Florida Community Research Articles

44191 As Food Insecurity Worsens During COVID-19, Negative Mental Health Impact on Community Members Increases

ABSTRACT IMPACT: For community engagement to be impactful and reduce health inequity, it needs to address timely needs in the community, including COVID-19 impacts. Here, we describe how pre- and post-COVID-19 food insecurity worsened mental health among community members served by HealthStreet University of Florida community engagement program. OBJECTIVES/GOALS: COVID-19 impacts the economic vitality and the mental health of communities; research and engagement activities must consider the context in which we are practicing and the needs of our community members. METHODS/STUDY POPULATION: HealthStreet, the University of Florida community engagement program, sends Community Health Workers (CHWs) where people congregate to assess social determinants of health and medical histories, used to make referrals to services and research opportunities. CHWs conducted follow-up COVID-19 assessments measuring perceived stress, loneliness, depression, anxiety, binge drinking, and opioid use, as well as high blood pressure and food insecurity. Here, we consider mental health outcomes among 1,300 adults who reported being food insecure either at some time in the past 12 months at baseline, or at the COVID-19 follow-up assessment, and completed both. Chi-Square Test was used to determine p-values. RESULTS/ANTICIPATED RESULTS: Overall, at the COVID-19 follow-up assessment, 37.1% (of 1,300) were still food insecure during COVID-19 (same), 20.3% (had become food insecure during COVID-19 (worse) and 42.6% were no longer food insecure (better). Those who were no longer food insecure were more likely to report less stress, while those still food insecure were more likely to report the highest stress and loneliness (p<0.0001), while the worse off group was in the middle. Those who stayed food insecure were most likely to report depression and anxiety, and also high blood pressure and using opioids (p<.05) compared to those getting worse or better. Binge drinking behavior was not significantly different across groups. DISCUSSION/SIGNIFICANCE OF FINDINGS: Community engagement activities across CTSIs must be sensitive to the needs of their communities. HealthStreet findings show that new and continuing food insecurity negatively influence mental health problems, pointing to the need for engagement to address multiple problems.

Phenological synchrony between a weed (Dioscorea bulbifera) and a biocontrol agent (Lilioceris cheni) in the introduced range, Florida: implications for biological control

ABSTRACT Dioscorea bulbifera has invaded, smothered, and disrupted ecological functions of native plant communities in Florida. Vines senesce in late fall, then overwinter as tubers and aerial bulbils which sprout in spring and repeat the growth cycle. A foliage-feeding beetle Lilioceris cheni, introduced from Asia as a biocontrol agent has established throughout D. bulbifera's range in Florida. Synchronies among the growth phenology of the weed, life stages of biocontrol agents and weather conditions, are considered essential for the successful suppression of an introduced weed. We conducted a common garden study that encompassed pre-biocontrol release attributes of D. bulbifera followed by a 5-yr post-L. cheni release impacts study on its natural infestations in four sites. We gathered monthly data on D. bulbifera and L. cheni and assessed possible synchronies between their life stages and with local weather variables. Air and soil temperatures and total rainfall showed positive correlation with timing of D. bulbifera vine emergence/senescence, vine coverage, adult beetle emergence from diapause, and their life stages (egg clutches, larvae, and adults). Vine sprouting and beetle emergence in two southern sites began in February and April, and in the remaining two northern sites in March and May, respectively. Vine sprouting and beetle emergence was initiated at 15 and 20°C, respectively. All sites achieved maximum vine coverage in July. Bulbil development, oviposition by overwintering adults, and vine damage by adult and larval feeding began in June. These sequences of events indicated phenological synchrony of the beetle and air potato life stages in Florida.

Board Capital and Board Effectiveness: An Examination of Florida Community Foundations

Community foundations have considerable potential for positive social change in the communities they serve yet are understudied in nonprofit management literature. This exploratory study considers board capital of community foundations and the impact this has on board effectiveness. Based on survey data from 71 community foundation board members and executive directors representing 13 community foundations, the study uses regression to test hypotheses. The study finds that board capital, measured by human capital, structural capital, and social capital, plays a factor in board effectiveness. Further, community foundation boards in the survey population are highly effective and have unique attributes that make them distinct from other types of boards. Findings have potential for significant insight on an important segment of nonprofit sector organizations.

