents of other races/ethnicities (chi(2)[4, n = 32] = 9.29, P < .05). Findings provide support for tailoring nutrition education programs to meet the diverse needs of this target audience. Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    Reid, Megan; Golub, Andrew; Vazan, Peter

    2014-12-01

    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.

  6. Management of severe acute malnutrition in low-income and middle-income countries.

    PubMed

    Trehan, Indi; Manary, Mark J

    2015-03-01

    Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environmental enteropathy, poor complementary feeding practices, and chronic and acute infections, contribute to the development of SAM. Careful anthropometry is key to making an accurate diagnosis of SAM and can be performed by village health workers or even laypeople in rural areas. The majority of children can be treated at home with ready-to-use therapeutic food under the community-based management of acute malnutrition model with recovery rates of approximately 90% under optimal conditions. A small percentage of children, often those with HIV, tuberculosis or other comorbidities, will still require inpatient therapy using fortified milk-based foods.

  7. Illness care at home or in health institutions: the decision process in a low income community.

    PubMed

    Hoga, Luiza Akiko Komura

    2008-01-01

    The aim of this research was to describe the experiences of a group of women about the decision making process related to illness care at home or in health care institutions. The thematic oral history method was applied. The descriptive categories were: a) The poor have their own way of taking care of health and illness; b) The main support to fight the illness is belief in God; c) Medical care is the last resource, when healing resources are not enough and the illness is dangerous. In low income families, the cultural background, associated to the socioeconomic conditions, permeate the decision with regard to taking care of the illness at home or to seek institutionalized medical care. This knowledge is essential for meaningful health care from the perspective of individuals and families.

  8. 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

  9. Engaging low-income parents in childhood obesity prevention from start to finish: a case study.

    PubMed

    Jurkowski, Janine M; Green Mills, Lisa L; Lawson, Hal A; Bovenzi, Mary C; Quartimon, Ronald; Davison, Kirsten K

    2013-02-01

    Prevention of childhood obesity is a national priority. Parents influence young children's healthy lifestyles, so it is paradoxical that obesity interventions focus primarily on children. Evidence and theory suggest that including parents in interventions offers promise for effective childhood obesity prevention. This case study engaged parents' as co-researchers in the design, implementation and evaluation of an intervention for low-income families with a child enrolled in Head Start. Parent engagement mechanisms include: (1) targeted partnership development (2) operationalizing a Community Advisory Board (CAB) that was the key decision making body; (3) a majority of CAB members were parents who were positioned as experts, and (4) addressing structural barriers to parent participation. Lessons learned are provided for future research, and practice.

  10. Utilization of mobile phones for accessing menstrual regulation services among low-income women in Bangladesh: a qualitative analysis.

    PubMed

    Messinger, Chelsea Jordan; Mahmud, Ilias; Kanan, Sushama; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

    2017-01-14

    As many as one-third of all pregnancies in Bangladesh are unplanned, with nearly one-half of these pregnancies ending in either menstrual regulation (MR) or illegal clandestine abortion. Although MR is provided free of charge, or at a nominal cost, through the public sector and various non-profits organizations, many women face barriers in accessing safe, affordable MR and post-MR care. Mobile health (mHealth) services present a promising platform for increasing access to MR among low-income women at risk for clandestine abortion. We sought to investigate the knowledge, attitudes and practices regarding mHealth of both MR clients and formal and informal sexual and reproductive healthcare providers in urban and rural low-income settlements in Bangladesh. A total of 58 interviews were conducted with MR clients, formal MR providers, and informal MR providers in four low-income settlements in the Dhaka and Sylhet districts of Bangladesh. Interview data was coded and qualitatively analysed for themes using standard qualitative research practices. Our findings suggest that low-income MR clients in Bangladesh have an inadequate understanding of how to use their mobile phones to obtain health service information or counselling related to MR, and correspondingly low levels of formal or informal mHealth service utilization. Few were aware of any formal mHealth services in place in their communities, despite the fact that providers stated that hotlines were available. Overall, MR clients expressed positive opinions of mHealth services as a means of improving women's access to affordable and timely MR. Formal and informal MR providers believed that mobile phones had benefits with respect to information dissemination and making appointments, but emphasized the necessity of in-person consultations for effective sexual and reproductive healthcare. We report low utilization yet high acceptability of mHealth services among low-income MR clients in Bangladesh. Expanding formal and

