Community Prevention Programs Research Articles

Relationships between familial HIV/AIDS and symptoms of anxiety and depression: the mediating effect of bullying victimization in a prospective sample of South African children and adolescents.

South African children and adolescents living in HIV/AIDS-affected families are at elevated risk of both symptoms of anxiety and depressive symptoms. Poverty and HIV/AIDS-related stigma are additional risk factors for these negative mental health outcomes. Community level factors, such as poverty and stigma, are difficult to change in the short term and identifying additional potentially malleable mechanisms linking familial HIV/AIDS with mental health is important from an intervention perspective. HIV/AIDS-affected children are also at increased risk of bullying victimization. This longitudinal study aimed to determine whether prospective relationships between familial HIV/AIDS and both anxiety symptoms and depressive symptoms operate indirectly via bullying victimization. Adolescents (M = 13.45 years, 56.67 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up one year later (n = 3,401, 96.70 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces, and door-to-door sampling included all households with a resident child/adolescent. Familial HIV/AIDS at baseline assessment was not directly associated with mental health outcomes 1 year later. However, significant indirect effects operating via bullying victimization were obtained for both anxiety and depression scores. Importantly, these effects were independent of poverty, HIV/AIDS-related stigma, and baseline mental health, which highlight bullying victimization as a potential target for future intervention efforts. The implementation and rigorous evaluation of bullying prevention programs in South African communities may improve mental health outcomes for HIV/AIDS-affected children and adolescents and this should be a focus of future research and intervention.

Collecting costs of community prevention programs: communities putting prevention to work initiative.

Community-based programs require substantial investments of resources; however, evaluations of these programs usually lack analyses of program costs. Costs of community-based programs reported in previous literature are limited and have been estimated retrospectively. To describe a prospective cost data collection approach developed for the Communities Putting Prevention to Work (CPPW) program capturing costs for community-based tobacco use and obesity prevention strategies. A web-based cost data collection instrument was developed using an activity-based costing approach. Respondents reported quarterly expenditures on labor; consultants; materials, travel, and services; overhead; partner efforts; and in-kind contributions. Costs were allocated across CPPW objectives and strategies organized around five categories: media, access, point of decision/promotion, price, and social support and services. The instrument was developed in 2010, quarterly data collections took place in 2011-2013, and preliminary analysis was conducted in 2013. Preliminary descriptive statistics are presented for the cost data collected from 51 respondents. More than 50% of program costs were for partner organizations, and over 20% of costs were for labor hours. Tobacco communities devoted the majority of their efforts to media strategies. Obesity communities spent more than half of their resources on access strategies. Collecting accurate cost information on health promotion and disease prevention programs presents many challenges. The approach presented in this paper is one of the first efforts successfully collecting these types of data and can be replicated for collecting costs from other programs.

An assessment of the role of perceived benefits, barriers and self-efficacy in predicting dietary behavior in male and female high school students in the city of Izeh, Iran.

Introduction:Paying attention to improving the nutritional status of adolescents can be one of the most effective fundamental measures for preventing chronic diseases, particularly cardiovascular diseases in later life. Identifying the predicting elements in different behaviors is one of the most effective ways that can be considered in prevention programs in different communities, particularly in developing countries. The purpose of was to determine the perceived efficacy, benefits and barriers related to a healthy nutrition pattern and the relation of these variables with a healthy diet in male and female high school students in Izeh city.Materials and Methods:In this cross-sectional descriptive and analytic study conducted throughout high schools in Izeh City, the subjects were 500 students (300 girls and 200 boys) from the 1390-91 school years who were selected through the multistage random sampling method; the acquired data was then studied and analyzed. The data for this study was gathered through a multi-sectional questionnaire (that included demographic characteristics, self-efficacy, perceived benefits and barriers). The Independent t-test, Spearman's Correlation, Pearson's Correlation Coefficient and Linear Regression were used to interpret and analyze the data.Results:Data analysis showed that the mean age of male participants was 15.67 ± 0.95 years and females 15.86 ± 1.16 years. The mean score for healthy eating patterns in male students was 46.83 ± 14.86 and in female students 44.20 ± 14.16 respectively. The mean score for perceived benefits of healthy eating in girls was significantly higher than that in boys. There was a direct meaningful relationship between the mean score of benefits and perceived self-efficacy with the healthy eating behaviors in the two sexes, (P < 0.001). The results of the multiple linear regression analysis revealed that the most important predictive factors in the students’ healthy eating behavior are self-efficacy and perceived benefits respectively and that perceived barriers is not an influencing predictor in healthy eating patterns.Conclusion:The results of this study showed that many factors influence students’ diet pattern and undeniably the role of these factors are not alike in the two sexes. The results also showed that perceived self-efficacy and benefits of healthy nutrition strengthens healthy eating behavior in students and thus these factors should be considered by health authorities in the country in any future programming.