When the Pandemic Impacts the Most Vulnerable: Analyzing Crisis and Risk Messages Aimed at Latinx Individuals about COVID-19

Guided by the IDEA model, this pilot study analyzes the perceptions about coronavirus (COVID-19) messages created to be distributed to the Latinx community in the United States. This study has been conducted to test the research questions proposed and the instruments so a second study can be executed based on Latinx populations in Florida communities. A survey was distributed among students from different ethnicities. A comparative analysis was run with the responses from the students who identified as Latinx and the students who identified as non-Latinx. The results demonstrated that components such as internalization, explanation, and action are present in the messages distributed to both groups. The results also showed that only two dimensions of the IDEA model's components demonstrated significant differences between both groups. This research suggests that message tailoring could improve message effectiveness within each area of the IDEA model.

Gingles Unraveled: Hispanic Voting Cohesion in South Florida

The Voting Rights Act protects the ability of racial and language minority groups to elect candidates of choice by prohibiting states and localities from diluting those groups’ votes when drawing electoral districts. The Fair Districts provisions of the Florida Constitution include a similar ban on vote dilution, plus further protections against diminishing (retrogressing) existing minority voting strength. A key element of proving vote dilution or retrogression is that the minority group votes cohesively. Historically, minority voting cohesion has often been uncontested or easily proven in VRA suits. But in South Florida, Hispanic citizens are voting less cohesively than they used to. This Article investigates the legal issues that arise when the assumption of cohesion unravels. First, this Article investigates to what extent the Hispanic community in South Florida is cohesive. It then proposes several alternative approaches to the vote dilution and retrogression framework to better align doctrine with the real-world conditions of voters and communities.

Can Re-Enrollment Campaigns Help Dropouts Return to College? Evidence From Florida Community Colleges

In this study, we develop and implement a text messaging re-enrollment campaign to encourage former community college students to return to college. Former students are randomly assigned to one of two treatment groups that either receives information to simplify the re-enrollment process or receives both information and a one-course tuition waiver. We find that providing information and a one-course tuition waiver to former students increases their likelihood of re-enrollment by 1.5 percentage points (21.1%), enrolling in multiple courses by 0.9 percentage points (16.4%), full-time enrollment by 0.5 percentage points (21.7%), and persistence by 0.6 percentage points (23.1%). This study highlights the importance of targeted interventions that address informational and financial barriers facing former students.

Improving Communication for Older Adults During Disaster Events

Management of any disaster event (i.e., hurricanes, flooding, wildfires, viral pandemic) is a complicated task. An important and frequently overlooked aspect of efficient disaster response is effective information exchange among emergency managers, aging and social service providers, and those impacted by the disaster. Breakdowns in communication are regularly cited as failures in actual emergency situations. Older adults have unique challenges to effective communication during a disaster event. Further, messaging platforms may be inaccessible to older adults. Given the lack of data collected on the role of effective communication for older adults in a disaster event, we developed this symposium to highlight lessons learned for facilitating disaster communication among older community members and discuss how policy can further disaster communication efforts. The first presentation highlights the advantages of using targeted marketing communication channels to encourage older adults to prepare and recover from a disaster, as well as the value of collaborative partnerships in this communication. The second presentation introduces results from research collected from older adults on their use of social media to stay informed before and after Hurricane Matthew. The third presentation explores whether assisted living communities in Florida’s affected counties evacuated or sheltered in place in the context of emergency management communications concerning evacuation. The fourth presentation highlights the experiences of older persons in Houston’s communication post-Hurricane Harvey from an aging service provider’s perspective. The final presentation discusses disaster literacy and how this model can be used to enhance outcomes at all phases of a disaster. Disasters and Older Adults Interest Group Sponsored Symposium.