  11. 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

  12. Family orientation, language, and anxiety among low-income Latino youth.

    PubMed

    Martinez, William; Polo, Antonio J; Carter, Jocelyn Smith

    2012-05-01

    There is emerging evidence that Latino youth report higher levels of anxiety symptoms than children from other ethnic groups. Although often implicated, cultural variables have not been systematically evaluated to determine their relationship to anxiety symptoms in Latino youth. The present study examined family orientation values, as measured by family obligation and affiliative obedience, and their relationship to youth anxiety symptoms. The sample consisted of 133 Latino students (grades 5th through 7th) of low-income backgrounds in an urban public school setting. Structural equation models revealed that higher family orientation was associated with separation anxiety/panic (β=.32) and harm avoidance (β=.51). Models employing language proficiency and use mirrored those employing family orientation, suggesting that language fluency captures, in part, family socialization values. The results provide support for the impact of culture in the assessment and specific needs of Latino youth with anxiety problems.

  13. Is operational research delivering the goods? The journey to success in low-income countries.

    PubMed

    Zachariah, Rony; Ford, Nathan; Maher, Dermot; Bissell, Karen; Van den Bergh, Rafael; van den Boogaard, Wilma; Reid, Tony; Castro, Kenneth G; Draguez, Bertrand; von Schreeb, Johan; Chakaya, Jeremiah; Atun, Rifat; Lienhardt, Christian; Enarson, Don A; Harries, Anthony D

    2012-05-01

    Operational research in low-income countries has a key role in filling the gap between what we know from research and what we do with that knowledge-the so-called know-do gap, or implementation gap. Planned research that does not tangibly affect policies and practices is ineffective and wasteful, especially in settings where resources are scarce and disease burden is high. Clear parameters are urgently needed to measure and judge the success of operational research. We define operational research and its relation with policy and practice, identify why operational research might fail to affect policy and practice, and offer possible solutions to address these shortcomings. We also propose measures of success for operational research. Adoption and use of these measures could help to ensure that operational research better changes policy and practice and improves health-care delivery and disease programmes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Catastrophic health payments and health insurance: some counterintuitive evidence from one low-income country.

    PubMed

    Ekman, Björn

    2007-10-01

    The purpose of the study is to quantitatively analyze the role of health insurance in the determinants of catastrophic health payments in a low-income country setting. The study uses the most recent publicly available household level data from Zambia collected in 1998 containing detailed information on health care utilization and spending and on other key individual, household, and community factors. An econometric model is estimated by means of multivariate regression. The main results are counterintuitive in that health insurance is not found to provide financial protection against the risk of catastrophic payments; indeed, insurance is found to increase this risk. Reasons for the findings are discussed using additional available information focusing on the amount of care per illness episode and the type of care provided. The key conclusion is that the true impact of health insurance is an empirical issue depending on several key context factors, including quality assurance and service provision oversight.

  15. 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.

  16. 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.