Bias-motivated bullying and psychosocial problems: Implications for HIV risk behaviors among young men who have sex with men

The present study aimed to determine whether the experience of bias-motivated bullying was associated with behaviors known to increase the risk of HIV infection among young men who have sex with men (YMSM) aged 18–29, and to assess whether the psychosocial problems moderated this relationship. Using an Internet-based direct marketing approach in sampling, we recruited 545 YMSM residing in the USA to complete an online questionnaire. Multiple linear regression analyses tested three regression models where we controlled for sociodemographics. The first model indicated that bullying during high school was associated with unprotected receptive anal intercourse within the past 12 months, while the second model indicated that bullying after high school was associated with engaging in anal intercourse while under the influence of drugs or alcohol in the past 12 months. In the final regression model, our composite measure of HIV risk behavior was found to be associated with lifetime verbal harassment. None of the psychosocial problems measured in this study – depression, low self-esteem, and internalized homonegativity – moderated any of the associations between bias-motivated bullying victimization and HIV risk behaviors in our regression models. Still, these findings provide novel evidence that bullying prevention programs in schools and communities should be included in comprehensive approaches to HIV prevention among YMSM.

재가 노인의 낙상 경험률과 관련 요인

Purpose: The purpose of this study was to investigate the prevalence, characteristics, and factors related to falls occurring among the community-dwelling elderly. Methods: The subjects were 299 community-dwelling-elderly in Jeju Province. Data were collected via in-person interviews by five visiting nurses in October, 2012. Fall risk assessment tools developed by the CDC, K-ADL, HDS-K, and GDS were used for data collection. Results: A significant number of subjects (34.1%) had experienced a fall at least once within the last six months. Living arrangements, strokes, urinary incontinence, main daily activities, and depression were significant factors related to these falls. Other risk factors included heavy use of medications, difficulties in walking and standing, needing arms to stand up from a chair, and hearing loss. Conclusion: The results reveal critical factors related to falls among the community-dwelling elderly. These information should be used to develop and implement fall prevention programs in communities.

Maltreatment experiences and associated factors prior to admission to residential care: A sample of institutionalized children and youth in western Kenya

ObjectivesThis study aims to determine the prevalence of maltreatment experienced by institutionalized children prior to their admission to Charitable Children's Institutions (orphanages) in western Kenya, and to describe their socio-demographic characteristics, reasons for admission, and the factors associated with prior experiences of maltreatment. MethodsA systematic file review was undertaken in five CCIs. Demographic, prior caregiving settings and maltreatment data were extracted. Forms of maltreatment were recorded according to WHO and ISPCAN guidelines. Logistic regression was used in bivariate and multivariable analyses of factors associated with reasons for placement and forms of maltreatment. ResultsA total of 462 files were reviewed. The median (interquartile range) age of children was 6.8 (5.08) years at admission, 56% were male, and 71% had lost one or both parents. The reasons for admission were destitution (36%), abandonment (22%), neglect (21%), physical/sexual abuse (8%), and lack of caregiver (8%). The majority of child and youth residents had experienced at least one form of maltreatment (66%): physical abuse (8%), sexual abuse (2%), psychological abuse (28%), neglect (26%), medical neglect (18%), school deprivation (38%), abandonment (30%), and child labor (23%). The most common reason for non-orphans to be admitted was maltreatment (90%), whereas the most common reason for orphans to be admitted was destitution (49%). Girls (adjusted odds ratio, AOR: .61, 95% CI: .39–.95) and orphans (AOR: .04, 95% CI: .01–.17) were both independently less likely to have a history of maltreatment irrespective of whether it was the reason for admission. Children whose primary caregiver had not been a parent (AOR: .36, 95% CI: .15–.86) and orphans (AOR: .17, 95% CI: .06–.44) were less likely to have been admitted for maltreatment, while children who were separated from siblings were more likely to have been admitted for maltreatment (AOR: 1.62, 95% CI: 1.01–2.60). ConclusionsThe high prevalence of maltreatment prior to admission, particularly among nonorphans, suggests the need for better child abuse and neglect prevention programs in communities, and psychosocial support services in institutions. The significant proportion of children admitted for poverty, predominantly among orphans, indicates that community-based poverty-reduction programs might reduce the need for institutionalization.