Availability of Audiology Services in Assisted Living Communities in Florida

Florida has one of the largest populations of older adults in the U.S., and as a result the state also has a high prevalence of hearing loss. Given the growth of assisted living as a housing option for older adults, the purpose of this study was to determine the availability of audiology services in assisted living communities (ALCs) across Florida. Data on ALC location, characteristics and audiology service availability were collected from the Florida Agency for Health Care Administration (AHCA). County socioeconomic data were collected from the U.S. Department of Labor. Logistic regression and chi2 tests were used to examine the relationship between county socioeconomics and whether an ALC provided audiology services. We found that of the 3090 ALCs in Florida, audiology services were present in only 57 (3.2%). ALCs with audiology services were significantly more likely to be located in counties with a higher education level and a higher average income. This suggests a shortage of ALCs with audiology services in counties where residents have fewer resources. The results are concerning, given that individuals with fewer resources are less able to pay for audiology services on their own and evidence showing that poor hearing health late in life impacts individuals’ health and quality of life. Policy implications will be discussed, including the need for more ALCs to provide audiology services in counties with fewer resources. One possible solution is tele-audiology, which would enable a single audiologist to diagnose and prescribe hearing aids to patients in underserved areas.

The complexity of diversity and importance for equitable philanthropy

AbstractThe current U.S. climate of racial and social injustice has prompted a renewed call for diverse and equitable ways to rethink community philanthropy. Community foundations are vehicles for community philanthropy which offer vast benefits for social improvement and community development. The board of directors ensures these organizations fulfill their mission, making decisions on funding priorities and holding the organization functionally and fiscally responsible. Drawing on constructs of diversity and representative bureaucracy and a case study of Florida community foundations, we suggest that diversity is understood in different ways and the presence of diverse board members may be linked to advancing the interests of diverse communities and in achieving outcomes that assist in the needs of certain social groups. Increased understanding of diversity can improve foundation and philanthropic effectiveness and bring broader social change by promoting equity and social justice among community‐based philanthropic organizations.

Conducting an immersive community-based assessment of post-hurricane experience among Puerto Ricans: lived experience of medical ecology in an environmental disaster and migration

BackgroundTwo devastating sequential hurricanes impacted Puerto Rico during September of 2017. The hurricanes were traumatic and created social and ecological upheaval throughout Puerto Rico, and subsequently in communities of Central Florida where affected Puerto Ricans migrated. The 2017 hurricane season exposed and exacerbated previous long-standing socio-political, economic, environmental, and health crises, generating a humanitarian emergency in the country. The consequences of these human-ecological disasters destroyed much of Puerto Rico’s residential and environmental infrastructure, displacing thousands of people and resulting in an unprecedented migration to the United States. We report on the lived experience of the investigator team and partnership in conducting community-based formative research subsequent to this disaster, research that aimed to identify salient issues relating to the impact of Hurricanes Irma and María on Puerto Rican communities both in Puerto Rico and in Central Florida.DiscussionThe challenges faced during the conduct of this research include but are not limited to (1) emotional distress of participants and team members, (2) access to affected populations, and (3) precarious environmental factors, such as unstable infrastructure. To address these challenges, the researchers applied a Critical Medical Ecological paradigm along with qualitative methods to assist constructing explanatory models while obtaining internally-valid (from the community perspective), cathartic narrative accounts of the lived experience of hurricane survivors. The experience of the research team may help inform other investigators conducting applied research during a humanitarian crisis.ConclusionLessons learned in this research included: (1) usefulness of applying the Critical Medical Ecological model in the development of the project, (2) incorporating participation and methods that prioritize authenticity, (3) understanding the trauma experience and using study methods sensitive to it, and (4) innovating with best approaches to conduct the study given the challenges in post-hurricane Puerto Rico. These lessons could provide new insights on how to conduct in-depth participatory health research with community members who have been traumatized and – often – displaced. This research also demonstrates the value of pre-existing partnerships, critical consciousness in the field team, and medical ecological modeling as experiential for organizing complex, inter-related, multi-level variables that explain community and individual impact of environmental disasters.

A mixed-methods approach to understanding perceptions of hepatitis B and hepatocellular carcinoma among ethnically diverse Black communities in South Florida.

Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC), disproportionately affects minorities. Compared to other races, Blacks more often present with advanced HCC and have decreased survival. We observed higher HBV-associated HCC rates among Blacks than reported nationally. In our center, Haitian Blacks had the highest rates of HBV-associated HCC and shorter survival compared to other Blacks. We investigated knowledge and perceptions regarding HBV and HCC among Blacks born in the United States or Haiti. Using community partnerships, participants were recruited via word of mouth, email, social media or from Hepatology clinic. Focus groups were conducted in Haitian Creole or English and stratified by birthplace, gender and infection status. Discussions were audio-recorded and transcribed verbatim. A constant comparative method was used for data analysis; themes are based on conversational details. There were 55 participants; 49% were male and 27% had chronic HBV. Only 42% of Haitian Blacks knew about HBV prior to participation vs. 78% of African Americans, p 0.03. Both groups expressed that fear, mistrust of the medical establishment, denial and stigma might compel persons to avoid seeking care. Both groups attributed higher rates of late stage HCC diagnosis in Blacks to inadequate financial resources and education. Those with HBV reported confusion regarding their infection and suboptimal communication with healthcare providers. In two communities disproportionately affected by HBV, misconceptions about disease transmission, stigma, low health literacy and decreased access to care may limit detection for HBV. Culturally relevant community-based interventions are needed to increase HBV detection.

Correlates related to follow-up in a community engagement program in North Central Florida.

This analysis identifies the correlates of 60- and 120-day telephone-based study follow-ups among community-dwelling adults in North Central Florida. Six thousand three hundred and fortyparticipants were recruited by Community Health Workers from the University of Florida's community engagement program with a face-to-face baseline and two phone follow-ups assessing indicators of health. Physical disability versusnone (adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.2─1.9), high trust in research versusnone (aOR, 1.5; 95% CI, 1.1─2.1), history of research participation versusnone (aOR, 1.6; 95% CI, 1.3─2.0), having health insurance versusnone (aOR, 1.4; 95% CI,1.1─1.7), interest in research participation versusnone (aOR, 1.8; 95% CI, 1.3─2.7), and no drug use versusdrug use (aOR, 0.5; 95% CI, 0.3─0.9) significantly predicted completion of follow-up. Health and social factors such as disability, insurance, history of and interest in research, trust and no drug use significantly predicted completing two follow-ups. These findings can facilitate efforts to minimize attrition in the research enterprise.

Aging and thriving with HIV: a photovoice project with long-term HIV survivors in Miami, Florida

ABSTRACT Background Long-term survivors of HIV in Miami, Florida are facing critical health and social issues as they age with this disease. Methods Using PhotoVoice methodology, nine Latino/a activist-artists were recruited to take pictures depicting their everyday life-challenges to be used in several photography exhibits aimed at informing local policy direction. Results The group identified a positive approach to aging with HIV as a priority at the individual, community and policy level, emphasizing policy alternatives to the negative and disease-ridden stereotypes that embed current discussions on living and aging with HIV. The activists highlight specific community and policy solutions that respond to the growing needs of long-term survivors of HIV/AIDS among Latino communities in South Florida. Conclusions The findings suggest that Miami (and areas with a large HIV-positive population) may benefit from community and policy solutions that take a successful aging approach and build upon the resiliency of this population.

A Geodemographic Service Coverage Analysis of Travel Time to Glaucoma Specialists in Florida.