  17. Home Safety and Low-Income Urban Housing Quality

    PubMed Central

    Shields, Wendy; McDonald, Eileen; Frattaroli, Shannon; Bishai, David; Ma, Xia

    2012-01-01

    OBJECTIVES: Living in substandard housing may be one factor that increases the risk of fire and burn injuries in low-income urban environments. The purposes of this study are to (1) describe the frequency and characteristics of substandard housing in urban homes with young children and (2) explore the hypothesis that better housing quality is associated with a greater likelihood of having working smoke alarms and safe hot water temperatures. METHODS: A total 246 caregivers of children ages 0 to 7 years were recruited from a pediatric emergency department and a well-child clinic. In-home observations were completed by using 46 items from the Housing and Urban Development’s Housing Quality Standards. RESULTS: Virtually all homes (99%) failed the housing quality measure. Items with the highest failure rates were those related to heating and cooling; walls, ceilings, and floors; and sanitation and safety domains. One working smoke alarm was observed in 82% of the homes, 42% had 1 on every level, and 62% had safe hot water temperatures. For every increase of 1 item in the number of housing quality items passed, the odds of having any working smoke alarm increased by 10%, the odds of having 1 on every level by 18%, and the odds of having safe hot water temperatures by 8%. CONCLUSIONS: Many children may be at heightened risk for fire and scald burns by virtue of their home environment. Stronger collaboration between housing, health care, and injury prevention professionals is urgently needed to maximize opportunities to improve home safety. PMID:23147973

  18. Psychiatric Disorders and Treatment in Low-Income Pregnant Women

    PubMed Central

    Flick, Louise H.; Homan, Sharon M.; Campbell, Claudia; McSweeney, Maryellen; Gallagher, Mary Elizabeth

    2010-01-01

    Abstract Aims This study estimated the prevalence of twenty-two 12-month and lifetime psychiatric disorders in a sample of 744 low-income pregnant women and the frequency that women with psychiatric disorders received treatment. Method To identify psychiatric disorders, the Diagnostic Interview Schedule (DIS) was administered to Medicaid or Medicaid-eligible pregnant women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The sample was stratified by the rural or urban location of the WIC sites in southeastern Missouri and the city of St. Louis. Eligible women were enrolled at each site until their numbers were proportional to the racial distribution of African American and Caucasian pregnant women served there. Results The 12-month prevalence of one or more psychiatric disorders was 30.9%. Most common were affective disorders (13.6%), particularly major depressive disorder (8.2%) and bipolar I disorder (5.2%). Only 24.3% of those with a psychiatric disorder reported that they received treatment in the past year. Lifetime prevalence of at least one disorder was 45.6%, with affective disorders being the most frequent (23.5%). Caucasian women were more likely than African Americans to have at least one 12-month disorder, with the difference largely accounted for by nicotine dependence. Higher prevalence of lifetime disorders was also found in Caucasian women, particularly affective disorders and substance use disorders. There were no differences in the prevalence of 12-month or lifetime psychiatric disorders by the urban or rural residence of subjects. Conclusions With nearly one third of pregnant women meeting criteria for a 12-month psychiatric disorder and only one fourth receiving any type of mental health treatment, comprehensive psychiatric screening during pregnancy is needed along with appropriate treatment. PMID:20524895

  19. Depressive symptoms in low-income women in rural Mexico.

    PubMed

    Fleischer, Nancy L; Fernald, Lia C; Hubbard, Alan E

    2007-11-01

    Depression is a leading cause of death and disability worldwide. This paper reports a cross-sectional analysis of demographic, socioeconomic, physical, and psychosocial factors associated with depressive symptoms among poor women in rural Mexico. A cross-sectional study of 5457 women, age 20-70 years, were interviewed from a random sample of households from 279 poor communities with fewer than 2500 inhabitants in 7 rural Mexican states. Depressive symptoms were assessed using the Spanish translation of the Center for Epidemiologic Studies-Depression scale. Several other individual- and household-level variables were also obtained. Using hierarchical modeling, linear regression analysis, and population intervention model parameters, we explored correlates of depressive symptoms in this population. Most of the variation in depressive symptoms was at the individual level. Psychosocial factors were most strongly correlated with depressive symptoms; perceived stress, lack of personal control or social support, and low social status exhibited the strongest associations. Using the US-based standard Center for Epidemiologic Studies-Depression cutoff score of 16, 51% of this population fall into the category "at risk" for clinical depression; however, this cutoff may not be the most appropriate in this context. This sample of low-income women in rural Mexico reported a relatively high prevalence of depressive symptoms. The analyses suggest that reducing perceived stress would have the largest potential impact on depressive symptoms in this population. However, any interventions should take into account the broad context of the population's overall health. The alleviation of poverty, improvement of educational opportunities, and other interventions to address root causes of poor mental health must also be considered.