Traumatic Deaths in Children

Trauma is a leading cause of death among children. Detailed knowledge of the epidemiology of traumatic childhood deaths is necessary for allocating available treatment resources and for preventing injuries at both community and regional levels. To our knowledge, there has been no report comparing urban to rural pediatric deaths of this nature. A retrospective review of all deceased patients who were treated in an urban pediatric emergency department was performed. Patients were categorized into 2 groups, namely, urban versus rural, during analyses for comparison in this study. A total of 1498 patients died at our institution during the study period, with 124 being attributable to an injury for a rate of 9.5 injury-related deaths per study period year. Overall, most injury-related deaths were accidental. Urban deaths involved younger patients and were more likely to be abusive and more likely to have been seen for an injury in a clinic or emergency department within 2 months of their death. Rural deaths involved older patients and were more likely to be a result of an accidental injury. Patterns of injury have been linked with injury locales that can aid the emergency provider in the assessment of children who die as a result of injury. Despite the challenges involved, there is a clear need to further identify differences in patterns of fatal injuries in urban and rural areas and to better translate and evaluate prevention and intervention programs in rural communities.

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A systematic review on the effectiveness of community and school-based injury prevention programs on risk behavior and injury risk in children

Introduction: Next to the health enhancing effects of physical activity (PA), potential negative outcomes in terms of injury should not be underestimated. Especially in children in whom it was found that injury also affects continued participation in PA. Injury prevention has been mostly applied in the sports setting, but arguably in children prevention strategies are better suited outside the sports setting. This review was conducted to evaluate the effectiveness of PA related injury prevention strategies in the community or school-setting.

An Assessment of Community Capacity to Prevent Adolescent Alcohol Consumption

To effectively address the issue of youth alcohol use, communities need to have sufficient infrastructure and capacity in place to operate effective prevention programs. This study evaluates community capacity in the state of Hawai'i, using the Capacity Assessment Survey administered to stakeholders in the youth alcohol prevention system. Capacity is quantified with gap scores, which measure the discrepancy between an agency's performance of an attribute and the attribute's relative importance. Six assessment areas, termed capacity domains, are defined. Results are given for each county and the state overall. Based on these results, communities need to prioritize capacity-building efforts specifically in the domains of effectiveness, funding/resource availability, and sustainability. Organization, workforce skills/knowledge, and cultural competency were categorized as relative strengths in comparison, but gap scores are nevertheless significantly greater than 0 ("ideal"; p < .001), indicating these areas need improvement as well. Suggestions for improvement in each capacity domain are given. This assessment is the first step in a five-step planning process to implement youth alcohol prevention programs in communities in Hawai'i.

Knowledge translation and establishing community prevention programs for Australian Football

Introduction: Community Australian Football is known to be both a popular sport and a common setting for injury. Accordingly, there has been an increasing amount of research attention given towards preventing injuries in this context over the past 10–15 years.

Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts

BackgroundNutrition-related chronic diseases (NRCD) are rising quickly in developing countries, and the nutrition transition is a major contributor. Low-income countries have not been spared. Health issues related to nutritional deficiencies also persist, creating a double burden of malnutrition (DBM). There is still a major shortage of data on NRCD and DBM in Sub-Saharan Africa. A research program has been designed and conducted in partnership with West African institutions since 2003 to determine how the nutrition transition relates to NRCD and the DBM in order to support prevention efforts.MethodsIn Benin, cross-sectional studies among apparently healthy adults (n=540) from urban, semi-urban and rural areas have examined cardiometabolic risk (hypertension, obesity, dyslipidemia, insulin resistance) in relation to diet and lifestyle, also factoring in socio-economic status (SES). Those studies were followed by a longitudinal study on how risk evolves, opening the way for mutual aid groups to develop a prevention strategy within an action research framework. In Burkina Faso, a cross-sectional study on the nutritional status and dietary patterns of urban school-age children (n=650) represented the initial stages of an action research project to prevent DBM in schools. A cross-sectional study among adults (n=330) from the capital of Burkina Faso explored the coexistence, within these individuals, of cardiometabolic risk factors and nutritional deficiencies (anemia, vitamin A deficiency, chronic energy deficiency), as they relate to diet, lifestyle and SES.ResultsThe studies have shown that the prevalence of NRCD is high among the poor, thereby exacerbating social inequalities. The hypothesis of a positive socio-economic (and rural–urban) gradient was confirmed only for obesity, whereas the prevalence of hypertension, insulin resistance and dyslipidemia did not prove to be higher among affluent city dwellers. Women were particularly affected by abdominal obesity, at 48% compared to 6% of men. Protective factors against the risk of NRCD were physical activity and adequate micronutrient intake. The research also showed that nutritional deficiencies were not restricted to schoolchildren in rural areas because in the capital of Ouagadougou, for example, 40% of schoolchildren were anaemic and 40% were vitamin A deficient. Partnership research has expanded to include advocacy and human resources training.ConclusionThese initial studies on NRCD in West Africa indicate the relevance and urgency of prevention, even among low-income groups and countries. They show that the fight against NRCD as well as nutritional deficiencies should focus on women. Seeing how researchers from the African partner institutions have connections with decision-making authorities, the research findings could have an impact on prevention policies and programs in communities and schools alike. Greater support must nevertheless be provided to lobbying and advocacy work for an even greater impact. As well, the sustainability of the research program remains a challenge that requires resource mobilization and training for the purpose.