Approximately 1 in 9 Florida residents over the age of 65 years (438,642 people) live more than an hour away from a glaucoma specialist, which represents a significant barrier to care. To describe access to glaucoma care for Florida's elderly population using travel time to American Glaucoma Society (AGS) member offices. For this cross-sectional service coverage analysis, a list of AGS member locations was extracted from the AGS website, and addresses were geocoded using ArcGIS Online. Driving time regions were created using the service area tool in ArcGIS Pro 2.4 and overlaid with 2010 United States Census and 2016 American Community Survey data for all Florida residents age 65 or older. Fifty-eight AGS member providers with 65 locations were identified and geocoded. There were 3,797,625 individuals aged over 65 years in Florida, of which 1,153,320 (30.4%) lived within 15 minutes of driving time from an AGS provider's office, 2,586,825 (68.1%) within 30 minutes, 3,358,983 (88.4%) within 60 minutes, and 3,491,815 (91.9%) within 120 minutes. The areas with the lowest access include rural areas near Lake Okeechobee and the Florida Panhandle. The population living beyond a 60-minute drive was more likely to be White, non-Hispanic and older, but less likely to be living below the federal poverty level or receiving public assistance than the population living within a 60-minute drive. There is a significant travel burden for the elderly community of Florida to reach AGS providers. Additional studies could help identify other social barriers to accessing glaucoma providers in Florida and beyond in an effort to improve patient compliance and, ultimately, vision outcomes.

Differences in cardio-metabolic risk profiles and functional capacity in a contemporary multiethnic community in north east florida- The VIDASANA Project

Differences in cardio-metabolic risk profiles and functional capacity in a contemporary multiethnic community in north east florida- The VIDASANA Project

Willingness to Participate in Health Research Among Community-Dwelling Middle-Aged and Older Adults: Does Race/Ethnicity Matter?

IntroductionOlder adults, including racial and ethnic minorities, are underrepresented in research. As the US population ages, the number of older racial and ethnic minority individuals will increase. Including these individuals in research is an important step towards reducing health disparities.MethodsWe used data from HealthStreet, a University of Florida community engagement program which uses community health workers to assess the health of the community, to assess willingness to participate in different types of health research by race/ethnicity. Descriptive statistics and logistic regression models were used to assess willingness to participate among adults aged 50 and older, by race/ethnicity (n = 4694).ResultsOur sample was 42.0% non-Hispanic White, 52.8% non-Hispanic Black, and 5.2% Hispanic. Non-Hispanic White participants reported more past research participation than non-Hispanic Black and Hispanic participants (28.7% vs. 19.0% and 19.2%, respectively). Compared with non-Hispanic White participants, non-Hispanic Black participants were less willing to participate in most types of studies, while Hispanic participants were less willing to participate in studies that might be seen as invasive (required blood sample, genetic sample, or participants to take medicine, or use of medical equipment).ConclusionsOur study provides investigators with a general profile of research preferences by race/ethnicity; compared with non-Hispanic White individuals, non-Hispanic Black individuals are less willing to participate in most studies, while Hispanic individuals are less willing to participate in studies that may be seen as invasive or demanding. It is imperative to include diverse older adults in health research. By tailoring research based on preferences we can improve recruitment in underrepresented populations.

P84 Perceived Healthfulness of Environment of Low-Income Communities by Community Extension Nutrition Educators

<h3>Background</h3> The environment in which people live affects food and physical activity decisions, but low-income communities often lack the resources to support more healthful choices. Understanding the perceived barriers and facilitators to engaging in healthful practices in communities is an important first step in developing targeted interventions to improve health. <h3>Objective</h3> To determine Extension nutrition educators' perceptions about the healthfulness of the environment in the communities they serve. <h3>Study Design, Setting, Participants</h3> Focus groups (n = 16) and in-depth interviews (n = 6) were conducted in English (n = 11) and Spanish (n = 5) with Extension nutrition educators (n = 84) working in low-income communities in Kansas, Florida, New Hampshire, Rhode Island, South Dakota, Tennessee, and West Virginia. Trained focus group moderators used a semi-structured script to ask questions about the healthfulness of the community environment in which they work. <h3>Measurable Outcome/Analysis</h3> Audio recorded focus groups and in-depth interviews were transcribed verbatim and content analyzed to identify themes. <h3>Results</h3> Across all states, participants described a healthy lifestyle as a multifaceted approach to wellness that promotes healthy eating, physical activity, and mental and spiritual health. Perceived barriers for English and Spanish participants included the lack of access to and availability of healthy food and public transportation; lack of nutrition education and nutrition resources; and limited mental health resources. Spanish participants emphasized the need for culturally and linguistically appropriate nutrition materials and suggested that participant attrition from education programs was due to the increased anxiety related to participants' immigration status. Perceived facilitators were limited but included access to trustworthy education resources and food banks/pantries. <h3>Conclusions</h3> Extension nutrition educators across several states listed similar barriers and facilitators to a healthy lifestyle for low-income individuals. Data will be used to develop focus group questions for low-income community residents with a long-range goal of developing a survey to measure perceived healthfulness of low-income communities.