  20. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries

    PubMed Central

    Gelaye, Bizu; Rondon, Marta; Araya, Ricardo; Williams, Michelle A.

    2016-01-01

    Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise fi ndings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries. PMID:27650773

  1. Sustainable sanitation systems for low income urban areas - A case of the city of Bulawayo, Zimbabwe

    NASA Astrophysics Data System (ADS)

    Chinyama, A.; Chipato, P. T.; Mangore, E.

    Lack of basic sanitation systems threaten environmental and human health in low income urban communities. In 2005, the Government of Zimbabwe carried out a cleanup exercise in urban areas involving the destruction of illegal structures which left many people homeless. As a solution to this problem, the government embarked on an extensive housing construction exercise on unserviced land; the ‘Garikai/Hlalani Kuhle’ development programme. The objective of this paper was to investigate the sanitation status in one such area (Cowdray Park Extension, Bulawayo) and determine a sustainable sanitation system for the improved collection of wastewater from the unserviced low income urban area. The study was carried out between October 2010 and February 2011. The sanitation status as well as the residents’ preferences for improved sanitation and the economic set up of the community for the study area was determined through use of questionnaires to the residents. The local authority was then consulted to recommend sanitation facilities and system for the area that met regulatory requirements. A literature study identified sanitation options that were applicable to low income and high density urban areas. The baseline survey found that 61% of the people in the study area lacked sanitation facilities and practiced open defecation. The majority of the residents (70%) preferred ‘flush and discharge’ system sanitation facilities, which was in line with the local council’s requirements. On-site sanitation options were found not to be feasible as per the council regulations and the findings of the literature study, for areas with a high density of houses. Therefore a sewerage system was designed using the conventional sewerage design approach as well as the simplified sewerage design approach in order to determine the collection system that would best meet the needs of the community. In conclusion, the community was in dire need of a sanitation system and a waterborne

  2. Predicting Mortality in Low-Income Country ICUs: The Rwanda Mortality Probability Model (R-MPM)

    PubMed Central

    Kiviri, Willy; Fowler, Robert A.; Mueller, Ariel; Novack, Victor; Banner-Goodspeed, Valerie M.; Weinkauf, Julia L.; Talmor, Daniel S.; Twagirumugabe, Theogene

    2016-01-01

    -MPM is an alternative risk prediction model with fewer variables and better predictive power. If validated in other critically ill patients in a broad range of settings, the model has the potential to improve the reliability of comparisons used for critical care research and quality improvement initiatives in low-income countries. PMID:27196252

  3. 75 FR 15352 - Universal Service Support for Low-Income Consumers; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 54 Universal Service Support for Low-Income Consumers; Correction AGENCY: Federal...) receiving Universal Service low-income support. That document inadvertently deleted a sentence from 47...

  4. A New Majority: Low Income Students Now a Majority in the Nation's Public Schools. Research Bulletin

    ERIC Educational Resources Information Center

    Southern Education Foundation, 2015

    2015-01-01

    For the first time in recent history, a majority of the schoolchildren attending the nation's public schools come from low income families. The latest data collected from the states by the National Center for Education Statistics (NCES), evidence that 51 percent of the students across the nation's public schools were low income in 2013. The…

  5. Early Math Trajectories: Low-Income Children's Mathematics Knowledge from Age 4 to 11

    ERIC Educational Resources Information Center

    Rittle-Johnson, Bethany; Fyfe, Emily R.; Hofer, Kerry G.; Farran, Dale C.