Effects of Communities That Care on the Adoption and Implementation Fidelity of Evidence-Based Prevention Programs in Communities: Results from a Randomized Controlled Trial

This paper describes findings from the Community Youth Development Study (CYDS), a randomized controlled trial of the Communities That Care (CTC) prevention system, on the adoption and implementation fidelity of science-based prevention programming in 24 communities. Data were collected using the Community Resource Documentation (CRD), which entailed a multi-tiered sampling process and phone and web-based surveys with directors of community-based agencies and coalitions, school principals, service providers, and teachers. Four years after the initiation of the CTC prevention system, the results indicated increased use of tested, effective prevention programs in the 12 CTC intervention communities compared to the 12 control communities, and significant differences favoring the intervention communities in the numbers of children and families participating in these programs. Few significant differences were found regarding implementation quality; respondents from both intervention and control communities reported high rates of implementation fidelity across the services provided.

A review of validated youth prevention and positive youth development programs in Asia

In view of the intensification of adolescent developmental issues in different Asian contexts, there is an urgent need for developing prevention and positive youth development programs in different Asian communities. In this paper, adolescent prevention and positive youth development programs in Asia which have been evaluated by studies adopting true experimental or quasi-experimental designs are reviewed. Several observations are highlighted from this review. First, compared with Western societies, the number of validated programs in different Asian communities was extremely low. Second, there were comparatively more programs addressing substance abuse than other mental health problems. Third, compared with evaluated prevention programs, there were very few positive youth development programs. Finally, there were very few rigorously designed evaluative studies of prevention and positive youth development programs over a long period of time.

The forensic nurse and violence prevention and response in public health

Title 17 U.S.C. 101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. LCDR Ferguson is a military service member. This work was prepared as part of her official duties. Title 17 U.S.C. 105 provides that Copyright protection under this title is not available for any work of the U.S. Government. The forensic nurse who responds to incidents of violence, such as sexual assault, domestic violence, gang violence, human trafficking, homicide, and suicide frequently devotes long hours providing professional health care and forensic nursing expertise to a variety of patient populations. In attempting to both improve the patient care process and mitigate occurrences of violence in the community, one of the problems forensic nurses encounter is that there are a limited number of opportunities to share expertise with violence prevention and response (VIPR) programs in local communities or on national stage. In addition, for nongraduate forensic nurses within healthcare and/or public health programs, there is little opportunity to develop population based research using cohorts subjected to violence, develop or implement VIPR programs, or test valid and reliable tools that evaluate the outcomes in those programs. While a number of current advocacy and behavioral health programs exist to address violence prevention and intervention across the United States, evidence supports healthcare programs responding to violence still remain inadequately developed and often do not include the

Prevention of severe injuries in preschool children: what are the priorities?

Injury is the leading cause of death in childhood. Most of these injuries are preventable events. With limited resources, strategies for prevention should target severe injuries and be based on...

Mexican-American Neighborhood's Social Capital and Attitudes About Violence

Measurement of the effectiveness of violence prevention interventions is in a developmental phase. Social capital provides a framework within which to examine this topic from a community perspective. The purpose of this study was to examine the relationships among three measures of social capital and attitudes about violence among Mexican-Americans. A cross-sectional survey was conducted of households randomly selected by block in two adjacent Mexican-American communities. Demographics, attitudes about and experiences with violence, and three measures of social capital (collective efficacy, neighborhood block conditions, community integration) were assessed. Descriptive, bivariate, and logistic regression analyses were used to examine indicators of violence attitudes and experiences. Of the 473 respondents who completed the survey, 323 (68%%) were female, 393 (83%%) were Mexican-American, 395 (84%%) were born in the US, and 346 (72%%) owned their own homes. Participants with high measures of collective efficacy were 1.68 times more likely to have negative attitudes about violence (CI 1.06–2.65) and 15.25 times more likely to have negative attitudes about couple violence (CI 9.05–25.74). Participants with high scores on neighborhood block conditions were 2.33 times more likely to have negative attitudes about couple violence (CI 1.40–3.87). Scores on community integration were not significant indicators of participants' tolerance and experiences with violence. Two measures of social capital were positively associated with and predictive of negative attitudes toward violence. The results suggest that primary violence prevention programs in Mexican-American communities should focus on strengthening a sense of collective efficacy and improving neighborhood conditions.