Salient factors among Hispanic parents in South Florida rural communities for vaccinating their children against human papillomavirus

PurposeFew studies have tried to understand the factors related to HPV vaccination among Hispanics living in rural communities in the United States (US). Nationally, HPV vaccination among Hispanics is suboptimal (26.1%) compared to the HealthyPeople 2020 goal of 80% and even more suboptimal in rural communties. This study aimed to determine the salient factors among Hispanic parents for vaccinating their children against HPV and for designing a future HPV prevention intervention for Hispanics. Design and methodsA descriptive qualitative design was used. Saturation was reached after conducting four focus groups with 23 Hispanic parents from rural communities in South Florida. Directed content analysis using the Theory of Planned Behavior (TPB) constructs was used to analyze the transcripts. ResultsAll TPB constructs were identified as salient factors for HPV vaccination including background factors, attitudes towards the behavior, perceived norms, perceived behavioral control, actual control, intention, and behavior. ConclusionsAddressing HPV vaccination by developing educational programs based on the TPB and tailored to meet the needs of Hispanic parents is urgently needed to prevent HPV among Hispanics in rural US communities. This approach can also serve as a directive to target HPV vaccination among Hispanics in other rural areas in the US. Practice implicationsPediatric nurses must proactively promote and recommend the HPV vaccine (HPVV), educate parents on having sex-related discussions with their children, include children in the HPVV education and decision, bundle the HPVV with other child vaccines, and utilize reminder systems to ensure completion of the vaccine series.

The COVID-19 Pandemic-Can open access modeling give us better answers more quickly?

The COVID-19 Pandemic-Can open access modeling give us better answers more quickly?

Understanding Access to Healthy Foods and Grocery Shopping Patterns Among Community Residents in Underserved Neighborhoods in Tampa, Florida

Abstract Objectives It is widely accepted that low-income and racial/ethnic minority neighborhoods are disproportionately affected by diet-related adverse health outcomes. Access to healthy foods has also been shown to be a determinant of more optimal dietary intake and health. This study aimed to conduct a survey to examine grocery shopping patterns and food access among community residents in underserved neighborhoods; the study was conducted in partnership with community organizations. Methods A survey was administered cross-sectionally. Twenty-seven questions adapted from previous research regarding grocery shopping patterns and food access were included. Community residents aged ≥18 years in East Tampa, a designated Florida Community Redevelopment Area (CRA), were recruited at community events/meetings, and an online version of the survey was distributed through the email listserv of community partners. A total of 126 residents participated; the majority was African American, female, and ≥35 years of age. Descriptive statistics were used for data analysis. GIS mapping was subsequently used to examine the residents’ accessibility to grocery stores within the neighborhoods. Results The majority (58%) of the participants reported that they usually buy most of their groceries at supermarkets, followed by large chain stores (41%), farmers markets (11%), and discount stores (10%). There were 4 major stores in the neighborhoods identified as preferred grocery stores. Most participants indicated that they use cash (52%) or EBT card (30%) for grocery shopping, and 33% regularly get food from food pantries. Most residents use their own cars (76%) for transportation and indicated that it takes ≤30 minutes (87%) to get their groceries. Ninety participants (71%) indicated that a new supermarket nearby would help them get food easier, followed by a new farmers market. In an open-ended question, some reported that mobile food trucks or delivery services would make it easier to get the foods. A specific location for a new supermarket was identified by each participant. Conclusions Community residents demanded a new supermarket or farmers market with better variety of fresh produce. The results of this study have been discussed with the community partners and the CRA advisory committee. Funding Sources University of South Florida, College of Public Health Internal Faculty Awards.