    2016-01-01

    Early mathematics knowledge is a strong predictor of later academic achievement, but children from low-income families enter school with weak mathematics knowledge. An Early Math Trajectories model is proposed and evaluated within a longitudinal study of 517 low-income American children from age 4 to 11. This model includes a broad range of math…

  6. Preschool Writing and Premathematics Predict Grade 3 Achievement for Low-Income, Ethnically Diverse Children

    ERIC Educational Resources Information Center

    Manfra, Louis; Squires, Christina; Dinehart, Laura H. B.; Bleiker, Charles; Hartman, Suzanne C.; Winsler, Adam

    2017-01-01

    The present study was designed to explore the association between preschool academic skills and Grade 3 achievement among a sample of ethnically diverse children from low-income families. Data were collected from a sample of 1,442 low-income, ethnically diverse children in preschool and associated with Grade 3 achievement in reading and…

  7. Early Math Trajectories: Low-Income Children's Mathematics Knowledge from Age 4 to 11

    ERIC Educational Resources Information Center

    Rittle-Johnson, Bethany; Fyfe, Emily R.; Hofer, Kerry G.; Farran, Dale C.

    2016-01-01

    Early mathematics knowledge is a strong predictor of later academic achievement, but children from low-income families enter school with weak mathematics knowledge. An Early Math Trajectories model is proposed and evaluated within a longitudinal study of 517 low-income American children from age 4 to 11. This model includes a broad range of math…

  8. Living with Welfare Reform: A Survey of Low Income Families in Illinois.

    ERIC Educational Resources Information Center

    Illinois Univ., Chicago. Center for Urban Economic Development.

    In 1998, the Illinois statewide coalition Work, Welfare and Families, in partnership with the Chicago Urban League, undertook a study to assess the effects of welfare reform on low-income families and children across Illinois. The findings were derived from three sources: a self-administered survey of 2,166 low-income clients of Illinois social…

  9. 13 CFR 108.710 - Requirement to finance Low-Income Enterprises.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Requirement to finance Low-Income Enterprises. 108.710 Section 108.710 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS... Eligibility of A Small Business for Nmvc Financing § 108.710 Requirement to finance Low-Income Enterprises. (a...

  10. Relations between Housing Characteristics and the Well-Being of Low-Income Children and Adolescents

    ERIC Educational Resources Information Center

    Coley, Rebekah Levine; Leventhal, Tama; Lynch, Alicia Doyle; Kull, Melissa

    2013-01-01

    Extant research has highlighted the importance of multiple characteristics of housing but has not comprehensively assessed a broad range of housing characteristics and their relative contributions to children's well-being. Using a representative, longitudinal sample of low-income children and adolescents from low-income urban neighborhoods (N =…

  11. Basic Facts about Low-Income Children: Children under 18 Years, 2013. Fact Sheet

    ERIC Educational Resources Information Center

    Jiang, Yang; Ekono, Mercedes; Skinner, Curtis

    2015-01-01

    Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Being a child in a low-income or poor family does not happen by chance. Parental education and…

  12. Arts Enrichment and Preschool Emotions for Low-Income Children at Risk

    ERIC Educational Resources Information Center

    Brown, Eleanor D.; Sax, Kacey L.

    2013-01-01

    No studies to date examine the impact of arts-integrated preschool programming on the emotional functioning of low-income children at risk for school problems. The present study examines observed emotion expression and teacher-rated emotion regulation for low-income children attending Settlement Music School's Kaleidoscope Preschool Arts…

  13. Benefits of High Quality Childcare for Low-Income Mothers: The Abecedarian Study.

    ERIC Educational Resources Information Center

    Pungello, Elizabeth; Campbell, Frances A.; Miller-Johnson, Shari

    This follow-up study examined the long-term effects of providing 5 years of high-quality childcare for low-income mothers participating in the Abecedarian study, a randomized trial of early childhood educational intervention for children from low-income families. Participating in the age-21 follow-up were 100 of the original 109 biological…

  14. Promoting Fathers' Engagement with Children: Preventive Interventions for Low-Income Families

    ERIC Educational Resources Information Center

    Cowan, Philip A.; Cowan, Carolyn Pape; Pruett, Marsha Kline; Pruett, Kyle; Wong, Jessie J.