The Superobese Mother and Ethnic Disparities in Preterm Birth

We assessed the association between preterm birth and obesity subtypes across racial/ethnic groups. We analyzed data on 540981 women from birth cohort files for the State of Florida from 2004 to 2007. Obese women were categorized using body mass index (BMI) values as class I obese (30.0 < or = BMI < or = 34.9), class II obese (35.0 < or = BMI < or = 39.9), class III or extremely obese (40 < or = BMI < or = 49.9), and superobese (BMI > or = 50.0). Logistic regression was used to obtain adjusted estimates. About 28% of women were obese, with the highest rate (40.9%) registered among black gravidas, while whites and Hispanics had comparable rates (24.3% vs 25.5%, respectively). Superobesity was also most prevalent in blacks (1.3%). Among obese women, the risk for preterm birth was greatest among blacks (OR, 1.71; 95% CI, 1.65-1.77), while whites (OR, 1.15; 95% CI, 1.12-1.19) and Hispanics (OR, 1.22; 95% CI, 1.18-1.27) had significantly lower and comparable risk levels. Extremely obese and superobese women are emerging high-risk groups for adverse birth outcomes, and black women appear to bear the heaviest burden. The disproportionately rising trend in extreme forms of obesity among black women is of utmost concern and represents a clarion call for infusion of more resources into obesity prevention programs in black communities.

Creating Community Responsibility for Child Protection: Possibilities and Challenges

Deborah Daro and Kenneth Dodge observe that efforts to prevent child abuse have historically focused on directly improving the skills of parents who are at risk for or engaged in maltreatment. But, as experts increasingly recognize that negative forces within a community can overwhelm even well-intentioned parents, attention is shifting toward creating environments that facilitate a parent's ability to do the right thing. The most sophisticated and widely used community prevention programs, say Daro and Dodge, emphasize the reciprocal interplay between individual-family behavior and broader neighborhood, community, and cultural contexts. The authors examine five different community prevention efforts, summarizing for each both the theory of change and the empirical evidence concerning its efficacy. Each program aims to enhance community capacity by expanding formal and informal resources and establishing a normative cultural context capable of fostering collective responsibility for positive child development. Over the past ten years, researchers have explored how neighborhoods influence child development and support parenting. Scholars are still searching for agreement on the most salient contextual factors and on how to manipulate these factors to increase the likelihood parents will seek out, find, and effectively use necessary and appropriate support. The current evidence base for community child abuse prevention, observe Daro and Dodge, offers both encouragement and reason for caution. Although theory and empirical research suggest that intervention at the neighborhood level is likely to prevent child maltreatment, designing and implementing a high-quality, multifaceted community prevention initiative is expensive. Policy makers must consider the trade-offs in investing in strategies to alter community context and those that expand services for known high-risk individuals. The authors conclude that if the concept of community prevention is to move beyond the isolated examples examined in their article, additional conceptual and empirical work is needed to garner support from public institutions, community-based stakeholders, and local residents.

Factors Related to Tobacco Use Among Adolescents in Southern Taiwan

Identifying the factors related to the initiation and continuance of smoking among youth has been regarded as a crucial step for school nurses and public health nurses to develop effective smoking prevention and cessation programs in schools and communities. The purpose of this study was to investigate the factors related to adolescent tobacco use in southern Taiwan. A total of 4,500 study samples were selected at random from the students of all high schools located in Pingdong County. This process yielded 3,307 valid samples (a 73.5% response rate). Study results found 62.4% (n = 2,063) reported never having smoked before. Thirty-eight percent (n = 1,244) of participants had experience using tobacco, 59.3% (n = 738) reported being ex-smokers, and 40.7% (n = 506) were current smokers. This study found that having friends who offered cigarettes, academic achievement, father's educational level, perceived peer smoking behavior to be primary influences on smoking, attitude, and self-efficacy and significant predicators of adolescents' current smoking behaviors. Parents' marital status and having classmate who offered cigarettes were significant predictors of adolescent smoking behavior. Study findings can provide a basis for school and public health nurses to design effective smoking prevention and cessation programs in schools and community settings. This study suggests further experimental studies are necessary to test the effectiveness of tobacco control programs designed in reference to the findings of this study.