    2009-01-01

    Few programs to enhance fathers' engagement with children have been systematically evaluated, especially for low-income minority populations. In this study, 289 couples from primarily low-income Mexican American and European American families were randomly assigned to one of three conditions and followed for 18 months: 16-week groups for fathers,…

  15. The Experiences of Low-Income Latina/o Families in an Urban Voucher, Parochial School

    ERIC Educational Resources Information Center

    Joseph, Tatiana; Vélez, William; Antrop-González, René

    2017-01-01

    Catholic schools have become a popular choice for many low income families Latino/a families. Families enrollment in these schools are often faced with the mandate to participate. However, regardless of the mandate, some schools often experience low parental participation. The purpose of this study is to document the experiences of low income,…

  16. Do No-Loan Policies Change the Matriculation Patterns of Low-Income Students?

    ERIC Educational Resources Information Center

    Waddell, Glen R.; Singell, Larry D., Jr.

    2011-01-01

    We examine whether there is discernable variation in the matriculation patterns of low-income students at public flagship institutions around changes in institutional financial-aid policies that target resident, low-income students with need-based aid. Overall, our results suggests that need is not being met on the extensive margin and that…

  17. Barriers to and Facilitators of Healthful Eating and Physical Activity in Low-Income Schools

    ERIC Educational Resources Information Center

    Hammerschmidt, Patricia; Tackett, Wendy; Golzynski, Matthew; Golzynski, Diane

    2011-01-01

    Objective: To identify barriers to and facilitators of healthful eating and physical activity in low-income schools as perceived by school-affiliated staff. Methods: Perceptions of barriers and facilitators were measured in low-income schools through two online surveys (Kindergarten-8th grade and high school). Sixty-nine (Kindergarten-8th grade)…

  18. Experiences of the Single Low-Income African American Mothers in Their Maternal Protective Role

    ERIC Educational Resources Information Center

    Ivory, Shirley Clark

    2010-01-01

    This study was an IRB approved qualitative investigation of experiences of the single low-income African American mothers in their maternal protective role. In-depth interviews and a focus group were conducted with 13 single-low income women who met the criteria for participation in the study, in an effort to understand the social context in which…

  19. Effects of Tuition Price, Grant Aid, and Institutional Revenue on Low-Income Student Enrollment

    ERIC Educational Resources Information Center

    Lassila, Nathan E.

    2011-01-01

    Evidence of greater economic stratification brings challenges to higher education's enrollment of low-income students. With a growing proportion of potential college students coming from low-income households, increasing their post-secondary participation rate is vital in developing and growing the pool of educated individuals for the labor force…

  20. EITC Participation and Association with Financial Distress among Rural Low-Income Families

    ERIC Educational Resources Information Center

    Gudmunson, Clinton G.; Son, Seohee; Lee, Jaerim; Bauer, Jean W.

    2010-01-01

    This study examined Earned Income Tax Credit (EITC) participation among rural, low-income families, by income level, and investigated whether nonparticipation corresponds with increased financial distress. Rates of EITC participation among 314 rural low-income mothers were lower than national averages, especially among the lowest earners. There…

  1. Effects of Tuition Price, Grant Aid, and Institutional Revenue on Low-Income Student Enrollment

    ERIC Educational Resources Information Center

    Lassila, Nathan E.

    2011-01-01

    Evidence of greater economic stratification brings challenges to higher education's enrollment of low-income students. With a growing proportion of potential college students coming from low-income households, increasing their post-secondary participation rate is vital in developing and growing the pool of educated individuals for the labor force…

  2. The Association between Narratives and Theory of Mind for Low-Income Preschoolers

    ERIC Educational Resources Information Center

    Curenton, Stephanie M.

    2004-01-01

    This study investigated the relationship between narrative skills and theory of mind for low-income children. Two groups of low-income preschoolers, one African American (n = 33) and one European American (n = 36), created a narrative and participated in a false belief task. The European Americans outperformed African Americans on the false belief…

  3. Role of Service Learning Activities: Assessing and Enhancing Food Security in Low-Income Families

    ERIC Educational Resources Information Center

    Duerr, Lynn

    2007-01-01

    Many low-income families are at risk for food insecurity. In addition, with the aging of America, multigenerational families are becoming more prevalent, resulting in excessive strain and burden on the resources of low-income families. Family and consumer sciences educators need to teach their students about factors that contribute to food…

  4. Critical Components of a Summer Enrichment Program for Urban Low-Income Gifted Students

    ERIC Educational Resources Information Center

    Kaul, Corina R.; Johnsen, Susan K.; Witte, Mary M.; Saxon, Terrill F.

    2015-01-01

    Effective program models are needed for low-income youth. This article describes one successful summer enrichment program, University for Young People's Project Promise, and outlines three key components of a Partnership for Promoting Potential in Low-Income Gifted Students (Partnership Model), which is based on Lee, Olszewski-Kubilius, and…

  5. ASSESSING EXPOSURES TO ENVIRONMENTAL CONTAMINANTS IN MINORITY AND LOW INCOME COMMUNITIES

    EPA Science Inventory

    Research has shown that minority and low income communities are often at greater risk of impact from environmental hazards. Many studies use surrogate measures of exposure for minority and low income populations due the lack of actual data on exposures in these communities. T...

  6. Borrowing and Working of Low-Income Students: The Impact of a Summer Transition Program

    ERIC Educational Resources Information Center

    De La Rosa, Mari Luna

    2012-01-01

    This study focuses on how low-income students determine employment and student loan borrowing options before they begin college, as part of the final stages of their college choice process. More specifically, this study asks, "during a six-week summer transition program, what choices are made by low-income students with employment or borrowing…

  7. The Voice of Low-Income Adolescent Mothers on Infant Feeding

    ERIC Educational Resources Information Center

    Horodynski, Mildred A.; Mills, Kristen J.

    2014-01-01

    Adolescent mothers' feeding practices impact infant weight gain. Infant obesity, especially in low-income families, is rapidly increasing. The aim of the exploratory study reported here was to identify factors affecting low-income African American and non-Hispanic White adolescent mothers' infant feeding practices and useful learning modalities.…

  8. Religious Involvement and Attitudes toward Parenting among Low-Income Urban Women

    ERIC Educational Resources Information Center

    Hill, Terrence D.; Burdette, Amy M.; Regnerus, Mark; Angel, Ronald J.

    2008-01-01

    The authors employ data from the Welfare, Children, and Families project, a probability sample of 2,402 low-income women with children living in low-income neighborhoods in Boston, Chicago, and San Antonio, to test whether religious attendance is associated with parental satisfaction, perceived parental demands, and parental distress over 2 years.…

  9. Contemporary Work and Family Issues Affecting Marriage and Cohabitation among Low-Income Single Mothers

    ERIC Educational Resources Information Center

    Joshi, Pamela; Quane, James M.; Cherlin, Andrew J.

    2009-01-01

    In this paper, we advance and test an integrative model of the effects of employment status, nonstandard work schedules, male employment, and women's perceptions of economic instability on union formation among low-income single mothers. On the basis of the longitudinal data from 1,299 low-income mothers from the Three-City Welfare Study, results…

  10. Contemporary Work and Family Issues Affecting Marriage and Cohabitation among Low-Income Single Mothers

    ERIC Educational Resources Information Center

    Joshi, Pamela; Quane, James M.; Cherlin, Andrew J.

    2009-01-01

    In this paper, we advance and test an integrative model of the effects of employment status, nonstandard work schedules, male employment, and women's perceptions of economic instability on union formation among low-income single mothers. On the basis of the longitudinal data from 1,299 low-income mothers from the Three-City Welfare Study, results…

  11. Health Care, Health and Illness Behavior of Low Income Families in the State of Maine.

    ERIC Educational Resources Information Center

    Bolaria, Bhopinder S.

    This study on health care and health and illness of low income families is based on findings from interviews with 301 low-income families in the state of Maine. The findings show that a majority of the families have various health or medical problems which need immediate attention. These problems range from dental care and chronic medical…

  12. Role of Service Learning Activities: Assessing and Enhancing Food Security in Low-Income Families

    ERIC Educational Resources Information Center

    Duerr, Lynn

    2007-01-01

    Many low-income families are at risk for food insecurity. In addition, with the aging of America, multigenerational families are becoming more prevalent, resulting in excessive strain and burden on the resources of low-income families. Family and consumer sciences educators need to teach their students about factors that contribute to food…

  13. Engagement with Print: Low-Income Families and Head Start Children

    ERIC Educational Resources Information Center

    Lynch, Jacqueline

    2008-01-01

    This research examined the types of print literacy activities low-income parents reported engaging in with their four-year-old children. There were 38 parents of children involved in Head Start, a pre-school program for children from low-income families living in the USA, who participated in this study. Children were assessed on their knowledge…

  14. Parenting and Child Health: A Study of Low-Income Hispanic and African American Families

    ERIC Educational Resources Information Center

    Nievar, M. Angela; Ramisetty-Mikler, Suhasini

    2011-01-01

    Children in low-income and ethnic minority families are more likely to be in poor health, which may impact physical and economic well-being in adulthood. This study explored how maternal depression and parenting efficacy were associated with child health outcomes in a sample of minority low-income families (N = 311). Results demonstrate that…

  15. Youth from Low-Income Families. Vulnerable Youth and the Transition to Adulthood. ASPE Research Brief

    ERIC Educational Resources Information Center

    Kent, Adam

    2009-01-01

    In 2007, nearly 40 percent of children in the United States lived in low-income families--families with incomes at or below 200 percent of the federal poverty level (FPL). Youth from low-income families are vulnerable to poor outcomes as adults, as these youth often lack the resources and opportunities found to lead to better outcomes. This fact…

  16. Child Disinhibition, Parent Restriction, and Child Body Mass Index in Low-Income Preschool Families

    ERIC Educational Resources Information Center

    Sparks, Martha A.; Radnitz, Cynthia L.

    2013-01-01

    Objective: To examine both unique and interactive effects of parent restrictive feeding and child disinhibited eating behavior on child body mass index (BMI) in low-income Latino and African American preschoolers. Methods: The sample included 229 parent-child pairs, the majority of whom were low-income and Latino (57%) or African American (25%).…

  17. Helping Low-Income Mothers with Criminal Records Achieve Self-Sufficiency.

    ERIC Educational Resources Information Center

    Brown, Rebecca

    2000-01-01

    This issue of WIN (Welfare Information Network) Issue Notes focuses on helping low-income mothers with criminal records achieve self-sufficiency. Section 1 offers background. Section 2 answers these policy questions: why states might want to focus on serving low-income mothers with criminal records; how states can encourage employers to hire…

  18. 24 CFR 791.402 - Determination of low-income housing needs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... needs. 791.402 Section 791.402 Housing and Urban Development Regulations Relating to Housing and Urban... 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....

  19. Increasing Work Opportunities for Low-Income Workers through TANF and Economic Development Programs.

    ERIC Educational Resources Information Center

    Friedman, Pamela

    2002-01-01

    The numerous layoffs of low-income workers that occurred when the nation's economy slowed in 2001 have created numerous challenges for local Temporary Assistance for Needy Families (TANF) programs. By increasing collaboration between community economic development and workforce development efforts to serve low-income residents, states and…

  20. The Voice of Low-Income Adolescent Mothers on Infant Feeding

    ERIC Educational Resources Information Center

    Horodynski, Mildred A.; Mills, Kristen J.

    2014-01-01

    Adolescent mothers' feeding practices impact infant weight gain. Infant obesity, especially in low-income families, is rapidly increasing. The aim of the exploratory study reported here was to identify factors affecting low-income African American and non-Hispanic White adolescent mothers' infant feeding practices and useful learning modalities.…